Med Surg Mixed Review Questions

Inspection of a patient's skin color is part of the assessment of the integumentary system. Cyanosis, which is a late indicator of hypoxia, is present when the unoxygenated hemoglobin level is: (pg 475)

5 g/dL

After teaching a patient scheduled for ambulatory surgery using moderate sedation, the nurse determines that the patient has understood the teaching based on which of the following statements? (pg 429)

"I'll be sleepy but able to respond to your questions."

Which is a potential complication of a low pressure in the endotracheal tube cuff? (pg 531-34)

Aspiration pneumonia

Which term refers to a graft derived from one part of a client's body and used on another part of that same client's body? (pg 1859)

Autograft

A client is transferred from the postanesthesia care unit (PACU) to an inpatient care unit. What will the nurse assess first? (pg 438)

Breathing

Which medication classification may be used for contact dermatitis? (pg 1820)

Corticosteroids

At which time does the nurse realize that it is best to begin teaching about care needed during the postoperative period? (pg 397)

During the preoperative period

A patient with uncontrolled diabetes is scheduled for a surgical procedure. What chief life-threatening hazard should the nurse monitor for? (pg 405)

Hypoglycemia

The nurse assesses the client and observes reddish-purple to dark blue macules, plaques, and nodules. The nurse recognizes that these manifestations are associated with which condition? (pg 1859)

Kaposi sarcoma

Which term will the nurse use to document the inability of a client to breathe easily unless positioned upright? (pg 471)

Orthopnea

A nurse is assessing a patient's nails and observes Beau's lines. Which of the following depicts this condition? (pg 1810)

Pictured

The nurse is caring for a client during an intra operative procedure. When assessing vital signs, which result indicates a need to alert the anesthesiologist immediately? (pg 431)

Temperature of 102.5°F (39°C)

To treat a client with acne vulgaris, the physician is most likely to order which topical agent for nightly application? (pg 1860)

Tretinoin (retinoic acid [Retin-A])

Which of the following clinical manifestations increases the risk for evisceration in the postoperative client? (pg 451)

Valsalva maneuver

A nurse caring for a patient with a pulmonary embolism understands that a high ventilation-perfusion ratio may exist. What does this mean for the patient? (pg 468)

Ventilation exceeds perfusion

While assessing a patient at the clinic the nurse notes patchy, milky white spots. The nurse knows that this finding is a symptom of what? (pg 1805)

Vitiligo

A nurse is assisting with a subclavian vein central line insertion when the client's oxygen saturation drops rapidly. He complains of shortness of breath and becomes tachypneic. The nurse suspects the client has developed a pneumothorax. Further assessment findings supporting the presence of a pneumothorax include: (pg 629)

diminished or absent breath sounds on the affected side.

When the indication for surgery is without delay, the nurse recognizes that the surgery will be classified as (pg 400)

emergency

A client is being seen by the physician because of an unrelenting headache, facial tenderness, low-grade fever, and dark yellow nasal discharge. The client reports seeming to develop sinus infections "all the time." Which factor may predispose the client to sinusitis? (pg 495)

interference with sinus drainage

A client has been newly diagnosed with emphysema. The nurse should explain to the client that by definition, ventilation: (pg 477)

is breathing air in and out of the lungs

During a procedure, a client's temperature begins to rise rapidly. This is likely the result of which complication? (pg 432)

malignant hyperthermia

The patient asks the nurse why food is withheld before surgery. What is the best response by the nurse? (pg 411)

"Aspiration is a concern and can be a complication if food or fluid is taken close to the surgery time."

A client exhibits a sudden and complete loss of voice and is coughing. The nurse states (pg 507)

"Do not smoke and avoid being around others who are smoking."

A patient is complaining of a headache after receiving spinal anesthesia. What does the nurse understand may be the cause of the headache related to the spinal anesthesia? (Select all that apply.) (pg 429)

- Leakage of spinal fluid from the subarachnoid space - Size of the spinal needle used - Degree of patient hydration

A client who has been admitted for weakness and taking fluids poorly is unable to move well in the bed and requires assistance. What are this client's risk factors for developing pressure sores? Select all that apply. (pg 1822)

-dehydration -immobility -inactivity

For the client who is taking aspirin, it is important to stop taking this medication at least how many day(s) before surgery? (pg 406)

7

The nurse is preparing to discharge a client from the PACU using a PACU room scoring guide. With what score can the client be transferred out of the recovery room? (pg 443)

7

Which of the following is accurate regarding status asthmaticus? (pg 642)

A severe asthma episode that is refractory to initial therapy

The nurse is providing discharge instructions to a client who has nasal packing in place following nasal surgery. Which discharge instructions would be most appropriate for the client? (pg 513)

Avoid sports activities for 6 weeks.

