Nursing Medical Surgical Quiz
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Questions and Answers

Why should an aluminum hydroxide antacid be administered at least 1 hour after an enteric-coated drug?

  • It neutralizes the drug before it reaches the intestines.
  • It enhances digestion in the stomach.
  • It can cause premature release of the enteric-coated drug in the stomach. (correct)
  • It increases the effectiveness of the enteric-coated drug.
  • What is the normal ratio of carbonic acid to bicarbonate ions in acid-base balance?

  • 1 part carbonic acid to 20 parts bicarbonate. (correct)
  • 1 part carbonic acid to 15 parts bicarbonate.
  • 1 part carbonic acid to 10 parts bicarbonate.
  • 1 part carbonic acid to 30 parts bicarbonate.
  • What is the recommended blood cholesterol level for optimal health?

  • Less than 250 mg/dl
  • Less than 150 mg/dl
  • Less than 300 mg/dl
  • Less than 200 mg/dl (correct)
  • What is a common clinical manifestation of left-sided heart failure?

    <p>Pink-tinged sputum</p> Signup and view all the answers

    Which symptom is an early sign of ketoacidosis?

    <p>Polyuria caused by osmotic diuresis.</p> Signup and view all the answers

    Which of the following is NOT a guideline for caring for a patient during a seizure?

    <p>Force something into the patient’s mouth</p> Signup and view all the answers

    What is a potential complication of severe acute pancreatitis?

    <p>Hypovolemia as a common and fatal complication.</p> Signup and view all the answers

    In patients with septal hypertrophy, what happens to afterload?

    <p>It increases</p> Signup and view all the answers

    What does a return of brown dialysate during peritoneal dialysis suggest?

    <p>Bowel perforation.</p> Signup and view all the answers

    What should a nurse do for a patient after an amputation within the first 24 hours?

    <p>Elevate the stump</p> Signup and view all the answers

    Which treatment is used for status epilepticus?

    <p>IV diazepam and phenytoin.</p> Signup and view all the answers

    What should a patient who has undergone a total knee replacement do with their affected leg?

    <p>Elevate the leg while remaining in a semi-Fowler position.</p> Signup and view all the answers

    Which of the following is associated with Parkinson’s disease?

    <p>Progressive muscle rigidity</p> Signup and view all the answers

    Which structure's blood supply is typically obstructed by atheromatous plaque, causing claudication pain?

    <p>Extremities</p> Signup and view all the answers

    Which sign indicates that spinal shock is resolving?

    <p>Return of reflex activity in the arms and legs.</p> Signup and view all the answers

    What is the primary purpose of Valsalva’s maneuver?

    <p>To force exhalation against a closed glottis</p> Signup and view all the answers

    Who is considered the ideal donor for kidney transplantation?

    <p>An identical twin</p> Signup and view all the answers

    Which medication is commonly used to reduce premature ventricular contractions?

    <p>Lidocaine</p> Signup and view all the answers

    During a myocardial infarction, which ventricle typically sustains the most damage?

    <p>Left ventricle</p> Signup and view all the answers

    What is the universal sign indicating choking?

    <p>Clutching the hand to the throat</p> Signup and view all the answers

    What dietary recommendations are appropriate for a patient with hepatitis A?

    <p>Moderately high fat and high carbohydrate</p> Signup and view all the answers

    Which of the following is a classic symptom of arterial insufficiency in the leg?

    <p>Intermittent claudication</p> Signup and view all the answers

    What is the most common finding in patients with bladder carcinoma?

    <p>Gross, painless hematuria</p> Signup and view all the answers

    What is a contraindication for the parenteral administration of heparin sodium?

    <p>Recent surgery or trauma</p> Signup and view all the answers

    What is a common symptom of hypokalemia?

    <p>Muscle weakness</p> Signup and view all the answers

    What is the most appropriate intervention during cardiac arrest if an IV route is unavailable?

    <p>Administer epinephrine endotracheally</p> Signup and view all the answers

    Which of the following dietary considerations is advised for a patient with a pressure ulcer?

    <p>High-calorie, high-protein diet</p> Signup and view all the answers

    What is considered a normal fasting blood glucose level?

    <p>80 to 120 mg/dl</p> Signup and view all the answers

    What indicates digoxin toxicity in a patient?

    <p>Nausea and vomiting</p> Signup and view all the answers

    Which condition is characterized by daily urine output of less than 100 ml?

    <p>Anuria</p> Signup and view all the answers

    What is one of the first treatments for a fractured, dislocated femur?

    <p>Reduction and immobilization</p> Signup and view all the answers

    What surgical procedure is performed to remove the herniated portion of an intervertebral disk?

    <p>Laminectomy</p> Signup and view all the answers

    What is the most common cause of coronary artery disease?

    <p>Atherosclerosis</p> Signup and view all the answers

    What symptom is most commonly associated with pulmonary embolism?

    <p>Chest pain</p> Signup and view all the answers

    How should a patient be positioned for thoracentesis if upright position is not possible?

    <p>On the unaffected side</p> Signup and view all the answers

    Which of the following medications causes urine discoloration to orange or red?

