MED SURG FINAL EXAM QUESTION BANK.

MED SURG FINAL EXAM QUESTION BANK (From Exams 1-3 & ATI’s)
Exam 1
1. A patient has received atropine before surgery and complains of dry mouth. Which action by the nurse is best? Answer: Tell the patient dry mouth is an expected side effect.
2. A patient arrives at the ambulatory surgery center for a scheduled laparoscopy procedure in outpatient surgery. Which information is of most concern to the nurse? Answer: The patient is planning to drive home after surgery.
3. As the nurse prepares a patient the morning of surgery, the patient refuses to remove a wedding ring, saying, "I have never taken it off since the day I was married." Which response by the nurse is best? Answer: Suggest that the patient give the ring to a family member to keep.
4. The outpatient surgery nurse reviews the complete blood cell (CBC) count results for a patient who is scheduled for surgery in a few days. The results are white blood cell (WBC) count 10.2 × 103/µL; hemoglobin 15 g/dL; hematocrit 45%; platelets 150 × 103/µL. Which action should the nurse take? Answer: Continue to prepare the patient for the surgical procedure.
5. A 36-year-old female is admitted for an elective surgical procedure. Which information obtained by the nurse during the preoperative assessment is most important to report to the anesthesiologist before surgery? Answer: The patient's statement that her last menstrual period was 8 weeks ago
6. Which information in the preoperative patient's medication history is most important to communicate to the health care provider? Answer: The patient takes garlic capsules daily.
7. A patient who takes a diuretic and a β-blocker to control blood pressure is scheduled for breast reconstruction surgery. Which patient information is most important to communicate to the health care provider before surgery? Answer: Serum potassium 3.2 mEq/L
8. Monitored anesthesia care (MAC) is going to be used for a closed, manual reduction of a dislocated shoulder. What does the nurse anticipate? Answer: Starting an IV in the patient’s unaffected arm.
9. While in the holding area, a patient reveals to the nurse that his father had a high fever after surgery. What action by the nurse is a priority? Answer: Alert the anesthesia care provider of the family member’s reaction to surgery
10. The nurse facilitates student clinical experiences in the surgical suite. Which action, if performed by a student, would require the nurse to intervene? Answer: The student wears street clothed in the semi-restricted area.
11. The operating room nurse is providing orientation to a student nurse. Which action would the nurse list as a major responsibility of a scrub nurse? Answer: Keep both hands above the operating table level

12. A patient in surgery receives a neuromuscular blocking agent as an adjunct to general anesthesia. While in the PACU, what assessment finding is most important for the nurse to report? Answer: Weak chest movement
13. Which action in the perioperative patient plan of care can the charge nurse delegate to a surgical technologist? Answer: Pass sterile instruments and supplies to the surgeon and scrub technician
14. When caring for a patient who has received general anesthetic, the circulating nurse notes red, raised wheals on the patient’s arms. Which action should the nurse take? Answer: Notify the ACP
15. The NG tube is removed 2nd day postop, pt is placed on a clear, liquid diet. 4 hrs later the pt complains of sharp, cramping gas pains. What action by the RN is most appropriate? Answer: assist the patient to ambulate
16. On admission of a patient to the postanesthesia care unit (PACU), the blood pressure (BP) is 122/72. Thirty minutes after admission, the BP falls to 114/62, with a pulse of 74 and warm, dry skin. Which action by the nurse is most appropriate? Answer: Continue to take vital signs every 15 minutes.
17. A postop patient has not voided for 8 hrs after surgery…. what action should the nurse take first? Answer: Bladder scan
18. A patient is transferred from the postanesthesia care unit (PACU) to the clinical unit. Which action by the nurse on the clinical unit should be performed first? Answer: Take the patient's vital signs.
19. A postop pt has a nursing dx of ineffective airway clearance. The nurse determines that interventions for this nursing diagnosis have been successful if which is observed? Answer: Patients breath sounds are clear to auscultation
20. In the postanesthesia care unit (PACU), a patient's vital signs are blood pressure 116/72, pulse 74, respirations 12, and SpO2 91%. The patient is sleepy but awakens easily. Which action should the nurse take first? Answer: Encourage the patient to take deep breaths.
21. Which action could the PACU nurse delegate to an UAP? Answer: Help with transfer onto a stretcher
22. An older pt is being dc from the ambulatory surgical unit following L eye surgery. The pt tells the nurse, “I don’t know if I can take care of myself once I’m home”. Which action by the nurse is most appropriate? Answer: discuss specific concerns regarding self-care
23. A patient is admitted with possible botulism poisoning after eating home-canned green beans. Which intervention ordered would the nurse question? Answer: Encourage oral fluids to 3L/day
24. A 22-year-old patient who sustained a T2 spinal cord injury 10 days ago tells the nurse "i want to be transferred to a hospital where the nurses know what they are doing"… Answer: Request patient to take part in their care

