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Course Introduction
Medical-Surgical Nursing focuses on the comprehensive care and management of adult patients with a variety of medical conditions and surgical procedures. This course emphasizes the development of critical thinking, clinical reasoning, and evidence-based practice in assessing, planning, implementing, and evaluating nursing care for adults.
Topics include pathophysiology, pharmacology, perioperative care, infection control, wound management, fluid and electrolyte balance, pain management, and the principles of patient safety. Students gain essential skills through simulations, case studies, and clinical experiences to prepare for professional practice in diverse healthcare settings.
Recommended Textbook
Goulds Pathophysiology for the Health Professions 5th Edition by VanMeter
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28 Chapters
1204 Verified Questions
1204 Flashcards
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36 Verified Questions
36 Flashcards
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Sample Questions
Q1) Which of the following statements is TRUE?
A) Alteration of DNA does not change cell function.
B) Damaged cells may be able to repair themselves.
C) All types of cells die at the same rate.
D) Mild ischemia causes immediate cell death.
Answer: B
Q2) All of the following are part of the Seven Steps to Health EXCEPT:
A) follow cancer screening guidelines.
B) use sun block agents whenever exposed.
C) participate in strenuous exercise on a regular daily basis.
D) choose high fiber, lower fat foods.
Answer: C
Q3) A short-term illness that develops very quickly with perhaps a high fever or severe pain is called:
A) acute.
B) latent.
C) chronic.
D) manifestation.
Answer: A
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Sample Questions
Q1) One of the factors involved in the increased need for water in infants is:
A) proportionally smaller body surface area.
B) higher metabolic rate.
C) smaller respiratory capacity.
D) greater surface area of exposed mucous membranes.
Answer: B
Q2) Which two ions are most important for acid-base balance in the body?
A) K+, Na+
B) Cl- and HCO<sub>3</sub>-
C) Ca<sup>++</sup>, Na<sup>+</sup>
D) Na<sup>+</sup>, Cl<sup>-</sup>
Answer: B
Q3) Hypokalemia refers to a condition in which the serum has a very low level of which ion?
A) Sodium
B) Phosphate
C) Calcium
D) Potassium
Answer: D
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Sample Questions
Q1) At which site are most drugs metabolized and prepared for excretion?
A) Liver
B) Kidneys
C) Circulating blood
D) Lymphoid tissue
Answer: A
Q2) In traditional Asian medicine, acupoints are usually located:
A) over pain or other sensory receptors.
B) where blood vessels branch.
C) over joints.
D) on designated meridians.
Answer: D
Q3) What is the reaction called when two drugs interact to produce a result much greater than the sum of individual effects?
A) Antagonism
B) Beneficial
C) Synergism
D) Potentiation
Answer: C
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Sample Questions
Q1) A headache that is related to changes in cerebral blood flow is classified as a/an ________ headache.
A) tension
B) sinus
C) migraine
D) intracranial
Q2) Pain that is caused by trauma or disease involving the peripheral nerves is referred to as:
A) neuropathic pain.
B) central pain.
C) neurogenic pain.
D) referred pain.
Q3) Which of the following is a characteristic of chronic pain?
A) It usually initiates a physiological stress response.
B) It always involves a strong emotional response such as high anxiety.
C) It is more difficult to diagnose and treat than is acute pain.
D) It involves tissue damage to a specific organ.
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Sample Questions
Q1) A burn area in which the epidermis and part of the dermis is destroyed is classified as:
A) full-thickness.
B) deep partial-thickness.
C) superficial partial-thickness.
D) first-degree.
Q2) All of the following are factors that promote healing EXCEPT:
A) good nutrition: protein, vitamins A and C.
B) a clean, undisturbed wound.
C) effective circulation.
D) advanced age.
Q3) Application of ice to an injured knee reduces edema by:
A) promoting return of lymph fluid.
B) causing local vasoconstriction.
C) increasing the rate of tissue repair.
D) causing systemic vasodilation.
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Sample Questions
Q1) The primary pathological effect of influenza virus is:
A) destruction of the mucosa in the lower respiratory tract.
B) replication of the virus in respiratory secretions.
C) destruction of leukocytes and macrophages in the lungs.
D) inflammation and necrosis of the upper respiratory epithelium.
Q2) Opportunistic infection may develop when:
A) pathogens enter the body but cannot colonize the site of entry.
B) an imbalance occurs in the normal resident flora.
C) host resistance increases, and the balance of resident flora is restored.
