NMC MEDICAL AND SURGICAL NURSING QUESTIONS AND ANSWERS-1

NMC MEDICAL AND SURGICAL NURSING QUESTIONS AND ANSWERS-1

 

 

11. The management of diarrhea diseases includes the following

i. Chemotherapy

ii. Dietary management

iii. Rehydration therapy

iv. Symptomatic Management

a. i, ii and iii

b. i, iii and iv

c. ii, iii and iv

d. i, ii, iii and iv

 

12. When writing goal/outcomes for clients, the nurse should do which of the following?

a. Combine no more than two nursing diagnoses per goal

b. Combine related diagnoses and write a goal for this set

c. Involve the client in determining the goals/desired outcomes

d. Write goals that the treatment team believes are important.

 

 

13. The client you are assigned to has four nursing diagnoses. Which of the following would you assign the highest priority?

a. Chest pain related to cough secondary to pneumonia

b. Risk for altered family processes secondary to hospitalization

c. Self-care deficit related to activity intolerance

d. Self-esteem deficit situational

 

 

14. You are doing the evaluation step of the nursing process and find that two of the goals for the client have not been met. Which of the following actions would be the best on your part.?

a. Assess client’s motivation for complying with the care plan

b. Determine if the client has a knowledge deficit causing non attainment

c. Reassess problem, then review care plan and revise as needed

d. Stop working on these goals, as evaluation is the last step.

 

 

15. The nurse is checking the placement of nasogastric tube prior to giving medication and feeding. Which of the following is the preferred and most accurate method of testing?

a. Aspirate 20 to 30ml of gastrointestinal secretions and test the pH

b. Insert 2 to 20mm of air into the tube while listening over the stomach with a stethoscope

c. Insert 15 to 20cc of water into the stomach and listen with the stethoscope

d. Place and open end of the tube into a glass of water and check for bubbles

 

 

16. When charting in the client’s record or chart, the nurse need to do which one of the following things?

a. Chart every two hours

b. Cross out errors so others cannot read them

c. Date and sign each entry

d. Use ballpoint pen and not pencil

 

 

17. The nurse prepares a care plan for patient care to ……..

a. Change the nursing actions to improve the patient’s response

b. Determine if the patient has tolerated the care

c. Eliminate the need for the patient to make decisions

d. Promote consistency of care from nurses on all shifts

 

 

18. Diagnostic investigations of meningitis include the following EXCEPT

a. Computerized Tomography

b. Magnetic Resonance Imagining

c. Lumbar puncture

d. Ultrasonography

 

 

19. The main focus of medical asepsis is

a. Destroy all the microorganisms in the hospital setting

b. Prevent the spread of organisms from one patient to another

c. Prevent the spread of communicable disease in the community

d. Prevent any organisms from coming into contact with the patient

 

 

20. Gastric ulcer may be managed surgically using the following approaches except

a. Antrectomy

b. Billroth’s operation

c. Gastrectomy

d. Vagotomy

 

NMC MEDICAL AND SURGICAL NURSING QUESTIONS AND ANSWERS-1

 

21. Rehabilitation is necessary in fracture management to improve

a. Alignment

b. Bone healing

c. Bone strength

d. Weight gaining

 

 

22. Patient undergoing general surgery in instructed to take nothing by mouth. This is to…….

a. Make the patient relax for the surgery

b. Prevent aspiration during surgery

c. Promote early recovery from anaesthesia

d. Promote easy administration of general anaesthesia

 

 

23. Post operative thrombosis can be prevented by

i. Breathing exersices

ii. Early ambulation

iii. Passive exercise

iv. Maintenance of intake and output chart

a. i and ii

b. ii and iii

c. i, ii, and iii

d. i, ii, iii and iv

 

 

24. In managing post operative vomiting, the nurse ………

i. Passes a Ryler’s tube and aspirates often if it continues

ii. Provides light nourishing diets

iii. Provides a clean vomit bowel and mouth wash for patient each time

iv. Sets a tray for intravenous fluids to be given

a. i and iv

b. i, ii and iv

c. i, iii, and iv

d. ii, iii and iv

 

 

25. The most common cause of third day post -operative fever ………………….

a. Trauma of surgery

b. Urinary tract infection

c. Wound dehiscence

d. Wound infection

 

