Medical-Surgical Nursing Exam Questions 4 (50

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Perioperative nursing Various Medical-Surgical Nursing topics
1.) A client is receiving
NPH insulin 20 units subq
at 7:00 AM daily, at 3 PM
how would the nurse finds
if the client were having a
hypoglycemic reaction?
A.) Feel the client and bed
for dampness
B.) Observe client kussmaul
respirations
C.) Smell clients breathe
for acetone odor
D.) Check clients pupils for
dilation
2.) Postoperative
thyroidectomy nursing
care includes which
measures?
A.) Have the client speak
every 5-10 mins if
hoarseness is present
B.) Provide a low calcium
diet to prevent
hypercalcemia
C.) Check the dressing all
the back of the neck for
bleeding
D.) Apply a soft cervical
collar to restrict neck
movement
3.) What would the nurse
note as typical findings on
the assessment of a client
with acute pancreatitis?
A.) Steatorrhea, abd. Pain,
fever
B.) Fever, hypoglycemia,
DHN
C.) Melena, persistent
vomiting, hyperactive bowel
sounds
D.) Hypoactive bowel
sounds, decreased amylase
and lipase levels
4.) A client is found to be
comatose and
hypoglycemic with a blood
suger level 50 mg/dl. What
nursing action is
implemented first?
A.) Infuse 1000 ml of D5W
over a 12-hour period
B.) Administer 50% glucose
IV
C.) Check the clients urine
for the presence of sugar
and acetone
D.) Encourage the client to
drink orange juice with
added sugar
5.) Which medication will
the nurse have available
for the emergency
treatment of tetany in the
client who has had a
thyroidectomy?
A.) Calcium chloride
B.) Potassium chloride
C.) Magnesium sulfate
D.) Sodium bicarbonate
6.) What is the primary
action of insulin in the
body?
A.) Enhances the transport
of glucose across cell walls
B.) Aids in the process of
gluconeogenesis
C.) Stimulates the
pancreatic beta cells
D.) Decreases the intestinal
absorption of glucose
7.) What will the nurse
teach the diabetic client
regarding exercise in his
/her treatment program?
A.) During exercise the
body will use carbohydrates
for energy production,
which in turn will decrease
the need for insulin
B.) With an increase in
activity the body will utilize
more carbohydrates;
therefore more insulin will
be required.
C.) The increase in activity
results in an increase in the
utilization of insulin;
therefore the client should
decrease his/her
carbohydrate intake
D.) Exercise will improve
pancreatic circulation and
stimulate the islet of
Langerhans to increase the
production of intrinsic
insulin
8.) The nurse is caring for
a client who has
exophthalmos associated
with her thyroid disease.
What is the cause of
exophthalmos?
A.) Fluid edema in the
retro-orbital tissues which
force the eyes to protrude
B.) Impaired vision, which
causes the client to squint in
order to see
C.) Increased eye
lubrication, which makes
the client blink less
D.) Decrease in extraocular
eye movements, which
results in the thyroid
stare.
9.) What is characteristic
symptom of hypoglycemia
that should alert nurse to
an early insulin reaction?
A.) Diaphoresis
B.) Drowsiness
C.) Severe thirst
D.) Coma
10.) A client is scheduled
for routine glycosylated
hemoglobin (HbA1c) test.
What is important for the
nurse to tell the client
before this test?
A.) Drink only water after
midnight and come to the
clinic early in the morning
B.) Eat a normal breakfast
and be at the clinic 2 hours
because of the multiple
blood draws
C.) Expect to be at the clinic
for several hours because of
the multiple blood draws
D.) Come to the clinic at the
earliest convenience to have
blood drawn
11.) A client has been
inhalation vasopressin
therapy. What will the
nurse evaluate to
determine the therapeutic
response to this
medication?
