1
NP 3 & NP 4 MED-SURG FREE NLE REVIEW
QUESTIONS AND ANSWERS
SPECIFIC TO REAL EXAM
The appendix is a small pouch attached to the large intestine.
Appendicitis is characterized by inflammation of the appendix. A patient with
appendicitis is at risk for developing:
A. hemorrhage
B. pulmonary edema
C. peritonitis
D. bowel obstruction
.
.
.
ANSWER: C
Peritonitis is caused by the rupture of the appendix either due to increased
intraluminal pressure or transmural swelling and inflammation. Signs of
peritonitis include hyperthermia and board-like abdominal rigidity.
Choices A and D are incorrect because they are not complications of appendicitis.
Renal failure could result if the patient develops septic shock, but it is not a direct
complication of appendicitis
What common side effect should the nurse monitor in a client who just received
epidural anesthesia?
A. Fever
B. Bradycardia
C. Hypotension
D. Pallor
Answer is C
Ratio : hypotension is a common side effect of epidural anesthesia. The nurse
should monitor the patient's BP in the post-operative period.
,2
In an elderly client who is being treated with narcotics, what should be the nurse's
highest priority?
A. Assessing the client's ability to swallow
B. Checking the client's liver function
C. Monitoring the clients's serum creatinine levels
D. Assessing the client's range of motion
.
.
.
.
.
ANSWER: B
Elderly clients have slowed liver function that results in delayed excretion of the
drug. This may potentially lead to hepatotoxicity.
A client Extracellular fluid fall behind 20% of his normal body weight. The nurse
finding on assessment may include EXCEPT
A.Weight loss
B.Edema
C.Increase Output
D.Decrease Intake
#Clue #fVD #except
Correct Answer B.
Urolithiasis is the presence of calculi (stones) in the urinary tract. There are many
types of renal calculi, depending on the etiology. Your patient has calcium oxalate
stones. The following should be avoided by the patient, except:
A. apple
B. black tea
C. banana
D. spinach
.
.
.
ANSWER: C - Banana
,3
Black tea, cocoa, citrus fruits, apples, grapes, peanuts, chocolate and spinach are
foods that are source of oxalate. Reduction of urinary oxalate content may help
prevent calcium oxalate stones from forming.
A client with refractory myasthenia gravis undergoes plasmapheresis therapy. The
nurse determines that the therapy was effective if the client demonstrates
improvements in:
A. Vital capacity
B. Leg strength
C. Ptosis
D. Diplopia
.
.
.
.
.
Answer( lippincott ): A
Plasmapheresis therapy removes the anti-bodies that cause MG; therefore, the
lung muscles will function with greater strength delivering more vital capacity.
MG affects the upper limbs, and an increase in leg strength is not an outcome of
plasmapheresis. Once the MG client has symptoms of ptosis and diplopia, they
will not be reversed by plasmapheresis therapy.
From an ECG reading, a QRS complex represents
A. Atrial depolarization
B. Ventricular depolarization
C. Atrial repolarization
D. Ventricular repolarization
.
.
.
ANSWER: B
QRS complex represents ventricular depolarization. The QRS complex is normally
less than 0.12seconds in duration. T wave represents the ventricular
repolarization, the time when the cells regain the negative charge; also called the
, 4
resting state. P wave represents the atrial depolarization. Atrial repolarization is
not distinctly recognized because its wave has low amplitude and it occurs at the
same time as ventricular depolarization
Which assessment finding is most indicative of pericarditis?
A. Third heart sound
B. Pericardial friction rub
C. Rales auscultated at the right lower lobe
D. Pain not relieved by a change in position
.
.
.
ANSWER: B
The high-pitched, scratchy sound is heard at the left lower sternal border. It is
produced by the pericardial layers (inflamed and rough) when their surfaces rub
against each other. A third heart sound is not present in a client with pericarditis,
but may be present in left-sided heart failure. The lungs when auscultated are
typically clear. Pain is worse when the client is lying down but is relieved by sitting
up and leaning forward.
A client with emphysema experiences a sudden episode of shortness of breath
and is diagnosed with a spontaneous pneumothorax. The client asks, "How could
this have happened?" What likely cause of the spontaneous pneumothorax
should the nurses' response take into consideration?
A. Pleural friction rub
B.Tracheoesophageal fistula
C.Rupture of a subpleural bleb
D.Puncture wound of the chest wall
Answer:C The etiology of a spontaneous pneumothorax is commonly the rupture
of blebs on the lung surface. Blebs are similar to blisters, but are filled with air.
