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2023 Med Surg Test bank ( Red HESI Test bank Med-Surg and otherresources) Including NCLEX Exam Q&As With Rationales 300 QUESTIONS AND ANSWERS$11.49
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2023 Med Surg Test bank ( Red HESI Test bank Med-Surg and otherresources) Including NCLEX Exam Q&As With Rationales 300 QUESTIONS AND ANSWERS
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Course
2023 Med Surg
Institution
2023 Med Surg
2023 Med Surg Test bank ( Red HESI Test bank Med-Surg and
otherresources) Including NCLEX Exam Q&As With
Rationales 300 QUESTIONS AND ANSWERS
1. The nurse evaluates that discharge teaching for a patient hospitalized with
pneumonia has been most effective when the patient states which of the ...
2023 Med Surg Test bank ( Red HESI Test bank Med-Surg and
otherresources) Including NCLEX Exam Q&As With
Rationales 300 QUESTIONS AND ANSWERS
1. The nurse evaluates that discharge teaching for a patient hospitalized with
pneumonia has been most effective when the patient states which of the following
measures to prevent a relapse?
A. "I will increase my food intake to 2400 calories a day to keep my immune
system well."
B. "I must use home oxygen therapy for 3 months and then will have a chest x-ray
to reevaluate."
C. "I will seek immediate medical treatment for any upper respiratory infections."
D. "I should continue to do deep-breathing and coughing exercises for at least 6
weeks." - D. "I should continue to do deep-breathing and coughing exercises for at
least 6 weeks." It is important for the patient to continue with coughing and deep
breathing exercises for 6 to 8 weeks until all of the infection has cleared from the
lungs. A patient should seek medical treatment for upper respiratory infections that
persist for more than 7 days. Increased fluid intake, not caloric intake, is required
to liquefy secretions. Home O2 is not a requirement unless the patient's
oxygenation saturation is below normal.
2. After admitting a patient to the medical unit with a diagnosis of pneumonia, the
nurse will verify that which of the following physician orders have been completed
before administering a dose of cefotetan (Cefotan) to the patient?
A. Serum laboratory studies ordered for AM
B. Pulmonary function evaluation
C. Orthostatic blood pressures
D. Sputum culture and sensitivity - D. Sputum culture and sensitivityThe nurse
should ensure that the sputum for culture and sensitivity was sent to the laboratory
before administering the cefotetan. It is important that the organisms are correctly
identified (by the culture) before their numbers are affected by the antibiotic; the
test will also determine whether the proper antibiotic has been ordered (sensitivity
testing). Although antibiotic administration should not be unduly delayed while
,waiting for the patient to expectorate sputum, all of the other options will not be
affected by the administration of antibiotics.
3. Which of the following nursing interventions is most appropriate to enhance
oxygenation in a patient with unilateral malignant lung disease?
A. Positioning patient on right side.
B. Maintaining adequate fluid intake
C. Performing postural drainage every 4 hours
D. Positioning patient with "good lung down" - D. Positioning patient with "good
lung down" Therapeutic positioning identifies the best position for the patient
assuring stable oxygenation status. Research indicates that positioning the patient
with the unaffected lung (good lung) dependent best promotes oxygenation in
patients with unilateral lung disease. For bilateral lung disease, the right lung down
has best ventilation and perfusion. Increasing fluid intake and performing postural
drainage will facilitate airway clearance, but positioning is most appropriate to
enhance oxygenation.
4. A 71-year-old patient is admitted with acute respiratory distress related to cor
pulmonale. Which of the following nursing interventions is most appropriate
during admission of this patient?
A. Delay any physical assessment of the patient and review with the family the
patient's history of respiratory problems.
B. Perform a comprehensive health history with the patient to review prior
respiratory problems.
C. Perform a physical assessment of the respiratory system and ask specific
questions related to this episode of respiratory distress.
D. Complete a full physical examination to determine the effect of the respiratory
distress on other body functions. - C. Perform a physical assessment of the
respiratory system and ask specific questions related to this episode of respiratory
distress.Because the patient is having respiratory difficulty, the nurse should ask
specific questions about this episode and perform a physical assessment of this
system. Further history taking and physical examination of other body systems can
proceed once the patient's acute respiratory distress is being managed.
