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study guide for medical surgical unit, Exams of Medicine

Central CollegeMedicine

this is a study guide over 2 chapters covered on the same unit

Typology: Exams

2016/2017

Uploaded on 06/26/2022

Zacley1113
Zacley1113 🇺🇸

3 documents

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Study Guide Module 6 Med/Surg 2
1. An 85-year-old patient who has been NPO since midnight last night for diagnostic testing
just completed the procedure. Which intervention is most important?
D. Offer 4 ounces of water or juice every hour.
2. The nurse cautions the diabetic patient that diabetes affects the blood flow through the
kidney. Which statement indicates that the patient understands the nurse’s teaching?
B. “Diabetes causes changes to blood vessels, which impacts blood flow to my kidneys.”
3. The nurse explains that when the kidney suffers an autoimmune inflammatory reaction, the
glomeruli lose their ability to function effectively. The nurse is describing the etiology of which
problem?
A. Glomerulonephritis
4. The nurse is caring for a confused patient who requires bladder training. Which component of
the bladder training program can the nurse safely delegate to the nursing assistant?
D. Recording instances of linen changes and fluids offered.
5. When the patient asks why he has so many urinary tract infections (UTIs), the nurse informs
the patient that his recurrent UTIs most likely result from which causative factor?
A. Bacteria that colonize in the kidney.
6. How can nephrotoxic drugs such as doxycycline and rifampin cause kidney damage?
B. Chemical alterations of glomeruli
7. In order to keep optimal flow through the urinary system, a person should have a minimum
daily intake of how many mL of fluid?
C. 2000 mL
8. The nurse is caring for a patient who has been taking sulfa drug for a urinary tract infection
(UTI). Which intervention is most important for the nurse to add to the patient’s care plan?
D. Increase fluid intake to 1.5 L/day
9. The nurse reviewing laboratory reports for a patient admitted for acute pyelenophritis. Which
finding is most concerning to the nurse?
D. Creatinine of 2.0 mg/dL
10. A patient is scheduled to undergo a cystogram. Which statement indicates that the patient
accurately understands the nurse’s teaching about prevention of potential complications of the
test?
D. “I should drink plenty of fluids after the test is over.”
11. The nurse is caring for a woman suspected of having a vaginal fistula. Which finding
supports the potential diagnosis?
A. Pneumaturia
12. When the nurse is caring for a patient who reports he has blood that begins when he
initiates the urine stream and then abates. Based on underlying pathophysiology, the nurse
concludes that the hematuria is occurring in which location?
D. In the urethra.
13. The nurse is collecting data from a patient who complains of having urinary frequency. The
nurse should inquire about which dietary habit?
B. Caffeine intake
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Study Guide Module 6 Med/Surg 2

