Medical Surgical Nursing Advance Question Answer
1. When caring for a client with a diagnosis of diabetes insipidus, which nursing intervention should be the priority?
(a) Watching for signs and symptoms of septic shock
(b) Maintaining adequate fluid intake
(c) Checking weight every 3 days
(d) Monitoring urine for specific gravity greater than 1.030
2. A client is brought to the emergency room in an unresponsive state, and a diagnosis of hyperglycemic hyperosmolar nonketotic syndrome is made. The nurse would immediately prepare to initiate which of the following anticipated physician’s orders?
(a) Endotracheal intubation
(b) 100 units of NPH insulin
(c) Intravenous infusion of normal saline
(d) Intravenous infusion of sodium bicarbonate
3. A client is admitted to a hospital with a diagnosis of diabetif ketoacidosis (DKA). The initial blood glucose level was 950 mg/dL. A continuous intravenous infusion of regular insulin is initiated, along with intravenous rehydration with normal saline. The serum glucose level is now 240 mg / dL. The nurse would next prepare to administer which of the following?
(a) Ampule of 50% dextrose
(b) NPH insulin subcutaneously
(c) Intravenous fluids containing 5% dextrose
(d) Phenytoin (dilantin) for the prevention of seizures
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4. A physician has prescribed propylthiouracil (PTU) for a client with hyperthyroidism and the nurse develops a plan of care for the client. A priority nursing assessment to be included in the plan regarding this medication is to assess for:
(a) Relief of pain
(b) Signs of renal toxicity
(c) Signs and symptoms of hyperglycemia
(d) Signs and symptoms of hypothyroidism
5. After hypophysectomy, a client complains of being thirsty and having to urinate frequently. The initial nursing action is to:
(a) Increase fluid intake
(b) Document the complaints
(c) Assess for urinary glucose
(d) Assess urine specific gravity
6. A nurse is caring for a client after hypophysectomy. The nurse notices clear nasal drainage from the client’s nostril. The initial nursing action would be to:
(a) Lower the head of the bed
(b) Test the drainage for glucose
(c) Obtain a culture of the drainage
(d) Continue to observe the drainage
7. A client is admitted to an emergency room, and a diagnosis of myxedema coma is made. Which action would the nurse prepare to carry out initially?
(a) Warm the client
(b) Maintain a patient airway
(c) Administer thyroid hormone
(d) Administer fluid replacement
8. A nurse notes that a client with type 1 diabetes mellitus has lipodystrophy on both upper thighs. The nurse would appropriately inquire whether the client
(a) Rotates sites for injection
(b) Administers the insulin at a 45 degree angle
(c) Cleanses the skin with alcohol before each injection
(d) Aspirates for blood before injection into the subcutaneous tissue
9. A client is diagnosed with pheochromocytoma. A nurse prepares a plan of care for the client; while planning, the nurse understands that pheochromocytoma is a condition that:
(a) Causes profound hypotension
(b) Is maintained by severe hypoglycemia
(c) Is not curable and is treated symptomatically
(d) Causes the release of excessive amounts of catecholamines
10. A nurse is preparing to provide instructions to a client with Addison’s disease regarding diet therapy. The nurse knows that which of the following diets most likely would be prescribed for this client?
(a) High-fat intake
(b) Low-protein intake
(c) Normal sodium intake
(d) Low-carbohydrate intake
11. A nursing instructor asks a student to describe the pathophysiology that occurs in Cushing’s disease. Which statement by the student indicates an accurate understanding of this disorder?
(a) “Cushing’s disease results from an oversecretion of insulin.”
(b) “Cushing’s disease results from an undersecretion of corticotropic hormones.”
(c) “Cushing’s disease results from an undersecretion of mineralocorticoid hormones.”
(d) “Cushing’s disease results from an increased pituitary secretion of adrenocorticotropic hormone.”
12. A client is examined and found to have pinpoint, pink-to-purple, nonbalancing macular lesions 1 to 3 mm in diameter. The nurse documents this assessment as:
13. A client is diagnosed with atopic dermatitis. He is upset and asks how to avoid another out-break. The nurse determines that the client needs information regarding:
(a) Avoiding bacterial infections
(b) Avoiding fungal infections.
(c) Hereditary factors
(d) Avoiding viral infections.
14. A client is diagnosed with a fungal infection of the scalp. The nurse would document this as:
(a) Tinea capitis
(b) Tinea corporis
(c) Tinea cruris
(d) Tinea pedis
15. An intubated client with full-thickness, circumferential burns to the chest is experiencing pressure from edema that is inhibiting chest wall expansion. The nurse anticipates that which of the following is the priority intervention for the client?
(c) Needle thoracentesis
(d) Insertion of a chest tube
16. A client has just arrived at the emergency department after sustaining a major burn injury. During the first 8 hours after the injury, the nurse will assess the client for which of the following?
(a) Hyponatremia and hypokalemia
(b) Hyponatremia and hyperkalemia
(c) Hypernatremia and hypokalemia
(d) Hypernatremia and hyperkalemia
17. A client has just been admitted to the hospital after sustaining partial-thickness burns to both lower extremities and portions of the trunk. The nurse is aware that the most important I.V. fluid to administer is:
(b) Dextrose 5% in water
(c) Lactated Ringer’s solution
(d) Normal saline solution with 2 mEq of potassium per 100 ml
18. A client has recently had a skin graft. What is the most important instruction for the nurse to give the client?
(a) Continue physical therapy
(b) Protect the graft from direct sunlight
(c) Use cosmetic camouflage techniques
(d) Apply lubricating lotion to the graft site
19. A client has a stage II sacral pressure ulcer that is being treated with a transparent film dressing. The nurse is aware that:
(a) the dressing maintains a moist environment for the wound
(b) the dressing is allowed to dry out before removal
(c) a gauze dressing covers the transparent film dressing.
(d) the transparent film dressing should be tightly packed into the wound
20. A client received burns to his entire back and left arm. The nurse uses the Rules of Nines to calculate that he has sustained burns to what percentage of his body?