D) contaminated food or water is unknowingly ingested.
Q3) Which of the following is a function of interferons?
A) They block the invasion of pathogenic bacteria.
B) They reduce the inflammatory response to local infection.
C) They increase host cell resistance to viral invasion.
D) They may facilitate the spread of some cancer cells.
Q4) Prions cannot be cultured in a PETRI plate of media because:
A) they take so long to grow.
B) they require extensive amounts of specialized nutrients.
C) they are proteinaceous particles, not living organisms.
D) they are viruses that don't grow on conventional media.
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Sample Questions
Q1) Which of the following is NOT a cause of immunodeficiency?
A) Hypoplasia of the thymus
B) Delayed hypersensitivity
C) Immunosuppressive drugs
D) Atrophy of the lymph nodes
Q2) Which of the following statements regarding immunoglobulins is TRUE?
A) They consist of a unique sequence of amino acids.
B) They are produced in the red bone marrow.
C) They are attached to mucosal membranes at entry points into the body.
D) IgA binds to allergens.
Q3) A diagnosis of HIV positive means that:
A) the number of T lymphocytes in the circulating blood is decreased.
B) significant opportunistic infection is present in the body.
C) the individual has AIDS.
D) the virus and its antibodies are present in the blood.
Q4) The term tolerance refers to:
A) surveillance and destruction of new cancer cells by the immune system.
B) the ability of the immune system to ignore "self" cells.
C) the ability of T and B lymphocytes to work together.
D) the role of lymphoid tissue in the body defenses.
Page 9
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Sample Questions
Q1) Which type of microbe causes Tinea infections?
A) Fungus
B) Virus
C) Gram-negative bacterium
D) Mite
Q2) How are antiviral drugs effective in treating a viral infection?
A) They destroy the virus if administered for at least 2 weeks.
B) They limit the acute stage and viral shedding.
C) They prevent any systemic effects of viruses.
D) They prevent any secondary bacterial infection.
Q3) Which of the following factors has contributed to the increased incidence of Kaposi's sarcoma?
A) Excessive sun exposure
B) Increased number of nevi
C) Increase in immunosuppressed individuals
D) Presence of more seborrheic keratoses
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Sample Questions
Q1) How does the joint appear during an exacerbation of rheumatoid arthritis?
A) Relatively normal
B) Enlarged, firm, crepitus with movement
C) Deformed, pale, and nodular
D) Red, warm, swollen, and tender to touch
Q2) Which of the following statements does NOT apply to osteoporosis?
A) Bone resorption is greater than bone formation.
B) It causes compression fractures of the vertebrae.
C) Osteoporosis is always a primary disorder.
D) It often leads to kyphosis and loss of height.
Q3) What limits joint movement in osteoarthritis?
A) The osteophytes and irregular cartilage surface
B) The wider joint space
C) Decreased amount of synovial fluid in the cavity
D) Fibrosis involving the joint capsule and ligaments
Q4) Which of the following may precipitate an attack of gout?
A) A sudden increase in serum uric acid levels
B) Severe hypercalcemia
C) Mild trauma to the toes
D) Development of a tophus
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49 Verified Questions
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Sample Questions
Q1) Vitamin K is required by the liver to synthesize:
A) heparin.
B) prothrombin.
C) amino acids.
D) bilirubin.
Q2) Why is pernicious anemia treated with injections of vitamin B ?
A) An immune reaction in the stomach would destroy the vitamin.
B) Digestive enzymes would destroy the vitamin.
C) The vitamin irritates the gastric mucosa.
D) The ingested vitamin would not be absorbed into the blood.
Q3) Which of the following applies to sickle cell trait?
A) Most hemoglobin is in the form of HgS
B) Sickling of erythrocytes occurs with severe hypoxia.
C) Painful sickling crises with multiple infarctions occur frequently.
D) A child's skeletal growth is delayed.
Q4) Predisposing factors to leukemia commonly include:
A) exposure to radiation.
B) certain fungal and protozoal infections.
C) familial tendency.
D) cigarette smoking.

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Sample Questions
Q1) A rare illness that involves the overgrowth of lymphoid tissue, although not itself considered a cancer is:
A) Castleman disease.
B) hyperlymphatic disease.
C) hypolymphatic disease.
D) Ann Arbor disease.
Q2) One of the reasons non-Hodgkin's lymphomas are harder to treat than Hodgkin's lymphomas is that they:
A) tend to be much larger than Hodgkin's lymphomas.
