RN exams medical-surgical practice questions, set 33
RN exams · medical-surgical
RN exams medical-surgical practice questionsset 33
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 is providing care to a patient with an indwelling urinary catheter. Which intervention is most important to prevent infection?
A. Empty the drainage bag every 8 hours.
B. Ensure the catheter is secured to the patient\'s leg.
C. Maintain a closed drainage system.
D. Irrigate the catheter daily.
Show answer and rationale
Correct answer: C — Maintain a closed drainage system.
The most important intervention to prevent infection in a patient with an indwelling urinary catheter is to maintain a closed drainage system (Option C). A closed system prevents bacteria from entering the catheter and causing infection. Keeping the system closed also reduces the risk of contamination. Emptying the drainage bag every 8 hours (Option A) is important but does not address the prevention of infection directly. Ensuring the catheter is secured to the patient's leg (Option B) is essential for preventing accidental dislodgement but does not directly prevent infection. Irrigating the catheter daily (Option D) can actually introduce bacteria into the catheter and increase the risk of infection. Therefore, maintaining a closed drainage system is the most crucial intervention for infection prevention in patients with indwelling urinary catheters.
Question 2
The nurse is caring for a patient who states, \'You are the only nurse who understands about my pain. Can\'t you give me an extra dose of pain medication?\' How should the nurse respond to the patient\'s request?
A. Explain that dosage schedules are by physician\'s orders.
B. Ignore the request.
C. Tell the patient that his behavior is manipulative.
D. Agree to give an extra dose of pain medication.
Show answer and rationale
Correct answer: A — Explain that dosage schedules are by physician\'s orders.
The correct response is A: "Explain that dosage schedules are by physician's orders." It is important for the nurse to clarify to the patient that medication doses are prescribed by the physician based on the patient's condition and needs. Giving extra doses without proper authorization can be harmful and is not in the patient's best interest. Ignoring the request (B) is not a professional or ethical response, as it does not address the patient's concerns. Labeling the patient's behavior as manipulative (C) can damage the nurse-patient relationship and is not beneficial. Agreeing to give an extra dose (D) goes against proper medication administration protocols and could result in adverse consequences for the patient. Therefore, the best course of action is to educate the patient on the importance of following the prescribed dosage schedules.
Question 3
The nurse is caring for a patient with hyperthyroidism. Which symptom should the nurse expect to find?
A. Weight gain
B. Bradycardia
C. Heat intolerance
D. Constipation
Show answer and rationale
Correct answer: C — Heat intolerance
The correct answer is C: "Heat intolerance." Hyperthyroidism is a condition where the thyroid gland produces too much thyroid hormone, leading to symptoms such as increased metabolism and heat intolerance. Patients with hyperthyroidism often feel excessively hot, sweaty, and have difficulty tolerating warm temperatures. Weight gain (option A) is not typically associated with hyperthyroidism, as patients may actually experience weight loss due to increased metabolism. Bradycardia (option B) refers to a slow heart rate, which is not a common symptom of hyperthyroidism as it usually causes tachycardia (rapid heart rate). Constipation (option D) is more commonly associated with hypothyroidism, where the thyroid gland is underactive. Therefore, the nurse should expect to find heat intolerance as a symptom in a patient with hyperthyroidism.
Question 4
A patient with asthma is receiving albuterol. Which assessment finding indicates that the medication is effective?
A. Decreased wheezing
B. Increased heart rate
C. Increased blood pressure
D. Decreased respiratory rate
Show answer and rationale
Correct answer: A — Decreased wheezing
The correct answer is A: 'Decreased wheezing.' Albuterol is a bronchodilator commonly used to treat asthma by relaxing the muscles in the airways, which helps to improve airflow to the lungs. Wheezing is a common symptom of asthma due to narrowed airways. Therefore, a decrease in wheezing indicates that the medication is effectively dilating the airways and improving airflow, making it easier for the patient to breathe. Increased heart rate (option B) and increased blood pressure (option C) are not typically desired effects of albuterol and may indicate adverse reactions. Decreased respiratory rate (option D) may not necessarily indicate the effectiveness of albuterol in treating asthma. Thus, the most appropriate assessment finding to determine the effectiveness of albuterol in treating asthma is a decrease in wheezing.
Question 5
The nurse is caring for a patient who is receiving oxygen therapy. Which assessment finding indicates that the therapy is effective?
A. The patient is sleeping comfortably.
B. The patient\'s respiratory rate is 20 breaths per minute.
C. The patient\'s oxygen saturation is 98%.
D. The patient\'s skin is warm and dry.
Show answer and rationale
Correct answer: C — The patient\'s oxygen saturation is 98%.
