Medical-Surgical Nursing Exam 7

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Exam Mode – Questions and choices are randomly arranged, time limit of 1min per question, answers and grade will be revealed after finishing the exam.

Text Mode – Text version of the exam

1. Before being discharged, Mr. Heywood must be taught principles of good body mechanics. The nurse would be correct in telling Mr. Heywood that when he picks up something, he should:

1. Flex both his knees
2. Keep his feet together
3. Lift with arms extended
4. Bend from the waist

2. The nurse applies a commercially made hot moist pack, called a hydrocollator, to the client’s lower back. To reduce the potential for a thermal injury the nurse should plan to:

1. Wrap the pack in several thick towels
2. Rub skin lotion over the back area
3. Place a pillow between hint and the back
4. Position the client on rubber ring

3. Which one of the following observations would most indicate to the nurse that the skin over Mr. Heywood’s coccyx is becoming impaired? The skin:

1. Looks shiny over boy prominences
2. Appears red when pressure in relieved
3. Feels cool and clammy
4. Is moist and warm

4. Before turning Mr. Heywood to wash his back, which instruction should the nurse provide to minimize his discomfort?

1. “Hold your breath as you are turning.”
2. “Move your upper body first then legs.”
3. “Curl up in a ball before you move.”
4. “Avoid twisting your body while moving.”

5. Which of the following should the nurse use to provide support to Mr. Heywood’s spine?

1. A sheep skin pad
2. An air mattress
3. A bed board
4. A foam square

6. Mr. Heywood is to remain in bed for the time being. Which position would the nurse find gives Mr. Heywood the most comfort?

1. On his back with the head and knees elevated
2. On his side with hips and legs straight
3. On his abdomen with his head to the side
4. On his back with his head and knees straight

7. Mr. Heywood is receiving 10 mg of Diazepam (Vatium) orally t.i.d. Besides diminishing anxiety, the nurse explains that this medication is also used to:

1. Reduce emotional depression
2. Relax skeletal muscles
3. Promote restful sleep
4. Relieve inflammation

8. Mr. Barry Heywood, a construction worker, has been experiencing periodic bouts of law back pain. Now, in addition to the pain that radiates into his buttocks, he has some numbness and tingling in his legs. The physician suspects that Mr. Heywood has a herniated intervertebral disk in the lumbar spine. While assessing the disk to indicate that the pain is increased when:

1. Eating
2. Sneezing
3. Resting
4. Urinating

9. Mr. Rumsey, who has not regained consciousness, rushed to surgery where his arm is amputated above the elbow. When Mr. Rumsey reacts from the anesthesia, he sees that his forearm is missing. He screams obscenities and sobs uncontrollably. Which of the following is the best action the nurse can take at this time?

1. Leave the room until he has worked through his anger
2. Stay with him quietly in the room at his bedside
3. Tell him to get control of himself
4. Call the hospital chaplain for him

10. In what position should the nurse place Mr. Rumsey while continuing with his assessment and care?

1. Prone
2. Supine extended
3. On his back with his legs elevated
4. On his side with his neck

11. During a farming accident Mr. Steve Rumsey’s arm gets caught in a corn auger. His lower left arm and band are crushed. Which of the following assessments would the nurse typically find when the paramedics bring Mr. Rumsey to the hospital in shock? The client would have:

1. Decreased heart rate
2. Decreasing blood pressure
3. Increasing bowel sounds
4. Increasing urine output

12. Ms. Angela Freeman has acute low back pain. She’ has pelvic-belt traction, which she uses intermittently throughout the day. When the nurse helps Ms. Freeman apply the pelvic traction, it would be best to place the top of the belt:

1. Just below the ribcage
2. Even with her waistline
3. Level with the iliac crest
4. Where it is most comfortable

13. Ms. Rizal has acute rheumatoid arthritis. Her hands and spine are involved. When the nurse admits Ms. Rizal is most likely to tell the nurse that the first symptoms that caused her to seek health care was:

1. Stiff, sore joints
2. Generalized fatigue
3. Stabbing hand pain
4. Disuse of fingers

14. Before Ms. Elkins leaves the emergency department, the nurse demonstrates hew to apply the roller bandage. She is told to remove it for approximately 20 minutes and re-apply it three times a day. It is essential that the nurse tells Ms. Elkins to loosen-the bandage if:

1. Her toes feel fairly warm
2. Her ankle feels painful
3. Her toes appear swollen
4. She wears a cotton sock

15. The x-ray reveals that the bones are intact. The physician tells Ms. Elkins that she has severely sprained ankle. The physician directs the nurse to wrap Ms. Elkins foot with an elastic roller bandage referred to by some as an Ace bandage. Where should the nurse begin applying the bandage?

