Medical Surgical Nursing Practice Questions

Medical Surgical Nursing Practice Questions Related

Review Medical Surgical Nursing Practice Questions related questions and content

A client just had a flexible bronchoscopy. Which of the following nursing actions is appropriate?

  • A. Withhold food and liquids until the client's gag reflex returns.
  • B. Irrigate the client's throat every 4 hours.
  • C. Have the client refrain from talking for 24 hours.
  • D. Suction the client's oropharynx frequently.
Correct Answer: A

Rationale: The correct answer is A: Withhold food and liquids until the client's gag reflex returns. After a flexible bronchoscopy, the client may have a decreased gag reflex due to topical anesthesia used during the procedure, which increases the risk of aspiration. Withholding food and liquids helps prevent aspiration until the gag reflex returns, usually within 1-2 hours.

B: Irrigating the client's throat every 4 hours is unnecessary and may not be indicated post-bronchoscopy.

C: Having the client refrain from talking for 24 hours is not necessary after a flexible bronchoscopy unless specifically instructed by the healthcare provider.

D: Suctioning the client's oropharynx frequently is not indicated unless there is a clinical indication for it, such as excessive secretions or respiratory distress. Frequent suctioning can increase the risk of trauma to the airway.

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A client is postoperative with shallow respirations at 9/min. Which acid-base imbalance should the nurse identify the client as being at risk for developing initially?

  • A. Respiratory acidosis
  • B. Respiratory alkalosis
  • C. Metabolic acidosis
  • D. Metabolic alkalosis
Correct Answer: A

Rationale: The correct answer is A: Respiratory acidosis. Shallow respirations at 9/min indicate hypoventilation, leading to retention of CO2 and respiratory acidosis. This is because inadequate removal of CO2 results in an increase in carbonic acid concentration, leading to a decrease in blood pH. Respiratory alkalosis (B) is unlikely with shallow respirations. Metabolic acidosis (C) results from nonrespiratory factors. Metabolic alkalosis (D) is not related to respiratory rate.

In an emergency department, a healthcare provider is preparing to care for a client with multiple system trauma following a motor vehicle crash. What should be the priority focus of care?

  • A. Airway protection
  • B. Decreasing intracranial pressure
  • C. Stabilizing cardiac arrhythmias
  • D. Preventing musculoskeletal disability
Correct Answer: A

Rationale: The correct answer is A: Airway protection. The priority focus of care in a client with multiple system trauma is to ensure a patent airway to maintain oxygenation and ventilation. Without a clear airway, the client can rapidly deteriorate. Airway management takes precedence over other interventions to prevent hypoxia and respiratory failure. Decreasing intracranial pressure (B) and stabilizing cardiac arrhythmias (C) are important but secondary to ensuring adequate oxygenation. Preventing musculoskeletal disability (D) is not the immediate concern in this critical situation.

Rewrite each of the following questions asked by the nurse so that it is an open-ended question designed to gather information about the patient’s functional health patterns.

  • A. Are you having any pain?
  • B. Do you have a good relationship with your spouse?
  • C. How long have you been ill?
  • D. Do you exercise regularly?
Correct Answer: B

Rationale: N/A

A client has developed atelectasis postoperatively. Which of the following findings should the nurse expect?

  • A. Facial flushing
  • B. Increasing dyspnea
  • C. Decreasing respiratory rate
  • D. Friction rub
Correct Answer: B

Rationale: The correct answer is B: Increasing dyspnea. Atelectasis is a condition where the lung tissue collapses, leading to decreased oxygen exchange and resulting in symptoms like dyspnea (difficulty breathing). This occurs because the collapsed lung tissue reduces the surface area available for gas exchange, leading to decreased oxygen saturation and increased work of breathing.

Facial flushing (choice A) is not typically associated with atelectasis. Decreasing respiratory rate (choice C) may not be a reliable indicator as the body may compensate by increasing respiratory rate to maintain oxygenation. Friction rub (choice D) is more commonly associated with conditions like pleurisy or pneumonia, not atelectasis.

A client has a chest tube in place connected to wall suction due to a right-sided pneumothorax. The client complains of chest burning. Which of the following actions should be taken?

  • A. Increase the wall suction.
  • B. Strip the chest tube.
  • C. Clamp the chest tube.
  • D. Reposition the client.
Correct Answer: D

Rationale: The correct answer is D: Reposition the client. This action should be taken because chest burning could indicate that the chest tube is irritating the pleura. Repositioning the client may help alleviate the pressure on the pleura, reducing discomfort. Increasing wall suction (A) could worsen the irritation. Stripping the chest tube (B) is outdated and can cause damage. Clamping the chest tube (C) can lead to tension pneumothorax.

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