GARDEN CITY UNIVERSITY COLLEGESCHOOL OF NURSING

Index Number............................................................... Section A Time Allowed: 45 minutesMOCK EXAMINATION, AUGUST 2014SURGERY AND SURGICAL NURSINGTIME ALLOWED 45 minutesCANDIDATES No. NAMENote. For each of the following questions select the most appropriate and write in the space provided (Ans..)1. A client has a bone marrow aspiration performed. After the procedure, what is the first nursing action? a. Begin frequent monitoring of the clients vital signsb. Cleanse the area with an antiseptic lotionc. Position the client on the affected site d. Briefly apply pressure over the aspiration site Ans

2. After a client has had cardiac surgery the nurse suspects the following signs of cardiac tamponade EXEPT ?a. Increased central venous pressureb. Jugular vein distention c. Hypertentiond. TarchycardiaAns.. 3. The nurse is advising a client about the risks associated with failing to seek treatment for acute pharyngitis caused by beta-hemolytic streptococcus. For what health problem or complication is the client at risk of?a. COPDb. Endocarditisc. Anemiad. Reyes syndromeAns..

4. The emergency department nurse is admitting an adult client after an automile collision. The physician estimates that the client has lost about 15% to 20% of blood volume. Which of the following assessment finding is the nurse expecting the client to exhibit?a. Respiration of 16 cycles/minuteb. A urine output of 60mls/hourc. An apical heart rate of 142 beats/minuted. A BP of 140/90mmhgAns..

5. To assess the effectiveness of a vasodilator administered to a client, what should the nurse assess?a. The pulse rateb. Cardiac outputc. Breath soundsd. Blood pressureAns..6. A client has returned to the surgical unit from the recovery unit after splenectomy. In the Immediate postoperative period, the nurse specifically should observe for potential complications.I. ShockII. Abdominal distentionIII. InfectionIV. Pulmonary complicationsa. I onlyb. II and III onlyc. I, III and IV only d. I, II and IV onlyAns..

7. After open-heart surgery a client develops a temperature of 38.8 degree Celsius. The nurse notifies the physician because elevated temperature..a. May indicate cerebral edemab. Increase the cardiac outputc. Are likely to lead to diaphoresisd. May lead to bleeding.Ans..

8. A patient has chest tubes attached to a chest tube drainage system. When caring for this patient, what should the nurse do?a. Empty the drainage at the end of the shiftb. Change the dressing daily using aseptic techniquec. Palpate the surrounding area for crepitusd. Clamp the chest tubes when suctioning Ans..

9. A patient is finding it difficult to void after an indwelling catheter has been removed. This may be due to:a. An interruption in his normal voiding habitsb. Fluid imbalancec. Nervous tension following the procedured. The patients recent sedentary lifestyleAns..

10. The nurse would explain a suprapubic prostatectomy to a patient that it differs from other surgical procedures of the prostate in that:a. A major complication of impotence may occurb. An incision is made directly into the bladderc. An indwelling catheter is not required after surgeryd. The postoperative convalescence period is shorterAns..11. To prevent bleeding after prostatectomy the patient should be advised to avoid straining on defaecation. The nurse should therefore advise him to increase intake of:a. Green leafy vegetablesb. Meal and fishc. Milk productsd. Ripe plantain and yamsAns..12. Following spinal injury a patient should be encouraged to drink fluids primarily to prevent:a. Dehydrationb. Fluid and electrolyte imbalancec. Skin breakdownd. Urinary tract infectionAns..13. Cardiac massage and resuscitation may be necessary in the case of:a. Anoxiab. Dyspnoeac. Electric shockd. Sudden cessation of pulse beat.Ans..14. A 50kg patient had about 40% of total burn surface area after using the rule of nines. The physician prescribed about 6litres of IV fluids (Ringers lactate) for the patient. The nurse is aware that the fluid prescribed is.a. Out of proportionb. To give the patient energyc. Given to replace the fluid lossd. To prevent the blister formationAns..15. Controlling bleeding and covering the wound with sterile dressing is to prevent .. and ..respectively?a. Cardiogenic shock and contaminationb. Haemorrhagic shock and infectionc. Increasing BP and infectiond. Decreasing BP and further damage Ans..16. An adult patient was admitted to the ward with haematemesis as a results of peptic ulcer. The nurse agrees with all the treatment modalities EXECPTa. Bed rest b. IV fluids c. NSAIDd. Nil per osAns..17. The principle to follow when changing a surgical dressing of a patient is to:a. Confine the microorganisms to the woundb. Keep the area free of microorganismsc. Keep the number of opportunistic microorganisms to a minimumd. Protect self from microorganisms in the woundAns..18. An effective first aid treatment for acid burns on the skin is to flush them with water and then apply a solution of sodiuma. Bicarbonateb. Chloridec. Hydroxided. SulphateAns..19. The condition of an adult patient with burns of 36% of the body according to Wallaces Rule of Nine would be considered to bea. 10 | Page

