Med-Surg Certification Real Exams year after year
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A)
"Third-spacing" can cause which form of shock?
A. Anaphylactic
B. Hypovolemic
C. Septic
D. Cardiovascular Correct Answers B. Hypovolemic
Third-spacing = movement of fluid out of the vascular system
into the interstitial areas, resulting in loss of fluid leading to
hypovolemic shock
A 18-year-old male is admitted after a motor-vehicle accident
with air-bag release. He complains of chest tightness and is
restless and anxious. Heart sounds are barely audible on
auscultation. The patient is most likely experiencing what
condition?
A. Cardiac tamponade
B. Acute myocardial infarction
C. Pulmonary edema
D. Aortic aneurysm Correct Answers A. Cardiac tamponade
We know that this patient sustained trauma to the chest. Cardiac
tamponade occurs when there is fluid build up around the heart
that applies pressure to the heart and impairs its ability to pump
adequately. This can happen with trauma or uncontrolled
bleeding from an open heart procedure. Signs and symptoms
,include chest pain and pressure, muffled heart tones, shortness
of breath, and jugular vein distention
A 24 year-old factory worker with a history of asthma presents
to the emergency department with difficulty breathing. During
the respiratory assessment of the patient, the nurse would expect
to auscultate:
A. diminished breath sounds and crackles in lung bases
B. moist crackles in lung bases
C. distant breath sounds and expiratory wheezes
D. bronchial breath sounds in lung bases Correct Answers C.
distant breath sounds and expiratory wheezes
A 30 year-old man with chronic traumatic brain injury was
admitted for a surgical procedure and is to be discharged. The
nurse should modify his discharge instructions by:
1. Providing detailed oral instructions
2. Providing detailed written instructions
3. Having him repeat the instructions
4. Having sustained eye contact during the instruction Correct
Answers 3. Having him repeat the instructions
A 30-year-old female has been diagnosed with Cushing's
syndrome. The nurse knows the patient is most likely to exhibit
which symptoms?
A. Hypertension and hirsutism
B. Hyperkalemia and obesity
C. Hypotension and anemia
,D. Menstrual irregularities and hypoglycemia Correct Answers
A. Hypertension and hirsutism
Hypertension may result from fluid retention due to
mineralcorticoid excess, and they may also exhibit hirsutism
(abnormal hair growth).
For Answers (B, C, D) while they may also exhibit truncal or
generalized obesity as well as menstrual irregularities, it is
patient's with Addison's Disease that would exhibit
Hyperkalemia, Hypoglycemia and Hypotension (it is the
opposite in Cushing's Syndrome).
A 48 year-old patient with suspected gastrointestinal (GI)
bleeding undergoes diagnostic endoscopy, which determines the
site of bleeding is a duodenal ulcer. The nurse explains to the
patient that bleeding ulcers are most commonly related to which
of the following?
a. Intake of spicy foods
b. Use of salicylates
c. History of smoking
d. Severe retching and vomiting Correct Answers b. Use of
salicylates
Most bleeding ulcers are related to the presence of Helicobacter
pylori or drug use, especially aspirin and aspirin-containing
produces (salicylates) or nonsteroidal anti-inflammatory drugs.
Severe retching and vomiting are associated with esophageal
bleeding. Spicy floods do not cause ulcers.
, A 50-year-old woman weighs 85kg and has a history of cigarette
smoking, high blood pressure, high sodium intake, and
sedentary lifestyle. When developing an individualized care plan
for her, the nurse determines that the most important risk factors
for peripheral artery disease that need to be modified are:
A. Weight and diet
B. Activity level and diet
C. Cigarette smoking and high blood pressure
D. Sedentary lifestyle and high blood pressure Correct Answers
C. Cigarette smoking and high blood pressure
These really all need to be addressed but smoking most of all,
especially combined with high BP
A 60-year-old African American male who works as a soccer
coach, is admitted with hypertension. On admission his blood
pressure was 210/108 mmHg. His last total cholesterol level was
156 mg/dl, and a random blood glucose was 110 mg/dl. Which
is unalterable risk factor for hypertension?
A. His blood glucose level
B. His cholesterol level
C. His occupation
D. His ethnicity Correct Answers D
Other risk factors: elevated serum lipids, DM, sedentary lifestyle
A 63 year old female patient contacts the clinic to report that she
is has been extremely fatigued, is sleeping 12 hours a night, is
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