 

26. The nurse is ready to transfer a patient from the ward into the operating room. Which action of the nurse would be most appropriate?

a. Administer all the daily medication

b. Ensure that the client has voided

c. Practice post operative breathing exercise

d. Verify that the client has not eaten the last 24hours

 

 

27. Inflammation can be caused by a/an

i. Burn

ii. Chemical

iii. Organism

iv. Wound

a. i, ii, and iii

b. i, iii and iv

c. ii, iii and iv

d. i, ii, iii, and iv

 

28. What additional laboratory test should be performed on any African American client who sustains serious burn injury?
A. Total protein
B. Tissue type antigens
C. Prostate-specific antigen
D. Hemoglobin S electrophoresis

 

29. Which type of fluid should the nurse expect to prepare and administer as fluid resuscitation during the emergent phase of burn recovery?
A. Colloids
B. Crystalloids
C. Fresh-frozen plasma
D. Packed red blood cells

NMC MEDICAL AND SURGICAL NURSING QUESTIONS AND ANSWERS-1

30. The client with a dressing covering the neck is experiencing some respiratory difficulty. What is the nurse’s best first action?
A. Administer oxygen.
B. Loosen the dressing
C. Notify the emergency team.
D. Document the observation as the only action.

 

31. The client who experienced an inhalation injury 6 hours ago has been wheezing. When the client is assessed, wheezes are no longer heard. What is the nurse’s best action?
A. Raise the head of the bed.
B. Notify the emergency team
C. Loosen the dressings on the chest.
D. Document the findings as the only action.

 

32. Ten hours after the client with 50% burns is admitted, her blood glucose level is 90 mg/dL(5.0mmol/L). What is the nurse’s best action?
A. Notify the emergency team
B. Document the finding as the only action
C. Ask the client if anyone in her family has diabetes mellitus
D. Slow the intravenous infusion of dextrose 5% in Ringer’s lactate

 

33. On admission to the emergency department the burned client’s blood pressure is 90/60, with an apical pulse rate of 122. These findings are an expected result of what thermal injury–related response?
A. Fluid shift
B. Intense pain
C. Haemorrhage
D. Carbon monoxide poisoning

34. Twelve hours after the client was initially burned, bowel sounds are absent in all four abdominal quadrants. What is the nurse’s best action?
A. Reposition the client onto the right side.
B. Document the finding as the only action
C. Notify the emergency team
D. Notify the emergency team

35. Which clinical manifestation indicates that the burned client is moving into the fluid remobilization phase of recovery?
A. Increased urine output, decreased urine specific gravity
B. Increased peripheral edema, decreased blood pressure
C. Decreased peripheral pulses, slow capillary refill
D. Decreased serum sodium level, increased haematocrit

 

36. What is the priority nursing diagnosis during the first 24 hours for a client with full-thickness chemical burns on the anterior neck, chest, and all surfaces of the left arm?
A. Risk for ineffective breathing pattern
B. Decreased tissue perfusion
C. Risk for disuse syndrome
D. Disturbed body image

 

37. The client has experienced an electrical injury, with the entrance site on the left hand and the exit site on the left foot. What are the priority assessment data to obtain from this client on admission?
A. Airway patency
B. Heart rate and rhythm
C. Orientation to time, place, and person
D. Current range of motion in all extremities

 

38. In assessing the client’s potential for an inhalation injury as a result of a flame burn, what is the most important question to ask the client on admission?
A. “Are you a smoker?”
B. “When was your last chest x-ray?”
C. “Have you ever had asthma or any other lung problem?”
D. “In what exact place or space were you when you were burned?”

