All Free Medical Surgical Nursing MCQs with Answers

• A. Pain and resistance when the neck is flexed
• B. Painless flexion of the neck toward the chest
• C. Marked weakness only in one lower limb
• D. Loss of sensation in a glove pattern

Explanation: Neck stiffness and resistance to passive neck flexion suggest meningeal irritation.

• A. Gingival enlargement and bleeding
• B. Severe urinary frequency and thirst
• C. Persistent dry cough and hoarseness
• D. Yellow discoloration of the sclera

Explanation: Phenytoin can cause gingival hyperplasia, especially when oral hygiene is poor, so regular dental care is important.

• A. Keep the head midline and elevate the head of the bed
• B. Place the patient flat and flex the neck forward
• C. Encourage repeated coughing to clear secretions
• D. Position the patient prone with the hips flexed

Explanation: A midline head position with moderate head elevation promotes venous drainage from the brain and may reduce intracranial pressure.

• A. Spinal shock
• B. Autonomic dysreflexia
• C. Neurogenic shock
• D. Brown-Séquard syndrome

Explanation: Spinal shock causes temporary loss of motor activity, sensation and reflexes below the injury, producing flaccid paralysis.

• A. Urgent non-contrast CT scan of the head
• B. Routine electroencephalogram after breakfast
• C. Lumbar puncture before neurological assessment
• D. Cervical spine radiograph before blood testing

Explanation: An urgent non-contrast CT scan helps distinguish an ischaemic stroke from intracranial haemorrhage before antiplatelet treatment is given.

• A. Possible phenytoin toxicity requiring review
• B. Expected improvement in seizure control
• C. Evidence of bacterial meningitis
• D. A normal response to intravenous fluid

Explanation: Nystagmus and ataxia are recognised signs of phenytoin toxicity and require prompt clinical review, including assessment of the drug level…

• A. Rise slowly and pause before walking
• B. Stop all prescribed medicines immediately
• C. Drink less fluid before getting out of bed
• D. Turn quickly to improve balance reactions

Explanation: Parkinson disease and antiparkinson medicines can contribute to orthostatic hypotension, so the patient should change position slowly and…

• A. A temporary worsening related to infection
• B. A definite permanent spinal cord lesion
• C. A new bacterial infection of the meninges
• D. A typical adverse effect of levodopa therapy

Explanation: Infection and fever can temporarily worsen existing multiple sclerosis symptoms without representing a new demyelinating relapse.

• A. Maintain airway support and suction secretions as needed
• B. Offer frequent oral fluids to clear the throat
• C. Place the patient supine without head support
• D. Give oral tablets with a small amount of water

Explanation: Airway protection and breathing take priority in a patient with reduced consciousness, so secretions should be cleared while airway…

• A. Report the new upper-limb neurological change immediately
• B. Massage both arms to restore normal circulation
• C. Encourage walking to test the patient's strength
• D. Apply heat to the neck to relax tight muscles

Explanation: New motor or sensory changes after spinal cord injury may indicate neurological deterioration and require immediate reporting and…

• A. States the name of the hospital only
• B. Follows a simple command only
• C. States the name, place and current time
• D. Withdraws the hand from painful stimulation

Explanation: Orientation means the patient correctly identifies important aspects of person, place and time.

• A. Left-sided neglect
• B. Expressive aphasia
• C. Right-sided hemianopia
• D. Impaired hearing on the left

Explanation: Left-sided neglect is an inability to attend to or recognise the left side, commonly associated with a right hemispheric stroke.

• A. Offer sips of water
• B. Place the patient in a side-lying position
• C. Restrain the arms and legs
• D. Ask the patient to walk to the bed

Explanation: Side-lying positioning helps maintain airway drainage during the postictal period and supports the breathing priority.

• A. Increasing alertness after rest
• B. New inability to obey a simple command
• C. Pulse of 76 beats per minute
• D. Equal hand grips bilaterally

Explanation: A new inability to follow commands suggests worsening level of consciousness or neurological function and requires prompt reporting.

• A. Loss of one ankle reflex
• B. Fasciculations in one hand
• C. Spasticity below the lesion
• D. Flaccid weakness in one finger

Explanation: Spasticity is an upper motor neuron feature caused by a central nervous system lesion such as spinal cord damage.

• A. Encourage large bites to shorten the meal
• B. Position the patient upright during meals
• C. Give thin liquids rapidly between bites
• D. Place the patient flat after each mouthful

Explanation: An upright position supports safer swallowing and reduces aspiration risk.

• A. Schedule demanding tasks during peak fatigue
• B. Alternate activity with planned rest periods
• C. Exercise until severe weakness develops
• D. Use hot baths before every activity

Explanation: Planned rest periods, pacing and energy conservation help reduce fatigue in multiple sclerosis.

• A. Reposition regularly and inspect the skin
• B. Apply a heating pad to the sacral area
• C. Massage reddened skin over bony areas
• D. Limit protein to reduce urine output

Explanation: Loss of sensation increases the risk of unnoticed pressure injury, so regular repositioning and frequent skin inspection are essential.

• A. Mild thirst after exercise
• B. New severe abdominal pain and vomiting
• C. Occasional hunger before meals
• D. Slightly increased sleep after dosing

Explanation: Severe abdominal pain and vomiting may indicate pancreatitis, a serious adverse effect of sodium valproate.

• A. Keep the patient flat and offer oral fluids
• B. Turn the patient to the side and assess the airway
• C. Encourage ambulation to improve circulation
• D. Dim the lights and postpone neurological checks

Explanation: Drowsiness and vomiting increase the risk of airway obstruction and aspiration, so airway assessment and side-lying positioning take…