b. Criticalc. Faird. Goode. Poor

Ans..20. With fracture involving the humerus the nurse should immediately ..?a. Stabilize the arm in a slingb. Give victim water to drinkc. Elevate the foot endd. Use wooding splint to immobilize fractured arm.Ans..21. A patient complains of severe pains 2 days following surgery. The nurse should firsta. Administer the prn analgesicb. Ensure the patient is having enough restc. Find out when the last analgesic was givend. Take the patients vital signsAns..22. When a patient is semi conscious, the nurse should expect the person to be unable to:a. Control eliminationb. Hear voicesc. Move spontaneouslyd. React to painful stimuli23. A patient who has sustained head injury regains consciousness and is able to move the extremities. This suggests non involvement of thea. Basal gangliab. Parietal lobesc. Postcentral gyrusd. Precental gyrusAns..24. A patient is transferred to the recovery ward after laparotomy with a nasogastric tube connected to suction apparatus. The patient started vomiting coloured fluid. The nurse shoulda. Administer anti-emeticsb. Check the patency of the tubec. Elevate the head of the bedd. Remove the NG tube and cleanAns..25. Before a patient signs a consent form for an abdominoperineal resection, the nurse should explain to him that the surgery will probably result in a a. Permanent colostomy and impotenceb. Permanent ileostomy in the jejunumc. Temporary colostomy in the descending colond. Temporary colostomy with diminished libidoAns..26. Following an amputation, the nurse can help a patient prepare the residual limb for a prosthesis by encouraging him to:a. Abduct the residual limb when ambulatingb. Hang the residual limb off the bed frequentlyc. Periodically press the end of the residual limb against a pillowd. Soak the residual limb in warm water twice a dayAns..27. When assessing a patient with cancer of the tongue, the specific sign the nurse should expect to find is:a. Bleeding gumsb. Halitosisc. Leukoplakiad. Substenal painAns..28. Following a subtotal gastrectomy for cancer of the stomach, the patient develops dumping syndrome. The nurse would explain this to the junior nurse as:a. Buildup of faeces and gas within the large intestineb. Nausea due to a full stomachc. Rapid passage of osmotic fluid into the jejunumd. Reflux of intestinal contents into the oesophagusAns..29. A serious danger to which a patient with intestinal obstruction is exposed because of intestinal suction is excessive loss of:a. Energy carbohydratesb. Protein enzymesc. Vitamins and mineralsd. Water and electrolyes.Ans..30. A client with peptic ulcer is about to begin a therapeutic regimen that includes a bland diet, antacids and ranitidine. Before the client is discharged, the nurse should provide which instruction?a. Eat three balance meals every day b. Stop taking the drugs when your symptoms subsidec. Avoid aspirin and products that produce aspirind. Increase your intake of fluids containing caffeineAns..31. On the 2nd post-operative day a patient complains of pain in the right calf. The nurse should first:a. Apply warm fomentation b. Elevate the extremity above the heartc. Notify the doctord. Record the symptoms on nurses notesAns..32. Clients who have undergone gastrectomy may develop pernicious anaemia becausea. Vitamin B12 is only absorbed in the stomachb. Haemapoietic factor is secreted in the stomachc. Parietal cells of the stomach secrete the intrinsic factord. Chief cells in the stomach promote the secretion of the extrinsic factorAns..33. Emergency equipment that should be at the bedside of a patient after a thyroidectomy includes:a. A tracheostomy set and oxygenb. An airway with rebreathing bagc. A sterile sinus forceps with gauze swabsd. Two ampoules of sodium bicarbonateAns..34. A patient who sustains a fracture of the cervical spine is likely to have:a. Brain damageb. Hemiplegiac. Paraplegiad. Ruptured uterus Ans..

