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Medical-Surgical Nursing 75 Items Test

Medical-Surgical Nursing 75 Items Test

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Published by wiffato
email wiffatillo@yahoo.com for d answers and rationale.
email wiffatillo@yahoo.com for d answers and rationale.

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Published by: wiffato on Feb 18, 2010
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02/12/2014

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1.Atenolon hydrochloride (Tenormin) is prescribed for a hospitalized client. The nurse will performwhich of the following as a priority action before administering the medication?a.Listen to the client’s lung sounds.b.Assess the client for muscle weakness.c.Check the client’s blood pressure.d.Check the most recent electrolyte levels.2.A nurse is preparing to administer Furosemide (Lasix) to a client with a diagnosis of heart failure.The most important laboratory test result for the nurse to check before administering thismedication is:a.Blood urea nitrogenb.Cholesterol levelc.Potassium leveld.Creatinine level3.A nurse caring for a male client with a diagnosis of gastrointestinal (GI) bleeding reviews theclient’s laboratory results and notes a hematocrit level of 30%. The nurse would:a.Report the abnormally low levelb.Report the abnormally high level.c.Inform the client that the laboratory result is normal.d.Place the normal report in the client’s medical record.4.A nurse provides dietary instructions to a client who will be taking warfarin sodium (Coumadin).The nurse tells the client to avoid which food item?a.Cottage cheeseb.Grapesc.Watermelond.Spinach5.A client who has been receiving parenteral nutrition by way of a central venous access devicecomplains of chest pain and dyspnea. The nurse quickly assesses the client’s vital signs and notesthat the pulse rate has increased and that the blood pressure has dropped. The nurse determinesthat the client is most likely experiencing :a.Fluid imbalanceb.Air embolismc.Sepsisd.Fluid overload6.A client receiving intravenous (IV) fluid therapy complains of burning and a feeling of tightness atthe IV insertion site. On assessment, the nurse detects coolness and swelling at the site ad notesthat the IV rate has slowed. The nurse determines that which of the following has occurred?a.Thrombosisb.Infectionc.Infiltrationd.Phlebitis
 
7.A physician orders 1 unit of packed red blood cells to be infused over 4 hours. The unit of bloodcontains 250 mL. The drop factor is 15 drops per 1 mL. The nurse prepares to set the flow rate athow man drops per minute?a.10 gtts.b.16 gtts.c.18 gtts.d.20 gtts.8.A nurse is preparing to administer 30 mEq of liquid potassium chloride (KCl) to an adult client.The label on the medication bottle reads 40mEq of KCl per 15 mL. The nurse prepares how manymilliliters of KCl to administer the correct dose of medication?a.11 mLb.15 mLc.2- mLd.50 mL9.A nurse provides instructions to a client about the use of an incentive spirometer. The nursedetermines that the client needs further instruction about its use if the client says she must:a.Place the lips completely over the mouthpieceb.Inhale slowly, maintaining a constant flow.c.After maximal inspiration, hold the breath for 10 seconds and then exhale.d.Sit upright when using the device10.A nurse is monitoring a client with a closed chest tube drainage system. The nurse notesfluctuation of the fluid level in the water-seal chamber during inspiration and expiration. On thebasis of this finding, the nurse determines that:a.There is a leak in the system.b.The chest tube is functioning as expected.c.The amount of suction needs to be decreased.d.The occlusive dressing at the insertion site needs reinforcement.11.A nurse is providing morning care to a client who has a closed chest tube drainage system totreat a pneumothorax. When the nurse turns the client to the side, the chest tube is accidentallydislodged from the chest. The nurse immediately applies sterile gauze over the chest tubeinsertion and next:a.Calls the physicianb.Places the client in Trendelenburg positionc.Replaces the chest tube systemd.Obtains a pulse oximetry reading12.A nurse reviews the medication history of a client admitted to the hospital and notes that theclient is taking leflunomide (Arava). During assessment of the client, the nurse asks whichquestion to determine effectiveness?a.“Are you experiencing heartburn?” b.“Do you have any joint pain?” c.“Are you having any diarrhea?” d.“Do you have frequent headaches?” 
 
13.A nurse is checking lochia discharge in a woman in the immediate postpartum period. The nursenotes that the lochia is bright read and contains some small clots. The nurse determines that thisfinding :a.Is normalb.Indicates that the client is hemorrhagingc.Indicates the need to increase oral fluidsd.Indicates the need to contact he physician14. A nulliparous woman asks the nurse when she will feel fetal movements. The nurse responds bytelling the woman that the first recognition of fetal movement will occur at approximately:a.10 weeks of gestationb.12 weeks of gestationc.14 weeks of gestationd.18 weeks of gestation15. A nurse is performing a vaginal assessment of a pregnant client in labor. The nurse notes that theumbilical cord is protruding from the vagina. The nurse would immediately:a.Administer oxygen to the client.b.Transport the client to the delivery room.c.Place an external fetal monitor on the client.d.In gloved fingers into the vagina to the cervix and exert upward pressure against thepresenting part.16.A nurse is assessing a pregnant client in the second trimester of pregnancy who was admitted tothe maternity unit which a suspected diagnosis of abruption placentae. Which finding would thenurse expect to note if this condition is present?a.Abdominal painb.Nontender uterusc.Soft uterusd.Painless vaginal bleeding17.A nurse in the labor room is caring for client in the first stage of labor. On assessing the fetalpatterns, the nurse notes an early deceleration of fetal heart rate (FHR) on the monitor strip. Theappropriate nursing action is to:a.Place the mother in a Trendelenburg position.b.Document the findings and continue to monitor the fetal patterns.c.Administer oxygen to the client by face mask.d.Contact the physician.18.A pregnant client in the third trimester of pregnancy with a diagnosis of mild preeclampsia isbeing monitored at home for gestation hypertension. The home care nurse teaches the clientabout the signs that need to be reported to the physician and tells the client to call the physicianif:a.The blood pressure reading is between 122/80 and 138/88mmHg.b.Urine output increases.c.Weight increases by more than 1 pound in a week.d.Fetal movements are more than four per hour.

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