RN exams medical-surgical practice questions, set 38
RN exams · medical-surgical
RN exams medical-surgical practice questionsset 38
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
What a patient has bleeding after surgery the PACU nurse, expects which color if coming from the arterial source?
A. Darkly-colored, blood flows fast.
B. Bright red and spurts with the heartbeat.
C. slow, dark-colored, generally ooze.
D. Pinkish colored- slowly flowing.
Show answer and rationale
Correct answer: B — Bright red and spurts with the heartbeat.
The correct answer is B: Bright red and spurts with the heartbeat. This type of bleeding indicates arterial bleeding, which is oxygen-rich blood coming directly from the arteries. Arterial bleeding is bright red in color due to the high oxygen content and spurts with the heartbeat as it is under higher pressure. This rapid spurting is characteristic of arterial bleeding and requires immediate attention to control the bleeding source.
Choices A, C, and D are incorrect because they describe characteristics of venous bleeding, not arterial bleeding. Venous bleeding is dark in color, flows slowly, and generally oozes as it is oxygen-depleted blood returning to the heart. Therefore, the correct answer is B based on the specific characteristics of arterial bleeding.
Question 2
A patient presents with chronic low back pain and radicular symptoms radiating down the leg. MRI reveals a herniated disc at the L5-S1 level with compression of the adjacent nerve root. Which surgical procedure is commonly performed to decompress the nerve root and alleviate symptoms?
A. Spinal fusion
B. Laminectomy
C. Discectomy
D. Foraminotomy
Show answer and rationale
Correct answer: C — Discectomy
A discectomy is a surgical procedure commonly performed to decompress the nerve root by removing a portion of the herniated disc that is pressing on the nerve. In cases of herniated discs causing radicular symptoms (such as pain radiating down the leg), a discectomy can help alleviate the compression on the nerve, reduce symptoms, and improve the patient's condition. This procedure involves removing the portion of the disc that is herniated or bulging out to relieve pressure on the nerve root, allowing for improved function and reduced pain. Spinal fusion, laminectomy, and foraminotomy are other surgical procedures that are not typically performed for the direct decompression of the nerve root in cases of herniated discs at a specific level like the L5-S1 level.
Question 3
What is the lag phase of the primary antibody response?
A. 1-3 days
B. 5-10 days
C. 10-15 days
D. No lag phase
Show answer and rationale
Correct answer: B — 5-10 days
The lag phase of the primary antibody response refers to the time it takes for the immune system to generate specific antibodies after initial exposure to an antigen. The correct answer is B (5-10 days) because during this period, B cells are activated, undergo proliferation, differentiate into plasma cells, and start producing antibodies. This process takes time as the immune system needs to recognize the antigen, mount a response, and produce sufficient antibodies. Option A (1-3 days) is too short for the full activation and differentiation of B cells. Option C (10-15 days) is too long for the typical lag phase duration. Option D (No lag phase) is incorrect because there is always a lag phase before the peak antibody production in the primary immune response.
Question 4
An adult client is admitted to the hospital with a diagnosis of kidney stones. The healthcare provider prescribes IV fluids, x-rays, blood work, and a Foley catheter for the client. The nurse is caring for the client 3 days after admission and documents morning vital signs of 101°F, heart rate 92, respirations 25, and blood pressure 120/80. The urinary output has decreased, and the urine is cloudy and dark amber. Based on this data, which conclusion by the nurse is the most appropriate?
A. The client has passed the kidney stones.
B. The client is in acute renal failure.
C. The client has developed a respiratory infection.
D. The client has a probable urinary tract infection.
Show answer and rationale
Correct answer: D — The client has a probable urinary tract infection.
The correct answer is D: The client has a probable urinary tract infection. The rationale is as follows:
1. Cloudy and dark amber urine is indicative of possible infection in the urinary tract.
2. Decreased urinary output along with abnormal urine color suggests an issue with the urinary system.
3. Fever, elevated heart rate, and increased respiratory rate can indicate a systemic response to infection.
4. The combination of clinical findings points towards a urinary tract infection rather than kidney stones, renal failure, or respiratory infection.
Summary: Options A, B, and C are incorrect because they do not align with the client's clinical presentation, which strongly suggests a urinary tract infection based on the combination of symptoms and signs observed.
Question 5
While preparing the operating room (OR) for a surgical procedure, the nurse notices a spill of bodily fluids on the floor. What is the nurse's priority action?
A. Clean up the spill using appropriate infection control measures
B. Document the spill in the environmental services log
C. Place warning signs to alert others about the spill
D. Continue with the preparation of the OR as planned
Show answer and rationale
Correct answer: A — Clean up the spill using appropriate infection control measures
The nurse's priority action when noticing a spill of bodily fluids on the floor while preparing the operating room for a surgical procedure is to clean up the spill using appropriate infection control measures. This is essential to prevent the spread of infections and ensure a safe surgical environment for both patients and healthcare providers. Cleaning up the spill promptly and properly reduces the risk of contamination and subsequent infections. Once the spill is cleaned up, the nurse can then proceed with documenting the spill, placing warning signs to alert others, and continuing with the preparation of the OR as planned. But the initial priority is to eliminate the immediate threat posed by the spill through proper cleaning and infection control measures.
