Medical Surgical Nursing (Quiz)

ANS: A
1.) A client is receiving NPH insulin 20 units subq at 7:00 AM
daily, at 3 PM how would the nurse finds if the client were having 8.) The nurse is caring for a client who has exophthalmos
a hypoglycemic reaction? associated with her thyroid disease. What is the cause of
A.) Feel the client and bed for dampness exophthalmos?
B.) Observe client kussmaul respirations A.) Fluid edema in the retro-orbital tissues which force the eyes to
C.) Smell client’s breathe for acetone odor protrude
D.) Check client’s pupils for dilation B.) Impaired vision, which causes the client to squint in order to see
C.) Increased eye lubrication, which makes the client blink less
ANS: A -diaphoresis D.) Decrease in extraocular eye movements, which results in the
“thyroid stare.”
2.) Postoperative thyroidectomy nursing care includes which
measures? ANS: A
A.) Have the client speak every 5-10 mins if hoarseness is present
B.) Provide a low calcium diet to prevent hypercalcemia 9.) What is characteristic symptom of hypoglycemia that should
C.) Check the dressing all the back of the neck for bleeding alert nurse to an early insulin reaction?
D.) Apply a soft cervical collar to restrict neck movement A.) Diaphoresis
B.) Drowsiness
ANS: C C.) Severe thirst
D.) Coma
3.) What would the nurse note as typical findings on the
assessment of a client with acute pancreatitis? ANS: A
A.) Steatorrhea, abd. Pain, fever
B.) Fever, hypoglycemia, DHN 10.) A client is scheduled for routine glycosylated hemoglobin
C.) Melena, persistent vomiting, hyperactive bowel sounds (HbA1c) test. What is important for the nurse to tell the client
D.) Hypoactive bowel sounds, decreased amylase and lipase levels before this test?
A.) Drink only water after midnight and come to the clinic early in
ANS: A the morning
B.) Eat a normal breakfast and be at the clinic 2 hours because of the
4.) A client is found to be comatose and hypoglycemic with a multiple blood draws
blood suger level 50 mg/dl. What nursing action is implemented C.) Expect to be at the clinic for several hours because of the multiple
first? blood draws
A.) Infuse 1000 ml of D5W over a 12-hour period D.) Come to the clinic at the earliest convenience to have blood
B.) Administer 50% glucose IV drawn
C.) Check the client’s urine for the presence of sugar and acetone
D.) Encourage the client to drink orange juice with added sugar ANS: D

ANS: B 11.) A client has been inhalation vasopressin therapy. What will
the nurse evaluate to determine the therapeutic response to this
5.) Which medication will the nurse have medication?
available for the emergency treatment of tetany in the client who A.) Urine specific gravity
has had a thyroidectomy? B.) Blood glucose
A.) Calcium chloride C.) Vital signs
B.) Potassium chloride D.) Oxygen saturation levels
C.) Magnesium sulfate
D.) Sodium bicarbonate ANS: A

ANS: A 12.) A client with diagnosis of type 2 diabetes has been ordered a
course of prednisone for her severe arthritic pain. An expected
6.) What is the primary action of insulin in the body? change that requires close monitoring by the nurse is;
A.) Enhances the transport of glucose across cell walls A.) Increased blood glucose level
B.) Aids in the process of gluconeogenesis B.) Increased platelet aggregation
C.) Stimulates the pancreatic beta cells C.) Increased ceatinine clearance
D.) Decreases the intestinal absorption of glucose D.) Increased ketone level in urine

ANS: A ANS: A

7.) What will the nurse teach the diabetic client regarding 13.) The nurse performing an assessment on a client who has
exercise in his /her treatment program? been receiving long-term steroid therapy would expect to find:
A.) During exercise the body will use carbohydrates for energy A.) Jaundice
production, which in turn will decrease the need for insulin B.) Flank pain
B.) With an increase in activity the body will utilize more C.) Bulging eyes
carbohydrates; therefore more insulin will be required. D.) Central obesity
C.) The increase in activity results in an increase in the utilization of
insulin; therefore the client should decrease his/her carbohydrate ANS: D
intake
D.) Exercise will improve pancreatic circulation and stimulate the 14.) A diabetic client receives a combination of regular and NPH
islet of Langerhans to increase the production of intrinsic insulin insulin at 0700 hours. The nurse teaches the client to be alert for
signs of hypoglycemia at A.) Atropine (Atrposil) 1-2 drops in each eye now
A.) 1200 and 1300 hours B.) Hydrochloride (Diuril) 25 mg PO daily
B.) 1100 and 1700 hours C.) Propanolol (Inderal) 20 mg PO 2 times a day
C.) 1000 and 2200 hours D.) Carbanyl choline (Isopto carbachol) eye drops; 1 drop 2 times a
D.) 0800 and 1100 hours day

