Ch. 16-19 Medical-Surgical Review Questions
Which symptom would occur in a patient with a detached retina? A. Flashing lights and floaters B. Homonymous hemianopia C. Loss of central vision D. Ptosis
A
A patient with AIDS is prescribed zidovudine (Retrovir), 200 mg by mouth every 4 hours. When teaching the patient about this drug, the nurse should provide which instruction? A. "Take zidovudine with meals." B. "Take zidovudine on an empty stomach." C. "Take zidovudine every 4 hours around the clock." D. "It is ok to continue herbal supplements."
C
An 18-year-old patient complains of fatigue, weight loss, and a low-grade fever and symmetrical pain in the fingers, elbows, and ankles. Which condition is suspected? A. Anemia B. Leukemia C. Rheumatic arthritis D. SLE
C
An annual Pap test is most important in patients: A. with a history of recurrent candidiasis. B. who became pregnant before age 20. C. infected with HPV. D. who have used oral contraceptives for a short time.
C
Which nursing intervention will the nurse include in the plan of care for a patient with atelectasis? A. Administer oxygen continuously at 2 L/minute. B. Encourage cough and deep-breathing every 4 hours. C. Have the patient use an incentive spirometer every hour. D. Assist the patient with ambulation up to a chair every day.
C
A patient with a small, in situ breast nodule asks the nurse about her treatment options. Which treatments would be considered for this patient? A. Lumpectomy and radiation B. Partial mastectomy and radiation C. Partial mastectomy and chemotherapy D. Total mastectomy and chemotherapy
A
On the first day after thoracotomy, the nurse's assessment of the patient reveals a temperature of 100F (37.8C), a heart rate of 96 beats/minute, blood pressure of 136/86 mm Hg, and shallow respirations of 24 breaths/minute, with rhonchi heard at the lung bases. The patient reports incisional pain at a level of 6 out of 10. What is the priority nursing intervention? A. Providing pain medication as ordered B. Assisting the patient out of bed to ambulate C. Administering ibuprofen (Motrin) as ordered to reduce fever D. Encouraging the patient to cough and deep-breathe
A
The nurse is assessing a male patient with syphilis. Which symptom most likely prompted him to seek medical attention? A. Rashes on the palms of the hands and soles of the feet B. Cauliflower-like warts on the penis C. Painful red papules on the shaft of the penis D. Foul-smelling discharge from the penis
A
The nurse is caring for a patient who underwent stapedectomy. To prevent postoperative complications, the nurse should instruct the patient to: A. sneeze with her mouth open. B. frequently blow her nose. C. clean her operated ear with a cotton-tipped applicator twice a day. D. resume bending and straining when she's no longer experiencing ear pain.
A
The nurse is providing care for a patient with AIDs and Pneumocystis jiroveci pneumonia. The patient is receiving trimethoprim/sulfamethoxazole (Bactrim). What's the best evidence that the therapy is working? A. Patient is afebrile and SOB has resolved. B. Whitening of lung fields on the chest X-ray. C. Improved patient vitality and activity tolerance. D. Development of leukocytosis.
A
The nurse is teaching a male patient to perform monthly testicular self-examinations. What is the appropriate point to make? A. Testicular cancer is highly curable. B. Testicular cancer is difficult to diagnose. C. Testicular cancer is the number one cause of cancer deaths in men. D. Testicular cencer is more common in older men.
A
The provider diagnosed a patient, age 3, with left otitis media and recommended "watching and waiting." Which of the following statements is correct in educating the patient's mother? A. If symptoms worsen or don't get better in 2 days, have the provider see the patient again for evaluation. B. Give over-the-counter cough medicine as needed. C. The child will need ear tubes or hearing will be lost. D. If the ear begins draining, put some clove oil in it until you see the provider.
