Medical-Surgical Nursing Question
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Course Introduction
Medical-Surgical Nursing is a foundational course that prepares students to provide comprehensive care to adult patients experiencing a wide range of medical and surgical conditions. The course emphasizes the application of the nursing process in assessing, planning, implementing, and evaluating individualized care for patients in various healthcare settings. Students will gain critical knowledge of pathophysiology, pharmacology, and acute and chronic disease management, while developing skills in patient safety, clinical reasoning, and interprofessional collaboration. Key topics include perioperative care, pain management, fluid and electrolyte balance, infection control, and evidence-based nursing interventions to promote optimal patient outcomes.
Recommended Textbook
Health Assessment for Nursing Practice 6th Edition by Wilson
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634 Verified Questions
634 Flashcards
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Chapter 1: Introduction to Health Assessment
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14 Verified Questions
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Sample Questions
Q1) For which person is a screening assessment indicated?
A) The person who had abdominal surgery yesterday
B) The person who is unaware of his high serum glucose levels
C) The person who is being admitted to a long-term care facility
D) The person who is beginning rehabilitation after a knee replacement
Answer: B
Q2) The nurse documents which information in the patient's history?
A) The patient's skin feels warm to the touch.
B) The patient is scratching his arm.
C) The patient's temperature is 100° F.
D) The patient complains of itching.
Answer: D
Q3) Which activity illustrates the concept of primary prevention?
A) Monthly breast self-examination
B) Annual cervical (Papanicolaou test) examination
C) Education about living with asthma
D) Exercising three times a week
Answer: D
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3
Chapter 2: Obtaining a Health History
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Sample Questions
Q1) Which data do nurses document under the heading of Past Health History? (Select all that apply.)
A) Father has Alzheimer disease.
B) Last tetanus in 2009
C) Had chicken pox as a child
D) Drinks three to four beers each day
E) Had a dental examination 6 months ago
Answer: B, C, E
Q2) A patient comes to the ambulatory surgery center for an elective procedure this morning. While giving the admission history, the patient states she is allergic to latex. What is the most appropriate response by the nurse at this time?
A) Removing all latex products from the patient's room
B) Using powdered gloves when providing care to this patient
C) Informing the surgeon that the patient has type I hypersensitivity to latex
D) Questioning the patient about symptoms experienced in the past with latex
Answer: D
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Chapter 3: Techniques and Equipment for Physical Assessment
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Sample Questions
Q1) The patient asks about the meaning of his visual assessment of 20/40 using a Snellen visual acuity chart. What is the nurse's appropriate response?
A) "20/40 means your vision is about two times normal."
B) "A person with corrected vision can see at 20 feet what you can see at 40 feet."
C) "A person with normal vision can see at 20 feet what you can see at 40 feet."
D) "A person with normal vision can see at 40 feet what you can see at 20 feet."
Answer: D
Q2) The nurse is unable to hear the patient's breath sounds. What checks does the nurse make of the stethoscope to determine the cause of this problem?
A) Ensure the stethoscope tubing is at least 20 inches long.
B) Ensure the valve is open to the diaphragm on the head of the stethoscope.
C) Ensure the earpieces are pointed toward the back of the ears.
D) Ensure the bell is placed firmly against the patient's skin.
Answer: B
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Chapter 4: General Inspection and Measurement of Vital Signs
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Sample Questions
Q1) Nurses understand that a patient's diastolic pressure represents which physiologic function?
A) The pressure needed to open the aortic and pulmonic valves
B) The pressure in blood vessels when the ventricles contract
C) The pressure of the blood returning to the heart from the venous system
D) The pressure in blood vessels when the ventricles are relaxed
Q2) A nurse is taking vital signs of an adult patient whose oxygen saturation is 96%. The patient's temperature is 102° F, blood pressure is 130/86, pulse is 100 beats/min, and respiratory rate is 26 breaths/min. Which factor may be contributing to the elevated respiratory rate?
A) The patient's temperature
B) The patient's oxygen saturation
C) The patient's pulse rate
D) The patient's blood pressure
Q3) Which of these respiratory rates are within normal limits?
