Digiulio M., Keogh J. Medical-Surgical Nursing Demystified
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(c) avoid acidic foods such as citrus or tomato.
(d) all of the above.
60. The first priority to care for the patient with a new fracture includes assessing:
(a) respiratory rate and effort, as well as pulse.
(b) the fracture site for bleeding.
(c) for signs of infection at the wound site of an open fracture.
(d) for circulation and sensation distal to the fracture site.
61. John presents with bronchitis. He thinks that he might have chronic bron-
chitis and asks you to explain the difference between them. You respond by
saying:
(a) Acute bronchitis lasts for three consecutive months and is reversible.
(b) Acute bronchitis lasts seven to ten days.
(c) Chronic bronchitis lasts three consecutive months in two consecutive
years. This results in a blockage of the airways which cannot be
reversed. Acute bronchitis is caused by a viral or bacterial infection
and lasts about ten days. Blockage of the airways is reversible in
acute bronchitis.
(d) I’ll ask your physician to explain the differences during his rounds.
62. Sam is diagnosed with having a myocardial infarction after experiencing
chest pain and pain radiating to his arms, jaw, and back. He asks what a
myocardial infarction is. You respond by saying:
(a) You had a heart attack.
(b) Your aortic valve was malformed at birth, causing a disruption in blood
flow.
(c) All patients who are as overweight as you will have a heart attack
(d) One or more arteries that supply blood to your heart are blocked, there-
by preventing blood from flowing to your cardiac muscles.
63. Tim presents with an acute episode of gout. You expect the physician to
prescribe:
(a) nonsteroidal anti-inflammatory medications and colchicine.
(b) allopurinol and aspirin.
(c) antibiotics and acetaminophen.
(d) bisphosphonates and calcium.
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Final Exam
64. Gregory has gastrointestinal bleeding and is experiencing hematochezia.
You recognize this as:
(a) vomiting of bright red or maroon blood.
(b) passage of black, tarry stool.
(c) passage of red or maroon-colored stool.
(d) coffee ground emesis.
65. Sue is diagnosed with congestive heart failure. What medication would you
expect to administer to strengthen myocardial contractility?
(a) Nitroprusside.
(b) Digoxin.
(c) Nitroglycerine ointment.
(d) Furosemide.
66. Tom reports abdominal pain that started over the periumbilical area and
moved to the right lower quadrant area. Tom probably has:
(a) Crohn’s disease.
(b) cholecystitis.
(c) appendicitis.
(d) diverticulitis.
67. Joan is diagnosed with a ruptured aneurysm. She wonders why this wasn’t
picked up in her annual physicial. You respond by saying:
(a) The physician must have misread the x-ray.
(b) The aneurysm must have developed since the physical.
(c) Aneurysms are often asymptomatic.
(d) Don’t be too concerned because this happens all the time.
68. Build-up of bile salts may cause the systemic symptom of:
(a) hypotension.
(b) pruritis (itching).
(c) ecchymosis (bruising).
(d) urticaria (hives).
69. Mary, who is diagnosed with osteomyelitis, may not heal properly unless
she has:
(a) debridement and drainage of the area.
(b) immobilization of the area.
(c) ice packs alternating with moist heat, applied externally.
(d) internal fixation device inserted.
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70. Treatment of the patient with appendicitis includes:
(a) transfusion to replace blood loss.
(b) bowel prep for cleansing.
(c) surgical removal of appendix.
(d) medications to lower pH within stomach.
71. Patients with pernicious anemia are treated with:
(a) oral iron.
(b) oral folic acid.
(c) parenteral vitamin B
12
.
(d) oral prednisone.
72. Patients with a paralytic ileus typically have:
(a) intravenous fluid replacement and a nasogastric tube connected to
suction.
(b) surgical correction of the problem.
(c) endoscopic injection of botulinum toxin or esophageal dilation.
(d) endoscopy to allow biopsy followed with broad-spectrum antibiotics.
73. Joan has osteoporosis. She has an increased risk for:
(a) infection in the bone.
(b) peripheral blood clot formation.
(c) fracture formation.
(d) painful joint inflammation.
74. On assessment of the abdomen in a patient with peritonitis, you would expect
to find:
(a) a soft abdomen with bowel sounds every 2 to 3 seconds.
(b) rebound tenderness and guarding (protecting).
(c) hyperactive, high-pitched bowel sounds and a firm abdomen.
