Medical-Surgical Nursing
Chapter Exam Questions
Course Introduction
Medical-Surgical Nursing is a foundational course that introduces students to the principles and practices of caring for adult patients experiencing a variety of acute and chronic health conditions. Emphasizing the nursing process, this course covers topics such as patient assessment, development of care plans, pharmacological management, postoperative care, and the integration of interdisciplinary collaboration. Students gain essential clinical skills, including the ability to prioritize nursing interventions, manage care across diverse populations, and respond to medical emergencies. The course also highlights the importance of evidence-based practice, ethical considerations, and cultural competence within the rapidly evolving field of medical-surgical nursing.
Recommended Textbook
Medical Surgical Nursing Critical Thinking for Person Centred Care 3rd Edition by
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Page 2
Priscilla Lemone
Chapter 1: Medical-Surgical Nursing in the Twenty-First Century
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Sample Questions
Q1) The nurse is preparing a person to return home following a brief hospitalisation. Which of the following is most important in preparing to teach the patient how to care for himself after discharge?
A)The person's ability to follow both verbal and written orders.
B)The ability to support the person's decision making.
C)Familiarity with adult learning principles.
D)The ability to use critical thinking.
Answer: C
Q2) The nurse is creating outcome criteria for the nursing diagnoses for a person. Which of the following would the nurse include when creating the criteria? They should be written:
A)to address the person, be time-specific and measurable.
B)as achievable nursing goals.
C)as verifiable statements.
D)as psychomotor actions.
Answer: A
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Chapter 2: Health and Illness in Adults
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Sample Questions
Q1) What is meant by the term 'iatrogenic disease'? A disease:
A)of unknown cause.
B)caused by aspects of healthcare management.
C)that developed in utero.
D)that results from lifestyle choices.
Answer: B
Q2) A person tells the nurse, 'All the people in my family hold extra weight around their hips and legs.' The nurse realises this person is describing which health risk factor?
A)Ethnicity.
B)Educational level.
C)Socioeconomic background.
D)Genetic makeup.
Answer: D
Q3) Which of the following is an Australian National Health Priority Area?
A)Back pain.
B)Visual impairment.
C)Mental health.
D)Malnutrition.
Answer: C
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Page 4
Chapter 3: Nursing Care of People Having Surgery
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Sample Questions
Q1) A person who is recovering from abdominal surgery has a Penrose drain in situ. Which of the following should the nurse include in the care of this person?
A)Empty the drain every 30 minutes.
B)Clean the wound with normal saline every two hours.
C)Remove the drain 24 hours postoperatively.
D)Make sure there is a safety pin on the end of the drain.
Answer: D
Q2) A person is being positioned for a hip replacement procedure. In which of the following positions will this person most likely be placed?
A)Lateral chest.
B)Supine.
C)Lithotomy.
D)Prone.
Answer: A
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Chapter 4: Nursing Care of People Experiencing Loss, Grief, and Death
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Sample Questions
Q1) A nurse who provided care for a terminally ill person does not want to spend any time with the grieving family and begins to provide care for another person. What is this nurse demonstrating?
A)Acceptance.
B)Blunting.
C)Detachment.
D)Empathy.
Q2) A recently widowed woman is seen wearing dark clothing and dark glasses and carrying her late husband's coffee cup. What is this woman demonstrating?
A)A normal response to a loss.
B)Morbid fixation.
C)Exaggerated grief response.
D)Joy.
Q3) A recently widowed woman states, 'I wanted to ask him for a divorce and then he died.' This person is at risk of which of the following?
A)Accelerated grief reaction.
B)A dysfunctional grief reaction.
C)A typical grief reaction process.
D)Psychosomatic disorders.
Page 6
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Chapter 5: Nursing Care of People With Problems of Substance Misuse
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Q1) A person who was sexually abused as a child tells the nurse, 'I just like to try different drugs recreationally.' Which phrase of the following is most likely correct about this person? The person:
A)has a mental illness.
B)wants to fit into her peer group.
C)has an addictive personality.
D)has low self-esteem and difficulty expressing emotions.
Q2) Which is an adverse effect of marijuana use?
A)Loss of appetite.
B)Constricted pupils.
C)Hot flushes.
D)Anxiety.
Q3) Which manifestation is associated with cocaine withdrawal?
A)Vivid dreams.
B)Constricted pupils.
C)Excessive lacrimation.
D)Numbness of the extremities.
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Page 7
Chapter 6: Nursing Care of People Experiencing Disasters
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Q1) An Australian emergency room nurse is caring for a person admitted who was in a motor vehicle accident. What would be an appropriate nursing intervention for this nurse to implement?
A)Intubation
B)Insert IV cannulae
C)Staple wounds
D)Insert chest tube
Q2) What is a tool used in the Australian emergency department to standardize the structure of communication?
A)ISBAR
B)Nurses notes
C)Progress notes
D)Narrative records
Q3) The nurse is planning the coding for a triage disaster plan. What are the colours most associated with triage? Select all that apply.
A)Black
B)Red
C)Yellow
D)Purple .
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Chapter 7: Genetic Implications of Adult Health Nursing
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Q1) On completion of genetic testing, a person is happy to learn that she has a negative test result. What does this person need to understand?
A)This is not a guarantee that she will never develop a genetically caused disease.
B)Her children might develop disease from chromosomal translocation.
C)Any children she has will be free from genetic diseases.
D)She will never experience a genetically caused disease.
Q2) A mother who has given birth to a baby with Down syndrome refuses to allow any family members to visit her or the newborn. What is the person demonstrating?
