Mastering Medical-Surgical Nursing: 250 Critical Questions and In-Depth
Answers for Clinical Excellence and Exam Preparation
Question 1: What is the primary role of the medical-surgical nurse in patient care?
Answer 1:
The primary role is to provide holistic care to adult patients undergoing treatment for acute and
chronic medical conditions, including preoperative, intraoperative, and postoperative phases,
emphasizing assessment, monitoring, and intervening to promote recovery and prevent
complications.
Question 2: How do you perform a thorough respiratory assessment?
Answer 2:
By inspecting for symmetry and effort, palpating for tenderness or masses, percussing to
identify areas of dullness or hyperresonance, auscultating breath sounds for abnormalities such
as crackles or wheezes, and noting oxygen saturation and respiratory rate.
Question 3: What are the clinical signs of hypoxia to watch for in surgical patients?
Answer 3:
Early signs include restlessness, confusion, tachycardia, and tachypnea; late signs can be
cyanosis, bradycardia, and altered level of consciousness, requiring immediate intervention.
Question 4: What nursing interventions help prevent postoperative pulmonary complications?
Answer 4:
Encouraging deep breathing exercises, incentive spirometry, early mobilization, adequate pain
control to enable effective coughing, and maintaining optimal hydration to thin secretions.
Question 5: How do you assess and manage pain in postoperative patients?
Answer 5:
Assess using pain scales, observe nonverbal cues, administer prescribed analgesics, employ non-
pharmacologic methods such as positioning and relaxation, and evaluate effectiveness regularly.
Question 6: What are the signs and symptoms of deep vein thrombosis (DVT) in surgical
patients?
Answer 6:
Unilateral leg swelling, warmth, redness, tenderness on palpation, and sometimes a positive
Homan’s sign, with the risk heightened by immobility and certain medical conditions.
,Question 7: What strategies can prevent DVT after surgery?
Answer 7:
Early ambulation, use of compression stockings or pneumatic devices, anticoagulant therapy as
prescribed, and patient education on leg exercises.
Question 8: How do you assess fluid balance in medical-surgical patients?
Answer 8:
Monitoring intake and output, daily weights, skin turgor, mucous membranes, blood pressure,
pulse rate, and laboratory values such as electrolytes and hematocrit.
Question 9: What are the common causes and signs of fluid volume overload?
Answer 9:
Causes include heart failure, kidney disease, and excessive IV fluids; signs include edema,
hypertension, bounding pulse, jugular vein distension, and pulmonary crackles.
Question 10: How does the nurse manage a patient with electrolyte imbalances like
hyperkalemia?
Answer 10:
By monitoring ECG changes, administering potassium-binding agents, promoting potassium
excretion through diuretics or dialysis, and ensuring cardiac monitoring.
Question 11: What is the purpose of preoperative patient education?
Answer 11:
To reduce anxiety, explain the procedure, prepare patients for postoperative care, and promote
adherence to instructions.
Question 12: How do you recognize and manage surgical site infections?
Answer 12:
Look for redness, swelling, warmth, purulent drainage, fever; manage with wound care,
antibiotics, and possible surgical intervention.
Question 13: What are nursing priorities in postoperative care during the immediate recovery
phase?
Answer 13:
Monitoring airway, breathing, circulation, level of consciousness, pain, surgical site, and
complications such as bleeding.
,Question 14: How do you support patients psychologically during medical-surgical
hospitalization?
Answer 14:
Provide emotional support, active listening, education about conditions and treatments, i nvolve
family, and refer to counseling if needed.
Question 15: What is the importance of nutritional assessment in medical-surgical patients?
Answer 15:
To identify malnutrition risks that may impair healing and recovery, and to plan appropriate
dietary interventions.
Question 16: How do you assess and manage wounds in medical-surgical patients?
Answer 16:
Inspect for size, depth, exudate, odor, and signs of infection; clean and dress wounds according
to protocols, promote healing, and document observations.
Question 17: What are the clinical features and nursing management of shock?
Answer 17:
Features include hypotension, tachycardia, cold clammy skin, altered mental status;
management focuses on preserving airway, breathing, circulation, fluid resuscitation, and
monitoring organ function.
Question 18: How can nurses detect early signs of sepsis?
