Medical Surgical Nursing 2025/ 2026 Exam Prep Questions and Answers PDF

MEDICAL SURGICAL NURSING.pdf MEDICAL SURGICAL NURSING.pdf MEDICAL SURGICAL NURSING.pdf

..MEDICAL SURGICAL NURSING, featuring verified solutions for nursing students. This 2025 updated! 1
Man  TOTALITY ADRENAL CORTEX
 Suprasystem Glucocorticoids/Steroids
o Individual, family, community, society  Gluconeogenesis (formation of new glucose from fats and
 Subsystem proteins)  increased CHON catabolism (breakdown)  (-)
nitrogen balance (catabolism>anabolism)
Stress Response/SMR (Sympatho-medullary Response/ SAMR o Positive nitrogen balance (more protein
(Sympatho-adreno-medullary response)/GAS (General Adaptation anabolism)
Response) Mineralocorticoid/Aldosterone
 Diaphoresis  Fluid and sodium retention
 Increased B o Oliguria <400 ml /24 hrs.
 Increased PR o Anuria <100 ml /24 hrs.
 Increased rate/depth resp.  Potassium excretion
 Pallor
 Cold clammy NEUROHYPOPHYSEAL (Hypophysis Cerebri/Sella Turcica)
 Weight loss Anterior (Adenohypophysis)
 Weakness  TSH
 Anorexia  ACTH
 Diarrhea  FSH
 Constipation  LH
 Urinary frequency  MSH (Melanocyte-Stimulating Hormone)
 Oiguria  SH (Somatotrophic Hormone)
 Anuria
 GH
 Transient hyperglycemia
Posterior (Neurohypophysis)
 Increased in visual acuity
 ADH
 Oxytocin
 Hypothalamus
o Sympatho-adrenal medullary
ENDOCRINE
o Adreno-cortical
Hypoactivity
o Neurohypophyseal
 Congenital absence of glands
Adrenal glands  Surgical removal of gland
 On top of kidneys  Idiopathic atrophy of glands
 Adrenal medulla Hyperactivity
o Inner portion  Tumor within or outside the gland
o Secretes catecholamines:  Failure of kidneys to secrete hormones
EPINEPHRINE/ADRENALINE  Failure of liver to deactivate of hormones
 Vasodilator (coronary artery, cerebral
artery, peripheral blood vessels) DECREASED APG ACTIVITY
 Vasoconstrictor (peripheral arterioles) Pituitary dwarfism
 Glycogenolysis (breakdown of  Dwarf (doubled size of infant)
glycogen in liver) Frohlicks Syndrome
NOREPINEPHRINE/NORADRENALINE  Dwarf, obese, mentally retarded, genital atrophy
 Vasoconstrictor Simmonds disease/ Pituitary Cachexia
 Wizened old man, mental lethargy, teeth start to fall,
ADRENAL MEDULLA amenorrhea, absence of spermatogenesis
Epi/Norepi (Sympathetic/Adrenergic)
 Dilated coronary arteries  increased myocardial INCREASED APG ACTIVITY
perfusion  increased myocardial contraction  Gigantism
increased PR  Before closure of epiphyseal line
 Dilated peripheral blood vessels  Rapid growth of long bones
 Relaxation of smooth muscular bronchioles o Prolongation/elongation of long bones
bronchodilation  increased rate/depth respiration Acromegaly
 Constricted peripheral arterioles  increased  After closure of epiphyseal line
peripheral resistance  increased BP  Increased in bone thickness and hypertrophy of soft tissues
 Constricted arteries of skin  decreased blood supply o Enlargement of cartilages
 pallor  Nose
 Increased glycogenolysis  transient hyperglycemia  Ears
 Sweat glands  stimulation o Enlargement of larynx
 GIT  decreased gastric secretion  decreased  Deepened voice
gastric motility o Progmathism/protrusion of jaw
 No urine  Separation of teeth
o Urinary bladder muscles relaxes o Thickening of lips and oral mucous membrane
o Urinary sphincter  close o Lengthening of chin
 Pupils  dilation  increased visual acuity o Broad hands/spade-like fingers
o Enlargement of visceral organs




:Med-Surg 1 exam que stions, Med-Surg 1 test bank, nursing exam questions a nd a nswers, verifie d Med-S urg sol utions, NCLEX-style practice que stions, me dical-surg ical nursing re view, nursing study guide 2025, Med-Surg exam prep, nursing te st ba nk PDF, Me d-Surg 1 practice questions_




