MEDICAL SURGICAL NURSING FINAL
EXAMS
1. A patient is being admitted to the hospital on the day before a scheduled surgery.
What is the most appropriate initial question for the nurse to ask this preoperative
patient?
a) "What did your surgeon say to you about the type of surgery you are having?"
b) "What questions do you have about your surgery?"
c) "What type of surgery are you having and why are you having it done?"
d) "What do you know about what will be done to you?" - CORRECT ANSWER-c)
"What type of surgery are you having and why are you having it done?"
2. A benzodiazepine has been administered to a patient preoperatively. After the drug
has been administered, the nurse plans to monitor the patient for which side effects?
Select all that apply.
a) Anxiety
b) Hypotension
c) Hypocalcemia
d) Level of Consciousness
e) Sedation - CORRECT ANSWER-a) Anxiety
d) Level of Consciousness
e) Sedation
3. A preoperative patient has an elevated hemoglobin and hematocrit. What would the
nurse suspect regarding the significance of this increased value?
a) Immune deficiency
b) Kidney dysfunction
c) Malignancy
d) Dehydration - CORRECT ANSWER-d) Dehydration
4. Which activities should the nurse carry out in the preoperative period for a client
scheduled for surgery? Select all that apply.
a) Identify potential or actual health problems.
b) Verify the presence of a signed consent form.
c) Assess patient's response to interventions.
d) Intervene to prevent complications.
,e) Assess effectiveness of teaching related to postoperative recovery. - CORRECT
ANSWER-a) Identify potential or actual health problems.
b) Verify the presence of a signed consent form.
e) Assess effectiveness of teaching related to postoperative recovery.
5. A patient having surgery has a degree of risk associated with the surgery. The nurse
would evaluate which patient-related factors as contributing to a high degree of risk
associated with surgery? Select all that apply.
a) Type of institution where surgery is performed
b) Involvement of vital organs
c) Average nutritional status
d) Low likelihood of procedure complications
e) A history of respiratory disease and diabetes - CORRECT ANSWER-b) Involvement
of vital organs
e) A history of respiratory disease and diabetes
6. A patient has just entered the postanesthesia care unit (PACU) from surgery. For
which priority needs should the nurse immediately assess the postoperative patient?
a) Vital signs, level of consciousness, presence of pain
b) Skin coloring, surgical incision, limb movements
c) Skin temperature, blood pressure, mental status
d) Temperature, emotional status, wound drainage - CORRECT ANSWER-a) Vital
signs, level of consciousness, presence of pain
7. The nurse in the postanesthesia care unit (PACU) is assessing a postoperative
patient. Which indicators suggest to the nurse an alteration in tissue perfusion? Select
all that apply.
a) Pallor or cyanosis
b) Difficulty with mobility
c) Pain in the incision area
d) Fluid loss
e) Decreased urinary output - CORRECT ANSWER-a) Pallor or cyanosis
d) Fluid loss
e) Decreased urinary output
8. After surgery, the nurse encourages the patient to move from side to side at least
every 2 hours. The patient questions this activity. How does the nurse explain the
purpose of this intervention?
a) Assist peristalsis to return more quickly
b) Lessen muscle weakness
c) Increase patient's ability to sleep
d) Let the lungs alternatively achieve maximum expansion - CORRECT ANSWER-d)
Let the lungs alternatively achieve maximum expansion
,9. The nurse is creating a plan of care for a postoperative patient. The nursing diagnosis
in acute pain. What would be appropriate outcomes for this patient? Select all that
apply.
a) Balanced fluid intake and output
b) Seeks help as needed
c) Absence of nonverbal signs of pain
d) Performs leg exercises as instructed
e) Verbally rates pain as 3 on a 1 to 10 scale - CORRECT ANSWER-c) Absence of
nonverbal signs of pain
e) Verbally rates pain as 3 on a 1 to 10 scale
10. The patient has been in the postanesthesia care unit (PACU) for one hour. The
patient is now groggy but able to respond to voice commands. While assessing the
patient, for what reason would the nurse check the bedclothes underneath the patient?
