Nursing Board Review: Medical Surgical Nursing Practice Test Part 2
by · June 23, 2010
Review Questions on Medical Surgical Nursing.
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Medical Surgical Nursing2
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Assessment of a client with possible thrombophlebitis to the left leg and a deep vein thrombosis is done by pulling up on the toes while gently holding down on the knee. The client complains of extreme pain in the calf. This should be documented as:
positive tourniquet test
positive homan’s sign
negative homan’s sign
negative tourniquet test
Question 1 Explanation:
Pain in the calf while pulling up on the toes is abnormal and indicates a positive test. If the client feels nothing or just feels like the calf muscle is stretching, it is considered negative. A tourniquet test is used to measure for varicose veins.
A patient is admitted to the medical surgical unit following surgery. Four days after surgery, the patient spikes a 38.9 degrees C oral temperature and exhibits a wet, productive cough. The nurse assesses the patient with understanding that an infection that is acquired during hospitalization is known as:
a community acquired infection
an iatrogenic infection
a nosocomial infection
an opportunistic infection
Question 2 Explanation:
Nosocomial, or hospital-acquired are infections acquired during hospitalization for which the patient isn’t being primarily treated. Community acquired or opportunistic infections may not be acquired during hospitalization. An iatrogenic infection is caused by the doctor or by medical therapy. And an opportunistic infection affects a compromised host.
Nurse Edward is performing discharge teaching for a newly diagnosed diabetic patient scheduled for a fasting blood glucose test. The nurse explains to the patient that hyperglycemia is defined as a blood glucose level above:
Question 3 Explanation:
Hyperglycemia is defined as a blood glucose level greater than 120 mg/dl. Blood glucose levels of 120 mg/dl, 130 mg/dl and 150 mg/dl are considered hyperglycemic. A blood glucose of 100 mg/dl is normal.
Chvostek’s sign is associated with which electrolyte impabalnce?
Question 4 Explanation:
Chvostek’s sign is a spasm of the facial muscles elicited by tapping the facial nerve and is associated with hypocalcemia. Clinical signs of hypokalemia are muscle weakness, leg cramps, fatigue, nausea and vomiting. Muscle cramps, anorexia, nausea and vomiting are clinical signs of hyponatremia. Clinical manifestations associated with hypophosphatemia include muscle pain, confusion, seizures and coma.
Which of the following statement is true regarding the visual changes associated with cataracts?
Both eyes typically cataracts at the same time
The loss of vision is experienced as a painless, gradual blurring
The patient is suddenly blind
The patient is typically experiences a painful, sudden blurring of vision.
Question 5 Explanation:
Typically, a patient with cataracts experiences painless, gradual loss of vision. Although both eyes may develop at different rates.
Nurse Marian is caring for a client with haital hernia, which of the following should be included in her teaching plan regarding causes:
To avoid heavy lifting
A dietary plan based on soft foods
Its prevalence in young adults
Its prevalence in fair-skinned individuals
Question 6 Explanation:
Heavy lifting is one factor that leads to development of a hiatal hernia. Dietary factors involve limiting fat intake, not restricting client to soft foods. It is more prevalent in individuals who are middle-aged or older. Fair-skinned individuals are not prone to this condition.
Joseph has been diagnosed with hepatic encephalopathy. The nurse observes flapping tremors. The nurse understands that flapping tremors associated with hepatic encephalopathy are also known as:
Question 7 Explanation:
Flapping tremors associated with hepatic encephalophaty are asterixis. Aphasia is the inability to speak. Ascites is an accumulation of fluid in the peritoneal cavity. Astacia is the inability to stand or sit still.
A client with anemia has a hemoglobin of 6.5 g/dL. The client is experiencing symptoms of cerebral tissue hypoxia. Which of the following nursing interventions would be most important in providing care?