Answer 18:
Monitor for fever or hypothermia, tachycardia, tachypnea, altered mental status, and lab
indicators like elevated white blood cells and lactic acid.
Question 19: What are key components in the nursing care of patients with respiratory failure?
Answer 19:
Maintain airway patency, administer oxygen therapy, monitor respiratory status, assist with
mechanical ventilation if needed, and provide suctioning.
Question 20: How do you assess neurological status in medical-surgical patients?
Answer 20:
Use Glasgow Coma Scale, pupil response, motor and sensory assessments, and monitor for
changes in level of consciousness.
, Question 21: What is the nurse’s role in managing patients with diabetes mellitus undergoing
surgery?
Answer 21:
Manage blood glucose levels, monitor for hypo/hyperglycemia, adjust medications, and
coordinate perioperative care to reduce infection risk.
Question 22: How do you recognize and intervene in cases of acute kidney injury (AKI)?
Answer 22:
Monitor urine output, serum creatinine, and fluid balance; manage underlying causes, ensure
hydration, and collaborate on dialysis if indicated.
Question 23: What are symptoms and interventions for congestive heart failure (CHF) in
hospitalized patients?
Answer 23:
Symptoms include dyspnea, edema, fatigue; interventions include oxygen administration,
medications like diuretics, fluid management, and cardiac monitoring.
Question 24: How does the nurse care for a patient with chronic obstructive pulmonary disease
(COPD)?
Answer 24:
Facilitate airway clearance, administer bronchodilators and steroids, monitor oxygen levels
carefully, and encourage smoking cessation.
Question 25: What precautions are necessary when administering blood transfusions?
Answer 25:
Verify patient identity, check compatibility, monitor for reactions, and document vitals before,
during, and after transfusion.
Question 26: How do you manage a patient experiencing postoperative nausea and vomiting?
Answer 26:
Administer antiemetics, maintain hydration, encourage slow oral intake, and monitor
electrolytes.
Question 27: What are signs of electrolyte imbalance following surgery?
Answer 27:
Muscle cramps, arrhythmias, confusion, and changes in deep tendon reflexes.
Question 28: How do you prevent pressure ulcers in immobile medical-surgical patients?
Answers for Clinical Excellence and Exam Preparation
Question 1: What is the primary role of the medical-surgical nurse in patient care?
Answer 1:
The primary role is to provide holistic care to adult patients undergoing treatment for acute and
chronic medical conditions, including preoperative, intraoperative, and postoperative phases,
emphasizing assessment, monitoring, and intervening to promote recovery and prevent
complications.
Question 2: How do you perform a thorough respiratory assessment?
Answer 2:
By inspecting for symmetry and effort, palpating for tenderness or masses, percussing to
identify areas of dullness or hyperresonance, auscultating breath sounds for abnormalities such
as crackles or wheezes, and noting oxygen saturation and respiratory rate.
Question 3: What are the clinical signs of hypoxia to watch for in surgical patients?
Answer 3:
Early signs include restlessness, confusion, tachycardia, and tachypnea; late signs can be
cyanosis, bradycardia, and altered level of consciousness, requiring immediate intervention.
Question 4: What nursing interventions help prevent postoperative pulmonary complications?
Answer 4:
Encouraging deep breathing exercises, incentive spirometry, early mobilization, adequate pain
control to enable effective coughing, and maintaining optimal hydration to thin secretions.
Question 5: How do you assess and manage pain in postoperative patients?
Answer 5:
Assess using pain scales, observe nonverbal cues, administer prescribed analgesics, employ non-
pharmacologic methods such as positioning and relaxation, and evaluate effectiveness regularly.
Question 6: What are the signs and symptoms of deep vein thrombosis (DVT) in surgical
patients?
Answer 6:
Unilateral leg swelling, warmth, redness, tenderness on palpation, and sometimes a positive
Homan’s sign, with the risk heightened by immobility and certain medical conditions.
,Question 7: What strategies can prevent DVT after surgery?
Answer 7:
Early ambulation, use of compression stockings or pneumatic devices, anticoagulant therapy as
prescribed, and patient education on leg exercises.
Question 8: How do you assess fluid balance in medical-surgical patients?
