MED SURG 2016 Test Questions
TEST I
1. Man worried about getting osteoporosis like his wife – Tell him he should get a bone density test.
2. Giving platelets – use short infusion set with no filter.
3. Neck vein distention while pt sitting up in bed receiving blood products – slow down the infusion
4. Pt with terminal disease, family says they’re withdrawn – nurse says this is normal in end of life
5. Pt’s family concerned that the pt isn’t eating – nurse tells them to tell pt that food is available when they’re hungry and don’t force them to eat.
6. Which pt do you give a new graduate nurse at the end of 3 month training? – colostomy
7. Home health nurse visits at 0800, what is of most concern to her? – pt is weaker than on her last visit.
8. Which action shows a nurse understands a client’s condition with CHF and diabetes that is in hospice? – give them a piece of cake
9. Pt is in hospice – nurse encourages them to tell about their life
10. Dr fills out DNR order according to pt’s wishes, family wants CPR, what do you do? Honor the DNR
11. What will you assess for in an elderly pt that is malnourished? Depression, tooth problems, transportation, check labs
12. Elderly pt is combative, what do you do first? Reorient and talk calmly
13. Pt has central line with Flolan running and gets interrupted, what will you do? Call the Dr immediately
14. Pt on 2 round of chemo that finished 3 days ago and calls and says he has lots of hematuria – call physician
nd
15. MVA pt bleeding profusely from abdomen, what’s your first action? Start 18 gauge IV and hang NS
16. Pneumonectomy – encourage use of incentive spirometer
17. Pleurodesis position – leaning forward and upright
18. Pt has DIC – fibrinogen level is decreased
19. What do you do to prevent drug/drug interactions? Tell pt to bring all OTC, supplements and med with them to dr’sappt
20. Elderly pt he can’t learn things like he used to, what do you do? Stay with the pt longer
21. Most effective way to assess the elderly? Geriatric assessment tool
22. Spiritual distress goal – reconnect themselves with their higher power
23. 28 yo AIDS pt with dementia – needs palliative care and pain control
24. Pt who can’t donate blood – post pregnancy has 6 week old – needs to be 6 mo before donating
25. Assess which pt to see first – pt with peptic ulcer vomiting blood
26. Pt had pneumonia 3 months ago, what statement is most worrisome? I don’t go on walks like I used to
27. Early sign of lung cancer – hoarseness
28. Hospice incontinence – Insert foley for comfort
29. Collaborative care for pleural effusion – morphine
30. Patient develops DIC from – septicemia
31. DIC – abnormal clotting cascade – give FFP
32. Admission interview for elderly – ask if they wear hearing aid or glasses
33. A pt is dying and asks if they are – tell the truth
34. Pt has lung cancer and has a liver scan, you tell them the reason for the scan is because – different treatment is needed if the cancer has metastasized to the
liver
35. Pt teaching for compliance with hypertension meds – tell them that hypertension eventually leads to heart failure
36. Pt has an acute MI, what do you start them on? ACE inhibitor
37. Nurse is taking a pt’s history, what is of most concern? States that their shoes fit tighter
38. Woman comes to the ER with bruises on upper arms and face, what do you do? Get the forensic nurse to examine her
39. Alcoholic dad in ER, what do you do? Talk calmly and lowly
40. Pt with AIDS yells at every nurse, what do you do? Discuss options with the staff
41. Which pt gets a black triage tag? Unresponsive head injury
42. Which person gets seen first? Chest pain with diaphoresis
43. HIV med Sustiva is an – NNRTI
44. Calcium intake - 1500 mg
45. HIV WBC lymphocyte count is decreased and viral load is increased – lab work results
46. How to minimize infection in an AIDS pt – change IV tubing daily
47. Prevent infection in AIDS pt – soak toothbrush in bleach
48. How to make a positive diagnosis of HIV – positive ELISA and western blot tests
49. Pt exposed to HIV has negative test at 1 week, what would be the rationale for the negative test? Still in primary phase and viral load is not showing up
50. What puts you at least risk for HIV? Donating blood
51. Pt has blunt trauma to abdomen from MVA, what test will you do? Ultrasound
52. Test for CHF? BNP
53. Snakebite – keep pt still and remove restrictive clothing
54. Pt’s hands hard, white and numb – Put in warm water, move extremeties
55. Math problem – 2.5 tabs
TEST II
1. Pt comes in with frostbite and husband used hand warmers and rubbed them, what will this cause? More tissue damage
2. Pt had near drowning in lake, what do you watch for? Pulmonary edema
3. Hypothermia pt getting moved, what do you need to do? Use a cardiac monitor
,4. Pt with swollen leg and suspected DVT, what do you do? Infuse isotonic solution
