Medical-Surgical Nursing
Exam Answer Key
Course Introduction
Medical-Surgical Nursing is a foundational course that focuses on the care of adult patients experiencing a wide range of medical conditions and surgical interventions. The course covers the principles and practices essential for effective assessment, planning, implementation, and evaluation of patient care. Through a combination of theoretical knowledge and clinical experience, students learn to address the holistic needs of patients, manage complex health problems, utilize critical thinking skills, and apply evidence-based practices. Topics include fluid and electrolyte balance, perioperative care, management of chronic and acute illnesses, pain management, infection control, and the use of relevant technologies and interdisciplinary collaboration within the healthcare setting.
Recommended Textbook
Clinical Nursing Skills and Techniques 9th Edition by Perry FAAN
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44 Chapters
1283 Verified Questions
1283 Flashcards
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Page 2
Chapter 1: Using Evidence in Practice
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20 Verified Questions
20 Flashcards
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Sample Questions
Q1) __________________ are the gold standard for research.
Answer: Randomized controlled trials
Individual randomized controlled trials (RCTs)are the gold standard for research (Titler and others,2001).An RCT establishes cause and effect and is excellent for testing therapies.
Q2) _________________ is a guide for making accurate,timely,and appropriate clinical decisions.
Answer: Evidence-based practice
Evidence-based practice is a guide for making accurate,timely,and appropriate clinical decisions.
Q3) A systematic review explains whether the evidence that you are searching for exists and whether there is good cause to change practice.In _____________,all entries include information on systematic reviews.Individual randomized controlled trials (RCTs)are the gold standard for research.
Answer: The Cochrane Database
A systematic review explains whether the evidence that you are searching for exists and whether there is good cause to change practice.In The Cochrane Database,all entries include information on systematic reviews.Individual randomized controlled trials (RCTs)are the gold standard for research.
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Page 3
Chapter 2: Admitting, Transfer, and Discharge
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25 Verified Questions
25 Flashcards
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Sample Questions
Q1) Which of the following are considered "advance directives"? (Select all that apply. )
A)Living will
B)Power of attorney for health care
C)Notarized handwritten document
D)Nursing progress note
Answer: A,B,C
Q2) The patient arrives in the emergency department complaining of severe abdominal pain and vomiting,and is severely dehydrated.The physician orders IV fluids for the dehydration and an IV antiemetic for the patient.However,the patient states that she is fearful of needles and adamantly refuses to have an IV started.The nurse explains the importance of and rationale for the ordered treatment,but the patient continues to refuse.What should the nurse do?
A)Summon the nurse technician to hold the arm down while the IV is inserted.
B)Use a numbing medication before inserting the IV.
C)Document the patient's refusal and notify the physician.
D)Tell the patient that she will be discharged without care unless she complies. Answer: C
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Chapter 3: Communication and Collaboration
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30 Verified Questions
30 Flashcards
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Sample Questions
Q1) The patient states,"I don't know what my family will think about this." The nurse wishes to use the communication technique of clarification.Which of the following statements would fit that need best?
A)"You don't know what your family will think?"
B)"I'm not sure that I understand what you mean."
C)"I think it would be helpful if we talk more about your family."
D)"I sense that you may be anxious about something."
Answer: B
Q2) The nurse is assessing a patient who says that she is feeling fine.The patient,however,is wringing her hands and is teary eyed.The nurse should respond to the patient in which of the following ways?
A)"You seem anxious today.Is there anything on your mind?"
B)"I'm glad you're feeling better.I'll be back later to help you with your bath."
C)"I can see you're upset.Let me get you some tissue."
D)"It looks to me like you're in pain.I'll get you some medication."
Answer: A
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Chapter 4: Documentation and Informatics
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25 Flashcards
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Sample Questions
Q1) Nursing documentation must have which of the following characteristics? (Select all that apply. )
A)Factual
B)Organized
C)Public
D)Complete
Q2) Multidisciplinary care plans that include key interventions and expected outcomes within an established time frame are known as _______________.
Q3) Which is an acceptable format to use in documentation?
A)SOAPIE
B)HIPAA
C)DAR
D)EHR
Q4) The patient is ready to go home from the hospital.What does the nurse provide to the patient and his family before he leaves the facility?
A)Discharge summary
B)Standardized care plan
C)Patient care summary
D)Flow sheet
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Chapter 5: Vital Signs
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Sample Questions
Q1) An irregular heartbeat,often found in children,that speeds up with inspiration and slows down with expiration is known as a sinus ___________.
Q2) The patient has been in the hospital for several days for urosepsis.He has been responding favorably to treatment,and his vital signs have been "normal" for 2 days.When the nurse takes his vital signs,however,the patient's apical pulse is 152 and regular.The nurse suspects that the:
A)patient is having a reaction to his narcotic medication.
B)patient may be suffering from hypothermia.
C)patient's fever may have returned.
D)patient may be an athlete.
Q3) The patient is an 86-year-old woman who is being admitted for dehydration and pneumonia.The patient is lying in bed but tells the nurse that she needs to go to the bathroom.The nurse tells the patient that she will stay with her and will help her get there.The patient states,"That's OK.I can make it on my own." The nurse should:
A)help the patient to the bathroom and stay with her.
B)allow the patient to get up on her own and go to the bathroom.
