Med Surg Final Exam Questions and Correct
Answers Updated
Question 1
A patient is scheduled for a cardiac catheterization with coronary angiography. Before
the test, the nurse informs the patient that:
a. it will be important to lie completely still during the procedure.
b. a flushed feeling may be noted when the contrast dye is injected.
c. monitored anesthesia care will be provided during the procedure.
d. arterial pressure monitoring will be required for 24 hours after the test.
Correct Answer
b. a flushed feeling may be noted when the contrast dye is injected.
Question 2
A nurse is caring for a client who has a fractured right hip. Which of the following
types of traction should the nurse expect the client to have prior to hip arthroplasty
surgery?
a. Balanced skeletal traction
b. Pelvic belt
c. Pelvic sling
d. Buck's traction
Correct Answer
D. Buck's traction---Buck's traction is used prior to hip arthroplasty to maintain
alignment and prevent muscle spasms prior to surgery.
Incorrect Answers:
A. Balanced skeletal traction is used to stabilize fractures of the femur or pelvis, not
the hip. Skeletal traction involves the surgical insertion of pins, tongs, wires, or
screws; this is sometimes used to stabilize long bone and vertebral fractures. B. A
pelvic belt is used to treat back pain and does not provide traction prior to hip
arthroplasty.
C. A pelvic sling is used to stabilize pelvic fractures, not hip fractures.
Page 1 of 136
,Question 3
A nurse is providing discharge teaching to a client who had a sickle cell crisis. Which
of the following statements indicates that the client understands the instructions?
a. "I should try to drink at least 2 liters of fluid per day."
b. "I can still fly out to visit my sister in Colorado for a while."
c. "Physical activity is good for me, but I need to avoid overexertion."
d. "I can still go skiing during the cold winter months."
Correct Answer
C. "Physical activity is good for me, but I need to avoid overexertion."---To help
prevent a recurrence of sickle cell crisis, the client should avoid overexertion from
especially strenuous activities.
Question 4
A nurse in an acute care facility is planning care for a client who is alert but
temporarily immobile due to a total hip arthroplasty. Which of the following
interventions should the nurse plan to take to prevent a complication of immobility?
a. Move the client from supine to a low Fowler's position every 2-3 hr to help prevent
orthostatic hypotension
b. Limit fluid intake to 1 L (33.8 oz) in 24 hr to help prevent dependent edema
c. Encourage the client to turn from side to side every 3-4 hr to help prevent
respiratory complications
d. Instruct the client to perform foot and leg exercises every 1-2 hr while awake to
help prevent thrombophlebitis
Correct Answer
D. Instruct the client to perform foot and leg exercises every 1-2 hr while awake to
help prevent thrombophlebitis---- Antiembolic exercises (e.g. flexion of the knees
and rolls and pumps of the feet and ankles) every 1-2 hours help prevent
thrombophlebitis, which is a complication of immobility.
Page 2 of 136
,Question 5
After 2 months of tuberculosis (TB) treatment with isoniazid (INH), rifampin (Rifadin),
pyrazinamide (PZA), and ethambutol, a patient continues to have positive sputum
smears for acid-fast bacilli (AFB). Which action should the nurse take next?
a. Teach about treatment for drug-resistant TB treatment.
b. Ask the patient whether medications have been taken as directed.
c. Schedule the patient for directly observed therapy three times weekly.
d. Discuss with the health care provider the need for the patient to use an injectable
antibiotic.
Correct Answer
B.
The first action should be to determine whether the patient has been compliant
with drug therapy because negative sputum smears would be expected if the TB
bacillus is susceptible to the medications and if the medications have been taken
correctly. Assessment is the first step in the nursing process. Depending on whether
the patient has been compliant or not, different medications or directly observed
therapy may be
indicated. The other options are interventions based on assumptions until an
assessment has been completed.
Question 6
Which assessment of a 62-year-old patient who has just had an intravenous
pyelogram (IVP) requires immediate action by the nurse?
a. The heart rate is 58 beats/minute.
b. The patient complains of a dry mouth.
c. The respiratory rate is 38 breaths/minute.
d. The urine output is 400 mL after 2 hours.
Correct Answer
C. The increased respiratory rate indicates that the patient may be experiencing an
allergic reaction to the contrast medium used during the procedure. The nurse
should immediately assess the patients oxygen saturation and breath sounds. The
other data are not unusual findings following an IVP.
Page 3 of 136
, Question 7
A nurse in the emergency department is preparing to discharge a client following a
Grade II (moderate) ankle sprain. Which of the following instructions should the nurse
plan to give to the client?
a. Perform passive range-of-motion exercises of the ankle hourly
b. Keep the affected extremity in a dependent position
c. Wrap a loose dressing around the affected ankle
d. Apply cold compresses to the extremity intermittently
Correct Answer
D. Apply cold compresses to the extremity intermittently--- Cold minimizes swelling
and erythema to the affected area. Therefore, the nurse should instruct the client to
apply cold compresses for no more than 20 minutes at a time.
Question 8
A nurse is providing preoperative teaching for a client with colorectal cancer who is
scheduled to undergo colostomy placement with a perineal wound. Which of the
following statements by the client indicates an understanding of the teaching?
a. "Not having any more rectal pain will be a relief."
b. "I will need to sit on a rubber donut when I am in the chair."
c. "I can have only liquids for 2 days before the surgery."
d. "The colostomy will start working about 7 days after the surgery."
Correct Answer
C. "I can have only liquids for 2 days before the surgery."---The client should
consume a full or clear liquid diet for 24 to 48 hours before the surgery to decrease
bulk. The client should consume a low-residue diet for several days prior to surgery
to decrease peristalsis.
