Medical Surgical Nursing

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1.

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?

Position the patient in a Fowler’s position

2. The patient complains of mild incisional pain during coughing following surgery.
What is the nurse’s best advice to the patient?

Apply pressure against the incision with a pillow

3. If diabetic patient capillary blood glucose level is 60mg/dl, what is the


recommended intravenous fluid to be administered to the patient?

25% dextrose

4. What is the first nursing diagnosis to be formulated for the patient diagnosed
with pneumonia?

Impaired gas exchange

5. Mr. Y’s postoperative vital signs are a blood pressure of 80/50 mm Hg, a pulse of
140, and respirations of 32. Suspecting hypovolemic shock, what is the nurse’s
best initial action?

Place the client in modified Trendelenberg’s position.


6. What is the reason for giving tablet Nitroglycerine sublingually for a patient with
Angina pectoris?

Nitroglycerine will produce coronary vasodilation that improves the coronary blood flow
in 3 – 5 mins.
7. What is the appropriate action of nurse before and after endotracheal
suctioning?

Hyperoxygenate the patient

8. What is the average time for suctioning (ET) the client?

5 to 15 seconds

9. What is the recommended diet for the patient with pulmonary tuberculosis?

Protein rich diet

10. While palpating the Appendicitis patient, the nurse elicits the tenderness upon
removal of pressure rather than application of pressure to the abdomen. What is
the clinical sign called?

Rebound tenderness

11. What is the most common cause of orthopnea?

Congestive heart failure

12. The patient experiences breathing difficulty while lying in recumbent position.
What is the sign called?

Orthopnea

13. Mr. Y is diagnosed with tuberculosis and taking tablet Rifampicin. What is the
specific information to be given to Mr. Y regarding tablet Rifamficin?

Rifampicin turns the urine colour to reddish orange.

14. What is the drug of choice for anaphylaxis?

Adrenaline
15. Name the intravenous fluid used to treat hyponatremia?

3% Normal saline

16. What is the angle of insertion of needle for intradermal injection?

5 – 15 degree

17. What is the abnormal finding seen in the fingers for patient with chronic hypoxia?

Clubbing of fingers

18. Name the abnormal respiratory pattern caused by Diabetic ketoacidosis

Kussmaul’s respiration

19. In which condition, the patient experiences hoarseness or aphonia and severe
cough?

Acute Laryngitis

20. Write any two nursing measures to loosen the thick mucus secretions?

Increase fluid intake, steam inhalation, coughing, humidified oxygen, chest


physiotherapy

21. In a Tuberculin skin test, which size of induration indicates positive for
tuberculosis?

10mm or greater

22. Which area is called as Erb’s point?

Third intercostals space to the left of the sternum

23. What is the reason for cardiac murmurs?


Turbulent or regurgitant blood flow due to malfunctioned valve

24. Whether excess fluid volume indicates hyponatremia or hypernatremia?

Hyponatremia

25. What is the normal sodium level in the blood?

135 to 145mmol/l

26. Which blood test to be done before undergoing Intravenous Pyelogram?

Serum creatinine

27. How will you measure PR interval in ECG?

From the beginning of the P wave to the beginning of the QRS complex

28. What is the instruction given before discharging the current in defibrillator?

All clear

29. What is the maximum amount of voltage delivered through defibrillator?

360 joules

30. Name any two cardiac biomarkers

Creatinine kinase, Creatinine kinase isoenzyme, Myoglobin, Troponin I, Lactic


dehydrogenase

31. Is heparin antiplatelet or anticoagulant?

Anticoagulant

32. Mention any four cardinal signs of cardiogenic shock

Bradycardia, hypotension, decreased urinary output, cool and clammy skin, diaphoresis
33. What are the parameters to be monitored when the patient is receiving ACE
inhibitors?

