SURGICAL PROCTORED EXAM QUESTIONS & ANSWERS

A patient is hospitalized for initiation of regional antibiotic irrigation for acute osteomyelitis of the right femur. Which intervention will be included in the plan of care? a. Immobilization of the right leg b. Avoiding administration of nonsteroidal anti-inflammatory drugs (NSAIDs) c. Frequent weight-bearing exercise d. Support of the right leg in a flexed position - ANSWERSThe correct answer is: Immobilization of the right leg Discharge teaching for the patient with esophageal reflux disease includes instructing the patient to: a. Decrease protein intake b. Elevate the foot of the bed with 6-inch blocks c. Eat a high-carbohydrate snack before bed d. Reduce caffeine intake and smoking - ANSWERSThe correct answer is: Reduce caffeine intake and smoking Once healing has occurred, persons with a hip prosthesis are encouraged to participate in: a. High-impact exercises such as swimming b. Low-impact exercises such as jogging c. High-impact exercises such as bowling d. Low-impact exercises such as walking - ANSWERSThe correct answer is: Low-impact exercises such as walking patient with glaucoma who has been using timolol (Timoptic) drops for several days tells the nurse that the eyedrops cause eye burning and visual blurriness for a short time after administration. The best response to the patient's statement is a. "These symptoms are caused by glaucoma and may indicate a need for an increased dosage of the eyedrops." b. "The drops are uncomfortable, but it is very important for you to use them as prescribed to retain your vision." c. "These are normal side effects of the drug, which should become less noticeable with time." d. "If you occlude the puncta after you administer the drops, it will help relieve these side effects." - ANSWERSThe correct answer is: "The drops are uncomfortable, but it is very important for you to use them as prescribed to retain your vision." Patients should be taught that Zollinger-Ellison syndrome is: a. An ulcerative syndrome caused by a gastrinoma b. An infectious syndrome caused by Helicobacter pylori c. Related to the indiscriminate use of nonsteroidal antiinflammatory drugs (NSAIDs) d. A type of peptic ulcer related to stress - ANSWERSThe correct answer is: An ulcerative syndrome caused by a gastrinoma After a patient has a short-arm plaster cast applied in the emergency department, which statement by the patient indicates a good understanding of the nurse's discharge teaching? a. "I can use a cotton-tipped applicator to rub lotion on any dry areas under the cast." b. "I should avoid moving my fingers and elbow until the cast is removed." c. "I can get the cast wet as long as I dry it right away with a hair dryer." d. "I will apply an ice pack to the cast over the fracture site for the next 24 hours." - ANSWERSThe correct answer is: "I will apply an ice pack to the cast over the fracture site for the next 24 hours." The leading cause of blindness in the elderly is: a. Glaucoma b. Macular degeneration c. Ocular tumors d. Retinal detachment - ANSWERSThe correct answer is: Macular degeneration Which describes a fracture located at a 45-degree angle to the long axis of bone? a. Oblique fracture b. Impacted fracture c. Avulsion fracture d. Compound fracture - ANSWERSThe correct answer is: Oblique fracture Dumping syndrome after gastric surgery: a. Can be controlled by increasing fluid ingestion b. Produces a sudden decrease in blood glucose, initiating gastric emptying c. Is caused by rapid emptying of hypertonic chyme into the jejunum d. Is treated most effectively with a high-cholesterol, low-fat diet and fluid restriction - ANSWERSThe correct answer is: Is caused by rapid emptying of hypertonic chyme into the jejunum When performing an eye examination, the nurse will assess for accommodation by a. observing the pupils when the patient focuses on a close object and then on a distant object. b. shining a light into the patient's eye and watching the pupil response in the opposite eye. c. touching the patient's pupil with a small piece of sterile cotton and watching for a blink reaction. d. covering one eye for 1 minute and noting the pupil reaction when the cover is removed. - ANSWERSAccommodation is defined as the ability of the lens to adjust to various distances. Which is classic indication of hip fracture? a. Internal rotation of the injured leg b. Shortening and external rotation of the injured leg c. Groin pain accompanied by urinary retention d. Absence of pedal pulses on the affected side - ANSWERSThe correct answer is: Shortening and external rotation of the injured leg After ear surgery, patients are taught to: a. Open the mouth and nose while coughing b. Take medication to suppress coughing c. Avoid coughing for the first week after surgery d. Cough as infrequently as possible - ANSWERSThe correct answer is: Open the mouth and nose while coughing Long-term drug therapy for the patient with gastroesophageal reflux disease includes proton-pump inhibitors such a a. Diazepam (Valium) b. Omeprazole (Prilosec) c. Bethanechol (Urecholine) d. Metoclopramide (Reglan) - ANSWERSThe correct answer is: Omeprazole (Prilosec) Which is the most common complication after hip or knee replacement? a. Deep vein thrombosis b. Paralytic ileus c. Pneumonia d. Joint dislocation - ANSWERSThe correct answer is: Deep vein thrombosis Which situation needs correcting when noted