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RN exams medical-surgical practice questions, set 10

RN exams · medical-surgical

RN exams medical-surgical practice questions set 10

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 RN exams exam guide or more RN exams 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

A client has a wound on the lower leg that is covered with dry, yellow crusts. The nurse recognizes this as an indication of:

  1. A. Slough
  2. B. Eschar
  3. C. Granulation tissue
  4. D. Epithelial tissue
Show answer and rationale

Correct answer: A — Slough

Slough is the correct answer, as it refers to dead tissue that appears as dry, yellow crusts on a wound's surface, indicating tissue that needs removal to promote healing. Slough can vary in color (white, yellow, green, or brown) and texture (soft, moist, or dry), and its presence suggests the wound is not fully progressing toward recovery without intervention like debridement. Eschar is also dead tissue but is typically black, brown, or tan, with a hard, leathery texture, often serving as a natural barrier in some cases but potentially impeding healing in others. Granulation tissue is healthy, new tissue that appears red or pink, shiny, and moist, signaling active healing, not crusting. Epithelial tissue is the thin, smooth layer forming over granulation tissue in the final healing stages, not matching the dry, yellow description. The dry, yellow crusts clearly point to slough, distinguishing it from the other options based on appearance and role in wound progression.

Question 2

What is the primary function of anaphylotoxins (e.g., C3a, C4a, C5a) in the immune system?

  1. A. Suppressing inflammation
  2. B. Facilitating antigen presentation
  3. C. Inducing inflammation and recruiting immune cells
  4. D. Neutralizing pathogens
Show answer and rationale

Correct answer: C — Inducing inflammation and recruiting immune cells

The correct answer is C: Inducing inflammation and recruiting immune cells. Anaphylotoxins, such as C3a, C4a, and C5a, are small molecules that are released during complement activation. They play a crucial role in enhancing inflammation by attracting immune cells to the site of infection or injury. 1. Anaphylotoxins induce inflammation by stimulating the release of histamine and other inflammatory mediators. 2. They promote vasodilation and increase vascular permeability, allowing immune cells to easily reach the affected area. 3. Anaphylotoxins also act as chemoattractants, recruiting neutrophils, macrophages, and other immune cells to the site of inflammation to help fight against pathogens. 4. These molecules do not suppress inflammation (choice A), facilitate antigen presentation (choice B), or neutralize pathogens (choice D). Their primary function is to amplify the immune response by inducing inflammation and recruiting immune cells to combat infections

Question 3

What is the immunologic term to indicate the process that eliminates developing T cells whose T-cell receptors bind too strongly to self-peptide/MHC complexes?

  1. A. Negative selection
  2. B. Positive selection
  3. C. Peripheral tolerance
  4. D. Lineage commitment
Show answer and rationale

Correct answer: A — Negative selection

Negative selection is the correct answer because it refers to the process that eliminates developing T cells with high affinity for self-peptide/MHC complexes to prevent autoimmune reactions. During negative selection, T cells that bind too strongly to self-antigens are deleted or rendered functionally inactive. This ensures that only T cells with moderate affinity for self-antigens are allowed to mature and participate in immune responses. Summary of other choices: B: Positive selection involves the selection of T cells that can recognize self-peptide/MHC complexes, promoting their maturation and survival. C: Peripheral tolerance refers to mechanisms that maintain self-tolerance in the mature immune system, not specifically related to eliminating self-reactive T cells during development. D: Lineage commitment is the process by which precursor cells differentiate into specific immune cell types and is not directly related to eliminating self-reactive T cells.

Question 4

A 72-year-old male patient has arrived at the outpatient unit to receive an infusion of alemtuzumab (Compath). The patient tells the nurse this is the second time his chronic lymphocytic leukemia has relapsed and the second time he will receive this drug because he failed alemtuzumab therapy after being treated with an alkylating agent. What is the nurse's priority action?

  1. A. Calling the physician and questioning the order
  2. B. Washing your hands
  3. C. Beginning an intravenous infusion
  4. D. Canceling the infusion
Show answer and rationale

Correct answer: A — Calling the physician and questioning the order

The correct answer is A: Calling the physician and questioning the order. This is the priority action because the patient's history of relapse and prior failure of alemtuzumab therapy after receiving an alkylating agent raises concerns about potential drug interactions, contraindications, or other issues that need to be clarified with the physician before proceeding with the infusion. It is crucial to ensure patient safety and the effectiveness of the treatment by confirming the appropriateness of the order. Summary of other choices: B: Washing your hands - While hand hygiene is important, it is not the priority in this situation. C: Beginning an intravenous infusion - Starting the infusion without clarifying the order and potential issues first could be harmful to the patient. D: Canceling the infusion - While canceling the infusion may be necessary depending on the physician's response, it is not the initial action to take without consulting the physician first.

