50 item Medical-Surgical Nursing Practice Test

Mr. Duffy is admitted to the CCU with a diagnosis of R/O MI. He presented in the ER with a typical description of pain associated with an MI, and is now cold and clammy, pale and dyspneic. He has an IV of D5W running, and is complaining of chest pain. Oxygen therapy has not been started, and he is not on the monitor. He is frightened. 1. The nurse is aware of several important tasks that should all be done immediately in order to give Mr. Duffy the care he needs. Which of the following nursing interventions will relieve his current myocardial ischemia? a. stool softeners, rest b. O2 therapy, analgesia c. Reassurance, cardiac monitoring d. Adequate fluid intake, low-fat diet 2. During the first three days that Mr. Duffy is in the CCU, a number of diagnostic blood tests are obtained. Which of the following patterns of cardiac enzyme elevation are most common following an MI? a. SGOT, CK, and LDH are all elevated immediately. b. SGOT rises 4-6 hours after infarction with CK and LDH rising slowly 24 hours later. c. CK peaks first (12-24 hours), followed by the SGOT (peaks in 24-36 hours) and then the LDH (peaks 3-4 days). d. CK peaks first and remains elevated for 1 to 2 weeks. 3. On his second day in CCU Mr. Duffy suffers a life-threatening cardiac arrhythmia. Considering his diagnosis, which is the most probable arrhythmia? a. atrial tachycardia b. ventricular fibrillation c. atrial fibrillation d. heart block 4. Mr. Duffy is placed on digitalis on discharge from the hospital. The nurse planning with him for his discharge should educate him as to the purpose and actions of his new medication. What should she or he teach Mr. Duffy to do at home to monitor his reaction to this medication? a. take his blood pressure b. take his radial pulse for one minute c. check his serum potassium (K) level d. weigh himself everyday You are speaking to an elderly group of diabetics in the OPD about eye health and the importance of visits to the ophthalmologist. 5. You decide to discuss glaucoma prevention. Which of the following diagnostic tests should these clients request from their care provider? a. fluorescein stain b. snellen’s test c. tonometry d. slit lamp 6. You also explain common eye changes associated with aging. One of these is presbyopia, which is: a. Refractive error that prevents light rays from coming to a single focus on the retina.

Drug toxicity is a major concern in uremia. you know that: a. Weakness. lighter in color than the retina. sometimes stippled. Poor distant vision c. A gradual lessening of the power of accommodation 7. Precautions should be taken with prescription drugs. 8. glomerular disease b. Kaplan who has chronic renal failure (uremia) 9. The point of maximum impulse (PMI) is an important landmark in the cardiac exam. Ciliary flush caused by congestion of the ciliary artery. You know that all but one of the following may eventually result in uremia. d. b. Which option is not implicated? a.smelling breath. uncontrolled hypertension c. which is quite avascular. infections. renal disease secondary to drugs.b. toxins. or radiations d. pruritus c. Icterus. all of the above 10. The half-life of many drugs is decreased in uremia. Ruddy complexion 11. c. which will interfere with vision. Poor near vision d. b. Kaplan in an attempt to stabilize him. Polyuria. Area where the central retinal artery and vein appear on the retina. Head of the optic nerve. c. Reddish orange in color. but most OTC medications are safe for him to use. thus dosage may have to be increased to be effective. Some of the diabetic clients are interested in understanding what is visualized during funduscopic examination. Drug therapy is not usually affected by this diagnosis d. Numerous drugs have been used on Mr. b. polydipsia. You are assigned to cardiac clinic to fill in for a colleague for 3 weeks. You did the initial assessment on Mr. During your discussion you describe the macular area as: a. anorexia. A pterygium. fruity. The area of central vision. What classical signs and symptoms did you note? a. individualization of therapy and often a decrease in dose is essential. a pinguecula. seen on the temporal side of the optic disc. seen on the nasal side of the field. Kaplan when he came to your unit. You are caring for Mr. which is normal slightly raised fatty structure under the conjunctiva that may gradually increase with age. b. d. You begin by reviewing assessment of the cardiovascular system in your mind and asking yourself the following: 12. One of the clients has noted a raised yellow plaque on the nasal side of the conjunctiva. You explain that this is called: a. c. which may be due to liver disease. Regarding his diagnosis and management of his drugs. Which statement best describes the location of the PMI in the healthy adult? . polyphagia d.