A) 16-month-old; 42
B) 6-year-old; 20
C) 14-year-old; 26
D) 40-year-old; 10
Page 6
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Chapter 5: Cultural Assessment
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Sample Questions
Q1) Which of the components described below represent the Filipino culture? (Select all that apply.)
A) Tagalog and Cebuano are the primary dialects spoken.
B) Orientation to the past is evident in their respect for elders.
C) The family, rather than the individual, is the unit.
D) Most Filipinos are Catholic.
E) Filipinos like to eat rice with most meals.
F) Sharing is common since interdependence is important.
Q2) A Hispanic patient tells an African-American nurse, "You are African-American and can't possibly understand how a person like me feels." What is an appropriate response by the nurse at this time?
A) Find a nurse who is not African-American to interview the patient.
B) Ask the patient, "Why do you think that, since we just met?"
C) Note that the patient is very defensive about being racially different.
D) Encourage the patient to describe what he means by his statement.
Q3) Which example below best characterizes a patient's race?
A) The language spoken in the patient's home is Tagalog.
B) The patient's family follows a kosher diet.
C) The patient and his family have blonde hair and fair skin.
D) The patient's grandparents came to the United States from Germany.
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Chapter 6: Pain Assessment
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Sample Questions
Q1) A patient reports "right shoulder pain that comes and goes" as the chief complaint. During the physical examination, the patient asks why the upper right abdomen is being examined for shoulder pain. What is the appropriate response from the nurse?
A) "A comprehensive examination is required to determine the cause of your pain."
B) "There may be associated problems that have not produced any symptoms yet that we want to identify."
C) "Yes, this can be confusing, but if you will be patient I'm sure we can find something to help you."
D) "It does seem odd, but the gallbladder doesn't have pain receptors of its own, so the pain shows up in the shoulder."
Q2) How do nurses assess a patient's pain?
A) By assessing physiologic changes of the patient
B) By understanding the sensory experience related to the amount of tissue damage
C) By the patient's medical diagnosis or surgical procedure
D) By asking the patient to rate the pain being experienced
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8
Chapter 7: Mental Health Assessment
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Sample Questions
Q1) While assessing a man during a physical examination for work, the nurse suspects alcohol use. Which assessment tool is appropriate in this situation?
A) AUDIT screening tool
B) Rapid eye test
C) Mental status examination
D) HITS screening tool
Q2) During a sports physical for a 16-year-old girl, the nurse asks which question to collect data about drug use?
A) "Many teenagers have tried street drugs. Have you tried these drugs?"
B) "Tell me which street drugs your friends have offered to you?"
C) "Do most of your friends drink alcohol or do street drugs?"
D) "Your high school has a reputation for drug use. Do you use drugs?"
Q3) In contrasting the assessment of mental status from mental health, a nurse recognizes that data for the mental status examination are obtained using which techniques?
A) Asking them about their relatives who have mental health disorders
B) Having them demonstrate their ability to reason and calculate
C) Asking them to recall how they have coped with daily stress
D) Having them describe their mood and emotions
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Page 9
Chapter 8: Nutritional Assessment
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Sample Questions
Q1) A woman who is 4 feet 11 inches tall is told by her provider to lose weight so that she is closer to her desired body weight. She asks the nurse, How can I find out what my desired body weight should be? The nurse responds, Let me show you how to calculate it. Your desired body weight (DBW) should be ____ lb.
Q2) A patient with mild renal disease has been put on a 2200-calorie per day diet plan with the lowest recommended amount of protein. During discharge teaching, the nurse explains to this patient how to use nutrition labels to determine the amount of protein in the product. The nurse explains, however, that the label is based on 2000 calories. Which is the appropriate formula to teach this patient the least amount of protein he can eat on his prescribed diet?
A) 2200 calories × 0.15 = 330/9 calories/gram = 36.6 g
B) 2200 calories × 0.10 = 220/4 calories/gram = 55 g
C) 2200 calories × 0.20 = 440/9 calories/gram = 48.8 g
D) 2200 calories × 0.12 = 264/4 calories/gram = 66 g
Q3) Which patient may require additional nutritional assessment?
