Eb. Manangan - 4b-3 Bet Q Medsurg

UNIVERSITY of the ASSUMPTION
Unisite Subdivision, Del Pilar, City of San Fernando 2000, Pampanga, Philippines
Intensive Nursing Practicum (Hospital and Community Setting)

C-NCM121RLE
ACTIVITY NO. 1
BOARD EXAM TYPE QUESTIONS
In Partial Fulfillment
of the Requirements for the
C-Related Learning Experience 121
Intensive Nursing Practicum (Hospital and Community Setting) Subject in Level 4
Submitted by:
MANANGAN, Eugene B.
BSN 4B-3
2nd Semester
Submitted to:
Mrs. Maria Ana Buenaventura RN, MAN
Clinical Instructor
Jan 30, 2023
College of Nursing and Pharmacy

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MEDICAL AND SURGICAL NURSING
MUSCULOSKELETAL
1. A 49-year-old client was admitted for surgical repair of a Colles’ fracture. An external fixator was placed during surgery.
The surgeon explains that this method of repair:
A. has very low complication rate

B. maintains reduction and overall hand function
C. is less bothersome than a cast
D. is best for older people
Rationale: Complex intra-articular fractures are repaired with external fixators because they have a better long-term outcome
than those treated with casting. This is especially true in a young client. The incidence of complications, such as pin tract
infections and neuritis, is 20% to 60%. Clients must be taught how to do pin care and assess for development of neurovascular
complications.
Correct answer: B.
A. While the external fixator may have certain benefits, it is not necessarily associated with a very low complication rate
(option A). Complications such as pin-site infections, joint stiffness, and nerve or blood vessel injuries can still occur.
C. The statement that the external fixator is less bothersome than a cast (option C) may vary depending on the individual's
experience and preferences. Some patients may find the external fixator more comfortable and convenient, while others
may prefer a cast.
D. The statement that the external fixator is best for older people (option D) may not be universally true. The choice of
treatment depends on various factors, including the severity of the fracture, the patient's overall health, and their specific
needs. Other treatment options, such as internal fixation or cast immobilization, may also be suitable for older individuals.
REFERENCES:
Hinkle J, L., K. H., & Overbaugh, K. (2021). Brunne and Suddarth’s Textbook of Medical-Surgical Nursing. LWW.
2. The nurse is performing wound care on a foot ulcer in a client with type 1 diabetes mellitus. Which technique demonstrates
surgical asepsis?

A. Putting on sterile gloves then opening a container of sterile saline.
B. Cleaning the wound with a circular motion, moving from outer circles toward the center.
C. Changing the sterile field after sterile water is spilled on it.
D. Placing a sterile dressing ½” (1 cm) from the edge of the sterile field.
Rationale: To prevent contamination and maintain a sterile environment during procedures. In this case, putting on sterile
gloves before opening a container of sterile saline helps maintain the sterility of the gloves and the saline solution.
Correct answer: A.
B. Option B, cleaning the wound with a circular motion from outer circles toward the center, describes a clean technique
rather than surgical asepsis.
C. Option C, changing the sterile field after sterile water is spilled on it, is necessary to maintain the sterility of the field after
contamination.
D. Option D, placing a sterile dressing ½” (1 cm) from the edge of the sterile field, does not specifically demonstrate surgical
asepsis. It refers to the placement of the sterile dressing within the sterile field but does not address the technique used to
maintain sterility.
REFERENCES:

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3. The nurse is assessing the casted extremity of a client. Which sign is indicative of infection?
A. Dependent edema
B. Diminished distal pulse
C. Presence of a "hot spot" on the cast
D. Coolness and pallor of the extremity
Rationale: A "hot spot" on the cast is more specifically associated with a potential infection. A "hot spot" refers to an area of
increased warmth or localized heat on the cast, which can be a sign of inflammation and infection.
Correct answer: C.
A. Dependent edema (option A) is the swelling that occurs in the dependent part of the body due to impaired circulation or
fluid accumulation. While it can be a sign of other issues, it is not specific to infection.
B. Diminished distal pulse (option B) can indicate compromised blood flow to the extremity, which can be a concern.
However, it does not specifically indicate infection and can be caused by other factors as well.
D. Coolness and pallor of the extremity (option D) can suggest impaired blood flow, but it is not specific to infection and can
be caused by various other factors.
REFERENCES:
GASTROINTESTINAL
1. The client who has had an abdominal perineal resection is being discharged. Which discharge information should the
nurse teach?
A. The stoma should be a white, blue, or purple color

