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Comprehensive Medical-Surgical Nursing Practice Questions

Enhance Your Clinical Knowledge with In-Depth Practice Scenarios

medical nursing practice questions

Key Takeaways

  • Comprehensive Coverage: Includes a wide range of topics from headaches to reconstructive surgery.
  • Detailed Scenarios: Each question is designed to simulate real-world clinical situations.
  • Evidence-Based Answers: Provides rationales to reinforce learning and understanding.

Headaches

Practice Questions

  1. A patient reports experiencing a severe, pulsating headache accompanied by nausea and heightened sensitivity to light. Which type of headache is most likely, and what immediate nursing intervention should be prioritized?

    • A) Tension headache; apply a warm compress to the neck.
    • B) Migraine headache; administer prescribed triptans and ensure a quiet environment.
    • C) Cluster headache; provide oxygen therapy.
    • D) Sinus headache; prescribe decongestants.
      Answer: B) Migraine headache; administer prescribed triptans and ensure a quiet environment.

  2. Which assessment finding differentiates a cluster headache from other types of headaches?

    • A) Pain localized to the frontal region.
    • B) Occurs in cyclical patterns or clusters.
    • C) Associated with muscle tension in the neck.
    • D) Gradual onset with diffuse pain.
      Answer: B) Occurs in cyclical patterns or clusters.

  3. A patient with a history of migraines is prescribed sumatriptan. What critical teaching point should the nurse emphasize?

    • A) Take the medication on an empty stomach for better absorption.
    • B) Avoid using more than one migraine medication simultaneously.
    • C) Report any severe chest pain or irregular heartbeat immediately.
    • D) Increase caffeine intake to enhance the drug’s effectiveness.
      Answer: C) Report any severe chest pain or irregular heartbeat immediately.

Assessment of Visual Function

Visual Acuity and Peripheral Vision

  1. Describe the proper procedure a nurse should follow when assessing a patient's visual acuity using a Snellen chart.

    • Answer: The nurse should ensure the patient is at the appropriate distance from the chart, typically 20 feet. The patient covers one eye without pressing on it, reads the smallest line of letters he or she can see, and the process is repeated for the other eye.

  2. What constitutes a normal pupillary light reflex, and what abnormal findings might indicate a potential neurological issue?

    • Answer: A normal pupillary light reflex involves both pupils constricting equally and promptly when exposed to light. Abnormal findings include unequal pupil sizes (anisocoria), sluggish response, or no response in one or both pupils, which may indicate neurological damage.

  3. How does a nurse assess a patient's peripheral vision, and which conditions could lead to deficits in this area?

    • Answer: Peripheral vision can be assessed using confrontation testing, where the nurse compares the patient's visual fields by moving an object from the periphery towards the center while the patient focuses on a central point. Deficits may indicate glaucoma, stroke, or retinal detachment.

Visual Disorders

Visual Acuity Disorders

  1. A patient with myopia reports difficulty seeing distant objects clearly. What nursing interventions can improve their daily functioning and quality of life?

    • A) Encourage regular use of corrective lenses as prescribed.
    • B) Suggest limiting screen time to reduce eye strain.
    • C) Recommend surgical intervention as the first option.
    • D) Advise the use of over-the-counter eye drops.
      Answer: A) Encourage regular use of corrective lenses as prescribed.

  2. Differentiate between myopia, hyperopia, and presbyopia in terms of their primary visual deficits.

    • Answer:
      • Myopia: Difficulty seeing distant objects clearly.
      • Hyperopia: Difficulty focusing on close objects.
      • Presbyopia: Age-related loss of near vision due to lens stiffening.

Vision Loss Related to Opioid Use

  1. A patient on long-term opioid therapy reports blurred vision. What should be the nurse’s priority action?

    • A) Increase the opioid dosage to manage pain better.
    • B) Conduct a comprehensive ocular assessment and notify the physician.
    • C) Advise the patient to use over-the-counter eye drops.
    • D) Encourage the patient to track the frequency of blurred vision episodes.
      Answer: B) Conduct a comprehensive ocular assessment and notify the physician.

  2. How should the nurse educate a patient about the potential ocular side effects of long-term opioid use?

    • Answer: The nurse should inform the patient that long-term opioid use can lead to reduced pupil size (miosis), blurred vision, and potentially optic neuropathy, emphasizing the importance of reporting any visual changes promptly.

Conjunctivitis

  1. A patient presents with red, itchy eyes and purulent discharge. What type of conjunctivitis is most likely, and what nursing care is required?

