Med/Surg Test

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MarieRN
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186496
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Med/Surg Test
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2012-12-02 14:03:01
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1114 Med Surg
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Chapters 27, 28, and 40
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  1. To minimize headache following a lumbar puncture, what should be increased?
    a. Calcium
    b. Fluid intake
    c. Potassium
    d.  Ambulation
    b
  2. The family should be advised that a craniotomy can take as long as:
    a. 2 hours.
    b. 6 hours.
    c. 12 hours.
    d. 25 hours.
    c
  3. As ICP increases and perfusion is reduced, oxygen delivery to cerebral tissue is:
    a. increased.
    b. bypassed.
    c. reduced.
    d. stopped.
    c
  4. A patient with increased ICP has a "blown pupil". Which of the following descirbes this condition?
    a. Dilated
    b. Pinpoint
    c. Reacts to light
    d. Unequal to the other pupil
    a
  5. The pupils may become dilated and fixed as ICP rises due to pressure on the:
    a. oculomotor nerve.
    b. cerebellum.
    c. hypothalamus.
    d. optic nerve.
    a
  6. Which neurons transmit information toward the central nervous system (CNS)?
    a. Sensory
    b. Motor
    c. Efferent
    d. Axon
    a
  7. A type of headache in which the pain is usually unilateral and has a warning is called:
    a. cluster.
    b. migraine.
    c. tension.
    d. sinus.
    b
  8. What is used in the initial management of bacterial meningitis?
    a. Corticosteroids
    b. Antihistamines
    c. Anticholinergics
    d. Antimicrobials
    d
  9. What is the priority common source of anxiety for many patients with Guillain-Barre syndrome?
    a. Communication
    b. Self-esteem
    c. Circulation
    d. Elminiation
    a
  10. In order to reduce the symptoms of Parkinson disease, what is L-dopa converted to as it crosses the blood-brain barrier?
    a. Epinephrine
    b. Dopamine
    c. Norepinephrine
    d. Acetylcholine
    b
  11. Which cranial nerve is tested by asking the patient to swallow on command?
    a. Vagus (CN X)
    b. Trigeminal (CN V)
    c. Facial (CN VII)
    d. Glossopharyngeal (CN IX)
    d
  12. In a patient with myasthenia gravis, what does rapid improvement of muscle strength after administration of edrophonium chloride (Tensilon) indicate?
    a. Hypertensive crisis
    b. Adrenergic crisis
    c. Myasthenic crisis
    d. Cholinergic crisis
    c
  13. A nurse is caring for a patient with amyolateral sclerosis. What is the priority patient problem?
    a. Impaired physical mobility
    b. Ineffective airway clearance
    c. Impaired verbal communication
    d. Decreased cardiac output
    b
  14. What is the priority cause of nutritional problems in patients with amyolateral sclerosis?
    a. Oropharyngeal muscle weakness
    b. Paralysis of respiratory muscles
    c. Dysphagia
    d. Progressive illnesss of patient
    c
  15. A 27-year-old man was injured in a motorcycle accident 3 days ago. He is now alert and oriented to person and place but not to time. What is the most reliable indicator of mental status in this patient?
    a. Blood pressure
    b. Pulse
    c. Level of consciousness
    d. Pupil equality
    c
  16. What is a late sign of increased ICP due to pressure on the third cranial nerve?
    a. Jerky tracking of eyes
    b. Altered motor function
    c. Dilated pupils
    d. Hemiparesis
    c
  17. How high should this patient's bed be raised to prevent increased ICP?
    a. 15 degrees
    b. 30 degrees
    c. 45 degrees
    d. 90 degrees
    b
  18. Which part of the brain receives and interprets sensory information?
    a. Frontal lobe
    b. Parietal lobe
    c. Occipital lobe
    d. Temporal lobe
    b
  19. Which part of the cerebrum initiates motor activity for various parts of the body?
    a. Frontal lobe
    b. Parietal lobe
    c. Occipital lobe
    d. Temporal lobe
    a
  20. Which part of the brain controls balance, coordination, and posture?
    a. Frontal lobe
    b. Cerebellum
    c. Thalamus
    d. Cerebrum
    b
  21. One of the most important needs of the acute stroke patient is to be turned and repositioned at least every:
    a. 2 hours.
