MEDICAL-SURGICAL NURSING
Name:___________________________________________________________________ Date:____________
1. In counseling a client with ulcerative colitis for 25 years about health plans, the nurse would include the advice
that the client should
A. Avoid red meat C. obtain genetic counseling
B. reduce physical exercise D. Schedule regular proctoscopic exams
2. The out-patient clinic nurse is caring for a 66-year-old woman with insulin-dependent diabetes mellitus (IDDM).
Because the client is unwilling to perform blood glucose monitoring, she tests her urine for sugar and acetone. The
nurse knows that blood glucose monitoring is preferred over urine testing for glucose because
A. the renal threshold for glucose is elevated in the elderly.
B. blood glucose monitoring is easier and less costly for clients to perform.
C. urine testing for glucose provides false-positive readings.
D. determination of the color on a reagent strip varies from person to person.
3. The Clinical instructor is supervising a student nurse administering an enema to a patient. During the
administration, it is MOST important for the Student nurse to take which of the following actions?
A. Place the solution 20 inches above the anus.
B. Adjust the temperature of the solution.
C. Insert the tube six inches.
D. Position the patient left side-lying (Sim's) with knee flexed.
4. Which of the following types of foods should the nurse encourage in the diet of a client with
hypoparathyroidism?
A. High in phosphorus. C. Low in sodium.
B. High in calcium. D. Low in potassium.
5. The nurse suggests that the client not eat or drink anything just before going to bed. The appropriateness of this
comment is based on which of these understandings about GERD?
A. The client is less likely to awaken during the night with heartburn if the stomach is empty.
B. Early-morning vomiting will be less of a problem if the stomach is empty.
C. Drinking or eating before lying down causes decreased respirations due to increased pressure on the lungs.
D. The client may develop fluid overload if fluids are taken just before going to bed.
6. The nurse explains to a client with Crohn’s disease who is recovering from a fourth bowel resection that because
of the multiple resections, the client may develop
A. malabsorption syndrome C. peritonitis
B. ulcerative colitis D. chronic constipation
7. Which nursing observation would suggest that a client has developed an Addisonian crisis?
A. Muscular weakness and fatigue. C. Dark pigmentation of the skin.
B. Restlessness and rapid, weak pulse. D. Gastrointestinal disturbances and anorexia
8. Which information should the nurse recognize as being the MOST pertinent to the diagnosis of cholecystitis?
A. Flatulence. C. Right upper abdominal pain.
B. Nausea and vomiting. D. Dyspepsia.
9. The nurse recognizes that the teaching about the pathophysiology of ulcerative colitis needs reinforcement when
the 13 year old client says
A. “ulcerative colitis involves contiguous areas of bowel”
B. “I will grow out of my disease”
C. “I know that physical exertion and fatigue can bring on an attack”
D. “My symptoms with the disease will come and go”
10. The nurse should caution the client with hypothyroidism to avoid
A. warm environmental temperatures. C. increased physical exercise.
B. narcotic sedatives. D. a diet high in fiber.
11. The nurse would explain to the diabetic client that the decreased vision he has experienced is due to which of
the following?
A. Bleeding into the inner ocular chamber of the eye.
, B. Gradual separation of the retina from the base of the eye.
C. An increase in the size of the vessels in the back of the eye.
D. Gradual destruction and degeneration of the retina.
12. A client who is scheduled for a barium enema indicates that she understands the nurse’s preprocedure
instructions when she says
A. “I will need to eat a high-fiber diet during the 2 days before the test.”
B. “I will need to use laxatives and enemas to clean out my bowel before this test.”
C. “I’m not sure if I can drink the 2 quarts of water I need the day before the test.”
D. “I will be prepared for the barium enema when I get to the hospital for the test.”
13. The nurse knows that Cortisol is responsible for
A. preparing the body for "flight or fight." C. converting proteins and fat into glucose.
B. regulating the calcium metabolism. D. enhancing musculoskeletal activity.
14. The nurse is caring for a three-month-old infant that is scheduled for a barium swallow in the morning. Prior to
the procedure, the MOST appropriate nursing action would be to
A. offer the infant only clear liquids. C. feed the infant regular formula.
B. make the infant NPO for three hours. D. maintain the infant NPO for six hours.
15. In preparing a teaching plan regarding colostomy irrigations, the nurse should include which of the following?
A. The colostomy needs to be irrigated at the same time every day.
B. Irrigate the colostomy after meals to increase peristalsis.
C. Insert the catheter about ten inches into the stoma.
D. The solution should be very warm to increase dilation and flow.
16. A 34-year-old man comes to the clinic for the results of a glycosylated hemoglobin assay (HbA1c). Which
statement, if made by the client to the nurse, indicates an understanding of this procedure?
