Midterm Focus on Adult Health
MedSurg Nursing Test Questions And
Correct Answers.
A 70-year-old elderly patient is admitted to the preoperative unit for a liver resection that is scheduled
for 6 hours of surgery. What is one of the basic principles that should guide the preoperative nurse's
assessment?
A. Elderly patients do not experience as much preoperative anxiety as younger patients.
B. The elderly patient has less physiologic reserve than the younger patient.
C. Elderly patients experience less pain.
D. Preoperative pain assessment and teaching should occur following the procedure as the elderly
patient may not retain the information. - Answer B. The elderly patient has less physiologic reserve
than the younger patient.
RATIONALE Preoperative pain assessment and teaching are important to the elderly patient. These
patients may have a combination of chronic illnesses and health issues in addition to the specific one for
which surgery is indicated. Health care staff must remember that the hazards of surgery for the aged are
proportional to the number and severity of coexisting health problems and the nature and duration of
the operative procedure. It is, therefore, important to be guided by the principle that the elderly has less
physiologic reserve (the ability of an organ to return to normal after a disturbance in its equilibrium).
A nurse is caring for a postoperative patient who had spinal anesthesia. The patient complains of
headache. What action should the nurse take?
A. Lower the head of the patient's bed.
B. Keep the patient lying flat, maintain a quiet environment, and keep the patient hydrated.
C. Encourage the patient to lay on his right side.
D. Do nothing, as this is a normal response to the spinal anesthesia. - Answer B. Keep the patient lying
flat, maintain a quiet environment, and keep the patient hydrated.
,RATIONALE Headache may be an after-effect of spinal anesthesia. Factors related to headache include,
size of the spinal needle used, the leakage of the fluid from subarachnoid space through the puncture
site and the patients hydration status. Measures that increase cerebrospinal pressure are helpful in
relieving headache.
When does the postoperative phase begin?
A. Admission of the patient to the OR
B. Admission of the patient to the PACU and ending when the patient is discharged to the unit/ home
C. Admission of the patient to the PACU and ending with follow-up evaluation in the clinical
setting/home
D. Admission to the PACU - Answer B. Admission of the patient to the PACU and ending when the
patient is discharged to the unit or home
RATIONALE The postoperative phase does not just end when the patient is discharged to the unit or to
home. The goal of postoperative management is to restore the patient to previous state or acceptable
return of equilibrium. This phase includes teaching, promoting recovery, follow-up care, and referrals
essential for recovery and rehabilitation.
A nurse is caring for a postoperative patient on POD 2. The patient had a large upper abdominal incision.
While assessing the patient at the beginning of the shift, the nurse noted decreased breath sounds,
crackles, and a mild cough. What is the patient most likely experiencing?
A. Atelectasis
B. Pneumonia
C. Acute bronchitis
D. Hypoxemia - Answer A. Atelectasis
RATIONALE Many factors such as age, smoking, long duration of surgery, incisional site (chest and upper
abdomen), as well as comorbidities and associated with an increased risk for postoperative pulmonary
complications. Atelectasis remains a risk for the patient who is not moving well, not coughing well or
performing deep-breathing as a result of a large incisional site. The nurse must be alert and aware of
these signs and symptoms.
, Surgical wound healing occurs in:
A. Two phases: inflammatory and maturation
B. Three phases: inflammatory, proliferative, and maturation
C. First-, second-, and third-intention wound healing
D. First and proliferative phase - Answer B. Three phases: inflammatory, proliferative, and maturation
RATIONALE Wounds heal in three phases and the duration of the phases can vary in length. First- second-
and third-intention wound healing is the mechanical process of wound healing.
Before an ABG is drawn from the patient's radial artery, what test should be performed?
A. Doppler flow test
B. Allen test
C. Babinski test
D. Ankle Brachial Index (ABI) - Answer B. Allen test
RATIONALE
The Allen test is used to assess for adequate perfusion of the hand via the ulnar artery prior to
puncturing the radial artery for an arterial blood gas. This test assesses patency of the ulnar artery
and/or collateral circulation.
A patient has a chronic cough with thick sputum. He undergoes a bronchoscopy for diagnostic purposes.
Following the bronchoscopy, which action by the nurse is most appropriate?
A. Encourage fluid intake to promote elimination of contrast media.
B. Monitor hemoglobin and hematocrit to evaluate blood loss.
C. Check vital signs every 15 minutes for 4 hours.
D. Keep NPO until the gag reflex returns. - Answer D. Keep NPO until the gag reflex returns.
MedSurg Nursing Test Questions And
Correct Answers.
