GARDEN CITY UNIVERSITY COLLEGE

SCHOOL OF NURSING
Index Number...............................................................
Section A
Time Allowed: 45 minutes
MOCK EXAMINATION, AUGUST 2014
SURGERY AND SURGICAL NURSING
TIME ALLOWED 45 minutes
CANDIDATES No. NAME

Note. 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 signs
b. Cleanse the area with an antiseptic lotion
c. 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 pressure
b. Jugular vein distention
c. Hypertention
d. Tarchycardia
Ans..
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. COPD
b. Endocarditis
c. Anemia
d. Reyes syndrome
Ans..
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/minute
b. A urine output of 60mls/hour
c. An apical heart rate of 142 beats/minute
d. A BP of 140/90mmhg
Ans..

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5. To assess the effectiveness of a vasodilator administered to a client, what should the

nurse assess?
a. The pulse rate
b. Cardiac output
c. Breath sounds
d. Blood pressure
Ans..
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.
Shock
II.
Abdominal distention
III.
Infection
IV.
Pulmonary complications
a. I only
b. II and III only
c. I, III and IV only
d. I, II and IV only
Ans..
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 edema
b. Increase the cardiac output
c. Are likely to lead to diaphoresis
d. 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 shift
b. Change the dressing daily using aseptic technique
c. Palpate the surrounding area for crepitus
d. 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:

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a. An interruption in his normal voiding habits

b. Fluid imbalance
c. Nervous tension following the procedure
d. The patients recent sedentary lifestyle

Ans..

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 occur
b. An incision is made directly into the bladder
c. An indwelling catheter is not required after surgery
d. The postoperative convalescence period is shorter
Ans..
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 vegetables
b. Meal and fish
c. Milk products
d. Ripe plantain and yams
Ans..
12. Following spinal injury a patient should be encouraged to drink fluids primarily to
prevent:
a. Dehydration
b. Fluid and electrolyte imbalance
c. Skin breakdown
d. Urinary tract infection

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Ans..
13. Cardiac massage and resuscitation may be necessary in the case of:
a. Anoxia
b. Dyspnoea
c. Electric shock
d. 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 proportion
b. To give the patient energy
c. Given to replace the fluid loss
d. To prevent the blister formation
Ans..
15. Controlling bleeding and covering the wound with sterile dressing is to prevent
.. and ..respectively?
a. Cardiogenic shock and contamination
b. Haemorrhagic shock and infection
c. Increasing BP and infection
d. 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 EXECPT
a. Bed rest
b. IV fluids
c. NSAID
d. Nil per os
Ans..
17. The principle to follow when changing a surgical dressing of a patient is to:
a. Confine the microorganisms to the wound
b. Keep the area free of microorganisms
c. Keep the number of opportunistic microorganisms to a minimum
d. Protect self from microorganisms in the wound
Ans..

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18. An effective first aid treatment for acid burns on the skin is to flush them with water
and then apply a solution of sodium
a. Bicarbonate
b. Chloride
c. Hydroxide
d. Sulphate
Ans..
19. The condition of an adult patient with burns of 36% of the body according to
Wallaces Rule of Nine would be considered to be
a. Critical
b. Fair

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c. Good
d. Poor

e.
An
s..
20. With fracture involving the humerus the nurse should immediately ..?
a. Stabilize the arm in a sling
b. Give victim water to drink
c. Elevate the foot end
d. Use wooding splint to immobilize fractured arm.
f.
Ans..
21. A patient complains of severe pains 2 days following surgery. The nurse should first
a. Administer the prn analgesic
b. Ensure the patient is having enough rest
c. Find out when the last analgesic was given
d. Take the patients vital signs
Ans..
22. When a patient is semi conscious, the nurse should expect the person to be unable to:
a. Control elimination
b. Hear voices
c. Move spontaneously
d. React to painful stimuli
23. A patient who has sustained head injury regains consciousness and is able to move the
extremities. This suggests non involvement of the
a. Basal ganglia
b. Parietal lobes
c. Postcentral gyrus
d. Precental gyrus
g.
An
s..
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
should
a. Administer anti-emetics
b. Check the patency of the tube
c. Elevate the head of the bed
d. Remove the NG tube and clean
h.
An
s..
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 impotence
b. Permanent ileostomy in the jejunum
c. Temporary colostomy in the descending colon
d. Temporary colostomy with diminished libido
i.
An
s..
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 ambulating

