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NMC MEDICAL AND SURGICAL NURSING QUESTIONS AND ANSWERS SOLUTION-2

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NMC MEDICAL AND SURGICAL NURSING QUESTIONS AND ANSWERS SOLUTION-2

1. Varicose veins can recur in other veins after surgery. What types of veins are commonly varicose?
A. Calf veins
B. Lesser saphenous veins
C. Reticular veins
D. Spider veins

2. When a thrombus develops initially in the veins as a result of stasis or hypercoagulability but without inflammation, the process is referred to as………..
A. deep vein thrombosis
B. phlebothrombosis
C. thrombophlebitis
D. venous thrombosis

3. In constrictive pericarditis, the inflammation of the pericardium is characterized by all the following except?
A. Contracture
B. Kussmaul’s sign
C. Scarring
D. thickening

4. The Virchow’s triad plays a significant role in the development of deep vein thrombosis. They include………
I. Hypercoagulability of blood
II. Drug usage
III. Venous stasis
IV. Vessel wall injury

A. I and II only
B. I, II and III only
C. I, II and IV only
D. I, III and IV only

5. The nurse can best explain positive Pratt’s sign of a person suffering from Deep Vein Thrombosis (DVT) to a junior Nurse by saying there is
A. calf pain associated with dorsiflexion of the leg
B. calf pain associated with walking
C. pain that occur with squeezing the calf
D. pain with abduction of the limb

6. The type of non -small lung cancinoma that develop from mucus producing (glandular cell) is?
A. Adenocarcinoma
B. Large cell carcinoma
C. Small cell carcinoma
D. Squamous cell carcinoma

7. Parts of the abdominal hernia may include the following EXCEPT?
A. Body
B. content
C. Neck
D. Omphalocele

8. Fractures of the lower ribs are associated with injury to which of the following organs?
A. diaphragm and stomach
B. kidneys and liver
C. lungs and heart
D. spleen and liver

9. A trauma client is admitted to the emergency room following a motor vehicle accident. Examination reveals that the left side of the chest moves inward when the client inhales. The findings is suggestive of
A. Flail chest
B. Mediastinal shift
C. Pneumothorax
D. Pulmonary contusion

10. All the following are signs and symptoms of late lung cancer EXCEPT?
A. Dysphagia
B. Dyspnea
C. Facial paralysis
D. Joint pain

11. A volvulus can be explained as
A. a loop of bowels causing obstruction
B. a protrusion of an organ through the walls that contains it.
C. telescoping of a proximal loop of bowel into a distal loop causing obstruction
D. twisting of a loop of bowels causing obstruction

12. In appendicitis, pain is felt in the right lower quadrant of the patient’s abdomen when the left lower quadrant is palpated. This is known as?
A. Brudzinskins’s sign
B. McBurney’s point
C. rebound tenderness
D. Rovsing’s sign

13. Which of the under listed may be manifestation of a duodenal ulcer?
A. Vomiting after meals
B. Hematemesis
C. Pain relieved by food ingestion
D. Pain half hour after meals

14. The nurse is assessing a patient for constipation. Which of the following is the first review that the nurse should conduct in order to identify the cause of the constipation?
A. activity levels
B. alcohol consumption
C. current medication
D. usual pattern of elimination

15. The nurse understands that the diagnosis of oral cancer is confirmed with?
A. Biopsy
B. Gram Stain
C. Oral culture
D. Oral washings for cytology

16. Which of the following lab studies should be done periodically if the client is taking warfarin sodium?
A. Blood glucose
B. Erythrocyte count
C. Stool specimen for occult blood
D. White blood cell count

17. In managing a patient with constrictive pericarditis, the goal of the nurse is to…………..
A. control pain
B. improve heart function
C. prevent dyspnea
D. reduce edema

18. A client with an inguinal hernia asks the nurse why he should have surgery when he has had a hernia for years. The nurse understands that surgery is recommended to?
A. Decrease secretion of bile salts
B. Increase intestinal motility
C. Prevent strangulation of the bowel
D. Prevent malabsorptive disorders

