Download MCQs for Nursing students 2

MCQ for Nursing Students 2
A child is admitted to the hospital with a diagnosis of Wilms tumor, stage II.
Which of the following statements most accurately describes this stage?
A. The tumor is less than 3 cm. in size and requires no chemotherapy.
B. The tumor did not extend beyond the kidney and was completely resected.
C. The tumor extended beyond the kidney but was completely resected.
D. The tumor has spread into the abdominal cavity and cannot be resected.
The answer is C. The tumor extended beyond the kidney but was completely resected.
The staging of Wilms tumor is confirmed at surgery as follows: Stage I, the tumor is limited
to the kidney and completely resected; stage II, the tumor extends beyond the kidney
but is completely resected; stage III, residual non hematogenous tumor is confined to
the abdomen; stage IV, hematogenous metastasis has occurred with spread beyond the
abdomen; and stage V, bilateral renal involvement is present at diagnosis.
A teen patient is admitted to the hospital by his physician who suspects a
diagnosis of acute glomerulonephritis. Which of the following findings is
consistent with this diagnosis? Note: More than one answer may be correct.
A. Urine specific gravity of 1.040.
B. Urine output of 350 ml in 24 hours.
C. Brown (“tea-colored”) urine.
D. Generalized edema.
The answer is A, B, and C
Acute glomerulonephritis is characterized by high urine specific gravity
related to oliguria as well as dark “tea colored” urine caused by large
amounts of red blood cells. There is periorbital edema, but generalized
edema is seen in nephrotic syndrome, not acute glomerulonephritis.
Which of the following conditions most commonly causes acute
glomerulonephritis?
A. A congenital condition leading to renal dysfunction.
B. Prior infection with group A Streptococcus within the past 10-14
days.
C. Viral infection of the glomeruli.
D. Nephrotic syndrome.
The answer is B. Prior infection with group A Streptococcus within the past 10-14 days.
Acute glomerulonephritis is most commonly caused by the immune response to a prior
upper respiratory infection with group A Streptococcus. Glomerular inflammation
occurs about 10-14 days after the infection, resulting in scant, dark urine and retention
of body fluid. Periorbital edema and hypertension are common signs at diagnosis.
An infant with hydrocele is seen in the clinic for a follow-up visit at 1 month of age. The
scrotum is smaller than it was at birth, but fluid is still visible on illumination. Which of
the following actions is the physician likely to recommend
A. Massaging the groin area twice a day until the fluid is gone.
B. Referral to a surgeon for repair.
C. No treatment is necessary; the fluid will be reabsorbed normally.
D. Keeping the infant in a flat, supine position until the fluid is gone.
The answer is C. No treatment is necessary; the fluid is reabsorbing normally.
A hydrocele is a collection of fluid in the scrotum that results from a patent tunica
vaginalis. Illumination of the scrotum with a pocket light demonstrates the clear
fluid. In most cases the fluid reabsorbs within the first few months of life and no
treatment is necessary. Massaging the area or placing the infant in a supine
position would have no effect. Surgery is not indicated.
A nurse is caring for a patient with peripheral vascular disease (PVD). The patient
complains of burning and tingling of the hands and feet and cannot tolerate touch of
any kind. Which of the following is the most likely explanation for these symptoms?
A. Inadequate tissue perfusion leading to nerve damage.
B. Fluid overload leading to compression of nerve tissue.
C. Sensation distortion due to psychiatric disturbance.
D. Inflammation of the skin on the hands and feet.
The answer is
A. Inadequate tissue perfusion leading to nerve damage.
Patients with peripheral vascular disease often sustain nerve damage as a result of
inadequate tissue perfusion. Fluid overload is not characteristic of PVD. There is
nothing to indicate psychiatric disturbance in the patient. Skin changes in PVD
are secondary to decreased tissue perfusion rather than primary inflammation.
