Med Surg Exam 5 Practice Questions

The nurse in the perioperative area is preparing a client for surgery and notices that the client looks sad. The client says, "I'm scared of having cancer. It's so horrible and I brought it on myself. I should have quit smoking years ago." What would be the nurse's best response to the client? A. "It's okay to be scared. What is it about cancer that you're afraid of?" B. "It's normal to be scared. I would be, too. We'll help you through it." C. "Don't be so hard on yourself. You don't know if your smoking caused the cancer." D. "Do you feel guilty because you smoked?"

A. "It's okay to be scared. What is it about cancer that you're afraid of?"

A 65-year-old client has been told by the physician that his prostate cancer was graded at stage IIB. The client inquires if this means he is going to die soon. The best response by the nurse is which of the following? A. "Prostate cancer at this stage is very slow growing." B. "Prostate cancer at this stage is very fast growing." C. "Prostate cancer at this stage has spread to the bone." D. "Prostate cancer at this stage is difficult to predict."

A. "Prostate cancer at this stage is very slow growing."

The nursing team on an oncology unit consists of a registered nurse, a licensed vocational nurse (LVN), and an unlicensed assistance personnel (UAP). Which client should be assigned to the RN? A. A 52-year-old client with lung cancer admitted for acute dyspnea B. A 45-year-old client receiving tube feedings C. A 28-year-old client being evaluated for a bone marrow transplant D. A 65-year-old client diagnosed with endometrial cancer who underwent an abdominal hysterectomy 3 days ago

A. A 52-year-old client with lung cancer admitted for acute dyspnea

A client diagnosed with cancer is receiving chemotherapy. The nurse should assess which of the following diagnostic values while the client is receiving chemotherapy? A. Bone marrow cells B. Liver tissues C. Heart tissues D. Pancreatic enzymes

A. Bone marrow cells

Which of the following is the most reliable early indicator of an infection in a client who is neutropenic? A. Fever B. Chills C. Tachycardia D. Dyspnea

A. Fever

The nurse is caring for a patient receiving a continuous norepinephrine (Levophed) IV infusion. Which patient assessment information indicates that the infusion rate may be too high? a. High blood pressure b. Slow heart rate c. Low pulmonary arterial wedge pressure d. Decreased systemic vascular resistance

A. High blood pressure

The primary reason that a herpes simplex virus (HSV) infection is a serious concern to a client with human immunodeficiency virus (HIV) infection is that it: A. Is an acquired immunodeficiency virus (AIDS)-defining illness B. Is curable only after 1 year of antiviral therapy C. Leads to cervical cancer D. Causes severe electrolyte imbalances

A. Is an AIDS defining illness

The healthcare provider is teaching a patient who has tested positive for human immunodeficiency virus (HIV) about the antiretroviral medication maraviroc. Which of the following statements best describes how this drug is effective against HIV? A. The HIV virus is prevented from entering the target cells B. The cellular membrane of the HIV virus is disrupted C. New virus particles lose their ability to be infectious D. The process of viral DNA synthesis is suppressed

A. The HIV virus is prevented from entering the target cells

A patient who has tested positive for the human immunodeficiency virus (HIV) arrives at the clinic with a report of fever, nonproductive cough, and fatigue. The patient's CD4 count is 184 cells/mcL. How should the healthcare provider interpret these findings? A. The patient is diagnosed with acquired immunodeficiency syndrome (AIDS) B. The patient is now in the latent stages of HIV infection C. These findings provide evidence that the patient has seroconverted D. This is an expected finding because the patient has tested positive for HIV

A. The patient is diagnosed with acquired immunodeficiency syndrome (AIDS)

A client is to have radiation therapy after a modified radical mastectomy. The nurse should teach the client to care for the skin at the site of therapy by: A. Washing the area with water B. Exposing the area to dry heat C. Applying an ointment to the area D. Using talcum powder on the area

