MED SURG

Question 1 of 54

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You have been caring for a 58-year-old male who underwent a radical neck dissection. He is being transferred from the PACU to a step-down unit. You are giving handover to the nurse from the step-down unit. What is the main purpose of your report?

Select one of the following:

  • To anticipate patient needs and potential problems

  • To make the patient and family more comfortable, knowing that someone cares

  • To make sure that all post-op orders will be followed on the new unit

  • To help the new nurse make sure that s/he has a good understanding of the patient's tubes and drains

Question 2 of 54

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Which of the following statements is true regarding delayed awakening?

Select one of the following:

  • It is a form of delirium that requires swift intervention.

  • It is a medical emergency.

  • It may occur in patients with renal insufficiency.

  • It is always accompanied by other symptoms, such as hypoxemia, hypoventilation, and low BP.

Question 3 of 54

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Select all appropriate nursing interventions directed at preventing pulmonary complications post-operatively.

Select one or more of the following:

  • Encourage deep breathing and coughing

  • Place the patient in a supine position

  • Encourage early ambulation

  • Manage pain effectively

  • Teach the patient how to use an incentive spirometer

Question 4 of 54

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You are caring for a 72-year-old female who underwent a hysterectomy, salpingo-oopherectomy, and bilateral LND. She is post-op day 2. You received handover this morning and the night nurse told you that the patient has had a low urine output. During your assessment, you notice that her extremities are cold, her BP is low, her HR is high, and she seems restless. You suspect that the patient may be experiencing...

Select one of the following:

  • hypovolemic shock

  • hemorrhage

  • orthostatic hypotension

  • emergent delirium

Question 5 of 54

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Of the following nursing interventions, which is the most important to prevent cardiac complications?

Select one of the following:

  • Encouraging leg exercises while in bed

  • Frequent turning and re-positioning (e.g. q2h)

  • Administering anticoagulants (e.g. heparin)

  • Encouraging early ambulation

Question 6 of 54

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What is the minimum amount of urine output we want patients to have?

Select one of the following:

  • 30cc/h

  • 60cc/h

  • 100cc/h

  • 10cc/h

Question 7 of 54

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Select all correct characteristics of pain.

Select one or more of the following:

  • multidimensional

  • always caused by identifiable tissue damage

  • subjective

  • objective

  • over-reported

  • the most common cause of disability among working-age adults in Canada

Question 8 of 54

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In Canada, nurses routinely administer the smallest prescribed dose of analgesics when a range of doses is prescribed.

Select one of the following:

  • True
  • False

Question 9 of 54

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The manifestations of acute pain reflect the ________ nervous system activation, whereas chronic pain manifests as predominantly ________ changes.

Select one of the following:

  • sympathetic; behavioural

  • parasympathetic; behavioural

  • sympathetic; affective

  • central; lifestyle

Question 10 of 54

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The intensity of acute postoperative pain is a significant predictor of the presence and severity of persistent postoperative pain.

Select one of the following:

  • True
  • False

Question 11 of 54

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What does the acronym PQRST stand for with regard to assessing pain?

Select one of the following:

  • provokes; quality; radiates; severity; time

  • provokes; quantity; region; severity; time

  • persistence; quality; radiates; severity; time

  • provokes; quality; region; severity; threshold

Question 12 of 54

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A patient's self report of pain is very unreliable; it is the responsibility of the nurse and other healthcare providers to corroborate self reporting with other data.

Select one of the following:

  • True
  • False

Question 13 of 54

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What is one of the most important the first signs that a patient may be developing a tolerance to a certain analgesic?

Select one of the following:

  • The patient begins to experience regular end-of-dose failure

  • The patient's self-report does not change (i.e. pre-dose 9/10, post-dose still 9/10)

  • The patient starts to exhibit signs of withdrawal

  • The family says that the patient needs to get a higher dose

Question 14 of 54

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You are caring for an 82-year-old female who is recovering from a hip replacement. The patient is experiencing acute pain in addition to her chronic pain. The daughter asks you, "Why aren't the doctors giving her naproxen? I use it all the time and it works for me." What is the best response to the daughter's question?