(d) ascites and increased vascular pattern on the skin.
75. Steve, who is diagnosed with pneumonia following recent intrathoracic sur-
gery, will likely be prescribed:
(a) cephalosporin, such as cefazolin.
(b) penicillin, such as amocicillin.
(c) fluoroquinolone, such as levofloxacin.
(d) tetracycline, such as doxycycline.
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Final Exam
76. Following treatment with fluoxetine, a selective serotonin reuptake inhib-
itor for depression, Mary hardly sleeps, is hyperactive, easily distracted,
and appears elated. You would expect her physician to:
(a) continue the selective serotonin reuptake inhibitor.
(b) start a mood stabilizer.
(c) switch to a tricyclic antidepressant.
(d) add a monoamine oxidase inhibitor.
77. To clean a wound, it is best to use:
(a) hydrogen peroxide to bubble away the debris.
(b) tap water.
(c) saline.
(d) It is best not to disturb a healing wound.
78. Instructions for a patient at risk for testicular cancer include:
(a) restrict potassium, phosphate, sodium, protein in diet.
(b) self-catheterization of ileal reservoir.
(c) testicular self exam.
(d) change in color of urine is to be expected.
79. Paralytic ileus may occur as a postoperative complication. Which of the
following patients would cause you the greatest concern about the devel-
opment of paralytic ileus?
(a) Kim, a 27-year-old post-laparscopic appendectomy
(b) Joyce, a 39-year-old post-open right hemicolectomy
(c) Nancy, a 56-year-old post-mediastinoscopy
(d) John, a 47-year-old post-total joint replacement
80. Felicia’s family is concerned because Felicia states that she is hearing voices.
This is a sign of:
(a) bipolar disorder.
(b) schizophrenia.
(c) panic disorder.
(d) bulimia nervosa.
81. Your postoperative patient develops a cellulitis in her leg. Your nursing
treatments would include:
(a) keeping both her legs elevated as much as possible.
(b) encouraging ambulation as much as possible to help with the blood flow.
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(c) application of ice four times a day for one hour each to reduce inflam-
mation.
(d) application of moisturizing lotion three times daily to keep the skin
moist.
82. A patient with a second-degree burn has a greater risk for:
(a) constipation.
(b) infection.
(c) hypotension.
(d) hyperglycemia.
83. Alex is a 78-year-old married man with sudden onset of confusion and dis-
orientation; he is exhibiting combative behavior. He has no previous psy-
chiatric history. A psychiatric consultation has been called. You suspect
Alex has:
(a) delirium.
(b) psychosis.
(c) depression.
(d) panic disorder.
84. Sue is having a minor procedure performed. Which type of anesthesia is
most likely to be used?
(a) General.
(b) Epidural.
(c) Regional.
(d) Conscious sedation.
85. Sue has a mild dermatitis rash and asks for advice. You respond by saying:
(a) Wash the area with an antiseptic soap frequently to keep the area clean.
(b) Use an antifungal ointment.
(c) Use talcum powder to soothe the inflamed skin.
(d) Use a mild steroidal cream.
86. Karen is suspected of having a hormone imbalance. What would you expect
to monitor?
(a) Electrolyte levels.
(b) Thyroid studies, FSH, and LH.
(c) Caloric intake.
(d) All of the above.
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Final Exam
87. Which member of the surgical team does not scrub in the operating room?
(a) The surgeon.
(b) The circulating nurse.
(c) The scrub nurse or surgical tech.
(d) The holding area nurse.
88. Mary has been dieting and exercising daily. Her weight is well below the
recommended minimum for her height. Assessment for Mary would include
looking for:
(a) ecchymosis and extraocular movements.
(b) temporal wasting and irregular heart rhythm.
(c) peripheral edema and rales.
(d) periorbital edema and chorea.
89. Steps to prevent a pressure ulcer may include:
(a) not disturbing the patient.
(b) changing the position of a bed-bound patient every 4 hours.
(c) vigorously rubbing the skin with alcohol.
(d) avoiding pressure on the heels of a bed-bound patient.
90. When assessing a skin lesion, you look for A—asymmetry, B—irregular
borders, C—variegated colors, D—diameter, and E—
(a) edema.
(b) erythema.
(c) elevation.
(d) ever-changing.
91. Mandy is a 17-year-old female. On physical examination you note partial
erosion of her tooth enamel and callus formation on the posterior aspect of
the knuckles of her hand. This is indicative of:
(a) a connective tissue disorder; she should be referred to dermatology.