    <p>Phenazopyridine (Pyridium)</p> Signup and view all the answers

    What is the appropriate action if blood is not transfused within 30 minutes?

    <p>Return it to the blood bank</p> Signup and view all the answers

    What position is recommended for a patient using a closed chest drainage system?

    <p>Semi-Fowler position</p> Signup and view all the answers

    Which type of bag allows manual delivery of oxygen to patients who cannot breathe independently?

    <p>Handheld resuscitation bag</p> Signup and view all the answers

    What should be done if blood is discolored and contains gas bubbles?

    <p>Return it to the blood bank</p> Signup and view all the answers

    Study Notes

    Patient Conditions and Treatments

    • Hypokalemia: Serum potassium level below 3.5 mEq/L; symptoms include muscle weakness and cardiac arrhythmias.
    • Epinephrine Administration: During cardiac arrest, if an IV route is unavailable, it may be given endotracheally.
    • Pernicious Anemia: Caused by vitamin B12 malabsorption; presents with gastrointestinal and neurological symptoms.

    Nutrition and Diet

    • Pressure Ulcer Management: High-protein, high-calorie diet recommended unless contraindicated.
    • Hepatitis A Diet: Moderately high in fat and rich in carbohydrates and proteins; largest meal in the morning.
    • Total Parenteral Nutrition (TPN): If interrupted, administer dextrose 5% in water to prevent hypoglycemia.

    Diagnostic Tests and Indicators

    • CK-MB Isoenzyme: Used to assess tissue damage due to myocardial infarction.
    • Fasting Blood Glucose: Normal levels are 80 to 120 mg/dl after a 12-hour fast.
    • Tuberculin Skin Test: A positive result is induration of 10 mm or greater.

    Cardiac and Respiratory Emergencies

    • Myocardial Infarction: Greatest risk of mortality within the first 24 to 48 hours; pain due to myocardial ischemia.
    • Universal Sign for Choking: Clutching the hand to the throat.
    • Left-Sided Heart Failure: Symptoms include pulmonary congestion, pink-tinged sputum, and dyspnea.

    Surgical and Intervention Techniques

    • Laminectomy: Surgical removal of herniated intervertebral disk portion.
    • Vagotomy: Surgical procedure for gastric ulcers to reduce acid secretion.
    • Thoracentesis Positioning: Patient should be seated upright or on the unaffected side.

    Neurological Conditions

    • Parkinson’s Disease: Characterized by muscle rigidity, akinesia, and tremors.
    • Status Epilepticus: Life-threatening emergency involving a series of rapidly repeating seizures.
    • Spinal Shock: Return of reflex activity below injury level indicates resolution.

    Complications and Monitoring

    • Anuria: Defined as daily urine output of less than 100 ml.
    • Fat Embolism Risk: Highest in the first 48 hours post long bone fracture; characterized by respiratory distress.
    • Hemolytic Transfusion Reaction: Early sign is urticaria; avoid transfusing contaminated blood.

    Vascular and Blood Disorders

    • Deep Vein Thrombosis (DVT): Risk of pulmonary embolism; common cause is atherosclerosis.
    • Arterial Insufficiency: Intermittent claudication is a classic symptom; due to atheromatous plaque obstruction.
    • Metabolic Acidosis: Caused by excessive production or retention of acid ions, or abnormal bicarbonate loss.

    Fundaments of Care

    • Patient Positioning in Shock: Elevate legs no more than 45 degrees to help venous return; contraindicated in head injury patients.
    • Gingival Hyperplasia: Adverse effect of phenytoin (Dilantin).
    • Blood Transfusion Protocol: Transfusions should occur within 30 minutes; discolored blood indicates contamination.

    General Nursing Practices

    • IV Heparin Contraindications: Include renal or liver disease, GI bleeding, recent surgery, and pregnancy.
    • Evacuation for Post-Stoma Care: Use hydrogen peroxide solution for mouth care in stomatitis.
    • Patient Comfort Post-Hysterectomy: Sexual intercourse contraindicated for 3 weeks (vaginal) or 6 weeks (abdominal) post-surgery.

    Complications of Chronic Conditions

    • Respiratory Compromise: Leading cause of death in burn victims; infection is the second most common.
    • Disequilibrium Syndrome: Can occur during dialysis; causes nausea and twitching due to rapid fluid shifts.
    • Trismus: Painful spasms from tetanus affecting mastication and swallowing.

    Miscellaneous Medical Facts

    • Brown Dialysate: During peritoneal dialysis, a return of this color suggests bowel perforation.
    • Pulmonary Embolism Symptoms: Chest pain is the most common symptom; can be fatal.
    • Chronic Systemic Fungal Infection: Symptoms of histoplasmosis resemble those of tuberculosis.

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    Description

    Test your knowledge on key medical surgical nursing concepts. This quiz covers topics like hypokalemia, cardiac emergencies, and pernicious anemia, focusing on the signs, symptoms, and critical interventions required. Perfect for nursing students looking to reinforce their understanding of vital topics.

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