B. Limit ambulation to prevent the pouch from coming off
C. Take pain medication when the pain level is at an "8"
D. Empty the pouch when it is one-third to one-half full
Rationale: Empty the pouch when it is one-third to one-half full. Regular emptying of the pouch helps maintain comfort, prevent
leakage, and ensure proper functioning of the ostomy appliance.
Correct answer: D.
A. After an abdominal perineal resection, a stoma is created, which is an opening on the abdominal wall for waste
elimination. The stoma should be observed for normal appearance and color. However, option A stating that the stoma
should be white, blue, or purple is incorrect. A healthy stoma should be pink to red in color, indicating good blood supply.
B. Option B, limiting ambulation to prevent the pouch from coming off, is not accurate. Ambulation is generally encouraged
after surgery to promote healing and prevent complications such as blood clots. The pouch is securely attached to the skin
around the stoma and should not come off with regular movement.
C. Option C, taking pain medication when the pain level is at an "8", is not appropriate. Pain medication should be taken as
prescribed by the healthcare provider, following the recommended dosage and schedule. Waiting for the pain level to reach
a specific number may result in inadequate pain control.
REFERENCES:
2. The client diagnosed with IBD (Inflammatory Bowel Disease) is prescribed total parental nutrition (TPN). Which intervention
should the nurse implement?
A. Check the client's glucose level

B. Administer an oral hypoglycemic
C. Assess the peripheral intravenous site
D. Monitor the client's oral food intake

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Rationale: Checking the client's glucose level is important when administering TPN to monitor for hyperglycemia or
hypoglycemia. TPN can significantly impact blood glucose levels, and regular monitoring is necessary to ensure that the client's
blood glucose remains within the target range.
Correct answer: A.
B. Administering an oral hypoglycemic (option B) is not appropriate in this situation since the client is receiving nutrition
intravenously and not through oral intake.
C. Assessing the peripheral intravenous site (option C) is important for any client receiving intravenous therapy, including
TPN, to ensure proper functioning of the IV line and monitor for any signs of complications.
D. Monitoring the client's oral food intake (option D) is not relevant in this case, as the client is receiving nutrition through
TPN and is not expected to have oral food intake.
REFERENCES:
3. Nurse Jopar is providing a discharge teaching to a client with chronic cirrhosis. His wife asks her to explain why there is so much
emphasis on bleeding precautions. Which of the following provides the most appropriate response?
A. “The increased production of bile decreases clotting factors.”

B. “The liver affected by cirrhosis is unable to produce clotting factors.”
C. “The low protein diet will result in reduced clotting.”
D. “The required medications reduce clotting factors.”
Rationale: In cirrhosis, the liver undergoes extensive damage and scarring, which can impair its normal functions, including the
production of clotting factors. The liver is responsible for synthesizing various clotting factors necessary for proper blood clot
formation. In cirrhosis, the liver's ability to produce these clotting factors is compromised, leading to an increased risk of bleeding
and difficulty in achieving adequate clotting.
Correct answer: B.
A. Option A, stating that the increased production of bile decreases clotting factors, is not accurate. Bile production is not
directly related to clotting factor production.
C. Option C, suggesting that a low protein diet will result in reduced clotting, is not the primary reason for bleeding
precautions in cirrhosis. While protein intake can affect clotting factors, the primary reason for bleeding precautions in
cirrhosis is the liver's inability to produce adequate clotting factors.
D. Option D, stating that the required medications reduce clotting factors, is not a general characteristic of medications used
in cirrhosis management. It is important to consider specific medications and their effects on clotting factors on a
case-by-case basis.
REFERENCES:
4. A male client undergone a colon resection. While turning him, wound dehiscence with evisceration occurs. Nurse Trix first
response is to:
A. Call the physician

B. Placed a saline-soaked sterile dressing on the wound
C. Take a blood pressure and pulse
D. Pull the dehiscence closed
Rationale: To protect the exposed organs and prevent further contamination or injury. Placing a saline-soaked sterile dressing
on the wound helps to keep the area moist, prevent the organs from drying out, and reduce the risk of infection.
Correct answer: B.
A. While it is important to notify the physician (option A) and provide a comprehensive assessment of the client's vital signs
C. (Option C), these actions should be done after the initial step of covering the wound with a sterile dressing
to protect the exposed organs.
D. Pulling the dehiscence closed (option D) is not appropriate and should not be done by the nurse. This is a surgical
intervention that should be performed by a healthcare provider in an appropriate setting.

