Medical-Surg Questions

Question 23

A client with pneumonia has arterial blood gases of pH 7.33 (7.35-7.45), PaO2 94 (80-100), PaCO2 49 (35-45), HCO3 25 (22-26). Which intervention should the nurse implement?

• Assist the client to cough and deep breath (Correct Answer)
• Administer oxygen via nasal cannula
• Assist the client to breath into a paper bag
• Administer sodium bicarbonate

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Question 24

The nurse evaluates the admission assessment data for a 59-year-old client with end-stage liver disease. Which findings are significant?

• Weight gain (Significant)
• Black, tarry stools (Significant)
• LOC (Significant)
• Abdominal distension (Significant)
• Respiratory rate (Significant)
• Dyspnea (Significant)
• Temperature (Significant)
• Orthopnea (Significant)

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Question 25

Classify the following assessment findings from the admission records as most consistent with Ascites, Bleeding Esophageal Varices, or Hepatic Encephalopathy.

• Muscle twitching: Hepatic Encephalopathy
• Abdominal distension with bulging flanks: Ascites
• Orthpnea and dyspnea: Ascites
• Black, tarry stools: Bleeding Esophageal Varices
• Rapid weight gain: Ascites
• Agitation, confusion, impaired thinking: Hepatic Encephalopathy
• Hyperreflexia: Hepatic Encephalopathy
• Tachycardia and hypotension: Bleeding Esophageal Varices Medical-Surg Questions

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Question 26

Five days post-op liver transplantation surgery, assessment finds the client is drowsy, has increasing jaundice, and a temperature of 101.9F. Which clinical determination is most accurate?

• The client is experiencing an expected recovery
• The client is experiencing acute graft rejection
• The client is experiencing systemic infection
• The client is experiencing hepatic encephalopathy

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Question 27

Identify the findings that support the determination of acute graft rejection.

• Increasing jaundice (Correct Answer)
• Fever (Temp 101.9F) (Correct Answer)
• Elevated ALT (46 units/L) (Correct Answer)
• Tacrolimus Level 4 ng/mL
• RR 22

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Question 28

Which findings five days after treatment for rejection indicate a therapeutic response?

• Client has pale yellow skin and white sclera (Correct Answer)
• Client alert and oriented x 3 with moderate pain (Correct Answer)
• ALT 30 units/L; AST 31 units/L (Correct Answer)
• Temperature 100.2F
• Tacrolimus Level 2 ng/mL

Question 42

The nurse is caring for a client after bariatric surgery. Which assessment finding would indicate that the client is experiencing an anastomotic leak?

• Client complains of inability to pass gas and cramping
• Client complains of headache and ringing in the ears
• Client complains of tingling and burning in both hands
• Client complains of abdominal pain and racing heart rate

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Question 43

The nurse is caring for a client with bleeding esophageal varices with new orders for the somatostatin receptor agonist octreotide acetate. When the client asks how the medication works, which statement by the nurse is appropriate?

• “Octreotide acetate decreases pressure within the varices.”
• “Octreotide acetate helps reduce gastric discomfort.”
• “Octreotide acetate increases production of gastrin and serotonin.”
• “Octreotide acetate will help you to stay calm and relax more.”

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Question 44

The nurse is caring for a client with long term ascites who is scheduled for placement of a transjugular intrahepatic portosystemic shunt (TIPS). Which statement by the client indicates a need for further instruction?

• “I don’t want to have another surgery to remove the stent.”
• “The shunt will be placed through my jugular vein.”
• “I will need to schedule regular ultrasounds for a year.”
• “The procedure is minimally invasive, so risks are decreased.”

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Question 45

The nurse is reviewing assessment data and lab values for a client admitted with a small bowel obstruction. Which findings correlate with the client’s diagnosis? (Select all that apply)

• Serum potassium of 2.8 mEq/L (3.5-5)
• Abdominal pain in upper quadrants
• Metabolic alkalosis
• Low pitched bowel sounds
• Serum sodium of 121 (136-145)
• Loss of 12 lb without dieting

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Question 46

The nurse is caring for a client prescribed the beta blocker Propranolol for esophageal varices and the client asks, “What does the medication do to treat my condition?” Which response by the nurse is appropriate?

• “This medication prevents bleeding by lowering blood pressure.”
• “This medication is used to slow your heart rate.”
• “This medication is injected to dry up the bleeding varices.”
• “This medication is given to increase urine output.”

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Question 47

The nurse is providing education on diet planning for a client diagnosed with diverticulosis. The nurse knows the teaching is effective when the client selects which meal for dinner? Medical-Surg Questions

• Spicy roasted chicken with corn and a cup of coffee with cream
• Baked fish with steamed carrots, wheat dinner roll, and glass of unsweetened tea
• Spaghetti with meat sauce, sliced cucumbers, and hot tea with lemon
• Chicken Caesar salad with sliced almonds, cup of bean soup, and glass of low-fat milk

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Question 48

The nurse is coming on shift and receives report on the clients listed below. Which client should the nurse see first?

• Client with diverticulitis complaining of left lower quadrant pain with temperature reading of 100.2F
• Client with colon obstruction who has been passing ribbon-like stools for the past 4 hours
• Client who is 12 hours postoperative colon resection who is complaining of nausea
• Client with small bowel obstruction who has an NG tube to low suction, with potassium level of 2.3.

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Question 49

A nurse is caring for a client with hepatic portal-systemic encephalopathy (PSE) who is thin and frail, and the family expresses concerns that the client is receiving little dietary protein. Which response by the nurse is appropriate?

• “Low dietary protein is needed to prevent fluid from leaking into the abdomen.”
• “Increasing dietary protein will help the client gain weight and muscle mass.”
• “A low-protein diet will help the liver rest and will restore liver function.”
• “Less protein in the diet will help reduce confusion associated with liver failure.”

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Question 50

The nurse is caring for a client with a bowel obstruction who has a newly placed nasogastric (NG) tube. Which nursing intervention is the priority for this client in relation to care of the NG tube?

• Turn the suction down to a lower setting while ascultating bowel sounds
• Secure the tube to the client’s chin to avoid skin breakdown on the nose
• Flush the tube with water every 2 hours to maintain patency of the tube
• Assess for proper placement of the tube, tube patency and output every 4 hours