 

39. When assessing a patient with a fracture of the neck of the femur, the nurse would expect to find
A. Abduction with external rotation
B. Abduction with internal rotation
C. Lengthening of the affected limb with internal rotation
D. Shortening of the affected extremities with external rotation

 

40. Intramedullary nailing is used in the treatment of
A. Fracture of the neck of femur
B. Fracture of the shaft of femur
C. Intertrochanteric fracture of the femur
D. Slipped epiphysis of the femur

 

NMC MEDICAL AND SURGICAL NURSING QUESTIONS AND ANSWERS-1

 

41. To prevent hip flexion contractures in following amputation of the lower limb, the nurse should teach patient to
A. Lie on the abdomen 30 minutes four times daily
B. Perform quadriceps muscle setting exercise twice daily
C. Sit in a chair for 3 minutes three times daily
D. Turn from side to side three times daily

 

42. When there is a disaster involving a number of people which of the following will need a priority care? Those with;
A. Close fracture of major bones
B. Partial thickness of 10% of the body
C. Severe lacerations involving open fracture of major bones
D. Significant perforation or penetrating abdominal wounds

 

43. When changing a patient post-operative dressing, the nurse is careful not to introduce microorganism into the wound. This is an example of
A. Concurrent sepsis
B. Medical asepsis
C. Surgical asepsis
D. Wound asepsis

44. A disease occurring when a clostridium organism enters a wound producing a toxin that causes crepitus is
A. Anthrax
B. Botulism
C. Gas gangrene
D. Tetanus

 

45. An effective first aid burns treatment for alkali burns is to flush it with
A. A dilute base
B. An antibiotic solution
C. A salt solution
D. A weak acid solution

 

46. A skin graft that is taken from another portion a patient’s own body is called
A. A heterograft
B. An allograft
C. An autograph
D. A xenograft

 

47. A patient who is to receive a radiation for breast cancer says to the nurse ‘my father said I will get a radiation burns” the best response by the nurse would be
A. “ a localized skin reaction usually occurs”
B. “ daily application of emollient will prevent the burns
C. “have they had experience with this treatment before?”
D. “it would be no worse than being in a hair drier”

 

48. The immediate post-operative care for a patient who has had a colostomy performed should include
A. Keeping the skin around the stoma clean and dry
B. Limiting fluid intake for several days
C. Teach the patient how to change the colostomy bag
D. Withhold all fluid for 72 hours

 

49. As part of the preparation of patient for sigmoidoscopy the nurse should
A. Administer an enema in the morning of the test
B. Explain to the patient that he will swallow a white substance
C. Provide a container for the collection of stool
D. Withholds all fluids and food for 24 hours

 

50. Antibiotic therapy is given to patient with gastric ulcer to
A. Augment the immune system
B. Potentiate the effect of antacid
C. Reduce hydrochloric acid secretion
D. Treat helicobacter pylori infection

 

51. Following a subtotal gastrectomy for cancer of the stomach the patient develop dumping syndrome which refers to
A. Building up of gasses and faeces in the large intestine
B. Nausea due to full stomach
C. Rapid passage of osmotic fluid into the jejunum
D. Reflux of intestinal content into the oesophagus

 

52. When caring of a patient with Naso-gastric tube attached to a suction, the nurse should
A. Allow the patient to have sips of water unless nauseated
B. Irrigate the tube with normal saline
C. Use sterile technique when irrigating the tube
D. Withdraw the tube quickly when decompression is terminated

 

53. Following gastrectomy the patient may develop pernicious anaemia because of
A. Chief cells in the stomach promote the secretion of extrinsic factor
B. The haemopoietic factor is secreted in the stomach
C. The parietal cell of the stomach is not available to secrete intrinsic factor
D. Vitamin B12 is only absorbed in the stomach

 

54. A patient has been put on IV solution of 0.45% sodium chloride. This solution regarding human blood is…
A. hypotonic solution
B. hypertonic solution
C. isometric solution
D. isotonic solution

 

55. When a patient is on gastric lavage or prolong vomiting the nurse assess him for ……
A. acidosis
B. alkalosis
C. loss of osmotic pressure of the blood
D. loss of oxygen from the blood

 

56. Prolong bed rest after surgery promotes haemostasis which may result in deep vein thrombosis resulting in…
A. cerebral embolism
B. coronary occlusion
C. dry gangrene
D. pulmonary embolism

 

57. A patient who has had splenectomy would be expected to complain of?
A. Excessive moist respiration
B. Pain on expiration
C. Pain on inspiration
D. Shortness of breath

 

58. After cholecystectomy the patient diet would be?
A. High in fat and carbohydrate to meet energy demands
B. High in protein and calories to promote wound healing
C. Low in fat to avoid painful contraction of the wound area
D. Low in protein and carbohydrate to help patient loss weight.

