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

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1.  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.
2.  In a client with enteritis and frequent diarrhea, the nurse should anticipate an acidbase imbalance of:
A.
B.
C.
D.
3.  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.
4.  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.
5.  Which of the following is t he most critical intervention needed for a client with myxedema coma?
A.
B.
C.
D.
6.  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.
7.  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.
8.  Which statement is true about crackles?
A.
B.
C.
D.
9.  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.
10.  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.
11.  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.
12.  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.
13.  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.
14.  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.
15.  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.
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16.  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.
17.  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.
18.  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.
Discuss this Question
19.  For a client with a head injury whose neck has been stabilized, the preferred bed position is:
A.
B.
C.
D.
20.  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.
21.  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.
22.  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.
23.  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.
24.  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.
25.  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.
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