WorksheetsMed Surg 2 Final Exam (Ladetto)
Total questions: 55
Worksheet time: 37mins
What are complication of Breast Cancer to Consider
Recurrence and Metabolic Disease
Feeling fatigue
Feeling of neuropathy
Risk of anemia, bruising/bleeding, and infection
What is the most important clinical manifestation of Endometrial Cancer?
Spreads to pelvic region and para-aortic LNs
Pain late in disease process
Complications of metastases (lung, bone, liver, brain)
Abnormal uterine bleeding
CD4 count less than 200 cells/mm3 is automatically have AIDS
True
False
What is the Gold Standard Lab Value for MI
Troponin I
Myoglobin
CK-MB
AST and LDH
What are the clinical manifestations of left-sided HF?
Crackles
Breathlessness
Wheezes
Pulmonary Congestion
What the important priority to check the chest tube is patent?
(a)
A client with a three-way Foley catheter is receiving CBI following bladder surgery. The nurse notes the following over the last 6 hours:
Total output measured in the drainage bag: 4,860 mL
Normal saline irrigation infused: 3,000 mL
The provider ordered 50 mL sterile water instilled for a bladder scan attempt during that period.
30 mL of catheter flush was performed due to blockage.
What is the client’s true urine output for the 6-hour period?
What are clinical manifestations of R-sided Heart failure?
Crackles in the lungs
JVD
weight gain from edema and ascites
distended abdomen
hepatomegaly
What are manifestations for fluid overload?
bounding pulse
distended neck veins
crackles heard in lung fields
hypoxic
sunken eyeballs
In trach care, always oxygenate the patient before suctioning
true
false
What is a Pneumothorax?
air that is trapped in the pleural cavity.
blood accumulation that is caused from trauma or disease.
excess fluid which can be caused by heart failure or infections.
The purpose of Coumadin for a client with atrial fibrillation is to:
Strengthen heart contractions
Reduce clot formation
Lower blood pressure
increases heart contractility
A nurse is caring for a client receiving a blood transfusion. Which finding requires the nurse to stop the transfusion immediately?
Back pain
Mild crackles
Temperature increase of 0.8°F
Fatigue
What is a PTCA?
A surgical bypass procedure
A cardioversion procedure
A percutaneous balloon used to open coronary arteries
A noninvasive stress test
Which rhythm requires transcutaneous pacing?
Atrial flutter
Ventricular tachycardia
Second-degree type II heart block
Sinus tachycardia
Which finding is MOST concerning for a client with leukemia?
Pallor
Nosebleeds
Bruising
Platelets 18,000
What group of medications are commonly prescribed to patients with atrial fibrillation?
ARBs
BBs
CCBs
Blood Thinners
What is nonsurgical procedure to treat Afib?
catheter ablation
defibrillator
electrical cardioversion
Pacemaker
A child diagnosed with aplastic anemia is admitted to the hospital. The parents ask the nurse what aplastic anemia is. Which response by the nurse is accurate?
“Aplastic anemia causes a proliferation of white blood cells.”
“Aplastic anemia is characterized by abnormally shaped red blood cells.”
“Aplastic anemia is caused by the bone marrow producing inadequate cells.”
“Aplastic anemia is a disorder that occurs after a viral illness.”
A nurse is assessing a client’s risk factors for testicular cancer. Which of the following puts the client at the greatest risk for developing testicular cancer?
Undescended testes
Hypertension
Hx of smoking
Obesity
A nurse is caring for a client with hyperthyroidism. Which of the following actions should the nurse take to reduce the risk of thyroid storm?
Encourage frequent ambulation
Maintain a low-stimulation environment
Increase environmental temperature
Provide high-fiber meals
What dysrhythmia is this?
2nd Heart Block Type 2
2nd Heart Block Type 1
3rd degree heart block
First degree heart block
What is the dysrhythmia shown?
ventricular fibrillation
sinus rhythm
ventricular tacycardia
asystole
What is the dysrhythmia shown?
Bradycardia
First degree heart block
Third degree heart block
SVT
A nurse is assessing a client with a history of multiple myeloma. Which of the following findings should the nurse expect?