MEDICAL SURGICAL NURSING.pdf MEDICAL SURGICAL NURSING.pdf MEDICAL SURGICAL NURSING.pdf

,MEDICAL SURGICAL NURSING.pdf MEDICAL SURGICAL NURSING.pdf MEDICAL SURGICAL NURSING.pdf

..MEDICAL SURGICAL NURSING, featuring verified solutions for nursing students. This 2025 updated! 2
 Management  Calcium gluconate
o Cobalt therapy
 Radiation o Given with vit. D (tachysterol)
o Surgical removal  Dihydrotachysterol
 Hypophysectomy  Hytakerol
o Inhibit production of growth hormone  Calciferol
(subcutaneously)  Calcifediol
o Somatostatin  Calcidiol
 Sandostatin ADRENAL CORTEX
 Octreotide/actreotide 1. Glucocorticoid/steroid – gluconeogenesis
 Fat  increased lipolysis  abnormal fat distribution
DIABETES INSIPIDUS  CHON  increased CHON catabolism  tissue
 Disorder in water metabolism  decreased ADH  prevent starvation & muscle wasting
renal tubules reabsorption of water  polyuria = 5-29 L/24 2. Mineralocorticoid/aldosterone
hrs.  Polydipsia  diluted (decreased specific gravity = 3. Androgen
1.010-1.025)  increased Na (135-145 mEq/L)
 All electrolyte testing do not require NPO Cushing’s
 Increased GMA

ADH  Increased 3S
o Oily preparations (Deep IM)  lipodystrophy (rotate o Sugar
route of administration)  Hyperglycemia
 Pitressin Tannate  Moon facies
 Vasopressin – vasoconstrictor  HPN  Buffalo hump
o Nasal sprays (clear nasal passages)  Truncal obesity
 Desmopressin Acetate o Salt
 Lypressin  Fluid retention  Increased BP
 Anti-lipidemic  Hypernatremia
o Clofibrate/Atromid S/Clo 5  Hypokalemia
o Sex
SIADH  Virilism
 Increased ADH  Masculinization
 Fluid retention  Hirsutism
o Increased IV volume (hypervolemia)  Management
 Increased BP o Cobalt therapy
 Increased renal perfusion  o Adrenalectomy
enhance/increased GFR/ increased o Cortisol inhibitors
UO  no leg edema  Aminogluthetemide
o Electrolyte dilution  Dilutional hyponatremia   Trilostane
fluid move into the cell  Metyrapone
 Cerebral edema  Increased ICP  Metotane
 Cellular overhydration Addison’s
 Management  Decreased GMA
o Hypophysectomy  Decreased 3S
o Inhibit production of ADH o Sugar
 Demeclocyline/Declomycin PO  Hypoglycemia
 Stimulate anterior pituitary gland 
Parathormone increased ACTH  MSH  tan
 Promote reabsorption of Ca in the renal tubules and complexion  bronze-skinned
excretion of P, essential for blood coagulation, regulate o Salt
cardiac rhythmicity  Decreased IV volume  hypotension
Hypoparathyroidism  Hyponatremia
 Hypocalcemia = hyperphosphatemia  Hyperkalemia  myocardial irritability
o 4.5-5.5 mEq/L  altered electrical conduction 
o 8-11 mg/dL dysrhythmias  heart arrest
o High calcium diet o Sex
 Tetany  Management
o (+) Chvostek – tap the Facial nerve (below the o Steroids
temporals)  muscle twitching of face
o Trousseau – occlude blood flow of an extremity Conns/Primary aldosteronism
for 1-2 minutes  carpopedal spasm  Adenoma of adrenal cortex (benign)
 Management  Hyperactivity
o Can be given sea foods but not milk, dairy Pheochromocytoma
products and egg (rich in phosphorus) so check  Adenoma of adrenal medulla (benign)
levels of phosphorus if among the choices, all is  Hyperactivity
with calcium  5H
o Calcium preparations (after meals) o Hypertension
 Calcium carbonate o Headache
 Calcium Lactate o Hyperglycemia
 Calcium Chloride 10% o Hypermetabolism
:Med-Surg 1 exam que stions, Med-Surg 1 test bank, nursing exam questions a nd a nswers, verifie d Med-S urg sol utions, NCLEX-style practice que stions, me dical-surg ical nursing re view, nursing study guide 2025, Med-Surg exam prep, nursing te st ba nk PDF, Me d-Surg 1 practice questions_




