Med Surg 2 - Exam 2 NCLEX Questions and answers

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Med Surg 2 - Exam 2 NCLEX Questions Which method is best to use when confirming initial placement of a blindly inserted small-bore NG feeding tube? a. x-ray. b. air insufflation. c. observing ... patient for coughing. d. pH measurement of gastric aspirate. Correct Answer: a. x-ray. A patient is receiving peripheral parenteral nutrition. The parenteral nutrition solution is completed before the new solution arrives on the unit. The nurse gives a. 20% intralipids. b. 5% dextrose solution. c. 0.45% normal saline solution. d. 5% lactated Ringer's solution. Correct Answer: b. 5% dextrose solution. A patient with anorexia nervosa shows signs of malnutrition. During initial refeeding, the nurse carefully assesses the patient for a. hyperkalemia. b. hypoglycemia. c. hypercalcemia. d. hypophosphatemia. Correct Answer: d. hypophosphatemia. A patient was admitted with a fractured hip after being found on the floor of her home. She was extremely malnourished and started on parenteral nutrition (PN) 3 days ago. Which assessment finding would be of most concern to the nurse? Blood glucose level of 125 mg/dL Serum phosphate level of 1.9 mg/dL White blood cell count of 10,500/µL Serum potassium level of 4.6 mEq/L Correct Answer: Serum phosphate level of 1.9 mg/dL A patient is admitted with anorexia nervosa and a serum potassium level of 2.4 mEq/L. What complication is most important for the nurse to observe for in this patient? Muscle weakness Cardiac dysrhythmias Increased urine output Anemia and leukopenia Correct Answer: Cardiac dysrhythmias A patient who has sustained severe burns in a motor vehicle accident is starting parenteral nutrition (PN). Which principle should guide the nurse's administration of PN? Administration of PN requires clean technique. Central PN requires rapid dilution in a large volume of blood. Peripheral PN delivery is preferred over the use of a central line. Only water-soluble medications may be added to the PN by the nurse. Correct Answer: Central PN requires rapid dilution in a large volume of blood. Which focused assessments would have priority in the care of a patient recently started on parenteral nutrition (PN)? Skin integrity and skin turgor Electrolyte levels and daily weights Auscultation of lung and bowel sounds Peripheral edema and level of consciousness Correct Answer: Electrolyte levels and daily weights The patient has parenteral nutrition (PN) infusing with amino acids and dextrose. During shift change, the nurse reports the tubing, bag, and dressing were changed 20 hours ago. What care should the incoming nurse plan to deliver (select all that apply.)? Giving the patient insulin if needed Ensuring that the next bag has been ordered Checking amount of solution left in the bag Assessing the insertion site and change the tubing Verifying the accuracy of the new solution and ingredients Correct Answer: Ensuring that the next bag has been ordered Checking amount of solution left in the bag Verifying the accuracy of the new solution and ingredients A 35-year-old female patient is admitted to the emergency department with acute abdominal pain. Which medical diagnoses should you consider as possible causes of her pain (select all that apply)? a. Gastroenteritis b. Ectopic pregnancy c. Gastrointestinal bleeding d. Irritable bowel syndrome e. Inflammatory bowel disease Correct Answer: a. Gastroenteritis b. Ectopic pregnancy c. Gastrointestinal bleeding d. Irritable bowel syndrome e. Inflammatory bowel disease Assessment findings suggestive of peritonitis include (select all that apply) a. rebound tenderness. b. a soft, distended abdomen. c. dull, intermittent abdominal pain. d. shallow respirations with bradypnea. e. observing that the patient is lying still. Correct Answer: a. rebound tenderness. e. observing that the patient is lying still. The nurse performs a detailed assessment of the abdomen of a patient with a possible bowel obstruction, knowing that manifestations of an obstruction in the large intestine are (select all that apply) a. persistent abdominal pain. b. marked abdominal distention. c. diarrhea that is loose or liquid. d. colicky, severe, intermittent pain. e. profuse vomiting that relieves abdominal pain. Correct Answer: a. persistent abdominal pain. b. marked abdominal distention. In contrast to diverticulitis, the patient with diverticulosis a. has rectal bleeding. b. often has no symptoms. c. has localized cramping pain. d. frequently develops peritonitis. Correct Answer: b. often has no symptoms. The nurse is caring for a patient admitted with a suspected bowel obstruction. The nurse auscultating the abdomen listens for which type of bowel sounds that are consistent with the patient's clinical picture? Low-pitched and rumbling above the area of obstruction High-pitched and hypoactive below the area of obstruction Low-pitched and hyperactive below the area of obstruction High-pitched and hyperactive above the area of obstruction Correct Answer: High-pitched and hyperactive above the area of obstruction The nurse is preparing to insert a nasogastric (NG) tube into a patient with a suspected small intestinal obstruction that is vomiting. The patient asks the nurse why this procedure is necessary. What response by the nurse is most appropriate? "The tube will help to drain the stomach contents and prevent further vomiting." "The tube will push past the area that is blocked and thus help to stop the vomiting." "The tube is just a standard procedure before many types of surgery to the abdomen." "The tube will let us measure your stomach contents so we can give you the right IV fluid replacem [Show More]

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