B) involve multiple nodes and widespread metastases.
C) are not affected by the newer drug treatments.
D) are asymptomatic until they reach stage IV.
Q3) The spleen has a number of important functions, which include:
A) lymph production, hematopoiesis, platelet production.
B) hematopoiesis, destruction of old erythrocytes, blood reservoir.
C) defense from infection, metabolism of vitamins, platelet production.
D) lipid metabolism, production of hemoglobin, water absorption.
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Sample Questions
Q1) What would indicate decompensated acidosis related to shock?
A) Serum bicarbonate level below normal
B) PCO<sub>2</sub> above normal
C) Serum pH below normal range
D) Urine pH of 4.5
Q2) In an infant, the initial indication of congestive heart failure is often:
A) distended neck veins.
B) feeding problems.
C) low-grade fever and lethargy.
D) frequent vomiting.
Q3) Shock develops in patients with severe burns as a result of:
A) extensive hemorrhage.
B) pain and loss of plasma.
C) direct damage to the heart.
D) extensive hemolysis of erythrocytes.
Q4) Rheumatic heart disease usually manifests in later years as:
A) swollen heart valves and fever.
B) cardiac arrhythmias and heart murmurs.
C) thrombus formation and septic emboli.
D) petechial hemorrhages of the skin and mucosa.
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Sample Questions
Q1) Pulmonary edema causes severe hypoxia because of:
A) decreased diffusion of carbon dioxide from the alveoli.
B) interference with expansion of the lungs.
C) constant cough and hemoptysis.
D) decreased recoil of lungs and ineffective expiration.
Q2) The central chemoreceptors in the medulla are normally most sensitive to:
A) low oxygen level.
B) low concentration of hydrogen ions.
C) elevated oxygen level.
D) elevated carbon dioxide level.
Q3) What is the most common cause of viral pneumonia?
A) Rhinovirus
B) Influenza virus
C) Haemophilus influenzae
D) Pneumococcus
Q4) Lobar pneumonia is usually caused by:
A) Mycoplasma pneumoniae.
B) Streptococcus pneumoniae.
C) Legionella pneumophila.
D) Pneumocystis carinii.
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Sample Questions
Q1) Common manifestations of rabies infection include:
A) headache, foaming at the mouth, and difficulty swallowing.
B) difficulty walking and coordinating movements.
C) decreased sensitivity to sound and touch.
D) vomiting, liver and kidney damage.
Q2) Typical signs of a TIA include:
A) rapidly increasing intracranial pressure.
B) loss of consciousness.
C) transient muscle weakness in a hand or leg.
D) headache, photophobia, and nuchal rigidity.
Q3) All of the following may precipitate a seizure EXCEPT:
A) hypoglycemia.
B) hypoventilation.
C) brain abscess.
D) high fever in young child.
Q4) Which of the following impairments results from infection by the polio virus?
A) Pain and paresthesia in a cranial nerve or dermatome
B) Loss of motor and sensory function in the peripheral nerves
C) Inflammation and increased intracranial pressure
D) Loss of function of motor neurons of the spinal cord and medulla
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Sample Questions
Q1) Narrow-angle glaucoma develops when the angle is decreased between the: A) retina and ciliary process.
B) lens and ciliary body.
C) iris and cornea.
D) iris and lens.
Q2) Trachoma is an eye infection caused by:
A) influenza virus.
B) Candida albicans.
C) Staphylococcus bacteria.
D) Chlamydia bacteria.
Q3) Which fluid is found surrounding the optic disc?
A) Aqueous humor
B) Vitreous humor
C) Cerebrospinal fluid
D) Tears
Q4) Why does vertigo occur with Ménière's syndrome?
A) Fluid is lost from the inner ear.
B) Increased blood pressure causes edema in the middle and inner ears.
C) Damage occurs to the vestibular branch of the auditory nerve.
D) Excessive endolymph impairs the function of hair cells in the labyrinth.
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Sample Questions
Q1) Which of the following applies to diabetic macro-angiography?
1) It affects the small arteries and arterioles.
2) It is related to elevated serum lipids.
3) It leads to increased risk of myocardial infarction and peripheral vascular disease.
4) It frequently causes damage to the kidneys.
A) 1, 3
B) 1, 4
C) 2, 3
D) 2, 4
Q2) Goiters may be caused by:
A) hypothyroid conditions only.
B) either hypothyroid or hyperthyroid conditions.
C) hyperthyroid conditions only.
D) fungal infections such as candidiasis.