MEDICAL SURGICAL NURSING.pdf MEDICAL SURGICAL NURSING.pdf MEDICAL SURGICAL NURSING.pdf

,MEDICAL SURGICAL NURSING.pdf MEDICAL SURGICAL NURSING.pdf MEDICAL SURGICAL NURSING.pdf

..MEDICAL SURGICAL NURSING, featuring verified solutions for nursing students. This 2025 updated! 3
o Hyperhidrosis o E.g. 11am PO RAI 131 6 millicuries  24 hr.
 Management urine  1pm scanner
o Cobalt therapy  N: 0.9%-2.4 millicuries
o Surgical removal of adrenal medullary  Low: 0.67
 Assessment  High: 3.6
o VMA (Vanillylmandellic Acid) o Directly proportional to uptake
 Level of catecholamine o Inversely proportional to urine
 Blood 0.2-0.9 mg%  Thyroid Scan
 Urine 0.2-7 mg/24 hrs. o Evaluate RAI 131 stored by thyroid gland to
determine size, shape, location of thyroid gland
Thyroid glands
 Isthmus – connects the two lobes of the thyroid glands HYPOTHYROIDISM
 Thyroid hormones  Onset of symptoms
o T3 – tri-iodothyronine o Cretinism - childhood
o T4 – Thyroxine o Myxedema - adulthood
o Thyrocalcitonin  Cause
 Plasma iodide + tyrosine (amino acid) = thyroglobulin o Primary – failure of thyroid gland to secrete T3 T4
(storage form)  T3, T4 o Secondary – failure of anterior pituitary gland to
o Level of hormones are related to feedback secrete TSH
mechanism  S/sx
o Stunted growth
Anterior pituitary gland  trophic hormone  target organ o Delayed onset of puberty
 TSH  thyroid gland  T3 T4 o Low VS
 ACTH  Adrenal cortex  SSS o Mentally sluggish
o Cold intolerant
Assessments o Hypometabolic = weight gain
 PBI (Protein Bound Iodine)  Management
o Evaluate amount of iodine attached to the protein o Supplement thyroid extract
molecule of the blood  Proloid
o 4-8 ug %  Cytomel
o No intake of iodine for 3-4 days  Synthroid
 Sea foods  Euthroid
 Iodized salt  Thyrolar
 Cough syrup  Thyrax
 Salicylate (ASA)  Ectroxine
 Estrogenic preparations  Thyroxine
 Dyes  Levo-thyronine
 T3 T4 Determination  Lio-thyronine
o T3 70-170 ug %
 More potent than T4 HYPERTHYROIDISM
 Will not bind with iodine  Grave’s/Basedoue/Parry’s disease/ Thyroitoxicosis/Toxic
 Can readily/penetrate a cell to Goiter
stimulate metabolism  Theories:
o T4 4.7-11 ug % o LATS (Long-acting thyroid stimulator)
o No special preparations  Gammaglobulin
 TSH Test  Cause iodine accumulation and
o 0.4-6.11 ug/ml thyroid hyperplasia
o Decreased T3 T4  APG  stimulate TSH  Triad Symptoms
o Increased T3 T4  APG  inhibit TSH  Goiter
o Inversely proportional to thyroid function  Eye signs
 BMR  Hyperthyroidism
o Evaluate O2 consumption when at rest o Elevated T3 T4
o NPO 12 hrs. and good night sleep o EPS
o  Anterior pituitary gland will release an
 TBMR exophthalmos producing substance
o Theoretical basal metabolic rate  Exophthalmos (protrusion
o 20-30 of eyeball)
o Pulse pressure + PR/min – 111  Proptosis (downward
o Not definitive displacement of eyeball)
 RAIU (Radioactive Iodine Uptake)  Lid lag
o Evaluate amount of radioactive iodine 131  Infrequent blinking
accumulated by the thyroid gland and excreted  Fixed stare
by the kidneys  Peri-orbital edema
o No intake of iodine  Von Graefe (failure of
o Uptake = 15-40% eyelids to follow movement
o Urine = 40-80% of eyes when the patient
o PO RAI 131 cocktail (with brassy taste)  24 hr. looks down)
urine  2-4 hr. scanner
:Med-Surg 1 exam que stions, Med-Surg 1 test bank, nursing exam questions a nd a nswers, verifie d Med-S urg sol utions, NCLEX-style practice que stions, me dical-surg ical nursing re view, nursing study guide 2025, Med-Surg exam prep, nursing te st ba nk PDF, Me d-Surg 1 practice questions_




