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RN exams medical-surgical practice questions, set 11

RN exams · medical-surgical

RN exams medical-surgical practice questions set 11

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 venous ulcer on the lower leg that is treated with compression therapy. The nurse instructs the client to elevate the leg above the level of the heart whenever possible. What is the rationale for this instruction?

  1. A. To reduce edema and venous pressure
  2. B. To increase arterial blood flow and oxygenation
  3. C. To prevent infection and inflammation
  4. D. To stimulate nerve regeneration and sensation
Show answer and rationale

Correct answer: A — To reduce edema and venous pressure

Choice A is correct because elevating the leg above the heart reduces edema and venous pressure, which is the primary rationale for this instruction in managing a venous ulcer. Venous ulcers stem from chronic venous insufficiency, causing blood pooling, increased pressure, and swelling in the lower legs. Elevation leverages gravity to enhance venous return to the heart, alleviating these issues and supporting healing. Increasing arterial blood flow and oxygenation is more relevant to arterial ulcers, where elevation might worsen perfusion by countering gravity's aid to arterial flow. Preventing infection and inflammation is critical but not directly tied to elevation; it relies more on wound care practices like cleansing and dressings. Stimulating nerve regeneration and sensation is unrelated to venous ulcers or elevation, as neuropathy isn't a primary concern here. Thus, reducing edema and venous pressure best explains the benefit of elevation in this context.

Question 2

A patient presents with severe headache, photophobia, and neck stiffness. On examination, there is nuchal rigidity and positive Kernig and Brudzinski signs. Which of the following neurological conditions is most likely responsible for these symptoms?

  1. A. Migraine headache
  2. B. Cluster headache
  3. C. Meningitis
  4. D. Subarachnoid hemorrhage
Show answer and rationale

Correct answer: C — Meningitis

The correct answer is C: Meningitis. The patient's symptoms of severe headache, photophobia, neck stiffness, nuchal rigidity, and positive Kernig and Brudzinski signs are classic signs of meningitis. Meningitis is an inflammation of the meninges surrounding the brain and spinal cord, leading to these specific neurological symptoms. Migraine headache (A) typically presents with a throbbing headache, nausea, and sensitivity to light and sound, but does not typically cause neck stiffness or positive meningeal signs. Cluster headache (B) is characterized by severe unilateral headache with autonomic symptoms like tearing or nasal congestion, but does not typically cause neck stiffness or positive meningeal signs. Subarachnoid hemorrhage (D) presents with sudden severe headache often described as "the worst headache of my life," and may cause neck stiffness, but typically does not present with photophobia or positive meningeal signs like Kernig and Brudzinski signs.

Question 3

Which of the following word pairs is (are) appropriate?

  1. A. iatcgument-gland
  2. B. integument-tissue
  3. C. integument-organ
  4. D. all the above
Show answer and rationale

Correct answer: C — integument-organ

The integumentary system is a complex structure that serves as the body's outer covering, including skin, hair, nails, and glands. While 'iatcgument-gland' appears to be a typo and does not make sense in this context, 'integument-tissue' refers to the skin as a type of tissue, which is accurate but incomplete. The term 'integument-organ' is the most appropriate because the integumentary system is classified as an organ system in anatomy, encompassing multiple tissues (epithelial, connective, etc.) working together. 'All the above' would only be correct if all pairs were valid, but the first option is not, likely due to a transcription error. The focus on the integument as an organ aligns with its role in protection, temperature regulation, and sensory reception, making it more than just a tissue or a gland-related structure. Thus, the precise pairing is one that recognizes its status as an organ, reflecting its integrated functions and anatomical significance.

Question 4

Multi-photon microscopy has proved to be an invaluable tool for the evaluation of the dynamics of immune responses in vivo. The following is a list of observations derived from intra-vital microscopy. Identify the incorrect statement.

  1. A. T cells make stable and prolonged contacts with APC presenting the specific antigen in the paracortex
  2. B. In the absence of antigens B cells move at the same speed and randomly in follicles
  3. C. In the presence of infection specific B cells quickly direct themselves towards the source of antigen
  4. D. Dendritic cells move rapidly through the germinal centre during an immune response
Show answer and rationale

Correct answer: D — Dendritic cells move rapidly through the germinal centre during an immune response

The correct answer is D because dendritic cells do not typically move rapidly through the germinal center during an immune response. Dendritic cells usually interact with T cells in the paracortex to present antigens, and they are not known to migrate rapidly through the germinal center. A: This statement is correct as T cells do make stable and prolonged contacts with APCs in the paracortex during immune responses. B: This statement is incorrect as B cells do not move at the same speed and randomly in follicles in the absence of antigens. They respond to signals and cues in the microenvironment. C: This statement is correct as specific B cells can quickly direct themselves towards the source of antigen during an infection. In summary, choice D is incorrect because dendritic cells do not move rapidly through the germinal center during an immune response, while the other choices accurately describe behaviors of immune cells during immune responses.

