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NURS MED SURG MSN 5410 EXAM QUESTIONS WITH ANSWERS 2023 A+ SUCCESS ASSUARED
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NURS MED SURG MSN 5410 EXAM QUESTIONS WITH ANSWERS 2023 A+ SUCCESS ASSUARED
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NURS MED SURG MSN 5410 EXAM QUESTIONS WITHANSWERS 2023 A+ SUCCESS ASSUARED
1- UTERO ATONY- first thing we do when we see utero relax and mommy has s&s
of hemorrhage (hypovolemis shock)—
1st intervention we do : assess for boggy uterus and the
1st nursing intervention is – Massage the uterus and also assess for bladder
The nurse finds a 6-hour postpartum client sitting in a pool of blood. The client's skin is cool and clammy. Blood pressure is 88/55
mm Hg, pulse is 120 bpm, and respirations are 40 breaths per minute. Which action does the nurse take first?
a. Runs to the nurse’s station to get help and notifies the health care provider.
b. Places the client in high Fowler's position and applies oxygen by nasal cannula.
c. Gently massages the client's uterus with two hands, and verbally calls for help.
d. Inserts an indwelling urinary catheter and increases the client's IV fluid rate.
Which nursing action is
most appropriate to correct a boggy uterus that is displaced above and to the right of the umbilicus?
a. Notify the physician of an impending hemorrhage.
b. Assess the blood pressure and pulse.
c. Evaluate the lochia.
d. Assist the patient in emptying her bladder.
ANS: D
Urinary retention may cause overdistention of the urinary bladder, which lifts and
displaces the uterus. Nursing actions need to be implemented before notifying the physician. It
is important to evaluate blood pressure, pulse, and lochia if the bleeding continues; however, the
focus at this point in time is to assist the patient in emptying her bladder.
2- PKU—Before discharge baby from hospital PKU needs to be performed by obtaining
blood from the heel 24-72 hr after baby born and the baby had been fed either
breastmilk or formula. What is to expect to see a musky odor urine(biggest S&S) if
the levels are high baby will suffer mental retardation
What is the teaching for that? Recommend parent low protein diet
What kind of cereal will be recommended
for pte’s w/PKU –LOFENOLAC
A low phenylalanine diet is prescribed for a 4-year-old with phenylketonuria (PKU). The nurse evaluates
that the mother understands her child's dietary restrictions if she eliminates which food from the child's
diet?
a.Sliced apples.
b.French fries.
,NURS MED SURG MSN 5410 EXAM QUESTIONS WITH
ANSWERS 2023 A+ SUCCESS ASSUARED
c.Fruit juices.
d.Cheese sandwich
ANS: D
ANS: Cheese sandwich
Phenylalanine, an essential amino acid, is found in protein-containing foods, especially milk, dairy products
such as cheese (D), and meat. Fruits, vegetables, and breads are low in phenylalanine. (A), or fruit in
general, is allowed on a phenylalanine diet. (B) is high in fat and has little food value but is within the
dietary restrictions. (C) would be allowed on a low phenylalanine diet.
A client is preparing to take her 1-day-old infant home from the hospital. The nurse discusses the test for
phenylketonuria (PKU) with the mother. The nurse’s teaching should be based on an understanding that
the test is most reliable after which of the following?
a.a source of protein has been ingested
b.the meconium has been excreted.
c.the danger of hyperbilirubinemia has passed.
d.the effects of delivery have subsided.
Needed Info: PKU: genetic disorder caused by a deficiency in liver enzyme phenylalanine hydroxylase.
Body can’t metabolize essential amino acid phenylalanine, allows phenyl acids to accumulate in the blood.
If not recognized, resultant high levels of phenylketone in the brain cause mental retardation. Guthrie test:
screening for PKU. Treatment: dietary restriction of foods containing phenylalanine. Blood levels of
phenylalanine monitored to evaluate the effectiveness of the dietary restrictions.
3- TPN:
Complications: hypoglicemia and hyperglicemia- no need have a doctor order- nurse needs to
follow Blood Sugar every 4hr.TPN is giving for 2 purposes; pte will be on NPO for long time
(30 days if problem no resolve doctor will put a different order). TPN central line= PICC , TPN
contain a lot of glucose molecules inside and that’s why the patient is at risk or hypo or
hyperglycemia. The peripheral line to administer the fact emulsification. The TPN cannot stop
abruptly because will have S&S of hypoglycemia- the rate needs to be decreased to be
discontinuous.
The client has been receiving total parenteral nutrition (TPN) for several days. The central venous
access device became dislodged and the nurse notes that the TPN has not been running for several hours.
