KAPLAN ADULT HEALTH MED SURG EXAM 2023 ACTUAL EXAM 200 QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+

KAPLAN ADULT HEALTH MED SURG
EXAM 2023 ACTUAL EXAM 200
QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS)
|ALREADY GRADED A+
A patient diagnosed with chronic obstructive pulmonary disease (COPD) is drowsy
and unable to expectorate secretions. The nurse should take which of the following
actions.
1. Force fluids
2. Administer high-flow oxygen via mask
3. Perform nasotracheal suction
4. Perform postural drainage. - ....ANSWER....Answer Perform nasotracheal suction
RATIONALE: If patient is unable to expectorate sections, suctioning is appropriate;
auscultate breath sounds to determine if suctioning is required.
Which of the following actions is essential for the nurse to take after arterial blood
gases are drawn?
1. Apply pressure to puncture site
2. Check and record vital signs
3. Give 100% oxygen
4. Assess for presences of ulnar pulse - ....ANSWER....Answer: Apply pressure to
puncture site
RATIONALE: Blood gases measure acid/base balance; following arterial puncture,
pressure should be applied to the site for a full five minutes by the clock to prevent
bleeding or hematoma formation.
The nurse teaches pursed-lip breathing to a patient diagnosed with COPD. The
nurse understands which of the following BEST describes the underlying purpose of
this type of breathing?
1. Prevent air trapping
2. Strengthen oral musculature
3. Promote deep relaxation
4. Enhance inspiration capacity - ....ANSWER....Answer: Prevent air trapping
RATIONALE: As air is pushed against the small opening between the lips, the
resistance created goes backwards and through the airways and pushes them open
throughout expiration; pursing lips also prolongs exhalation; all this results in a delay
of airway compression or collapse, allowing more air to escape and preventing air
trapping; in pursed lip breathing, the patient breathes in deeply through the nose,
hold it for a moment, and then exhales slowly through lips that are almost closed or
pursed as if the patient were going to whistle; exhalation should be at least twice as
long as inhalation.
The nurse cares for patients on the medical/surgical unit. The nurse expects postural
drainage to e ordered for which of the following patients?
1. A patient diagnosed with cystic fibrosis.
2. A patient diagnosed with ascities due to cirrhosis.
3. A patient diagnosed with lymphedema
4. A patient diagnosed with a subdural hematoma. - ....ANSWER....Answer: A patient
diagnosed with cystic fibrosis.
RATIONALE Postural drainage is a treatment of choice for cystic fibrosis because of
serious respiratory dysfunction; postural drainage involves using gravity, along with
percussion and vibration to facilitate drainage of secretions form bronchi and lungs
into the trachea where coughing and suctioning can expel them; involves patient
assuming a range of positions, most of them with the head down.
The clinic nurse instructs a client in the used of a metered dose inhaler (MDI). Which
statement by the client indicates the need for further teaching?
1. I will breathe in deeply and slowly as I press down on the canister.
2. I will hold the mouth piece 2 inches in front of my mouth
3. I will count to 10 on my fingers after I breathe in
4. I will be careful not to shake the canister before I use it - ....ANSWER....Answer: I
will be careful not to shake the canister before I use it.
RATIONALE Incorrect understanding; before using the canister it should be shaken
vigorously to disperse and mix the aerosol propellant with the medication in order to
ensure correct dosage is administered; MDI is a hand held device which enables a
person to intermittently give themselves an exact amount of medication in a readily
absorable form.
A client undergoes nasal surgery. The nurse instructs the client to not blow the nose.
What is the reason for this instruction?
1. Blowing increases intracranial pressure
2. Blowing decreased the client's oxygen supply
3. Blowing encourages bruising and edema.
4. Blowing may cause a nasal fracture. - ....ANSWER....Answer: Blowing encourages
bruising and edema.
RATIONALE Clients undergoing nasal surgery are instructed not to blow their noses
in the post-op periods because it can cause bruising and edema. Patients should not
blow nose up to 2 weeks after the procedure to prevent bleeding.
The nurse cares for a patient receiving oxygen per nasal cannula. Which of the
following observations requires an IMMEDATE intervention by the nurse?
1.A visitor arrives with a strong odor of cigarettes on the clothing.
2. The electric plug for the suction machine has 3 prongs rather 2.
3. The patient complains of a dry mouth and has a cracked lip.
4. A visitor is putting clear nail polish on the fingernails of the patient. -
....ANSWER....Answer: A visitor is putting clear nail polish on the fingernails of the
patient.
RATIONALE No flammable solution containing oil or alcohol should be in a room
where oxygen is being delivered; nail polish-clear or not-is such a solution; oils
should not be used on a patient receiving oxygen or on the equipment, while oxygen
itself does not burn, its presence will be a catalyst supporting and increasing
combustion, all electrical equipment must be in perfect condition and grounded;
using matches, lighter fluid, or smoking is prohibited.
A patient requires an emergency tracheostomy. When caring for the tracheostomy,
the nurse should take which of the following actions?
1. Suction every hour
2. Clean the inner cannula after suctioning.
3. Clean site every four hours
4. Hyperextend the patient's neck to maintain patency. - ....ANSWER....Answer.
Clean site every four hours.
RATIONALE Cleaning the site very four hours will help prevent infection
The nurse should lubricate catheter used to suction a patient's tracheostomy with
which of the following?
1. Sterile water
2. Mineral oil
3. Hydrogen peroxide
4. K-Y jelly - ....ANSWER....Answer: Sterile water
RATIONALE Sterile water is the preferred lubricant because it won't irritate the
tissues; can also use sterile saline
The nurse prepares to suction the endotracheal tube of a patient on a mechanical
ventilator. Which of the following ventilator settings should be adjusted by the nurse
before and after this procedure?
1. Tidal volume
2. Respiratory rate
3. Fraction of inspired oxygen (FIO2)
4. Flow - ....ANSWER....Answer: Fraction of inspired oxygen (FIO2)
RATIONALE: Fraction of inspired oxygen is the concentration of oxygen that is
delivered to the patient, it is determined by the ABG values and the condition of the
patient; the range that can be provided is 21% to 100%; suctioning can cause
desaturation or hypoexmia, so hyperoxygenation should be done before and after
the procedure to prevent this occurrence; increasing the FIO2 is one way to do this;
manually ventilation the patient is another, the nurse must be certain to return the
FIO2 to its previous setting once the hyperoxygenation is completed.
The nurse performs nutritional counseling for a patient who is diagnosed with COPD.
It is most important for the nurse to advise the patient to avoid consuming which
nutrient in high amounts?
1. Carbohydrates
2. Calories
3. Protein
4. Fats - ....ANSWER....Answer: Carbohydrates
RATIONALE: Excessive carb loads can increase CO2 production since they are
broken down into glucose, CO2 and water when metabolized; this may render the
COPD patient unable to exhale, and hypercapnic (increase CO2 in blood) respiratory
failure could then result; COPD illness itself affects oxygen delivery to all tissues;
there is decreased ability to exchange gas, decreased oxygenation in blood,
increased CO2 levels in blood; COPD patients need a diet high in calories, protein,
and less in carbs.