NMC Past Questions on Surgery and Surgical Nursing Set 2

NMC Past Questions on Surgery and Surgical Nursing Set 2

51. The Nurse should explain to the patient with gonorrhea that treatment will include both Ceftriaxone and Doxycycline because:
A. High rate of coexisting chlamydia and gonorrhea needs dual coverage
B. No single agent successfully eradicates all strains of gonorrhea
C. Most patients do not respond to Ceftriaxone alone

52. In a defaulted peptic ulcer patient, the MOST likely complication could be the following EXCEPT:
A. Stress
B. Haemorrhage
C. Perforation

53. Mr. Seidu Awudu has undergone an ear surgery. Two weeks post-operative, he has weakness of one half of the face and diagnosed with Bell’s palsy. Which of the cranial nerves is involved?
A. 7th
B. 3rd
C. 5th

54. Afua Adams has been brought to the ward after mastectomy. She complains of soreness, numbness and tightness around the chest. As the Nurse on duty, you would explain to Madam Adams that this:
A. Normally occurs days to months after mastectomy
B. Indicates a complication in the heart
C. Shows that the disease has spread to other organs

55. When a patient is semi-conscious, the Nurse should expect the patient to be unable to:
A. React to painful stimuli
B. Move spontaneously
C. Control elimination

56. A 24-year-old woman comes into your office after spilling hot tea on her hand. The affected area is red with a few blisters. On examination, the burn blanches with pressure. The patient notes worsening pain when the burn is exposed to the cold wind. How would you classify this burn?
A. Deep partial-thickness
B. Full thickness
C. Superficial partial-thickness

57. Maame Adwoa is on admission in the female surgical ward after an open cholecystectomy. What will you include in your teaching about exercise to promote recovery?
A. Dorsiflex the feet
B. Tighten abdominal muscles
C. Flexion of the toes

58. The action to be taken when a Nurse suspects that a patient’s wound is infected is:
A. Clean the wound with a bactericidal solution twice daily
B. Take a swab for bacteriological examination
C. Change the dressing aseptically

59. Mrs. Asantewaa Amoako, a 38-year-old trader has been booked for skin grafting after she sustained 3rd degree burns of the lower and upper extremities. Which of the following therapies would be used in treatment of skin grafts and reconstructive flaps with compromised blood flow?
_Answer not provided in options; common therapy is topical nitroglycerin or hyperbaric oxygen, but not listed._

60. Mr. Kwabena Danso, an 86-year-old farmer with hypertension presents to the clinic with a painful big toe. The patient eats a diet of fresh grains, lots of meat, and dairy products and abstains from alcohol. He has not had any recent falls or injuries to his foot that he recalls. You diagnosed him with gout. Which of the following details in this patient’s history put him at an increased risk for gout?
A. Blood pressure medication
B. Consumption of dairy products
C. Patient’s age

61. Maame Adwoa Mansa, a 25-year-old seamstress was admitted to the ward with the intention for a repair of fistula-in-ano. After assessment, she has decided to postpone the surgery due to some cultural beliefs. What will be the nurse’s role in this case?
A. Call in the surgeon to discharge her
B. Call in the chaplain to help her with counseling
C. Allow patient to go since she came herself

62. A patient has undergone a four hour abdominal surgery under spinal anesthesia. She was transferred to the Surgical Unit and started complaining of severe incisional pain after one and half hours. The patient’s skin is pale and surgical dressing is dry and intact. The MOST common preventable complication of abdominal surgery is:
A. Atelectasis
B. Thrombophlebitis
C. Fluid and electrolyte imbalance

63. Which of these sutures would the nurse give to the surgeon when he needs a nonabsorbable suture?
A. Fascia
B. Plain catgut
C. Chromic catgut

64. A priority nursing diagnosis for a patient with ulcerative colitis is:
A. High risk for infection
B. Ineffective coping
C. Diarrhea related to hypermotility

65. A patient on admission in your ward is suspected to have cancer of the oral cavity and throat. Which of the following data from the patient during history taking increases the risk of the patient’s condition?
A. Adult onset of diabetes
B. A history of smoking
C. Worked as a banker

66. Ataa Broni has an anterior neck mass. She had a lateral neck X-ray done and confirms a mass in the airway. One of the under listed procedures will aid visualization of the mass with the help of a laryngeal mirror.
A. Indirect laryngoscopy
B. Direct laryngoscopy
C. Rigid laryngoscopy

