Advanced Medical-Surgical Nursing Test
Questions
Course Introduction
Advanced Medical-Surgical Nursing is designed to deepen students' clinical judgment and critical thinking skills in the management of adult patients with complex health problems. This course covers the pathophysiology, assessment, and evidence-based management of acute and chronic conditions affecting multiple body systems, including cardiovascular, respiratory, renal, neurological, and gastrointestinal disorders. Emphasis is placed on advanced interventions, collaborative care, and the application of current research in clinical practice. Students will engage in comprehensive case studies and simulations to develop expertise in prioritizing care, recognizing and responding to changes in patient status, and coordinating interdisciplinary care in diverse healthcare settings.
Recommended Textbook
Critical Care Nursing Diagnosis and Management 8th Edition by Linda D. Urden
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41 Chapters
1210 Verified Questions
1210 Flashcards
Source URL: https://quizplus.com/study-set/2075
Page 2
Chapter 1: Critical Care Nursing Practice
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20 Verified Questions
20 Flashcards
Source URL: https://quizplus.com/quiz/41299
Sample Questions
Q1) During World War II,what type of wards were developed to care for critically injured patients?
A) Intensive care
B) Triage
C) Shock
D) Postoperative
Answer: C
Q2) What considerations are taken into account in evidence-based nursing practice?
A) Clinical expertise of the nurse
B) Availability of staff and facility equipment
C) Research evidence on the topic
D) Patient knowledge of the disease
E) Patient preference regarding care
Answer: A,C,E
Q3) Prayer,guided imagery,and massage are all examples of what type of treatment?
A) Alternative therapy
B) Holistic care
C) Complementary care
D) Individualized care
Answer: C
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Chapter 2: Ethical Issues
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19 Verified Questions
19 Flashcards
Source URL: https://quizplus.com/quiz/41300
Sample Questions
Q1) Truth-telling is an example of what ethical principle?
A) Justice
B) Beneficence
C) Autonomy
D) Nonmaleficence
Answer: C
Q2) The nurse is using the SFNO approach to case analysis to facilitate ethical decision making.Which question is important to ask when considering stakeholders?
A) Are there reasons to give priority to one stakeholder over another?
B) Will the stakeholders abide by the decision?
C) Will the stakeholders want to be present during the ethics consultation?
D) Do the stakeholders understand how to use the SFNO model?
Answer: A
Q3) What is the first step of the ethical decision-making process?
A) Consulting with an authority
B) Identifying the health problem
C) Delineating the ethical problem from other types of problems
D) Identifying the patient as the primary decision maker
Answer: B
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Page 4
Chapter 3: Legal Issues
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25 Verified Questions
25 Flashcards
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Sample Questions
Q1) Which agency is responsible for maintaining the expectations and limits of nursing practice?
A) State Hospital Association
B) Court system
C) State Board of Nursing
D) State Department of Health
Answer: C
Q2) The ability to practice as a licensed professional nurse is a privilege granted by what entity?
A) Employee contract
B) State legislature
C) State boards of nursing
D) Congress
Answer: B
Q3) Which situation would be considered a failure of proper implementation?
A) Not identifying and analyzing symptoms appropriately
B) Not documenting the patient's response to pain medication
C) Not recognizing a malfunctioning chest tube
D) Not asking the patient about code or no code wishes
Answer: B
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Chapter 4: Genetic Issues
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20 Verified Questions
20 Flashcards
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Sample Questions
Q1) What is the study of heredity particularly as it relates to the transfer heritable physical characteristics called?
A) Chromatids
B) Karyotype
C) Genetics
D) Histones
Q2) What was the Genetic Information Nondiscrimination Act (GINA)of 2008 designed to prevent from happening?
A) Abuse of genetic information in employment and health insurance decisions
B) Genetic counselors from reporting results to the health insurance companies
C) Mandatory genetics testing of all individuals with certain diseases
D) Information sharing between biobanks that are studying the same genetic disorders
Q3) A specialized class of proteins that organizes the double-stranded DNA into what looks like a tightly coiled telephone cord is known which of the following?
A) Chromatids
B) Karyotype
C) Genomics
D) Histones
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6
Chapter 5: Patient and Family Education
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25 Verified Questions
25 Flashcards
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Sample Questions
Q1) When writing goals and outcomes,what should be incorporated in the outcome statement?
A) An action oriented intervention list
B) An observable verb
C) The objectives for the nurse
D) The length of the education session
Q2) According to Malcolm Knowles' andragogy,what are characteristics of the adult learner?
A) Autonomy
B) Experience
C) Instructor-driven assessments
D) Peer-directed motivation
E) Individualism
Q3) Which questions can a nurse use to obtain assessment information to determine the immediate need for education?
