HINDUSTHAN COLLEGE OF NURSING

COIMBATORE
MEDICAL AND SURGICAL NURSING -II
Multiple choice questions
Topic: ENT

[Link] main goal of treatment for acute glomerulonephritis is to:

a. Encourage activity.
b. encourage high protein intake.
c. maintain fluid balance.
d. teach intermittent urinary catheterization.
2. Nursing diagnoses mostly differ from medical diagnoses, in that they are:
a. Dependent upon medical diagnoses for the direction of appropriate interventions.
b. Primarily concerned with caring, while medical diagnoses are primarily concerned
with curing.
c. Primarily concerned with human response, while medical diagnoses are primarily
concerned with pathology.
d. Primarily concerned with psychosocial parameters, while medical diagnoses are
primarily concerned with physiologic parameters.
3. A patient who received spinal anesthesia four hours ago during surgery is transferred to the
surgical unit and, after 90 minutes, now reports severe incisional pain. The patient's blood
pressure is 170/90 mmHg, pulse is 108 beats/min, temperature is 99oF (37.2oC), and
respirations are 30 breaths/min. The patient's skin is pale, and the surgical dressing is dry and
intact. The most appropriate nursing intervention is to:
a. Medicate the patient for pain.
b. Place the patient in a high Fowler position and administer oxygen.
c. Place the patient in a reverse Trendelenburg position and open the IV line.
d. Report the findings to the provider.
4. To prevent a common, adverse effect of prolonged use of phenytoin sodium (Dilantin),
patients taking the drug are instructed to:
a. Avoid crowds and obtain an annual influenza vaccination.
b. Drink at least 2 L of fluids daily, including 8 to 10 glasses of water.
c. Eat a potassium-rich, low-sodium diet.
d. Practice good dental hygiene and report gum swelling or bleeding.
5. The most common, preventable complication of abdominal surgery is:
a. atelectasis.
 b. fluid and electrolyte imbalance.
c. thrombophlebitis.
d. urinary retention.
6. A 78-year-old patient is scheduled for transition to home after treatment for heart disease.
The patient's spouse, who has chronic obstructive pulmonary disease, plans to care for the
patient at home. The spouse says that their grown children, who live nearby, will help. The
best approach to discharge planning is to:
a. Arrange nursing home placement for the couple.
b. Consult the spouse's healthcare provider about the spouse's ability to care for the
patient.
c. Contact the children to ascertain their commitment to help.
d. Discuss community resources with the spouse and offer to make referrals.
7. During an assessment of a patient who sustained a head injury 24 hours ago, the medical-
surgical nurse notes the development of slurred speech and disorientation to time and place.
The nurse's initial action is to:
a. Continue the hourly neurologic assessments.
b. Inform the neurosurgeon of the patient's status.
c. Prepare the patient for emergency surgery.
d. Recheck the patient's neurologic status in 15 minutes.
8. For the evaluation feedback process to be effective, the medical-surgical nurse who is a
manager:
a. Conducts weekly meetings with staff members.
b. Considers staff members' interests and abilities when delegating tasks.
c. Informs staff members regularly of how well they are performing their jobs.
d. Provides goals for staff members to meet.
9. An 80-year-old patient is placed in isolation when infected with methicillin-resistant
Staphylococcus aureus. The patient was alert and oriented on admission, but is now having
visual hallucinations and can follow only simple directions. The medical-surgical nure
recognizes that the changes in the patient's mental status are related to:
a. A fluid and electrolyte imbalance.
b. A stimulating environment.
c. Sensory deprivation.
d. Sundowning.
10. To prepare a patient on the unit for a bronchoscopic procedure, the medical-surgical nurse
administers an IV sedative. The nurse then instructs the licensed practical nurse to:
a. Educate the patient about the procedure.
b. Give the patient small sips of water only.
c. Measure the patient's blood pressure and heart rate.
d. Take the patient to the bathroom one more time.
11. Which physiological response is often associated with surgery-related stress?
a. Bronchial constriction.
b. Decreased cortisol levels.
c. Peripheral vasodilation.
d. Sodium and water retention.
12. A patient's family does not know the patient's end-of-life care preferences, but assumes
that they know what is best for the patient under the circumstances. This assumption reflects:
a. Justice.
b. Paternalism.
c. Pragmatism.
d. Veracity.
13. Which statement by a patient with diabetes indicates an understanding of the medication
insulin glargine injection (Lantus)?
a. "Lantus causes weight loss."
b. "Lantus is used only at night."
c. "The duration of Lantus is six hours."
d. "There is no peak time for Lantus."
14. Which action occurs primarily during the evaluation phase of the nursing process?
a. Data collection.
b. Decision-making and judgment.
c. Priority-setting and expected outcomes.
d. Reassessment and audit.
15. What is primarily a developmental task of middle age?
a. Learning and acquiring new skills and information.
b. Rediscovering or developing satisfaction in one's relationship with a significant other.
c. Relying strongly upon spiritual beliefs.
d. Risk-taking and its perceived consequences.
16. The medical-surgical nurse, who cares for a patient newly diagnosed with cancer,
observes the patient becoming angry with the physicians and nursing staff. The best approach
to diffuse the emotionally charged discussion is to:
a. allow the patient and family members time to be alone.
b. arrange time for the patient to speak with another patient with cancer.
c. direct the discussion and validation of emotion, without false reassurance.
d. request a consultation from a social worker on the oncology unit.
17. It is hospital policy to assess and record a patient's heart rate before administering digoxin
(Lanoxin). By auditing the nursing records to determine the frequency of compliance with
this policy, the quality assessment and improvement committee is conducting:
 a. a process analysis.
b. a quality analysis.
c. a system analysis.
d. an outcome analysis.
18. The nursing diagnosis for a patient with a myocardial infarction is activity intolerance.
The plan of care includes the patient outcome criterion of:
a. Agreeing to discontinue smoking.
b. Ambulating 50 feet without experiencing dyspnea.
c. Experiencing no dyspnea on exertion.
d. Tolerating activity well.
19. A nursing department in an acute care setting decides to redesign its nursing practice
based on a theoretical framework. The feedback from patients, families, and staff reflects that
caring is a key element. Which theorist best supports this concept?
a. Erikson.
b. Maslow.
c. Rogers.
d. Watson.
20. Which statement by a patient demonstrates an accurate understanding about herbal
supplements?
a. "Herbs may interact with prescribed medications but not other herbs."
b. "Most herbs have been tested and found to be safe and therapeutic."
c. "The Food and Drug Administration regulates herbs and allows advertising."
d. "There is no standardization among the manufacturers of herbs in this country."
21. For a patient with Crohn disease, the medical-surgical nurse recommends a diet that is:
a. high in fiber, and low in protein and calories.
b. high in potassium.
c. low in fiber, and high in protein and calories.
d. low in potassium.
22. When examining a patient who is paralyzed below the T4 level, the medical-surgical
nurse expects to find:
a. Flaccidity of the upper extremities.
b. Hyperreflexia and spasticity of the upper extremities.
c. Impaired diaphragmatic function requiring ventilator support.
d. Independent use of upper extremities and efficient cough.
23. After completing a thorough neurological and physical assessment of a patient who is
admitted for a suspected stroke, the medical-surgical nurse anticipates the next step in the
immediate care of this patient will include:
a. Administering tissue plasminogen activator.
 b. Obtaining a CT scan of the head without contrast.
c. Obtaining a neurosurgical consultation.
d. Preparing for carotid Doppler ultrasonography.
24. The first step in applying the quality improvement process to an activity in a clinical
setting is to:
a. Assemble a team to review and revise the activity.
b. Collect data to measure the status of the activity.
c. Identify a problem for improvement.
d. Set a measurable standard for the activity.
25. The medical-surgical nurse performs a dressing change on a patient with a history of non-
insulin-dependent diabetes. The patient questions why the wound is not healing. Recognizing
a teaching opportunity, what response does the nurse offer the patient?
a. "Are you eating enough carbohydrates in your diet?"
b. "Have you limited your exercise because of the wound?"
c. "How much sleep are you getting at night?"
d. "How often do you check your blood sugar levels at home?"