Keep going past these 15 questions
Missed-question review, longer banks, and the rest of 20,000+ nursing practice questions open when you start studying.
Stems and choices stay public so you can still reason. Correct answers and full rationales unlock with the rest of the bank.
Question 6
Incident Reports (IRs) shall be collected for the day and due investigations scheduled by the quality Department. Upon completion of the investigation, the IRS ____.
A. must be completed and stored on the open cabinet
B. can be stored on the table top for easy retrieval
C. must be summarized monthly and stored in a secured cabinet
D. classified by cate so they can be easily accessibility
Correct answer:
Incident Reports (IRs) must be summarized monthly and stored in a secured cabinet for several reasons. Firstly, summarizing the IRs monthly allows for a consolidated overview of the incidents that have occurred, highlighting any recurring patterns or trends that may need to be addressed. By storing the summarized IRs in a secured cabinet, the information is kept confidential and protected from unauthorized access. This practice also ensures that the reports are organized and easily accessible for future reference or audits. Storing the IRs on an open cabinet, table top, or with a classification system that may not be easily understandable can lead to potential breaches of confidentiality or difficulty in retrieving and understanding the information when needed.
Sandro is taking pemoline (Cylert) for ADHD. The nurse must be aware of which of the following side effects?
A. Decreased red blood cell count
B. Elevated white blood cell count
C. Decreased thyroid stimulating hormones
D. elevated liver function test results
Correct answer:
Pemoline (Cylert) is a central nervous system stimulant used in the treatment of ADHD. One of the significant potential side effects of pemoline is hepatotoxicity, which can manifest as elevated liver function test results. Therefore, the nurse must monitor the patient's liver function regularly while they are taking pemoline to monitor for any signs of liver damage or dysfunction. It is essential to educate the patient about the signs and symptoms of liver problems, such as jaundice (yellowing of the skin or eyes), abdominal pain, nausea, or dark urine, and to report any such symptoms immediately to their healthcare provider. Regular monitoring and early detection of liver function abnormalities can help prevent severe liver damage in patients taking pemoline.
A client has frequent bursts of ventricular tachycardia on the cardiac monitor. What should the nurse be most concerned about with this dysrhythmia?
A. It can develop into ventricular fibrillation at any time
B. It is almost impossible to convert to a normal rhythm
C. It is uncomfortable for the client, giving a sense of impending doom
D. It produces a high cardiac output that quickly leads to cerebral and myocardial ischemia
Correct answer:
The correct answer is A because ventricular tachycardia can deteriorate into ventricular fibrillation, a more life-threatening rhythm. Ventricular tachycardia is a precursor to ventricular fibrillation due to the rapid, disorganized electrical activity of the ventricles. This can lead to ineffective pumping of the heart, causing decreased cardiac output and potential cardiac arrest. Choices B, C, and D are incorrect because ventricular tachycardia can be converted to a normal rhythm with prompt intervention such as medications or electrical cardioversion. The sense of impending doom and discomfort described in choices C and D are more commonly associated with other dysrhythmias, such as atrial fibrillation or atrial flutter, rather than ventricular tachycardia.
The nurse is bathing a client and discovers a pressure ulcer on the buttocks. Which nursing intervention, following completion of the bath, is completed first?
A. Position the client off of the ulcer.
B. Massage the ulcerated area vigorously.
C. Place antibiotic cream over the ulcerated area.
D. Notify the health care provider and await orders.
Correct answer:
The correct answer is A: Position the client off of the ulcer. This is the first intervention because it helps relieve pressure on the affected area, promoting healing and preventing further damage. By repositioning the client, blood flow is improved, reducing the risk of further tissue breakdown.
Choice B (Massage the ulcerated area vigorously) is incorrect as it can cause further damage to the already compromised tissue. Choice C (Place antibiotic cream over the ulcerated area) should only be done after proper assessment and orders from the healthcare provider. Choice D (Notify the health care provider and await orders) is important, but repositioning the client to relieve pressure should be the immediate priority to prevent worsening of the pressure ulcer.
In comparison with the term infant, the preterm infant has
A. more subcutaneous fat.
B. well-developed flexor muNscleRs. I G
C. few blood vessels visible through the skin.
D. greater surface area in proportion to weight.
Correct answer:
The correct answer is D: greater surface area in proportion to weight. Preterm infants have a higher surface area to weight ratio due to their smaller size and underdeveloped body systems. This increased surface area makes them more susceptible to heat loss and requires special care to maintain their body temperature.
A: more subcutaneous fat - This is incorrect because preterm infants actually have less subcutaneous fat compared to full-term infants.