A) "How can we help you today?"
B) "Can you tell me why you take each medication?"
C) "Are you in pain?"
D) "Are these people your main support system?"
E) "How well do you understand the directions?"
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Chapter 6: Psychosocial and Spiritual Alterations and Management
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25 Verified Questions
25 Flashcards
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Sample Questions
Q1) A patient is admitted with the diagnosis of gunshot wound to the head due to a suicide attempt.While the patient is in the critical care unit,the plan of care should include which intervention?
A) Limiting interaction with the patient due to antisocial behaviors exhibited by the suicidal attempt
B) Overlooking the patient's need to talk about the incident
C) Validating the patient's worth and self-esteem
D) Discontinuing any psychotropic medications
Q2) Which statement regarding patients with an external locus of control is true?
A) They believe that they can influence the outcome of their illness.
B) They should be forced to take control of their discharge planning.
C) They usually start out with an internal locus of control until a major illness occurs.
D) They believe that events are related to chance or fate.
Q3) Anxiety can cause emotional changes in which part of the brain?
A) Hypothalamus
B) Limbic system
C) Cerebral cortex
D) Pituitary gland
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Chapter 7: Nutrition Alterations and Management
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30 Verified Questions
30 Flashcards
Source URL: https://quizplus.com/quiz/41305
Sample Questions
Q1) Proteins are energy-yielding nutrients that provide important structural and functional duties within the body.What is one important physiologic function of proteins?
A) Maintaining osmotic pressure
B) Providing minerals in the body
C) Maintaining blood glucose
D) Providing a stored source of energy
Q2) The patient is receiving corticosteroid treatment for neurologic alterations.The patient should be routinely monitored for what common complication of this type of therapy?
A) Hyponatremia
B) Hyperalbuminemia
C) Hyperkalemia
D) Hyperglycemia
Q3) Which signs would alert the nurse to possible nutritional alterations?
A) Impaired wound healing
B) Edema
C) Nail growth
D) Muscle atrophy
E) Diaphoresis
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Page 9
Chapter 8: Pain and Pain Management
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20 Verified Questions
20 Flashcards
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Sample Questions
Q1) Which assessment findings might indicate respiratory depression after opioid administration?
A) Flushed, diaphoretic skin
B) Shallow respirations with a rate of 24 breaths/min
C) Tense, rigid posture
D) Snoring
Q2) What are the neural processes of encoding and processing noxious stimuli associated with pain called?
A) Perception
B) Nociception
C) Transduction
D) Transmission
Q3) C fibers are small-diameter,unmyelinated fibers that transmit what type of pain?
A) Aching
B) Sharp
C) Prickling
D) Concentrated
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10
Chapter 9: Sedation,Agitation,and Delirium Management
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20 Verified Questions
20 Flashcards
Source URL: https://quizplus.com/quiz/41307
Sample Questions
Q1) What are the risk factors for delirium?
A) Hypertension, alcohol abuse, and benzodiazepine administration
B) Coma, hypoxemia, and trauma
C) Dementia, hypertension, and pneumonia
D) Coma, alcohol abuse, hyperglycemia
Q2) A patient is admitted with acute respiratory distress syndrome (ARDS).The patient has been intubated and is mechanically ventilated.The patient is becoming increasingly agitated,and the high-pressure alarm on the ventilator has been frequently triggered.Despite the nurse's actions,the patient continues to be agitated,triggering the high-pressure alarm on the ventilator.Which medication would be appropriate to sedate the patient this time?
A) Midazolam 2 to 5 mg intravenous push (IVP) every 5 to 15 minutes until the patient is no longer triggering the alarm
B) Haloperidol 5 mg IVP stat
C) Propofol 5 mcg/kg/min by IV infusion
D) Fentanyl 25 mcg IVP over a 15-minute period
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Chapter 10: End-Of-Life Care
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19 Verified Questions
19 Flashcards
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Sample Questions
Q1) A patient was admitted several weeks ago with an acute myocardial infarction and subsequently underwent coronary artery bypass grafting surgery.Since a cardiac arrest 5 days ago,the patient has been unresponsive.An electroencephalogram shows no meaningful brain activity.The patient is placed on a morphine drip to alleviate suspected operative pain and assist in sedation.The patient continues to grimace and fight the ventilator.What nursing intervention would be appropriate?
A) Increase the morphine dosage until no signs of pain or discomfort are present.
B) Increase the morphine drip, but if the patient's respiratory rate drops below 10 breaths/min, return to the original dosage.
C) Gradually decrease the morphine and switch to Versed to avoid respiratory depression.