ANS: B ANS: A

15.) It is important for the nurse to teach the client that
metformin (Glcucophage):
A.) May cause nocturia
B.) Should be taken at night
C.) Should be taken with meals
D.) May increase the effects of aspirin
ANS: C
16.) A nurse assessing a client with SIADH would expect to find
laboratory values of:
A.) Serum Na= 150 mEq/L and low urine osmolality
B.) Serum K= 5 mEq/L and low serum osmolality
C.) Serum Na=120 mEq/L and low serum osmolality
D.) Serum K= 3 mEq/L and high serum osmolality
ANS: C
17.) A priority nursing diagnostic for a client admitted to the
hospital with a diagnosis of diabetes insipidus is:
A.) Sleep pattern deprivation related nocturia
B.) Activity intolerance r/t muscle weakness
C.) Fluid volume excess r/t intake greater that output
D.) Risk for impaired skin integrity r/t generalized edema
ANS: B
18.) A client admitted with a pheochrocytoma returns from the
operating room after adrenalectomy. The nurse should carefully
assess this client for:
A.) Hypokalemia
B.) Hyperglycemia
C.) Marked Na and water intake
D.) Marked fluctuations in BP
22.) A client tells you she has heard that glaucoma may be a
hereditary problem and she is concerned about her adult
children. What is the best response?
A.) “There is no need for concern; glaucoma is not hereditary order.”
B.) “Screening for glaucoma should be included in an annual eye
exam for everyones over 50.”
C.) “There may be a genetic factor with glaucoma and your children
over 30 y/o should be screened yearly.”
D.) “Are your grandchildren complaining of any eye problems?
Glaucoma generally skips a generation.”
ANS: C
23.) What will be important to include in the nursing care for the
client with angle-closure glaucoma?
A.) Evaluation of medications to determine if any of them cause an
increase in IOP is a side effect.
B.) Observation for an increase in loss of vision; it can be reversed if
promptly identified.
C.) Control BP to decrease the client’s potential loss of peripheral
vision.
D.) Assessment for a level of discomfort; the client may experience
considerable pain until the optic nerve atrophies
ANS: A
24.) A child is scheduled for a myringotomy. What goal of this
procedure will the nurse discuss with the parents?
A.) Promote drainage from the ear
B.) Irrigate the Eustachian tube
C.) Correct a malformation in the inner ear
D.) Equalize pressure on the tympanic membrane
ANS: A

ANS: D 25.) After a client’s eye has been anesthetized, what instructions
will be important for the nurse to give the client?
19.) When caring for client in thyroid crisis, the nurse would A.) Do not watch TV for at least one day
question an order for: B.) Do not rub the eye for 15-20 minutes
A.) IV fluid C.) Irrigate the eye every hour to prevent dryness
B.) Propanolol (Inderal) D.) Wear sunglasses when in direct sunlight for the next 6 hours
C.) Prophylthiouracil
D.) A hyperthermia blanket ANS: B

