MEDICAL SURGICAL NURSING

MEDICAL SURGICAL NURSING

1. Marco who was diagnosed with brain tumor was

scheduled for craniotomy. In preventing the

development of cerebral edema after surgery,

the nurse should expect the use of:

a. Diuretics

b. Antihypertensive

c. Steroids

d. Anticonvulsants

2. Halfway through the administration of blood,

the female client complains of lumbar pain. After

stopping the infusion Nurse Hazel should:

a. Increase the flow of normal saline

b. Assess the pain further

c. Notify the blood bank

d. Obtain vital signs.

3. Nurse Maureen knows that the positive

diagnosis for HIV infection is made based on

which of the following:

a. A history of high risk sexual behaviors.

b. Positive ELISA and western blot tests

c. Identification of an associated

opportunistic infection

d. Evidence of extreme weight loss and

high fever

4. Nurse Maureen is aware that a client who has

been diagnosed with chronic renal failure

recognizes an adequate amount of high-biologicvalue

protein when the food the client selected

from the menu was:

a. Raw carrots

b. Apple juice

c. Whole wheat bread

d. Cottage cheese

5. Kenneth who has diagnosed with uremic

syndrome has the potential to develop

complications. Which among the following

complications should the nurse anticipates:

a. Flapping hand tremors

b. An elevated hematocrit level

c. Hypotension

d. Hypokalemia

6. A client is admitted to the hospital with benign

prostatic hyperplasia, the nurse most relevant

assessment would be:

a. Flank pain radiating in the groin

b. Distention of the lower abdomen

c. Perineal edema

d. Urethral discharge

7. A client has undergone with penile implant.

After 24 hrs of surgery, the client’s scrotum was

edematous and painful. The nurse should:

a. Assist the client with sitz bath

b. Apply war soaks in the scrotum

c. Elevate the scrotum using a soft support

d. Prepare for a possible incision and

drainage.

8. Nurse hazel receives emergency laboratory

results for a client with chest pain and

immediately informs the physician. An increased

myoglobin level suggests which of the following?

a. Liver disease

b. Myocardial damage

c. Hypertension

d. Cancer

9. Nurse Maureen would expect the client with

mitral stenosis would demonstrate symptoms

associated with congestion in the:

a. Right atrium

b. Superior vena cava

c. Aorta

d. Pulmonary

10. A client has been diagnosed with hypertension.

The nurse priority nursing diagnosis would be:

a. Ineffective health maintenance

b. Impaired skin integrity

c. Deficient fluid volume

d. Pain

11. Nurse Hazel teaches the client with angina about

common expected side effects of nitroglycerin

including:

a. high blood pressure

b. stomach cramps

c. headache

d. shortness of breath

12. The following are lipid abnormalities. Which of

the following is a risk factor for the development

of atherosclerosis and PVD?

a. High levels of low density lipid (LDL)

cholesterol

b. High levels of high density lipid (HDL)

cholesterol

c. Low concentration triglycerides

d. Low levels of LDL cholesterol.

13. Which of the following represents a significant

risk immediately after surgery for repair of aortic

aneurysm?

a. Potential wound infection

b. Potential ineffective coping

c. Potential electrolyte balance

d. Potential alteration in renal perfusion

14. Nurse Josie should instruct the client to eat

which of the following foods to obtain the best

supply of Vitamin B12?

a. dairy products

b. vegetables

c. Grains

d. Broccoli

15. Karen has been diagnosed with aplastic anemia.

The nurse monitors for changes in which of the

following physiologic functions?

a. Bowel function

b. Peripheral sensation

c. Bleeding tendencies

d. Intake and out put

16. Lydia is scheduled for elective splenectomy.

Before the clients goes to surgery, the nurse in

charge final assessment would be:

a. signed consent

b. vital signs

c. name band

d. empty bladder

17. What is the peak age range in acquiring acute

lymphocytic leukemia (ALL)?

a. 4 to 12 years.

