MEDICAL-SURGICAL NURSING

QUIZ __

1. Some lifetime habits and hobbies affect postoperative respiratory function. If the client has smoked
3 packs of cigarettes a day for the past 10 years, the nurse will anticipate increased risk for:

a. Delayed coagulation

b. Delayed wound healing

c. Perioperative anxiety and stress

d. Postoperative respiratory function

2. Which of the following should be given the highest priority when receiving a patient in the OR?

a. Assess the level of consciousness

b. Check for jewelry, gowns manicures, and dentures.

c. Assess vital signs

d. Verify patient identification and informed consent

3. The scrub nurse and the circulating nurse also counted the sharps and miscellaneous items like
instruments before the procedure. Continuous accounting for these items can primarily:

a. Shorten surgical cases turnover by 15 to 30 minutes

b. Improve hospital miscellaneous revenue

c. Minimize injuries and or liabilities to the sterile surgical team

d. Expedite the procedure thus shortening the surgical time

4. When you say sterile, it means:

a. The material is clean

b. The material has no microorganisms nor spores present that might cause an infection

c. There is a black stripe on the paper indicator

d. The material as well as the equipment are sterilized and had undergone a rigorous sterilization
process

5. In the preoperative area, the nurse notices that the surgical permit has not been signed; however, the
client has been medicated with Ativan (lorazepam) and Demerol (meperidine). What should the nurse
do?

a. Have the client sign the permit

b. Have the client’s friend sign the permit

c. Notify the doctor

d. Sign the permit for the client

6. The nurse empties a Jackson-Pratt drainage bulb. Which of the following nursing interventions
ensures the correct functioning of the drain?
a. Irrigating it with normal saline

1
 b. Connecting it to low intermittent suction

c. Compressing it and then plugging it to establish suction

d. Connecting it to a drainage bag and clamping it off

7. Surgeries like I and D (incision and drainage) and debridement and relatively short procedures but
considered dirty cases. When are this procedure best scheduled.
a. Last cases

b. According to availability of anesthesiologist

c. In between cases

d. According to the surgeon’s preference

8. After administration of preoperative medications Versed (midazolam hydrochloride) and Demerol

(meperidine hydrochloride), the client states the need to void. Which of the following is the most
appropriate action by the nurse?

a. Assist the client to the bathroom

b. Insert a Foley catheter

c. Offer the client the bedpan

d. Palpate the client’s bladder

9. The client’s identification armband was removed to start an intravenous line as part of the
preoperative preparation. The transport team has arrived to transport the client to the operating
room. The nurse notices that the client’s identification band is not on his wrist. What is the nurse’s
best response?
a. Place a new identification armband on the client’s wrist before transport

b. Send the removed armband with the chart and the client to the operating room

c. Tape the cut armband back unto the client’s wrist

d. Send the client without an armband because she can verbally identify herself

10. The nurse develops a plan of care for the immediate postoperative period for client who had a
thyroidectomy. The plan should include measures to:

a. Correct fluid and electrolyte balance

b. Administer medication to decrease vascularity of the

thyroid glands

c. Promote range of the motion exercises to the neck

d. Prevent complications of respiratory obstruction

11. As a perioperative nurse, how can you best meet the safety need of the client after administering
preoperative narcotic?

a. Put side rails up and ask the client not to get out the bed

b. Send the client to the OR with the family

c. Allow client to get up to go to the comfort room

d. Obtain consent form

2
12. If you are the nurse in charge for scheduling surgical case, what important information do you need
to ask the surgeon?

1. Who is your internist?

2. Who is your assistant and anesthesiologist?

3. What is your preferred time and type of surgery?

4. Who are your anesthesiologist and internist?

a. 1,2,3

b. 2,3

c. 1,3

d. 3,4

13. A nurse has conducted preoperative teaching for a client schedule for surgery in 1 week. The client
has a history of arthritis and has been taking acetylsalicylic acid (aspirin). The nurse determines that
the client needs additional teaching if the client state.

a. “Aspirin can cause bleeding after surgery”

b. “I need to continue to take the aspirin as prescribed until the day of surgery”

c. “Aspirin can cause my ability to clot blood to be abnormal”

d. “I need to discontinue the aspirin 48 hours before the scheduled surgery”

14. A male adult patient on mechanical ventilator is receiving pancuronium bromide (pavulon), 0.01
mg/kg I.V. as needed. Which assessment finding indicates that the patient needs another
pancuronium dose?

a. Leg movement

b. Fighting the ventilator

c. Lip movement

d. Finger movement

15. A nurse instructs a female client to use the pursed-lip method of breathing and the client asks the
nurse about the purpose of this type of breathing. The nurse responds, knowing that the primary
purpose of pursed-lip breathing is to:

a. Promote carbon dioxide elimination

b. Promote oxygen intake

c. Strengthen the diaphragm

d. Strengthen the intercoastal muscles

16. A nurse is teaching a male client with chronic respiratory failure how to use a metered-dose inhaler
correctly. The nurse instructs the client to:

a. Inhale quickly

b. Inhale through the nose

c. Hold the breath after inhalation

d. Take two inhalations during on breath

3
17. Pneumocystis carinii infections are commonly treated with which of the following medications?

