All Medical Surgical Nursing MCQs

Question 1

A patient with a suspected acute stroke suddenly develops facial drooping, slurred speech and weakness of the right arm. What is the priority nursing action?

Accepted Answer

Activate the stroke response and note symptom onset

Answer

Give oral fluids to prevent dehydration

Answer

Place the patient flat and leave to rest

Answer

Administer a sedative to reduce muscle activity

Question 2

Which assessment finding most strongly suggests raised intracranial pressure in an adult patient?

Accepted Answer

Widening pulse pressure with decreasing pulse rate

Answer

Increased appetite with warm, flushed skin

Answer

Rapid pulse with low blood pressure

Answer

Frequent diarrhoea with abdominal cramping

Question 3

A patient is having a generalized tonic-clonic seizure in the ward. Which action should the nurse take first?

Accepted Answer

Clear nearby objects and protect the head

Answer

Restrain the arms to prevent fractures

Answer

Insert a tongue blade between the teeth

Answer

Offer water immediately after the jerking begins

Question 4

A patient with suspected bacterial meningitis is admitted to the hospital. Which nursing action is most appropriate initially?

Accepted Answer

Use droplet precautions according to facility policy

Answer

Encourage visitors to share personal eating utensils

Answer

Place the patient in a brightly lit room

Answer

Delay antibiotics until neck stiffness resolves

Question 5

Which pupil finding should the nurse report immediately in a patient being monitored after a head injury?

Accepted Answer

One newly dilated pupil that reacts poorly to light

Answer

Equal pupils that constrict briskly to light

Answer

Mild tearing when exposed to bright light

Answer

Pupils that become smaller in dim light

Question 6

Which finding is most characteristic of an upper motor neuron lesion?

Accepted Answer

Spasticity with exaggerated deep tendon reflexes

Answer

Flaccid paralysis with absent reflexes

Answer

Muscle wasting with fasciculations

Answer

Reduced muscle tone with a normal plantar response

Question 7

A patient with a cervical spinal cord injury suddenly develops severe headache, sweating above the injury, nasal congestion and a blood pressure of 190/100 mmHg. What is the priority nursing action?

Accepted Answer

Sit the patient upright and assess for bladder distension

Answer

Place the patient flat and offer oral fluids

Answer

Apply a warm blanket and reduce room lighting

Answer

Encourage the patient to walk to improve circulation

Question 8

Which statement by a patient taking levodopa for Parkinson disease shows correct understanding of the treatment?

Accepted Answer

I should change positions slowly to reduce dizziness

Answer

I should stop the medicine when my tremor improves

Answer

I should double the next dose if I forget one dose

Answer

I should expect the medicine to cure the disease permanently

Question 9

A patient with multiple sclerosis reports new blurred vision, leg weakness and increasing fatigue during a hot afternoon. Which instruction is most appropriate?

Accepted Answer

Use cooling measures and plan rest periods

Answer

Perform strenuous exercise until the weakness stops

Answer

Take hot baths to relax the affected muscles

Answer

Avoid all activity permanently to prevent relapse

Question 10

A patient opens the eyes only when spoken to, speaks in confused sentences and withdraws the arm from painful stimulation. What Glasgow Coma Scale score should the nurse record?

Accepted Answer

11

Answer

9

Answer

10

Answer

12

Question 11

A patient admitted after an ischemic stroke is alert but has a wet voice and coughing when trying to drink water. Which nursing action is the priority?

Accepted Answer

Keep the patient nil by mouth and request a swallowing assessment

Answer

Offer thickened fluids and reassess the cough later

Answer

Place the patient flat and encourage repeated swallowing

Answer

Give oral medicines with water to test swallowing ability

Question 12

A patient with epilepsy has continuous generalized convulsions lasting more than five minutes without regaining consciousness. How should the nurse interpret this finding?

Accepted Answer

Status epilepticus requiring urgent treatment

Answer

A typical postictal state after a brief seizure

Answer

A focal seizure with preserved awareness

Answer

A sleep-related movement disorder needing observation

Question 13

A patient with suspected bacterial meningitis is receiving the first dose of an appropriate antibiotic. Which infection-control measure is required initially?

Accepted Answer

Use droplet precautions until 24 hours of effective antibiotics

Answer

Use contact precautions until the patient is afebrile

Answer

Use airborne precautions throughout the admission

Answer

Use standard precautions without additional measures

Question 14

A patient with a head injury has increasing drowsiness but is breathing independently and has stable vital signs. Which positioning action is most appropriate while urgent review is arranged?

Accepted Answer

Elevate the head about 30 degrees and keep the neck midline

Answer

Place the patient flat with the neck turned toward the side

Answer

Flex the hips sharply to improve venous drainage

Answer

Place the patient prone with the head lower than the chest

Question 15

A patient with a closed head injury has clear fluid draining from one nostril. What should the nurse do?

Accepted Answer

Apply a loose sterile dressing and notify the clinician

Answer

Pack the nostril firmly with gauze to stop the drainage

Answer

Ask the patient to blow the nose to clear the passage

Answer

Insert a nasogastric tube through the affected nostril

Question 16

A patient with a recent high thoracic spinal cord injury has a blood pressure of 78/44 mmHg, a pulse of 48 beats per minute and warm, dry skin. Which complication should the nurse suspect?

Accepted Answer

Neurogenic shock caused by loss of sympathetic tone

Answer

Hypovolemic shock caused by excessive fluid loss

Answer

Septic shock caused by an unrecognized infection

Answer

Obstructive shock caused by a pulmonary embolus

Question 17

A patient with Parkinson disease freezes while beginning to walk. Which nursing instruction is most helpful?

Accepted Answer

Stop safely, shift weight, and step over an imaginary line

Answer

Walk faster immediately to prevent the feet from stopping

Answer

Pull the patient forward by the arm to restart movement

Answer

Remain completely still until the freezing episode ends

Question 18

A patient with multiple sclerosis has urinary urgency, leg weakness and difficulty emptying the bladder. Which assessment is most important before planning bladder care?

Accepted Answer

Measure residual urine after the patient voids

Answer

Restrict all fluids after the evening meal

Answer

Insert an indwelling catheter without assessment

Answer

Encourage the patient to delay voiding for several hours

Question 19

Which finding is most consistent with a lower motor neuron lesion?

Accepted Answer

Flaccid weakness with muscle wasting and reduced reflexes

Answer

Spastic weakness with increased tone and brisk reflexes

Answer

Positive Babinski response with preserved muscle bulk

Answer

Slow voluntary movement with increased resistance to motion

Question 20

A patient with an acute spinal cord injury cannot feel pinprick below the umbilicus but can move both legs weakly. Which documentation is most useful for monitoring neurological change?

Accepted Answer

Record the exact sensory level and grade movement in each limb

Answer

Document only whether the patient reports back pain

Answer

Record the blood pressure once during every shift

Answer

Describe the legs as normal because some movement remains

All Free Medical Surgical Nursing MCQs with Answers