Blood pressure, urinary output, serum sodium, potassium and creatinine

34. What is the most characteristic sign of Pericarditis?

Friction rub

35. Expand VAP

Ventilator Associated Pneumonia

36. Expand SIMV

Synchronized Intermittent Mechanical Ventilator

37. Expand CPAP

Continuous Positive Airway Pressure

38. Expand CABG

Coronart Artery Bypass Grafting

39. Expand TURP

Trans Urethral Resection of Prostate

40. Write the action of Atorvas

Lipid lowering agent

41. Write the action of Enlapril

ACE inhibitors

42. Write the action of Amlodipine


Calcium channel blockers

43. Write the action of Nitroglycerine

Vasodilators

44. Mention any two isotonic fluids

0.9% Normal saline, Ringer lactate

45. When the patient is receiving calcium gluconate, the nurse should monitor?
Heart rate, ECG

46. What is the common causative organism for pharyngitis


Group A beta hemolytic streptococci
47. Mention any four cardinal symptoms of pulmonary tuberculosis
Dyspnea, chest pain, cough, hemoptysis, fever, weight loss, loss of appetite, night sweats
48. Mention any two first line drugs used for tuberculosis
Rifampicin, Ethambutol, Pyrazinamide, Isoniazid
49. Name the abnormal breath sound present in Bronchial asthma
Wheeze
50. Mention two non-invasive modes of ventilation
CPAP, BiPAP
51. Mention two invasive modes of ventilation
Volume controlled, Pressure controlled, Synchronized intermittent
52. What is the percentage of oxygen delivered through nasal prongs?
24% to 40%
53. If bicarbonate level is below normal in ABG, how will you interpret it?
Metabolic Acidosis
54. If Pressure of Carbon dioxide is high in ABG report, how wil you interpret it?
Respiratory acidosis
55. List any four cardinal signs of Angina
Chest pain, breathing difficulty, palpitations, excessive sweating, dizziness
56. What are the tablets used as a loading dose for Myocardial infarction?
Aspirin, Clopidogrel and Atorvastatin
57. Mention the thrombolytic agent used for Myocardial infarction
Streptokinase
58. Mention two beta blockers
Atenolol, Propanolol, Mesoprolol
59. What is the compression rate per minute in CPR?
100 compressions/minute
60. Mention the four types of blood products used for blood transfusion
Packed red blood cell, Platelets, Whole blood, Plasma
61. Mention the route of drug administration for giving test dose
Intradermal
62. Mention any four cardinal symptoms of renal calculi
Flank pain, back pain, dysuria, fever, vomiting, chills
63. What is the normal glomerular filtration rate?
120ml/minute
64. Mention two types of dialysis
Peritoneal dialysis and hemodialysis
65. What is the normal value of Serum Urea?
15 to 45mg/dl
66. What is the normal value of Serum Creatinine?
0.6 to 1.2mg/dl
67. Write the action of Frusemide
Loop diuretics
68. Mention any two signs of cirrhosis of liver
Ascitis, jaundice, pruritus, spider angioma, palmar erythema, pedal edema
69. Mention any two complications of cirrhosis of liver
Portal hypertension, oesophageal varices, thrombocytopenia, hepatic encephalopathy,
spleenomegaly
70. Mention two cardinal signs of Appendicitis
Mc Burney’s sign, Rovsing’s sign, rebound tebderness
71. What is the normal range of bowel sound heard per minute?
5 to 20bowel sound per minute
72. Expand ORIF
Open Reduction Internal Fixation
73. Mention any four signs of rheumatoid arthritis
Swan neck deformity, subcutaneous nodules, ulnar dirft & joint stiffness
74. In which condition, softening of bone is present?
Osteomalacia
75. In which condition, the serum uric acid is increased?
Gout
76. What is the normal fasting blood glucose level?
70 to 110mg/dl
77. Mention any four cardinal signs of Diabetic ketoacidosis

78. What is the condition called enlargement of thyroid gland?


Goitre
Which blood products can be infused rapidly?
Platelets
When monitoring the patient who is receiving blood transfusion, the nurse would analyze an
elevated body temperature as indicating?
Transfusion reaction
When Patient is in fluid volume deficit, what are the changes that the nurse can be expected in
vital signs?
Tachycardia and hypotension
When serum calcium level increases, which hormone secretes to move calcium from plasma to
bone?
Calcitonin
What would be the minimum daily requirement of sodium for an adult?
2gm of sodium
When the patient is exhibiting signs of hypernatremia and dehydration, what would be the most
appropriate nursing intervention?
Record I/O chart and weight daily
The nurse is caring for a client with ascites. What is the best method for determining early
ascites?
Daily measurement of abdominal girth
Which type of diet implicated in the development of Diverculosis
Low fiber diet
Which complication of gastric resection should the nurse teach the client to watch for?
Dumping syndrome
A client with irritable bowel syndrome is being prepared for discharge. Which of the following
meal plans should the nurse give the client?
Low fiber low fat diet
A client has a percutaneous endoscopic gastrostomy tube inserted for tube feedings. Before
starting a continuous feeding, the nurse should place the client in which position?
Semi Fowler's position
The client being seen in a physician’s office has just been scheduled for a barium swallow the
next day. The nurse instruct the client to follow before the test is
Fast for 8hours before the test
What the nurse would monitor for adverse reactions to aluminum-containing antacids such as
aluminum hydroxide?
Constipation
The nurse is monitoring a client for the early signs of dumping syndrome. Which symptom
indicates this occurrence?
Tachycardia, sweating, pallor, syncope, vertigo, palpitation
To determine whether the patient has duodenal ulcer, the nurse would assess the most frequent
symptom of duodenal ulcer is?
Pain is relieved by food intake
How Milk of Magnesium alleviates constipation?
Increases the absorption of water in the colon
A client presents to the emergency room, reporting that he has been vomiting every 30 to 40
minutes for the past 8 hours. Frequent vomiting puts him at risk for which of the electrolyte
imbalance?
Hypokalemia
A patient underwent umbilical hernia repair. What is the prime discharge advice that the nurse
should give to the patient?
Avoid coughing
After the acute phase of congestive heart failure, the nurse should instruct the client to restrict the
electrolyte in the diet is?
Sodium
In the early postoperative period following a transurethral surgery, the most common
complication the nurse should observe for is
Hemorrhage
What is the independent nursing intervention to prevent thrombus formation in the postoperative
period?
Active and passive leg exercises
What would be the early finding in the ECG for a patient with myocardial infarction?
ST segment elevation
79. What is the normal TSH level?
80. Mention any two complications of HIV
81. Mention the causative organism of Syphilis
Traponema pallidum
82. Mention the causative organism of Gonorrhea
Neisseria gonorrhoea
83. Mention the causative organism of leprosy
mycobacterium leprae
84. Mention any two indications of Abdominal paracentesis
85. Mention any two indications of Thoracentesis
86. Mention any two indications of Thoracentesis
87. Mention any two indications of Intravenous Pyelogram
88. Mention any two sites for bone marrow aspiration
89. Mention any two indications of upper GI endoscopy
90. Mention any two indications of colonoscopy
91. Mention any two anesthetic agents
92. Name the solution used to preserve specimen

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