35. The most effective treatment for nasal polyp is by:a. Cauterization with diathermyb. Cutting with a scalpel bladec. Excising with a snared. Ligating with a sutureAns..36. Which of these is the patient expected to complain of following cystoscopy?a. Bloody urineb. Burning and frequencyc. Colicky abdominal paind. Urinary retentionAns..37. Torsion of the testis occurs when:a. There is benign enlargement of the prostate glandb. There is collection of fluid in the tunica vaginalisc. There is dilatation of the venous plexus above the testisd. The testis rotates within the tunica vagunalisAns..38. Bladder irrigation is done within 72 hours of prostatectomy to prevent:a. Bladder distentionb. Clot formationc. Urethral strictured. Wound infectionAns..39. The rationale for irrigating a colostomy is:a. Control odourb. Ensure cleanliness and dryness for the comfort of the patientc. Regulates bowel movementd. Stimulate peristalsisAns..40. A client is receiving an anticoagulant for pulmonary embolism. Which drug should the nurse instruct the client to avoid taking without informing the doctor.?A. ClindamycinB. Ferrous sulphateC. Acetylsalicylic acidD. Chlorpromazine Ans..41. Which of the underlisted is the MOST common post -operative respiratory complication in the elderly?a. Hypoxiab. Pleurisyc. Pneumoniad. Pulmonary oedemaAns..42. Which of these drugs is administered when a patient develops tetany after subtotal thyroidectomya. Sodium bicarbonateb. Calcium gluconatec. Sodium phosphated. Potassium chlorideAns..43. When a patient returns from theater after thyroidectomy the nurse should assess for injury to the pharyngeal nerve by:a. Asking patient to speakb. Checking the patient for neck oedemac. Observing the patient for signs of tetanyd. Palpating the patients neck for blood seepageAns..44. The most serious complication associated with chronic inflammation of the bowel is:a. Bleedingb. Obstructionc. Paralytic ileusd. PerforationAns..45. When giving enema the patient should be placed in the:a. Fowlers positionb. Knee-chest positionc. Left sims positiond. Prone positionAns..46. The nurse should protect the patients skin surrounding a colostomy opening by using:a. Barrier creamb. Methylated spiritc. Mineral oild. Tincture benzoinAns..47. A patient who has had a colostomy should follow a diet that is:a. As close to normal as possibleb. High in carbohydratesc. Low in fibre contentd. Rich in proteinAns..48. The main purpose of under-water sealed drainage system is to:a. Drain air and blood from the pleural cavityb. Drain air, fluid and blood from the pleural cavityc. Prevent air and fluid from entering the lungsd. Prevent air from entering the pleural cavityAns..49. The principle to follow when changing a surgical dressing of a patient is to:a. Confine the microorganisms to the woundb. Keep the area free of microorganismsc. Keep the number of opportunistic microorganisms to a minimumd. Protect self from microorganisms in the woundAns..50. A Client is frustrated and embarrassed by urinary incontinence. Which of the following measures should the nurse include in a bladder retraining program?a. Establishing a predetermined fluid intake pattern for the clientb. Encouraging the client to increase the time between voidings.c. Restricting fluid intake to reduce the need to voidd. Assessing present elimination patternsAns..51. The most common cause of acute abdomen arising from the left upper quadrant isa. Acute cholecystitisb. Peptic ulcer diseasec. Ectopic gestationd. Meckels diverticulumAns..52. A client is admitted with suspected atelectasis. Which clinical indicator does the nurse expect to identify when assessing the client?a. Diminished breath soundsb. Slow, deep respirationsc. A dry, unproductive coughd. A normal temperatureAns..53. A client is diagnosed with hiatal hernia. Which statement indicates effective client teaching about hiatal hernia and its treatment?a. Ill eat three large meals everyday without any food restrictionsb. Ill lie down immediately after mealsc. Ill gradually increase the amount of heavy lifting I dod. Ill eat frequent small, bland, diet that are high in fiberAns..54. A thoracentesis is performed. Following the procedure, it is most important for the nurse to observe the client for?a. Periods of confusionb. Expectoration of bloodc. Increased breath soundsd. None of the aboveAns..

55. After a client had bronchoscopy, the nurse takes which of these action to prevent laryngeal edemaa. Keep the client in the semi-fowlers positionb. Offer the client liberal amounts of fluidc. Place ice chips in the clients mouth d. Tell the client to suck on the medicated lozengesAns..56. The nurse assesses a male clients respiratory status. Which observation indicates that the client is experiencing difficulty breathing?a. Diaphragmatic breathingb. Use of accessory musclesc. Pursed-lip breathingd. Controlled breathingAns..57. A relatively common lethal inherited disease in which mucous secretions in the lungs thick to be transported easily is calleda. Asthmab. Cyctic fibrosisc. Emphysemad. Chronic bronchitis Ans..58. To prevent GERD in a client with hiatal hernia, the nurse should provide which discharge instruction?a. Lie down after meals to promote digestionb. Avoid coffee and alcoholic beveragesc. take antacids with mealsd. Limit fluid intake with mealsAns..59. Damage to the recurrent laryngeal nerve during lung surgeries may result in a. Coarse voiceb. Hoarse voicec. Shrill voiced. Deep voiceAns..60. Varicose veins are usually the result of:a. Atherosclerotic plagues along the veinb. Defective valves within the veinsc. External compression of the muscles of the legsd. The formation of thrombophlebitisAns.