D) Ask the family to leave the room because their presence is causing undue stress to the patient.
Q2) What is the most common complaint heard from families of dying patients?
A) Poor nursing care
B) Inadequate communication
C) Lack of consistent plan of care
D) Confusion among health care team members
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Chapter 11: Cardiovascular Anatomy and Physiology
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25 Verified Questions
25 Flashcards
Source URL: https://quizplus.com/quiz/41309
Sample Questions
Q1) What is the normal resting membrane potential of a myocardial cell?
A) 10 to 20 mV
B) 30 to 40 mV
C) -20 to -30 mV
D) -80 to -90 mV
Q2) Which of the following is most descriptive of the capillary?
A) Large diameter, low pressure
B) Small diameter, high pressure
C) Large diameter, high pressure
D) Small diameter, low pressure
Q3) The atrioventricular (AV)node delays the conduction impulse from the atria (0.8-1.2 seconds)for what reasons?
A) To limit the amount of blood that fills the ventricle from the atria
B) To provide time for the ventricles to fill during diastole
C) To limit the number of signals the ventricles receive in some rhythms
D) To allow the atria to rest between signals
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Chapter 12: Cardiovascular Clinical Assessment
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25 Verified Questions
25 Flashcards
Source URL: https://quizplus.com/quiz/41310
Sample Questions
Q1) Abnormal heart sounds are labeled S3 and S4 and are referred to as what when auscultated during a tachycardic episode?
A) Korotkoff sounds
B) Grating murmurs
C) Blowing murmurs
D) Gallops
Q2) The nurse assesses the dorsalis pedis and posterior tibial pulses as weak and thready.What should the nurse document for the pulse volume?
A) 0
B) 1+
C) 2+
D) 3+
Q3) When checking the patient's back,the nurse pushes her thumb into the patient's sacrum.An indentation remains.What assessment finding should the nurse document?
A) Sacral compromise
B) Delayed skin turgor
C) Pitting edema
D) Dehydration
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14
Chapter 13: Cardiovascular Diagnostic Procedures
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74 Verified Questions
74 Flashcards
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Sample Questions
Q1) What is the target range for an international normalized ratio (INR)?
A) 1.0 to 2.0
B) 1.5 to 3.0
C) 1.5 to 2.5
D) 2.0 to 3.0
Q2) A patient returns from the cardiac catheterization laboratory after angioplasty and stent placement (ECG changes had indicated an inferior wall myocardial infarction in progress).Which lead would best monitor this patient?
A) Varies based on the patient's clinical condition and recent clinical history
B) Lead V3
C) Lead V1
D) Lead II
Q3) Which statement made by a patient would indicate the need for further education before an electrophysiology procedure?
A) "I need to take all my heart medications the morning of the procedure."
B) "The doctor is going to make my heart beat wrong on purpose."
C) "I will be awake but relaxed during the procedure."
D) "I will be x-rayed during the procedure."
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15
Chapter 14: Cardiovascular Disorders
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34 Verified Questions
34 Flashcards
Source URL: https://quizplus.com/quiz/41312
Sample Questions
Q1) A patient is admitted with an acute inferior myocardial infarction (MI).A 12-lead electrocardiogram (ECG)is done to validate the area of infarction.Which finding on the ECG is most conclusive for infarction?
A) Inverted T waves
B) Tall, peaked T waves
C) ST segment depression
D) Pathologic Q waves
Q2) Which clinical manifestation is usually the first symptom of peripheral arterial disease (PAD)?
A) Cramping when walking
B) Thrombophlebitis
C) Pulmonary embolism
D) Cordlike veins
Q3) The nurse is caring for a patient with left-sided heart failure.The nurse suspects the patient is developing pulmonary edema.Which finding would confirm the nurse's suspicions?
A) Pulmonary crackles
B) Peripheral edema
C) Pink, frothy sputum
D) Elevated central venous pressure
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Chapter 15: Cardiovascular Therapeutic Management
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35 Verified Questions
35 Flashcards
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Sample Questions
Q1) Why are vasopressors used cautiously in the treatment of critical care patients?
A) They cause vasoconstriction of the smooth muscles.
B) They cause vasodilation of the smooth muscles.
C) They increase afterload.
D) They decrease preload.
Q2) Which calcium channel blocker is beneficial in the treatment of patients with coronary artery disease or ischemic stroke?
A) Nifedipine
B) Nicardipine
C) Clevidipine
D) Diltiazem
Q3) A patient has an implantable cardioverter defibrillator (ICD)for chronic ventricular tachydysrhythmias.What action should the nurse take when the patient's rhythm deteriorates to ventricular fibrillation?
