Quiz Medicine Surgery

1. Where is the asthma medication placed prior to starting the nebulizer treatment?
a. The medication does not need to be added, it is already in the nebulizer cup
b. The medication is squirted into the bottom half of the nebulizer cup
c. The medication is put into the facemask or mouthpiece
d. The medication goes into the tubing for the nebulizer machine
ANSWER: B

2. The test for checking mean plasma glucose concentration over the previous 8 – 10 weeks
is:
A. Hemoglobin A1C
B. Oral Glucose Tolerance Test
C. Fructosamine Test
D. Fasting Plasma Glucose Concentration

ANSWER: A – HgbA1c expresses the amount of hemoglobin that is combined with glucose.

3. What is the probable source of bright red blood in the stool?

a. Stomach
b. Small intestine
c. Lower gastrointestinal tract
d. Higher intestinal tract

ANSWER: C

4. What is an urgent reason for catheterizing a patient?

A. Acute urinary retention
B. Urinary tract infection
C. Incontinence
D. Because they asked

ANSWER: A – because the client is in pain or retention is resulting in renal impairment

5. Aminophylline (theophylline) is prescribed for a client with acute bronchitis. A nurse

administers the medication, knowing that the primary action of this medication is to:
A. Promote expectoration.
B. Suppress the cough.
C. Relax smooth muscles of the bronchial airway.
D. Prevent infection.

ANSWER: C. Relax smooth muscles of the bronchial airway. Aminophylline is a

bronchodilator that directly relaxes the smooth muscles of the bronchial airway. 

6. A nurse teaches a client about the use of a respiratory inhaler. Which action by the client
indicated a need for further teaching?
A. Removes the cap and shakes the inhaler well before use.
 B. Press the canister down with your finger as he breathes in.
C. Inhales the mist and quickly exhales.
D. Waits 1 to 2 minutes between puffs if more than one puff has been prescribed.

ANSWER: C. Inhales the mist and quickly exhales. Take the inhaler out of the mouth. If the
client can, he should hold his breath as he slowly counts to 10. This lets the medicine reach deep
into the lungs. The client should be instructed to hold his or her breath at least 10 to 15 seconds
before exhaling the mist.

7. A major side effect of insulin use that can be life threatening is:
A. Hyperglycemia
B. Stomach upset
C. Hypoglycemia
D. Tremors

ANSWER: C. Hypoglycemia The action of insulin will lower glucose levels, which may prove
fatal if levels drop too low. Hypoglycemia is, by far, the most common adverse effect of insulin
therapy. The other adverse effects of insulin therapy include weight gain, and rarely electrolyte
disturbances like hypokalemia, especially when used along with other drugs causing
hypokalemia.

8. The client has orders for a nasogastric (NG) tube insertion. During the procedure,
instructions that will assist in the insertion would be:
A. Instruct the client to tilt his head back for insertion in the nostril, then flex his neck for the
final insertion.
B. After insertion into the nostril, instruct the client to extend his neck.
C. Introduce the tube with the client’s head tilted back, then instruct him to keep his head upright
for final insertion.
D. Instruct the client to hold his chin down, then back for insertion of the tube.

ANSWER: A. Instruct the client to tilt his head back for insertion in the nostril, then flex
his neck for the final insertion. NG insertion technique is to have the client first tilt his head
back for insertion into the nostril, then to flex his neck forward and swallow. A common error
when placing the tube is to direct the tube in an upward direction as it enters the nares; this will
cause the tube to push against the top of the sinus cavity and cause increased discomfort. The tip
should instead be directed parallel to the floor, directly toward the back of the patient's throat.

9. Your patient had surgery to form an arteriovenous fistula for hemodialysis. Which
information is important for providing care for the patient?

A. The patient shouldn’t feel pain during initiation of dialysis.

B. The patient feels best immediately after the dialysis treatment.
C. Using a stethoscope for auscultating the fistula is contraindicated.
D. Taking a blood pressure reading on the affected arm can cause clotting of the fistula.
ANSWER: D. Taking a blood pressure reading on the affected arm can cause clotting of the
fistula. Pressure on the fistula or the extremity can decrease blood flow and precipitate clotting,
so avoid taking blood pressure on the affected arm. For the most effective hemodialysis, the
patient needs good vascular access with an arteriovenous (AV) fistula or an AV graft that
provides adequate blood flow. 

10. Your patient is 2 hours post-op from a cast placement on the right leg. The patient has
family in the room. Which action by the significant other requires you to re-educate the
patient and family about cast care?

A. Gently moving the cast with the fingertips of the hands every 2 hours to help with drying.
B. Positioning the cast at heart level with pillows.
C. Checking the color and temperature of the right foot.
D. Using a hair dryer on the cool setting to help with drying.
ANSWER: A. The cast should always be moved with the palms of the hands (NOT finger tips)
during the drying period to prevent dent formation because this can cause the development of
ulcers under the skin where the dents develop.
11. A client is taking an antacid for treatment of a peptic ulcer. Which of the following
statements best indicates that the client understands how to correctly take the antacid?
A. “I should take my antacid before I take my other medications.”
B. “I need to decrease my intake of fluids so that I don’t dilute the effects of my antacid.”
C. “My antacid will be most effective if I take it whenever I experience stomach pains.”
D. “It is best for me to take my antacid 1 to 3 hours after meals.”

