Prepare for your Medical Surgical Nursing exam with these practice questions and answers. This comprehensive guide covers cardiac, respiratory, gastrointestinal, renal, neurological, and endocrine nursing care.
Q: Which patients are at risk for fluid volume excess?A. 64 year old male with a diagnosis of kidney failureB. 46 year old male who is training for a marathonC. 35 year old male with diarrhea and vomiting for the past 2 daysD. 83 year old female with a diagnosis of a stroke and has trouble talking
Answer: A
Q: Which solution is considered a hypertonic IV solution?A. 0.9% sodium chlorideB. Total parenteral nutritionC. 0.45% sodium chlorideD. Lactated Ringers solution
Answer: B
Q: What happens to the size of cells within the tissues when an isotonic IV solution is administered?A. Cells enlargeB. Cells shrinkC. The size of the cells remain unchanged
Answer: C
Q: True or False: The principle intracellular cation in the body is sodium.
Answer: False
Q: A nurse is planning care for a client with a fluid volume deficit. Which of the following are appropriate nursing actions? (Select all that apply)A. Administer a diureticB. Turn the patient at least ever two hoursC. infuse a hypertonic IV solution as orderedD. Teach the patient to sit on the side of bed first before standingE. Assess the patient’s level of consciousness and mental status
Answer: B, D, E
Q: The nurse recognizes which of the following statements are true regarding Fluid Volume Deficit/dehydration in older adults? (Select all that apply)A. The kidneys are less able to concentrate urineB. Diuretics and laxative use can increase fluid lossC. The perception of thirst increases with age in older adultsD. Poor skin turgor is a reliable indicator of dehydration in the elderlyE. Lack of air conditioning in hot weather is a risk factor for fluid volume deficit
Answer: A, B, E
Q: Tachycardia is present in which type of fluid imbalance?A. Fluid volume excessB. Fluid volume deficitC. Both fluid volume excess and fluid volume deficit
Answer: C
Q: Decreased serum osmolality is present in which type of fluid imbalance?A. Fluid volume excessB. Fluid volume deficitC. Both fluid volume excess and fluid volume deficit
Answer: A
Q: Jugular vein distention is present in which type of fluid imbalance?A. Fluid volume excessB. Fluid volume deficitC. Both fluid volume excess and fluid volume deficit
Answer: A
Q: Mr. Smith is a patient who has been admitted to a nursing unit with a diagnosis of heart failure resulting in fluid volume excess. Upon entering his room Mr. Smith complains of difficulty breathing. What should be the nurse’s first action?A. Contact the primary care providerB. Assess his fluid status by obtaining a daily weightC. Elevate the head of bed and obtain an oxygen saturation levelD. Administer a diuretic to help correct his diagnosis of a fluid volume excess
Answer: C
Q: The nurse is assigned to care for all of the following patients. Which patient is at risk for hypokalemia? (select all that apply)A. 64 year old with a diagnosis of kidney failureB. 35 year old with diarrhea and vomiting for the past 2 daysC. 83 year old with a hypertension who uses salt substitutesD. 26 year old in a motor vehicle accident who received 3 units of bloodE. 19 year old with a history of anorexia, laxative abuse, and diuretic use
Answer: B, E
Q: Which body system is associated with the most severe consequences due to imbalances in sodium?A. RenalB. RespiratoryC. NeurologicD. Gastrointestinal
Answer: C
Q: Increased thirst is a symptom of which disorders? Select all that applyA. DehydrationB. Cerebral edemaC. HypernatremiaD. HypophosphatemiaE. Hypomagnesaemia
Answer: A, C
Q: A patient with a fluid volume deficit is monitored for his fluid volume status with hourly measurements of his urine output. Which clinical finding should the nurse report to the primary care provider?A. Urine output of 30 mLs at 10am and 25 mLs at 11amB. Urine output of 100 mLs at 10am and 75 mLs at 11amC. Urine output of 45 mLs at 10 am and 60 mLs at 11amD. Urine output of 50 mLs at 10am and 100 mLs at 11am
Answer: A
Q: True or False: A phosphate deficiency usually occurs along with low serum potassium and calcium levels.
