Nursing textbooks medical-surgical practice questions, set 36
Nursing textbooks · medical-surgical
Nursing textbooks medical-surgical practice questionsset 36
You practice adult health stems across systems, then name the action that changes the outcome. Five of the 15 questions include the correct answer and rationale. The other ten keep answers in the study hub. Continue with the Nursing textbooks exam guide or more Nursing textbooks practice questions.
Five medical-surgical questions with answers
Cover the key. Write the first action. Then open the rationale and name why the other choices fail.
Question 1
The nurse is caring for an 84-year-old client who is being admitted for diagnostic studies for a potential renal disorder. The nurse planning care has initiated a care plan of 'knowledge deficiency related to poor understanding of diagnostic studies as manifested by client statements of not understanding diagnostic procedures and elevated anxiety.' Which nursing intervention(s) does the nurse include in the plan of care?
A. Assess client's level of understanding.
B. Provide written reading material.
C. Remain with client and answer questions.
D. Administer an ordered sedative.
E. Use simple language.
Show answer and rationale
Correct answer: A — Assess client's level of understanding.
The nurse is caring for a client who is unsure of the diagnostic study and is anxious. The nursing interventions to assist the client begin with understanding knowledge base following an assessment of understanding. Next, remaining with client and answering questions in simple terms alleviates anxiety and opens teaching and communication. If all consents are signed, an ordered sedative may diminish client anxiety. Providing written material at this time is not helpful and may increase anxiety. All instruction should be primarily directed toward the client but include all family members.
Question 2
The nurse is caring for a client who has a history of urine reflux. To assess the client for this urinary complication, which nursing action is best?
A. Ask the client if voiding sufficient quantities has been a problem.
B. Monitor the client's intake and output for inconsistency.
C. Have the client void into a collection device.
D. Palpate the client's bladder for distension.
Show answer and rationale
Correct answer: D — Palpate the client's bladder for distension.
Normally, urine flows in one direction because of peristaltic action and because the ureters enter the bladder at an oblique angle. The reflux of urine (urine that flows backward) can occur secondary to a distended bladder. By palpating for bladder distension, the nurse is able to determine that reflux urine traveled back to the bladder instead of traveling from the bladder down the urethra. All of the other options provide data that can be helpful, but actually feeling for the distension is best. Using a bladder scanner would also provide an amount of urine in the bladder.
Question 3
A patient returns to the clinic with recurrent dysuria after being treated with trimethoprim-sulfamethoxazole for 3 days. Which of the following actions should the nurse plan to take?
A. Remind the patient about the need to drink 1000 mL of fluids daily.
B. Obtain a midstream urine specimen for culture and sensitivity testing.
C. Teach the patient to take the prescribed trimethoprim-sulfamethoxazole for at least 3 more days.
D. Suggest that the patient drink cranberry juice to treat the symptoms.
Show answer and rationale
Correct answer: B — Obtain a midstream urine specimen for culture and sensitivity testing.
Since uncomplicated urinary tract infections (UTIs) are usually successfully treated with 3 days of antibiotic therapy, this patient will need a urine culture and sensitivity to determine appropriate antibiotic therapy. Although daily intake of cranberry juice has been purported to assist in treating, there is currently no conclusive evidence to support advocating this treatment. The fluid intake should be increased to at least 1000 mL/day. Since the UTI has persisted after treatment with trimethoprim-sulfamethoxazole, the patient is likely to need a different antibiotic.
Question 4
A nurse is working with a female patient who has developed stress urinary incontinence. Pelvic floor muscle exercises have been prescribed by the primary care provider. How can the nurse best promote successful treatment?
A. Clearly explain the potential benefits of pelvic floor muscle exercises.
B. Ensure the patient knows that surgery will be required if the exercises are unsuccessful.
C. Arrange for biofeedback when the patient is learning to perform the exercises.
D. Contact the patient weekly to ensure that she is performing the exercises consistently.
Show answer and rationale
Correct answer: C — Arrange for biofeedback when the patient is learning to perform the exercises.
Research shows that written or verbal instruction alone is usually inadequate to teach an individual how to identify and strengthen the pelvic floor for sufficient bladder and bowel control. Biofeedback-assisted pelvic muscle exercise (PME) uses either electromyography or manometry to help the individual identify the pelvic muscles as he or she attempts to learn which muscle group is involved when performing PME. This objective assessment is likely superior to weekly contact with the patient. Surgery is not necessarily indicated if behavioral techniques are unsuccessful.
Question 5
The nurse is caring for a patient who had a nephrectomy after having massive trauma to the kidney. Which of the following assessment findings obtained postoperatively is most important to communicate to the surgeon?