C)allow the patient to go to the bathroom and call for help if needed.
D)insert a Foley catheter.
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7
Chapter 6: Health Assessment
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45 Flashcards
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Sample Questions
Q1) A late sign of decreased oxygen levels may cause a change in skin color known as
Q2) Which patient position maximizes the nurse's ability to assess the patient's body for symmetry?
A)Sitting
B)Supine
C)Prone
D)Dorsal recumbent
Q3) Which is the best position in which to place the patient to hear low-pitched cardiovascular sounds?
A)Supine
B)Sitting up
C)Dorsal recumbent
D)Left lateral recumbent
Q4) Petechiae are noted on the patient as a result of the nurse finding:
A)bluish-black patches.
B)tenting.
C)pinpoint-sized red dots.
D)large areas of raised,irritated skin.
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Chapter 7: Specimen Collection
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Sample Questions
Q1) A patient is to have a venipuncture to obtain a blood sample to check ammonia levels.What should the nurse do when given this information?
A)Use pre-warmed test tubes.
B)Keep the specimen out of the light.
C)Avoid use of a tourniquet during the procedure.
D)Place the samples on ice before sending them to the lab.
Q2) When performing a venipuncture,the nurse should:
A)inject with the needle at a 45-degree angle.
B)select a vein that is rigid and cordlike,and that rolls when palpated.
C)perform the needle insertion immediately after cleansing the skin with alcohol.
D)place the thumb of the nondominant hand about 1 inch below the site and pull the skin taut.
Q3) In explaining to the patient about obtaining a sputum specimen to diagnose tuberculosis,the nurse explains which of the following? (Select all that apply. )
A)Specimens are best obtained in the early morning.
B)Acid-fast bacilli (AFB)smears require three consecutive morning samples.
C)Bacteria accumulate as secretions pool.
D)Specimens should be obtained at bedtime.
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Chapter 8: Diagnostic Procedures
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30 Verified Questions
30 Flashcards
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Sample Questions
Q1) ____________ are sterile invasive procedures involving the removal of body fluids or tissue for diagnostic procedures.
Q2) Under which circumstances should a nurse contact the physician to postpone an angiography?
A)If a patient has been nothing by mouth (NPO)for only 1 hour.
B)If a patient's femoral site has been shaved and cleansed with an antiseptic.
C)If the patient received Benadryl as a preprocedure medication.
D)When test results reveal a blood urea nitrogen (BUN)level of 15 mg/100 mL and a creatinine level of 0.8 mg/mL.
Q3) Both aspiration and biopsy diagnose and differentiate which of the following? (Select all that apply. )
A)Leukemia
B)Certain malignancies
C)Heart disease
D)Thrombocytopenia/anemia
Q4) _____________________ is often used for diagnostic or surgical procedures that do not require complete anesthesia in acute care,surgical care,and outpatient care settings.
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Page 10
Chapter 9: Medical Asepsis
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26 Verified Questions
26 Flashcards
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Sample Questions
Q1) OSHA and CDC guidelines require health care workers who care for suspected or confirmed TB patients to wear special ________________.
Q2) Before entering the room of a patient on isolation where all protective barriers are required,the nurse first puts on the: A)gown.
B)gloves.
C)eyewear.
D)mask/respirator.
Q3) The nurse knows that the basic concept of all patient care that is implemented to prevent the spread of infection from blood,body fluids,secretions,excretions,nonintact skin,and mucus membranes is __________________.
Q4) The patient is admitted with mumps.The nurse knows that she will have to:
A)put the patient in a private room.
B)place the patient on standard precautions.
C)wear a mask when closer than 3 feet to the patient.
D)place the patient on contact precautions.
Q5) The nurse is preparing to provide care for the patient.Before making patient contact,she washes her hands.This practice is known as __________________.
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Chapter 10: Sterile Technique
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17 Verified Questions
17 Flashcards
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Sample Questions
Q1) The minimum standard for infection control as established by the Centers for Disease Control and Prevention (CDC)is _______________.
Q2) When performing sterile aseptic procedures,the nurse must create a _____________ in which objects can be handled with minimal risk for contamination.
Q3) When removing the mask after an aseptic procedure,what should the nurse do first?
A)Remove gloves.
B)Untie top strings of mask.
C)Untie bottom strings of mask.
D)Untie top strings and let mask hang.
Q4) Nurses commonly use surgical asepsis in which of the following situations? (Select all that apply. )
A)In labor and delivery areas
B)When inserting an intravenous catheter
C)When treating patients with surgical incisions or burns
D)When inserting a urinary catheter
E)When dressing an MRSA-positive wound
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Chapter 11: Safe Patient Handling, Transfer, and Positioning
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31 Verified Questions
31 Flashcards
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Sample Questions
Q1) Patients at risk for complications and/or injury from improper positioning include patients with which of the following? (Select all that apply. )
A)Poor nutrition
B)Loss of sensation
C)Impaired muscle development
D)Poor circulation
Q2) The patient is an elderly man who has just been admitted for a probable cerebrovascular accident.The patient is nonverbal and does not respond to requests but is able to turn himself in bed.The nurse notices that the patient likes to lie on his right side,and soon after being turned by the nursing staff,the patient turns back to his right side.The nurse in this case should:
A)allow the patient to lie on his right side continuously because he seems comfortable.
