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Med-Surg Practice Questions: Fluid, Electrolyte, and Acid-Base Balance; Wound Care, Exams of Surgical Pathology

York CollegeSurgical Pathology

A series of multiple-choice questions covering key concepts in medical-surgical nursing, focusing on fluid and electrolyte balance, acid-base disorders, and wound care. the questions assess understanding of various physiological processes, diagnostic indicators, and appropriate nursing interventions. it's a valuable resource for nursing students preparing for exams or reinforcing their knowledge.

Typology: Exams

2024/2025

Available from 04/24/2025

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Med Surg Practice Questions (Exam #1) WITH CORRECT
ANSWERS
1. What responses does the nurse expect as a result of infusing
500 mL liter of a 3% saline intravenous solution into a client over
a 1-hour time period?
a) Plasma volume osmolarity increases; blood pressure increases
b) Plasma volume osmolarity decreases; blood pressure increases
c) Plasma volume osmolarity increases; blood pressure decreases
d) Plasma volume osmolarity decreases; blood pressure
decreases: a) Plasma volume osmolarity increases; blood pressure
increases
2. The nurse is reviewing laboratory results and notes that a
client's serum sodium level is 150 mEq/L. The nurse reports the
serum sodium level to the health care provider (HCP) and the HCP
prescribes dietary instructions based on the sodium level. Which
food item does the nurse instruct the client to avoid?
a) Peas
b) Nuts
c) Cauliflower
d) Processed oat cereals: d) Processed oat cereals
3. The nurse cares for a client with dehydration. Which signs or
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Download Med-Surg Practice Questions: Fluid, Electrolyte, and Acid-Base Balance; Wound Care and more Exams Surgical Pathology in PDF only on Docsity!

Med Surg Practice Questions (Exam #1) WITH CORRECT

ANSWERS

  1. What responses does the nurse expect as a result of infusing 500 mL liter of a 3% saline intravenous solution into a client over a 1-hour time period? a) Plasma volume osmolarity increases; blood pressure increases b) Plasma volume osmolarity decreases; blood pressure increases c) Plasma volume osmolarity increases; blood pressure decreases d) Plasma volume osmolarity decreases; blood pressure decreases: a) Plasma volume osmolarity increases; blood pressure increases
  2. The nurse is reviewing laboratory results and notes that a client's serum sodium level is 150 mEq/L. The nurse reports the serum sodium level to the health care provider (HCP) and the HCP prescribes dietary instructions based on the sodium level. Which food item does the nurse instruct the client to avoid? a) Peas b) Nuts c) Cauliflower d) Processed oat cereals: d) Processed oat cereals
  3. The nurse cares for a client with dehydration. Which signs or

symptoms is the nurse likely to observe in this client? Select all that apply a) The client's heart rate is 110 beats/min b) The client's respiratory rate is 9 breaths/min c) The client's serum osmolarity is low d) The client's serum potassium is 5.2 mEq/L e) The client's serum sodium level is 148 mEq/L: a) The client's heart rate is 110 beats/min d) The client's serum potassium is 5.2 mEq/L e) The client's serum sodium level is 148 mEq/L

