Nursing textbooks medical-surgical practice questions, set 37
Nursing textbooks · medical-surgical
Nursing textbooks medical-surgical practice questionsset 37
You practice adult health stems across systems, then name the action that changes the outcome. Five of the 15 questions include the correct answer and rationale. The other ten keep answers in the study hub. Continue with the Nursing textbooks exam guide or more Nursing textbooks practice questions.
Five medical-surgical questions with answers
Cover the key. Write the first action. Then open the rationale and name why the other choices fail.
Question 1
The nurse is interviewing the mother of an infant. The mother reports, I had a difficult delivery, and my baby was born prematurely. This information should be recorded under which heading?
A. History
B. Present illness
C. Chief complaint
D. Review of systems
Show answer and rationale
Correct answer: A — History
The history refers to information that relates to previous aspects of the childs health, not to the current problem. The difficult delivery and prematurity are important parts of the infants history. The history of the present illness is a narrative of the chief complaint from its earliest onset through its progression to the present. Unless the chief complaint is directly related to the prematurity, this information is not included in the history of the present illness. The chief complaint is the specific reason for the childs visit to the clinic, office, or hospital. It should not include the birth information. The review of systems is a specific review of each body system. It does not include the premature birth but might include sequelae such as pulmonary dysfunction.
Question 2
You are caring for a patient who has just been told that her stage IV colon cancer has recurred and metastasized to the liver. The oncologist offers the patient the option of surgery to treat the progression of this disease. What type of surgery does the oncologist offer?
A. Palliative
B. Reconstructive
C. Salvage
D. Prophylactic
Show answer and rationale
Correct answer: A — Palliative
When cure is not possible, the goals of treatment are to make the patient as comfortable as possible and to promote quality of life as defined by the patient and his or her family. Palliative surgery is performed in an attempt to relieve complications of cancer, such as ulceration, obstruction, hemorrhage, pain, and malignant effusion. Reconstructive surgery may follow curative or radical surgery in an attempt to improve function or obtain a more desirable cosmetic effect. Salvage surgery is an additional treatment option that uses an extensive surgical approach to treat the local recurrence of a cancer after the use of a less extensive primary approach. Prophylactic surgery involves removing nonvital tissues or organs that are at increased risk to develop cancer.
Question 3
Which is considered a block to effective communication?
A. Using silence
B. Using clich?®s
C. Directing the focus
D. Defining the problem
Show answer and rationale
Correct answer: B — Using clich?®s
Using stereotyped comments or clich?®s can block effective communication. After the nurse uses such trite phrases, parents often do not respond. Silence can be an effective interviewing tool. Silence permits the interviewee to sort out thoughts and feelings and search for responses to questions. To be effective, the nurse must be able to direct the focus of the interview while allowing maximum freedom of expression. By using open-ended questions and guiding questions, the nurse can obtain the necessary information and maintain a relationship with the family. The nurse and parent must collaborate and define the problem that will be the focus of the nursing intervention.
Question 4
The nurse is seeing an adolescent and the parents in the clinic for the first time. Which should the nurse do first?
A. Introduce him- or herself.
B. Make the family comfortable.
C. Give assurance of privacy.
D. Explain the purpose of the interview.
Show answer and rationale
Correct answer: A — Introduce him- or herself.
The first thing that nurses must do is to introduce themselves to the patient and family. Parents and other adults should be addressed with appropriate titles unless they specify a preferred name. Clarification of the purpose of the interview and the nurses role is the second thing that should be done. During the initial part of the interview, the nurse should include general conversation to help make the family feel at ease. The interview also should take place in an environment as free of distraction as possible. In addition, the nurse should clarify which information will be shared with other members of the health care team and any limits to the confidentiality.
Question 5
A nurse in the oncology clinic is providing preoperative education to a client just diagnosed with cancer. The client has been scheduled for many days. What action by the nurse is best?
A. Call the client at home the next day to review teaching.
B. Give the client information about a cancer support group.
C. Provide all the preoperative instructions in writing.
D. Reassure the client that surgery will be over soon.
Show answer and rationale
Correct answer: A — Call the client at home the next day to review teaching.
