NMC Past Questions on Surgery and Surgical Nursing

NMC Past Questions on Surgery and Surgical Nursing

1. Mrs. Emelia Adeyoba reported to the OPD with complaints of abdominal pain that feels worse after eating, fever, nausea and vomiting. Cullen’s sign was elicited on examination. Which of the following conditions will you suspect?
A. Acute Cholecystitis
B. Acute pancreatitis
C. Acute appendicitis

2. Following sub-total gastrectomy for cancer of the stomach, the patient develops dumping syndrome. The nurse explains this to the junior nurse as:
A. Rapid passage of osmotic fluid into the jejunum
B. Build-up of faeces and gas within the large intestine
C. Passage of food from the stomach to the intestines

3. Ama Norya, a 42-year-old mother of three has been transferred to your ward from recovery ward after myomectomy. As the recipient nurse, your first nursing action will be:
A. Check for vital signs
B. Check rate of IV infusion
C. Assess for pain

4. Before a patient signs a consent form for an Abdominopelvic resection, the nurse should explain to him that the surgery will probably result in a:
A. Permanent ileostomy in the jejunum
B. Temporary colostomy in the descending colon
C. Permanent colostomy and impotence

5. A 48-year old patient undergoes open repair of a femur fracture sustained in a motor vehicle collision. Three days post-op, she develops a low grade fever, tachypnea, pleuritic chest pain and a cough. CT scan reveals a pulmonary embolism. Which of the following findings is most likely to be associated with this condition?
A. Decreased pulmonary arterial pressure
B. Decreased A-a gradient
C. Positive D-dimer test

6. Following extensive and prolonged surgery, it is important that the nurse observes the patient for depletion of which electrolyte?
A. Chloride
B. Potassium
C. Calcium

7. The rationale for wearing face masks by the surgical team is to:
A. Minimize the possibility of wound infection
B. Reduce the risk of transmitting a cold to the patient
C. Promote the sterile state of the theatre room

8. Which suture will be used to close the subcutaneous tissue after a laparotomy?
A. Chronic catgut
B. Plain catgut
C. Linen thread

9. To monitor adequate fluid in Mr. Otoo Ayivor who has undergone a thoracic surgery, the nurse would:
A. Monitor and record hourly intake
B. Administer intravenous fluids
C. Monitor effects of diuretics

10. An optimal teaching plan for an out-patient with stomach cancer receiving radiation therapy should include information about:
A. Skin care, nutrition, community resources
B. Avitaminosis, stoma care, community resources
C. Cancer support groups, alopecia, stomatitis

11. A patient is evaluated by nurse Joloto after a fall. Nurse Joloto is likely to use varus stress of the knee in the evaluation. This action of the nurse is referred to as:
A. Force that moves the joint away from the midline
B. Movement of joint toward the midline of the body
C. Stress on the Vagus nerve

12. Which of the following refers to a metabolic bone disorder characterized by inadequate mineralization of the bone matrix?
A. Rheumatoid arthritis
B. Ankylosing spondylitis
C. Osteoporosis

13. Which of the following instruments should the nurse add when setting a trolley for the Doctor to conduct vaginal examination?
A. Cusco’s speculum
B. Hager’s dilator
C. Artery forceps

14. A 5-year-old boy was brought to the hospital with tympanic membrane perforation. He has been booked for surgery. Which of the following surgical procedure will the Doctor perform for the patient?
A. Ossiculoplasty
B. Myringotomy
C. Blepharotomy

15. Mr. Appiah Kangaba, a 20-year-old university student was involved in inter-university football competition. Accidentally, he fell on his outstretched arm and hand. Physical examination revealed pain, pronounced swelling and silver-fork deformity at the wrist. As a staff nurse with the Sports Medical Team, which of the following types of fracture is Mr. Appiah likely to suffer from?
I. Colle’s fracture
II. Pot’s fracture
III. Greenstick
IV. Comminuted
Correct Answer: I

16. A 63-year-old man with history of tobacco use, diabetes, and hypertension presents with severe symptoms of claudication. His left lower extremity is cool to touch and his left big toe shows shiny skin, absent hair and no palpable dorsal pedis or posterior tibialis pulses. The arterial brachial index confirms peripheral arterial disease. What is the next step in the management of this patient?
A. Supervised exercise program
B. Smoking cessation
C. Surgical consultation