The correct answer is C. Oxygen saturation (SpO2) is a direct indicator of how well the patient's body is being oxygenated. A saturation of 98% indicates that the oxygen therapy is effective in improving the oxygen levels in the blood. While the other options may also be positive signs, they do not directly indicate the effectiveness of oxygen therapy. The patient sleeping comfortably (option A) may be a good sign but is more subjective. A respiratory rate of 20 breaths per minute (option B) is within the normal range but does not confirm the effectiveness of oxygen therapy. The patient's skin being warm and dry (option D) is a general assessment finding that does not specifically relate to oxygen therapy effectiveness. Therefore, monitoring oxygen saturation is crucial in assessing the success of oxygen therapy.
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Question 6
While sitting in the cafeteria, a nurse overhears two nursing students discussing a patient admitted for chemical detoxification. What is the best action by the nurse?
A. Report the incident to their instructor.
B. Report the incident to the nursing supervisor.
C. Discuss the incident with the students immediately.
D. Ignore the incident.
Correct answer:
The best action for the nurse to take in this scenario is to discuss the incident with the students immediately (Option C). By addressing the situation promptly, the nurse can clarify any misunderstandings, provide guidance on patient confidentiality, and reinforce the importance of professionalism in healthcare settings. Reporting the incident to their instructor or nursing supervisor may be necessary in certain cases, but directly addressing the students first allows for a teaching moment and an opportunity to correct any inappropriate behavior. Ignoring the incident (Option D) is not advisable as it could potentially lead to further breaches of patient confidentiality. Therefore, discussing the incident with the students immediately is the most appropriate and proactive response in this situation.
A patient presents with sudden-onset, severe eye pain, headache, nausea, and vomiting. On examination, the affected eye appears red, with a steamy cornea and mid-dilated, non-reactive pupil. Which of the following conditions is most likely responsible for this presentation?
A. Acute angle-closure glaucoma
B. Central retinal artery occlusion
C. Optic neuritis
D. Corneal ulcer
Correct answer:
The described presentation is classic for acute angle-closure glaucoma. This condition is characterized by sudden-onset severe eye pain, headache, nausea, and vomiting. The red eye, steamy cornea (corneal edema), and mid-dilated non-reactive pupil are consistent with acute angle-closure glaucoma. The sudden increase in intraocular pressure leads to impaired aqueous humor outflow, causing these symptoms. Immediate intervention is required to prevent permanent vision loss in such cases. Central retinal artery occlusion would present with sudden painless vision loss. Optic neuritis typically presents with vision loss and pain with eye movements. Corneal ulcer presents with eye discomfort, foreign body sensation, and may have a history of corneal trauma or contact lens wear.
What PRIORITY precautionary measure should be done by the nurse during the oxygen therapy?
A. Limit visitors.
B. Attach "No Smoking" signage
C. Check humidifler's water regularly.
D. Connect bait to oxygen tank.
Correct answer:
Checking the humidifier's water regularly is the priority precautionary measure that should be done by the nurse during oxygen therapy. Maintaining adequate water in the humidifier ensures proper humidification of the oxygen delivered to the patient, helping prevent mucous membrane dryness and irritation. Dry mucous membranes can lead to discomfort, increased risk of infection, and potential damage to the respiratory system. Therefore, ensuring the humidifier's water level is appropriate is crucial for the safety and well-being of the patient receiving oxygen therapy. Limiting visitors, attaching "No Smoking" signage, and connecting the bait to the oxygen tank are important precautions as well, but checking the humidifier's water is the priority measure in this scenario.
Which intervention is most helpful in determining the need for oxygen therapy for a patient with chronic obstructive pulmonary disease (COPD)?
A. Ask the patient whether he needs supplemental oxygen.
B. Assess the patient\'s level of fatigue.
C. Evaluate the complete blood count (CBC).
D. Use a pulse oximeter on the patient\'s ear lobe.
Correct answer:
Using a pulse oximeter on the patient's earlobe is the most appropriate intervention for determining the need for oxygen therapy in a patient with COPD. Pulse oximetry provides a quick and non-invasive way to measure the patient's oxygen saturation levels, which is crucial in assessing the need for supplemental oxygen. Oxygen therapy is typically initiated when the patient's oxygen saturation levels fall below a certain threshold. Asking the patient about their need for oxygen or assessing fatigue may not provide accurate information on the patient's oxygenation status, while evaluating a CBC does not directly assess oxygen needs in COPD. Therefore, using a pulse oximeter is the most direct and reliable method for determining the need for oxygen therapy in this scenario.