A)Poor maternal-child bonding.
B)Denial.
C)Postpartum depression.
D)Anxiety and guilt.
Q3) Which of the following conditions results from an autosomal pattern of inheritance?
A)Cystic fibrosis.
B)Huntington disease.
C)Down syndrome.
D)Duchenne muscular dystrophy.
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Chapter 8: Nursing Care of People in Pain
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Sample Questions
Q1) The nurse is helping a person in pain by providing therapeutic massage to the painful area. Which pain control method is the nurse using?
A)Cutaneous stimulation.
B)Acupuncture.
C)Transcutaneous electrical nerve stimulation (TENS).
D)Physiotherapy.
Q2) A person who has had a below-knee amputation appears to be experiencing pain in the amputated foot. What type of pain is this?
A)Central.
B)Acute postoperative.
C)Phantom.
D)Visceral.
Q3) A person with a long history of pain rarely appears to be in pain and often forgoes the use of pain medication. Which of the following is correct? The person has:
A)a low pain tolerance.
B)minimal levels of pain.
C)a high pain tolerance.
D)incident pain.
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Chapter 9: Nursing Care of People With Altered Fluid, Electrolyte,
Acid-Based Balance
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Sample Questions
Q1) A person's blood gases show a pH above 7.53 and a bicarbonate level of 36 mEq/L. Which acid-base disorder is the person demonstrating
A)Respiratory acidosis
B)Respiratory alkalosis
C)Metabolic acidosis
D)Metabolic alkalosis
Q2) An older adult is at home after being diagnosed with a fluid volume excess. Which of the following should the community nurse instruct this person to do?
A)Try to sleep on one pillow.
B)Keep legs in a dependent position.
C)Avoid wearing shoes while in the home.
D)Wear support hose.
Q3) A person with fluid retention related to renal problems is admitted to the hospital. The nurse realises that this person could possibly have which of the following electrolyte imbalances?
A)Hypercapnia
B)Hypocalcaemia
C)Hypernatraemia
D)Hypophosphataemia
Page 11
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Chapter 10: Nursing Care of People Experiencing Trauma and Shock
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Q1) A nurse is caring for a person in hypovolemic shock. Which type of blood product should the nurse plan to administer?
A)Lipids.
B)Plasma.
C)Whole blood.
D)Platelets.
Q2) The nurse suspects that a person is a victim of abuse. Which of the following would give the nurse this impression?
A)Injuries that do not correlate with the person's story of the injury.
B)Caring attitude between the person and significant other.
C)Evidence of adequate fluid intake.
D)Spontaneous movement of all four extremities.
Q3) The nurse is determining a person's cardiac output. Which of the following completes the equation the nurse can use to make this assessment?
A)Systemic vascular resistance Ă— stroke volume.
B)Systolic blood pressure Ă— heart rate.
C)Mean arterial pressure Ă— stroke volume.
D)Stroke volume Ă— heart rate.
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Chapter 11: Nursing Care of People With Infections
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Q1) A person who is demonstrating an inflammatory response is prescribed a non-steroidal anti-inflammatory drug (NSAID). The nurse realises that this medication will result in which of the following?
A)Inhibition of prostaglandin synthesis
B)Increase in the flow of serous exudate
C)Reduction in the production of leukotrienes
D)Increase in the production of histamine
Q2) A person with methicillin-resistant Staphylococcus aureus (MRSA)is no longer responding to the medication vancomycin. What is this person most likely demonstrating?
A)VISA
B)VRE
C)MDR-TB
D)ESBL
Q3) A person has elevated blood levels of immunoglobulin IgM. What does this suggest to the nurse? The person is:
A)in the early stages of an infection.
B)experiencing a hypersensitivity response.
C)responding to bacterial toxins.
D)in the later stages of an infection.
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Chapter 12: Nursing Care of People With Altered Immunity
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Sample Questions
Q1) A person who received a kidney transplant 6 months prior is demonstrating an alteration in his blood urea nitrogen (BUN)level. The nurse realises that this person is demonstrating:
A)an acute tissue rejection.
B)evidence of improved kidney functioning.
C)an allergic response.
D)a functional decline as an early indicator of rejection.
Q2) An HIV-positive person comes into the clinic complaining of increasing pain in his feet and legs. The nurse realises that this person is demonstrating a(n):
A)reaction to the antiviral medications.
B)nervous system manifestation of the disease.
C)secondary peripheral vascular disease.
D)minor opportunistic infection of the lower limbs.
Q3) A person is recovering from a skin graft where the skin of a pig is sutured to the person's ear. Which type of graft is this?
A)Xenograft
B)Allograft
C)Autograft
D)Isograft
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Page 14
Chapter 13: Nursing Care of People With Cancer
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Sample Questions
Q1) A person is prescribed external radiation as part of his cancer treatment. Which of the following should be included in this person's instructions? Select all that apply.
A)Use an electric razor to shave the treatment area.
B)Apply an ice pack if the skin becomes irritated.
C)Wash the skin with soap and water.
D)Do not wash off the treatment marks.
Q2) A person has breast cancer. Where is a common metastatic site for this cancer?
A)Vertebrae
B)Lungs
C)Colon
D)Spleen
Q3) A person who is newly diagnosed with cancer says to the nurse, 'I don't want to spend my final days on earth in a hospital bed.' What is the nurse's best response?
A)'Why do you feel so negative about being in the hospital?'
B)'You should enjoy the life you have left'.
C)'You are not going to die from cancer'.
