Medical Surgical Test Questions

53問 • 3年前

問題一覧

Which of the following laboratory values should a nurse expect to be elevated in a patient who has pancreatitis ?

Serum Amylase

SITUATION : CLIENTS WITH PANCREATITIS The initial diagnosis of pancreatitis is confirmed if the client's blood shows a significant in elevation of which of the following serum values ?

Amylase

Which of the following signs and symptoms would the nurse expect to see in a client with acute pancreatitis ?

Jaundice

The nurse evaluates the client's most recent laboratory data. Which laboratory findings would be consistent with a diagnosis of acute pancreatitis ?

Hyperglycemia

The initial plan for a client with pancreatitis most likely would focus on which of the following as a priority?

Resting the gastrointestinal tract

The nurse carefully monitors the client with acute pancreatitis for which of the following complications ?

Pneumonia

SITUATION : CLIENTS WITH PANCREATITIS The nurse is discharging a client with chronic pancreatitis . Which of the following measures would be essential to include in the client's discharge instruction ?

Diet modifications avoiding high -fat foods, caffeine and alcohol

The nurse about the is asked risk factors for pancreatitis . The nurse responds that which of the following clients is more likely to develop pancreatitis ?

Client with a stone lodged in the pancreatic duct

Which nonpharmacologic measure is particularly useful for a client with acute pancreatitis?

Placement in a side - lying position with knees to chest and pillow against the abdomen

During a home health visit , you are assessing how a patient takes the prescribed pancreatic enzyme . The patient is unable to swallow the capsule whole , so they open the capsule and mix the beads inside the capsule with food / drink . Which food or drink is safe for the patient to mix the beads with :

Applesauce

The physician orders a patient with pancreatitis to take a pancreatic enzyme . What assessment finding demonstrates the pancreatic enzymes are working properly ?

Abdominal girth is decreased

Situation : Client with Diabetes Mellitus Keyser, a 50 year old college professor of medical anthropology with a history of type 2 DM for the past 10 years. He has been controlling his glucose by taking glyburide and using a 2000-calorie diet recommended by his endocrinologist. He is aware of the higher incidence of type 2 DM nowadays and is open to anything he can learn about it. His blood glucose level had been fairly consistent with an average AM reading of 200mg /dl . He is 6'2 ' and weighs 220 , having lost 10lbs the past month. Six months after hospitalization for viral pneumonia , Keyser is readmitted for hyperglycemia . He has been running higher blood glucose levels (280 to 300mg/dl) and has lost 10 lbs. He is currently on a medical leave of absence from work. His medical history includes a myocardial infarction , hypertensionand renal insufficiency over Which of the following patient statements about the diabetic diet regime is correct ?

"Foods that are high in mono and poly fats are avocados, olives, and nuts."

A patient with diabetes asks you about what type of exercise they should perform throughout the week. The best response is:

Swimming

A patient is scheduled to take 10 units of Humulin N at 1100. When is the patient most susceptible for hypoglycemia ?

1900

A patient has a blood glucose of 400. Which of the following medications could be the cause of this?

Prednisone

A patient is scheduled to take 5 units of Humulin R and 10 units of NPH. What is the proper way of mixing these insulins?

Draw up the Humulin R insulin first and then the NPH insulin

Which of the following insulins has no peak but a duration of 24 hours ?

Lantus

SITUATION: CLIENTS WITH DIABETES MELLITUS The nurse conducts a health history for a client with type I diabetes mellitus. Which of the following client statements best describes the onset characteristics of this type of diabetes ?

One day passed out after had terrible nausea, vomiting and abdominal pain.

Which of the following should be included in the assessment of a client with diabetes mellitus who is experiencing a hypoglycemic reaction? Select all that apply : 1. Tremors 2. Flushed skin 3. Nervousness 4. Profuse perspiration 5. Extreme thirst 6. Constricted pupils

1,3,4

Which of the following nutritional goals would be most important in the teaching plan for a client with diabetes mellitus?

