201 Nursezone Medical-surgical Nursing Final Coaching Part 2 (26 To 50)

25 Questions | By Nsgzonemedsurg | Last updated: Mar 19, 2022 | Total Attempts: 128

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Medical Surgical Nursing Quizzes & Trivia

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1.

SITUATION: A 70 year old male client came into the outpatient department with complaints of fatigue, productive cough, and chest pains. Further assessment of this client was done in the department Nurse Dina is preparing to obtain a sputum specimen from the client. Which of the following interventions will aid in obtaining the specimen?
- A.
  
  Restricting fluids
- B.
  
  Having the client take three deep breaths
- C.
  
  Asking the client to spit directly into the specimen container
- D.
  
  Asking the client to obtain the specimen after eating
2.

SITUATION: A 70 year old male client came into the outpatient department with complaints of fatigue, productive cough, and chest pains. Further assessment of this client was done in the department Further assessment is done to this client and tuberculosis is suspected. The nurse reviews the results of which diagnostic test that will confirm this diagnosis?
- A.
  
  Bronchoscopy
- B.
  
  Chest x-ray film
- C.
  
  Sputum culture
- D.
  
  Tuberculin syringe test
3.

SITUATION: A 70 year old male client came into the outpatient department with complaints of fatigue, productive cough, and chest pains. Further assessment of this client was done in the department Isoniazid (INH) and Rifampicin (Rifadin) have been prescribed for this client. Which of the following, if noted by the nurse in the client’s history would require doctor’s notification?
- A.
  
  Hepatitis B
- B.
  
  Meningitis
- C.
  
  Allergy to penicillin
- D.
  
  Diabetes mellitus
4.

SITUATION: A 70 year old male client came into the outpatient department with complaints of fatigue, productive cough, and chest pains. Further assessment of this client was done in the department The client is now being treated with INH and Rifadin. Instructions regarding these medications are given by the nurse to the client. Which of the following statements are included in the plan?
- A.
  
  “You must discontinue the medication if gastrointestinal irritation occurs”
- B.
  
  “You must take the medication with meals”
- C.
  
  “The entire year-long course of the medication needs to be completed”
- D.
  
  “Fluids must be increased while taking this medication to prevent renal failure”
5.

SITUATION: A 70 year old male client came into the outpatient department with complaints of fatigue, productive cough, and chest pains. Further assessment of this client was done in the department Nurse Diana is teaching a client with tuberculosis about dietary elements that should be increased in the diet. The nurse suggest that the client increase intake of:
- A.
  
  Potatoes and fish
- B.
  
  Eggs and spinach
- C.
  
  Grains and broccoli
- D.
  
  Meats and citrus fruits
6.

SITUATION: An unconscious, 46 year old Muslim, is admitted to the emergency room. He is not breathing and no pulse is appreciated. Treatments were started and arterial blood gas measurements were made The nurse in the emergency room is performing cardiopulmonary resuscitation (CPR) on the client. When the nurse performs chest compressions, the nurse understands that correct hand placement is located over the:
- A.
  
  Lower half of the sternum
- B.
  
  Upper third of the sternum
- C.
  
  Upper half of the sternum
- D.
  
  Lower third of the sternum
7.

SITUATION: An unconscious, 46 year old Muslim, is admitted to the emergency room. He is not breathing and no pulse is appreciated. Treatments were started and arterial blood gas measurements were made Nurse Freddie reviews the arterial blood gas values of the client. The results indicate respiratory acidosis. Which of the following values would indicate that this acid-base imbalance exists?
- A.
  
  HCO3 of 22 mEq/L
- B.
  
  PCO2 of 30 mmHg
- C.
  
  PH of 7.50
- D.
  
  PH of 7.25
8.

SITUATION: An unconscious, 46 year old Muslim, is admitted to the emergency room. He is not breathing and no pulse is appreciated. Treatments were started and arterial blood gas measurements were made If the arterial blood gas measurements reveal a pH 7.25, a low bicarbonate level, a normal carbon dioxide level, a normal oxygen level, and an elevated potassium level, what does it denote?
- A.
  
