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Medical-Surgical Nursing

Review Questions

Medical-Surgical NursingReview Questions

Review Questions

1 .
What is the primary way oxygen enters the blood and travels?
  1. Oxygen enters capillaries by diffusion, then attaches to hemoglobin.
  2. Oxygen enters capillaries by perfusion, then attaches to hemoglobin.
  3. Oxygen enters capillaries by diffusion, then attaches to platelets.
  4. Oxygen enters capillaries by perfusion, then attaches to platelets.
2 .
What condition could impact both oxygenation and ventilation?
  1. congestive heart failure
  2. hypertension
  3. lung cancer
  4. asthma
3 .
You are providing care to a patient with postoperative atelectasis. The patient states, “The doctor told me parts of my lungs aren’t working. I don’t understand, I had surgery on my colon.” What is an example of a response by the nurse accurately summarizes atelectasis?
  1. “The anesthesia caused problems for your lungs that should wear off in 12 to 24 hours.”
  2. “Due to swelling from the surgery, your airways have narrowed.”
  3. “When you’re not able to breathe as deeply as usual, maybe because of discomfort, small parts of the lung become collapsed.”
  4. “Most likely there is a minor hemorrhage in your lungs related to the surgery; it usually resolves on its own.”
4 .
When assessing the components of an upper respiratory airway assessment, what should the nurse do after auscultating with a stethoscope?
  1. Palpate the patient’s chest.
  2. Position the patient.
  3. Note if the patient has any audible sounds with breathing.
  4. Note for any accessory muscle use with inspiration or expiration.
5 .
What term is used for a harsh, high-pitched sound, heard on inspiration, often loud enough to hear without a stethoscope?
  1. stridor
  2. wheezes
  3. rales
  4. crepitus
6 .
What assessment finding would the nurse utilize to discuss bulbous enlargement of the fingertips?
  1. clubbing
  2. tripod
  3. hypoxemia
  4. stridor
7 .
How can bronchiectasis be best summarized?
  1. a chronic condition that results in widened, damaged airways
  2. a chronic condition that is caused by fluid accumulation in the lining of the lung
  3. a chronic condition that results from medication toxicity
  4. a chronic condition that is caused by blood clots in the lung
8 .
What diagnostic would best support a diagnosis of bronchiectasis?
  1. patient reporting a constant cough
  2. chest x-ray with evidence of atelectasis
  3. elevated eosinophils
  4. patient reporting green frothy sputum
9 .
You are providing care for a patient with bronchiectasis. They report that they just coughed up sputum that was “mostly blood.” What is the priority nursing intervention?
  1. Ensure that suction is available and ready to use.
  2. Notify the treating clinician.
  3. Apply supplemental oxygen via nasal cannula.
  4. Obtain sputum sample and send to the laboratory.
10 .
When providing patient education to a patient with bronchiectasis, what teaching points does the nurse include? Select all that apply.
  1. Immunization against preventable respiratory illnesses can help prevent complications.
  2. Exposure to air pollution can worsen disease.
  3. Avoiding secondhand smoke is helpful for patients with bronchiectasis.
  4. All patients with bronchiectasis should avoid smoking.
11 .
What is a known trigger of asthma exacerbations?
  1. hormonal fluctuations
  2. warm air
  3. steroids
  4. immobility
12 .
What diagnostic would the nurse anticipate if a patient is suspected to have asthma?
  1. pulmonary function test
  2. arterial blood gas
  3. capnography
  4. bronchodilation
13 .
You are working in a primary care office and receive a phone call from a patient with asthma. They state that their symptoms have been worse, and they’ve needed to use rescue medications frequently. They say, “My asthma action plan says to go to the hospital, but I feel like I can manage this at home.” How should the nurse respond?
  1. “As long as your rescue medications are providing relief, it’s okay to monitor things at home for the next two to four hours.”
  2. “You need to go to the hospital immediately. Your symptoms could get even more severe, very quickly.”
  3. “I’ll discuss this with the physician and call you back later today.”
  4. “Doubling the dose of your rescue medications should stabilize your symptoms.”
14 .
You are providing care to a patient with asthma. They state, “When I get really short of breath, I use the steroid inhaler, but it doesn’t seem to be helping.” How should the nurse respond?