D)'Please tell me more about how you are feeling right now'.
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Chapter 14: A Person-Centred Approach to Assessing the
Integumentary
System
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Q1) During the assessment of a person's integumentary status, the nurse notes: 'vitiligo present bilateral hands.'' This documentation means that the person has:
A)dark, asymmetrical coloured patches.
B)yellowing of the skin.
C)patches of white spots.
D)grey cast to the skin.
Q2) The nurse is planning to assess an Indigenous Australian's integumentary status. Which of the following findings would indicate the presence of cyanosis in this person?
A)Bluish-tinged mucous membranes
B)Yellow sclera
C)Orange-green cast to the skin
D)Cherry-red nail beds
Q3) The nurse is preparing to assess a person's integumentary status. Which of the following techniques should the nurse use to conduct this assessment?
A)Percussion and palpation
B)Inspection and palpation
C)Inspection and percussion
D)Palpation and auscultation
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Chapter 15: Nursing Care of People With Integumentary Disorders
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Q1) A person in a wheelchair has a history of sacral pressure ulcer formation. Which instruction should be included in the person's teaching?
A)Sit on a donut.
B)Shift the weight every 15 minutes to hourly.
C)Have a family member pull the person up in the wheelchair.
D)Stay in one position as long as possible.
Q2) A middle-aged person with a history of sun exposure has broken blood vessels on the cheeks. How should the nurse document this finding?
A)Psoriasis.
B)Keratosis.
C)Telangiectases.
D)Cherry angiomas.
Q3) A young person asks what can be done to remove acne scars. What should the nurse suggest to this person?
A)Laser treatment.
B)Blepharoplasty.
C)Chemical peeling.
D)Skin graft.
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Chapter 16: Nursing Care of People With Burns
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Sample Questions
Q1) A person with full-thickness burns is prescribed a gastrointestinal medication. What is the primary action of this medication?
A)Promote peristalsis.
B)Prevent the onset of stress ulcers.
C)Treat a pre-existing duodenal ulcer.
D)Minimise anorexia.
Q2) A person has extensive burns involving the front of both legs. Using the Wallace rule of nines, what percentage of this person's total body surface area is burned?
A)9.
B)18.
C)27.
D)36.
Q3) Following surgical debridement, a person with full-thickness burns does not bleed. What should this finding indicate to the nurse?
A)Hypovolemia is present.
B)The procedure needs to be repeated.
C)Peripheral vascular shutdown is occurring.
D)The procedure is no longer indicated.
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Chapter 17: A Person-Centred Approach to Assessing the Endocrine System
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Q1) A person is waiting to learn the results of a fasting blood sugar test. Which value should suggest to the nurse that the person is prediabetic?
A)3.3 mmol/L.
B)4.4 mmol/L.
C)6.6 mmol/L.
D)8.8 mmol/L.
Q2) A person scheduled for a test for glycosylated haemoglobin (HbA1c)level asks about the purpose of the test. How should the nurse respond to this person?
A)'It's to check for pituitary functioning.'
B)'It's a blood test to check for thyroid dysfunction.'
C)'It's a blood test to check for adrenal functioning.'
D)'It's to check for pancreas functioning.'
Q3) A person being tested for hyperglycaemia is pleased to learn that an oral glucose tolerance test is not needed. ''What might cancellation of the test indicate?
A)Consistently high fasting blood glucose levels.
B)Variable blood glucose levels.
C)Normal liver functioning.
D)Normal pituitary functioning.
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Chapter 18: Nursing Care of People With Endocrine Disorders
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Q1) A person is newly diagnosed with hyperthyroidism. Which manifestation is consistent with this diagnosis?
A)Muscle weakness.
B)Blurred vision.
C)Bradycardia.
D)Lethargy.
Q2) A 35-year-old woman who takes oral contraceptives is prescribed steroid therapy. What should be included when teaching the person about this medication?
A)Monitor blood glucose levels.
B)Avoid salt.
C)Consider changing the form of contraception.
D)Check blood pressure daily.
Q3) A person is recovering from a bilateral adrenalectomy. Which action should the nurse take to monitor for the development of adrenal insufficiency?
A)Change the wound dressing using clean technique.
B)Restrict dietary protein.
C)Place on fluid restriction.
D)Monitor strict fluid intake and output.
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Chapter 19: Nursing Care of People With Diabetes Mellitus
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Q1) A person with diabetes is unable to lose weight despite careful dieting and consuming only sugar-free soft drinks. How should the nurse respond to this person?
A)'How much water are you drinking every day?'
B)'Sugar-free drinks still have some calories.'
C)'Are you sure you are buying only sugar-free items?'
D)'It is very difficult to stick to a weight loss diet.'
Q2) A person says, 'I'm glad I only have diabetes. Many of my friends have heart problems.' What would be an appropriate response for the nurse to make to this person?
A)'Diabetes can affect your heart if it is not properly controlled.'
B)'I agree that you are fortunate to only have diabetes.'
C)'You are lucky because heart problems are much more serious than diabetes.'
D)'Your friends probably have diabetes too.'
Q3) A person with diabetes mentions a plan to lose 15 kg in 2 months. What should this statement indicate to the nurse?
A)Gastric bypass surgery is needed.
B)The person is highly motivated.
C)The goal is unrealistic.
D)The goal is achievable.
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Chapter 20: A Person-Centred Approach to Assessing the
Gastrointestinal
System
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Q1) During the calculation of a person's caloric intake, the nurse learns that the person ingests 175 grams of carbohydrates per day. How many kilojoules does this volume of carbohydrate translate into?