b. 20 to 30 years

c. 40 to 50 years

d. 60 60 70 years

18. Marie with acute lymphocytic leukemia suffers

from nausea and headache. These clinical

manifestations may indicate all of the following

except

a. effects of radiation

b. chemotherapy side effects

c. meningeal irritation

d. gastric distension

19. A client has been diagnosed with Disseminated

Intravascular Coagulation (DIC). Which of the

following is contraindicated with the client?

a. Administering Heparin

b. Administering Coumadin

c. Treating the underlying cause

d. Replacing depleted blood products

20. Which of the following findings is the best

indication that fluid replacement for the client

with hypovolemic shock is adequate?

a. Urine output greater than 30ml/hr

b. Respiratory rate of 21 breaths/minute

c. Diastolic blood pressure greater than 90

mmhg

d. Systolic blood pressure greater than 110

mmhg

21. Which of the following signs and symptoms

would Nurse Maureen include in teaching plan

as an early manifestation of laryngeal cancer?

a. Stomatitis

b. Airway obstruction

c. Hoarseness

d. Dysphagia

22. Karina a client with myasthenia gravis is to

receive immunosuppressive therapy. The nurse

understands that this therapy is effective

because it:

a. Promotes the removal of antibodies that

impair the transmission of impulses

b. Stimulates the production of

acetylcholine at the neuromuscular

junction.

c. Decreases the production of

autoantibodies that attack the

acetylcholine receptors.

d. Inhibits the breakdown of acetylcholine

at the neuromuscular junction.           

23. A female client is receiving IV Mannitol. An

assessment specific to safe administration of the

said drug is:

a. Vital signs q4h

b. Weighing daily

c. Urine output hourly

d. Level of consciousness q4h

24. Patricia a 20 year old college student with

diabetes mellitus requests additional

information about the advantages of using a pen

like insulin delivery devices. The nurse explains

that the advantages of these devices over

syringes include:

a. Accurate dose delivery

b. Shorter injection time

c. Lower cost with reusable insulin

cartridges

d. Use of smaller gauge needle.

25. A male client’s left tibia is fractures in an

automobile accident, and a cast is applied. To

assess for damage to major blood vessels from

the fracture tibia, the nurse in charge should

monitor the client for:

a. Swelling of the left thigh

b. Increased skin temperature of the foot

c. Prolonged reperfusion of the toes after

blanching

d. Increased blood pressure

26. After a long leg cast is removed, the male client

should:

a. Cleanse the leg by scrubbing with a brisk

motion

b. Put leg through full range of motion

twice daily

c. Report any discomfort or stiffness to the

physician

d. Elevate the leg when sitting for long

periods of time.

27. While performing a physical assessment of a

male client with gout of the great toe,

NurseVivian should assess for additional tophi

(urate deposits) on the:

a. Buttocks

b. Ears

c. Face

d. Abdomen

28. Nurse Katrina would recognize that the

demonstration of crutch walking with tripod gait

was understood when the client places weight

on the:

a. Palms of the hands and axillary regions

b. Palms of the hand

c. Axillary regions

d. Feet, which are set apart

29. Mang Jose with rheumatoid arthritis states, “the

only time I am without pain is when I lie in bed

perfectly still”. During the convalescent stage,

the nurse in charge with Mang Jose should

encourage:

a. Active joint flexion and extension

b. Continued immobility until pain subsides

c. Range of motion exercises twice daily

d. Flexion exercises three times daily

30. A male client has undergone spinal surgery, the

nurse should:

a. Observe the client’s bowel movement

and voiding patterns

b. Log-roll the client to prone position

c. Assess the client’s feet for sensation and

circulation

d. Encourage client to drink plenty of fluids

31. Marina with acute renal failure moves into the

diuretic phase after one week of therapy. During

this phase the client must be assessed for signs

of developing:

a. Hypovolemia

b. renal failure

c. metabolic acidosis

d. hyperkalemia

32. Nurse Judith obtains a specimen of clear nasal

drainage from a client with a head injury. Which

of the following tests differentiates mucus from

cerebrospinal fluid (CSF)?

a. Protein

b. Specific gravity

c. Glucose

d. Microorganism

33. A 22 year old client suffered from his first tonicclonic

seizure. Upon awakening the client asks

the nurse, “What caused me to have a seizure?