19. In managing a patient with varicose veins, which of the following lifestyle changes would you NOT recommend for him/her?
A. avoid wearing high heels for long periods
B. engage in physical activities
C. use of compression stockings
D. wear tight clothing only in the day

20. Which of the following medications would not be recommended in managing deep vein thrombosis in a pregnant woman?
A. low molecular weight heparin
B. staphylokinase
C. standard heparin
D. warfarin

21. Which of the under listed type of cancer is strongly related to cigarette smoking?
A. adenocarcinoma
B. large cell carcinoma
C. non-small cell lung cancer
D. small cell lung cancer

22. The nurse assesses a patient for a possible pulmonary embolism. The nurse looks for the most frequent sign of?
A. Cough
B. haemoptysis
C. syncope
D. tachypnea

23. The client pulls out the chest tube and fails to report the occurrence to the nurse. When the nurse discovers the incidence, he should take which initial action?
A. Call the doctor
B. Cover the insertion site with Vaseline gauze
C. Order a chest x-ray
D. Reinsert the tube

24. The condition that occurs when air escapes from a laceration in the lung itself and enters the pleural space is known as?
A. chylothorax
B. spontaneous pneumothorax
C. tension pneumothorax
D. traumatic pneumothorax

25. The nurse is assessing a trauma client in the emergency room when she notes a penetrating abdominal wound with exposed viscera. The nurse should?
A. Apply a clean dressing to protect the wound
B. Cover the area with petroleum gauze
C. Cover the exposed viscera with sterile saline gauze
D. Gently replace the abdominal contents

26. As a result of a fractured rib the patient may develop ?
A. Herniation of the diaphragm
B. Obstructive lung disease
C. Pneumothorax
D. Scoliosis

27. Following subtotal gastrectomy for cancer of the stomach the patient develops dumping syndrome. The nurse would explain this to the junior nurse as?
A. Build-up of faeces and gas within the large intestine
B. Nausea due to a full stomach
C. Rapid passage of osmotic fluid into the jejunum
D. Reflex of the intestinal contents into the esophagus

28. The organism commonly identified and implicated in the peptic ulcer disease is?
A. E.coli
B. Fosubacterium
C. Helicobacter pylori
D. Rotavirus

29. Which of the following is the commonest complication likely to occur in patients diagnosed with deep vein thrombosis (DVT)?
A. Angina Pectoris
B. Oesophageal Atresia
C. Pulmonary Embolism
D. Thromboplebitis

30. Which of the following pulmonary condition creates its own cavitation?
A. Bronchogenic carcinoma
B. Emphysema
C. Epyema
D. Lung abscess

31. A 2-year-old is hospitalized with suspected intussusceptions. Which finding is associated with intussusceptions?
A. ‘‘currant jelly” stools
B. palpable mass over the flank
C. projectile vomiting
D. “Ribbonlike” stools

32. 40 year old woman has been scheduled for Myomectomy. Why is it necessary for this client to be admitted preoperatively prior to the surgery?
A. To identify the problems that may increase the operative risk and predispose client to postoperative problems.
B. To prevent the problems that may increase the operative risk.
C. To reduce the problems that may increase the operative risk.
D. To treat the problems that may increase the operative risk and predispose client to postoperative problems.