    b. 4 hours.
    c. 8 hours.
    d. 12 hours.
    a
  22. Turning and repositioning the stroke patient will reduce the incidence of:
    a. hypertension.
    b. skin breakdown.
    c. headache.
    d. cerebral edema.
    b
  23. A warning condition for a possible later stroke is:
    a. TIA.
    b. paralysis.
    c. hemorrhage.
    d. cyanosis.
    a
  24. Which diagnostic test shows narrowing of cerebral blood vessels?
    a. CT scan
    b. MRI
    c. EEG
    d. Angiography
    d
  25. The main focus of the rehabilitation phase following a stroke is to:
    a. cure the disease process.
    b. assist the patient into remission.
    c. prevent another stroke from occurring.
    d. return the patient to the highest functional level possible.
    d
  26. The most frequent cause of death following a stroke is:
    a. kidney failure.
    b. pneumonia.
    c. seizure.
    d. heart attack.
    b
  27. What (approximate) percentage of individuals who experience a TIA will have a stroke within 5 years?
    a. 10%
    b. 20%
    c. 30%
    d. 40%
    c
  28. What is a priority problem immediately following a stroke?
    a. Oxygenation
    b. Hydration
    c. Nutrition
    d. Thermoregulation
    a
  29. What is a common sensory-perceptual problem in a patient with a stroke?
    a. Weakness
    b. Paralysis
    c. Diplopia
    d. Dysphagia
    c
  30. A patient who does not feel pressure or pain due to lost sensation following a stroke is at risk for:
    a. aphasia.
    b. paralysis.
    c. injury.
    d. infection.
    c
  31. A patient experiencing an acute stroke should receive a thrombolytic drug within:
    a. 90 minutes.
    b. 2 hours.
    c. 3 hours.
    d. 6 hours.
    a
  32. Which term is used to describe speech impaired to the point that the person has almost no ability to communicate?
    a. Global aphasia
    b. Expressive aphasia
    c. Receptive aphasia
    d. Nonfluent aphasia
    a
  33. Glomerular filtrate and blood plasma are essentially the same, except that the filtrate does not have:
    a. water.
    b. sodium.
    c. potassium.
    d. proteins.
    d
  34. As the blood passes through the glomerulis, which element is too large to pass through the semipermeable membrane?
    a. Serum sodium
    b. Serum potassium
    c. Plasma protein
    d. Glucose
    c
  35. The normal pH of urine is:
    a. 1.0-3.0
    b. 4.5-8.0
    c. 8.5-10.0
    d. 10.5-3.0
    b
  36. The body normally excretes how many liters of urine per day?
    a. 0.5 liter
    b. 1-2 liters
    c. 5 liters
    d. 7-10 liters
    b
  37. Two substances that are present in blood but not normally present in urine are:
    a. sodium and chloride.
    b. glucose and protein.
    c. calcium and magnesium.
    d. potassium and bicarbonate.
    b
  38. Glomerular damage may be indicated by the presence of which of the following in urine?
    a. Sodium
    b. Chloride
    c. Protein
    d. Potassium
    c
  39. The presence of how much urine usually causes the urge to urinate?
    a. 100-150 mL
    b. 200-400 mL
    c. 500-600 mL
    d. 800-1000 mL
    b
  40. Blood pressure is regulated through fluid volume maintenance and release of the hormone:
    a. aldosterone.
    b. renin.
    c. antidiuretic hormone.
    d. parathormone.
    b
  41. A change in blood volume will result in change in:
    a. body temperature.
    b. heart rate.
    c. blood pressure.
    d. respiratory rate.
    c
  42. Decreased oxygen in renal blood triggers the secretin of:
    a. aldosterone.
    b. antidiuretic hormone.
    c. epinephrine.
    d. erythropoietin.
    d
  43. Patients in renal failure have a deficiency of erythropoietin, which causes them to have:
    a. pneumonia.
    b. anemia.
    c. seizures.
    d. hypertenion.
    b
  44. A common age-related problem in males related to the urinary system is:
    a. urethral obstruction.
    b. incontinence.
    c. relaxed pelvic musculature.
    d. lack of testosterone.
