MED-SURG CERTIFICATION EXAM
150+ QUESTIONS COMPLETE WITH
100% CORRECT ANSWERS AND
DETAILED RATIONALE
A patient who has recently been diagnosed with tuberculosis using a skin test
tells the nurse, "I feel fine and can breathe just great!" Which of the following
responses is correct?
A. You likely have a latent infection that could be infectious to others.
B. You are in the process of developing an infection that will make you quite ill.
C. You may have tuberculosis that affects your liver instead of your lungs.
D. We made need to rerun test, as this type of test often gives false results.
Answer: You likely have a latent infection that could be infectious to others.
Rationale: Tuberculosis (TB) can be either active or latent, and can remain in the
latent state for decades. Patients who have a latent TB infection can still transmit
the disease to others. TB skin tests may require further testing to validate positive
results, but it is not often inaccurate. TB affects the lungs, not the liver.
You are caring for an 82 y/o male patient admitted the previous day with COPD
exacerbation. Since admission, he has not eaten well & refuses to get out of bed
because he can't "catch his breath". During assessment, you notice a 2 cm red
spot with localized warmth located over the sacrum that's blanchable. The Dr
orders a hydrocolloid dressing for the patient's sacral area. What is the rationale
for using this type of wound dressing?
A. It protects the wound & encourages a moist environment
,B. It contains a solution to clean the wound environment
C. It provides an antibiotic sponge to decrease bacteria & help the healing
process
D. It can be changed several times without damaging the wound bed
Answer: It protects the wound & encourages a moist environment
Rationale: Management of partial thickness (superficial) ulcers involves covering
with a noncontact layer, hydrocolloid hydrogel, or transparent film dressing as the
wound tends to heal more quickly with a moisture retentive dressing that's not
changed as frequently compared to conventional dressings.
Hydrocolloid dressings do not contain solutions or antibiotics. Rather, normal
saline or commercial wound cleaners should be used prior to placing an ew
dressing. Hydrogen peroxide & betadine should be avoided. Shear, friction, &
pressure to wound should also be avoided during healing.
Your patient is complaining of pain upon readmission to the med/surg floor
following a Roux-en-Y Gastric Bypass surgery (RYGB). When addressing the
patient's pain, your response is based on the fact that:
A. Hypersomnia is common in unrelieved pain
B. Physiological measures are the most sensitive in bariatric patients
C. Pain increases the immune response
D. Pain decreases gastrointestinal motility
Answer: Pain decreases gastrointestinal motility
Rationale: The consequences of unrelieved pain include
-Prolonged stress response
-Increased HR, BP, & oxygen demand
-Decreased gastrointestinal motility
-Decreased immune response
,-Delayed healing
-Increased risk for chronic pain
The nurse is admitting a patient who had a myocardial infarction 3 weeks ago.
The patient is being admitted for shortness of breath, joint achiness, anxiety,
bilateral pitting edema in the lower extremities, and nausea. Which of the
following tests is most important for this patient?
A. Serum sodium
B. Brain natriuretic peptide
C. Troponin I
D. Albumin
Answer: Brain natriuretic peptide
Rationale: BNP is elevated by the body in an attempt to compensate for heart
failure & is an indication if heart failure is present. The patient's symptoms
combined with the recent history of MI are strongly indicative of heart failure, &
BNP should be tested. Although the other tests should be performed as well, BNP
is the highest priority for this patient.
In shock, the release of norepinephrine due to the adrenal response of the
endocrine system has which of the following effects on the cardiovascular
system?
A. Promotes reabsorption of sodium, conserving circulating fluid volume &
maintaining cardiac output
B. Promotes the reabsorption of water, conserving circulating fluid volume and
maintaining cardiac output
C. Vasoconstriction of peripheral and renal vessels, leading to increased renal
perfusion, rise in systemic BP, & increased venous return
D. INcreased heart rate, increased strength of cardiac contractions leading to
increased cardiac output & increased BP
, Answer: Vasoconstriction of peripheral and renal vessels, leading to increased
renal perfusion, rise in systemic BP, & increased venous return
Rationale: Vasoconstriction of peripheral & renal vessels, leading to increased
renal perfusion, rise in systemic BP, & increased venous return.
In shock, the release of norepinephrine due to the adrenal response (of the
endocrine system) has the following effects on the cardiovascular system:
-Vasoconstriction of peripheral and renal vessels, leading to increased renal
perfusion
-Rise in systemic BP
-Increased venous return
Epinephrine (not norepinephrine) increases HR & strength of cardiac contractions.
Aldosterone (not norepinephrine) promotes reabsorption of water & sodium
When caring for a female patient who will be undergoing a total
proctocolectomy with ileostomy for her Crohn's disease, which of these
comments made before surgery would indicate that hse has concerns about her
body image?
A. "I'm concerns that this may be only the first of many surgeries to come."
B. "I will have to discontinue my gym membership."
C. "I'm so afraid I may not survive the surgery."
D. "I need to go shopping for bigger, baggier clothing"
Answer: "I need to go shopping for bigger, baggier clothing"
Rationale: Psychosocial support is necessary as a part of nursing interventions
regarding body image concerns. Body image refers to a person interacts with
others. The patient doesn't need to buy special clothing after ileostomy surgery,
although some minor adjustments may be needed for comfort (such as stretch
underwear or pantyhose for support).
