Medical-Surgical Nursing Exam Sample Questions

These sample questions apply to all exams taken on or after October 25, 2014.

The following sample questions are similar to those on the examination but do not represent the full range of content or levels of difficulty. The answers to the sample questions are provided after the last question.

To respond to the sample questions, first enter your first and last names in the boxes below (this information will not be recorded; it is strictly for purposes of identifying your results). Then click the button corresponding to the best answer for each question. When you are finished, click the "Evaluate" button at the bottom of the page. A new browser window will open, displaying your results, which you may print, if you wish.

This practice exam is not timed, and you may take it as many times as you wish. Good luck!

1. The main goal of treatment for acute glomerulonephritis is to:

 encourage activity.
 encourage high protein intake.
 maintain fluid balance.
 teach intermittent urinary catheterization.

2. Nursing diagnoses mostly differ from medical diagnoses in that they are:

 dependent upon medical diagnoses for the direction of appropriate interventions.
 primarily concerned with caring, while medical diagnoses are primarily concerned with curing.
 primarily concerned with human response, while medical diagnoses are primarily concerned with pathology.
 primarily concerned with psychosocial parameters, while medical diagnoses are primarily concerned with physiologic parameters.

3. A patient who received spinal anesthesia four hours ago during surgery is transferred to the surgical unit and, after one and a half hours, now reports severe incisional pain. The patient's blood pressure is 170/90 mm Hg, pulse is 108 beats/min, temperature is 99^oF (37.2^oC), and respirations are 30 breaths/min. The patient's skin is pale, and the surgical dressing is dry and intact. The most appropriate nursing intervention is to:

 medicate the patient for pain.
 place the patient in a high Fowler position and administer oxygen.
 place the patient in a reverse Trendelenburg position and open the IV line.
 report the findings to the provider.

4. To prevent a common, adverse effect of prolonged use of phenytoin sodium (Dilantin), patients taking the drug are instructed to:

 avoid crowds and obtain an annual influenza vaccination.
 drink at least 2 L of fluids daily, including 8 to 10 glasses of water.
 eat a potassium-rich, low sodium diet.
 practice good dental hygiene and report gum swelling or bleeding.

5. The most common, preventable complication of abdominal surgery is:

 atelectasis.
 fluid and electrolyte imbalance.
 thrombophlebitis.
 urinary retention.

6. A 78-year-old patient is scheduled for transition to home after treatment for heart disease. The patient's spouse, who has chronic obstructive pulmonary disease, plans to care for the patient at home. The spouse says that their grown children, who live nearby, will help. The best approach to discharge planning is to:

 arrange nursing home placement for the couple.
 consult the spouse's healthcare provider about the spouse's ability to care for the patient.
 contact the children to ascertain their commitment to help.
 discuss community resources with the spouse and offer to make referrals.

7. During an assessment of a patient who sustained a head injury 24 hours ago, the medical-surgical nurse notes the development of slurred speech and disorientation to time and place. The nurse's initial action is to:

 continue the hourly neurologic assessments.
 inform the neurosurgeon of the patient's status.
 prepare the patient for emergency surgery.
 recheck the patient's neurologic status in 15 minutes.

8. For the evaluation feedback process to be effective, a manager:

 conducts weekly meetings with staff members.
 considers staff members' interests and abilities when delegating tasks.
 informs staff members regularly of how well they are performing their jobs.
 provides goals for staff members to meet.

9. An 80-year-old patient is placed in isolation when infected with methicillin-resistant Staphylococcus aureus. The patient was alert and oriented on admission, but is now having visual hallucinations and can follow only simple directions. The medical-surgical nurse recognizes that the changes in the patient's mental status are related to:

 a fluid and electrolyte imbalance.
 a stimulating environment.
 sensory deprivation.
 sundowning.

10. To prepare a patient on the unit for a bronchoscopic procedure, a medical-surgical nurse administers the IV sedative. The medical-surgical nurse then instructs the licensed practical nurse to:

 educate the patient about the pending procedure.
 give the patient small sips of water only.
 measure the patient's blood pressure and pulse readings.
 take the patient to the bathroom one more time.