Page 4 of 136
Answers Updated
Question 1
A patient is scheduled for a cardiac catheterization with coronary angiography. Before
the test, the nurse informs the patient that:
a. it will be important to lie completely still during the procedure.
b. a flushed feeling may be noted when the contrast dye is injected.
c. monitored anesthesia care will be provided during the procedure.
d. arterial pressure monitoring will be required for 24 hours after the test.
Correct Answer
b. a flushed feeling may be noted when the contrast dye is injected.
Question 2
A nurse is caring for a client who has a fractured right hip. Which of the following
types of traction should the nurse expect the client to have prior to hip arthroplasty
surgery?
a. Balanced skeletal traction
b. Pelvic belt
c. Pelvic sling
d. Buck's traction
Correct Answer
D. Buck's traction---Buck's traction is used prior to hip arthroplasty to maintain
alignment and prevent muscle spasms prior to surgery.
Incorrect Answers:
A. Balanced skeletal traction is used to stabilize fractures of the femur or pelvis, not
the hip. Skeletal traction involves the surgical insertion of pins, tongs, wires, or
screws; this is sometimes used to stabilize long bone and vertebral fractures. B. A
pelvic belt is used to treat back pain and does not provide traction prior to hip
arthroplasty.
C. A pelvic sling is used to stabilize pelvic fractures, not hip fractures.
Page 1 of 136
,Question 3
A nurse is providing discharge teaching to a client who had a sickle cell crisis. Which
of the following statements indicates that the client understands the instructions?
a. "I should try to drink at least 2 liters of fluid per day."
b. "I can still fly out to visit my sister in Colorado for a while."
c. "Physical activity is good for me, but I need to avoid overexertion."
d. "I can still go skiing during the cold winter months."
Correct Answer
C. "Physical activity is good for me, but I need to avoid overexertion."---To help
prevent a recurrence of sickle cell crisis, the client should avoid overexertion from
especially strenuous activities.
Question 4
A nurse in an acute care facility is planning care for a client who is alert but
temporarily immobile due to a total hip arthroplasty. Which of the following
interventions should the nurse plan to take to prevent a complication of immobility?
a. Move the client from supine to a low Fowler's position every 2-3 hr to help prevent
orthostatic hypotension
b. Limit fluid intake to 1 L (33.8 oz) in 24 hr to help prevent dependent edema
c. Encourage the client to turn from side to side every 3-4 hr to help prevent
respiratory complications
d. Instruct the client to perform foot and leg exercises every 1-2 hr while awake to
help prevent thrombophlebitis
Correct Answer
D. Instruct the client to perform foot and leg exercises every 1-2 hr while awake to
help prevent thrombophlebitis---- Antiembolic exercises (e.g. flexion of the knees
and rolls and pumps of the feet and ankles) every 1-2 hours help prevent
thrombophlebitis, which is a complication of immobility.
Page 2 of 136
,Question 5
After 2 months of tuberculosis (TB) treatment with isoniazid (INH), rifampin (Rifadin),
pyrazinamide (PZA), and ethambutol, a patient continues to have positive sputum
smears for acid-fast bacilli (AFB). Which action should the nurse take next?
a. Teach about treatment for drug-resistant TB treatment.
b. Ask the patient whether medications have been taken as directed.
c. Schedule the patient for directly observed therapy three times weekly.
d. Discuss with the health care provider the need for the patient to use an injectable
antibiotic.
Correct Answer
B.
The first action should be to determine whether the patient has been compliant
with drug therapy because negative sputum smears would be expected if the TB
bacillus is susceptible to the medications and if the medications have been taken
correctly. Assessment is the first step in the nursing process. Depending on whether
the patient has been compliant or not, different medications or directly observed
therapy may be
indicated. The other options are interventions based on assumptions until an
assessment has been completed.
Question 6
Which assessment of a 62-year-old patient who has just had an intravenous
pyelogram (IVP) requires immediate action by the nurse?
a. The heart rate is 58 beats/minute.
b. The patient complains of a dry mouth.
c. The respiratory rate is 38 breaths/minute.
d. The urine output is 400 mL after 2 hours.
Correct Answer
C. The increased respiratory rate indicates that the patient may be experiencing an
allergic reaction to the contrast medium used during the procedure. The nurse
should immediately assess the patients oxygen saturation and breath sounds. The
other data are not unusual findings following an IVP.
Page 3 of 136
, Question 7
A nurse in the emergency department is preparing to discharge a client following a
Grade II (moderate) ankle sprain. Which of the following instructions should the nurse
plan to give to the client?
a. Perform passive range-of-motion exercises of the ankle hourly
b. Keep the affected extremity in a dependent position
c. Wrap a loose dressing around the affected ankle
d. Apply cold compresses to the extremity intermittently
Correct Answer
D. Apply cold compresses to the extremity intermittently--- Cold minimizes swelling
and erythema to the affected area. Therefore, the nurse should instruct the client to
apply cold compresses for no more than 20 minutes at a time.
Question 8
A nurse is providing preoperative teaching for a client with colorectal cancer who is
scheduled to undergo colostomy placement with a perineal wound. Which of the
following statements by the client indicates an understanding of the teaching?
a. "Not having any more rectal pain will be a relief."
b. "I will need to sit on a rubber donut when I am in the chair."
c. "I can have only liquids for 2 days before the surgery."
d. "The colostomy will start working about 7 days after the surgery."
Correct Answer
C. "I can have only liquids for 2 days before the surgery."---The client should
consume a full or clear liquid diet for 24 to 48 hours before the surgery to decrease
bulk. The client should consume a low-residue diet for several days prior to surgery
to decrease peristalsis.
Page 4 of 136
