Review Med surg final exam (ecpi college)

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Med surg final exam (ecpi college)

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Total Questions : 95

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Question 1:

Medications classified as proton pump inhibitors include: (select all that apply (Select one or more)

A. Omeprazole B. Esomeprazole C. Pantoprazole D. Maalox E. Metronidazole

Answer and Explanation

Choice A:

Omeprazole is a proton pump inhibitor (PPI) that reduces gastric acid secretion by blocking the H⁺/K⁺ ATPase enzyme in the stomach lining.

Choice B:

Esomeprazole is a PPI and the S-isomer of omeprazole, also used to decrease stomach acid production.

Choice C:

Pantoprazole is another PPI commonly prescribed for gastroesophageal reflux disease (GERD) and erosive esophagitis.

Choice D:

Maalox is an antacid that neutralizes existing stomach acid but does not inhibit its production like PPIs.

Choice E:

Metronidazole is an antibiotic used to treat bacterial and protozoal infections, not a PPI.

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Question 2:

The nurse is assessing vital signs of a patient who has peritonitis. Which of the following vital signs indicate septic shock? Select all that apply.

A. Low heart rate B. High blood pressure C. High respiration rate D. Low respiration rate E. Fever F. High heart rate G. Low blood pressure

Answer and Explanation

Choice A:

Septic shock typically causes tachycardia (increased heart rate), not bradycardia.

Choice B:

Septic shock is usually associated with hypotension due to widespread vasodilation and capillary leak.

Choice C:

Tachypnea (increased respiratory rate) is a compensatory response to metabolic acidosis in septic shock.

Choice D:

A decreased respiratory rate is not characteristic of septic shock and may suggest impending respiratory failure.

Choice E:

Fever is a common sign of systemic infection and early sepsis.

Choice F:

Tachycardia is an early sign of septic shock due to compensatory mechanisms trying to maintain perfusion.

Choice G:

Hypotension is a hallmark of septic shock, indicating inadequate tissue perfusion.

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Question 3:

Which of the following medications do not decrease or neutralize stomach acid secretion?

A. ranitidine (zantac) B. pantoprazole (protonix) C. metronidazole (flagyl) D. omeprazole (prilosec)

Answer and Explanation

Choice A:

Ranitidine is an H2 receptor blocker that decreases stomach acid production.

Choice B:

pantoprazole (Protonix) – Pantoprazole is a proton pump inhibitor (PPI) that significantly reduces gastric acid secretion.

Choice C:

metronidazole (Flagyl) – Metronidazole is an antibiotic used to treat anaerobic bacterial infections; it has no effect on stomach acid secretion.

Choice D:

omeprazole (Prilosec) – Omeprazole is a proton pump inhibitor that blocks acid production in the stomach

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Question 4:

Norovirus is the most common cause of what:

A. pylori B. gastroenteritis C. stomatitis D. gastritis

Answer and Explanation

Choice A:

pylori –Helicobacter pylori is a bacterium, not a condition, and is associated with peptic ulcer disease, not caused by norovirus.

Choice B:

gastroenteritis –Norovirus is the leading cause of acute gastroenteritis worldwide, resulting in symptoms such as vomiting, diarrhea, and stomach cramps.

Choice C:

stomatitis –Stomatitis refers to inflammation of the mouth and lips, commonly caused by viruses like herpes simplex, not norovirus.

Choice D:

gastritis –Gastritis is inflammation of the stomach lining, often due to H. pylori infection, alcohol, or NSAIDs—not norovirus.

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Question 5:

The client presents to the emergency room complaining of severe abdominal pain, nausea, and anorexia. The client admits to binge drinking alcohol frequently, eating spicy foods, and takes aspirin frequently for his sore shoulder. The nurse suspects that the client may have developed?

A. Select one: B. Cholecystitis. C. Gastritis. D. Appendicitis. E. Esophageal cancer.

Answer and Explanation

Choice A:

Cholecystitis – Cholecystitis involves inflammation of the gallbladder, typically presenting with right upper quadrant pain and is often triggered by fatty meals, not directly by alcohol, spicy foods, or aspirin.

Choice B:

Gastritis – Gastritis is inflammation of the stomach lining, commonly caused by irritants such as alcohol, spicy foods, and NSAIDs (like aspirin). Symptoms include abdominal pain, nausea, and anorexia—all present in this client.