Select one of the following:

  • "Naproxen is a type of drug called a nonsteroidal anti-inflammatory drug and it isn't given to elderly patients because of the risk of it causing a bleed in the digestive system."

  • "Naproxen is an old class of drug that isn't prescribed much anymore."

  • "Naproxen is too weak of a drug and it wouldn't do anything to help your mother's pain."

  • "You should ask the physician when she comes by."

Question 15 of 54

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Which of the following is the best definition of "failure to rescue"?

Select one of the following:

  • Preventable injury to or death of a patient that resulted from our inability to detect, recognize, and prevent acute deterioration

  • The failure of the healthcare team to detect and recognize deterioration

  • The failure of nurses to regularly observe the patient (e.g. monitoring of vital signs is not prioritized)

  • Death that occurs after a patient develops a complication before admission to hospital

Question 16 of 54

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Which of the following is the most common cause of coronary artery disease (CAD)?

Select one of the following:

  • Atherosclerosis

  • Previous myocardial infarction

  • Familial history of CAD

  • Smoking

Question 17 of 54

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Select all modifiable risk factors from the following list.

Select one or more of the following:

  • physical inactivity

  • obesity

  • hypertension

  • serum lipid levels

  • tobacco use

  • genetics

  • age

  • sex

Question 18 of 54

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You enter a patient's room at the start of your shift. The patient says, "Nurse, I have a funny feeling in my chest and I feel like I might throw up." What is the best course of action?

Select one of the following:

  • Begin a focused assessment based on your suspicion of myocardial infarction

  • Bring the patient a bucket in case he throws up and encourage the patient to drink lots of fluids

  • Check the patient's list of prescribed medications to rule out these symptoms as side effects

  • Call the Rapid Response Team because this patient is having a heart attack

Question 19 of 54

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Stable angina can progress to unstable angina.

Select one of the following:

  • True
  • False

Question 20 of 54

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Pain at rest is unusual for patients with chronic stable angina.

Select one of the following:

  • True
  • False

Question 21 of 54

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What is the cause of insufficient oxygen supply in patients with chronic stable angina?

Select one of the following:

  • Artherosclerosis

  • Myocardial myopathy

  • Hypocalcemia

  • Hypovolemia

Question 22 of 54

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What is the most common reported symptom of chronic stable angina?

Select one of the following:

  • Heaviness in the chest

  • Sharp pain in the chest

  • Radiating pain down the right arm

  • Nausea and vomiting

Question 23 of 54

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A patient reports feeling pressure, burning, and crushing sensation in their chest. You notice that their forehead is dotted with sweat. What might this patient be experiencing?

Select one of the following:

  • myocardial infarction

  • an episode of stable angina

  • heartburn

  • an episode of unstable angina

Question 24 of 54

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A patient reports feeling episodes of heaviness in their chest that last 3-5 minutes. The pain goes away when they sit down and rest and feels similarly to heartburn. What is this patient most likely experiencing?

Select one of the following:

  • Stable angina

  • Unstable angina

  • Myocardial infarction

  • Gastro-esophageal reflux disease

Question 25 of 54

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Which form of atypical chronic stable angina is asymptomatic and is associated with diabetes mellitus?

Select one of the following:

  • Silent ischemia

  • Nocturnal angina

  • Angina decubitus

  • Prinzmetal's angina

Question 26 of 54

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Which form of atypical chronic stable angina occurs only while lying down and is relieved by standing or sitting?

Select one of the following:

  • Silent ischemia

  • Nocturnal angina

  • Angina decubitus

  • Prinzmetal's angina

Question 27 of 54

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The etiology of acute coronary syndrome is the deterioration of a once stable plaque that stimulates platelet aggregation and local vasoconstriction with thrombus formation. Which of the following result(s) in partial occlusion of the coronary arteries?

