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 27 of 30
- A. Daily weight at the same time
- B. Urine colour once per shift
- C. Blood pressure after meals
- D. Oral intake recorded at bedtime
Explanation: A daily weight taken under similar conditions reflects changes in total body water.
Correct answer: Daily weight at the same time- A. Apply a warm pack to the flank
- B. Encourage oral fluids if not restricted
- C. Administer the prescribed antibiotic
- D. Teach proper perineal hygiene
Explanation: Pyelonephritis is a kidney infection, so timely administration of the prescribed antibiotic treats the cause and helps prevent sepsis.
Correct answer: Administer the prescribed antibiotic- A. Concentrated urine with a high specific gravity
- B. Muddy brown granular casts in the urine
- C. Small urine volume after fluid loss
- D. Clear urine with no abnormal sediment
Explanation: Muddy brown granular casts are associated with tubular epithelial injury and acute tubular necrosis, an intrinsic kidney injury.
Correct answer: Muddy brown granular casts in the urine- A. Mild ankle edema in the evening
- B. Sudden shortness of breath and chest pain
- C. Foamy urine after waking
- D. A gradual increase in appetite
Explanation: Nephrotic syndrome increases the risk of venous thrombosis because proteins that prevent clotting are lost in urine.
Correct answer: Sudden shortness of breath and chest pain- A. Damaged kidneys may not remove extra potassium
- B. Salt substitutes always cause severe sodium loss
- C. Potassium is removed only during peritoneal dialysis
- D. High-potassium foods directly damage the bladder
Explanation: Reduced kidney function can impair potassium excretion, causing hyperkalaemia and potentially dangerous cardiac dysrhythmias.
Correct answer: Damaged kidneys may not remove extra potassium- A. I will drink enough fluid to keep my urine pale
- B. I will remain in bed to prevent stone movement
- C. I will avoid all calcium-containing foods
- D. I will take antibiotics whenever flank pain starts
Explanation: Adequate fluid intake helps dilute urine and reduces the concentration of stone-forming substances.
Correct answer: I will drink enough fluid to keep my urine pale- A. Recent exposure to contrast or nephrotoxic medicines
- B. Preference for sweet or salty foods
- C. Usual bedtime and sleeping position
- D. History of seasonal nasal symptoms
Explanation: Contrast agents and medicines such as aminoglycosides or nonsteroidal anti-inflammatory drugs can cause intrinsic renal injury.
Correct answer: Recent exposure to contrast or nephrotoxic medicines- A. Serum potassium of 6.2 mmol/L
- B. Haemoglobin of 10.2 g/dL
- C. Serum phosphate of 5.1 mg/dL
- D. Blood urea nitrogen of 58 mg/dL
Explanation: A markedly elevated potassium level can cause life-threatening cardiac dysrhythmias, so it requires urgent assessment and treatment.
Correct answer: Serum potassium of 6.2 mmol/L- A. Insert a prescribed urinary catheter
- B. Measure urine output after drainage
- C. Assess the abdomen for bladder distension
- D. Encourage the patient to drink two litres immediately
Explanation: Large additional fluid intake may worsen bladder distension when the patient cannot empty the bladder.
Correct answer: Encourage the patient to drink two litres immediately- A. Inspect the catheter tubing for kinks
- B. Place the patient flat and restrict movement
- C. Add extra dialysate to increase pressure
- D. Stop all future dialysis exchanges
Explanation: A kinked or compressed catheter can obstruct dialysate flow and cause discomfort from poor drainage.
Correct answer: Inspect the catheter tubing for kinks- A. Fluid volume deficit and electrolyte loss
- B. Pulmonary edema and severe hypertension
- C. Hypervolemia and dependent edema
- D. Complete urinary obstruction and anuria
Explanation: During the diuretic phase, the kidneys may produce large amounts of dilute urine without restoring normal concentrating ability.
Correct answer: Fluid volume deficit and electrolyte loss- A. Urinary loss of immunoglobulins weakens defense
- B. Reduced urine flow allows bacteria to multiply
- C. High blood pressure damages the white blood cells
- D. Excess albumin prevents normal antibody production
Explanation: Nephrotic syndrome causes increased glomerular permeability, allowing proteins including immunoglobulins to be lost in urine.
Correct answer: Urinary loss of immunoglobulins weakens defense- A. Warm the solution using a prescribed warming device
- B. Heat the solution rapidly in a household microwave
- C. Refrigerate the solution until the exchange begins
- D. Add antibiotics routinely before every exchange
Explanation: Peritoneal dialysis solution is warmed to body temperature with an approved warming device to reduce abdominal discomfort and cramping.
Correct answer: Warm the solution using a prescribed warming device- A. Limit high-phosphate foods as prescribed
- B. Increase cola drinks to improve hydration
- C. Take phosphate binders only between meals
- D. Add extra dairy products to replace lost protein
Explanation: Phosphate retention in chronic kidney disease can contribute to pruritus and bone-mineral problems.
Correct answer: Limit high-phosphate foods as prescribed- A. Dialysis disequilibrium syndrome
- B. Peritoneal dialysis peritonitis
- C. Renal colic from a ureteric stone
- D. Uncomplicated urinary tract infection
Explanation: Dialysis disequilibrium syndrome can occur when rapid removal of urea causes cerebral fluid shifts, especially during early treatments.
Correct answer: Dialysis disequilibrium syndrome- A. Advise the patient to discuss stopping it with the prescriber
- B. Tell the patient to double the dose with meals
- C. Explain that it protects kidney blood flow
- D. Recommend replacing it with another NSAID
Explanation: Nonsteroidal anti-inflammatory drugs can reduce renal blood flow and worsen kidney injury, particularly in chronic kidney disease.
Correct answer: Advise the patient to discuss stopping it with the prescriber- A. Assess airway, breathing, and oxygen saturation
- B. Measure the abdominal girth and check for edema
- C. Ask about the usual pattern of bowel movements
- D. Inspect the urine for visible sediment
Explanation: Deep, rapid respirations and drowsiness may indicate metabolic acidosis, which can impair breathing and consciousness.
Correct answer: Assess airway, breathing, and oxygen saturation- A. Burning urination with urinary frequency
- B. High fever with chills and flank pain
- C. Costovertebral angle tenderness with vomiting
- D. Sepsis with hypotension and altered consciousness
Explanation: Dysuria and frequency commonly occur with a lower urinary tract infection.
Correct answer: Burning urination with urinary frequency- A. Hemoglobin level
- B. Serum amylase level
- C. Urine ketone level
- D. Total bilirubin level
Explanation: Reduced erythropoietin production by diseased kidneys contributes to anemia, so epoetin alfa is monitored mainly through hemoglobin and…
Correct answer: Hemoglobin level- A. Monitor blood pressure, urine output, and electrolytes
- B. Clamp the catheter for several hours to prevent shock
- C. Encourage a large oral fluid intake without assessment
- D. Remove the catheter immediately after drainage begins
Explanation: Rapid relief of obstruction can be followed by post-obstructive diuresis, causing excessive fluid and electrolyte loss.
Correct answer: Monitor blood pressure, urine output, and electrolytes