A) Apply an external defibrillator to the patient.
B) Call a code and start cardiopulmonary resuscitation (CPR) on the patient.
C) Wait for the ICD to defibrillate the patient.
D) Turn the ICD off and administer epinephrine.
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17
Chapter 16: Pulmonary Anatomy and Physiology
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40 Verified Questions
40 Flashcards
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Sample Questions
Q1) What anatomic regions are considered physiologic dead space?
A) Respiratory bronchiole and unperfused alveoli
B) Trachea and perfused alveoli
C) Trachea and unperfused alveoli
D) Trachea and mainstem bronchi
Q2) The oxygen saturation of a healthy individual rarely reaches 100% on room air.This can best be explained by what concept?
A) Physiologic shunting
B) Alveolar capillary diffusion
C) Collateral air passages
D) Anatomic dead space
Q3) The lobes are divided into 18 segments.How many are on the right lung?
A) 3
B) 8
C) 10
D) 15
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18
Chapter 17: Pulmonary Clinical Assessment
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30 Verified Questions
30 Flashcards
Source URL: https://quizplus.com/quiz/41315
Sample Questions
Q1) A patient is admitted with acute respiratory failure secondary to pneumonia.Upon auscultation,the nurse hears creaking,leathery,coarse breath sounds in the lower anterolateral chest area during inspiration and expiration.This finding is indicative of what condition?
A) Emphysema
B) Atelectasis
C) Pulmonary fibrosis
D) Pleural effusion
Q2) What assessment technique involves having the patient breathe in and out slowly with an open mouth?
A) Inspection
B) Palpation
C) Percussion
D) Auscultation
Q3) Which statement describes the major difference between tachypnea and hyperventilation?
A) Tachypnea has increased rate; hyperventilation has decreased rate.
B) Tachypnea has decreased rate; hyperventilation has increased rate.
C) Tachypnea has increased depth; hyperventilation has decreased depth.
D) Tachypnea has decreased depth; hyperventilation has increased depth.
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Chapter 18: Pulmonary Diagnostic Procedures
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30 Verified Questions
30 Flashcards
Source URL: https://quizplus.com/quiz/41316
Sample Questions
Q1) A bronchoscopy is indicated for a patient with what condition?
A) Pulmonary edema
B) Ineffective clearance of secretions
C) Upper gastrointestinal bleed
D) Instillation of surfactant
Q2) A patient is admitted with acute lung failure secondary to pneumonia.Arterial blood gas (ABG)values on the current ventilator settings are pH,7.37; PaCO ,50 mm Hg; and HCO ¯,27 mEq/L.What is the correct interpretation of the patient's ABG values?
A) Compensated respiratory acidosis
B) Compensated metabolic alkalosis
C) Uncompensated respiratory alkalosis
D) Uncompensated metabolic acidosis
Q3) Ventilation-perfusion (V/Q)scans are ordered to evaluate the possibility of which of the following?
A) Pulmonary emboli
B) Acute myocardial infarction
C) Emphysema
D) Acute respiratory distress syndrome
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Chapter 19: Pulmonary Disorders
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24 Verified Questions
24 Flashcards
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Sample Questions
Q1) Which therapeutic measure would be the most effective in treating hypoxemia in the presence of intrapulmonary shunting associated with acute respiratory distress syndrome (ARDS)?
A) Sedating the patient to blunt noxious stimuli
B) Increasing the FiO on the ventilator
C) Administering positive-end expiratory pressure (PEEP)
D) Restricting fluids to 500 mL per shift
Q2) What condition develops when air enters the pleural space from the lung on inhalation and cannot exit on exhalation?
A) Tension pneumothorax
B) Sucking chest wound
C) Open pneumothorax
D) Pulmonary interstitial empyema
Q3) What psychologic factors contribute to long-term mechanical ventilation dependence?
A) Fear
B) Delirium
C) Lack of confidence
D) Depression
E) Trust in the stuff
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Chapter 20: Pulmonary Therapeutic Management
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30 Verified Questions
30 Flashcards
Source URL: https://quizplus.com/quiz/41318
Sample Questions
Q1) Which interventions minimize the complications associated with suctioning an artificial airway?
A) Hyperoxygenate the patient prior to the start of the procedure
B) Hyperoxygenate the patient after each pass of the suction catheter
C) Limit the duration of each suction pass to 20 seconds
D) Instill 5 to 10 mL of normal saline to facilitate secretion removal
E) Use intermittent suction to avoid damaging tracheal tissue
Q2) Which of the following are complications of endotracheal tubes?