B: well-developed flexor muscles - This is incorrect as preterm infants typically have less muscle tone and may exhibit muscle weakness.
C: few blood vessels visible through the skin - This is incorrect as preterm infants often have fragile skin with visible blood vessels due to their underdeveloped skin layers.
What is the lag phase of the primary antibody response?
A. 1-3 days
B. 5-10 days
C. 10-15 days
D. No lag phase
Correct answer:
The lag phase of the primary antibody response refers to the time it takes for the immune system to generate specific antibodies after initial exposure to an antigen. The correct answer is B (5-10 days) because during this period, B cells are activated, undergo proliferation, differentiate into plasma cells, and start producing antibodies. This process takes time as the immune system needs to recognize the antigen, mount a response, and produce sufficient antibodies. Option A (1-3 days) is too short for the full activation and differentiation of B cells. Option C (10-15 days) is too long for the typical lag phase duration. Option D (No lag phase) is incorrect because there is always a lag phase before the peak antibody production in the primary immune response.
Laboratory findings indicate that a client's serum potassium level is 2.5 mEq/L. What action should the nurse take?
A. Inform the healthcare provider of the need for potassium replacement.
B. Prepare to administer a glucose-insulin-potassium replacement.
C. Change the plan of care to include hourly urinary output measurement.
D. Instruct the client to increase daily intake of potassium-rich foods.
Correct answer:
A serum potassium level of 2.5 mEq/L is critically low, indicating severe hypokalemia. The immediate action the nurse should take is to inform the healthcare provider of the need for potassium replacement. Option B, preparing to administer glucose-insulin-potassium replacement, is not the first-line intervention; it may be considered in specific situations but requires a healthcare provider's prescription. Option C, changing the plan of care to include hourly urinary output measurement, is not the priority when managing critically low potassium levels. Option D, instructing the client to increase daily intake of potassium-rich foods, is not appropriate in this acute situation where immediate intervention is needed to address the dangerously low potassium level.
WHICH OF THE FOLLOWING IS THE PURPOSE OF RECORD KEEPING?
A. Quantify medication usage
B. Historical background
C. Archive
D. Quality health care
Correct answer:
The purpose of record keeping in healthcare is primarily to ensure quality health care. Maintaining accurate and up-to-date records of patient information, including medical history, treatments, medications, and test results, allows healthcare providers to make informed decisions about patient care. Access to complete and organized records helps in providing timely and effective treatments, reducing errors, and ensuring continuity of care. By tracking and documenting patient care, healthcare professionals can assess outcomes, monitor progress, and improve overall quality of healthcare services. Additionally, thorough record keeping also supports communication between healthcare providers and facilitates coordination of care across different healthcare settings.
A patient with a history of peptic ulcer disease is prescribed proton pump inhibitors (PPIs) for ulcer healing. Which information is important for the nurse to include in patient education about PPI therapy?
A. PPIs should be taken on an empty stomach.
B. PPIs should be discontinued once symptoms resolve.
C. PPIs may increase the risk of gastrointestinal bleeding.
D. PPIs should be taken with antacids for optimal effect.
Correct answer:
While proton pump inhibitors (PPIs) are commonly prescribed for the treatment of peptic ulcer disease to help heal ulcers and reduce acid production, it is important for the nurse to educate the patient about potential risks associated with PPI therapy. PPIs have been associated with an increased risk of gastrointestinal bleeding, especially in patients with a history of peptic ulcer disease. It is crucial for the patient to be aware of this risk and to take precautions, such as avoiding other medications that can increase bleeding risk and informing healthcare providers about any signs of bleeding, such as black stools or abdominal pain. Educating the patient about this potential adverse effect allows for early recognition and prompt intervention if necessary.
While providing teaching to a client who is postoperative following coronary artery bypass graft (CABG) surgery and is receiving opioid medications to manage discomfort, which of the following desired effects of medications should the nurse identify as most important for the client's recovery?
A. It decreases the client's level of anxiety.
B. It facilitates the client's deep breathing.
C. It enhances the client's ability to sleep.
D. It reduces the client's blood pressure.
Correct answer:
The correct answer is B because facilitating the client's deep breathing is crucial post-CABG surgery to prevent complications such as atelectasis and pneumonia. Deep breathing helps improve lung expansion and oxygenation, promoting healing and preventing respiratory issues.
A: While decreasing anxiety is important for overall well-being, it is not directly related to the client's recovery post-CABG surgery.
C: Enhancing sleep is beneficial for healing, but it is not as critical as ensuring proper respiratory function in the immediate postoperative period.
D: While reducing blood pressure may be desirable in some cases, it is not the most important effect to focus on post-CABG surgery; maintaining adequate oxygenation through deep breathing takes precedence.
RN exams medical-surgical practice questions, set 38 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
No. Nursier is independent practice. Register through the official path named on the RN exams exam guide.
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.
Keep going past these 15 questions
Missed-question review, longer banks, and the rest of 20,000+ nursing practice questions open when you start studying.
