Advanced Medical Surgical Exam Review. Updated

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Advanced Medical Surgical Exam Review. Updated 2024-2025 with Correct Answers.

Exam Review

• A nurse is planning care for a client who is 2 hr. postoperative following a transurethral

resection of the prostate. The client is receiving continuous bladder irrigation (CBI).Which of the following interventions should the nurse include?Remind the client he might feel a constant urge to void.

Rationale: the client receiving continuous bladder irrigation will experience a

continuous urge to void due to pressure on the internal sphincter from the catheter balloon.

• A nurse is monitoring the urinary output of an adult client who had a colon resection.

Which of the following 24 hr. output totals indicate oliguria?380mL This urinary output indicates oliguria, which is defined as less than 400ml of total output in 24 hr. or less than 30ml per hour.

• A nurse is reviewing the BUN and creatinine levels of an older adult client who has

chronic kidney disease. The nurse should expect which of the following findings? BUN 45 mg/dL and creatinine 8 mg/dL Rationale: An elevation of both BUN and creatinine is an expected finding of chronic kidney disease.

• A nurse is teaching a group of newly licensed nurses on effective techniques for

counseling clients about sexually transmitted infections (STIs). Which of the following statements should the nurse include in the teaching? 1 / 3

pg. 2 "Ask about the client’s exposure to any past or present STIs." Rationale: The nurse should assess the client exposure to any past or present STIs and any treatment taken.

• A nurse is caring for a client who has a Jackson-Pratt (JP) drain in place after surgery for an

open reduction and internal fixation. The nurse should understand that the JP drain was placed for which of the following purposes?To prevent fluid from accumulating in the wound Rationale: The purpose of a JP drain is to promote healing by draining fluid from a wound.This prevents pooling of blood and fluid, which can contribute to discomfort, delay healing, and provide a medium for infection. The JP drainage tube is threaded through the skin into the wound near the surgical incision and is held in place by sutures.

• A client is starting celecoxib to treat osteoarthritis. The nurse should instruct the client to

watch for and report which of the following adverse effects?Black, tarry stools Rationale: Celecoxib can cause gastrointestinal bleeding. The client should watch for and report black, dark-colored, or bloody stools, abdominal pain, or coffee-ground emesis. The nurse also should instruct the client to take celecoxib with food to reduce gastric irritation.

• A nurse is caring for a client immediately following a hemodialysis treatment. For which

of the following manifestations will the nurse administer a PRN dose of phenytoin?Headache, restlessness Rationale: Headache and restlessness are manifestations of disequilibrium syndrome, which occurs during or after hemodialysis due to the rapid shift of fluids, pH, and osmolarity between fluid and blood that occurs.. This condition can cause cerebral edema leading to seizures and coma, and a PRN dose of the anticonvulsant phenytoin should be administered.

• A nurse is providing discharge teaching for a client who is postoperative following a

simple mastectomy. The client is to begin outpatient radiation therapy the next day.Which of the following instructions about maintaining skin integrity should the nurse include?Do not apply heat to the area of irradiation.Rationale: This instruction will help the client avoid tissue damage. Radiated tissue becomes thinner and might lack tissue receptors that would otherwise alert the client to a potential 2 / 3

pg. 3 burn injury. When outdoors in sunlight, the client should wear protective clothing over the area of irradiation.

• A nurse is caring for a client whose Papanicolaou (Pap) test cytology results are

abnormal. Which of the following procedures should the nurse anticipate for this client?Colposcopy Rationale: The nurse should anticipate follow-up visit for a client who has an abnormal Pap test to include a colposcopy and directed biopsy. The specimen obtained from endocervical testing is examined for abnormal cells.

• A nurse is assessing a client who is 48 hr postoperative following abdominal surgery.

Which of the following findings should the nurse report to the provider?Yellow-green drainage on the surgical incision Rationale: Thick yellow-green drainage is indicative of an infection and should be reported immediately.

• A nurse is caring for a client who has undergone a transurethral prostatectomy.

Following catheter removal, the nurse should inform the client that he should expect which of the following variations in the color of his urine?Pale pink Rationale: The client should expect to pass some small clots and tissue in his urine for few a days, which may give the urine a pale pink color. By 2 to 3 days after surgery, around the time of discharge, his urine should be clear yellow

• A nurse in a clinic is caring for a female client who was exposed to gonorrhea. Which of

the following actions should the nurse take?Obtain information about the client’s recent sexual experiences.Rationale: The nurse should get information from the client about the types of sexual exposure they may have had to thoroughly assess them.

• A nurse is caring for a client who is 2 hr postoperative following a transurethral resection

of the prostate (TURP) gland. Which of the following assessments should the nurse view to be an indication of a postoperative complication?

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