Q3) Which of the following hormonal imbalances causes diabetes insipidus?
A) Increased insulin
B) Decreased glucocorticoids
C) Deficit of ADH
D) Deficit of T<sub>3</sub> and T<sub>4</sub>
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Q1) What is the likely effect of long-term exposure to a hepatotoxin?
A) Full recovery to normal tissue after the toxic material has been removed
B) Acute onset of vomiting, steatorrhea, and jaundice
C) Continued mild inflammation of the liver without permanent damage
D) Gradual irreversible damage to the liver and cirrhosis
Q2) How does chemical peritonitis and shock frequently result from acute pancreatitis?
A) Inflammation and increased vascular permeability of the peritoneum affect fluid balance.
B) Erosion in the intestinal wall causes release of bacteria.
C) Fat necrosis and hypocalcemia develop.
D) Secretions from the pancreas and intestine become more acidic.
Q3) Yellow or greenish stained vomitus usually indicates the presence of:
A) bile.
B) blood.
C) protein.
D) bacteria.
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Q1) Under what circumstances do cells in the kidneys secrete renin?
A) The urine pH decreases.
B) Blood flow in the afferent arteriole decreases.
C) Serum potassium levels are high.
D) Serum osmotic pressure increases.
Q2) Which of the following describes the correct flow of blood in the kidney?
A) Afferent arteriole to the peritubular capillaries to the venule
B) Efferent arteriole to the glomerular capillaries to the peritubular capillaries
C) Peritubular capillaries to the glomerular capillaries to the venule
D) Afferent arteriole to the glomerular capillaries to the efferent arteriole
Q3) What is the primary reason for hypocalcemia developing during end-stage renal failure or uremia?
A) Decreased parathyroid hormone secretion
B) Insufficient calcium in the diet
C) Excessive excretion of calcium ions in the urine
D) A deficit of activated vitamin D and hyperphosphatemia
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Q1) What is a significant early sign of endometrial carcinoma?
A) A positive Pap test
B) Minor vaginal bleeding or spotting
C) Infection resistant to treatment
D) Painful intercourse
Q2) What is the cause of syphilis?
A) A gram-negative diplococcus
B) An anaerobic protozoa
C) A virus
D) An anaerobic spirochete
Q3) Which is considered to be the stage of carcinoma in situ in cervical cancer?
A) The invasive stage
B) The stage of mild dysplasia
C) The time before it can be detected by a Pap test
D) Noninvasive severe dysplasia
Q4) Balanitis is the infection and inflammation of the:
A) vagina.
B) glans penis.
C) fallopian tubes.
D) testes.
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Sample Questions
Q1) One of the general effects of a malignant cancer is cachexia, which is:
A) severe bleeding.
B) severe tissue wasting.
C) severe fatigue.
D) multiple opportunistic infections.
Q2) Which of the following is a characteristic of a benign tumor?
A) It is unencapsulated and invasive.
B) It consists of undifferentiated cells.
C) It exerts systemic effects.
D) Cells appear relatively normal.
Q3) What type of normal cells are often damaged during chemotherapy and radiation treatments?
A) Epithelial cells
B) Skeletal muscle cells
C) Nerve tissue
D) Collagen and fibrous tissue
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Q1) Developmental disorders can result from all the following EXCEPT:
A) exposure to radiation.
B) mercury in foods and water.
C) drugs and alcohol.
D) folic acid.
Q2) The most invasive prenatal screening test for fetal abnormalities is:
A) ultrasonography.
B) amniocentesis.
C) X-ray.
D) blood tests.
Q3) Agents that cause damage during embryonic or fetal development are called: A) teratogenic.
B) mutagenic.
C) multifactorial agents.
D) polygenic agents.
Q4) Ultrasonography during pregnancy would be helpful in detecting fetal: A) enzyme deficits.
B) structural anomalies.
C) chromosomal defects.
D) hormonal abnormalities.

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Q1) Adolescent pregnancy is often considered high risk because of:
A) inadequate prenatal care.
B) poor nutrition and lack of vitamin supplements.
C) iron deficiency anemia.
D) All of the above
Q2) Which of the following indicates development of pregnancy-induced hypertension?
A) Proteinuria, edema, and weight gain
B) Persistent blood pressure measuring above 140/90
C) Vaginal bleeding
D) Blood clots forming in the legs
Q3) Edema and congestion normally develop in many tissues during pregnancy as a result of:
A) reduced kidney function.
