Galen College NU 189 Exam 1 (pdf) | 2026/2027 | Med-Surg II Q&A |
Medical-Surgical Nursing
1. Which of the following best describes the primary purpose of the nursing
process?
A) To ensure all patients receive identical care regardless of individual needs
B) To provide a systematic, problem-solving framework for delivering
individualized nursing care
C) To delegate all care decisions to the physician
D) To document patient outcomes after discharge
Correct Answer: To provide a systematic, problem-solving framework for
delivering individualized nursing care
Rationale: The nursing process (ADPIE) is a critical thinking method that
guides assessment, diagnosis, planning, implementation, and evaluation. It
ensures care is tailored to each patient's unique needs, not a one-size-fits-all
approach, forming the foundation of clinical decision-making.
2. A nurse is assessing a patient who reports joint pain, stiffness, and a
"bull's-eye" rash on the thigh. Which condition should the nurse suspect?
A) Osteoarthritis
B) Rheumatoid arthritis
C) Lyme disease
D) Gout
Correct Answer: Lyme disease
Rationale: Lyme disease is an inflammatory disorder of connective tissue
transmitted by tick bites. It is characterized by a bull's-eye rash (erythema
,migrans), swollen lymph nodes, joint pain and stiffness, fever, and headache.
The other conditions present with different symptom patterns.
3. What kind of disorder is osteoarthritis?
A) Inflammatory disorder of connective tissue
B) Autoimmune disorder
C) Degenerative joint disease
D) Systemic metabolic disorder
Correct Answer: Degenerative joint disease
Rationale: Osteoarthritis is a degenerative joint disease characterized by the
breakdown of articular cartilage, leading to joint pain, stiffness, and
decreased range of motion. It is not autoimmune or inflammatory in nature.
4. A patient is diagnosed with gout. The nurse understands that gout is
caused by:
A) Autoimmune destruction of joint tissue
B) The buildup of uric acid crystals in the joints
C) Degeneration of articular cartilage
D) Bacterial infection of the synovial fluid
Correct Answer: The buildup of uric acid crystals in the joints
Rationale: Gout is a systemic disease caused by hyperuricemia (excessive
uric acid in the blood), which leads to the deposition of urate crystals in joints
and surrounding tissues. This causes acute inflammatory arthritis, typically
affecting the big toe.
,5. The nurse is caring for a patient with scleroderma. Which finding is
characteristic of localized scleroderma?
A) Dysrhythmias and heart failure
B) Thick, white or pale skin patches surrounded by a purple border
C) Joint deformities and nodules
D) Bull's-eye rash and fever
Correct Answer: Thick, white or pale skin patches surrounded by a purple
border
Rationale: Localized scleroderma affects the skin and connective tissue,
causing patches that are thick, white, or pale in the center and surrounded
by a purple border. Systemic scleroderma can affect internal organs such as
the heart.
6. A patient with systemic scleroderma is at risk for which cardiovascular
complication?
A) Hypertension only
B) Dysrhythmias, heart failure, and pericarditis
C) Myocardial infarction
D) Deep vein thrombosis
Correct Answer: Dysrhythmias, heart failure, and pericarditis
Rationale: Systemic scleroderma can affect the heart, leading to
dysrhythmias, congestive heart failure, and pericarditis. These complications
require close cardiac monitoring and management.
7. The nurse is caring for a patient who is immobile following a hip fracture.
Which complication is associated with immobility?
, A) Increased cardiac output
B) Muscle hypertrophy
C) Atelectasis
D) Improved bone density
Correct Answer: Atelectasis
Rationale: Immobility leads to respiratory complications including atelectasis
(partial or complete collapse of the lung) and pneumonia due to decreased
lung expansion and pooling of secretions. Other complications include
muscle atrophy, joint contractures, and pressure ulcers.
8. A patient who has been on bed rest for several days develops
constipation. The nurse recognizes this as a complication of immobility
affecting which body system?
A) Respiratory system
B) Gastrointestinal system
C) Cardiovascular system
D) Neurological system
Correct Answer: Gastrointestinal system
Rationale: GI immobility complications include constipation and bowel
impaction. Decreased physical activity slows peristalsis, leading to stool
retention and constipation.