ANSWER: D. “It is best for me to take my antacid 1 to 3 hours after meals.” Antacids

are most effective if taken 1 to 3 hours after meals and at bedtime. When an antacid is taken on
an empty stomach, the duration of the drug’s action is greatly decreased. Taking antacids 1 to 3
hours after a meal lengthens the duration of action, thus increasing the therapeutic action of the
drug.

12. The nurse would question an order for which type of antacid in patients with chronic renal
failure?
A. Aluminum-containing antacids
B. Calcium-containing antacids
C. Magnesium-containing antacids
D. All choices mentioned.
ANSWER: C. Magnesium-containing antacids Magnesium-containing antacids can cause
hypermagnesemia in patients with chronic renal failure. Antacids that contain magnesium have a
laxative effect that may cause diarrhea, and in patients with renal failure, they may cause
increased magnesium levels in the blood, because of the reduced ability of the kidneys to
eliminate magnesium from the body in the urine.

12. The client with chronic renal failure who is scheduled for hemodialysis this morning is
due to receive a daily dose of enalapril (Vasotec). The nurse should plan to administer
this medication:
A. Just before dialysis.
B. During dialysis.
C. On return from dialysis.
D. The day after dialysis.

Answer: C. On return from dialysis Antihypertensive medications such as enalapril are given

to the client following hemodialysis. This prevents the client from becoming hypotensive during
dialysis and also from having the medication removed from the bloodstream by dialysis.

13. A client is diagnosed with chronic renal failure and told she must start hemodialysis.
Client teaching would include which of the following instructions?

A. Follow a high potassium diet.

B. Strictly follow the hemodialysis schedule.
C. There will be a few changes in your lifestyle.
D. Use alcohol on the skin and clean it due to integumentary changes.

ANSWER: B. Strictly follow the hemodialysis schedule. To prevent life-threatening

complications, the client must follow the dialysis schedule. Compliance in hemodialysis patients
is most often measured by monitoring levels of blood urea nitrogen, potassium, and phosphorus
and by observing the amount of weight gain between dialysis treatments. The most compliant
patients tend to be married, skilled professionals with a high level of self-concept.

14. The cardinal rule when determining a dressing change for a pressure ulcer is:
A. keep the ulcer tissue dry and the surrounding intact skin moist
B. keep the ulcer tissue moist and the surrounding intact skin dry
C. keep the ulcer tissue and surrounding intact skin moist
D. keep the ulcer tissue and surrounding intact skin dry

ANSWER: B

15. All of the following are correct statements on surgical drains, EXCEPT:

A. Open drains drain fluid collected in gauze pad or stoma bags.

B. In closed drains, the risk of infection is reduced.
C. Penrose drain drains into a bag or bottle.
D. Closed drains include hemovac and passive drains have no suction.
ANSWER: C Penrose drain is an open drain. Closed drains into a bag or bottle.

16. The nurse is assessing for stoma prolapse in a client with a colostomy. The nurse would
observe which of the following if stoma prolapse occurred?
A. Sunken and hidden stoma
B. Dark- and bluish-colored stoma
C. Narrowed and flattened stoma
D. Protruding stoma
ANSWER: D. Protruding stoma A prolapsed stoma is one which the bowel protruded through
the stoma. Prolapse is a complication associated more with colostomies than with ileostomies,
and is more frequent in those with loop colostomies, particularly loop stomas located in the
transverse colon, than with end stomas. (End stomas result from a complete cut through the
intestine with the end pulled through the abdominal wall, while loop stomas result when an
intestinal loop is pulled through the abdominal wall and an incision made into part of the loop.)

17. The nurse will provide preoperative teaching on deep breathing, coughing, and turning
exercises. When is the best time to provide the preoperative teachings?
A. Before administration of preoperative medications.
B. The afternoon or evening prior to surgery.
C. Several days prior to surgery.
D. Upon admission of the client in the recovery room.

ANSWER: B The best time to provide preoperative teaching is the afternoon or evening prior
to surgery. This time, the patient had finished undergoing different laboratory and diagnostic
procedures. Therefore, he/she can now concentrate on the teachings. Teachings given days
before surgery may tend to be forgotten. Teachings given before administration of
preoperative medications may not be understood anymore because the anxiety level is more
likely high during this time.

18. Which of the following drugs is administered to minimize respiratory secretions

preoperatively?

A. Valium (diazepam)
B. Phenergan (promethazine)
C. Atropine sulfate
D. Demerol (Meperidine)

ANSWER: C. Atropine Sulfate, an anticholinergic, minimizes respiratory secretions

preoperatively. It helps the aspiration of secretions.

19. The nurse is transferring the patient from the postanesthesia care unit to the surgical unit.
Which of the following is the primary reason for the gradual change of position of the patient?
A. To prevent muscle injury.
B. To prevent sudden drop of blood pressure.
C. To prevent respiratory distress.
D. To promote comfort.

ANSWER: B

20. Which of the following are not members of the sterile team in the operating room, except:
A. Surgeon
B. Scrub nurse
C. Radiology technician
 D. Circulating nurse

ANSWER: D - The anesthesiologist and circulating nurse are not members of the sterile surgical
team. The surgeon, radiology technician, scrub nurse directly come in contact with the sterile
field. They comprise the sterile surgical team.