Med Surg Final Exam Practice Questions

28. A patient has a bone density score of -2.8. What action by the nurse is best? a. Asking the patient to complete a food diary b. Planning to teach about bisphosphonates c. Scheduling another scan in 2 years d. Scheduling another scan in 6 months

B

5. A nurse prepares a patient who is scheduled for an arthroscopy of the shoulder. Which action by the nurse is most important? a. Assess serum aspartate aminotransferase (AST) levels. b. Ensure that informed consent is on the chart. c. Position the patient flat after the procedure. d. Reinforce the dressing if it becomes saturated.

B

6. A nurse obtains a health history on a client prior to administering prescribed sumatriptan succinate (Imitrex) for migraine headaches. Which condition would alert the nurse to hold the medication and contact the healthcare provider? a. Bronchial asthma b. Prinzmetal's angina c. Diabetes mellitus d. Chronic kidney disease

B

10. A nurse plans care for a patient with lower back pain from a work-related injury. Which intervention would the nurse include in this patient's plan of care? a. Encourage the patient to stretch the back by reaching toward the toes. b. Massage the affected area with ice twice a day. c. Apply a heating pad for 20 minutes at least four times daily. d. Advise the patient to avoid warm baths or showers.

C

11. A nurse is caring for a patient with paraplegia who is scheduled to participate in a rehabilitation program. The patient states, "I do not understand the need for rehabilitation; the paralysis will not go away and it will not get better." How would the nurse respond? a. "If you don't want to participate in the rehabilitation program, I'll let the provider know." b. "Rehabilitation programs have helped many patients with your injury. You should give it a chance." c. "The rehabilitation program will teach you how to maintain the functional ability you have and prevent further disability." d. "When new discoveries are made regarding paraplegia, people in rehabilitation programs will benefit first."

C

The weather center has just issued a hurricane warning. What type of disaster warning does the nurse anticipate will be activated? A.Pandemic B.Internal disaster C.External disaster D.Mass casualty event

C

1. A nurse is field-triaging patients after an industrial accident. Which patient condition would the nurse triage with a red tag? a. Dislocated right hip and an open fracture of the right lower leg b. Large contusion to the forehead and a bloody nose c. Closed fracture of the right clavicle and arm numbness d. Multiple fractured ribs and shortness of breath

D

12. A nurse cares for a patient who presents with an acute exacerbation of multiple sclerosis (MS). Which prescribed medication would the nurse prepare to administer? a. Baclofen (Lioresal) b. Interferon beta-1b (Betaseron) c. Dantrolene sodium (Dantrium) d. Methylprednisolone (Medrol)

D

13. A nurse prepares a patient for prescribed magnetic resonance imaging (MRI). Which action would the nurse implement prior to the test? a. Implement nothing by mouth (NPO) status for 8 hours. b. Withhold all daily medications until after the examination. c. Administer morphine sulfate to prevent claustrophobia during the test. d. Place the patient in a gown that has cloth ties instead of metal snaps.

D

An emergency nurse is performing disaster triage following the crash of a 737 jetliner. Which patient does the nurse assign a black tag? A.26-year-old with confusion, yet ambulatory B.40-year-old with an open femur fracture C.54-year-old with facial lacerations D.42-year-old with full-thickness burns to torso and extremities

D

20. A patient with a stroke has damage to Broca's area. What intervention to promote communication is best for this patient? a. Assess whether or not the patient can write. b. Communicate using "yes-or-no" questions. c. Reinforce speech therapy exercises. d. Remind the patient not to use neologisms.

A

3. A nurse prepares to teach a patient who has experienced damage to the left temporal lobe of the brain. What action would the nurse take when providing education about newly prescribed medications to this patient? a. Help the patient identify each medication by its color. b. Provide written materials with large print size. c. Sit on the patient's right side and speak into the right ear. d. Allow the patient to use a white board to ask questions.

C

34. A nurse assesses a patient with a rotator cuff injury. Which finding would the nurse expect to assess? a. Inability to maintain adduction of the affected arm for more than 30 seconds b. Shoulder pain that is relieved with overhead stretches and at night c. Inability to initiate or maintain abduction of the affected arm at the shoulder d. Referred pain to the shoulder and arm opposite the affected shoulder

C

27. A nurse is providing community education about preventing traumatic musculoskeletal injuries related to car crashes. Which group does the nurse target as the priority for this education? a. High school football team b. High school homeroom class c. Middle-aged men d. Older adult women

A

30. A patient had a bunionectomy with osteotomy. The patient asks why healing may take up to 3 months. What explanation by the nurse is best? a. "Your feet have less blood flow, so healing is slower." b. "The bones in your feet are hard to operate on." c. "The surrounding bones and tissue are damaged." d. "Your feet bear weight so they never really heal."