ANS: D 26.) A child diagnosed with conjunctivitis. Which statement

reflects that the child understood the nurse’s teaching?
20.) A client is prescribed levothyroxine (Synthroid) daily. The A.) “It’s okay for me to let my friends use my sunglasses while we
most important instruction to give the client for administration of are playing together.”
this drug is: B.) “It’s okay for me to softly rub my eye, as long as I use the back of
A.) Taper dose and discontinue if mental and emotional statuses my hand.”
stabilize C.) “I can pick the crustly stuff out of my eyelashes with my fingers
B.) Take it at bedtime to avoid the side effects of nausea and flatus when I wake up in the morning.”
C.) Call the M.D. immediately at the onset of palpitations or D.) “I will use my own washrag and towel while my eyes are sick.”
nervousness
D.) Decrease intake of juices and fruits with high potassium and ANS: D
calcium contents
27.) What medication would the nurse anticipate giving a client
ANS: C with Meniere’s dse?
A.) Nifedipine
21.) The nurse would question which medication order for a B.) Amoxicillin
client with acute-angled glaucoma? C.) Propanolol
D.) Hydrochloride (Hydro DIURIL)
ANS: D
28.) When teaching a family and a client about the use of a
hearing aid, the nurse will base the teaching on what information
regarding the hearing aid?
A.) Provides mechanical transmission for damaged part of the ear
B.) Stimulates the neural network of the inner ear to amplify sound
C.) Amplifies sound but does not improve the ability to hear
D.) Tunes out extraneous noise in the lower-frequency sound
spectrum
ANS: C
29.) What statement by the client recovering from cataract
surgery would indicate to the nurse need for additional teaching?
A.) “I’ll call if I have a significant amount of pain.”
B.) “I’ll continue to take my Metamucil for another week.”
C.) “I’ll just do some laundry this afternoon instead of going to
work.”
D.) “I’ll take my acetazolamide (Diamox) drops with my other
morning medications
ANS: C
30.) A client is walking down the hall and begins to experience
vertigo. What is the most important nursing action when this
occurs?
A.) Have the client sit in a chair and lower his head
B.) Administer meclizine (Antivert) PO
C.) Assist the client to sit or lie down
D.) Assess if the occurrence is vertigo or dizziness
ANS: C
31.) Which client is at highest risk for retinal detachment?
A.) 4-year old with amblyopia
B.) 17 y/o who plays physical contact
C.) 33 y/o with severe ptosis and diplopia
D.) 72 y/o with nystagmus and Bell’s palsy
ANS: B
32.) To promote and maintain safety for a client after a
stapedectomy. What would be included in the nursing care plan?
A.) Implement fall precautions
B.) Prevent aspirations
C.) Begin oxygen 2-4L/min via nasal cannula
D.) Change inner ear dressing when saturated
ANS: A
33.) The nurse would question the administration of which eye
drop in a patient with increased ICP?
A.) Artificial tears
B.) Betaxolol (Betoptic)
C.) Acetazolamide (Diamox)
D.) Epinephrine HCL (Epirate)
ANS: D
34.) A client is being admitted for problems with Meniere’s
disease. What is most important to the nurse to assess?
A.) Diet history
B.) Screening hearing test
C.) Effect on client’s activities of daily living (ADLs)
D.) Frequency and severity
ANS: D
35.) A client calls the nurse regarding an accident that just
occurred during which an unknown chemical was splashed in his
eyes. What is the most important for the nurse to tell the client to
do immediately?
A.) Rinse the eye with large amount of water or saline solution
B.) Put a pad soaked in the sterile saline solution over the eye
C.) Go to the closest emergency room
D.) Have a co-worker visually checks the eye for a foreign body
ANS: A
36.) A 25- year old woman comes to the clinic complaining of
dizziness, weakness and palpitations. What will be important for
the nurse to initially evaluate when obtaining the health history?
A.) Activity and exercise patterns
B.) Nutritional patterns
C.) Family health status
D.) Coping and stress tolerance
ANS: B
37.) A child with leukemia is being discharged after beginning
chemotherapy. What instructions will the nurse include in the
teaching plan for the parents of this child?
A.) Provide a diet low in protein and high in carbohydrates
B.) Avoid fresh vegetables that are not cooked or peeled
C.) Notify the M.D. if the child’s temperature exceeds 101F (39C)
D.) Increase the use of humidifiers throughout the house
ANS: B
38.) Which client is most likely to have iron deficiency anemia?
A.) A client with cancer receiving radiation therapy twice a week
B.) A toddler whose primary nutritional intake is milk
C.) A client with peptic ulcer who had surgery 6 weeks ago
D.) A 15-year old client in sickle cell crisis
ANS: B
39.) A client has an order for one unit of whole blood. What is a
correct nursing action?
A.) Initiate an IV with 5% dextrose in water (D5W) to maintain a
patent access site
B.) Initiate the transfusion within 30 minutes of receiving the blood
C.) Monitor the client’s vital signs for the first 5 minutes
D.) Monitor V/S every 2 hours during the transfusion
ANS: B
40.) The nurse is caring for a client who is receiving a blood
transfusion. The transfusion was started 30 mins ago at a rate of
100 ml/hr. The client begins to complain of low back pain and
headache and is increasing restless, what is the first nursing
action?
A.) Slow the infusion and evaluate the V/S and client’s history of
transfusion reaction
B.) Stop the transfusion, disconnect the blood tubing and begin a
primary infusion of normal saline solution
C.) Stop the infusion of blood and begin infusion of NSS from the Y
connector
D.) Recheck the unit of blood for correct identification numbers and
cross-match information
ANS: B
41.) The nurse is preparing to start an IV infusion before the
administration of a unit of packed red blood cells, what fluid will 48.) The client with COPD is to be discharged home while
the nurse select to maintain the infusion before hanging the unit receiving continuous oxygen at a rate of 2 L/min via cannula.
of blood? What information does the nurse provide to the client and his
A.) D5W wife regarding the use of oxygen at home?
B.) D5W/.45NaCl A.) Because of his need for oxygen, the client will have to limit
C.) LR solution activity at home
D.) .9% Na Cl B.) The use of oxygen will eliminate the client’s shortness of breath
C.) Precautions are necessary because oxygen can spontaneously
ANS: D ignite and explode
D.) Use oxygen during activity to relieve the strain on the client’s
42.) A client in sickle cell crisis is admitted to the emergency heart
department what are the priorities of care?
A.) Nutrition, hydration, electrolyte balance ANS: A
B.) Hydration, pain management, electrolyte balance
C.) Hydration, oxygenation, apin management 49.) The wife of a client with COPD is worried about caring for
D.) Hydration, oxygenation, electrolyte balance her husband at home. Which statement by the nurse provides the
most valid information?
ANS: C A.) “You should avoid emotional situations that increase his
shortness of breathe.”
43.) A client in the ICU has been diagnosed with DIC. The nurse B.) “Help your husband arrange activities so that he does as little
will anticipate administering which of the following fluids? walking as possible.”
A.) Packed RBC C.) “Arrange a schedule so your husband does all necessary activities
B.) Fresh Frozen plasma (FFP) before noon; then he can rest during the afternoon and evening.”
C.) Volume expanders, such as D10W D.) “Your husband will be no more short of breath when he walks but
D.) Whole blood that will not hurt him.”

