College Exams & Notes

Master your nursing exams with comprehensive practice questions and detailed explanations

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QUESTION #1
Medical-Surgical Exam 2 Med-Surg
A client with emphysema should receive only 1 to 3 L/minute of oxygen, if needed, or he may lose his hypoxic drive. Which of the following statements is correct about the hypoxic drive?
A The client doesn’t notice he needs to breathe.
B The client breathes only when his oxygen levels climb above a certain point.
C The client breathes only when his oxygen levels dip below a certain point.
D The client breathes only when his carbon dioxide levels dip below a certain point.

Explanations

A
Clients with COPD still sense the need to breathe; the stimulus is altered, not absent.
B
Rising oxygen levels do not stimulate respiration.
C
In some COPD clients, chronically elevated CO₂ blunts the normal drive to breathe, making low oxygen levels the primary respiratory stimulus.
D
CO₂ rising—not falling—normally stimulates breathing in healthy individuals.
QUESTION #2
Medical-Surgical Exam 2 Med-Surg
A child attending day camp has asthma, and her parent sent with her all her medicine in a small carry bag. The child has an asthma attack that is severe enough to warrant a rescue drug. Which medication from the child’s bag is best to use for the acute symptoms?
A Omalizumab
B Fluticasone
C Salmeterol
D Albuterol

Explanations

A
This is a monoclonal antibody used for long-term control of allergic asthma, not for acute attacks.
B
This inhaled corticosteroid is for maintenance therapy and does not provide rapid relief.
C
This long-acting beta-agonist is not used for acute symptom relief and can be dangerous if used alone during an attack.
D
This long-acting beta-agonist is not used for acute symptom relief and can be dangerous if used alone during an attack.
QUESTION #3
Medical-Surgical Exam 2 Med-Surg
The nurse has a prescription to give a client salmeterol, 2 puffs, and beclomethasone dipropionate, 2 puffs, by metered-dose inhaler. The nurse should administer the medication using which procedure?
A Beclomethasone first and then the salmeterol
B Salmeterol first and then the beclomethasone
C Alternating a single puff of each, beginning with salmeterol
D Alternating a single puff of each, beginning with beclomethasone

Explanations

A
Inhaled corticosteroids should not be given before bronchodilators because airway narrowing reduces steroid delivery.
B
Salmeterol is a bronchodilator that opens the airways, allowing the corticosteroid to reach deeper into the lungs and work more effectively.
C
Medications should be given one at a time, completing all puffs of the bronchodilator first.
D
This combines incorrect sequencing with improper administration technique.
QUESTION #4
Medical-Surgical Exam 2 Med-Surg
The nurse has given a client taking ethambutol information about the medication. The nurse determines that the client understands the instructions if the client states that he or she will immediately report which findings?
A Impaired sense of hearing
B Gastrointestinal side effects
C Orange-red discoloration of body secretions
D Difficulty in discriminating the color red from green

Explanations

A
Hearing loss is associated with ototoxic drugs like aminoglycosides, not ethambutol.
B
Mild GI upset can occur but is not an emergency finding.
C
This is a known effect of rifampin, not ethambutol, and is not dangerous.
D
Ethambutol can cause optic neuritis, leading to decreased visual acuity and loss of red–green color discrimination, which must be reported immediately.
QUESTION #5
Medical-Surgical Exam 2 Med-Surg
A client is to begin a 6-month course of therapy with isoniazid. The nurse should plan to teach the client to take which action?
A Use alcohol in small amounts only.
B Report yellow eyes or skin immediately.
C Increase intake of Swiss or aged cheeses.
D Avoid vitamin supplements during therapy.