9. Which of the following is a genitourinary complication of immobility?
A) Constipation
B) Atelectasis
Medical-Surgical Nursing
1. Which of the following best describes the primary purpose of the nursing
process?
A) To ensure all patients receive identical care regardless of individual needs
B) To provide a systematic, problem-solving framework for delivering
individualized nursing care
C) To delegate all care decisions to the physician
D) To document patient outcomes after discharge
Correct Answer: To provide a systematic, problem-solving framework for
delivering individualized nursing care
Rationale: The nursing process (ADPIE) is a critical thinking method that
guides assessment, diagnosis, planning, implementation, and evaluation. It
ensures care is tailored to each patient's unique needs, not a one-size-fits-all
approach, forming the foundation of clinical decision-making.
2. A nurse is assessing a patient who reports joint pain, stiffness, and a
"bull's-eye" rash on the thigh. Which condition should the nurse suspect?
A) Osteoarthritis
B) Rheumatoid arthritis
C) Lyme disease
D) Gout
Correct Answer: Lyme disease
Rationale: Lyme disease is an inflammatory disorder of connective tissue
transmitted by tick bites. It is characterized by a bull's-eye rash (erythema
,migrans), swollen lymph nodes, joint pain and stiffness, fever, and headache.
The other conditions present with different symptom patterns.
3. What kind of disorder is osteoarthritis?
A) Inflammatory disorder of connective tissue
B) Autoimmune disorder
C) Degenerative joint disease
D) Systemic metabolic disorder
Correct Answer: Degenerative joint disease
Rationale: Osteoarthritis is a degenerative joint disease characterized by the
breakdown of articular cartilage, leading to joint pain, stiffness, and
decreased range of motion. It is not autoimmune or inflammatory in nature.
4. A patient is diagnosed with gout. The nurse understands that gout is
caused by:
A) Autoimmune destruction of joint tissue
B) The buildup of uric acid crystals in the joints
C) Degeneration of articular cartilage
D) Bacterial infection of the synovial fluid
Correct Answer: The buildup of uric acid crystals in the joints
Rationale: Gout is a systemic disease caused by hyperuricemia (excessive
uric acid in the blood), which leads to the deposition of urate crystals in joints
and surrounding tissues. This causes acute inflammatory arthritis, typically
affecting the big toe.
,5. The nurse is caring for a patient with scleroderma. Which finding is
characteristic of localized scleroderma?
A) Dysrhythmias and heart failure
B) Thick, white or pale skin patches surrounded by a purple border
C) Joint deformities and nodules
D) Bull's-eye rash and fever
Correct Answer: Thick, white or pale skin patches surrounded by a purple
border
Rationale: Localized scleroderma affects the skin and connective tissue,
causing patches that are thick, white, or pale in the center and surrounded
by a purple border. Systemic scleroderma can affect internal organs such as
the heart.
6. A patient with systemic scleroderma is at risk for which cardiovascular
complication?
A) Hypertension only
B) Dysrhythmias, heart failure, and pericarditis
C) Myocardial infarction
D) Deep vein thrombosis
Correct Answer: Dysrhythmias, heart failure, and pericarditis
Rationale: Systemic scleroderma can affect the heart, leading to
dysrhythmias, congestive heart failure, and pericarditis. These complications
require close cardiac monitoring and management.
7. The nurse is caring for a patient who is immobile following a hip fracture.
Which complication is associated with immobility?
, A) Increased cardiac output
B) Muscle hypertrophy
C) Atelectasis
D) Improved bone density
Correct Answer: Atelectasis
Rationale: Immobility leads to respiratory complications including atelectasis
(partial or complete collapse of the lung) and pneumonia due to decreased
lung expansion and pooling of secretions. Other complications include
muscle atrophy, joint contractures, and pressure ulcers.
8. A patient who has been on bed rest for several days develops
constipation. The nurse recognizes this as a complication of immobility
affecting which body system?
A) Respiratory system
B) Gastrointestinal system
C) Cardiovascular system
D) Neurological system
Correct Answer: Gastrointestinal system
Rationale: GI immobility complications include constipation and bowel
impaction. Decreased physical activity slows peristalsis, leading to stool
retention and constipation.
9. Which of the following is a genitourinary complication of immobility?
A) Constipation
B) Atelectasis