A nurse is assessing a clinic patient with a diagnosis of hepatitis A. Which of the
following is the most likely route of transmission?
A. Sexual contact with an infected partner.
B. Contaminated food.
C. Blood transfusion.
D. Illegal drug use.
The answer is B. Contaminated food.
Hepatitis A is the only type that is transmitted by the fecal-oral route
through contaminated food. Hepatitis B, C, and D are transmitted
through infected bodily fluids.
A leukemia patient has a relative who wants to donate blood for transfusion.
Which of the following donor medical conditions would prevent this?
A. A history of hepatitis C five years previously.
B. Cholecystitis requiring cholecystectomy one year previously.
C. Asymptomatic diverticulosis.
D. Crohn’s disease in remission.
A history of hepatitis C five years previously.
Hepatitis C is a viral infection transmitted through bodily fluids, such as blood,
causing inflammation of the liver. Patients with hepatitis C may not donate
blood for transfusion due to the high risk of infection in the recipient.
Cholecystitis (gallbladder disease), diverticulosis, and history of Crohn’s disease
do not preclude blood donation.
The answer is A.
A physician has diagnosed acute gastritis in a clinic patient. Which of the
following medications would be contraindicated for this patient?
A. Naproxen sodium (Naprosyn).
B. Calcium carbonate.
C. Clarithromycin (Biaxin).
D. Furosemide (Lasix).
The answer is A. Naproxen sodium (Naprosyn).
Naproxen sodium is a nonsteroidal anti-inflammatory drug that can cause inflammation of
the upper GI tract. For this reason, it is contraindicated in a patient with gastritis.
Calcium carbonate is used as an antacid for the relief of indigestion and is not
contraindicated. Clarithromycin is an antibacterial often used for the treatment of
Helicobacter pylori in gastritis. Furosemide is a loop diuretic and is contraindicated in a
patient with gastritis.
The nurse is conducting nutrition counseling for a patient with cholecystitis.
Which of the following information is important to communicate?
A. The patient must maintain a low calorie diet.
B. The patient must maintain a high protein/low carbohydrate diet.
C. The patient should limit sweets and sugary drinks.
D. The patient should limit fatty foods.
The answer is D. The patient should limit fatty foods.
Cholecystitis, inflammation of the gallbladder, is most commonly caused
by the presence of gallstones, which may block bile (necessary for fat
absorption) from entering the intestines. Patients should decrease dietary
fat by limiting foods like fatty meats, fried foods, and creamy desserts to
avoid irritation of the gallbladder.
. A patient admitted to the hospital with myocardial infarction develops severe
pulmonary edema. Which of the following symptoms should the nurse expect the
patient to exhibit?
A. Slow, deep respirations.
B. Stridor.
C. Bradycardia.
D. Air hunger.
Answer: D. Air hunger.
Patients with pulmonary edema experience air hunger, anxiety, and agitation. Respiration
is fast and shallow and heart rate increases. Stridor is noisy breathing caused by
laryngeal swelling or spasm and is not associated with pulmonary edema.
A nurse is evaluating a postoperative patient and notes a moderate amount of
serous drainage on the dressing 24 hours after surgery. Which of the following is
the appropriate nursing action?
A. Notify the surgeon about evidence of infection immediately.
B. Leave the dressing intact to avoid disturbing the wound site.
C. Remove the dressing and leave the wound site open to air.
D. Change the dressing and document the clean appearance of the
wound site.
The answer is D.
Change the dressing and document the clean appearance of the wound site.
A moderate amount of serous drainage from a recent surgical site is a sign of normal healing. Purulent
drainage would indicate the presence of infection. A soiled dressing should be changed to avoid
bacterial growth and to examine the appearance of the wound. The surgical site is typically covered by
gauze dressings for a minimum of 48-72 hours to ensure that initial healing has begun.
A patient returns to the emergency department less than 24 hours after having a
fiberglass cast applied for a fractured right radius. Which of the following patient
complaints would cause the nurse to be concerned about impaired perfusion to the
limb?