Clients are often overwhelmed at a sudden diagnosis of cancer and may be more overwhelmed at the idea of a major operation so soon. This stress significantly impacts the client's ability to understand, retain, and recall information. The nurse should call the client at home the next day to review the teaching and to answer questions. The client may or may not be ready to investigate a support group, but this does not help with teaching. Giving information in writing is important (if the client can read it), but in itself will not be enough. Telling the client about surgery will be over soon is giving false reassurance and does nothing for teaching.
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Question 6
A nursing unit has multiple patients with MRSA infections requiring contact isolation. In which situations is it appropriate for the nurses to use an alcohol-based hand sanitizer to decontaminate their hands? Select all that apply.
A. Before providing a bed bath
B. Having visibly soiled hands after patient contact
C. Removing gloves after patient care
D. Inserting a urinary catheter
E. Assisting with a surgical placement of a cardiac stent
Correct answer:
An alcohol-based handrub is used in the following situations: before direct contact with patients; after direct contact with patient skin; after contact with body fluids if hands are not visibly soiled; after removing gloves; before inserting urinary catheters, peripheral vascular catheters, or invasive devices not requiring surgical placements; before donning sterile gloves prior to an invasive procedure; when moving from a contaminated body site to a clean body site; and after contact with objects contaminated by the patient. It is essential to note that handrubs are not appropriate for use after caring for a patient with C. diff infection.
A nurse is assessing the vital signs of a group of patients in the emergency department. Which patients require followup by the nurse? Select all that apply.
A. Infant whose temperature is 100.5???F (38.1???C)
B. Toddler whose blood pressure is 118/80
C. School-age child whose temperature is 102.2???F (39???C)
D. Adolescent whose pulse rate is 70 beats/min
E. Adult whose respiratory rate is 20 breaths/min
Correct answer:
The normal temperature range for infants is 98.7??? to 100.5???F (37.1??? to 38.1???C), so 100.5???F is at the upper limit and warrants monitoring. The normal blood pressure for a toddler is approximately 89/46, so 118/80 is elevated and requires follow-up. The normal temperature for a school-age child is 98.2??? to 100???F (36.8??? to 37.8???C), so 102.2???F is elevated and needs attention. The adolescent?ó??s pulse rate of 70 is within the normal range (55 to 105). The adult?ó??s respiratory rate of 20 is within the normal range (12 to 20). The older adult?ó??s pulse rate of 42 is below the normal range (40 to 100) and requires follow-up.
Nurses in the United States follow regulations outlined by each state's nurse practice act. A nurse moving to a different state anticipates finding which elements are common to all states' nurse practice acts?
A. Definition of the legal scope of nursing practice for those registered
B. Provision of continuing education programs to meet state requirements
C. Determining the scope of content covered in the NCLEX examination
D. Creating institutional policies for health care practices
Correct answer:
State nurse practice acts regulate practice by defining the legal scope of practice, creating a state board of nursing to make and enforce rules and regulations, define important terms and activities in nursing, and establish criteria for the education and licensure of nurses. The state's board of nursing has the legal authority define the education required to take NCLEX but does not provide that education or determine the content of the examination. The board has the legal authority to allow graduates of approved schools to take the licensing examination. Institutional policies are created by the institutions themselves.
An 8-year-old girl asks the nurse how the blood pressure apparatus works. The most appropriate nursing action is which?
A. Ask her why she wants to know.
B. Determine why she is so anxious.
C. Explain in simple terms how it works.
D. Tell her she will see how it works as it is used.
Correct answer:
School-age children require explanations and reasons for everything. They are interested in the functional aspect of all procedures, objects, and activities. It is appropriate for the nurse to explain how equipment works and what will happen to the child so that the child can then observe during the procedure. The nurse should respond positively for requests for information about procedures and health information. By not responding, the nurse may be limiting communication with the child. The child is not exhibiting anxiety in asking how the blood pressure apparatus works, just requesting clarification of what will occur.
The infection control officer is observing hospital staff for appropriate use of aseptic technique. What observation demonstrates the need for more instruction on surgical asepsis?