Answer 8:
Monitoring intake and output, daily weights, skin turgor, mucous membranes, blood pressure,
pulse rate, and laboratory values such as electrolytes and hematocrit.
Question 9: What are the common causes and signs of fluid volume overload?
Answer 9:
Causes include heart failure, kidney disease, and excessive IV fluids; signs include edema,
hypertension, bounding pulse, jugular vein distension, and pulmonary crackles.
Question 10: How does the nurse manage a patient with electrolyte imbalances like
hyperkalemia?
Answer 10:
By monitoring ECG changes, administering potassium-binding agents, promoting potassium
excretion through diuretics or dialysis, and ensuring cardiac monitoring.
Question 11: What is the purpose of preoperative patient education?
Answer 11:
To reduce anxiety, explain the procedure, prepare patients for postoperative care, and promote
adherence to instructions.
Question 12: How do you recognize and manage surgical site infections?
Answer 12:
Look for redness, swelling, warmth, purulent drainage, fever; manage with wound care,
antibiotics, and possible surgical intervention.
Question 13: What are nursing priorities in postoperative care during the immediate recovery
phase?
Answer 13:
Monitoring airway, breathing, circulation, level of consciousness, pain, surgical site, and
complications such as bleeding.
,Question 14: How do you support patients psychologically during medical-surgical
hospitalization?
Answer 14:
Provide emotional support, active listening, education about conditions and treatments, i nvolve
family, and refer to counseling if needed.
Question 15: What is the importance of nutritional assessment in medical-surgical patients?
Answer 15:
To identify malnutrition risks that may impair healing and recovery, and to plan appropriate
dietary interventions.
Question 16: How do you assess and manage wounds in medical-surgical patients?
Answer 16:
Inspect for size, depth, exudate, odor, and signs of infection; clean and dress wounds according
to protocols, promote healing, and document observations.
Question 17: What are the clinical features and nursing management of shock?
Answer 17:
Features include hypotension, tachycardia, cold clammy skin, altered mental status;
management focuses on preserving airway, breathing, circulation, fluid resuscitation, and
monitoring organ function.
Question 18: How can nurses detect early signs of sepsis?
Answer 18:
Monitor for fever or hypothermia, tachycardia, tachypnea, altered mental status, and lab
indicators like elevated white blood cells and lactic acid.
Question 19: What are key components in the nursing care of patients with respiratory failure?
Answer 19:
Maintain airway patency, administer oxygen therapy, monitor respiratory status, assist with
mechanical ventilation if needed, and provide suctioning.
Question 20: How do you assess neurological status in medical-surgical patients?
Answer 20:
Use Glasgow Coma Scale, pupil response, motor and sensory assessments, and monitor for
changes in level of consciousness.
, Question 21: What is the nurse’s role in managing patients with diabetes mellitus undergoing
surgery?
Answer 21:
Manage blood glucose levels, monitor for hypo/hyperglycemia, adjust medications, and
coordinate perioperative care to reduce infection risk.
Question 22: How do you recognize and intervene in cases of acute kidney injury (AKI)?
Answer 22:
Monitor urine output, serum creatinine, and fluid balance; manage underlying causes, ensure
hydration, and collaborate on dialysis if indicated.
Question 23: What are symptoms and interventions for congestive heart failure (CHF) in
hospitalized patients?
Answer 23:
Symptoms include dyspnea, edema, fatigue; interventions include oxygen administration,
medications like diuretics, fluid management, and cardiac monitoring.
Question 24: How does the nurse care for a patient with chronic obstructive pulmonary disease
(COPD)?
Answer 24:
Facilitate airway clearance, administer bronchodilators and steroids, monitor oxygen levels
carefully, and encourage smoking cessation.
Question 25: What precautions are necessary when administering blood transfusions?
Answer 25:
Verify patient identity, check compatibility, monitor for reactions, and document vitals before,
during, and after transfusion.
Question 26: How do you manage a patient experiencing postoperative nausea and vomiting?
Answer 26:
Administer antiemetics, maintain hydration, encourage slow oral intake, and monitor
electrolytes.
Question 27: What are signs of electrolyte imbalance following surgery?
Answer 27:
Muscle cramps, arrhythmias, confusion, and changes in deep tendon reflexes.
Question 28: How do you prevent pressure ulcers in immobile medical-surgical patients?