A

31. A patient with osteoporosis is going home, where the patient lives alone. What action by the nurse is best? a. Arrange a home safety evaluation. b. Ensure that the patient has a walker at home. c. Help the patient look into assisted living. d. Refer the patient to Meals on Wheels.

A

33. An emergency department nurse triages a patient with diabetes mellitus who has fractured her arm. Which action would the nurse take first? a. Remove the medical alert bracelet from the fractured arm. b. Immobilize the arm by splinting the fractured site. c. Place the patient in a supine position with a warm blanket. d. Cover any open areas with a sterile dressing.

A

A patient with a spinal cord injury at C5-C6 reports a sudden severe headache. The patient is flushed. Vital signs include a blood pressure of 190/100 mm Hg and heart rate of 52 beats/min. What is the priority nursing intervention? A.Notify the health care provider. B.Place the patient in a sitting position. C.Check the patient for fecal impaction. D.Check the urinary catheter for kinks or obstruction.

B

14. A nurse cares for a patient with amyotrophic lateral sclerosis (ALS). The patient states, "I do not want to be placed on a mechanical ventilator." How would the nurse respond? a. "You should discuss this with your family and health care provider." b. "Why are you afraid of being placed on a breathing machine?" c. "Using the incentive spirometer each hour will delay the need for a ventilator." d. "What would you like to be done if you begin to have difficulty breathing?"

D

16. A patient with myasthenia gravis has the priority patient problem of inadequate nutrition. What assessment finding indicates that the priority goal for this patient problem has been met? a. Ability to chew and swallow without aspiration b. Eating 75% of meals and between-meal snacks c. Intake greater than output 3 days in a row d. Weight gain of 3 lbs (1.4 kg) in 1 month

D

15. A patient with Guillain-Barré syndrome is admitted to the hospital. The nurse plans caregiving priority to interventions that address which priority patient problem? a. Anxiety b. Low fluid volume c. Inadequate airway d. Potential for skin breakdown

C

19. A patient experiences impaired swallowing after a stroke and has worked with speech-language pathology on eating. What nursing assessment best indicates that a priority goal for this problem has been met? a. Chooses preferred items from the menu b. Eats 75 to 100% of all meals and snacks c. Has clear lung sounds on auscultation d. Gains 2 lbs (1 kg) after 1 week

C

29. A patient has a metastatic bone tumor. What action by the nurse takes priority? a. Administer pain medication as prescribed. b. Elevate the extremity and apply moist heat. c. Handle the affected extremity with caution. d. Place the patient on protective precautions.

C

4. A nurse plans care for an 83-year-old patient who is experiencing age-related sensory perception changes. Which intervention would the nurse include in this patient's plan of care? a. Provide a call button that requires only minimal pressure to activate. b. Write the date on the patient's white board to promote orientation. c. Ensure that the path to the bathroom is free from clutter. d. Encourage the patient to season food to stimulate nutritional intake.

C

18. A nurse receives a report on a patient who had a left-sided stroke and has homonymous hemianopsia. What action by the nurse is most appropriate for this patient? a. Assess for bladder retention and/or incontinence. b. Listen to the patient's lungs after eating or drinking. c. Prop the patient's right side up when sitting in a chair. d. Rotate the patient's meal tray when the patient stops eating.

D

32. A nurse cares for a patient who had a wrist cast applied 3 days ago. The patient states, "The cast is loose enough to slide off." How would the nurse respond? a. "Keep your arm above the level of your heart." b. "As your muscles atrophy, the cast is expected to loosen." c. "I will wrap a bandage around the cast to prevent it from slipping." d. "You need a new cast now that the swelling is decreased."

D

21. A patient is in the clinic for a follow-up visit after a moderate traumatic brain injury. The patient's spouse is very frustrated, stating that the patient's personality has changed and the situation is intolerable. What action by the nurse is best? a. Explain that personality changes are common following brain injuries. b. Ask the patient why he or she is acting out and behaving differently. c. Refer the patient and spouse to a head injury support group. d. Tell the spouse that this is expected and he or she will have to learn to cope.

A

When caring for a patient with Parkinson disease, the nurse understands that progressive difficulty with which factor is a primary expected outcome? A.Nutrition B.Elimination C.Motor ability D.Effective communication

C

•The nurse is assessing a patient with Parkinson disease. The nurse notes that the patient has resistance to passive movement of the lower extremities with mildly restrictive movement. Which documentation is most appropriate? a. Rigidity b. Cogwheel c. Plastic d. Lead pipe

C

17. A patient in the family practice clinic has restless leg syndrome. Routine laboratory work reveals white blood cells 8000/mm3 (8 ´ 109/L), magnesium 0.8 mEq/L (0.4 mmol/L), and sodium 138 mEq/L (138 mmol/L). What action by the nurse is best? a. Advise the patient to restrict fluids. b. Assess the patient for signs of infection. c. Have the patient add table salt to food. d. Instruct the patient on a magnesium supplement.

