IEPN 150 Medical-Surgical Practice Test Questions and answers best guaranteed Success Late, Exams of Nursing

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 Larry, 5 years old is admitted with chickenpox. His vital signs are T 102.3°F; HR 110 bpm; RR 24/min. To appropriately control the spread of infection, the nurse would implement which of the following precautions? a. Respiratory isolation. b. Airborne precaution. c. Contact precaution. d. Reverse isolation. Answer: C  Sandra is admitted with diagnosis of Angina Pectoris. The physician ordered NTG 1 tablet sublingually PRN for chest pain. Potency of NTG should be questioned when: a. Pain relief is delayed. b. Tingling sensation was not experienced by the patient. c. The patient was complaining of headache. d. The blood pressure drops to 80/60. Answer: A  Jennifer has now fully recovered from Anorexia Nervosa and is now ready to be discharged to home. Her self-esteem is much improved and the nutritionist is willing to work with her food choices. The nurse who is aware that the client has become a lacto-vegetarian will

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suggest which of the following food menus? a. Baked chicken, rice, yogurt, fruit. b. Yogurt, fresh fruit, vegetable. c. Scrambled eggs, bread, fresh fruits, vegetables. d. Fresh fruits, spinach, broccoli, sea foods.  How can the nurse assist the patient to die without having her license revoked? a. Give lethal injection. b. Remove the non-rebreather mask. c. Place the patient in the palliative care. d. Do not allow the patient to drink. Answer: B  After a right total knee replacement, the client’s right leg is placed in a continuous passive motion (CPM) machine. Nursing responsibilities when caring for a client with this apparatus would include which of the following? a. Adjusting the settings as needed to prevent client discomfort. b. Increasing the range-of-motion settings at least every 8 hours. c. Maintaining proper positioning on the CPM machine. d. Discontinuing the CPM therapy when the client’s range- of-motion increases.

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Answer: C—the nurse must frequently evaluate the positioning of the client’s leg, the range-of-motion setting, and the client’s response to the therapy.  When administering an IM injection to a neonate, which of the following muscles would the nurse consider as the best injection site? b. Deltoid c. Dorsogluteal d. Ventrogluteal e. Vastus lateralis Answer: D—the vastus lateralis has less danger of injuring nerves, blood vessels, or bony structures at this site.  A client is scheduled to undergo an abdominal perineal resection with a permanent colostomy. Which of the following measures would be an anticipated part of the client’s preoperative care? a. Keep the client NPO for 24 hours before surgery. b. Administer neomycin sulfate the evening before surgery. c. Inform the client that TPN will likely be implemented after surgery. d. Advise the client to limit physical activity. Answer: B—to decrease the colon’s bacterial count.

IEPN 150 Medical-Surgical Practice Test Questions

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 Which of the following physical findings would the nurse consider suggestive of physical abuse? a. Lacerations to the knees. b. Laceration to the chin. c. Bruises on the forearms and elbows. d. Bruises on the abdomen. Answer: D  When an RN is suspicious of child abuse the responsibility of the nurse is to: a. Tell the doctors. b. Ask the parents what is the problem. c. Contact the state authorities. d. Tell the nursing supervisor. Answer: C—legal  Which of the following children would be most at risk for abuse? a. The child of a teenager who lives with her family and boyfriend. b. The child of new immigrant who is living with a large group of immigrants in the community. c. The child of a newly divorced parent who has been having difficulty paying the bills. d. The child of parents who travel frequently for business and leave the child with a caretaker.

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Answer: C  Which of the following children in this group would the nurse identify at risk for abuse? a. A 4-year-old with Cerebral Palsy and requires 24-hour care. b. A child with Leukemia who requires frequent hospitalization. c. A child who lives with a parent who has AIDS. d. A child who hits his sisters and brothers for attention. Answer: A  A 10-year-old girl has just been diagnosed with diabetes. Which of the following developmental tasks may not be accomplished due to the new challenge? a. Industry. b. Autonomy. c. Independence. d. Trust. Answer: A—school age children.  A 5-year-old who is hospitalized wakes up in the middle of the night crying that he is seeing monsters. What should the nurse do? a. Call the MD and ask for an order for a sedative. b. Close the door to reduce noise. c. Tell him you will remove the monster from the room so he will be