1. Below the knee
2. Above the knee
3. Across the phalanges
4. At the metatarsals

16. Following an injury in which Ms. Leona Elkins while climbing stairs, she experiencing immediate swelling of her ankle and pain on movement. Her physician has sent her to the hospital for x-ray. Which on of the following nursing measures would be most helpful for relieving the swelling while preparing to obtain the x-ray of Ms. Elkin’s lower leg?

1. Dangle the foot
2. Elevate the foot
3. Exercise the foot
4. Immobilize the foot

SITUATION: Mr. Ramos was barbecuing outdoors when the gas tank exploded. He sustained second degree and third degree burns of the anterior portion of BOTH arms, the upper half of his anterior trunk and the anterior and posterior portions of his left lower extremity.

17. The BEST initial management of burns that can be employed at the scene is generally which of the following:

1. Pour cold water over the burned areas
2. Apply clean dressing to the affected area
3. Rinse the area with mild soap and water
4. Apply tomato juice and ointment over the area

18. At the emergency room, the nurse assessed the extent of the burn on the patient’s body. Based on the rules of nine. Which of the following is the BEST estimate of the burn?

1. 36%
2. 45%
3. 27%
4. 54%

19. Which one of the following .blood value determinations is most likely be useful to evaluate the adequacy of the fluid replacement?

1. Creatinine levels
2. Blood urea nitrogen
3. Hematocrit level
4. C02 tension

20. The nurse is administering the prescribed IVF. When she evaluated the patient, she suspected fluid overload because of which finding?

1. Dark and scant urine output
2. Moist rates
3. Bradycardia and hypotension
4. Facial flushing and twitching

21. The doctor orders MAFENIDE for application over the bum area. The nurse understands that one disadvantage of this drug is that:

1. It causes lactic acidosis
2. It must be constantly applied
3. It has minimal eschar penetration
4. It is bacteriostatic

SITUATION: MARK Lester had been diagnosed with Stage 1 bronchogenic cancer. He had undergone lobectomy on the left lower lung. A two-bottle drainage system is inserted.

22. The patient is placed on bed post-operatively in what position?

1. Prone
2. Trendelenburg
3. Right side
4. Left side

23 Water-seal chest drainage involves attaching the chest tube to a:

1. Suction machine directly
2. Rubber tube/glass tube that is submerged underwater
3. Rubber tube that is left open to air
4. A closed drainage bottle with sterile water and no external opening

24. If the nurse sees fluid moving up and down during inspiration and expiration on the water seal bottle, she should:

1. Do nothing as this is expected
2. Immediately check the bottle for leaks
3. Call the physician immediately and damp the chest tube
4. Cover the wound with wet sterile gauze and send someone to calf the physician

25. If the nurse sees vigorous and continuous bubbling in the second bottle, she should:

1. Momentarily clamp the tube to note for air leak
2. Administer oxygen to the patient
3. Attempt to change a new bottle
4. Pull the chest tube out to remove the air leak

Answers

1. A. Flex both his knees
2. B. Wrap the pack in several thick towels
3. B. Appears red when pressure in relieved
4. D. “Avoid twisting your body while moving.”
5. B. An air mattress
6. A. On his back with the head and knees elevated 
7. B. Relax skeletal muscles
8. B. Sneezing
9. B. Stay with him quietly in the room at his bedside
10. C. On his back with his legs elevated
11. B. Decreasing blood pressure
12. C. Level with the iliac crest
13. A. Stiff, sore joints
14. C. Her toes appear swollen
15. D. At the metatarsals
16. D. Immobilize the foot
17. A. Pour cold water over the burned areas
18. A. 36%
19. C. Hematocrit level
20. B. Moist rates
21. A. It causes lactic acidosis
22. C. Right side
23. D. A closed drainage bottle with sterile water and no external opening
24. A. Do nothing as this is expected
25. A. Momentarily clamp the tube to note for air leak