A. Washing the area with water

A client with lung cancer is being cared for by his wife at home. His pain is increasing in severity. The nurse recognizes that teaching has been effective when the wife does which of the following? SELECT ALL THAT APPLY A. Administers long-acting or sustained-release oral pain medication (OxyContin) regularly around the clock B. Administers immediate-release medication (oxycodone) for breakthrough pain C. Avoids long-acting opioids due to her concern about addiction D. Uses music for distraction as well as heat or cold in combination with medications E. Substitutes acetaminophen (Tylenol) to avoid tolerance to the medications F. Has her husband use a pain-rating scale to measure the effectiveness at reaching his individual pain goal

ABDF

The healthcare provider is teaching a patient who has been diagnosed with acquired immunodeficiency syndrome (AIDS) about the need for multi-drug therapy. Which of the following best explains the rationale for using more than one antiretroviral medication to treat AIDS? A. This combination of medications will eliminate the AIDS virus from your body." B. "This is intended to keep the virus from developing resistance to the medications." C. "You will not be able to transmit the disease while you take this medication combination." D. "You will experience less side effects when you take a combination of medications."

B. "This is intended to keep the virus from developing resistance to the medications."

A patient's localized infection has progressed to the point where septic shock is now suspected. Which of the following is an appropriate treatment modality for this patient? a. Insulin infusion b. Aggressive fluid resuscitation c. Intravenous administration of epinephrine d. Administration of nitrates and β-adrenergic blockers

B. Aggressive fluid resusciation

A 42-year-old is interested in making dietary changes to reduce the risk of colon cancer. What dietary selections should the nurse suggest? A. Croissant, granola and peanut butter squares, whole milk B. Bran muffin, skim milk, stir-fried broccoli C. Granola, bagel with cream cheese, cauliflower salad D. Oatmeal raisin cookies, baked potato with sour cream, turkey sandwich

B. Bran muffin, skim milk, stir-fried broccoli

The healthcare provider is teaching a student about the disease process. Which of the following information should the healthcare provider include? A. The HIV virus divides quickly inside red blood cells B. HIV RNA is transcribed into DNA C. HIV begins to phagocytize host immune cells D. HIV RNA is inserted into the host cell mitochondria

B. HIV RNA is transcribed into DNA

The nurse would recognize which of the following clinical manifestations as suggestive of sepsis? a. Respiratory rate of seven breaths per minute b. Hyperglycemia in the absence of diabetes c. Sudden diuresis unrelated to drug therapy d. Bradycardia with sudden increase in blood pressure

B. Hyperglycemia in the absence of diabetes

When caring for a patient in acute septic shock, the nurse would anticipate a. Administering osmotic and/or loop diuretics. b. Infusing large amounts of intravenous fluids. c. Administering intravenous diphenhydramine d. Assisting with insertion of a ventricular assist device (VAD).

B. Infusing large amounts of intravenous fluids

Cancer prevalence is defined as: A. The likelihood cancer will occur in a lifetime B. The number of persons with cancer at a given point in time C. The number of new cancers in a year D. All cancer cases more than 5 years old

B. The number of persons with cancer at a given point in time.

Which interventions should the nurse perform prior to suctioning a patient who has an ET using open-suction techniques? SELECT ALL THAT APPLY a. Put on clean gloves b. Administer a bronchodilator c. Perform a cardiopulmonary assessment d. Hyperoxygenate the patient for 30 seconds e. Insert a few drops of normal saline into the ET to break up secretions

C D

A patient who has been diagnosed with acquired immunodeficiency syndrome (AIDS) develops an oral Candida infection. When teaching the patient, the healthcare provider will include which of the following instructions? A. "Rinse your mouth often with a commercial mouthwash." B. "Include plenty of citrus juices in your diet." C. "Select foods that are soft or pureed." D. "Include hot soups and beverages with each meal."