A.) Urine specific gravity
B.) Blood glucose
C.) Vital signs
D.) Oxygen saturation
levels
12.) A client with diagnosis
of type 2 diabetes has been
ordered a course of
prednisone for her severe
arthritic pain. An
expected change that
requires close monitoring
by the nurse is;
A.) Increased blood glucose
level
B.) Increased platelet
aggregation
C.) Increased ceatinine
clearance
D.) Increased ketone level
in urine
13.) The nurse performing
an assessment on a client
who has been receiving
long-term steroid therapy
would expect to find:
A.) Jaundice
B.) Flank pain
C.) Bulging eyes
D.) Central obesity
14.) A diabetic client
receives a combination of
regular and NPH insulin
at 0700 hours. The nurse
teaches the client to be
alert for signs of
hypoglycemia at
A.) 1200 and 1300 hours
B.) 1100 and 1700 hours
C.) 1000 and 2200 hours
D.) 0800 and 1100 hours
15.) It is important for the
nurse to teach the client
that metformin
(Glcucophage):
A.) May cause nocturia
B.) Should be taken at night
C.) Should be taken with
meals
D.) May increase the effects
of aspirin
16.) A nurse assessing a
client with SIADH would
expect to find laboratory
values of:
A.) Serum Na= 150 mEq/L
and low urine osmolality
B.) Serum K= 5 mEq/L and
low serum osmolality
C.) Serum Na=120 mEq/L
and low serum osmolality
D.) Serum K= 3 mEq/L and
high serum osmolality
17.) A priority nursing
diagnostic for a client
admitted to the hospital
with a diagnosis of
diabetes insipidus is:
A.) Sleep pattern
deprivation related nocturia
B.) Activity intolerance r/t
muscle weakness
C.) Fluid volume excess r/t
intake greater that output
D.) Risk for impaired skin
integrity r/t generalized
edema
18.) A client admitted with
a pheochrocytoma returns
from the operating room
after adrenalectomy. The
nurse should carefully
assess this client for:
A.) Hypokalemia
B.) Hyperglycemia
C.) Marked Na and water
intake
D.) Marked fluctuations in
BP
19.) When caring for client
in thyroid crisis, the nurse
would question an order
for:
A.) IV fluid
B.) Propanolol (Inderal)
C.) Prophylthiouracil
D.) A hyperthermia blanket
20.) A client is prescribed
levothyroxine (Synthroid)
daily. The most important
instruction to give the
client for administration
of this drug is:
A.) Taper dose and
discontinue if mental and
emotional statuses stabilize
B.) Take it at bedtime to
avoid the side effects of
nausea and flatus
C.) Call the M.D.
immediately at the onset of
palpitations or nervousness
D.) Decrease intake of
juices and fruits with high
potassium and calcium
contents
21.) The nurse would
question which medication
order for a client with
acute-angled glaucoma?
A.) Atropine (Atrposil) 1-2
drops in each eye now
B.) Hydrochloride (Diuril)
25 mg PO daily
C.) Propanolol (Inderal) 20
mg PO 2 times a day
D.) Carbanyl choline
(Isopto carbachol) eye
drops; 1 drop 2 times a day
22.) A client tells you she
has heard that glaucoma
may be a hereditary
problem and she is
concerned about her adult
children. What is the best
response?
A.) There is no need for
concern; glaucoma is not
hereditary order.
B.) Screening for
glaucoma should be
included in an annual eye
exam for everyones over
50.
C.) There may be a genetic
factor with glaucoma and
your children over 30 y/o
should be screened yearly.
D.) Are your grandchildren
complaining of any eye
problems? Glaucoma
generally skips a
generation.
23.) What will be
important to include in the
nursing care for the client
with angle-closure
glaucoma?
A.) Evaluation of
medications to determine if
any of them cause an
increase in IOP is a side
effect.
B.) Observation for an
increase in loss of vision; it
can be reversed if promptly
identified.
C.) Control BP to decrease
the clients potential
loss of peripheral vision.
D.) Assessment for a level
of discomfort; the client
may experience
considerable pain until the
optic nerve atrophies
24.) A child is scheduled
for a myringotomy. What
goal of this procedure will
the nurse discuss with the
parents?
A.) Promote drainage from
the ear
B.) Irrigate the Eustachian
tube
C.) Correct a malformation
in the inner ear
D.) Equalize pressure on the
tympanic membrane
25.) After a clients eye
has been anesthetized,
what instructions will be
important for the nurse to
give the client?
A.) Do not watch TV for at
least one day
B.) Do not rub the eye for
15-20 minutes
C.) Irrigate the eye every
hour to prevent dryness
D.) Wear sunglasses when
in direct sunlight for the
next 6 hours
26.) A child diagnosed
with conjunctivitis. Which
statement reflects that the
child understood the
nurses teaching?
A.) Its okay for me to let
my friends use my
sunglasses while we are
playing together.
B.) Its okay for me to
softly rub my eye, as long as
I use the back of my hand.