17. Master Ayi Tetteh, a 5-year-old sustained burns and was admitted to your ward. The objective of managing Ayi would include:
I. Prevention of deformity
II. Prevention of infection
III. Provision of adequate diet
IV. Replacement of lost fluids and adequate diet
*C. I, II, IV

18. Predisposing causes of cancer of the larynx include:
I. Air pollution
II. Chronic respiratory infection
III. Heavy alcohol ingestion
IV. Poor dental hygiene
*C. I, II, III

19. Director in a law firm reported to the hospital with complaints of bleeding haemorrhoids. He is shy and withdrawn. What will be the primary role of the nurse before assessment?
A. Assure client of good care
B. Call in the surgeon
C. Let a male nurse take history

20. To promote healing and prevent formation of necrotic tissue formation of venous ulcers, which of the following procedures may be performed with this condition?
A. Regular wound dressing with povidone
B. Wound debridement
C. Incision and drainage

21. Mrs. Amina Oteng, a 55-year-old woman diagnosed as having Mitral Stenosis is on admission on your ward, she is to have mitral valve replacement performed for her. A possible cause of Mrs. Oteng’s condition would be:
A. High blood pressure
B. Calcium deposits
C. Reflux of blood

22. A 19-year-old female who bites her nails presents with pain that she relates to a hangnail. On examination, there is painful, fluctuant area with erythema at the proximal nail bed. She has full painless range of motion of the joints of her finger. Sensation is intact. What is the patient’s diagnosis?
A. Herpetic whitlow
B. Onychomycosis
C. Paronychia

23. A 60-year-old woman has reported to the hospital with complaint of urinary incontinence. Which of the following is true?
A. Topical vaginal estrogen therapy can contribute to urinary incontinence
B. Obesity is a risk factor for urinary incontinence
C. Pessaries not recommended for stress urinary incontinence in post-menopausal women

24. What would be your immediate intervention when a patient’s tracheostomy tube dislodges?
A. Insert the tube and give oxygen
B. Go and get a new tube
C. Inform the doctor to give you directions

25. Which of the following methods of prostatectomy is NOT an open surgical removal of the prostate?
A. Trans-urethral
B. Supra-pubic
C. Perineal

26. A 52-year-old man spilled hot coffee on a small portion of his thigh. The burn blisters is painful. The burn blanches on examination. Which of the following is the best treatment for the burn?
A. Topical triamcinolone
B. Prophylactic antibiotics
C. Polysporin with Mepitel dressing

27. Features of hyperparathyroidism include:
A. Elevated serum calcium
B. Renal colic if patient has had calculi
C. Carpopedal spasm

28. Which of the following is the most common cause of acute scrotal pain in adults in the outpatient setting?
A. Epididymitis
B. Inguinal hernia
C. Trauma

29. Nurse is evaluating plan of care for a client with acute abdominal pain at the male surgical ward. Which of the following would the Nurse consider as expected outcomes?
I. Resolution of cause
II. Relief of abdominal pain
III. Freedom from complications
IV. Normal fluid and electrolytes
*A. I, II, III, IV

30. Which of the following is a feature of pre-eclampsia?
A. Increased potassium
B. Increased potassium transaminases
C. Hyponatremia

31. Which of the following is TRUE about antibiotic management in a patient with sepsis?
A. Most patients should receive at least a two week course of antibiotics
B. Use of more than one antibiotic is preferable
C. Every hour of delay in initiation of antibiotics is associated with increase in progression to septic shock

32. A final year student Nurse asked to explain lordosis to him. Your response will be “an excessive inward curvature of the……………….. spine”:
A. Cervical
B. Thoracic
C. Lumbar

33. Which of the following clinical signs is associated with grating from friction of bones and cartilage or entrance of air into an open fracture?
A. Crepitus
B. Ecchymosis
C. Crackles

34. A 75-year-old man with a history of type 1 von Willebrand disease (vWD) and an Hgb of 14.3g/dl is scheduled for total hip replacement surgery. Which of the following is the most appropriate treatment to decrease risk of severe bleeding during his procedure?
A. Low dose activated factor VII
B. Pre-operative erythropoietin
C. Prophylactic DDAVP

