Detailed Answer Key For Medical
Surgical Exam Latest Update
2024-2025 Graded A+
,Detailed Answer Key
Medical Surgical, A+
1. A nurse is reviewing the cause of gout with a group of nurses. Which of the following statements should the nurse
make?
A. "Uric acid levels drop and calcium forms precipitate."
FEEDBACK: With gout, patients have hyperuricemia, rather than a reduction in uric acid.
B. "Tophi form in the kidneys and they impair the excretion of uric acid."
FEEDBACK: Tophi, or deposits in tissues near a joint, develop in chronic, late-stage gout. They are not part
ofthe primary disease process.
C. "The intra-articular deposition of urate crystals causes inflammation."
FEEDBACK: Gout, or gouty arthritis, develops when urate crystals deposit in joints and tissues and cause
inflammation and pain.
D. "Articular cartilage thins, leading to splitting and fragmentation."
FEEDBACK: Gout does not thin and fragment cartilage.
2. A nurse is teaching a group of patients about osteoarthritis. Which of the following recommendations should
thenurse include in the teaching?
A. Use Echinacea to manage joint pain.
FEEDBACK: The nurse may include the use of complementary and alternative therapies in the teaching.
However, Echinacea is used for the treatment of the common cold, not osteoarthritis. Alternative
therapies that are used for osteoarthritis include glucosamine, chondroitin, and topical capsaicin.
B. Apply ice to the joint before exercising.
FEEDBACK: The nurse should recommend that the patients begin exercising immediately following
the application of heat. This reduces pain and improves mobility, allowing for increased
range-of-motion during exercises. Cold application may be applied following exercise to
decrease discomfort and inflammation.
C. Maintain a recommended body weight.
FEEDBACK: Obesity is a risk factor for the development of osteoarthritis. Maintenance of an ideal weight
isone way a patient can prevent added wear and tear on joints and promote overall joint
health.
D. Reduce the amount of purine in the diet.
FEEDBACK: The nurse should recognize that limiting purine in the diet, which is often found in organ
meats,is recommended for patients who have gout.
3. A nurse is caring for a patient who has had a myocardial infarction. Upon his first visit to cardiac rehabilitation,
hetells the nurse that he doesn't understand why he needs to be there because there is nothing more to do, as
the
Page 1
,Detailed Answer Key
Medical Surgical, A+
damage is done. Which of the following is the correct nursing response?
A. "Cardiac rehabilitation cannot undo the damage to your heart but it can help you get back to your previous
level of activity safely."
FEEDBACK: With this response, the nurse uses the therapeutic communication technique of presenting
reality by indicating her perception of the situation for the patient.
B. "It’s not unusual to feel that way at first, but once you learn the routine, you’ll enjoy it."
FEEDBACK: With this response, the nurse illustrates the nontherapeutic communication technique of giving
reassurance, thus discouraging the patient from further communication.
C. "Exercise is good for you and good for your heart."
FEEDBACK: With this response, the nurse illustrates the nontherapeutic communication techniques of
disagreeing and giving advice.
D. "Your doctor is the expert here, and I’m sure he would only recommend what is best for you."
FEEDBACK: With this response, the nurse illustrates the nontherapeutic communication technique of
defending.
4. A nurse is caring for a patient who has heart failure and a potassium level of 2.4 mEq/L. The nurse should
identifywhich of the following medications as the cause of the patient’s low potassium level?
A. Furosemide
FEEDBACK: Furosemide is a loop (high-ceiling) diuretic that inhibits the reabsorption of sodium and
chlorideand results in diuresis, which decreases potassium through excretion in the distal
nephrons.
Hypokalemia is an adverse effect of furosemide.
B. Nitroglycerin
FEEDBACK: A potassium level of 2.4 mEq/L is not an adverse effect of nitroglycerin. Nitroglycerin is a
vasodilator medication to treat angina.
C. Metoprolol
FEEDBACK: A potassium level of 2.4 mEq/L is not an adverse effect of metoprolol. Metoprolol
is abeta-blocker that slows the heart rate and improves contractility of the heart
muscle.
D. Spironolactone
FEEDBACK: Spironolactone is a potassium-sparing diuretic medication; therefore, hyperkalemia is an
adverse effect of this medication.
5. A nurse is caring for a patient who is postoperative following an open reduction internal fixation (ORIF) of a femur
fracture. Which of the following parameters should the nurse include in the evaluation of the neurovascular status of
the patient's affected extremity? (Select all that apply.)