A)2900
B)5800
C)11 700
D)26 000
Q2) A person with diabetes tells the nurse that she eats a sweet potato each day because it 'naturally lowers blood sugar levels.' In addition to this information, which vitamin is this person ingesting on a daily basis?
A)Vitamin A
B) Vitamin B<sub>6</sub>
C) Vitamin C
D) Vitamin D
Q3) Which condition might develop in a person eating a diet high in meat and cheese?
A)Skin lesions
B)Vitamin C excess
C)Increase in adipose tissue
D)Muscle wasting
22
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Chapter 21: Nursing Care of People With Nutritional Disorders
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Q1) Which waist-to-hip ratio increases the risk of a female developing stroke, elevated insulin levels, and an abnormal lipid profile?
A)0.2
B)0.3
C)0.5.
D)0.8
Q2) A female has a body mass index (BMI)of 27. Which of the following would be an appropriate documentation by the nurse?
A)Underweight
B)Normal weight
C)Overweight
D)Obese
Q3) During a physical assessment, the nurse suspects that the person might be experiencing metabolic syndrome. Which of the following assessment findings would provide evidence for this nurse's assumption?
A)Blood pressure of 150/96
B)Hypoglycaemia
C)High HDL cholesterol
D)Bradycardia
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Chapter 22: Nursing Care of People With Upper
Gastrointestinal Disorders
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Q1) A person with gastritis is commencing therapy with the anti-ulcer agent sucralfate (Carafate). What would the nurse teach the person about using this medication?
A)The medication may be taken with antacids.
B)The medication is likely to cause nausea.
C)Shake the suspension well.
D)Take the medication with meals.
Q2) A person with nausea says, 'I'm tired of taking this medication. All it does is make me feel nausea.' Which of the following could the nurse instruct this person to do?
A)Suggest that the person take the medication with a large meal.
B)Encourage the person to reduce the dosage of the medication to reduce the nausea.
C)Persist with the medication.
D)Suggest eating a dry cracker to help with the nausea.
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Chapter 23: Nursing Care of People With Bowel Disorders
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Q1) A person comes into the outpatient clinic for testing because of chronic constipation. What might this person have evidence of?
A)Inflammatory bowel diseases
B)External haemorrhoids
C)Gastroenteritis
D)Irritable bowel syndrome
Q2) The nurse is assessing a person with a pancreatic disorder. The nurse realises the person might be experiencing digestive problems that affect which section of the intestines?
A)Jejunum
B)Ascending colon
C)Duodenum
D)Transverse colon
Q3) The nurse is beginning the interview of an older person with a bowel disorder. Which of the following might be an appropriate question to begin this interview?
A)'Older people often become preoccupied about their bowels.'
B)'Do you have any other health-related problems?'
C)'I see here that you have a problem with constipation.'
D)'Many people your age become fixated about their bowels.'
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Page 25
Chapter 24: Nursing Care of People With Gallbladder, Liver, and Pancreatic Disorders
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Q1) A person who is being evaluated for liver trauma that was sustained in a motor vehicle accident is found to have a negative peritoneal lavage. What is the person demonstrating?
A)Haematoma formation
B)Severe liver lacerations
C)No abdominal bleeding
D)Clotting factor malfunction
Q2) A person with acute pancreatitis is uncomfortable in bed. Which of the following positions might improve this person's comfort level?
A)Assist to a standing position and ambulate.
B)Elevate the head of the bed 45 degrees.
C)Lay flat in bed.
D)Sit up in bed.
Q3) A person's indirect (unconjugated)bilirubin blood levels will rise with which condition?
A)Biliary obstruction
B)Pancreatitis
C)Transfusion reaction
D)Alcoholic cirrhosis of the liver
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Chapter 25: A Person-Centred Approach to Assessing the Renal System
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Q1) After stating the need to 'go to the bathroom', a person voids 450 ml of urine. What is this person's urine output considered to be?
A)Low
B)Normal
C)High
D)Diluted
Q2) The nurse is able to percuss a dull tone over a person's bladder. What is this finding suggestive of?
A)Bladder cancer
B)Urinary retention
C)A normal finding
D)Ureteral blockage
Q3) The nurse is preparing to catheterise a person after the person has just independently voided. What is the purpose of this catheterisation? To:
A)check for the presence of kidney stones.
B)evaluate for residual urine.
C)serve as a urine output baseline.
D)evaluate renal function.
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Chapter 26: Nursing Care of People With Urinary Tract Disorders
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Q1) Which is the preferred method of bladder emptying for an elderly person who is prone to developing urinary tract infections?
A)Crede manoeuvre.
B)Intermittent catheterisation.
C)Asking the person to void every two hours.
D)Indwelling urinary catheterisation.
Q2) An elderly person with diabetes is diagnosed with a flaccid bladder. Which of the following should be included in the care of this person?
A)Instruction about the Crede method for bladder emptying.
B)Instruction about ways to maintain acidic urine.
C)Instruction about the use of anticholinergic medications.
D)Reminder to increase fluid intake.
Q3) A man has a history of calcium calculi. Which of the following medications can be prescribed to help treat this person's condition?
A)Indomethacin.
B)Allopurinol (Progout).
C)A thiazide diuretic.
D)Amoxycillin.
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Chapter 27: Nursing Care of People With Kidney Disorders
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Q1) A person with diabetes and heart disease is diagnosed with chronic kidney disease. The nurse realises that extra care should be taken with this person if prescribing which of the following classifications of medications?
A)Metformin.