    • A) Viral conjunctivitis; recommend warm compresses and isolate to prevent spread.
    • B) Allergic conjunctivitis; administer antihistamines and avoid allergens.
    • C) Bacterial conjunctivitis; apply antibiotic drops and educate on hand hygiene.
    • D) Chemical conjunctivitis; flush eyes with saline solution.
      Answer: C) Bacterial conjunctivitis; apply antibiotic drops and educate on hand hygiene.

  2. What are the key differences in presentation between bacterial, viral, and allergic conjunctivitis?

    • Answer:
      • Bacterial: Redness, purulent discharge (thick, yellow or green).
      • Viral: Redness, watery discharge, often associated with upper respiratory infections.
      • Allergic: Itching, redness, watery or stringy discharge, usually bilateral and associated with exposure to allergens.

Corneal Abrasion

  1. A patient with a corneal abrasion complains of severe eye pain and photophobia. What are the most appropriate nursing interventions?

    • A) Apply warm compresses and encourage blinking.
    • B) Administer analgesics and prescribe antibiotic ointment.
    • C) Recommend avoiding eye movement and rest.
    • D) Suggest using artificial tears frequently.
      Answer: B) Administer analgesics and prescribe antibiotic ointment.

  2. What teaching should the nurse provide to prevent further injury to the cornea for a patient recovering from a corneal abrasion?

    • Answer: The nurse should instruct the patient to wear protective eyewear, avoid rubbing the eyes, maintain eye hygiene, and use prescribed medications as directed to promote healing and prevent infection.

Cataracts

  1. A patient diagnosed with cataracts reports cloudy vision and difficulty driving at night. What preoperative teaching should the nurse provide?

    • A) Inform the patient that cataract surgery is non-invasive and requires no anesthesia.
    • B) Educate the patient about the surgical procedure, potential risks, and postoperative expectations.
    • C) Advise the patient to stop taking all medications a week before surgery.
    • D) Suggest beginning eye exercises to strengthen vision prior to surgery.
      Answer: B) Educate the patient about the surgical procedure, potential risks, and postoperative expectations.

  2. What are the postoperative nursing priorities for a patient who has undergone cataract surgery?

    • Answer: Monitor for signs of infection or increased intraocular pressure, ensure proper use of prescribed eye drops, protect the eye from injury, and educate the patient on activity restrictions to promote healing.

Glaucoma

  1. A patient with glaucoma is prescribed timolol eye drops. What essential teaching should the nurse provide?

    • A) Administer the drops immediately after waking up.
    • B) Ensure the dropper touches the eye to enhance absorption.
    • C) Instruct the patient to avoid touching the dropper to any surface to prevent contamination.
    • D) Advise the patient to wear contact lenses while using the drops.
      Answer: C) Instruct the patient to avoid touching the dropper to any surface to prevent contamination.

  2. Differentiate between open-angle and angle-closure glaucoma in terms of pathophysiology and presentation.

    • Answer:
      • Open-angle Glaucoma: Gradual increase in intraocular pressure due to blocked drainage canals; often asymptomatic initially.
      • Angle-closure Glaucoma: Sudden blockage of the drainage angle, leading to rapid increase in eye pressure; presents with severe pain, blurred vision, and nausea.

Macular Degeneration

  1. A patient with age-related macular degeneration (AMD) is struggling with reading. What nursing interventions can assist in improving their quality of life?

    • A) Encourage the use of magnifying glasses and adequate lighting.
    • B) Advise participation in strenuous physical activities to improve circulation.
    • C) Suggest limiting all reading activities to reduce eye strain.
    • D) Recommend discontinuing use of reading glasses.
      Answer: A) Encourage the use of magnifying glasses and adequate lighting.

  2. What are the primary differences between dry and wet age-related macular degeneration?

    • Answer:
      • Dry AMD: Characterized by gradual loss of central vision due to the thinning of the macula; more common but progresses slower.
      • Wet AMD: Involves abnormal blood vessel growth beneath the retina, leading to rapid and severe vision loss.

Retinal Detachment

  1. A patient reports sudden flashes of light and an increase in floaters. What is the nurse’s priority action?

    • A) Schedule an ophthalmology appointment within a week.
    • B) Perform a bedside retinal scan.
    • C) Prepare the patient for immediate transport to an ophthalmologist.
    • D) Reassure the patient and advise rest.
      Answer: C) Prepare the patient for immediate transport to an ophthalmologist.

  2. What postoperative care is essential for a patient who has undergone surgery for retinal detachment?

    • Answer: Monitor for signs of re-detachment, ensure head positioning as prescribed, administer prescribed medications, and educate the patient on activity restrictions to promote healing.

