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 8 of 30

Hard
  • A. Slow the transfusion and reassess after 15 minutes
  • B. Stop the transfusion and keep the IV line open with normal saline
  • C. Administer the next prescribed unit using new tubing
  • D. Give an antipyretic and continue the transfusion slowly

Explanation: These findings suggest an acute transfusion reaction, so the transfusion must be stopped immediately.

Correct answer: Stop the transfusion and keep the IV line open with normal saline
Very hard
  • A. Equal chest movement on both sides
  • B. Auscultated breath sounds over both lungs
  • C. Continuous waveform capnography showing exhaled carbon dioxide
  • D. A pulse oximeter reading of 96 percent

Explanation: Continuous waveform capnography confirms exhaled carbon dioxide and is the most reliable immediate method for confirming tracheal…

Correct answer: Continuous waveform capnography showing exhaled carbon dioxide
Hard
  • A. Insert a padded tongue blade into the mouth
  • B. Restrain the arms and legs to prevent injury
  • C. Protect the airway and prepare the prescribed benzodiazepine
  • D. Offer oral water after each convulsion stops

Explanation: Prolonged seizure activity threatens breathing and requires rapid anticonvulsant treatment, so airway protection and preparation of a…

Correct answer: Protect the airway and prepare the prescribed benzodiazepine
  • A. Calcium gluconate
  • B. Sodium bicarbonate
  • C. Potassium chloride
  • D. Regular insulin

Explanation: Absent reflexes and respiratory depression indicate magnesium toxicity.

Correct answer: Calcium gluconate
  • A. Place the patient flat and encourage oral fluids
  • B. Elevate the head, maintain airway support and notify the emergency team
  • C. Give a sedative and dim the room lights
  • D. Perform repeated deep suctioning to stimulate consciousness

Explanation: Reduced consciousness, vomiting and unequal pupils may indicate rising intracranial pressure with possible herniation.

Correct answer: Elevate the head, maintain airway support and notify the emergency team
Very hard
  • A. Uncompensated respiratory acidosis
  • B. Uncompensated metabolic acidosis
  • C. Uncompensated respiratory alkalosis
  • D. Fully compensated metabolic alkalosis

Explanation: The low pH shows acidaemia, and the raised PaCO2 identifies a respiratory cause.

Correct answer: Uncompensated respiratory acidosis
Hard
  • A. Begin chest compressions immediately
  • B. Administer intravenous adrenaline
  • C. Assess the patient and check the electrodes and cable connections
  • D. Prepare the defibrillator for an unsynchronised shock

Explanation: The patient clearly has circulation, so the monitor tracing is probably artefact or a disconnected lead.

Correct answer: Assess the patient and check the electrodes and cable connections
  • A. Offer small sips of cool water
  • B. Apply a non-rebreather oxygen mask and call for early airway evaluation
  • C. Wait for facial swelling before preparing airway equipment
  • D. Place the patient supine and encourage coughing

Explanation: Soot and hoarseness suggest inhalation injury, and airway swelling can progress rapidly.

Correct answer: Apply a non-rebreather oxygen mask and call for early airway evaluation
  • A. Encourage the patient to walk to assess leg movement
  • B. Apply a pelvic binder according to emergency protocol
  • C. Massage the abdomen to locate the bleeding site
  • D. Place the patient in a sitting position without support

Explanation: Pelvic fractures can cause major concealed haemorrhage even without external bleeding.

Correct answer: Apply a pelvic binder according to emergency protocol
  • A. Oropharyngeal airway
  • B. Nasopharyngeal airway
  • C. Cuffed endotracheal tube
  • D. Supraglottic airway device

Explanation: An oropharyngeal airway holds the tongue away from the posterior pharynx in an unconscious patient without a gag reflex.

Correct answer: Oropharyngeal airway
Moderate
  • A. Intravenous isotonic fluid replacement
  • B. Subcutaneous long-acting insulin
  • C. Oral potassium replacement
  • D. Intravenous sodium bicarbonate routinely

Explanation: Circulatory support is the immediate priority because severe dehydration causes hypovolaemia and shock in diabetic ketoacidosis.