orthopnea. dysfunction of the left ventricle c. 5th intercostal space. which valve closure is best evaluated? a. Baker. papillary muscle ischemia and dysfunction . c. intercostal space. the left anterior descending and left circumflex: both supply the left ventricle Sally Baker. thickening of the pericardium b. the right coronary artery forms almost a complete circle around the heart. ventricular ischemia b. left ventricular hypertrophy 17. low-pitched rumbling diastolic murmur. Aortic d. precordial thrill. blood enters the right and left coronary arteries during systole only c. 7th intercostal space. and paroxysmal nocturnal dyspnea have become unmanageable. small crepitant rales at the bases of the lungs c. several abnormal findings can be observed. You know those mitral valve prolapse is usually a benign cardiac condition. weak. and peripheral and facial cyanosis in severe disease d. chest x-ray shows left ventricular hypertrophy 18. the right and left coronary arteries are the first of many branches off the ascending aorta b. S1 b. hemoptysis. 7-9 cm to the left of the midsternal line. The pulmonic component of which heart sound is best heard at the 2nd LICS at the LSB? a. irregular pulse. This chest pain is probably caused by: a. Mitral 14. She is scheduled for surgery to repair her mitral valve. Baker has decided to have surgical correction of her stenosed valve at this time because her subjective complaints of dyspnea. Apex of the heart. The coronary arteries furnish blood supply to the myocardium. yet supplies only the right ventricle d. Apex of the heart. the health care provider auscultates the heart. 7-9 cm to the left of the midsternal line. b. the left coronary artery has two main branches. pulmonary hypertension d. is admitted to the hospital with an established diagnosis of mitral stenosis. S4 15. 13. a 40-year-old woman. Ms. During the physical examination of the well adult client. Tricuspid b. S3 d. When the stethoscope is placed on the 5th intercostal space along the left sternal border. You are seeing more clients with diagnoses of mitral valve prolapse. Base of the heart. intercostal space. Pulmonic c. Which of the following is a true statement relative to the coronary circulation? a. These complaints are probably due to: a. S2 c.a. 16. but may be associated with atypical chest pain. 7-9 cm to the left of the midsternal line. and parasternal lift b. 7-9 cm to the left of the midsternal line. On physical exam of Ms. Which of the following is not one of the usual objective findings associated with mitral stenosis? a. right heart failure c. Base of the heart. d.

which is always associated with smoking? a. The nurse should expect: a. Of the four basic cell types of lung cancer listed below. visual loss c. Secondary to hyperglycemia 24. Secondary to hypoglycemia d. cancer of the pancreas d. Today the episode lasted for 15 minutes. Pneumonectomy: removal of the entire lung b. a long term heavy smoker. TIA’s or transient ischemic attacks c. is admitted to your unit. He is right handed. DM. Liberatore suffers a left sided CVA. Decortication: removal of the reibs or sections of ribs d. cancer of the bowel 20. Helping the client deal with depression secondary to the diagnosis and its treatment b. Oliver. Chemotherapy may be used in combination with surgery in the treatment of lung cancer. small cerebral hemorrhages b. The admission diagnosis is impending CVA. cancer of the prostate b.d. Special nursing considerations with chemotherapy include all but which of the following? a. Careful attention to blood count results 22. age 76. Liberatore has been experiencing are probably: a. Wedge resection: removal of one or more lobes of a lung c. cardiac arrythmias Mr. bronchoalveolar carcinoma 21. His possible diagnosis is cancer of the lung. Thoracoplasty: removal of fibrous membrane that develops over visceral pleura as a result of emphysema Mr. The episodes Mr. Liberatore. Explaining that the reactions to chemotherapy are minimal c. squamous cell carcinoma (epidermoid) c. 23. Which of the following operative procedures of the thorax is paired with the correct definition? a. hyperlipidemia. Mr. He has a past medical history of hypertension. Recently he has had several episodes where he stops talking in midsentence and stares into space. 19. no alterations in speech d. cancer of the lung c. is admitted to the hospital for a diagnostic workup. left-sided paralysis b. The most common lethal cancer in males between their fifth and seventh decades is: a. adenocarcinoma b. Upper motor neuron disease may be manifested in which of the following clinical signs? . no impairment of bladder function 25. undifferenciated carcinoma d. Careful observation of the IV site of the administration of the drugs d.

