Medical Surgical Nursing Test Ii (practice)- Www.rnpedia.com

100 Questions  I  By Rnpedia on May 16, 2012
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1.  When caring for a client with esophageal varices, the nurse knows that bleeding in this disorder usually stems from:
A.
B.
C.
D.
2.  Which nursing diagnosis is most appropriate for an elderly client with osteoarthritis?
A.
B.
C.
D.
3.  The nurse assesses a client with urticaria. The nurse understands that urticaria is another name for:
A.
B.
C.
D.
4.  The nurse is caring for a client who is to undergo a lumbar puncture to assess for the presence of blood in the cerebrospinal fluid (CSF) and to measure CSF pressure. Which result would indicate n abnormality?
A.
B.
C.
D.
5.  The nurse is caring for a client with a colostomy. The client tells the nurse that he makes small pin holes in the drainage bag to help relieve gas. The nurse should teach him that this action:
A.
B.
C.
D.
6.  A 28 yr-old nurse has complaints of itching and a rash of both hands. Contact dermatitis is initially suspected. The diagnosis is confirmed if the rash appears:
A.
B.
C.
D.
7.  A nurse is caring for a client who has a tracheostomy and temperature of 39º C. which intervention will most likely lower the client’s arterial blood oxygen saturation?
A.
B.
C.
D.
8.  The nurse is reviewing the laboratory report of a client who underwent a bone marrow biopsy. The finding that would most strongly support a diagnosis of acute leukemia is the existence of a large number of immature:
A.
B.
C.
D.
9.  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 (ACS) guidelines, the nurse should recommend that the women:
A.
B.
C.
D.
10.  Which statement is true about crackles?
A.
B.
C.
D.
11.  When instructions should be included in the discharge teaching plan for a client after thyroidectomy for Grave’s disease?
A.
B.
C.
D.
12.  For a client newly diagnosed with radiationinduced thrombocytopenia, the nurse should include which intervention in the plan of care?
A.
B.
C.
D.
13.  Because diet and exercise have failed to control a 63 yr-old client’s blood glucose level, the client is prescribed glipizide (Glucotrol). After oral administration, the onset of action is:
A.
B.
C.
D.
14.  A client who recently had a cerebrovascular accident requires a cane to ambulate. When teaching about cane use, the rationale for holding a cane on the uninvolved side is to:
A.
B.
C.
D.
15.  A client is admitted to the health care facility with active tuberculosis. The nurse should include which intervention in the plan of care?
A.
B.
C.
D.
16.  A Client is scheduled to have a descending colostomy. He’s very anxious and has many questions regarding the surgical procedure, care of stoma, and lifestyle changes. It would be most appropriate for the nurse to make a referral to which member of the health care team?
A.
B.
C.
D.
17.  The nurse is caring for a client who ahs had an above the knee amputation. The client refuses to look at the stump. When the nurse attempts to speak with the client about his surgery, he tells the nurse that he doesn’t wish to discuss it. The client also refuses to have his family visit. The nursing diagnosis that best describes the client’s problem is:
A.
B.
C.
D.
18.  A 62 yr-old client diagnosed with pyelonephritis and possible septicemia has had five urinary tract infections over the past two years. She’s fatigued from lack of sleep; urinates frequently, even during the night; and has lost weight recently. Test reveal the following: sodium level 152 mEq/L, osmolarity 340 mOsm/L, glucose level 125 mg/dl, and potassium level 3.8 mEq/L. which of the following nursing diagnoses is most appropriate for this client?
A.
B.
C.
D.
19.  A client with a spinal cord injury and subsequent urine retention receives intermittent catheterization every 4 hours. The average catheterized urine volume has been 550 ml. The nurse should plan to:
A.
B.
C.
D.
20.  A client with autoimmune thrombocytopenia and a platelet count of 800/uL develops epistaxis and melena. Treatment with corticosteroids and immunoglobulins has been unsuccessful, and the physician recommends a splenectomy. The client states, “I don’t need surgery—this will go away on its own.” In considering her response to the client, the nurse must depend on the ethical principle of:
A.