b. Hang the residual limb off the bed frequently

c. Periodically press the end of the residual limb against a pillow
d. Soak the residual limb in warm water twice a day
j.
An
s..
27. When assessing a patient with cancer of the tongue, the specific sign the nurse should
expect to find is:
a. Bleeding gums
b. Halitosis
c. Leukoplakia
d. Substenal pain
k.
An
s..
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 intestine
b. Nausea due to a full stomach
c. Rapid passage of osmotic fluid into the jejunum
d. Reflux of intestinal contents into the oesophagus
Ans..
29. A serious danger to which a patient with intestinal obstruction is exposed because of
intestinal suction is excessive loss of:
a. Energy carbohydrates
b. Protein enzymes
c. Vitamins and minerals
d. Water and electrolyes.
l.
An
s..
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 subside
c. Avoid aspirin and products that produce aspirin
d. Increase your intake of fluids containing caffeine
m.
An
s..
nd
31. On the 2 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 heart
c. Notify the doctor
d. Record the symptoms on nurses notes
n.
An
s..
32. Clients who have undergone gastrectomy may develop pernicious anaemia because
a. Vitamin B12 is only absorbed in the stomach

b. Haemapoietic factor is secreted in the stomach

c. Parietal cells of the stomach secrete the intrinsic factor
d. Chief cells in the stomach promote the secretion of the extrinsic factor
o.
An
s..
33. Emergency equipment that should be at the bedside of a patient after a thyroidectomy
includes:
a. A tracheostomy set and oxygen
b. An airway with rebreathing bag
c. A sterile sinus forceps with gauze swabs
d. Two ampoules of sodium bicarbonate
p.
An
s..
34. A patient who sustains a fracture of the cervical spine is likely to have:
a. Brain damage
b. Hemiplegia
c. Paraplegia
d. Ruptured uterus
q.
An
s..
r.
35. The most effective treatment for nasal polyp is by:
a. Cauterization with diathermy
b. Cutting with a scalpel blade
c. Excising with a snare
d. Ligating with a suture
s.
An
s..
36. Which of these is the patient expected to complain of following cystoscopy?
a. Bloody urine
b. Burning and frequency
c. Colicky abdominal pain
d. Urinary retention
t.
An
s..
37. Torsion of the testis occurs when:
a. There is benign enlargement of the prostate gland
b. There is collection of fluid in the tunica vaginalis
c. There is dilatation of the venous plexus above the testis
d. The testis rotates within the tunica vagunalis
u.
An
s..
38. Bladder irrigation is done within 72 hours of prostatectomy to prevent:
a. Bladder distention
b. Clot formation
c. Urethral stricture
d. Wound infection

v.
An
s..
39. The rationale for irrigating a colostomy is:
a. Control odour
b. Ensure cleanliness and dryness for the comfort of the patient
c. Regulates bowel movement
d. Stimulate peristalsis
Ans..
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. Clindamycin
B. Ferrous sulphate
C. Acetylsalicylic acid
D. Chlorpromazine
w.
An
s..
41. Which of the underlisted is the MOST common post -operative respiratory
complication in the elderly?
a. Hypoxia
b. Pleurisy
c. Pneumonia
d. Pulmonary oedema
Ans..
42. Which of these drugs is administered when a patient develops tetany after subtotal
thyroidectomy
a. Sodium bicarbonate
b. Calcium gluconate
c. Sodium phosphate
d. Potassium chloride
x.
An
s..
43. When a patient returns from theater after thyroidectomy the nurse should assess for
injury to the pharyngeal nerve by:
a. Asking patient to speak
b. Checking the patient for neck oedema
c. Observing the patient for signs of tetany
d. Palpating the patients neck for blood seepage
y.
An
s..
44. The most serious complication associated with chronic inflammation of the bowel is:
a. Bleeding
b. Obstruction
c. Paralytic ileus
d. Perforation
z.
An
s..
45. When giving enema the patient should be placed in the:
a. Fowlers position
b. Knee-chest position