    a
  45. If crystals on the skin are observed during the examination of patients with urinary disorders, this is recorded as:
    a. ashen skin.
    b. edema.
    c. uremic frost.
    d. scaly skin.
    c
  46. Tissue turgor is evaluated in patients with urinary disorders to detect:
    a. uremic frost.
    b. Kussmaul's respirations.
    c. infection
    d. dehydration.
    d
  47. If patients with urinary disorders have an odor of urine on their breath, this may indicate:
    a. urinary tract infection.
    b. kidney failure.
    c. cardiac failure.
    d. diabetes mellitus.
    b
  48. Patients with urinary disorders who have potassium imbalances may have:
    a. uremic frost.
    b. heart irregularities.
    c. hypertension.
    d. rapid respirations.
    b
  49. The edema found in renal failure is described as:
    a. dependent.
    b. peripheral.
    c. pitting.
    d. generalized.
    d
  50. In patients with renal failure, the skin over edematous areas is likely to be described as:
    a. warm and moist.
    b. dry and flushed.
    c. pink and intact.
    d. pale and thick.
    b
  51. Normally, urine is sterile and slightly:
    a. alkaline.
    b. acidic.
    c. pyuric.
    d. hematuric.
    b
  52. A diagnostic test for the identification of microorganisms present in urine is:
    a. blood urea nitrogen.
    b. urinalysis.
    c. urine culture.
    d. creatinine clearance.
    c
  53. Which blood test needs to be within normal limites before a renal biopsy is performed?
    a. Electrolytes
    b. Blood urea nitrogen
    c. Serum creatinine
    d. Clotting studies
    d
  54. After a renal biopsy, what is the most important side effect to watch for?
    a. Infection
    b. Dyspnea
    c. Bleeding
    d. Fatigue
    c
  55. Following a cystoscopy, at firs the urine will be:
    a. colorless.
    b. pink-tinged.
    c. tea-colored.
    d. orange.
    b
  56. Following cystoscopy, urine should lighten to its usual color within:
    a. 4-6 hours.
    b. 8-10 hours.
    c. 24-48 hours.
    d. 60-72 hours.
    c
  57. Following cystoscopy, belladonna and opium suppositories may be ordered to reduce:
    a. bladder spasm.
    b. hematuria.
    c. infection.
    d. back pain.
    a
  58. Bladder perforation is rare following cystoscopy, but it may be indicated by severe:
    a. hematuria.
    b. abdominal pain.
    c. tachycardia.
    d. hypotension.
    b
  59. The most common healthcare-associated infections are:
    a. skin infections.
    b. wound infections.
    c. urinary tract infections.
    d. blood infections.
    c
  60. The pain of urethritis may be reduced by:
    a. antiemetics.
    b. back massage.
    c. sitz baths.
    d. meditation.
    c
  61. The passage of renal calculi is facilitated by:
    a. bedrest.
    b. opiates.
    c. restricted fluids.
    d. ambulation.
    d
  62. Which is a common symptom of pyelonephritis?
    a. Polyuria
    b. Hypotension
    c. Bradycardia
    d. Flank pain
    d
  63. The most common type of glomerulonephritis follows a respiratory tract infection caused by:
    a. staphylococcus.
    b. a virus.
    c. a fungus.
    d. streptococcus.
    d
  64. A patient is in the acute phase of glomerulonephritis. Bedrest is ordered to prevent or treat heart failure and sever hypertension that result from:
    a. fluid volume deficit.
    b. fluid overload.
    c. altered renal tissue perfusion.
    d. respiratory disress.
    b
  65. In which of the following groups is the incidence of uric acid stones high?
    a. Jewish males
    b. Caucasian femailes
    c. African-American females
    d. Hispanic males
    a
  66. When a person is dehydrated, the kidneys conserve water, causing urine to be:
    a. dilute.
    b. cloudy.
    c. alkaline.
    d. concentrated.
    d
  67. A major nursing concern for patients with renal calculi is:
    a. frequent ambulation.
    b. emotional support.
    c. range-of-motion exercises.
    d. pain relief.
    d
  68. The treatment of choice for renal cancer is:
    a. lithotripsy.
    b. radical nephrectomy.
    c. cystectomy.
    d. nephrostomy.