on a patient in Buck's traction? a. Weights are touching the floor at the end of the bed b. Patient's affected leg is resting well away from the footboard c. Patient's affected leg is positioned parallel to the edge of the bed d. The patient's affected heel is supported off the bed - ANSWERSThe correct answer is: Weights are touching the floor at the end of the bed Which menu choice by a patient with osteoporosis indicates that the nurse's teaching about appropriate diet has been effective? a. Oatmeal with skim milk and fruit yogurt b. Two-egg omelet and a half grapefruit c. Whole wheat toast and fruit jelly d. Pancakes with syrup and bacon - ANSWERSThe correct answer is: Oatmeal with skim milk and fruit yogurt A patient who has had an open reduction and internal fixation (ORIF) of left lower leg fractures complains of constant severe pain in the leg, which is unrelieved by the prescribed morphine. Pulses are faintly palpable and the foot is cool. Which action should the nurse take next? a. Check the patient's blood pressure. b. Assess the incision for redness. c. Notify the health care provider. d. Reposition the left leg on pillows. - ANSWERSThe correct answer is: Notify the health care provider The patient's clinical manifestations suggest compartment syndrome and delay in diagnosis and treatment may lead to severe functional impairment. The data do not suggest problems with blood pressure or infection. Elevation of the leg will decrease arterial flow and further reduce perfusion. Which of the following observations made by the nurse who is evaluating the crutch-walking technique of a patient who is to have no weight bearing on the right leg indicates that the patient can safely ambulate independently? a. The patient advances the right leg and both crutches together and then advances the left leg. b. The patient keeps the padded area of the crutch firmly in the axillary area when ambulating c. The patient moves the left crutch with the left leg and then the right crutch with the right leg. d. The patient uses the bedside chair to assist in balance as needed when ambulating in the room. - ANSWERSThe correct answer is: The patient advances the right leg and both crutches together and then advances the left leg. A patient with lower leg fracture has an external fixation device in place and is scheduled for discharge. Which information will the nurse include in the discharge teaching? a. "The external fixator can be removed during the bath or shower." b. "Prophylactic antibiotics are used until the external fixator is removed." c. "You will need to remain on bed rest until bone healing is complete." d. "You will need to assess and clean the pin insertion sites daily. - ANSWERSThe correct answer is: "You will need to assess and clean the pin insertion sites daily." Which patient needs to be evaluated by use of the Romberg test? A person who has a: a. History of dizziness b. Rinne test result of AC>BC c. History of presbycusis d. Conductive hearing loss - ANSWERSThe correct answer is: History of dizziness Which information will be best for the nurse to include when teaching a patient with peptic ulcer disease (PUD) about dietary management of the disease? a. "High-protein foods are least likely to cause pain." b. "You should avoid eating many raw fruits and vegetables." c. "You will need to remain on a bland diet indefinitely." d. "Avoid foods that cause pain after you eat them." - ANSWERSThe correct answer is: "Avoid foods that cause pain after you eat them." Which is the most reliable clinical indicator of compartment syndrome? a. Elevated blood pressure in the injured extremity b. Severe, unrelenting pain in the affected limb c. Decreased capillary refill time and warm skin temperature d. Paresthesia and skin pallor - ANSWERSThe correct answer is: Severe, unrelenting pain in the affected limb The nurse may test the patient's balance by using which test? a. Kernig b. Rinne c. Romberg d. Weber - ANSWERSThe correct answer is: Romberg The underlying physiological problem in patients with glaucoma is: a. Increased intraocular pressure b. Infection of the anterior chamber c. Degeneration of the optic nerve d. Opacity of the lens - ANSWERSThe correct answer is: Increased intraocular pressure Which nursing measure is contraindicated for the patient who has undergone oral surgery? a. Mouth irrigations b. Using cotton applicators for oral care c. Brushing teeth and gums d. Rinsing mouth with normal saline - ANSWERSThe correct answer is: Brushing teeth and gums A patient has a long-arm plaster cast applied for immobilization of a fractured left radius. Until the cast has completely dried, the nurse should a. handle the cast with the palms of the hands b. place gauze around the cast edge to pad any roughness. c. cover the cast with a small blanket to absorb the dampness. d. keep the left arm in a dependent position. - ANSWERSThe correct answer is: handle the cast with the palms of the hands. patient who is nauseated and vomiting up blood-streaked fluid is admitted to the hospital with acute gastritis. To determine possible risk factors for gastritis, the nurse will ask the patient about a. history of recent weight gain or loss. b. the amount of fat in the diet. c. use of nonsteroidal anti-inflammatory drugs (NSAIDs). d. any family history of gastric problems. - ANSWERSThe correct answer is: use of nonsteroidal anti-inflammatory drugs (NSAID