  1. An 85-year-old patient who has been NPO since midnight last night for diagnostic testing just completed the procedure. Which intervention is most important? D. Offer 4 ounces of water or juice every hour.
  2. The nurse cautions the diabetic patient that diabetes affects the blood flow through the kidney. Which statement indicates that the patient understands the nurse’s teaching? B. “Diabetes causes changes to blood vessels, which impacts blood flow to my kidneys.”
  3. The nurse explains that when the kidney suffers an autoimmune inflammatory reaction, the glomeruli lose their ability to function effectively. The nurse is describing the etiology of which problem? A. Glomerulonephritis
  4. The nurse is caring for a confused patient who requires bladder training. Which component of the bladder training program can the nurse safely delegate to the nursing assistant? D. Recording instances of linen changes and fluids offered.
  5. When the patient asks why he has so many urinary tract infections (UTIs), the nurse informs the patient that his recurrent UTIs most likely result from which causative factor? A. Bacteria that colonize in the kidney.
  6. How can nephrotoxic drugs such as doxycycline and rifampin cause kidney damage? B. Chemical alterations of glomeruli
  7. In order to keep optimal flow through the urinary system, a person should have a minimum daily intake of how many mL of fluid? C. 2000 mL
  8. The nurse is caring for a patient who has been taking sulfa drug for a urinary tract infection (UTI). Which intervention is most important for the nurse to add to the patient’s care plan? D. Increase fluid intake to 1.5 L/day
  9. The nurse reviewing laboratory reports for a patient admitted for acute pyelenophritis. Which finding is most concerning to the nurse? D. Creatinine of 2.0 mg/dL
  10. A patient is scheduled to undergo a cystogram. Which statement indicates that the patient accurately understands the nurse’s teaching about prevention of potential complications of the test? D. “I should drink plenty of fluids after the test is over.”
  11. The nurse is caring for a woman suspected of having a vaginal fistula. Which finding supports the potential diagnosis? A. Pneumaturia
  12. When the nurse is caring for a patient who reports he has blood that begins when he initiates the urine stream and then abates. Based on underlying pathophysiology, the nurse concludes that the hematuria is occurring in which location? D. In the urethra.
  13. The nurse is collecting data from a patient who complains of having urinary frequency. The nurse should inquire about which dietary habit? B. Caffeine intake
  1. The student nurse is attempting to irrigate an indwelling catheter. Which action best indicates that the student nurse accurately understands the correct procedure? A. The student nurse irrigates using a steady, gentle stream.
  2. The patient confides that sneezing makes her “wet her pants.” The nurse recognizes this cardinal sign of which type of incontinence? B. Stress incontinence
  3. The nurse is caring for a frustrated patient reports that she still involuntarily voids despite two surgeries to correct incontinence. Which statement indicates that the patient accurately understands the nurse’s teaching about incontinence management after surgery? B. “I will talk to my health care provider about a pessary”
  4. The nurse is instructing a patient about use of vaginal weight training. Which technique indicates that the patient accurately understands the nurse’s teaching? C. The patient inserts the smallest cone and holds it in place with muscle tightening for 15 minutes before removing it.
  5. A patient has just returned to the nursing unit after having a renal biopsy. Which intervention is most important to include in the patient’s nursing care plan? B. Instruct the patient to avoid laughing and use a pillow to splint when sneezing.
  6. The nurse is caring for a patient who recently had abdominal surgery. Which assessment finding requires the nurse’s immediate attention? D. urine output of 20 mL in the last hour.
  7. The nurse caring for a patient with deteriorating kidney function. Laboratory work indicates 900 mg of uric acid in 24 hours. In addition to administering prescribed medication, which dietary modification should the nurse address? A. Limit servings of beef to 3-ounce portions.
  8. Which statements accurately describe the functions of the kidneys? Select all that apply. A. Regulation of electrolytes B. Regulation of fluid volume C. Regulation of blood pressure D. Secretion of erythropoietin.
  9. Which age-related changes occur in the urinary system? Select all that apply. A. Prostate hypertrophy B. Decreased renin secretion. C. Decreased bladder muscle tone.
  10. When discussing bladder health with a patient, the nurse emphasizes the importance of regular voiding in a timely manner. Which statements indicate that the patient accurately understands the underlying rationale for this recommendation? Select all that apply. A. Urinating regularly will prevent prolonged exposure of the bladder wall to harmful wastes. B. Allowing my bladder to overfill causes the walls to overstretch. C. A full bladder can cause undue strain on the urinary sphincters.
  11. While caring for a patient with an indwelling catheter, which interventions are important for the nurse to include in the plan of care? Select all that apply. A. Observe tube placement and note the level of urine in the collection bag. D. Use a syringe to deflate the balloon before discontinuing the catheter.

