Free CMSRN Medical-Surgical Nursing General Questions and Answers — Questions and Answers
Question 1: On the day of operation, a patient with type 2 diabetes mellitus is admitted, and their glucose level is 610 mg/dl. The patient may be at risk for the following, according to the perianesthesia nurse:
- Hyperkalemia (Correct answer)
- Diabetic Ketoacidosis
- Hyperalcemia
- Diabetic Inspidu
Correct answer: Hyperkalemia
The patient is at risk for "Diabetic ketoacidosis (DKA)," a dangerous consequence of diabetes marked by hyperglycemia, ketosis, and metabolic acidosis, if they have a history of type 2 diabetes mellitus and a glucose level of 610 mg/dl upon admission. Patients with type 1 diabetes are most affected, however people with type 2 diabetes may also experience it, particularly after stressful procedures like surgery. As a result, the perianesthesia nurse needs to watch out for any indications that the patient is experiencing DKA. In the setting of type 2 diabetes mellitus, uncontrolled hyperglycemia is generally not associated with hypercalcemia, diabetes insipidus, or hyperkalemia.
Question 2: Shana was diagnosed with gastroesophageal reflux disease following an EGD (GERD). Edna is taught by the nurse how to reduce symptoms. Which of the following Edna statements suggests that more instruction is required?
- “I will try to eat smaller meals more frequently.”
- “I will sleep with the head of the bed elevated about 12 inches.”
- “I will be sure to drink tea instead of coffee.” (Correct answer)
- “I will take a walk after I eat.”
Correct answer: “I will be sure to drink tea instead of coffee.”
Explanation: <br> The client with GERD is encouraged to eat smaller, low-fat frequent meals and to avoid lying down after eating. Clients are instructed not to eat for at least 2 hours before bedtime and avoid foods that decrease lower esophageal pressure, such as anything containing caffeine (coffee, tea, cola, chocolate).
Question 3: Before being released, a patient with a fractured left leg must learn the three-point gait. Which directive ought the nurse to deliver to this patient?
- “Move your right crutch and left foot forward together, and then swing the right foot and left crutch in one movement.”
- “Advance your right crutch, swing the left foot forward, advance the left crutch, and then bring the right foot forward.”
- “Using one movement, advance your left foot and both crutches and then bring right leg forward.” (Correct answer)
- “While partially bearing weight on your left leg, advance both crutches and then bring your right leg forward.”
Correct answer: “Using one movement, advance your left foot and both crutches and then bring right leg forward.”
Explanation: <br> In the three-point gait, both crutches and the affected “bad” leg and foot moved together, with the unaffected “good” leg and foot following.
Question 4: A customer who had suffered an amputation is being urged by the nurse to put on a prosthetic right away. The benefit of taking this quick action is
- Better fit of the prosthesis
- Ability to ambulate sooner (Correct answer)
- Less chance of phantom limb sensation
- Dressing changes are not necessary
Correct answer: Ability to ambulate sooner
Explanation: <br> When the prosthesis is in place immediately following surgery, the client can stand up several hours postoperatively and walk the next day. The operative site is closed to outside contamination and benefits from improved circulation due to ambulation.
Question 5: Mr. Scott, a 55-year-old mechanic, was diagnosed with adult-onset diabetes. The nurse will know that Mr. Daniels understands the symptoms of a hyperglycemic reaction if he verbalized,
- “I may feel nauseated, even vomiting, and some episodes of diarrhea.”
- “I will experience weight gain, a normal breath, and constant thirst.”
- “I will experience thirst, always going to the bathroom to pee, and will also have decreased appetite.”
- “I may feel flushed cheeks, will have acetone breath, and increased thirst.” (Correct answer)
Correct answer: “I may feel flushed cheeks, will have acetone breath, and increased thirst.”
Explanation: <br> “I may feel flushed cheeks, will have acetone breath, and increased thirst”, is the statement that the client understands the manifestations of a hyperglycemic reaction.
Question 6: Millet, age 32, visited a day clinic to report a sudden weight gain. She also reported to the nurse on duty that her abdomen is now bigger than before and her face looks “swollen” and rounded. Which additional assessment finding would lead the nurse to suspect that Millet has Cushing’s syndrome rather than obesity?