Providing rest periods throughout the day
Instituting energy conservation techniques
Assisting in ambulation to the bathroom
Checking temperature of water prior to bathing
Question 8 Explanation:
Cerebral tissue hypoxia is commonly associated with dizziness. The greatest potential risk to the client with dizziness is injury, especially with changes in position. Planning for periods of rest and conserving energy are important with someone with anemia because of his or her fatigue level but most important is safety.
The proper way to open an envelop-wrapped sterile package after removing the outer package or tape is to open the first position of the wrapper:
away from the body
to the left of the body
to the right of the body
toward the body
Question 9 Explanation:
when opening an envelop-wrapped sterile package, reaching across the package and using the first motion to open the top cover away from the body eliminates the need to later reach across the steri9le field while opening the package. To remove equipment from the package, opening the first portion of the package toward, to the left, or to the right of the body would require reaching across a sterile field.
A client with congestive heart failure has digoxin (Lanoxin) ordered everyday. Prior to giving the medication, the nurse checks the digoxin level which is therapeutic and ausculates an apical pulse. The apical pulse is 63 bpm for 1 full minute. The nurse should:
Hold the Lanoxin
Give the half dose now, wait an hour and give the other half
Call the physician
Give the Lanoxin as ordered
Question 10 Explanation:
The Lanoxin should be held for a pulse of 60 bpm. Nurses cannot arbitrarily give half of a dose without a physician’s order. Unless specific parameters are given concerning pulse rate, most resources identify 60 as the reference pulse.
Hazel Murray, 32 years old complains of abrupt onset of chest and back pain and loss of radial pulses. The nurse suspects that Mrs. Murray may have:
Dissecting abdominal aorta
Dissecting thoracic aneurysm
Question 11 Explanation:
A dissecting thoracic aneurysm may cause loss of radical pulses and severe chest and back pain. An MI typically doesn’t cause loss of radial pulses or severe back pain. CVA and dissecting abdominal aneurysm are incorrect responses.
Which of the following findings would strongly indicate the possibility of cirrhosis?
Question 12 Explanation:
Although option D is correct, it is not a strong indicator of cirrhosis. Pruritus can occur for many reasons. Options A and C are incorrect, fluid accumulations is usually in the form of ascites in the abdomen. Hepatomegaly is an enlarged liver, which is correct. The spleen may also be enlarged.
Nursing management of the client with a UTI should include:
Taking medication until feeling better
Decreasing caffeine drinks and alcohol
Question 13 Explanation:
Caffeine and alcohol can increase bladder spasms and mucosal irritation, thus increase the signs and symptoms of UTI. All antibiotics should be taken completely to prevent resistant strains of organisms.
Nurse Alexandra is establishing a plan of care for a client newly admitted with SIADH. The priority diagnosis for this client would be which of the following?
Fluid volume deficit
Anxiety related to disease process
Fluid volume excess
Risk for injury
Question 14 Explanation:
SIADH results in fluid retention and hyponatremia. Correction is aimed at restoring fluid and electrolyte balance. Anxiety and risk for injury should be addressed following fluid volume excess.
An 8 year old boy is brought to the trauma unit with a chemical burn to the face. Priority assessment would include which of the following?
BP and pulse
Patency of airway
Amount of pain
Question 15 Explanation:
A burn face, neck or chest may cause airway closure because of the edema that occurs within hours. Remember the ABC’s: airway, breathing and circulation. Airway always comes first, even before pain. The nurse will also assess options B and D, but these are not the highest priority assessments.
A client was involved in a motor vehicular accident in which the seat belt was not worn. The client is exhibiting crepitus, decrease breath sounds on the left, complains of shortness of breath, and has a respiratory rate of 34 breaths per minute. Which of the following assessment findings would concern the nurse most?
Temperature of 102 degrees F and productive cough
ABG with PaO2 of 92 and PaCO2 of 40 mmHg
Trachea deviating to the right
Question 16 Explanation:
A mediastinal shift is indicative of a tension pneumothorax along with the other symptoms in the question. Since the individual was involved in a MVA, assessment would be targeted at acute traumatic injuries to the lungs, heart or chest wall rather than other conditions indicated in the other answers. Option A is common with pneumonia; values in option B are not alarming; and option D is typical of someone with COPD.
