NCLEX - RN LICENSE EXAM PREPARATION
MEDICAL / SURGICAL NURSING - QUESTIONS & ANSWERS+RATIONALES
Copyright 1999-2003. All rights reserved. No part of this material may be reprinted, reproduced,
transmitted, stored in a retrieval system, or mechanical, including photocopying or recording, now existing
or hereinafter invented, nor may any part of this course be used for teaching without the prior written
permission of Dynasty School.
UNIT 8 - MEDICAL/SURGICAL NURSING
8. CRASH EXAMINATION -#6
1. Jill Means, 36, has had a vaginal radium implant placed as one of the treatments for her cervical
cancer. She calls to tell you that during a coughing spell it has 'been pushed out'. You should:
A. place signs on the door stating radioactivity danger.
B. have Jill reinsert the applicator like a tampon.
C. call the physician and apprise him of the situation.
D. use forceps to place the applicator in the receptacle.
(D)
A. Signs should be placed on the door after the implant has been done, and not just when
the implant is dislodged.
B. By picking the applicator up, Jill would experience burns on her fingers/hands that would
be avoidable, so need to teach her not to do so. The applicator has been contaminated, it
would not be replaced in any case.
C. Calling the physician and apprising him would certainly be necessary, but would be done
after the applicator has been taken care of.
D. Lead containers should be available to place the applicator in, and forceps would be
used to do so to protect from radiation burns.
#2. Which of the following would you include as risk factors for the development of skin cancer when
assessing the integumentary system?
A. Advancing age
B. Positive family history
C. Dark pigmentation
D. White collar job
(B)
A. Advancing age by itself is not a risk factor. If that person has been exposed to a lot of sun
there may be increased risk, but that information is not given here.
B. There is a known genetic risk, with some cancers being seen to be present in families
with low risk factors.
C. Those with dark pigmentation develop skin cancer, but at a lower rate than those with low
amounts of pigmentation.
D. White collar jobs, which occur in offices and inside buildings, are a low risk for skin
cancer.
Dynasty School (www.dynasty-school.com) - © Copyright. All rights reserved. 8-601
Licensing School for Appraisal, CPA, Tax, Insurance, Real Estate, Contractors,
Notary, Nurse, Food Handlers, and Securities
,NCLEX - RN LICENSE EXAM PREPARATION
MEDICAL / SURGICAL NURSING - QUESTIONS & ANSWERS+RATIONALES
3. During a shower three days ago, Jeremy Robb, 19, discovered a firm lump in his left testis. He
went to the student health center at his university, was referred to a local physician and was
admitted to the hospital for a left orchiectomy and lymph node resection. Risk factors for cancer
of the testes include:
A. smoking.
B. undescended testicle.
C. multiple sex partners.
D. genital trauma.
(B)
A. Smoking has been linked to cancer of the lungs, bladder, and pancreas, but has not
been linked directly to cancer of the testes.
B. Males who had undescended testicle(s) have been found to have a higher incidence of
cancer of the testes later. It is theorized that the internal heat the testes are exposed to
while in the abdomen causes the damage to the testes.
C. Multiple sex partners is a risk for genital warts, AIDS, and sexually transmitted diseases,
but has not been shown to be a risk for cancer of the testes.
D. Genital trauma more likely causes bladder and ureteral damage.
4. Ramona Gunther, 18, was diagnosed with Stage II Hodgkins disease and is preparing to receive
external radiation therapy. She tells the nurse she is scared 'about having to get radiation
treatments all over my body.' Which of the following is the most appropriate response?
A. 'The dose will be very low based on the disease staging.'
B. 'With Stage II, you'll only have radiation over half your body.'
C. I know it's scary, but it will help to decrease the potential of fractures.'
D. 'You know you don't have to worry about being radioactive.'
(B)
A. The dose of radiation is not based on the staging of the disease alone, and there is not
enough information to know that the dose will be low.
B. With Stage II, the involved lymph nodes are all on the same side of the diaphragm, so the
radiation will be given on that part of the body.
C. The potential of fractures occurs because of the cancer, but the radiation is not given for
that reason.
D. She has not stated that she's afraid of being radioactive, so this answer does not address
her concern.
5. Stephen Douglas has been in an automobile accident. The most effective IV solution for a patient
having hypovolemic shock would be:
A. hypertonic.
B. isotonic.
C. hypotonic.
D. colloids.
(B)
Dynasty School (www.dynasty-school.com) - © Copyright. All rights reserved. 8-602
Licensing School for Appraisal, CPA, Tax, Insurance, Real Estate, Contractors,
Notary, Nurse, Food Handlers, and Securities
, NCLEX - RN LICENSE EXAM PREPARATION
MEDICAL / SURGICAL NURSING - QUESTIONS & ANSWERS+RATIONALES
A. Hypertonic IV fluids would be used to draw fluid off tissue in edematous situations such
as third spacing.