B) Calcium channel blockers.
C)Beta-blockers.
D) Paracetamol.
Q2) An elderly person is scheduled for a CT scan with and without contrast dye. Which action should be performed prior to this CT scan?
A)Measure the person's weight.
B) Assess vital signs.
C)Keep the person NBM.
D) Monitor renal functioning.
Q3) A person is admitted with signs of chronic kidney disease. Which of the following is indicative of metabolic acidosis?
A)Oliguria.
B) Muscle cramps.
C)Photophobia.
D) Kussmaul's respirations.
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Chapter 28: A Person-Centred Approach to Assessing the
Cardiovascular and Lymphatic
Systems
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Q1) The person's ECG shows the following characteristics: PR interval .08, QRS .08 and isoelectric ST segment. What do these characteristics indicate?
A)Faster than normal conduction from the SA node to the ventricles, slower than normal conduction through the ventricles and normal ST segment.
B)Normal conduction from the SA node to the ventricles, normal conduction through the ventricles and abnormal ST segment.
C)Faster than normal conduction from the SA node to the ventricles, normal conduction through the ventricles and normal ST segment.
D)Normal conduction from the SA node to the ventricles, faster conduction through the ventricles and abnormal ST segment.
Q2) Bradycardia occurs when the nurse assesses an apical heart rate of how many beats per minute in an adult?
A)Less than 60.
B)60-90.
C)90.
D)Greater than 100.
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Chapter 29: Nursing Care of People With Coronary Heart Disease
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Q1) At which location will S1 be heard the loudest?
A)Right sternal border at the second intercostal space.
B)Left sternal border at the fifth intercostal space.
C)Left midclavicular line at the fifth intercostal space.
D)Right midclavicular line at the third intercostal space.
Q2) The person's ECG shows the following characteristics: PR interval .08, QRS .08 and isoelectric ST segment. What do these characteristics indicate?
A)Faster than normal conduction from the SA node to the ventricles, slower than normal conduction through the ventricles and normal ST segment.
B)Normal conduction from the SA node to the ventricles, normal conduction through the ventricles and abnormal ST segment.
C)Faster than normal conduction from the SA node to the ventricles, normal conduction through the ventricles and normal ST segment.
D)Normal conduction from the SA node to the ventricles, faster conduction through the ventricles and abnormal ST segment.
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Page 31
Chapter 30: Nursing Care of People With Cardiac Disorders
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Q1) A person is commenced on a diet consisting of foods high in complex carbohydrates and fibre, low in cholesterol and low in fat. What else should the program also include?
A)Exercising three times a week for 30 minutes and eat only organic foods.
B)Supervised exercise twice a week and a daily multivitamin.
C)Vigorous aerobic exercise daily for 30 minutes and eat only organic foods.
D)Walking 45 minutes most days of the week.
Q2) When teaching about metabolic syndrome, what is the most accurate information for the nurse to explain?
A)'This syndrome is not a concern for females unless they smoke.'
B)'This syndrome can be avoided by taking daily vitamins and drinking two litres of water a day.'
C)'This syndrome affects only older adults.'
D)'This syndrome is caused by overweight, physical inactivity and genetic factors.'
Q3) What should a person who is taking a statin medication be monitored for?
A)Blood urea nitrogen and serum creatinine levels.
B)Constipation and sudden back pain.
C)Blood glucose and uric acid levels.
D)Serum cholesterol and liver enzymes.
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Chapter 31: Nursing Care of People With Vascular and Lymphatic Disorders
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Q1) Which of the following would be severely impaired in a patient with cardiogenic pulmonary edema?
A)Right Ventricle
B)Left Atrium
C)Left Ventricle
D)Right Atrium
Q2) Which of the following statements by the person is significant when obtaining the health history of a person who is being assessed for possible congestive heart failure?
A)'I am sleepy after I eat lunch each day.'
B)'I feel better with my legs down when I sit up in my favourite chair.'
C)'I break out into a cold sweat when I eat a large meal.'
D)'In order to breathe I have to prop myself up on three pillows to sleep at night.'
Q3) As blood is flowing through the body, the mitral and triscuspid valves are fully open during which of the following?
A)Diastole
B)Systole
C)Stroke volume
D)Ejection fraction
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Chapter 32: Nursing Care of People With Hematologic Disorders
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Q1) A person is being treated for acquired haemolytic anemia. Which of the following assessment findings would suggest that the condition is severe?
A)Bradycardia
B)Misshaped limbs due to pathological fractures
C)Splenomegaly
D)Liver tenderness
Q2) A person with aplastic anemia is demonstrating signs of increased blood cell production. Which of the following should be done to support this person?
A)Encourage exercise to further stimulate blood cell production.
B)Continue with blood transfusions as prescribed.
C)Plan to administer fresh frozen plasma.
D)Plan to discontinue blood transfusions.
Q3) In which of the following factors is haemophilia A characterized by a deficiency ?
A)Factor IX
B)Factor vW
C)Factor VIII
D)Factor X
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Page 34
Chapter 33: A Person-Centred Approach to Assessing the
Respiratory
System
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Q1) During the assessment of a person's respiratory status, the nurse locates the manubrium and the body of the sternum. What is this also called?
A)Mid-axillary line
B)Intercostal space
C)Xiphoid process
D)Angle of Louis
Q2) During the assessment of a person's nasal cavities, the nurse notes watery nasal discharge and pale turbinates. What are these findings consistent with?