B)prevent the patient from lying on his right side until he no longer wishes to lie on that side.
C)frequently assess the patient and turn him more frequently.
D)allow the patient to lie on his right side until a pressure ulcer develops and he can no longer lie on that side.
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Page 13
Chapter 12: Exercise Mobility
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27 Verified Questions
27 Flashcards
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Sample Questions
Q1) The nurse is caring for a patient who has just been treated for a broken leg.She needs to teach the patient how to use crutches.Which crutch gait is most appropriate for this patient?
A)Four-point gait
B)Three-point gait
C)Two-point gait
D)Swing-to gait
Q2) When teaching the use of a three-point crutch gait,the nurse should instruct the patient to move:
A)both crutches and the affected leg first,then the stronger leg.
B)the right crutch,left foot,left crutch,and right foot in sequence.
C)the left crutch and right foot,then move the right crutch and left foot.
D)both crutches,then lift and swing the legs forward as far as the crutches.
Q3) When the four gaits listed below are compared,which is the most stable of the crutch gaits?
A)Four-point gait
B)Three-point gait
C)Two-point gait
D)Swing-to gait
Q4) ____________ refers to an ability to move about freely.
14
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Chapter 13: Support Surfaces and Special Beds
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27 Verified Questions
27 Flashcards
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Sample Questions
Q1) A patient is on bed rest after sustaining injuries in a car accident.Which nursing action helps prevent complications of immobility?
A)Decreasing fluid intake to ease dependent edema
B)Turning the patient every 2 hours and providing a low-air-loss mattress
C)Raising the head of the bed to maximize the patient's lung inflation
D)Bathing and feeding the patient to decrease energy expenditure
Q2) The patient will be going home but still requires an air-fluidized bed.Before discharge,it will be necessary for the company that is leasing the bed to inspect the home for accessibility and ________________.
Q3) After comparing the benefits of the following support surfaces,the nurse realizes that a patient with multiple trauma and/or spinal cord injury is expected to be placed on a(n):
A)Rotokinetic bed.
B)bariatric bed.
C)flotation mattress.
D)air-fluidized mattress.
Q4) The nurse understands that an _____________________ using foam,air,water,or gel can be placed on top of the mattress to provide pressure relief.
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Page 15
Chapter 14: Patient Safety
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32 Verified Questions
32 Flashcards
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Sample Questions
Q1) To promote patient safety,government standards regarding mechanical and physical restraints state that:
A)alternative measures are to be implemented before restraints are used.
B)the nurse's judgment is all that is required for restraint use.
C)restraints should be used immediately for all patients who may need them.
D)restraints cannot be used except to prevent others from being harmed.
Q2) A patient is well known to the hospital staff from previous admissions and is prone to wandering at night.For patient safety,the physician writes an order for "belt restraint prn." What should the nurse do upon reviewing this order?
A)Apply a belt restraint on the patient as needed.
B)Have the patient sign an "informed consent" form.
C)Inform the physician that "prn" restraint orders are unacceptable.
D)Obtain a signed "informed consent" from a family member.
Q3) After recognizing that a patient has received an electrical shock and removing the source of the shock,what should the nurse do next?
A)Call for assistance.
B)Immediately start CPR.
C)Obtain emergency equipment.
D)Assess for the presence of a pulse.
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Page 16
Chapter 15: Disaster Preparedness
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Sample Questions
Q1) Personal protective equipment (PPE)is categorized by the level of safety provided.Standard work uniforms or work clothes offer what level of protection?
A)Level A
B)Level B
C)Level C
D)Level D
Q2) An outbreak of influenza A in the same geographical location is known as an __________.
Q3) Disaster nursing differs from general nursing because when caring for patients during a disaster:
A)the focus is on caring for the sickest people first.
B)using a color tag system reduces the amount of emotional stress on the nurse.
C)the focus is no longer on airway,breathing,and circulation.
D)the focus is on caring for those most likely to survive.
Q4) For safety reasons,rescue workers should be upwind and uphill from a toxic chemical disaster scene to avoid exposure.The exception is when ____________ has been released,because it is lighter than air.
Q5) It is recommended that every household prepares a ____________.
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Chapter 16: Pain Management
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37 Verified Questions
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Sample
Questions
Q1) The patient had knee-replacement surgery and has a local infusion pump to provide a local anesthetic to the surgical site.The patient puts on the call light and complains that pain at the site is more intense than it has ever been and is getting worse.The nurse checks the site and finds that the dressing is damp but intact.The infusion pump is pumping,and there is medication in the bag.The most probable cause of the problem might be the:
A)catheter may be clogged.
B)pump may be releasing too much drug into the site.
C)catheter may be displaced.
D)patient may be exaggerating the pain.
Q2) The nurse frequently must assess a patient who is experiencing pain.When assessing the intensity of the pain,the nurse should:
A)ask whether there are any precipitating factors.
B)question the patient about the location of the pain.
C)offer the patient a pain scale to objectify the information.
D)use open-ended questions to find out about the sensation.
Q3) ___________ has an identifiable cause and rapid onset and generally disappears with healing.
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Page 18
Chapter 17: Palliative Care
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Sample Questions
Q1) The nurse is preparing to assist the patient at the end stage of her life.To provide comfort for the patient in response to anticipated symptom development,the nurse plans to:
A)decrease the patient's fluid intake.
