377 Medical-surgical - Nursing Practice Test (26 To 50)

25 Questions | Total Attempts: 98

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377 Medical-surgical - Nursing Practice Test (26 To 50)

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Questions and Answers
  • 1. 
    SITUATION: Julie, an 18-year-old girl, is brought into the ER by her mother with the chief complaint of sudden visual disturbance that began half an hour ago and was described as double vision and flashing lights   During your assessment of Julie she tells you all visual symptoms are gone but that she now has a severe pounding headache over her left eye. You suspect Julie may have:
    • A. 

      A tension headache

    • B. 

      The aura and headache of migraine

    • C. 

      A brain tumor

    • D. 

      A conversion reaction

  • 2. 
    SITUATION: Julie, an 18-year-old girl, is brought into the ER by her mother with the chief complaint of sudden visual disturbance that began half an hour ago and was described as double vision and flashing lights   You explain to Julie and her mother that migraine headaches are caused by:
    • A. 

      An allergic response triggered by stress

    • B. 

      Dilation of cerebral arteries

    • C. 

      Persistent contraction of the muscles of the head, neck and face

    • D. 

      Increased intracranial pressure

  • 3. 
    SITUATION: Julie, an 18-year-old girl, is brought into the ER by her mother with the chief complaint of sudden visual disturbance that began half an hour ago and was described as double vision and flashing lights   A thorough history reveals that hormonal changes associated with menstruation may have triggered Julie’s migraine attack. In investigating Julie’s history what factors would be least significant in migraine?
    • A. 

      Seasonal allergies

    • B. 

      Trigger foods such as alcohol, MSG, chocolate

    • C. 

      Family history of migraine

    • D. 

      Warning sign of onset, or aura

  • 4. 
    SITUATION: Julie, an 18-year-old girl, is brought into the ER by her mother with the chief complaint of sudden visual disturbance that began half an hour ago and was described as double vision and flashing lights   A client with muscle contraction headache will exhibit a pattern different for Julie’s. Which of the following is more compatible with tension headache?
    • A. 

      Severe aching pain behind both eyes

    • B. 

      Headache worse when bending over

    • C. 

      A bandlike burning around the neck

    • D. 

      Feeling of tightness bitemporally, occipitally, or in the neck

  • 5. 
    SITUATION: Mr. Snyder is admitted to your unit with a brain tumor. The type of tumor he has is currently unknown. You begin to think about the way brain tumors are classified   Glioma is an intracranial tumor. Which of the following statements about gliomas do you know to be false?
    • A. 

      50% of all intracranial tumors are gliomas

    • B. 

      Gliomas are usually benign

    • C. 

      They grow rapidly and often cannot be totally excised from the surrounding tissue

    • D. 

      Most glioma victims die within a year after diagnosis

  • 6. 
    SITUATION: Mr. Snyder is admitted to your unit with a brain tumor. The type of tumor he has is currently unknown. You begin to think about the way brain tumors are classified   Acoustic neuromas produce symptoms of progressive nerve deafness, tinnitus, and vertigo due to pressure and eventual destruction of:
    • A. 

      CN7

    • B. 

      CN5

    • C. 

      CN8

    • D. 

      CN11

  • 7. 
    SITUATION: Mr. Snyder is admitted to your unit with a brain tumor. The type of tumor he has is currently unknown. You begin to think about the way brain tumors are classified   Whether Mr. Snyder’s tumor is benign or malignant, it will eventually cause increased intracranial pressure. Signs and symptoms of increasing intracranial pressure may include all of the following, except:
    • A. 

      Headache, nausea, and vomiting

    • B. 

      Papilledema, dizziness, mental status changes

    • C. 

      Obvious motor deficits

    • D. 

      Increased pulse rate, drop in blood pressure

  • 8. 
    SITUATION: Mr. Snyder is admitted to your unit with a brain tumor. The type of tumor he has is currently unknown. You begin to think about the way brain tumors are classified   Mr. Snyder is scheduled for surgery in the morning, and you are surprised to find out that there is no order for an enema. You assess the situation and conclude that the reason for this is:
    • A. 

      Mr. Snyder has had some mental changes due to the tumor and would find an enema terribly traumatic

    • B. 

      Straining to evacuate the enema might increase the intracranial pressure

    • C. 

      Mr. Snyder had been on clear liquids and then was NPO for several days, so an enema is not necessary

    • D. 

      An oversight and you call the physician to obtain the order

  • 9. 
    SITUATION: Mr. Snyder is admitted to your unit with a brain tumor. The type of tumor he has is currently unknown. You begin to think about the way brain tumors are classified   Postoperatively Mr. Snyder needs vigilant nursing care including all of the following, except:
    • A. 

      Keeping his head flat

    • B. 

      Assessments q ½ hour of LOC, VS, papillary responses, and mental status

    • C. 

      Helping him avoid straining at stool, vomiting, or coughing

    • D. 

      Providing a caring, supportive atmosphere for him and his family

  • 10. 
    SITUATION: Mr. Snyder is admitted to your unit with a brain tumor. The type of tumor he has is currently unknown. You begin to think about the way brain tumors are classified   Potential postintracranial surgery problems include all but which of the following?
    • A. 

      Increased ICP

    • B. 

      Extracranial hemorrhage

    • C. 

      Seizures

    • D. 

      Leakage of cerebrospinal fluid

  • 11. 
    SITUATION: Mrs. Hogan, a 43-year-old woman, is admitted to your unit for cholecystectomy   You are responsible for teaching Mrs. Hogan deep breathing and coughing exercises. Why are these exercises especially important for Mrs. Hogan?
    • A. 

