MED SURG FINAL EXAM 2023

MED SURG FINAL EXAM 2023

COMPLETE ANSWERS 100% CORRECT

AND EXPLAINED

A nurse is caring for a client who has pancreatitis. The nurse should expect which of the following lab results to be below expected reference range?

• Amylase
• Alkaline phosphatase
• Bilirubin
• Calcium - Correct Answer D) Calcium

A client who has pancreatitis is expected to have a decreased calcium and magnesium levels due to fat necrosis A nurse is caring for a client who has DKA. Which of the following lab findings should the nurse expect?

• Negative urine ketones
• BUN 32 mg/dl
• pH 7.43
• HCO3 23mEq/L - Correct Answer B) BUN 32 mg/dl

DKA results in osmotic diuresis and subsequent dehydration. The nurse should expect the client who has DKA to have an elevated BUN, Creatinine, and specific gravity levels resulting from excess glucose present in the urine.A nurse is providing discharge instructions to a client who has a partial thickness burn on the hand. Which of the following instructions should the nurse include?

• Change the dressing Q72 hours
• Immobilize the hand with a pressure dressing
• take pain medication 30 minutes after changing the dressing
• Wrap the fingers with individual dressings - Correct Answer D) Wrap the fingers with

individual dressings The nurse should instruct the client to wrap the fingers individually to allow for functional use of the hand while healing occurs. The nurse should also instruct the client to preform ROM exercises to each finger Q hour while awake to promote function of the injured hand.A nurse is planning care for a client who has extensive burn injuries and is immunocompromised. Which of the following precautions should the nurse include in the plan of care to prevent pseudomonas aeruginosa infection?

• Encourage the client to eat raw fruits and vegetables
• Avoid placing plants of flowers in the clients room
• Limit visitors to members of the clients immediate family
• Wear an N95 respirator mask when providing care to the client. - Correct Answer B)

Avoid placing plants of flowers in the clients room 1 / 3

Live plants can harbor P. aeruginosa and this bacterium can infect burn wounds and cause life-threatening complications.A nurse in an emergency department is caring for a client who reports vomiting and diarrhea for the last 3 days. which of the following findings should indicate to the nurse that the client is experiencing fluid volume deficit?

• heart rate 110/min
• Blood pressure 138/90
• Urine specific gravity 1.020
• BUN 15 - Correct Answer A) heart rate 110/min

A client who has a 3-day history of vomiting and diarrhea is likely to have fluid volume deficit and an elevated heart rate A nurse in an emergency department is reviewing the providers prescriptions for a client who sustained a rattlesnake bite to the lower leg. Which of the following prescriptions should the nurse expect?

• Apply ice to the puncture wounds
• Initiate corticosteroid therapy
• Keep the clients leg above heart level
• Administer an opioid analgesic to the client - Correct Answer D) Administer an opioid

analgesic to the client To promote comfort following a rattlesnake bite A nurse is providing teaching to a client who has CKD and a new prescription for erythropoietin. Which of the following statements by the client indicates and understanding of the teaching?

• I should take calcium supplements so the med will work better in my system
• I am taking this med to increase my energy level
• This med can cause my blood pressure to drop
• I will not need to restrict protein in my diet while taking this medication - Correct

Answer B) I am taking this med to increase my energy level The goal of erythropoietin therapy is to increase the level of hematocrit in clients who have anemia. When the medication is effective, the client should have a decrease in fatigue and an improvement in activity tolerance.A nurse is reviewing the lab results of a client who has cirrhosis. Which of the following lab values should the nurse expect?

• Decreased PT
• Elevated bilirubin
• Decreased ammonia
• Elevated Albumin - Correct Answer B) Elevated bilirubin

Bilirubin levels reflect the livers ability to conjugate and excrete bilirubin, a byproduct of the hemolysis of red blood cells. Bilirubin levels rise with liver disease and clinically reflect the clients degree of jaundice. 2 / 3

A nurse in a community clinic is caring for a client who reports increase in the frequency of migraine headaches. To help reduce the risk of migraine headaches, which of the following foods should the nurse recommend the client avoid?

• Shellfish
• Aged cheese
• Peppermint candy
• Enriched pasta - Correct Answer B) Aged cheese

Food that contain tyramine, such as ages cheese and sausage, can trigger migraine headaches.A nurse is planning to provide discharge teaching for the family of an older client who has hemianopsia and is at risk for falls. Which of the following instructions should the nurse include?

• Keep the clients personal care items in the bathroom
• Keep the overhead lights on in the clients bedroom while the client is sleeping
• Remind the client to scan their complete range of vision during ambulation
• Secure the clients extension cords under carpeting. - Correct Answer C) Remind the

client to scan their complete range of vision during ambulation The nurse should instruct the family to remind the client who has hemianopsia, or blindness in half of the visual field, to use visual scanning to look over their complete range of vision during ambulation. This practice can accommodate for the loss of vision and help reduce the risk for falls.A nurse is providing teaching to a client who has esophageal cancer and is to undergo radiation therapy. Which of the following statements should the nurse identify as an indication that the client understands the teaching?A)I will wash the ink markings off the radiation area after each treatment

• I will use my hands rather than a washcloth to clean the radiation area
• I will be able to be out in the sun 1 month after my radiation treatments are done
• I will use a heating pad on my neck if if becomes sore during radiation therapy. -

Correct Answer B) I will use my hands rather than a washcloth to clean the radiation area The client should gently wash the radiation area with their hands using warm water and a mild soap to protect the skin from further irritation.A nurse is preparing a client who has supraventricular tachycardia for elective cardioversion. Which of the following prescribed medications should the nurse instruct the client to withhold for 48 hours prior to cardioversion?

• Enoxaparin
• Metformin
• Diazepam
• Digoxin - Correct Answer D) Digoxin

Cardiac glycosides such as digoxin, are withheld prior to cardioversion. These medications can increase ventricular irritability and put the client at risk for ventricular fibrillation after the synchronized countershock of cardioversion

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