a. Chlorpropamide

b. Pentamidine

c.Allopurinol

d. Lorazepam

18. On auscultation, which finding suggest a right pneumothorax?

a. Bilateral inspiratory and expiratory crackles

b. Absence of breath sound in the right thorax

c. Inspiratory wheezes in the right thorax

d. Bilateral pleural friction rub

19. A female client is suspected of having a pulmonary embolus. A nurse assesses the client, knowing
that which of the following is a common clinical manifestation of pulmonary embolism?

a. Bradypnea

b. Bradycardia

c. Dyspnea

d. Decreased respiratory rate

20. A nurse is caring for a female client diagnosed with tuberculosis. Which assessment, if made by the
nurse is inconsistent with the usual clinical presentation of tuberculosis and may indicate the
development of a concurrent problem?

a. Cough

b. High grade fever

c. Chills and night sweats

d. Anorexia and weight loss

21. Which of the following pulmonary term correlates with the definition: noted obstruction of the
trachea or larynx.

a. Stridor

b. Rhonchi

c. Wheezes

d. Vesicular

22. What type of solution should be given to the patient having signs and symptoms of edema?

a. Hypotonic

b. Hypertonic

c. Isotonic

d. Isometric

4
23. This pertains to the facial twitching once the face anterior to the earlobe is being tapped?

a. Chvostek sign

b. Hypernatremia

c. Psoa’s sign

d. Trousseau sign

24. The nurse administers sodium polystyrene sulfonate (Kayexalate) knowing that the drug reduces
hyperkalemia by:

a. Inhibiting potassium absorption sites in the GI tract

b. Altering the effects of aldosterone in the kidney tubules

c. Exchange sodium ions for potassium ions in the GI tract, thereby increasing potassium excretion

in the feces.

d. Promoting diarrhea, thereby decreasing potassium absorption from the gut

25. The physician has written the following orders for the client with excess fluid volume. The client’s
morning assessment includes bounding peripheral pulses, weight gain of 2 pounds, pitting ankle
edema, and moist crackles bilaterally. Which order takes priority at this time?

a. Weigh client every morning

b. Administer furosemide (Lasix) 40 mg IV push

c. Maintain accurate intake and output

d. Restrict fluid to 1500 mL per day

SITUATION 1: Nurse Irene was assigned to admit a 33-year-old client complaining a reflux in his
esophagus 1-2 hours after eating or lying down for almost two weeks before consultation. Physicians’
diagnosis is hiatal hernia.

26. The nurse understands that hiatal hernia is caused by:

a. increased esophageal muscle pressure.

b. weakness in diaphragmatic muscle and increased intrabdominal pressure.

c. weakness of esophageal muscle, causing the stomach to slide.

d. weakness of diaphragmatic muscle and the esophageal muscle.

27. To confirm the diagnosis of hiatal hernia, the nurse prepares the client for which of the following
diagnostic tests?

a. Abdominal x-ray series

b. Barium swallow

c. Lower gastrointestinal (GI) series

d. Chest X-ray

28. The nurse wants to promote comfort of the client with esophageal reflux. Which of the instruction is
APPROPRIATE for the client?

5
 a. Maintain a high carbohydrate diet.

b. Lie down immediately after eating.

c. Sleep with the head elevated by 30 degrees.

d. Take ice-cold beverages after meals.

29. The client continues to complain of body weakness and inability to take in the much needed food due
to esophageal reflux. The nurse would plan for which high priority nursing diagnosis?

a. Inadequate nutrition intake.

b. Risk for deficient fluid volume.

c. Interrupted rest.

d. Risk for infection.

30. To prevent increase in gastric acid secretion, Nurse Irene instructs the client to avoid:

a. being dehydrated

b. gastric mucosal irritants like aspirin.

c. abrupt discontinuance of medication

d. cigarette smoking.

SITUATION 2: Gerard, 56 years old, underwent partial gastrectomy with gastrojejunostomy.

31.The physician emphasized that Vitamin B12 levels will be routinely monitored. Which of the
following mechanism CORRECTLY explains the possibility of the patient developing Vitamin B12
deficiency?

a. Vitamin B12 is primarily absorbed in the duodenum.

b. Fast emptying of food from the stomach interferes with Vitamin B12 absorption.

c. Intrinsic factor necessary for absorption of vitamin B12 is inadequate.

d. Inadequate liver storage of Vitamin B12 due to decreased stomach size

32. Which of the following group of manifestations will the nurse expect in case of Vitamin B12
deficiency develops in the patient?

a. Pallor, weakness, spoon shaped nails, smooth sore tongue.

b. Progressive weakness, shortness of breath, palpitations, cheilosis

c. Fatigue, irritability, pallor, painful swelling of the hands

d. Slight jaundice, fatigue, paresthesia, glossitis

33. The nurse identified iron deficiency anemia as a potential problem. Which of the following
specifically would PREDISPOSE the patient to this problem.

a. Rapid gastric emptying due to gastrojejunostomy

b. Inadequate intake of food rich in iron.

c. Excessive loss of blood during surgery

d. Inability to eat large meals

6
34. The nurse understands that Iron deficiency anemia results in decrease red blood cells which are:

a. abnormally crescent shape

b. large and immature

c. microcytic and hypochromic

d. fragile and megaloblastic

35. Priority nursing diagnosis identified by the nurse for Gerard is “Imbalanced nutrition related to
patient’s inadequate intake of food.” Which of the following is an APPROPRIATE intervention?

a. based on list of patient’s choice of food, prepare diet plan.

b. plan diet with family members in consultation with dietician.

c. prepare a diet plan taking into consideration the patient’s preferred eating pattern.

d. have physician order a specific diet for the patient.