A. Severe itching under the cast.
B. Severe pain in the right shoulder.
C. Severe pain in the right lower arm.
D. Increased warmth in the fingers.
Severe pain in the right lower arm.
Impaired perfusion to the right lower arm as a result of a closed cast may cause
neurovascular compromise and severe pain, requiring immediate cast removal. Itching
under the cast is common and fairly benign. Neurovascular compromise in the arm
would not cause pain in the shoulder, as perfusion there would not be affected.
Impaired perfusion would cause the fingers to be cool and pale. Increased warmth
would indicate increased blood flow or infection.
The answer is
C.
An older patient with osteoarthritis is preparing for discharge. Which of the
following information is correct.
A. Increased physical activity and daily exercise will help decrease discomfort
associated with the condition.
B. Joint pain will diminish after a full night of rest.
C. Nonsteroidal anti-inflammatory medications should be taken on an empty
stomach.
D. Acetaminophen (Tylenol) is a more effective anti-inflammatory than
ibuprofen (Motrin).
The answer is : A. Increased physical activity and daily exercise will help
decrease discomfort associated with the condition.
Physical activity and daily exercise can help to improve movement and
decrease pain in osteoarthritis. Joint pain and stiffness are often at their
worst during the early morning after several hours of decreased
movement. Acetaminophen is a pain reliever, but does not have antiinflammatory activity. Ibuprofen is a strong anti-inflammatory, but
should always be taken with food to avoid GI distress.
Which patient should NOT be prescribed alendronate (Fosamax) for
osteoporosis?
A. A female patient being treated for high blood pressure with an ACE
inhibitor.
B. A patient who is allergic to iodine/shellfish.
C. A patient on a calorie restricted diet.
D. A patient on bed rest who must maintain a supine position.
The answer is D.
A patient on bed rest who must maintain a supine position.
Alendronate can cause significant gastrointestinal side effects, such as esophageal
irritation, so it should not be taken if a patient must stay in supine position. It
should be taken upon rising in the morning with 8 ounces of water on an empty
stomach to increase absorption. The patient should not eat or drink for 30
minutes after administration and should not lie down. ACE inhibitors are not
contraindicated with alendronate and there is no iodine allergy relationship.
Which of the following strategies is NOT effective for prevention of Lyme
disease?
A. Insect repellant on the skin and clothes when in a Lyme endemic
area.
B. Long sleeved shirts and long pants.
C. Prophylactic antibiotic therapy prior to anticipated exposure to ticks.
D. Careful examination of skin and hair for ticks following anticipated
exposure.
Prophylactic antibiotic therapy prior to anticipated exposure to ticks.
Prophylactic use of antibiotics is not indicated to prevent Lyme disease. Antibiotics
are used only when symptoms develop following a tick bite. Insect repellant
should be used on skin and clothing when exposure is anticipated. Clothing should
be designed to cover as much exposed area as possible to provide an effective
barrier. Close examination of skin and hair can reveal the presence of a tick before a
bite occurs.
Answer: is C.
A nurse is performing routine assessment of an IV site in a patient receiving both
IV fluids and medications through the line. Which of the following would
indicate the need for discontinuation of the IV line as the next nursing action?
A. The patient complains of pain on movement.
B. The area proximal to the insertion site is reddened, warm, and
painful.
C. The IV solution is infusing too slowly, particularly when the limb is
elevated.
D. A hematoma is visible in the area of the IV insertion site.
The area proximal to the insertion site is reddened, warm, and painful.
An IV site that is red, warm, painful and swollen indicates that phlebitis has developed and the
line should be discontinued and restarted at another site. Pain on movement should be
managed by maneuvers such as splinting the limb with an IV board or gently shifting the
position of the catheter before making a decision to remove the line. An IV line that is
running slowly may simply need flushing or repositioning. A hematoma at the site is likely a
result of minor bleeding at the time of insertion and does not require discontinuation of the
line.
