Quiz: NCLEX Practice Test For Medical Surgical Nursing

50 Questions | Total Attempts: 3120

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Quiz: NCLEX Practice Test For Medical Surgical Nursing - Quiz

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Questions and Answers
  • 1. 
    After surgery, Gina returns from the Post-anesthesia Care Unit (Recovery Room) with a nasogastric tube in place following a gall bladder surgery. She continues to complain of nausea. Which action would the nurse take? 
    • A. 

      Call the physician immediately.

    • B. 

      Administer the prescribed antiemetic.

    • C. 

      Check the patency of the nasogastric tube for any obstruction.

    • D. 

      Change the patient’s position.

  • 2. 
    Mr. Perez is in continuous pain from cancer that has metastasized to the bone. Pain medication provides little relief and he refuses to move. The nurse should plan to:
    • A. 

      Reassure him that the nurses will not hurt him

    • B. 

      Let him perform his own activities of daily living

    • C. 

      Handle him gently when assisting with required care

    • D. 

      Complete A.M. care quickly as possible when necessary

  • 3. 
    A client returns from the recovery room at 9AM alert and oriented, with an IV infusing. His pulse is 82, blood pressure is 120/80, respirations are 20, and all are within normal range. At 10 am and at 11 am, his vital signs are stable. At noon, however, his pulse rate is 94, blood pressure is 116/74, and respirations are 24. What nursing action is most appropriate? 
    • A. 

      Notify his physician.

    • B. 

      Take his vital signs again in 15 minutes.

    • C. 

      Take his vital signs again in an hour.

    • D. 

      Place the patient in shock position.

  • 4. 
    A 56 year old construction worker is brought to the hospital unconscious after falling from a 2-story building. When assessing the client, the nurse would be most concerned if the assessment revealed:
    • A. 

      Reactive pupils

    • B. 

      A depressed fontanel

    • C. 

      Bleeding from ears

    • D. 

      An elevated temperature

  • 5. 
    Which of the ff. statements by the client to the nurse indicates a risk factor for CAD? 
    • A. 

      “I exercise every other day.”

    • B. 

      “My father died of Myasthenia Gravis.”

    • C. 

      “My cholesterol is 180.”

    • D. 

      “I smoke 1 1/2 packs of cigarettes per day.”

  • 6. 
    Mr. Braga was ordered Digoxin 0.25 mg. OD. Which is poor knowledge regarding this drug? 
    • A. 

      It has positive inotropic and negative chronotropic effects

    • B. 

      The positive inotropic effect will decrease urine output

    • C. 

      Toxixity can occur more easily in the presence of hypokalemia, liver and renal problems

    • D. 

      Do not give the drug if the apical rate is less than 60 beats per minute.

  • 7. 
    Valsalva maneuver can result in bradycardia. Which of the following activities will not stimulate Valsalva’s maneuver? 
    • A. 

      Use of stool softeners.

    • B. 

      Enema administration

    • C. 

      Gagging while toothbrushing.

    • D. 

      Lifting heavy objects

  • 8. 
    The nurse is teaching the patient regarding his permanent artificial pacemaker. Which information given by the nurse shows her knowledge deficit about the artificial cardiac pacemaker? 
    • A. 

      Take the pulse rate once a day, in the morning upon awakening

    • B. 

      May be allowed to use electrical appliances

    • C. 

      Have regular follow up care

    • D. 

      May engage in contact sports

  • 9. 
    A patient with angina pectoris is being discharged home with nitroglycerine tablets. Which of the following instructions does the nurse include in the teaching? 
    • A. 

      “When your chest pain begins, lie down, and place one tablet under your tongue. If the pain continues, take another tablet in 5 minutes.”

    • B. 

      “Place one tablet under your tongue. If the pain is not relieved in 15 minutes, go to the hospital.”

    • C. 

      “Continue your activity, and if the pain does not go away in 10 minutes, begin taking the nitro tablets one every 5 minutes for 15 minutes, then go lie down.”

    • D. 

      “Place one Nitroglycerine tablet under the tongue every five minutes for three doses. Go to the hospital if the pain is unrelieved.

  • 10. 
    A client with chronic heart failure has been placed on a diet restricted to 2000mg. of sodium per day. The client demonstrates adequate knowledge if behaviors are evident such as not salting food and avoidance of which food? 
    • A. 

      Whole milk

    • B. 

      Canned sardines

    • C. 

      Plain nuts

    • D. 

      Eggs

  • 11. 
    A student nurse is assigned to a client who has a diagnosis of thrombophlebitis. Which action by this team member is most appropriate? 
    • A. 

      Apply a heating pad to the involved site.

    • B. 

      Elevate the client’s legs 90 degrees.

    • C. 

      Instruct the client about the need for bed rest.

    • D. 

      Provide active range-of-motion exercises to both legs at least twice every shift.

  • 12. 
    A client receiving heparin sodium asks the nurse how the drug works. Which of the following points would the nurse include in the explanation to the client? 
    • A. 

      It dissolves existing thrombi.

    • B. 

      It prevents conversion of factors that are needed in the formation of clots.

    • C. 

      It inactivates thrombin that forms and dissolves existing thrombi.

    • D. 

      It interferes with vitamin K absorption.

  • 13. 
    The nurse is conducting an education session for a group of smokers in a “stop smoking” class. Which finding would the nurse state as a common symptom of lung cancer? : 
    • A. 