A) A male patient with a blood glucose level of 100 mg/dl
B) A pregnant patient with a hemoglobin level of 10.5 g/dl
C) A female patient with a prealbumin level of 25 mg/dl
D) A male patient with a serum triglyceride level of 100 mg/dl
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Page 10
Chapter 9: Skin, Hair, and Nails
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Sample Questions
Q1) A patient complains of itching on her feet. On inspection the nurse observes weeping vesicles and skin that is softened and broken down between the toes. What explanation does the nurse give the patient about the cause of this skin disorder?
A) "Your itching is caused by a bacterial infection."
B) "Your itching is caused by an allergic reaction."
C) "Your itching is caused by a viral infection."
D) "Your itching is caused by a fungal infection."
Q2) What findings does a nurse expect when inspecting and palpating a patient's nails?
A) A nail base angle of not more than 90 degrees.
B) Whitish to clear nails in darker-skinned patients.
C) Nail surface is smooth and rounded.
D) Transverse depression running across the nails.
Q3) How does the nurse recognize jaundice in a dark-skinned patient?
A) Inspect the conjunctiva for ashen-gray color.
B) Inspect the nail beds for a deeper brown or purple skin tone.
C) Inspect the palms and soles for yellowish-green color.
D) Inspect the oral mucous membrane for yellow color.
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Page 11
Chapter 10: Head, Eyes, Ears, Nose, and Throat
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Sample Questions
Q1) A patient comes to the clinic for evaluation after a sinus infection. To evaluate the therapy, the nurse uses transillumination to assess the sinuses and notes which finding indicating recovery from a frontal sinus infection?
A) The soft palate illuminates brightly when the light source is placed against the lateral nose.
B) No illumination is noted when the light source is placed firmly against the lateral nose.
C) A bright glow illuminates the hard palate when the light source is placed against each temporal bone.
D) A reddish light is noted above the eyebrows when the light is placed against each supraorbital rim.
Q2) A patient complains of a lesion in his nose. Which technique does a nurse use to inspect the nasal mucosa?
A) Inserts a nasal speculum horizontally into the patient's affected nares
B) Inserts a nasal speculum obliquely into the patient's affected nares
C) Uses a light source from the ophthalmoscope
D) Inserts a nasal speculum vertically into the patient's affected nares
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Page 12
Chapter 11: Lungs and Respiratory System
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Sample Questions
Q1) A patient is suspected of having a lung consolidation. A nurse uses the three techniques for assessing vocal resonance in this patient. What is the expected finding among the three procedures that will help eliminate consolidation as a problem?
A) The nurse documents clearly hearing the patient say "99."
B) The nurse documents hearing muffled sounds when the patient says "1-2-3."
C) The nurse documents hearing no sounds when the patient says "e-e-e."
D) The nurse documents clearly hearing the patient say "a-a-a."
Q2) A nurse is auscultating the lungs of a healthy male patient and hears crackles on inspiration. What action can the nurse take to ensure this is an accurate finding?
A) Make sure the bell of the stethoscope is used, rather than the diaphragm.
B) Hold stethoscope firmly to prevent movement when placed over chest hair.
C) Ask the patient not to talk while the nurse is listening to the lungs.
D) Change the patient's position to ensure accurate sounds.
Q3) A patient tells the nurse that he has smoked 1 \(\frac{1}{2}\) packs of cigarettes a day for 14 years. The number of packs the nurse should record in the medical record is ___ pack-years.
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13
Chapter 12: Heart and Peripheral Vascular System
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Sample Questions
Q1) While assessing edema on a male patient's lower leg, the nurse notices that there is a slight imprint of his fingers where he palpated the patient's leg. How does the nurse document this finding?
A) No edema
B) 1+ edema
C) 2+ edema
D) 3+ edema
Q2) Which patient's statement helps a nurse distinguish between chest pain originating from pericarditis rather than from angina?
