Medical-Surgical Nursing Exam 6

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1. A client with myasthenia gravis ask the nurse why the disease has occurred. The nurse bases the reply on the knowledge that there is:

  1. A genetic in the production acetylcholine
  2. A reduced amount of neurotransmitter acetylcholine
  3. A decreased number of functioning acetylcholine receptor sites
  4. An inhibition of the enzyme ACHE leaving the end plates folded

2. A client with an inflamed sciatic nerve is to have a conventional transcutaneous electrical nerve stimulation (TENS) device applied to the painful nerve pathway. When operating the TENS unit the nurse should

  1. Maintain the same dial setting everyday
  2. Turn the machine several times a day for 10 to 20 minutes
  3. Adjust the TENS dial until the client perceives pain relief and comfort
  4. Apply the color-coded electrodes anywhere it is comfortable for the client

3. Although no cause has been determined for scleroderma, it is thought to be caused by:

  1. Autoimmunity
  2. Ocular motility
  3. Increased amino acid metabolism
  4. Defective sebaceous gland formation

4. The nurse must help the client with pemphigus vulgaris deal with the resulting:

  1. Infertility
  2. Paralysis
  3. Skin lesions
  4. Impaired digestion

5. The nurse should explain to the client with psoriasis that treatment usually involves:

  1. Avoiding exposure to the sum
  2. Topical application of steroids
  3. Potassium permanganate baths
  4. Debridement of necrotic plaques

6. The nurses should assess a client with psoriasis

  1. Pruritic lesions
  2. Multiple petechiae
  3. Shiny, scaly lesions
  4. Erythematous macules

7. A urine specimen for ketones should be removed from a client’s retention catheter by:

  1. Disconnecting the catheter and draining it into a clean container
  2. Cleansing the drainage valve and removing it from the catheter bag
  3. Wiping the catheter with alcohol and draining it into a sterile test tube
  4. Using a sterile syringe to remove it from clamped, cleansed catheter

8. Following an abdominal cholecystectomy, the nurse should assess for signs of respiratory complications because the:

  1. Incision is in close proximity to the diaphragm
  2. Length of time required for surgery is prolonged
  3. Client’s resistance is lowered because of bile in the blood
  4. Bloodstream is invaded by microorganisms from the biliary tract

9. The nurse assess the client with cholecystitis for the development of obstructive jaundice, which would be evidenced by:

  1. Inadequate absorption of fat-soluble K
  2. Light amber urine, dark brown stools, yellow skin
  3. Dark-colored urine, clay colored stools, itchy skin
  4. Straw-colored urine, putty-colored stools, yellow sclerae

10. A client with cholelithiasis experience discomfort after ingesting fatty foods because.

  1. Fatty foods are hard to digest
  2. Bile flow into the intestine is obstructed
  3. The liver is manufacturing inadequate bile
  4. There is inadequate closure of the Ampulla of Vater

11. The chief complaint in a client with Vincent’s Angina is:

  1. Chest pain
  2. Shortness of breath
  3. Shoulder discomfort
  4. Bleeding oral ulcerations

12. Clients with fractured mandibles usually have them immobilized with wires. The life-threatening problem that can develop postoperatively is:

  1. Infection
  2. Vomiting
  3. Osteomyelitis
  4. Bronchospasm

13. As a result of fractured ribs, the client may develop:

  1. Scoliosis
  2. Paradoxical respiration
  3. Obstructive lung-disease
  4. Hernation of the diaphragm

14. A client has a bone marrow aspiration performed, immediately after the procedure, the nurse should:

  1. Position the client on the affected side
  2. Begin frequent monitoring of vital signs
  3. Cleanse the site with an antiseptic solution
  4. Briefly apply pressure over the aspiration site

15. Following a bilateral lumbar sympathectomy a client has a sudden drop in blood pressure but no. evidence of bleeding. The nurse recognizes that this is most likely caused by:

  1. An inadequate fluid intake
  2. The after effects of anesthesia
  3. A reallocation of the blood supply
  4. An increased level of epinephrine

16. The occurrence of chronic illness is greatest in:

  1. Older adult
  2. Adolescents
  3. Young children
  4. Middle-aged adults

17. A client with full-thickness burns on the chest has a skin graft. During the 1s124 hours after a skin graft, care of the donor site includes immediately reporting.