Explanations

A
Alcohol should be avoided, not limited, because it increases the risk of isoniazid-induced hepatotoxicity.
B
Jaundice is a sign of liver toxicity, a serious adverse effect of isoniazid that requires prompt evaluation.
C
Isoniazid can interact with tyramine-containing foods, so aged cheeses should be avoided.
D
Clients are often prescribed vitamin B₆ (pyridoxine) to prevent peripheral neuropathy, so supplements should not be avoided.
QUESTION #6
Medical-Surgical Exam 2 Med-Surg
A client has been taking isoniazid for 2 months. The client complains to the nurse about numbness, paresthesia, and tingling in the extremities. The nurse interprets that the client is experiencing which problem?
A Hypercalcemia
B Peripheral neuritis
C Small blood vessel spasm
D Impaired peripheral circulation

Explanations

A
Elevated calcium levels cause symptoms such as weakness, confusion, and constipation, not tingling and numbness.
B
Isoniazid can cause vitamin B₆ (pyridoxine) deficiency, leading to peripheral neuropathy with numbness and tingling.
C
Vasospasm causes pallor or pain with cold exposure, not sensory changes like paresthesia.
D
Circulatory impairment presents with coolness, color changes, or diminished pulses rather than tingling sensations.
QUESTION #7
Medical-Surgical Exam 2 Med-Surg
The nurse performs an admission assessment on a client with a diagnosis of tuberculosis. The nurse should check the results of which diagnostic test to confirm this diagnosis?
A Chest x-ray
B Bronchoscopy
C Sputum culture
D Tuberculin skin test

Explanations

A
Chest imaging may show lesions suggestive of TB but cannot definitively confirm active infection.
B
This may be used to obtain specimens but is not the primary diagnostic test for confirmation.
C
Identification of Mycobacterium tuberculosis in sputum culture confirms active tuberculosis.
D
This indicates exposure or latent infection, not active disease.
QUESTION #8
Medical-Surgical Exam 2 Med-Surg
The nurse is preparing to give a bed bath to an immobilized client with tuberculosis. The nurse should wear which items when performing this care?
A Surgical mask and gloves
B Particulate respirator, gown, and gloves
C Particulate respirator and protective eyewear
D Surgical mask, gown, and protective eyewear

Explanations

A
A surgical mask does not provide adequate protection against airborne transmission of tuberculosis.
B
TB requires airborne precautions (N95 or equivalent), and a bed bath involves close contact, so gown and gloves are also needed.
C
Eye protection is not routinely required for TB, and gloves/gown are needed for direct care.
D
Surgical masks do not protect the nurse from inhaling airborne TB particles.
QUESTION #9
Medical-Surgical Exam 2 Med-Surg
The nurse has conducted discharge teaching with a client diagnosed with tuberculosis who has been receiving medication for 2 weeks. The nurse determines that the client has understood the information if the client makes which statement?
A “I need to continue medication therapy for 1 month.”
B “I can’t shop at the mall for the next 6 months.”
C “I can return to work if a sputum culture comes back negative.”
D “I should not be contagious after 2–3 weeks of medication therapy.”

Explanations

A
TB treatment typically lasts 6–12 months, so this reflects incorrect understanding.
B
Isolation is not required for the entire duration of therapy once the client is no longer contagious.
C
Return to work usually depends on clinical improvement and decreased infectiousness, not just one culture result.
D
Clients with TB generally become noninfectious after 2–3 weeks of effective treatment, if symptoms improve and adherence is confirmed.
QUESTION #10
Medical-Surgical Exam 2 Med-Surg
To prevent decannulation of a tracheostomy tube, what does the nurse do?
A Obtain an order for continuous upper extremity restraints
B Secure the tube in place using ties or fabric fasteners
C Allow some flexibility in motion of the tube while coughing
D Instruct the patient to hold the tube with a tissue while coughing

Explanations

A
Restraints are not routinely used and are inappropriate unless there is a clear safety indication.
B
Properly secured tracheostomy ties or fasteners prevent accidental displacement or decannulation.
C
Excessive movement increases the risk of dislodgement rather than preventing it.
D
Patients should not manipulate the tube, as this can cause accidental removal.
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