The answer is B.
A hospitalized patient has received transfusions of 2 units of blood over the past few
hours. A nurse enters the room to find the patient sitting up in bed, dyspneic and
uncomfortable. On assessment, crackles are heard in the bases of both lungs, probably
indicating that the patient is experiencing a complication of transfusion. Which of the
following complications is most likely the cause of the patient’s symptoms?
A. Febrile non-hemolytic reaction.
B. Allergic transfusion reaction.
C. Acute hemolytic reaction.
D. Fluid overload.
The answer is D. Fluid overload.
Fluid overload occurs when then the fluid volume infused over a short period is too great
for the vascular system, causing fluid leak into the lungs. Symptoms include dyspnea,
rapid respirations, and discomfort as in the patient described. Febrile non-hemolytic
reaction results in fever. Symptoms of allergic transfusion reaction would include
flushing, itching, and a generalized rash. Acute hemolytic reaction may occur when a
patient receives blood that is incompatible with his blood type. It is the most serious
adverse transfusion reaction and can cause shock and death.
A patient in labor and delivery has just received an amniotomy. Which of the
following is correct? Note: More than one answer may be correct.
A. Frequent checks for cervical dilation will be needed after the
procedure.
B. Contractions may rapidly become stronger and closer together after
the procedure.
C. The FHR (fetal heart rate) will be followed closely after the
procedure due to the possibility of cord compression.
D. The procedure is usually painless and is followed by a gush
of amniotic fluid.
The answer is B, C, and D
Uterine contractions typically become stronger and occur more closely together
following amniotomy. The FHR is assessed immediately after the procedure and
followed closely to detect changes that may indicate cord compression. The
procedure itself is painless and results in the quick expulsion of amniotic fluid.
Following amniotomy, cervical checks are minimized because of the risk of
infection
A nurse is counseling the mother of a newborn infant with hyperbilirubinemia.
Which of the following instructions by the nurse is NOT correct?
A. Continue to breastfeed frequently, at least every 2-4 hours.
B. Follow up with the infant’s physician within 72 hours of discharge
for a recheck of the serum bilirubin and exam.
C. Watch for signs of dehydration, including decreased urinary output
and changes in skin turgor.
D. Keep the baby quiet and swaddled, and place the bassinet in a dimly
lit area.
The answer is D. Keep the baby quiet and swaddled, and place the bassinet in a dimly lit
area.
An infant discharged home with hyperbilirubinemia (newborn jaundice) should be placed in a
sunny rather than dimly lit area with skin exposed to help process the bilirubin. Frequent
feedings will help to metabolize the bilirubin. A recheck of the serum bilirubin and a
physical exam within 72 hours will confirm that the level is falling and the infant is thriving
and is well hydrated. Signs of dehydration, including decreased urine output and skin
changes, indicate inadequate fluid intake and will worsen the hyperbilirubinemia.
A nurse is giving discharge instructions to the parents of a healthy newborn.
Which of the following instructions should the nurse provide regarding car
safety and the trip home from the hospital?
A. The infant should be restrained in an infant car seat, properly secured in the
back seat in a rear-facing position.
B. The infant should be restrained in an infant car seat, properly secured in the
front passenger seat.
C. The infant should be restrained in an infant car seat facing forward or rearward
in the back seat.
D. For the trip home from the hospital, the parent may sit in the back seat and hold
thenewborn.
The answer is A. The infant should be restrained in an infant car seat, properly secured
in the back seat in a rear-facing position.
All infants under 1 year of age weighing less than 20 lbs. should be placed in a rear-facing
infant car seat secured properly in the back seat. Infant car seats should never be placed
in the front passenger seat. Infants should always be placed in an approved car seat
during travel, even on that first ride home from the hospital.
An infant
A. Massaging
The answer is A, B, C, D, E