  1. “Let’s review the instructions for each of your inhalers. The steroid inhalers are long-acting so aren’t typically meant to be used when symptoms are flaring.”
  2. “It sounds like the dose might need to be increased.”
  3. “Are you rinsing your mouth with water after use? That’s important to do with steroid inhalers.”
  4. “Let’s talk to the doctor; I think another round of lung function testing might help us get some answers.”
15 .
Your patient is being evaluated for a potential new diagnosis of asthma. They state, “I don’t think I need any tests, I’m sure I have it. A lot of people in my family have asthma, and I tried one of their inhalers and it made me feel better.” How should the nurse respond?
  1. “A family history and a response to medication like that confirms the diagnosis.”
  2. “Those symptoms certainly suggest asthma; to conclusively diagnose it, we’ll need to do a CT scan of your chest.”
  3. “Those symptoms sound like asthma. To be sure, we’ll need to do some tests called spirometry.”
  4. “We’ll do a blood test to be confirm that it’s definitely asthma.”
16 .
What risk is associated with steroid inhaler use?
  1. oral Candida infection
  2. wheezing
  3. tachycardia
  4. barrel-shaped chest
17 .
Which of the following values would represent a diagnostic finding of COPD?
  1. FEV1 0.5 (FEV1 levels < 0.7 represent a diagnosis of COPD)
  2. FEV1 0.8
  3. pulse oximeter reading 91 percent
  4. carbon dioxide level 46 mm HG
18 .
While providing care for a patient hospitalized with a COPD exacerbation requiring supplemental oxygen therapy, what is a priority intervention?
  1. Titrate supplemental oxygen up to an oxygen saturation level of 100 percent.
  2. Use no more than 1–2 L of supplemental oxygen.
  3. Assess for signs of CO2 retention thirty to sixty minutes after starting oxygen.
  4. Assess for signs of peripheral vasoconstriction related to supplemental oxygen.
19 .
Identify the abnormal lung sounds associated with pneumothorax:
  1. diminished or absent
  2. stridor
  3. wheezing
  4. crackles
20 .
What dressing would be appropriate to place over a chest tube that has become dislodged?
  1. sterile gauze
  2. band aid
  3. Vaseline gauze
  4. paper towel
21 .
When providing care for a patient with a pneumothorax being treated with a chest tube, what action does the nurse take if the tube becomes dislodged?
  1. Apply sterile gauze at the insertion site.
  2. Start CPR immediately.
  3. Apply 100 percent oxygen via face mask.
  4. Apply a three-sided occlusive dressing.
22 .
You are caring for a sixty-two-year-old patient with COPD, admitted for a large left-sided pneumothorax. A chest tube has been in place for two days connected to a drainage system. What physical assessment finding suggests resolution of the pneumothorax?
  1. lung sounds audible in all lung fields
  2. trachea is midline
  3. ongoing air leakage in chest drainage system
  4. oxygen requirement has resolved
23 .
What is the primary risk factor to develop pneumonia during a hospitalization?
  1. COPD
  2. age > 65
  3. smoking
  4. diabetes
24 .
What indicator would the nurse expect to find when the patient is having a therapeutic response to antibiotics for pneumonia?
  1. white count 12,500/microliter
  2. pulse oximetry 90 percent
  3. patient reporting improved dyspnea
  4. a smaller consolidation on chest x-ray
25 .
Your patient states, “The doctor told me they think I have pneumonia, and I’ll need some tests. How will we know for sure if I have pneumonia?” What is an example of an accurate response from the nurse?
  1. “To conclusively diagnose pneumonia, an invasive test called bronchoscopy is necessary.”
  2. “A sample of mucus, or sputum, needs to be tested to identify the organism causing pneumonia.”
  3. “A chest x-ray is usually how we diagnose pneumonia.”
  4. “Blood tests provide conclusive evidence of pneumonia.”
26 .
A patient is being treated in an inpatient unit for suspected community-acquired bacterial pneumonia. A COVID test was negative. They have a strong, frequent cough, productive of sputum. What PPE is indicated during direct patient care?
  1. gloves
  2. fit tested respirator and face shield
  3. surgical mask and eye protection
  4. fit tested respirator
27 .
Identify a symptom commonly present in active TB infection.
  1. night sweats
  2. weight gain
  3. stridor
  4. frothy sputum
28 .
