Questions 108

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Med Surg RN NCLEX Questions Questions

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Question 1 of 5

A nurse receives the taped change-of-shift report for assigned clients and prioritizes client rounds. In what order should the nurse assess these clients?

Correct Answer: A,C,B,D

Rationale: The client with a new endotracheal tube (
A) is highest priority due to airway risk. The febrile client with cellulitis (
C) is next for infection monitoring. The stroke client (
B) is stable 4 days post-event. The I.V. fluid client (
D) is lowest priority.

Question 2 of 5

A health care provider has just inserted nasal packing for a client with epistaxis. The client is taking ramipril (Altace) for hypertension. What should the nurse instruct the client to do?

Correct Answer: D

Rationale: Avoiding rigorous aerobic exercise prevents increased blood pressure, which could worsen epistaxis. Aspirin increases bleeding risk. Omitting ramipril is not indicated without physician guidance. Removing packing is unsafe and should be done by a healthcare provider.

Question 3 of 5

Before undergoing a transsphenoidal hypophysectomy, the client asks the nurse how the surgeon will close the incision made in the dura. The nurse should respond based on the knowledge that:

Correct Answer: C

Rationale: A fascial patch is commonly used to repair the dura during transsphenoidal hypophysectomy to prevent CSF leaks.

Question 4 of 5

A client has been in the position shown in the figure for surgery. The nurse should document that the client has been in which of the following positions?

Question Image

Correct Answer: C

Rationale: The client is in the lithotomy position. The reverse Trendelenburg position is when the client is lying supine with the head lower than the rest of the body. A low Fowler’s position is when the client is sitting up at a 30- to 45-degree angle. The prone position is when the client is lying face down.

Question 5 of 5

A client with uric acid stones is prescribed a low-purine diet. Which food is allowed?

Correct Answer: C

Rationale: Apples are low in purines, suitable for a uric acid stone diet.

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The nurse is conducting a postoperative assessment of a client on the first day after renal surgery. Which of the following findings would be most important for the nurse to report to the physician?
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