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Medical Surgical Nursing (Quiz) A.

) Calcium chloride
B.) Potassium chloride
1.) A client is receiving NPH insulin 20 units C.) Magnesium sulfate
subq at 7:00 AM daily, at 3 PM how would the D.) Sodium bicarbonate
nurse finds if the client were having a
hypoglycemic reaction? ANS: A
A.) Feel the client and bed for dampness
B.) Observe client kussmaul respirations 6.) What is the primary action of insulin in
C.) Smell client’s breathe for acetone odor the body?
D.) Check client’s pupils for dilation A.) Enhances the transport of glucose across
cell walls
ANS: A -diaphoresis B.) Aids in the process of gluconeogenesis
C.) Stimulates the pancreatic beta cells
2.) Postoperative thyroidectomy nursing care D.) Decreases the intestinal absorption of
includes which measures? glucose
A.) Have the client speak every 5-10 mins if
hoarseness is present ANS: A
B.) Provide a low calcium diet to prevent
hypercalcemia 7.) What will the nurse teach the diabetic
C.) Check the dressing all the back of the neck client regarding exercise in his /her
for bleeding treatment program?
D.) Apply a soft cervical collar to restrict neck A.) During exercise the body will use
movement carbohydrates for energy production, which in
turn will decrease the need for insulin
ANS: C B.) With an increase in activity the body will
utilize more carbohydrates; therefore more
3.) What would the nurse note as typical insulin will be required.
findings on the assessment of a client with C.) The increase in activity results in an increase
acute pancreatitis? in the utilization of insulin; therefore the client
A.) Steatorrhea, abd. Pain, fever should decrease his/her carbohydrate intake
B.) Fever, hypoglycemia, DHN D.) Exercise will improve pancreatic circulation
C.) Melena, persistent vomiting, hyperactive and stimulate the islet of Langerhans to increase
bowel sounds the production of intrinsic insulin
D.) Hypoactive bowel sounds, decreased
amylase and lipase levels ANS: A

ANS: A 8.) The nurse is caring for a client who has


exophthalmos associated with her thyroid
4.) A client is found to be comatose and disease. What is the cause of exophthalmos?
hypoglycemic with a blood suger level 50 A.) Fluid edema in the retro-orbital tissues which
mg/dl. What nursing action is implemented force the eyes to protrude
first? B.) Impaired vision, which causes the client to
A.) Infuse 1000 ml of D5W over a 12-hour period squint in order to see
B.) Administer 50% glucose IV C.) Increased eye lubrication, which makes the
C.) Check the client’s urine for the presence of client blink less
sugar and acetone D.) Decrease in extraocular eye movements,
D.) Encourage the client to drink orange juice which results in the “thyroid stare.”
with added sugar
ANS: A
ANS: B
9.) What is characteristic symptom of
5.) Which medication will the nurse have hypoglycemia that should alert nurse to an
available for the emergency treatment of early insulin reaction?
tetany in the client who has had a A.) Diaphoresis
thyroidectomy? B.) Drowsiness
C.) Severe thirst
D.) Coma A.) 1200 and 1300 hours
B.) 1100 and 1700 hours
ANS: A C.) 1000 and 2200 hours
D.) 0800 and 1100 hours
10.) A client is scheduled for routine
glycosylated hemoglobin (HbA1c) test. What ANS: B
is important for the nurse to tell the client
before this test? 15.) It is important for the nurse to teach the
A.) Drink only water after midnight and come to client that metformin (Glcucophage):
the clinic early in the morning A.) May cause nocturia
B.) Eat a normal breakfast and be at the clinic 2 B.) Should be taken at night
hours because of the multiple blood draws C.) Should be taken with meals
C.) Expect to be at the clinic for several hours D.) May increase the effects of aspirin
because of the multiple blood draws
D.) Come to the clinic at the earliest ANS: C
convenience to have blood drawn
16.) A nurse assessing a client with SIADH
ANS: D would expect to find laboratory values of:
A.) Serum Na= 150 mEq/L and low urine
11.) A client has been inhalation vasopressin osmolality
therapy. What will the nurse evaluate to B.) Serum K= 5 mEq/L and low serum osmolality
determine the therapeutic response to this C.) Serum Na=120 mEq/L and low serum
medication? osmolality
A.) Urine specific gravity D.) Serum K= 3 mEq/L and high serum
B.) Blood glucose osmolality
C.) Vital signs
D.) Oxygen saturation levels ANS: C