c. Left sims position

d. Prone position
aa.
An
s..
46. The nurse should protect the patients skin surrounding a colostomy opening by using:
a. Barrier cream
b. Methylated spirit
c. Mineral oil
d. Tincture benzoin
ab.
An
s..
47. A patient who has had a colostomy should follow a diet that is:
a. As close to normal as possible
b. High in carbohydrates
c. Low in fibre content
d. Rich in protein
Ans..
48. The main purpose of under-water sealed drainage system is to:
a. Drain air and blood from the pleural cavity
b. Drain air, fluid and blood from the pleural cavity
c. Prevent air and fluid from entering the lungs
d. Prevent air from entering the pleural cavity
Ans..
49. The principle to follow when changing a surgical dressing of a patient is to:
a. Confine the microorganisms to the wound
b. Keep the area free of microorganisms
c. Keep the number of opportunistic microorganisms to a minimum
d. Protect self from microorganisms in the wound
ac.
An
s..
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 client
b. Encouraging the client to increase the time between voidings.
c. Restricting fluid intake to reduce the need to void
d. Assessing present elimination patterns
ad.
An
s..
51. The most common cause of acute abdomen arising from the left upper quadrant is
a. Acute cholecystitis
b. Peptic ulcer disease
c. Ectopic gestation
d. Meckels diverticulum
ae.
An
s..
52. A client is admitted with suspected atelectasis. Which clinical indicator does the nurse
expect to identify when assessing the client?
a. Diminished breath sounds
b. Slow, deep respirations

c. A dry, unproductive cough

d. A normal temperature
af.
An
s..
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 restrictions
b. Ill lie down immediately after meals
c. Ill gradually increase the amount of heavy lifting I do
d. Ill eat frequent small, bland, diet that are high in fiber
ag.
An
s..
54. A thoracentesis is performed. Following the procedure, it is most important for the
nurse to observe the client for?
a. Periods of confusion
b. Expectoration of blood
c. Increased breath sounds
d. None of the above
ah.
An
s..
ai.
aj.
55. After a client had bronchoscopy, the nurse takes which of these action to prevent
laryngeal edema
a. Keep the client in the semi-fowlers position
b. Offer the client liberal amounts of fluid
c. Place ice chips in the clients mouth
d. Tell the client to suck on the medicated lozenges
ak.
An
s..
56. The nurse assesses a male clients respiratory status. Which observation indicates that
the client is experiencing difficulty breathing?
a. Diaphragmatic breathing
b. Use of accessory muscles
c. Pursed-lip breathing
d. Controlled breathing
al.
An
s..
57. A relatively common lethal inherited disease in which mucous secretions in the lungs
thick to be transported easily is called
a. Asthma
b. Cyctic fibrosis
c. Emphysema
d. Chronic bronchitis
am. An
s..

58. To prevent GERD in a client with hiatal hernia, the nurse should provide which
discharge instruction?
a. Lie down after meals to promote digestion
b. Avoid coffee and alcoholic beverages
c. take antacids with meals
d. Limit fluid intake with meals
an.
An
s..
59. Damage to the recurrent laryngeal nerve during lung surgeries may result in
a. Coarse voice
b. Hoarse voice
c. Shrill voice
d. Deep voice
ao.
Ans..
60. Varicose veins are usually the result of:
a. Atherosclerotic plagues along the vein
b. Defective valves within the veins
c. External compression of the muscles of the legs
d. The formation of thrombophlebitis
Ans.
ap.
aq.