11. Which physiological response is often associated with surgery-related stress?

 Bronchial constriction
 Decreased cortisol levels
 Peripheral vasodilation
 Sodium and water retention

12. A patient's family does not know the patient's end-of-life care preferences, but assumes that they know what is best for the patient under the circumstances. This assumption reflects:

 justice.
 paternalism.
 pragmatism.
 veracity.

13. Which statement by a patient with diabetes mellitus indicates an understanding of the medication insulin glargine (Lantus)?

 "Lantus causes weight loss."
 "Lantus is used only at night."
 "The duration of Lantus is six hours."
 "There is no peak time for Lantus."

14. Which action occurs primarily during the evaluation phase of the nursing process?

 Data collection
 Decision-making and judgment
 Priority-setting and expected outcomes
 Reassessment and audit

15. Which action best describes a sentinel event alert?

 Documenting the breakdown in communication during a shift report
 Indicating that a community or institution is unsafe
 Recording the harm done when a medication error occurs
 Signaling the need for immediate investigation and response

16. Which is primarily a developmental task of middle age?

 Learning and acquiring new skills and information
 Rediscovering or developing satisfaction in one's relationship with a significant other
 Relying strongly upon spiritual beliefs
 Risk taking and its perceived consequences

17. A medical-surgical nurse, who is caring for a patient with a new diagnosis of cancer, observes the patient becoming angry with the physicians and nursing staff. The best approach to diffuse the emotionally charged discussion is to:

 allow the patient and family members time to be alone.
 arrange time for the patient to speak with another patient with cancer.
 direct the discussion and validation of emotion, without false reassurance.
 request a consultation from a social worker on the oncology unit.

18. It is hospital policy to assess and record a patient's pulse before administering digoxin (Lanoxin). By auditing the nursing records to determine the frequency of compliance with this policy, the quality assessment and improvement committee is conducting:

 a process analysis.
 a quality analysis.
 a system analysis.
 an outcome analysis.

19. The nursing diagnosis for a patient with a myocardial infarction is activity intolerance. The plan of care includes the patient outcome criterion of:

 agreeing to discontinue smoking.
 ambulating 50 feet without experiencing dyspnea.
 experiencing no dyspnea on exertion.
 tolerating activity well.

20. A nursing department in an acute care setting decides to redesign its nursing practice based on a theoretical framework. The feedback from patients, families, and staff reflects that caring is a key element. Which theorist best supports this concept?

 Erikson
 Maslow
 Rogers
 Watson

21. Which statement by a patient demonstrates an accurate understanding about herbal supplements?

 "Herbs may interact with prescribed medications but not other herbs."
 "Most herbs have been tested and found to be safe and therapeutic."
 "The Food and Drug Administration regulates herbs and allows advertising."
 "There is no standardization among the manufacturers of herbs in this country."

22. For a patient with Crohn's disease, the medical-surgical nurse recommends a diet that is:

 high in fiber, and low in protein and calories.
 high in potassium.
 low in fiber, and high in protein and calories.
 low in potassium.

23. When examining a patient who is paralyzed below the T4 level, the medical-surgical nurse expects to find:

 flaccidity of the upper extremities.
 hyperreflexia and spasticity of the upper extremities.
 impaired diaphragmatic function requiring ventilator support.
 independent use of upper extremities and efficient cough.

24. After completing a thorough neurological and physical assessment of a patient who is admitted for a suspected stroke, a medical-surgical nurse anticipates the next step in the immediate care of this patient to include:

 administering tissue plasminogen activator.
 obtaining a computed tomography scan of the head without contrast.
 obtaining a neurosurgical consultation.
 preparing for carotid Doppler ultrasonography.

25. The first step in applying the quality improvement process to an activity in a clinical setting is to:

 assemble a team to review and revise the activity.
 collect data to measure the status of the activity.
 select an activity for improvement.
 set a measurable standard for the activity.