Eye Trauma

  1. A patient arrives with a foreign object embedded in the eye. What is the nurse’s immediate action?

    • A) Attempt to remove the object manually.
    • B) Apply a cold compress to reduce swelling.
    • C) Cover the eye with a sterile dressing and avoid removing the object.
    • D) Flush the eye with sterile saline solution immediately.
      Answer: C) Cover the eye with a sterile dressing and avoid removing the object.

  2. What are the signs of a penetrating eye injury, and how should the nurse respond?

    • Answer: Signs include severe pain, bleeding, irregular pupil shape, and decreased vision. The nurse should protect the eye, avoid applying pressure, cover it with a sterile dressing, and arrange immediate medical evaluation.

Assessment of Auditory Function

Auditory Assessments

  1. Explain the steps a nurse should take to perform the Weber and Rinne tests during an auditory assessment.

    • Answer:
      • Weber Test: Place a vibrating tuning fork at the center of the patient's forehead and ask where the sound is heard (left, right, or both). It helps determine unilateral hearing loss.
      • Rinne Test: Compare air conduction (placing the tuning fork near the ear canal) with bone conduction (placing it on the mastoid process) to differentiate between conductive and sensorineural hearing loss.

  2. What are the normal findings for an otoscopic examination, and what abnormalities might indicate an ear infection?

    • Answer: Normal otoscopic findings include a pearly gray tympanic membrane with visible light reflex and no signs of redness or fluid. Abnormalities like a red, bulging tympanic membrane with fluid behind it suggest an otitis media infection.

Hearing Disorders

Hearing Loss

  1. A patient with sensorineural hearing loss is considering a hearing aid. What teaching should the nurse provide?

    • A) Hearing aids will completely restore normal hearing.
    • B) Regular maintenance and cleaning of the device are essential for optimal performance.
    • C) Hearing aids should be worn only during nighttime to avoid dependency.
    • D) The patient will not require any additional auditory training or support.
      Answer: B) Regular maintenance and cleaning of the device are essential for optimal performance.

  2. Differentiate between conductive and sensorineural hearing loss.

    • Answer:
      • Conductive Hearing Loss: Occurs when sound waves are unable to effectively reach the inner ear; often due to obstructions or damage in the outer or middle ear (e.g., earwax buildup, otitis media).
      • Sensorineural Hearing Loss: Results from damage to the inner ear or auditory nerve; often permanent and associated with aging or exposure to loud noises.

External Otitis

  1. A patient diagnosed with external otitis reports ear pain and clear drainage. What are the most appropriate nursing interventions?

    • A) Encourage the patient to dry the ear thoroughly after bathing.
    • B) Advise the patient to insert cotton swabs to keep the ear canal clean.
    • C) Recommend the use of over-the-counter decongestants.
    • D) Suggest avoiding all forms of hearing aids.
      Answer: A) Encourage the patient to dry the ear thoroughly after bathing.

  2. What teaching should the nurse provide to prevent recurrent external otitis?

    • Answer: The nurse should educate the patient to keep the ears dry, avoid inserting foreign objects into the ear canal, use earplugs during swimming, and follow proper hygiene practices to prevent irritation or infection.

Otitis Media

  1. A child diagnosed with otitis media is prescribed amoxicillin. What teaching should the nurse provide to the parents?

    • A) Hair should be kept dry during the antibiotic course.
    • B) The child can stop taking the antibiotic once symptoms improve.
    • C) Complete the full course of antibiotics even if the child feels better.
    • D) Encourage the child to play without rest to strengthen the immune system.
      Answer: C) Complete the full course of antibiotics even if the child feels better.

  2. What are the signs of complications from otitis media, such as mastoiditis?

    • Answer: Signs include persistent ear pain, redness and swelling behind the ear, fever, and tenderness over the mastoid bone. These symptoms require immediate medical attention to prevent further complications.

Tinnitus

  1. A patient presents with constant ringing in their ears. What nursing interventions can help manage this condition?

    • A) Encourage the patient to listen to loud music to distract from the ringing.
    • B) Recommend the use of hearing aids to amplify external sounds.
    • C) Advise the patient to reduce exposure to noise and consider sound therapy.
    • D) Suggest increasing caffeine intake to mitigate symptoms.
      Answer: C) Advise the patient to reduce exposure to noise and consider sound therapy.

  2. What are the potential causes of tinnitus, and how can the nurse address them?

    • Answer: Tinnitus can be caused by exposure to loud noises, age-related hearing loss, ear infections, ototoxic medications, and underlying health conditions like hypertension. The nurse can address them by identifying and mitigating underlying causes, recommending sound therapy, cognitive behavioral therapy, and ensuring medication management to avoid ototoxic drugs.