 

59. The clinic nurse is preparing to test the visual acuity of a client using a Snellen chart. Which of the following identifies the accurate procedure for this visual acuity test?
A. Both eyes are assessed together, followed by the assessment of the right and then the left eye.
B. The right eye is tested followed by the left eye, and then both eyes are tested.
C. The client is asked to stand at a distance of 40ft. from the chart and is asked to read the largest line on the chart.
D. The client is asked to stand at a distance of 40ft from the chart and to read the line that can be read 200 ft away by an individual with unimpaired vision

 

60. . Aling Martha, a 73-year-old widow, tells to the nurse during the admission process that she was recently diagnosed with age-related hearing loss. Upon receiving such information, the nurse is correct if he suspects?
A. Meniere’s disease
B. Otalgia
C. Otitis media
D. Presbycusis

 

NMC MEDICAL AND SURGICAL NURSING QUESTIONS AND ANSWERS-1

 

61. For a client diagnosed with epistaxis, which intervention would be included in the care plan?
A. Performing several abdominal thrust (Heimlich) maneuvers
B. Compressing the nares to the septum for 5 to 10 minutes
C. Apply an ice collar to the neck area
D. Encouraging warm saline throat gargles.

 

62. The nurse is caring for a preoperative patient. The patient asks the nurse what types of anaesthesia cause a loss of sensation in a specific area of the body while the patient remains alert. Which of these responses should the nurse give?
I. “Epidural anaesthesia.”
II. “General anaesthesia.”
III. “Local anaesthesia.”
IV. “Spinal anaesthesia.”
A. I, II and IV
B. I, II and III
C. II, III and IV
D. I, III and IV

 

63. The nurse is caring for a patient after a hernia repair who reports pain of 4 on a 0 to 10 scale. The patient’s orders include ibuprofen (Motrin) 400 mg orally every 6 hours prn for pain. Which of the following actions should the nurse take?
A. Start the ibuprofen on the second postoperative day.
B. Hold the ibuprofen due to risk of gastrointestinal (GI) upset.
C. Give the ibuprofen as ordered for pain
D. Consult the physician for a stronger analgesic.

 

64. The nurse recommends early ambulation as ordered be included in the patient’s plan of care. Which of the following can be prevented by early ambulation?
A. Increased peristalsis
B. Coughing
C. Thrombophlebitis
D. Impaired wound healing

 

65. The nurse is contributing to the intraoperative plan of care for a patient undergoing an appendectomy. Which of these would be an intraoperative outcome for this patient?
A. Verbalizes fears
B. Demonstrates leg exercises
C. Remains free from injury
D. States understanding of discharge instructions

 

66. The nurse is caring for a patient who has developed an increased temperature during the first 24hours postoperatively. Which of these actions is a priority for the nurse to take?
A. Providing passive range of motion exercises
B. Encouraging coughing and deep breathing
C. Giving antipyretic medication
D. Restricting oral fluids

 

67. The nurse is caring for a patient 23 hours after abdominal surgery. Which of the following patient data collection findings would require the nurse to take action?
A. Hypoactive bowel sounds in four quadrants
B. Report of flatus
C. Lack of appetite
D. Abdominal distention

 

68. The nurse is contributing to the preoperative patient’s plan of care. Which of these statements by the patient would alert the nurse to plan interventions to help prevent postoperative complications?
A. “I am 60 years old and in good health.”
B. “This is my second surgery in 2 years.”
C. “I have not had anything to eat or drink for 8 hours.”
D. “I have chronic obstructive pulmonary disease.”

 

69. The nurse assists in preparing patients for surgery. Which of these patients would the nurse recognize as being in the best condition for surgery and at lower risk for complications?
A. A 23-year-old patient 30 pounds less than ideal weight
B. A 40-year-old patient who plans to quit smoking after surgery
C. A 55-year-old patient who is a marathon runner
D. A 66-year-old patient who is obese

 

70. The nurse is caring for a patient who is to have a liver biopsy. The nurse recognizes that this is an example of which category of surgical procedures?
A. Diagnostic
B. Preventive
C. Curative
D. Palliative

