Miami Regional University
MSN5410 Advanced Medical Surgical Nursing Practice Questions
WEEK 2 Summer 2023
1. A nurse teaches patients at a
... [Show More] community center about risks for dehydration. Which patient is at greatest risk for dehydration?
A. A 36-year-old who is prescribed long-term steroid therapy
B. A 55-year-old receiving hypertonic intravenous fluids
C. A 76-year-old who is cognitively impaired
D. An 83-year-old with congestive heart failure
2. A nurse is caring for a patient who exhibits dehydration-induced confusion. Which intervention does the nurse implement first?
A. Measure intake and output every 4 hours.
B. Apply oxygen by mask or nasal cannula.
C. Increase the IV flow rate to 250 mL/hr.
D. Place the patient in a high-Fowler’s position.
3. After teaching a patient who is being treated for dehydration, a nurse assesses the patient’s understanding. Which statement indicates that the patient correctly understood the teaching?
A. “I must drink a quart (liter) of water or other liquid each day.”
B. “I will weigh myself each morning before I eat or drink.”
C. “I will use a salt substitute when making and eating my meals.”
D. “I will not drink liquids after 6 PM so I won’t have to get up at night.”
4. A nurse assesses a patient who is prescribed a medication that inhibits angiotensin I from converting into angiotensin II (angiotensin-converting enzyme [ACE] inhibitor). For which expected therapeutic effect does the nurse assess?
A. Blood pressure decrease from 180/72 to 144/50 mm Hg
B. Daily weight increase from 121 to 125 lbs (55 kg to 57 kg)
C. Heart rate decrease from 100 to 82 beats/min
D. Respiratory rate increase from 12 to 15 breaths/min
5. A nurse is assessing patients on a medical-surgical unit. Which adult patient does the nurse identify as being at greatest risk for insensible water loss?
A. Patient taking furosemide (Lasix)
B. Anxious patient who has tachypnea
C. Patient who is on fluid restrictions
D. Patient who is constipated with abdominal pain
6. A nurse is evaluating a patient who is being treated for dehydration. Which assessment result does the nurse correlate with a therapeutic response to the treatment plan?
A. Increased respiratory rate from 12 to 22 breaths/min
B. Decreased skin turgor on the patient’s posterior hand and forehead
C. Increased urine specific gravity from 1.012 to 1.030 g/mL
D. Decreased orthostatic light-headedness and dizziness
7. After teaching a patient who is prescribed a restricted sodium diet, a nurse assesses the patient’s understanding. Which food choice for lunch indicates that the patient correctly understood the teaching?
A. Slices of smoked ham with potato salad
B. Bowl of tomato soup with a grilled cheese sandwich
C. Salami and cheese on whole-wheat crackers
D. Grilled chicken breast with glazed carrots
8. A nurse is assessing patients for fluid and electrolyte imbalances. Which patient will the nurse assess first for potential hyponatremia?
A. A 34-year-old on NPO status who is receiving intravenous D5W
B. A 50-year-old with an infection who is prescribed a sulfonamide antibiotic
C. A 67-year-old who is experiencing pain and is prescribed ibuprofen (Motrin)
D. A 73-year-old with tachycardia who is receiving digoxin (Lanoxin)
9. A nurse teaches a patient who is at risk for mild hypernatremia. Which statement does the nurse include in this patient’s teaching?
A. “Weigh yourself every morning and every night.”
B. “Check your radial pulse twice a day.”
C. “Read food labels to determine sodium content.”
D. “Bake or grill the meat rather than frying it.”
10. A nurse is caring for a patient who has the following laboratory results: potassium 3.4 mEq/L (3.4 mmol/L), magnesium 1.8 mEq/L (0.74 mmol/L), calcium 8.5 mEq/L (2.13 mmol/L), and sodium 144 mEq/L (144 mmol/L). Which assessment does the nurse complete first?
A. Depth of respirations
B. Bowel sounds
C. Grip strength
D. Electrocardiography
11. A nurse cares for a patient who has a serum potassium of 7.5 mEq/L (7.5 mmol/L) and is exhibiting cardiovascular changes. Which prescription will the nurse implement first?
A. Prepare to administer sodium polystyrene sulfate (Kayexalate) 15 g by mouth.
B. Provide a heart-healthy, low-potassium diet.
C. Prepare to administer dextrose 20% and 10 units of regular insulin IV push.
D. Prepare the patient for hemodialysis treatment.
12. A nurse is assessing patients on a medical-surgical unit. Which patient is at risk for hypokalemia?
A. Patient with pancreatitis who has continuous nasogastric suctioning
B. Patient who is prescribed an angiotensin-converting enzyme (ACE) inhibitor
C. Patient in a motor vehicle crash who is receiving 6 units of packed red blood cells
D. Patient with uncontrolled diabetes and a serum pH level of 7.33
13. A nurse is assessing a patient with hypokalemia, and notes that the patient’s handgrip strength has diminished since the previous assessment 1 hour ago. What action does the nurse take first?
A. Assess the patient’s respiratory rate, rhythm, and depth.
B. Measure the patient’s pulse and blood pressure.
C. Document findings and monitor the patient.
D. Call the healthcare provider. [Show Less]