Med Surge Final Exam

1…. A nurse is reviewing the laboratory data of a client who has acute pancreatitis. The nurse

should expect to find an elevation of which of following values?

Amylase

Rational

Amylase is an enzyme that changes complex sugars into simple sugars that can be used by the

body. It is produced by the pancreas and salivary glands and released into the mouth, stomach,

and intestines to aid in digestion. The amylase level of a client who has acute pancreatitis

usually increases within 12 to 24 hr and can remain elevated for 2 to 3 days.

2…. A nurse in a clinic is interviewing a client who has a possible diagnosis of endometriosis.

Which of the following findings in the client's history should the nurse recognize as consistent

with a diagnosis of endometriosis?

Dysmenorrhea that is unresponsive to NSAIDs.

Rational

Endometriosis is a condition in which the type of tissue that lines the uterus implants in

locations outside the uterus. This typically causes pelvic pain around the time of the menstrual

period but can cause pain at other times in the cycle. The discomfort is often unrelieved by the

use of NSAIDs.

 1 / 4

3…. A rehabilitation nurse is caring for a client who has had a spinal cord injury that resulted in

paraplegia. After a week on the unit, the nurse notes that the client is withdrawn and

increasingly resistant to rehabilitative efforts by the staff. Which of the following actions should

the nurse take?

Establish a plan of care with the client that sets attainable goals.

Rational

The nurse should develop a plan of care for this client with mutually set goals. This action

invests the client in the rehabilitation process, which encourages feelings of ownership for it,

and sees the goals as more attainable

4….A nurse in a burn treatment center is caring for a client who is admitted with severe burns

to both lower extremities and is scheduled for an escharotomy. The client's spouse asks the

nurse what the procedure entails. Which of the following nursing statements is appropriate?

Large incisions will be made in the eschar to improve circulation.

Rational

An escharotomy is a surgical incision made to release pressure and improve circulation in a part

of the body that has a deep burn and is experiencing excessive swelling. Burn injuries that

encircle a body part, such as an arm or the chest, can cause swelling and tightness in the

affected area, resulting in reduced circulation. Making surgical incisions into the burned tissue

allows the skin to expand, reduces tightness and pressure, and improves circulation.

 2 / 4

5….A nurse is caring for a client who has suspected cholecystitis. The nurse should expect the

client's urine to appear which of the following colors?

Dark and foamy

Rational

The nurse should expect the client to have dark and foamy urine, which indicates the kidneys

are filtering excess bilirubin from the blood.

6….A nurse is caring for an older adult client who has rheumatoid arthritis (RA) and is taking

aspirin 650 mg every 4 hours. Which of the following diagnostic tests should the nurse monitor

to evaluate the effectiveness of this medication?

Erythrocyte sedimentation rate (ESR)

Rational

Rheumatoid arthritis is a chronic inflammatory disease. ESR is useful in detecting and

monitoring tissue inflammation in clients with RA. As the disease improves the ESR decreases.

7….A nurse is providing dietary teaching to a client who has a history of recurring calcium

oxalate kidney stones. Which of the following instructions should the nurse include in the

teaching?

Drink 3 L of fluid every day.

 3 / 4

Rational

The nurse should instruct the client to drink at least 3 to 4 L of fluid every day to dilute the

urine and reduce the risk for stone formation.

8….A nurse is assessing a client who has disseminated intravascular coagulation (DIC). Which of

the following findings should the nurse expect?

Excessive thrombosis and bleeding

Rational

The nurse should expect excessive thrombosis and bleeding of mucous membranes because

both DIC impairs both coagulation and anticoagulation pathways.

9….A nurse is caring for a middle adult client who has just received the diagnosis of endometrial

cancer. In taking a nursing history, which of the following manifestations is likely to be reported

by this client?

Postmenopausal bleeding

Rational

Endometrial cancer involves cancerous growth of the endometrium (lining of the uterus). The

most common manifestation of endometrial cancer is abnormal uterine bleeding, including

postmenopausal bleeding and bleeding between normal periods in premenopausal women.

Powered by qwivy(www.qwivy.org)

 4 / 4