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REFERENCES:
ENDOCRINE
1. A 21-year-old male has been seen in the clinic for a thickening in his right testicle. The physician ordered a human
chorionic gonadotropin (HCG) level. The nurse’s explanation to the client should include the fact that:
A. The test will evaluate prostatic function.

B. The test was ordered to identify the site of a possible infection.
C. The test was ordered because clients who have testicular cancer has elevated levels of HCG.
D. The test was ordered to evaluate the testosterone level.
Rationale: The test was ordered because clients who have testicular cancer have elevated levels of HCG. This information
helps the client understand the purpose of the test and its relevance to the evaluation of his condition.
Correct answer: C.
A. Option A, stating that the test will evaluate prostatic function, is incorrect. HCG is not primarily used to assess prostatic
function.
B. Option B, suggesting that the test was ordered to identify the site of a possible infection, is not accurate. HCG levels are
not typically used to diagnose or locate infections.
D. Option D, mentioning that the test was ordered to evaluate the testosterone level, is also incorrect. While HCG can affect
testosterone production, the primary reason for ordering an HCG level test in this context is to assess for testicular cancer.
REFERENCES:
2. Early this morning, a female client had a subtotal thyroidectomy. During evening rounds, nurse Tina assesses the client, who now
has nausea, a temperature of 105° F (40.5° C), tachycardia, and extreme restlessness. What is the most likely cause of these
signs?
A. Diabetic ketoacidosis
B. Thyroid crisis
C. Hypoglycemia
D. Tetany
Rationale: Thyroid crisis usually occurs in the first 12 hours after thyroidectomy and causes exaggerated signs of
hyperthyroidism, such as high fever, tachycardia, and extreme restlessness.
Correct answer: B.
A. Diabetic ketoacidosis (option a) is a complication of uncontrolled diabetes characterized by hyperglycemia, metabolic
acidosis, and ketone production. The client's symptoms are not consistent with diabetic ketoacidosis.
C. Hypoglycemia (option c) refers to low blood glucose levels, which can cause symptoms such as weakness, confusion,
and sweating. The client's symptoms are not suggestive of hypoglycemia.
D. Tetany (option d) is a condition characterized by involuntary muscle contractions due to low levels of calcium in the blood.
While tetany can occur after thyroid surgery due to hypocalcemia, the client's symptoms are more consistent with thyroid
crisis.
REFERENCES:
3. Nurse Oliver should expect a client with hypothyroidism to report which health concerns?
A. Increased appetite and weight loss

B. Puffiness of the face and hands
C. Nervousness and tremors
D. Thyroid gland swelling

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Rationale: Puffiness of the face and hands is a common symptom reported by clients with hypothyroidism. This is often due to
fluid retention, which can occur as a result of decreased metabolic rate and impaired fluid balance regulation.
Correct answer: B.
A. Increased appetite and weight loss (option a) are more commonly associated with hyperthyroidism, an overactive thyroid
gland.
C. Nervousness and tremors (option c) are also more commonly associated with hyperthyroidism, as an excess of thyroid
hormones can increase the body's metabolic rate and lead to symptoms such as nervousness, restlessness, and tremors.
D. Thyroid gland swelling (option d) is a symptom that can occur in both hypothyroidism and hyperthyroidism. However, it is
more commonly associated with hyperthyroidism, specifically in conditions such as Graves' disease.
REFERENCES:

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Eb. Manangan - 4b-3 Bet Q Medsurg

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UNIVERSITY of the ASSUMPTION

Intensive Nursing Practicum (Hospital and Community Setting)

Jan 30, 2023

College of Nursing and Pharmacy

MEDICAL AND SURGICAL NURSING

A. has very low complication rate

College of Nursing and Pharmacy

A. The stoma should be a white, blue, or purple color

A. Check the client's glucose level

College of Nursing and Pharmacy

A. “The increased production of bile decreases clotting factors.”

A. Call the physician

College of Nursing and Pharmacy

A. The test will evaluate prostatic function.

A. Increased appetite and weight loss

College of Nursing and Pharmacy

College of Nursing and Pharmacy

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