B. Isotonic solutions are used to increase intravascular volume, to increase perfusion of vital
organs.
C. Hypotonic fluids are used to rehydrate tissue in those with severe, or prolonged fluid
deprivation.
D. Colloids increase tonicity of intravascular fluids, pulling water into the vascular system
from tissue.
6. Alex Rowe develops hives after having eaten strawberries. He states he has strawberries before,
and has never had a problem with them before. This is an example of:
A. an idiosyncratic response to food.
B. an autoimmune disorder.
C. a Type I hypersensitivity response.
D. an example of immunosuppression.
(C)
A. Idiosyncratic response means it occurs because of an unknown reason. This response to
something the body has been exposed to before is not unknown.
B. Autoimmune disorders are ones in which the body attacks self-cells. This example is an
outside antigen.
C. Type I hypersensitivities are those that occur when the body, previously sensitized to a
substance, is then exposed a second time and reacts.
D. Immunosuppression occurs when the immune system is not working. Mr. Rowe's
immune system responded to the antigen, so it is not suppressed.
#7. Allison Lynn, 20, is a student in a health sciences class and asks you to further explain the
reason for lack of insulin in Type I Diabetes. You state that the most accepted theory is that:
A. the insulin produced is not effective at the tissue level.
B. not enough insulin is made to manage the metabolic needs.
C. inflammation of the pancreas causes irregular release of insulin.
D. the body's immune system destroyed the cells that make insulin.
(D)
A. Type I diabetes is the definition of that disease process that occurs when no insulin is
produced, so there is no insulin to get to the cell level. Some Type II diabetes occurs
because of insulin resistance.
B. No insulin is being produced. This is one pathophysiological cause of Type II diabetes.
C. Pancreatitis does cause irregular release of insulin, but not all people with pancreatitis
develop Type I diabetes
D. An autoimmune process is the most accepted theory of the root cause of Type I diabetes.
The body produces an antibody which attacks and destroys the beta cells, leading to a
lack of insulin.
Dynasty School (www.dynasty-school.com) - © Copyright. All rights reserved. 8-603
Licensing School for Appraisal, CPA, Tax, Insurance, Real Estate, Contractors,
Notary, Nurse, Food Handlers, and Securities
MEDICAL / SURGICAL NURSING - QUESTIONS & ANSWERS+RATIONALES
Copyright 1999-2003. All rights reserved. No part of this material may be reprinted, reproduced,
transmitted, stored in a retrieval system, or mechanical, including photocopying or recording, now existing
or hereinafter invented, nor may any part of this course be used for teaching without the prior written
permission of Dynasty School.
UNIT 8 - MEDICAL/SURGICAL NURSING
8. CRASH EXAMINATION -#6
1. Jill Means, 36, has had a vaginal radium implant placed as one of the treatments for her cervical
cancer. She calls to tell you that during a coughing spell it has 'been pushed out'. You should:
A. place signs on the door stating radioactivity danger.
B. have Jill reinsert the applicator like a tampon.
C. call the physician and apprise him of the situation.
D. use forceps to place the applicator in the receptacle.
(D)
A. Signs should be placed on the door after the implant has been done, and not just when
the implant is dislodged.
B. By picking the applicator up, Jill would experience burns on her fingers/hands that would
be avoidable, so need to teach her not to do so. The applicator has been contaminated, it
would not be replaced in any case.
C. Calling the physician and apprising him would certainly be necessary, but would be done
after the applicator has been taken care of.
D. Lead containers should be available to place the applicator in, and forceps would be
used to do so to protect from radiation burns.
#2. Which of the following would you include as risk factors for the development of skin cancer when
assessing the integumentary system?
A. Advancing age
B. Positive family history
C. Dark pigmentation
D. White collar job
(B)
A. Advancing age by itself is not a risk factor. If that person has been exposed to a lot of sun
there may be increased risk, but that information is not given here.
B. There is a known genetic risk, with some cancers being seen to be present in families
with low risk factors.
C. Those with dark pigmentation develop skin cancer, but at a lower rate than those with low
amounts of pigmentation.
D. White collar jobs, which occur in offices and inside buildings, are a low risk for skin
cancer.