  1. Small amount of yellowish green oozing
  2. A moderate area of serosanguinous oozing
  3. Epithelialization under the non-adherent dressing
  4. Separation of the edges of the non-adherent dressing

18. During peritoneal dialysis the nurse observes that drainage of dialysate from the peritoneal cavity has ceased before the required amount has drained out The nurse should assist the client to:

  1. Turn from side to side
  2. Drink 8 ounces of water
  3. Deep breathe and cough
  4. Periodically rotate the catheter

19. A client has ear surgery. An early response that may be associated with possible damage to the motor branch of the facial nerve is:

  1. A bitter metallic state
  2. Dryness of the lips and mouth
  3. A sensation of pain behind the ear
  4. An inability to wrinkle the forehead

20. After a prostatectomy, a client complains of painful bladder spasms. To limit these spasms the nurse should:

  1. Administer a narcotic every 4 hours
  2. Irrigate the Foley catheter with 60 ml of normal saline
  3. Encourage the client not to contract his muscles as if he were voiding
  4. Advance the catheter to relieve the pressure against the prostatic fossa

21. After 1 week a client with acute renal failure moves, into the diuretic phase. During this phase the client must be carefully assessed for signs of:

  1. Hypovolemia
  2. Hyperkalemia
  3. Metabolic acidosis
  4. Chronic renal failure

22. The nurse checks for hypocalcemia by placing a blood pressure cuff on a client’s arm and inflating it. After about 3 minutes the client develops carpopedial spasm. The nurse records this finding as a positive:

  1. Homan’s sign
  2. Romberg sign
  3. Chvostek’s skin
  4. Trosseau’s sign

23. A client is scheduled for a below-the-knee amputation of the right leg. Legally, the client may not sign the operative consent if:

  1. Ambivalent feelings regarding operation are present
  2. Any sedative type of medication has recently been administration
  3. A discussion of alternative with 2 physicians have not been performed and recorded
  4. A complete history and physical have not been performed

24. The nurse is assigned to check a client’s continuous bladder irrigation. Which one of the following solution is normally used for continuous or intermittent bladder and catheter irrigations?

  1. Hydrogen peroxide
  2. Bacteriostatic water
  3. Sterile normal saline
  4. Plain water

25. When continuous bladder irrigation is used following prostate surgery, the rate of flow is adjusted:

  1. To run at 60 drops per minutes
  2. According to the client’s oral intake
  3. To maintain an output of 500 ml every 8 hours
  4. To keep the drainage to light pink

26. The nurse is assigned to teach a class in health behaviors to young man. Which of the following can be stated as a probably cause of cancer of the penis?

  1. A diet high in acidic foods
  2. Poor personal hygiene
  3. Exercise
  4. Circumcision

27. The nurse is assigned to give perineal care to an uncircumcised male client. Which of the following is correct?

  1. The anal area is washed at a separate time
  2. The foreskin is retracted and the area beneath the foreskin is cleansed
  3. The foreskin should not be retracted except by a physician
  4. The scrotum is carefully washed with sterile normal saline

28. A female nurse is assigned to obtain a history from & client with a urinary tract problem an sexual dysfunction. Which of the following statements might place the client more at ease and willing to give a. history of his problem?

  1. “When dud you first notice this problem?
  2. “Why do you think you have a problem?”
  3. “Do you think you sexual dysfunction is psychological?”
  4. “Does your sexual dysfunction seem to be related to your urinary tract problem?”

29. A client is scheduled for an ultrasound examination of the prostate. To describe the procedure to the client, the nurse should plan to relate that:

  1. The procedure is performed using a cystoscope
  2. A probe will be inserted into the rectum
  3. A flat disk is placed on the abdomen
  4. This procedure uses x-rays to produce a visual image

30. To effectively teach men the importance of testicular self-examination, the nurse should know that testicular carcinoma:

  1. Rarely metastasizes
  2. Has a high incidence of early metastasis
  3. Cannot be detected by laboratory tests
  4. Must first be biopsied to confirm the diagnosis

31. A nurse is assigned to instruct a client in the method of testicular self-examination. The instruction should include mention that the best time to perform this task is:

  1. Immediately after getting out of bed in the morning
  2. Immediately before going to bed
  3. In the morning after breakfast
  4. After a warm bath or shower