A. Blood pressure is 102/58.
B. Incisional pain level is 8/10.
C. Urine output is 20 ml/hour for 2 hours.
D. Crackles are heard at both lung bases.
Show answer and rationale
Correct answer: C — Urine output is 20 ml/hour for 2 hours.
Because the urine output should be at least 0.5 ml/kg/hour, a 20 ml output for 2 hours indicates that the patient may have decreased renal perfusion because of bleeding, inadequate fluid intake, or obstruction at the suture site. The blood pressure requires ongoing monitoring but does not indicate inadequate perfusion at this time. The patient should cough and deep breathe, but the crackles do not indicate a need for an immediate change in therapy. The incisional pain should be addressed, but this is not as potentially life-threatening as decreased renal perfusion.
Keep going past these 15 questions
Missed-question review, longer banks, and the rest of 20,000+ nursing practice questions open when you start studying.
Ten more Nursing textbooks medical-surgical questions
Stems and choices stay public so you can still reason. Correct answers and full rationales unlock with the rest of the bank.
Question 6
Which of the following explanations should the nurse provide to a patient who asks, 'What is a cystoscopy?'
A. Your health care provider will insert a lighted tube into the bladder, and little catheters will be inserted through the tube into your kidney.
B. Your health care provider will place a catheter into an artery in your groin and inject a dye that will visualize the blood supply to the kidneys.
C. Your health care provider will inject a radioactive solution into a vein in your arm and the distribution of the isotope in your kidneys and bladder will be checked.
D. Your health care provider will insert a lighted tube into the bladder through your urethra, inspect the bladder, and instill a dye that will outline your bladder on x-ray.
Correct answer:
With a cystoscopy, a cystoscope is inserted into the bladder for direct visualization, and then contrast solution is injected through the scope so that x-rays can be taken. The response beginning, 'Your health care provider will place a catheter' describes a renal arteriogram procedure. The response beginning, 'Your health care provider will inject a radioactive solution' describes a nuclear scan. The response beginning, 'Your health care provider will insert a lighted tube into the bladder, and little catheters will be inserted' describes a retrograde pyelogram.
A patient with renal failure secondary to diabetic nephropathy has been admitted to the medical unit. What is the most life-threatening effect of renal failure for which the nurse should monitor the patient?
A. Accumulation of wastes
B. Retention of potassium
C. Depletion of calcium
D. Lack of BP control
Correct answer:
Retention of potassium is the most life-threatening effect of renal failure. Aldosterone causes the kidney to excrete potassium, in contrast to aldosterones effects on sodium described previously. Acidbase balance, the amount of dietary potassium intake, and the flow rate of the filtrate in the distal tubule also influence the amount of potassium secreted into the urine. Hypocalcemia, the accumulation of wastes, and lack of BP control are complications associated with renal failure, but do not have same level of threat to the patients well-being as hyperkalemia.
A nurse is educating a client undergoing treatment for genitourinary tract bacterial infections on an outpatient basis. What instructions should the nurse offer the client as part of the client teaching plan?
A. Notify the primary health care provider if abdominal pain occurs.
B. Discontinue the therapy if symptoms vanish.
C. Decrease fluid intake if symptoms subside.
D. Increase fluid intake to at least 2000 mL/day.
Correct answer:
The nurse should instruct the client to increase the fluid intake to at least 2000 mL/day to help remove bacteria from the genitourinary tract when caring for a client with a genitourinary tract bacterial infection. The nurse should stress the importance of continued therapy even if symptoms vanish or the client feels better after a few doses. The nurse should encourage continued increased fluid intake even if the symptoms subside. Abdominal pain is not commonly associated with genitourinary tract bacterial infections, so this instruction would not be necessary.
The nurse is caring for a patient who describes changes in his voiding patterns. The patient states, I feel the urge to empty my bladder several times an hour and when the urge hits me I have to get to the restroom quickly. But when I empty my bladder, there doesnt seem to be a great deal of urine flow. What would the nurse expect this patients physical assessment to reveal?
A. Hematuria
B. Urine retention
C. Dehydration
D. Renal failure
Correct answer:
Increased urinary urgency and frequency coupled with decreasing urine volumes strongly suggest urine retention. Hematuria may be an accompanying symptom, but is likely related to a urinary tract infection secondary to the retention of urine. Dehydration and renal failure both result in a decrease in urine output, but the patient with these conditions does not have normal urine production and decreased or minimal flow of urine to the bladder. The symptoms of urgency and frequency do not accompany renal failure and dehydration due to decreased urine production.
The nurse is caring for a patient with an indwelling urinary catheter. The nurse is aware that what nursing action helps prevent infection in a patient with an indwelling catheter?