    b
  69. The location of the flank incision following nephrectomy causes pain with expansion of the:
    a. abdomen.
    b. pelvis.
    c. cerebrum.
    d. thorax.
    d
  70. Which is the most common malignancy of the urinary tract?
    a. Cancer of the kidney
    b. Cervical cancer
    c. Bladder cancer
    d. Liver cancer
    c
  71. The most frequent symptom of bladder cancer is intermittent:
    a. glycosuria.
    b. proteinuria.
    c. pyuria.
    d. hematuria.
    d
  72. When the bladder is removed completely, urinary diversion is sometimes provided, which allows urine to be excreted through the:
    a. urethra.
    b. ileal conduit.
    c. ureter.
    d. cystoscopy.
    b
  73. Which is the most effective means of assessing changes in fluid status of patients in acute renal failure?
    a. Monitoring edema
    b. Recording intake and output.
    c. Weight daily
    d. Taking vital signs
    c
  74. When 90-95% of kidney function is lost, the patient is considered to be in:
    a. acute renal failure.
    b. chronic renal failure.
    c. renal shock.
    d. renal oliguria.
    b
  75. The most life-threatening effecto f renal failure is:
    a. hypernatremia.
    b. hyponatremia.
    c. hyperkalemia.
    d. hypokalemia.
    c
  76. When a kidney is obtained from a living related donor, the 1-year survival rate for transplantation is about:
    a. 30-33%.
    b. 65-70%.
    c. 75-80%.
    d. 95-97%.
    d
  77. Which mediation is the transplant recipient given to control the body's response to foreign tissue?
    a. Analgesics
    b. Immunosuppressants
    c. Anticholinergics
    d. Antihistamines
    b
  78. Which specific nursing diagnosis is related to the possibility of organ rejection after renal transplantation?
    a. Risk for injury
    b. Altered role performance
    c. Anxiety
    d. Diarrhea
    c
  79. Complications of lithotripsy include:
    a. bruising.
    b. congestive heart failure.
    c. dyspnea.
    d. thrombus.
    a
  80. Risk factors for bladder cancer include:
    a. obesity.
    b. cigarette smoking.
    c. a high-purine diet.
    d. a sedentary lifestyle.
    b
  81. Which procedure is contraindicated in patients with known renal insufficiency or diabetes mellitus?
    a. Intravenous pyelogram (IVP)
    b. Flat plate
    c. Renal scan
    d. Ultrasonography
    a
  82. The eyes of a patient with a urinary disorders are examined and periorbital edema is present. What is the reason for periorbital edema in this patient?
    a. Dehydration
    b. Fluid retention
    c. Uremic frost
    d. Kussmaul's respirations
    b
  83. If patients with urinary disorders have dyspnea, this may be a sign of:
    a. dehydration.
    b. uremic frost.
    c. potassium imbalance.
    d. fluid overload.
    d
  84. Inspection of the genitalia durin examination of patients with urinary disorders must always be done utilizing:
    a. auscultation.
    b. palpation.
    c. Standard Precautions.
    d. aseptic technique.
    c
  85. To measure residual volume, the patient must be catheterized immediately after voiding. Which of the following is an abnormal finding?
    a. 5 mL
    b. 10 mL
    c. 25 mL
    d. 75 mL
    d
  86. Following urologic surgery, which of the following outputs should be reported to they physician?
    a. Less than 30 mL/hour
    b. Less tan 50 mL/hour
    c. Less than 70 mL/hour
    d. Less than 100 mL/hour
    a
  87. An older patient with pyelonephritis experiences a suddenly increased fluid volume. Which complication may develop for which the nurse must monitor?
    a. Hypotension
    b. Congestive heart failure
    c. Seizures
    d. Thrombophlebitis
    b
  88. A patient has had a nephrectomy and is protecting his chest by not breathing deeply. For which related complication must the nurse monitor?
    a. Hemorrhage
    b. Infection
    c. Atelectasis
    d. Shock
    c
  89. Preoperative care for a patient undergoing an ileal of sigmoid conduit includes thorough preparation of the intestinal tract. Which antibiotic is administered that is not absorbed from the intestinal tract?
    a. Keflex
    b. Penicillin
    c. Neomycin
    d. Tetracycline
    c

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