Medical-Surgical Nursing
Midterm Exam
Course Introduction
Medical-Surgical Nursing is a foundational course designed to provide students with comprehensive knowledge and skills necessary for the care of adult patients experiencing a variety of medical and surgical conditions. The course focuses on understanding the pathophysiology, assessment, diagnosis, planning, implementation, and evaluation of care for patients in acute and chronic care settings. Emphasis is placed on critical thinking, evidence-based practice, patient safety, and interdisciplinary collaboration to promote optimal health outcomes. Students learn to apply the nursing process, integrate pharmacological and technological interventions, and demonstrate effective communication and clinical judgement in the management of complex patient scenarios.
Recommended Textbook
Adult Health Nursing 6th Edition by Barbara Christensen
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676 Verified Questions
676 Flashcards
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Page 2
Chapter 1: Introduction to Anatomy and Physiology
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Sample Questions
Q1) List in order of complexity the structural levels of organization of the body. Place a comma between each answer choice (a, b, c, d, etc.).
A)Body as a whole
B)Cellular
C)Organs
D)Tissue
E)Chemical
F) System
Answer: E, B, D, C, F, A
Q2) Movement of water from an area of lower concentration to an area of higher concentration is called
A) absorption.
B) filtration.
C) diffusion.
D) osmosis.
Answer: D
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Page 3
Chapter 2: Care of the Surgical Patient
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Sample Questions
Q1) A patient is on postoperative day 2 after a nephrectomy. The nurse is aware that the most effective way to increase her peristalsis is
A) ambulation.
B) an enema.
C) encouraging hot liquids.
D) administering a laxative.
Answer: A
Q2) An informed consent was to be obtained from the patient for his scheduled open cholecystectomy. Which circumstance could prevent the patient from signing his informed consent?
A) Pain radiating to the scapula
B) An injection of Demerol, 75 mg IM, 1 hour ago
C) The presence of jaundice and scleral icterus
D) His concern over his insurance company not covering the procedure
Answer: B
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4
Chapter 3: Care of the Patient With an Integumentary Disorder
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43 Flashcards
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Sample Questions
Q1) Parasitic skin diseases are identified as pediculosis or scabies. The difference between pediculosis and scabies is
A) pediculosis only occurs in poor living conditions.
B) scabies only occurs when there is poor hygiene.
C) scabies is caused by mites that burrow into the skin.
D) lice is caused by mites that attach themselves to bare areas of the skin.
Answer: C
Q2) A patient, age 46, reports to his physician's office with urticaria and papules on his hands and arms. He says, "It itches so badly." In assessing the patient, the nurse should gather data regarding recent
A) travel to foreign countries.
B) upper respiratory tract infection.
C) changes in medication.
D) contact with people who have an infectious disease.
Answer: C
Q3) The most deadly skin cancer is ________________.
Answer: melanoma
Malignant melanoma is a cancerous neoplasm that invades the epidermis, dermis, and sometimes the subcutaneous tissue.
Page 5
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Chapter 4: Care of the Patient With a Musculoskeletal Disorder
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Sample Questions
Q1) The patient has been diagnosed as having gouty arthritis. He asks the nurse to explain the cause of the inflammation of his great toe. The most appropriate nursing response is
A) "You have calcium oxalate deposits that are seen in gouty arthritis."
B) "The inflammation is from small accumulations of uric acid crystals which are called tophi."
C) "The small nodules are not related to the arthritis condition."
D) "You have fat deposits that are common with gouty arthritis."
Q2) Among the most common fractures in older women are _______fractures.
Q3) A patient, age 64, has osteoarthritis of the left hip. He has had a left total hip replacement. The nurse should
A) encourage use of the high Fowler's position.
B) administer oxygen through a nasal cannula.
C) encourage use of an incentive spirometer.
D) turn the patient frequently from side to side.
Q4) In gangrene, there is an acute infection to the skeletal muscle. If untreated, _________ will destroy the tissue.
Q5) __________ traction is utilized to provide support for the patient with a hip fracture.
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Chapter 5: Care of the Patient With a Gastrointestinal Disorder
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39 Verified Questions
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Sample Questions
Q1) The most important nursing intervention to assure the patency of a nasogastric tube (NG) is to:
A) Clamp nasogastric tube 30 minutes twice a day.