A. Vigorously clean the meatus area daily.
B. Apply powder to the perineal area twice daily.
C. Empty the drainage bag at least every 8 hours.
D. Irrigate the catheter every 8 hours with normal saline.
Correct answer:
To reduce the risk of bacterial proliferation, the nurse should empty the collection bag at least every 8 hours through the drainage spout, and more frequently if there is a large volume of urine. Vigorous cleaning of the meatus while the catheter is in place is discouraged, because the cleaning action can move the catheter, increasing the risk of infection. The spout (or drainage port) of any urinary drainage bag can become contaminated when opened to drain the bag. Irrigation of the catheter opens the closed system, increasing the likelihood of infection.
The nurse is caring for a patient following rectal surgery who voids about 50 mL of urine every 30-60 minutes. Which of the following nursing actions is best?
A. Use a bladder scan device to check the postvoiding residual.
B. Monitor the patient's intake and output over the next few hours.
C. Have the patient take small amounts of fluid frequently throughout the day.
D. Reassure the patient that this is normal after rectal surgery because of anesthesia.
Correct answer:
A bladder scan device can be used to check for residual urine after the patient voids. Because the patient's history and clinical manifestations are consistent with overflow incontinence, it is not appropriate to have the patient drink small amounts. Although overflow incontinence is not unusual after surgery, the nurse should intervene to correct the physiological problem, not just reassure the patient. The patient may develop reflux into the renal pelvis as well as discomfort from a full bladder if the nurse waits to address the problem for several hours.
The nurse is teaching parents of a child with cri du chat syndrome about this disorder. The nurse understands parents understand the teaching if they make which statement?
A. This disorder is very common.
B. This is an autosomal recessive disorder.
C. The crying pattern is abnormal and catlike.
D. The child will always have a moon-shaped face.
Correct answer:
Typical of this disease is a crying pattern that is abnormal and catlike. Cri du chat, or cats cry, syndrome is a rare (one in 50,000 live births) chromosome deletion syndrome, not autosomal recessive, resulting from loss of the small arm of chromosome 5. In early infancy this syndrome manifests with a typical but nondistinctive facial appearance, often a moon-shaped face with wide-spaced eyes (hypertelorism). As the child grows, this feature is progressively diluted, and by age 2 years, the child is indistinguishable from age-matched control participants.
Which is a consequence of the physical punishment of children, such as spanking?
A. The psychologic impact is usually minimal.
B. The childs development of reasoning increases.
C. Children rarely become accustomed to spanking.
D. Misbehavior is likely to occur when parents are not present.
Correct answer:
Through the use of physical punishment, children learn what they should not do. When parents are not around, it is more likely that children will misbehave because they have not learned to behave well for their own sake but rather out of fear of punishment. Spanking can cause severe physical and psychologic injury and interfere with effective parentchild interaction. The use of corporal punishment may interfere with the childs development of moral reasoning. Children do become accustomed to spanking, requiring more severe corporal punishment each time.
Parents ask the nurse if there was something that should have been done during the pregnancy to prevent their childs cleft lip. Which statement should the nurse give as a response?
A. This is a type of deformation and can sometimes be prevented.
B. Studies show that taking folic acid during pregnancy can prevent this defect.
C. This is a genetic disorder and has a 25% chance of happening with each pregnancy.
D. The malformation occurs at approximately 5 weeks of gestation; there is no known way to prevent this.
Correct answer:
Cleft lip, an example of a malformation, occurs at approximately 5 weeks of gestation when the developing embryo naturally has two clefts in the area. There is no known way to prevent this defect. Deformations are often caused by extrinsic mechanical forces on normally developing tissue. Club foot is an example of a deformation often caused by uterine constraint. Cleft lip is not a genetic disorder; the reasons for this occurring are still unknown. Taking folic acid during pregnancy can help to prevent neural tube disorders but not cleft lip defects.
Which is characteristic of X-linked recessive inheritance?
A. There are no carriers.
B. Affected individuals are principally males.
C. Affected individuals are principally females.
D. Affected individuals will always have affected parents.
Correct answer:
In X-linked recessive disorders, the affected individuals are usually male. With recessive traits, usually two copies of the gene are needed to produce the effect. Because the male only has one X chromosome, the effect is visible with only one copy of the gene. Females are usually only carriers of X-linked recessive disorders. The X chromosome that does not have the recessive gene will produce the normal protein, so the woman will not show evidence of the disorder. The transmission is from mother to son. Usually the mother and father are unaffected.
About these Nursing textbooks medical-surgical questions
Nursing textbooks medical-surgical practice questions, set 36 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
No. Nursier is independent practice. Register through the official path named on the Nursing textbooks exam guide.
The first five questions already include the rationale. Start full practice to unlock the remaining keys, missed-question review, and the rest of the bank.
Keep going past these 15 questions
Missed-question review, longer banks, and the rest of 20,000+ nursing practice questions open when you start studying.