25. The nurse will explain to the patient who has a T2 spinal cord transection injury that… Answer: function of both arms should be retained
26. A 27-year-old patient is hospitalized with new onset of Guillain-Barré syndrome. The most essential assessment for the nurse to carry out is? Answer: observing respiratory rate and effort.
27. A construction worker arrives at an urgent care center with a deep puncture wound after an old nail penetrated his boot.. The patient reports having had a tetanus booster 6 years ago. The nurse will anticipate? Answer: administration of the tetanus-diphtheria (Td) booster.
28. Which assessment data for a patient who has GBS will require the nurses most immediate action? Answer: The patient is continuously drooling saliva
29. A 35 yr old pt who has had a spinal cord injury returned home following rehab. The home care RN notes the spouse is performing many of the activities the pt has been managing unassisted in rehab… Answer: develop a plan to increase pt independence in consult with pt and spouse
30. Which nursing action will the home health nurse include in the plan of care for a patient with paraplegia at the T4 level in order to prevent autonomic dysreflexia? Answer: Assist in planning a prescribed bowel program.
31. When giving home care instructions to a patient who has comminuted L forearm fractures ana long-arm cast, which info should the nurse include? Answer: Call the health care provider for numbness of the hand
32. Which statement by the pt indicates a good understanding of the nurse’s teaching about a new short-arm synthetic cast? Answer: “I will apply an ice pack to the cast over the fracture site off and on for 24 hrs”
33. Which dc instruction will the ED nurse include for a pt w/ a sprained ankle? Answer: use pillows to elevate the ankle above the heart
34. A pt w/ a complex pelvic fracture from a MVC is on bed rest. Which nursing assessment finding indicates a potential complication? Answer: Abdomen is distended and bowel sounds are absent
35. How often should pin site care be performed? Daily with sterile cotton tipped applicator. Books says to use chlorhexidine not hydrogen peroxide.
36. A pt who is to have NWB on the R leg is learning to walk w/ crutches. Which observation by the nurse indicates the pt can ambulate independently? Answer: The pt advances the right leg and both crutches together and then advances the left leg
37. A pt is being dc in 3 days after hip arthroplasty using the posterior approach. Which action requires intervention? Answer: The pt leans over to pull on shoes and socks
38. Which info will the nurse teach seniors at a community recreation center about ways to prevent fractures? Answer: Buy shoes that provide good support and are comfortable

39. When caring for a preoperative patient on the day of surgery, which actions included in the plan of care can the nurse delegate to unlicensed assistive personnel (UAP)? (Select all that apply.)
Answers: Obtain and document baseline vital signs, remove nail polish and apply pulse oximeter, Transport the patient by stretcher to the operating room.
40. Which actions will the nurse include in the surgical time-out procedure before surgery? Answer: Verify pt ID band number, ask pt to state procedure, pt state name and DOB

