RN-BC: Medical-Surgical Certification Review
Questions with Accurate Answers
Abuse Screening correct answer Look for: expression of fear, anxiety, depression,
and/or anger; flat affect; loss of
appetite; injuries inconsistent or improbable to story; chronic pelvic pain,
headaches, vaginitis, IBS, guarding
Ask about: activities or actions of others that make the patient feel
uncomfortable, sad, or angry; direct language may also be appropriate
Suspicious behavior: repeated visits, erratic attendance at appointments,
increased substance abuse, suicidal attempts, heightened startle responses,
abnormal distance placed between patient and staff; partner/caregiver hostility,
talking for the patient, monitoring patient answers to questions, doesn't leave
bedside
What to do: ask questions in private; know state laws for reporting abuse (child,
elder, disabled); competent adults can decide to report, not report, stay, or leave
situation; collaborate for safe housing and support resources
Tools: Woman Abuse Screening Tool (WAST), Abuse Assessment Screen
Adult Learning correct answer The education process should reflect the nursing
process (assess, plan, implement, evaluate)
• Multiple sensory avenues for learning increases learning and retention.
• Doing and saying (teach-back) is more effective than reading and hearing.
• Learning needs: patient goals met through instruction
• Non-learning needs: patient goals met through something other than
instruction or in combination with instruction
Basic Learning Styles:
,• Visual: reading instructions or watching demonstration
• Hearing: listening to instructions while performing
• Tactile: hands-on
Advocacy correct answer What it is: action or series of actions that argues for,
speaks in favor of,
recommends, or supports another person, place, or thing
Nursing Advocacy:
• Integrates individuality, professionalism, and empowering
• Involves a process of analyzing, counseling, responding, and shielding
An effective nursing advocate actively participates in supporting patients'
wishes and needs through listening, educating, and collaborating. The ANA
2001 Code of Ethics includes:
• The nurse's primary commitment is to the patient, whether an individual,
family, group, or community.
• The nurse promotes, advocates for, and strives to protect the health, safety,
and rights of the patient. (ANA, 2001)
Allergies/Sensitivities correct answer Remember, any substance has the potential
to cause a reaction. Ask about:
• Foods: eggs (vaccinations), shellfish (iodine), peanuts, lactose intolerance, meat
(vaccinations and insulin)
• Medications: especially the ones used to TREAT allergic reactions
(antihistamines, H2 blockers, steroids, etc.)
• Herbs and supplements: any reactions to OTC formulas
,• Environmental: cleaning chemicals, soaps or detergents, pollen,
perfumes, bees
• Family Hx: any medication or food allergies in immediate family; helps identify
potential risks if the patient has yet to be exposed to certain medications in his
lifetime
• Anything else that 1) causes a rash or itching, or 2) causes difficulty breathing
Appendicitis correct answer Possible Causes: bowel cancer, infection, barium
ingestion, fecal mass
Notable symptoms: RLQ abd pain, fever, tachycardia, N/V, Rovsing's sign
Diagnostic Test(s): elevated WBCs, abd U/S, CT scan
Nursing Dx: Acute Pain, Risk for infection
Nursing Tx: Fowler's position, IV access, prep for surgery, minimal pain
medication prior to surgery to avoid masking changes in pain
Med/Surg Tx: IV fluids, antibiotics, possible NG tube, antiemetics, appendectomy
Watch For: sudden decrease in pain may indicate rupture; notify MD
immediately
Diet: NPO
Contraindicated: No heat applications over abdomen, no deep palpation of
RLQ
Other: Fatal if untreated; bowel perforation and sepsis can occur in less than 36
hours
Bandura and Self-Efficacy correct answer What it is:
, Per psychologist Albert Bandura, self-efficacy is a person's belief in their innate
abilities to succeed in a given situation; this belief is influenced by behaviors,
environment, and cognitive factors (how a person thinks).
Nursing Application:
Strengthening patient self-efficacy is a nursing intervention defined in the NIC list
for care plans. Some sources consider self-efficacy the most important condition
for successful behavior change. Nurses can assist in behavior modification,
environment changes, and cognitive factors by using case management
techniques, care conferencing, and teaching.
Bowel Sounds correct answer Begin in LRQ and move clockwise; listen up to 5
minutes in each quadrant. Bowel sounds should be evaluated in light of other GI
symptoms.
• Normal: more active prior to a meal
• Hypoactive: normal during sleep and after surgery or spinal anesthesia;
may indicate constipation
• Hyperactive: increased frequency and/or volume; may indicate Crohn's,
diarrhea, food allergy, GI bleed, enteritis, ulcerative colitis
• Absent: paralytic ileus, mesenteric artery occlusion, mechanical blockage
• Very high-pitched: may indicate early bowel obstruction
Care Conference correct answer What it is:
A gathering of multidisciplinary health professionals to plan and evaluate patient
care; does not include patient or family.