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safe. d. Tell him that monsters are not real and comfort him. Answer: D  An example of a child displaying the task of autonomy would be: a. Negativism of toddlers. b. Stranger anxiety. c. Competitive sports. d. Peer dressing alike. Answer: A—allows the child gaining control over his environment.  What is the most appropriate way to take the temperature of an 18- month-old with severe diarrhea? a. Rectal b. Oral c. Axillary d. Do not take the temperature. Answer: C

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A client with iron-deficiency anemia is prescribed liquid iron supplements. The nurse evaluates the client’s understanding of how to take this drug. Which of the following statements indicates the client has adequate knowledge? “I can use antidiarrheal drugs if I develop diarrhea.” “I will report any black stools to the physician.” “I will check my gums for any bleeding.” “I will dilute the medication and drink it with a straw.” Answer: D— it help decrease the likelihood of staining the teeth. Clients with diabetes mellitus require frequent vision assessment. The nurse should instruct the client about which of the following eye problems most likely to be associated with diabetes mellitus? Cataracts Retinopathy Astigmatism Glaucoma Answer: B—this is the major cause of blindness. Which of the following interventions will assist the client in taking Dilantin as prescribed? Calling him daily for the first week after hospital discharge. Having a family member monitor him to ensure compliance. Providing him with written and verbal instructions about the medicine. Emphasizing that embarrassing seizures may occur again if he does not have the medicine. Answer: C—this will increase understanding of the medication regimen. The initial BP of a client with head injury is 124/80 mmHg. As his condition worsens, pulse pressure increases. Which of the following BP readings indicates a pulse pressure greater than the initial pressure? a. 102/60 mmHg. b. 110/90 mmHg. c. 140/100 mmHg. d. 160/100 mmHg. Answer: D—PP is 44. The nurse assesses the client’s colostomy stoma for edema. Which of the following signs and symptoms might indicate excessive stomal edema? Elevated temperature. Continuo us watery drainage. Complai nts of discomfo rt around the stoma. Absence of drainage from the ileostom y. Answer: D—signs of blockage. To more easily remove thick, tenacious secretion s when suctionin g a tracheost omy, the nurse should liquefy the secretion s before suctionin g by instilling the tracheost omy tube with 1 to 2 ml of sterile: Water Normal Saline Bacteriostatic Diluted hydrogen peroxide. Answer: B—less irritating to mucous membranes than the others. An elderly client in the medical floor has IV infusion of

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⅔ & ⅓ NS 100 cc to

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run for 12 hours. The IV tubing delivers 20 to 21 gtts./minute. What would be a significant finding if the IV is infiltrated? Skin is warm to touch with slight bleeding and swelling. Skin is warm to touch, swelling, slight bleeding at the insertion site. Skin is cold to touch, slight bleeding at the site and swelling. Skin cold to touch, swelling, decreased flow rate, pain at the site. Answer: D As the community health nurse follows up on a case, one her assigned clients in the community, a 16 year-old girl asks, “What will be my next dose of immunization?” The nurse’s most appropriate response is: Booster on DPT and chickenpox vaccine. DPT, HIB, Hepatitis B vaccine. Second dose of DPT, Polio, and HIB. Measles, Mumps, Rubella Vaccine. Answer: B A community health who is giving health teaching on disease prevention has appropriately shared information about chickenpox vaccine when she says Children under 12 years of age should receive one dose. Infants and children should receive 2 doses. The vaccine is 70% to 90% effective in preventing the disease. It is recommended to all children younger than 18 years of age. Answer: C Which of the following goals would be appropriate for the client with hepatitis B? Measures to prevent the spread of infection. Low Na+, low protein diet. Use of sedatives for sleep problem. Avoid social activities with friends. Answer: A—to prevent the spread of infection.  Which of the following expected outcomes would be appropriate for the client who has ulcerative colitis? a. The client maintains a daily record of intake and output. b. The client verbalizes the importance of small, frequent feedings. c. The client uses a heating pad to decrease abdominal cramping. d. The client accepts that a colostomy is inevitable at some time in his life. Answer: B—to decrease GI stimulation.

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 An essential aspect of the plan of care for the client after cataract removal surgery would be to: a. Increase cardiac output. b. Prevent fluid volume excess. c. Maintain a darkened environment. d. Promote safety at home. Answer: D—to reduce risk of injury.  Which of the following nursing diagnoses would receive the greatest priority in the care of an unconscious client with a head injury? a. Impaired gas exchange related to shallow irregular breathing b. Risk for injury related to disorientation and decreased level of consciousness c. Disturbed Sensory Perception related to decreased level of consciousness d. Ineffective Airway Clearance related to inability to remove respiratory secretions. Answer: D  A child newly diagnosed with rheumatic fever is to receive penicillin therapy. Which of the following statements by the parents would

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lead the nurse to judge that the parents understand the teaching about penicillin as part of the treatment plan for rheumatic fever.