a) Determine drainage from tubes or drains
b) Assess for fluid balance
c) Detect for possible hemorrhage
d) Monitor perspiration - CORRECT ANSWER-c) Detect for possible hemorrhage
11. A 65-year-old was diagnosed and treated for right lower lobe pneumonia 4 days
ago. Today, the patient came to the ED reporting abrupt onset of chest pain that is
worse with inspiration. The nurse knows that the symptoms are consistent with:
a) Pleurisy
b) Stable angina
c) Bacteremia
d) Meningitis - CORRECT ANSWER-a) Pleurisy
12. The ED nurse is caring for Ginny, a 45-year-old female with a recent history of
sexual assault. Ginny came to the ED crying and shaking and stated that she had
dyspnea, feeling like she was choking and couldn't breathe, chest pain, and sweating.
Ginny reports that the symptoms started about 15 minutes before she came to the ED.
Ginny's symptoms are consistent with:
a) Myocardial Infarction
b) Pneumonia
c) Panic Attack
d) Influenza - CORRECT ANSWER-c) Panic Attack
13. A 86-year-old female has recent changes in her mental status, reports having no
appetite, and is running a low grade fever. The nurse suspects:
a) Delirium
b) Dementia
c) Urinary tract infection
d) Hypokalemia - CORRECT ANSWER-c) Urinary tract infection
14. Ted is a 76-year-old male who fell at home and sustained a fracture of his right hip.
He is being admitted to your unit and will have surgery in the morning. Ted has a past
, medical history of urinary calculi, benign prostatic hypertrophy, and hypertension. When
he arrived to the medical-surgical unit, he has a strong body odor and visible dirt on his
body. An indwelling urinary catheter was placed in the ED. Ted is at greatest risk for a
UTI is related to:
a) History of benign prostatic hypertrophy (BPH)
b) Poor hygiene
c) Indwelling urinary catheter
d) History of urinary calculi
e) His age - CORRECT ANSWER-c) Indwelling urinary catheter
15. A nurse knows that the patient teaching on the pneumococcal vaccine to a 65-year-
old patient has been effective when the patient states:
a) "The injection will protect me from the flu this year"
b) "I am now protected from getting pneumonia during my lifetime"
c) "I will need re-vaccination in five years"
d) "Now I won't need antibiotics when I get pneumonia" - CORRECT ANSWER-c) "I will
need re-vaccination in five years"
16. A patient is 14 hours postop from a surgical decompression for compartment
syndrome at the site of an ORIF on the left femur. On assessment, the urine output is
100mL in 8 hours, and has a dark, reddish brown color. Based on this assessment
finding, the nurse will:
a) Check to see if the myoglobin levels decreased
b) Administer an ordered prn fluid bolus to reverse fluid volume deficit
c) Nothing; this is an expected finding following surgery
d) Assess the patient for signs of acute kidney injury - CORRECT ANSWER-d) Assess
the patient for signs of acute kidney injury
17. A nurse has completed cast care teaching following the application of a plaster cast.
The nurse knows that patient teaching has been effective when the patient states:
a) "I can shower and then pat the cast dry."
b) "If I wrap my cast in plastic, it will last longer."
c) "I will call my physician if I have an increase in pain or swelling."
d) "I will apply ice on the cast over the fracture site for the next 48 hours." - CORRECT
ANSWER-c) "I will call my physician if I have an increase in pain or swelling."
18. A 75-year-old male with a history of heart failure (HF) and diabetes mellitus type 2
presents to the ED with abdominal pain. A CT scan with contrast reveals a bowel
obstruction that requires surgical resection. On post-operative day 1, the patient
develops a severe headache and mental status changes. The resident orders a CT
scan with contrast of the head. Before sending the patient to the CT scan, what action is
a priority for the nurse?
a) Perform a complete neurological assessment before sending the patient to the CT
scan
b) Evaluate the morning creatinine and BUN lab results
EXAMS
1. A patient is being admitted to the hospital on the day before a scheduled surgery.
What is the most appropriate initial question for the nurse to ask this preoperative
patient?
a) "What did your surgeon say to you about the type of surgery you are having?"
b) "What questions do you have about your surgery?"
c) "What type of surgery are you having and why are you having it done?"
d) "What do you know about what will be done to you?" - CORRECT ANSWER-c)
"What type of surgery are you having and why are you having it done?"