Page 2
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Detailed Answer Key
Medical Surgical, A+
A. Color
B. Temperature
C. Ecchymosis
D. Skin integrity
E. Sensation
FEEDBACK: Color is correct. Patients who have sustained trauma to an extremity, such as a fracture, are
at increased risk for neurovascular compromise. The nurse should check the color of the
patient's affected extremity as part of this assessment. The nurse should identify pallor or
cyanosis of theextremity as an indication of peripheral neurovascular dysfunction and should
notify the provider.Temperature is correct. Patients who have sustained trauma to an extremity,
such as a fracture, are at increased risk for neurovascular compromise. The nurse should
monitor the temperature of the extremity as a part of this assessment and identify skin that is
cool or cold to the touch as having decreased perfusion to the tissues of the extremity, which is
an indication of peripheral neurovascular dysfunction. The nurse should report skin that is cool to
the touch to the provider.Ecchymosis is incorrect. Ecchymosis, or bruising, is an expected
finding with leg injuries and is not a component of a neurovascular check.Skin integrity is
incorrect. While the nurse should assess the incision of a patient who is postoperative following
an open reduction and internal fixation of the femur, it is not a component of a neurovascular
check.Sensation is correct. Patients who have sustained trauma to an extremity, such as a
fracture, are at increased risk for neurovascular compromise. The nurse should assess the
patient's extremity for numbnessor tingling. The nurse should recognize diminished pain or
paresthesia as an indication of damage to the nerves or peripheral neurovascular dysfunction
and should report it to the provider.
6. A nurse is monitoring a patient following a thoracentesis. The nurse should identify which of the
followingmanifestations as a complication and contact the provider immediately?
A. Serosanguineous drainage from the puncture site
FEEDBACK: A small amount of serosanguineous drainage at the puncture site is expected after a
thoracentesis.
B. Discomfort at the puncture site
FEEDBACK: Mild discomfort at the puncture site is expected after a thoracentesis.
C. Increased heart rate
FEEDBACK: Patients are at risk for developing pulmonary edema or cardiovascular distress due
mediastinalcontent shift after the aspiration of a large amount of fluid from the patient's pleural
space.
Therefore, the patient may experience an increase in heart and respiratory rate, along with
coughing with blood-tinged frothy sputum, and tightness in the chest. These findings require
notification of the provider immediately.
D. Decreased temperature
FEEDBACK: Infection is possible after any invasive procedure; however, it takes time to develop and
increases the body temperature.
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Surgical Exam Latest Update
2024-2025 Graded A+
,Detailed Answer Key
Medical Surgical, A+
1. A nurse is reviewing the cause of gout with a group of nurses. Which of the following statements should the nurse
make?
A. "Uric acid levels drop and calcium forms precipitate."
FEEDBACK: With gout, patients have hyperuricemia, rather than a reduction in uric acid.
B. "Tophi form in the kidneys and they impair the excretion of uric acid."
FEEDBACK: Tophi, or deposits in tissues near a joint, develop in chronic, late-stage gout. They are not part
ofthe primary disease process.
C. "The intra-articular deposition of urate crystals causes inflammation."
FEEDBACK: Gout, or gouty arthritis, develops when urate crystals deposit in joints and tissues and cause
inflammation and pain.
D. "Articular cartilage thins, leading to splitting and fragmentation."
FEEDBACK: Gout does not thin and fragment cartilage.
2. A nurse is teaching a group of patients about osteoarthritis. Which of the following recommendations should
thenurse include in the teaching?
A. Use Echinacea to manage joint pain.
FEEDBACK: The nurse may include the use of complementary and alternative therapies in the teaching.
However, Echinacea is used for the treatment of the common cold, not osteoarthritis. Alternative
therapies that are used for osteoarthritis include glucosamine, chondroitin, and topical capsaicin.
B. Apply ice to the joint before exercising.
FEEDBACK: The nurse should recommend that the patients begin exercising immediately following
the application of heat. This reduces pain and improves mobility, allowing for increased
range-of-motion during exercises. Cold application may be applied following exercise to
decrease discomfort and inflammation.
C. Maintain a recommended body weight.
FEEDBACK: Obesity is a risk factor for the development of osteoarthritis. Maintenance of an ideal weight
isone way a patient can prevent added wear and tear on joints and promote overall joint
health.
D. Reduce the amount of purine in the diet.
FEEDBACK: The nurse should recognize that limiting purine in the diet, which is often found in organ
meats,is recommended for patients who have gout.
3. A nurse is caring for a patient who has had a myocardial infarction. Upon his first visit to cardiac rehabilitation,
hetells the nurse that he doesn't understand why he needs to be there because there is nothing more to do, as
the
Page 1
,Detailed Answer Key
Medical Surgical, A+
damage is done. Which of the following is the correct nursing response?