A
Which antibody is involved in anaphylaxis? A. IgE B. IgA C. IgG D. IgM
A
A patient in the postoperative phase of abdominal surgery has orders to advance the diet as tolerated. The patient has tolerated ice ships and a clear liquid diet. As the next step, the nurse would expect advancement to which type of diet? A. soft B. general C. full liquid D. sodium-restricted
C
The nurse is assessing a 32-year-old patient with otosclerosis. The nurse should be aware that the patient's hearing loss: A. will resolve in 4 to 6 weeks without intervention. B. typically affects both ears. C. occurred suddenly. D. is associated with ear pain.
B
The nurse is speaking to a group of women about early detection of breast cancer. The average age of the women in the group is 47. Following the American Cancer Society guidelines, the nurse should recommend that the women: A. perform BSE annually. B. have a mammogram annually. C. have a hormonal receptor assay annually. D. have a practitioner conduct a clinical examination every 2 years.
B
The nurse is teaching a patient with a detached retina who underwent scleral buckling on the left eye. The procedure included gas injection into the vitreous. Which of the following statements indicates that the patient understands the nurse's instructions? A. "I should lie on my abdomen with my head turned to the right." B. "I'll lie face down with my head turned to the left." C. "I'll lie face up with my head turned to the right." D. "I should lie on my back with my head turned to the left."
B
Which action will the nurse undertake to follow principles of asepsis? A. Maintaining a sterile environment B. Keeping the environment as clean as possible C. Testing for microorganisms in the environment D. Cleaning an environment until it is free from germs
B
Which finding distinguishes rheumatoid arthritis from osteoarthritis? A. Crepitus with ROM B. Symmetry of joint involvement C. Elevated serum uric acid levels D. Dominance in weight-bearing joints
B
Which patient has the highest risk of ovarian cancer? A. A 30-year-old woman taking an oral contraceptive B. A 45-year-old woman who has never been pregnant C. A 40-year-old woman with three children D. A 36-year-old who had her first child at age 22
B
Which position would be the most appropriate for a patient who has undergone stapedectomy? A. On the affected side B. On the unaffected side C. Prone D. Sims'
B
A patient undergoes a surgical procedure that requires the use of general anesthesia. For which condition does the nurse monitor the patient? A. anemia. B. atelectasis. C. dehydration. D. peripheral edema.
B
An 89-year-old patient has eye pressures of 27 OD and 29 OS. When questioned, the patient has noticed seeing halos around lights for a year or 2, but denies pain, blurred vision, or headache. A visual field exam shows reduced peripheral vision. Which of the following is most likely? A. Normal aging eyes B. Open-angle glaucoma C. Acute angle-closure glaucoma D. Cataracts
B
In caring for a patient after cataract surgery, the nurse should tell the patient to notify his physician of which of the following conditions? A. Blurred vision B. Eye pain C. Glare D. Itching
B
Nocturia and urinary hesitancy in the absence of any observable cause suggests which condition? A. Endometriosis B. Benign prostatic hyperplasia (BPH) C. Prostatitis D. Renal calculi
B
A 72-year-old patient is being discharged from same-day surgery after having a cataract removed from his right eye. Which discharge instruction should the nurse give the patient? A. "Sleep on the operative side." B. "Resume all activities as before." C. "Don't rub or place pressure on the eyes." D. "Wear an eye shield all day and remove it at night."
C
The nurse has just administered preoperative medication to a patient will have surgery in 30 minutes. What is the appropriate nursing action after medication administration? A. Obtain vital signs B. direct the patient to the bathroom down the hall. C. place the bed in low position with the side rails up. D. confirm that the medication will immediately induce sleep.
C
The nurse is caring for a 7-year-old boy with unilateral ear pain since yesterday. The provider notes an inflamed ear canal with debris, and has diagnosed uncomplicated right external otitis. Which of the following instructions is correct? A. You will need to have a tympanostomy tube placed to drain the fluid from your middle ear. B. Use a cotton swab to clear out your ears once a week; this will help prevent future infections. C. When you put in the antibiotic drops, lay down on your left side and leave the drops in for 3 to 5 minutes before getting up. D. Pull the wick out in an hour.
