Midsurgi 2

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Sample questions from Midsurgi 2

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.At change of shift on a medical-surgical unit, the nurse receives report on four clients. Which client should the nurse assess first?

   • A.A client with diabetes whose premeal glucose is 218 mg/dL and who is waiting for prescribed insulin
   • B.A client 6 hours after thyroidectomy who reports tingling around the mouth and has a newly hoarse voice
   • C.A client with a urinary tract infection who has a temperature of 38.1 C and is due for acetaminophen
   • D.A client with chronic obstructive pulmonary disease whose oxygen saturation is 90% on the prescribed 2 L/min and who is speaking comfortably

   Rationale: Perioral tingling can signal hypocalcemia after thyroid surgery, and new hoarseness may indicate airway compromise. The stable oxygen saturation is within the COPD client's prescribed range, while the fever and glucose elevation require follow-up but are not the most immediate threats. Airway and rapidly evolving postoperative complications take priority.

2. 2.In a rehabilitation unit, an RN is assigning care to a licensed practical nurse (LPN) and an unlicensed assistive personnel (UAP). Which task is appropriate to delegate to the UAP?

   • A.Obtain and record the daily weight of a stable client with heart failure
   • B.Assess a client who reports new dizziness when standing
   • C.Evaluate the response to a newly administered pain medication
   • D.Teach a client how to use a walker after hip surgery

   Rationale: Obtaining a routine daily weight for a stable client is a predictable task that can be delegated to a UAP. Assessments, teaching, and evaluation require nursing judgment and remain the RN's responsibility. The RN should communicate the weight parameters that require reporting.

3. 3.Refer to the client's chart. Which actions should the nurse take now for this client with a possible acute coronary syndrome? Select all that apply.

   • A.Obtain a 12-lead ECG promptly
   • B.Administer the prescribed sublingual nitroglycerin after checking blood pressure and contraindications
   • C.Notify the rapid response team or provider about the new symptoms and ECG changes
   • D.Delay reassessment until the next scheduled vital signs
   • E.Encourage the client to walk to reduce anxiety

   Rationale: The client's new chest pressure, diaphoresis, and evolving ST depression require prompt ECG evaluation, escalation, and treatment as prescribed; blood pressure and contraindications must be checked before nitroglycerin. Walking increases myocardial oxygen demand during possible ischemia. Waiting for scheduled observations risks missing deterioration.

4. 4.A client with chronic kidney disease asks why the prescribed epoetin alfa is being given. Which response by the nurse is most accurate?

   • A.It replaces the iron that is lost during dialysis.
   • B.It prevents your blood from forming clots in the dialysis access.
   • C.It helps your kidneys remove excess potassium from your blood.
   • D.It stimulates red blood cell production to treat anemia.

   Answer and rationale are in the full material.

5. 5.A client with heart failure is prescribed furosemide 40 mg IV. Which finding is most important for the nurse to report before administering the dose?

   • A.Mild bilateral ankle edema
   • B.Urine output 55 mL/hr
   • C.Potassium 2.9 mEq/L
   • D.Blood pressure 118/72 mm Hg

   Answer and rationale are in the full material.