A thorough history reveals that hormonal changes associated with menstruation may have triggered Julie’s migraine attack. The type of tumor he has is currently unknown. Which of the following statements about gliomas do you know to be false? a. A client with muscle contraction headache will exhibit a pattern different for Julie’s. hyporeflexia c. During your assessment of Julie she tells you all visual symptoms are gone but that she now has a severe pounding headache over her left eye. spastic paralysis. seasonal allergies b. 26. is brought into the ER by her mother with the chief complaint of sudden visual disturbance that began half an hour ago and was described as double vision and flashing lights. a brain tumor d. an allergic response triggered by stress b. Glioma is an intracranial tumor. CN8 d. You explain to Julie and her mother that migraine headaches are caused by: a. presence of babinski reflex b.a. In investigating Julie’s history what factors would be least significant in migraine? a. trigger foods such as alcohol. or aura 29. dilation of cerebral arteries c. a conversion reaction 27. gliomas are usually benign c. most glioma victims die within a year after diagnosis 31. 50% of all intracranial tumors are gliomas b. warning sign of onset. The ossicles . decreased or absent voluntary movement Julie. CN5 b. or in the neck Mr. severe aching pain behind both eyes b. chocolate c. fasciculations d. MSG. they grow rapidly and often cannot be totally excised from the surrounding tissue d. and vertigo due to pressure and eventual destruction of: a. a bandlike burning around the neck d. headache worse when bending over c. persistent contraction of the muscles of the head. Which of the following is more compatible with tension headache? a. hyperreflexia. a tension headache b. Acoustic neuromas produce symptoms of progressive nerve deafness. You begin to think about the way brain tumors are classified. muscle atrophy. Snyder is admitted to your unit with a brain tumor. occipitally. an 18-year-old girl. neck and face d. feeling of tightness bitemporally. 30. family history of migraine d. the aura and headache of migraine c. CN7 c. tinnitus. increased intracranial pressure 28. flaccid paralysis. You suspect Julie may have: a.

32. so an enema is not necessary d. increased pulse rate. and vomiting b.000. vomiting. Hogan is scheduled for surgery 2 days later and is to be given atropine 0. You assess the situation and conclude that the reason for this is: a. to notify the surgeon at once. Snyder had been on clear liquids and then was NPO for several days. Mr. VS. this is an elevated WBC indicating an inflammatory reaction b. Snyder has had some mental changes due to the tumor and would find an enema terribly traumatic b. Straining to evacuate the enema might increase the intracranial pressure c. is admitted to your unit for cholecystectomy. Potential postintracranial surgery problems include all but which of the following? a. headache. Providing a caring. to call the laboratory for a STAT repeat WBC d. supportive atmosphere for him and his family 35. dizziness. because she is probably overweight and will be less willing to breathe. Assessments q ½ hour of LOC. Snyder needs vigilant nursing care including all of the following except: a. Mr Snyder is scheduled for surgery in the morning. Signs and symptoms of increasing intracranial pressure may include all of the following except: a. the incision in gallbladder surgery is in the subcostal area. Why are these exercises especially important for Mrs. to record this finding in a prominent place on the preop checklist and in your preop notes c. papilledema. leakage of cerebrospinal fluid Mrs. Your responsibility at this point is: a. Helping him avoid straining at stool. Hogan? a.3 mg IM . Postoperatively Mr. they prevent postoperative atelectasis and pneumonia b. Keeping his head flat b. Mr. or coughing d. Hogan’s planned cholecystectomy she awakens with a pain in her right scapular area and thinks she slept in poor position. none. and you are surprised to find out that there is no order for an enema. Hogan. drop in blood pressure 33. and mental status c. This is not an unusual finding 38. mental status changes c. Hogan deep breathing and coughing exercises. which makes the client reluctant to take a deep breath and cough c. Mrs. papillary responses. a 43-year-old woman. An oversight and you call the physician to obtain the order 34. it will eventually cause increased intracranial pressure. nausea. 36. seizures d. extracranial hemorrhage c. You are responsible for teaching Mrs. cough. increased ICP b. On the morning of Mrs. Whether Mr Snyder’s tumor is benign or malignant. While doing the preop check list you note that on her routine CB report her WBC is 15. and move postoperatively 37. obvious motor deficits d.