B.
C.
D.
21.  Which assessment finding indicates dehydration?
A.
B.
C.
D.
22.  A client is chronically short of breath and yet has normal lung ventilation, clear lungs, and an arterial oxygen saturation (SaO2) 96% or better. The client most likely has:
A.
B.
C.
D.
23.  Which statement about fluid replacement is accurate for a client with hyperosmolar hyperglycemic nonketotic syndrome (HHNS)?
A.
B.
C.
D.
24.  A school cafeteria worker comes to the physician’s office complaining of severe scalp itching. On inspection, the nurse finds nail marks on the scalp and small light-colored round specks attached to the hair shafts close to the scalp. These findings suggest that the client suffers from:
A.
B.
C.
D.
25.  Which of the following is an adverse reaction to glipizide (Glucotrol)?
A.
B.
C.
D.
26.  A 21 year-old male has been seen in the clinic for a thickening in his right testicle. The physician ordered a human chorionic gonadotropin (HCG) level. The nurse’s explanation to the client should include the fact that:
A.
B.
C.
D.
27.  When the nurse performs a neurologic assessment on Anne Jones, her pupils are dilated and don’t respond to light.
A.
B.
C.
D.
28.  A 20 yr-old woman has just been diagnosed with Crohn’s disease. She has lost 10 lb (4.5 kg) and has cramps and occasional diarrhea. The nurse should include which of the following when doing a nutritional assessment?
A.
B.
C.
D.
29.  The nurse is caring for a client who underwent a subtotal gastrectomy 24 hours earlier. The client has a nasogastric (NG) tube. The nurse should:
A.
B.
C.
D.
30.  The least serious form of brain trauma, characterized by a brief loss of consciousness and period of confusion, is called:
A.
B.
C.
D.
31.  A male client should be taught about testicular examinations:
A.
B.
C.
D.
32.  When assessing the client with celiac disease, the nurse can expect to find which of the following?
A.
B.
C.
D.
33.  Which nursing diagnosis takes the highest priority for a client with Parkinson’s crisis?
A.
B.
C.
D.
34.  A client with a forceful, pounding heartbeat is diagnosed with mitral valve prolapse. This client should avoid which of the following?
A.
B.
C.
D.
35.  A client with type 1 diabetes mellitus has been on a regimen of multiple daily injection therapy. He’s being converted to continuous subcutaneous insulin therapy. While teaching the client bout continuous subcutaneous insulin therapy, the nurse would be accurate in telling him the regimen includes the use of:
A.
B.
C.
D.
36.  Turn and reposition the client a minimum of every 8 hours.
A.
B.
C.
D.
37.  A client with a history of hypertension is diagnosed with primary hyperaldosteronism. This diagnosis indicates that the client’s hypertension is caused by excessive hormone secretion from which organ?
A.
B.
C.
D.
38.  For the first 72 hours after thyroidectomy surgery, the nurse would assess the client for Chvostek’s sign and Trousseau’s sign because they indicate which of the following?
A.
B.
C.
D.
39.  The nurse is caring for a client with a fractures hip. The client is combative, confused, and trying to get out of bed. The nurse should:
A.
B.
C.
D.
40.  Which action should take the highest priority when caring for a client with hemiparesis caused by a cerebrovascular accident (CVA)?
A.
B.
C.
D.
41.  The nurse is formulating a teaching plan for a client who has just experienced a transient ischemic attack (TIA). Which fact should the nurse include in the teaching plan?
A.
B.
C.
D.
42.  A client with a serum glucose level of 618 mg/dl is admitted to the facility. He’s awake and oriented, has hot dry skin, and has the following vital signs: temperature of 100.6º F (38.1º C), heart rate of 116 beats/minute, and blood pressure of 108/70 mm Hg. Based on these assessment findings, which nursing diagnosis takes the highest priority?
A.
B.
C.
D.
