Custom Exam Medb Surg 250

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Sample questions from Custom Exam Medb Surg 250

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

1. 1.A 72-year-old client is admitted to a medical-surgical unit with pneumonia. The nurse receives handoff on four clients. Which client should the nurse assess first?

   • A.A client 1 day after hip replacement who reports pain of 7 out of 10 after physical therapy
   • B.A client with heart failure who has bilateral ankle edema and asks for help with a low-sodium menu
   • C.A client with pneumonia, oxygen saturation 88% on 2 L/min by nasal cannula, and new restlessness
   • D.A client with diabetes whose premeal blood glucose is 214 mg/dL and who is awaiting scheduled insulin

   Rationale: New restlessness with oxygen saturation of 88% despite supplemental oxygen suggests worsening hypoxemia and requires immediate assessment and intervention. Edema, postoperative pain, and an elevated glucose need care but do not indicate the same immediate threat to oxygenation. Use airway and breathing priorities when deciding which client to see first.

2. 2.A 64-year-old client with a new ileostomy is preparing for discharge from the surgical unit. The client is alert, has stable vital signs, and asks what care to perform at home. Which actions should the nurse include in the teaching? Select all that apply.

   • A.Empty the pouch when it is about one-third to one-half full
   • B.Restrict fluids to reduce ileostomy output
   • C.Clean the peristomal skin gently and dry it before applying a new barrier
   • D.Report a stoma that becomes dusky or black
   • E.Measure the stoma and cut the skin barrier opening to fit closely around it

   Rationale: A close-fitting barrier protects skin, and emptying the pouch before it becomes heavy helps prevent leakage. A dusky or black stoma can indicate impaired perfusion and needs prompt evaluation. Gentle cleansing and drying support skin integrity; restricting fluids is unsafe because ileostomy output can cause dehydration.

3. 3.A 58-year-old client with chronic kidney disease is scheduled for a contrast-enhanced CT scan in the radiology department. The client takes metformin and has an estimated glomerular filtration rate of 28 mL/min/1.73 m2. What should the nurse do first?

   • A.Ask the client to sign the consent form for the scan
   • B.Notify the prescribing clinician and radiology team about the kidney function and metformin use
   • C.Give the client's scheduled metformin with a small sip of water
   • D.Encourage the client to drink 500 mL of water immediately before transport

   Rationale: The low estimated glomerular filtration rate and metformin use require coordination with the prescriber and radiology team before contrast exposure. Continuing metformin without review could increase the risk of medication-related complications if renal function worsens. Hydration may be part of a plan, but the team must first evaluate the client's risk and orders; consent does not address this safety concern.

4. 4.A 46-year-old client with a new prescription for warfarin is being discharged after treatment for deep vein thrombosis. The client's INR is 2.4 and vital signs are stable. Which statement by the client indicates correct understanding of the discharge plan?

   • A.I will take an extra dose if I notice bruising
   • B.I should avoid all foods that contain vitamin K
   • C.I can stop the medication once my leg swelling is gone
   • D.I will keep my intake of foods with vitamin K consistent from week to week

   Answer and rationale are in the full material.

5. 5.A charge nurse on a medical-surgical unit is assigning clients to a registered nurse (RN) and a licensed practical nurse (LPN). Which assignment is appropriate for the LPN?

   • A.A stable client with chronic obstructive pulmonary disease who needs scheduled oral medications and reinforcement of inhaler teaching
   • B.A client with a new stroke who needs the first neurologic assessment after arrival
   • C.A client with a sudden drop in blood pressure after surgery who needs evaluation
   • D.A newly admitted client with chest pain who requires an initial assessment

   Answer and rationale are in the full material.