5. Pt taking digoxin has nausea and difficulty breathing, what should you teach him? Call your HCP
6. Effective teaching for HAART therapy? Multiple drugs lower the viral load
7. Pt on 2 g sodium diet, what do they need to avoid? Milk products
8. Pt asks nurse about heart transplant, what do you tell him? Many factors go in to choosing candidate.
9. Collaborative care for patient? Administer meds
10. Digoxin and HCTZ together – potassium level is 3.0 and dangerous
11. S3 is heard during auscultation – assess for left heart failure
12. Who is going to be assessed first? Sucking chest wound
13. AIDS pt classification for bacterial endocarditis – B2
14. AIDS pt with PCP and leg ulcer, what nursing dx will he have? Impaired gas exchange
15. AIDS pt with decreased weight and malnourished – encourage mouth care
16. During disaster, media wants info – direct them to disaster command post
17. CHF with coughing, increased BP, increased respirations, what should RN do? Assess for acute congestive heart failure manifestations
18. Pt with difficulty breathing, what ‘s your first action? High fowler’s
19. Beta blocker (coreg) for 12 weeks, what sign is of most concern – BP 88/42
20. Ejection fraction 38% - decreased tissue perfusion
21. Lady in ER feels dizzy then falls unconscious, what’s your first action? Establish patent airway
22. Pt says they feel as if something gave way, what will you do first? Assess for serosanguinous drainage
23. Pt with hepatitis, what are the signs and symptoms – fatigue and diarrhea
24. What is the best way to prevent spreading of Hep A? wash hands
25. Pt has bowel evisceration, what will you do first? Put on a sterile dressing
26. Pt went on a trip to Mexico and now has diarrhea, what do you tell him to do? Drink Gatorade
27. Who to assess first? Pt that had severe abdominal pain that suddenly stops
28. Pt with nausea and vomiting for 4 days, what is of most concern? They’re lethargic and confused
29. Indication that pt needs pain meds after sx? Shallow breathing
30. Crohn’s teaching – times of remission/exacerbations
31. Hep B – no treatment
32. Hemorrhaging esophageal varicies, what is highest priority? Maintenance of airway
33. Nausea and vomiting, dehydration action – 250 ml/hr of NS
34. Crohn’s pt says I can’t take it anymore – I see you’re upset, I will sit and talk with you
35. Zantac – decreased irritation of esophageal varicies
36. What shows need for further teaching in pt with ileostomy? I will irrigate everyday
37. Highest priority for acute pancreatitis? Respiration
38. Cirrhosis with end stage renal disease – monitor for PSE by GI bleeding
39. Megaloblastic anemia – B12 injection
40. Lethargic and difficult to arouse – check level of consciousness
41. NSAID use – bleeding ulcer needs laparotomy
42. Stab wound – check BP and pulse
43. Pt has excessive diarrhea – use witch hazel compresses for inflammation
44. Gunshot wound – tell them ileostomy is temporary
, 45. Pt with Crohn’s has brown foul smelling urine – assess for fistula
46. Appendicitis – use ice pack
47. IBS – have it for a long time, and learn to deal with it
48. Appendicitis – Rovsing’s sig
49. Diet high in calcium for osteoporosis – broccoli and yogurt
50. 76 year old lady with osteoporosis, what is the best exercise? Bike
51. Pt comes in with new onset of cluster headaches – nurse should expect to take complete history
52. Pt in hospital with moderate headache at base of skull bilaterally – give Tylenol
53. Pt has fever, chills, pain at consovertebral angle – get urine culture
54. Pt has nuchal rigidity, positive brozinski ? sign and rash – meningitis
55. Oliguria phase has 250 ml of emesis and 150 ml of urine, how much fluid will you give them? 1000 ml – 500 for what they lost plus an extra 500
for sensible loss
1. COPD,
a. Lower to 2L/ cannula
2. Diverticulosis,
a. high fiber diet w/fluids
3. After surgery (woman) shortness of breath
a. Prepare for for intubate
4. Blind and diaphoretic
a. Assist to Bathroom
5. Gave woman insulin, has chills:
a. Check CBG again
6. Radiation port
a. Keep out of sun
7. Man after bypass surgery, anestomis leakage
a. Strict fluid replacement
8. After hemorrhage, bringing sacral
a. Check vitals
9. Vomit looks like coffee grounds
a. Get vitals
10. Lady with MS after falling
a. Neuro assess
11. Start pt eating again
a. Low sodium broth, no hot tea, lemon popsicle
12. Lady vomits bile colored:
13. Isolate spring breaker (stiff neck)
14. Transurethral resection blood clots
a. Increase irrigation/flow rate
15. Restrictions renal calculo
a. Tea and chocolate
16. Prostate enlarged
a. Urinary retention
17. Chin absess
a. Check for airway patency
TEST I
1. Man worried about getting osteoporosis like his wife – Tell him he should get a bone density test.
2. Giving platelets – use short infusion set with no filter.
3. Neck vein distention while pt sitting up in bed receiving blood products – slow down the infusion
4. Pt with terminal disease, family says they’re withdrawn – nurse says this is normal in end of life
5. Pt’s family concerned that the pt isn’t eating – nurse tells them to tell pt that food is available when they’re hungry and don’t force them to eat.