Questions with Accurate Answers
Abuse Screening correct answer Look for: expression of fear, anxiety, depression,
and/or anger; flat affect; loss of
appetite; injuries inconsistent or improbable to story; chronic pelvic pain,
headaches, vaginitis, IBS, guarding
Ask about: activities or actions of others that make the patient feel
uncomfortable, sad, or angry; direct language may also be appropriate
Suspicious behavior: repeated visits, erratic attendance at appointments,
increased substance abuse, suicidal attempts, heightened startle responses,
abnormal distance placed between patient and staff; partner/caregiver hostility,
talking for the patient, monitoring patient answers to questions, doesn't leave
bedside
What to do: ask questions in private; know state laws for reporting abuse (child,
elder, disabled); competent adults can decide to report, not report, stay, or leave
situation; collaborate for safe housing and support resources
Tools: Woman Abuse Screening Tool (WAST), Abuse Assessment Screen
Adult Learning correct answer The education process should reflect the nursing
process (assess, plan, implement, evaluate)
• Multiple sensory avenues for learning increases learning and retention.
• Doing and saying (teach-back) is more effective than reading and hearing.
• Learning needs: patient goals met through instruction
• Non-learning needs: patient goals met through something other than
instruction or in combination with instruction
Basic Learning Styles:
,• Visual: reading instructions or watching demonstration
• Hearing: listening to instructions while performing
• Tactile: hands-on
Advocacy correct answer What it is: action or series of actions that argues for,
speaks in favor of,
recommends, or supports another person, place, or thing
Nursing Advocacy:
• Integrates individuality, professionalism, and empowering
• Involves a process of analyzing, counseling, responding, and shielding
An effective nursing advocate actively participates in supporting patients'
wishes and needs through listening, educating, and collaborating. The ANA
2001 Code of Ethics includes:
• The nurse's primary commitment is to the patient, whether an individual,
family, group, or community.
• The nurse promotes, advocates for, and strives to protect the health, safety,
and rights of the patient. (ANA, 2001)
Allergies/Sensitivities correct answer Remember, any substance has the potential
to cause a reaction. Ask about:
• Foods: eggs (vaccinations), shellfish (iodine), peanuts, lactose intolerance, meat
(vaccinations and insulin)
• Medications: especially the ones used to TREAT allergic reactions
(antihistamines, H2 blockers, steroids, etc.)
• Herbs and supplements: any reactions to OTC formulas
,• Environmental: cleaning chemicals, soaps or detergents, pollen,
perfumes, bees
• Family Hx: any medication or food allergies in immediate family; helps identify
potential risks if the patient has yet to be exposed to certain medications in his
lifetime
• Anything else that 1) causes a rash or itching, or 2) causes difficulty breathing
Appendicitis correct answer Possible Causes: bowel cancer, infection, barium
ingestion, fecal mass
Notable symptoms: RLQ abd pain, fever, tachycardia, N/V, Rovsing's sign
Diagnostic Test(s): elevated WBCs, abd U/S, CT scan
Nursing Dx: Acute Pain, Risk for infection
Nursing Tx: Fowler's position, IV access, prep for surgery, minimal pain
medication prior to surgery to avoid masking changes in pain
Med/Surg Tx: IV fluids, antibiotics, possible NG tube, antiemetics, appendectomy
Watch For: sudden decrease in pain may indicate rupture; notify MD
immediately
Diet: NPO
Contraindicated: No heat applications over abdomen, no deep palpation of
RLQ
Other: Fatal if untreated; bowel perforation and sepsis can occur in less than 36
hours
Bandura and Self-Efficacy correct answer What it is:
, Per psychologist Albert Bandura, self-efficacy is a person's belief in their innate
abilities to succeed in a given situation; this belief is influenced by behaviors,
environment, and cognitive factors (how a person thinks).
Nursing Application:
Strengthening patient self-efficacy is a nursing intervention defined in the NIC list
for care plans. Some sources consider self-efficacy the most important condition
for successful behavior change. Nurses can assist in behavior modification,
environment changes, and cognitive factors by using case management
techniques, care conferencing, and teaching.
Bowel Sounds correct answer Begin in LRQ and move clockwise; listen up to 5
minutes in each quadrant. Bowel sounds should be evaluated in light of other GI
symptoms.
• Normal: more active prior to a meal
• Hypoactive: normal during sleep and after surgery or spinal anesthesia;
may indicate constipation
• Hyperactive: increased frequency and/or volume; may indicate Crohn's,
diarrhea, food allergy, GI bleed, enteritis, ulcerative colitis
• Absent: paralytic ileus, mesenteric artery occlusion, mechanical blockage
• Very high-pitched: may indicate early bowel obstruction
Care Conference correct answer What it is:
A gathering of multidisciplinary health professionals to plan and evaluate patient
care; does not include patient or family.