2. A benzodiazepine has been administered to a patient preoperatively. After the drug
has been administered, the nurse plans to monitor the patient for which side effects?
Select all that apply.
a) Anxiety
b) Hypotension
c) Hypocalcemia
d) Level of Consciousness
e) Sedation - CORRECT ANSWER-a) Anxiety
d) Level of Consciousness
e) Sedation
3. A preoperative patient has an elevated hemoglobin and hematocrit. What would the
nurse suspect regarding the significance of this increased value?
a) Immune deficiency
b) Kidney dysfunction
c) Malignancy
d) Dehydration - CORRECT ANSWER-d) Dehydration
4. Which activities should the nurse carry out in the preoperative period for a client
scheduled for surgery? Select all that apply.
a) Identify potential or actual health problems.
b) Verify the presence of a signed consent form.
c) Assess patient's response to interventions.
d) Intervene to prevent complications.
,e) Assess effectiveness of teaching related to postoperative recovery. - CORRECT
ANSWER-a) Identify potential or actual health problems.
b) Verify the presence of a signed consent form.
e) Assess effectiveness of teaching related to postoperative recovery.
5. A patient having surgery has a degree of risk associated with the surgery. The nurse
would evaluate which patient-related factors as contributing to a high degree of risk
associated with surgery? Select all that apply.
a) Type of institution where surgery is performed
b) Involvement of vital organs
c) Average nutritional status
d) Low likelihood of procedure complications
e) A history of respiratory disease and diabetes - CORRECT ANSWER-b) Involvement
of vital organs
e) A history of respiratory disease and diabetes
6. A patient has just entered the postanesthesia care unit (PACU) from surgery. For
which priority needs should the nurse immediately assess the postoperative patient?
a) Vital signs, level of consciousness, presence of pain
b) Skin coloring, surgical incision, limb movements
c) Skin temperature, blood pressure, mental status
d) Temperature, emotional status, wound drainage - CORRECT ANSWER-a) Vital
signs, level of consciousness, presence of pain
7. The nurse in the postanesthesia care unit (PACU) is assessing a postoperative
patient. Which indicators suggest to the nurse an alteration in tissue perfusion? Select
all that apply.
a) Pallor or cyanosis
b) Difficulty with mobility
c) Pain in the incision area
d) Fluid loss
e) Decreased urinary output - CORRECT ANSWER-a) Pallor or cyanosis
d) Fluid loss
e) Decreased urinary output
8. After surgery, the nurse encourages the patient to move from side to side at least
every 2 hours. The patient questions this activity. How does the nurse explain the
purpose of this intervention?
a) Assist peristalsis to return more quickly
b) Lessen muscle weakness
c) Increase patient's ability to sleep
d) Let the lungs alternatively achieve maximum expansion - CORRECT ANSWER-d)
Let the lungs alternatively achieve maximum expansion
,9. The nurse is creating a plan of care for a postoperative patient. The nursing diagnosis
in acute pain. What would be appropriate outcomes for this patient? Select all that
apply.
a) Balanced fluid intake and output
b) Seeks help as needed
c) Absence of nonverbal signs of pain
d) Performs leg exercises as instructed
e) Verbally rates pain as 3 on a 1 to 10 scale - CORRECT ANSWER-c) Absence of
nonverbal signs of pain
e) Verbally rates pain as 3 on a 1 to 10 scale
10. The patient has been in the postanesthesia care unit (PACU) for one hour. The
patient is now groggy but able to respond to voice commands. While assessing the
patient, for what reason would the nurse check the bedclothes underneath the patient?
