A - ANSWER-The nurse includes which nursing diagnosis in the plan
of care for the patient admitted with pneumonia?
A. Anxiety related to hypoxia
B. Deficient knowledge related to cause of disorder
C. Fear related to the threat of pain
D. Ineffective breathing pattern related to decreased
su...
Med Surg Exam 1
Questions With
Correct Answers!!
A - ANSWER-The nurse includes which nursing diagnosis in the plan
of care for the patient admitted with pneumonia?
A. Anxiety related to hypoxia
B. Deficient knowledge related to cause of disorder
C. Fear related to the threat of pain
D. Ineffective breathing pattern related to decreased
surfactant
C - ANSWER-The nurse is reviewing orders on the patient who is to
receive supplemental oxygen. It is a priority for the
nurse to follow up with the provider about which
order?
A. Nasal cannula at 2 L/min
B. Venturi mask at 24% concentration
C. Nasal cannula at 8 L/min
D. Venturi mask at 50% concentration
A, B, C, E - ANSWER-What is the most important information for the nurse
to include in the teaching plan about management of
home oxygen therapy? (Select all that apply.)
,A. Do not change the settings of the oxygen without
the health-care provider's permission.
B. Place "No smoking" signs within the home.
C. Oxygen is a fire hazard.
D. Others may smoke around you as long as you do
not smoke.
E. Keep a fire extinguisher near the oxygen source
A, D - ANSWER-The nurse is caring for a patient who is receiving
oxygen therapy via the Venturi mask. Which
complications are associated with oxygen therapy?
(Select all that apply.)
A. Oxygen toxicity
B. Cachexia
C. Bradycardia
D. Absorption atelectasis
E. Increased dead space
A - ANSWER-The nurse is caring for a patient who has just been
orally intubated. Which action should the nurse
take first?
A. Assess for symmetrical chest rise and fall with
ventilation
B. Provide mouth care to assure a clean oral cavity
C. Assess the need for nutritional support by an oral
nasogastric tube
D. Provide a communication board for the patient
and family
D - ANSWER-When the nurse is performing postural drainage for
the patient, which factor promotes the movement
,of secretions to the upper airways?
A. Dilation of alveoli
B. Action of the cilia
C. Muscle contraction
D. Force of gravity
B - ANSWER-A nursing preceptor is observing a newly hired nurse
prioritizing patient rounds. Correct prioritization of
assigned patients is indicated if the new nurse assesses
which patient first?
A. A patient with cellulitis of the right lower leg
B. A patient who was extubated 2 hours ago
C. A patient who was ordered nebulizer
treatments prn
D. A patient with an IV of D51
/2 NS at 125 mL/hr
D - ANSWER-You are preparing a patient for surgery and have
asked her to verify her information on her patient
identification band. She tells you that the birth
date is incorrect on her identification band. The most
appropriate action by the nurse at this time is which
of the following?
A. Cross out the birth date and put the correct one in
its place with the nurse's initials.
B. Ask the family members to validate the patient's
birth date.
C. Call the surgeon's office to validate the birth date.
D. Ask the admissions office to please send a corrected
identification band.
, A, C, D - ANSWER-The nurse should report the following findings from
a patient's history as an increased risk for DVTs
postoperatively. (Select all that apply.)
A. History of smoking
B. Age
C. History of DVTs with previous pregnancy
D. Borderline hypertension
E. Allergies
C - ANSWER-Which of the following patients presents the greatest
risk for a negative response to anesthesia?
A. A 40-year-old male with high blood pressure
B. A 20-year-old female with no prior surgical history
C. A 29-year-old female with a history of stage II
acute renal failure
D. An 85-year-old male who drinks one glass of
scotch every night
A - ANSWER-During the initial assessment and admission questions,
the nurse asks Maria for the time of her last oral
intake. The patient replies, "I had dinner last night at
8 p.m., but I took a few sips of water this morning
with my vitamins. The nurse's best response is which
of the following?
A. Explain to the patient that just a sip of water
should not be a problem for anesthesia but that
the vitamins may be a problem. We will pass that
information on to the anesthesiologist.
B. Tell the patient that the sip of water is not an issue
because it was only a sip.
C. Inform the patient that her surgery will not be
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