Include all essential food components in the diet plan

The nurse is observing a staff member preparing to give a client in diabetic ketoacidosis 40 units of NPH insulin IV bolus. Which of the following interventions by the nurse is appropriate?

Tell the staff member that the only regular insulin may be administered intravenously

Which of the following should the nurse include in the medication instructions for a client taking chlorpropamide (Diabetes)?

Avoid drinking alcohol

SITUATION : CLIENTS WITH DIABETES MELLITUS A client with diabetes mellitus receives Humulin regular insulin 8 units subcutaneously at 7:30am. The nurse would be most alert to signs of hypoglycemia at what time during the day ?

09:30 am to 11:30 am

During the routine visit to the physician's office for monitoring of diabetic control, an older client with diabetes mellitus complains to the nurse of vision changes. The client describes blurring of the vision with difficulty in reading and with driving at night. Given the client's history, the nurse interprets that the client is probably developing :

Cataracts

The nurse is discussing the treatment regimen for a client newly diagnosed with type 1 diabetes mellitus . While discussing Insulin administration , the client asks, "Why can I just take a pill like my friend does ?" which of the following statement indicates the client understands the nurse's explanation?

Because my body does not produce insulin, I must receive the injection.

The nurse is caring for two clients newly diagnosed with diabetes mellitus. One client has type 1 diabetes and the other client has type 2 diabetes. The nurse understands that the main difference between newly diagnosed type 1 and type 2 diabetes mellitus that in type 1 diabetes

Complications are not present at time of diagnosis

Which nursing Intervention takes priority when a client is first admitted with hyperglycemic hyperoemolar nonketotic syndrome (HHNS) ?

Administering fluid replacements

The nurse concludes that a client newly diagnosed with type 1 diabetes mellitus requires further teaching after the client makes which statement?

I will not take my insulin if im sick and cannot eat

The nurse is caring for a client with a diagnosis of diabetes. When monitoring this client for hyperglycemia , the nurse understands that the adaptations associated with diabetic coma result from an excess accumulation in the blood of :

Ketones from rapid fat breakdown , causing acidosis

Laboratory test are performed on a client with diabetic ketoacidosis . Which should the nurse expect the tests to reveal ?

Low CO2 level

1. The family decides to wean the patient from the ventilator support. The family talks to the nurse about their decision to get the nurses support. Which of the following actions is NOT appropriate ? The Nurse :

Participates in the decision making process by offering the family information about the advantages and disadvantages of continued ventilator support

Two hour after the ventilator support was discontinued , the patient dies. The nurse discusses with the family the possibility of donating the deceased person's organs . The following are guidelines in organ or tissue donation. 1. Religious beliefs in organ donation and transplantation must be respected 2. Donors must be free of infectious disease and cancer 3. Consent or written orders by the physician are necessary for referral to an organ procurement organization 4. The family of the deceased should be offered an opportunity to speak with a knowledgeable organ procurement coordinator 5. The person requesting for organ donation does not have to believe in the benefits of organ donation does not have to believe in the benefits of organ donation but should support the process with a positive attitude Which of the guidelines should the nurse observe?

1, 2, 3, 4, 5

The legal definition of death that facilitates organ donation is the cessation of ______

Function of the entire brain

The patient is pronounced dead by the physician. Which of the following nursing actions VIOLATES the standards of care for a dead person ?

Keeping the dead person in a sitting position until the family has arrived and said their goodbyes

The family goes through the stages of grieving . What are the stages in the grieving process ? 1. Acceptance 2. Depression 3. Denial 4. Bargaining 5. Anger

3 5 4 2 1

Situation 6 - A male teenager was wheeled in the Emergency Department ( ED) for stab wound The ED nurse suspects the kidneys may have been injured . 6. The nurse assesses the patient for complications. Which are the MOST COMON complications? 1. Urinary leakage 2. Delayed bleeding from the damage 3. Abscess formation 4. Paralytic ileus 5. Renal failure

3, 4

The nurse knows that with renal trauma further complications may occur such as: 1. Secondary hemorrhage usually due to infection 2. Renal artery stenosis 3. Renal atrophy 4. Hypotension 5. Hydronephrosis Which are the POSSIBLE complications ?