  Compensated Respiratory acidosis
- B.
  
  Metabolic acidosis
- C.
  
  Overcompensated respiratory acidosis
- D.
  
  Metabolic alkalosis
9.

SITUATION: An unconscious, 46 year old Muslim, is admitted to the emergency room. He is not breathing and no pulse is appreciated. Treatments were started and arterial blood gas measurements were made Airway was established through an endotracheal tube to the unconscious client. During the suctioning procedure, the nurse notes on the monitor that the heart rate decreases. Which is the initial nursing intervention?
- A.
  
  Notify the doctor immediately
- B.
  
  Stop the procedure and re-oxygenate the client
- C.
  
  Continue to suction
- D.
  
  Make sure that the suction is limited to 10 seconds
10.

SITUATION: An unconscious, 46 year old Muslim, is admitted to the emergency room. He is not breathing and no pulse is appreciated. Treatments were started and arterial blood gas measurements were made The intubated, still unconscious client suddenly presents with a ventricular tachycardia. The medical team tried to return a normal heart rhythm but failed. Cardiac arrest then followed. Upon the death of the client, the nurse does which appropriate action?
- A.
  
  Talk to the family about organ donation
- B.
  
  Encourage the family to perform an autopsy
- C.
  
  Give the family some time alone with their dead relative
- D.
  
  Discuss with the family the death of their loved one
11.

SITUATION: Mrs. Polka, a 62 year old housewife who cares for her two grandchildren, is admitted to the emergency department with complaints of chest pain. She is diaphoretic and pale and reports pain “under my left breast that pushes to my back.” She rates the pain an 8 on a scale of 1 to 10. She is placed on oxygen therapy and an IV line is inserted. Cardiac serum markers are drawn and sent to the laboratory. Her vital signs are temperature: 36.9°C, heart rate: 110 bpm, and BP: 108/68 Mrs. Polka has a 12-lead ECG taken during her stay in the ER. The nurse examines the tracing for which ECG change caused my myocardial ischemia:
- A.
  
  Depressed ST segment
- B.
  
  U wave
- C.
  
  Prolonged PR interval
- D.
  
  Widened QRS complex
12.

SITUATION: Mrs. Polka, a 62 year old housewife who cares for her two grandchildren, is admitted to the emergency department with complaints of chest pain. She is diaphoretic and pale and reports pain “under my left breast that pushes to my back.” She rates the pain an 8 on a scale of 1 to 10. She is placed on oxygen therapy and an IV line is inserted. Cardiac serum markers are drawn and sent to the laboratory. Her vital signs are temperature: 36.9°C, heart rate: 110 bpm, and BP: 108/68 Dysrhythmias are a common complication of myocardial infarction (MI). The client has developed atrial fibrillation with a ventricular rate of 150 bpm. The nurse assesses the client for:
- A.
  
  Nausea and vomiting
- B.
  
  Flat neck veins
- C.
  
  Hypotension and dizziness
- D.
  
  Hypertension and headache
13.

SITUATION: Mrs. Polka, a 62 year old housewife who cares for her two grandchildren, is admitted to the emergency department with complaints of chest pain. She is diaphoretic and pale and reports pain “under my left breast that pushes to my back.” She rates the pain an 8 on a scale of 1 to 10. She is placed on oxygen therapy and an IV line is inserted. Cardiac serum markers are drawn and sent to the laboratory. Her vital signs are temperature: 36.9°C, heart rate: 110 bpm, and BP: 108/68 Two days has passed after the admission and the client with MI developed a bilateral 2+ edema in her lower extremities. The nurse would plan to do which of the following next?
- A.
  
  The diuretic medication administration should be changed from morning to evening
- B.
  
  Monitor daily weights starting on the following morning
- C.
  
  Request a sodium restriction of 3 grams/day from the doctor
- D.
  
