MED SURG FINAL EXAM NEWEST 2024 ACTUAL EXAM 100 QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+
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Course
MED SURG
Institution
MED SURG
MED SURG FINAL EXAM NEWEST 2024 ACTUAL EXAM 100
QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) |ALREADY GRADED A+
MED SURG FINAL EXAM NEWEST 2024 ACTUAL EXAM 100
QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) |ALREADY GRADED A+
MED SURG FINAL EXAM NEWEST 2024 ACTUAL EXAM 100
QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) |ALREADY GRADED A+
A nurse is caring for a female client in the emergency department who reports shortness of breath and
pain in the lung area. She states that she started taking birth control pills 3 weeks ago and that she
smokes. Her heart rate is 110/min, respiratory rate 40/min, and blood pressure 140/80 mm Hg. Her
arterial blood gases are pH 7.50, PaCO2 29 mm Hg, PaO2 60 mm Hg, HCO3 20 mEq/L, and SaO2 86%.
Which of the following is the priority nursing intervention? - CORRECT ANSWER-Administer oxygen via
face mask.
Rational: The pH reflects alkalosis, and the low PaCO2 indicates that the lungs are involved, so the client
has respiratory alkalosis. The client's oxygen saturation is low, so one priority is to administer oxygen via
mask attempting to achieve an oxygen saturation of at least 95%. The greatest risk to this client is
hypoxia, thus the priority is to restore oxygenation.
A nurse is caring for a client who has a chest tube connected to a closed drainage system and needs to
be transported to the x-ray department. Which of the following actions should the nurse take? -
CORRECT ANSWER-Keep the drainage system below the level of the client's chest at all times.
During transport, the drainage system should be kept below the level of the client's chest to prevent air
and drainage fluid from re-entering the thoracic cavity.
A nurse in the intensive care unit is providing teaching for a client prior to removal of an endotracheal
tube. Which of the following instructions should the nurse include in the teaching? - CORRECT ANSWER-
Avoid speaking for long periods."
The client should avoid speaking for long periods to promote gas exchange.
A nurse is monitoring a client following a thoracentesis. The nurse should identify which of the following
manifestations as a complication and contact the provider immediately? - CORRECT ANSWER-Increased
heart rate
Clients are at risk for developing pulmonary edema or cardiovascular distress due mediastinal content
shift after the aspiration of a large amount of fluid from the client's pleural space.
Therefore, the client may experience an increase in heart and respiratory rate, along with coughing with
blood-tinged frothy sputum, and tightness in the chest. These findings require notification of the
provider immediately.
A nurse is caring for a client who develops a pulmonary embolism. Which of the following interventions
should the nurse implement first? - CORRECT ANSWER-Administer oxygen therapy.
,The greatest risk to the safety of a client who has a pulmonary embolism is hypoxemia with respiratory
distress and cyanosis. Oxygen therapy should be applied by the nurse using a nasal cannula or mask.
Pulse oximetry should be initiated to monitor oxygen saturation.
A nurse in an emergency department is caring for a client who has a sucking chest wound resulting from
a gunshot. The client has a blood pressure of 100/60 mm Hg, a weak pulse rate of 118/min, and a
respiratory rate of 40/min. Which of the following actions should the nurse take? - CORRECT ANSWER-
Administer oxygen via nasal cannula.
The client has an increased respiratory rate and heart rate, indicating that she is having respiratory
difficulty. The sucking chest wound indicates the client has a pneumothorax and/or a hemothorax.
Administering oxygen will increase the oxygen exchange in the lungs and the oxygen available to the
tissues.
A nurse is caring for a client whose arterial blood gas results show a pH of 7.3 and a PaCO2 of 50 mm Hg.
The nurse should identify that the client is experiencing which of the following acidbase imbalances? -
CORRECT ANSWER-Respiratory alkalosis
With uncompensated respiratory acidosis, the pH is less than 7.35 and the PaCO2 is greater than 45 mm
Hg.
A client admitted to the hospital for evaluation of chest pain has no abnormal serum cardiac markers 4
hours after the onset of pain. What noninvasive diagnostic test can be used to differentiate angina from
other types of chest pain? - CORRECT ANSWER-Exercise stress test
An exercise stress test will reveal ECG changes that indicate impaired coronary circulation when the
oxygen demand of he heart is increased. A single ECG is not conclusive for CAD, and negative findings do
not rule out CAD. Coronary angiography can detect narrowing of coronary arteries but is an invasive
procedure. Echocardiograms of various types may identify abnormalities of myocardial wall motion
under stress but are indirect measures of CAD.
The nurse is caring for a patient who becomes severely nauseated during chemotherapy. Which
intervention is the most appropriate? - CORRECT ANSWER-provide antiemetic medication 30 to 60 mins
before chemotherapy begins
A patient is receiving 3% NaCl solution for correction of hyponatremia. During administration of the
solution, the most important assessment for the nurse to monitor is - CORRECT ANSWER-A lung sounds.
Hypertonic solutions cause water retention, so the patient should be monitored for symptoms of fluid
excess. Crackles in the lungs may indicate the onset of pulmonary edema and are the most serious of
the symptoms of fluid excess listed. Bounding peripheral pulses, peripheral edema, or changes in urine
, output also are important to monitor when administering hypertonic solutions, but they do not indicate
acute respiratory or cardiac decompensation.
The nurse has administered 3% saline to a patient with hyponatremia. Which one of these assessment
data will require the most rapid response by the nurse? - CORRECT ANSWER-There are crackles audible
throughout both lung fields.
Crackles throughout both lungs suggest that the patient may be experiencing pulmonary edema, a life-
threatening adverse effect of hypertonic solutions. The increased pulse rate and blood pressure and the
appearance of the urine also should be reported, but they are not as dangerous as the presence of fluid
in the alveoli.
A patient presents to the emergency department with the complaint of diarrhea for the past 48 hours.
The nurse anticipates which fluid therapy initially? - CORRECT ANSWER-0.9% sodium chloride
Which assessment finding about a patient who has a serum calcium level of 7.0 mEq/L is most important
for the nurse to report to the health care provider? - CORRECT ANSWER-The patient is experiencing
laryngeal stridor.
Laryngeal stridor may lead to respiratory arrest and requires rapid action to correct the patient's calcium
level. The other data also are consistent with hypocalcemia, but do not indicate a need for immediate
action.
A recently admitted patient has a small cell carcinoma of the lung, which is causing the syndrome of
inappropriate antidiuretic hormone (SIADH). The nurse will monitor carefully for - CORRECT ANSWER-
decreased serum sodium level.
SIADH causes water retention and a decrease in serum sodium level. Weight loss, increased urine
output, and elevated serum hematocrit may be associated with excessive loss of water, but not with
SIADH and water retention.
A patient with hypercalcemia is being cared for on the medical unit. Nursing actions included on the care
plan will include - CORRECT ANSWER-encouraging fluid intake up to 4000 ml every day.
To decrease the risk for renal calculi, the patient should have an intake of 3000 to 4000 ml daily.
Ambulation helps decrease the loss of calcium from bone and is encouraged in patients with
hypercalcemia. Trousseau's and Chvostek's signs are monitored when there is a possibility of
hypocalcemia. There is no indication that the patient needs frequent assessment of lung sounds,
although these would be assessed every shift.
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