B)limit the use of pain medication.
C)provide larger meals with more seasoning.
D)determine patient wishes and select appropriate therapies.
Q2) After the death of a patient and before other nursing interventions are implemented,the nurse should:
A)place the patient in a supine position and elevate the head of the bed 30 degrees.
B)wait an hour to prepare the patient for viewing.
C)place the patient in a side-lying position to allow drainage.
D)exclude the family while the body is being prepared.
Q3) Nurses provide _______________ that is defined as care of the body after death in a manner consistent with the patient's religious and cultural beliefs.
Q4) _____________ helps people live as well as possible through the dying process.
Q5) An _______________ is the surgical dissection of a body after death.
Q6) The irreversible absence of all brain function is termed ______________.
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Chapter 18: Personal Hygiene and Bed Making
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Sample Questions
Q1) When evaluating the shaving of a patient done by a family member,the nurse determines that the technique is done appropriately when:
A)long strokes are used.
B)the razor is held at a 45-degree angle to the skin.
C)shaving is done against the direction of hair growth.
D)a cool cloth is used on the skin before the shave.
Q2) In relation to hygiene and the acute care setting,the nurse knows that which of the following statements is true?
A)The disposable bath is a less desirable form of bathing than the traditional basin bath.
B)The disposable bath is a more desirable form of bathing than the traditional basin bath.
C)The disposable bath is more desirable for patients who can bathe independently.
D)The disposable bath is not an acceptable form of bathing in the acute care setting.
Q3) The first line of defense against external injury and infection contains several thin layers of cells undergoing different stages of maturation.This first line of defense is known as the _______.
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Chapter 19: Care of the Eye and Ear
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Sample Questions
Q1) The patient is brought into the emergency department after a motor vehicle accident.The patient is unresponsive.The nurse is concerned about whether or not the patient wears contact lenses because contact lenses that are not removed can cause
Q2) When providing care to a patient who has splashed bleach into his eye,the nurse will:
A)remove the patient's contacts immediately.
B)flush the eye from the outer to the inner canthus.
C)reinsert contacts as soon as irrigation is done.
D)irrigate toward the lower conjunctival sac.
Q3) The elderly patient is instructed to store his hearing aid in a(n):
A)cold place.
B)container that keeps out moisture.
C)easy to reach place.
D)a cup of water.
Q4) A _____________ is a small,battery-powered,electronic device that amplifies sound.
Q5) The substance found in the ear canal that has an antibacterial effect and maintains an acid pH is called ______________.
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Chapter 20: Safe Medication Preparation
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Sample Questions
Q1) When medications are administered,which action by the nurse is appropriate?
A)Administering medications prepared by another nurse
B)Using sterile technique for nonparenteral medications
C)Leaving medication at the bedside when the patient is in the bathroom
D)Documenting the reason for medication refusal in the nurse's notes
Q2) The dose ordered for a patient is 75 mg IM.The medication is available in a 50-mg/mL solution.The nurse prepares ________________ mL.
Q3) The nurse administers 100 mg of a drug at 0800.The drug's biological half-life is 4 hours.A serum drug level is drawn at 1600.The nurse should anticipate ___________ milligrams will be left in the body at 1600?
Q4) The intended or desired physiological response to a medication is known as its
Q5) A patient reports a pain level of 7 out of 10 and receives 10 mg of morphine IV.The nurse knows that IV morphine has an onset of 1 to 2 minutes,a peak of 20 minutes,and a duration of 4 to 5 hours.The patient asks when he will start to feel some pain relief.The nurse should respond that relief should begin in _____________.
Q6) Medication safety is always one of the ______________ set by The Joint Commission.
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Chapter 21: Administration of Nonparenteral Medications
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Sample Questions
Q1) A nurse is preparing to administer eardrops to an adult patient.Which action should be taken by the nurse?
A)Warm the medication to room temperature using warm water.
B)Pull the pinna down and back to straighten the ear canal.
C)Apply gentle pressure or massage to the pinna of the ear.
D)Remove cerumen from the inner ear canal with a cotton-tipped applicator.
Q2) The nurse is preparing to administer an eye ointment to the patient.Which action by the nurse is appropriate?
A)Clean away drainage or crusts by wiping from the outer to the inner canthus.
B)Instruct the patient to keep the eye open for 2 minutes after instillation.
C)Apply a thin ribbon evenly along the inner edge of the lower eyelid.
D)Instruct the patient to avoid wiping the eye after instillation.
Q3) The nurse is preparing to administer a medication.Which of the following is the most critical to assess before medication administration?
A)Diet history
B)Allergy history
C)Surgical history
D)Drug tolerance
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23
Chapter 22: Administration of Parenteral Medications
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Sample Questions
Q1) A patient with multiple intravenous lines has blood infusing in the right antecubital space,parenteral nutrition infusing through a right subclavian line,and normal saline with potassium infusing in the left forearm.An intravenous medication is ordered stat.The nurse will use the line in the ____________ to administer the medication.
Q2) A patient has medication ordered to be given by intravenous (IV)bolus.The nurse recognizes which advantage of this type of administration?
A)There is a slower onset of medication effects.
B)Medications are given over a longer time frame.