A. "This test is performed by sticking my finger and measuring the results."
B. "This test needs to be performed in the morning before I eat breakfast."
C. "This test indicates how well my blood sugar has been controlled the past 6-8 weeks."
D. "I must follow my diet carefully for several days before the test."
17. The physician diagnoses Graves' disease for a 28-year-old woman seen in the clinic. The nurse would expect the
client to exhibit which of the following symptoms?
A. Lethargy in the early morning. C. Weight loss of 10 lb in 3 weeks.
B. Sensitivity to cold. D. Reduced deep tendon reflexes.
18. The nurse planning to irrigate a nasogastric (NG) tube prepares to use
A. half-strength peroxide. C. normal saline.
B. sterile water. D. tap water.
19. A 23-year-old man with Addison's disease comes to the health clinic. The nurse should expect the client to
report that his skin has become
A. darker and more pigmented. C. puffy and scaly.
B. ruddy and oily. D. pale and dry.
20.The nurse administers alternating doses of two antacids into the NG tube of a client with a duodenal ulcer. The
finding that best indicates that this drug regimen has been successful is
A. absent NG tube drainage. C. mild diarrhea.
B. increase in gastric pH. D. decreased abdominal rigidity.
21. Which of the following nursing actions has the HIGHEST priority in caring for the client with
hypoparathyroidism?
A. Develop a teaching plan.
B. Plan measures to deal with cardiac dysrhythmias.
C. Take measures to prevent a respiratory infection.
D. Assess laboratory results.
22. For a client with cirrhosis who had 1000 ml of ascitic fluid removed during a peritoneal tap 20 minutes ago, the
intervention that would have priority is
A. frequently monitoring vital signs. C. administering pain medications.
B. assessing for deep tendon reflex. D. assisting with ambulation.
Name:___________________________________________________________________ Date:____________
1. In counseling a client with ulcerative colitis for 25 years about health plans, the nurse would include the advice
that the client should
A. Avoid red meat C. obtain genetic counseling
B. reduce physical exercise D. Schedule regular proctoscopic exams
2. The out-patient clinic nurse is caring for a 66-year-old woman with insulin-dependent diabetes mellitus (IDDM).
Because the client is unwilling to perform blood glucose monitoring, she tests her urine for sugar and acetone. The
nurse knows that blood glucose monitoring is preferred over urine testing for glucose because
A. the renal threshold for glucose is elevated in the elderly.
B. blood glucose monitoring is easier and less costly for clients to perform.
C. urine testing for glucose provides false-positive readings.
D. determination of the color on a reagent strip varies from person to person.
3. The Clinical instructor is supervising a student nurse administering an enema to a patient. During the
administration, it is MOST important for the Student nurse to take which of the following actions?
A. Place the solution 20 inches above the anus.
B. Adjust the temperature of the solution.
C. Insert the tube six inches.
D. Position the patient left side-lying (Sim's) with knee flexed.
4. Which of the following types of foods should the nurse encourage in the diet of a client with
hypoparathyroidism?
A. High in phosphorus. C. Low in sodium.
B. High in calcium. D. Low in potassium.
5. The nurse suggests that the client not eat or drink anything just before going to bed. The appropriateness of this
comment is based on which of these understandings about GERD?
