Medical-Surgical Nursing questions and answers

Question: Why should a client with prosthetic heart valve take antibiotics before dental procedure?

Answer Choices:
A. All murmurs need prophylaxis
B. Valvular disease increases gum disease
C. Only if fever is present
D. To prevent infection around the artificial valve

Answer: D. To prevent infection around the artificial valve

Question: Client with exophthalmos, tachycardia, low TSH (0.04). Which medication?

Answer Choices:
A. Methimazole
B. Alprazolam
C. Lisinopril
D. Methotrexate

Answer: A. Methimazole

Question: Client with pulmonary and peripheral edema post-holiday meal. Complete sentence: due to preload and afterload → ? EF

Answer Choices:
A. Increased preload and afterload → decreased EF
B. Decreased preload and afterload → increased EF

Answer: A. Increased preload and afterload → decreased EF

Question: Which of the following describes the proposed mechanism of action of FDA approved medications for the treatment of tardive dyskinesia (valbenazine, deutetrabenazine)?

Answer Choices:
Antagonism of acetylcholine receptors in the substantia nigra dopamine pathway
Inhibition of vesicular monoamine transporter 2 (VMAT2), a transporter that regulates monoamine uptake from the cytoplasm to the synaptic vesicle for storage and release
Partial agonism of nicotinic receptors which prevents activity in the prefrontal cortex
Inhibition of acetylcholinesterase, which enhances cholinergic stimulation of movement centers

Answer: Inhibition of vesicular monoamine transporter 2 (VMAT2), a transporter that regulates monoamine uptake from the cytoplasm to the synaptic vesicle for storage and release

Question: Which of the following groups of atypical antipsychotics are most likely to cause metabolic effects?

Answer Choices:
Ziprasidone, risperidone, asenapine
Olanzapine, aripiprazole, paliperidone
Risperidone, lurasidone, asenapine
Olanzapine, quetiapine, clozapine

Answer: Olanzapine, quetiapine, clozapine

Question: Which of the following mood stabilizers has a number of drug-drug interactions and auto-induces its own metabolism?

Answer Choices:
Carbamazepine
Oxcarbazepine
Divalproex
Lamotrigine

Answer: Carbamazepine

Question: Match injury risk cue with neuromuscular condition

Answer Choices:
Muscle Spasticity → MS
Ascending Paralysis → Guillain-Barré
Bilateral Pain → Fibromyalgia
Choreiform Movements → Huntington’s
Swan Neck Deformity → Rheumatoid Arthritis

Answer: As matched above.

Question: MS patient: What instruction helps decrease fatigue?

Answer Choices:
A. Daily aerobics
B. Soak in hot tub
C. Avoid overheating activities
D. Sleep less than 6 hours

Answer: C. Avoid overheating activities

Question: Heart failure client. What is the priority outcome?

Answer Choices:
A. Urinate 210 mL in 8 hours
B. Pain will decrease
C. Ambulate 50 feet
D. Perfusion will improve (less edema/crackles) after furosemide

Answer: D. Perfusion will improve (less edema/crackles)

Question: Which of the following exerts an action that can be described as “producing a conformational change in the receptor that causes no change in signal transduction”?

Answer Choices:
Agonist
Partial agonist
Antagonist
Inverse agonist

Answer: Antagonist

Question: Client with MG has drooping eyelids, difficulty swallowing. At risk for?

Answer Choices:
A. Impaired communication
B. Respiratory muscle weakness
C. Myxedema coma
D. Balance problems

Answer: B. Respiratory muscle weakness

Question: After giving furosemide 40 mg IV, which findings indicate therapeutic response?

Answer Choices:
Lung sounds with less crackles
Serum sodium 133
Urine output 1200 mL in 8 hrs
SpO₂ 93% on 2L
Lungs with expiratory wheezes

Answer: Lung sounds with less crackles

Urine output 1200 mL in 8 hrs

SpO₂ 93% on 2L

Question: Client with morning joint pain >1 hour and stiff fingers likely has?

Answer Choices:
A. Rheumatoid arthritis
B. Fractures
C. Osteoporosis
D. Osteoarthritis

Answer: A. Rheumatoid arthritis

Question: Heart failure client with pulmonary edema. Which actions are appropriate?

Answer Choices:
Limit sodium in diet
Administer potassium
Administer furosemide
Apply oxygen

Answer: Limit sodium: Appropriate

Administer potassium: Not Appropriate (K = 4.9)

Administer furosemide: Appropriate

Apply oxygen: Appropriate

Question: Client with Guillain-Barré reports leg paralysis, chest numbness, SOB. Priority problem?

Answer Choices:
A. Prevent pressure sores
B. Teach assistive device
C. Maintain airway
D. Control pain

Answer: C. Maintain airway

Question: Which lab value is consistent with acute coronary syndrome (ACS)?

Answer Choices:
A. Decreased triglycerides
B. Elevated BNP
C. Elevated troponin
D. Elevated CRP

Answer: C. Elevated troponin

Question: 80-year-old post-hip ORIF refusing PT, shallow breaths, diminished lung sounds. Priority action?

Answer Choices:
A. Incentive spirometer
B. Prone position
C. Administer narcotics
D. Request antidepressant

Answer: A. Incentive spirometer

Question: Client has signs of heart failure. What are the 3 priority problems?

Answer Choices:
A. Decreased cardiac output
B. Infection
C. Impaired gas exchange
D. Activity intolerance
E. Decreased perfusion

Answer: A. Decreased cardiac output, C. Impaired gas exchange, E. Decreased perfusion

Question: Client admitted with pneumonia, platelets dropped from 210,000 to 46,000. What is the priority action?

Answer Choices:
A. Remove peripheral IV
B. Increase IV fluids
C. Stop heparin
D. Discontinue antibiotic

Answer: C. Stop heparin

Question: Client in ER with chest pain and SOB. What are appropriate nursing actions? (Select all that apply)

Answer Choices:
A. Obtain 12-lead ECG
B. Administer metoprolol
C. Administer aspirin
D. Supine position
E. Oxygen at 4L NC

Answer: A, C, E