Medical Surgical Nursing (Quiz)
) Calcium chloride
1.) A client is receiving NPH insulin 20 units
subq at 7:00 AM daily, at 3 PM how would the
nurse finds if the client were having a
hypoglycemic reaction?
A.) Feel the client and bed for dampness
B.) Observe client kussmaul respirations
C.) Smell client’s breathe for acetone odor
D.) Check client’s pupils for dilation
ANS: A -diaphoresis
2.) Postoperative thyroidectomy nursing care
includes which measures?
A.) Have the client speak every 5-10 mins if
hoarseness is present
B.) Provide a low calcium diet to prevent
hypercalcemia
C.) Check the dressing all the back of the neck
for bleeding
D.) Apply a soft cervical collar to restrict neck
movement
ANS: C
3.) What would the nurse note as typical
findings on the assessment of a client with
acute pancreatitis?
A.) Steatorrhea, abd. Pain, fever
B.) Fever, hypoglycemia, DHN
C.) Melena, persistent vomiting, hyperactive
bowel sounds
D.) Hypoactive bowel sounds, decreased
amylase and lipase levels
ANS: A
4.) A client is found to be comatose and
hypoglycemic with a blood suger level 50
mg/dl. What nursing action is implemented
first?
A.) Infuse 1000 ml of D5W over a 12-hour period
B.) Administer 50% glucose IV
C.) Check the client’s urine for the presence of
sugar and acetone
D.) Encourage the client to drink orange juice
with added sugar
ANS: B
5.) Which medication will the nurse have
available for the emergency treatment of
tetany in the client who has had a
thyroidectomy?
A.
B.) Potassium chloride
C.) Magnesium sulfate
D.) Sodium bicarbonate
ANS: A
6.) What is the primary action of insulin in
the body?
A.) Enhances the transport of glucose across
cell walls
B.) Aids in the process of gluconeogenesis
C.) Stimulates the pancreatic beta cells
D.) Decreases the intestinal absorption of
glucose
ANS: A
7.) What will the nurse teach the diabetic
client regarding exercise in his /her
treatment program?
A.) During exercise the body will use
carbohydrates for energy production, which in
turn will decrease the need for insulin
B.) With an increase in activity the body will
utilize more carbohydrates; therefore more
insulin will be required.
C.) The increase in activity results in an increase
in the utilization of insulin; therefore the client
should decrease his/her carbohydrate intake
D.) Exercise will improve pancreatic circulation
and stimulate the islet of Langerhans to increase
the production of intrinsic insulin
ANS: A
8.) The nurse is caring for a client who has
exophthalmos associated with her thyroid
disease. What is the cause of exophthalmos?
A.) Fluid edema in the retro-orbital tissues which
force the eyes to protrude
B.) Impaired vision, which causes the client to
squint in order to see
C.) Increased eye lubrication, which makes the
client blink less
D.) Decrease in extraocular eye movements,
which results in the “thyroid stare.”
ANS: A
9.) What is characteristic symptom of
hypoglycemia that should alert nurse to an
early insulin reaction?
A.) Diaphoresis
B.) Drowsiness
C.) Severe thirst
D.) Coma
ANS: A
10.) A client is scheduled for routine
glycosylated hemoglobin (HbA1c) test. What
is important for the nurse to tell the client
before this test?
A.) Drink only water after midnight and come to
the clinic early in the morning
B.) Eat a normal breakfast and be at the clinic 2
hours because of the multiple blood draws
C.) Expect to be at the clinic for several hours
because of the multiple blood draws
D.) Come to the clinic at the earliest
convenience to have blood drawn
ANS: D
11.) A client has been inhalation vasopressin
therapy. What will the nurse evaluate to
determine the therapeutic response to this
medication?
A.) Urine specific gravity
B.) Blood glucose
C.) Vital signs
D.) Oxygen saturation levels
ANS: A
12.) A client with diagnosis of type 2 diabetes
has been ordered a course of prednisone for
her severe arthritic pain. An expected change
that requires close monitoring by the nurse
is;
A.) Increased blood glucose level
B.) Increased platelet aggregation
C.) Increased ceatinine clearance
D.) Increased ketone level in urine
ANS: A
13.) The nurse performing an assessment on