After a tonsillectomy, a client is being prepared for discharge. The nurse should instruct the client to report which sign or symptom immediately? (pg 506)

Bleeding

The nurse assesses a patient with a heart rate of 42 and a blood pressure of 70/46. What type of hypoxia does the nurse determine this patient is displaying? (ch 19)

Circulatory hypoxia

The nurse is working with community groups. At which of the following locations would the nurse anticipate a possible scabies outbreak? (pg 1840)

College dormitory

What are the circulating nurse's responsibilities, in contrast to the scrub nurse's responsibilities? (pg 420)

Coordinating the surgical team

The nurse is assessing the lungs of a patient diagnosed with pulmonary edema. Which of the following would be expected upon auscultation? (pg 484)

Crackles at lung bases

The nurse is differentiating between a macule and a papule when evaluating a client's skin lesion. The nurse determines that the lesion is a papule when which characteristic is noted? (pg 1806)

Elevated and palpable

Which type of cell is believed to play a significant role in cutaneous immune system reactions? (pg 1799)

Langerhans cells

The nurse and nursing assistant are moving a client who slid down in the chair. What does the nurse encourage the assistant to avoid shearing when moving the client to a higher position in the chair? (pg 1827)

Lift the client, do not slide them.

A patient is visiting the physician to determine what type of allergy is causing a rash. What type of testing does the nurse anticipate the physician will schedule? (pg 1813)

Patch test

The nurse is assisting an older adult client with performing activities of daily living (ADL) and is brushing her hair. What does the nurse document as an abnormal finding? (ch 55)

Pearly white substance that is attached to the hair shaft that is not removed with brushing

The nurse documents the presence of granulation tissue in a healing wound. How should the nurse describe the tissue? (pg 450)

Pink to red and soft, bleeding easily

When is the ideal time to discuss preoperative teaching (pg 397)

Preadmission visit

You are caring for a client with chronic respiratory failure. What are the signs and symptoms of chronic respiratory failure? (pg 577)

Progressive loss of lung function associated with chronic disease

A patient's skin is examined and the nurse notes the presence of herpes simplex/zoster skin lesions. The nurse describes the lesions as: (pg 1806-08)

Pus-filled vesicles; circumscribed and elevated masses >0.5 cm.

An older adult client's skin has become dry and flaked. Which of the following is the cause of this condition? (pg 1802)

Reduction in sebum production

A 10-year-old child is brought to the office with complaints of severe itching in both hands that's especially annoying at night. On inspection, the nurse notes gray-brown burrows with epidermal curved ridges and follicular papules. The physician performs a lesion scraping to assess this condition. Based on the signs and symptoms, what diagnosis should the nurse expect? (pg 1840)

Scabies

A patient is complaining of severe itching that intensifies at night. The nurse decides to assess the skin using a magnifying glass and penlight to look for the "itch mite." What skin condition does the nurse anticipate finding? (pg 1840)

Scabies

A client is placed on the operating room table for the surgical procedure. Which surgical team member is responsible for handing sterile instruments to the surgeon and assistants? (pg 420)

Scrub nurse

A nurse has pharyngitis and will be providing self care at home. It is most important for the nurse to... (pg 504)

Seek medical help if he experiences inability to swallow

A patient comes to the clinic for the third time in 2 months with chronic bronchitis. What clinical symptoms does the nurse anticipate assessing for this patient? (pg 603)

Sputum and a productive cough

The nurse is caring for a patient with pleurisy. What symptoms does the nurse recognize are significant for this patient's diagnosis? (pg 553)

Stabbing pain during respiratory movement

A nurse is caring for a client who is three hours post op from open abdominal surgery. During routine assessment, the nurse notes the previously stable client now appears anxious, apprehensive, and has a blood pressure of 90/56. What does the nurse consider is the most likely cause of the client's change in condition? (pg 440)

The client is displaying early signs of shock.

A client is admitted to the health care facility with active tuberculosis (TB). What intervention should the nurse include in the client's care plan? (pg 546)

Wearing a disposable particulate respirator that fits snugly around the face

The nurse's assessment of a postop client reveals a temperature of 103.2°F, tachycardia, and client complaints of increased incisional pain. What does the nurse recognize that this client is experiencing? (pg 456)

Wound infection

The nurse is reading the physician's report of an elderly client's physical examination. The client demonstrates xanthelasma, which refers to which symptom? (pg 1803)

Yellowish waxy deposits on the eyelids

The classification of Stage II of COPD is defined as (pg 603)

moderate COPD

Hypothermia may occur as a result of (pg 431)

open body wounds

A client is being treated for acne vulgaris. What contributes to follicular irritation? (pg 1831)

overproduction of sebum

A client is scheduled to have surgery to address a cleft palate. What type of surgery would the nurse be preparing this client for? (pg 397)

reconstructive

A client experiences a head injury in a motor vehicle accident. The client's level of consciousness is declining, and respirations have become slow and shallow. When monitoring a client's respiratory status, which area of the brain would the nurse realize is responsible for the rate and depth? (pg 470)

the pons