43.  A client comes to the emergency department with chest pain, dyspnea, and an irregular heartbeat. An electrocardiogram shows a heart rate of 110 beats/minute (sinus tachycardia) with frequent premature ventricular contractions. Shortly after admission, the client has ventricular tachycardia and becomes unresponsive. After successful resuscitation, the client is taken to the intensive care unit. Which nursing diagnosis is appropriate at this time?
A.
B.
C.
D.
44.  A woman whose husband was recently diagnosed with active pulmonary tuberculosis (TB) is a tuberculin skin test converter. Management of her care would include:
A.
B.
C.
D.
45.  Parathyroid hormone (PTH) has which effects on the kidney?
A.
B.
C.
D.
46.  A client with three children who is still I the child bearing years is admitted for surgical repair of a prolapsed bladder. The nurse would find that the client understood the surgeon’s preoperative teaching when the client states:
A.
B.
C.
D.
47.  A client is admitted with a diagnosis of meningitis caused by Neisseria meningitides. The nurse should institute which type of isolation precautions?
A.
B.
C.
D.
48.  The nurse is performing wound care on a foot ulcer in a client with type 1 diabetes mellitus. Which technique demonstrates surgical asepsis?
A.
B.
C.
D.
49.  A client is hospitalized with a diagnosis of chronic renal failure. An arteriovenous fistula was created in his left arm for hemodialysis. When preparing the client for discharge, the nurse should reinforce which dietary instruction?
A.
B.
C.
D.
50.  A client received burns to his entire back and left arm. Using the Rule of Nines, the nurse can calculate that he has sustained burns on what percentage of his body?
A.
B.
C.
D.
51.  A visiting nurse is performing home assessment for a 59-yr old man recently discharged after hip replacement surgery. Which home assessment finding warrants health promotion teaching from the nurse?
A.
B.
C.
D.
52.  The nurse is administering eyedrops to a client with glaucoma. To achieve maximum absorption, the nurse should instill the eyedrop into the:
A.
B.
C.
D.
53.  The nurse is caring for client with a new donor site that was harvested to treat a new burn. The nurse position the client to:
A.
B.
C.
D.
54.  When assessing a client with partial thickness burns over 60% of the body, which of the following should the nurse report immediately?
A.
B.
C.
D.
55.  Which of the following is t he most critical intervention needed for a client with myxedema coma?
A.
B.
C.
D.
56.  A client with a history of an anterior wall myocardial infarction is being transferred from the coronary care unit (CCU) to the cardiac stepdown unit (CSU). While giving report to the CSU nurse, the CCU nurse says, “His pulmonary artery wedge pressures have been in the high normal range.” The CSU nurse should be especially observant for:
A.
B.
C.
D.
57.  The nurse is caring for a client who has just had a modified radical mastectomy with immediate reconstruction. She’s in her 30s and has tow children. Although she’s worried about her future, she seems to be adjusting well to her diagnosis. What should the nurse do to supporther coping?
A.
B.
C.
D.
58.  Following a small-bowel resection, a client develops fever and anemia. The surface surrounding the surgical wound is warm to touch and necrotizing fasciitis is suspected. Another manifestation that would most suggest necrotizing fasciitis is:
A.
B.
C.
D.
59.  A client is hospitalized with a diagnosis of chronic glomerulonephritis. The client mentions that she likes salty foods. The nurse should warn her to avoid foods containing sodium because:
A.
B.
C.
D.
60.  A client is admitted to the hospital with an exacerbation of her chronic systemic lupus erythematosus (SLE). She gets angry when her call bell isn’t answered immediately. The most appropriate response to her would be:
A.
B.
C.
D.
61.  A 52 yr-old married man with two adolescent children is beginning rehabilitation following a cerebrovascular accident. As the nurse is planning the client’s care, the nurse should recognize that his condition will affect:
A.
B.
C.
D.
62.  The nurse is caring for a client with a cerebral injury that impaired his speech and hearing. Most likely, the client has experienced damage to the:
A.
B.
C.
D.