Which of the following would the nurse include

in the primary cause of tonic-clonic seizures in

adults more the 20 years?

a. Electrolyte imbalance

b. Head trauma

c. Epilepsy

d. Congenital defect

34. What is the priority nursing assessment in the

first 24 hours after admission of the client with

thrombotic CVA?

a. Pupil size and papillary response

b. cholesterol level

c. Echocardiogram

d. Bowel sounds

35. Nurse Linda is preparing a client with multiple

sclerosis for discharge from the hospital to

home. Which of the following instruction is most

appropriate?

176

a. “Practice using the mechanical aids that

you will need when future disabilities

arise”.

b. “Follow good health habits to change

the course of the disease”.

c. “Keep active, use stress reduction

strategies, and avoid fatigue.

d. “You will need to accept the necessity

for a quiet and inactive lifestyle”.

36. The nurse is aware the early indicator of hypoxia

in the unconscious client is:

a. Cyanosis

b. Increased respirations

c. Hypertension

d. Restlessness

37. A client is experiencing spinal shock. Nurse

Myrna should expect the function of the bladder

to be which of the following?

a. Normal

b. Atonic

c. Spastic

d. Uncontrolled

38. Which of the following stage the carcinogen is

irreversible?

a. Progression stage

b. Initiation stage

c. Regression stage

d. Promotion stage

39. Among the following components thorough pain

assessment, which is the most significant?

a. Effect

b. Cause

c. Causing factors

d. Intensity

40. A 65 year old female is experiencing flare up of

pruritus. Which of the client’s action could

aggravate the cause of flare ups?

a. Sleeping in cool and humidified

environment

b. Daily baths with fragrant soap

c. Using clothes made from 100% cotton

d. Increasing fluid intake           

41. Atropine sulfate (Atropine) is contraindicated in

all but one of the following client?

a. A client with high blood

b. A client with bowel obstruction

c. A client with glaucoma

d. A client with U.T.I

42. Among the following clients, which among them

is high risk for potential hazards from the

surgical experience?

a. 67-year-old client

b. 49-year-old client

c. 33-year-old client

d. 15-year-old client

43. Nurse Jon assesses vital signs on a client

undergone epidural anesthesia.

44. Which of the following would the nurse assess

next?

a. Headache

b. Bladder distension

c. Dizziness

d. Ability to move legs

45. Nurse Katrina should anticipate that all of the

following drugs may be used in the attempt to

control the symptoms of Meniere's disease

except:

a. Antiemetics

b. Diuretics

c. Antihistamines

d. Glucocorticoids

46. Which of the following complications associated

with tracheostomy tube?

a. Increased cardiac output

b. Acute respiratory distress syndrome

(ARDS)

c. Increased blood pressure

d. Damage to laryngeal nerves

47. Nurse Faith should recognize that fluid shift in a

client with burn injury results from increase in

the:

a. Total volume of circulating whole blood

b. Total volume of intravascular plasma

c. Permeability of capillary walls

d. Permeability of kidney tubules

48. An 83-year-old woman has several ecchymotic

areas on her right arm. The bruises are probably

caused by:

a. increased capillary fragility and

permeability

b. increased blood supply to the skin

c. self-inflicted injury

d. elder abuse

49. Nurse Anna is aware that early adaptation of

client with renal carcinoma is:

a. Nausea and vomiting

b. flank pain

c. weight gain

d. intermittent hematuria

50. A male client with tuberculosis asks Nurse Brian

how long the chemotherapy must be continued.

Nurse Brian’s accurate reply would be:

a. 1 to 3 weeks

b. 6 to 12 months

c. 3 to 5 months

d. 3 years and more