FINALS MEDICAL SURGICAL NURSING 2023 EXAM

FINALS MEDICAL SURGICAL NURSING
2023 EXAM
The nurse would analyze an arterial pH of 7.46 as indicating:
A. Acidosis
B. alkalosis
C. homeostasis
D. neutrality - CORRECT ANSWERS B. Alkalosis
Normal pH is 7.35-7.45. Alkalosis is indicated by a pH above 7.45
A rise in arterial pressure causes the baroreceptors and stretch receptors to signal an
inhibition of the sympathetic nervous system, resulting in:
A. decreased sodium reabsorption
B. increased sodium reabsorption
C. decreased urine output
D. increased urine output - CORRECT ANSWERS D. increased urine output
Arterial baroreceptors and stretch receptors help maintain fluid balance by increasing
urine output in response to a rise in arterial pressure.
Nurse John Joseph is totaling the intake and output for Elena Reyes, a client diagnosed
with septicemia who is on a clear liquid diet. The client intakes 8 oz of apple juice, 850
ml of water, 2 cups of beef broth, and 900 ml of half-normal saline solution and outputs
1,500 ml of urine during the shift. How many milliliters should the nurse document as
the client's intake.
A. 2,230
B. 2,740
C. 2,470
D. 2,320 - CORRECT ANSWERS C. 2,470
The fluid intake includes 8 oz (240 ml) of apple juice, 850 ml of water, 2 cups (480 ml) of
beef broth, and 900 ml of I.V. fluid for a total of 2,470 ml intake for the shift.
Which of the following is the most important physical assessment parameter the nurse
would consider when assessing fluid and electrolyte imbalance?
A. skin turgor
B. intake and output
C. osmotic pressure
D. cardiac rate and rhythm - CORRECT ANSWERS D. cardiac rate and rhythm
Cardiac rate and rhythm are the most important physical assessment parameter to
measure. Skin turgor, intake and output are physical assessment parameters a nurse
would consider when assessing fluid and electrolyte imbalance, but choice d is the most
important.
Pierro was noted to be displaying facial grimaces after nurse Kara assessed his
complaints of pain rated as 8 on a scale of 1 (no pain) 10 10 (worst pain). Which
intervention should the nurse do?
A. Administering the client's ordered pain medication immediately
B. Using guided imagery instead of administering pain medication
C. Using therapeutic conversation to try to discourage pain medication
D. Attempting to rule out complications before administering pain medication -
CORRECT ANSWERS D. Attempting to rule out complications before administering
pain medication
When intervening with a client complaining of pain, the nurse must always determine if
the pain is expected pain or a complication that requires immediate nursing intervention.
This must be done before administering the medication. Guided imagery should be
used along with, not instead of, administration of pain medication. The nurse should
medicate the client and not discourage medication.
When monitoring the daily weight of a patient with fluid volume deficit (FVD), the nurse
is aware that fluid loss may be considered when weight loss begins to exceed:
A. 0.25 lb
B. 0.50 lb
C. 1 lb
D. 1 kg - CORRECT ANSWERS B. 0.50 lb
Weight loss of more than 0.50 lb. is considered to be fluid loss.
Mr. Teban has a history of chronic obstructive pulmonary disease and has the following
arterial blood gas results: partial pressure of oxygen (PO2), 55 mm Hg, and partial
pressure of carbon dioxide (PCO2), 60 mm Hg. When attempting to improve the client's
blood gas values through improved ventilation and oxygen therapy, which is the client's
primary stimulus for breathing?
A. High PCO2
B. Low PO2
C. Normal pH
D. Normal bicarbonate (HCO3) - CORRECT ANSWERS B. Low PO2
A chronically elevated PCO2 level (above 50 mmHg) is associated with inadequate
response of the respiratory center to plasma carbon dioxide. The major stimulus to
breathing then becomes hypoxia (low PO2). High PCO2 and normal pH and HCO3
levels would not be the primary stimuli for breathing in this client.