Answer: False
Q: The nurse is caring for a patient who manifests muscle weakness that first began in the legs and has progressed to include weakness in the arms. Based on this information, what statement can be made about imbalances in potassium?A. These can be symptoms associated only with hypokalemiaB. These can be symptoms associated only with hyperkalemiaC. These symptoms are not related to imbalances in potassiumD. These symptoms can occur in either hypokalemia or hyperkalemia
Answer: D
Q: Which food source is high in potassium?A. EggsB. PearsC. SpinachD. Whole wheat
Answer: C
Q: When caring for a patient who is receiving potassium supplements, the nurse recognizes the need to do which of the following actions?A. Encourage the patient to use salt substitutes with mealsB. Give oral potassium by diluting it in fruit juice or cold waterC. Give potassium as a slow IV push medication over 1-2 minutesD. Monitor SpO2 levels (oxygen saturation) when administering via the IV route
Answer: B
Q: A nurse is caring for a patient who has dysrhythmias. Which laboratory result would the nurse expect to see for this patient?A. Sodium 165 mEq/LB. Potassium 6.8 mEq/LC. Hematocrit 40%D. Glucose 60 mL/dL
Answer: B
Q: Which clinical indicator would be expected in a patient with severe third spacing of fluids?A. Decreased serum osmolalityB. Fever greater than 101 FC. Orthostatic hypotensionD. Jugular vein distention
Answer: C
Q: A patient develops acute renal failure. Which acid-base imbalance should the nurse anticipate?A. Respiratory alkalosisB. Respiratory acidosisC. Metabolic alkalosisD. Metabolic acidosis
Answer: D
Q: A 23-year old patient is found unresponsive with a respiratory rate of 6 per minute after a narcotic overdose. Which acid-base imbalance should the nurse anticipate?A. Respiratory alkalosisB. Respiratory acidosisC. Metabolic alkalosisD. Metabolic acidosis
Answer: D
Q: The nurse is assessing a patient with chronic alcoholism for signs of hypocalcaemia. Which action should the nurse take to assess for Trouseeau’s signs?A. inflate a blood pressure cuff on the upper arm above systolic pressure for 2 to 5 minutesB. Tap the facial nerve in front of the ear and observe for contraction of the facial musclesC. Monitor neurological function including mental status and level of consciousnessD. Asses for numbness and tingling around the mouth and in the hands and feet
Answer: A
Q: Which disorder should the nurse recognize as a risk factor for hypocalcemia?A. diabetes mellitusB. HypoparatyroidismC. Myasthenia GravisD. Raynaud’s Disease
Answer: B
Q: What teaching should the nurse provide to a patient who has been prescribed calcium supplements?A. Drink plenty of fluids and eat a diet high in fiberB. headache is a common side effect of this medicationC. Take this mediation with a full glass of milkD. do not abruptly stop taking this medication
Answer: A
Q: The nurse would recognize the following as manifestations of hypocalcemia: (Select all that apply)A. Hyperactive reflexesB. Bone pain, fractureC. TetanyD. Numbness and tingling around the mouth
Answer: A, B, C, D
Q: The nurse is planning care for a client admitted to the hospital with chest pain. Which of the following lab results would the nurse recognize as most suggestive of a diagnosis of diabetes?A. Casual finger stick blood glucose of 126 mg/dLB. Hemoglobin A1C of 8%C. Oral Glucose Tolerance Test of 122 mg/dL at 2 hoursD. Pre-Prandial (before meals) finger stick blood glucose of 134 mg/dL
Answer: B
Q: The nurse is conducting a health history interview. Which symptoms should the nurse recognize as classic manifestations of Type 1 Diabetes Mellitus?A. obesityB. fatigueC. Excessive hungerD. excessive thirstE. Weight loss
Answer: B, C, D, E
Q: The nurse should be alert for signs of ______ after administering insulin to the patient.A. hypernatremiaB. hyperglycemiaC. HypoglycemiaD. Hyponatremia
Answer: C
Q: In determining if the patient is hypoglycemic, the nurse should assess for the following manifestations. Select all the apply:A. hungerB. SweatingC. Excessive urinationD. Decreased level of consciousnessE. Kussmaul’s Respirations
Answer: A, B, D
Q: Which factor can precipitate a delayed hypoglycemic reaction in the patient with diabetes?A. lack of physical activityB. too much food intakeC. ingestion of alcoholD. drugs such as acetaminophen
Answer: C