EATING AT LATE NIGHT, DAMAGING BRAIN

Washington: Be warned if you have a strong urge to eat late at night as a new study shows that this could be bad for your brain.

Eating late at night, especially during the hours when our bodies think they should be sleeping, could disrupt learning and memory.

The results of the study may pose a possible health concern not only for those eating late at night but for the millions who are engaged in shift work.

"We have this illusion that with the flip of a switch, we can work at any time and part of that is eating at any time," Christopher Colwell, professor, psychiatry and bio-behavioural sciences, University of California, Los Angeles was quoted as saying in Today.

Although the new research was done on mice, the general principles also apply to humans, the Inquisitr reported.

The modern lifestyle of working long hours does not allow the body's need to stick with a specific schedule to remain healthy.

The circadian rhythm follows a 24-hour cycle and regulates almost everything in our body, including hormones and behaviour.

Any disruption of this cycle may not only be harmful for the immune system but even lead to type 2 diabetes, Colwell suggested.

Referring to jet-lag, the author demonstrates how such a disruption may affect the brain function.

In the experiment, the researchers allowed one group of mice to eat at normal times, while a second group could only eat during their normal sleep time.

The mice eating during their normal sleeping times were "severely compromised" in remembering what they had learned.

They also had trouble recognising new objects and showed changes in the part of the brain that involved learning and memory.

Garlic - fight against lung infections

London -  Spicing up your food with garlic can help protect your lungs against infections, suggests new research.

A chemical found in garlic can kill bacteria that cause life-threatening lung infections in people with cystic fibrosis, a genetic disorder that mostly affects the lungs, the study noted.

The chemical - known as allicin - could be an effective treatment against a group of infectious bacteria that is highly resistant to most antibiotics.

“At a time when novel antimicrobial agents are urgently required, chemical and microbiological research has the potential to unlock the rich reservoir of antimicrobial compounds present in plants such as garlic,” said professor John Govan from the University of Edinburgh in Britain.

Allicin is produced naturally by garlic bulbs to ward off a closely-related group of plant pathogens found in soil and water habitats.

The bacteria - known as the Burkholderia cepacia complex (Bcc) causes serious and transmissible lung infections in people with cystic fibrosis.

The researchers found that allicin - which can be extracted by crushing raw garlic - inhibits the growth of bacteria.

Allicin kills Bcc bacteria by chemically modifying key enzymes, the researchers noted.

The team believes allicin-containing remedies could be used in combination with existing antibiotics to treat Bcc infections.

The study was published in the journal PLOS one.

How brain guards itself against virus attacks

How brain guards itself against virus attacks

The olfactory mucosa in the nose can serve as a conduit for a number of viruses to enter the brain including rabies, polio and influenza viruses. 

Infections in the central nervous system are rare thanks to our brain’s unique defence system that prevents viruses from invading, finds a study.

The research explains a long-standing mystery.

The olfactory mucosa in the nose can serve as a conduit for a number of viruses to enter the brain including rabies, polio and influenza viruses.

Yet infections in the central nervous system rarely occur.

The mechanism responsible for protecting the brain from viruses that successfully invade the olfactory bulb (OB), the first site of infection in nasal mucosa, remains elusive.

“Our work points to the remarkable ability of the immune system, even within the brain, to protect us against opportunistic viruses,” says Anthony van den Pol of Yale University.

Van den Pol and his colleagues discovered that in response to viral infection, cells in the olfactory bulb release long-distance signalling molecules that tell cells in uninfected parts of the brain to produce anti-viral interferon - a first line of defence against invading viruses.

In the study, normal mice wiped out the infection while mice lacking receptors for the initial signalling molecules succumbed as the viruses spread throughout the brain, proving the critical role of these molecules.

These signalling molecules are different than regular neurotransmitters.

Van den Pol noted that during neuronal signalling, neurotransmitters released by one cell travel across a mere 20 nanometers of synapse to the next nerve cell.

Yet, the long-distance signalling molecules diffuse up to 15 millimetres.

That distance is almost a million times greater than the distance across a synapse.