- Posterior neck fat pad and thin extremities (Correct answer)
- Large thighs and upper arms
- Pendulous abdomen and large hips
Correct answer: Posterior neck fat pad and thin extremities
Explanation: <br> Posterior neck fat pad and thin extremities are also noted in a client with Cushing’s syndrome. “Buffalo hump” is the accumulation of fat pads over the upper back and neck. Fat may also accumulate on the face, which suggest a “swollen” and rounded face. There is truncal obesity but the extremities are thin.
Question 7: The nurse's most accurate explanation of a thyroid scan to a colleague is that it:
- Measures the effect of TSH on thyroid function.
- Demonstrates decreased uptake of radioactive iodine in areas of possible malignancy. (Correct answer)
- Demonstrates increased uptake of radioactive iodine in areas of possible malignancy.
- Assists in differentiating between primary and secondary hypothyroidism.
Correct answer: Demonstrates decreased uptake of radioactive iodine in areas of possible malignancy.
Explanation: <br> A thyroid scan utilizes the uptake of radioactive iodine by the thyroid gland to determine the size, shape, and function of the gland.
Question 8: Twelve-year-old Shane loves skateboarding a lot. On her first attempt at learning the movements, she unintentionally fell. She was subsequently taken to the Emergency Department, where she was in excruciating pain. The left tibia's incomplete fracture was seen on the X-ray film. Her left leg was cast after the doctor prescribed a closed reduction. Which of the following is not the right way to help Shane?
- Exercise her toe
- Support Shane’s foot with the ankle in 90 degrees of flexion.
- Create a turning schedule for position changes every 3 hours. (Correct answer)
- Elevate entire extremity higher than the client’s heart for the first 24 to 48 hours.
Correct answer: Create a turning schedule for position changes every 3 hours.
The wrong kind of intervention is to design a turning timetable for position adjustments every three hours. It is recommended to arrange position changes every two hours in order to prevent deep vein thrombosis, pneumonia, and skin disintegration that can occur from immobility. For a client with closed reduction, the remaining options represent appropriate nursing interventions.
Question 9: An autoimmune condition known as Hashimoto's disease has been identified in Ms. JMM. Which of the following descriptions of the client's indications and symptoms most likely contributed to the diagnosis?
- Increased urination, weight gain, and purplish red striae
- Increased appetite, weight loss, hyperdefecation
- Increased urination, weight loss, increased thirst
- Decreased appetite, weight gain, constipation (Correct answer)
Correct answer: Decreased appetite, weight gain, constipation
Constipation, weight gain, and decreased appetite are signs of Hashimoto's disease, the most prevalent cause of hypothyroidism among clients. Additionally, fatigue, brittle nails, coarse hair, cramping in the muscles, weakness, and apnea are symptoms to be aware of. Choice A exhibits hyperthyroidism symptoms. Choice B's symptoms are indicative of uncontrolled diabetic mellitus. The symptoms listed in option D are indicative of hypercortisolism.
Question 10: Mrs. Jones, a known diabetic, is being taught by the nurse how to use a glucometer to check her blood sugar. The nurse will be able to determine that Mrs. Jones is capable of doing her fingerstick blood collection when she:
- uses the side of a fingertip as the puncture site. (Correct answer)
- avoids using the thumbs as puncture sites.
- avoids using the fingers of her dominant hand as puncture sites.
- uses the ball of a finger as the puncture site.
Correct answer: uses the side of a fingertip as the puncture site.
Verifying that the customer has understood the health instruction on using a glucometer to monitor blood glucose is done by puncturing the side of the fingertip. Because the sides of the fingertips contain fewer nerve endings than the balls of the finger, choosing the sides as the puncture sites will cause less agony. Thumbs and both hands can be utilized as puncture sites.
Question 11: The nurse should arrange for the following after a thyroid scan using radioactive iodine to check for a thyroid nodule:
- Radiation precautions that are limited to urine and feces.
- No special radiations precautions. (Correct answer)
- Complete radiation safety measures, such as putting the client in a separate room, must be implemented.
- Full radiation precautions to be instituted for 8 hours (the half-life of radioactive iodine).
Correct answer: No special radiations precautions.
After injecting radioactive iodine for the thyroid scan, no radiation protection measures are required. Option B relates to implants made of radium. When radioactive iodine therapy is used to reduce and regulate thyroid hypersecretion (hyperthyroidism), option C may be used. Option 4 does not represent standard radiation therapy practice.
Free CMSRN Medical-Surgical Nursing General Questions and Answers
On the day of operation, a patient with type 2 diabetes mellitus is admitted, and their glucose level is 610 mg/dl.
The patient may be at risk for the following, according to the perianesthesia nurse: