170 Nursezone Medical-surgical Nursing Application Exam Part 2 (1 To 25)

25 Questions | Total Attempts: 65

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Medical Surgical Nursing Quizzes & Trivia

Questions and Answers
  • 1. 
    SITUATION: Half of all leukemias are classified as acute. The rapid onset and progression of disease result in 100% mortality within days to months without appropriate therapy   A nurse is reviewing the laboratory report of a client who underwent a bone marrow biopsy. The finding that would most strongly support the diagnosis of acute leukemia is the existence of a large number of immature:
    • A. 

      Lymphocytes

    • B. 

      Thrombocytes

    • C. 

      Reticulocytes

    • D. 

      Leukocytes

  • 2. 
    SITUATION: Half of all leukemias are classified as acute. The rapid onset and progression of disease result in 100% mortality within days to months without appropriate therapy   The client with thrombocytopenia secondary to leukemia develops epistaxis. The nurse should instruct the client to:
    • A. 

      Lie supine with his neck extended

    • B. 

      Sit upright, leaning slightly forward

    • C. 

      Blow his nose and then put lateral pressure on his nose

    • D. 

      Hold his nose while bending forward at the waist

  • 3. 
    SITUATION: Half of all leukemias are classified as acute. The rapid onset and progression of disease result in 100% mortality within days to months without appropriate therapy   The nurse is teaching a client about risk factors associated with leukemia. The client needs further teaching if he states:
    • A. 

      “History of leukemia within our family increases my risk of having leukemia”

    • B. 

      “When I’m exposed to too much radiation leukemia could develop”

    • C. 

      “Down’s syndrome, Fanconi’s aplastic anemia, Bloom’s syndrome are some of congenital abnormalities that increases my risk of developing leukemia”

    • D. 

      “Leukemia is triggered by toxic substances that stimulate enhanced cell mediated immune process”

  • 4. 
    SITUATION: Half of all leukemias are classified as acute. The rapid onset and progression of disease result in 100% mortality within days to months without appropriate therapy   A patient is undergoing bone marrow transplantation of the sternum. How will the nurse position the patient on the operating table?
    • A. 

      Reverse Trendelenburg

    • B. 

      Lateral or supine

    • C. 

      Supine

    • D. 

      Jack knife

  • 5. 
    SITUATION: Half of all leukemias are classified as acute. The rapid onset and progression of disease result in 100% mortality within days to months without appropriate therapy   The nurse caring for the post bone marrow transplant understands that she should be alert for which signs and symptoms of graft-versus-host disease?
    • A. 

      Difficulty of breathing, cyanosis, increase in body temperature

    • B. 

      Erythematosus rash on palms, soles, ears and trunk

    • C. 

      Bulimia, severe abdominal pain, constipation

    • D. 

      Sudden drop of vital signs and loss of consciousness

  • 6. 
    SITUATION: Anemia may be due to acute or chronic blood loss. Increased destruction of RBCs can result from extrinsic sources, antibodies as in transfusion mismatch or from infectious agents and toxins   Which step should be done first when administering a blood transfusion?
    • A. 

      Verify the blood product and client identity

    • B. 

      Verify the physician’s order

    • C. 

      Verify the client identity and blood product with another nurse

    • D. 

      Assess the IV site

  • 7. 
    SITUATION: Anemia may be due to acute or chronic blood loss. Increased destruction of RBCs can result from extrinsic sources, antibodies as in transfusion mismatch or from infectious agents and toxins   A 70 year old client’s hematocrit and hemoglobin were 32.1% and 11.5% respectively. Based on these results, the most appropriate nursing intervention should be to:
    • A. 

      Conduct a complete nutritional assessment of the client

    • B. 

      Advise the client to have the test repeated in three months

    • C. 

      Nothing because these are expected values for this age

    • D. 

      Understand that mild anemia is an expected response to the aging process

  • 8. 
    SITUATION: Anemia may be due to acute or chronic blood loss. Increased destruction of RBCs can result from extrinsic sources, antibodies as in transfusion mismatch or from infectious agents and toxins   A physician has ordered a transfusion of whole blood for a client who had repair of a dissecting abdominal aortic aneurysm. What action should the nurse take after the transfusion has been initiated?
    • A. 