33. The nursing activities during preoperative phase include all the following EXCEPT?
A. Assessment
B. Identification of actual/potential health problems
C. Identification of surgical complications
D. Plan of care based on individual health needs

34. Intraoperative and postoperative aspiration could be prevented through preoperative food restrictions (fasting). Whiles waiting to have her elective epigastric hernia repair, Kuz unfortunately took porridge. After how many hours can she have her surgery done?
A. 3 hours
B. 4 hours
C. 5 hours
D. 6 hours

35. The nurse will perform which of these interventions for haemorrhage from wound site after surgery?
A. Change dressings and soiled linen
B. Prepare and send patient back to theatre
C. Reinforce dressings and observe patient
D. Serve prescribe medication

36. Deep-Breathing exercise is effectively taught?
A. Intra operatively
B. Peri operatively
C. Post operatively
D. Pre operatively

37. The main complaint of a patient with cancer of the prostate gland would be?
A. Dysuria
B. Oliguria
C. Retention of urine
D. Suppression of urine

38. The nurse is caring for a 12-year-old client with appendicitis. The client’s mother is a Jehovah’s Witness and refuses to sign the blood permit. What nursing action is most appropriate?
A. Encourage the mother to reconsider
B. Explain the consequences without treatment
C. Give the blood without permission
D. Notify the physician of the mother’s refusal

39. During the immediate postoperative period of pneumonectomy, the nurse should give the highest priority to?
A. Check the vital signs every 15 minutes
B. Maintaining a patent airway
C. Observing for haemorrhage
D. Recording intake and output

40. The most common symptoms of esophageal disease is?
A. Dysphagia
B. Nausea
C. Odynophagia
D. vomiting

NMC MEDICAL AND SURGICAL NURSING QUESTIONS AND ANSWERS-2

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41. In total gastrectomy with Billroth I, the esophagus is anastomosed to the?
A. Colon
B. Duodenum
C. Jejunum
D. Stomach

42. The nurse is preparing a client for elective surgery, which of following is the best time of instruction for preoperative teaching/education?
A. Afternoon or evening before the surgery
B. Morning or 4 hours before surgery
C. One week prior to surgery
D. Relatively close to the time of surgery

43. Which of the following statements about consent for surgery is INCORRECT?
A. Consent give detailed information and explanation on the nature and intention of the surgery
B. Consent give detailed information and explanation on the possible alternative measures
C. Consent give detailed information and explanation on the risks and benefits of the surgery
D. Consent gives detailed information and explanation on the right of surgeon to refuse surgery.

44. In an attempt to assess Mr. Boateng 44 year old cancer patient for pain, the nurse explained to the patient the meaning of numbers assigned to grades of pain (with 0 representing no pain and 10 representing the worst pain imaginable) and ask Mr. Boateng to identify how much pain he is having by choosing a number from 0 to 10. What pain assessment tool is being used by the nurse?
A. Numerical Rating scale
B. Pain Faces Scale
C. Pain ladder scale
D. Visual Analogue Scales

45. Palliative treatment surgery is performed to?
A. Cure of the condition
B. Provide therapy
C. Relieve pain
D. Treat a disease

46. The presence of one or more gallstones in the common bile duct is referred to as?
A. Cholecystitis
B. Cholecystostomy
C. Cholelithiasis
D. choledocholithiasis

47. Following repair of cleft palate, the child needs to adhere to which of the following diet?
A. bland diet
B. liquid diet
C. smooth diet
D. soft diet

48. What is the most common cause of intestinal obstructions?
A. Adhesions
B . Hernias
C. Neoplasms
D. volvulus

49. A post-operative patient expresses anxiety about upcoming surgery. Which response of the nurse would stimulate further discussion between the patient and the nurse?
A. Can you share with me your fears about surgery?
B. If it is any help, anyone is nervous before surgery
C. I have explained the entire surgical procedure to you
D. Let me tell you about the amount of pain you can expect.

50. Which of this will the nurse prepare the patient for first ‘If barium enema and upper GI series are both ordered’?
A. Barium enema
B. Both at the same time
C. The one available at the earliest time
D. Upper GI series

51. In assessing a peptic ulcer patient understanding to education on diet, which of these saying is appropriate? I will eat?
A. A diet that contain high fiber.
B. Balance diet
C. Diet that can be tolerated.
D. Three regular meal

52. The most critical factor in the immediate care of an infant after repair of cleft lip is?
A. Administration of drug to reduce secretion
B. Administration of IV infusion
C. Maintenance of patent air way
D. Prevention of vomiting

53. Which of the following is NOT a precipitating cause of hemorrhoids?
A. Constipation
B. Occlusion of the arterial blood supply to the rectum
C. Prolong sitting or standing
D. Pregnancy

54. Predisposing factors of appendicitis include?
A. Inadequate food intake
B. Kinking of the appendix
C. Presence of faecalith
D. Repeated throat infection.