MEDICAL SURGICAL NURSING.pdf MEDICAL SURGICAL NURSING.pdf MEDICAL SURGICAL NURSING.pdf

, MEDICAL SURGICAL NURSING.pdf MEDICAL SURGICAL NURSING.pdf MEDICAL SURGICAL NURSING.pdf

..MEDICAL SURGICAL NURSING, featuring verified solutions for nursing students. This 2025 updated! 4
 Dalyrimple sign (infrequent  Turn to sides
blinking and fixed stare)  Promote adequate nutrition and fluid and electrolytes
o S/sx o As soon as fully awake and with gag reflex
Increased T3 T4  (Elevation of palate and contraction of
 Diarrhea pharyngeal muscle)
 Voracious increase T3 T4 (Grave’s)  Promote adequate bowel-bladder elimination
 Over-excitability SNS (no o 6-8 hrs. after surgery
management sought) o If not within 6-8 hrs., palpate presence of bladder
o Diaphoresis distention
o Tremors  Encourage early ambulation
o Nervousness o Shorten convalescence period
o Palpitation o Boost patient’s moral
o Constipation o Get out of bed as soon as VS are stable
o Simple goiter/Endemic goiter/ Iodine-deficiency  Support the head and neck to prevent
goiter/ Non-toxic goiter flexion and hyperextension
o Goiter – enlargement of thyroid gland  Complications
 Hormone levels o Tetany
 May be normal,  Occurs upon accidental removal of
above/below normal parathyroid glands
because goiter is simply o 2 recurrent laryngeal nerves
enlargement  Hoarseness (edema of glottis)
Treatment Modalities  Aphonia
 Anti-thyroid preparation o Bleeding
 Prevent synthesis T3 T4 by blocking utilization of  Failure to tie/ligate the bleeders
iodine  Check for dampness at the nape
 Example  Check for feeling of choking
o Tapazole/methimazole  Evaluate VS
o PTU (Propylthiouracil)  Rapid, weak, feeble,
 Differential count thready pulse
o Neomercazole/Carbimazole  Rapid but shallow
 Adverse effects (prolonged use) respiration
o Agranulocytosis – infection o Respiratory obstruction
 Fever  Secondary to bleeding
 Complaint of sore throat  Accumulation of tracheo-bronchial
 Dyspnea secretion
 Iodine Preparation  Laryngospasm
 Lugol’s solution/KISS (Potassium Iodide  Laryngeal edema
Saturated Solution) o Thyroid crises/storm
o Reduce vascularity  High anxiety level pre-op
o Increase firmness of gland  Increased T3 TT4  anti-thyroid
o Promote storage of T3 T4 preparation for 3 months  euthyroid
 Adrenergic-blocking state, normal T3 T4  operation 
 Control symptoms of over-excitability of post-op stress, infection  increased
SNS T3 T4 (over-excitability of SNS)
 RAI 131  Fever with tachycardia
 Surgery  Anti-thyroid preparation
 Management
DIABETES MELLITUS
o High caloric diet
Assessments
o No colas/caffeinated beverages
o Monitor weight  FPG, RBS, PPBS, OGTT, Hgt
o Provide physical mental rest
o Provide calm/restful environment HHNK Coma/HHNS
o Elevate head to promote drainage and reduce  Hyperglycemia  hyperosmolar diuresis  glycosuria &
peri-orbital edema polyuria  ECF dehydration  cerebral dehydration 
CNS depression  HHNK
Surgeries DKA
 Sistrunk’s – thyroglossal cyst  Increased lipolysis  increased oxidation of fatty acids 
 Radical/Total thyroidectomy hyperlipidemia & ketone bodies  DKA
o Collar-line/Curvilinear Dawn’s phenomenon
 Partial/Sub-total thyroidectomy – 5/6 of 2 lobes  Normal blood sugar before night time  shoots up
hyperglycemia at the dawn
 Thyroid lobectomy
Somogyi/Rebound Hyperglycemia
 Isthmusectomy
 Maybe normal bood sugar before the client sleeps  blood
sugar depletes at around 2 am  shoots up at around 3 am
Post-thyroidectomy management
due to the counter hormone secreted in the body
 Promote patent airway
o Position Semi-Fowler’s
Rapid Short Intermediate Long/Slow
o Not High-Fowler’s – cause strain on neck muscle
(10-15 (6-8 hrs.)
which causes tension on suture line (bleeding)
min.)
:Med-Surg 1 exam que stions, Med-Surg 1 test bank, nursing exam questions a nd a nswers, verifie d Med-S urg sol utions, NCLEX-style practice que stions, me dical-surg ical nursing re view, nursing study guide 2025, Med-Surg exam prep, nursing te st ba nk PDF, Me d-Surg 1 practice questions_




MEDICAL SURGICAL NURSING.pdf MEDICAL SURGICAL NURSING.pdf MEDICAL SURGICAL NURSING.pdf