A)A viral infection
B)Cocaine use
C)Impaired nasal blood flow
D)Allergies
Q3) A person's blood oxygen saturation level is 99% on room air. Through which of the following structures does the nurse realise that the oxygenated blood is transported to the heart ?
A)Pulmonary arteries
B)Jugular veins
C)Pulmonary veins
D)Superior vena cava
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Chapter 34: Nursing Care of People With Upper Respiratory Disorders
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Q1) A person with epiglottitis is allergic to penicillin. What is the antibiotic of choice for this person?
A)Ampicillin (Austrapen)
B)Dicloxacillin (Diclocil)
C)Amoxicillin (Augmentin)
D)Rocephin (Ceftriaxone)
Q2) While recovering at home from a total laryngectomy, a person notices an increase in left shoulder weakness. What is this symptom consistent with?
A)Medication complication
B)Side effect of neck radiation therapy
C)Removal of the cervical lymph nodes
D)Damage to the spinal accessory nerve
Q3) A person is receiving anterior nasal packing for a nose bleed. Which of the following should be included in the instructions for this person?
A)Remove the packing in the morning.
B)The packing will be in place for at least 24 hours and up to 72 hours.
C)The packing will be needed for at least 1 week.
D)The packing will stay in place for 2 to 5 days.
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Chapter 35: Nursing Care of People With Ventilation Disorders
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Q1) A person is diagnosed with pleurisy. What does the nurse teach the person to do for the associated chest pain?
A)Warn the person to expect a fever to develop.
B)Teach the person how to splint the affected area when coughing.
C)Advise the person to maintain strict bed rest.
D)Only take the prescribed analgesic when the pain is severe.
Q2) A person who is being treated at home for pneumonia is demonstrating signs of increased confusion. What does this information indicate to the nurse? The person:
A)is experiencing an adverse effect of the prescribed medication.
B)has become dehydrated.
C)is improving.
D)could be experiencing a worsening of the pneumonia.
Q3) A person with lung cancer is demonstrating signs of complete tumour response after two courses of chemotherapy. What should the nurse conclude about this response? It is:
A)an indication that radiation therapy can now be commenced.
B)good for long-term survival from the disease.
C)a contraindication for further chemotherapy.
D)an indication that surgery can now be safely performed.
Page 37
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Chapter 36: Nursing Care of People With Gas Exchange Disorders
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Q1) A person with pulmonary hypertension has an elevated haematocrit level. What should be included in the nurse's discharge instructions?
A)Instructions about anticoagulant therapy
B)Discussion of the need for long-acting corticosteroids
C)Instructions about venesection
D)Instructions about fluid restrictions
Q2) A person is being instructed on the use of a metered-dose inhaler without a spacer for asthma. After firing a puff of the inhaler, how long should the person hold their breath?
A)20 to 30 seconds
B)No need to hold their breath
C)About 4 seconds
D)10 seconds
Q3) A person is believed to have a pulmonary embolism that was not diagnosed after a lung CT scan. Which of the following is an appropriate diagnostic test for this person?
A)Lung scan
B)Pulmonary angiography
C)Coagulation studies
D)Chest x-ray
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Chapter 37: A Person-Centred Approach to Assessing the
Musculoskeletal
System
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Q1) Put the following techniques of a musculoskeletal examination in the proper sequence.
A) Assess muscle mass by first inspecting for obvious increase or decrease in size.
B) Inspect and palpate the bones for any obvious deformity or changes in size, shape, or a painful response.
C) Measure the extremities for length and circumference, and compare limbs bilaterally.
D) Assess gait and posture.
Q2) A person is about to have a magnetic resonance imaging (MRI)to diagnose a soft tissue abnormality of the lower leg. The nurse should immediately notify the doctor about which of the following? The person:
A)did not eat breakfast due to earlier nausea.
B)has a pacemaker.
C)has sleep apnea.
D)has a history of hypotension.
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Chapter 38: Nursing Care of People With Musculoskeletal
Trauma
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Q1) A person is scheduled to have skeletal traction. What will happen with skeletal traction?
A)Manual traction is applied to the limb.
B)A surgical pin will be inserted into a bone and the traction will be applied to the pin.
C)A cast will be applied to the area and traction will be connected to the cast.
D)Weighted straight traction will be applied.
Q2) The nurse is teaching older adults about the risks for musculoskeletal trauma. What advice should the nurse include? Avoid:
A)wearing comfortable slippers.
B)installing grab bars next to the toilet.
C)injury by not using assistive devices at home.
D)fire by not cooking in the kitchen when alone.
Q3) Following hip replacement surgery, the person returns with an abductor pillow splint in place. What does this mean? The splint:
A)is only needed when the person rolls onto their side.
B)is used for the first day after surgery.
C)will stay on except when bathing.
D)is taken off while the person sleeps.
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Chapter 39: Nursing Care of People With Musculoskeletal Disorders
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Q1) The nurse is teaching a 68-year-old female, who is on oestrogen replacement, information about dietary calcium recommendations. Which dosage should be included in the nurse's teaching?
A)1000 mg per day.
B)800 mg per day.
C)700 mg per day.
D)300 mg per day.
Q2) What is one of the first symptoms that the nurse would expect to find on assessment of a person with osteoarthritis?
A)Pain and stiffness in one or more weight-bearing joints.
B)Muscle spasms and weakness.
C)Pain when at rest.
D)Crepitus in the joint with movement.
Q3) A 52-year-old person is prescribed raloxifene (Evista)for the treatment of osteoporosis. How does this medication work on postmenopausal women? By:
A)stimulating osteoblast activity and increasing bone formation.