A) Tracheoesophageal fistula
B) Cricoid abscess
C) Tracheal stenosis
D) Tube obstruction
E) Hemorrhage
Q3) A patient with acute lung failure has been on a ventilator for 3 days and is being considered for weaning.When entering the room,the ventilator inoperative alarm sounds.What action should the nurse take FIRST?
A) Troubleshoot the ventilator until the problem is found.
B) Take the patient off the ventilator and manually ventilate.
C) Call the respiratory therapist for help.
D) Silence the ventilator alarms until the problem is resolved.
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Chapter 21: Neurologic Anatomy and Physiology
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30 Verified Questions
30 Flashcards
Source URL: https://quizplus.com/quiz/41319
Sample Questions
Q1) What is the large opening at the base of the cranium called?
A) Cisterna magna
B) Median foramen
C) Foramen magnum
D) Lateral foramen
Q2) A patient with neurologic damage continues with extremely high core body temperature despite interventions to lower temperature.The nurse suspects the patient has sustained damage to which area of the brain?
A) Cerebrum
B) Cerebellum
C) Thalamus
D) Hypothalamus
Q3) Which type of hematoma results from traumatic injury involving the middle meningeal artery?
A) Subdural
B) Epidural
C) Subarachnoid
D) Intercerebral
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23
Chapter 22: Neurologic Clinical Assessment and Diagnostic
Procedures
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49 Verified Questions
49 Flashcards
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Sample Questions
Q1) Considering anatomic location,which cranial nerve will be affected first by downward pressure onto the infratentorial structures?
A) III
B) VI
C) IX
D) X
Q2) The nurse is precepting a new graduate nurse.The new graduate asks about testing the oculovestibular reflex.What should the nurse tell the new graduate?
A) The test should not be performed on an unconscious patient because of the risk of aspiration.
B) An abnormal response is manifested by conjugate, slow, tonic nystagmus, deviating toward the irrigated ear.
C) This test should be included in the nursing neurologic examination of a patient with a head injury.
D) This test is one of the final clinical assessments of brainstem function.
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Chapter 23: Neurologic Disorders and Therapeutic Management
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44 Verified Questions
44 Flashcards
Source URL: https://quizplus.com/quiz/41321
Sample Questions
Q1) Which patient has the best prognosis based on the cause of coma?
A) A 36-year-old man with closed head injury
B) A 50-year-old woman with hepatic encephalopathy
C) A 46-year-old woman with subarachnoid hemorrhage
D) A 72-year-old man with hypertensive intracerebral hemorrhage
Q2) A female right-handed patient has been admitted with an intracerebral hemorrhage.A computed tomography (CT)scan of the patient's head reveals a large left parietal area bleed.While assisting with personal care,the nurse notes that the patient is unable to comb her hair with her left hand.The nurse suspects the patient may be experiencing which complication?
A) Agnosia
B) Apraxia
C) Broca aphasia
D) Wernicke aphasia
Q3) Which medication is prescribed to decrease cerebral vasospasm?
A) Phenytoin
B) Phenobarbital
C) Nimodipine
D) Vecuronium
Page 25
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Chapter 24: Kidney Anatomy and Physiology
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Sample Questions
Q1) The initial filtering of the blood occurs in which structure?
A) The distal tubule
B) The proximal tubule
C) The glomerulus
D) The collecting tubule
Q2) Maintaining a normal range of serum potassium is important for what physiologic process?
A) Fluid regulation
B) Acid-base buffering
C) Nervous impulse conduction
D) Triggering antidiuretic hormone (ADH) release
Q3) When a patient's blood pressure drops,which physiologic mechanism helps maintain adequate glomerular blood flow?
A) Constriction of the afferent arteriole
B) Dilation of the efferent arteriole
C) Dilation of the collecting tubule
D) Constriction of the efferent arteriole
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Chapter 25: Kidney Clinical Assessment and Diagnostic Procedures
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20 Flashcards
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Sample Questions
Q1) A patient was admitted with acute kidney failure.Which urinalysis value reflects a decreased ability of the kidneys to concentrate urine?
A) pH of 5.0
B) Specific gravity of 1.000
C) No casts
D) Urine sodium of 140 mEq/24 h
Q2) A patient is admitted in acute heart failure secondary to renal insufficiency.The patient reports that over the past few weeks,his urine output has decreased,and he has developed peripheral edema and ascites.Which diagnostic tests would provide the best information about the internal kidney structures,such as the parenchyma,calyces,pelvis,ureters,and bladder?
