Download NURS 313 MEDICAL-SURGICAL NURSING FINAL EXAM 2025|ACTUAL 81Qs&As|ALREADY GRADED A+ and more Exams Nursing in PDF only on Docsity!
NURS 313 MEDICAL-SURGICAL NURSING FINAL
EXAM 2025|ACTUAL 81Qs&As|ALREADY GRADED
A+
Which laboratory result is important to communicate to the health care provider for a patient who is taking methotrexate to treat rheumatoid arthritis (RA)? A) The white blood cell (WBC) count is 1500/mL (normal range 5,000- 10,000/mL) B) Fasting blood glucose is 90 mg/dL (normal range 74-106 mg/dL) C) Rheumatoid factor is positive D) The rythrocyte sedimentation rate (ESR) is elevaeted. A) The white blood cell (WBC) count is 1500/mL (normal range 5,000- 10,000/mL) A postoperative patient has not voided for 8 hours after return to the clinical unit. Which action should the nurse take first? A) Insert a straight catheter as indicated on the PRN order. B) Encourage increased oral fluid intake. C) Assist the patient to ambulate to the bathroom. D) Perform a bladder scan. D) Perform a bladder scan. A patient becomes restless and agitated in the postanesthesia care unit (PACU) as he begins to regain consciousness. Which action would the nurse take first?
A) Turn the patient to a lateral position. B) Check the patient's oxygen saturation. C) Orient the patient and tell him surgery is over. D) Give the ordered postoperative pain medication. B) Check the patient's oxygen saturation. While in the PACU, the patient's blood pressure drops from an admission pressure of 126/82 to 106/78 with a pulse change of 70 to 94. After administering oxygen, which action would the nurse take next? A) Increase the rate of the IV fluids. B) Notify the anesthesia care provider. C) Perform neurovascular checks on the lower extremities. D) Use a cardiac monitor to assess the patient's heart rhythm. A) Increase the rate of the IV fluids. The nurse is preparing to discharge a patient from the ambulatory surgery center following an inguinal hernia repair. The nurse delays the release of the patient upon discovering that the patient: A) had IV morphine 45 minutes ago. B) has an oxygen saturation of 92%. C) has not voided since before surgery. D) had an episode of vomiting 30 minutes ago. C) has not voided since before surgery
C) Decreased peristalsis D) IV fluids E) Decreased mobility A) Anesthesia B) Opioid analgesics E) decreased mobility A patient who has diabetes and uses insulin to control blood glucose has been NPO since midnight before having a knee replacement surgery. Which action should the nurse take? A) Administer a lower dose of insulin because there will be no oral intake before surgery. B) Give the patient the usual insulin dose because stress will increase the blood glucose. C) Obtain a blood glucose measurement before any insulin administration. D) Withhold the usual scheduled insulin dose because the patient is NPO. C) Obtain a blood glucose measurement before any insulin administration. A patient arrives at the ambulatory surgery center for a scheduled laparoscopy procedure in outpatient surgery. Which information is of most concern to the nurse? A) The patient is planning to drive home after surgery. B) The patient's insurance does not cover outpatient surgery.