What diagnostic procedure would be able to determine if TB is in its active form?
  1. PPD skin test
  2. chest x-ray
  3. QuantiFERON blood test
  4. sputum sample
29 .
What is the priority action in the care of a patient with active TB?
  1. administration of antibiotics
  2. prevention of the spread of infection
  3. collecting a sputum specimen
  4. having the patient wear a mask
30 .
Your patient is being evaluated for suspected TB. They ask, “How will you know if I have TB or if it’s something else?” What is an example of an accurate response from the nurse?
  1. “A chest x-ray will provide the information that we need.”
  2. “A CT scan of your chest is used because it will provide more detailed images than an x-ray.”
  3. “A blood test provides conclusive information about if you have TB or not.”
  4. “We’ll take a sample of sputum—the mucus that you cough up—and send it to the lab.”
31 .
Your patient is being treated for active TB and has been receiving antibiotic therapy for the past month. They state, “Lately I’ve been forgetting to take the medication. But I’m feeling a lot better and not even coughing anymore. I figured I was done with it, so I stopped the medication.” What is an example of an appropriate response from the nurse?
  1. “Taking the medication is not optional. If you can’t take it as prescribed, we’ll be forced to admit you to the hospital for supervised treatment.”
  2. “You completed a month of treatment, that is usually adequate.”
  3. “Even though you are feeling better, you’ll need to finish another month of treatment.”
  4. “Let’s talk about ways to help you remember to take the medication. There are some electronic options that can be helpful.”
32 .
Identify the diagnostic test used to conclusively diagnose CF.
  1. sweat test
  2. chest x-ray
  3. chest CT
  4. pulmonary function tests
33 .
The patient has been prescribed an airway clearance vest. The parent asks, “Tell me again how this works.” Which statement by the nurse best summarizes how an airway clearance vest works?
  1. “A compressor sends air into and out of the vest. It causes vibrations and pressure that can help to break up mucus.”
  2. “The vest is worn at night and provides positive pressure to help keep the airway open.”
  3. “A snug-fitting vest provides postural support and helps them to be able to take deeper breaths.”
  4. “The vest sends air into and out of the mouth and nose. It causes vibrations and pressure that can help to break up mucus.”
34 .
You are providing care for a patient with cystic fibrosis admitted to the hospital for pneumonia. What action by the nurse takes priority?
  1. administering antibiotics
  2. obtaining a sputum sample for culture
  3. administering pancreatic enzymes
  4. assessing respiratory rate and oxygen saturation
35 .
What outcome suggests that the patient’s condition has improved?
  1. Lung sounds demonstrate bilateral crackles throughout lung fields.
  2. Patient is coughing approximately once an hour.
  3. The patient’s temperature is 38.8°C/102°F.
  4. The patient’s respiratory rate is 24.
36 .
Identify an environmentally triggered respiratory illness that can be cured.
  1. histoplasmosis
  2. asbestosis
  3. mesothelioma
  4. black lung disease (pneumoconiosis)
37 .
You are providing care for a patient with COPD who continues to smoke. When other clinicians had previously attempted to provide smoking cessation education, the patient had become defensive and dismissive. What is an example of an appropriate response from the nurse?
  1. “I need you to know that quitting smoking is the most significant thing you can do for your health today and in the future. We’ll support you every step of the way.”
  2. “We recommend that you cut back during times of illness.”
  3. “I know you weren’t ready to talk about your smoking at the last visit; let’s consider talking about it at your next visit.”
  4. “If you are unable to quit smoking, unfortunately you’ll need to find another physician. We only provide care to nonsmokers.”
38 .
Your patient has a new diagnosis of COPD. They have a twenty pack-year smoking history. They state, “I don’t think smoking had anything to do with it. I think this COPD must have been caused by all that time I spent working on engines, getting exposed to fumes and chemicals.” What is an example of an appropriate response from the nurse?
  1. “Smoking is the biggest risk factor for COPD, though workplace exposures and fumes do sometimes play a part.”
  2. “Smoking typically only causes COPD when there is a fifty pack-year history. Your workplace exposures are probably the primary cause.”
  3. “It’s most likely that you inherited a genetic disposition to COPD.”
  4. “Because you live in an area with unhealthy air quality, the COPD was most likely caused by dust and fumes in the air.”
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