A) Kidney-ureter-bladder (KUB)
B) Intravenous pyelography (IVP)
C) Renal ultrasonography (ECHO)
D) Renal angiography
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Chapter 26: Kidney Disorders and Therapeutic Management
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Sample Questions
Q1) A patient is admitted with sepsis and acute kidney injury (AKI).The patient is started on continuous renal replacement therapy (CRRT).The nurse knows that fluid that is removed each hour is charted as what on the CRRT flowsheet?
A) Convection
B) Diffusion
C) Replacement fluid
D) Ultrafiltrate
Q2) A patient was admitted with liver failure and acute kidney injury (AKI).Which intravenous solution should the nurse question if it were ordered for this patient?
A) D5W
B) 0.9% NaCl
C) Lactated Ringer solution
D) 0.45% NaCl
Q3) Which diuretics maybe combined to work on different parts of the nephron?
A) Loop and thiazide diuretics
B) Loop and osmotic diuretics
C) Osmotic and carbonic anhydrase inhibitor diuretics
D) Thiazide and osmotic diuretics
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Chapter 27: Gastrointestinal Anatomy and Physiology
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20 Verified Questions
20 Flashcards
Source URL: https://quizplus.com/quiz/41325
Sample Questions
Q1) When the ileum is distended,the ileogastric reflex inhibits what process?
A) Gastric absorption
B) Absorption in the jejunum
C) Gastric motility
D) Ileum motility
Q2) A patient has been admitted in acute liver failure.The nurse knows that the synthesis of fibrinogen is affected and will result in what problem?
A) Jaundice
B) Fluid retention and ascites
C) Delayed clotting
D) Hepatomegaly
Q3) What vessel delivers nutrient-rich blood from the gut,pancreas,spleen,and stomach to the liver?
A) Hepatic artery
B) Hepatic vein
C) Portal vein
D) Interlobular veins
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Chapter 28: Gastrointestinal Clinical Assessment and Diagnostic Procedures
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28 Verified Questions
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Sample Questions
Q1) The nurse has been caring for a patient with liver dysfunction.The practitioner has just performed a liver biopsy at the bedside.Following a liver biopsy,how would the nurse position the patient?
A) Left side for 2 hours
B) Right side for 2 hours
C) Left side for 6 to 8 hours
D) Right side for 6 to 8 hours
Q2) Preprocedural teaching of a patient undergoing a liver scan should include which instruction?
A) Drink at least 500 mL of fluids before the procedure.
B) Remain flat in bed for 12 hours after the procedure.
C) Stay flat and still during the procedure.
D) Sedation will be provided during the procedure.
Q3) What anatomic structures are part of inspection of the gastrointestinal system?
A) Teeth
B) Gums
C) Skin
D) Spleen
E) Abdomen
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Chapter 29: Gastrointestinal Disorders and Therapeutic Management
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Q1) A patient with a history of chronic alcoholism was admitted with acute pancreatitis.What intervention would the nurse include in the patient's plan of care?
A) Monitor the patient for hypovolemic shock from plasma volume depletion.
B) Observe the patient for hypoglycemia and hypercalcemia.
C) Initiate enteral feedings after the nasogastric tube is placed.
D) Place the patient on a fluid restriction to avoid the fluid sequestration.
Q2) An older patient reports taking cimetidine for several years.The nurse knows that this medication can cause central nervous system side effects.For what side effect would the nurse monitor the patient?
A) Tremors
B) Dizziness
C) Confusion
D) Hallucinations
Q3) Which nursing intervention is a priority for a patient with gastrointestinal hemorrhage?
A) Positioning the patient in a high-Fowler position
B) Ensuring the patient has a patent airway
C) Irrigating the nasogastric tube with iced saline
D) Maintaining venous access so that fluids and blood can be administered
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Chapter 30: Endocrine Anatomy and Physiology
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Q1) A patient is receiving insulin due to the development of steroid-induced hyperglycemia.In addition to lowering blood glucose levels,what other physiologic effect may occur when insulin is administered?
A) Breakdown of proteins
B) Hypercalcemia
C) Hypokalemia
D) Cellular dehydration
Q2) A patient has been admitted with a brain tumor.The patient starts to exhibit signs of an increase in antidiuretic hormone (ADH).When large amounts of ADH are released,the nurse should anticipate what change in the patient's sodium levels?
A) Increase
B) Decrease
C) Rapid increase than decrease
D) Depends on potassium level
Q3) Glucagon release is stimulated by which physiologic factor?
A) Increases in circulating insulin
B) Decreases in blood amino acids
C) Stimulation of the sympathetic nervous system
D) High blood glucose levels
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Chapter 31: Endocrine Clinical Assessment and Diagnostic Procedures
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Q1) A patient is admitted with hypernatremia secondary to diabetes insipidus (DI).Which test would help the practitioner differentiate between central and nephrogenic DI?