On assessement the nurse observe redness on the skin and document the client
has:
A.petechiae
B.rash
NP 3 & NP 4 MED-SURG FREE NLE REVIEW
QUESTIONS AND ANSWERS
SPECIFIC TO REAL EXAM
The appendix is a small pouch attached to the large intestine.
Appendicitis is characterized by inflammation of the appendix. A patient with
appendicitis is at risk for developing:
A. hemorrhage
B. pulmonary edema
C. peritonitis
D. bowel obstruction
.
.
.
ANSWER: C
Peritonitis is caused by the rupture of the appendix either due to increased
intraluminal pressure or transmural swelling and inflammation. Signs of
peritonitis include hyperthermia and board-like abdominal rigidity.
Choices A and D are incorrect because they are not complications of appendicitis.
Renal failure could result if the patient develops septic shock, but it is not a direct
complication of appendicitis
What common side effect should the nurse monitor in a client who just received
epidural anesthesia?
A. Fever
B. Bradycardia
C. Hypotension
D. Pallor
Answer is C
Ratio : hypotension is a common side effect of epidural anesthesia. The nurse
should monitor the patient's BP in the post-operative period.
,2
In an elderly client who is being treated with narcotics, what should be the nurse's
highest priority?
A. Assessing the client's ability to swallow
B. Checking the client's liver function
C. Monitoring the clients's serum creatinine levels
D. Assessing the client's range of motion
.
.
.
.
.
ANSWER: B
Elderly clients have slowed liver function that results in delayed excretion of the
drug. This may potentially lead to hepatotoxicity.
A client Extracellular fluid fall behind 20% of his normal body weight. The nurse
finding on assessment may include EXCEPT
A.Weight loss
B.Edema
C.Increase Output
D.Decrease Intake
#Clue #fVD #except
Correct Answer B.
Urolithiasis is the presence of calculi (stones) in the urinary tract. There are many
types of renal calculi, depending on the etiology. Your patient has calcium oxalate
stones. The following should be avoided by the patient, except:
A. apple
B. black tea
C. banana
D. spinach
.
.
.
ANSWER: C - Banana
,3
Black tea, cocoa, citrus fruits, apples, grapes, peanuts, chocolate and spinach are
foods that are source of oxalate. Reduction of urinary oxalate content may help
prevent calcium oxalate stones from forming.
A client with refractory myasthenia gravis undergoes plasmapheresis therapy. The
nurse determines that the therapy was effective if the client demonstrates
improvements in:
A. Vital capacity
B. Leg strength
C. Ptosis
D. Diplopia
.
.
.
.
.
Answer( lippincott ): A
Plasmapheresis therapy removes the anti-bodies that cause MG; therefore, the
lung muscles will function with greater strength delivering more vital capacity.
MG affects the upper limbs, and an increase in leg strength is not an outcome of
plasmapheresis. Once the MG client has symptoms of ptosis and diplopia, they
will not be reversed by plasmapheresis therapy.
From an ECG reading, a QRS complex represents
A. Atrial depolarization
B. Ventricular depolarization
C. Atrial repolarization
D. Ventricular repolarization
.
.
.
ANSWER: B
QRS complex represents ventricular depolarization. The QRS complex is normally
less than 0.12seconds in duration. T wave represents the ventricular
repolarization, the time when the cells regain the negative charge; also called the
, 4
resting state. P wave represents the atrial depolarization. Atrial repolarization is
not distinctly recognized because its wave has low amplitude and it occurs at the
same time as ventricular depolarization
Which assessment finding is most indicative of pericarditis?
A. Third heart sound
B. Pericardial friction rub
C. Rales auscultated at the right lower lobe
D. Pain not relieved by a change in position
.
.
.
ANSWER: B
The high-pitched, scratchy sound is heard at the left lower sternal border. It is
produced by the pericardial layers (inflamed and rough) when their surfaces rub
against each other. A third heart sound is not present in a client with pericarditis,
but may be present in left-sided heart failure. The lungs when auscultated are
typically clear. Pain is worse when the client is lying down but is relieved by sitting
up and leaning forward.
A client with emphysema experiences a sudden episode of shortness of breath
and is diagnosed with a spontaneous pneumothorax. The client asks, "How could
this have happened?" What likely cause of the spontaneous pneumothorax
should the nurses' response take into consideration?
A. Pleural friction rub
B.Tracheoesophageal fistula
C.Rupture of a subpleural bleb
D.Puncture wound of the chest wall
Answer:C The etiology of a spontaneous pneumothorax is commonly the rupture
of blebs on the lung surface. Blebs are similar to blisters, but are filled with air.
On assessement the nurse observe redness on the skin and document the client
has:
A.petechiae
B.rash