ANS: B ANS: C

44.) The nurse is assessing a client who has been given a diagnosis 50.) Which statement correctly describes suctioning through an
of polycythemia vera. What characteristics will the nurse endotracheal tube
anticipate finding when assessing this client? A.) The catheter is inserted into the endotracheal tube; intermittent
A.) Increased fatigue and bleeding tendencies suction is applied until no further secretions are retrieved; the catheter
B.) Hemoglobin below 13 mg/dl is then withdrawn.
C.) Headaches, dyspnea, claudication B.) The catheter is inserted through the nose, and the upper airway is
D.) Back pain, ecchymosis, and joint tenderness suctioned; the catheter is then removed from the upper airway and
inserted into the endotracheal tube to suction the lower airway
ANS: C C.) With suction applied, the catheter is inserted into the endotracheal
tube; when resistance is met, the catheter is slowly withdrawn
45.) A client has been diagnosed with pernicious anemia what will D.) The catheter is inserted into the endotracheal tube to a point of
the nurse teach this client regarding medication he will need to resistance, and intermittent suction is applied during withdrawal.
take after he goes home?
A.) Monthly Vit. B12 injections will be necessary ANS: D
B.) Ferrous sulfate PO daily will be prescribed
C.) Coagulation studies are important to evaluate medications Care of the clients with Eye and Ear Disorders
D.) Decrease intake of leafy green vegetables because of increased
Vit. K 1.) The primary problem in cataract is:
A.) Blurring of vision
Ans: A B.) Loss of peripheral vision
C.) Presence of floaters
46.) First postop day after a right lower lobe (RLL) lobectomy, D.) Halos around light
the client breathes and coughs but has difficulty raising mucus.
What indicates that the client is not adequately clearing Ans:A
secretions?
A.) Chest x-ray film shows right sided pleural fluid
B.) A few scattered crackles on RLL on auscultation 2.) The primary reason for performing iridectomy after cataract
C.) PCO2 increases from 35-45 mm Hg extraction is:
D.) Decrease in forced vital capacity A.) To prevent secondary glaucoma
B.) To improve the vision of the client
ANS: C C.) To prevent postop hemorrhage
D.) To reduce eye discomfort
47.) What nursing observations indicate that the cuff on an
endotracheal tube is leaking? Ans: A
A.) An increase in peak pressure on the ventilator
B.) Client is able to speak
C.) Increased swallowing efforts by client
D.) Increased crackles (rales) over left lung field 3.) Pterygium is caused primarily by:
A.) Exposure to sunlight
ANS: B B.) Exposure to dust
C.) Exposure to wind
D.) Exposure to chemicals
Ans: D
Ans: B

4.) The surgical procedure which involves removal of the eyeball is: 11.) In acute glaucoma, the obstruction to the flow of aqueous humor
A.) Enucleation is caused by:
B.) Evisceration A.) Thickening of the trabecular meshwork
C.) Exanteration B.) Displacement of the iris
D.) Extraction C.) Narrowing of the canal schlemm
D.) Constriction of the pupil
Ans: A
Ans: B

5.) A sterile chronic granulomatous inflammation of the meibomian

gland is: 12.) Which of the following is true about glaucoma?
A.) Chalazion A.) It is characterized by irreversible blindness
B.) Hordeulum B.) It is treated with mydriatics
C.) Uveitis C.) The IOP is 14-21mmHg
D.) Keratoconjunctivitis D.) Central vision is lost initially, followed by the peripheral vision