A. "Cardiac rehabilitation cannot undo the damage to your heart but it can help you get back to your previous
level of activity safely."
FEEDBACK: With this response, the nurse uses the therapeutic communication technique of presenting
reality by indicating her perception of the situation for the patient.
B. "It’s not unusual to feel that way at first, but once you learn the routine, you’ll enjoy it."
FEEDBACK: With this response, the nurse illustrates the nontherapeutic communication technique of giving
reassurance, thus discouraging the patient from further communication.
C. "Exercise is good for you and good for your heart."
FEEDBACK: With this response, the nurse illustrates the nontherapeutic communication techniques of
disagreeing and giving advice.
D. "Your doctor is the expert here, and I’m sure he would only recommend what is best for you."
FEEDBACK: With this response, the nurse illustrates the nontherapeutic communication technique of
defending.
4. A nurse is caring for a patient who has heart failure and a potassium level of 2.4 mEq/L. The nurse should
identifywhich of the following medications as the cause of the patient’s low potassium level?
A. Furosemide
FEEDBACK: Furosemide is a loop (high-ceiling) diuretic that inhibits the reabsorption of sodium and
chlorideand results in diuresis, which decreases potassium through excretion in the distal
nephrons.
Hypokalemia is an adverse effect of furosemide.
B. Nitroglycerin
FEEDBACK: A potassium level of 2.4 mEq/L is not an adverse effect of nitroglycerin. Nitroglycerin is a
vasodilator medication to treat angina.
C. Metoprolol
FEEDBACK: A potassium level of 2.4 mEq/L is not an adverse effect of metoprolol. Metoprolol
is abeta-blocker that slows the heart rate and improves contractility of the heart
muscle.
D. Spironolactone
FEEDBACK: Spironolactone is a potassium-sparing diuretic medication; therefore, hyperkalemia is an
adverse effect of this medication.
5. A nurse is caring for a patient who is postoperative following an open reduction internal fixation (ORIF) of a femur
fracture. Which of the following parameters should the nurse include in the evaluation of the neurovascular status of
the patient's affected extremity? (Select all that apply.)
Page 2
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Detailed Answer Key
Medical Surgical, A+
A. Color
B. Temperature
C. Ecchymosis
D. Skin integrity
E. Sensation
FEEDBACK: Color is correct. Patients who have sustained trauma to an extremity, such as a fracture, are
at increased risk for neurovascular compromise. The nurse should check the color of the
patient's affected extremity as part of this assessment. The nurse should identify pallor or
cyanosis of theextremity as an indication of peripheral neurovascular dysfunction and should
notify the provider.Temperature is correct. Patients who have sustained trauma to an extremity,
such as a fracture, are at increased risk for neurovascular compromise. The nurse should
monitor the temperature of the extremity as a part of this assessment and identify skin that is
cool or cold to the touch as having decreased perfusion to the tissues of the extremity, which is
an indication of peripheral neurovascular dysfunction. The nurse should report skin that is cool to
the touch to the provider.Ecchymosis is incorrect. Ecchymosis, or bruising, is an expected
finding with leg injuries and is not a component of a neurovascular check.Skin integrity is
incorrect. While the nurse should assess the incision of a patient who is postoperative following
an open reduction and internal fixation of the femur, it is not a component of a neurovascular
check.Sensation is correct. Patients who have sustained trauma to an extremity, such as a
fracture, are at increased risk for neurovascular compromise. The nurse should assess the
patient's extremity for numbnessor tingling. The nurse should recognize diminished pain or
paresthesia as an indication of damage to the nerves or peripheral neurovascular dysfunction
and should report it to the provider.
6. A nurse is monitoring a patient following a thoracentesis. The nurse should identify which of the
followingmanifestations as a complication and contact the provider immediately?
A. Serosanguineous drainage from the puncture site
FEEDBACK: A small amount of serosanguineous drainage at the puncture site is expected after a
thoracentesis.
B. Discomfort at the puncture site
FEEDBACK: Mild discomfort at the puncture site is expected after a thoracentesis.
C. Increased heart rate
FEEDBACK: Patients are at risk for developing pulmonary edema or cardiovascular distress due
mediastinalcontent shift after the aspiration of a large amount of fluid from the patient's pleural
space.
Therefore, the patient may experience an increase in heart and respiratory rate, along with
coughing with blood-tinged frothy sputum, and tightness in the chest. These findings require
notification of the provider immediately.
D. Decreased temperature
FEEDBACK: Infection is possible after any invasive procedure; however, it takes time to develop and
increases the body temperature.
Page 3
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