C. "Select foods that are soft or pureed."

A patient who has been receiving antiretroviral therapy (ART) to manage infection with human immunodeficiency virus (HIV) has an undetectable viral load. How would the healthcare provider interpret this information? A. More tests are needed to determine the effectiveness of ART B. HIV has been eliminated from the patient's blood C. ART has been effective in decreasing viral load D. ART can be discontinued for three months

C. ART has been effective in decreasing viral load.

The critical care nurse is caring for a 55-year old man who has a catheter in the right radial artery that is being used for continuous arterial blood pressure monitoring following his abdominal aortic aneurysm surgery. Which observation by the mires would require an emergency intervention? a. Calculated mean arterial pressure is 74 mmHg b. Patient's HOB elevation is at 30 degrees c. Capillary refill time in the right hand is 5 seconds d. Pressure bag attached to the arterial line is inflated to 270 mmHg

C. Capillary refill time in the right hand is 5 seconds

When caring for a critically ill patient who is being mechanically ventilated, the nurse will astutely monitor for which of the following clinical manifestations of multiple organ dysfunction syndrome (MODS)? a. Increased gastrointestinal (GI) motility b. Increased serum albumin c. Decreased blood urea nitrogen (BUN)/creatinine ratio d. Decreased respiratory compliance

C. Decreased BUN

The healthcare provider is teaching a patient who has a diagnosis of acquired immunodeficiency syndrome (AIDS) about food safety. Which of the following foods should the patient avoid to prevent foodborne illnesses A. Green salad B. Boiled eggs C. Deli meats D. Mozzarella cheese

C. Deli meats

A client is admitted to the recovery room after cystoscopy with biopsy. Before the nurse can discharge the client, the nurse should be sure the client: A. Has a bowel movement B. Has received the first dose of pain medication C. Has voided D. Has no blood in the urine

C. Has voided

Which of the following laboratory findings fits with a diagnosis of cardiogenic shock? a. Decreased liver enzymes b. Increased white blood cells c. Increased blood urea nitrogen and creatinine levels d. Decreased red blood cells, hemoglobin, and hematocrit

C. Increased BUN and Creatinine levels

The patient has developed cardiogenic shock after a left anterior descending myocardial infarction. Which circulatory-assist device should ten use expect to use for this patient? a. Cardiopulmonary bypass b. Impedance cardiograph c. Intra-aortic balloon pump d. Central venous pressure measurement

C. Intra-arotic balloon pump

The nursing management of a patient with an artificial airway includes a. Maintaining ET tube cuff pressure at 30 cm H2O b. Routine suctioning of the tube at least every two hours c. Observing for cardiac dysrhythmias during suctioning d. Prevention of tube dislodgement by limiting mouth care to lubrication of the lips

C. Observing for cardiac dysrhythmias during suctioning

A new staff nurse in the ICU is being trained on hemodynamic monitoring. The nurse educator for the unit determines that teaching has been effective when she observes the new nurse doing which of the following? a. Decreasing IV fluid administration rate for a CVP of 2 mmHg b. Utilizing the right radial arterial line for fluid administration c. Positing the zero-reference point transducer level with the phlebostatic axis d. Initiating prescribed treatment in response to monitor alarms

C. Positioning the zero-reference point transducer level with the phlebostatic axis

When planning care for a patient on a mechanical ventilator, the nurse understands that the application of positive end-expiratory pressure (PEEP) to the ventilator settings has which therapeutic effect? a. Increased inflation of the lungs b. Prevention of barotrauma to the lung tissue c. Prevention of alveolar collapse during expiration d. Increased fraction of inspired oxygen concentration administration

C. Prevention of alveolar collapse during expiration

Doxorubicin (Adriamycin) is prescribed for a female client with breast cancer. The client is distressed about hair loss. The nurse should do which of the following? A. Have the client wash and massage the scalp daily to stimulate hair growth B. Explain that hair loss is temporary and will quickly grow back to its original appearance C. Provide resources for a wig selection before hair loss begins D. Recommend that the client limit social contacts until hair regrows

C. Provide resources for a wig section before hair loss begins

The healthcare provider is assessing the skin of a patient who is at risk for becoming infected with the human immunodeficiency virus (HIV). Which of the following findings requires immediate follow-up by the healthcare provider? A. Ecchymoses on the legs B. Patches of dry, flaky skin C. Purplish-red raised lesions D. Numerous moles on the chest and back