63.  A client is admitted to the hospital following a burn injury to the left hand and arm. The client’s burn is described as white and leathery with no blisters. Which degree of severity is this burn?
A.
B.
C.
D.
64.  A client with a solar burn of the chest, back, face, and arms is seen in urgent care. The nurse’s primary concern should be:
A.
B.
C.
D.
65.  The nurse is providing home care instructions to a client who has recently had a skin graft. Which instruction is most important for the client to remember?
A.
B.
C.
D.
66.  A client with psoriasis visits the dermatology clinic. When inspecting the affected areas, the nurse expects to see which type of secondary lesion?
A.
B.
C.
D.
67.  A 49-yer-old client was admitted for surgical repair of a Colles’ fracture. An external fixator was placed during surgery. The surgeon explains that this method of repair:
A.
B.
C.
D.
68.  In an industrial accident, client who weighs 155 lb (70.3 kg) sustained full-thickness burns over 40% of his body. He’s in the burn unit receiving fluid resuscitation. Which observation shows that the fluid resuscitation is benefiting the client?
A.
B.
C.
D.
69.  Alzheimer’s disease is the secondary diagnosis of a client admitted with myocardial infarction. Which nursing intervention should appear on this client’s plan of care?
A.
B.
C.
D.
70.  On a routine visit to the physician, a client with chronic arterial occlusive disease reports stopping smoking after 34 years. To relive symptoms of intermittent claudication, a condition associated with chronic arterial occlusive disease, the nurse should recommend which additional measure?
A.
B.
C.
D.
71.  The nurse is caring for four clients on a stepdown intensive care unit. The client at the highest risk for developing nosocomial pneumonia is the one who:
A.
B.
C.
D.
72.  The nurse is teaching a client with chronic bronchitis about breathing exercises. Which of the following should the nurse include in the teaching?
A.
B.
C.
D.
73.  The nurse is teaching a client with a history of atherosclerosis. To decrease the risk of atherosclerosis, the nurse should encourage the client to:
A.
B.
C.
D.
74.  A 28 yr-old female nurse is seen in the employee health department for mild itching and rash of both hands. Which of the following could be causing this reaction?
A.
B.
C.
D.
75.  Before weaning a client from a ventilator, which assessment parameter is most important for the nurse to review?
A.
B.
C.
D.
76.  A physician orders gastric decompression for a client with small bowel obstruction. The nurse should plan for the suction to be:
A.
B.
C.
D.
77.  In a client with enteritis and frequent diarrhea, the nurse should anticipate an acidbase imbalance of:
A.
B.
C.
D.
78.  A client is receiving captopril (Capoten) for heart failure. The nurse should notify the physician that the medication therapy is ineffective if an assessment reveals:
A.
B.
C.
D.
79.  The nurse is providing postprocedure care for a client who underwent percutaneous lithotripsy. In this procedure, an ultrasonic probe inserted through a nephrostomy tube into the renal pelvis generates ultra-high-frequency sound waves to shatter renal calculi. The nurse should instruct the client to:
A.
B.
C.
D.
80.  Capillary glucose monitoring is being performed every 4 hours for a client diagnosed with diabetic ketoacidosis. Insulin is administered using a scale of regular insulin according to glucose results. At 2 p.m., the client has a capillary glucose level of 250 mg/dl for which he receives 8 U of regular insulin. Thenurse should expect the dose’s:
A.
B.
C.
D.
81.  Emergency medical technicians transport a 28 yr-old iron worker to the emergency department. They tell the nurse, “He fell from a two-story building. He has a large contusion on his left chest and a hematoma in the left parietal area. He has compound fracture of his left femur and he’s comatose. We intubated him and he’s maintaining an arterial oxygen saturation of 92% by pulse oximeter with a manual-resuscitation bag.” Which intervention by the nurse has thehighest priority?
A.
B.
C.
D.
82.  A 45-yr-old auto mechanic comes to the physician’s office because an exacerbation of his psoriasis is making it difficult to work. He tells the nurse that his finger joints are stiff and sore in the morning. The nurse should respond by:
A.
B.