6. Which pt do you give a new graduate nurse at the end of 3 month training? – colostomy
7. Home health nurse visits at 0800, what is of most concern to her? – pt is weaker than on her last visit.
8. Which action shows a nurse understands a client’s condition with CHF and diabetes that is in hospice? – give them a piece of cake
9. Pt is in hospice – nurse encourages them to tell about their life
10. Dr fills out DNR order according to pt’s wishes, family wants CPR, what do you do? Honor the DNR
11. What will you assess for in an elderly pt that is malnourished? Depression, tooth problems, transportation, check labs
12. Elderly pt is combative, what do you do first? Reorient and talk calmly
13. Pt has central line with Flolan running and gets interrupted, what will you do? Call the Dr immediately
14. Pt on 2 round of chemo that finished 3 days ago and calls and says he has lots of hematuria – call physician
nd
15. MVA pt bleeding profusely from abdomen, what’s your first action? Start 18 gauge IV and hang NS
16. Pneumonectomy – encourage use of incentive spirometer
17. Pleurodesis position – leaning forward and upright
18. Pt has DIC – fibrinogen level is decreased
19. What do you do to prevent drug/drug interactions? Tell pt to bring all OTC, supplements and med with them to dr’sappt
20. Elderly pt he can’t learn things like he used to, what do you do? Stay with the pt longer
21. Most effective way to assess the elderly? Geriatric assessment tool
22. Spiritual distress goal – reconnect themselves with their higher power
23. 28 yo AIDS pt with dementia – needs palliative care and pain control
24. Pt who can’t donate blood – post pregnancy has 6 week old – needs to be 6 mo before donating
25. Assess which pt to see first – pt with peptic ulcer vomiting blood
26. Pt had pneumonia 3 months ago, what statement is most worrisome? I don’t go on walks like I used to
27. Early sign of lung cancer – hoarseness
28. Hospice incontinence – Insert foley for comfort
29. Collaborative care for pleural effusion – morphine
30. Patient develops DIC from – septicemia
31. DIC – abnormal clotting cascade – give FFP
32. Admission interview for elderly – ask if they wear hearing aid or glasses
33. A pt is dying and asks if they are – tell the truth
34. Pt has lung cancer and has a liver scan, you tell them the reason for the scan is because – different treatment is needed if the cancer has metastasized to the
liver
35. Pt teaching for compliance with hypertension meds – tell them that hypertension eventually leads to heart failure
36. Pt has an acute MI, what do you start them on? ACE inhibitor
37. Nurse is taking a pt’s history, what is of most concern? States that their shoes fit tighter
38. Woman comes to the ER with bruises on upper arms and face, what do you do? Get the forensic nurse to examine her
39. Alcoholic dad in ER, what do you do? Talk calmly and lowly
40. Pt with AIDS yells at every nurse, what do you do? Discuss options with the staff
41. Which pt gets a black triage tag? Unresponsive head injury
42. Which person gets seen first? Chest pain with diaphoresis
43. HIV med Sustiva is an – NNRTI
44. Calcium intake - 1500 mg
45. HIV WBC lymphocyte count is decreased and viral load is increased – lab work results
46. How to minimize infection in an AIDS pt – change IV tubing daily
47. Prevent infection in AIDS pt – soak toothbrush in bleach
48. How to make a positive diagnosis of HIV – positive ELISA and western blot tests
49. Pt exposed to HIV has negative test at 1 week, what would be the rationale for the negative test? Still in primary phase and viral load is not showing up
50. What puts you at least risk for HIV? Donating blood
51. Pt has blunt trauma to abdomen from MVA, what test will you do? Ultrasound
52. Test for CHF? BNP
53. Snakebite – keep pt still and remove restrictive clothing
54. Pt’s hands hard, white and numb – Put in warm water, move extremeties
55. Math problem – 2.5 tabs
TEST II
1. Pt comes in with frostbite and husband used hand warmers and rubbed them, what will this cause? More tissue damage
2. Pt had near drowning in lake, what do you watch for? Pulmonary edema
3. Hypothermia pt getting moved, what do you need to do? Use a cardiac monitor
,4. Pt with swollen leg and suspected DVT, what do you do? Infuse isotonic solution
