Medical-Surgical Nursing Certification Flashcards

A patient with COPD is receiving supplemental oxygen at 2 L/min via nasal cannula. The nurse notes the patient's respiratory rate has decreased to 8/min and SpO2 is 99%. What is the concern?

Answer: The patient may rely on hypoxic drive, and high oxygen may suppress respiratory effort

Some patients with COPD depend on hypoxic drive to breathe; excessive supplemental oxygen can suppress this and cause respiratory depression.

A patient with acute pancreatitis is NPO and requesting pain relief. Which analgesic is preferred?

Answer: Hydromorphone IV

Hydromorphone is preferred for pancreatitis pain; meperidine is avoided due to toxic normeperidine metabolites, and morphine may cause sphincter of Oddi spasm.

A patient develops petechiae, oozing from IV sites, and a prolonged PT/PTT post-surgery. These findings are most consistent with:

Answer: Disseminated intravascular coagulation (DIC)

DIC is characterized by simultaneous clotting and bleeding, with petechiae, coagulation factor consumption, and prolonged PT/PTT.

When teaching a patient with heart failure about fluid restriction, the nurse explains that daily weights should be taken:

Answer: Each morning after voiding and before eating

Daily weights taken under standardized conditions (morning, after voiding, before eating) provide accurate fluid status monitoring.

A patient with SIADH has a serum sodium of 124 mEq/L and is asymptomatic. The appropriate initial treatment is:

Answer: Fluid restriction to 800–1000 mL/day

Fluid restriction is the first-line treatment for mild to moderate asymptomatic SIADH, addressing the underlying water excess.

Which sign/symptom differentiates pulmonary embolism (PE) from myocardial infarction (MI)?

Answer: Sudden onset pleuritic chest pain and hemoptysis with normal cardiac enzymes

Pleuritic chest pain (worsens with breathing), hemoptysis, and normal cardiac enzymes are characteristic of PE rather than MI.