Practice Test 1
A nurse is encouraging a post-operative patient to cough and to take deep breaths. This nursing action is due to the understanding by the nurse that retaining of pulmonary secretions can lead to
- Carbon dioxide retention
- Imbalance in fluid
- Pulmonary edema
Correct Answer : A. Pneumonia
Coughing and deep breathing exercises help to prevent post- operative complication: pneumonia. In pneumonia, there is inflammation of lung tissue which produces cough, crackles and dyspnea. The other above-mentioned situations would not arise because of retaining pulmonary secretions.
A patient with severe burns is scheduled for surgery for an allograft of right leg. What must be considered as the post-operative plan of care for this patient?
- Keep blanket above the right leg
- Keep the patient in prone position
- Immobilize and elevate the right leg
- Keep the right leg flat
- Mobilize the right leg
Correct Answer : C. Immobilize and elevate the right leg
The grafted right leg must be kept immobilized and elevated. This makes the graft get adhered to the wound and reduces edema. This also helps in wound healing and prevention of further complications. All other above-mentioned actions will disrupt the grafted site.
A nurse works in a community that has recently experienced a hurricane. The nurse tries to find housing and counsels for those in need. Which level of prevention does the nurse represent?
- Primary level
- Primary and secondary levels
- Secondary level
- Tertiary level
- Fourth level
Correct Answer : D. Tertiary level
The nurse represents tertiary level of prevention. There is reduction in the amount and degree of disability after the crisis. The injury and damage is possibly reduced following the crisis. The other above-mentioned levels are not seen in the activities that the nurse represents.
When caring for a patient posted for surgery, the nurse finds that the patient is not able to sign the consent form due to narcotic analgesic administration. Who should sign the consent instead of the patient?
- Court signs the consent
- Patient can go to surgery without a consent
- The hospital chaplain should sign the consent
- One family member can sign with two witnesses’ signatures
- Nurse can sign the consent
Correct Answer : D. One family member can sign with 2 witnesses’ signatures
The nurse can make one family member’s sign the consent with two witnesses’ signatures. The patient can go to surgery without consent only during emergency surgeries and when every effort to contact the family has failed. All other above-mentioned options are invalid for surgery.
When a nurse from a surgical unit is floated to the general unit, which of the following patients must be assigned to him/her?
- Heart failure
- New onset Type II- Diabetes
- Emergency appendectomy
Correct Answer : C. Emergency appendectomy
A nurse from a surgical unit will be comfortable in dealing with pre or post-operative patients. So the nurse can be assigned an emergency appendectomy patient. All other above-mentioned diagnosis are medical conditions which do not need immediate surgical intervention.
An 88-year-old woman is posted for surgery. Which of the following consent processes needs to be followed by a nurse in this case?
- Family members should sign the consent
- Provide adequate time for the patient to process the information and sign
- Ask the patient to sign immediately
- Ask her to go through the written instructions and sign immediately
- Explain to her that she is too old to sign the consent
Correct Answer : B. Provide adequate time for the patient to process the information and sign
Older patients must be given adequate time to process the information. The patient can sign the consent when oriented and possible. Asking her to sign immediately and providing with written instructions to sign immediately will not help the elderly patient, as she shall need time to process the information.
A hurricane warning was issued and the nurses of a hospital were asked to open a shelter. Which of the following would the nurses encourage the public to bring to the shelter?
- Medication and medical records
- Other electronics
Correct Answer : D. Medication and medical records
Medication and medical records must be brought to the shelter because after a hurricane, drugs cannot be purchased immediately. Some people can have chronic diseases and could be on medication. Space will be limited in the shelter so all other above mentioned things cannot be brought to the shelter. Animals are not allowed in a shelter.
A nurse is caring for a patient with radical neck dissection. The endo-tracheal tube was removed a few minutes ago. When observing which of the following must the nurse call the physician?
- Pink-tinged sputum occasionally
- Respiratory rate 24 breaths per minute
- Basilar crackles in right side
- Occasional cough
Correct Answer : A. Stridor
The physician must be notified when the patient develops stridor. Stridor is a loud-pitched coarse sound heard over the trachea. This indicates the presence of airway edema. This can put the patient at risk of airway blockage. Other above-mentioned symptoms are commonly present after E-T tube removal.