SITUATION 3: You are assigned in the medical ward with various GI patients:

36. The hospitalized client with GERD is complaining of chest discomfort that feels like heartburn
following a meal. After administering an ordered antacid, the nurse encourages the client to lie in which
of the following positions?

A. Supine with the head of the bed flat

B. On the stomach with the head flat

C. On the left side with the head of the bed elevated 30 degrees

D. On the right side with the head of the bed elevated 30 degrees

37. Which of the following tests can be used to diagnose ulcers?

A. Abdominal x-ray

B. Barium swallow

C. Computed tomography (CT) scan

D. Esophagogastroduodenoscopy (EGD)

38. Which of the following best describes the method of action of medications, such as ranitidine
(Zantac), which are used in the treatment of peptic ulcer disease?

A. Neutralize acid

B. Reduce acid secretions

C. Stimulate gastrin release

D. Protect the mucosal barrier

39. The nurse is providing discharge instructions to a client following gastrectomy. Which measure will
the nurse instruct the client to follow to assist in preventing dumping syndrome?

A. Eat high-carbohydrate foods

B. Limit the fluids taken with meals

C. Ambulate following a meal

D. Sit in a high-Fowlers position during meals

7
40. The client with GERD complains of a chronic cough. The nurse understands that in a client with GERD
this symptom may be indicative of which of the following conditions?

A. Development of laryngeal cancer

B. Irritation of the esophagus

C. Esophageal scar tissue formation

D. Aspiration of gastric contents

41. Which of the following dietary measures would be useful in preventing esophageal reflux?

A. Eating small, frequent meals

B. Increasing fluid intake

C. Avoiding air swallowing with meals

D. Adding a bedtime snack to the dietary plan

42. A client with peptic ulcer disease tells the nurse that he has black stools, which he has not reported
to his physician. Based on this information, which nursing diagnosis would be appropriate for this client?

A. Ineffective coping related to fear of diagnosis of chronic illness

B. Deficient knowledge related to unfamiliarity with significant signs and symptoms

C. Constipation related to decreased gastric motility

D. Imbalanced nutrition: Less than body requirements due to gastric bleeding

43. A client is taking an antacid for treatment of a peptic ulcer. Which of the following statements best
indicates that the client understands how to correctly take the antacid?

A. "I should take my antacid before I take my other medications."

B. "I need to decrease my intake of fluids so that I don't dilute the effects of my antacid."

C. "My antacid will be most effective if I take it whenever I experience stomach pains."

D. "It is best for me to take my antacid 1 to 3 hours after meals."

44. The nurse is reviewing the medication record of a client with acute gastritis. Which medication, if
noted on the client's record, would the nurse question?

A. Digoxin (Lanoxin)

B. Indomethacin (Indocin)

C. Furosemide (Lasix)

D. Propranolol hydrochloride (Inderal)

45. The client with peptic ulcer disease is scheduled for a pyloroplasty. The client asks the nurse about
the procedure. The nurse plans to respond knowing that a pyloroplasty involves:

A. Cutting the vagus nerve

B. Removing the distal portion of the stomach

C. Removal of the ulcer and a large portion of the cells that produce hydrochloric acid

D. An incision and resuturing of the pylorus to relax the muscle and enlarge the opening from the stomach
to the duodenum

8
46. The nurse would assess the client experiencing an acute episode of cholecystitis for pain that is
located in the right

A. Upper quadrant and radiates to the left scapula and shoulder

B. Upper quadrant and radiates to the right scapula and shoulder

C. Lower quadrant and radiates to the umbilicus

D. Lower quadrant and radiates to the back

47. When counseling a client in ways to prevent cholecystitis, which of the following guidelines is most
important?

A. Eat a low-protein diet

B. Eat a low-fat, low-cholesterol diet

C. Limit exercise to 10 minutes/day

D. Keep weight proportionate to height

48. Which of the following tests is most commonly used to diagnose cholecystitis?

A. Abdominal CT scan

B. Abdominal ultrasound

C. Barium swallow

D. Endoscopy

49. Which of the following factors should be the main focus of nursing management for a client
hospitalized for cholecystitis?

A. Administration of antibiotics

B. Assessment for complications

C. Preparation for lithotripsy

D. Preparation for surgery

50. You’re precepting a nursing student who is helping you provide T-Tube drain care. You explain to the
nursing student that the t-shaped part of the drain is located in what part of the biliary tract?

A. Cystic duct

B. Common hepatic duct

C. Common bile duct

D. Pancreatic duct