a client who has been receiving long-term
steroid therapy would expect to find:
A.) Jaundice
B.) Flank pain
C.) Bulging eyes
D.) Central obesity
ANS: D
14.) A diabetic client receives a combination
of regular and NPH insulin at 0700 hours.
The nurse teaches the client to be alert for
signs of hypoglycemia at
A.) 1200 and 1300 hours
B.) 1100 and 1700 hours
C.) 1000 and 2200 hours
D.) 0800 and 1100 hours
ANS: B
15.) It is important for the nurse to teach the
client that metformin (Glcucophage):
A.) May cause nocturia
B.) Should be taken at night
C.) Should be taken with meals
D.) May increase the effects of aspirin
ANS: C
16.) A nurse assessing a client with SIADH
would expect to find laboratory values of:
A.) Serum Na= 150 mEq/L and low urine
osmolality
B.) Serum K= 5 mEq/L and low serum osmolality
C.) Serum Na=120 mEq/L and low serum
osmolality
D.) Serum K= 3 mEq/L and high serum
osmolality
ANS: C
17.) A priority nursing diagnostic for a client
admitted to the hospital with a diagnosis of
diabetes insipidus is:
A.) Sleep pattern deprivation related nocturia
B.) Activity intolerance r/t muscle weakness
C.) Fluid volume excess r/t intake greater that
output
D.) Risk for impaired skin integrity r/t generalized
edema
ANS: B
18.) A client admitted with a pheochrocytoma
returns from the operating room after
adrenalectomy. The nurse should carefully
assess this client for:
A.) Hypokalemia
B.) Hyperglycemia
C.) Marked Na and water intake
D.) Marked fluctuations in BP
ANS: D
19.) When caring for client in thyroid crisis,
the nurse would question an order for:
A.) IV fluid
B.) Propanolol (Inderal)
C.) Prophylthiouracil
D.) A hyperthermia blanket
ANS: D
20.) A client is prescribed levothyroxine
(Synthroid) daily. The most important
instruction to give the client for
administration of this drug is:
A.) Taper dose and discontinue if mental and
emotional statuses stabilize
B.) Take it at bedtime to avoid the side effects of
nausea and flatus
C.) Call the M.D. immediately at the onset of
palpitations or nervousness
D.) Decrease intake of juices and fruits with high
potassium and calcium contents
ANS: C
21.) The nurse would question which
medication order for a client with acute-
angled glaucoma?
A.) Atropine (Atrposil) 1-2 drops in each eye now
B.) Hydrochloride (Diuril) 25 mg PO daily
C.) Propanolol (Inderal) 20 mg PO 2 times a day
D.) Carbanyl choline (Isopto carbachol) eye
drops; 1 drop 2 times a day
ANS: A
22.) A client tells you she has heard that
glaucoma may be a hereditary problem and
she is concerned about her adult children.
What is the best response?
A.) “There is no need for concern; glaucoma is
not hereditary order.”
B.) “Screening for glaucoma should be included
in an annual eye exam for everyones over 50.”
C.) “There may be a genetic factor with
glaucoma and your children over 30 y/o should
be screened yearly.”
D.) “Are your grandchildren complaining of any
eye problems? Glaucoma generally skips a
generation.”
ANS: C
23.) What will be important to include in the
nursing care for the client with angle-closure
glaucoma?
A.) Evaluation of medications to determine if any
of them cause an increase in IOP is a side
effect.
B.) Observation for an increase in loss of vision;
it can be reversed if promptly identified.
C.) Control BP to decrease the client’s potential
loss of peripheral vision.
D.) Assessment for a level of discomfort; the
client may experience considerable pain until the
optic nerve atrophies
ANS: A
24.) A child is scheduled for a myringotomy.
What goal of this procedure will the nurse
discuss with the parents?
A.) Promote drainage from the ear
B.) Irrigate the Eustachian tube
C.) Correct a malformation in the inner ear
D.) Equalize pressure on the tympanic
membrane
ANS: A
25.) After a client’s eye has been
anesthetized, what instructions will be
important for the nurse to give the client?
A.) Do not watch TV for at least one day
B.) Do not rub the eye for 15-20 minutes
C.) Irrigate the eye every hour to prevent
dryness
D.) Wear sunglasses when in direct sunlight for
the next 6 hours
ANS: B
26.) A child diagnosed with conjunctivitis.