Hogan’s status: her BP is gradually dropping and her pulse rate is increasing. allow her family to be with her before the medication takes effect c. Extubate. order whole blood for Mrs. place in lateral sims position to facilitate breathing 40. d. d. have her void soon after receiving the medication b. Mrs. 42. ventilate for 30 seconds then try again. Can be attempted for up to 2 minutes before you need to stop and ventilate the patient. Effective ventilations can always be given by one person. Endotracheal intubation: a. if Mrs. Be inserted "upside down" into the mouth opening and then rotated into the proper orientation as it is advanced into the mouth. c. b. Hogan will not be ambulated early d. c. Her vital signs are stable and her family is with her. Rapid and forceful ventilations are desirable so that adequate ventilation will be assured b. Not be used in a conscious patient. after the family leaves c. You have intubated the stomach. Tidal volumes will always be larger than when giving mouth to pocket mask ventilations. When giving bag-valve mask ventilations: a. Hogan returns to your clinical unit following discharge from the recovery room. Reduces the risk of aspiration of gastric contents. increase IV fluid rate of infusion and place in trendelenburg position c. Which nursing actions follow the giving of the preop medication? a. Hogan from the lab b. d.and Demerol 50 mg IM one hour preoperatively. c. Pull the tube back and listen again. The patient probably only has one lung. Mrs. after the physician writes the order b. the right. stat 41. Your most appropriate nursing action is to: a. Should be performed with the neck flexed forward making the chin touch the chest. As you continue to check her vital signs you note a continuing trend in Mrs. bring her valuables to the nursing station d. b. reinforce preop teaching 39. An oropharyngeal airway may: a. d. c. . Postoperative leg exercises should be inititated: a. Should be performed after a patient is found to be not breathing and two breaths have been given but before checking for a pulse. e. All of the above. Hogan is transported to the recovery room following her cholecystectomy. immediately report signs of shock to the head nurse and/or surgeon and monitor VS closely d. b. Prevent a patient from biting and occluding an ET tube. 44. If breath sounds are only heard on the right side after intubation: a. 43. Cricoid pressure may prevent gastric inflation during ventilations. Cause airway obstruction.

Is always given for a heart rate less than 60 bpm. When given IV. d. or patients who have swallowed caustic substances. Has a maximum total dosage of 0. b. c. 49. True b. False . It may cause a drop in blood pressure.03-0. 46. It is used for wide-complex tachycardia. pressing. pediatric patients. d. Which of the following is true about verapamil? a. b. A targeted history is rarely useful in making the diagnosis of MI.45. should always be given slowly. b. c. or heavy. The most common lethal arrhythmia in the first hour of an MI is: a. Requires visualization of the trachea before insertion. 50. 48. During an acute myocardial infarct (MI): a. Asystole c. c. An esophageal obturator airway (EOA): a. Ventricular fibrillation d. Chest pain will always be present.04 mg/kg IV in the setting of cardiac arrest. Can be inserted by any person trained in ACLS. A patient may have a normal appearing ECG. Should not be used with a conscious person. b. It is useful for treatment of severe hypotension. The chest pain is rarely described as crushing. Cannot be given via ET tube. First degree heart block. 47. Asystole should not be "defibrillated. Never causes regurgitation. It is a first line drug for Pulseless Electrical Activity." a. c. d. Pulseless Ventricular Tachycardia b. Atropine: a. d.

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