NMC MEDICAL AND SURGICAL NURSING QUESTIONS AND ANSWERS-1

71. A client has a tumour of the posterior pituitary gland. A nurse planning his care should include all the following EXCEPT?
A. Measure urine specific gravity
B. Monitor intake and output
C. Restrict fluids
D. Weigh the client daily

 

72. A client who is experiencing colon cancer is scheduled to undergo a colostomy. All the following interventions are appropriate to include in a preoperative teaching plan except?
A. Arrange for an enterostormal therapist to speak with the client about colostomy care
B. Encourage the client to express his feelings about changes in his body image
C. Encourage the client to rate his current level of discomfort on a 0-to-10
D. Explain the need for early postoperative ambulation

 

73. The correct procedure for auscultating the client’s abdomen for bowel sounds would include:
A. Encouraging the client to cough to stimulate movement of fluid and air through the abdomen
B. Listening for 5minutes in all four quadrants to confirm absence of bowel sound
C. Palpating the abdomen first to determine correct stethoscope placement
D. Placing the client on the left side to aid auscultation

 

74. A client is admitted to the hospital with a diagnosis of a right hip fracture. She complains of right hip pain and cannot move her right leg. Which of the following assessments made by the nurse indicates that the client has a typical sign of hip fracture? The client’s right leg is:
A. Adducted
B. Held in a flexed position
C. Rotated internally
D. Shorter than the leg on the unaffected side

 

75. Which of these may be given if urinary output is inadequate (less than 25mls an hour) in a 30 year old man with burns, despite adequate fluid replacement?
A. Dextrose in saline
B. Mannitol
C. Normal saline
D. Ringers lactate

 

76. Which of the following assessments would be important for the nurse to make to determine whether or not a client is recovering as expected from spinal anaesthesia?
A. Rate of capillary refill in the toes
B. Rate and depth of respirations
C. Level of consciousness
D. Degree of response to pinpricks in the legs and toes

 

77. The nurse has instructed the client about the correct positioning of his leg and hip following hip replacement surgery. Which of the following statements indicate that the client has understood these instructions?
A. I should avoid bending over to tie my shoe
B. I should avoid any unnecessary walking for about 3 months after my surgery
C. I may cross my legs as long as I keep my knees extended
D. I can sit in any chair that I find comfortable

 

78. An autograft is taken from the client’s left leg. The nurse should care for the donor site by
A. Applying a pressure dressing
B. Covering it with an occlusive dry dressing
C. Keeping the site clean and dry
D. Wrapping the extremity with an elastic bandage

 

79. The client has a nursing diagnosis of Constipation related to decreased mobility secondary to traction. A care plan that incorporates which of the following breakfasts would be most helpful in re-establishing a normal bowel routine?
A. An orange, raisin bran and milk, and wheat toast with butter
B. Corn flakes with sliced banana, milk and English muffin with jelly
C. Eggs and bacon, buttered white toast, orange juice and coffee
D. Orange juice, breakfast pastries (doughnut and Danish) and coffee

 

80. Which of the following observations should the post anesthesia care unit (PACU) nurse plan to make first when the client who has had a modified radical mastectomy returns from the operating room?
A. Checking the client’s dressings for drainage
B. Ensuring that the client’s airway is free of obstruction
C. Observing that drainage tubes are patent and functioning
D. Obtaining and recording vital signs

 

NMC MEDICAL AND SURGICAL NURSING QUESTIONS AND ANSWERS-1

 

81. A client is scheduled for radical neck surgery and a total laryngectomy. During the preoperative teaching, the nurse should prepare the client for which of the following postoperative possibilities?
A. Endotracheal intubation
B. Gastrostomy tube
C. Immediate speech therapy
D. Insertion of laryngectomy tube

 

82. The development of laryngeal cancer is most clearly linked to which of the following factors?
A. Overuse of artificial sweeteners
B. Low socioeconomic status
C. High-fat, low-fiber diet
D. Alcohol and tobacco use

 

83. An anticipated outcome for the client after cataract removal surgery would include which of the following?
A. The client describes methods to prevent an increase in intraocular pressure
B. The client states her infection is under control
C. The client states her vision is clear
D. The client states she is able to administer parenteral pain medication

 