ANSWER KEY:

Question 1
The right answer was maintain fluid balance.
Question 2
The right answer was primarily concerned with human response, while medical diagnoses are
primarily concerned with pathology.

Question 3
The right answer was medicate the patient for pain.

Question 4
The right answer was practice good dental hygiene and report gum swelling or bleeding.

Question 5
The right answer was atelectasis.

Question 6
The right answer was discuss community resources with the spouse and offer to make
referrals.

Question 7
The right answer was inform the neurosurgeon of the patient's status.

Question 8
The right answer was informs staff members regularly of how well they are performing their
jobs.

Question 9
The right answer was sensory deprivation.

Question 10
The right answer was measure the patient's blood pressure and heart rate.

Question 11
The right answer was Sodium and water retention.
Question 12
The right answer was paternalism.

Question 13
The right answer was "There is no peak time for Lantus."

Question 14
The right answer was Reassessment and audit.

Question 15
The right answer was Rediscovering or developing satisfaction in one's relationship with a
significant other.

Question 16
The right answer was direct the discussion and validation of emotion, without false
reassurance.

Question 17
The right answer was a process analysis.

Question 18
The right answer was ambulating 50 feet without experiencing dyspnea.

Question 19
The right answer was Watson.

Question 20
The right answer was "There is no standardization among the manufacturers of herbs in this
country."

Question 21
The right answer was low in fiber, and high in protein and calories.
Question 22
The right answer was independent use of upper extremities and efficient cough.

Question 23
The right answer was obtaining a CT scan of the head without contrast.

Question 24
The right answer was identify a problem for improvement.

Question 25
The right answer was "How often do you check your blood sugar levels at home?"