C)Medications given by IV bolus are less irritating to the veins.
D)Small volumes are used,so fluid overload can be avoided.
Q3) The nurse injects the medication into the loose connective tissue just under the dermis when giving a _____________ injection.
Q4) The nurse is preparing to draw up a medication using a filter needle and a syringe.This equipment is necessary when the medication is being withdrawn from an
Q5) An experienced nurse recognizes that the dorsogluteal injection site is no longer used for intramuscular injections because of the risk of damaging the
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Chapter 23: Oxygen Therapy
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Sample Questions
Q1) The nurse is reviewing lab results for a patient with hypoxemia.The nurse is aware that which of the following results may worsen the patient's hypoxemia? (Select all that apply. )
A)Low sodium levels
B)Low hemoglobin levels
C)Increased blood pH
D)Decreased blood pH
Q2) The nurse is caring for a patient on mechanical ventilation.The nurse determines that the endotracheal tube is properly placed by which assessment?
A)Auscultating both lungs and watching the rise and fall of both sides of the chest
B)Monitoring and comparing the blood pressure in both arms
C)Observing and measuring inspiratory and expiratory rates
D)Checking the settings on the ventilator and the low-pressure and high-pressure alarm settings
Q3) A condition in which oxygen is insufficient to meet the metabolic demands of the tissues and cells is known as __________________.
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Chapter 24: Performing Chest Physiotherapy
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Sample Questions
Q1) The nurse is teaching a patient how to use an Acapella device.What instruction should the nurse give to the patient?
A)Take a full deep breath in and fill your lungs.
B)Hold your breath for 5 to 10 seconds after placing the mouthpiece in your mouth.
C)Cough forcefully to clear your lungs while maintaining a tight seal on the mouthpiece.
D)Exhale slowly for 3 to 4 seconds through the device while it vibrates.
Q2) The nurse receives orders on several patients for chest percussion,vibration,and shaking.The nurse is aware that chest physiotherapy maneuvers are indicated for which patient?
A)18-year-old who sustained thoracic trauma from a motor vehicle accident
B)75-year-old with osteoporosis who is underweight
C)15-year-old with cystic fibrosis
D)20-year-old with a fractured clavicle
Q3) The nurse positions the patient flat on the back with a small pillow under the knees to drain the right and left _____________________.
Q4) The _______________ provides positive expiratory pressure (PEP)with oral airway oscillations.
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Chapter 25: Airway Management
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Sample Questions
Q1) The nurse is assessing several patients who have returned from surgery.Which finding most likely indicates a need for suctioning?
A)Complaint of pain when breathing
B)Cough producing thick yellow mucus
C)Oxygen saturation level of 88%
D)Drowsiness and respiratory rate of 8
Q2) A patient with a tracheostomy tube has thick,tenacious mucus that is difficult to remove.The nurse should choose which technique to suction the airway?
A)Normal saline instillation (NSI)before suctioning
B)Dry suctioning 1 time followed by NSI with suctioning 2 more times
C)Dry suctioning as long as the heart rate is above 60 beats/min
D)Dry suctioning
Q3) A patient with a tracheostomy tube is accidentally extubated.What should the nurse do immediately?
A)Call the health care provider.
B)Mechanically ventilate the patient.
C)Insert a new tracheostomy tube.
D)Hold the stoma open with the fingertips.
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Chapter 26: Cardiac Care
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Sample Questions
Q1) The nurse changes the ECG electrodes on a patient who is on a continuous cardiac monitor.The patient tells the nurse that the electrodes were just changed the previous day.Which of the following rationales is the correct explanation for the nurse to share with the patient?
A)Changing the electrodes more often than 24 hours can result in skin breakdown.
B)It is not necessary to change the electrodes daily.
C)It was not documented that the electrodes were changed.
D)Changing the electrodes daily will decrease the number of false alarms.
Q2) When describing the rationale for connecting electrodes to each limb and around the heart,the nurse shares with the patient which appropriate explanation?
A)The leads view a specific portion of the heart's surface to help determine which part has sustained damage.
B)Multiple leads are necessary to provide a three-dimensional view of the heart.
C)The electrodes are necessary to provide a shock to the heart if needed during cardiac conversion.
D)The limb electrodes are required to provide a backup study in the event of artifact.
Q3) ECG tracings that cannot be interpreted are known as _________________.
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Chapter 27: Closed Chest Drainage Systems
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30 Flashcards
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Sample Questions
Q1) For a patient with a pneumothorax,where does the nurse anticipate that the chest tube will be located?
A)Second to third intercostal space (apical),anterior
B)Fifth to sixth intercostal space,posterior
C)Fifth to sixth intercostal space,lateral
D)Mediastinal area
Q2) What is the expected amount of drainage for an adult patient with a posterior chest tube?
A)100 to 300 mL during the first 3 hours
B)10 to 50 mL during the first 2 hours
C)200 mL during the first 24 hours
D)400 to 500 mL during the first 24 hours
Q3) The nurse is caring for a patient who has a chest tube connected to a water seal.The patient is not on a ventilator.Which of the following would the nurse consider normal?
A)The fluid level in the water seal rises with inspiration.
B)The fluid level in the water seal falls with inspiration.
C)Constant bubbling occurs in the water seal.