ANS: A 17.) A priority nursing diagnostic for a client


admitted to the hospital with a diagnosis of
12.) A client with diagnosis of type 2 diabetes diabetes insipidus is:
has been ordered a course of prednisone for A.) Sleep pattern deprivation related nocturia
her severe arthritic pain. An expected change B.) Activity intolerance r/t muscle weakness
that requires close monitoring by the nurse C.) Fluid volume excess r/t intake greater that
is; output
A.) Increased blood glucose level D.) Risk for impaired skin integrity r/t generalized
B.) Increased platelet aggregation edema
C.) Increased ceatinine clearance
D.) Increased ketone level in urine ANS: B

ANS: A 18.) A client admitted with a pheochrocytoma


returns from the operating room after
13.) The nurse performing an assessment on adrenalectomy. The nurse should carefully
a client who has been receiving long-term assess this client for:
steroid therapy would expect to find: A.) Hypokalemia
A.) Jaundice B.) Hyperglycemia
B.) Flank pain C.) Marked Na and water intake
C.) Bulging eyes D.) Marked fluctuations in BP
D.) Central obesity
ANS: D
ANS: D
19.) When caring for client in thyroid crisis,
14.) A diabetic client receives a combination the nurse would question an order for:
of regular and NPH insulin at 0700 hours. A.) IV fluid
The nurse teaches the client to be alert for B.) Propanolol (Inderal)
signs of hypoglycemia at C.) Prophylthiouracil
D.) A hyperthermia blanket loss of peripheral vision.
D.) Assessment for a level of discomfort; the
ANS: D client may experience considerable pain until the
optic nerve atrophies
20.) A client is prescribed levothyroxine
(Synthroid) daily. The most important ANS: A
instruction to give the client for
administration of this drug is: 24.) A child is scheduled for a myringotomy.
A.) Taper dose and discontinue if mental and What goal of this procedure will the nurse
emotional statuses stabilize discuss with the parents?
B.) Take it at bedtime to avoid the side effects of A.) Promote drainage from the ear
nausea and flatus B.) Irrigate the Eustachian tube
C.) Call the M.D. immediately at the onset of C.) Correct a malformation in the inner ear
palpitations or nervousness D.) Equalize pressure on the tympanic
D.) Decrease intake of juices and fruits with high membrane
potassium and calcium contents
ANS: A
ANS: C
25.) After a client’s eye has been
21.) The nurse would question which anesthetized, what instructions will be
medication order for a client with acute- important for the nurse to give the client?
angled glaucoma? A.) Do not watch TV for at least one day
A.) Atropine (Atrposil) 1-2 drops in each eye now B.) Do not rub the eye for 15-20 minutes
B.) Hydrochloride (Diuril) 25 mg PO daily C.) Irrigate the eye every hour to prevent
C.) Propanolol (Inderal) 20 mg PO 2 times a day dryness
D.) Carbanyl choline (Isopto carbachol) eye D.) Wear sunglasses when in direct sunlight for
drops; 1 drop 2 times a day the next 6 hours

ANS: A ANS: B

22.) A client tells you she has heard that 26.) A child diagnosed with conjunctivitis.
glaucoma may be a hereditary problem and Which statement reflects that the child
she is concerned about her adult children. understood the nurse’s teaching?
What is the best response? A.) “It’s okay for me to let my friends use my
A.) “There is no need for concern; glaucoma is sunglasses while we are playing together.”
not hereditary order.” B.) “It’s okay for me to softly rub my eye, as long
B.) “Screening for glaucoma should be included as I use the back of my hand.”
in an annual eye exam for everyones over 50.” C.) “I can pick the crustly stuff out of my
C.) “There may be a genetic factor with eyelashes with my fingers when I wake up in the
glaucoma and your children over 30 y/o should morning.”
be screened yearly.” D.) “I will use my own washrag and towel while
D.) “Are your grandchildren complaining of any my eyes are sick.”
eye problems? Glaucoma generally skips a
generation.” ANS: D