A. I and II only
B. II and III only
C. I, II and IV only
D. II, III and IV only

55. A patient returns to the ward fully awake following a bronchoscopy and biopsy. The nurse should?
A. Advise the patient to cough frequently
B. Advise the patient to lie flat for 2 hours
C. Evaluate the presence of gag reflex
D. Provide ice chips to suck to reduce swelling

56. On the 3rd day after laparotomy a patient complains of severe pains in the right calf muscle. The nurse should first?
A. Apply hot fermentation to the part
B. Elevate the leg above the heart
C. Notify the surgeon
D. Record the symptom son the nurses notes

57. A patient who has had a colostomy should follow a diet that is?
A. As close to normal as possible
B. High in carbohydrates
C. Low in fiber content
D. Rich in protein

58. The main purpose of under- water sealed drainage system is to?
A. Drain air and blood from the pleural cavity
B. Drain air, fluid and blood from the pleural cavity.
C. Prevent air and fluid from entering the lung
D. Prevent air from entering the pleural cavity

59. Patient going for abdominal operation should urinate immediately before the operation in order to?
A. Eliminate one source of post-operative discomfort
B. Permit better visualization of other viscera
C. Prevent injury to the bladder during surgery
D. Prevent voiding on the operating table

60. A patient who has had a laparotomy has just returned from theatre. The nurse should assess for bleeding by?
A. Ask patient if her back feels wet
B. Assessing her level of consciousness
C. Checking the blood pressure
D. Examining dressing

61. Evidence of fluid imbalance in post-operative patient include the following
A. Patient complains of thirst
B. Patient’s lips are cracked
C. The is presence of moisture in the axillae
D. There is a reduction in urinary output

A. I, II and III only
B. I, II and IV only
C. II, III and IV only
D. I, II, III and IV only

62. When there is a burst abdomen post operatively the nurse should
A. Cover the abdominal content with towel soaked in saline A. I and II only
B. Dress the wound as usual B. I and III only
C. Inform the surgeon at once C. II and III only
D. Push the abdominal content back gently D. I,II,III and IV

A. I and II only
B. I and III only
C. II and III only
D. I, II, III and IV only

63. The catheter introduced into the chest during under water seal drainage is to
A.Ndrain blood and serum from the pleural cavity A. I and II only
B. facilitate gradual re-expansion of the lung B. II and IV only
C. liquefy bronchial secretions and stimulate coughing C. I, II and III only
D. prevent drying and irritation of bronchial mucosa D. II, III and IV

A. I and II only
B. I and IV only
C. I, II and III only
D. II, III and IV only

64. Which of the following position is most comfortable for patient with acute appendicitis?
A. Lying absolutely on the back
B. Lying on the side with right knee bent
C. Prone with the head turn to the one side
D. Sitting upright in a chair

65. An obese patient who had a laparotomy is complaining of symptoms of deep vein thrombosis (DVT). One of the signs of this condition is?
A. leg size diameter may be reduced
B. onset is sudden
C. skin temperature is cold

D. Superficial veins appear enlarged and prominent

66. Signs and symptoms that indicate to the nurse that a tension pneumothorax is developing in a patient with chest trauma include…..
A. decreased movement and diminished breath sounds on the affected side
B. dull percussion sounds on the injured side
C. muffled and distant heart sounds with decreasing blood pressure
D. severe respiratory distress and tracheal deviation

67. To prevent airway obstruction in the postoperative patient who is unconscious or semiconscious, the nurse?
A. Administers oxygen per mask
B. elevates the head of the bed
C. encourages deep breathing
D. Position the patient in a side-lying position