A 70-year-old elderly patient is admitted to the preoperative unit for a liver resection that is scheduled
for 6 hours of surgery. What is one of the basic principles that should guide the preoperative nurse's
assessment?
A. Elderly patients do not experience as much preoperative anxiety as younger patients.
B. The elderly patient has less physiologic reserve than the younger patient.
C. Elderly patients experience less pain.
D. Preoperative pain assessment and teaching should occur following the procedure as the elderly
patient may not retain the information. - Answer B. The elderly patient has less physiologic reserve
than the younger patient.
RATIONALE Preoperative pain assessment and teaching are important to the elderly patient. These
patients may have a combination of chronic illnesses and health issues in addition to the specific one for
which surgery is indicated. Health care staff must remember that the hazards of surgery for the aged are
proportional to the number and severity of coexisting health problems and the nature and duration of
the operative procedure. It is, therefore, important to be guided by the principle that the elderly has less
physiologic reserve (the ability of an organ to return to normal after a disturbance in its equilibrium).
A nurse is caring for a postoperative patient who had spinal anesthesia. The patient complains of
headache. What action should the nurse take?
A. Lower the head of the patient's bed.
B. Keep the patient lying flat, maintain a quiet environment, and keep the patient hydrated.
C. Encourage the patient to lay on his right side.
D. Do nothing, as this is a normal response to the spinal anesthesia. - Answer B. Keep the patient lying
flat, maintain a quiet environment, and keep the patient hydrated.
,RATIONALE Headache may be an after-effect of spinal anesthesia. Factors related to headache include,
size of the spinal needle used, the leakage of the fluid from subarachnoid space through the puncture
site and the patients hydration status. Measures that increase cerebrospinal pressure are helpful in
relieving headache.
When does the postoperative phase begin?
A. Admission of the patient to the OR
B. Admission of the patient to the PACU and ending when the patient is discharged to the unit/ home
C. Admission of the patient to the PACU and ending with follow-up evaluation in the clinical
setting/home
D. Admission to the PACU - Answer B. Admission of the patient to the PACU and ending when the
patient is discharged to the unit or home
RATIONALE The postoperative phase does not just end when the patient is discharged to the unit or to
home. The goal of postoperative management is to restore the patient to previous state or acceptable
return of equilibrium. This phase includes teaching, promoting recovery, follow-up care, and referrals
essential for recovery and rehabilitation.
A nurse is caring for a postoperative patient on POD 2. The patient had a large upper abdominal incision.
While assessing the patient at the beginning of the shift, the nurse noted decreased breath sounds,
crackles, and a mild cough. What is the patient most likely experiencing?
A. Atelectasis
B. Pneumonia
C. Acute bronchitis
D. Hypoxemia - Answer A. Atelectasis
RATIONALE Many factors such as age, smoking, long duration of surgery, incisional site (chest and upper
abdomen), as well as comorbidities and associated with an increased risk for postoperative pulmonary
complications. Atelectasis remains a risk for the patient who is not moving well, not coughing well or
performing deep-breathing as a result of a large incisional site. The nurse must be alert and aware of
these signs and symptoms.
, Surgical wound healing occurs in:
A. Two phases: inflammatory and maturation
B. Three phases: inflammatory, proliferative, and maturation
C. First-, second-, and third-intention wound healing
D. First and proliferative phase - Answer B. Three phases: inflammatory, proliferative, and maturation
RATIONALE Wounds heal in three phases and the duration of the phases can vary in length. First- second-
and third-intention wound healing is the mechanical process of wound healing.
Before an ABG is drawn from the patient's radial artery, what test should be performed?
A. Doppler flow test
B. Allen test
C. Babinski test
D. Ankle Brachial Index (ABI) - Answer B. Allen test
RATIONALE
The Allen test is used to assess for adequate perfusion of the hand via the ulnar artery prior to
puncturing the radial artery for an arterial blood gas. This test assesses patency of the ulnar artery
and/or collateral circulation.
A patient has a chronic cough with thick sputum. He undergoes a bronchoscopy for diagnostic purposes.
Following the bronchoscopy, which action by the nurse is most appropriate?
A. Encourage fluid intake to promote elimination of contrast media.
B. Monitor hemoglobin and hematocrit to evaluate blood loss.
C. Check vital signs every 15 minutes for 4 hours.
D. Keep NPO until the gag reflex returns. - Answer D. Keep NPO until the gag reflex returns.
