RN exams medical-surgical practice questions, set 35
RN exams · medical-surgical
RN exams medical-surgical practice questionsset 35
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
Nurse Carmi finally decided to make an in depth study of ONLY ONE SUBJECT of domestic violence. What design will she use?
A. Causality Design
B. Predictive Correlational Design
C. Descriptive Correlational Design
D. Descriptive Case Study Design
Show answer and rationale
Correct answer: D — Descriptive Case Study Design
A descriptive case study design is the most suitable approach when Nurse Carmi decides to make an in-depth study of only one subject of domestic violence. This design involves a comprehensive and detailed exploration of a single individual or a specific situation, allowing for an in-depth analysis of various aspects related to the subject. Since Nurse Carmi is focusing on studying only one subject, a case study design will enable her to gather detailed information, delve deep into the complexities of the individual's experiences, behaviors, and outcomes related to domestic violence. This design will provide a rich and holistic understanding of the single case being studied, offering valuable insights and potential implications for practice and intervention strategies.
Question 2
Nurse Nora notices patient's uterine contractions are 70 seconds long and occur every 90 seconds when assessing the frequency of her contractions after she receives oxytocin. what would be the nurse's FIRST action?
A. Give an emergency bolus of oxytocin to relaxed the uterus
B. Discontinue the administration of the oxytocin infusion
C. Increase the rate of client's IV infusion
D. Ask client to turn to her left side and breathe deeply
Show answer and rationale
Correct answer: B — Discontinue the administration of the oxytocin infusion
Patient's uterine contractions lasting 70 seconds and occurring every 90 seconds signify hyperstimulation, which can be a serious complication associated with oxytocin administration. This may result in decreased uterine perfusion, fetal distress, and other adverse effects. The first action should be to discontinue the oxytocin infusion to prevent further complications and allow the uterus to relax. Observations and assessment should continue to monitor the patient's condition and response after discontinuing the infusion. Giving an emergency bolus of oxytocin or increasing the IV infusion rate would exacerbate the hyperstimulation, and turning the client to her left side and breathing deeply would not address the underlying issue of oxytocin-induced hyperstimulation.
Question 3
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
Show answer and rationale
Correct answer: D — as early as possible and throughout the admission
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.
Question 4
A patient presents with watery diarrhea, abdominal cramps, and nausea after consuming contaminated water from a stream during a camping trip. Laboratory tests reveal oocysts in the stool sample. Which of the following parasites is most likely responsible for this infection?
A. Giardia lamblia
B. Entamoeba histolytica
C. Cryptosporidium parvum
D. Cyclospora cayetanensis
Show answer and rationale
Correct answer: C — Cryptosporidium parvum
The correct answer is C: Cryptosporidium parvum. This parasite is the most likely cause of the infection due to its presentation with watery diarrhea, abdominal cramps, and nausea after consuming contaminated water. Laboratory tests revealing oocysts in the stool sample further support this diagnosis as Cryptosporidium parvum is known to produce oocysts in the stool. Giardia lamblia (choice A) presents with similar symptoms but does not typically produce oocysts. Entamoeba histolytica (choice B) is more associated with bloody diarrhea and liver abscesses. Cyclospora cayetanensis (choice D) is also associated with watery diarrhea but is less common in this scenario. Thus, based on the symptoms and laboratory findings, Cryptosporidium parvum is the most likely culprit.
Question 5
Which of the following research designs is MOST APPROPRIATE for this study if the aim is to find a relationship between two variables in the study?
A. Phenomenological study
B. Exploratory
C. Experimental
D. Correlational
Show answer and rationale
Correct answer: D — Correlational
A correlational research design is most appropriate when the aim is to find a relationship between two variables. Correlational studies examine how variables are related to each other without manipulating them. This design allows researchers to determine the strength and direction of the relationship between variables, providing valuable insights into the potential associations between different factors. Phenomenological studies focus on understanding individuals' experiences, exploratory studies investigate a topic without predefined hypotheses, and experimental studies involve manipulating variables to observe their effects. Therefore, in the context of aiming to find a relationship between two variables, a correlational research design is the most suitable choice.
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Question 6
Which of the following represents the correct sequence of host immune defenses as encountered by a pathogen?