D)The fluid level in the water seal falls with expiration 3 days after insertion.
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Chapter 28: Emergency Measure for Life Support
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29 Flashcards
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Sample Questions
Q1) When using an automated external defibrillator,it is important for the nurse to ensure that no one is touching the patient:
A)after connecting the cable to the machine.
B)when the machine is plugged in.
C)while the pads are applied.
D)while the machine analyzes the rhythm.
Q2) The most common cause of airway obstruction in an unresponsive patient is the __________.
Q3) The nurse sees on the cardiorespiratory monitor that the patient's cardiac rhythm has changed from normal sinus rhythm to ventricular fibrillation.The nurse knows that the most effective means of converting this rhythm is:
A)cardiopulmonary resuscitation (CPR).
B)defibrillation.
C)oxygen.
D)precordial thump.
Q4) Many cardiac arrests are caused by irregular heart rhythms known as ________________.
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Chapter 29: Intravenous and Vascular Access Therapy
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44 Flashcards
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Sample Questions
Q1) Fluids that have the same osmolality as body fluids are used most often to replace extracellular volume and are known as _______________ fluids.
Q2) While assessing the patient's intravenous (IV)infusion,the nurse notes that it is infusing more slowly than it should be.What should the nurse do first?
A)Discontinue the IV.
B)Increase the rate of infusion.
C)Observe for fluid overload.
D)Check the position of the IV fluid and extremity.
Q3) The nurse needs to specifically prevent air emboli that may result from intravenous (IV)therapy.What should the nurse make sure to do to prevent air emboli?
A)Use a needleless system.
B)Prime the tubing completely.
C)Check for medication compatibility.
D)Select a larger-gauge needle or catheter.
Q4) An intravenous catheter that is inserted through a large arm vein and is advanced until the tip enters the central venous system is known as a __________________.
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Chapter 30: Blood Therapy
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29 Flashcards
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Sample Questions
Q1) The patient is scheduled to receive 1 unit of packed red blood cells (RBCs).She has small,fragile veins,and a 22-gauge intravenous (IV)patent catheter is in place.What should the nurse do?
A)Cancel the blood transfusion.
B)Insert a 16-gauge IV catheter into the antecubital fossa.
C)Use the IV catheter that is in place.
D)Transfuse the blood over 6 hours.
Q2) The patient has been home from the hospital for 10 days.On the last day of his hospitalization,he received 2 units of packed red blood cells (RBCs).This morning,he noticed that his skin had a yellow tint to it and his temperature was elevated.Which reaction might this patient be experiencing?
A)Delayed hemolytic transfusion reaction
B)Acute hemolytic transfusion reaction
C)Nonhemolytic febrile reaction
D)Severe allergic transfusion reaction
Q3) Under the ABO system,the blood type __________ can be given to any individual and is known as the "Universal Donor."
Q4) A transfusion in which the donor is the patient is known as an ______________ transfusion or autotransfusion.
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Chapter 31: Oral Nutrition
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28 Verified Questions
28 Flashcards
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Sample Questions
Q1) What is an appropriate technique for the nurse to use to prevent aspiration when assisting a patient with meals?
A)Keep the patient's head back and straight.
B)Offer thin-consistency foods.
C)Provide large amounts of fluids.
D)Have the patient sit up for 30 minutes after eating.
Q2) ______________ are measures of height;weight;head,arm,and muscle circumferences;and skinfold thickness.
Q3) The patient is admitted with a diagnosis of stroke.The nurse attempts to feed the patient,but the patient coughs and gags when food is placed in his mouth.What should the nurse do to assist this patient?
A)Feed the patient more slowly.
B)Feed the patient more quickly.
C)Contact the speech pathology department.
D)Ignore the cough and try again later.
Q4) The nurse recognizes that the patient is exhibiting signs of ______________ when she notices that he has difficulty holding food and fluid in his mouth and experiences difficulty moving it to his esophagus.
Q5) _______________ is useful for monitoring short-term changes in visceral protein.
Page 33
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Chapter 32: Enteral Nutrition
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23 Flashcards
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Sample Questions
Q1) The nurse,physician,and dietitian collaborate to select an enteral feeding formula for the patient.Their decision should be based on which of the following? (Select all that apply. )
A)Protein requirements of the patient
B)Digestive ability of the patient
C)Amount of lactose required
D)The patient's disease process
Q2) The nurse is caring for a patient in a chronic vegetative state with inadequate gastric emptying.The nurse would anticipate finding in a ________ tube placed to assist with this patient's nutritional needs.
Q3) The nurse determines that a nasogastric (NG)tube needs irrigation when she:
A)obtains more than 200 mL of residual volume.
B)obtains a small amount of thin watery residual.
C)does not encounter resistance when aspirating the residual.
D)obtains an unusually thick secretions.
Q4) A tube passed through the nose or mouth with the end terminating in the stomach or the small bowel,and used in feeding the patient for short periods is known as a
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Chapter 33: Parenteral Nutrition
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14 Flashcards
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Sample Questions
Q1) The patient will be discharged to home on parenteral nutrition (PN).The patient and his family education will need to perform which of the following care steps? (Select all that apply. )
A)Monitor the patient's weight.
B)Monitor the patient's serum glucose levels.
C)Measure the patient's intake and output.
D)Perform catheter care.