Which statement reflects that the child
understood the nurse’s teaching?
A.) “It’s okay for me to let my friends use my
sunglasses while we are playing together.”
B.) “It’s okay for me to softly rub my eye, as long
as I use the back of my hand.”
C.) “I can pick the crustly stuff out of my
eyelashes with my fingers when I wake up in the
morning.”
D.) “I will use my own washrag and towel while
my eyes are sick.”
ANS: D
27.) What medication would the nurse
anticipate giving a client with Meniere’s dse?
A.) Nifedipine
B.) Amoxicillin
C.) Propanolol
D.) Hydrochloride (Hydro DIURIL)
ANS: D
28.) When teaching a family and a client
about the use of a hearing aid, the nurse will
base the teaching on what information
regarding the hearing aid?
A.) Provides mechanical transmission for
damaged part of the ear
B.) Stimulates the neural network of the inner
ear to amplify sound
C.) Amplifies sound but does not improve the
ability to hear
D.) Tunes out extraneous noise in the lower-
frequency sound spectrum
ANS: C
29.) What statement by the client recovering
from cataract surgery would indicate to the
nurse need for additional teaching?
A.) “I’ll call if I have a significant amount of pain.”
B.) “I’ll continue to take my Metamucil for
another week.”
C.) “I’ll just do some laundry this afternoon
instead of going to work.”
D.) “I’ll take my acetazolamide (Diamox) drops
with my other morning medications
ANS: C
30.) A client is walking down the hall and
begins to experience vertigo. What is the
most important nursing action when this
occurs?
A.) Have the client sit in a chair and lower his
head
B.) Administer meclizine (Antivert) PO
C.) Assist the client to sit or lie down
D.) Assess if the occurrence is vertigo or
dizziness
ANS: C
31.) Which client is at highest risk for retinal
detachment?
A.) 4-year old with amblyopia
B.) 17 y/o who plays physical contact
C.) 33 y/o with severe ptosis and diplopia
D.) 72 y/o with nystagmus and Bell’s palsy
ANS: B
32.) To promote and maintain safety for a
client after a stapedectomy. What would be
included in the nursing care plan?
A.) Implement fall precautions
B.) Prevent aspirations
C.) Begin oxygen 2-4L/min via nasal cannula
D.) Change inner ear dressing when saturated
ANS: A
33.) The nurse would question the
administration of which eye drop in a patient
with increased ICP?
A.) Artificial tears
B.) Betaxolol (Betoptic)
C.) Acetazolamide (Diamox)
D.) Epinephrine HCL (Epirate)
ANS: D
34.) A client is being admitted for problems
with Meniere’s disease. What is most
important to the nurse to assess?
A.) Diet history
B.) Screening hearing test
C.) Effect on client’s activities of daily living
(ADLs)
D.) Frequency and severity
ANS: D
35.) A client calls the nurse regarding an
accident that just occurred during which an
unknown chemical was splashed in his eyes.
What is the most important for the nurse to
tell the client to do immediately?
A.) Rinse the eye with large amount of water or
saline solution
B.) Put a pad soaked in the sterile saline
solution over the eye
C.) Go to the closest emergency room
D.) Have a co-worker visually checks the eye for
a foreign body
ANS: A
36.) A 25- year old woman comes to the clinic
complaining of dizziness, weakness and
palpitations. What will be important for the
nurse to initially evaluate when obtaining the
health history?
A.) Activity and exercise patterns
B.) Nutritional patterns
C.) Family health status
D.) Coping and stress tolerance
ANS: B
37.) A child with leukemia is being
discharged after beginning chemotherapy.
What instructions will the nurse include in
the teaching plan for the parents of this
child?
A.) Provide a diet low in protein and high in
carbohydrates
B.) Avoid fresh vegetables that are not cooked or
peeled
C.) Notify the M.D. if the child’s temperature
exceeds 101F (39C)
D.) Increase the use of humidifiers throughout
the house
ANS: B
38.) Which client is most likely to have iron
deficiency anemia?
A.) A client with cancer receiving radiation
therapy twice a week
B.) A toddler whose primary nutritional intake is
milk
C.) A client with peptic ulcer who had surgery 6
weeks ago
