RN exams medical-surgical practice questions, set 39
RN exams · medical-surgical
RN exams medical-surgical practice questionsset 39
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
Which abnormality on the skin of an older patient is the priority to discuss immediately with the health care provider?
A. Dry, scaly patches on the face
B. Numerous varicosities on both legs
C. Petechiae on the chest and abdomen
D. Small dilated blood vessels on the face
Show answer and rationale
Correct answer: C — Petechiae on the chest and abdomen
The correct answer is C, petechiae on the chest and abdomen. Petechiae are small pinpoint hemorrhages that can indicate a serious underlying medical condition such as thrombocytopenia or a bleeding disorder. It is important to discuss this immediately with the healthcare provider to determine the cause and initiate appropriate treatment.
A: Dry, scaly patches on the face are likely related to skin issues and can be addressed during a routine dermatology visit.
B: Numerous varicosities on both legs are common in older individuals and usually do not require urgent attention unless causing pain or other complications.
D: Small dilated blood vessels on the face are typically cosmetic concerns and not urgent unless they are causing discomfort or affecting vision.
Question 2
Superoxide dismutase is an enzyme that catalyzes the conversion of oxygen radicals to peroxides. Which groups of organisms do not have this enzyme?
A. aerobes
B. facultative anaerobes
C. oxyduric anaerobes
D. oxylabile anaerobes
Show answer and rationale
Correct answer: D — oxylabile anaerobes
The correct answer is D: oxylabile anaerobes. These organisms cannot survive in the presence of oxygen and are sensitive to oxygen radicals. Superoxide dismutase is essential for organisms that are exposed to oxygen, as it helps convert harmful oxygen radicals into less harmful peroxides. Therefore, organisms that lack this enzyme, like oxylabile anaerobes, would not be able to detoxify oxygen radicals and would not survive in aerobic environments.
A: Aerobes have superoxide dismutase to protect against oxygen radicals.
B: Facultative anaerobes can switch between aerobic and anaerobic metabolism and would benefit from having superoxide dismutase.
C: Oxyduric anaerobes are resistant to oxygen and can still benefit from superoxide dismutase for detoxification.
Question 3
A client is moving to a new state and needs to find a new doctor and hospital there. What advice by the nurse is best?
A. Ask the hospitals there about standard nurse-client ratios.
B. Choose the hospital that has the newest technology.
C. Find a hospital that is accredited by The Joint Commission.
D. Use a facility affiliated with a medical or nursing school.
Show answer and rationale
Correct answer: C — Find a hospital that is accredited by The Joint Commission.
The correct answer is C: Find a hospital that is accredited by The Joint Commission. This is the best advice because The Joint Commission accreditation ensures that the hospital meets high-quality standards in patient care, safety, and performance. Accreditation indicates the hospital's commitment to providing excellent healthcare services.
A: Asking about nurse-client ratios is important for patient safety, but it is not the most critical factor when choosing a hospital.
B: Choosing a hospital based solely on technology does not guarantee quality care or safety.
D: Using a facility affiliated with a medical or nursing school may provide access to cutting-edge research and expertise, but it does not guarantee overall quality of care provided by the hospital.
Question 4
Her parents usually become anxious and confused during late in the afternoon and after dark. What do you call this phenomenon?
A. Agitation
B. Sundowning
C. Dark retreat
D. Dark reaction
Show answer and rationale
Correct answer: B — Sundowning
Sundowning is a phenomenon commonly seen in elderly individuals, particularly those with cognitive impairments like dementia, where they become more restless, anxious, confused, or agitated during late afternoon and evening hours, typically around sunset. This change in behavior can manifest as increased confusion, wandering, aggression, or vocalization. The exact cause of sundowning is not completely understood but may involve a combination of factors such as disruptions in the sleep-wake cycle, fatigue, decreased lighting, and hormonal imbalances. Managing sundowning behaviors may involve environmental modifications, maintaining a regular routine, ensuring proper lighting, and addressing any underlying medical conditions contributing to the behavior changes.
Question 5
A nurse is preparing to change a wet-to-dry dressing for a client who has a chronic wound on the lower leg. Which action by the nurse demonstrates proper technique?
