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Exam (elaborations)

Med Surg 2 - Final Exam

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Innate immunity - answer-Born with it (skin) Adaptive immunity - answer-developed throughout life (germs) Passive immunity - answer-gained through other sources (vaccine) During a mumps outbreak at a local school, a patient, who is a school teacher, is exposed. She has previously been immu...

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  • September 7, 2024
  • 16
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • Med Surg 2 -
  • Med Surg 2 -
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Med Surg 2 - Final Exam and answers
Innate immunity - answer-Born with it (skin)

Adaptive immunity - answer-developed throughout life (germs)

Passive immunity - answer-gained through other sources (vaccine)

During a mumps outbreak at a local school, a patient, who is a school teacher, is exposed. She has previously
been immunized for mumps. What type of immunity does she possess?
A. Acquired immunity
B. Natural immunity
C. Phagocytic immunity
D. Humoral immunity - answer-A

An infection control nurse is presenting an in service reviewing the immune response. The nurse describes the
clumping effect that occurs when a antibody acts like a crosslink between two antigens. What process is the
nurse explaining?
A. Agglutination
B. Cellular immune response
C. Humoral response
D. Phagocytic immune response - answer-A

A patient is being treated for bacterial pneumonia. In the first stages of illness, the patients claims to be feeling
better and I afebrile. The patient is most likely in which stage of the immune response?
A. Recognition stage
B. Proliferation stage
C. Response stage
D. Effector stage - answer-D

A nurse has admitted a patient who has been diagnosed with urosepsis. What immune response predominates in
sepsis?
A. Mitigated
B. Nonspecific
C. Cellular
D. Humoral - answer-D

A patient requires ongoing treatment and infection-control precautions because of an inherited deficit in
immune function. The nurse should recognize that this patient most likely has what type of immune disorder?
A. Primary immune deficiency
B. Gammopathy
C. Autoimmune disorder
D. Rheumatic disorder - answer-C

A patient is undergoing testing to determine the overall function of her immune system. What test can be
performed to evaluate the functioning of the patients cellular immune system?
A. Immunoglobulin testing
B. Delayed hypersensitivity skin test

,C. Specific antibody response
D. Total serum globulin assessment - answer-B

The nurse is completing a focused assessment a patients immune function. What should the nurse prioritize in
the physical assessment?
A. Percussion of the patients abdomen
B. Palpation of the patients liver
C. Auscultation of the patient apical heart rate
D. Auscultation of the patients apical heart rate - answer-D

A patients most recent laboratory findings indicate a GFR of 58 ml/min. The nurse should recognize what
implication of this diagnostic finding?
A. The patient is likely to have a decreased level of blood urea nitrogen (BUN)
B. The patient is at risk for hypokalemia
C. The patient is likely to have irregular voiding patterns
D. The patient is likely to have increased serum creatine levels - answer-D

A 45-year-old man with diabetic nephropathy has ESKD can lead to prerenal failure. Glomerulonephritis and
aminoglycoside toxicity are renal causes, and ureterolithiasis is a postrenal cause.
A. "Hemodialysis is a treatment option that is usually required three times a week."
B. "Hemodialysis is a program that will require you to commit to daily treatment"
C. "This will require you to have surgery and a catheter will need to be inserted into your abdomen"
D. "Hemodialysis is a treatment that is used for a few months until your kidney heals and starts to produce urine
again" - answer-A

A patient with ESKD is scheduled to begin hemodialysis. The nurse is working with the patient to adapt the
patients diet to maximize the therapeutic effect and minimize the risks of complications. The patients diet
should include which of the following modifications? Select all that apply.
A. Decreased protein intake
B. Decreased sodium intake
C. Increased potassium intake
D. Fluid restriction
E. Vitamin D Supplement - answer-A,B,D

A patient is admitted to the ICU after a motor vehicle accident. On the second day of the hospital admission, the
patient develops acute kidney injury. The patient is hemodynamically unstable, but renal replacement therapy is
needed to manage the patients hypervolemia and hyperkalemia. Which of the following therapies will the
patients hemodynamic status best tolerate?
A. Hemodialysis
B. Peritoneal dialysis
C. CVVHD
D. Plasmapheresis - answer-C

A 71 year old patient with ESKD has been told by the physician that it is time to consider hemodialysis until a
transplant can be found. The patient tells the nurse she is not sure she wants to undergo a kidney transplant.
What would be an appropriate response for the nurse to make?
A. "The decision is certainly yours to make, but be sure not to make a mistake"
B. "Kidney transplant in patients your age are as successful as they are in younger patients"
C. "I understand your hesitancy to commit to a transplant surgery. Success is comparatively rare."
D. "Have you talked this over with your family" - answer-B

, A patient with Chronic kidney disease has been hospitalized and is receiving hemodialysis on a scheduled basis.
The nurse should include which of the following actions in the plan of care?
A. Ensure that the patient moves the extremity with the vascular access site as little as possible
B. Change the dressing over the vascular access site at least every 12 hours
C. Utilize the vascular access site for infusion of IV fluids.
D. Assess for a thrill or bruit over the vascular access site each shift - answer-D

The physician has place a central venous pressure monitoring line in an acutely ill patient so right ventricular
function and venous blood return can be closely monitored. The results show decreased CVP. What does this
indicate?
A. Possible hypovolemia
B. Possible Myocardial infarction
C. Left-sided heart failure
D. Aortic valve regurgitation - answer-A

A brain natriuretic peptide sample has been drawn from an older adult patient who has been experience vital
fatigue and shortness of breath. This test will allow the care team to investigate the possibility of what
diagnosis?
A. Pleurisy
B. Heart failure
C. Valve dysfunction
D. Cardiomyopathy - answer-B

Lisinopril - answer-ACE inhibitor.
Helps to treat HBP or CHF

A patient with an occluded coronary artery is admitted and has an emergency percutaneous transluminal
coronary angioplasty. The patient is admitted to the cardiac critical care unit after the PTCA. For what
complication should the nurse most closely monitor the patient?
A. Hyperlipidemia
B. Bleeding at insertion site
C. Left ventricular hypertrophy
D. Congestive heart failure - answer-B

The nurse is assessing an older adult patient with numerous health problems. What assessment datum indicates
an increase in the patients risk for HF?
A. The patient take Lasix (Furosemide) 20 mg/day
B. The patients potassium level is 4.7 meq/L
C. The patient is an African American man
D. The patients age is greater than 65 - answer-D

The triage nurse in the ED is assessing a patient with chronic HF who has presented with worsening symptoms.
In reviewing the patients medical history, What is a potential primary cause of the patients HF?
A. Endocarditis
B. Pleural effusion
C. Atherosclerosis
D. Atrial-septal defect - answer-C

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