(b) self-induced vomiting; she likely has bulimia nervosa.
(c) self-mutilation; this correlates with anxiety.
(d) a genetic disorder; her siblings should also be tested.
92. Three days after surgery, Mark notices that the wound site is more painful
now than it was the day before. When you inspect the surgical site you are
looking for redness or inflammation. Other indicators of infection would
include:
(a) elevated RBC and elevated respiratory rate.
(b) elevated WBC and elevated temperature.
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Medical-Surgical Nursing Demystified
(c) elevated erythrocyte sedimentation rate and decreased pulse.
(d) decreased platelets and decreased blood pressure.
93. You are caring for a patient with an infected wound. You would expect:
(a) to prepare for sutures to close the wound.
(b) to use steri-strips to hold the edges together.
(c) to leave the wound open.
(d) to cover the wound with a loose, fluffy dressing.
94. Donna is a healthy, 46-year-old female scheduled for elective surgery next
week. You would include in her preoperative preparation:
(a) a pulmonary function test and chest x-ray.
(b) a CBC, chemistry panel, and pregnancy test.
(c) urine culture, thyroid panel, and cortisol level.
(d) glucose tolerance test, ankle-brachial index, and electrocardiogram
(EKG).
95. When staging a pressure ulcer, you correctly recognize a stage II ulcer as:
(a) redness, with no break in the skin.
(b) shallow ulcer with red base.
(c) dermis involvement with eschar.
(d) bone visible with no drainage.
96. Josie is the mother of a healthy 19-year-old having surgery tomorrow. After
the surgeon discusses the surgery, risks, and benefits with the patient and
her mother, the mother wants to sign the consent form. The most appropri-
ate response to this would be:
(a) Of course she can sign the consent form; after all, the patient is her
daughter.
(b) While you appreciate the concern for her daughter, the patient is a con-
senting adult and legally has to sign her own consent form.
(c) No consent form must be signed.
(d) Why don’t both the patient and her mother sign the form?
97. Appropriate treatment for a patient with cellulitis includes:
(a) petrolatum and vitamin A&D ointment.
(b) antibiotics, such as cephalexin, and over-the-counter analgesics.
(c) weight-bearing exercises and diuretics, such as furosemide.
(d) wet to dry dressings and steroids.
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Final Exam
98. Sixty-five-year-old Dominic is being transferred into the PACU from the
OR. Once there, initial assessment will focus on:
(a) airway, breathing, circulation, and wound site.
(b) intake, output, and intravenous access.
(c) abdominal sounds, oxygen level, and level of consciousness.
(d) pulse oximetry, pupil responses, and deep tendon reflexes.
99. Patient teaching for risk reduction of skin cancer should include:
(a) Having suspicious moles checked by a dermatologist.
(b) Daily sun exposure every one-half hour.
(c) Daily sun exposure of 1 hour to build tolerance.
(d) Applying moisturizer.
100. Denise is recovering from an open cholesystectomy. You know that be-
cause of the location of the surgery, she has an increased chance of post-
operative:
(a) myocardial infarction.
(b) respiratory complications.
(c) deep vein thrombosis.
(d) wound infection.
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Medical-Surgical Nursing Demystified
Answers to Quiz
and Exam Questions
Chapter 1
1. b 2. a 3. d 4. b 5. b
6. a 7. a 8. d 9. a 10. b
Chapter 2
1. b 2. a 3. b 4. c 5. c
6. c 7. a 8. c 9. a 10. b
Chapter 3
1. c 2. a 3. b 4. a 5. b
6. c 7. c 8. d 9. c 10. d
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Chapter 4
1. b 2. d 3. a 4. a 5. b
6. b 7. c 8. d 9. d 10. c
Chapter 5
1. b 2. d 3. a 4. a 5. c
6. b 7. a 8. b 9. c 10. a
Chapter 6
1. c 2. b 3. a 4. d 5. a
6. d 7. b 8. a 9. d 10. a
Chapter 7
1. c 2. b 3. d 4. a 5. b
6. c 7. d 8. b 9. a 10. a
Chapter 8
1. a 2. a 3. d 4. a 5. b
6. c 7. a 8. a 9. d 10. d
Chapter 9
1. b 2. a 3. c 4. c 5. a
6. c 7. d 8. d 9. a 10. b
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Medical-Surgical Nursing Demystified