      Check the client’s vital signs every half hour

    • B. 

      Add the total number of milliliters transfused to the intake and output

    • C. 

      Discontinue the primary IV of dextrose

    • D. 

      Stay with the client for 15 minutes to assess for any reactions

  • 9. 
    SITUATION: Anemia may be due to acute or chronic blood loss. Increased destruction of RBCs can result from extrinsic sources, antibodies as in transfusion mismatch or from infectious agents and toxins   If a client who is receiving a blood transfusion experiences an acute hemolytic reaction, which nursing intervention is the most important?
    • A. 

      Immediately stop the transfusion, infuse dextrose 5% in water, and call the physician

    • B. 

      Slow the transfusion and monitor the client closely

    • C. 

      Stop the infusion, notify the blood bank, and administer antihistamines

    • D. 

      Immediately stop the transfusion, infuse normal saline solution, notify the blood bank, and call the physician

  • 10. 
    SITUATION: Anemia may be due to acute or chronic blood loss. Increased destruction of RBCs can result from extrinsic sources, antibodies as in transfusion mismatch or from infectious agents and toxins   Four days after receiving 2 units of whole blood the patient exhibits anemia, and yellowish skin and sclera. Coomb’s test was positive. Fluid support was the management given to this patient. What type of blood transfusion reaction transpired?
    • A. 

      Acute hemolytic reaction

    • B. 

      Septic reaction

    • C. 

      Delayed hemolytic reaction

    • D. 

      Simple allergic reaction

  • 11. 
    SITUATION: As health care providers, nurses deal with allergic conditions far more than might be suspected. Allergic rhinitis, asthma, and dermatitis are just a few examples of these immunologic diseases   The nurse is aware that nutritional support of a client’s natural defense mechanisms would indicate the need for a diet high in:
    • A. 

      The essential fatty acids

    • B. 

      Dietary cellulose and fiber

    • C. 

      The amino acid, tryptophan

    • D. 

      Vitamins A, C, E and selenium

  • 12. 
    SITUATION: As health care providers, nurses deal with allergic conditions far more than might be suspected. Allergic rhinitis, asthma, and dermatitis are just a few examples of these immunologic diseases   A nurse does a PPD on a client suspected with pulmonary tuberculosis. After 5 to 8 minutes the nurse interprets the test results. Erythema with wheal formation less than 3 mm appeared. She documented this as a negative result. Did the nurse observe the correct steps and interpretation of the skin test?
    • A. 

      Yes, the procedure was done properly and the result is accurate

    • B. 

      No, the result must be read 48 to 72 hours after the skin test to obtain an accurate result

    • C. 

      No, erythema with wheal formation less than 3 mm denotes a positive result

    • D. 

      No, the result is inconclusive

  • 13. 
    SITUATION: As health care providers, nurses deal with allergic conditions far more than might be suspected. Allergic rhinitis, asthma, and dermatitis are just a few examples of these immunologic diseases   Mrs. Macaroon came in to the out-patient department complaining about runny nose, tearing of the eyes, and sneezing episodes. She reported that she has been busy supervising the renovation of their house. Loratadine (Claritin) was prescribed for her allergic rhinitis. Which statement when made by the client indicates understanding of the teaching regarding this medication?
    • A. 

      “This is an antihistamine, that’s why I’ll expect drowsiness with this medication”

    • B. 

      “This steroid nasal spray would be very useful in treating my allergy, it does not evoke a lot of side effects”

    • C. 

      “This Aerosol medication should have been started a week before the renovation to make it more effective, so I should expect immediate relief of my allergy”

    • D. 

      “This antihistamine, will not cause drowsiness. I’m happy I could still supervise the carpenters”

  • 14. 
    SITUATION: As health care providers, nurses deal with allergic conditions far more than might be suspected. Allergic rhinitis, asthma, and dermatitis are just a few examples of these immunologic diseases   The key nursing diagnosis for the client with hypersensitivity disorders is:
    • A. 

      Altered health maintenance related to lack of knowledge of disease process, treatment regimen and risk control methods

    • B. 

      Knowledge deficit; health promotion related to lack of informative sources regarding hypersensitivity disorders

    • C. 

      Risk for illness or injury related to unawareness of risk control methods

    • D. 

      Impaired psychosocial adjustment related to lack of health promotion behaviors

  • 15. 
    SITUATION: As health care providers, nurses deal with allergic conditions far more than might be suspected. Allergic rhinitis, asthma, and dermatitis are just a few examples of these immunologic diseases   A one year old male was brought to the outpatient department due to red, pruritic rashes on the cheeks and forehead. After consultation with the pediatrician, the nurse makes her home instructions which include all of the following. Select all that apply:   1. Use gentle soaps; 2. Instruct parent to keep fingernails of her child trimmed; 3. Bathe the child in a cool water to soothe itching; 4. Apply petroleum jelly to affected areas after bathing
    • A. 

      1 and 4

    • B. 

      1, 3 and 4

    • C. 

      1, 2 and 4

    • D. 

      1, 2, 3, and 4

  • 16. 
    SITUATION: A female client, aged 79 years, is admitted to the hospital with a diagnosis of bacterial pneumonia. She has a temperature of 106°F, is diaphoretic, has a productive cough, and is experiencing moderate shortness of breath   When obtaining the client’s health history, the nurse learns that she has long-standing osteoarthritis, follows a vegetarian diet, has never been seriously ill, and is very concerned with cleanliness. The client says, “I hope I can take a bath each day. I feel so dirty if I don’t bathe every day.” Which of the following factors would add most to the danger posed by her illness?
    • A. 

      The client’s age

    • B. 

      History of osteoarthritis

    • C. 

      Following a vegetarian diet

    • D. 

      Bathing daily in cold water

  • 17. 
    SITUATION: A female client, aged 79 years, is admitted to the hospital with a diagnosis of bacterial pneumonia. She has a temperature of 106°F, is diaphoretic, has a productive cough, and is experiencing moderate shortness of breath   A priority nursing diagnosis for this hospitalized client with bacterial pneumonia and shortness of breath would be:
    • A. 

      Altered cardiopulmonary tissue perfusion related to myocardial damage

    • B. 

      Potential self-care deficit related to fatigue

    • C. 

      Fluid volume deficit related to nausea and vomiting

    • D. 

      Altered thought processes related to inadequate pain relief

  • 18. 
    SITUATION: A female client, aged 79 years, is admitted to the hospital with a diagnosis of bacterial pneumonia. She has a temperature of 106°F, is diaphoretic, has a productive cough, and is experiencing moderate shortness of breath   Considering the client’s symptoms and condition, the nurse should include which of the following measures in the plan of care?
    • A. 

      Position changes every 4 hours

    • B. 

      Nasotracheal suctioning to clear secretions

    • C. 

      Frequent linen changes

    • D. 

      Frequent offering of a bedpan

  • 19. 
    SITUATION: A female client, aged 79 years, is admitted to the hospital with a diagnosis of bacterial pneumonia. She has a temperature of 106°F, is diaphoretic, has a productive cough, and is experiencing moderate shortness of breath   For the client with a productive cough and difficulty breathing, the nurse should obtain the body temperature at what site?
    • A. 

      Mouth

    • B. 

      Groin fold

    • C. 

      Rectum

    • D. 

      Axillae

  • 20. 
    SITUATION: A female client, aged 79 years, is admitted to the hospital with a diagnosis of bacterial pneumonia. She has a temperature of 106°F, is diaphoretic, has a productive cough, and is experiencing moderate shortness of breath   A client with bacterial pneumonia is coughing up tenacious, purulent sputum. Which of the following measures would most likely help liquefy these viscous secretions?
    • A. 

      Performing postural drainage

    • B. 

      Breathing humidified air

    • C. 

