RN exams medical-surgical practice questions, set 23
RN exams · medical-surgical
RN exams medical-surgical practice questionsset 23
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
The nurse and the nursing assistive personnel are assisting a postoperative patient to turn in bed. To assist in minimizing discomfort, which instruction should the nurse provide to the patient?
A. "Close your eyes and think about something pleasant."Â
B. "Hold your breath and count to three."Â
C. "Grab my shoulders with your hands."Â
D. "Place your hand over your incision."Â
Show answer and rationale
Correct answer: D — "Place your hand over your incision."Â
The correct answer is D: "Place your hand over your incision." This instruction is correct because it encourages the patient to provide support and gentle pressure to the incision area while turning, which can help reduce discomfort and provide a sense of security. This action can also prevent accidental disruption of the incision site.
A: "Close your eyes and think about something pleasant." This choice does not provide any physical support or guidance for the patient during the turning process.
B: "Hold your breath and count to three." This instruction is incorrect as holding one's breath can increase intra-abdominal pressure and potentially cause discomfort during the turning maneuver.
C: "Grab my shoulders with your hands." This choice does not address the specific need to provide support to the incision area and may not be the most effective way to minimize discomfort during turning.
Question 2
A woman in active labor demonstrates signs of cephalopelvic disproportion (CPD), with the fetal head failing to descend despite strong contractions. What nursing action should be prioritized to address this abnormal labor presentation?
A. Perform a pelvic exam to assess for CPD.
B. Assist the mother into a hands-and-knees position.
C. Administer intravenous oxytocin to augment contractions.
D. Prepare for immediate instrumental delivery.
Show answer and rationale
Correct answer: D — Prepare for immediate instrumental delivery.
When a woman in active labor demonstrates signs of cephalopelvic disproportion (CPD) with the fetal head failing to descend despite strong contractions, the nursing action that should be prioritized is to prepare for immediate instrumental delivery. CPD can lead to a prolonged and difficult labor, increasing the risks for both the mother and the fetus. In cases where the fetal head is not descending adequately and the mother's contractions are strong, instrumental delivery, like forceps or vacuum extraction, may be necessary to facilitate the safe delivery of the baby. It is important to act promptly to avoid potential complications associated with prolonged labor. Other actions, such as performing a pelvic exam, changing maternal positions, or administering oxytocin, may be considered but addressing the issue of CPD efficiently through instrumental delivery should take precedence in this scenario.
Question 3
What did Paul Ehrlich predict in immunology?
A. Existence of antibodies and their ability to bind toxins
B. Discovery of germ theory
C. Smallpox eradication
D. Development of vaccines
Show answer and rationale
Correct answer: A — Existence of antibodies and their ability to bind toxins
Paul Ehrlich predicted the existence of antibodies and their ability to bind toxins. He introduced the concept of the side-chain theory, proposing that cells have specific receptors (later known as antibodies) that can bind to toxins and neutralize them. This groundbreaking idea laid the foundation for modern immunology. Ehrlich's work was instrumental in understanding the immune response and paved the way for advancements in vaccine development and disease treatment.
Choice B (Discovery of germ theory) is incorrect because it was proposed by Louis Pasteur and Robert Koch, not Paul Ehrlich. Choice C (Smallpox eradication) is incorrect as Ehrlich did not predict smallpox eradication. Choice D (Development of vaccines) is incorrect because while Ehrlich's work contributed to vaccine development, his specific prediction was about antibodies and their toxin-binding ability, not vaccines in general.
Question 4
A nurse is caring for a client who is postoperative following surgical repair of a mandibular fracture with fixed
occlusion of the jaws in a closed position. Which of the following statements is the priority for the nurse to make?
A. "We can teach you some relaxation techniques to minimize your pain."
B. "Keep wire cutters with you at all times."
C. "Use a water pick device to keep your teeth clean."
D. "Consume a high-protein, liquid diet."
Show answer and rationale
Correct answer: B — "Keep wire cutters with you at all times."
The correct answer is B: "Keep wire cutters with you at all times." This is the priority statement because in the event of an emergency, such as airway obstruction or trauma, quick access to wire cutters is crucial to ensure timely removal of the jaw fixation wires. Without immediate access to wire cutters, the client may suffer serious complications.