C) The patient has not had surgery using general anesthesia before. D) The patient had a sip of water 4 hours before arriving. A) The patient is planning to drive home after surgery. A 68-year-old male scheduled for hernia repair at an ambulatory surgical center expresses concern that he will not have enough care at home and asks if he can stay in the hospital after the surgery. Which response would the nurse provide? A) "Who is available to help you at home after the surgery?" B) "I'm sure you will be able to manage at home after surgery. It is a simple procedure." C) "We will teach you everything you need to know to be able to care for yourself after surgery." D) "Your health insurance will pay for inpatient care only if complications develop during surgery." A) "Who is available to help you at home after the surgery?" A patient who takes a diuretic and a β-blocker to control blood pressure is scheduled for breast reconstruction surgery. Which patient information is most important to communicate to the health care provider before surgery? A) Serum potassium 3.2 mEq/L (normal range 3.5mEq/L-5mEq/L) B) Pulse rate 58 beats/minute C) Blood pressure 144/ D) Hematocrit 36% (normal range 37%-47%) A) Serum potassium 3.2 mEq/L (normal range 3.5mEq/L-5mEq/L)
taken? A) "Some medications may alter the patient's perceptions about surgery." B) "Some anesthetics alter renal and hepatic function, causing toxicity of other drugs." C) "Some medications may interact with anesthetics, altering the potency and effect of the drugs." D) "Routine medications are withheld the day of surgery, requiring dosage and schedule adjustments after surgery." C) "Some medications may interact with anesthetics, altering the potency and effect of the drugs." The nurse is preparing to administer a preoperative dose of cefazolin prior to an open cholecystectomy. Which explanation by the nurse about why the patient is receiving this medication is accurate? A) "It will prevent postoperative pneumonia." B) "It will treat your urinary tract infection (UTI)." C) "It will prevent postoperative surgical-site infection." D) "It will remove harmful bacteria from your intestines before surgery." C) "It will prevent postoperative surgical-site infection."
The patient received ten units of Humulin R at 0700. At 1030 the unlicensed nursing assistant tells the nurse the patient has a headache and is really acting "funny." Which action should the nurse implement first? A) Go to the patient's room and assess the patient for hypoglycemia. B) Instruct the assistant to obtain blood glucose level. C) Have the patient drink one, eight-ounce glass of orange juice. D) Prepare to administer one amp 50% Dextrose intravenously. A) Go to the patient's room and assess the patient for hypoglycemia. When a patient who takes metformin (Glucophage) to manage type 2 diabetes develops an allergic rash from an unknown cause, the health care provider prescribes prednisone (Deltasone), a corticosteroid. The nurse will anticipate that the patient may A) have rashes caused by metformin-prednisone interactions. B) require administration of insulin while taking prednisone. C) develop acute hypoglycemia while taking the prednisone. D) need a diet higher in calories while receiving prednisone. B) require administration of insulin while taking prednisone.
A) Provide a high-fat diet 24 hours prior to the test B) Hold the metformin for 48 hours prior to the test C) Obtain an informed consent form for the test D) Administer pancreatic enzymes prior to the test B) Hold the metformin for 48 hours prior to the test The nurse correlates which laboratory values with being diagnostic for DKA? (Select all that apply.) Select All That Apply A) serum bicarbonate of 18 mEq/L B) Negative anion gap C) Serum glucose of 350 mg/dL D) Positive anion gap E) Arterial pH of 7. A) serum bicarbonate of 18 mEq/L D) Positive anion gap Which prescription should the nurse anticipate when providing care to patient diagnosed with hyperosmolar hyperglycemic syndrome? A) Glucose bolus
B) Fluid replacement C) Potassium restriction D) Oral hypoglycemic agents B) Fluid replacement During an acute attack of diverticulitis, the nurse must initially: A) Treat the patient with daily medicated enemas. B) Prepare the patient for surgery to resect the involved colon. C) Provide the patient with a heating pad to apply to the left lower quadrant. D) Monitor the patient for signs of peritonitis while administering the prescribed antibiotics. D) Monitor the patient for signs of peritonitis while administering the prescribed antibiotics. The nurse develops a teaching plan for the client about how to prevent the transmission of hepatitis A. Which of the following discharge instructions is appropriate for the client? A) Spray the house to eliminate infected insects. B) Disinfect all clothing and eating utensils. C) Tell family members to wash their hands frequently. D) Tell family members to try to stay away from the client.