A. Innate responses; physical barriers; adaptive responses
B. Physical barriers; innate responses; adaptive responses
C. Adaptive responses; physical barriers; innate responses
D. Physical barriers; adaptive responses; innate responses
Correct answer:
The correct sequence is B: Physical barriers; innate responses; adaptive responses. Physical barriers like skin and mucous membranes are the first line of defense, followed by innate responses (e.g., inflammation, phagocytosis) that provide immediate, non-specific protection. Adaptive responses (e.g., antibody production, T cell activation) are the final defense mechanism, specifically targeting the pathogen. Choices A, C, and D are incorrect because they do not follow the correct chronological order of how host immune defenses are encountered by a pathogen. Option A and D have the innate and adaptive responses in the wrong order, while option C places adaptive responses before physical barriers, which is not accurate in terms of the sequence of host immune defenses.
The clinic health care worker notices that a client has a fungal infection on her nails that looks like the fungus is digesting the nail keratin. The nail appears opaque and white in color. The client states she has had this for years. The health care worker suspects the client has:
A. Candidiasis
B. Cellulitis
C. Onychomycosis
D. Tinea corporis
Correct answer:
The correct answer is C: Onychomycosis. This is a fungal infection of the nail caused by dermatophytes, yeasts, or molds. In this case, the description of the nail appearing opaque and white, with the fungus appearing to digest the keratin, is consistent with onychomycosis. The fact that the client has had this for years also aligns with the chronic nature of onychomycosis.
Explanation for why other choices are incorrect:
A: Candidiasis is a fungal infection caused by Candida species, typically affecting mucous membranes or skin folds, not nails.
B: Cellulitis is a bacterial infection involving the deeper layers of the skin, not related to fungal nail infections.
D: Tinea corporis is a fungal infection of the skin, commonly known as ringworm, not specific to nails.
A patient with terminal cancer experiences dyspnea and anxiety. Which intervention should the palliative nurse prioritize to address the patient's symptoms?
A. Administer oxygen therapy to relieve dyspnea.
B. Encourage the patient to practice relaxation techniques.
C. Prescribe opioid medications for symptom management.
D. Refer the patient to a respiratory therapist for breathing exercises.
Correct answer:
When a patient with terminal cancer experiences dyspnea (difficulty breathing) and anxiety, opioid medications are often prioritized by palliative care providers for symptom management. Opioids are effective in relieving dyspnea by acting as respiratory depressants and reducing the feeling of air hunger. Additionally, opioids have sedative effects that can help alleviate anxiety and promote relaxation. Therefore, in this situation, prescribing opioid medications would be the most appropriate intervention to address both the dyspnea and anxiety symptoms simultaneously. Oxygen therapy, relaxation techniques, and breathing exercises may also be useful adjunctive interventions, but opioid medications are typically prioritized for immediate symptom relief in this context.
Nurse Selma conducts her INITIAL assessment on Catherine. patient keeps on crying and constantly pulls her right ear. What is her MOST APPROPRIATE action?
A. Request parent to carry the child
B. Take Catherine's vital signs.
C. Refer to the attending physician.
D. Assess the description and frequency of pain.
Correct answer:
When a patient is crying and continuously pulling at a specific body part, such as Catherine pulling her right ear, it indicates discomfort or pain in that area. Nurse Selma's most appropriate action would be to further assess the description and frequency of the pain. This will help her identify the possible cause of the pain, whether it is due to an ear infection, injury, or any other underlying issue. Understanding the nature and intensity of the pain will guide Nurse Selma in providing appropriate care and intervention for Catherine. It is crucial to address the patient's pain promptly to ensure their comfort and well-being. Referring to the attending physician may be necessary after this initial assessment but assessing the pain should be the immediate priority.
Which of the following represents the correct sequence of host immune defenses as encountered by a pathogen?
A. Innate responses; physical barriers; adaptive responses
B. Physical barriers; innate responses; adaptive responses
C. Adaptive responses; physical barriers; innate responses
D. Physical barriers; adaptive responses; innate responses
Correct answer:
The correct sequence is B: Physical barriers; innate responses; adaptive responses. Physical barriers like skin and mucous membranes are the first line of defense, followed by innate responses (e.g., inflammation, phagocytosis) that provide immediate, non-specific protection. Adaptive responses (e.g., antibody production, T cell activation) are the final defense mechanism, specifically targeting the pathogen. Choices A, C, and D are incorrect because they do not follow the correct chronological order of how host immune defenses are encountered by a pathogen. Option A and D have the innate and adaptive responses in the wrong order, while option C places adaptive responses before physical barriers, which is not accurate in terms of the sequence of host immune defenses.