Incorrect choices:
A: "We can teach you some relaxation techniques to minimize your pain." - While pain management is important, it is not the priority in this situation where the immediate risk is airway compromise.
C: "Use a water pick device to keep your teeth clean." - Oral hygiene is important but not as critical as ensuring access to wire cutters for emergency situations.
D: "Consume a high-protein, liquid diet." - Nutrition is important for healing but is not as time-sensitive as having wire cutters readily available in case of an emergency.
Question 5
A high school teacher with ulnar drift caused by rheumatoid arthritis (RA) is scheduled for arthroplasty of several joints in the left hand. Which patient statement to the nurse indicates a realistic expectation for the surgery?
A. This procedure will correct the deformities in my fingers.'
B. I will not have to do as many hand exercises after the surgery.'
C. I will be able to use my fingers with more flexibility to grasp things.'
D. My fingers will appear more normal in size and shape after this surgery.'
Show answer and rationale
Correct answer: C — I will be able to use my fingers with more flexibility to grasp things.'
The correct answer is C: "I will be able to use my fingers with more flexibility to grasp things." This answer is correct because arthroplasty surgery aims to improve joint function and mobility rather than correcting deformities or changing the appearance of the fingers. Patients with ulnar drift caused by RA typically have limited mobility and flexibility in their fingers, so the goal of the surgery is to enhance the ability to use the fingers for daily tasks.
Choice A is incorrect because while the surgery may improve finger function, it may not fully correct all deformities caused by RA. Choice B is incorrect because hand exercises are typically an important part of the post-operative rehabilitation process to regain strength and mobility. Choice D is incorrect because while the surgery may improve the alignment of the joints, it may not significantly change the size or shape of the fingers.
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Question 6
The pharmacology instructor is explaining interleukins to the class. What would be the best definition of interleukins?
A. They are substances naturally produced and released by human cells that have been invaded by viruses.
B. They block the inflammatory reaction and decrease initial damage to cells.
C. They are chemicals used to communicate between leukocytes and stimulate immunity.
D. They attach to specific receptor sites and respond to very specific situations.
Correct answer:
Rationale for choice C: Interleukins are chemicals that facilitate communication between leukocytes, aiding in the stimulation of immunity. This is accurate because interleukins play a crucial role in regulating immune responses and coordinating interactions between different immune cells. They help in the activation, proliferation, and differentiation of leukocytes, thereby enhancing the body's immune defense mechanisms.
Summary of other choices:
A: Incorrect. Interleukins are not specifically related to responses against viral infections, but rather play a broader role in immune regulation.
B: Incorrect. Interleukins generally do not block inflammatory reactions; instead, they often promote immune responses.
D: Incorrect. While interleukins do bind to specific receptors, their functions are not limited to responding to very specific situations, but rather involve broader immune regulation.
A 29-year-old male is brought to the ED after being involved in a motor vehicular collision when his car struck a bridge abutment. He is intoxicated, has GCS 13, and complains of abdominal pain. His BP was 80mmHg systolic by palpation on admission, but rapidly increased to 110/70 with the administration of IV flui His heart rate is 120/min. The chest x-ray shows loss of aortic knob, widening of mediastinum, no rib fracture, and no hemopneumothorax. Contrast angiography:
A. "Is not indicated"
B. Should be performed after CT scan of the chest
C. Is positive for aortic rupture in 80% of similar cases
D. Is not necessary if the CT-scan of the chest is normal
Correct answer:
The correct answer is D: Is not necessary if the CT-scan of the chest is normal.
Rationale:
1. The patient presents with signs of possible aortic injury (e.g., widened mediastinum) after a high-speed motor vehicle collision.
2. CT scan of the chest is a sensitive imaging modality for detecting aortic injuries.
3. If the CT scan of the chest is normal, it effectively rules out aortic injury in this scenario.
4. Performing contrast angiography would be unnecessary if the initial CT scan is normal, as it would not provide additional diagnostic value and expose the patient to further risks.
Summary:
A: "Is not indicated" - Incorrect, as imaging is necessary to assess for aortic injury in this high-risk scenario.