ANS: C 27.) What medication would the nurse


anticipate giving a client with Meniere’s dse?
23.) What will be important to include in the A.) Nifedipine
nursing care for the client with angle-closure B.) Amoxicillin
glaucoma? C.) Propanolol
A.) Evaluation of medications to determine if any D.) Hydrochloride (Hydro DIURIL)
of them cause an increase in IOP is a side
effect. ANS: D
B.) Observation for an increase in loss of vision;
it can be reversed if promptly identified. 28.) When teaching a family and a client
C.) Control BP to decrease the client’s potential about the use of a hearing aid, the nurse will
base the teaching on what information ANS: A
regarding the hearing aid?
A.) Provides mechanical transmission for 33.) The nurse would question the
damaged part of the ear administration of which eye drop in a patient
B.) Stimulates the neural network of the inner with increased ICP?
ear to amplify sound A.) Artificial tears
C.) Amplifies sound but does not improve the B.) Betaxolol (Betoptic)
ability to hear C.) Acetazolamide (Diamox)
D.) Tunes out extraneous noise in the lower- D.) Epinephrine HCL (Epirate)
frequency sound spectrum
ANS: D
ANS: C
34.) A client is being admitted for problems
29.) What statement by the client recovering with Meniere’s disease. What is most
from cataract surgery would indicate to the important to the nurse to assess?
nurse need for additional teaching? A.) Diet history
A.) “I’ll call if I have a significant amount of pain.” B.) Screening hearing test
B.) “I’ll continue to take my Metamucil for C.) Effect on client’s activities of daily living
another week.” (ADLs)
C.) “I’ll just do some laundry this afternoon D.) Frequency and severity
instead of going to work.”
D.) “I’ll take my acetazolamide (Diamox) drops ANS: D
with my other morning medications
35.) A client calls the nurse regarding an
ANS: C accident that just occurred during which an
unknown chemical was splashed in his eyes.
30.) A client is walking down the hall and What is the most important for the nurse to
begins to experience vertigo. What is the tell the client to do immediately?
most important nursing action when this A.) Rinse the eye with large amount of water or
occurs? saline solution
A.) Have the client sit in a chair and lower his B.) Put a pad soaked in the sterile saline
head solution over the eye
B.) Administer meclizine (Antivert) PO C.) Go to the closest emergency room
C.) Assist the client to sit or lie down D.) Have a co-worker visually checks the eye for
D.) Assess if the occurrence is vertigo or a foreign body
dizziness
ANS: A
ANS: C
36.) A 25- year old woman comes to the clinic
31.) Which client is at highest risk for retinal complaining of dizziness, weakness and
detachment? palpitations. What will be important for the
A.) 4-year old with amblyopia nurse to initially evaluate when obtaining the
B.) 17 y/o who plays physical contact health history?
C.) 33 y/o with severe ptosis and diplopia A.) Activity and exercise patterns
D.) 72 y/o with nystagmus and Bell’s palsy B.) Nutritional patterns
C.) Family health status
ANS: B D.) Coping and stress tolerance

32.) To promote and maintain safety for a ANS: B


client after a stapedectomy. What would be
included in the nursing care plan? 37.) A child with leukemia is being
A.) Implement fall precautions discharged after beginning chemotherapy.
B.) Prevent aspirations What instructions will the nurse include in
C.) Begin oxygen 2-4L/min via nasal cannula the teaching plan for the parents of this
D.) Change inner ear dressing when saturated child?
A.) Provide a diet low in protein and high in
carbohydrates
B.) Avoid fresh vegetables that are not cooked or 41.) The nurse is preparing to start an IV
peeled infusion before the administration of a unit of
C.) Notify the M.D. if the child’s temperature packed red blood cells, what fluid will the
exceeds 101F (39C) nurse select to maintain the infusion before
D.) Increase the use of humidifiers throughout hanging the unit of blood?
the house A.) D5W
B.) D5W/.45NaCl
ANS: B C.) LR solution
D.) .9% Na Cl
38.) Which client is most likely to have iron
deficiency anemia? ANS: D
A.) A client with cancer receiving radiation
therapy twice a week 42.) A client in sickle cell crisis is admitted to
B.) A toddler whose primary nutritional intake is the emergency department what are the
milk priorities of care?
C.) A client with peptic ulcer who had surgery 6 A.) Nutrition, hydration, electrolyte balance
weeks ago B.) Hydration, pain management, electrolyte
D.) A 15-year old client in sickle cell crisis balance
C.) Hydration, oxygenation, apin management
ANS: B D.) Hydration, oxygenation, electrolyte balance

39.) A client has an order for one unit of ANS: C


whole blood. What is a correct nursing
action? 43.) A client in the ICU has been diagnosed
A.) Initiate an IV with 5% dextrose in water with DIC. The nurse will anticipate
(D5W) to maintain a patent access site administering which of the following fluids?
B.) Initiate the transfusion within 30 minutes of A.) Packed RBC
receiving the blood B.) Fresh Frozen plasma (FFP)
C.) Monitor the client’s vital signs for the first 5 C.) Volume expanders, such as D10W
minutes D.) Whole blood
D.) Monitor V/S every 2 hours during the
transfusion ANS: B