A) Water deprivation test
B) Serum osmolality
C) Serum antidiuretic hormone level
D) Antidiuretic hormone (ADH) test
Q2) A patient has been admitted with multiple trauma due to a motor vehicle accident several weeks ago.Given the prolonged critical illness,the nurse knows the patient may no longer secrete adequate amounts of what hormone?
A) Aldosterone
B) Adrenocorticotropic hormone (ACTH)
C) Cortisol
D) Antidiuretic hormone (ADH)
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Chapter 32: Endocrine Disorders and Therapeutic Management
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Q1) Which pathophysiologic mechanism occurs in the syndrome of inappropriate antidiuretic hormone (SIADH)?
A) Massive diuresis, leading to hemoconcentration
B) Dilutional hyponatremia, reducing sodium concentration to critically low levels
C) Hypokalemia from massive diuresis
D) Serum osmolality greater than 350 mOsm/kg
Q2) A patient weighs 140 kg and is 60 inches tall.The patient's blood sugar is being controlled by glipizide.Which topic would be important for the nurse to include in the patient's discharge education plan?
A) Signs of hyperglycemia
B) Proper injection technique
C) Weight loss
D) Increased caloric intake
Q3) Decreased urine osmolality is a sign of which disorder?
A) Hyperglycemia
B) Diabetes insipidus
C) Thyroid crisis
D) Syndrome of inappropriate secretion of antidiuretic hormone
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Chapter 33: Trauma
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Q1) A patient with multisystem trauma has been in the intensive care unit (ICU)for 6 days.The patient is still intubated and mechanically ventilated and has a chest tube,urinary drainage catheter,nasogastric tube,and two abdominal drains.The patient's vital signs include blood pressure (BP),92/66 mm Hg; heart rate (HR),118 beats/min; temperature (T),38.7° C; and central venous pressure (CVP),5 mm Hg.What is the most likely cause of this hemodynamic picture?
A) Septic shock
B) Hemorrhagic shock
C) Cardiogenic shock
D) Neurogenic shock
Q2) A patient has been admitted with muscle trauma and crush injuries.The nurse understands that this patient is at high risk for the development of acute kidney injury secondary to rhabdomyolysis.Which findings would suggest the patient is developing this complication?
A) Dark tea-colored urine
B) Decreased urine output
C) Hypoxemia
D) Diminished pulses
E) Increased serum creatine kinase level
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Chapter 34: Shock,sepsis,and Multiple-Organ Dysfunction Syndrome
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Q1) A patient is being admitted with cardiogenic shock secondary to acute heart failure.In addition to a diuretic,which medication would the nurse anticipate the practitioner ordering for the patient?
A) Epinephrine
B) Nitroprusside
C) Dobutamine
D) Nitroglycerine
Q2) The nurse is caring for a patient in cardiogenic shock.Which hemodynamic parameters would the nurse expect to note to support this diagnosis?
A) Increased right atrial pressure
B) Decreased pulmonary artery wedge pressure
C) Increased cardiac output
D) Decreased cardiac index
Q3) The nurse is caring for a patient with systemic inflammatory response syndrome (SIRS)due to pneumonia.What is SIRS due to infection called?
A) Infectivity
B) Anaphylaxis
C) Sepsis
D) Acute respiratory distress syndrome (ARDS)
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Chapter 35: Burns
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Q1) Which topical antimicrobial agent is commonly used as a broad-spectrum and fights against gram-positive and -negative bacteria?
A) Pure silver
B) Bacitracin
C) Mafenide acetate cream
D) Silver sulfadiazine
Q2) A patient is admitted after being burned in a car fire.The wound surface is red with patchy white areas that blanch with pressure but no blister formation.What kind of burn would the nurse document in the patient's record?
A) Superficial partial-thickness burn
B) Moderate partial-thickness burn
C) Deep dermal partial-thickness burn
D) Full-thickness burn
Q3) What is a leading cause of death in the hospitalized burn patient?
A) Smoke inhalation
B) Infection
C) Burn shock
D) Renal failure
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Chapter 36: Organ Donation and Transplantation
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Q1) After a pancreatic transplant with bladder exocrine drainage,the nurse would anticipate which order?
A) Continuous bladder irrigation
B) Intermittent insulin injections
C) Removal of the nasogastric tube as soon as the patient is alert
D) Daily hematocrit and hemoglobin levels
Q2) What happens to patients that meet criteria for imminent death?
A) They are placed on life support and referred to the organ procurement organizations.
B) They are referred to the organ procurement organizations at the time of their death.
C) They are referred to the organ procurement organizations in a timely manner.