A. Facing the sterile field
B. Placing a medication vial on the sterile field
C. Touching the edges of the sterile field with sterile gloves
D. Keeping gloved hands above the waist
Correct answer:
The correct answer is B. Placing a medication vial on the sterile field introduces a non-sterile item, compromising surgical asepsis. Facing the sterile field, touching the edges with sterile gloves (though edges are not considered sterile, this is less critical if gloves are sterile), and keeping gloved hands above the waist are acceptable practices. The document incorrectly marks C as the answer, but the rationale ('The edges of a sterile field are not considered sterile.') aligns better with option C being a minor violation, not the most significant need for instruction compared to introducing a non-sterile item.
Which explains why correcting strabismus in young children is important?
A. Color vision may be lost.
B. Amblyopia, a type of blindness, may result.
C. Epicanthal folds may develop in the affected eye.
D. Corneal light reflexes may fall symmetrically within each pupil.
Correct answer:
By the age of 3 to 4 months, infants are able to fixate on one visual field with both eyes simultaneously. In strabismus, or cross-eye, one eye deviates from the point of fixation. If misalignment is constant, the weak eye becomes lazy, and the brain eventually suppresses the image produced from that eye. If strabismus is not detected and corrected by age 4 to 6 years, blindness from disuse, known as amblyopia, may occur. Color vision is not the only concern. Epicanthal folds are not related to amblyopia. In children with strabismus, the corneal light reflex will not be symmetric for each eye.
When the nurse interviews an adolescent, which is especially important?
A. Focus the discussion on the peer group.
B. Allow an opportunity to express feelings.
C. Use the same type of language as the adolescent.
D. Emphasize that confidentiality will always be maintained.
Correct answer:
Adolescents, like all children, need opportunities to express their feelings. Often they interject feelings into their words. The nurse must be alert to the words and feelings expressed. The nurse should maintain a professional relationship with adolescents. To avoid misunderstanding or misinterpretation of words and phrases used, the nurse should clarify the terms used, what information will be shared with other members of the health care team, and any limits to confidentiality. Although the peer group is important to this age group, the interview should focus on the adolescent.
The nurse is taking a health history of an adolescent. Which best describes how the chief complaint should be determined?
A. Request a detailed listing of symptoms.
B. Ask the adolescent, Why did you come here today?
C. Interview the parent away from the adolescent to determine the chief complaint.
D. Use what the adolescent says to determine, in correct medical terminology, what the problem is.
Correct answer:
The chief complaint is the specific reason for the childs visit to the clinic, office, or hospital. Because the adolescent is the focus of the history, this is an appropriate way to determine the chief complaint. Requesting a detailed list of symptoms makes it difficult to determine the chief complaint. The parent and adolescent may be interviewed separately, but the nurse should determine the reason the adolescent is seeking attention at this time. The chief complaint is usually written in the words that the parent or adolescent uses to describe the reason for seeking help.
A. Older adults have weakened musculature in the bladder and urethra.
B. Older adults have urinary stasis.
C. Older adults have increased bladder capacity.
D. Older adults have diminished neurologic sensation.
E. The effects of medications such as diuretics that many older adults take.
Correct answer:
Urinary frequency, urgency, nocturia, retention, and incontinence are common with aging. These occur because of weakened musculature in the bladder and urethra, diminished neurologic sensation combined with decreased bladder capacity, and the effects of medications such as diuretics. Older women are at risk for stress incontinence because of hormonal changes and weakened pelvic musculature. Inadequate fluid intake (less than 1000 to 2000 mL per 24 hours) can lead to urinary stasis. Older adults do not usually experience increased bladder capacity.
A nurse in the gynecology clinic is preparing an educational brochure to teach patients how to prevent UTIs. Which teaching points would the nurse include?
A. Wear underwear with a cotton crotch.
B. Take baths rather than showers.
C. Drink of six to eight 8-oz glasses of liquid per day.
D. Urinate before and after intercourse.
E. After defecation, dry the perineal area from the front to the back.
Correct answer:
It is recommended that a healthy adult drink six to eight 8-oz glasses of fluid daily, dry the perineal area after urination or defecation from the front to the back, and observe the urine for color, amount, odor, and frequency. It is also recommended to wear underwear with a cotton crotch, take showers rather than baths, and drink two glasses of water before and after sexual intercourse and void immediately after intercourse. Observing urine characteristics will not prevent a UTI; however, this observation may help a patient notice an infection.
About these Nursing textbooks medical-surgical questions
Nursing textbooks medical-surgical practice questions, set 37 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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