B) decreased serum albumin.
C) increased blood volume.
D) increases in blood pressure.
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Q1) Three factors common to metabolic syndrome include:
A) presence of significant abdominal fat mass, changes in glucose metabolism, and changes in lipoprotein metabolism.
B) increased fat mass throughout the body, changes in glucose metabolism, and delayed sexual maturation.
C) significant increase of fat on hips and thighs, delayed linear growth, and change in calcium and vitamin D metabolism.
D) BMI at the 85th percentile, type 2 diabetes mellitus, and hypertension.
Q2) What are common local signs of osteomyelitis?
A) Joint swelling, limited movement
B) Deformity of a limb, pain at rest
C) Fever, leukocytosis, and malaise
D) A red, swollen area, pain increasing with movement
Q3) Bulimia nervosa is characterized by:
A) a refusal to eat.
B) extreme weight loss.
C) alternating binge eating and purging.
D) chronic diarrhea.
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Q1) Predisposing factors to osteoporosis in older women include all of the following EXCEPT:
A) decreased estrogen secretion.
B) genetic factors.
C) sedentary lifestyle.
D) decreased parathyroid hormone.
Q2) All of the following changes are associated with aging EXCEPT:
A) loss of elastic fibers.
B) decreased metabolic rate.
C) decreased secretion of all hormones.
D) degenerative vascular changes.
Q3) With advancing age, the major change in the cardiovascular system involves:
A) irregular impulse conduction in the heart.
B) a reduced number of collagen fibers to support cardiac muscle.
C) vascular degeneration, leading to arteriosclerosis and atherosclerosis.
D) the heart valves becoming thin and weak.
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Q1) Immobility may lead to dehydration primarily as a result of:
A) changes in hormonal secretions due to increased blood in the thorax.
B) destruction of the kidneys as a result of ischemia and necrosis.
C) blockage of the ureters, causing retention of urine.
D) toxins being produced by infectious microorganisms.
Q2) Which of the following is likely to develop when a leg is immobilized in a cast?
A) Contracture
B) Muscle hypertrophy
C) Muscle atrophy
D) Increased osteoblastic activity
Q3) What is a major factor predisposing to pulmonary infection in immobilized patients?
A) Decreased activity and demand for oxygen
B) Increased retention of CO<sub>2</sub>
C) Inability to sneeze forcefully
D) Stasis of secretions in the lungs
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Q1) Possible complications caused by prolonged, severe stress include all of the following EXCEPT:
A) hypertension.
B) tension headache.
C) diabetes mellitus.
D) blindness.
Q2) The stress response involves the integrated action of the: 1) hypothalamus.
2) hypophysis.
3) sympathetic nervous system.
4) adrenal glands.
A) 1, 3
B) 2, 3
C) 1, 2, 4
D) 1, 2, 3, 4
Q3) During the stress response, endorphins act as:
A) pain blockers.
B) cerebral function depressors.
C) stimulators of increased secretion of aldosterone and insulin.
D) an enhancer of the immune response.
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Q1) Which of the following statements is characteristic of alcohol?
A) It is primarily a CNS stimulant.
B) It may cause congenital defects in infants born to alcoholic mothers.
C) It does not interact with other drugs in the CNS.
D) It usually causes severe kidney damage.
Q2) Chronic alcoholism is likely to cause all of the following EXCEPT:
A) cirrhosis.
B) mental confusion.
C) loss of motor coordination.
D) altered personality and amnesia.
E) respiratory failure.
Q3) What is/are the typical effect(s) of psychedelic substances?
A) Drowsiness and euphoria
B) Marked stimulation of the central nervous system (CNS)
C) Lethargy and decreased metabolic rate
D) Altered perception and awareness as well as hallucinations
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Q1) Bites and stings cause disease in which three ways?
A) Injection of toxins, transmission of infectious agents, or allergic reactions
B) High fever and chills, transmission of infectious agents, or nausea and vomiting
C) Bone marrow damage, extensive skin rashes, or allergic reactions
D) Injection of neurotoxins, transmission of infectious agents, or kidney damage
Q2) Which of the following is a potential effect of a bite or sting?
A) Immediate heart failure
B) Anaphylaxis
C) Severe nausea, vomiting, and diarrhea
D) Bone marrow damage
Q3) Which of the following events would most likely cause a person to faint and experience difficulty breathing?
A) Exposure to gamma rays
B) Eating fish containing mercury
C) An insect sting
D) Inhalation of asbestos particles
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