  1. A nursing caring for an elderly adult client assesses for which symptoms of severe dehydration? Select all that apply a) Capillary refill of two seconds b) Decreased thirst sensation c) Dryness to oral mucosa d) Resting heart rate of 105 beats/min. e) Tenting of skin on hands: c) Dryness to oral mucosa d) Resting heart rate of 105 beats/min.
  1. A peroperative nurse is assessing a client prior to surgery. Which informa- tion would be most important to relay? a) use of herbs and supplements b) history of lactose intolerance c) no previous experience with surgery d) allergy to bee and wasp stings: a) use of herbs and supplements
  2. A peroperative nurse is reviewing morning labs on four clients waiting for surgery. Which would he report immediately? a) sodium: 134 mEq/L b) hemoglobin: 14.8 mg/dL c) potassium: 2.9 mEq/L d) creatinine: 1.2 mg/dL: c) potassium: 2.9 mEq/L
  1. A client needs to sign an informed consent but has questions about complications? What response by the nurse is best? a) have the client sign the consent, and then call the provider b) remind the client of what teaching the provider has done c) answer the questions and document that teaching was done d) do not have the client sign the consent and call the provider: d) do not have the client sign the consent and call the provider
  2. A postoperative client vomited. After cleaning and comforting the client, which action by the nurse is most important? a) encourage the client to eat dry toast b) auscultate lung sounds c) allow the client to rest d) document the episode: b) auscultate lung sounds
  3. The PACU charge nurse notes vital signs on four postoperative clients. What client would the nurse assess first? a) client with a RR of 6 b/min b) client with a pulse of 110 beats/min c) client with BP of 100/50 mmHg d) client with a temp of 96° F/35.6° C: a) client with a RR of 6 b/min
  4. The RN is watching another RN change a dressing and perform care on a drain. What action warrants an intervention?
  1. A PACU nurse is assessing a postop client with a NG tube. What lab value would warrant intervention? (SATA) a) pH: 7. b) bG: 120 mg/dL c) sodium: 142 mEq/L d) potassium: 2.9 mEq/L: a) pH: 7. d) potassium: 2.9 mEq/L
  2. A nurse provides care to reduce the incidence of surgical wound infection. What actions are best? (SATA) a) removing and replacing wet dressings b) performing proper HH c) leaving draining wounds open to air d) administering antibiotics for 72 hrs: a) removing and replacing wet dressings b) performing proper HH
  3. A postop nurse is assessing a pt who has a block. The pt has weak hand grasps. What assessment does the nurse do next? a) ability to raise head off the bed b) BP and pulse c) LOC d) signs of oxygenation: d) signs of oxygenation
  1. A nursing student is preparing to insert a vascular access device in an older patient. Which action by the nursing student requires intervention by the nurse? a) Performing hand hygiene prior to insertion b) Preparing for insertion immediately following cleaning with iodophors c) Using friction to clean the skin around the insertion site d) Clipping the hairs in the preferred insertion area: b) Preparing for insertion immediately following cleaning with iodophors
  2. A man with severe burns over 90% of his body has been brought to the ED. The rescue personnel were unable to establish IV access during transport to the hospital. Which type of IV device would be most appropriate at this time? a) PICC line b) Central Line

b) agitation c) positive Chvostek sign d) Kussmaul respirations: d) Kussmaul respirations

  1. The nurse is reviewing the orders for a client with COPD who was admitted for chest pain. Laboratory results indicate reveal mild respiratory acidosis. Which order will the nurse question? a) encourage oral fluids b) keep head of bed elevated c) oxygen therapy at 4 L/min as needed d) bedrest with bathroom privileges only: c) oxygen therapy at 4 L/min as needed
  2. Two days later first having a Stage 1 pressure ulcer, the client's sacral area appears to have an abrasion where the skin is not intact. What is the nurse's interpretation of this new finding?

a) stage I pressure injury b) stage II pressure injury c) stage III pressure injury d) stage IV pressure injury: b) stage II pressure injury

  1. Which additional intervention should be implemented with the develop- ment of a Stage 2 pressure ulcer? a) application of a transparent film dressing b) application of a dry cotton gauze dressing c) surgical debridement of the pressure injury d) administration of IV antibiotics every 8 hrs: a) application of a transparent film dressing
  2. A client who has been hiking in the woods comes to the ED with urticaria. After administering an antihistamine as prescribed, what teaching does the nurse provide? a) avoid outdoor activity b) use of sauna to relieve pain c) apply tea bags to the lesions d) consume 1-2 alcoholic beverages: a) avoid outdoor activity
  3. Upon removing a dressing from a wound, the nurse notices a strong odor. What is the appropriate nursing action? a) no action is necessary at this time
  1. When assessing the patient two hours after a thoracentesis, the nurse notes the skin around the puncture site is swollen and a crackling (crepitus) is felt and heard when pressure is applied to the area. What is the nurse's best action? a) Assess the patient's SPo2 levels at two separate sites b) Obtain a prescription to culture the site c) Document the finding as the only action d) Notify the respiratory health care provider: d) Notify the respiratory health care provider
  2. Which assessment finding for an older adult patient does the nurse ascribe to the natural aging process? a) Tightening of the vocal cords b) Decrease in residual volume c) Decrease in the anteroposterior diameter d) Decrease in respiratory muscle strength: d) Decrease in respiratory muscle strength
  3. Which assessment finding does the nurse interpret that is associated most closely with lung disease? a) Cough b) Dyspnea c) Chest pain