E)Limit the patient's activity.
Q2) To detect a common untoward effect of interrupting a parenteral nutrition (PN)infusion,the nurse should assess the patient for development of which symptom?
A)Fever
B)Chest pain
C)Erythema and induration
D)Shaking and dizziness
Q3) If parenteral nutrition (PN)must be discontinued suddenly,hang __________ in water at the same infusion rate to prevent hypoglycemia.
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Chapter 34: Urinary Elimination
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27 Flashcards
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Sample Questions
Q1) The nurse is caring for a patient who has an indwelling urinary catheter.Which intervention is most important to include in this patient's plan of care?
A)Maintaining tension on the tubing
B)Emptying the urinary collection bag every 24 hours
C)Cleaning in a circular motion from the meatus down the catheter
D)Keeping the drainage bag on the bed or attached to the side rails
Q2) The nurse is assessing a patient whose 24-hour output is 2400 mL.Which finding reflects the nurse's understanding of urine output?
A)Increased output
B)Decreased output
C)Normal output
D)Balanced output
Q3) A single-lumen catheter that is inserted into the bladder through the urethra only to empty the bladder and then is removed is known as a _______________ catheter.
Q4) The risk for catheter-associated urinary tract infection can be reduced by using ___________ when inserting the catheter.
Q5) _________________ is the volume of urine in the bladder after a normal voiding.
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Chapter 35: Bowel Elimination and Gastric Intubation
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27 Flashcards
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Sample Questions
Q1) When care is provided for a patient with an NG tube in place,which intervention is safest for the nurse to implement?
A)Tape the tube up and around the ear on the side of insertion.
B)Secure the tubing to the bed by the patient's head.
C)Mark the tube where it exits the nose.
D)Change the tubing daily.
Q2) The nurse prepares to exercise a digital removal of feces.To detect an untoward effect of this procedure,the nurse should assess the patient history for which condition?
A)Heart disease
B)Abdominal pain
C)Urinary infection
D)Diabetes mellitus
Q3) While the nurse is administering an enema,the patient complains of some cramping.Which action should the nurse take next?
A)Discontinue the procedure completely.
B)Increase the height of the solution.
C)Slow the rate of infusion.
D)Have the patient roll into a supine position.
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Chapter 36: Ostomy Care
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Sample Questions
Q1) A patient who has a urostomy is being discharged to home.Which instruction will the nurse to provide to the patient?
A)Restrict fluid intake to reduce urine output.
B)Report any mucus in his urine.
C)Keep unused pouches in the refrigerator.
D)Shower without covering the pouch.
Q2) The output from a urinary or fecal stoma is called the _______________.
Q3) The nurse is caring for a patient who had a colostomy placed 5 days earlier.The nurse notes that the stoma is red and moist.Which action should the nurse take?
A)Notify the physician immediately.
B)Apply pressure.
C)Document the condition of the stoma.
D)Change the appliance pouch.
Q4) In caring for a patient who has a pouch for a noncontinent urinary diversion,which nursing intervention is essential?
A)Empty the pouch when it is one-third to one-half full.
B)Remove the ureteral stents after 2 days.
C)Pouch the stoma with the patient sitting up.
D)Dispose of used pouches in the toilet.
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Chapter 37: Preoperative and Postoperative Care
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25 Flashcards
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Sample Questions
Q1) The goal of prophylactic antibiotic therapy is to protect the patient from infection with as little risk as possible.To achieve this goal,the nurse recognizes that antibiotics should be administered when they will be most beneficial.When would that be?
A)Twenty-four hours before surgery
B)For 2 weeks after surgery
C)For no longer than 24 hours after surgery
D)When signs of infection first appear
Q2) In planning care for a surgical patient,the patient asks the nurse what may be "left on" during the surgery.Understanding patient safety,the nurse tells the patient that which item may remain in place?
A)Hearing aid
B)Artificial limb
C)Pair of eyeglasses
D)Pair of contact lenses
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Chapter 38: Intraoperative Care
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17 Flashcards
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Sample Questions
Q1) Which of the following are principles of sterile procedure? (Select all that apply. )
A)Gowns are sterile from the chest and shoulder to table level.
B)Sterile persons must keep hands in view and above the waist and below the neck.
C)Sterile persons must fold arms across chest with hands tucked into the axillary region.
D)Unscrubbed persons must stay at least 6 inches away from the sterile field.
E)Sterile persons may position themselves with their back to the sterile field.
Q2) While the patient is in the operating room (OR)and the OR team is gowned and gloved,the nurse recommends completion of a safety checklist.The nurse understands that the checklist verifies which of the following? (Select all that apply. )
A)Patient identity
B)Patient allergies
C)Accurate marking of surgical site
D)Patient cultural preferences
E)Questions posed by the patient
Q3) The _______________ phase begins when the patient enters the operating room suite and ends with admission to the postanesthesia care unit (PACU).
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Chapter 39: Pressure Injury Prevention and Care
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19 Flashcards
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Sample Questions
Q1) The removal of devitalized tissue in a wound is known as ______________.
Q2) The nurse is planning care for her patient who has a stage II pressure ulcer.Care should include which of the following? (Select all that apply. )
A)A heat lamp to dry the wound
B)Application of topical antibiotics
C)Nutritional assessment
D)Maintaining moisture in the wound
Q3) When skin layers adhere to the linens and deeper tissue layer move downward,________ damage occurs.