32. Mr. Dorn has vasectomy. He asks the nurse why he just use a method of birth control because today he, had a sterilization procedure. The most correct answer is:

  1. The sperm count will not be negative until his testosterone level decrease
  2. Some minor surgery usually is necessary to ensure sterilization
  3. Some live sperm will be present in the ejaculatory fluid for a period of time
  4. Even though a vasectomy is performed, a condom is still recommended for 1 to 2 years

33. A client is scheduled for a cystectomy and asks the nurse what the physician will be able to see during the procedure. The most correct reply is the:

  1. Kidney and ureters
  2. Bladder and rectum
  3. Prostate and ureters
  4. Urethra and bladder

34. A client is scheduled for a cystectomy and asks the nurse what the physician will be able to see during the procedure. The most correct reply is the:

  1. Kidney and ureters
  2. Bladder and rectum
  3. Prostate and ureters
  4. Urethra and bladder

35. Nurse assistant attending a nursing conference hears that one of her clients has hydrocele. She asks the nurse how this condition is treated. The most common response is:

  1. Usually the problem requires more medical or surgical intervention
  2. Surgery may be necessary to correct the problem
  3. Wearing a scrotal support usually corrects She problem
  4. Drug therapy usually helps control the collection of fluid

36. The nurse is participating in a health class for young women. One subject is cancer of the ovary. Which of the following statements is correct?

  1. Early symptoms of cancer of the ovary are vague
  2. This type of cancer has a high cure rate
  3. Chemotherapy is not used for treating ovarian cancer
  4. The most prominent early symptoms is an irregular menstrual cycle

37. The nurse is asked to discuss the signs and symptoms of vaginitis caused by the fungus candida albicans with Ms. Barrows. Which one of the following is a usual sign and symptoms of this infection?

  1. Pain high in the abdomen
  2. Intensive vaginal and perineal itching
  3. Decrease in urinary output
  4. High fever

38. The nurse prepares to give Ms. Edwards a vaginal suppository, which is inserted by means of a special applicator supplied with the drug. Which one of the following is correct?

  1. Ask the client to void prior to inserting the suppository
  2. Lubricate the tip of the suppository with petroleum jelly
  3. Insert the applicator tip gently and with an upward and forward motion
  4. Insert the applicator approximately ½ inch and depress the plunger

39. The nurse is assigned to give Ms. Milton perineal care. When cleansing the perineum, the cotton ball or wash cloth is gently directed:

  1. Side to side across the labia majora
  2. Downward from the pubic area to the anus
  3. Upward from the anus to the pubic area
  4. Prom the urinary meatus to the vagina

40. The nurse is assigned to administer a vaginal irrigation (douche). Which of the following is correct?

  1. The irrigation is best administered with the client standing in a bathtub
  2. Before inserting, the nozzle is lubricated with petroleum jelly
  3. The temperature of the solution should be between 80°F and 84°F
  4. The nozzle is inserted downward and backward within the vagina

41. The nurse is assigned to teach health-seeking behaviors to young women. One topic the nurse plans to includes is the importance of the Pap test, which is used mainly to detect:

  1. Ovarian cyst
  2. Patency of the fallopian tube
  3. Cervical cancer
  4. Uterine infections

42. The physician asks the nurse to position a client for a vaginal examination. Which of the following position is normally used for this type of examination?

  1. Lithotomy position
  2. Sim’s position
  3. Dorsal recumbent position
  4. Left lateral position

43. Ms. Hull has had an electrocauterization of her cervix for chronic cervicitis. Following the procedure the nurse should instruct Ms. Hull to:

  1. Douche the next day to remove debris and blood cloth
  2. Avoid straining and heavy lifting until the physician permits this activity
  3. Stay in bed for the next 5 days
  4. Return in bed for the next 5 days

44. The nursing assistant is assigned to give Ms. Bailey, who has had an abdominal hysterectomy, a sitz bath. She is instructed to use the special sitz bath tub. She asks the nurse why the regular bath tub cannot be used. The most correct reply is based on the fact that a regular bath tab:

  1. Is more slippery and is dangerous when used for surgical clients
  2. Cannot supply water that is of the desired temperature for this procedure
  3. Applies heat to the legs and alters the desired effect of heat directed to the pelvic region
  4. Cannot be kept as clean as a special sitz bath tub

45. Which of the following solutions would be best for the nurse to use when cleaning the inner cannula of a tracheostomy tube?