A. Soaking the old dressing with sterile saline before removing it
B. Applying antibiotic ointment to the new dressing before placing it on the wound
C. Moistening the new dressing with sterile water before wringing it out and applying it to the wound
D. Covering the new dressing with an occlusive secondary dressing to prevent evaporation
Show answer and rationale
Correct answer: C — Moistening the new dressing with sterile water before wringing it out and applying it to the wound
Moistening the new dressing with sterile water, wringing it out, and applying it is the correct technique for a wet-to-dry dressing. This method mechanically debrides necrotic tissue as the dressing dries and adheres, lifting debris upon removal. Sterile water is preferred over saline to avoid sodium crystal formation, and wringing prevents maceration while ensuring contact with the wound bed. Soaking the old dressing reduces debridement by softening adhered tissue. Antibiotic ointment interferes with adhesion and risks resistance, countering the dressing's purpose. An occlusive cover traps moisture, promoting infection rather than drying for debridement. Proper technique with moistening and wringing balances efficacy and safety, optimizing chronic wound care.
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Question 6
The nurse assesses the uterine fundus of the mother. Which part of the abdomen will the nurse begin?
A. Symphysis pubis
B. Midline
C. Umbilicus
D. Sides of the abdomen
Correct answer:
The correct answer is C: Umbilicus. The nurse begins assessing the uterine fundus at the level of the umbilicus as it is a standard reference point for postpartum fundal height measurement. This location allows for consistency and accuracy in tracking the descent of the uterus back into the pelvic cavity. Starting at the umbilicus also helps in monitoring the involution process and prevents potential errors in fundal height assessment.
Symphysis pubis (A) is too low and not typically used as a reference point for uterine fundal assessment. Midline (B) is vague and does not provide a specific anatomical landmark. Sides of the abdomen (D) do not give a standardized starting point for measuring the uterine fundus, leading to potential variability in assessment.
In planning the care of the elderly, which should be the important consideration that Nurse Gina has to consider _____.
A. The educational qualification
B. Family support
C. Activities of daily liiving
D. Residence of the elderly
Correct answer:
Family support is a crucial consideration when planning the care of the elderly. The availability of family members to provide emotional support, assistance with daily activities, and decision-making can greatly impact the overall well-being of the elderly individual. Family support can help reduce feelings of isolation, ensure that the elderly person's needs are being met, and provide a sense of security and comfort. Additionally, involving family members in the care planning process can help create a collaborative and comprehensive care approach that considers the preferences and values of the elderly person. Considering the level of family support is essential for creating a care plan that meets the unique needs and circumstances of each elderly individual.
When conducting discharge teaching for a client diagnosed with diverticulosis, which diet instruction should the nurse include?
A. Eat a high-fiber diet and increase fluid intake.
B. Have small frequent meals and sit up for at least two hours after meals.
C. Eat a bland diet and avoid spicy foods.
D. Eat a soft diet with increased intake of milk and milk products.
Correct answer:
A high-fiber diet with increased fluid intake is the most appropriate diet instruction for a client diagnosed with diverticulosis. High-fiber foods help prevent constipation and promote bowel regularity, reducing the risk of complications such as diverticulitis. Adequate fluid intake is crucial to soften stool and aid in digestion. Choice B, having small frequent meals and sitting up after meals, may be beneficial for some gastrointestinal conditions but is not specific to diverticulosis. Choice C, eating a bland diet and avoiding spicy foods, is not necessary for diverticulosis management. Choice D, consuming a soft diet with increased milk and milk products, may worsen symptoms in diverticulosis due to the potential for increased gas production and bloating.
A patient with a history of nephrolithiasis presents with sudden-onset severe colicky flank pain radiating to the groin. On physical examination, there is tenderness over the costovertebral angle and hematuria. What is the most likely diagnosis?
A. Acute pyelonephritis
B. Renal artery embolism
C. Renal colic due to ureteral calculus
D. Renal infarction
Correct answer:
The correct answer is C: Renal colic due to ureteral calculus. The sudden-onset severe colicky flank pain radiating to the groin along with tenderness over the costovertebral angle and hematuria are classic symptoms of kidney stones (ureteral calculus). The pain results from the obstruction of urine flow by the stone, leading to increased pressure and spasm in the ureter. Acute pyelonephritis (choice A) presents with fever, chills, and systemic symptoms. Renal artery embolism (choice B) typically presents with acute onset severe flank pain but is associated with risk factors like atrial fibrillation. Renal infarction (choice D) presents with sudden-onset severe flank pain but is less likely than ureteral calculus in a patient with a history of nephrolithiasis.
Ms. Nena is specifically assigned to talk individually with community leaders like the primary grade teacher and the barangay official in charge of the health committee. Which data collection method will the nurse use?
A. Key informant interview
B. Participant observer
C. Community mapping
D. Social survey
Correct answer:
The correct answer is A: Key informant interview. Ms. Nena will use this method to gather in-depth information from knowledgeable individuals within the community. This approach allows her to gain insights and perspectives from key stakeholders, such as the primary grade teacher and barangay official, who have first-hand knowledge and experience. Key informant interviews are particularly useful for obtaining specific details, opinions, and insights that may not be easily accessible through other methods. In contrast, participant observer involves direct participation in community activities, community mapping focuses on spatial data collection, and social survey typically involves collecting data from a larger sample size rather than individual key informants.