Frequent bruising and bleeding
Hypertension and headaches
Hyperactive reflexes
Weight loss with diarrhea
Which is NOT an appropriate non-pharmacologic recommendation for a patient with gout?
Decrease alcohol intake
Increase intake of seafood
Decrease intake of red meats
Increase intake of vegetables
A nurse is teaching a client about preventing the transmission of Hepatitis A is transmitted by which of the following routes?
Maternal-fetal
fecal-oral contamination
genital sexual contact
blood to blood
A nurse is caring for a client receiving chemotherapy who has a neutrophil count of 900/mm³. Which of the following actions should the nurse take?
Encourage fresh fruits and vegetables
Place the client in a private room
Administer live vaccines
Assign the client to a shared room
Which statement by a client with sickle cell disease indicates understanding of health promotion strategies?
"I will avoid drinking fluids before bed.”
“I should increase fluid intake throughout the day.”
“Cold exposure helps reduce pain.”
“Exercise should be avoided at all times.”
A nurse is providing teaching about HIV transmission. Which of the following situations place a client at risk for acquiring HIV?
Receiving blood products
Sharing needles for IV drug use
Having unprotected sexual intercourse
Sharing eating utensils
Exposure to infected blood through an open wound
A nurse is reviewing laboratory results for a client newly diagnosed with breast cancer. Which of the following findings should the nurse expect?
Decreased platelet count
Decreased hemoglobin
Decreased hematocrit
Laboratory values within expected reference ranges
A nurse is teaching a client about the purpose of skin traction. Which of the following statements by the client indicates understanding of the teaching?
“It helps prevent bone loss by increasing calcium absorption.”
“It helps maintain proper alignment and decreases muscle spasms.”
“It improves circulation by increasing venous return.”
“It prevents joint contractures by increasing range of motion.”
A nurse is caring for a client admitted with an acute exacerbation of chronic obstructive pulmonary disease (COPD). Which of the following actions is the priority?
Encourage deep breathing and coughing
Administer oxygen at 2 L/min via nasal cannula
Provide a high-calorie, high-protein diet
Teach the client pursed-lip breathing
A nurse is providing teaching to a client diagnosed with folic acid deficiency anemia. Which of the following statements by the client indicates understanding of the teaching?
“I will increase my intake of green leafy vegetables.”
“I should avoid fortified grains and cereals.”
“I need monthly vitamin B12 injections.”
“I should limit foods high in folate.”
A nurse is providing teaching to a client scheduled for a bone marrow biopsy. Which of the following statements by the client indicates understanding of the procedure?
“I will need to lie flat for several hours after the procedure.”
“The procedure is painless because I will be under general anesthesia.”
“Pressure will be applied to the site after the procedure to prevent bleeding.”
“I should expect significant swelling at the biopsy site.”
A nurse is providing dietary teaching to a client diagnosed with prostate cancer. Which of the following statements by the client indicates understanding of the teaching?
“I should increase my intake of processed meats.”
“Animal fats will help improve my energy levels.”
“I should avoid fruits and vegetables.”
“I will reduce my intake of red meat and full-fat dairy products.”
A nurse is caring for a client who has just completed the last round of chemotherapy. Laboratory results show a platelet count of 48,000/mm³. Which of the following nursing actions is the priority?
Obtain a repeat CBC in 24 hours
Encourage ambulation in the hallway
Initiate bleeding precautions
Administer IM injections as prescribed
You are dispatched to a local residence for a 21-year-old male patient who has been found unresponsive and lying on the floor. Upon arrival to the residence, you are greeted by the patient’s father who tells you that his son has been found collapsed in his bedroom, unresponsive you tried to stimulate him by performing a sternum rub he didn't open his eyes but he did a flexion with his arms. What is the Glasgow score of this patient
4
5
6
7
8
A nurse is providing dietary teaching to a client diagnosed with iron-deficiency anemia. Which of the following foods should the nurse recommend to help improve the client’s iron status?
Select all that apply.
spinach
red meat
milk
orange juice
eggs
A nurse is evaluating a client’s understanding of dietary modifications for gout. Which of the following meal selections indicates the client needs further teaching?