A) "No, I have not done anything to strain chest muscles."
B) "If I take a deep breath, the pain gets much worse."
C) "This pain feels like there's an elephant sitting on my chest."
D) "Whenever this pain happens, it goes right away if I lie down."
Q3) A nurse determines that a patient's jugular venous pressure is 3.5 inches. What additional data does the nurse expect to find?
A) Weight loss
B) Tented skin turgor
C) Peripheral edema
D) Capillary refill greater than 5 seconds
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Page 14
Chapter 13: Abdomen and Gastrointestinal System
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Sample Questions
Q1) Which techniques does a nurse use to palpate a patient's right kidney?
A) Asks the patient to take a deep breath, elevates the patient's eleventh and twelfth ribs with the left hand, and deeply palpates for the right kidney with the right hand.
B) Asks the patient to exhale, elevates the patient's eleventh and twelfth ribs with the left hand, and deeply palpates for the right kidney with the right hand.
C) Asks the patient to take a deep breath, elevates the patient's right flank with the left hand, and deeply palpates for the right kidney with the right hand.
D) Asks the patient to exhale, elevates the patient's right flank with the left hand, and deeply palpates for the right kidney with the right hand.
Q2) The nurse recognizes which clinical finding as expected on palpation of the abdomen?
A) Inability to palpate the spleen
B) Left kidney rounded at 2 cm below the costal margin
C) Slight tenderness of the gallbladder on light palpation
D) Bounding pulsation of the aorta over the umbilicus
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15
Chapter 14: Musculoskeletal System
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Sample Questions
Q1) A patient reports joint pain interfering with sleep and morning joint stiffness for the first hour after getting out of bed. Considering this report, what abnormal findings does the nurse anticipate during the examination?
A) Abrupt onset of local tenderness, edema, and decreased range of motion of the shoulder and hip bilaterally
B) Decreased range of motion of one hip and knee with pain on flexion and crepitus during movement of these joints
C) Erythema in one great toe, ankle, and lower leg that is painful to the touch
D) Hot, painful, deformed, and edematous wrists and peripheral interphalangeal joints bilaterally
Q2) A nurse palpates the patient's jaw movement by placing two fingers in front of each ear and asking the patient to slowly open and close the mouth. What movement does the nurse ask the patient to do next?
A) Move the jaw side to side.
B) Swallow.
C) Smile.
D) Clench the teeth together.
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Chapter 15: Neurologic System
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Sample Questions
Q1) What technique does the nurse use to test the patellar deep tendon reflex?
A) Using the end of the handle on the reflex hammer, the nurse strokes the lateral aspect of the sole of the patient's foot from heel to ball.
B) Ask the patient to flex one knee to 90 degrees, while the nurse dorsiflexes the ankle and strikes the appropriate tendon on the foot with the flat end of the reflex hammer.
C) Ask the patient to flex one knee to 45 degrees, while the nurse plantar flexes the ankle and strikes the appropriate tendon of the ankle with the pointed end of the reflex hammer.
D) Ask the patient to flex one knee to 90 degrees, while the nurse strikes the appropriate tendon in the knee with the blunt end of the reflex hammer.
Q2) Which cranial nerve is assessed when a nurse asks a patient to stick out the tongue and move it side to side?
A) Vagus nerve (CN X)
B) Facial nerve (CN VII)
C) Abducens nerve (CN VI)
D) Hypoglossal nerve (CN XII)
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Page 17
Chapter 16: Breasts and Axillae
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Sample Questions
Q1) In assessing a patient with lymphedema after a mastectomy, the nurse expects which finding?
A) Fragile, thin, pale skin covering the area of lymphedema
B) Several brownish-red discolorations in the center of the affected arm
C) Unilateral nonpitting edema of the affected arm
D) Pitting edema of affected arm
Q2) When examining the lymph nodes of an adult female patient, the nurse recognizes which finding as normal?