Aling Puring has just been diagnosed with close-angle (narrow-angle) glaucoma. The nurse assesses the client for which of the following common presenting symptoms of the disorder?
dull eye pain
severe eye and face pain
impaired night vision
Question 17 Explanation:
Narrow-angle glaucoma develops abruptly and manifests with acute face and eye pain and is a medial emergency. Halo vision, dull eye pain and impaired night vision are symptoms associated with open-angle glaucoma.
Thomas Elison is a 79 year old man who is admitted with diagnosis of dementia. The doctor orders a series of laboratory tests to determine whether Mr. Elison’s dementia is treatable. The nurse understands that the most common cause of dementia in this population is:
Question 18 Explanation:
Alzheimer’s disease is the most common cause of dementia in the elderly population. AIDS, brain tumors and vascular disease are all less common causes of progressive loss of mental function in elderly patients.
A 24 year old male patient comes to the clinic after contracting genital herpes. Which of the following intervention would be most appropriate?
Encourage him to maintain bed rest for several days
Monitor temperature every 4 hours
Instruct him to avoid sexual contact during acute phases of illness
Encourage him to use antifungal agents regularly
Question 19 Explanation:
Herpes is a virus and is spread through direct contact. An antifungal would not be useful; bed rest and temperature measurement are usually not necessary.
Mang Edison is on bed rest has developed an ulcer that is full thickness and is penetrating the subcutaneous tissue. The nurse documents that this ulcer is in which of the following stages?
Question 20 Explanation:
A stage 3 ulcer is full thickness involving the subcutaneous tissue. A stage 1 ulcer has a defined area of persistent redness in lightly pigmented skin. A stage 2 ulcer involves partial thickness skin loss. Stage 4 ulcers extend through the skin and exhibit tissue necrosis and muscle or bone involvement.
A client with anemia due to chemotherapy has a hemoglobin of 7.0 g/dL. Which of the following complaints would be indicative of tissue hypoxia related to anemia?
fatigue relieved by rest
skin that is warm and dry to the touch
Question 21 Explanation:
Central tissue hypoxia is commonly associated with dizziness. Recognition of cerebral hypoxia is critical since the body will attempt to shunt oxygenated blood to vital organs.
Hyperkalemia can be treated with administration of 50% dextrose and insulin. The 50% dextrose:
causes potassium to be excreted
causes potassium to move into the cell
causes potassium to move into the serum
counteracts the effects of insulin
Question 22 Explanation:
The 50% dextrose is given to counteract the effects of insulin. Insulin drives the potassium into the cell, thereby lowering the serum potassium levels. The dextrose doesn’t directly cause potassium excretion or any movement of potassium.
Which of the following nursing interventions is contraindicated in the care of a client with acute osteomyelitis?
Apply heat compress to the affected area
Immobilize the affected area
Administer narcotic analgesics for pain
Administer OTC analgesics for pain
Question 23 Explanation:
Options B, C and D are appropriate nursing interventions when caring for a client diagnosed with osteomyelitis. The application of heat can increase edema and pain in the affected area and spread bacteria through vasodilation.
What laboratory test is a common measure of the renal function?
Alanine amino transferase (ALT)
Question 24 Explanation:
The BUN is primarily used as indicator of kidney function because most renal diseases interfere with its excretion and cause blood vessels to rise. Creatinine is produced in relatively constant amounts, according to the amount of muscle mass and is excreted entirely by the kidneys making it a good indicator of renal function.
Felicia Gomez is 1 day postoperative from coronary artery bypass surgery. The nurse understands that a postoperative patient who’s maintained on bed rest is at high risk for developing:
deep vein thrombosis (DVT)
dehiscence of the wound
Question 25 Explanation:
DVT, is the most probable complication for postoperative patients on bed rest. Options A, B and D aren’t likely complications of the post operative period.
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