Medsurg
1. A client, newly diagnosed with asthma is preparing for discharge. Which point should a nurse emphasize during the client’s teaching?
A. Contact care provider only if night time wheezing becomes a concern
B. Limit exposure to sources that trigger an attack
C. Use peak flow meter only if symptoms are worsening
D. Use inhaled steroid medication as a rescue inhaler
2. A nurse is caring for a client requiring positive pressure mechanical ventilation. The client has been fighting the ventilator-assisted breaths, and the client’s blood pressure has been steadily decreasing.
Which would be the most appropriate intervention by the nurse?
A. Place the client in the prone position
B. Notify the respiratory therapist to increase the positive pressure settings
C. Call the physician to suggest sedatives and paralytics
D. Prepare to administer intravenous aminophylline
3. A client, hospitalized for a severe case of pneumonia, is asking a nurse why a sputum sample is needed. The nurse should reply that the primary reason is to:
A. complete the first of three samples to be collected.
B. differentiate between pneumonia and atelectasis.
C. encourage expectoration of secretions.
D. help select the appropriate antibiotic.
4. A nurse is planning care for a client with AIDS who has been hospitalized for a Pneumocystis carinii infection. Which nursing diagnosis should be the nurse’s first priority for this client?
A. Fatigue related to hypermetabolism
B. Imbalanced nutrition, more than body requirements related to hypometabolism
C. Ineffective coping related to HIV diagnosis
D. Fluid volume excess related to oral and intravenous fluid intake
5. A client presents to an emergency department following a motorcycle crash. A nurse assesses the client and notes uncoordinated or paradoxical chest rise and fall as well as multiple bruises across the client’s chest and torso, crepitus, and tachypnea. Based on this assessment, the nurse should:
A. assist in the placement of a cervical collar.
B. anticipate the need to intubate the client.
C. provide chest compressions.
D. tape the chest wall.
6. A client experiencing acute respiratory failure will most likely demonstrate:
A. Hypocapnia, hypoventilation hyperoxemia
B. Hypocapnia, hyperventilation hyperoxemia
C. Hypercapnia, hyperventilation hypoxemia
D. Hypercapnia, hypoventilation hypoxemi
7.The physician orders continuous I.V. nitroglycerininfusion for the client with myocardial infarction. Essential nursing actions include which of the following?
A. Obtaining an infusion pump for the medication.
B. Monitoring blood pressure every 4 hours.
C. Monitoring urine output hourly.
D. Obtaining serum potassium levels daily.
8. The nurse is assessing clients at a health centre. Which client is at greatest risk for coronary artery disease?
A. A 32-year-old female with mitral valve prolapse who quit smoking 10 years ago.
B. A 43-year-old male with a family history of CAD and cholesterol level of 158.
C. A 56-year-old male with an HDL of 60 who takes atorvastatin (Lipitor).
D. A 65-year-old female
9. A client with heart failure is receiving digoxin intravenously. The nurse should determine the effectiveness of the drug by assessing which of the following?
A. Dilated coronary arteries.
B. Increased myocardial contractility.
C. Decreased cardiac arrhythmias.
D. Decreased electrical conductivity in the heart
10.The nurse teaches a client with heart failure to take oral furosemide in the morning. The primary reason for this is to help:
A. Prevent electrolyte imbalances.
B. Retard rapid drug absorption.
C. Excrete excessive fl uids accumulated during the night.
D. Prevent sleep disturbances during the night.
11. The nurse is admitting a 68-year-old male to the medical ward. The echocardiogram report revealed left ventricular enlargement. The nurse notes 2+ pitting oedema in the ankles when getting
the client into bed. Based on this finding, what should the nurse do first?
A. Assess respiratory status.
B. Draw blood for laboratory studies.
C. Insert a Foley catheter.
D. Weigh the client.
12. The nurse’s discharge teaching plan for the client with heart failure should stress the importance of which of the following?
A. Maintaining a high-fi ber diet.
B. Walking 2 miles every day.
C. Obtaining daily weights at the same time each day.
D. Remaining sedentary for most of the day.
13. An elderly woman is diagnosed with new onset atrial fibrillation. She is complaining of dyspnea and dizziness with a ventricular rate of 110 beats/min. Drug therapy in this situation is likely to include:
A. Atropine sulfate
B. Digoxin
C. Isoproterenol
D. Magnesium sulfate
14. The body will attempt to compensate for a failing heart by:
A. Increasing blood pressure, increasing cardiac output, and decreasing cardiac preload
B. Shunting, decreasing afterload, and decreasing heart rate
C. Increasing heart rate, ventricular chamber dilation, and left ventricular hypertrophy
D. Decreasing afterload, releasing epinephrine, and maintaining minimal venous return
15. Client’s with peripheral vascular disease should stop smocking. Because nicotine:
A. Constricts the superficial vessels, dilating; the deep vessels
B. Constricts the peripheral vessels and increases the force of flow
C. Dilate the superficial vessels but constricts the collateral circulation
D. Dilates the peripheral vessels, causing a reflex construction of visceral vessels
16. To promote comfort and allay anxiety before dialysis, the nurse would :
A. Allowing the patient’s family to remain during the procedure
B. Providing a chair and music of the patient’s choice
C. Educating the patient about the dialysis unit and equipment
D. Using distraction techniques while setting up necessary equipment
17. The initial management of patients with CRF, ACE inhibitors are administered to control:
A. Nausea and vomiting
B. Fluid retention
C. Intravascular fluid volume
D. Blood pressure
18. A client is to have a cystoscopy to rule out cancer of the bladder. Which of the following indicate that the client has developed a complication after the cystoscopy?
A. Dizziness.
B. Chills.
C. Pink-tinged urine.
D. Bladder spasms
19. A client who has been diagnosed with renal calculi reports that the pain is intermittent and less colicky. Which of the following nursing actions is most important at this time?
A. Report hematuria to the physician.
B. Strain the urine carefully.
C. Administer meperidine (Demerol) every 3 hours.
D. Apply warm compresses to the flank area.
20. A client has a ureteral catheter in place after renal surgery. A priority nursing action for care of
the ureteral catheter would be to:
A. Irrigate the catheter with 30 mL of normal saline every 8 hours.
B. Ensure that the catheter is draining freely.
C. Clamp the catheter every 2 hours for 30 minutes.
D. Ensure hat the catheter drains at least 30 mL/ hour.
SAQ
1. Explain the management of Cardiac Arrest ( 8 marks)
2. Outline the collaborative management of bronchial asthma
3. Outline the risk factors and pathophysiology urinary tract cancer (8 marks)
4. Explain collaborative management of Acute renal failure ( 8 marks)
5. Explain the collaborative management of deep vein thrombosis
LAQ
1. Mr JH is hospitalized suffering from of lung cancer
a) Explain the aetiology and risk factors for this condition ( 6 marks)
b) Using the nursing process describe the management of Mr JH both at the hospital and in the community ( 14 marks)
2. Mrs. TT is diagnosed with congestive cardiac failure and hospitalizedfor management.
a) Explain patho-physiology of congestive cardiac failure ( 4 marks )
b) Using the nursing process describe the management of Mrs. TT till discharge from the hospital ( 16 marks)