Grilled chicken with steamed vegetables
Lentil soup with whole-grain bread
Salmon with asparagus
Low-fat yogurt with fruit
A nurse is caring for a client with an arteriovenous (AV) fistula for hemodialysis. Which of the following nursing actions is appropriate?
Measure blood pressure in the arm with the AV fistula
Assess the fistula for a bruit and thrill each shift
Apply a tight dressing over the fistula site
Draw blood samples from the AV fistula
A nurse is reviewing laboratory results for a client with chronic kidney disease. Which of the following findings should the nurse expect?
Decreased creatinine
Increased potassium
Increased calcium
Decreased phosphorus
A nurse is reviewing the plan of care for a client with chronic kidney disease who is prescribed erythropoietin (epoetin alfa). Which of the following outcomes indicates the medication is effective?
Decreased potassium level
Increased hemoglobin level
Decreased blood urea nitrogen
Increased urine output
A nurse is providing discharge teaching to a client who has had a mechanical heart valve replacement. Which of the following medications should the nurse expect the client to take long term?
Aspirin
Clopidogrel
Heparin
Warfarin
A nurse is caring for a client 6 hours after a craniotomy. Which of the following findings requires immediate nursing intervention?
Intracranial pressure (ICP) of 18 mm Hg
Drowsiness that improves with stimulation
Headache rated 4/10
Clear drainage noted on the dressing
A nurse is caring for a client with hepatic encephalopathy. Which of the following findings should the nurse expect?
Alert and oriented behavior
Confusion and altered level of consciousness
Severe abdominal pain relieved by food
Bright red blood in the stool
A patient with a history of lumbar disc disease reports sudden onset of severe lower back pain, numbness in both legs, and difficulty controlling bladder function. Which action should the nurse take first?
Administer prescribed NSAIDs for pain relief.
Assess the patient for signs of cauda equina syndrome.
Encourage the patient to perform gentle lumbar exercises.
Schedule a follow-up appointment with the primary care provider in one week.
A nurse is caring for two patients with hyperglycemic crises. Patient A has type 1 diabetes and presents with hyperglycemia, fruity breath, Kussmaul respirations, and nausea. Patient B has type 2 diabetes and presents with profound hyperglycemia, extreme dehydration, and altered mental status, but minimal ketones. Which patient is exhibiting characteristics of diabetic ketoacidosis (DKA)?
Patient A
Patient B
Both Patient A and B
Neither Patient A nor B
A nurse is caring for a patient who had a new colostomy placed 2 days ago. The stoma appears pale pink, and the surrounding skin is intact. Which nursing action is the priority?
Notify the healthcare provider immediately.
Assess the stoma for color, edema, and bleeding.
Apply a dry dressing over the stoma.
Encourage the patient to begin a high-residue diet.
A patient with diabetes insipidus reports frequent urination during the day and night, resulting in disrupted sleep. Which nursing action is the priority?
Teach the patient strategies to improve sleep hygiene.
Restrict the patient’s fluid intake to reduce urination.
Monitor the patient’s fluid intake, urine output, and signs of dehydration.
Encourage the patient to increase sodium intake to prevent hyponatremia.
A nurse is reviewing lab results for a patient suspected of having Addison’s disease. Which findings would support this diagnosis?
Hypernatremia, hyperglycemia, and low potassium
Hyponatremia, hyperkalemia, and low cortisol levels
Hypercalcemia, high cortisol, and low potassium
Normal electrolytes with elevated aldosterone
A nurse is assessing a patient with suspected Cushing’s syndrome caused by excessive ACTH production. Which assessment finding should the nurse expect?
Hypotension and weight loss
Hyperpigmentation of the skin
Hyponatremia and hyperkalemia
Increased urine output and dehydration
A nurse is providing health promotion teaching to a patient newly diagnosed with Addison’s disease. Which statement should the nurse include in the teaching?
“You may stop taking your corticosteroid medication when your symptoms improve.”
“Increase your corticosteroid dose during periods of stress, illness, or surgery.”
“Limit your salt intake to prevent fluid retention.”
“Avoid wearing a medical alert bracelet unless symptoms worsen.”
