NCLEX Practice Test For Medical Surgical Nursing 2(Practice Mode)- Www.Rnpedia.Com

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NCLEX Practice Test For Medical Surgical Nursing 2(Practice Mode)- Www.Rnpedia.Com - Quiz

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Questions and Answers
  • 1. 
    A female client is admitted with a diagnosis of acute renal failure. She is awake, alert, oriented, and complaining of severe back pain, nausea and vomiting and abdominal cramps. Her vital signs are blood pressure 100/70 mm Hg, pulse 110, respirations 30, and oral temperature 100.4°F (38°C). Her electrolytes are sodium 120 mEq/L, potassium 5.2 mEq/L; her urinary output for the first 8 hours is 50 ml. The client is displaying signs of which electrolyte imbalance?
    • A. 

      Hyponatremia

    • B. 

      Hyperkalemia

    • C. 

      Hyperphosphatemia

    • D. 

      Hypercalcemia

  • 2. 
    Assessing the laboratory findings, which result would the nurse most likely expect to find in a client with chronic renal failure? 
    • A. 

      BUN 10 to 30 mg/dl, potassium 4.0 mEq/L, creatinine 0.5 to 1.5 mg/dl

    • B. 

      Decreased serum calcium, blood pH 7.2, potassium 6.5 mEq/L

    • C. 

      BUN 15 mg/dl, increased serum calcium, creatinine l.0 mg/dl

    • D. 

      BUN 35 to 40 mg/dl, potassium 3.5 mEq/L, pH 7.35, decreased serum calcium

  • 3. 
    Treatment with hemodialysis is ordered for a client and an external shunt is created. Which nursing action would be of highest priority with regard to the external shunt? 
    • A. 

      Heparinize it daily.

    • B. 

      Avoid taking blood pressure measurements or blood samples from the affected arm.

    • C. 

      Change the Silastic tube daily.

    • D. 

      Instruct the client not to use the affected arm.

  • 4. 
    Romeo Diaz, age 78, is admitted to the hospital with the diagnosis of benign prostatic hyperplasia (BPH). He is scheduled for a transurethral resection of the prostate (TURP). It would be inappropriate to include which of the following points in the preoperative teaching?
    • A. 

      TURP is the most common operation for BPH.

    • B. 

      Xplain the purpose and function of a two-way irrigation system.

    • C. 

      Expect bloody urine, which will clear as healing takes place.

    • D. 

      He will be pain free.

  • 5. 
    Roxy is admitted to the hospital with a possible diagnosis of appendicitis. On physical examination, the nurse should be looking for tenderness on palpation at McBurney’s point, which is located in the 
    • A. 

      Left lower quadrant

    • B. 

      Left upper quadrant

    • C. 

      Right lower quadrant

    • D. 

      Right upper quadrant

  • 6. 
    Mr. Valdez has undergone surgical repair of his inguinal hernia. Discharge teaching should include 
    • A. 

      Telling him to avoid heavy lifting for 4 to 6 weeks

    • B. 

      Instructing him to have a soft bland diet for two weeks

    • C. 

      Telling him to resume his previous daily activities without limitations

    • D. 

      Recommending him to drink eight glasses of water daily

  • 7. 
    A 30-year-old homemaker fell asleep while smoking a cigarette. She sustained severe burns of the face,neck, anterior chest, and both arms and hands. Using the rule of nines, which is the best estimate of total body-surface area burned? 
    • A. 

      18%

    • B. 

      22%

    • C. 

      31%

    • D. 

      40%

  • 8. 
    Nursing care planning is based on the knowledge that the first 24-48 hours post-burn are characterized by: 
    • A. 

      An increase in the total volume of intracranial plasma

    • B. 

      Excessive renal perfusion with diuresis

    • C. 

      Fluid shift from interstitial space

    • D. 

      Fluid shift from intravascular space to the interstitial space

  • 9. 
    If a client has severe bums on the upper torso, which item would be a primary concern? 
    • A. 

      Debriding and covering the wounds

    • B. 

      Administering antibiotics

    • C. 

      Frequently observing for hoarseness, stridor, and dyspnea

    • D. 

      Establishing a patent IV line for fluid replacement

  • 10. 
    Contractures are among the most serious long-term complications of severe burns. If a burn is located on the upper torso, which nursing measure would be least effective to help prevent contractures? 
    • A. 

      Changing the location of the bed or the TV set, or both, daily

    • B. 

      Encouraging the client to chew gum and blow up balloons

    • C. 

      Avoiding the use of a pillow for sleep, or placing the head in a position of hyperextension

    • D. 

      Helping the client to rest in the position of maximal comfort

  • 11. 
    An adult is receiving Total Parenteral Nutrition (TPN). Which of the following assessment is essential? 
    • A. 

      Evaluation of the peripheral IV site

    • B. 

      Confirmation that the tube is in the stomach

    • C. 

      Assess the bowel sound

    • D. 

      Fluid and electrolyte monitoring

  • 12. 
    Which drug would be least effective in lowering a client’s serum potassium level? 
    • A. 

      Glucose and insulin

    • B. 

      Polystyrene sulfonate (Kayexalate)

    • C. 

      Calcium glucomite

    • D. 