  Review the intake and output records for the last two days
14.

SITUATION: Mrs. Polka, a 62 year old housewife who cares for her two grandchildren, is admitted to the emergency department with complaints of chest pain. She is diaphoretic and pale and reports pain “under my left breast that pushes to my back.” She rates the pain an 8 on a scale of 1 to 10. She is placed on oxygen therapy and an IV line is inserted. Cardiac serum markers are drawn and sent to the laboratory. Her vital signs are temperature: 36.9°C, heart rate: 110 bpm, and BP: 108/68 Mrs. Polka has been transferred from a coronary care unit to a general medical unit with cardiac monitoring. A nurse plans to allow for which of the following client activities?
- A.
  
  Complete bed rest for 24 hours
- B.
  
  Bathroom privileges and self-care activities
- C.
  
  Unsupervised hallway ambulation with distances under 200 feet
- D.
  
  Any activity because the client is supervised
15.

SITUATION: Mrs. Polka, a 62 year old housewife who cares for her two grandchildren, is admitted to the emergency department with complaints of chest pain. She is diaphoretic and pale and reports pain “under my left breast that pushes to my back.” She rates the pain an 8 on a scale of 1 to 10. She is placed on oxygen therapy and an IV line is inserted. Cardiac serum markers are drawn and sent to the laboratory. Her vital signs are temperature: 36.9°C, heart rate: 110 bpm, and BP: 108/68 The RN in the coronary unit is planning assignments for the clients on the nursing unit. The RN needs to assign four clients and has a licensed practical nurse (LPN) and three nursing assistants on a nursing team. Which of the following clients would the nurse most appropriately assign to one of nursing assistants?
- A.
  
  Range-of-motion exercises in the morning
- B.
  
  Dressing change in a post-op client
- C.
  
  Instructing a client how to walk using a crutch
- D.
  
  Doing urinary catheterization on a client
16.

SITUATION: In preventing readmission in patients with heart failure, nurses make sure that clients know about each medication they will be taking and help clients create a schedule for them to follow at home Propanolol hydrochloride (inderal) has been prescribed to a client being discharged. In developing a medication teaching plan, a nurse would include which of the following instructions?
- A.
  
  Medication should be withheld if the pulse rate drops below 60 bpm
- B.
  
  Sauna is preferable for this client
- C.
  
  Exercise will prevent orthostatic hypotension
- D.
  
  Medication should be taken before meals to enhance absorption
17.

SITUATION: In preventing readmission in patients with heart failure, nurses make sure that clients know about each medication they will be taking and help clients create a schedule for them to follow at home A patient being discharged is taking warfarin sodium (Coumadin) and the nurse tells the client her discharge instructions. Which statement, if made by the client, reflects the need for further teaching?
- A.
  
  “Starting today I’ll have to limit my alcohol intake”
- B.
  
  “I will take my pills at the same time each day”
- C.
  
  “I will always use my Medic-alert bracelet”
- D.
  
  “I will take an enteric coated aspirin for my headache”
18.

SITUATION: In preventing readmission in patients with heart failure, nurses make sure that clients know about each medication they will be taking and help clients create a schedule for them to follow at home Nurse Klang is caring for a client receiving Dopamine (Inotropine). Which of the following potential nursing diagnoses is appropriate for this client?
- A.
  
  Disturbed sensory perception
- B.
  
  Impaired tissue perfusion
- C.
  
  Excess fluid volume
- D.
  
  Increased cardiac output
19.

SITUATION: In preventing readmission in patients with heart failure, nurses make sure that clients know about each medication they will be taking and help clients create a schedule for them to follow at home An older client comes to the community clinic. Furosemide (Lasix) is prescribed for the client. The nurse teaches the client about the medication. Which of the following statements, if made by the client, indicates need for further teaching?
- A.
  
  “I need to drink lots of coffee and tea to keep myself healthy”
- B.
  
  “If my ankles swell or my rings get tight I will call my doctor”
- C.
  