C. Purplish-red raised lesions

A client with human immunodeficiency virus (HIV) infection is taking zidovudine (AZT). The expected outcome of AZT is to: A. Destroy the virus B. Enhance the body's antibody production C. Slow replication of the virus D. Neutralize toxins produced by the virus

C. Slow replication of the virus

Which of the following clients is at highest risk for colorectal cancer? A. The client who smokes B. The client who eats a vegetarian diet C. The client who has been treated for Crohn's disease for 20 years D. The client who has a family history of lung cancer

C. The client who has been treated for Crohn's disease for 20 years

A male client with HIV infection becomes depressed and tells the nurse: "I have nothing worth living for now." Which of the following statements would be the best response by the nurse? A. "You are a young person and have a great deal to live for." B. "You should not be too depressed; we are close to finding a cure for AIDS." C. "You are right; it is very depressing to have HIV." D. "Tell me more about how you are feeling about being HIV positive."

D. "Tell me more about how you are feeling about being HIV positive"

When performing external chest compressions on an adult during cardiopulmonary resuscitation, the rescuer should depress the sternum a. 0.5 inches b. 1 inch c. 1.5 inches d. 2 inches

D. 2 inches

A client is receiving chemotherapy for the diagnosis of brain cancer. When teaching the client about contamination from excretion of the chemotherapy drugs within the first 48 hours, the nurse should instruct the client that: A. A bathroom can be shared with an adult who is not pregnant B. Urinary and bowel excretions are not considered contaminated C. Disposable plates and plastic utensils must be used during the entire course of chemotherapy D. Any contaminated linens should be washed separately and then washed a second time, if necessary

D. Any contaminated linens should be washed separately and then washed a second time, it necessary

A patient who is human immunodeficiency positive (HIV) positive is receiving a nucleoside reverse transcriptase inhibitor (NRTI). Which of these clinical findings would indicate the patient is experiencing an adverse effect of this medication? A. Increased blood glucose B. Weight gain C. Decreased hemoglobin D. Metabolic alkalosis

D. Decreased hemoglobin

A 68-year old male patient diagnosed with sepsis is orally intubated on mechanical ventilation. Which action is most important for the nurse to take? a. Use the open-suctioning technique b. Administer morphine for discomfort c. Limit noise and cluster care activities d. Elevate the head of the bed 30 degrees

D. Elevate the head of the bed 30 degrees

Postoperative nursing management of a client following radical neck dissection for laryngeal cancer requires: A. Complete bed rest minimizing head movement B. Vital signs once a shift C. Clear liquid diet started at 48 hours D. Frequent suctioning of the laryngectomy tube

D. Frequent suctioning of the laryngectomy tube

A massive gastrointestinal bleed has resulted in hypovolemic shock in an elderly patient. Which of the following is a priority nursing diagnosis? a. Acute pain b. Impaired tissue integrity c. Decreased cardiac output d. Ineffective tissue perfusion

D. Ineffective tissue perfusion

The nurse is caring for a patient who has been on a mechanical ventilator for several days. Which weaning parameter would tell the nurse whether or not the patient has enough muscle strength to breathe without assistance? a. Tidal volume b. Minute ventilation c. Forced vital capacity d. Negative inspiratory force

D. Negative Inspiratory force

In educating a client about human immunodeficiency virus (HIV), the nurse should take into account the fact that the most effective method known to control the spread of HIV infection is: A. Premarital serologic screening B. Prophylactic treatment of exposed people C. Laboratory screening of pregnant women D. Ongoing sex education about preventive behaviors

D. Ongoing sex education about preventive behaviours

A client asks the nurse to explain the meaning of her abdnormal Papanicolaou (Pap) smear result of atypical squamous cells. Which of the following concepts should the nurse include in the response? An atypical Pap smear means that A. Abnormal viral cells were found in the smear B. Cancer cells were found in the smear C. That Pap smear alone is not very important diagnostically because there are many false-positive results D. The cells could cause various conditions and help identify a problem early

D. The cells could cause various conditions and help identify a problem early