68. When assessing a pain in a patient with suspected appendicitis, the nurse would expect the pain to be in the nature of?
A. Rebound tenderness at Bartomier’s point
B. Rebound tenderness at Sitkovsky’s point
C. Rebound tenderness in Dunphy’s point
D. Rebound tenderness in McBurney’s point

69. Master Daniel reported to the emergency unit with complains of severe abdominal pains pointing to the right lower quadrant. Nurse Ann will be more careful in the immediate care by avoiding which of these actions before the diagnosis is made?
A. Complete assessment including the lower abdominal palpation
B. Enemas and analgesics
C. Enemas and sips of water
D. Sips of water and analgesic

70. A characteristic ‘Olive mass’ is identified in patients diagnose of?
A. Appendicitis
B. Diverticular disease
C. Intussusception
D. Pyloric stenosis

71. The development of intussusception is associated with which of the following risk factors?
A. Bronchogenic carcinoma
B. Immunosuppressive state
C. Pre-existing congenital anomaly.
D. Rotavirus infection

72. When caring for a patient diagnose with intestinal obstructions, the following are to be considered in his care EXCEPT?
A. Antiemetics
B. Energy balance
C. Fluid and electrolyte imbalance
D. Pain management

73. Telescoping of a loop of a bowel usually results in which of the following types of intestinal obstruction?
A. Closed loop
B. Functional
C. Ileus
D. Mechanical

74. Patient who went for gastric surgery (Antrectomy) involving the antrum is likely to suffer from?
A. Vitamin A deficiency
B. Vitamin B6 deficiency
C. Vitamin B12 deficiency
D. Vitamin C deficiency

75. When assessing a patient suspected of right indirect inguinal hernia, the nurse is expected to find?
A. A lump in the obturator foramen
B. A lump in the right scrotum
C. An irreducible bulge at the right femoral region
D Bulge from the posterior wall of the inguinal canal

76. Palpable sausage mass is characteristically identified in which of the under listed condition?
A. Appendicitis
B. Intussusception
C. Pyloric stenosis
D. volvulus

77. In patient diagnosed with appendicitis the nurse best assess positive Dunphy’s sign by?
A. Allowing the patient to cough
B. Allowing patient to lie on the left side
C. Palpate the right iliac region whiles he is on lie on the left
D. Pressing the Mcburney’s point to illicit rebound tenderness

78. A priority post-operative nursing diagnose for a patient immediately after appendectomy will be?
A. Acute pain related to the presence of postoperative wound
B. Deficient knowledge about the care and diseases related to lack of information.
C. Impaired nutrition less than body requirements related to anorexia, nausea.
D. Risk for infection related to surgical incision.

79. The T-tube in the common bile duct after choledechostomy is to?
A. Allow bile to drain until sufficient healing occurs
B. Permit drainage of excess fluid from the surgical site
C. Provide a means of elevating the potency of the bile duct
D. Reduces inflammation in the duodenum

80. Complications of varicose vein includes the following EXCEPT?
A. Chronic venous insufficiency
B. Formation of leg ulcers
C. Rupture of distended aneurysm
D. Thrombophlebitis

NMC MEDICAL AND SURGICAL NURSING QUESTIONS AND ANSWERS-2

81. Which of the following interventions below cause lyses of the clot formed within a vein or an artery?
A. Adjuvant
B. Anticoagulation
C. Sceroyherapy
D. Thrombolytic

82. A patient convalescing from abdominal surgery develops thrombophlebitis. Which sign will indicate to you that this complication has occurred?
A. Intermittent claudication
B. Localised warmth and tenderness of the leg
C. Pitting oedema of the lower extremities
D. Severe pain on extension of the extremities

83. The sequential order involved in the development of pyothorax is?
I. Exudates formation
II. Fibrinopurulent formation
III. Organisation formation