D) They are referred to a practitioner to make the decision if they are candidates for organ donation.
Q3) Who determines the medical suitability of the patient for organ donation?
A) The organ procurement organization (OPO) coordinator
B) The patient's family
C) The admitting health care provider
D) The transplant team
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Chapter 37: Hematologic and Oncologic Emergencies
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Q1) A patient was admitted with gram-negative sepsis a few days ago.Today the nurse notes continual oozing from intravenous sites and ecchymosis beneath the blood pressure cuff.The patient's platelet count is normal,and international normalized ratio (INR)is elevated.What other laboratory value would be valuable in definitively diagnosing the patient's condition?
A) Fibrin split products
B) D-Dimer level
C) Bleeding time
D) White blood cell count
Q2) The nurse is caring for a patient with type 2 heparin-induced thrombocytopenia (HIT).The nurse knows that pulmonary embolism is a serious complication of HIT.Which findings would alert the nurse to the presence of this complication?
A) Blanching of fingers and toes and loss of peripheral pulses
B) Chest pain, pallor, and confusion
C) Headache, impaired speech, and loss of motor function
D) Dyspnea, pleuritic pain, and rales
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Chapter 38: The Obstetric Patient
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Q1) A patient who is 32 weeks pregnant is admitted with a pneumothorax.What must the practitioner consider when placing a chest tube?
A) The diaphragm has been displaced 4 cm upward from its original location.
B) The diaphragm has been flattened and displaced 2 cm downward.
C) The lungs have shrunk to accommodate for the increase in abdominal size.
D) The lower lobes are one-half of their original size.
Q2) A multiparous woman was admitted at 36 weeks' gestation for nausea,vomiting,and severe epigastric pain.The fetal heart rate was normal.Severe preeclampsia was diagnosed.What is the treatment goal for this patient?
A) Maintaining maternal blood pressure greater than 140/90 mm Hg
B) Delaying delivery of the fetus as long as possible
C) Preventing maternal seizures, which may compromise fetal oxygenation
D) Limiting fluid intake to avoid postpartum edema.
Q3) What is the most common cause of obstetric cardiac arrest in pregnancy?
A) Anesthetic complications
B) Idiopathic peripartum cardiomyopathy
C) Pregnancy-induced hypertension
D) Hemorrhage
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Chapter 39: The Pediatric Patient
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Q1) The patient is a 1-month-old infant with stable supraventricular tachycardia (SVT)at a rate of 250 beats/min.She weighs 6 kg.How much adenosine should be given?
A) 0.05 mg rapid IV push
B) 0.1 mg rapid IV push
C) 0.6 mg rapid IV push
D) 0.5 mg rapid IV push
Q2) A 4-year-old child is admitted to the critical care unit with fever,chills,headache,vomiting,lethargy,photophobia,and nuchal rigidity.The patient has been unable to eat,and tube feedings are to be initiated.What is the preferred method for determining the insertion length of the nasogastric tube?
A) Measure from the naris to ear to xiphoid process.
B) Measure from the ear to the umbilicus.
C) Measure from the naris to the xiphoid to ear.
D) Measure from the naris to ear to a point between the xiphoid process and the umbilicus.
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Chapter 40: The Older Adult Patient
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Q1) Which parameter remains unchanged in an older person when he or she exercises?
A) Cardiac output
B) Heart rate
C) Blood pressure
D) Heart rhythm
Q2) An 82-year-old patient was admitted for pneumonia.The nurse knows that there are a number of age-related pulmonary changes that may affect this patient.What change would the nurse expect to find?
A) Increased tidal volumes
B) Weakening of intercostal muscles and the diaphragm
C) Improved cough reflex
D) Decreased sensation of the glottis
Q3) What is the chemical change in a drug called that renders it active or inactive?
A) Absorption
B) Metabolism
C) Excretion
D) Distribution
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Chapter 41: The Perianesthesia Patient
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Q1) Which of the following dysrhythmias are common in the postanesthetic period?
A) Ventricular tachycardia
B) Ventricular fibrillation
C) Supraventricular tachydysrhythmias
D) Sinus bradycardia
E) Premature ventricular contractions
Q2) Nursing management of a postoperative patient who is experiencing prolonged vomiting might benefit from which intervention?
A) Withholding all pain medication until the nausea has subsided
B) Removing the nasogastric tube
C) Inserting an oral airway
D) Increasing intravenous fluids
Q3) The nurse is assisting with intubation of a patient.Which depolarizing skeletal muscle relaxant medication would the nurse anticipate being given to the patient?
A) Succinylcholine
B) Pancuronium
C) Mivacurium
D) Rocuronium
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