Dynasty School (www.dynasty-school.com) - © Copyright. All rights reserved. 8-601
Licensing School for Appraisal, CPA, Tax, Insurance, Real Estate, Contractors,
Notary, Nurse, Food Handlers, and Securities
,NCLEX - RN LICENSE EXAM PREPARATION
MEDICAL / SURGICAL NURSING - QUESTIONS & ANSWERS+RATIONALES
3. During a shower three days ago, Jeremy Robb, 19, discovered a firm lump in his left testis. He
went to the student health center at his university, was referred to a local physician and was
admitted to the hospital for a left orchiectomy and lymph node resection. Risk factors for cancer
of the testes include:
A. smoking.
B. undescended testicle.
C. multiple sex partners.
D. genital trauma.
(B)
A. Smoking has been linked to cancer of the lungs, bladder, and pancreas, but has not
been linked directly to cancer of the testes.
B. Males who had undescended testicle(s) have been found to have a higher incidence of
cancer of the testes later. It is theorized that the internal heat the testes are exposed to
while in the abdomen causes the damage to the testes.
C. Multiple sex partners is a risk for genital warts, AIDS, and sexually transmitted diseases,
but has not been shown to be a risk for cancer of the testes.
D. Genital trauma more likely causes bladder and ureteral damage.
4. Ramona Gunther, 18, was diagnosed with Stage II Hodgkins disease and is preparing to receive
external radiation therapy. She tells the nurse she is scared 'about having to get radiation
treatments all over my body.' Which of the following is the most appropriate response?
A. 'The dose will be very low based on the disease staging.'
B. 'With Stage II, you'll only have radiation over half your body.'
C. I know it's scary, but it will help to decrease the potential of fractures.'
D. 'You know you don't have to worry about being radioactive.'
(B)
A. The dose of radiation is not based on the staging of the disease alone, and there is not
enough information to know that the dose will be low.
B. With Stage II, the involved lymph nodes are all on the same side of the diaphragm, so the
radiation will be given on that part of the body.
C. The potential of fractures occurs because of the cancer, but the radiation is not given for
that reason.
D. She has not stated that she's afraid of being radioactive, so this answer does not address
her concern.
5. Stephen Douglas has been in an automobile accident. The most effective IV solution for a patient
having hypovolemic shock would be:
A. hypertonic.
B. isotonic.
C. hypotonic.
D. colloids.
(B)
Dynasty School (www.dynasty-school.com) - © Copyright. All rights reserved. 8-602
Licensing School for Appraisal, CPA, Tax, Insurance, Real Estate, Contractors,
Notary, Nurse, Food Handlers, and Securities
, NCLEX - RN LICENSE EXAM PREPARATION
MEDICAL / SURGICAL NURSING - QUESTIONS & ANSWERS+RATIONALES
A. Hypertonic IV fluids would be used to draw fluid off tissue in edematous situations such
as third spacing.
B. Isotonic solutions are used to increase intravascular volume, to increase perfusion of vital
organs.
C. Hypotonic fluids are used to rehydrate tissue in those with severe, or prolonged fluid
deprivation.
D. Colloids increase tonicity of intravascular fluids, pulling water into the vascular system
from tissue.
6. Alex Rowe develops hives after having eaten strawberries. He states he has strawberries before,
and has never had a problem with them before. This is an example of:
A. an idiosyncratic response to food.
B. an autoimmune disorder.
C. a Type I hypersensitivity response.
D. an example of immunosuppression.
(C)
A. Idiosyncratic response means it occurs because of an unknown reason. This response to
something the body has been exposed to before is not unknown.
B. Autoimmune disorders are ones in which the body attacks self-cells. This example is an
outside antigen.
C. Type I hypersensitivities are those that occur when the body, previously sensitized to a
substance, is then exposed a second time and reacts.
D. Immunosuppression occurs when the immune system is not working. Mr. Rowe's
immune system responded to the antigen, so it is not suppressed.
#7. Allison Lynn, 20, is a student in a health sciences class and asks you to further explain the
reason for lack of insulin in Type I Diabetes. You state that the most accepted theory is that:
A. the insulin produced is not effective at the tissue level.
B. not enough insulin is made to manage the metabolic needs.
C. inflammation of the pancreas causes irregular release of insulin.
D. the body's immune system destroyed the cells that make insulin.
(D)
A. Type I diabetes is the definition of that disease process that occurs when no insulin is
produced, so there is no insulin to get to the cell level. Some Type II diabetes occurs
because of insulin resistance.
B. No insulin is being produced. This is one pathophysiological cause of Type II diabetes.
C. Pancreatitis does cause irregular release of insulin, but not all people with pancreatitis
develop Type I diabetes
D. An autoimmune process is the most accepted theory of the root cause of Type I diabetes.
The body produces an antibody which attacks and destroys the beta cells, leading to a
lack of insulin.
Dynasty School (www.dynasty-school.com) - © Copyright. All rights reserved. 8-603
Licensing School for Appraisal, CPA, Tax, Insurance, Real Estate, Contractors,
Notary, Nurse, Food Handlers, and Securities