5. Pt taking digoxin has nausea and difficulty breathing, what should you teach him? Call your HCP
6. Effective teaching for HAART therapy? Multiple drugs lower the viral load
7. Pt on 2 g sodium diet, what do they need to avoid? Milk products
8. Pt asks nurse about heart transplant, what do you tell him? Many factors go in to choosing candidate.
9. Collaborative care for patient? Administer meds
10. Digoxin and HCTZ together – potassium level is 3.0 and dangerous
11. S3 is heard during auscultation – assess for left heart failure
12. Who is going to be assessed first? Sucking chest wound
13. AIDS pt classification for bacterial endocarditis – B2
14. AIDS pt with PCP and leg ulcer, what nursing dx will he have? Impaired gas exchange
15. AIDS pt with decreased weight and malnourished – encourage mouth care
16. During disaster, media wants info – direct them to disaster command post
17. CHF with coughing, increased BP, increased respirations, what should RN do? Assess for acute congestive heart failure manifestations
18. Pt with difficulty breathing, what ‘s your first action? High fowler’s
19. Beta blocker (coreg) for 12 weeks, what sign is of most concern – BP 88/42
20. Ejection fraction 38% - decreased tissue perfusion
21. Lady in ER feels dizzy then falls unconscious, what’s your first action? Establish patent airway
22. Pt says they feel as if something gave way, what will you do first? Assess for serosanguinous drainage
23. Pt with hepatitis, what are the signs and symptoms – fatigue and diarrhea
24. What is the best way to prevent spreading of Hep A? wash hands
25. Pt has bowel evisceration, what will you do first? Put on a sterile dressing
26. Pt went on a trip to Mexico and now has diarrhea, what do you tell him to do? Drink Gatorade
27. Who to assess first? Pt that had severe abdominal pain that suddenly stops
28. Pt with nausea and vomiting for 4 days, what is of most concern? They’re lethargic and confused
29. Indication that pt needs pain meds after sx? Shallow breathing
30. Crohn’s teaching – times of remission/exacerbations
31. Hep B – no treatment
32. Hemorrhaging esophageal varicies, what is highest priority? Maintenance of airway
33. Nausea and vomiting, dehydration action – 250 ml/hr of NS
34. Crohn’s pt says I can’t take it anymore – I see you’re upset, I will sit and talk with you
35. Zantac – decreased irritation of esophageal varicies
36. What shows need for further teaching in pt with ileostomy? I will irrigate everyday
37. Highest priority for acute pancreatitis? Respiration
38. Cirrhosis with end stage renal disease – monitor for PSE by GI bleeding
39. Megaloblastic anemia – B12 injection
40. Lethargic and difficult to arouse – check level of consciousness
41. NSAID use – bleeding ulcer needs laparotomy
42. Stab wound – check BP and pulse
43. Pt has excessive diarrhea – use witch hazel compresses for inflammation
44. Gunshot wound – tell them ileostomy is temporary
, 45. Pt with Crohn’s has brown foul smelling urine – assess for fistula
46. Appendicitis – use ice pack
47. IBS – have it for a long time, and learn to deal with it
48. Appendicitis – Rovsing’s sig
49. Diet high in calcium for osteoporosis – broccoli and yogurt
50. 76 year old lady with osteoporosis, what is the best exercise? Bike
51. Pt comes in with new onset of cluster headaches – nurse should expect to take complete history
52. Pt in hospital with moderate headache at base of skull bilaterally – give Tylenol
53. Pt has fever, chills, pain at consovertebral angle – get urine culture
54. Pt has nuchal rigidity, positive brozinski ? sign and rash – meningitis
55. Oliguria phase has 250 ml of emesis and 150 ml of urine, how much fluid will you give them? 1000 ml – 500 for what they lost plus an extra 500
for sensible loss
1. COPD,
a. Lower to 2L/ cannula
2. Diverticulosis,
a. high fiber diet w/fluids
3. After surgery (woman) shortness of breath
a. Prepare for for intubate
4. Blind and diaphoretic
a. Assist to Bathroom
5. Gave woman insulin, has chills:
a. Check CBG again
6. Radiation port
a. Keep out of sun
7. Man after bypass surgery, anestomis leakage
a. Strict fluid replacement
8. After hemorrhage, bringing sacral
a. Check vitals
9. Vomit looks like coffee grounds
a. Get vitals
10. Lady with MS after falling
a. Neuro assess
11. Start pt eating again
a. Low sodium broth, no hot tea, lemon popsicle
12. Lady vomits bile colored:
13. Isolate spring breaker (stiff neck)
14. Transurethral resection blood clots
a. Increase irrigation/flow rate
15. Restrictions renal calculo
a. Tea and chocolate
16. Prostate enlarged
a. Urinary retention
17. Chin absess
a. Check for airway patency
