DHA Nursing Medical-Surgical Nursing 1 — Questions and Answers
Question 1: A patient post-coronary artery bypass graft (CABG) reports sudden onset chest pain and shortness of breath on day 2. What should the nurse assess first?
- Airway, breathing, and circulation (ABCs) (Correct answer)
- Pain scale rating
- Last bowel movement
- Urine output only
Correct answer: Airway, breathing, and circulation (ABCs)
Following cardiac surgery, sudden chest pain and dyspnoea may indicate life-threatening complications such as cardiac tamponade or pulmonary embolism, requiring immediate ABC assessment.
Question 2: Which laboratory value is the primary indicator of kidney function monitored in medical-surgical patients?
- Serum creatinine (Correct answer)
- Haemoglobin
- Serum albumin
- White blood cell count
Correct answer: Serum creatinine
Serum creatinine is the most reliable routine indicator of glomerular filtration rate and overall kidney function in clinical settings.
Question 3: What is the correct nursing intervention for a patient experiencing a generalised tonic-clonic seizure?
- Protect the patient from injury, position on side, and time the seizure (Correct answer)
- Restrain the patient's limbs firmly
- Insert a tongue depressor to prevent biting
- Give oral medication immediately
Correct answer: Protect the patient from injury, position on side, and time the seizure
During a seizure, nurses must protect the patient from injury, turn them to the side to prevent aspiration, and time the event to guide medical management.
Question 4: In a patient with a nasogastric (NG) tube, how should the nurse verify correct tube placement before feeding?
- Aspirate gastric contents and check pH (≤5.5) or confirm with X-ray (Correct answer)
- Listen for air insufflation sounds only
- Test with litmus paper placed in the mouth
- Rely on patient comfort as indicator
Correct answer: Aspirate gastric contents and check pH (≤5.5) or confirm with X-ray
Aspirating gastric contents and checking pH ≤5.5 or confirming with X-ray are evidence-based methods to verify NG tube placement and prevent aspiration.
Question 5: Which complication is most commonly associated with prolonged bed rest in post-surgical patients?
- Deep vein thrombosis (DVT) (Correct answer)
- Hyperglycaemia
- Hypertension
- Hyperkalaemia
Correct answer: Deep vein thrombosis (DVT)
Venous stasis from immobility during prolonged bed rest is the primary risk factor for deep vein thrombosis in post-surgical patients.
Question 6: A patient with type 2 diabetes is NPO for surgery. Which nursing action is most important regarding their antidiabetic medications?
- Clarify with the physician which medications to hold or adjust (Correct answer)
- Administer all medications as prescribed regardless
- Double the morning insulin dose
- Discontinue all medications permanently
Correct answer: Clarify with the physician which medications to hold or adjust
NPO status and surgical stress alter glucose metabolism; the nurse must clarify medication orders with the physician to prevent hypoglycaemia or dangerous hyperglycaemia.
DHA Nursing Medical-Surgical Nursing 1
A patient post-coronary artery bypass graft (CABG) reports sudden onset chest pain and shortness of breath on day 2.
What should the nurse assess first?