BRUNNER AND SUDDARTHS CANADIAN
TEXTBOOK OF MEDICAL SURGICAL
NURSING 4TH EDITION BY MOHAMED EL
HUSSEIN ACTUAL EXAM PAPER 2026 FULL
QUESTIONS AND CORRECT ANSWERS
⩥ In planning care for a client with an acute stroke resulting in right-side
hemiplegia, which positioning should the nurse use to maintain optimal
functioning?
A. supine with trochanter rolls to the hips
B. left lateral, supine, brief periods on the right side, and prone
C. sim's position alternated with right lateral position q2 hours
D. mid-fowler's with knees supported. Answer: B
After an acute stroke, a positioning and turning schedule that minimizes
lying on the affected side, which can impair circulation and cause pain,
and include the prone position to help prevent flexion contractures of the
hips, prepares the client for optimal functioning and ambulating.
⩥ The nurse is caring for a client who is admitted with a hemorrhagic
stroke. Which nursing action should be included in the plan of care?
A. perform active range of motion three times daily
B. monitor for Battle's sign every four hours
,C. teach measures to avoid the Valsalva maneuver
D. maintain the head of bed in a flat position. Answer: C
The Valsalva maneuver, straining with bowel movements while holding
one's breath, increases intracerebral pressure (ICP) which may induce
bleeding or rupture of cerebral blood vessels. Passive, not active ROM is
performed to avoid ICP, bleeding and rupture. Battle's sign, bruising
noted behind the ear, is a manifestation that may be seen with a basilar
skull fracture, not hemorrhagic stroke. The flat position for the head of
the bed is avoided because it increase venous congestion and ICP
⩥ A client with a recent history of blood in his stools is scheduled for a
proctosigmoidoscopy. The nurse should implement which protocols to
prepare the client for this procedure?
A. provide a clear-liquid diet 48 hours before the procedure
B. initiate pre-operative sedation
C. begins fast the morning of the procedure
D. administer an enema before the procedure
E. obtain consent for the procedure. Answer: A, C, D, E
The usual pre-operative preparation for this procedure entails obtaining
the client's consent to the procedure, a clear-liquid diet 24-48 hours prior
to the procedure, administration of an enema, and fasting on the morning
of the procedure. Pre-operative sedation is not he norm for this
procedure, although some healthcare providers administer a mild
tranquilizer
, ⩥ The nurse is assessing a client admitted from the emergency room
with gastrointestinal bleeding related to peptic ulcer disease (PUD).
Which physiological factors can produce ulceration?
A. hypersecretion of hydrochloric acid
B. vagal stimulation
C. an increased level of stress
D. an increased number of parietal cells
E. decreased duodenal inhibition. Answer: A, B, D, E
Hypersecretion of gastric juices and an increased number of parietal
cells that stimulate secretion are most often the causes of ulceration.
Vagal stimulation and decreased duodenal inhibition also increase the
secretion of caustic fluids. An increase stress level is not physiologic and
is not a direct cause of ulceration
⩥ When caring for a client with a percutaneous endoscopic gastrostomy
(PEG) tube, what protocols should the nurse implement for intermittent
feedings?
A. flushing the tube with 50 ml of normal saline solution after each
feeding
B. assessing residual amounts once a day
C. changign the enteral-feeding bag every 24 hours
D. keeping the head of the bed elevated 30 degrees
TEXTBOOK OF MEDICAL SURGICAL
NURSING 4TH EDITION BY MOHAMED EL
HUSSEIN ACTUAL EXAM PAPER 2026 FULL
QUESTIONS AND CORRECT ANSWERS
⩥ In planning care for a client with an acute stroke resulting in right-side
hemiplegia, which positioning should the nurse use to maintain optimal
functioning?
A. supine with trochanter rolls to the hips
B. left lateral, supine, brief periods on the right side, and prone
C. sim's position alternated with right lateral position q2 hours
D. mid-fowler's with knees supported. Answer: B
After an acute stroke, a positioning and turning schedule that minimizes
lying on the affected side, which can impair circulation and cause pain,
and include the prone position to help prevent flexion contractures of the
hips, prepares the client for optimal functioning and ambulating.
⩥ The nurse is caring for a client who is admitted with a hemorrhagic
stroke. Which nursing action should be included in the plan of care?
A. perform active range of motion three times daily
B. monitor for Battle's sign every four hours
,C. teach measures to avoid the Valsalva maneuver
D. maintain the head of bed in a flat position. Answer: C
The Valsalva maneuver, straining with bowel movements while holding
one's breath, increases intracerebral pressure (ICP) which may induce
bleeding or rupture of cerebral blood vessels. Passive, not active ROM is
performed to avoid ICP, bleeding and rupture. Battle's sign, bruising
noted behind the ear, is a manifestation that may be seen with a basilar
skull fracture, not hemorrhagic stroke. The flat position for the head of
the bed is avoided because it increase venous congestion and ICP
⩥ A client with a recent history of blood in his stools is scheduled for a
proctosigmoidoscopy. The nurse should implement which protocols to
prepare the client for this procedure?
A. provide a clear-liquid diet 48 hours before the procedure
B. initiate pre-operative sedation
C. begins fast the morning of the procedure
D. administer an enema before the procedure
E. obtain consent for the procedure. Answer: A, C, D, E
The usual pre-operative preparation for this procedure entails obtaining
the client's consent to the procedure, a clear-liquid diet 24-48 hours prior
to the procedure, administration of an enema, and fasting on the morning
of the procedure. Pre-operative sedation is not he norm for this
procedure, although some healthcare providers administer a mild
tranquilizer
, ⩥ The nurse is assessing a client admitted from the emergency room
with gastrointestinal bleeding related to peptic ulcer disease (PUD).
Which physiological factors can produce ulceration?
A. hypersecretion of hydrochloric acid
B. vagal stimulation
C. an increased level of stress
D. an increased number of parietal cells
E. decreased duodenal inhibition. Answer: A, B, D, E
Hypersecretion of gastric juices and an increased number of parietal
cells that stimulate secretion are most often the causes of ulceration.
Vagal stimulation and decreased duodenal inhibition also increase the
secretion of caustic fluids. An increase stress level is not physiologic and
is not a direct cause of ulceration
⩥ When caring for a client with a percutaneous endoscopic gastrostomy
(PEG) tube, what protocols should the nurse implement for intermittent
feedings?
A. flushing the tube with 50 ml of normal saline solution after each
feeding
B. assessing residual amounts once a day
C. changign the enteral-feeding bag every 24 hours
D. keeping the head of the bed elevated 30 degrees