Q: The nurse is treating an alert client with a blood sugar of 52 mg/dL. The nurse gives the client 4 ounces of orange juice. What action should the nurse take next?A. Place the patient in the side-lying positionB. Wait 15 minutesC. Recheck glucoseD. give 15 mg of carbohydrates
Answer: B
Q: The nurse is evaluating the patient’s knowledge regarding the treatment of hypoglycemia. The nurse should place the highest priority on determining the patient understands which of the following points?A. Symptoms indicating the need to notify the health care providerB. The importance of performing finger stick blood sugars before mealsC. when to ingest 4 ounces of juice or regular sodaD. The importance of maintaining a regular exercise regiment
Answer: C
Q: A diabetic patient is found unconscious at home and the family member calls the clinic. After determining that a glucometer is not available, what should the nurse advise the family to do?A. Have the patient drink 4 ounces of orange juiceB. Administer 10u of regular insulin subcutaneouslyC. Administer glucagon 1mg intramuscularly or subcutaneouslyD. call for an ambulance to transport the patient to a medical facility
Answer: C
Q: The nurse is teaching a patient who has been diagnosed with diabetes mellitus. Which statements should the nurse include in the teaching session regarding the complications of diabetes?a. “Wearing loosely fitting shoes is important to help avoid blisters and prevent possible amputation”b. “People with diabetes are less likely to have heart disease than those who do not have the disease.”c. “Lowering A1C levels to around 7% in the diabetic patient has shown to reduce the risk of complications”d. “Maintaining a diabetic diet is the most important thing you can do to help prevent the complications of diabetes”
Answer: C
Q: The nurse is conducting a teaching session regarding Sick Day Management for the patient with diabetes. What instructions should the nurse include?A. drink 8 oz of fluids every hour when you are sickB. It is important to monitor your blood sugar twice a dayC. Use over the counter Imodium if you have 2 or more lose stoolsD. Immediately report to the emergency room if you have vomiting longer than 2 hours
Answer: A.
Q: The home health nurse is caring for a patient with diabetes. Upon initial assessment, the patient’s vital signs are blood pressure 142/90, pulse 84, respirations 22, and temperature 101F. Which finding should be of the most immediate concern to the nurse?a. blood pressureb. pulsec. respirationsd. temperature
Answer: D
Q: Which of the following lab results indicates Prediabetes?a. A1C of 5.9%b. casual blood glucose of 142 mg/dLc. fasting blood glucose of 132 mg/dLd. oral glucose tolerance of 122 mg/dL
Answer: A
Q: The nurse is conducting a teaching session regarding prediabetes at a local health fair. Which point should the nurse include in the teaching session?a. People with prediabetes are at higher risk for developing diabetes and cardiovascular diseaseb. Daily insulin injections are recommended to prevent the complications associated with prediabetesc. aerobic exercise should be avoided in patients with prediabetes to prevent hypoglycemic episodesd. prediabetes is not a significant finding for most people, only those who have a genetic predisposition for diabetes should be concerned
Answer: A
Q: Which finding in the patient’s history should the nurse recognize as a major risk factor for Type II DM?a. smokingb. weight lossc. physical inactivityd. pancreatic cancer
Answer: C
Q: Chronic complications of uncontrolled Type I and Type II DM includes: Select all that apply:a. happinessb. coronary artery diseasec. stroked. retinopathye. nephropathy
Answer: B, C, D, E
Q: The nurse is caring for a patient in diabetic ketoacidosis who is being treated with intravenous Normal Saline and insulin. Which manifestation should the nurse immediately report to the primary care provider?a. headacheb. muscle weaknessc. polyuriad. thirst
Answer: B
Q: pH
Answer: 7.34-7.45
Q: PO2
Answer: 80-100 mmHg
Q: PCO2
Answer: 35-45 mmHg
Q: HCO3
Answer: 22-26 mEq/L
Q: SaO2
Answer: 95-99%
Q: WBC
Answer: 4,500-11,000 mm3
Q: Hgb
Answer: Men: 13.5-18 g/dLWomen: 12-15 g/dL
Q: Hct
Answer: Men: 40-54%Women: 36-46%
Q: Platelets
Answer: 150,000-350,000 mm3
Q: Glucose
Answer: 70-100 mg/dL
Q: Potassium
Answer: 3.4-5.3 mEq/L
Q: Sodium
Answer: 135-145 mEq/L
Q: BUN
Answer: 5-25 mg/dL
Q: Creatinine
Answer: 0.5-1.5 mg/dL
Q: PT
Answer: 11-13 seconds
Q: PTT/aPTT
Answer: 60-70 seconds / 20-35 seconds
Q: INR
Answer: 2.0-3.0
Q: Total cholesterol
Answer: <200 mg/dL
Q: glycosylated hemoglobin
Answer: 4.0-5.5%