All Free Medical Surgical Nursing MCQs with Answers
Every Medical Surgical Nursing question in the bank, across all chapters, each with the correct answer and a written explanation. Free and unlimited, with no account needed.
600 questions · page 26 of 30
- A. Collect the first urine passed after waking
- B. Clean the perineum and collect the midstream urine
- C. Insert an indwelling catheter before collecting urine
- D. Collect urine from the drainage bag of a catheter
Explanation: Cleaning the perineum and collecting midstream urine reduces contamination from skin and urethral organisms.
Correct answer: Clean the perineum and collect the midstream urine- A. Mild periorbital edema
- B. Urine that appears tea coloured
- C. Blood pressure of 170/100 mmHg
- D. Reduced appetite during breakfast
Explanation: Severe hypertension can cause complications such as encephalopathy, heart failure, or seizures, so it requires prompt reporting.
Correct answer: Blood pressure of 170/100 mmHg- A. Heavy proteinuria with low serum albumin
- B. Mild proteinuria with high serum albumin
- C. Glucosuria with low serum creatinine
- D. Hematuria with high serum calcium
Explanation: Damage to the glomerular filtration barrier causes heavy protein loss in urine, leading to hypoalbuminemia and edema.
Correct answer: Heavy proteinuria with low serum albumin- A. Prerenal injury caused by reduced renal perfusion
- B. Intrinsic injury caused by glomerular inflammation
- C. Postrenal injury caused by ureteric obstruction
- D. Chronic injury caused by long-term nephron loss
Explanation: Fluid loss reduces circulating volume and renal perfusion, producing prerenal acute kidney injury.
Correct answer: Prerenal injury caused by reduced renal perfusion- A. Measure blood pressure on the fistula arm
- B. Apply a tight dressing over the fistula daily
- C. Check for a thrill and bruit each shift
- D. Use the fistula arm for routine venipuncture
Explanation: A palpable thrill and audible bruit indicate blood flow through the fistula.
Correct answer: Check for a thrill and bruit each shift- A. Normal urine output
- B. Polyuria
- C. Oliguria
- D. Urinary frequency
Explanation: Adult urine output below 400 mL in 24 hours is commonly described as oliguria.
Correct answer: Oliguria- A. Red blood cell casts in the urine
- B. Clear urine with no formed elements
- C. Large glucose loss without ketones
- D. Many calcium crystals without blood
Explanation: Red blood cell casts form in damaged renal tubules after bleeding from the glomeruli and strongly support glomerulonephritis.
Correct answer: Red blood cell casts in the urine- A. Encourage vigorous oral fluids immediately
- B. Apply a warm compress and reassess later
- C. Report possible infected urinary obstruction promptly
- D. Ask the patient to walk until the stone passes
Explanation: Fever with obstruction suggests an infected, obstructed urinary tract, which can rapidly progress to sepsis and requires urgent medical…
Correct answer: Report possible infected urinary obstruction promptly- A. Place the patient supine and assess vital signs
- B. Offer a high-potassium fruit drink
- C. Ask the patient to stand and walk slowly
- D. Increase the prescribed ultrafiltration rate
Explanation: Hypotension during dialysis may result from excessive or rapid fluid removal, so the immediate priority is to support circulation and…
Correct answer: Place the patient supine and assess vital signs- A. I will drink extra water whenever my ankles swell
- B. I will record drinks, soup, ice, and other liquid foods
- C. I can ignore my daily weight if I have no thirst
- D. I will stop counting fluids on days when urine increases
Explanation: All liquid sources, including soup, ice, and liquid medicines, contribute to the daily fluid allowance and should be recorded.
Correct answer: I will record drinks, soup, ice, and other liquid foods- A. Prerenal kidney injury from reduced renal perfusion
- B. Intrinsic kidney injury from tubular damage
- C. Postrenal kidney injury from urinary obstruction
- D. Chronic kidney disease from gradual nephron loss
Explanation: The enlarged prostate obstructs urine flow, causing pressure to build above the obstruction and impairing kidney function.
Correct answer: Postrenal kidney injury from urinary obstruction- A. Reduced production of erythropoietin by the kidneys
- B. Increased production of erythropoietin by the liver
- C. Excessive destruction of platelets in the spleen
- D. Increased absorption of iron from the intestine
Explanation: Diseased kidneys produce less erythropoietin, so the bone marrow receives less stimulation to make red blood cells.
Correct answer: Reduced production of erythropoietin by the kidneys- A. Slow the next exchange and reassess the drainage
- B. Report suspected peritonitis promptly to the health-care provider
- C. Encourage the patient to walk to improve drainage
- D. Add extra fluid to the next dialysis exchange
Explanation: Cloudy dialysate with abdominal pain and fever strongly suggests peritonitis, a serious complication of peritoneal dialysis.
Correct answer: Report suspected peritonitis promptly to the health-care provider- A. Discard it after measuring the urine output
- B. Place it in a specimen container for laboratory analysis
- C. Flush it with tap water before returning it to the patient
- D. Store it in the medication refrigerator until discharge
Explanation: Stone analysis can identify its composition and guide prevention of recurrence.
Correct answer: Place it in a specimen container for laboratory analysis- A. Stop the medicine once the urine becomes clear
- B. Take the medicine for the prescribed course even if symptoms improve
- C. Save the remaining medicine for the next urinary infection
- D. Take the medicine only when urinary pain returns
Explanation: The full prescribed course helps eradicate the infection and reduces treatment failure and resistance.
Correct answer: Take the medicine for the prescribed course even if symptoms improve- A. A negative balance of 600 mL
- B. A positive balance of 600 mL
- C. A positive balance of 2,400 mL
- D. A negative balance of 2,400 mL
Explanation: Fluid balance equals intake minus output: 1,500 mL minus 900 mL equals a positive 600 mL.
Correct answer: A positive balance of 600 mL- A. Apply gentle skin care and reposition the patient regularly
- B. Restrict all movement to prevent loss of body protein
- C. Massage the swollen areas vigorously every four hours
- D. Place the patient in a dependent position for prolonged periods
Explanation: Severe edema stretches the skin and increases the risk of pressure injury and infection.
Correct answer: Apply gentle skin care and reposition the patient regularly- A. Irrigate the catheter routinely with sterile water
- B. Check the tubing for kinks and dependent loops
- C. Remove the catheter immediately without assessment
- D. Increase the patient’s fluid intake without checking the system
Explanation: A blocked or kinked drainage system is a common and correctable cause of absent urine flow.
Correct answer: Check the tubing for kinks and dependent loops- A. Place the patient on cardiac monitoring and notify the provider
- B. Offer a high-potassium fruit snack for additional energy
- C. Encourage ambulation to improve muscle strength
- D. Administer a potassium-containing intravenous fluid
Explanation: Severe hyperkalemia can cause life-threatening cardiac dysrhythmias, so cardiac monitoring and urgent reporting are the priority.
Correct answer: Place the patient on cardiac monitoring and notify the provider- A. It binds dietary phosphate in the intestine
- B. It directly increases erythropoietin production
- C. It dissolves urinary stones in the renal pelvis
- D. It prevents all bacterial infections of the urinary tract
Explanation: Calcium carbonate acts as a phosphate binder when taken with meals, reducing intestinal phosphate absorption.
Correct answer: It binds dietary phosphate in the intestine