ANS: B 44.) The nurse is assessing a client who has


been given a diagnosis of polycythemia vera.
40.) The nurse is caring for a client who is What characteristics will the nurse anticipate
receiving a blood transfusion. The finding when assessing this client?
transfusion was started 30 mins ago at a rate A.) Increased fatigue and bleeding tendencies
of 100 ml/hr. The client begins to complain of B.) Hemoglobin below 13 mg/dl
low back pain and headache and is C.) Headaches, dyspnea, claudication
increasing restless, what is the first nursing D.) Back pain, ecchymosis, and joint tenderness
action?
A.) Slow the infusion and evaluate the V/S and ANS: C
client’s history of transfusion reaction
B.) Stop the transfusion, disconnect the blood 45.) A client has been diagnosed with
tubing and begin a primary infusion of normal pernicious anemia what will the nurse teach
saline solution this client regarding medication he will need
C.) Stop the infusion of blood and begin infusion to take after he goes home?
of NSS from the Y connector A.) Monthly Vit. B12 injections will be necessary
D.) Recheck the unit of blood for correct B.) Ferrous sulfate PO daily will be prescribed
identification numbers and cross-match C.) Coagulation studies are important to
information evaluate medications
D.) Decrease intake of leafy green vegetables
because of increased Vit. K
ANS: B
Ans: A ANS: C

46.) First postop day after a right lower lobe 50.) Which statement correctly describes
(RLL) lobectomy, the client breathes and suctioning through an endotracheal tube
coughs but has difficulty raising mucus. A.) The catheter is inserted into the endotracheal
What indicates that the client is not tube; intermittent suction is applied until no
adequately clearing secretions? further secretions are retrieved; the catheter is
A.) Chest x-ray film shows right sided pleural then withdrawn.
fluid B.) The catheter is inserted through the nose,
B.) A few scattered crackles on RLL on and the upper airway is suctioned; the catheter
auscultation is then removed from the upper airway and
C.) PCO2 increases from 35-45 mm Hg inserted into the endotracheal tube to suction
D.) Decrease in forced vital capacity the lower airway
C.) With suction applied, the catheter is inserted
ANS: C into the endotracheal tube; when resistance is
met, the catheter is slowly withdrawn
47.) What nursing observations indicate that D.) The catheter is inserted into the
the cuff on an endotracheal tube is leaking? endotracheal tube to a point of resistance, and
A.) An increase in peak pressure on the intermittent suction is applied during withdrawal.
ventilator
B.) Client is able to speak ANS: D
C.) Increased swallowing efforts by client
D.) Increased crackles (rales) over left lung field Care of the clients with Eye and Ear Disorders

ANS: B 1.) The primary problem in cataract is:


A.) Blurring of vision
48.) The client with COPD is to be discharged B.) Loss of peripheral vision
home while receiving continuous oxygen at a C.) Presence of floaters
rate of 2 L/min via cannula. What information D.) Halos around light
does the nurse provide to the client and his
wife regarding the use of oxygen at home? Ans:A
A.) Because of his need for oxygen, the client
will have to limit activity at home
B.) The use of oxygen will eliminate the client’s 2.) The primary reason for performing iridectomy
shortness of breath after cataract extraction is:
C.) Precautions are necessary because oxygen A.) To prevent secondary glaucoma
can spontaneously ignite and explode B.) To improve the vision of the client
D.) Use oxygen during activity to relieve the C.) To prevent postop hemorrhage
strain on the client’s heart D.) To reduce eye discomfort

ANS: A Ans: A

49.) The wife of a client with COPD is worried


about caring for her husband at home. Which
statement by the nurse provides the most 3.) Pterygium is caused primarily by:
valid information? A.) Exposure to sunlight
A.) “You should avoid emotional situations that B.) Exposure to dust
increase his shortness of breathe.” C.) Exposure to wind
B.) “Help your husband arrange activities so that D.) Exposure to chemicals
he does as little walking as possible.”
C.) “Arrange a schedule so your husband does Ans: B
all necessary activities before noon; then he can
rest during the afternoon and evening.”
D.) “Your husband will be no more short of 4.) The surgical procedure which involves
breath when he walks but that will not hurt him.” removal of the eyeball is:
A.) Enucleation
B.) Evisceration
C.) Exanteration Ans:C
D.) Extraction

Ans: A 10.) The client with retinal detachment would


least likely manifest which of the following signs
& symptoms:
A.) Floating spots before the eyes
5.) A sterile chronic granulomatous inflammation B.) Flashes of light
of the meibomian gland is: C.) Progressive constriction of vision in one area
A.) Chalazion D.) Pain in the eye
B.) Hordeulum
C.) Uveitis Ans: D
D.) Keratoconjunctivitis