      They prevent postoperative atelectasis and pneumonia

    • B. 

      The incision in gallbladder surgery is in the subcostal area, which makes the client reluctant to take a deep breath and cough

    • C. 

      Because she is probably overweight and will be less willing to breathe, cough, and move postoperatively

  • 12. 
    SITUATION: Mrs. Hogan, a 43-year-old woman, is admitted to your unit for cholecystectomy   On the morning of Mrs. Hogan’s planned cholecystectomy she awakens with a pain in her right scapular area and thinks she slept in poor position. While doing the preop check list you note that on her routine CB report her WBC is 15,000. Your responsibility at this point is:
    • A. 

      To notify the surgeon at once; this is an elevated WBC indicating an inflammatory reaction

    • B. 

      To record this finding in a prominent place on the preop checklist and in your preop notes

    • C. 

      To call the laboratory for a STAT repeat WBC

    • D. 

      None. This is not an unusual finding

  • 13. 
    SITUATION: Mrs. Hogan, a 43-year-old woman, is admitted to your unit for cholecystectomy   Mrs. Hogan is scheduled for surgery 2 days later and is to be given atropine 0.3 mg IM and Demerol 50 mg IM one hour preoperatively. Which nursing actions follow the giving of the preop medication?
    • A. 

      Have her void soon after receiving the medication

    • B. 

      Allow her family to be with her before the medication takes effect

    • C. 

      Bring her valuables to the nursing station

    • D. 

      Reinforce preop teaching

  • 14. 
    SITUATION: Mrs. Hogan, a 43-year-old woman, is admitted to your unit for cholecystectomy   Mrs. Hogan is transported to the recovery room following her cholecystectomy. As you continue to check her vital signs you note a continuing trend in Mrs. Hogan’s status: her BP is gradually dropping and her pulse rate is increasing. Your most appropriate nursing action is to:
    • A. 

      Order whole blood for Mrs. Hogan from the lab

    • B. 

      Increase IV fluid rate of infusion and place in trendelenburg position

    • C. 

      Immediately report signs of shock to the head nurse and/or surgeon and monitor VS closely

    • D. 

      Place in lateral sims position to facilitate breathing

  • 15. 
    SITUATION: Mrs. Hogan, a 43-year-old woman, is admitted to your unit for cholecystectomy   Mrs. Hogan returns to your clinical unit following discharge from the recovery room. Her vital signs are stable and her family is with her. Postoperative leg exercises should be initiated:
    • A. 

      After the physician writes the order

    • B. 

      After the family leaves

    • C. 

      If Mrs. Hogan will not be ambulated early

    • D. 

      Stat

  • 16. 
    An oropharyngeal airway may:
    • A. 

      Cause airway obstruction

    • B. 

      Prevent a patient from biting and occluding an ET tube

    • C. 

      Be inserted "upside down" into the mouth opening and then rotated into the proper orientation as it is advanced into the mouth

    • D. 

      All of the above

  • 17. 
    Endotracheal intubation:
    • A. 

      Can be attempted for up to 2 minutes before you need to stop and ventilate the patient

    • B. 

      Reduces the risk of aspiration of gastric contents

    • C. 

      Should be performed with the neck flexed forward making the chin touch the chest

    • D. 

      Should be performed after a patient is found to be not breathing and two breaths have been given but before checking for a pulse

  • 18. 
    When giving bag-valve mask ventilations:
    • A. 

      Rapid and forceful ventilations are desirable so that adequate ventilation will be assured

    • B. 

      Effective ventilations can always be given by one person

    • C. 

      Cricoid pressure may prevent gastric inflation during ventilations

    • D. 

      Tidal volumes will always be larger than when giving mouth to pocket mask ventilations

  • 19. 
    If breath sounds are only heard on the right side after intubation:
    • A. 

      Extubate, ventilate for 30 seconds then try again

    • B. 

      The patient probably only has one lung, the right

    • C. 

      You have intubated the stomach

    • D. 

      Pull the tube back and listen again

  • 20. 
    An esophageal obturator airway (EOA):
    • A. 

      Can be inserted by any person trained in ACLS

    • B. 

      Requires visualization of the trachea before insertion

    • C. 

      Never causes regurgitation

    • D. 

      Should not be used with a conscious person, pediatric patients, or patients who have swallowed caustic substances

  • 21. 
    During an acute myocardial infarct (MI):
    • A. 

      A patient may have a normal appearing ECG

    • B. 

      Chest pain will always be present

    • C. 

      A targeted history is rarely useful in making the diagnosis of MI

    • D. 

      The chest pain is rarely described as crushing, pressing, or heavy

  • 22. 
    The most common lethal arrhythmia in the first hour of an MI is:
    • A. 

      Pulseless Ventricular Tachycardia

    • B. 

      Asystole

    • C. 

      Ventricular fibrillation

    • D. 

      First degree heart block

  • 23. 
    Which of the following is true about verapamil?
    • A. 

      It is used for wide-complex tachycardia

    • B. 

      It may cause a drop in blood pressure

    • C. 

      It is a first line drug for Pulseless Electrical Activity

    • D. 

      It is useful for treatment of severe hypotension

  • 24. 
    Atropine:
    • A. 

      Is always given for a heart rate less than 60 bpm

    • B. 

      Cannot be given via ET tube

    • C. 

      Has a maximum total dosage of 0.03-0.04 mg/kg IV in the setting of cardiac arrest

    • D. 

      When given IV, should always be given slowly

  • 25. 
    Asystole should not be "defibrillated"
    • A. 

      TRUE

    • B. 

      FALSE