Question 5

A nurse is preparing to assist with a thoracentesis procedure for a patient with pleural effusion. What action should the nurse prioritize to ensure procedural safety?

  1. A. Administering pre-procedure antibiotics to prevent infection
  2. B. Ensuring the patient empties their bladder before the procedure
  3. C. Positioning the patient upright with arms supported on a bedside table
  4. D. Confirming the patient's informed consent before the procedure
Show answer and rationale

Correct answer: D — Confirming the patient's informed consent before the procedure

Confirming the patient's informed consent before the procedure is the most crucial action for the nurse to prioritize to ensure procedural safety during a thoracentesis. Informed consent is a legal and ethical requirement that ensures the patient understands the purpose of the procedure, its potential risks, benefits, and alternatives. By confirming informed consent, the nurse ensures that the patient has the necessary information and has willingly agreed to undergo the procedure. This process promotes patient autonomy, prevents misunderstandings, and reduces the likelihood of legal issues related to the procedure. Additionally, verifying informed consent helps establish a foundation of trust between the healthcare team and the patient. While other actions like positioning the patient correctly and ensuring pre-procedure antibiotics may also contribute to the safety of the procedure, obtaining informed consent is the foundational step that must be prioritized.

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Question 6

Which of the following word pairs is (are) appropriate?

  1. A. iatcgument-gland
  2. B. integument-tissue
  3. C. integument-organ
  4. D. all the above
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Question 7

Which of the following word pairs is (are) appropriate?

  1. A. iatcgument-gland
  2. B. integument-tissue
  3. C. integument-organ
  4. D. all the above
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Question 8

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 9

The patient seems indecisive whether to breastfeed her baby or not. Which is the desired nursing action of Nurse Vera to help the pregnant patient make a decision on breastfeeding?

  1. A. Give pamphlets and books to read.
  2. B. Provide ample time for the patient to decide.
  3. C. Refer the patient to the nutrionist.
  4. D. Assist to identify breastfeeding goal and plan.
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Question 10

Which of the following is true of bladder retraining?

  1. A. The NA should encourage the resident to drink plenty of fluids even if incontinence is a problem.
  2. B. The NA does not need to keep a record of the resident's bladder habits.
  3. C. The NA does not need to wear gloves when handling body wastes.
  4. D. The NA should let the resident know when he is taking too long to urinate.
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Question 11

Which of the following can pass most easily through the epidermis?

  1. A. proteins
  2. B. lipid-soluble molecules
  3. C. water-soluble compounds
  4. D. salts
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Question 12

A client is hospitalized with a second episode of pulmonary embolism (PE). Recent genetic testing reveals the client has an alteration in the gene CYP2C19. What action by the nurse is best?

  1. A. Instruct the client to eliminate all vitamin K from the diet.
  2. B. Prepare preoperative teaching for an inferior vena cava (IVC) filter.
  3. C. Refer the client to a chronic illness support group.
  4. D. Teach the client to use a soft-bristled toothbrush.
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Question 13

When a patient arrives in the emergency department with a facial fracture, which action will the nurse take first?

  1. A. Assess for nasal bleeding and pain.
  2. B. Apply ice to the face to reduce swelling.
  3. C. Use a cervical collar to stabilize the spine.
  4. D. Check the patient’s alertness and orientation.
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Question 14

A patient with advanced dementia is bedbound and at risk of developing pressure ulcers. What intervention should the palliative nurse prioritize to prevent pressure ulcer formation?

  1. A. Turn the patient every 2 hours to relieve pressure on bony prominences.
  2. B. Apply barrier creams or moisture barriers to protect vulnerable skin areas.
  3. C. Use pressure-relieving support surfaces, such as specialized mattresses or cushions.
  4. D. Administer prophylactic antibiotics to prevent infection in at-risk skin areas.
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Question 15

Which of the following actions is indicated in the management of a patient with an open chest wound (sucking chest wound)?

  1. A. Applying a sterile dressing and occlusive dressing.
  2. B. Administering supplemental oxygen.
  3. C. Providing reassurance and emotional support.
  4. D. Elevating the patient's legs to improve venous return.
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About these RN exams medical-surgical questions

RN exams medical-surgical practice questions, set 11 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.

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The first five questions already include the rationale. Start full practice to unlock the remaining keys, missed-question review, and the rest of the bank.

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