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a. “Our child should take the medication until the physician discontinues it b. “How long will it take for the penicillin to help relieve the joint discomfort” c. “We need to also give these pills to our other children to prevent them from getting rheumatic fever” d. “We should give our child the medication on a full stomach” Answer: A  Which of the following would the nurse interpret as indicating that a child is receiving too much intravenous fluid too rapidly? a. Marked increase in abdominal girth b. Evidence of protein in the urine c. Dark amber colored urine d. Moist crackles in the lung fields Answer: D  The nurse is assessing the breath sounds of a client with emphysema. The nurse understands that the client’s respiratory status is affected by what primary pathophysiologic changes? a. Constricted airspaces in the lungs b. Destruction of alveolar walls

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c. Elevation of the diaphragm d. Increased airflow out of the lungs Answer: B  Which of the following signs and symptoms would alert the nurse to possible internal bleeding in a client who has undergone pulmonary lobectomy? a. Increased blood pressure and decreased pulse and respiratory rates b. Sanguineous drainage from the chest tube at a rate of 50 ml per hour during the past 3 hours. c. Restlessness and shortness of breath d. Urine output of 180 ml during the past 3 hours? Answer: C  The client would be experiencing a typical symptom of Meniere’s disease if, before an attack, he experienced : a. A severe headache b. Blurred vision c. Nausea d. A feeling of inner ear fullness Answer: D  During the conversation with the nurse, a victim of physical abuse

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says, “Let me try to explain why I stay with my husband .” Which of the following reasons would the client be least likely to mention? a. “I’m responsible for keeping my family together” b. “When it’s not too bad, the abuse adds spice to our relationship”

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c. “I love my husband” d. “I’m not sure I could get a job that pays a minimum wage” Answer: B  The nurse checks the client’s gag reflex. The recommended technique for testing the gag reflex is to : a. touch the back of the client’s throat with a tongue depressor b. observe the client for evidence of spontaneous swallowing when the neck is stroked. c. Place a few milliliters of water on the client’s tongue and note whether or not he swallows d. Observe the client’s response to the introduction of a catheter for endotracheal suctioning Answer: A  A client is intrusive and disruptive to other clients. He constantly walks about the unit interrupting others. Which plan should the nurse institute first in this situation? a. Escort the client to his room and explain that he cannot come out until he gets permission b. Set limits on the client’s behavior. Explain what is expected and what the consequences will be if limits are violated c. Ask another staff member to take the client to watch television

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for the next hour d. Bargain with the client. Explain which privileges he can attain if he can control his behavior Answer: B  When developing a plan of home care for the client with multiple sclerosis, the nurse should teach the client about which of the following complications most likely to occur? a. Ascites b. Contractures c. Fluid volume overload d. Myocardial infarction Answer: B  What client date would be most important for the nurse to consider in deciding to institute suicide precautions because of high-risk behavior? The client: a. State that he still has thoughts of harming himself but feels he can control them. b. States that he is worried about his child’s reaction c. Expresses guilt and shame about trying to harm himself d. Has recently attempted suicide with a lethal method Answer: D

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 A 34-year-old Russian female client who speaks very little English comes for check up and counseling. The nurse communicates with the client through an interpreter. On the 3rd^ visit, the nurse realizes that a nurse-client relationship has not been established yet. Which of the following nursing intervention taken by the nurse is most appropriate? a. Revalidate with the interpreter the client’s first impressions and expectations. b. Provide informative materials in the patient’s own language. c. Transfer the care to the client’s own culture in the community. d. Use gestures and non-verbal communication techniques in communicating with her. Answer: A  Nursing goal set for a client who only speaks Chinese is, “To establish a therapeutic nurse-client relationship.” The nurse who does not speak Chinese will do which of the following? a. Call for an interpreter. b. Transfer the client to the medical unit in which one of the nurses’ speaks the client’s language. c. Communicate with the client through sign language. d. Maintain eye contact when communicating with the client. Answer: A

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 Mrs. Brooks is an elderly female client who is actively participating in the rehab program at a certain facility. She expresses her desire to live by herself and thus would like to re-learn some of her skills. Important nursing action taken by the nurse would include: a. The nurse develops goals and objectives for the client. b. The client was referred to the community support group. c. The nurse and the client together makes inventory of the client’s skills which needed to be developed. d. The client was asked to make a list of the skills she would like to develop. Answer: C  The daughter of a diabetic client expresses her interest in learning how to give insulin to her mother. Which action taken by the nurse is appropriate? a. Determine what the daughter would like to know about diabetes. b. Teach the daughter the proper way of administering insulin. c. Supply the daughter with written learning materials. d. Provide the daughter brochure about diabetes. Answer: B  The daughter of the client with diabetes would like to know the proper way of doing the dressing on her mother’s leg ulcer. The nurse who taught the client’s daughter about dressing changes validates the

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learning by: a. Give the daughter opportunity to demonstrate how dressing is done.

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b. Allow the daughter to observe how dressings are changed. c. Ask the daughter discuss, in great detail, how dressings are done. d. Administer a written test to the daughter. Answer: A  A newly graduate nurse admitted a patient with certain diagnosis. The new graduate nurse will do which of the following to learn more about the patient’s diagnosis by: a. Obtain information from the patient’s family. b. Obtain information from the physician. c. Get a reference book and read about the diagnosis. d. Get information from your colleagues. Answer: C  Mr. Osborne who is assisting his wife in the labor, already on the second stage of labor, would like to go out to get a cup of coffee. The nurse will a. Tell the husband to stay with his wife. b. Get the husband a cup of coffee or juice. c. Tell the husband to inform his wife. d. Tell the husband that you can buy him coffee. Answer: C

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 Richard Torre, 33 years old, had undergone abdominal surgery for transverse colostomy. He was looking at the colostomy and listening very intently with the nurse’s explanation on how to do colostomy care when all of a sudden he turns his head away from the wound and closed his eyes. Interpretation made by the nurse on the patient’s behavior will be: a. The patient may not be ready yet to learn colostomy care. b. The patient intentionally ignores the nurse. c. The patient is too comfortable to the care given by the nurse. d. The patient refuses to learn. Answer: A  A group of teenagers with diabetes is gathered in the meeting hall of the community health center. How would the nurse assess the teenagers’ knowledge on their health condition? a. Allow the teenagers to eat whatever they want. b. Allow them to choose the food they like from a prepared menu. c. Call the dietician for nutrition education. d. Provide them information about Canada Food Guide. Answer: B  Who of the following patients is very prone to testicular cancer? a. A 28-year-old male who had undergone an orchiopexy when he

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was 5 years old. b. A 65-year-old male with enlarged prostate. c. A 70-year-old male with gynecomastia.

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d. A 50-year-old who has history of STDs. Answer: A  Nicholas, a 65-year-old male patient, was admitted with a diagnosis of fibromyalgia. Nursing interventions include therapeutic touch. The nurse will define therapeutic touch to the patient as: a. “This is the application of firm massage to soft tissues in the body.” b. “It is a body scrub-like massage that promotes relaxation of tensed muscles.” c. It is a process of transferring energy drawn from the client’s immediate surroundings and done through the healer’s moving hands.” d. It requires the use of electrical stimulation which blocks the client’s awareness of the disease.” Answer: C  Based on the findings on the recent research done, a staff nurse strongly believes that the unit protocol must be changed. Nursing action implemented to initiate a change would include: a. Approach the nursing manager and show her the critique of the article. b. Lead out in lobbying to gain support for the desired change.

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c. Present a revised protocol to the unit manager. d. Contact the author of the research and explore important strategies in implementing change. Answer: D  The relationship of nurses and doctors in a healthcare facility was strained due to some disagreement on certain medical protocol. What best approach would be helpful in resolving the conflict? a. Nurses and doctors should meet to discuss the issue. b. The doctors should be reported to medical regulatory board. c. Encourage patients to refuse signing the consent. d. Discuss the nursing concern with the unit manager. Answer: A  The community health nurse is visiting an elderly male client who is receiving palliative care. The client complains about his doctor and says to the nurse, “My doctor does not know anything. There’s nothing wrong with me. Look, I am stronger and I am going to be just fine in a month or so.” The most appropriate response made by the nurse would be: a. Say nothing. Listen to the client as he expresses his feelings of denial. b. Tell the client that he might be right.

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c. Ask the client if he is feeling angry. d. Tell the client to speak with his doctor. Answer: A  Lucy received the following patient report from the outgoing shift:

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