Question 5

The nurse is working in a clinic that is designed to provide health education and immunization. As such, the clinic aims to provide_______________

  1. A. diagnosis and treatment
  2. B. Secondary prevention
  3. C. Primary prevention
  4. D. Tertiary prevention
Show answer and rationale

Correct answer: C — Primary prevention

The correct answer is C: Primary prevention. In this scenario, the clinic focuses on preventing disease before it occurs through health education and immunization. Primary prevention aims to promote general health and prevent the onset of diseases. It targets the entire population to reduce the risk of disease occurrence. Incorrect Choices: A: Diagnosis and treatment - This choice involves identifying and treating existing health conditions, which is not the primary focus of a clinic designed for health education and immunization. B: Secondary prevention - This choice involves early detection and treatment of diseases to prevent complications, which is more focused on individuals who already have risk factors or symptoms, not on the general population. D: Tertiary prevention - This choice involves managing and treating complications of diseases to prevent further deterioration, which is not the primary goal of a clinic focused on health education and immunization.

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Question 6

The skin accounts for what percentage of the body weight?

  1. A. 2%
  2. B. 10%
  3. C. less than 2%
  4. D. 7%
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Question 7

The nurse is preparing a patient to receive immunosuppressant drugs on an outpatient basis. What is the priority for the nurse to arrange for this patient in the home environment?

  1. A. A caregiver who is skilled in cardiopulmonary resuscitation (CPR)
  2. B. A caregiver who will provide adequate nutrition
  3. C. Supportive care and comfort measures
  4. D. Arrange for a home care nurse to administer injections
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Question 8

A client with asthma is assessed by a nurse and presents with bilateral wheezing, decreased pulse oxygen saturation, and suprasternal retraction on inhalation. Which actions should the nurse take? (Select all that apply)

  1. A. Administer prescribed albuterol (Ventolin) inhaler.
  2. B. Assess the client for tracheal deviation.
  3. C. Administer oxygen to maintain saturations greater than 94%.
  4. D. Perform peak expiratory flow measurements.
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Question 9

The nurse has access to the results of a karyotype sent out for their patient via an electronic medical record. The parents have accessed the results on their MyChart phone application and have asked the nurse what the results 45, X mean. What is the best response from the nurse?

  1. A. The results indicate your child may have Turner syndrome.
  2. B. Your results are 45, X; you will have to wait to talk with the geneticist.
  3. C. Your results indicate that your daughter has a serious lifelong disease.
  4. D. I’m not sure; I’ll call the provider.
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Question 10

Which of the following statements is incorrect about celiac disease?

  1. A. There is a strong genetic association: more than 90% of celiac patients express the HLA allele DO2 or DO8
  2. B. It is technically an allergy but has some features of autoimmunity
  3. C. The disease is mainly caused by an abnormal innate response to gluten while adaptive cells are not involved
  4. D. The disease is entirely driven by gluten exposure. The gut lesions observed in these patients disappeared upon removal of gluten from the diet
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Question 11

What is the primary function of anaphylotoxins (e.g., C3a, C4a, C5a) in the immune system?

  1. A. Suppressing inflammation
  2. B. Facilitating antigen presentation
  3. C. Inducing inflammation and recruiting immune cells
  4. D. Neutralizing pathogens
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Question 12

What is the immunologic term to indicate the process that eliminates developing T cells whose T-cell receptors bind too strongly to self-peptide/MHC complexes?

  1. A. Negative selection
  2. B. Positive selection
  3. C. Peripheral tolerance
  4. D. Lineage commitment
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Question 13

A client is being administered the first dose of belimumab for a systemic lupus erythematosus flare. What actions by the nurse are most appropriate? (Select one that does not apply.)

  1. A. Observe the client for at least 2 hours afterward.
  2. B. Instruct the client about the monthly infusion schedule.
  3. C. Inform the client not to drive or sign legal papers for 24 hours.
  4. D. Ensure emergency equipment is working and nearby.
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Question 14

A male client expresses concern about how a hypophysectomy will affect his sexual function. Which of the following statements provides the most accurate information about the physiologic effects of hypophysectomy?

  1. A. Removing the source of excess hormone should restore the client's libido, erectile function, and fertility.
  2. B. Potency will be restored, but the client will remain infertile.
  3. C. Fertility will be restored, but impotence and decreased libido will persist.
  4. D. Exogenous hormones will be needed to restore erectile function after the adenoma is removed.
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Question 15

A client is being administered the first dose of belimumab for a systemic lupus erythematosus flare. What actions by the nurse are most appropriate? (Select one that does not apply.)

  1. A. Observe the client for at least 2 hours afterward.
  2. B. Instruct the client about the monthly infusion schedule.
  3. C. Inform the client not to drive or sign legal papers for 24 hours.
  4. D. Ensure emergency equipment is working and nearby.
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About these RN exams medical-surgical questions

RN exams medical-surgical practice questions, set 10 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.

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