B)inhibiting bone breakdown.
C)inhibiting osteoclast activity.
D)preventing bone loss by mimicking what oestrogen does for bone density.
Page 41
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Chapter 40: A Person-Centred Approach to Assessing the
Nervous
System
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Q1) What is the appearance of normal cerebral spinal fluid (CSF)?
A)Pink without sediment.
B)Clear and colourless.
C)Yellow.
D)Amber.
Q2) What should the nurse ask the person to do when assessing cranial nerve XII?
A)Shrug the shoulders and turn his or her head against resistance.
B) Stick out the tongue and move it from side-to-side.
C)Stand on one foot with his or her eyes closed.
D)Swallow a sip of water.
Q3) The nurse observes a person who has a lack of coordination, clumsy movements, and an unbalanced gait. What is this called?
A)Dysarthria.
B)Kinaesthesia.
C)Ataxia.
D)Flaccidity.
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Chapter 41: Nursing Care of People With Intracranial Disorders
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Q1) The nurse is caring for a person with vagal nerve stimulation therapy. What instructions should be given to this person?
A)'This therapy should improve your quality of life.'
B)'This treatment will prevent any seizures.'
C)'You will not need to take your antiepileptic medications after this therapy.'
D)'You will need to discharge the stimulator after a seizure.'
Q2) The person has a tonic-clonic seizure. What is the priority for nursing care during the seizure?
A)Protect the person from injury.
B)Hold the person tightly.
C)Insert a bite block to prevent the person from biting their tongue.
D)Perform neurological observations to determine the severity of the seizure.
Q3) The nurse is caring for a head-injured person with cerebral oedema and increased intracranial pressure (IICP). To prevent further transient increases from occurring, the nurse should implement which of the following interventions?
A)Implement measures to help the person avoid coughing, sneezing, and straining.
B)Position the person in the supine position.
C)Initiate and monitor an IV with normal saline.
D)Initiate oxygen administration.
Page 43
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Chapter 42: Nursing Care of People With Cerebrovascular and Spinal Cord Disorders
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Q1) What are prodromal manifestations prior to an intracranial aneurysm rupture? (Select all that apply.)
A)Visual deficits.
B)Headache.
C)Frequent nausea.
D)Eye pain.
Q2) While caring for the person with a spinal cord injury (SCI), the nurse elevates the head of the bed, removes TED stockings and continues to assess vital signs every 2-3 minutes, while searching for the cause in order to prevent loss of consciousness or death. By practicing these interventions, the nurse is avoiding the most dangerous complication of autonomic dysreflexia, which is:
A)tachycardia.
B)elevated blood pressure.
C)peripheral vascular shutdown.
D)bradypnoea.
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Chapter 43: Nursing Care of People With Neurologic Disorders
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Q1) A person is admitted to the hospital with a suspected case of botulism. The nurse realises that the botulism infection was likely caused by which of the following scenarios? The person:
A)had a dirty wound that developed this toxin.
B)caught the disease from close contact with an infected person.
C)ate food contaminated with the toxin.
D)contracted the disease through contaminated needle sharing.
Q2) Which medication is likely to be prescribed as part of the treatment for multiple sclerosis (MS)?
A)Rivastigmine tartrate (Exelon).
B)Sodium valproate (Epilim).
C)Azathioprine (Imuran).
D)MAO inhibitors.
Q3) A person with Guillain-Barré syndrome asks if they will get better. What is the nurse's best response?
A)'Recovery will be slow, but your chance of getting better is good.'
B)'Full recovery is not likely.'
C)'The disease usually progresses rapidly.'
D)'It takes many years to get over the disease.'
Page 45
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Chapter 44: A Person-Centred Approach to Assessing the
Eye and Ear
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Q1) A person who is recovering from a stroke is demonstrating vision changes. Why is this occurring?
A)The stroke occurred in the optic region of the person's brain.
B)The stroke has damaged the person's retina.
C)The person is unable to talk because of the stroke.
D)The person is experiencing another stroke.
Q2) A person is found to have small, raised lesions on the rim of the ear. What does this finding indicate?
A)Renal impairment
B)Hypertension
C)Cardiac disease
D)Gout
Q3) During a Weber test, an older person is found to have increased hearing in the right ear. With what is this finding consistent?
A)Sensorineural hearing loss in the right ear
B)Conductive hearing loss in the left ear
C)Possible buildup of cerumen or otitis media in the right ear
D)Perforated left ear drum
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Chapter 45: Nursing Care of People With Eye and Ear Disorders
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Q1) A person has a new set of contact lenses. What should be included when teaching this person? Select all that apply.
A)Once applied, only remove the contact lens when dirty.
B)Minor eye irritation is a common complaint and should not be a concern.
C)Contact the eye doctor if the eyes become red or tear.
D)Wash hands before and after applying the lenses.
Q2) A person is prescribed eye drops for acute conjunctivitis. What is the most important step that the nurse should instruct this person about self-instillation of this medication?
A)Proper handwashing before instilling the drops
B)Reuse of cotton swabs as needed
C)Rubbing the eyes only when necessary
D)Correct handwashing after instilling the drops
Q3) The nurse assesses a reduction in a person's peripheral vision. Which additional assessment should be performed?
A)Retina integrity
B)Intraocular pressure
C)Distant vision
D)Eye movements
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Chapter 46: A Person-Centred Approach to Assessing the
Male and Female Reproductive Systems
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Q1) A woman complains of severe menstrual cramps. What uterine structure is responsible for this complaint?
