Saudi Prometric Nursing Medical-Surgical Nursing 4 — Questions and Answers
Question 1: The nurse is caring for a patient with a hip fracture who is on Buck's traction. What is the primary purpose of this traction?
- Reduce muscle spasm and pain before surgery (Correct answer)
- Permanently align the fractured bone
- Replace the need for surgical fixation
- Prevent deep vein thrombosis
Correct answer: Reduce muscle spasm and pain before surgery
Buck's traction (skin traction) is used preoperatively for hip fractures to reduce muscle spasm, relieve pain, and maintain alignment until surgical repair. It is not a definitive treatment but a temporary comfort and stabilization measure.
Question 2: A patient is diagnosed with hyperthyroidism. Which symptom is most expected?
- Tachycardia, weight loss, and heat intolerance (Correct answer)
- Bradycardia, weight gain, and cold intolerance
- Muscle weakness and hypercalcemia
- Hypotension and fatigue
Correct answer: Tachycardia, weight loss, and heat intolerance
Hyperthyroidism (excess thyroid hormone) causes increased metabolic rate, resulting in tachycardia, weight loss despite increased appetite, heat intolerance, diaphoresis, and nervousness. These are the opposite of hypothyroid symptoms.
Question 3: A nurse is inserting a peripheral IV catheter. Which vein is preferred for the initial attempt in an adult?
- Distal veins of the forearm or dorsum of the hand (Correct answer)
- Antecubital fossa (AC) vein
- Femoral vein
- Internal jugular vein
Correct answer: Distal veins of the forearm or dorsum of the hand
Peripheral IV cannulation should start distally (forearm/dorsum of hand) and proceed proximally if needed. Starting distally preserves more proximal options if the distal site fails. The AC is avoided for routine access as it limits arm movement.
Question 4: A patient with a chest tube is being transported. Which action is correct?
- Keep the drainage system below the level of the chest at all times (Correct answer)
- Clamp the chest tube during transport
- Disconnect the chest tube from the drainage system
- Place the drainage system on the patient's lap
Correct answer: Keep the drainage system below the level of the chest at all times
The chest tube drainage system must always remain below the level of the chest to allow gravity drainage and prevent fluid from draining back into the pleural space. Clamping is only done per specific orders and briefly.
Question 5: A patient post-gastrectomy experiences dizziness, sweating, and palpitations 30 minutes after eating. This presentation is most consistent with:
- Dumping syndrome (Correct answer)
- Reactive hypoglycemia
- Anastomotic leak
- Aspiration pneumonia
Correct answer: Dumping syndrome
Early dumping syndrome occurs 15–30 minutes after eating in post-gastrectomy patients when undigested food rapidly enters the small intestine, causing fluid shifts and vasomotor symptoms like dizziness, sweating, and palpitations.
Question 6: The nurse is caring for a patient with Cushing's syndrome. Which assessment finding is expected?
- Moon face, buffalo hump, and purple striae (Correct answer)
- Thin, wasted appearance with bronze skin
- Hypotension and weight loss
- Hair loss and dry skin
Correct answer: Moon face, buffalo hump, and purple striae
Cushing's syndrome results from excess cortisol and causes characteristic features: moon face (facial fat redistribution), buffalo hump (fat deposit at nape of neck), purple striae (stretch marks), central obesity, and hypertension.
Saudi Prometric Nursing Medical-Surgical Nursing 4
The nurse is caring for a patient with a hip fracture who is on Buck's traction.
What is the primary purpose of this traction?