C.) I can pick the crustly
stuff out of my eyelashes
with my fingers when I
wake up in the morning.
D.) I will use my own
washrag and towel while
my eyes are sick.
27.) What medication
would the nurse anticipate
giving a client with
Menieres dse?
A.) Nifedipine
B.) Amoxicillin
C.) Propanolol
D.) Hydrochloride (Hydro
DIURIL)
28.) When teaching a
family and a client about
the use of a hearing aid,
the nurse will base the
teaching on what
information regarding the
hearing aid?
A.) Provides mechanical
transmission for damaged
part of the ear
B.) Stimulates the neural
network of the inner ear to
amplify sound
C.) Amplifies sound but
does not improve the ability
to hear
D.) Tunes out extraneous
noise in the lower-frequency
sound spectrum
29.) What statement by
the client recovering from
cataract surgery would
indicate to the nurse need
for additional teaching?
A.) Ill call if I have a
significant amount of pain.
B.) Ill continue to take my
Metamucil for another
week.
C.) Ill just do some
laundry this afternoon
instead of going to work.
D.) Ill take my
acetazolamide (Diamox)
drops with my other
morning medications
30.) A client is walking
down the hall and begins
to experience vertigo.
What is the most
important nursing action
when this occurs?
A.) Have the client sit in a
chair and lower his head
B.) Administer meclizine
(Antivert) PO
C.) Assist the client to sit or
lie down
D.) Assess if the occurrence
is vertigo or dizziness
31.) Which client is at
highest risk for retinal
detachment?
A.) 4-year old with
amblyopia
B.) 17 y/o who plays
physical contact
C.) 33 y/o with severe ptosis
and diplopia
D.) 72 y/o with nystagmus
and Bells palsy
32.) To promote and
maintain safety for a client
after a stapedectomy.
What would be included
in the nursing care plan?
A.) Implement fall
precautions
B.) Prevent aspirations
C.) Begin oxygen 2-4L/min
via nasal cannula
D.) Change inner ear
dressing when saturated
33.) The nurse would
question the
administration of which
eye drop in a patient with
increased ICP?
A.) Artificial tears
B.) Betaxolol (Betoptic)
C.) Acetazolamide
(Diamox)
D.) Epinephrine HCL
(Epirate)
34.) A client is being
admitted for problems
with Menieres disease.
What is most important to
the nurse to assess?
A.) Diet history
B.) Screening hearing test
C.) Effect on clients
activities of daily living
(ADLs)
D.) Frequency and severity
35.) A client calls the
nurse regarding an
accident that just occurred
during which an unknown
chemical was splashed in
his eyes. What is the most
important for the nurse to
tell the client to do
immediately?
A.) Rinse the eye with large
amount of water or saline
solution
B.) Put a pad soaked in the
sterile saline solution over
the eye
C.) Go to the closest
emergency room
D.) Have a co-worker
visually checks the eye for a
foreign body
36.) A 25- year old woman
comes to the clinic
complaining of dizziness,
weakness and palpitations.
What will be important
for the nurse to initially
evaluate when obtaining
the health history?
A.) Activity and exercise
patterns
B.) Nutritional patterns
C.) Family health status
D.) Coping and stress
tolerance
37.) A child with leukemia
is being discharged after
beginning chemotherapy.
What instructions will the
nurse include in the
teaching plan for the
parents of this child?
A.) Provide a diet low in
protein and high in
carbohydrates
B.) Avoid fresh vegetables
that are not cooked or
peeled
C.) Notify the M.D. if the
childs temperature exceeds
101F (39C)
D.) Increase the use of
humidifiers throughout the
house
38.) Which client is most
likely to have iron
deficiency anemia?
A.) A client with cancer
receiving radiation therapy
twice a week
B.) A toddler whose
primary nutritional intake is
milk
C.) A client with peptic
ulcer who had surgery 6
weeks ago
D.) A 15-year old client in
sickle cell crisis
39.) A client has an order
for one unit of whole
blood. What is a correct
nursing action?
A.) Initiate an IV with 5%
dextrose in water (D5W) to
maintain a patent access site
B.) Initiate the transfusion
within 30 minutes of
receiving the blood
C.) Monitor the clients vital
signs for the first 5 minutes
D.) Monitor V/S every 2
hours during the transfusion
40.) The nurse is caring
for a client who is
receiving a blood
transfusion. The
transfusion was started 30
mins ago at a rate of 100
ml/hr. The client begins to
complain of low back pain
and headache and is
increasing restless, what is
the first nursing action?