      Clapping and percussing over the affected lung

    • D. 

      Performing coughing and deep-breathing exercises

  • 21. 
    SITUATION: Mrs. Romero, an elderly tube-fed resident from a nursing home is admitted with recent changes in level of consciousness. Her skin and mouth are very dry, and her urine is scant and dark yellow. Laboratory assessment reveals sodium, 150 mEq/dl; chloride, 106 mEq/dl; BUN, 25 mg/dl; and creatinine, 1.2   What do these assessment findings suggest?
    • A. 

      Hypovolemic hyponatremia

    • B. 

      Hypovolemic hypernatremia

    • C. 

      Hypervolemic hypernatremia

    • D. 

      Hypervolemic hyponatremia

  • 22. 
    SITUATION: Mrs. Romero, an elderly tube-fed resident from a nursing home is admitted with recent changes in level of consciousness. Her skin and mouth are very dry, and her urine is scant and dark yellow. Laboratory assessment reveals sodium, 150 mEq/dl; chloride, 106 mEq/dl; BUN, 25 mg/dl; and creatinine, 1.2   What precautions will be needed to prevent further fluid and electrolyte shifts? Select all that apply: 1. Monitor client for response to IV fluid replacement of hypoosmolar electrolyte solutions; 2. Monitor patient for absence of clinical manifestations of  hypernatremia and return to normal sodium levels; 3. Prevent osmotic dieresis from D5W by maintaining the prescribed rate; 4. Use IV pumps in high risk patients; 5. Initiate safety and seizure precautions if the patient manifests weakness or cerebral changes; 6. Offer water and fluids every 2 to 3 hours
    • A. 

      All except 4

    • B. 

      All except 1

    • C. 

      All except 6

    • D. 

      All of the above

  • 23. 
    SITUATION: Mrs. Romero, an elderly tube-fed resident from a nursing home is admitted with recent changes in level of consciousness. Her skin and mouth are very dry, and her urine is scant and dark yellow. Laboratory assessment reveals sodium, 150 mEq/dl; chloride, 106 mEq/dl; BUN, 25 mg/dl; and creatinine, 1.2   The nurse notes that the blood urea nitrogen (BUN) is 25 mg/dl. Which of the following diseases can be a result of increased BUN?
    • A. 

      Renal insufficiency

    • B. 

      Rhabdomyolysis

    • C. 

      End stage renal disease

    • D. 

      Glomerulonephritis

  • 24. 
    SITUATION: Mrs. Romero, an elderly tube-fed resident from a nursing home is admitted with recent changes in level of consciousness. Her skin and mouth are very dry, and her urine is scant and dark yellow. Laboratory assessment reveals sodium, 150 mEq/dl; chloride, 106 mEq/dl; BUN, 25 mg/dl; and creatinine, 1.2   One of nurse Julie’s diagnosis of the patient is altered oral mucous membranes related to lack of body water secondary to hypernatremia. Which of the following outcomes is the most appropriate?
    • A. 

      Moist oral mucous membrane maintained

    • B. 

      No occurrence of further deterioration of the oral mucous membranes and moist oral mucous membranes maintained

    • C. 

      Oral fluid intake initiated every hour

    • D. 

      Decreased thirst

  • 25. 
    SITUATION: Mrs. Romero, an elderly tube-fed resident from a nursing home is admitted with recent changes in level of consciousness. Her skin and mouth are very dry, and her urine is scant and dark yellow. Laboratory assessment reveals sodium, 150 mEq/dl; chloride, 106 mEq/dl; BUN, 25 mg/dl; and creatinine, 1.2   Mrs. Romero’s family calls and wants to know “if she will make it?”’ How would the nurse respond?
    • A. 

      “Mrs. Romero has already been stabilized; you might want to come see her”

    • B. 

      “Mrs. Romero needs you; it is better that you come by”

    • C. 

      “I am not allowed to provide any information over the phone… it is better for you to visit her”

    • D. 

      “I am not allowed to discuss this matter with you, please wait while I call the attending physician”

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