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
Correct answer:
Cryptosporidium parvum is a protozoan parasite that commonly causes waterborne illness characterized by watery diarrhea, abdominal cramps, and nausea. This parasite is often transmitted through contaminated water sources such as streams or lakes. Laboratory tests identifying oocysts in the stool sample are indicative of Cryptosporidium infection. Giardia lamblia can also cause similar symptoms, but the presence of oocysts points more towards Cryptosporidium in this case. Entamoeba histolytica causes amoebic dysentery with bloody diarrhea and is usually associated with fecal-oral transmission through contaminated food or water. Cyclospora cayetanensis typically causes prolonged watery diarrhea and is associated with the ingestion of contaminated food or water.
A patient with chronic obstructive pulmonary disease (COPD) presents with increased dyspnea, wheezing, and productive cough. Which of the following medications is most appropriate for bronchodilation and symptom relief in this patient?
A. Albuterol (salbutamol)
B. Diphenhydramine (Benadryl)
C. Montelukast (Singulair)
D. Prednisone
Correct answer:
Albuterol (salbutamol) is a short-acting beta agonist bronchodilator commonly used for quick relief of bronchoconstriction in patients with COPD. It works by relaxing the smooth muscles in the airways, allowing for easier breathing and improved airflow. The patient's increased dyspnea, wheezing, and productive cough are indicative of bronchoconstriction, and albuterol is the most appropriate medication to provide rapid bronchodilation and symptom relief in this situation. Diphenhydramine (Benadryl) is an antihistamine and not typically used for bronchodilation in COPD. Montelukast (Singulair) is a leukotriene receptor antagonist that may be used in the maintenance treatment of COPD but is not the initial choice for acute symptom relief. Prednisone is a cortic
A client with congestive heart failure has been receiving digoxin (lanoxin). Which finding indicates that the medication is having a desired effect?
A. Increased weight
B. Increased urinary output
C. Improved appetite
D. Increased pedal edema
Correct answer:
Digoxin is a medication commonly used in the treatment of congestive heart failure because it helps to improve cardiac output and reduce heart failure symptoms. One of the desired effects of digoxin is an increase in urinary output. This is because digoxin helps to improve cardiac function, which can lead to better circulation and increased kidney perfusion. As a result, the kidneys are better able to filter and excrete excess fluid, leading to increased urine output. Therefore, an increase in urinary output indicates that the digoxin is having a positive effect in managing the client's congestive heart failure. The other options, such as increased weight, improved appetite, and increased pedal edema, are not indicative of a desired effect of digoxin therapy.
A patient presents with chest pain, dyspnea, and a friction rub heard on auscultation. An electrocardiogram (ECG) shows diffuse ST-segment elevation. Which cardiovascular disorder is most likely responsible for these symptoms?
A. Stable angina
B. Unstable angina
C. Acute myocardial infarction
D. Pericarditis
Correct answer:
The clinical presentation of chest pain, dyspnea, and a friction rub heard on auscultation is suggestive of pericarditis. The diffuse ST-segment elevation seen on the electrocardiogram (ECG) is a classic finding in pericarditis, known as the "universal sign." In contrast, stable angina typically presents with chest pain on exertion that is relieved by rest or nitroglycerin, while unstable angina presents with chest pain at rest or with minimal exertion. Acute myocardial infarction would typically present with ST-segment elevation in specific leads correlating with the area of myocardial ischemia/infarction. However, in the context of diffuse ST-segment elevation and symptoms suggestive of inflammation (friction rub), the most likely diagnosis is pericarditis.
A client with type 1 diabetes mellitus has a blood glucose level of 620 mg/dL. After the nurse calls the physician to report the finding and monitors the client closely for:
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
Correct answer:
In the scenario described, a client with a blood glucose level of 620 mg/dL and type 1 diabetes mellitus is at risk of developing metabolic acidosis. In type 1 diabetes, the lack of sufficient circulating insulin leads to an increase in blood glucose levels. As the body cells utilize all available glucose, the breakdown of fats for energy results in the production of ketones, leading to metabolic acidosis. Metabolic alkalosis, respiratory acidosis, and respiratory alkalosis are not typically associated with uncontrolled type 1 diabetes. Metabolic alkalosis is more commonly linked to conditions such as vomiting or excessive diuretic use, while respiratory acidosis and respiratory alkalosis are related to respiratory system imbalances in carbon dioxide levels.
RN exams medical-surgical practice questions, set 39 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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