All Free Medical Surgical Nursing MCQs with Answers

• A. Regular insulin
• B. NPH insulin
• C. Insulin glargine
• D. Insulin lispro

Explanation: Insulin glargine is a long-acting insulin formulated to provide a steady release and must not be mixed with other insulins.

• A. Assess respiratory effort and airway protection
• B. Measure the patient’s urine output
• C. Inspect the patient’s feet for injury
• D. Ask about the usual meal pattern

Explanation: Increasing drowsiness can reduce airway protection, while deep rapid breathing indicates severe metabolic acidosis.

• A. Take an extra dose before the study
• B. Discuss temporarily withholding it with the prescriber
• C. Replace it with rapid-acting insulin permanently
• D. Stop taking all diabetic medicines for one week

Explanation: Metformin may need to be withheld around iodinated contrast exposure because impaired renal function can increase the risk of lactic…

• A. Give sweet juice slowly by mouth
• B. Place glucose gel between the teeth
• C. Administer prescribed glucagon and call for help
• D. Give the person the next scheduled insulin dose

Explanation: An unconscious person may aspirate any oral food, drink or gel. Prescribed glucagon can raise blood glucose when the patient cannot…

• A. Persistent microalbuminuria
• B. Occasional post-meal thirst
• C. A single normal urine test
• D. Mild sweating before breakfast

Explanation: Persistent urinary albumin loss can be an early sign of diabetic kidney damage, often appearing before a major fall in renal function.

• A. The medicine prevents all insulin reactions
• B. The medicine may mask warning signs of hypoglycaemia
• C. The medicine should be stopped after one normal reading
• D. The medicine always causes severe hyperglycaemia

Explanation: Beta blockers such as propranolol can blunt adrenergic warning signs of hypoglycaemia, especially tachycardia and tremor.

• A. Encourage the patient to walk in the corridor
• B. Check for hypocalcaemia and notify the prescriber
• C. Offer a high-fibre snack with extra fluids
• D. Place the patient in a warm shower

Explanation: Perioral tingling and carpopedal spasm suggest hypocalcaemia caused by impaired parathyroid function after thyroid surgery.

• A. High sodium and low potassium
• B. Low sodium and high potassium
• C. High calcium and low glucose only
• D. Low sodium and low potassium

Explanation: Primary adrenal insufficiency causes deficient aldosterone, leading to sodium loss and potassium retention.

• A. Institute seizure precautions and notify the prescriber
• B. Encourage the patient to drink several litres of water
• C. Offer a low-sodium diet with unrestricted fluids
• D. Ambulate the patient independently every hour

Explanation: Severe hyponatraemia can cause cerebral oedema, confusion and seizures, so safety and seizure precautions are the immediate priority.

• A. Shake the vial vigorously before drawing the dose
• B. Roll the vial gently between the palms before drawing the dose
• C. Warm the vial in hot water for several minutes
• D. Draw the dose immediately after removing the vial from the refrigerator

Explanation: NPH insulin is a suspension, so it should be gently rolled to mix the insulin evenly without creating bubbles.

• A. Take the tablet now and skip breakfast
• B. Take the tablet with a glass of milk only
• C. Wait to take the tablet until ready to eat
• D. Double the next dose after eating breakfast

Explanation: Glipizide stimulates insulin release and can cause hypoglycaemia when taken without an adequate meal.

• A. High glucose, high bicarbonate and low ketones
• B. High glucose, low bicarbonate and positive ketones
• C. Normal glucose, high bicarbonate and positive ketones
• D. Low glucose, low bicarbonate and negative ketones

Explanation: Diabetic ketoacidosis causes insulin deficiency, increased ketone production and metabolic acidosis.

• A. Continue wearing the shoe until the blister dries
• B. Apply a heating pad to improve circulation
• C. Protect the area and avoid pressure on the heel
• D. Open the blister with a sterile needle at home

Explanation: A diabetic foot blister should be protected from further pressure and assessed for infection or tissue damage.

• A. Rub the eyes firmly to remove the gritty feeling
• B. Use prescribed lubricating drops and protect the eyes
• C. Restrict fluids to reduce swelling around the eyes
• D. Apply topical steroid cream directly into the eyes

Explanation: Thyroid eye disease can cause incomplete eyelid closure, corneal dryness and injury.

• A. Assess airway patency and respiratory effectiveness
• B. Measure the patient’s usual daily calorie intake
• C. Inspect the skin for changes in pigmentation
• D. Ask about the patient’s recent bowel pattern

Explanation: Severe hypothyroidism can progress to myxoedema coma, causing respiratory depression and reduced consciousness.

• A. Urine output decreases to a normal amount
• B. The patient reports mild thirst before lunch
• C. The patient gains weight rapidly and develops a headache
• D. Urine becomes less dilute during treatment

Explanation: Desmopressin reduces excessive urine loss, but too much water retention can cause hyponatraemia.

• A. I should exercise even when urine ketones are positive
• B. I will carry a fast source of glucose during exercise
• C. I can skip glucose monitoring on exercise days
• D. I should inject insulin into the exercising muscle before activity

Explanation: Exercise can lower blood glucose, so a patient with insulin-treated diabetes should carry a rapid source of glucose and monitor glucose as…

• A. Adrenocorticotropic hormone
• B. Antidiuretic hormone
• C. Prolactin
• D. Thyroid-stimulating hormone

Explanation: Excess prolactin can suppress reproductive hormones and cause amenorrhoea with galactorrhoea.

• A. Encourage vigorous exercise to lower the glucose
• B. Check urine or blood ketones before exercise
• C. Give the patient a high-fat snack immediately
• D. Tell the patient to omit the next insulin dose

Explanation: Hyperglycaemia with nausea may indicate developing ketone production, and exercise can worsen metabolic acidosis when insulin is…

• A. High aldosterone, low renin and low potassium
• B. Low aldosterone, high renin and high potassium
• C. High aldosterone, high renin and high potassium
• D. Low aldosterone, low renin and low potassium

Explanation: Primary hyperaldosteronism causes excessive aldosterone secretion, usually from an adrenal source.