C
The nurse is caring for a patient who was given pain medication before leaving the PACU. Upon returning to the medical-surgical room, the patient reports experiencing pain and requests more pain medication. Which is the appropriate nursing action? A. Document the pain level only. B. Give a half dose of the as-needed ordered medication. C. Notify the practitioner that the patient is continuing to experience pain. D. Tell the patient that it will be 4 hours before more pain medication can be given.
C
The nurse is preparing a female patient with SLE for discharge. Which instructions should the nurse include in the teaching plan? A. Exposure to sunlight will help control skin rashes. B. No activity limitations are necessary between flareups. C. Report any changes in urination pattern. D. Corticosteroids may be stopped when symptoms are relieved.
C
The nurse is providing care for a patient following right cataract removal surgery. In which position should the nurse place the patient? A. Right-side lying B. Prone C. Supine D. Trendelenburg's
C
The patient's intake and output record contains the following information: milk, 180mL; orange juice, 60 mL; one serving scrambled eggs; one slice toast; one can Ensure oral nutritional supplement, 240mL; I.V. dextrose 5% in water at 100 mL/hour; 50 mL water after twice daily medications. Medications are given at 9:00am and 9:00pm. How will the nurse document the patient's total intake for the 7am to 3pm shift? A. 1,000 mL B. 1,250 mL C. 1,330 mL D. 1,380 mL
C
When planning to teach an adolescent female patient about PID, which of the following statements should the nurse include? A. "Good hygiene practices prevent the development of PID." B. "The use of hormonal contraceptives decreases the risk of PID." C. "PID can lead to long-term complications of the reproductive tract." D. "Infants born to adolescents with PID are at risk for birth defects."
C
Which statement should the nurse include when teaching a patient newly diagnosed with testicular cancer? A. "Testicular cancer isn't responsive to chemotherapy, but it's highly curative with surgery." B. "Radiation therapy is never used so that the unaffected testicle can remain healthy." C. "Testicular self-examination is still important because testicular cancer increases the risk of developing a second tumor." D. "Taking testosterone after orchiectomy prevents changes in appearance and sexual function."
C
A patient is admitted with acute bronchitis. During the admission interview, the patient tells the nurse about an allergy to bananas. Based on this statement, the patient may also have an allergy to which drug or substance? A. IV contrast dye B. Cephalosporins C. Penicillins D. Latex
D
A patient with SLE who receives immunosuppressants develops a fever. The nurse should: A. administer prescribed antipyretics. B. place the patient in isolation. C. apply cooling measures immediately. D notify physician.
D
A patient with rheumatoid arthritis has a history of long-term NSAID use and, consequently, has developed peptic ulcer disease. To treat this condition, the nurse should expect to administer: A. antibiotics. B. ticlopidine. C. prednisone. D. misoprostol.
D
In a patient who has HIV infection, the CD4+ level is measured to determine the: A. presence of opportunistic infections. B. level of the viral load. C. if they are cured of the infection. D. the ability of the immune system to fight infections.
D
On a follow-up visit after having a vaginal hysterectomy, a 32-year-old patient has has swelling and pain in the left calf. Which complication does this suggest? A. Hematoma B. Hypovolemia C. Infection D. Thrombus
D
The nurse is caring for a patient with a postoperative wound evisceration. What is the priority nursing action? A. Place the patient on nothing-by-mouth status. B. Explain to the patient what is happening, and provide support. C. Avoid pushing the protruding organs back into the abdominal cavity. D. Cover the protruding organs with sterile gauze moistened with sterile saline solution.
D
The nurse is evaluating a patient postoperatively for infection. Which assessment finding requires further immediate nursing intervention? A. A rectal temperature of 100F (37.8C) B. The presence of an indwelling urinary catheter C. A white blood cell (WBC) count of 9,000uL D. Redess, warmth, and tenderness in the incision area.
D
Which of the following increases a 40-year-old patient's risk of developing cataracts? A. A history of frequent streptococcal throat infections B. Maternal exposure to rubella during pregnancy C. Increased IOP D. Prolonged use of steroidal anti-inflammatory agents
D