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  • MEDICAL SURGICAL NURSING
    1. Following surgery, Mario complains of mild incisional pain while
    performing deep- breathing and coughing exercises. The nurse’s best
    response would be:
    A. “Pain will become less each day.”
    B. “This is a normal reaction after surgery.”
    C. “With a pillow, apply pressure against the incision.”
    D. “I will give you the pain medication the physician ordered.”
    Answer: (C) “With a pillow, apply pressure against the incision.”
    Applying pressure against the incision with a pillow will help lessen the
    intra-abdominal pressure created by coughing which causes tension on the
    incision that leads to pain.
    2. The nurse needs to carefully assess the complaint of pain of the elderly
    because older people
    A. are expected to experience chronic pain
    B. have a decreased pain threshold
    C. experience reduced sensory perception
    D. have altered mental function
    Answer: (C) experience reduced sensory perception
    Degenerative changes occur in the elderly. The response to pain in the
    elderly maybe lessened because of reduced acuity of touch, alterations in
    neural pathways and diminished processing of sensory data.
    3. Mary received AtropineSO4 as a pre-medication 30 minutes ago and is
    now complaining of dry mouth and her PR is higher, than before the
    medication was administered. The nurse’s best
    A. The patient is having an allergic reaction to the drug.
    B. The patient needs a higher dose of this drug
    C. This is normal side-effect of AtSO4
    D. The patient is anxious about upcoming surgery
    Answer: (C) This is normal side-effect of AtSO4
  • Atropine sulfate is a vagolytic drug that decreases oropharyngeal
    secretions and increases the heart rate.
    4. Ana’s postoperative vital signs are a blood pressure of 80/50 mm Hg, a
    pulse of 140, and respirations of 32. Suspecting shock, which of the
    following orders would the nurse question?
    A. Put the client in modified Trendelenberg's position.
    B. Administer oxygen at 100%.
    C. Monitor urine output every hour.
    D. Administer Demerol 50mg IM q4h
    Answer: (D) Administer Demerol 50mg IM q4h
    Administering Demerol, which is a narcotic analgesic, can depress
    respiratory and cardiac function and thus not given to a patient in shock.
    What is needed is promotion for adequate oxygenation and perfusion. All
    the other interventions can be expected to be done by the nurse.
    5. Mr. Pablo, diagnosed with Bladder Cancer, is scheduled for a cystectomy
    with the creation of an ileal conduit in the morning. He is wringing his hands
    and pacing the floor when the nurse enters his room. What is the best
    approach?
    A. "Good evening, Mr. Pablo. Wasn't it a pleasant day, today?"
    B. "Mr, Pablo, you must be so worried, I'll leave you alone with your
    thoughts.
    C. “Mr. Pablo, you'll wear out the hospital floors and yourself at this rate."
    D. "Mr. Pablo, you appear anxious to me. How are you feeling about
    tomorrow's surgery?"
    Answer: (D) "Mr. Pablo, you appear anxious to me. How are you
    feeling about tomorrow's surgery?"
    The client is showing signs of anxiety reaction to a stressful event.
    Recognizing the client’s anxiety conveys acceptance of his behavior and
    will allow for verbalization of feelings and concerns.
    6. After surgery, Gina returns from the Post-anesthesia Care Unit
    (Recovery Room) with a nasogastric tube in place following a gall bladder
    surgery. She continues to complain of nausea. Which action would the
  • nurse take?
    A. Call the physician immediately.
    B. Administer the prescribed antiemetic.
    C. Check the patency of the nasogastric tube for any obstruction.
    D. Change the patient’s position.
    Answer: (C) Check the patency of the nasogastric tube for any
    obstruction.
    Nausea is one of the common complaints of a patient after receiving
    general anesthesia. But this complaint could be aggravated by gastric
    distention especially in a patient who has undergone abdominal surgery.
    Insertion of the NGT helps relieve the problem. Checking on the patency of
    the NGT for any obstruction will help the nurse determine the cause of the
    problem and institute the necessary intervention.
    7. Mr. Perez is in continuous pain from cancer that has metastasized to the
    bone. Pain medication provides little relief and he refuses to move. The
    nurse should plan to:
    A. Reassure him that the nurses will not hurt him
    B. Let him perform his own activities of daily living
    C. Handle him gently when assisting with required care
    D. Complete A.M. care quickly as possible when necessary
    Answer: (C) Handle him gently when assisting with required care
    Patients with cancer and bone metastasis experience severe pain
    especially when moving. Bone tumors weaken the bone to appoint at which
    normal activities and even position changes can lead to fracture. During
    nursing care, the patient needs to be supported and handled gently.
    8. A client returns from the recovery room at 9AM alert and oriented, with
    an IV infusing. His pulse is 82, blood pressure is 120/80, respirations are
    20, and all are within normal range. At 10 am and at 11 am, his vital signs
    are stable. At noon, however, his pulse rate is 94, blood pressure is 116/74,
    and respirations are 24. What nursing action is most appropriate?
    A. Notify his physician.
    B. Take his vital signs again in 15 minutes.

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