1,2,3,5

The nurse assesses the patient to determine the extent of injury. Which of the following signs is a CARDINAL sign of renal trauma?

Hematuria

The nurse writes a nursing diagnosis for the patient with the stab wound. The MOST appropriate nursing diagnosis is :

Deficient fluid volume related to blood in the urine

The physician prescribes Magnetic Resonance Imaging (MRI ) of both kidneys to confirm clinical suspicion and determine the severity of the injury. Which of the following activities is a PRIMARY nursing consideration in preparing the patient for MRI ?

Coordinate the MRI with other patient care activities and inform the patient about the test

Situation 7 : Nurse Ashley is a staff nurse in the oncology units of tertiary hospital. She reads literature on antineoplastic medications Nurse Ashley understands the importance of continuing professional development. Which of the following is the MAIN purpose of continuing professional development ?

To update one's professional knowledge and competence

Nurse Ashley reads that the drug Cyclophosphamide (Cytoxan) is given to patients with breast cancer. Nurse Ashley understands that this drug is :

Cell cycle phase -non-specific

Nurse Ashley reads in the literature that a patient with breast cancer taking Cytoxan should observe the following . Given a case, what should Nurse Ashley instruct a patient to do?

Increase fluid intake 2000 to 3000 mL daily

Nurse Ashley understands that patients receiving antineoplastic medications should do which of the following? 1. Drink beverages containing alcohol in moderate amounts 2. Consult with the physician before receiving immunizations 3. Be sure to receive flu and pneumonia immunizations 4. Take aspirin (Acetysalicylic Acid, ASA) as for headache

2 only

An incident was described in the literature where a patient developed stomatitis after receiving a course of antineoplastic medications. Which of the following actions would be BEST for a nurse to do ?

Rinse the mouth with diluted baking soda or saline

Situation 9 Nurse Mirasol is the attending nurse of a 40-year-old female admitted in the medical unit with a probable diagnosis of Scleroderma The patient complains of pain in her fingertips and pallor followed by blanching of the extremities and redness. Nurse Mirasol knows that these symptoms characteristic of which of the following disorders?

Raynaud's phenomenon

Nurse Mirasol assesses the skin of the patient . Which phase of skin changes occur FIRST and are usually painless and symmetrical ?

Edematous

Nurse Mirasol writes a nursing diagnosis for the patient . Which of the following is a PRIORITY nursing diagnosis ?

Impaired Skin Integrity

Nurse Mirasol assists the patient in coping with the disorder. During the early stages of a chronic disease, patients tend to focus on which of the following behaviors ?

Understanding the disease process

Nurse Mirasol prepares a discharge plan of care for the patient . Which of the following objectives are MOST appropriate ? The patient should 1. Try to prevent breakdown of skin and ulceration 2. Avoid activities that trigger pain 3. Modify diet to include legumes 4. Avoid exposure to extreme cold temperature

1, 2, 4

Situation 11 Marie , an oncology nurse assists in the care of patients with cancer One of her patients is a 50- year old female named Marcela is in the terminal stage of breast cancer. She tells the Nurse Marie, have given up. I have no hope left. I am ready to die." Which of the following responses of Nurse Marie is MOST therapeutic ?

You have given up hope ?

Marcela says to Nurse Marie. "I don't like to spend my final days on earth in a hospital." The BEST response of Nurse Marie would be :

Can you please tell me more how you are feeling right now ?

Marcela tells Nurse Marie that her younger sister was recently diagnosed with cancer. She is concerned because she is aware that breast cancer "runs in the family " but she could not recall any family member diagnosed with bone or lung cancer . Nurse Marie's BEST response would be :

I am sorry to hear about your sister's recent diagnosis. Most probably your sister has breast cancer that has metastasized or spread to the bone and lungs.

Pathognomonic sign

Castle Aranza · 60問 · 3年前

Pathognomonic sign