Medical-Surgical Nursing MCQ Flashcards

A patient with acute respiratory distress syndrome (ARDS) is mechanically ventilated. Which ventilator strategy is consistent with lung-protective ventilation?

Answer: Tidal volume of 4-6 mL/kg ideal body weight

Lung-protective ventilation in ARDS uses low tidal volumes (4-6 mL/kg IBW) to minimize ventilator-induced lung injury from barotrauma and volutrauma.

A patient develops sudden-onset shortness of breath and hypotension 3 days after hip arthroplasty. Which complication is most likely?

Answer: Pulmonary embolism

Pulmonary embolism classically presents with sudden dyspnea and hypotension in the post-operative period due to DVT embolizing to the pulmonary vasculature.

A nurse is preparing to administer 40 mEq potassium chloride IV to a patient with hypokalemia. Which action is most important?

Answer: Dilute in at least 100 mL and infuse no faster than 10 mEq/hr

Potassium chloride must be diluted and infused slowly (≤10 mEq/hr peripheral) to prevent cardiac dysrhythmias and venous irritation.

Which finding in a patient with a urinary catheter most strongly suggests catheter-associated urinary tract infection (CAUTI)?

Answer: Urine that appears cloudy with a foul odor and patient has fever

Cloudy, malodorous urine combined with fever in a catheterized patient meets clinical criteria for suspected CAUTI and warrants urine culture.

A patient with Addison's disease is admitted for surgery. Which perioperative consideration is most critical?

Answer: Administering stress-dose corticosteroids

Patients with Addison's disease cannot mount a cortisol stress response; stress-dose corticosteroids must be administered perioperatively to prevent adrenal crisis.

A patient receiving chemotherapy for colon cancer has an absolute neutrophil count (ANC) of 400/mm³. Which visitor restriction is most appropriate?

Answer: Restrict all visitors with signs of infection

Severe neutropenia (ANC <500) requires neutropenic precautions, including restricting visitors with any infection signs to prevent transmission of potentially fatal infections.

A patient with a newly created colostomy appears tearful and states, 'I'll never be able to go out in public again.' Which nursing response is most therapeutic?

Answer: Acknowledge the patient's feelings and discuss concerns about body image

Acknowledging the patient's feelings validates their emotional response and opens therapeutic communication to address body image and psychosocial concerns.