Exam 2
1. A pts cap BG level is 120 mg/dL 6 hrs after the nurse initiated a parenteral nutrition infusion. The appropriate action by the nurse is to
a. Recheck BG 4-6 hrs later
2. After abdominal surgery, a pt w/ protein calorie malnutrition that is receiving PN; what is the best indicator of adequate nutrition?
a. Surgical incision is healing normally
3. When caring for a pt with a soft, silicone NG tube in place for tube feeding the nurse will
a. Flush the tubing after checking for residual volume
4. A 76 yr old woman w/ a BMI of 17 kg/m2 and a low serum albumin level is being admitted by the nurse. Which assessment finding will the nurse expect to find?
a. Pitting edema
5. A healthy adult woman who weighs 145 lb asks the clinic nurse about the minimum daily requirement for protein. How many grams of protein will the nurse recommend?
a. 53
6. Which menu choice best indicates that the pt is implementing the nurses suggestion to choose high-calorie, high-protein food?
a. Fried chicken with potatoes and gravy
7. The nurse will be teaching self-management to pts after gastric bypass surgery. Which info will the nurse plan to include?
a. Drink fluids between meals but not with meals
8. A pt is being admitted for bariatric surgery. Which nursing action can the nurse delegate to UAP?
a. Assist with IV insertion by holding adipose tissue out of the way
9. After the nurse teaches a pt about the recommended amounts of foods from animal and plant sources, which menu selections indicate that the initial instructions about diet have been understood?
a. 3 oz of roasted pork, a cup of corn, and a cup of carrot sticks
10. Which item should the nurse offer to the pt who is to restart oral intake after being NPO due to nausea and vomiting?
a. Dish of lemon gelatin
11. Which info will the nurse include when teaching adults to decrease the risk of cancers of the tongue and buccal mucosa?
a. Avoid use of cigarettes and smokeless tobacco
12. Which info will the nurse include when teaching a pt with peptic ulcer disease about the effect of zantac?
a. Ranitidine decreases gastric acid secretion

13. A pt vomiting blood-streaked fluid is admitted to the hospital with acute gastritis. To determine possible risk factors for gastritis, the nurse will ask the pt about
a. Use of NSAIDs
14. The nurse explaining esomeprazole (Nexium) to a patient with recurring heartburn describes that the medication
a. Treats GERD by decreasing stomach acid production
15. A pt who has GERD is experiencing increasing discomfort. Which pt statement to the nurse indicates that additional teaching about GERD is needed?
a. “I eat small meals during the day and have a bedtime snack”
16. The health care provider prescribes antacids and sucralfate (Carafate) for treatment of a pts peptic ulcer. The nurse will teach the patient to take
a. Antacids after meals and sucralfate 30 minutes before meals
17. Which info will the nurse include for a pt that is newly diagnosed with GERD?
a. “Keep the HOB elevated on blocks”
18. A pt has peptic ulcer disease that has been associated with Helicobacter pylori. About which meds will the nurse plan to teach the patient?
a. Amoxicillin (Amoxil), clarithromycin (Biaxin), and omeprazole (Prilosec)
19. The nurse evaluates that admin of Hep B vaccine to a healthy pt has been effective when the pts blood specimen reveals
a. Anti-HBs
20. Which action should the nurse take to evaluate treatment effectiveness for a pt who has hepatic encephalopathy?
a. Ask the pt to extend both arms forward
21. Which info given by a 70 yr old pt during a health history indicates to the nurse that the pt should be screened for hep C?
a. The pt used IV drugs about 20 yrs ago
22. Which finding indicates to the nurse that lactulose is effective for an older adult who has advanced cirrhosis?
a. The pt is alert and oriented
23. A pt is transferred from the recovery room to a surgical unit after a transverse colostomy. The nurse observes the stoma to be deep pink with edema and a small amount of sanguineous drainage. The nurse should
a. Document stoma assessment findings
24. The nurse preparing for the annual physical exam of a 50 yr old man will plan to teach the patient about
a. Colonoscopy
25. A pt with a new ileostomy asks how much drainage to expect. The nurse explains that after the bowel adjusts to the ileostomy, the usual drainage will be about cups daily
a. 2
26. A pt with diverticulosis has a large bowel obstruction. The nurse will monitor for
a. Abdominal distention
27. A pt being admitted with an acute exacerbation of ulcerative colitis reports crampy abdominal pain and passing 15 or more bloody stools a day. The nurse will plan to
a. Discontinue the pts oral food intake
28. A pt has a new diagnosis of Crohn’s disease after having frequent diarrhea and a weight loss of 10 lb over 2 months. The nurse will plan to teach about
a. Medication use

29. Which assessment should the nurse perform first for a pt who just vomited bright red blood?
a. Taking the BP and the pulse
30. After bariatric surgery, a pt who is being discharged tells the nurse “I prefer to be independent. I am not interested in any support groups” which reponse by the nurse is best?
a. “Tell me what types of resources you think you might use after surgery”
31. 0.25 mL dilaudid
32. 85 mL/hr RBC
33. In what quadrant is the liver located?
a. Left upper and right upper
34. Picture
a.


















35. 0.8 mL enoxaparin
36. 2 tablets digoxin
37. 20 mcg sodium
38. 2 tablets aspirin
Exam 3