A serum potassium level of 3.2 mEq/L (reference range 3.5-4.5 mEq/L) is reported for a patient with cirrhosis who has scheduled doses of spironolactone (Aldactone) and furosemide (Lasix) due. Which action would the nurse take? A) Administer both drugs. B) Withhold both drugs. C) Administer the furosemide. D) Administer the spironolactone. D) Administer the spironolactone. A new clinic patient with joint swelling and pain is being tested for systemic lupus erythematosus (SLE). Which test will provide the most specific findings for the nurse to review? A) Antinuclear antibody (ANA) B) Anti-smith antibody (Anti-Sm) C) Lupus erythematosus (LE) cell prep D) Rheumatoid factor (RF) B) Anti-smith antibody (Anti-Sm) Which laboratory result is important to communicate to the health care provider for a patient who is taking methotrexate to treat rheumatoid arthritis (RA)?
A) The white blood cell (WBC) count is 1500/mL (normal range 5,000- 10,000/mL) B) Fasting blood glucose is 90 mg/dL (normal range 74-106 mg/dL) C) Rheumatoid factor is positive D) The erythrocyte sedimentation rate (ESR) is elevated. A) The white blood cell (WBC) count is 1500/mL (normal range 5,000- 10,000/mL) A patient is 12 hours post-partial thyroidectomy. During the postoperative phase the nurse asks the patient about any numbness or tingling of the face, mouth, or extremities for which of the following purposes? A) Early identification of hypocalcemia B) Detection of nerve damage related to surgery C) Early identification of low thyroid hormone. D) Detection of thyroid-induced hypoglycemia. A) Early identification of hypocalcemia The nurse is caring for a patient who just returned to the surgical unit following a thyroidectomy. The nurse is most concerned if which is observed? A) The patient reports of increased thirst.
B) perform glucose monitoring for hyperglycemia. C) avoid immunizations due to high risk for infections. D) stop steroids immediately if the patient gains weight. B) perform glucose monitoring for hyperglycemia. During the emergent phase of burn care, which assessment will be most useful in determining whether the patient is receiving adequate fluid infusion? A) Monitor daily weight. B) Check skin turgor. C) Measure hourly output. D) Assess mucous membranes. C) Measure hourly output. Which patient should the nurse assess first? A) A patient with full-thickness leg burns who is scheduled for a dressing change. B) A patient with smoke inhalation who has wheezes and altered mental status. C) A patient with burns who is complaining of level 8 (0 to 10 scale) pain. D) A patient with partial-thickness burns who is receiving IV fluids at 500 mL/hr. B) A patient with smoke inhalation who has wheezes and altered mental status.
It is necessary for the nurse manager to delegate tasks to the staff. Which of the following is a requirement of the delegation process? A) Working alongside the staff to evaluate their care. B) Assuming they will complete the task as directed. C) Communicating the work assignment in understandable terms. D) Obtaining the employee's voluntary acceptance of the task. C) Communicating the work assignment in understandable terms. Discharge planning for clients begins: A) When the acute care treatments have been completed. B) After a diagnosis has been established. C) Upon admission to a health care facility. D) Once the long-term needs are identified. C) Upon admission to a health care facility. The nurse is planning assignments. Which task can be safely delegated to an unlicensed assistive personnel (UAP)?
C) Compare blood pressures in the left and right arms. D) Assess for a bruit at the fistula site D) Assess for a bruit at the fistula site Which of the following would be seen in acute kidney injury (AKI)? Select all that apply. Select All That Apply A) Decreased serum BUN B) Oliguria C) Decreased serum potassium D) Hematuria E) Increased serum creatinine B) Oliguria E) Increased serum creatinine Which urinary diversion is a continent diversion created by the formation of an ileal pouch with a stoma for catheterization? A) Orthotopic neobladder B) Kock pouch
C) Ileal conduit D) Cutaneous ureterostomy B) Kock pouch What can patients at risk for renal lithiasis do to prevent the stones from forming? A) Lead an active lifestyle B) Limit protein and acidic food in diet C) Drink enough fluids to produce dilute urine D) Take prophylactic antibiotics to control UTIs C) Drink enough fluids to produce dilute urine When should palliative care be initiated for patients diagnosed with small cell lung cancer? A) After chemotherapy B) Upon diagnosis C) Upon patient request D) After surgery B) Upon diagnosis