d) Sputum production: b) Dyspnea

  1. The surgery for a client scheduled for an 8:00 a.m. procedure is delayed until 11:00 a.m. What is the appropriate nursing action regarding administra- tion of preoperative prophylactic antibiotics? a) Administer at 8:00 a.m. as originally prescribed. b) Adjust the administration time to be given at 10:00 a.m. c) Do not administer, as preoperative prophylactic antibiotics are optional. d) Hold the antibiotic until immediately following surgery, and then adminis- ter.: b) Adjust the administration time to be given at 10:00 a.m.
  2. The nurse is caring for a client who is to undergo surgery at 6:00 am today. Which assessment data will the nurse communicate immediately to the surgeon and anesthesia provider? SATA a) BP 130/72 mmHg
  1. The nurse has prepared a client for transport from the medical-surgical unit to surgery. Which client statement will the nurse respond to as the priority? a) "When I eat shrimp, my tongue swells and I have trouble breathing" b) "I'm feeling more anxious about my surgery than I thought I would be" c) "I'm not sure what I will do if insurance doesn't cover this expensive hip replacement" d) "My sister had anesthesia a few months ago and she said she didn't like the way she felt": a) "When I eat shrimp, my tongue swells and I have trouble breathing"
  2. The nurse is caring for a client who has been readmitted to the medical-sur- gical unit following surgery for a hernia repair completed under general anes- thesia. What is the priority nursing assessment? a) perform thorough auscultation of the lungs b) assess response to pinprick stimulation from meet to mid-chest level c) determine level of consciousness and response to environmental stimuli

d) compare BP findings from preoperative assessment to the present: a) perform thorough auscultation of the lungs

  1. In the early postoperative phase, which assessment finding in a client who had an epidural during surgery requires immediate nursing intervention? a) BP of 142/90 mmHg b) headache of 4 on a 1-10 scale c) gradual return of motor function d) increase in back pain when coughing: a) BP of 142/90 mmHg
  2. The nurse is caring for a client who reports being fearful of becoming dependent on opioid pain medication after surgery. What is the appropriate nursing response? SATA a) "Why do you think you're going to get hooked?" b) "Don't worry, I won't give you any opioid medications" c) "Have you had concerns with drug dependence in the past?" d) "Tell me what makes you most fearful about taking opioid medication" e) "There are proper ways of taking opioids so you will not be dependent": c) "Have you had concerns with drug dependence in the past?" d) "Tell me what makes you most fearful about taking opioid medication" e) "There are proper ways of taking opioids so you will not be dependent"
  3. The nurse is completing a preoperative physical assessment for a client

worsens" d) "Let's try some relaxation exercises to help address the discomfort you are feeling": b) "Can you describe the pain you are having, and rate it on a 1- 10 scale"

  1. What clinical indicators are most relevant for the nurse to monitor during IV fluid replacement for a client with dehydration? SATA a) BP b) DTR c) hand-grip strength d) pulse rate and quality e) skin turgor f) urine output: a) BP d) pulse rate and quality f) urine output
  2. The client who is confined to bed in the recumbent position has gained 5 lbs (2.3 kg) in the past 24 hrs. In which area does the nurse assess skin turgor for accurate determination of dependent edema? a) foot and ankle b) forehead c) sacrum d) chest: c) sacrum
  1. With which client does the nurse remain alert for and assess most fre- quently for signs and symptoms of hypokalemia to prevent harm? a) 72 y/o taking the diuretic spironolactone for control of HTN b) 62 y/o receiving an IV solution of LR at a rate of 200 mL/hr c) 42 y/o trauma victim receiving a third infusion of packed RBC in 12 hrs d) 22 y/o receiving an IV infusion of regular insulin to manage an episode of ketoacidosis: d) 22 y/o receiving an IV infusion of regular insulin to manage an episode of ketoacidosis
  2. In reviewing the electrolytes of a client, the nurse notes the serum potassi- um level has increased from 4.6 mEq/L (mmol/L) to 6.1 mEq/L (mmol/L). Which assessment does the nurse perform first to prevent harm? a) Deep tendon reflexes b) Oxygen saturation c) Pulse rate and rhythm d) Respiratory rate and depth: c) Pulse rate and rhythm