a) Determine drainage from tubes or drains
b) Assess for fluid balance
c) Detect for possible hemorrhage
d) Monitor perspiration - CORRECT ANSWER-c) Detect for possible hemorrhage
11. A 65-year-old was diagnosed and treated for right lower lobe pneumonia 4 days
ago. Today, the patient came to the ED reporting abrupt onset of chest pain that is
worse with inspiration. The nurse knows that the symptoms are consistent with:
a) Pleurisy
b) Stable angina
c) Bacteremia
d) Meningitis - CORRECT ANSWER-a) Pleurisy
12. The ED nurse is caring for Ginny, a 45-year-old female with a recent history of
sexual assault. Ginny came to the ED crying and shaking and stated that she had
dyspnea, feeling like she was choking and couldn't breathe, chest pain, and sweating.
Ginny reports that the symptoms started about 15 minutes before she came to the ED.
Ginny's symptoms are consistent with:
a) Myocardial Infarction
b) Pneumonia
c) Panic Attack
d) Influenza - CORRECT ANSWER-c) Panic Attack
13. A 86-year-old female has recent changes in her mental status, reports having no
appetite, and is running a low grade fever. The nurse suspects:
a) Delirium
b) Dementia
c) Urinary tract infection
d) Hypokalemia - CORRECT ANSWER-c) Urinary tract infection
14. Ted is a 76-year-old male who fell at home and sustained a fracture of his right hip.
He is being admitted to your unit and will have surgery in the morning. Ted has a past
, medical history of urinary calculi, benign prostatic hypertrophy, and hypertension. When
he arrived to the medical-surgical unit, he has a strong body odor and visible dirt on his
body. An indwelling urinary catheter was placed in the ED. Ted is at greatest risk for a
UTI is related to:
a) History of benign prostatic hypertrophy (BPH)
b) Poor hygiene
c) Indwelling urinary catheter
d) History of urinary calculi
e) His age - CORRECT ANSWER-c) Indwelling urinary catheter
15. A nurse knows that the patient teaching on the pneumococcal vaccine to a 65-year-
old patient has been effective when the patient states:
a) "The injection will protect me from the flu this year"
b) "I am now protected from getting pneumonia during my lifetime"
c) "I will need re-vaccination in five years"
d) "Now I won't need antibiotics when I get pneumonia" - CORRECT ANSWER-c) "I will
need re-vaccination in five years"
16. A patient is 14 hours postop from a surgical decompression for compartment
syndrome at the site of an ORIF on the left femur. On assessment, the urine output is
100mL in 8 hours, and has a dark, reddish brown color. Based on this assessment
finding, the nurse will:
a) Check to see if the myoglobin levels decreased
b) Administer an ordered prn fluid bolus to reverse fluid volume deficit
c) Nothing; this is an expected finding following surgery
d) Assess the patient for signs of acute kidney injury - CORRECT ANSWER-d) Assess
the patient for signs of acute kidney injury
17. A nurse has completed cast care teaching following the application of a plaster cast.
The nurse knows that patient teaching has been effective when the patient states:
a) "I can shower and then pat the cast dry."
b) "If I wrap my cast in plastic, it will last longer."
c) "I will call my physician if I have an increase in pain or swelling."
d) "I will apply ice on the cast over the fracture site for the next 48 hours." - CORRECT
ANSWER-c) "I will call my physician if I have an increase in pain or swelling."
18. A 75-year-old male with a history of heart failure (HF) and diabetes mellitus type 2
presents to the ED with abdominal pain. A CT scan with contrast reveals a bowel
obstruction that requires surgical resection. On post-operative day 1, the patient
develops a severe headache and mental status changes. The resident orders a CT
scan with contrast of the head. Before sending the patient to the CT scan, what action is
a priority for the nurse?
a) Perform a complete neurological assessment before sending the patient to the CT
scan
b) Evaluate the morning creatinine and BUN lab results