D.) A 15-year old client in sickle cell crisis
ANS: B
39.) A client has an order for one unit of
whole blood. What is a correct nursing
action?
A.) Initiate an IV with 5% dextrose in water
(D5W) to maintain a patent access site
B.) Initiate the transfusion within 30 minutes of
receiving the blood
C.) Monitor the client’s vital signs for the first 5
minutes
D.) Monitor V/S every 2 hours during the
transfusion
ANS: B
40.) The nurse is caring for a client who is
receiving a blood transfusion. The
transfusion was started 30 mins ago at a rate
of 100 ml/hr. The client begins to complain of
low back pain and headache and is
increasing restless, what is the first nursing
action?
A.) Slow the infusion and evaluate the V/S and
client’s history of transfusion reaction
B.) Stop the transfusion, disconnect the blood
tubing and begin a primary infusion of normal
saline solution
C.) Stop the infusion of blood and begin infusion
of NSS from the Y connector
D.) Recheck the unit of blood for correct
identification numbers and cross-match
information
ANS: B
41.) The nurse is preparing to start an IV
infusion before the administration of a unit of
packed red blood cells, what fluid will the
nurse select to maintain the infusion before
hanging the unit of blood?
A.) D5W
B.) D5W/.45NaCl
C.) LR solution
D.) .9% Na Cl
ANS: D
42.) A client in sickle cell crisis is admitted to
the emergency department what are the
priorities of care?
A.) Nutrition, hydration, electrolyte balance
B.) Hydration, pain management, electrolyte
balance
C.) Hydration, oxygenation, apin management
D.) Hydration, oxygenation, electrolyte balance
ANS: C
43.) A client in the ICU has been diagnosed
with DIC. The nurse will anticipate
administering which of the following fluids?
A.) Packed RBC
B.) Fresh Frozen plasma (FFP)
C.) Volume expanders, such as D10W
D.) Whole blood
ANS: B
44.) The nurse is assessing a client who has
been given a diagnosis of polycythemia vera.
What characteristics will the nurse anticipate
finding when assessing this client?
A.) Increased fatigue and bleeding tendencies
B.) Hemoglobin below 13 mg/dl
C.) Headaches, dyspnea, claudication
D.) Back pain, ecchymosis, and joint tenderness
ANS: C
45.) A client has been diagnosed with
pernicious anemia what will the nurse teach
this client regarding medication he will need
to take after he goes home?
A.) Monthly Vit. B12 injections will be necessary
B.) Ferrous sulfate PO daily will be prescribed
C.) Coagulation studies are important to
evaluate medications
D.) Decrease intake of leafy green vegetables
because of increased Vit. K
Ans: A
46.) First postop day after a right lower lobe
(RLL) lobectomy, the client breathes and
coughs but has difficulty raising mucus.
What indicates that the client is not
adequately clearing secretions?
A.) Chest x-ray film shows right sided pleural
fluid
B.) A few scattered crackles on RLL on
auscultation
C.) PCO2 increases from 35-45 mm Hg
D.) Decrease in forced vital capacity
ANS: C
47.) What nursing observations indicate that
the cuff on an endotracheal tube is leaking?
A.) An increase in peak pressure on the
ventilator
B.) Client is able to speak
C.) Increased swallowing efforts by client
D.) Increased crackles (rales) over left lung field
ANS: B
48.) The client with COPD is to be discharged
home while receiving continuous oxygen at a
rate of 2 L/min via cannula. What information
does the nurse provide to the client and his
wife regarding the use of oxygen at home?
A.) Because of his need for oxygen, the client
will have to limit activity at home
B.) The use of oxygen will eliminate the client’s
shortness of breath
C.) Precautions are necessary because oxygen
can spontaneously ignite and explode
D.) Use oxygen during activity to relieve the
strain on the client’s heart
ANS: A
49.) The wife of a client with COPD is worried
about caring for her husband at home. Which
statement by the nurse provides the most
valid information?
A.) “You should avoid emotional situations that
increase his shortness of breathe.”
B.) “Help your husband arrange activities so that
he does as little walking as possible.”
C.) “Arrange a schedule so your husband does