35. Which of the following intravenous fluids would the Nurse get ready in a surgical shock?
A. Ringers Lactate
B. Dextrose 50%
C. Normal saline

36. The greatest percentage of an adult’s total body water is contained in which fluid compartment?
A. Intracellular
B. Interstitial
C. Extracellular

37. You have been assigned by the charge nurse to examine a patient who has sustained burns from gas explosion. He has burns on his right arm, chest and abdomen. He has superficial burns on the right side of his neck and face. Using the rule of 9, calculate the estimated body surface of burnt area:
A. 45%
B. 49.5%
C. 27%

38. Daniel Akpaso, a 5-year-old boy on admission at the pediatric ward with a history of sore throat, difficulty in swallowing when eating, fever and chills. He was diagnosed with tonsillitis and has been booked for tonsillectomy. To rule out any systemic or related condition, in Daniel, which of the following actions will the nurse take?
A. Conduct a thorough physical examination
B. Involve mother in the care
C. Consult the doctor in charge

39. Madam Atswei Mansa, a 42-year-old is recovering from anaesthesia after myomectomy. On admission, her initial BP was 120/80mmHg, 30 minutes later, her BP recorded was 112/60mmHg with pulse rate of 70bpm. Her skin was dry and warm to touch. What would be the MOST appropriate nursing action to take as the Nurse in Charge?
A. Administer oxygen
B. Notify the surgeon
C. Check vital signs every 15 minutes

40. Mr. Wilfred Sam has undergone tracheostomy. Which of the following would be the Nurse’s main goal for placing sterile moist gauze under the tracheostomy tube?
A. Promote adequate ventilation
B. Ensure humidification of inspired air
C. Maintain a patent airway

41. You have been tasked by the Charge Nurse to perform catheter hygiene for a bedridden patient. The correct method in carrying out this procedure is to:
A. Use cotton wool balls for each swabbing to and from the urethra
B. Wipe away from the urethral outlet using soap and water
C. Use gauze swab in methylated spirit to wipe around the urethra

42. You have been informed by the Emergency Unit to prepare and receive a patient with the diagnosis of intrinsic renal failure. What is the most common cause of intrinsic renal failure?
A. Ischemic injury
B. Nephrotoxin
C. Obstruction of the urethra

43. Osteomyelitis is the inflammation of the bones, especially in the arms and foot. This condition in most cases is caused by:
A. Pseudomonas
B. Salmonella
C. Staphylococcus aureus

44. Which of the under listed will indicate a third degree burns?
A. Dark colouration of the skin
B. Blister formation
C. Absence of pain at the site

45. Nurse Kodjo is carrying out routine wound dressing on the surgical ward. He must know that:
A. Sealed wound may be dressed without gloves
B. All wounds must be dressed with gloved hands
C. Dressing on a wound must be changed only when it is wet

46. Mr. Ankomah Boateng has been diagnosed of having benign prostatic hypertrophy which:
A. Predisposes to hydronephrosis
B. Causes an elevated acid phosphatase
C. Is a congenital abnormality

47. A nursing diagnosis of self-esteem disturbance related to perception of scars is identified for a patient with Buruli ulcer. Which of the following goals will take the utmost PRIORITY?
A. Promoting wound haemostasis
B. Preventing further injury
C. Promoting positive body image and coping

48. The nursing and medical team have to ensure that the ward is kept clean and safe for all patients. The BEST way a nurse can prevent cross-infection is by:
A. Preceding patient contact with hand washing
B. Performing aseptic technique correctly
C. Enforcing strict isolation procedures

49. Maame Afua Konadu has been admitted to your ward with appendicitis. The predisposing causes of her condition include:
I. Inadequate food intake
II. Kinking of the appendix
III. Presence of faecalith
IV. Persistent throat infection
Correct Answer: II, III, IV

50. Patient with traumatic head injury requires assistance in turning and positioning because of immobility and unconsciousness. Hyponatremia is common after head injury due to:
A. Sodium shifts in both intracellular and extracellular activities, electrolytes and volume
B. Sodium shifts in extracellular fluid, electrolytes and volume
C. Sodium shifts in intracellular fluid, electrolytes and volume