Vertigo

  1. A patient experiencing vertigo reports dizziness and nausea. What are the most appropriate nursing interventions?

    • A) Encourage the patient to change positions rapidly to alleviate symptoms.
    • B) Provide a clutter-free environment and assist with slow repositioning.
    • C) Administer diuretics as prescribed to reduce dizziness.
    • D) Encourage the patient to consume caffeinated beverages.
      Answer: B) Provide a clutter-free environment and assist with slow repositioning.

  2. Differentiate between peripheral and central vertigo.

    • Answer:
      • Peripheral Vertigo: Caused by issues within the inner ear, such as benign paroxysmal positional vertigo (BPPV) or Meniere’s disease; often accompanied by hearing loss or tinnitus.
      • Central Vertigo: Results from problems in the brain, particularly the cerebellum or brainstem; may be associated with other neurological symptoms like dizziness, double vision, or difficulty walking.

Meniere’s Disease

  1. A patient with Meniere’s disease reports an acute episode. What nursing care is required during this time?

    • A) Encourage the patient to engage in vigorous physical activity.
    • B) Administer anti-nausea medications and provide a quiet environment.
    • C) Suggest the patient avoid all salt intake to reduce fluid retention.
    • D) Advise the patient to expose themselves to bright lights to alleviate symptoms.
      Answer: B) Administer anti-nausea medications and provide a quiet environment.

  2. What lifestyle modifications can the nurse recommend to manage Meniere’s disease effectively?

    • Answer: The nurse can recommend reducing salt intake to minimize fluid retention, avoiding caffeine and alcohol, managing stress, avoiding sudden head movements, and adhering to prescribed medication regimens to control symptoms and prevent acute episodes.

Assessment of Integumentary Function

Skin Integrity Assessment

  1. Describe the steps a nurse should take to assess a patient’s skin integrity.

    • Answer: The nurse should perform a systematic head-to-toe examination, noting skin color, moisture, temperature, texture, and any lesions or abnormalities. Special attention should be given to pressure points, areas of previous injury, and signs of infection or dermatitis.

  2. What are the key components of a skin assessment for a patient with a history of skin cancer?

    • Answer: Key components include inspecting for new or changing moles, irregular borders, asymmetry, color variation, diameter larger than a pencil eraser, and any signs of ulceration or bleeding. Additionally, palpating for any lumps or thickened areas is essential.

Skin Disorders

Bacterial Skin Infections

  1. A patient presents with cellulitis. What are the most appropriate nursing interventions?

    • A) Apply heat to the affected area to reduce swelling.
    • B) Administer prescribed antibiotics and elevate the affected limb.
    • C) Encourage the patient to massage the area to improve circulation.
    • D) Recommend over-the-counter analgesics without a prescription.
      Answer: B) Administer prescribed antibiotics and elevate the affected limb.

  2. What teaching should the nurse provide to prevent recurrent bacterial skin infections?

    • Answer: The nurse should educate the patient on proper skin hygiene, keeping wounds clean and covered, avoiding sharing personal items, promptly treating minor cuts and abrasions, and maintaining overall health to boost the immune system.

Herpes Simplex Virus

  1. A patient with herpes simplex virus (HSV) presents with painful lesions. What nursing interventions can help manage these symptoms?

    • A) Encourage the patient to touch and manipulate the lesions to promote healing.
    • B) Apply warm compresses to reduce pain and discomfort.
    • C) Advise the patient to take high doses of vitamin C supplements.
    • D) Suggest using antiseptic solutions to cleanse the lesions frequently.
      Answer: B) Apply warm compresses to reduce pain and discomfort.

  2. What teaching should the nurse provide to prevent the transmission of HSV?

    • Answer: The nurse should instruct the patient to avoid direct contact with active lesions, practice good hand hygiene, refrain from sharing personal items like towels or razors, use condoms during sexual activity, and inform all sexual partners of the infection status to prevent transmission.

Fungal Infections

  1. A patient with a fungal skin infection reports itching and scaling. What are the most appropriate nursing interventions?

    • A) Encourage the patient to soak the affected area in hot water.
    • B) Apply topical antifungal agents as prescribed and keep the area dry.
    • C) Advise the patient to wear tight-fitting clothing to protect the skin.
    • D) Recommend over-the-counter antibiotic creams.
      Answer: B) Apply topical antifungal agents as prescribed and keep the area dry.