      Dyspnea on exertion

    • B. 

      Foamy, blood-tinged sputum

    • C. 

      Wheezing sound on inspiration

    • D. 

      Cough or change in a chronic cough

  • 14. 
    When suctioning mucus from a client’s lungs, which nursing action would be least appropriate? 
    • A. 

      Lubricate the catheter tip with sterile saline before insertion.

    • B. 

      Use sterile technique with a two-gloved approach

    • C. 

      Suction until the client indicates to stop or no longer than 20 second

    • D. 

      Hyperoxygenate the client before and after suctioning

  • 15. 
    Dr. Santos prescribes oral rifampin (Rimactane) and isoniazid (INH) for a client with a positive Tuberculin skin test. When informing the client of this decision, the nurse knows that the purpose of this choice of treatment is to 
    • A. 

      Cause less irritation to the gastrointestinal tract

    • B. 

      Destroy resistant organisms and promote proper blood levels of the drugs

    • C. 

      Gain a more rapid systemic effect

    • D. 

      Delay resistance and increase the tuberculostatic effect

  • 16. 
    Mario undergoes a left thoracotomy and a partial pneumonectomy. Chest tubes are inserted, and one-bottle water-seal drainage is instituted in the operating room. In the postanesthesia care unit Mario is placed in Fowler’s position on either his right side or on his back to 
    • A. 

      Reduce incisional pain.

    • B. 

      Facilitate ventilation of the left lung.

    • C. 

      Equalize pressure in the pleural space.

    • D. 

      Increase venous return

  • 17. 
    A client with COPD is being prepared for discharge. The following are relevant instructions to the client regarding the use of an oral inhaler EXCEPT 
    • A. 

      Breath in and out as fully as possible before placing the mouthpiece inside the mouth.

    • B. 

      Inhale slowly through the mouth as the canister is pressed down

    • C. 

      Hold his breath for about 10 seconds before exhaling

    • D. 

      Slowly breath out through the mouth with pursed lips after inhaling the drug.

  • 18. 
    A client is scheduled for a bronchoscopy. When teaching the client what to expect afterward, the nurse’s highest priority of information would be 
    • A. 

      Food and fluids will be withheld for at least 2 hours

    • B. 

      Warm saline gargles will be done q 2h.

    • C. 

      Coughing and deep-breathing exercises will be done q2h.

    • D. 

      Only ice chips and cold liquids will be allowed initially.

  • 19. 
    The nurse enters the room of a client with chronic obstructive pulmonary disease. The client’s nasal cannula oxygen is running at a rate of 6 L per minute, the skin color is pink, and the respirations are 9 per minute and shallow. What is the nurse’s best initial action? 
    • A. 

      Take heart rate and blood pressure

    • B. 

      Call the physician

    • C. 

      Lower the oxygen rate

    • D. 

      Position the client in a Fowler’s position.

  • 20. 
    The nurse is preparing her plan of care for her patient diagnosed with pneumonia. Which is the most appropriate nursing diagnosis for this patient? 
    • A. 

      Fluid volume deficit

    • B. 

      Decreased tissue perfusion.

    • C. 

      Impaired gas exchange.

    • D. 

      Risk for infection

  • 21. 
    A nurse at the weight loss clinic assesses a client who has a large abdomen and a rounded face. Which additional assessment finding would lead the nurse to suspect that the client has Cushing’s syndrome rather than obesity? 
    • A. 

      Large thighs and upper arms

    • B. 

      Pendulous abdomen and large hips

    • C. 

      Abdominal striae and ankle enlargement

    • D. 

      Posterior neck fat pad and thin extremities

  • 22. 
    Which statement by the client indicates understanding of the possible side effects of Prednisone therapy? 
    • A. 

      “I should limit my potassium intake because hyperkalemia is a side-effect of this drug.”

    • B. 

      “I must take this medicine exactly as my doctor ordered it. I shouldn’t skip doses.”

    • C. 

      “This medicine will protect me from getting any colds or infection.”

    • D. 

      “My incision will heal much faster because of this drug.”

  • 23. 
    A client, who is suspected of having Pheochromocytoma, complains of sweating, palpitation and headache. Which assessment is essential for the nurse to make first? 
    • A. 

      Pupil reaction

    • B. 

      Hand grips

    • C. 

      Blood pressure

    • D. 

      Blood glucose

  • 24. 
    The nurse is attending a bridal shower for a friend when another guest, who happens to be a diabetic, starts to tremble and complains of dizziness. The next best action for the nurse to take is to: 
    • A. 

      Encourage the guest to eat some baked macaroni

    • B. 

      Call the guest’s personal physician

    • C. 

      Offer the guest a cup of coffee

    • D. 

      Give the guest a glass of orange juice

  • 25. 
    An adult, who is newly diagnosed with Graves disease, asks the nurse, “Why do I need to take Propanolol (Inderal)?” Based on the nurse’s understanding of the medication and Grave’s disease, the best response would be: 
    • A. 

      “The medication will limit thyroid hormone secretion.”

    • B. 

      “The medication limit synthesis of the thyroid hormones.”

    • C. 

      “The medication will block the cardiovascular symptoms of Grave’s disease.”

    • D. 

      “The medication will increase the synthesis of thyroid hormones.”

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