A) Visible superficial nodes
B) Palpable supraclavicular nodes
C) Nonpalpable lymph nodes in the axilla
D) Enlarged, fixed nodes in the neck
Q3) In assessing the breast of a male patient, the nurse places him in which position?
A) Standing with hands over the head
B) Supine with the hand on the side being examined placed behind the head
C) Sitting with arms at the side
D) Bending forward 45 degrees at the waist
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18
Chapter 17: Reproductive System and the Perineum
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Sample Questions
Q1) While giving a history, the patient reports having herpes genitalis. Based on this information, which finding does the nurse anticipate during the assessment?
A) Small vesicles on the genitalia
B) Single, firm, painless, open sore
C) Pain when palpating the cervix
D) Malodorous greenish-yellow vaginal discharge
Q2) During the initial inspection of the female genitalia, the nurse recognizes which finding as normal?
A) The labia minora are hair-covered and lying within the labia majora.
B) The cervical os in the multiparous woman has the shape of a small circle.
C) The vaginal vestibule lies between the labia minora and contains the urinary meatus.
D) The openings of Skene and Bartholin glands are visible posteriorly.
Q3) While taking a history of a patient with an enlarged prostate, the nurse expects the patient to report which symptom?
A) Painful urination with each voiding
B) Blood in the urine upon arising
C) Waking from sleep to urinate
D) Incontinence throughout the day
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19
Chapter 18: Developmental Assessment Throughout the Life Span
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Sample Questions
Q1) The parents of a toddler express concern that the child is not progressing the same way as their other children did at that age. What is the most appropriate suggestion the nurse can give the parents about monitoring the progress of the toddler?
A) Advising the parents to take the toddler to the clinic every 2 months for reevaluation
B) Teaching the parents how to use the Denver II test to assess for gross motor movement, language, fine motor movement, and personal-social skills
C) Suggesting that the child needs more time to reach the milestones and that additional monitoring is not necessary
D) Informing the parents about the ages and stages questionnaire (ASQ), which identifies developmental delays in children from 4 to 60 months
Q2) Interviewing patients in middle adulthood, the nurse recognizes which behavior as an expected developmental task for this age group?
A) Finding meaning in life
B) Establishing autonomy as an individual
C) Increased self-understanding
D) Dissatisfaction with one's interpersonal relationships
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Chapter 19: Assessment of the Infant, Child, and Adolescent
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Sample Questions
Q1) Which finding during inspection of the mouth of a 1-month-old infant requires further investigation?
A) A small loose tooth in the lower jaw
B) Tongue overlapping the floor of the mouth
C) Whitish epithelial cells on the roof of the mouth
D) White patches on the tongue that scrape off easily
Q2) In assessing the eyes of a 4-month-old infant, a nurse shines a penlight in the infant's eyes and notices that the light reflection is not in the same location in each eye. What is the nurse's most appropriate response to this finding?
A) Perform the cover-uncover test.
B) Document it as an expected finding at this age.
C) Document abnormal function of cranial nerves IV (trochlear) and VI (abducens).
D) Refer the infant to an ophthalmologist.
Q3) How does a nurse collect baseline measurements of a 6-month-old infant?
A) Measure the chest circumference around the lower ribs.
B) Ask the parent how much the infant's weight has changed since birth.
C) Measure the head just above the ears and eyebrows.
D) Ask the parent to hold the infant while the nurse measures the length.
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Chapter 20: Assessment of the Pregnant Patient
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Sample Questions
Q1) In prioritizing patient care, the nurse would give immediate attention to the pregnant patient with which clinical manifestation?
A) Darkened eyelids
B) Seeing spots
C) Excessive eye dryness
D) Pale conjunctiva
Q2) A nurse assesses fetal heart rates when patients are examined in the maternity clinic. The nurse determines which fetus needs further assessment?
A) The fetus with a heart rate of 150 beats/min
B) The fetus with a heart rate of 140 beats/min
C) The fetus with a heart rate of 130 beats/min
D) The fetus with a heart rate of 110 beats/min
Q3) A nurse documents as abnormal which finding of a pregnant patient?
