HARAR HEALTH SCIENCE COLLAGE

MEDICAL-SURGICAL FINAL EXAM FOR 2NDYEAR COMPREHEMSIVE NURSE

CHOOSE THE BEST ANSWER FROM THE GIVEN ALTERNATIVE

1.A client is admitted to the emergency room with renal calculi and is complaining of moderate
to severe flank pain and nausea . The client’s temperature is 100.8 degrees Fahrenheit. The
priority nursing goal for this client is:

A. Maintain fluid and electrolyte balance C. Control nausea

B. Manage pain D. Prevent urinary tract infection

2.A client who has type O Rh-positive blood gives birth. The neonate has type B Rh-negative
blood. When the nurse assesses the neonate 11 hours after birth, the infant’s skin appears yellow.
What is the most likely cause?

A. Neonatal sepsis B. Rh incompatibility C. Physiologic jaundice D. ABO incompatibility

3.A mother is concerned about the diet of her child that has noncomplicated acute
glomerulonephritis. What is the appropriate diet regimen you must teach as a nurse?

A.Low-protein, low-potassium diet. B.Regular diet, no added salt.

C.Low-sodium, low-protein diet. D.Low-sodium, high-protein diet.

3.An eleven-month-old infant is brought to the pediatric clinic. The nurse suspects that the child
has iron deficiency anemia. Because iron deficiency anemia is suspected, which of the following
is the most important information to obtain from the infant’s parents?

A. Normal dietary intake.

B. Relevant socio cultural, economic, and educational background of the family.

C. Any evidence of blood in the stools

D. A history of maternal anemia during pregnancy

4. Which of the following C/M IS NOT related with cystitis?

A. Urgency B. Frequency C. Anuria D. Dysuria

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5 ._________ Inflammation of renal pelvis.

A. Pyelonephritis B. pancresities C. Cystitis D. Nephrosis

6 . The client comes to your health center with UTI .you ordered to the patient co-trimoxazole
tablet. Nursing education given to the patient should be:-

A. High fluid intake

B. Timely medication

C. Void every two hour

D. All

7 ._________ increased level of nitrogenous waste in the blood.

A. Heamaturia B. Azothemia C. Edema D. None

8. Which of the following is caused by auto-immune infection?

A.Glumerulonephritis B. Pyelonephritis C. Cystitis D.Uretheratits

8. Which of the following food is NOTrecommended for a patient with kidney stone.

A. Lemon with water C. Milk

B. Orange D. Apple

9. Which of the following is the cause of cystitis.

A. E. coli C. Pseudomonas

B .Tetanus D. Pertusis

10.A nurse is reviewing the laboratory report of a client with a tentative diagnosis of kidney
failure. What mechanism does the nurse expect to be maintained when ammonia is excreted by
healthy kidneys?

1. Osmotic pressure of the blood

2. Acid-base balance of the body

3. Low bacterial levels in the urine

4. Normal red blood cell production .

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11. A nurse is caring for a client with albuminuria resulting in edema. What pressure change
does the nurse determine as the cause of the edema?

1. Decrease in tissue hydrostatic pressure

2. Increase in plasma hydrostatic pressure

3. Increase in tissue colloid osmotic pressure

4. Decrease in plasma colloid oncotic pressure

12.A nurse is concerned that a client is at risk for developing hyperkalemia. Which disease does
the client have that has caused this concern?

1. Crohn

2. Cushing

3. End-stage renal

4. Gastroesophageal reflux.

13,A client’s serum potassium level has increased to 5.8 mEq/L. What action should the nurse
implement first?

1. Call the laboratory to repeat the test.

2. Take vital signs and notify the health care provider. 3. Inform the cardiac arrest team to place
them on alert.

4. Take an electrocardiogram and have lidocaine available.

14. What clinical indicators should the nurse expect a client with hyperkalemia to exhibit? Select
all that apply.

1. Tetany 2. Seizures

3. Diarrhea 4. Weakness 5. Dysrhythmias.

15.What clinical finding indicates to a nurse that a client may have hypokalemia?

1. Edema

2. Muscle spasms

3. Kussmaul breathing

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4. Abdominal distention

16.A nurse is caring for a client with a diagnosis of polycythe¬mia vera. The client asks, “Why
do I have an increased tendency to develop blood clots?” Which effect of the poly¬cythemia
vera should the nurse explain increases the risk of these thromboses?

1. Elevated blood pressure

2. Increased blood viscosity

3. Fragility of the blood cells

4. Immaturity of red blood cells

17.A client who is weak, dyspneic, and jaundiced has a bilirubin level greater than 2 mg/100 mL
blood volume. With which problem are these clinical findings consistent?

1. Hemolytic anemia

2. Pernicious anemia

3. Decreased rate of red blood cell destruction

4. Low oxygen-carrying capacity of erythrocytes

18.A female client has a low hemoglobin level, which is attrib¬uted to an iron deficiency. Which
foods should the nurse recommend that the client increase in the diet? Select all that apply.

1. Spinach

2. Broccoli

3. Beef liver

4. Baked beans

19. Chicken breastA nurse is counseling a woman who had recurrent urinary tract infections.
What factor should the nurse explain is the reason why women are at a greater risk than men for
con¬tracting a urinary tract infection?

1. Altered urinary pH

2. Hormonal secretions

3. Juxtaposition of the bladder

4. Proximity of the urethra to the anus

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20.A client in a nursing home is diagnosed with urethritis. What should the nurse plan to do
before initiating antibiotic therapy prescribed by the health care provider?