67. The tonsils are composed of lymphoid tissues situated bilaterally in the:
A. Nasopharynx
B. Oropharynx
C. Larynx

68. Before cholecystectomy, the surgeon orders Vitamin K. This is administered because it is used in the formation of:
A. Cholecystokinin
B. Prothrombin
C. Bilirubin

69. Mr. Kwesi Adom has been diagnosed with chronic prostatitis. What is the preferred antibiotic agent/class for Mr. Adom’s condition?
A. Penicillin
B. Fluoroquinolones
C. Tetracyclines

70. Mr. Kofi Nkansah is on admission with inguinal hernia. He has been scheduled for herniorrhaphy. As part of his physiological preparation, the nurse will do the following:
I. Administer prescribed intravenous fluid
II. Assess for skin infection on the face
III. Check vital signs and record
IV. Remove dentures if any
B. I, III and IV

71. Which of the following drug classes is the first line of treatment for patients with erectile dysfunction?
A. Central alpha agonists
B. Prostaglandins
C. 5-phosphodiesterase inhibitors

72. Mr. Kwasi Imoro, aged 50 is on admission at your ward with burns of the right upper limb. His wound was observed to be infected and he is to have debridement of the wound done at the theatre. The main goal of debridement include removal of the following EXCEPT:
A. Metastatic cells
B. Invasive bacteria
C. Devitalized tissue

73. Mustaph Ogoe, a 30-year-old farmer underwent open reduction and internal fixation (ORIF) for a hip fracture. On ward rounds, patient appeared stable and had normal vital signs. Few hours later, his brother frantically calls you to his room and says Ogoe is suddenly acting confused and has difficulty in breathing. Which of the following complications may explain the clinical manifestations of the patient?
I. Deep vein thrombosis
II. Pulmonary embolism
III. Compartment syndrome
IV. Cerebral hypoxia
B. I and II

74. Mr. Kofi Yaro has been on admission on the surgical ward with an infected leg wound which he sustained in a road traffic accident. He has been receiving antibiotics. He recorded a temperature of 38.5°C during one of the routine vital signs check. What nursing action would be appropriate?
A. Tepid sponge patient
B. Administer aspirin every 4 to 6 hours
C. Recheck temperature every 4 hours

75. A patient who has undergone an esophagectomy for esophageal cancer develops increasing pain, fever and dyspnea when a full liquid diet is started post operatively. The nurse recognizes that these symptoms are MOST indicative of:
A. Esophageal perforation with fistula
B. Intolerance to feeding
C. Leakage of food into the mediastinum

76. A 5-year-old girl presents with a recurrent UTI. Physical examination indicates possible sexual abuse. The child’s mother is a single parent and lives with her boyfriend. She claimed she is “certain” that the boyfriend has not sexually abused the child. She requests confidentiality and states she will not leave the child alone with the boyfriend. Which of the MOST appropriate next step?
A. Report this case immediately to DOVVSU
B. Follow-up soon to verify compliance
C. Without clear evidence of abuse, do not report this incident to authorities

77. To prevent bleeding after prostatectomy, the patient should be advised to stop straining on defaecation. The nurse should therefore advise him to increase his intake of:
A. Green leafy vegetables
B. Milk and dairy products
C. Milk and fish

78. Mr. Frank Akowuah, a 70-year-old farmer is on admission with ulcerative colitis. A serious complication of his condition could be:
A. Paralytic ileus
B. Haemorrhage
C. Perforation

79. Ms. Kakraba Forson has intermittent bleeding per vagina. She reported to the hospital and was diagnosed of myoma. She has been booked for hysterectomy and has asked you to explain the procedure to her. Your response will be the removal of the:
A. Uterus and cervix
B. Uterus, cervix and fallopian tube
C. Uterus and vagina

80. Kojo Abusu is an 18-year-old boy who reported to the OPD with multiple boils in the axilla and perineal areas. He is diagnosed with furunculosis and is being managed on Flucloxacillin. How will you educate the patient on dosage of Flucloxacillin?
A. 250mg qid x 7 days
B. 200mg qid x 7 days
C. 500mg qid x 7 days