D. The patient’s blood pressure is 110/74.

  1. As chronic glomerulonephritis progresses, how is the kidney usually affected? B. The kidney atrophies.
  2. The nurse is caring for a patient with glomerulonephritis. Which finding best leads the nurse to suspect that the patient is developing nephrotic syndrome? A. Ascites
  3. A patient has a kidney stone lodged in the ureter. He questions why it must be removed. What response is most appropriate? B. “If the stone is removed, it could block urine flow from the kidney and cause swelling within the kidney”
  4. The nurse is caring for a patient who underwent a right nephrostomy to relieve hydronephrosis. Which intervention is most important for this patient? C. Assess urinary output from the left kidney.
  5. The nurse is caring for a 50-year-old female who presented to the emergency department after being involved in a motor vehicle collision. The patient displays marked tenderness and spasm in the suprapubic area and a non pulsating mass. The nurse anticipates that this patient will undergo additional workup for which complication? A. Bladder trauma
  6. The nurse is caring for a patient who is postoperative after a bladder repair. The patient complains of pain. Which independent nursing intervention is best? B. Apply a cold compress to the surgical site.
  7. The nurse is caring for a patient who received an installation of doxorubicin (Adriamycin) into the bladder for treatment of cancer in situ. What should the nurse do next? A. Reposition the patient every 15 to 30 minutes.
  8. The nurse is caring for a patient who is scheduled to undergo hemodialysis. Based on awareness of potential complications, the nurse correctly withholds which medication? A. Lisinopril (Zestril)
  9. The nurse is discussing alternative therapies with a patient who has cystitis. The patient asks the nurse if there are any dietary changes that might help. What response is most appropriate? C. Vitamin C may help decrease the frequency of cystitis.
  10. The nurse is assessing a patient who is being treated for acute pyelonephritis. When finding best indicates to the nurse that the patient is in the early stages of pyelonephritis? D. Flank pain
  11. The nurse is caring for a child suspected of having acute glomerulonephritis. When reviewing the health history, which finding is most concerning to the nurse? A. Recent upper respiratory infection
  12. In which situations should the nurse question an order for carbenicillin for a patient with a urinary infection? Select all that apply. B. The patient is older than 80 years of age. C. The patient is allergic to penicillin. D. The patient takes oral contraceptives.
  1. The nurse is caring for a patient with a urinary tract infection (UTI) who is to receive cefazolin (Ancef). The nurse should carefully monitor the patient for which side effects? Select all that apply. A. Vaginitis C. Arrhythmias D. Rash E. Confusion
  2. A patient has been admitted to the acute care facility to rule out glomerulonephritis. Which assessment findings are supportive of the potential diagnosis? Select all that apply. A. Flank pain B. Hematuria C. Periorbital edema E. Hypertension
  3. The nurse is caring for a patient who is undergoing plasmapheresis. The nurse should carefully monitor the patient for which potential complications? Select all that apply. B. Bleeding at the puncture site C. A bruit at the shunt site D. Decreasing blood pressure E. Signs of hyperkalemia
  4. The nurse is collecting the health history of a patient who has had multiple episodes of renal calculi formation. Which findings increase the patient’s risk for the development of renal calculi? Select all that apply. A. Uric acid crystals in the urine B. Frequent bacterial urinary infections C. Excessive fluid intake D. Prolonged bed rest E. Parathyroid gland tumor
  5. The home health nurse is caring for a patient with chronic renal failure. Which assessment findings indicate that the patient is experiencing uremic syndrome? Select all that apply. A. Restless legs B. Dry, scaly skin C. Crystals in the elbows D. Muscle cramps
  6. The nurse caring for a patient who has just has an arteriovenous (AV) access created in his right forearm. Which findings are important for the nurse to assess? Select all that apply. A. Presence of bruit on auscultation of the AV site B. Capillary refill of the left hand D. Adequate elevation of the right arm.
  7. The nurse is aware that 80% of the UTIs in females are the result of contamination from E. coli
  8. Hypovolemic shock- prerenal ARF
  9. Vascular changes related to diabetes mellitus- Intrarenal ARF
  10. Ureteral obstruction- Postrenal ARF
  11. Prostate hypertrophy- Postrenal ARF

and is concerned that this problem will worsen. Which instructions may facilitate management of incontinence? Select all that apply. A. Instruction of proper wiping techniques to prevent bacterial infection. B. Education on bladder training and Kegel exercises C. Information on personal hygiene measures to prevent perianal breakdown D. Information of incontinence products and appliances E. Importance of establishing a regular toileting schedule.

  1. The nurse is reviewing the urinalysis results of an older adult patient admitted with elevated temperature and incontinence. Which urinalysis properties are indicative of an infection? Select all that apply. B. Foul odor D. pH of 8.
  2. Which interventions will help stimulate urination when a patient is experiencing postoperative urinary retention? Select all that apply. B. Administration of bethanechol chloride (Urecholine) C. Pouring warm water over the perineum
  3. Fluoxetine, erythromycin, clarithromycin, ketoconazole, itraconazole, miconazole, vinblastine, ritonavir, and nefazodone may inhibit the metabolism of which drugs? Select all that apply) B. Tolterodine D. Darifenacin F. Solifenacin
  4. The nurse is caring for a patient taking Pyridium for the diagnosis of UTI. What should the nurse report to the health care provider? Select all that apply. B. Yellow sclera E. Increased pain and burning.