D

2. An emergency department (ED) charge nurse prepares to receive patients from a mass casualty within the community. What is the role of this nurse during the event? a. Ask ED staff to discharge patients from the medical-surgical units in order to make room for critically injured victims. b. Call additional medical-surgical and critical care nursing staff to come to the hospital to assist when victims are brought in. c. Inform the incident commander at the mass casualty scene about how many victims may be handled by the ED. d. Direct medical-surgical and critical care nurses to assist with patients currently in the ED while emergency staff prepare to receive the mass casualty victims.

D

7. After teaching the wife of a client who has Parkinson disease, the nurse assesses the wife's understanding. Which statement by the client's wife indicates that she correctly understands changes associated with this disease? a. "His masklike face makes it difficult to communicate, so I will use a white board." b. "He should not socialize outside of the house due to uncontrollable drooling." c. "This disease is associated with anxiety causing increased perspiration." d. "He may have trouble chewing, so I will offer bite-sized portions."

D

An ED nurse informs the charge nurse that he can't sleep or eat after providing care for school shooting victims last week. What is the appropriate charge nurse response? A."I know how hard it is but the memories will fade eventually." B."You look stressed. If you take a few days off, I'll cover your shifts." C."We have to be stronger than that. We see disasters all of the time." D."The occupational nurse can help you explore critical incident stress debriefing options."

D

The nurse understand which of the following is a risk factor associated with the development of multiple sclerosis? A.Smoking B.High-fat diet C.Age greater than 70 D.Gender

D

22. A patient who had a severe traumatic brain injury is being discharged home, where the spouse will be a full-time caregiver. What statement by the spouse would lead the nurse to provide further education on home care? a. "I know I can take care of all these needs by myself." b. "I need to seek counseling because I am very angry." c. "Hopefully things will improve gradually over time." d. "With respite care and support, I think I can do this."

A

23. A patient has a brain tumor and is receiving phenytoin (Dilantin). The spouse questions the use of the drug, saying that the patient does not have a seizure disorder. What response by the nurse is best? a. "Increased pressure from the tumor can cause seizures." b. "Preventing febrile seizures with a tumor is important." c. "Seizures always occur in patients with brain tumors." d. "This drug is used to sedate the patient with a brain tumor."

A

24. A nurse is providing community screening for risk factors associated with stroke. Which patient would the nurse identify as being at highest risk for a stroke? a. A 27-year-old heavy-cocaine user b. A 30-year-old who drinks a beer a day c. A 40-year-old who uses seasonal antihistamines d. A 65-year-old who is active and on no medications

A

26. A patient is distressed at body changes related to kyphosis. What response by the nurse is best? a. Ask the patient to explain more about these feelings. b. Explain that these changes are irreversible. c. Offer to help select clothes to hide the deformity. d. Tell the patient that safety is more important than looks.

A

5. A nurse delegates care to the unlicensed assistive personnel (UAP). Which statement would the nurse include when delegating care for a patient with cranial nerve II impairment? a. "Tell the patient where food items are on the breakfast tray." b. "Place the patient in a high-Fowler's position for all meals." c. "Make sure the patient's food is visually appetizing." d. "Assist the patient by placing the fork in the left hand."

A

8. A nurse witnesses a client with late-stage Alzheimer's disease eat breakfast. Afterward the client states, "I am hungry and want breakfast." How would the nurse respond? a. "I see you are still hungry. I will get you some toast." b. "You ate your breakfast 30 minutes ago." c. "It appears you are confused this morning." d. "Your family will be here soon. Let's get you dressed."

A

9. A nurse delegates care for a client with Parkinson disease to an unlicensed assistive personnel (UAP). Which statement would the nurse include when delegating this client's care? a. "Allow the client to be as independent as possible with activities." b. "Assist the client with frequent and meticulous oral care." c. "Assess the client's ability to eat and swallow before each meal." d. "Schedule appointments early in the morning to ensure rest in the afternoon."

A

The family of a patient with Alzheimer's disease (AD) reports increasing symptoms of paranoia in the patient. Which nursing response is most appropriate? A. "There is often an underlying psychiatric condition with AD." B. "Some patients with dementia may experience paranoia, delusions, and even hallucinations." C. "This is a sign of rapid progression of the AD." D. "Inform the patient that their feelings are not real."

B

In assessing a patient with low back pain, which priority assessment question or statement will the nurse provide? A."How long have you had back pain?" B."How does your back pain affect your activities of daily living?" C."Tell me about your pain and what interventions are helpful in managing your pain." D."Have you ever had magnetic resonance imaging to find a cause for your back pain?"

C