Exam (elaborations)
MED SURG 201 Medical Surgical Final Exam- Questions and Answers; West Coast University
- Course
- MED SURG 201
- Institution
- Rasmussen College
MED SURG 201 Medical Surgical Final Exam- Questions and Answers;
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MED SURG
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MED SURG 201 Medical Surgical Final
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Exam- Questions and ANSWERS
12/21/2024
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,MED SURG 201 Medical Surgical Final Exam- Questions and
ANSWERS
1
,FINAL EXAM PASADO
4. A patient who was admitted to the hospital with hyperglycemia and newly diagnosed diabetes mellitus
is scheduled for discharge the second day after admission. When implementing patient teaching, what is
the priority action forthe nurse?
a. Instruct about the increased risk for cardiovascular disease.
b. Provide detailed information about dietary control of glucose.
c. Teach glucose self-monitoring and medication administration.
d. Give information about the effects of exercise on glucose control.
ANSWER * C
When time is limited, the nurse should focus on the priorities of teaching. In this situation, the patient
should know how to test blood glucose and administer medications to control glucose levels. The patient
will need further teaching about the role of diet, exercise, various medications, and the many potential
complications of diabetes, but these topics can be addressed through planning for appropriate referrals.
14. A 75-year-old patient is admitted for pancreatitis. Which tool would be the most appropriate for the
nurse to use during the admission assessment?
a. Drug Abuse Screening Test (DAST-10)
b. Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised (CIWA-Ar)
c. Screening Test-Geriatric Version (SMAST-G)
d. Mini-Mental State Examination
ANSWER * C
Because the abuse of alcohol is a common factor associated with the development of pancreatitis, the
first assessment step is to screen for alcohol use using a validated screening questionnaire. The SMAST-
G is a short-form alcoholism screening instrument tailored specifically to the needs of the older adult. If
the patient scores positively on the SMAST-G, then the CIWA-Ar would be a useful tool for determining
treatment. The DAST-10 provides more general information regarding substance use. The Mini-Mental
State Examination is used to screen for cognitive impairment.
1. The sister of a patient diagnosed with BRCA gene–related breast cancer asks the nurse, “Do you
think I should be tested for the gene?” Which response by the nurse is most appropriate?
a. “In most cases, breast cancer is not caused by the BRCA gene.”
b. “It depends on how you will feel if the test is positive for the BRCA gene.”
c. “There are many things to consider before deciding to have genetic testing.”
d. “You should decide first whether you are willing to have a bilateral mastectomy.”
ANSWER * C
Although presymptomatic testing for genetic disorders allows patients to take action (such as
mastectomy) to prevent the development of some genetically caused disorders, patients also need to
consider that test results in their medical record may affect insurance, employability, etc.
Telling a patient that a decision about mastectomy should be made before testing implies that the nurse
has made a judgment about what the patient should do if the test is positive. Although the patient may
need to think about her reaction if the test is positive, other issues (e.g., insurance) also should be
considered. Although most breast cancers are not related to BRCA gene mutations, the patient with a
BRCA gene mutation has a markedly increased risk for breast cancer.
2
, 7. The nurse in the outpatient clinic has obtained health histories for these new patients. Which patient
may need referral for genetic testing?
a. 35-year-old patient whose maternal grandparents died after strokes at ages 90 and 96
b. 18-year-old patient with a positive pregnancy test whose first child has cerebral palsy
c. 34-year-old patient who has a sibling with newly diagnosed polycystic kidney disease
d. 50-year-old patient with a history of cigarette smoking who is complaining of dyspnea
ANSWER * C
The adult form of polycystic kidney disease is an autosomal dominant disorder and frequently it is
asymptomatic until the patient is older. Presymptomatic testing will give the patient information that will be
useful in guiding lifestyle and childbearing choices. The other patients do not have any indication of genetic
disorders or need for genetic testing.
14. An adolescent patient seeks care in the emergency department after sharing needles forheroin
injection with a friend who has hepatitis B. To provide immediate protection from infection, what
medication will the nurse administer?
a. Corticosteroids
b. Gamma globulin
c. Hepatitis B vaccine
d. Fresh frozen plasma
ANSWER * B
The patient should first receive antibodies for hepatitis B from injection of gamma globulin. The hepatitis
B vaccination series should be started to provide active immunity. Fresh frozen plasma and
corticosteroids will not be effective in preventing hepatitis B in the patient.
6. A patient who is diagnosed with cervical cancer that is classified as Tis, N0, M0 asks the nurse what the
letters and numbers mean. Which response by the nurse is most appropriate?
a. “The cancer involves only the cervix.”
b. “The cancer cells look almost like normal cells.”
c. “Further testing is needed to determine the spread of the cancer.”
d. “It is difficult to determine the original site of the cervical cancer.”
ANSWER * A
Cancer in situ indicates that the cancer is localized to the cervix and is not invasive at this time. Cell
differentiation is not indicated by clinical staging. Because the cancer is in situ, the origin is the cervix.
Further testing is not indicated given that the cancer has not spread.
10. External-beam radiation is planned for a patient with cervical cancer. What instructions should the nurse
give to the patient to prevent complications from the effects of the radiation?
a. Test all stools for the presence of blood.
b. Maintain a high-residue, high-fiber diet.
c. Clean the perianal area carefully after every bowel movement.
d. Inspect the mouth and throat daily for the appearance of thrush.
ANSWER * C
3
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