150+ QUESTIONS COMPLETE WITH
100% CORRECT ANSWERS AND
DETAILED RATIONALE
A patient who has recently been diagnosed with tuberculosis using a skin test
tells the nurse, "I feel fine and can breathe just great!" Which of the following
responses is correct?
A. You likely have a latent infection that could be infectious to others.
B. You are in the process of developing an infection that will make you quite ill.
C. You may have tuberculosis that affects your liver instead of your lungs.
D. We made need to rerun test, as this type of test often gives false results.
Answer: You likely have a latent infection that could be infectious to others.
Rationale: Tuberculosis (TB) can be either active or latent, and can remain in the
latent state for decades. Patients who have a latent TB infection can still transmit
the disease to others. TB skin tests may require further testing to validate positive
results, but it is not often inaccurate. TB affects the lungs, not the liver.
You are caring for an 82 y/o male patient admitted the previous day with COPD
exacerbation. Since admission, he has not eaten well & refuses to get out of bed
because he can't "catch his breath". During assessment, you notice a 2 cm red
spot with localized warmth located over the sacrum that's blanchable. The Dr
orders a hydrocolloid dressing for the patient's sacral area. What is the rationale
for using this type of wound dressing?
A. It protects the wound & encourages a moist environment
,B. It contains a solution to clean the wound environment
C. It provides an antibiotic sponge to decrease bacteria & help the healing
process
D. It can be changed several times without damaging the wound bed
Answer: It protects the wound & encourages a moist environment
Rationale: Management of partial thickness (superficial) ulcers involves covering
with a noncontact layer, hydrocolloid hydrogel, or transparent film dressing as the
wound tends to heal more quickly with a moisture retentive dressing that's not
changed as frequently compared to conventional dressings.
Hydrocolloid dressings do not contain solutions or antibiotics. Rather, normal
saline or commercial wound cleaners should be used prior to placing an ew
dressing. Hydrogen peroxide & betadine should be avoided. Shear, friction, &
pressure to wound should also be avoided during healing.
Your patient is complaining of pain upon readmission to the med/surg floor
following a Roux-en-Y Gastric Bypass surgery (RYGB). When addressing the
patient's pain, your response is based on the fact that:
A. Hypersomnia is common in unrelieved pain
B. Physiological measures are the most sensitive in bariatric patients
C. Pain increases the immune response
D. Pain decreases gastrointestinal motility
Answer: Pain decreases gastrointestinal motility
Rationale: The consequences of unrelieved pain include
-Prolonged stress response
-Increased HR, BP, & oxygen demand
-Decreased gastrointestinal motility
-Decreased immune response
,-Delayed healing
-Increased risk for chronic pain
The nurse is admitting a patient who had a myocardial infarction 3 weeks ago.
The patient is being admitted for shortness of breath, joint achiness, anxiety,
bilateral pitting edema in the lower extremities, and nausea. Which of the
following tests is most important for this patient?
A. Serum sodium
B. Brain natriuretic peptide
C. Troponin I
D. Albumin
Answer: Brain natriuretic peptide
Rationale: BNP is elevated by the body in an attempt to compensate for heart
failure & is an indication if heart failure is present. The patient's symptoms
combined with the recent history of MI are strongly indicative of heart failure, &
BNP should be tested. Although the other tests should be performed as well, BNP
is the highest priority for this patient.
In shock, the release of norepinephrine due to the adrenal response of the
endocrine system has which of the following effects on the cardiovascular
system?
A. Promotes reabsorption of sodium, conserving circulating fluid volume &
maintaining cardiac output
B. Promotes the reabsorption of water, conserving circulating fluid volume and
maintaining cardiac output
C. Vasoconstriction of peripheral and renal vessels, leading to increased renal
perfusion, rise in systemic BP, & increased venous return
D. INcreased heart rate, increased strength of cardiac contractions leading to
increased cardiac output & increased BP
, Answer: Vasoconstriction of peripheral and renal vessels, leading to increased
renal perfusion, rise in systemic BP, & increased venous return
Rationale: Vasoconstriction of peripheral & renal vessels, leading to increased
renal perfusion, rise in systemic BP, & increased venous return.
In shock, the release of norepinephrine due to the adrenal response (of the
endocrine system) has the following effects on the cardiovascular system:
-Vasoconstriction of peripheral and renal vessels, leading to increased renal
perfusion
-Rise in systemic BP
-Increased venous return
Epinephrine (not norepinephrine) increases HR & strength of cardiac contractions.
Aldosterone (not norepinephrine) promotes reabsorption of water & sodium
When caring for a female patient who will be undergoing a total
proctocolectomy with ileostomy for her Crohn's disease, which of these
comments made before surgery would indicate that hse has concerns about her
body image?
A. "I'm concerns that this may be only the first of many surgeries to come."
B. "I will have to discontinue my gym membership."
C. "I'm so afraid I may not survive the surgery."
D. "I need to go shopping for bigger, baggier clothing"
Answer: "I need to go shopping for bigger, baggier clothing"
Rationale: Psychosocial support is necessary as a part of nursing interventions
regarding body image concerns. Body image refers to a person interacts with
others. The patient doesn't need to buy special clothing after ileostomy surgery,
although some minor adjustments may be needed for comfort (such as stretch
underwear or pantyhose for support).