all necessary activities before noon; then he can
rest during the afternoon and evening.”
D.) “Your husband will be no more short of
breath when he walks but that will not hurt him.”
ANS: C
50.) Which statement correctly describes
suctioning through an endotracheal tube
A.) The catheter is inserted into the endotracheal
tube; intermittent suction is applied until no
further secretions are retrieved; the catheter is
then withdrawn.
B.) The catheter is inserted through the nose,
and the upper airway is suctioned; the catheter
is then removed from the upper airway and
inserted into the endotracheal tube to suction
the lower airway
C.) With suction applied, the catheter is inserted
into the endotracheal tube; when resistance is
met, the catheter is slowly withdrawn
D.) The catheter is inserted into the
endotracheal tube to a point of resistance, and
intermittent suction is applied during withdrawal.
ANS: D
Care of the clients with Eye and Ear Disorders
1.) The primary problem in cataract is:
A.) Blurring of vision
B.) Loss of peripheral vision
C.) Presence of floaters
D.) Halos around light
Ans:A
2.) The primary reason for performing iridectomy
after cataract extraction is:
A.) To prevent secondary glaucoma
B.) To improve the vision of the client
C.) To prevent postop hemorrhage
D.) To reduce eye discomfort
Ans: A
3.) Pterygium is caused primarily by:
A.) Exposure to sunlight
B.) Exposure to dust
C.) Exposure to wind
D.) Exposure to chemicals
Ans: B
4.) The surgical procedure which involves
removal of the eyeball is:
A.) Enucleation
B.) Evisceration
C.) Exanteration
D.) Extraction
Ans: A
5.) A sterile chronic granulomatous inflammation
of the meibomian gland is:
A.) Chalazion
B.) Hordeulum
C.) Uveitis
D.) Keratoconjunctivitis
Ans: A
6.) The following are nursing interventions for a
blind person EXCEPT:
A.) When approaching the client, talk before
touching
B.) Orient the client to the environment
C.) When assisting the client during ambulation,
the nurse stays beside the client
D.) Promote the independence in activities of
daily living
Ans: C
7.) Otosclerosis is characterized by:
A.) Increased endolymphatic pressure
B.) Replacement of normal bones by spongy
and highly-vascularized bones and the stapes
become fixed with the oval window
C.) Rupture of the tympanic membrane
D.) Damage of the labyrinth or acoustic nerve
Ans: B
8.) Hyperopia is corrected with that type of lens?
A.) Concave lens
B.) Convex lens
C.) Aphakic lens
D.) Bifocal lens
Ans: B
9.) The following are appropriate nursing
interventions after cataract extraction EXCEPT:
A.) Place the client in supine position or turn
towards unoperated side
B.) Advise the client to avoid bending, stooping
or lifting heavy objects for several weeks postop
C.) Instruct the client to limit fluid intake
D.) Advise the client to protect his eyes with eye
pad and eye shield for a week
Ans:C
10.) The client with retinal detachment would
least likely manifest which of the following signs
& symptoms:
A.) Floating spots before the eyes
B.) Flashes of light
C.) Progressive constriction of vision in one area
D.) Pain in the eye
Ans: D
11.) In acute glaucoma, the obstruction to the
flow of aqueous humor is caused by:
A.) Thickening of the trabecular meshwork
B.) Displacement of the iris
C.) Narrowing of the canal schlemm
D.) Constriction of the pupil
Ans: B
12.) Which of the following is true about
glaucoma?
A.) It is characterized by irreversible blindness
B.) It is treated with mydriatics
C.) The IOP is 14-21mmHg
D.) Central vision is lost initially, followed by the
peripheral vision
Ans: A
13.) The following drugs maybe administered to
the client with glaucoma EXCEPT:
A.) Diamox (Acetazolamide)
B.) Pilocarpine
C.) Atropine SO4
D.) Timolol maleate
Ans: C
14.) The client with retinal detachment had
undergone scleral buckling. The following are
appropriate nursing interventions EXCEPT:
A.) Position the client with the area of
detachment dependent
B.) Cover the eyes with pressure dressing
C.) Advise the client to avoid reading for few
weeks D.) Itching
D.) Encourage the client to increase fluid intake
Ans: B
Ans: A