Ans: A Ans: A

6.) The following are nursing interventions for a blind person

EXCEPT: 13.) The following drugs maybe administered to the client with
A.) When approaching the client, talk before touching glaucoma EXCEPT:
B.) Orient the client to the environment A.) Diamox (Acetazolamide)
C.) When assisting the client during ambulation, the nurse stays B.) Pilocarpine
beside the client C.) Atropine SO4
D.) Promote the independence in activities of daily living D.) Timolol maleate

Ans: C Ans: C

7.) Otosclerosis is characterized by:

A.) Increased endolymphatic pressure
B.) Replacement of normal bones by spongy and highly-vascularized 14.) The client with retinal detachment had undergone scleral
bones and the stapes become fixed with the oval window buckling. The following are appropriate nursing interventions
C.) Rupture of the tympanic membrane EXCEPT:
D.) Damage of the labyrinth or acoustic nerve A.) Position the client with the area of detachment dependent
B.) Cover the eyes with pressure dressing
Ans: B C.) Advise the client to avoid reading for few weeks
D.) Encourage the client to increase fluid intake
8.) Hyperopia is corrected with that type of lens?
A.) Concave lens Ans: A
B.) Convex lens
C.) Aphakic lens
D.) Bifocal lens
15.) Which of the following is the most characteristic manifestation
Ans: B of Meniere’s Dse?
A.) Tinnitus
9.) The following are appropriate nursing interventions after cataract B.) Headache
extraction EXCEPT: C.) Vertigo
A.) Place the client in supine position or turn towards unoperated side D.) Nausea and Vomiting
B.) Advise the client to avoid bending, stooping or lifting heavy
objects for several weeks postop Ans: C
C.) Instruct the client to limit fluid intake
D.) Advise the client to protect his eyes with eye pad and eye shield
for a week
16.) The diet of the client with Meniere’s disease should be:
Ans:C A.) Low-Protein
B.) Low-fats
C.) Low-potassium
10.) The client with retinal detachment would least likely manifest D.) Low-Sodium
which of the following signs & symptoms:
A.) Floating spots before the eyes Ans: D
B.) Flashes of light
C.) Progressive constriction of vision in one area
D.) Pain in the eye
17.) Which of the following is inappropriate nursing intervention for
the client with hearing impairment: 24.) The following are characteristics of conductive hearing loss
A.) Talk in clearly enunciated words using normal tone of voice EXCEPT:
B.) Talk directly in front of the client A.) The client hears better in a noisy environment
C.) Use speech with gestures B.) The client talks in a loud voice
D.) Use high-pitch voice C.) The client hears and understands telephone conversation well
D.) The external or the middle ear is damaged
Ans: D
Ans: B

18.) Which of the following dx tests compare air conduction with 25.) It is an eye disorder characterized by lessening of the effective
bone conduction powers of accommodation:
A.) Rinne’s test A.) Myopia
B.) Weber’s test B.) Presbyopia
C.) Barany’s Rotation Test C.) Hypertropia
D.) Caloric Ice Test D.) Presbycusis

Ans: A Ans:B

19.) A client who had cataract should be told to call his MD if he has
which of the following situations? 26.) The following drugs dilate the pupils EXCEPT:
A.) Blurred Vision A.) Atropine SO4
B.) Eye Pain B.) Neosynephrine
C.) Glare C.) Scopolamine
D.) Itching D.) Pilocarpine

Ans: B

20.) The following are appropriate nursing interventions after ear

surgery EXCEPT:
A.) Position the client on the operated side
B.) Instruct the client not to blow the nose for at least 2 weeks
C.) Observe for signs and symptoms of 7th cranial nerve damage
D.) Advise the client against wathing TV or fast-moving objects for
few weeks postop

Ans: A

21.) Which of the ff test assesses visual acuity

A.) Snellen’s Test
B.) Ishihara Plate
C.) Retinoscopy
D.) Tonometry

Ans: A

22.) Which of the following nursing interventions has priority when a

client has a foreign body protruding from the eye?
A.) Irrigate the eye with sterile saline
B.) Assess visual acuity with snellen’s chart
C.) Remove the foreign body with sterile gauze
D.) Patch both eyes until seen by Opthalmologist

Ans: A

23.) A client is diagnosed with Meniere’s disease. Which of the

following nursing diagnosis should take priority for the client?
A.) Altered body image
B.) Risk for injury
C.) Impaired social interaction
D.) Ineffective coping

Ans: B