Correct answer: Intravenous isotonic fluid replacement
  • A. Give 15 g of rapid-acting carbohydrate
  • B. Give the usual dose of rapid-acting insulin
  • C. Provide a meal high in fat and protein
  • D. Ask the patient to rest and recheck later

Explanation: A conscious patient who can swallow should receive about 15 g of rapidly absorbed carbohydrate, followed by a glucose recheck after about…

Correct answer: Give 15 g of rapid-acting carbohydrate
  • A. Draw cloudy insulin before clear insulin
  • B. Draw clear insulin before cloudy insulin
  • C. Shake both insulin vials vigorously first
  • D. Mix glargine with NPH in the same syringe

Explanation: Regular insulin is clear and NPH insulin is cloudy, so clear insulin is drawn up before cloudy insulin.

Correct answer: Draw clear insulin before cloudy insulin
Very hard
  • A. Marked hyperglycaemia with little or no ketosis
  • B. Abdominal pain with deep rapid respirations
  • C. Positive serum ketones with metabolic acidosis
  • D. A fruity odour on the patient's breath

Explanation: Hyperosmolar hyperglycaemic state usually causes extreme hyperglycaemia, profound dehydration and altered mental status with minimal…

Correct answer: Marked hyperglycaemia with little or no ketosis
  • A. Walk barefoot indoors to strengthen the feet
  • B. Inspect the feet every day using a mirror if needed
  • C. Soak the feet in hot water before applying lotion
  • D. Cut the nails deeply into the corners each week

Explanation: Daily inspection helps the patient identify blisters, cuts and infection before they become serious ulcers.

Correct answer: Inspect the feet every day using a mirror if needed
Hard
  • A. Stop basal insulin until food intake returns
  • B. Check glucose and ketones more often than usual
  • C. Drink only sugar-free fluids regardless of glucose level
  • D. Exercise to lower the blood glucose level

Explanation: Illness can increase counter-regulatory hormones and insulin requirements, even when the patient is eating less.

Correct answer: Check glucose and ketones more often than usual
  • A. Progressive autoimmune destruction of pancreatic beta cells
  • B. Peripheral insulin resistance with gradual beta-cell failure
  • C. Excess cortisol causing persistent insulin resistance
  • D. Reduced thyroid hormone causing slow glucose absorption

Explanation: Type 1 diabetes results from destruction of pancreatic beta cells, causing little or no endogenous insulin production.

Correct answer: Progressive autoimmune destruction of pancreatic beta cells
  • A. Place the patient in a cool environment and assess vital signs frequently
  • B. Encourage vigorous exercise to reduce nervous energy
  • C. Offer a high-fibre meal before completing the assessment
  • D. Apply extra blankets to prevent heat loss

Explanation: Fever, severe tachycardia and confusion may indicate thyroid storm, a life-threatening emergency.

Correct answer: Place the patient in a cool environment and assess vital signs frequently
  • A. Intravenous hydrocortisone with isotonic fluid replacement
  • B. Fluid restriction with a low-sodium diet
  • C. Insulin infusion with potassium restriction
  • D. Levothyroxine with oral calcium supplements

Explanation: These findings suggest an adrenal crisis caused by inadequate cortisol and aldosterone, with shock risk from hypovolaemia.

Correct answer: Intravenous hydrocortisone with isotonic fluid replacement
Hard
  • A. Restrict oral fluids to prevent worsening polyuria
  • B. Administer prescribed desmopressin and monitor fluid balance
  • C. Give rapid-acting insulin and check urine ketones
  • D. Provide a low-protein diet and limit sodium strictly

Explanation: Diabetes insipidus results from inadequate antidiuretic hormone effect, causing excessive loss of dilute water.

Correct answer: Administer prescribed desmopressin and monitor fluid balance