B: Should be performed after CT scan of the chest - Incorrect, as contrast angiography is not necessary if the CT scan is normal.
C: Is positive for aortic rupture in 80% of similar cases -
“Rapunzel, Rapunzel, let down your long hair.â€
A. axillary
B. lanugo
C. definitive
D. angora
Correct answer:
Hair types in humans vary by developmental stage and location. The reference to Rapunzel's long hair evokes an image of prominent, mature hair, likely scalp hair. Axillary hair grows in the armpits, not typically long or fairy-tale-like. Lanugo is fine, soft hair on fetuses, shed before or shortly after birth, not long or durable. Definitive hair refers to terminal hair coarse, pigmented hair like that on the scalp, eyebrows, or beard which replaces vellus hair (fine, short hair) during development and fits the context of long, strong hair. Angora, a rabbit breed or wool type, is irrelevant to human hair. Scalp hair, as definitive hair, grows long due to extended anagen (growth) phases, often reaching lengths associated with Rapunzel's legendary tresses. This hair type's permanence and prominence in adults align with the literary allusion, distinguishing it from temporary or unrelated hair forms.
A. Existence of antibodies and their ability to bind toxins
B. Discovery of germ theory
C. Smallpox eradication
D. Development of vaccines
Correct answer:
Paul Ehrlich predicted the existence of antibodies and their ability to bind toxins. He introduced the concept of the side-chain theory, proposing that cells have specific receptors (later known as antibodies) that can bind to toxins and neutralize them. This groundbreaking idea laid the foundation for modern immunology. Ehrlich's work was instrumental in understanding the immune response and paved the way for advancements in vaccine development and disease treatment.
Choice B (Discovery of germ theory) is incorrect because it was proposed by Louis Pasteur and Robert Koch, not Paul Ehrlich. Choice C (Smallpox eradication) is incorrect as Ehrlich did not predict smallpox eradication. Choice D (Development of vaccines) is incorrect because while Ehrlich's work contributed to vaccine development, his specific prediction was about antibodies and their toxin-binding ability, not vaccines in general.
Which of the following is NOT part of the anatomy of the nail?
A. Nail Body
B. Nail Head
C. Nail Matrix
D. Eponychium
Correct answer:
The nail's anatomy includes specific structures, but 'nail head' is not among them. The nail body (or plate) is the hard, visible keratinized portion covering the nail bed. The nail matrix, beneath the proximal nail fold, is the growth zone where new cells form, pushing the nail forward. The eponychium, or cuticle, is the skin fold at the nail's base, protecting the matrix. These are standard nail components, derived from epidermal keratinization. 'Nail head' is not a recognized anatomical term in human nail structure possibly a confusion with other contexts (e.g., a tool) or a misnomer. In contrast, terms like lunula (the white crescent) or hyponychium (skin beneath the nail's free edge) are valid but not listed. The absence of 'nail head' in anatomical texts and its irrelevance to nail growth or function distinguish it as the incorrect option, aligning with standard dermatological descriptions.
A patient presents with a palpable, non-tender mass in the right neck, just below the angle of the mandible. Ultrasound imaging demonstrates a well-defined, hypoechoic lesion with cystic components. Which of the following conditions is most likely responsible for this presentation?
A. Branchial cleft cyst
B. Thyroglossal duct cyst
C. Lymphadenopathy
D. Parotid gland tumor
Correct answer:
The presentation of a palpable, non-tender mass in the right neck, just below the angle of the mandible, along with ultrasound imaging findings of a well-defined, hypoechoic lesion with cystic components, is classic for a branchial cleft cyst. Branchial cleft cysts are congenital anomalies that arise from remnants of the branchial clefts or pouches during embryonic development. They are typically located along the anterior border of the sternocleidomastoid muscle, just below the mandible. Ultrasound imaging often shows a cystic lesion with well-defined borders and hypoechoic content, which is consistent with the described findings. Thyroglossal duct cysts usually present as midline neck masses that move with swallowing or tongue protrusion, not in the location described in the scenario. Lymphadenopathy would present as enlarged lymph nodes that may be tender and associated with systemic symptoms.
In order to determine the patient's ability to concentrate and focus, which would be the PRIORITY nursing action?