Select one or more of the following:

  • unstable angina

  • non-ST segment elevation myocardial infarction

  • ST segment elevation myocardial infarction

Question 28 of 54

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You are caring for a patient who has unstable angina. The patient's son asks you, "Why did my dad have a heart attack?" Which of the following is the best response?

Select one of the following:

  • "Unstable angina is not a heart attack. It is a condition that leads to a narrowing of the arteries that deliver oxygen-rich blood to the heart. It is important that your father seek medical attention if his chest pain gets worse and is accompanied by other new symptoms."

  • "Your father had a heart attack because he has a history of coronary artery disease in his family."

  • "Certain risk factors, such as abdominal obesity, smoking, and high cholesterol, can lead to problems, such as a heart attack. It will be very important for your father to make alterations to his lifestyle."

  • "You should ask the physician."

Question 29 of 54

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What is the first line of treatment for patients with a confirmed MI?

Select one of the following:

  • Percutaneous coronary intervention (PCI)

  • Fibrinolytic therapy

  • Morphine

  • Oxygen delivered via non-rebreather mask

Question 30 of 54

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_______ is the term for a state of decreased partial pressure of oxygen in arterial blood, whereas ________ is the term for a state of increased partial pressure of carbon dioxide in arterial blood.

Select one of the following:

  • hypoxemia; hypercapnia

  • hypercapnia; hypoxemia

Question 31 of 54

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Pneumonia, pulmonary edema, and ventilator-induced lung injury are all common causes of...

Select one of the following:

  • hypoxemia

  • hypercapnia

  • myocardial infarct

  • shock

Question 32 of 54

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COPD, drug overdoses with CNS depressants, and trauma to the spinal cord are all common causes of...

Select one of the following:

  • hypoxemia

  • hypercapnia

  • hypertension

  • the progression of stable angina to unstable angina

Question 33 of 54

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A patient reports having morning headaches, feeling disoriented, and generalized weakness. You note that the patient exhibits dyspnea and shallow respirations. You suspect that this client is exhibiting signs of....

Select one of the following:

  • hypoxemia

  • hypercapnia

  • unstable angina

  • hemorrhage

Question 34 of 54

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A patient reports feeling agitated. She is unable to speak without pausing and has a prolonged expiration. You suspect that she is exhibiting signs of...

Select one of the following:

  • hypoxemia

  • hypercapnia

  • stable angina

  • COPD

Question 35 of 54

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Your patient is tachycardic, tachypnic, and has a decreased O2 saturation. You note an audible stridor and nasal flaring. You suspect that this patient...

Select one of the following:

  • has an airway obstruction

  • is hypoxemic

  • is experiencing an inflammatory response

  • has overdosed

Question 36 of 54

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Select all of the subjective forms of data from the following:

Select one or more of the following:

  • psychosocial assessment

  • past health history

  • medications

  • allergies

  • system review

  • physical examination

  • laboratory results (e.g. blood work)

  • diagnostic testing

Question 37 of 54

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While performing preoperative teaching, a patient asks when she needs to stop drinking water before the surgery. Based on the most recent practice guidelines, the nurse tells the patient that:

Select one of the following:

  • she must be NPO after breakfast

  • she need to be NPO after midnight

  • she can drink clear fluids up to 2 hours before surgery

  • she can drink clear fluids up until she is moved to the OR

Question 38 of 54

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Choose the term that matches this description: "a minimally depressed level of consciousness with maintenance of the patient's protective airway reflexes."

Select one of the following:

  • Procedural sedation

  • General anesthesia

  • Local anesthesia

  • Epidural

Question 39 of 54

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Choose the term that best matches the following description: "The technique of choice for surgical procedures requiring significant skeletal muscle relaxation, control of respirations, or long procedures."

Select one of the following:

  • General anesthesia

  • Local anesthesia

  • Procedural sedation

  • Spinal block

Question 40 of 54

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Choose the term that best matches the following description: "Injection of anesthetic into the CSF below L2."