Q4) The patient with a nasogastric (NG)tube in place may experience skin breakdown:
A)in the nose.
B)on the tongue.
C)behind the ears.
D)around the lips.
Q5) A _______________ is a localized injury to the skin and/or underlying tissue,usually over a bony prominence,as a result of pressure,or pressure in combination with shear and/or friction.
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Chapter 40: Wound Care and Irrigations
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Sample Questions
Q1) What should the nurse do to reestablish the vacuum of the Hemovac system after emptying?
A)Place a safety pin on the part of the drain outside the body.
B)Replace the cap immediately after emptying.
C)Pin the drainage tubing to the patient's gown.
D)Place the Hemovac on a flat surface.
Q2) The physician expects that the patient's wound will have an output of close to 500 mL/day.The nurse anticipates placement of which of the following?
A)Dry sterile dressing
B)Jackson-Pratt (JP)drain
C)Hemovac drain
D)No drain
Q3) When teaching about wound care in the home environment,the nurse instructs the patient and caregiver to:
A)make normal saline with 8 teaspoons of salt and 1 gallon of distilled water.
B)use normal saline for 1 week and then discard it.
C)not apply topical anesthetics before wound care.
D)call the physician's office to have someone come to the home and complete the wound care.
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Page 42
Chapter 41: Dressings, Bandages, and Binders
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Sample Questions
Q1) How should the nurse proceed when applying a pressure bandage?
A)Elevate the extremity or area of bleeding.
B)Wrap pressure-bandage gauze in a proximal-to-distal direction.
C)Apply pressure to diminish the pulse to the distal body part.
D)Wrap tape around the circumference of the site to secure the gauze padding.
Q2) The nurse is demonstrating a dressing change to a nursing student.What key safety features should be emphasized during the process? (Select all that apply. )
A)Knowing the type of wound
B)Knowing the expected amount of drainage
C)Knowing the patient's blood type
D)Knowing whether drainage tubes are present
Q3) A _______________ is a clear,adherent,nonabsorptive,polyurethane moistureand vapor-permeable dressing that often is used for protection over high-friction areas and over intravenous (IV)catheters.
Q4) A __________ dressing comes in direct contact with the wound bed.
Q5) ___________ healing takes place when tissue is cleanly cut and the margins are reapproximated.
Q6) _______________ dressings are used for wounds that require debridement.
Q7) _____________ dressings cover or hold primary dressings in place.
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Chapter 42: Therapeutic Use of Heat and Cold
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23 Flashcards
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Sample Questions
Q1) When the skin is exposed to warm or hot temperatures,which of the following occurs? (Select all that apply. )
A)Vasodilatation
B)Vasoconstriction
C)Perspiration
D)Piloerection
Q2) When reviewing the documentation of patients on the unit,a nurse determines that one of the patients is at higher risk for injury from a local heat application to an extremity.Which condition poses this risk?
A)Arthritis
B)Renal calculi
C)Pulmonary disease
D)Peripheral neuropathy
Q3) Which of the following conditions would require using caution in applying cold therapy?
A)Chronic pain
B)Joint trauma
C)Circulatory insufficiency
D)Sprains
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Page 44
Chapter 43: Home Care Safety
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Sample Questions
Q1) Dementia is characterized by a gradual,progressive,irreversible _______ dysfunction.
Q2) While performing a home visit with an elderly patient,the nurse notices that the patient's dress is less tidy than in previous visits,finds an open orange juice container in the pantry cabinet instead of the refrigerator and a roll of paper towels in the refrigerator.How should the nurse respond?
A)Begin rearranging the patient's storage,and show her how it needs to be done.
B)Tell the patient that this is not acceptable.
C)Complete a Mini-Mental State Examination (MMSE)or short Geriatric Depression Scale (GDS).
D)Realize that elderly patients do things differently.
Q3) The nurse is assessing the home of an elderly patient for safety issues.Which of the following actions would reassure the nurse? (Select all that apply. )
A)Cleaning the stove top
B)Putting a shower chair in the bathroom
C)Installing adequate lighting in all living areas
D)Placing emergency numbers close to the telephone
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Chapter 44: Home Care Teaching
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Sample Questions
Q1) What does the nurse teach the patient and caregiver to do when setting up and changing administration sets for continuous tube feedings to preserve medical asepsis?
A)Add formula to formula already hung to prevent waste.
B)Store unused formula at room temperature to prevent spasm.
C)Hang only enough formula that will be infused in a 4- to 6-hour period.
D)Change the administration set every 48 hours.
Q2) The nurse will train the tracheostomy patient and caregiver that reusable supplies need to be disinfected at least weekly.Which of the following methods is recommended for cleaning tracheostomy supplies at home? (Select all that apply. )
A)Boil reusable (boilable)supplies for 5 minutes.Allow to cool and dry.
B)Boil reusable (boilable)supplies for 15 minutes.Allow to cool and dry.
C)Soak reusable supplies in equal parts of vinegar and water for 30 minutes.Remove,rinse thoroughly,and dry.
D)Soak reusable supplies in prepared solutions of quaternary ammonium chloride compounds according to the manufacturer's instructions.Rinse and dry.
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