B) Monitor NG for patency and irrigate with sterile normal saline PRN as ordered.
C) Cleanse nares at least once each shift; lubricate with a petrolatum ointment.
D) Administer mouth care every 24 hours.
Q2) Flexible sigmoidoscopy should be performed every ________ years.
Q3) After barium swallow contrast studies are performed, the nurse should ensure that the patient
A) drinks adequate amounts of water.
B) remains in bed for 6 hours.
C) eats nothing until the gag reflex returns.
D) expels all barium rectally.
Q4) The end-products of carbohydrate and protein digestion are absorbed by the A) bloodstream.
B) blood vessels in the villi.
C) lymphatic system.
D) lymph vessels in the villi.
Q5) Colonoscopy should be performed every ________ years.
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Chapter 6: Care of the Patient With a Gallbladder, Liver, Biliary Tract, or Exocrine Pancreatic Disorder
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Sample Questions
Q1) An essential nursing measure to prevent peritonitis after a paracentesis is
A) thoroughly cleansing the skin of the abdominal wall.
B) examining ascites for bacteria.
C) providing oral or intravenous fluids.
D) maintaining sterile technique during the procedure.
Q2) What are the indications for a liver transplant? (Select all that apply.)
A) Congenital biliary abnormalities
B) Hepatic malignancy
C) Chronic hepatitis
D) Cirrhosis due to alcoholism
E) Gallbladder disease
Q3) The patient's cirrhosis of the liver has also caused a dilation of the veins of her lower esophagus secondary to vessel hypertension, resulting in her developing the complications of:
A) Varices
B) Diverticulosis
C) Crohn's disease
D) Achalasia cyst
Q4) ___________ is a condition characterized by yellowing of the sclera and the skin.
Page 8
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Chapter 7: Care of the Patient With a Blood or Lymphatic Disorder
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43 Flashcards
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Sample Questions
Q1) The average life span of an erythrocyte is A) a few days to several years.
B) 120 days.
C) 5 to 9 days. D) several years.
Q2) The patient, age 35, is admitted with aplastic anemia. He asks the nurse what aplastic anemia is. An accurate response would be that A) the activity of the bone marrow is depressed. B) the bone marrow fails to produce lymphocytes. C) the bone marrow fails to produce red blood cells. D) red cells are absent as a result of chronic blood loss.
Q3) Hematological diseases are often associated with skin impairment. Petechiae and ecchymoses are seen in A) iron-deficiency anemia. B) pernicious anemia.
C) hemophilia A. D) agranulocytosis.
Q4) The organ that forms lymphocytes is the __________.
Q5) A sudden reduction in blood volume may lead to _________ shock.
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Chapter 8: Care of the Patient With a Cardiovascular or a Peripheral Vascular Disorder
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50 Flashcards
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Sample Questions
Q1) The patient, age 26, is hospitalized with cardiomyopathy. While obtaining a nursing history from her, the nurse recognizes that the increased incidence of cardiomyopathy in young adults who have minimal risk factors for cardiovascular disease is related to A) cocaine use.
B) viral infections.
C) vitamin B1 deficiencies.
D) pregnancy.
Q2) Which nursing intervention reduces myocardial oxygen demand?
A) Supplying a portable oxygen unit during activity
B) Encouraging participation in cardiac rehabilitation program
C) Elevating the head of the bed 30 to 45 degrees
D) Positioning patient in supine position
Q3) A patient admitted from the emergency room with a diagnosis of heart failure and a NYHA classification of IV is requesting ambulation to the bathroom. Which nursing intervention would be appropriate for this patient?
A) Assist the patient to the bathroom.
B) Obtain a bedside commode.
C) Offer a urinal or bedpan.
D) Obtain assistance of another nurse and ambulate the patient to the bathroom.
Page 10
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Chapter 9: Care of the Patient With a Respiratory Disorder
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36 Flashcards
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Sample Questions
Q1) Which instruction by the nurse is inappropriate for teaching the proper technique for collection a sputum specimen?
A) Bring the sputum up from the lungs.
