Med Surg RN NCLEX Practice Questions
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Question 1 of 5.
A client is scheduled to have an elective mandibular osteotomy to correct a mandibular fracture sustained in an accident 6 months earlier. Which statement by the client indicates to the nurse maladaptive coping?
A. Å“I will be glad to have my jaw fixed because my wife thinks I do not look like myself.'Â
B. Å“I am somewhat afraid to have the surgery but feel OK about it.'Â
C. Å“My wife will help me, but I don't think I will need that much help.'Â
D. Å“I am ready to get this over with.'Â
Explanation: The statement about the wife's perception suggests the client's motivation is external and may reflect poor self-image or reliance on others' opinions, indicating maladaptive coping. The other statements show acceptance, realistic fear, or confidence, which are more adaptive.
Question 2 of 5.
A client with acute chest pain is receiving I.V. morphine sulfate. Which of the following results are intended effects of morphine in this client? Select all that apply.
A. Reduces myocardial oxygen consumption.
B. Promotes reduction in respiratory rate.
C. Prevents ventricular remodeling.
D. Reduces blood pressure and heart rate.
E. Reduces anxiety and fear.
Explanation: Morphine reduces pain, which lowers myocardial oxygen demand (A), decreases blood pressure and heart rate through vasodilation and reduced sympathetic response (D), and alleviates anxiety and fear (E). It does not prevent ventricular remodeling or directly reduce respiratory rate in this context.
Question 3 of 5.
Which of the following is an expected outcome for a client on the second day of hospitalization after a myocardial infarction (MI)? The client:
A. Has severe chest pain.
B. Can identify risk factors for MI.
C. Agrees to participate in a cardiac rehabilitation walking program.
D. Can perform personal self-care activities without pain.
Explanation: By the second day post-MI, the client should be able to perform self-care activities without pain, indicating stabilization. Severe pain is not expected, and risk factor identification or rehabilitation planning may occur later.
Question 4 of 5.
An older, sedentary adult may not respond to emotional or physical stress as well as a younger individual because of:
A. Left ventricular atrophy.
B. Irregular heartbeats.
C. Peripheral vascular occlusion.
D. Pacemaker placement.
Explanation: Aging leads to left ventricular atrophy, reducing cardiac reserve and impairing the heart's ability to respond to stress, unlike irregular heartbeats or pacemakers.
Question 5 of 5.
The nurse should teach the client that signs of digoxin toxicity include which of the following?
A. Rash over the chest and back.
B. Increased appetite.
C. Visual disturbances such as seeing yellow spots.
D. Elevated blood pressure.
Explanation: Visual disturbances, like seeing yellow spots (xanthopsia), are a hallmark of digoxin toxicity, requiring prompt reporting.
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