5. When planning appropriate nursing interventions for a patient with metastatic
lung cancer and a 60-pack-year history of cigarette smoking, the nurse recognizes
,that the smoking has most likely decreased the patient's underlying respiratory
defenses because of impairment of which of the following?
A. Reflex bronchoconstriction
B. Ability to filter particles from the air
C. Cough reflex
D. Mucociliary clearance - D. Mucociliary clearance Smoking decreases the ciliary
action in the tracheobronchial tree, resulting in impaired clearance of respiratory
secretions, chronic cough, and frequent respiratory infections.
6. While ambulating a patient with metastatic lung cancer, the nurse observes a
drop in oxygen saturation from 93% to 86%. Which of the following nursing
interventions is most appropriate based upon these findings?
A. Continue with ambulation as this is a normal response to activity.
B. Move the oximetry probe from the finger to the earlobe for more accurate
monitoring during activity.
C. Obtain a physician's order for supplemental oxygen to be used during
ambulation and other activity.
D. Obtain a physician's order for arterial blood gas determinations to verify the
oxygen saturation. - C. Obtain a physician's order for supplemental oxygen to be
used during ambulation and other activity. An oxygen saturation level that drops
below 90% with activity indicates that the patient is not tolerating the exercise and
needs to have supplemental oxygen applied.
7. The nurse is caring for a 73-year-old patient who underwent a left total knee
arthroplasty. On the third postoperative day, the patient complains of shortness of
breath, slight chest pain, and that "something is wrong." Temperature is 98.4o F,
blood pressure 130/88, respirations 36, and oxygen saturation 91% on room air.
Which of the following should the nurse first suspect as the etiology of this
episode?
A. Septic embolus from the knee joint
B. Pulmonary embolus from deep vein thrombosis
C. New onset of angina pectoris
D. Pleural effusion related to positioning in the operating room - B. Pulmonary
embolus from deep vein thrombosis The patient presents the classic symptoms of
pulmonary embolus: acute onset of symptoms, tachypnea, shortness of breath, and
chest pain.
, 8. In the case of pulmonary embolus from deep vein thrombosis, which of the
following actions should the nurse take first?
A. Notify the physician.
B. Administer a nitroglycerin tablet sublingually.
C. Conduct a thorough assessment of the chest pain.
D. Sit the patient up in bed as tolerated and apply oxygen. - D. Sit the patient up in
bed as tolerated and apply oxygen.The patient's clinical picture is consistent with
pulmonary embolus, and the first action the nurse takes should be to assist the
patient. For this reason, the nurse should sit the patient up as tolerated and apply
oxygen before notifying the physician.
9. The nurse is caring for a postoperative patient with sudden onset of respiratory
distress. The physician orders a STAT ventilation-perfusion scan. Which of the
following explanations should the nurse provide to the patient about the procedure?
A. This test involves injection of a radioisotope to outline the blood vessels in the
lungs, followed by inhalation of a radioisotope gas.
B. This test will use special technology to examine cross sections of the chest with
use of a contrast dye.
C. This test will use magnetic fields to produce images of the lungs and chest.
D. This test involves injecting contrast dye into a blood vessel to outline the blood
vessels of the lungs. - A. This test involves injection of a radioisotope to outline the
blood vessels in the lungs, followed by inhalation of a radioisotope gas.A
ventilation-perfusion scan has two parts. In the perfusion portion, a radioisotope is
injected into the blood and the pulmonary vasculature is outlined. In the ventilation
part, the patient inhales a radioactive gas that outlines the alveoli.
10. During assessment of a 45-year-old patient with asthma, the nurse notes
wheezing and dyspnea. The nurse interprets that these symptoms are related to
which of the following pathophysiologic changes?
A. Laryngospasm
B. Overdistention of the alveoli
C. Narrowing of the airway
D. Pulmonary edema - C. Narrowing of the airwayNarrowing of the airway leads
to reduced airflow, making it difficult for the patient to breathe and producing the
characteristic wheezing.
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