All Free Medical Surgical Nursing MCQs with Answers

• A. Gastric outlet obstruction
• B. Perforation with peritonitis
• C. Acute pancreatitis
• D. Uncomplicated gastritis

Explanation: Sudden severe pain with a rigid, silent abdomen suggests perforation and peritonitis.

• A. Take it with a high-fat meal
• B. Take it on an empty stomach
• C. Take it only when pain begins
• D. Take it together with antacids

Explanation: Sucralfate forms a protective coating over the ulcer and works best on an empty stomach.

• A. Metabolic alkalosis
• B. Respiratory alkalosis
• C. Metabolic acidosis
• D. Respiratory acidosis

Explanation: Vomiting removes hydrochloric acid and may produce metabolic alkalosis, especially when fluid and chloride losses are prolonged.

• A. Skip lesions throughout the bowel
• B. Continuous inflammation beginning in the rectum
• C. Transmural fistula formation
• D. Cobblestone mucosa in the ileum

Explanation: Ulcerative colitis causes continuous mucosal inflammation that usually begins in the rectum and extends proximally.

• A. The obstruction is resolving
• B. The bowel may have perforated
• C. The patient is becoming comfortable
• D. The nasogastric tube is working

Explanation: A sudden reduction in colicky pain with worsening distension and tachycardia can indicate bowel ischemia or perforation.

• A. Three large meals high in fat
• B. Small frequent meals with adequate calories
• C. A fasting period until jaundice clears
• D. A high-salt diet to prevent weakness

Explanation: Small frequent meals are easier to tolerate and help maintain energy when nausea and anorexia are present.

• A. Mild pruritus after bathing
• B. Increasing abdominal collateral veins
• C. Occasional heartburn after meals
• D. A small bruise at an injection site

Explanation: Prominent abdominal collateral veins, sometimes called caput medusae, develop when portal blood is diverted through systemic veins.

• A. Serum potassium
• B. Serum calcium
• C. Haemoglobin level
• D. Blood amylase

Explanation: Spironolactone is a potassium-sparing diuretic, so hyperkalaemia is an important adverse effect to detect.

• A. Lactulose
• B. Rifaximin
• C. Diazepam
• D. Spironolactone

Explanation: Diazepam is a benzodiazepine that can cause sedation and further depress consciousness in hepatic encephalopathy.

• A. Use a hard-bristled toothbrush
• B. Use gentle oral care with a soft toothbrush
• C. Floss forcefully between all teeth
• D. Apply alcohol-based mouthwash frequently

Explanation: A soft toothbrush and gentle technique reduce trauma and bleeding in a patient with impaired clotting.

• A. Famotidine
• B. Omeprazole
• C. Sucralfate
• D. Magnesium hydroxide

Explanation: Famotidine is an H2 receptor antagonist that decreases gastric acid secretion.

• A. Use contact precautions and dedicated equipment
• B. Place the patient in protective isolation
• C. Encourage raw fruit and salad intake
• D. Administer an antidiarrhoeal without review

Explanation: C. difficile spreads through contaminated hands and surfaces, so contact precautions and dedicated equipment are required.

• A. Metabolic alkalosis
• B. Metabolic acidosis
• C. Respiratory alkalosis
• D. Respiratory acidosis

Explanation: Loss of gastric hydrochloric acid through prolonged vomiting commonly causes metabolic alkalosis.

• A. Fluid has accumulated in the peritoneal cavity
• B. The liver has become filled with swallowed air
• C. The stomach has stopped producing digestive enzymes
• D. The abdominal muscles have become permanently shortened

Explanation: Ascites is the accumulation of fluid in the peritoneal cavity, commonly related to portal hypertension and low albumin in cirrhosis.

• A. Treat the hypoglycaemia according to protocol
• B. Restrict all oral and intravenous fluids
• C. Administer a sedative for agitation
• D. Place the patient in a dark room only

Explanation: Severe hypoglycaemia can directly cause altered consciousness and is an immediate reversible threat to the brain.

• A. Small frequent meals with adequate calories
• B. Prolonged fasting to rest the liver
• C. A high-sodium diet to improve appetite
• D. Routine severe protein restriction for all patients

Explanation: Small frequent meals and an evening snack help prevent muscle breakdown and provide adequate energy in cirrhosis.

• A. Report the symptoms for infection assessment
• B. Advise doubling the corticosteroid dose
• C. Reassure the patient that infection is expected
• D. Recommend stopping the drug suddenly

Explanation: Corticosteroids suppress immune responses, so fever and respiratory symptoms require prompt assessment for infection.

• A. Clarify the procedure because trauma may cause bleeding
• B. Proceed because rectal procedures reduce portal pressure
• C. Give an intramuscular injection before examination
• D. Ask the patient to strain during the examination

Explanation: Rectal trauma and straining can precipitate bleeding in a patient with portal hypertension and fragile collateral vessels.

• A. Bile flow into the intestine is reduced
• B. The patient has improved liver function
• C. The findings confirm excessive gastric acid
• D. The changes are caused by increased intestinal iron

Explanation: Dark urine and pale stools can occur when impaired bile flow prevents normal bilirubin excretion into the intestine.

• A. Shake the suspension well before measuring
• B. Take it only with an empty stomach at bedtime
• C. Mix it with another medicine in the same cup
• D. Stop all prescribed ulcer treatment immediately

Explanation: Suspensions must be shaken so the medication is evenly distributed before the dose is measured.