A. The client is less likely to awaken during the night with heartburn if the stomach is empty.
B. Early-morning vomiting will be less of a problem if the stomach is empty.
C. Drinking or eating before lying down causes decreased respirations due to increased pressure on the lungs.
D. The client may develop fluid overload if fluids are taken just before going to bed.
6. The nurse explains to a client with Crohn’s disease who is recovering from a fourth bowel resection that because
of the multiple resections, the client may develop
A. malabsorption syndrome C. peritonitis
B. ulcerative colitis D. chronic constipation
7. Which nursing observation would suggest that a client has developed an Addisonian crisis?
A. Muscular weakness and fatigue. C. Dark pigmentation of the skin.
B. Restlessness and rapid, weak pulse. D. Gastrointestinal disturbances and anorexia
8. Which information should the nurse recognize as being the MOST pertinent to the diagnosis of cholecystitis?
A. Flatulence. C. Right upper abdominal pain.
B. Nausea and vomiting. D. Dyspepsia.
9. The nurse recognizes that the teaching about the pathophysiology of ulcerative colitis needs reinforcement when
the 13 year old client says
A. “ulcerative colitis involves contiguous areas of bowel”
B. “I will grow out of my disease”
C. “I know that physical exertion and fatigue can bring on an attack”
D. “My symptoms with the disease will come and go”
10. The nurse should caution the client with hypothyroidism to avoid
A. warm environmental temperatures. C. increased physical exercise.
B. narcotic sedatives. D. a diet high in fiber.
11. The nurse would explain to the diabetic client that the decreased vision he has experienced is due to which of
the following?
A. Bleeding into the inner ocular chamber of the eye.
, B. Gradual separation of the retina from the base of the eye.
C. An increase in the size of the vessels in the back of the eye.
D. Gradual destruction and degeneration of the retina.
12. A client who is scheduled for a barium enema indicates that she understands the nurse’s preprocedure
instructions when she says
A. “I will need to eat a high-fiber diet during the 2 days before the test.”
B. “I will need to use laxatives and enemas to clean out my bowel before this test.”
C. “I’m not sure if I can drink the 2 quarts of water I need the day before the test.”
D. “I will be prepared for the barium enema when I get to the hospital for the test.”
13. The nurse knows that Cortisol is responsible for
A. preparing the body for "flight or fight." C. converting proteins and fat into glucose.
B. regulating the calcium metabolism. D. enhancing musculoskeletal activity.
14. The nurse is caring for a three-month-old infant that is scheduled for a barium swallow in the morning. Prior to
the procedure, the MOST appropriate nursing action would be to
A. offer the infant only clear liquids. C. feed the infant regular formula.
B. make the infant NPO for three hours. D. maintain the infant NPO for six hours.
15. In preparing a teaching plan regarding colostomy irrigations, the nurse should include which of the following?
A. The colostomy needs to be irrigated at the same time every day.
B. Irrigate the colostomy after meals to increase peristalsis.
C. Insert the catheter about ten inches into the stoma.
D. The solution should be very warm to increase dilation and flow.
16. A 34-year-old man comes to the clinic for the results of a glycosylated hemoglobin assay (HbA1c). Which
statement, if made by the client to the nurse, indicates an understanding of this procedure?
A. "This test is performed by sticking my finger and measuring the results."
B. "This test needs to be performed in the morning before I eat breakfast."
C. "This test indicates how well my blood sugar has been controlled the past 6-8 weeks."
D. "I must follow my diet carefully for several days before the test."
17. The physician diagnoses Graves' disease for a 28-year-old woman seen in the clinic. The nurse would expect the
client to exhibit which of the following symptoms?
A. Lethargy in the early morning. C. Weight loss of 10 lb in 3 weeks.
B. Sensitivity to cold. D. Reduced deep tendon reflexes.
18. The nurse planning to irrigate a nasogastric (NG) tube prepares to use
A. half-strength peroxide. C. normal saline.
B. sterile water. D. tap water.
19. A 23-year-old man with Addison's disease comes to the health clinic. The nurse should expect the client to
report that his skin has become
A. darker and more pigmented. C. puffy and scaly.
B. ruddy and oily. D. pale and dry.
20.The nurse administers alternating doses of two antacids into the NG tube of a client with a duodenal ulcer. The
finding that best indicates that this drug regimen has been successful is
A. absent NG tube drainage. C. mild diarrhea.
B. increase in gastric pH. D. decreased abdominal rigidity.
21. Which of the following nursing actions has the HIGHEST priority in caring for the client with
hypoparathyroidism?
A. Develop a teaching plan.
B. Plan measures to deal with cardiac dysrhythmias.
C. Take measures to prevent a respiratory infection.
D. Assess laboratory results.
22. For a client with cirrhosis who had 1000 ml of ascitic fluid removed during a peritoneal tap 20 minutes ago, the
intervention that would have priority is
A. frequently monitoring vital signs. C. administering pain medications.
B. assessing for deep tendon reflex. D. assisting with ambulation.