  “I will sit up slowly before standing each morning”
- D.
  
  “I will take my medication every morning with meals”
20.

SITUATION: In preventing readmission in patients with heart failure, nurses make sure that clients know about each medication they will be taking and help clients create a schedule for them to follow at home Mr. Rivera arrives in the emergency room after complaining of unrelieved chest pain for 2 days. The pain has subsided slightly but never disappeared, when the nurse approaches the client with a 0.4 mg nitroglycerin sublingual tablet, the client states “I don’t need that, there is nothing wrong with my heart.” The nurse interprets that the client is exhibiting which type of reaction?
- A.
  
  Anger
- B.
  
  Phobia
- C.
  
  Denial
- D.
  
  Depression
21.

SITUATION: A 70 year old woman and her husband came to a clinic. The woman reveals a 10 year history of ear infection. She is experiencing sensorineural hearing loss. During her clinic appointment, she tells the nurse that her right ear is painful and is keeping her awake at night. She explains that she can hear most sounds, although sounds on the right side seem to be coming through a filter The nurse caring for this client knows that the client’s age and history of ear infection is an important data for diagnosis. The gradual sensorineural loss caused by degeneration in the inner ear or auditory nerve is called:
- A.
  
  Presbystasis
- B.
  
  Presbycusis
- C.
  
  Labyrinthisis
- D.
  
  Mastoiditis
22.

SITUATION: A 70 year old woman and her husband came to a clinic. The woman reveals a 10 year history of ear infection. She is experiencing sensorineural hearing loss. During her clinic appointment, she tells the nurse that her right ear is painful and is keeping her awake at night. She explains that she can hear most sounds, although sounds on the right side seem to be coming through a filter The nurse plans care for this patient and formulates a diagnosis. Which diagnosis will be the priority?
- A.
  
  Impaired verbal communication related to decreased hearing
- B.
  
  Impaired social interaction related to perceive inability to interact with others
- C.
  
  Ineffective individual coping related to loss of hearing
- D.
  
  Pain related to inflammation in the middle ear
23.

SITUATION: A 70 year old woman and her husband came to a clinic. The woman reveals a 10 year history of ear infection. She is experiencing sensorineural hearing loss. During her clinic appointment, she tells the nurse that her right ear is painful and is keeping her awake at night. She explains that she can hear most sounds, although sounds on the right side seem to be coming through a filter During a hearing assessment, the nurse notes that the sounds lateralizes to the client’s left ear with the Weber test. The nurse analyzes these results as:
- A.
  
  A sensorineural or conductive loss
- B.
  
  A normal finding
- C.
  
  A conductive hearing loss in the right ear
- D.
  
  The presence of tympanosclerosis
24.

SITUATION: A 70 year old woman and her husband came to a clinic. The woman reveals a 10 year history of ear infection. She is experiencing sensorineural hearing loss. During her clinic appointment, she tells the nurse that her right ear is painful and is keeping her awake at night. She explains that she can hear most sounds, although sounds on the right side seem to be coming through a filter Which of the following approaches by the nurse will facilitate communication?
- A.
  
  Speak closer and louder
- B.
  
  Speak directly into the impaired ear
- C.
  
  Repeat statements for the client
- D.
  
  Speak in a normal tone
25.

SITUATION: A 70 year old woman and her husband came to a clinic. The woman reveals a 10 year history of ear infection. She is experiencing sensorineural hearing loss. During her clinic appointment, she tells the nurse that her right ear is painful and is keeping her awake at night. She explains that she can hear most sounds, although sounds on the right side seem to be coming through a filter Her husband is diagnosed with Meniere’s Disease and complains of vertigo. Which instruction would the nurse give to the client to assist him in controlling the vertigo?
- A.
  
  Watch the television at a 12 feet distance
- B.
  
  Decrease carbohydrates in diet
- C.
  
  Increase sodium in diet
- D.
  
  Avoid sudden head movements