A nurse is caring for a patient who is posted for surgery. Which of the following would make the nurse suspect that the patient is in cardiogenic shock?
- Muffled heart sounds
- Cardiac index greater than 2.2 L/min
- Bounding pulses
- Increased cardiac output
- Increased heart sounds
Correct Answer : A. Muffled heart sounds
In cardiogenic shock, there will be muffled heart sounds or decreased heart sounds. This is caused by myocardium’s decreased ability to pump blood. This is due to weakening by blood or fluid, which causes decreased cardiac index, decreased cardiac output and weak, thread pulse. All other above-mentioned symptoms are not related to cardiogenic shock.
A nurse is caring for a patient with burn in knee. The patient has undergone autograft and grafting to burn site. Which of the following order prescribed is appropriate for this patient?
- Immobilization of the affected knee
- Mobilization of the patient out of bed
- Placing the affected extremity in a dependent position
- Massaging the extremity
- Changing the extremity to different positions
Correct Answer : A. Immobilization of the affected knee
The physician’s order will be to immobilize the affected knee. The autograft placed over the joint would require the patient to keep it immobilized for three to seven days. This helps the graft to adhere properly. All other above-mentioned options can disrupt the grafted site.
A nurse is caring for a patient who is being prepared for surgery. The patient has history of alcohol abuse. Which of the following would be risky for the patient undergoing surgery?
- Impaired liver metabolism
- CNS stimulation
- Intact liver metabolism
Correct Answer : A. Impaired liver metabolism
During surgery, the patient will be administered with drugs, which can have increased effectiveness because of impaired liver metabolism. The patient will not be able to filter out the drugs properly. All other above-mentioned symptoms are not risky for the patient undergoing surgery.
12. What is the beneficial feature after an escharotomy?
- Appearance of granulation tissue
- Bleeding from the site
- Reduced edema
- Palpable distal pulses
- Redness in and around the site
Correct Answer : D. Palpable distal pulses
Escharotomy aims at curing compartment syndrome along with the palpable distal pulses. Bleeding occurs as a complication, with redness in and around the site. Appearance of granulation tissue and reduced edema are not therapeutic effects of escharotomy.
A patient is having high fever, tachycardia and sweating. He is in hyper metabolic condition. Which of the following medication would have caused this malignant hyperpyrexia in this patient?
Correct Answer : B. Sevoflurane
Sevoflurane’s side effect is malignant hyperpyrexia. It is used as a gaseous anesthetic agent. It is predominantly given for gaseous induction and maintenance. Suxamethonium is also known to cause malignant hyperpyrexia. Dantrolene is a cure for malignant hyperpyrexia. All other above-mentioned drugs are not associated with malignant hyperpyrexia.
Which of the following is not true regarding rapid sequence induction in anesthesia?
- Ketamine can be used as an induction agent
- Cricoid pressure is needed
- ET tube is needed for airway
- Administration of suxamethonium
- BVM for oxygenation
Correct Answer : E. BVM for oxygenation
Bag valve mask ventilation is not used. The patient can haveair accumulation in the stomach, when BVM is used. There are chances of aspiration because of high intra-gastric pressure. The patient must be oxygenated first, by using high flow oxygen before anesthesia administration. Bagging must not be performed, except during resuscitation. All other above-mentioned options are correct in rapid sequence induction.
Which one of the following is considered wrong regarding surgical emphysema in the chest, by a nurse?
- It is a medical emergency
- It occurs usually after thoracic surgeries
- It occurs due to perforated esophagus
- It appears on apices of chest x-ray
- It occurs due to COPD
Correct Answer : E. It occurs due to COPD
Surgical emphysema is not caused by COPD. Surgical emphysema is an emergency condition. There will be a finding of air, seen within the subcutaneous tissues of the thorax in chest X-ray. Perforated esophagus is known to cause it. The air moves up till the neck. It obstructs the airway and may also go down the arms.