84. A client is recovering from a gastric resection for peptic ulcer disease. Which of the following outcomes indicates that the goal of adequate nutritional intake is being achieved 3 weeks following surgery?
A. Increases food intake and tolerance gradually
B. Experiences occasional episodes of nausea and vomiting
C. Experiences a rapid weight gain within 1 week
D. Drinks 2000 mL/day of water

 

85. What would be the most important nursing intervention in caring for the client’s residual limb during the first 24 hours after amputation of the left leg?
A. Keeping the residual limb flat on the bed
B. Elevating the residual limb on a pillow
C. Applying traction to the residual limb
D. Abducting the residual limb on a scheduled basis

 

86. After the client returns from surgery for a deviated nasal septum, the nurse would anticipate placing her in what position?
A. Supine
B. Semi-Fowler’s
C. Reverse Trendelenburg’s
D. Left side-lying

 

87. While suctioning a client’s laryngectomy tube, the nurse inserts the catheter?
A. Until the client begins coughing
B. Until resistance is met, then withdraw it 1-2 cm
C. As the client exhales
D. About 1-2 inches

 

88. When caring for road traffic accident victims the nurse would prioritise care and provide treatment first for a patient with
A. A fractured femur
B. A penetrating abdominal wound
C. Head injury
D. Ventricular fibrillation

 

89. A 65 year old is exhibiting signs of confusion and has a temperature of 40oC. He is diabetic with purulent drainage from her right big toe. His blood pressure is 70/40mmHg. His pulse is 100bpm and respiration rate is 42cpm. The patient’s symptoms are indicative of which type of shock?
A. Septic
B. Neurogenic
C. Hypovolaemic
D. Anaphylatic

 

90. On the fourth postoperative day, a chest catheter is removed from a patient who had lung surgery. It is important to observe the patient for the possible development of which of these complications?
A. Hemothorax
B. Pleural effusion
C. Pneumonia
D. Tension pneumothorax

 

91. A nurse is caring for a client who underwent surgical repair of detached retina in the eye. Which of the following interventions is the nurse NOT required to perform?
A. Administer stool softeners
B. Discourage bending down
C. Encourage deep breathing and coughing
D. Orient the client to his environment

 

92. A nurse in planning care for a client with hyperthyroidism. Which of the following nursing interventions is least appropriate?
A. Instill isotonic eyedrops as necessary
B. Keep the environment warm
C. Provide rest periods
D. Weigh the client daily

 

93. A client who is receiving chemotherapy for breast cancer develops myelosuppression. Which of the following instructions should the nurse NOT include in the client’s discharge teaching plan?
A. Avoid activities that may cause bleeding
B. Avoid crowded places such as shopping malls
C. Increase intake of fresh fruits and vegetables
D. Wash hands frequently

 

94. The development of cervical carcinoma is usually associated with one of the following predisposing agent.
A. Epstein Barr Virus
B. Herpes Simplex Virus
C. Human Papilloma Virus
D. Helicobacter Pylori

 

95. A malignant tumor__________.
A. is usually slow growing
B. grows by expansion
C. gains access to the blood and lymphatic channels
D. demonstrates cells that are differentiated

 

96. A contracture is?
A. A result of necrosis of the skin adjacent to a wound
B. A result of infected cavity beneath the skin
C. A contraction of scar tissue across joints
D. A condition of excessive thickening of a scar

 

97. Which of the following is  NOT a chemical mediator of inflammation?
A. Serotonin
B. Prostagladin
C. Hystamine
D. Neutrophils

 

98. Which of the following forms of healing occurs with wounds that are aseptically made with minimal tissue destruction?
A. Healing by 3rd intention
B. Healing by 2nd intention
C. Healing by 1st intention
D. Healing by 4th intention

 

99. Proper attire for the semi restricted area of the surgery department is……………
A. street clothing
B. street clothing with the addition of shoe cover
C. surgical attire and head cover
D. surgical attire, head cover and mask

 

100. Important nursing roles related to prevention and detection of cancer include……………
A. instructing people to eat low-fibre refined-carbohydrate diets
B. instructing persons on ways to increase capacity to cope with able cancer
C. teaching people to have annual screening tests for all detectable cancer sites
D. using people’s natural fear of cancer to motivate changes in unhealthy lifestyle

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