A) Facial swelling in a woman who is 20 weeks pregnant
B) 1+ pitting ankle edema in a woman who is 26 weeks pregnant
C) Pinkish-red blotches of the hands in a woman at 32 weeks gestation
D) Blotchy, brownish pigmentation of the face in a woman at 36 weeks gestation
Q4) If a patient's last menstrual period was May 13, her estimated date of birth is
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Chapter 21: Assessment of the Older Adult
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Q1) What finding does a nurse look for when assessing the skin of an older adult with solar lentigo?
A) Yellowish, thin papules with a central depression
B) Pigmented, raised, wartlike lesions on the face or trunk
C) Small, soft, pigmented tags of skin on the face and neck
D) Irregular, flat, deeply pigmented macules on sun-exposed areas
Q2) Which assessment finding of older adult patients indicates expected respiratory function?
A) Increased elasticity of the alveoli
B) Flaccidity of the chest wall
C) Reduced inspiratory and expiratory effort
D) Decreased anteroposterior diameter
Q3) When assessing the skin of an older adult, a nurse notices pigmented, raised warty-appearing lesions on the trunk. How does a nurse document this finding?
A) Solar lentigo
B) Basal cell skin cancer
C) Seborrheic keratosis
D) Sebaceous hyperplasia
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Chapter 22: Conducting a Head-to-Toe Examination
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Q1) Which techniques does a nurse use routinely to collect data when assessing the abdomen of a patient? (Select all that apply.)
A) Testing for presence of abdominal reflexes
B) Inspecting skin for contour, scars, lesions, vascularity, and bulges
C) Percussing in all quadrants for tone
D) Lightly palpating for tenderness, guarding, and masses
E) Auscultating for bowel sounds, bruits, and venous hums
F) Deeply palpating for tenderness, guarding, and masses
Q2) Which techniques does a nurse routinely use to collect data when assessing the lower extremities of a patient? (Select all that apply.)
A) Inspecting of legs, ankles, and feet for skin characteristics and hair distribution
B) Assessing for knee stability with the drawer test, McMurray test, or Apley test
C) Palpating lower legs and feet for temperature, pulses, and tenderness
D) Assessing for nerve root compression with straight leg raises
E) Palpating hips for stability and tenderness
F) Testing for patellar and Achilles deep tendon reflexes bilaterally
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24
Chapter 23: Documenting the Comprehensive Health Assessment
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Sample Questions
Q1) Which data do nurses document under the category of personal and psychosocial health history? (Select all that apply.)
A) Allergies to medications or food
B) Diet and foods eaten on a regular basis
C) Type of employment
D) Address and date of birth
E) Activities that promote health
F) Use of tobacco and alcohol
Q2) Which documentation by a nurse is most descriptive?
A) Heart sounds normal.
B) Few ectopic beats heard during auscultation.
C) S1 murmur is heard at second right sternal border.
D) Pulse within normal limits.
Q3) A patient reports she has shortness of breath and peripheral edema. Under which category does the nurse document these data?
A) Review of systems
B) Present health status
C) Past health history
D) Functional ability
25
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Chapter 24: Adapting Health Assessment to the Hospitalized Patient
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Sample Questions
Q1) During the assessment, the nurse determines that the patient's Glasgow Coma Scale score is 15. What is the meaning of this number for this patient?
A) This patient is fully conscious.
B) This patient has movement but does not open the eyes or speak.
C) This patient is unable to respond to any stimuli.
D) This patient opens the eyes but does not speak or move.
Q2) Which patient using respiratory equipment requires skin assessment? (Select all that apply.)
A) A patient using a nasal cannula
B) A patient with a tracheostomy
C) A patient using an incentive spirometer
D) A patient using a Ventimask
E) A patient with an IV
Q3) How does a nurse assess perfusion to the foot when a patient has a cast from the left middle calf to the toes?
A) Palpate the popliteal pulse of the left leg.
B) Palpate the posterior tibial pulse of the left leg.
C) Assess movement and sensation of the left toes.
D) Assess the capillary refill of the left toes.
Page 26
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