B) Maintain adequate fluid intake.
C) Collect specimens after meals.
D) Notify the staff as soon as the specimen is collected so it can be sent to the laboratory without delay.
Q2) The nurse identifies a nursing diagnosis of Ineffective airway clearance for a patient, age 64, who has undergone a pneumonectomy. A common etiology for this nursing diagnosis in patients who have had a pneumonectomy is
A) thick, copious secretions.
B) surgical incision pain.
C) presence of chest tubes.
D) mechanical ventilation.
Q3) What does a nurse teach an adult male who has had a tonsillectomy?
A) Eat solid food during the first 24 hours.
B) Do not eat or drink anything for the first 24 hours.
C) Apply a heating pad to the neck during the first 24 hours.
D) Avoid coughing and clearing the throat during the first week postoperatively.
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Page 11
Chapter 10: Care of the Patient With a Urinary Disorder
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Sample Questions
Q1) As the nurse and the dietitian review a patient's diet plan with her, she becomes very angry, shouting that with her diabetes and now the kidney failure, there is just nothing she can eat. She says she might as well eat what she wants, because these diseases will kill her anyway. Based on the patient's response, which nursing diagnosis does the nurse identify?
A) Noncompliance, risk for, related to feelings of anger
B) Risk for ineffective health maintenance, related to complexity of therapeutic regimen
C) Anticipatory grieving, related to actual and perceived losses
D) Ineffective coping, related to emotional liability
Q2) The patient is scheduled for a transurethral resection of the prostate. During preoperative teaching, it is important to emphasize that after surgery he should expect
A) red drainage from the catheter.
B) limited intake of fluids.
C) a sodium-restricted diet.
D) incisional drainage.
Q3) _________ training involves developing the muscles of the perineum to improve voluntary control over voiding; bladder training may be modified for different problems.
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Page 12
Chapter 11: Care of the Patient With an Endocrine Disorder
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Sample Questions
Q1) A patient has returned to his room after a thyroidectomy. He is presenting with signs and symptoms of thyroid crisis. During thyroid crisis, exaggerated hyperthyroid manifestations may lead to the development of the potentially lethal complication of A) severe nausea and vomiting.
B) bradycardia.
C) delirium with restlessness.
D) congestive heart failure.
Q2) Hypothyroidism is treated with replacement therapy. The patient should be instructed to eat well-balanced meals including intake of iodine. Which food is rich in iodine?
A) Eggs
B) Dairy products
C) Bread and cereal
D) Fruit
Q3) A condition with a deficiency in growth hormone is called _____________ ____________.
Q4) Only ________insulin can be administered intravenously.
Q5) Another term for hyperglycemic reaction is ____________ ______________.
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Chapter 12: Care of the Patient With a Reproductive Disorder
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39 Verified Questions
39 Flashcards
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Sample Questions
Q1) Vaginal fistulas are caused by an ulcerating process resulting from (Select all that apply.)
A) cancer.
B) radiation.
C) poor hygiene.
D) multiple sexual partners.
E) weakening of tissue from pregnancies.
F) surgical interventions.
Q2) The nurse provides discharge teaching for a patient regarding her activity level as she recovers from her modified radical mastectomy. Which statement by her indicates to the nurse that the teaching has been successful?
A) "I should sleep on the side opposite my mastectomy."
B) "I should keep my right arm supported in a sling when I am up and around until my incision is healed."
C) "I can do whatever exercises and activities I want as long as I don't elevate my right hand above my head."
D) "I should take aspirin before moving or exercising my arm to prevent pain during the exercises."
Q3) ________ are produced in the seminiferous tubules and stored in the epididymis.
Page 14
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Chapter 13: Care of the Patient With a Visual or Auditory Disorder
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38 Verified Questions
38 Flashcards
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Sample Questions
Q1) During a nursing history related to a patient's activity-exercise functional health pattern, the patient comments that he cannot bend over and lift an object without becoming dizzy and that he frequently has to stop physical activities because of dizziness and nausea. Which structure of this patient's ear is most likely to have a dysfunction causing his symptoms?
