NCLEX Questions: Take This Practice Paper For Medical Surgical Nursing
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- 1.The nurse is performing her admission assessment of a patient. When grading arterial pulses, a 1+ pulse indicates:
- A.
Above normal perfusion.
- B.
Absent perfusion.
- C.
Normal perfusion.
- D.
Diminished perfusion.
- 2.Murmurs that indicate heart disease are often accompanied by other symptoms such as:
- A.
Dyspnea on exertion.
- B.
Subcutaneous emphysema
- C.
Thoracic petechiae
- D.
Periorbital edema
- 3.Which pregnancy-related physiologic change would place the patient with a history of cardiac disease at the greatest risk of developing severe cardiac problems?
- A.
Decrease heart rate
- B.
Decreased cardiac output
- C.
Increased plasma volume
- D.
Increased blood pressure
- 4.The priority nursing diagnosis for the patient with cardiomyopathy is:
- A.
Anxiety related to risk of declining health status
- B.
Ineffective individual coping related to fear of debilitating illness
- C.
Fluid volume excess related to altered compensatory mechanisms.
- D.
Decreased cardiac output related to reduced myocardial contractility.
- 5.A patient with thrombophlebitis reached her expected outcomes of care. Her affected leg appears pink and warm. Her pedal pulse is palpable and there is no edema present. Which step in the nursing process is described above?
- A.
Planning
- B.
Implementation
- C.
Analysis
- D.
Evaluation
- 6.An elderly patient may have sustained a basilar skull fracture after slipping and falling on an icy sidewalk. The nurse knows that basilar skull factures:
- A.
Are the least significant type of skull fracture.
- B.
May have cause cerebrospinal fluid (CSF) leaks from the nose or ears.
- C.
Have no characteristic findings.
- D.
Are always surgically repaired.
- 7.Which of the following types of drugs might be given to control increased intracranial pressure (ICP)?
- A.
Barbiturates
- B.
Carbonic anhydrase inhibitors
- C.
Anticholinergics
- D.
Histamine receptor blockers
- 8.The nurse is teaching family members of a patient with a concussion about the early signs of increased intracranial pressure (ICP). Which of the following would she cite as an early sign of increased ICP?
- A.
Decreased systolic blood pressure
- B.
Headache and vomiting
- C.
Dilated pupils that don’t react to light
- D.
Dilated pupils that don’t react to light
- 9.Jessie James is diagnosed with retinal detachment. Which intervention is the most important for this patient?
- A.
Admitting him to the hospital on strict bed rest
- B.
Patching both of his eyes
- C.
Referring him to an ophthalmologist
- D.
Preparing him for surgery
- 10.Dr. Bruce Owen, a chemist, sustained a chemical burn to one eye. Which intervention takes priority for a patient with a chemical burn of the eye?
- A.
Patch the affected eye and call the ophthalmologist.
- B.
Administer a cycloplegic agent to reduce ciliary spasm.
- C.
Immediately instill a tropical anesthetic, then irrigate the eye with saline solution.
- D.
Administer antibiotics to reduce the risk of infection
- 11.The nurse is assessing a patient and notes a Brudzinski’s sign and Kernig’s sign. These are two classic signs of which of the following disorders?
- A.
Cerebrovascular accident (CVA)
- B.
Meningitis
- C.
Seizure disorder
- D.
Parkinson’s disease
- 12.A patient is admitted to the hospital for a brain biopsy. The nurse knows that the most common type of primary brain tumor is:
- A.
Meningioma
- B.
Angioma
- C.
Hemangioblastoma
- D.
Glioma
- 13.The nurse should instruct the patient with Parkinson’s disease to avoid which of the following?
- A.
Walking in an indoor shopping mall
- B.
Sitting on the deck on a cool summer evening
- C.
Walking to the car on a cold winter day
- D.
Sitting on the beach in the sun on a summer day
- 14.Gary Jordan suffered a cerebrovascular accident that left her unable to comprehend speech and unable to speak. This type of aphasia is known as:
- A.
Receptive aphasia
- B.
Expressive aphasia
- C.
Global aphasia
- D.
Conduction aphasia
- 15.Kelly Smith complains that her headaches are occurring more frequently despite medications. Patients with a history of headaches should be taught to avoid:
- A.
Freshly prepared meats.
- B.
Citrus fruits.
- C.
Skim milk
- D.
Chocolate
- 16.Immediately following cerebral aneurysm rupture, the patient usually complains of:
- A.
Photophobia
- B.
Explosive headache
- C.
Seizures
- D.
Hemiparesis
- 17.Which of the following is a cause of embolic brain injury?
- A.
Persistent hypertension
- B.
Subarachnoid hemorrhage
- C.
Atrial fibrillation
- D.
Skull fracture
- 18.Although Ms. Priestly has a spinal cord injury, she can still have sexual intercourse. Discharge teaching should make her aware that:
- A.
She must remove indwelling urinary catheter prior to intercourse.
- B.
She can no longer achieve orgasm.
- C.
Positioning may be awkward.
- D.
She can still get pregnant.
- 19.Ivy Hopkins, age 25, suffered a cervical fracture requiring immobilization with halo traction. When caring for the patient in halo traction, the nurse must:
- A.
Keep a wrench taped to the halo vest for quick removal if cardiopulmonary resuscitation is necessary.
- B.
Remove the brace once a day to allow the patient to rest.
- C.
Encourage the patient to use a pillow under the ring.
- D.
Remove the brace so that the patient can shower.
- 20.The nurse asks a patient’s husband if he understands why his wife is receiving nimodipine (Nimotop), since she suffered a cerebral aneurysm rupture. Which response by the husband indicates that he understands the drug’s use?
- A.
“Nimodipine replaces calcium.”
- B.
“Nimodipine promotes growth of blood vessels in the brain.”
- C.
“Nimodipine reduces the brain’s demand for oxygen.”
- D.
“Nimodipine reduces vasospasm in the brain.”
- 21.Many men who suffer spinal injuries continue to be sexually active. The teaching plan for a man with a spinal cord injury should include sexually concerns. Which of the following injuries would most likely prevent erection and ejaculation?
- A.
C5
- B.
C7
- C.
T4
- D.
S4
- 22.Cathy Bates, age 36, is a homemaker who frequently forgets to take her carbamazepine (Tegretol). As a result, she has been experiencing seizures. How can the nurse best help the patient remember to take her medication?
- A.
Tell her take her medication at bedtime.
- B.
Instruct her to take her medication after one of her favorite television shows.
- C.
Explain that she should take her medication with breakfast.
- D.
Tell her to buy an alarm watch to remind her.
- 23.Richard Barnes was diagnosed with pneumococcal meningitis. What response by the patient indicates that he understands the precautions necessary with this diagnosis?
- A.
“I’m so depressed because I can’t have any visitors for a week.”
- B.
“Thank goodness, I’ll only be in isolation for 24 hours.”
- C.
“The nurse told me that my urine and stool are also sources of meningitis bacteria.”
- D.
“The doctor is a good friend of mine and won’t keep me in isolation.”
- 24.In early symptom associated with amyotrophic lateral sclerosis (ALS) includes:
- A.
Fatigue while talking
- B.
Change in mental status
- C.
Numbness of the hands and feet
- D.
Spontaneous fractures
- 25.When caring for a patient with esophageal varices, the nurse knows that bleeding in this disorder usually stems from:
- A.
Esophageal perforation
- B.
Pulmonary hypertension
- C.
Portal hypertension
- D.
Peptic ulcers
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