A)Internal os
B)Uterine fundus
C)Endometrium
D)Myometrium
Q2) The nurse is teaching a man about production of the male sex hormones. Which of the following are correctly listed by the nurse as playing a role in production of androgens? Select all that apply.
A)Testes
B)Epididymis
C)Adrenal cortex
D)Seminal vesicles
Q3) The nurse is preparing to examine a man's reproductive organs. Which of the following should the nurse do in preparation for this examination? Select all that apply.
A)Ask the man to lie down on the exam table.
B)Arrange for a private examination room.
C)Use clean hands for the examination.
D)Ask the man to empty his bladder.
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Chapter 47: Nursing Care of Men With Reproductive System and
Breast Disorders
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Q1) A man is concerned about ongoing premature ejaculation. What can the nurse do to assist this man?
A)Tell the man that the condition is temporary and will disappear in time.
B)Assess his current medications for possible side effects.
C)Determine whether the man is experiencing significant levels of stress.
D)Suggest that the man wear a condom with sexual activity.
Q2) A woman asks the nurse for help because her husband has not been able to attain an erection in several months. What can the nurse do to help this person?
A)Suggest that they both see a marriage counsellor.
B)Assess for their most recent sexual practices.
C)Provide a prescription for sildenafil citrate (Viagra).
D)Suggest that they both seek psychiatric counselling.
Q3) A 35-year-old man is concerned about his inability to sustain an erection. On what should the nurse focus when assessing this person?
A)Level of physical activity
B)Employment history
C)Substance use or abuse
D)Marital status
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Chapter 48: Nursing Care of Women With Reproductive
System and Breast Disorders
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Q1) A woman who was just diagnosed with breast cancer is scheduled for a lumpectomy. What signs should indicate to the nurse that this woman is demonstrating anticipatory grieving?
A)Making calls to her girlfriends
B)Doing a crossword puzzle
C)Laughing loudly at her roommate's jokes
D)Sitting quietly, occasionally crying
Q2) A woman is experiencing a reoccurrence of endometrial cancer. What is the treatment of choice for this situation?
A)Partial abdominal hysterectomy
B)Testosterone supplementation
C)Chemotherapy
D)Progesterone therapy
Q3) A woman complains about increasing premenstrual symptoms over the past few years and thinks, 'something must be wrong.' What is this woman experiencing?
A)Dysmenorrhoea
B)Menorrhagia
C)Normal pattern of premenstrual syndrome
D)Early menopausal symptoms
Page 50
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Chapter 49: Nursing Care of People With Sexually
Transmitted Infections
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Q1) A woman has the complaint of a 'weird rash' on her hands and feet. Which of the following should the nurse include in the care of this woman? (Select all that apply.)
A)Conduct a complete sexual history assessment.
B)Find out if the woman has experienced a chancre sore on her mouth or genital area.
C)Ask if the woman has experienced a foul-smelling vaginal discharge.
D)Ask the woman if she uses a public swimming pool or spa
Q2) A woman who was just diagnosed with chlamydia says, 'I thought I was really sick. This isn't anything.' Which of the following should the nurse respond to this woman?
A)'You're right. This is minor infection.'
B)'The infection is extremely common.'
C)'This is one cause of sterility and ectopic pregnancy in women.'
D)'You're lucky that you only need treatment and not your partner.'
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Chapter 50: Mental Healthcare in the Australian Context
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Q1) What is bipolar affective disorder?
A)Alternating between undereating and overeating
B)Recurrent episodes of extreme mood swings
C)Experiences of hallucinations, delusions and thought disorders
D)Alternating between obsessive compulsive disorder and anxiety disorder
Q2) As part of the process of assisting in the recovery of a person with a mental illness, what does the term modelling mean?
A)Interacting with people the person knew before hospitalisation
B)Observing and incorporating the behaviour of others
C)Being able to talk with others
D)Having people assist in maintaining clear distinctions
Q3) What is a common symptom of psychotic illness?
A)Heavy alcohol consumption
B)Delusions
C)An angry, irritated mood
D)Lack of motivation or energy
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Chapter 51: Community Care
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Q1) Which of the following is a socioeconomic factor that determines the health of Australians?
A)Physical activity
B)Culture
C)Education
D)Alcohol and tobacco use
Q2) A 79-year-old person is planning to have a laminectomy. In which of the following healthcare settings is this person most likely going to have this procedure? A(an):
A)day surgery hospital
B)acute care hospital
C)rehabilitation hospital
D)outpatient clinic
Q3) The nurse is teaching a group of persons at a senior citizen's centre about ways to reduce their blood pressure through exercise and recreation. What type of care is this nurse providing?
A)Community health
B)Skilled nursing
C)Community-based
D)Ambulatory
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Page 53
Chapter 52: Nursing Care of Clients in Regional, Rural and Remote Areas of Australia
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Q1) How does the participation rate for health screening programs among rural and remote communities compare to the participation rate of urban communities?
A)It is lower.
B)It is the same.
C)It is higher.
D)It is significantly higher.
Q2) What are four of the components of the initial emergency response to persons with potentially life-threatening conditions?
A)Danger, breathing, circulation and education
B)Danger, rescue, cognition and airway
C)Airway, circulation, disability and exposure
D)Rescue, airway, circulation and diagnosis
Q3) Which of the following statements relates to remote area healthcare? Select all that apply.
A)Doctors make up a large proportion of remote area health workers.
B)Many health services are often not available or intermittently available.
C)Health services are delivered predominantly on a needs basis.
D)Remote area nurses are often independent practitioners.
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