A 54-yr-old woman who recently reached menopause and has a family history of osteoporosis is diagnosed with osteopenia following densitometry testing. In teaching the woman, the nurse explains that
A. with a family history of osteoporosis, there is no way to prevent or slow bone resorption.
B. estrogen replacement therapy must be started to prevent rapid progression to osteoporosis.
C. continuous, low-dose corticosteroid treatment is effective in stopping the course of osteoporosis.
D. calcium loss from bones can be slowed by increasing calcium intake and weight-bearing exercise.
Correct answer:
The correct answer is D. Increasing calcium intake and weight-bearing exercise can help slow calcium loss from bones, which is crucial in managing osteopenia and preventing progression to osteoporosis. Calcium is essential for bone health, and weight-bearing exercises help strengthen bones.
A: Incorrect. Family history of osteoporosis does not mean it cannot be prevented or slowed down. Lifestyle modifications can help manage the condition.
B: Incorrect. Estrogen replacement therapy is not the only option for managing osteopenia. It may have risks and benefits that should be discussed with a healthcare provider.
C: Incorrect. Corticosteroid treatment is not typically recommended for osteopenia or osteoporosis management. It can have adverse effects on bone health.
A patient with atopic dermatitis has been using a high-potency topical corticosteroid ointment for several weeks. The nurse should assess for which adverse effect?
A. Thinning of the affected skin
B. Alopecia of the affected areas
C. Dryness and scaling in the area
D. Reddish-brown skin discoloration
Correct answer:
The correct answer is A: Thinning of the affected skin. High-potency topical corticosteroids can lead to skin atrophy, causing thinning of the skin with prolonged use. This adverse effect is important to assess for as it can increase the risk of skin fragility and potential for skin tears or bruising.
Choice B: Alopecia of the affected areas is not typically associated with the use of topical corticosteroids, so it is an incorrect choice.
Choice C: Dryness and scaling are common symptoms of atopic dermatitis itself, not directly caused by the corticosteroid ointment, making this choice incorrect.
Choice D: Reddish-brown skin discoloration is not a common adverse effect of topical corticosteroids and is not typically seen with their use, making this choice incorrect.
A premature infant has been admitted to the NICU for both respiratory and nutritional support. When should the nurse begin discharge teaching to the family?
A. after the infant has met goals of a mature breathing pattern and their percentile on the growth chart
B. as the infant is extubated and transitioned to nasal cannula
C. when the family shows interest in caring for their neonate independently
D. as early as possible and throughout the admission
Correct answer:
The correct answer is D because discharge teaching should start as early as possible and continue throughout the admission to ensure the family receives adequate education and support. Starting early allows for more time to address any concerns, teach necessary skills, and build confidence in caring for the premature infant. This approach promotes better outcomes for both the infant and the family.
Choice A is incorrect because waiting for the infant to meet specific goals may delay essential education and support for the family. Choice B is incorrect as it focuses on a specific medical intervention rather than comprehensive teaching. Choice C is incorrect because interest alone may not indicate readiness or understanding of the care required for a premature infant.
A patient presents with a pruritic, erythematous rash with scaly plaques and satellite papules and pustules in the inguinal folds and gluteal cleft. The patient reports recent antibiotic use for a urinary tract infection. Which of the following conditions is most likely responsible for this presentation?
A. Candidiasis (cutaneous candidiasis)
B. Tinea cruris (jock itch)
C. Erythrasma
D. Intertrigo
Correct answer:
The presentation described indicates a candidal infection, which commonly occurs in warm, moist body areas like inguinal folds and gluteal cleft. The pruritic, erythematous rash with scaly plaques and satellite papules and pustules is characteristic of cutaneous candidiasis. The recent antibiotic use for urinary tract infection likely disrupted the normal skin flora, predisposing the patient to a Candida overgrowth. Tinea cruris (jock itch) can also present similarly, but the presence of satellite papules and pustules is more indicative of candidiasis. Erythrasma typically presents as well-defined brown-red patches without satellite lesions, and intertrigo is a more generic term referring to inflammation of skin folds that can have various causes, including candidiasis.
A client calls the clinic to report exposure to poison ivy and an itchy rash that is not helped with over-the-counter antihistamines. What response by the nurse is most appropriate?
A. Antihistamines do not help poison ivy.
B. There are different antihistamines to try.
C. You should be seen in the clinic right away.
D. You will need to take some IV steroids.
Correct answer:
The correct answer is C: "You should be seen in the clinic right away." This response is appropriate because poison ivy rashes can worsen and may require prescription medications like corticosteroids. Seeing a healthcare provider ensures proper diagnosis and treatment.
A: "Antihistamines do not help poison ivy." - Incorrect, as antihistamines may provide some relief for itching but are not the primary treatment for poison ivy rashes.
B: "There are different antihistamines to try." - Incorrect, as trying different antihistamines may not address the underlying issue of poison ivy exposure.
D: "You will need to take some IV steroids." - Incorrect, as IV steroids are typically reserved for severe cases and should be prescribed by a healthcare provider after evaluation.
RN exams medical-surgical practice questions, set 33 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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