      Aluminum hydroxide

  • 13. 
    A nurse is directed to administer a hypotonic intravenous solution. Looking at the following labeled solutions, she should choose 
    • A. 

      0.45% NaCl

    • B. 

      0.9% NaCl

    • C. 

      D5W

    • D. 

      D5NSS

  • 14. 
    A patient is hemorrhaging from multiple trauma sites. The nurse expects that compensatory mechanisms associated with hypovolemia would cause all of the following symptoms EXCEPT 
    • A. 

      Hypertension

    • B. 

      Oliguria

    • C. 

      Tachycardia

    • D. 

      Tachypnea

  • 15. 
    Maria Sison, 40 years old, single, was admitted to the hospital with a diagnosis of Breast Cancer. She was scheduled for radical mastectomy. Nursing care during the preoperative period should consist of 
    • A. 

      Assuring Maria that she will be cured of cancer

    • B. 

      Assessing Maria’s expectations and doubts

    • C. 

      Maintaining a cheerful and optimistic environment

    • D. 

      Keeping Maria’s visitors to a minimum so she can have time for herself

  • 16. 
    Maria refuses to acknowledge that her breast was removed. She believes that her breast is intact under the dressing. The nurse should 
    • A. 

      Call the MD to change the dressing so Kathy can see the incision

    • B. 

      Recognize that Kathy is experiencing denial, a normal stage of the grieving process

    • C. 

      Reinforce Kathy’s belief for several days until her body can adjust to stress of surgery.

    • D. 

      Remind Kathy that she needs to accept her diagnosis so that she can begin rehabilitation exercises.

  • 17. 
    A chemotherapeutic agent 5FU is ordered as an adjunct measure to surgery. Which of the ff. statements about chemotherapy is true?
    • A. 

      It is a local treatment affecting only tumor cells

    • B. 

      It affects both normal and tumor cells

    • C. 

      It has been proven as a complete cure for cancer

    • D. 

      It is often used as a palliative measure.

  • 18. 
    Which is an incorrect statement pertaining to the following procedures for cancer diagnostics? 
    • A. 

      Biopsy is the removal of suspicious tissue and the only definitive method to diagnose cancer

    • B. 

      Ultrasonography detects tissue density changes difficult to observe by X-ray via sound waves.

    • C. 

      CT scanning uses magnetic fields and radio frequencies to provide cross-sectional view of tumor

    • D. 

      Endoscopy provides direct view of a body cavity to detect abnormality.

  • 19. 
    A post-operative complication of mastectomy is lymphedema. This can be prevented by 
    • A. 

      Ensuring patency of wound drainage tube

    • B. 

      Placing the arm on the affected side in a dependent position

    • C. 

      Restricting movement of the affected arm

    • D. 

      Frequently elevating the arm of the affected side above the level of the heart.

  • 20. 
    Which statement by the client indicates to the nurse that the patient understands precautions necessary during internal radiation therapy for cancer of the cervix?
    • A. 

      “I should get out of bed and walk around in my room.”

    • B. 

      “My 7 year old twins should not come to visit me while I’m receiving treatment.”

    • C. 

      “I will try not to cough, because the force might make me expel the application.”

    • D. 

      “I know that my primary nurse has to wear one of those badges like the people in the x-ray department, but they are not necessary for anyone else who comes in here.”

  • 21. 
    High uric acid levels may develop in clients who are receiving chemotherapy. This is caused by: 
    • A. 

      The inability of the kidneys to excrete the drug metabolites

    • B. 

      Rapid cell catabolism

    • C. 

      Toxic effect of the antibiotic that are given concurrently

    • D. 

      The altered blood ph from the acid medium of the drugs

  • 22. 
    Which of the following interventions would be included in the care of plan in a client with cervical implant? 
    • A. 

      Frequent ambulation

    • B. 

      Unlimited visitors

    • C. 

      Low residue diet

    • D. 

      Vaginal irrigation every shift

  • 23. 
    Which nursing measure would avoid constriction on the affected arm immediately after mastectomy?
    • A. 

      Avoid BP measurement and constricting clothing on the affected arm

    • B. 

      Active range of motion exercises of the arms once a day.

    • C. 

      Discourage feeding, washing or combing with the affected arm

    • D. 

      Place the affected arm in a dependent position, below the level of the heart

  • 24. 
    A client suffering from acute renal failure has an unexpected increase in urinary output to 150ml/hr. The nurse assesses that the client has entered the second phase of acute renal failure. Nursing actions throughout this phase include observation for signs and symptoms of 
    • A. 

      Hypervolemia, hypokalemia, and hypernatremia.

    • B. 

      Hypervolemia, hyperkalemia, and hypernatremia.

    • C. 

      Hypovolemia, wide fluctuations in serum sodium and potassium levels.

    • D. 

      Hypovolemia, no fluctuation in serum sodium and potassium levels.

  • 25. 
    An adult has just been brought in by ambulance after a motor vehicle accident. When assessing the client, the nurse would expect which of the following manifestations could have resulted from sympathetic nervous system stimulation? 
    • A. 

      A rapid pulse and increased RR

    • B. 

      Decreased physiologic functioning

    • C. 

      Rigid posture and altered perceptual focus

    • D. 

      Increased awareness and attention

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