  1. IsopropyI alcohol
  2. Sodium hydrochloride
  3. Hydrogen peroxide
  4. Providone-iodine

46. The nurse observes that the client’s knee is swollen and painful. Consequently; which one of the following nursing measures should be carried out?

  1. Perform passive range of motion during each shift
  2. Help to change positions to achieve comfort
  3. Ambulate with him at frequent intervals
  4. Encourage quadriceps setting exercises

47. If Ms. Drake tells the nurse her feet are cold. Which of the following nursing action would be best

  1. Apply a hot water bottle
  2. Use an electric heating pad
  3. Wrap them in a warm blanket
  4. Elevate her feet on a stool

48. Which of the following would indicate to the nurse that the stationary thrombus in Ms. Fleming suddenly develops?

  1. Chest pains
  2. Leg cramps
  3. Numbness in the foot
  4. Swelling of the knee

49. Following a total abdominal hysterectomy Ms. Sara Fleming develops a slightly elevated temperature and swelling in the right call of her leg. The physician prescribes warm moist compresses for the client’s affected leg. Which of the following nursing actions is correct when applying the warm moist compress? The nurse:

  1. Heats the water to 120°F
  2. Uses a sterile technique
  3. Inspect the skin every 4 hours
  4. Covers the wet gauze with a towel

50. Ms. Betty Lynch, age 29, holes that she has recently developed a skin problem and makes an appointment to be seen in a clinic specializing diagnosis of psoriasis is made by the physician. When examining Mr. Lynch’s skin for areas of psoriasis, the nurse should look for:

  1. Weeping lesions on the trunk of the body
  2. Patches of redness covered with silvery scales
  3. Areas of redness surrounded by crusts
  4. A rash characterized by raised, pus-filled lesions
Answers
  1. C. A decreased number of functioning acetylcholine receptor sites
  2. C. Adjust the TENS dial until the client perceives pain relief and comfort
  3. A. Autoimmunity
  4. C. Skin lesions
  5. B. Topical application of steroids
  6. C. Shiny, scaly lesions
  7. D. Using a sterile syringe to remove it from clamped, cleansed catheter
  8. A. Incision is in close proximity to the diaphragm
  9. B. Light amber urine, dark brown stools, yellow skin
  10. B. Bile flow into the intestine is obstructed
  11. D. Bleeding oral ulcerations
  12. B. Vomiting
  13. B. Paradoxical respiration
  14. D. Briefly apply pressure over the aspiration site
  15. C. A reallocation of the blood supply
  16. A. Older adult
  17. A. Small amount of yellowish green oozing
  18. A. Turn from side to side
  19. D. An inability to wrinkle the forehead
  20. C. Encourage the client not to contract his muscles as if he were voiding
  21. A. Hypovolemia
  22. D. Trosseau’s sign
  23. B. Any sedative type of medication has recently been administration
  24. C. Sterile normal saline
  25. D. To keep the drainage to light pink
  26. B. Poor personal hygiene
  27. B. The foreskin is retracted and the area beneath the foreskin is cleansed
  28. A. “When dud you first notice this problem?
  29. B. A probe will be inserted into the rectum
  30. B. Has a high incidence of early metastasis
  31. D. After a warm bath or shower
  32. C. Some live sperm will be present in the ejaculatory fluid for a period of time
  33. D. Urethra and bladder
  34. D. Urethra and bladder
  35. B. Surgery may be necessary to correct the problem
  36. A. Early symptoms of cancer of the ovary are vague
  37. B. Intensive vaginal and perineal itching
  38. A. Ask the client to void prior to inserting the suppository
  39. B. Downward from the pubic area to the anus
  40. D. The nozzle is inserted downward and backward within the vagina
  41. B. Patency of the fallopian tube
  42. A. Lithotomy position
  43. B. Avoid straining and heavy lifting until the physician permits this activity
  44. C. Applies heat to the legs and alters the desired effect of heat directed to the pelvic region
  45. C. Hydrogen peroxide
  46. B. Help to change positions to achieve comfort
  47. C. Wrap them in a warm blanket
  48. B. Leg cramps
  49. D. Covers the wet gauze with a towel
  50. B. Patches of redness covered with silvery scales