A) Middle ear
B) Organ of Corti
C) Semicircular canals
D) Cochlea
Q2) A patient is prescribed eyedrops that constrict the pupil, permitting aqueous humor to flow. The nurse would reinforce the teaching by referring to the drops as A) mydriatics.
B) miotics.
C) osmotics.
D) inhibitors.
Q3) _____________ is a medical term for blurred vision.
Q4) Decreasing visual acuity is a sign of _________ __________.
Q5) Schiƶtz tonometry is a diagnostic test for __________.
Page 15
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Chapter 14: Care of the Patient With a Neurologic Disorder
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Sample Questions
Q1) The patient, injured in an automobile accident, is being evaluated in the emergency department for possible head injury. Which test should not be done if there is an indication of increased intracranial pressure?
A) CT scan
B) MRI scan
C) Lumbar puncture
D) Electroencephalogram
Q2) A patient, age 45, is to have a myelogram to confirm the presence of a herniated intervertebral disk. Which nursing action should be planned for her with respect to this diagnostic test?
A) Obtain an allergy history before the test.
B) Ambulate the patient when she is returned to her room after the test.
C) Warn her that paralysis could result from injection of the contrast medium.
D) Keep her NPO for 6 to 8 hours after the test.
Q3) The best nursing intervention for restlessness in a patient with a head injury is
A) sedation with an available narcotic.
B) restraints to prevent injury.
C) assessing for pain or distended bladder.
D) encouraging verbalization of the problem.
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Page 16
Chapter 15: Care of the Patient With an Immune Disorder
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Sample Questions
Q1) Which is a factor that contributes to the extent of an allergic response to an allergen?
A) The integrity of the skin
B) The time of year in which one is exposed
C) The amount of exposure
D) Exposure to one's clothing
Q2) A patient comes to the emergency department with dyspnea, wheezing, and urticaria over the arms and face after being stung by a bee. The nurse would begin immediate care for this patient because he or she is having a(n)
A) asthma attack.
B) anaphylactic reaction.
C) pulmonary embolism.
D) acute psychotic episode.
Q3) Which are autoimmune diseases? (Select all that apply.)
A) Lupus erythematosus
B) Glomerulonephritis
C) Polio
D) Rheumatoid arthritis
E) Thrombocytopenic purpura
F) Osteoarthritis
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Page 17
Chapter 16: Care of the Patient With HIV-Aids
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Sample Questions
Q1) A patient is concerned about telling others he has HIV infection. In discussing his concerns, which response by the nurse is most appropriate?
A) Care providers and sexual partners should be told about his diagnosis.
B) There is no reason to hide his disease.
C) Secrecy is a poor idea because it will lower his self-esteem.
D) His diagnosis will be obvious to most people with whom he will come into contact.
Q2) Most children with AIDS contracted their disease (Select all that apply.)
A) during intrauterine life with an HIV-positive mother.
B) during the birth process of an HIV-positive mother.
C) from other children who are HIV positive.
D) from receiving a transfusion contaminated with the HIV virus.
E) from breast feeding by an HIV-positive mother.
Q3) In addition to handwashing, what important precaution must the nurse take when changing the dressing of an AIDS patient?
A) Wearing mask
B) Wearing gown and gloves
C) Wearing gloves
D) Strict isolation
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18
Chapter 17: Care of the Patient With Cancer
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Sample Questions
Q1) An effective antiemetic drug given intravenously to block receptors on the endings of nerve cells in the brain and gastrointestinal tract, given once a day in a 5-minute infusion, is called
A) prochlorperazine (Compazine).
B) metoclopramide (Reglan).
C) granisetron (Kytril).
D) pentoxifylline (Trental).
Q2) A patient, age 59, has lost 10 pounds in the first 3 weeks of her radiation therapy and does not eat because nothing tastes good. Which is an appropriate nursing diagnosis for her?
A) Ineffective health maintenance related to lack of knowledge of nutritional requirements during radiation therapy
B) Risk for infection related to poor nutrition
C) Imbalanced nutrition: less than body requirements, related to anorexia
D) Ineffective therapeutic regimen management related to refusal to eat
Q3) The term ____________ is used for various substances that are known to contribute to cancer.
Q4) _________ is the term for uncontrolled or abnormal growth of cells. They may be benign or malignant.
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