20.) The following are appropriate nursing

15.) Which of the following is the most interventions after ear surgery EXCEPT:
characteristic manifestation of Meniere’s Dse? A.) Position the client on the operated side
A.) Tinnitus B.) Instruct the client not to blow the nose for at
B.) Headache least 2 weeks
C.) Vertigo C.) Observe for signs and symptoms of 7th
D.) Nausea and Vomiting cranial nerve damage
D.) Advise the client against wathing TV or fast-
Ans: C moving objects for few weeks postop

Ans: A

16.) The diet of the client with Meniere’s disease

should be: 21.) Which of the ff test assesses visual acuity
A.) Low-Protein A.) Snellen’s Test
B.) Low-fats B.) Ishihara Plate
C.) Low-potassium C.) Retinoscopy
D.) Low-Sodium D.) Tonometry

Ans: D Ans: A

22.) Which of the following nursing interventions

17.) Which of the following is inappropriate
nursing intervention for the client with hearing
impairment:
A.) Talk in clearly enunciated words using
normal tone of voice
B.) Talk directly in front of the client
C.) Use speech with gestures
D.) Use high-pitch voice
has priority when a client has a foreign body
protruding from the eye?
A.) Irrigate the eye with sterile saline
B.) Assess visual acuity with snellen’s chart
C.) Remove the foreign body with sterile gauze
D.) Patch both eyes until seen by
Opthalmologist

Ans: D Ans: A

18.) Which of the following dx tests compare air 23.) A client is diagnosed with Meniere’s
conduction with bone conduction disease. Which of the following nursing
A.) Rinne’s test diagnosis should take priority for the client?
B.) Weber’s test A.) Altered body image
C.) Barany’s Rotation Test B.) Risk for injury
D.) Caloric Ice Test C.) Impaired social interaction
D.) Ineffective coping
Ans: A
Ans: B
19.) A client who had cataract should be told to
call his MD if he has which of the following 24.) The following are characteristics of
situations? conductive hearing loss EXCEPT:
A.) Blurred Vision A.) The client hears better in a noisy
B.) Eye Pain environment
C.) Glare B.) The client talks in a loud voice
C.) The client hears and understands telephone
conversation well
D.) The external or the middle ear is damaged

Ans: B

25.) It is an eye disorder characterized by

lessening of the effective powers of
accommodation:
A.) Myopia
B.) Presbyopia
C.) Hypertropia
D.) Presbycusis

Ans:B

26.) The following drugs dilate the pupils

EXCEPT:
A.) Atropine SO4
B.) Neosynephrine
C.) Scopolamine
D.) Pilocarpine