A. Asked for the academic performance
B. Conduct paper and pencil test
C. Assess the mental status of the patient
D. Refer the patient to the psychiatrist
Correct answer:
Assessing the mental status of the patient is the PRIORITY nursing action to determine the patient's ability to concentrate and focus. This assessment includes evaluating the patient's level of alertness, orientation, memory, thought processes, and mood. By observing the patient's mental status, the nurse can gain valuable information about the patient's cognitive function, attention span, and ability to concentrate. This assessment will help guide further interventions and care planning for the patient. Asking for academic performance or conducting paper and pencil tests may be useful tools to assess concentration and focus, but they should come after a comprehensive evaluation of the patient's mental status. Referring the patient to a psychiatrist may be necessary based on the assessment findings, but it should not be the first step in determining the patient's ability to concentrate and focus.
A patient presents with palpitations, dizziness, and syncope. An electrocardiogram (ECG) shows ventricular tachycardia. Which cardiovascular disorder is most likely responsible for these symptoms?
A. Stable angina
B. Unstable angina
C. Atrial fibrillation
D. Ventricular tachycardia
Correct answer:
The correct answer is D: Ventricular tachycardia. Ventricular tachycardia is a serious arrhythmia that can lead to palpitations, dizziness, and syncope due to the rapid and abnormal heart rhythm originating in the ventricles. This arrhythmia can be life-threatening if not promptly treated.
A: Stable angina is characterized by chest discomfort or pain due to reduced blood flow to the heart muscle, usually during physical exertion or stress. It does not typically present with palpitations, dizziness, or syncope.
B: Unstable angina is a more severe form of angina where symptoms occur even at rest. While it can lead to serious complications like heart attack, it does not commonly present with palpitations, dizziness, or syncope.
C: Atrial fibrillation is a common arrhythmia originating in the atria, leading to an irregular and often rapid heartbeat. While it can cause palpitations and dizziness,
A postpartum client is breastfeeding and expresses discomfort during feedings due to sore nipples. What nursing intervention should be prioritized to alleviate nipple soreness?
A. Educating the client on proper latch technique
B. Recommending the use of nipple shields during feedings
C. Applying lanolin cream to the nipples after each feeding
D. Encouraging the use of breast pumps instead of direct breastfeeding
Correct answer:
Proper latch technique is the most important nursing intervention to alleviate nipple soreness in a breastfeeding client. When a baby latches on correctly, it helps prevent nipple trauma and soreness. Educating the client on how to achieve a proper latch, such as ensuring the baby's mouth covers both the nipple and areola, can significantly reduce discomfort during feedings. Improving the latch can also enhance milk transfer, leading to better breastfeeding outcomes for both the mother and baby. While lanolin cream (choice C) can provide some relief for sore nipples, addressing the root cause by correcting the latch is crucial for long-term comfort and successful breastfeeding. Using nipple shields (choice B) or encouraging the use of breast pumps (choice D) should not be the first line of intervention when addressing sore nipples, as they do not address the underlying issue of latch technique.
A patient presents with grouped vesicles on an erythematous base, affecting the lips and perioral region. The patient reports a history of similar episodes triggered by sunlight exposure and stress. Which of the following conditions is most likely responsible for this presentation?
A. Herpes simplex labialis (cold sores)
B. Perioral dermatitis
C. Angular cheilitis
D. Allergic contact dermatitis
Correct answer:
The patient's presentation with grouped vesicles on an erythematous base affecting the lips and perioral region, triggered by sunlight exposure and stress, is classic for herpes simplex labialis, commonly known as cold sores. Herpes simplex virus type 1 (HSV-1) is responsible for cold sores and is highly contagious. Recurrent episodes can be triggered by factors like UV exposure, stress, illness, and hormonal changes. Symptoms typically start with tingling or burning sensations before progressing to grouped vesicles that rupture, forming crusts. Treatment may involve antiviral medications to reduce the severity and duration of symptoms. Perioral dermatitis typically presents with papules and pustules around the mouth, while angular cheilitis involves fissures and inflammation at the corners of the mouth. Allergic contact dermatitis would present with erythema, pruritus, and possibly vesicles in
RN exams medical-surgical practice questions, set 23 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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