“The success of the immune system in blocking two unrelated viruses, vesicular stomatitis virus and cytomegalo virus, suggests that our results may generalise to many other viruses that can enter the brain through the olfactory nerve,” said van den Pol.

UAE new rules - nurses - MOH - DOH - HAAD

An agreement has paved the way for professionals from the health ministry to work freely across the country. The move is expected to further enhance the quality of healthcare in the UAE and also counter any staff shortages.

His Highness Shaikh Mohammed bin Rashid Al Maktoum, Vice-President and Prime Minister of the UAE and Ruler of Dubai, on Wednesday attended the signing of an agreement for the unification of licences for medical practitioners in the country, on the sidelines of his visit to the Arab Health Exhibition and Congress at the Dubai International Convention and Exhibition Centre. Also present was Shaikh Hamdan bin Mohammed bin Rashid Al Maktoum, Crown Prince of Dubai.

“A new step on the right path in order to unify the regulations, laws and procedures governing this noble human profession,” said Shaikh Mohammed while commending the signing of the agreement. 

The ruling will be applicable within the next three months.

The agreement was signed by Minister of Health, Abdul Rahman bin Mohammed Al Owais, Director-General of the Dubai Health Authority (DHA) Essa Al Maidoor, and Dr Maha Barakat, Director-General of the Abu Dhabi Health Authority (Haad).

Health authorities of Dubai and Abu Dhabi had signed an agreement in 2012 to allow medical professionals of both emirates to work freely for each other. The move was followed by Dubai Healthcare City.

Wednesday’s signing now allows professionals from the health ministry to work for the authorities and vice versa. Over 200 professionals from the DHA have been licensed by Haad since the agreement  and vice versa.

Commenting on the agreement, Al Maidoor said: “We are living in one country…we have doctors and technical staff in different fields of medicine who change their places between the emirates.

“So in this way we are unifying when the doctor is tested or interviewed by any of the authorities, he practice freely between any other emirate,” he said.

“This will be more flexible, unify the requirements between the emirates and guarantee the quality of work,” he added.

Al Maidoor said that a legislation would govern the agreement and in case of violation, action would be taken.

Currently, there are 18,000 licensed professionals in the private and government health sector in Dubai and 22,000 in Abu Dhabi.

No comment was available from the health ministry.

Health professionals, however, said that though it would now be easier to share expertise and experience especially in some sub-specialties of the medical field, general practitioners may not be able to benefit much. Some UAE national specialists are already allowed to work between both emirates. 

5 reasons why beer is good for your health

For all those who believe that drinking beer may pose a threat to your health, recent studies have found that the drink has several surprising health benefits if consumed in moderate amounts.

Here are some amazing health benefits of beer:

• Drinking two beers a day can help in maintaining bone strength as it contains silicon which helps in strengthening bones.
• If consumed in the right amount, beer is good for one's mental health and reduces the risk of developing Alzheimer's.
• Since it is made of barley, it is an excellent source of fibre and hence consuming beer improves heart health and lowers cholesterol levels.
• Studies suggest that consumption of beer in moderate amounts reduces the risk of heart strokes.
• Since beer contains high water content, it helps reduce the risk of developing kidney stones.

Young female smokers at higher risk of most common type of breast cancer

 A new study has revealed that young women, who have been smoking a pack of cigarettes a day for a decade, are at higher risk of most common type of breast cancer.

According to the researchers, young women who are current or recent smokers and had been smoking a pack a day for at least 10 years, had a 60 percent increased risk of estrogen receptor positive breast cancer.

However, it was found that smoking had no link to a woman's risk of triple-negative breast cancer.

Christopher Li of the Fred Hutchinson Cancer Research Center, Seattle, and his colleagues conducted a population-based study consisting of 778 patients with estrogen receptor positive breast cancer, 182 patients with triple-negative breast cancer and 938 cancer-free controls.

Li said that the health hazards associated with smoking are numerous and well known and his study suggests that smoking might increase the risk of the most common molecular subtype of breast cancer but not influence risk of one of the rarer, more aggressive subtypes.

The study was published in Cancer journal of the American Cancer Society.