1. Prepare for urinary catheterization.

2. Teach how to perform perineal care.

3. Start a twenty-four-hour urine collection.

4. Obtain a urine specimen for culture and sensitivityA

21.nurse is assessing the urine of a client with a urinary tract infection. For which characteristic
should the nurse assess each specimen of urine?

1. Clarity

2. Viscosity

3. Glucose level

4. Specific gravity

22. nurse is caring for a client with glomerulonephritis. What should the nurse instruct the client
to do to prevent recur¬rent attacks?

1. Take showers instead of tub baths.

2. Continue the same restrictions on fluid intake.

3. Avoid situations that involve physical activity.

4. Seek early treatment for respiratory tract infections

23.The pathology report states that a client’s urinary calculus is composed of uric acid. Which
nutrients should the nurse instruct the client to avoid? Select all that apply.

1. Eggs

2. Fruit

3. Organ meats

4. Meat extracts

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24. Raw vegetables. A nurse is caring for a client with a diagnosis of renal calculi of calcium
phosphate composition. Which type of diet should the nurse explore with the client when
providing discharge information?

1. Low purine

2. Low calcium

3. High phosphorus

4. High alkaline ash

25. A pathology report states that a client’s urinary calculus is composed of uric acid. Which
should the nurse instruct the client to avoid?

1. Milk

2. Liver

3. Cheese

4. Vegetables

26. A nurse is caring for a client with end-stage renal disease. Which clinical indicators of end-
stage renal disease should the nurse expect? Select all that apply.

1. Polyuria

2. Jaundice

3. Azotemia

4. Hypertension

5. Polycythemia

27.A nurse is assessing a client with a diagnosis of kidney failure for clinical indicators of
metabolic acidosis. What should the nurse conclude is the reason why metabolic acidosis
devel¬ops with kidney failure?

1. Inability of the renal tubules to secrete hydrogen ions and conserve bicarbonate

2. Depressed respiratory rate by metabolic wastes, causing carbon dioxide retention

3. Inability of the renal tubules to reabsorb water to dilute the acid contents of blood

4. Impaired glomerular filtration, causing retention of sodium and metabolic waste products

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28. A nurse is caring for a client with a diagnosis of chronic kidney failure who has just been told
by the health care provider that hemodialysis is necessary. Which clinical man¬ifestation
indicates the need for hemodialysis?

1. Ascites 2. Acidosis

3. Hypertension 4. Hyperkalemia

29 .which of the following blood type & blood group transfused with out cross match during
war field.

A. A+ B.AB+ C.O- D.O+.

30. A defect in a myeloid stem cell can NOT cause problems with which of the following blood
cells

B. A .Erythrocyte B .Lymphocyte C .leukocyte D. Platelet production

31.All of them necessary for normal erythrocyte production EXCEPT

C. A .Iron, B .Vitamin B6 C .CHO D .Protein

32. Which of the following is NOT the most common Hematologic tests used to identify
Hematologic disorder

D. A. HCT B .HGB C .CBC D .Autopsy

33.Which of the following Hematologic tests best to assess the quantity and quality of each type
of cell produced within the marrow.

E. A. Biopsy B. ESR C. Blood smear D .Creatinine

34. ___________ is a condition in which the hemoglobin concentration is lower than normal

F. A .Hematopoiesis B .Leucopenia C. Anemia D .Leukemia

35. Which of the following is the cause of leukemia

A. Genetic influences B .Viral pathogenesis

C .Radiation exposure D .Idiopathic

36._______________ is the most common non lymphocytic leukemia

A. Acute Myeloid Leukemia B. Chronic Leukemia

C. Chronic Myeloid Leukemia D .All

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37 .If a patient comes to your hospital with acute bleeding from GI & the doctor ordered you
blood request for b/d group & RH .Then the result is B/D group----B+ & HCT—21%. List All
recommended for transfusion after cross match for this patient should be _________.

A .B+ whole blood B .O+ whole blood

C .AB+ packed cell D .O- whole blood

38 .If a patient comes to your hospital with acute bleeding from GI & the doctor ordered you
blood request for b/d group & RH .Then the result is B/D group----O+. Best option for
transfusion after cross match for this patient should be _________.

A .A+ whole blood B .O+ Packed cell

C .AB+ packed cell D .O- whole blood E .B& D option

39 .If the patient transfused for three unit the patient HGB increased________gm/%. (1unit---
350ml)

A .5 B .3 C. 6 D .2

40 .Which of the following is FALSE about Megaloblastic anemia.

A. The cause is deficiencies of vitamin B12 or folic acid

B. The erythrocytes that are produced are abnormally small

C. myeloid stem cell are also abnormal

D. A bone marrow analysis reveals hyperplasia

41 .Which of the following is Typical manifestations of anemia.

A .Weakness B .Restlessness C .Paleness D .All

42.____________ Refers to an increased level of leukocytes in the circulation

A .leukocytosis B. Leukopenia C .lymphoid D .Neutropenia

43. _________ are neoplasms of lymphoid tissue, usually derived from B lymphocytes.

A. leukocytosis B .Leukemia C. The lymphomas D .None

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 FILL IN THE BLANK

1. Referance interval for K+ in our body_________

ANSWER SHEET
NAME_________________________ ID._________________
SN

1 11 21 31 41

2 12 22 32 42

3 13 23 33 43

4 14 24 34 44

5 15 25 35 45

6 16 26 36 46

7 17 27 37 47

8 18 28 38 48

9 19 29 39 49

10 20 30 40 50

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