Ans: A
11.) In acute glaucoma, the obstruction to the
6.) The following are nursing interventions for a flow of aqueous humor is caused by:
blind person EXCEPT: A.) Thickening of the trabecular meshwork
A.) When approaching the client, talk before B.) Displacement of the iris
touching C.) Narrowing of the canal schlemm
B.) Orient the client to the environment D.) Constriction of the pupil
C.) When assisting the client during ambulation,
the nurse stays beside the client Ans: B
D.) Promote the independence in activities of
daily living

Ans: C 12.) Which of the following is true about


glaucoma?
7.) Otosclerosis is characterized by: A.) It is characterized by irreversible blindness
A.) Increased endolymphatic pressure B.) It is treated with mydriatics
B.) Replacement of normal bones by spongy C.) The IOP is 14-21mmHg
and highly-vascularized bones and the stapes D.) Central vision is lost initially, followed by the
become fixed with the oval window peripheral vision
C.) Rupture of the tympanic membrane
D.) Damage of the labyrinth or acoustic nerve Ans: A

Ans: B
13.) The following drugs maybe administered to
8.) Hyperopia is corrected with that type of lens? the client with glaucoma EXCEPT:
A.) Concave lens A.) Diamox (Acetazolamide)
B.) Convex lens B.) Pilocarpine
C.) Aphakic lens C.) Atropine SO4
D.) Bifocal lens D.) Timolol maleate

Ans: B Ans: C

9.) The following are appropriate nursing


interventions after cataract extraction EXCEPT:
A.) Place the client in supine position or turn 14.) The client with retinal detachment had
towards unoperated side undergone scleral buckling. The following are
B.) Advise the client to avoid bending, stooping appropriate nursing interventions EXCEPT:
or lifting heavy objects for several weeks postop A.) Position the client with the area of
C.) Instruct the client to limit fluid intake detachment dependent
D.) Advise the client to protect his eyes with eye B.) Cover the eyes with pressure dressing
pad and eye shield for a week C.) Advise the client to avoid reading for few
weeks D.) Itching
D.) Encourage the client to increase fluid intake
Ans: B
Ans: A

20.) The following are appropriate nursing


15.) Which of the following is the most interventions after ear surgery EXCEPT:
characteristic manifestation of Meniere’s Dse? A.) Position the client on the operated side
A.) Tinnitus B.) Instruct the client not to blow the nose for at
B.) Headache least 2 weeks
C.) Vertigo C.) Observe for signs and symptoms of 7th
D.) Nausea and Vomiting cranial nerve damage
D.) Advise the client against wathing TV or fast-
Ans: C moving objects for few weeks postop

Ans: A

16.) The diet of the client with Meniere’s disease


should be: 21.) Which of the ff test assesses visual acuity
A.) Low-Protein A.) Snellen’s Test
B.) Low-fats B.) Ishihara Plate
C.) Low-potassium C.) Retinoscopy
D.) Low-Sodium D.) Tonometry

Ans: D Ans: A

22.) Which of the following nursing interventions


17.) Which of the following is inappropriate has priority when a client has a foreign body
nursing intervention for the client with hearing protruding from the eye?
impairment: A.) Irrigate the eye with sterile saline
A.) Talk in clearly enunciated words using B.) Assess visual acuity with snellen’s chart
normal tone of voice C.) Remove the foreign body with sterile gauze
B.) Talk directly in front of the client D.) Patch both eyes until seen by
C.) Use speech with gestures Opthalmologist
D.) Use high-pitch voice

Ans: D Ans: A

18.) Which of the following dx tests compare air 23.) A client is diagnosed with Meniere’s
conduction with bone conduction disease. Which of the following nursing
A.) Rinne’s test diagnosis should take priority for the client?
B.) Weber’s test A.) Altered body image
C.) Barany’s Rotation Test B.) Risk for injury
D.) Caloric Ice Test C.) Impaired social interaction
D.) Ineffective coping
Ans: A
Ans: B
19.) A client who had cataract should be told to
call his MD if he has which of the following 24.) The following are characteristics of
situations? conductive hearing loss EXCEPT:
A.) Blurred Vision A.) The client hears better in a noisy
B.) Eye Pain environment
C.) Glare B.) The client talks in a loud voice
C.) The client hears and understands telephone
conversation well
D.) The external or the middle ear is damaged

Ans: B

25.) It is an eye disorder characterized by


lessening of the effective powers of
accommodation:
A.) Myopia
B.) Presbyopia
C.) Hypertropia
D.) Presbycusis

Ans:B

26.) The following drugs dilate the pupils


EXCEPT:
A.) Atropine SO4
B.) Neosynephrine
C.) Scopolamine
D.) Pilocarpine