Select one of the following:

  • Spinal block

  • Epidural block

  • General anesthesia

  • Procedural sedation

Question 41 of 54

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How much blood is in the average human body?

Select one of the following:

  • 5-6 L

  • 10 L

  • 2-3 L

  • 4-5 L

Question 42 of 54

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The three main components of blood are plasma, erythrocytes, and the buffy coat. Plasma makes up __% of the blood, whereas erythrocytes make up __% of blood. The remainder is the buffy coat.

Select one of the following:

  • 55; 45

  • 45; 55

  • 20; 70

  • 90; 8

Question 43 of 54

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Health Canada is responsible for regulating blood donation, whereas it is the responsibility of the Canadian Blood Services and Hema-Quebec to actually screen donations.

Select one of the following:

  • True
  • False

Question 44 of 54

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How much whole blood is collected per donation?

Select one of the following:

  • 300 mL

  • 500 mL

  • 250 mL

  • 800 mL

Question 45 of 54

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__ is known as the "universal donor" of RBCs, whereas __ is known as the "universal recipient" of RBCs.

Select one of the following:

  • O; AB

  • AB; O

  • A; B

  • O; B

Question 46 of 54

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Bob's blood type is O. Maria is type B. In theory, can Bob donate blood to Maria?

Select one of the following:

  • Yes.

  • No, however, Maria could in theory donate blood to Bob.

Question 47 of 54

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Peter's blood type is AB. Susan's blood type is B. In theory, could Peter donate plasma to Susan?

Select one of the following:

  • Yes.

  • No, however, Susan could donate plasma to Peter.

Question 48 of 54

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You are caring for a patient who has thrombocytopenia. You suspect that this patient may be ordered a transfusion of which of the following?

Select one of the following:

  • Fresh Frozen Plasma

  • Platelets

  • Albumin

  • Cryoprecipitate

Question 49 of 54

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You are caring for a patient who needs treatment for a massive bleed, who also has a low fibrinogen concentration. You suspect that this patient may be ordered a transfusion of which of the following?

Select one of the following:

  • Fresh Frozen Plasma

  • Platelets

  • Cryoprecipitate

  • Albumin

Question 50 of 54

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Can an RN independently obtain informed consent prior to a procedure or surgery?

Select one of the following:

  • No, however, it is the nurse's responsibility to ensure that consent has been given.

  • No. It is not the nurse's responsibility to deal with consent.

  • Yes, an RN can obtain informed consent from a patient.

  • Yes, an RN can obtain informed consent from a patient so long as there is another nurse who can sign the form as a witness.

Question 51 of 54

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When administering blood products, the nurse knows that s/he can only use _____ to administer, as other solutions will cause hemolysis.

Select one of the following:

  • normal saline

  • ringer's lactate

  • D5W

  • 2/3 + 1/3 with 20 KCl

Question 52 of 54

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Blood products should be administered over a period of ___ if tolerated. The maximum infusion time for a blood product is ___.

Select one of the following:

  • 2 hours; 4 hours

  • 30 minutes; 1 hour

  • 4 hours; 6 hours

  • 1 hour; 2 hours

Question 53 of 54

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Select all common signs of a transfusion reaction:

Select one or more of the following:

  • fever

  • urticaria

  • decreased LOC

  • dyspnea

  • hypotension

  • hypertension

Question 54 of 54

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You are administering a blood product to your patient. 15 minutes after the start of the infusion, the patient reports nausea. You notice he is experiencing dyspnea, urticaria, and a fever. You suspect he is having a transfusion reaction. What should you do first?

Select one of the following:

  • Stop the transfusion.

  • Document your findings.

  • Recheck patient ID and blood product tags.

  • Notify the MD and the blood bank.

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Ashling Ligate
Quiz by , created over 1 year ago

Quiz to prepare for the med surg final exam.

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Ashling Ligate
Created by Ashling Ligate over 1 year ago
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