81. Which of the under listed symptoms of fluid and electrolyte imbalance caused by colitis of which the nurse should report immediately?
A. Extreme muscle weakness and tachycardia
B. Nausea, vomiting, leg and stomach cramps
C. Development of tetany with muscle spasm

82. A patient with metastatic colorectal cancer is scheduled for both chemotherapy and radiation therapy. Patient teaching regarding these therapies would include an explanation that:
A. Radiation is routinely used as adjuvant therapy
B. Chemotherapy and radiation can be used as palliative treatment
C. Chemotherapy can be used to cure colorectal cancer

83. Baby Kwabena is a new born. He is to undergo circumcision one week post-delivery. Neonatal circumcision is an important protective measure against carcinoma of the:
A. Prepuce
B. Glans penis
C. Corpus cavernosum

84. Ms. Brikisi is a 32-year-old chain smoker. She has a hoarse voice during phonation and has inspiratory stridor. She is diagnosed with metastatic lesion in the larynx. She is to undergo surgery to aid phonation and respiration as well as administer chemotherapy. One of the under listed is the surgery to be done.
A. Oesophagoscopy
B. Tracheostomy
C. Laryngectomy

85. A patient presents with wrist drop. The Charge Nurse would be concerned about compression of which of the following nerve?
A. Ulnar
B. Radial
C. Median

86. A man sustained cut while gardening. Why would he be given anti-tetanus immunization?
A. For increased active immunity
B. For immediate protection by antibodies
C. To provide a target for lymphocytes

87. Mrs. Anabert Koomson has been scheduled for craniotomy. This type of operation is performed to:
I. Evacuate a blood clot
II. Relieve intracranial pressure
III. Remove a tumour
IV. Stop haemorrhage in the brain
A. I, II, III and IV

88. Mr. Kofi Kakabuka developed venous ulcer due to chronic venous insufficiency. To determine the appropriate dressings to be applied, the Nurse will consider all the following EXCEPT:
A. Availability of staff
B. Frequency of required dressing changes
C. Ability to absorb wound drainage

89. The Nurse’s priority when caring for a patient with second degree burns is to:
A. Encourage passive movement to prevent contractures
B. Monitor blood pressure and pulse hourly to assess shock
C. Order a high protein and vitamin diet and push in fluids

90. Baba Yakubu, a 52-year-old teacher has undergone haemorrhoidectomy. His postoperative care should include:
A. Encouraging showers when needed
B. Administration of enemas to promote defaecation
C. Administration of laxatives and stool-softeners

91. Which of the following is not a precipitating cause of haemorrhoids?
A. Constipation
B. Occlusion of arterial blood supply to the rectum
C. Prolonged sitting or standing

92. The source of succus entericus is in the:
A. Duodenum
B. Small intestines
C. Large intestines

93. In health educating the patient with glaucoma, the nurse would advise her to avoid factors that will increase intraocular pressure such as:
A. Excessive consumption of salt
B. Emotional upset
C. Excessive consumption of organ meat

94. Madam Esi Nyarkoa has just been brought to the ward after successfully undergoing mastectomy of the left breast. Nurse encourages her to begin deep breathing and leg exercises. The aim of these exercises is to prevent:
A. Pulmonary embolism
B. Deep vein thrombosis
C. Fluid retention

95. Which of the following is pulmonary disease is characterized by loss of elastic recoil, chronic hyperinflation of the lungs, and increased AP chest diameter?
A. Chronic bronchitis
B. Emphysema
C. Asthma

96. When assessing the urine of a patient with urinary tract infection, the Nurse should assess each sample for:
A. Clarity
B. Sugar and acetone
C. Specific gravity

97. The Charge Nurse at the intensive care unit provides an incentive spirometer to her postoperative tray in order to do which of the following?
A. Provide supplemental oxygen
B. Increase the patient’s lung volume
C. Increase the patient’s respiratory rate

98. Maame Yaa Nyame, a 30-year-old caterer was admitted to the burns unit with 2nd degree burns. Which of the following will you include in her pain management?
I. Nitrous Oxide
II. Hypnosis
III. Warm soaks
IV. Relaxation
A. I, II and III

99. Which of the following is NOT an indication for colostomy:
A. Acute abdomen
B. Diverticulosis
C. Cancer of the rectum

100. Which of the following is the MOST common symptom of Achalasia that patients complain of?
A. Sub-sternal chest pain
B. Halitosis
C. Dysphagia