C.
D.
83.  While in skilled nursing facility, a client contracted scabies, which is diagnosed the day after discharge. The client is living at her  daughter’s home with six other persons. During her visit to the clinic, she asks a staff nurse, “What should my family do?” the most accurate response from the nurse is:
A.
B.
C.
D.
84.  A young man was running along an ocean pier, tripped on an elevated area of the decking, and struck his head on the pier railing. According to his friends, “He was unconscious briefly and then became alert and behaved as though nothing had happened.” Shortly afterward, he began complaining of a headache and asked to be taken to the emergency department. If the client’s intracranial pressure (ICP) is increasing, the nurse would expect to observe which of thefollowing signs first?
A.
B.
C.
D.
85.  A client has a medical history of rheumatic fever, type 1 (insulin dependent) diabetes mellitus, hypertension, pernicious anemia, and appendectomy. She’s admitted to the hospital and undergoes mitral valve replacement surgery. After discharge, the client is scheduled for a tooth extraction. Which history finding is a major risk factor for infective endocarditis?
A.
B.
C.
D.
86.  The nurse is reviewing the laboratory results of a client with rheumatoid arthritis. Which of the following laboratory results should the nurse expect to find?
A.
B.
C.
D.
87.  The nurse is providing care for a client who has a sacral pressure ulcer with wet-to-dry dressing. Which guideline is appropriate for a wet-to-dry dressing?
A.
B.
C.
D.
88.  A 70 yr-old client with a diagnosis of leftsided cerebrovascular accident is admitted to the facility. To prevent the development of diffuse osteoporosis, which of the following objectives is most appropriate?
A.
B.
C.
D.
89.  When caring for a client with the nursing diagnosis Impaired swallowing related to neuromuscular impairment, the nurse should:
A.
B.
C.
D.
90.  A client with a head injury is being monitored for increased intracranial pressure (ICP). His blood pressure is 90/60 mmHG and the ICP is 18 mmHg; therefore his cerebral perfusion pressure (CPP) is:
A.
B.
C.
D.
91.  The nurse is assessing a postcraniotomy client and finds the urine output from a catheter is 1500 ml for the 1st hour and the same for the 2nd hour. The nurse should suspect:
A.
B.
C.
D.
92.  The nurse has just completed teaching about postoperative activity to a client who is going to have a cataract surgery. The nurse knows the teaching has been effective if the client:
A.
B.
C.
D.
93.  Following a full-thickeness (3rd degree) burn of his left arm, a client is treated with artificial skin. The client understands postoperative care of the artificial skin when he states that during the first 7 days after the procedure, he’ll restrict:
A.
B.
C.
D.
94.  For a client with a head injury whose neck has been stabilized, the preferred bed position is:
A.
B.
C.
D.
95.  A client with pneumonia is receiving supplemental oxygen, 2 L/min via nasal cannula. The client’s history includes chronic obstructive pulmonary disease (COPD) and coronary artery disease. Because of these findings, the nurse closely monitors the oxygen flow and the client’s respiratory status. Which complication may arise if the client receives a high oxygen concentration?
A.
B.
C.
D.
96.  A client experiences problems in body temperature regulation associated with a skin impairment. Which gland is most likely involved?
A.
B.
C.
D.
97.  For a client in addisonian crisis, it would be very risky for a nurse to administer:
A.
B.
C.
D.
98.  Ottorrhea and rhinorrhea are most commonly seen with which type of skull fracture?
A.
B.
C.
D.
99.  After a cerebrovascular accident, a 75 yr old client is admitted to the health care facility. The client has left-sided weakness and an absent gag reflex. He’s incontinent and has a tarry stool. His blood pressure is 90/50 mm Hg, and his hemoglobin is 10 g/dl. Which of the following is a priority for this client?
A.
B.
C.
D.
100.  A 52 yr-old female tells the nurse that she has found a painless lump in her right breast during her monthly self-examination. Which assessment finding would strongly suggest that this client’s lump is cancerous?
A.
B.
C.
D.
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