A. I and II, III only
B. I III and II only
C. III, II and I only
D. II, III and I only

84. The impudence to the smooth flow of blood from the right ventricle to the pulmonary trunk could be due to faulty or stenosis of?
A. Aortic valve
B. Mitral vulve
C. Pulmonic valve
D. Tricuspid valve

85. During the inhalation phase in ventricular interdependence in people with constrictive pericarditis, the negative thoracic pressure causes?
A. Left atria bulging
B. Left ventricular bulging
C. Right atria bulging
D. Right ventricular bulging

86. Unless contraindicated patient with cardiothoracic problems are placed in which position post operatively after recovery from anesthesia?
A. High fowlers
B. Lithotomy
C. Sim’s lateral
D. Trendelenburg

87. A priority nursing diagnosis for a patient who has undergone cardiac surgery is?
A. Alteration in fluid volume and electrolytes balance related to decrease blood volume(potential)
B. Alteration in renal perfusion related to decrease cardiac output (potential)
C. Decrease cardiac output related to blood loss
D. Pain related to operative trauma

88. Which of the following measure will increase the chance of venous return?
A. Aiding venous return through the wearing of stockings
B. Operating on the patient with the heels slightly elevated
C. Preoperative administration of estrogen
D. Taking pressure of the calves

89. The deficiency of alpa-1-antitrypsin is associated with which of the underling pulmonary conditions?
A. Emphysema
B. Pulmonary embolism
C. Secondary pneumothorax
D. Tension pneumothorax

90. The most identified feature of a patient diagnosed with emphysema thoracic is?
A. Barrel chest
B. Bloody sputum
C. Copious sputum
D. Tenacious sputum

91. Routing milking and / or stripping of chest tube to maintain patency is no more recommended for the? following reasons EXCEPT
A. Can cause damage to the pleural tissue
B. Dangerously increase intrapleural pressure
C. Decrease fluid and blood drained from the pleural
D. Newer tubes are coated with nonthrombogenic

92. When a thrombus develops initially in the veins as a results of stasis or hypercoagulability but without inflammation, the process is referred to as………..
A. deep vein thrombosis
B. phlebothrombosis
C. thrombophlebitis
D. venous thrombosis

93. In constrictive pericarditis,the inflammation of the pericardium is characterized by all the following EXCEPT?
A. Contracture
B. Kussmaul’s sign
C. Scarring
D. thickening

94. The nurse can best explain positive pratt’s sign of a person suffering from Deep Vein Thrombosis to a junior Nurse by saying there is?
A. calf pain associated with dorsiflexion of the leg
B. calf pain associated with walking
C. pain that occur with squeezing the calf
D. pain with abduction of the limb

95. If a victim of spinal cord injury exhibited signs of respiratory arrest, you might suspect damage to which region of the spinal cord?
A. Cervical
B. Lumbar
C. Sacral
D. Thoracic

96. The region in the brain stem responsible for maintaining consciousness and awakening from sleep is the?
A. limbic system
B. Pyramids
C. reticular activating system
D. thalamus

97. The initial cause of hypovolemia during the emergent phase of burn injury is?
A. decreased vascular oncotic pressure
B. fluid loss from denuded skin surfaces
C. increased capillary permeability
D. loss of sodium to the interstitium

98. Which of the special senses has little effect in activating the reticular activating system during arousal from sleep?
A. auditory impulses
B. olfactory impulses
C. touch pressure impulses
D. visual impulse

99. Phantom pain?
A. is associated with hypochondriacs
B. is due to generation nerve impulses in severed neurons after amputation of a limb
C. Refers to the registering of pain in some place rather than the site of actual tissue damage.
D. Results from eating foods that are too highly seasoned.

100. The initial intervention in the emergency management of a burn of any type is to?
A. assess for other associated injuries
B. establish an IV line with a large-gauge needle
C. establish and maintain airway
D. remove the patient from the burn source, and stop the burning process.

NMC MEDICAL AND SURGICAL NURSING QUESTIONS AND ANSWERS SOLUTION-2