The nurse would monitor the client for which of the following complications related to the stopped TPN
infusion?
a. Hypocalcemia
b. Hypoglycemia
c. Sepsis
d. Hyperkalemia
,NURS MED SURG MSN 5410 EXAM QUESTIONS WITH
ANSWERS 2023 A+ SUCCESS ASSUARED
Hypoglycemia = The client's body has adjusted to higher blood glucose levels as a result of receiving TPN
with high dextrose concentrations. Abruptly stopping TPN can result in hypoglycemia. The other answers
are incorrect.
4- TETRALOGY OF FALLOT: a congenital malformation a cyanotic effect, heart congenital
malformation . what is the reason when the baby is suffering from this condition a cyanotic defect
will means that the blood that will be transport from the left ventricle to the rest of the body will no
carry oxygen and that’s the reason baby will present cyanotic. They will develop hypercyanotic
texpell no oxygen at all—place the baby in a squatting position will increased the venous return
back to the heart and release the cyanotic S&S of the baby. What is the reason to place the baby in
squatting position?
When a father asks why his child with tetralogy of Fallot seems to favor a squatting position, the
nurse would explain that squatting:
a. increases the return of venous blood back to the heart.
b. decreases arterial blood flow away from the heart.
c. is a common resting position when a child is tachycardic.
d. increases the workload of the heart.
ANS: A
e. The squatting position allows the child to breathe more easily because systemic venous return is
increased.
The nurse explained how to position an infant with tetralogy of Fallot if the infant suddenly becomes
cyanotic. The nurse can determine the father understood the instructions when he states “If the baby turns
blue, I will:
a. place the baby with his knees bent up toward his chest.”
b. lay him down on a firm surface with his head lower than the rest of his body.”
c. immediately put the baby upright in an infant seat.”
d. put the baby in supine position with his head elevated.”
ANS: A
In the event of a paroxysmal hypercyanotic or “tet” spell, the infant should be placed in a knee-chest
position.
▶ Tetralogy of Fallot – Four defects that result in mixed blood flow: Pulmonary stenosis - Ventricular
septal defect - Overriding aorta- Right ventricular hypertrophy
▶ Signs and Symptoms:
➢ Cyanosis, severe dyspnea, clubbing of the fingers, hyper-cyanotic spells, and acidosis
➢ Murmur, polycythemia, and clot formation
➢ Child frequently assuming a squatting position (decreases venous return)
➢ Failure to thrive and growth retardation
, NURS MED SURG MSN 5410 EXAM QUESTIONS WITH
ANSWERS 2023 A+ SUCCESS ASSUARED
5- FALL PRECAUTION FOR ELDERLY
What do you do at night to prevent falls? Dim light at night- no rigs, no cables, no crowded places
6- REYE’S SYNDROME-
How do you minime syndrome? NO ASPIRIN
What action may be beneficial in reducing the risk of Reye’s syndrome?
a.Immunization against the disease
b.Medical attention for all head injuries
c.Prompt treatment of bacterial meningitis
d. Avoidance of aspirin and ibuprofen for children with varicella or those suspected of having influenza
ANS: D
Although the etiology of Reye’s syndrome is obscure, most cases follow a common viral illness, either
varicella or influenza. A potential association exists between aspirin therapy and the development of Reye’s
syndrome; thus use of aspirin is avoided. No immunization currently exists for Reye’s syndrome. Reye’s
syndrome is not correlated with head injuries or bacterial meningitis.
The nurse is planning to teach parents about prevention of Reye’s syndrome. What information would
the nurse include in this teaching?
a. Use aspirin instead of acetaminophen for children with viral illness.
b. Advise parents to have their children immunized against Reye’s syndrome.
c. Avoid giving salicylate-containing medications to a child who has viral
symptoms.
ethargy.
d. Get the child tested for Reye’s syndrome if the child exhibits fever, vomiting, and
ANS: C
Prevention of Reye’s syndrome includes educating parents not to give aspirin-containing medication to
children with viral symptoms.
Why are acetylsalicylic acid (ASA) and other salycilate drugs avoided for use in children with viral
infections?
a. Aspirin is associated with the development of Reye’s syndrome.
b. Aspirin would drop a child’s body temperature below normal.
c. Children are at higher risk for bleeding with aspirin use.
d. A child’s liver is unable to metabolize aspirin.
Aspirin is associated with the development of Reye’s syndrome.
When children have a viral infection and are given aspirin, Reye’s syndrome—a liver disease that can lead
to coma, mental retardation, and death—may develop.
7- AMNIOCENTESIS-
At what week will you perform the test? 16 – 20 weeks?
How do you manage the bladder- 16 weeks? Full after 20 weeks? Empty
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