  2. What teaching should the nurse provide to prevent recurrent fungal infections?

    • Answer: The nurse should educate the patient to keep skin clean and dry, wear breathable fabrics, avoid sharing personal items, use antifungal powders or sprays in susceptible areas, and maintain a healthy immune system through proper nutrition and hygiene.

Psoriasis

  1. A patient with psoriasis reports thick, scaly plaques on their elbows and knees. What nursing interventions can help manage these symptoms?

    • A) Apply warm oils to the affected areas to soften scales.
    • B) Encourage the patient to use prescribed topical corticosteroids.
    • C) Advise the patient to avoid moisturizing the skin.
    • D) Suggest skipping medication during flare-ups to assess natural healing.
      Answer: B) Encourage the patient to use prescribed topical corticosteroids.

  2. What are the potential complications of psoriasis, and how can the nurse address them?

    • Answer: Potential complications include psoriatic arthritis, increased risk of cardiovascular disease, and depression. The nurse can address them by ensuring timely referrals to specialists, promoting a healthy lifestyle, providing psychological support, and educating the patient on medication adherence and symptom monitoring.

Skin Trauma

  1. A patient presents with a laceration. What are the steps for proper wound cleaning and dressing?

    • Answer: The nurse should first assess the wound for severity, control any bleeding, clean the area with saline or antiseptic solution, remove any debris, apply an appropriate dressing to protect the wound, and monitor for signs of infection. Tetanus prophylaxis should also be considered if indicated.

  2. What teaching should the nurse provide to prevent infection in a patient with skin trauma?

    • Answer: The nurse should instruct the patient to keep the wound clean and dry, change dressings as prescribed, avoid picking at scabs, use prescribed antibiotics if indicated, and recognize signs of infection such as increased redness, swelling, warmth, or discharge.

Pressure Injuries

  1. A patient with limited mobility is at risk for pressure injuries. What nursing interventions can help prevent them?

    • A) Reposition the patient every two hours and use pressure-relieving devices.
    • B) Encourage the patient to stay in the same position to minimize movement.
    • C) Apply tight bandages to secure the patient in bed.
    • D) Use standard mattresses without additional support.
      Answer: A) Reposition the patient every two hours and use pressure-relieving devices.

  2. Describe the stages of pressure injuries and how the nurse should manage each stage.

    • Answer:
      • Stage I: Non-blanchable erythema of intact skin. Manage by relieving pressure and protecting the area.
      • Stage II: Partial-thickness skin loss with exposed dermis. Manage with appropriate dressings and prevent infection.
      • Stage III: Full-thickness skin loss potentially involving subcutaneous tissue. Manage with advanced wound care and possible surgical intervention.
      • Stage IV: Full-thickness skin and tissue loss with exposed bone, tendon, or muscle. Manage with specialized wound care, infection control, and possible surgical debridement.

Skin Cancer

  1. A patient with a suspicious skin lesion is scheduled for a biopsy. What teaching should the nurse provide?

    • A) Inform the patient that biopsy results will be available immediately.
    • B) Instruct the patient to keep the biopsy site clean and dry, and report any signs of infection.
    • C) Advise the patient to avoid any sun exposure to the biopsy site after healing.
    • D) Recommend using over-the-counter creams to speed up healing.
      Answer: B) Instruct the patient to keep the biopsy site clean and dry, and report any signs of infection.

  2. Differentiate between basal cell carcinoma, squamous cell carcinoma, and melanoma.

    • Answer:
      • Basal Cell Carcinoma: Most common; appears as pearly or waxy bump, rarely metastasizes.
      • Squamous Cell Carcinoma: Presents as firm, red nodules or scaly patches; has a higher risk of metastasis than basal cell carcinoma.
      • Melanoma: Least common but most deadly; characterized by irregular borders, multiple colors, and diameter larger than 6mm.

Reconstructive Surgery

  1. A patient is scheduled for reconstructive surgery following a mastectomy. What preoperative teaching should the nurse provide?

    • A) Inform the patient that mobility will not be restricted post-surgery.
    • B) Explain the importance of maintaining a positive outlook and adhering to postoperative care instructions.
    • C) Advise the patient that no pain management will be necessary after surgery.
    • D) Encourage the patient to sleep immediately after surgery to promote healing.
      Answer: B) Explain the importance of maintaining a positive outlook and adhering to postoperative care instructions.

  2. What are the postoperative nursing priorities for a patient who has undergone reconstructive surgery?

    • Answer: Postoperative priorities include monitoring for signs of infection or complications, managing pain effectively, ensuring proper wound care, assisting with mobility and exercises to prevent lymphedema, providing emotional support, and educating the patient on self-care and follow-up appointments.

References


Last updated January 21, 2025
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