Mutations in which of the following genes are considered a risk factor for Crohn's disease?
A. TLR-4
B. NOD2
C. NADPH oxidase
D. IL-2
Correct answer:
The correct answer is B: NOD2. Mutations in the NOD2 gene have been strongly associated with an increased risk of Crohn's disease. NOD2 is involved in the immune response to bacteria in the gut, and mutations in this gene can lead to dysregulation of the immune system, contributing to the development of Crohn's disease.
A: TLR-4 is involved in the recognition of bacterial components but mutations in this gene are not strongly linked to Crohn's disease.
C: NADPH oxidase is important for the production of reactive oxygen species in immune cells but mutations in this gene are not known to be a risk factor for Crohn's disease.
D: IL-2 is a cytokine involved in immune regulation but mutations in this gene are not associated with an increased risk of Crohn's disease.
Mutations in which of the following genes are considered a risk factor for Crohn's disease?
A. TLR-4
B. NOD2
C. NADPH oxidase
D. IL-2
Correct answer:
The correct answer is B: NOD2. Mutations in the NOD2 gene have been strongly associated with an increased risk of Crohn's disease. NOD2 is involved in the immune response to bacteria in the gut, and mutations in this gene can lead to dysregulation of the immune system, contributing to the development of Crohn's disease.
A: TLR-4 is involved in the recognition of bacterial components but mutations in this gene are not strongly linked to Crohn's disease.
C: NADPH oxidase is important for the production of reactive oxygen species in immune cells but mutations in this gene are not known to be a risk factor for Crohn's disease.
D: IL-2 is a cytokine involved in immune regulation but mutations in this gene are not associated with an increased risk of Crohn's disease.
A woman in active labor is diagnosed with uterine rupture, resulting in fetal distress and maternal hemorrhage. What nursing intervention is essential in managing this obstetric emergency?
A. Initiating immediate oxytocin infusion
B. Preparing for immediate instrumental delivery
C. Performing an emergency cesarean section
D. Administering intravenous magnesium sulfate
Correct answer:
Uterine rupture is a severe obstetric complication that requires prompt and decisive management to prevent adverse outcomes for both the mother and the baby. In cases of uterine rupture leading to fetal distress and maternal hemorrhage, performing an emergency cesarean section is crucial. This intervention allows for rapid delivery of the baby, relieving the distress on the fetus and enabling immediate access to manage the maternal hemorrhage. By performing a timely cesarean section, healthcare providers can expedite the delivery process and effectively address both the fetal and maternal complications associated with uterine rupture. This intervention is essential in saving lives and reducing the risk of further complications in such a critical obstetric emergency.
It is not enough for the nurse to listen, but she also has, to validate what she has heard. The importance of validation are the following EXCEPT _____
A. perceptions influence the interpretation of a message
B. most patients are cognitively impaired
C. Eye contact does not necessarily send the same message
D. assists clarifying thoughts
Correct answer:
The importance of validation in the context of communication and nursing care does not include the assumption that most patients are cognitively impaired. It would be more appropriate to approach patient interactions with the assumption that patients are capable of understanding and coherent communication. Validation is important because it helps ensure that the nurse has truly understood the patient's message, prevents misinterpretation, and fosters a sense of empathy and trust in the nurse-patient relationship. Additionally, validating the patient's thoughts and feelings can help clarify confused thoughts and promote effective communication. The other options (A, C, and D) are all valid reasons emphasizing the significance of validation in effective communication.
What is the first medication to give to a patient with wheezing due to an allergic reaction?
A. Albuterol via nebulizer
B. Methylprednisolone 100 mg IV
C. Cromolyn 20 mg via nebulizer
D. Aminophylline 500 mg IV
Correct answer:
The correct answer is A, Albuterol via nebulizer. Albuterol is the first-line treatment for wheezing caused by an allergic reaction because it is a fast-acting bronchodilator that helps to quickly open the airways, providing immediate relief of symptoms. Choice B, Methylprednisolone 100 mg IV, is a corticosteroid used for its anti-inflammatory effects but is not the initial medication for acute wheezing in an allergic reaction. Choice C, Cromolyn 20 mg via nebulizer, is a mast cell stabilizer that can be used for prevention but is not the first choice for acute symptom relief. Choice D, Aminophylline 500 mg IV, is a bronchodilator with a narrow therapeutic window and more side effects compared to Albuterol, making it a less preferred option as the initial treatment.
RN exams medical-surgical practice questions, set 35 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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