Choice C:

Appendicitis – Appendicitis usually presents with right lower quadrant pain, often accompanied by fever and localized tenderness, which are not indicated here.

Choice D:

Esophageal cancer – Esophageal cancer typically presents with progressive dysphagia and weight loss over time, not acute abdominal pain or symptoms linked with recent behavior like binge drinking.

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Question 6:

The chronic inflammatory disease that involves all layers of the intestinal tract and commonly affects the distal ileum and proximal colon is called:

A. Select one: B. Crohn's disease C. irritable bowel disease D. ulcerative colitis E. celiac disease

Answer and Explanation

Choice A:

Crohn's disease – Crohn’s disease is a chronic inflammatory bowel disease that can affect any part of the gastrointestinal tract, most commonly the distal ileum and proximal colon. It is characterized by transmural (all layers) inflammation and may cause fistulas, strictures, and deep ulcerations.

Choice B:

irritable bowel disease – This appears to refer to irritable bowel syndrome (IBS), which is a functional disorder without inflammation or structural damage and does not affect the intestinal layers.

Choice C:

ulcerative colitis – Ulcerative colitis is limited to the colon and rectum and affects only the mucosal and submucosal layers, not all layers.

Choice D:

celiac disease – Celiac disease is an autoimmune disorder triggered by gluten ingestion, affecting the small intestine's mucosal lining, not involving all layers or the colon.

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Question 7:

A 25-year-old patient is admitted with appendicitis. Which statement by the patient requires immediate nursing intervention?

A. "I have no appetite." B. "The pain hurts so much it is making me nauseous." C. "If I position myself on my right side, it makes the pain less intense." D. "The pain seems to be gone now."

Answer and Explanation

Choice A:

"I have no appetite." – Loss of appetite (anorexia) is a common and expected symptom of appendicitis.

Choice B:

"The pain hurts so much it is making me nauseous." – Incorrect. Severe pain accompanied by nausea is typical in appendicitis and does not require immediate intervention beyond routine care.

Choice C:

"If I position myself on my right side, it makes the pain less intense." – Incorrect. Patients often find comfort in certain positions; this statement reflects a common coping mechanism.

Choice D:

"The pain seems to be gone now." – Correct. Sudden relief of pain in a patient with appendicitis may indicate rupture of the appendix, which is a medical emergency requiring immediate intervention due to the risk of peritonitis and sepsis.

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Question 8:

A 25-year-old patient is admitted with appendicitis. Which statement by the patient requires immediate nursing intervention?

A. "I have no appetite." B. "The pain hurts so much it is making me nauseous. C. "If I position myself on my right side, it makes the pain less intense." D. "The pain seems to be gone now."

Answer and Explanation

Choice A:

"I have no appetite." –Anorexia is a common symptom of appendicitis and is not alarming on its own.

Choice B:

"The pain hurts so much it is making me nauseous." –Nausea and severe pain are typical manifestations of appendicitis and do not require emergency intervention unless they worsen suddenly.

Choice C:

"If I position myself on my right side, it makes the pain less intense." –Patients often adjust positions for comfort, and this statement is not cause for alarm.

Choice D:

"The pain seems to be gone now." –Sudden disappearance of pain in a patient with appendicitis can indicate rupture of the appendix, which is a surgical emergency. This may lead to peritonitis and sepsis, requiring immediate medical attention.

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Question 9:

A patient with hypotension has an order for 500 mL of plasma protein fraction to be infused over 2 hours. How many milliliters per hour should the IV pump be programmed for?

Answer and Explanation

Correct Answer: "250" mL/hr

Explanation

To calculate the IV infusion rate in mL/hr, use the formula:
Rate (mL/hr) = Total Volume (mL) ÷ Time (hr)
Rate = 500 mL ÷ 2 hr = 250 mL/hr

Answer: 250 mL/hr

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Question 10:

The licensed prescriber orders penicillin V 300,000 units po four times a day for your patient with chronic otitis. The drug is supplied in oral solution 200,000 units/5 mL. How many milliliters will you administer per dose?

Answer and Explanation

Correct Answer: "7.5" mL

Explanation

To determine how many milliliters to administer per dose, use the formula:
Volume to administer = (Desired dose ÷ Available dose) × Volume on hand
Volume = (300,000 units ÷ 200,000 units) × 5 mL
Volume = 1.5 × 5 mL = 7.5 mL

Answer: 7.5 mL

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Med surg final exam (ecpi college)

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