A.) Slow the infusion and
evaluate the V/S and
clients history of
transfusion reaction
B.) Stop the transfusion,
disconnect the blood tubing
and begin a primary
infusion of normal saline
solution
C.) Stop the infusion of
blood and begin infusion of
NSS from the Y connector
D.) Recheck the unit of
blood for correct
identification numbers and
cross-match information
41.) The nurse is
preparing to start an IV
infusion before the
administration of a unit of
packed red blood cells,
what fluid will the nurse
select to maintain the
infusion before hanging
the unit of blood?
A.) D5W
B.) D5W/.45NaCl
C.) LR solution
D.) .9% Na Cl
42.) A client in sickle cell
crisis is admitted to the
emergency department
what are the priorities of
care?
A.) Nutrition, hydration,
electrolyte balance
B.) Hydration, pain
management, electrolyte
balance
C.) Hydration, oxygenation,
apin management
D.) Hydration, oxygenation,
electrolyte balance
43.) A client in the ICU
has been diagnosed with
DIC. The nurse will
anticipate administering
which of the following
fluids?
A.) Packed RBC
B.) Fresh Frozen plasma
(FFP)
C.) Volume expanders, such
as D10W
D.) Whole blood
44.) The nurse is assessing
a client who has been
given a diagnosis of
polycythemia vera. What
characteristics will the
nurse anticipate finding
when assessing this client?
A.) Increased fatigue and
bleeding tendencies
B.) Hemoglobin below 13
mg/dl
C.) Headaches, dyspnea,
claudication
D.) Back pain, ecchymosis,
and joint tenderness
45.) A client has been
diagnosed with pernicious
anemia what will the
nurse teach this client
regarding medication he
will need to take after he
goes home?
A.) Monthly Vit. B12
injections will be necessary
B.) Ferrous sulfate PO daily
will be prescribed
C.) Coagulation studies are
important to evaluate
medications
D.) Decrease intake of leafy
green vegetables because of
increased Vit. K
46.) First postop day after
a right lower lobe (RLL)
lobectomy, the client
breathes and coughs but
has difficulty raising
mucus. What indicates
that the client is not
adequately clearing
secretions?
A.) Chest x-ray film shows
right sided pleural fluid
B.) A few scattered crackles
on RLL on auscultation
C.) PCO2 increases from
35-45 mm Hg
D.) Decrease in forced vital
capacity
47.) What nursing
observations indicate that
the cuff on an
endotracheal tube is
leaking?
A.) An increase in peak
pressure on the ventilator
B.) Client is able to speak
C.) Increased swallowing
efforts by client
D.) Increased crackles
(rales) over left lung field
48.) The client with COPD
is to be discharged home
while receiving continuous
oxygen at a rate of 2
L/min via cannula. What
information does the nurse
provide to the client and
his wife regarding the use
of oxygen at home?
A.) Because of his need for
oxygen, the client will have
to limit activity at home
B.) The use of oxygen will
eliminate the clients
shortness of breath
C.) Precautions are
necessary because oxygen
can spontaneously ignite
and explode
D.) Use oxygen during
activity to relieve the strain
on the clients heart
49.) The wife of a client
with COPD is worried
about caring for her
husband at home. Which
statement by the nurse
provides the most valid
information?
A.) You should avoid
emotional situations that
increase his shortness of
breathe.
B.) Help your husband
arrange activities so that he
does as little walking as
possible.
C.) Arrange a schedule so
your husband does all
necessary activities before
noon; then he can rest
during the afternoon and
evening.
D.) Your husband will be
no more short of breath
when he walks but that will
not hurt him.
50.) Which statement
correctly describes
suctioning through an
endotracheal tube
A.) The catheter is inserted
into the endotracheal tube;
intermittent suction is
applied until no further
secretions are retrieved; the
catheter is then withdrawn.
B.) The catheter is inserted
through the nose, and the
upper airway is suctioned;
the catheter is then removed
from the upper airway and
inserted into the
endotracheal tube to suction
the lower airway
C.) With suction applied,
the catheter is inserted into
the endotracheal tube; when
resistance is met, the
catheter is slowly
withdrawn
D.) The catheter is inserted
into the endotracheal tube to
a point of resistance, and
intermittent suction is
applied during withdrawal.