Study with our Medical-Surgical Nursing Exam Question Qbank, Test 2. The questions include answers and detailed explanations. The exam subjects include sepsis, shock, hospital associated infections, chronic and acute pain management, cancer prevention, cancer diagnosis, treatments, hospice, respiratory disorders, adolescent care, renal, adolescent care, priorities of care, health promotion and maintenance, safe and effective care, and basic care and comfort.
Medical-Surgical Nursing Exam Question Qbank, Test 1
Medical-Surgical Nursing Exam Question Qbank, Test 3
Medical-Surgical Nursing Exam Question Qbank, Test 4
Medical-Surgical Nursing Exam Question Qbank, Test 5
Medical-Surgical Nursing Exam Question Qbank, Test 6
Medical Surgical Question 1: A 45-year-old male patient with a history of diabetes presents with a fever, productive cough, and shortness of breath. His chest X-ray reveals a consolidation in the right lower lobe. Which antibiotic would be the most appropriate initial choice for treating this suspected community-acquired pneumonia?
A) Vancomycin
B) Ciprofloxacin
C) Azithromycin
D) Amoxicillin-Clavulanate
Explanation: Azithromycin is a suitable initial choice for treating community-acquired pneumonia in an otherwise healthy individual with no recent antibiotic use. It covers common respiratory pathogens such as Streptococcus pneumoniae and atypical organisms like Mycoplasma and Chlamydia.
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Medical Surgical Question 2: A 30-year-old female presents with a severe skin infection characterized by redness, warmth, and fluctuant swelling. The infection has progressed rapidly, and there are streaks of redness extending from the affected area. What is the most appropriate initial treatment for this patient?
A) Oral cephalexin
B) Topical mupirocin
C) Intravenous vancomycin
D) Oral fluconazole
Explanation: The described clinical features, including rapid progression and streaking, suggest cellulitis with lymphangitis. Intravenous vancomycin should be initiated immediately to cover potential causative pathogens, including methicillin-resistant Staphylococcus aureus (MRSA).
Medical-Surgical Nursing Questions: Pneumonia Treatments
Medical Surgical Question 3: A 65-year-old male with a history of chronic obstructive pulmonary disease (COPD) is admitted with a COPD exacerbation. He is experiencing increased dyspnea, wheezing, and increased sputum production. What is the preferred initial treatment for this patient in managing his COPD exacerbation?
A) Systemic corticosteroids
B) Long-acting bronchodilators
C) Oxygen therapy
D) Antibiotics
Explanation: Oxygen therapy is the initial treatment of choice for patients with COPD exacerbations to correct hypoxemia. It improves oxygen saturation and reduces the workload on the heart and respiratory muscles, improving overall respiratory function. Cardiac, Cardiovascular
Medical-Surgical Nursing Questions Focus on Pneumonia: Causes and Diagnosis
Medical Surgical Question 4: A 55-year-old female patient presents with a sore throat, fever, and enlarged cervical lymph nodes. Examination reveals tonsillar exudates. Which of the following is the most appropriate treatment for this patient?
A) Oseltamivir
B) Amoxicillin
C) Azithromycin
D) Intravenous acyclovir
Explanation: The clinical presentation with tonsillar exudates is suggestive of streptococcal pharyngitis, which is best treated with antibiotics such as amoxicillin to prevent complications and reduce the duration of symptoms.
Medical Surgical Question 5: A 40-year-old male patient is postoperative following abdominal surgery. He develops a fever, increased abdominal pain, and purulent drainage from the surgical incision site. What is the most appropriate initial step in managing this patient’s suspected surgical site infection?
A) Continue postoperative antibiotics
B) Debride the wound
C) Perform a wound culture
D) Administer intravenous fluids
Explanation: When a surgical site infection is suspected, obtaining a wound culture is essential for identifying the specific causative pathogens and guiding appropriate antibiotic therapy. This step is crucial before modifying or continuing antibiotics or considering surgical interventions like debridement.
Medical-Surgical Nursing Questions: Focus on Medications for Pneumonia
Medical Surgical Question 6: A 60-year-old female patient with a history of rheumatoid arthritis is on chronic corticosteroid therapy. She presents with fever, malaise, and a new-onset cough with blood-tinged sputum. A chest X-ray reveals cavitary lesions in the upper lobes of both lungs. What is the most appropriate initial treatment for this patient’s suspected pulmonary infection?
A) Intravenous ampicillin-sulbactam
B) Isoniazid and rifampin
C) Intravenous fluconazole
D) Oral azithromycin
Explanation: The clinical presentation and chest X-ray findings are suggestive of reactivation tuberculosis in a patient on chronic corticosteroid therapy. Isoniazid and rifampin are the cornerstone drugs for the treatment of tuberculosis.
Medical Surgical Question 7: A 50-year-old male patient with a history of cirrhosis presents with a high fever, abdominal pain, and confusion. Examination reveals ascites and shifting dullness. Laboratory results show an elevated white blood cell count and a positive blood culture for Escherichia coli. What is the initial treatment of choice for this patient’s spontaneous bacterial peritonitis (SBP)? A) Intravenous ceftriaxone B) Intravenous vancomycin C) Oral fluconazole D) Intravenous metronidazole
Explanation: The presence of cirrhosis and SBP in this patient requires prompt antibiotic therapy with ceftriaxone or another third-generation cephalosporin to cover common pathogens associated with SBP.
Medical Surgical Question 8: A 35-year-old female patient presents with a skin abscess that is fluctuant and tender. Which procedure is most appropriate for managing this abscess?
A) Incision and drainage (I&D)
B) Topical antibiotic cream
C) Oral antibiotics
D) Steroid injection
Explanation: Fluctuant and tender skin abscesses typically require incision and drainage (I&D) as the primary treatment modality. This procedure allows for the evacuation of pus and facilitates faster healing.
Medical-Surgical Nursing Questions: Understanding Pneumonia Causes and Symptoms
Medical Surgical Question 9: A 25-year-old sexually active female presents with lower abdominal pain, fever, and cervical motion tenderness. She has a history of unprotected sexual intercourse. Which of the following is the most appropriate initial treatment for this patient’s suspected pelvic inflammatory disease (PID)?
A) Oral doxycycline and oral metronidazole
B) Intravenous ceftriaxone
C) Intravenous vancomycin
D) Oral fluconazole
Explanation: Intravenous ceftriaxone is a key component of the initial treatment for PID to cover Neisseria gonorrhoeae. Combination therapy with doxycycline and metronidazole is also essential to provide broad-spectrum coverage against other potential pathogens.
Medical Surgical Question 10: A 70-year-old male patient with a history of heart valve replacement presents with fever, chills, and sudden-onset severe back pain. A transesophageal echocardiogram reveals an aortic root abscess. What is the most appropriate initial treatment for this patient’s infective endocarditis?
A) Intravenous ceftriaxone and oral doxycycline
B) Intravenous vancomycin and gentamicin
C) Oral amoxicillin
D) Intravenous fluconazole
Explanation: The presence of an aortic root abscess in a patient with a prosthetic heart valve indicates infective endocarditis. The initial treatment includes a combination of intravenous vancomycin and gentamicin to cover common pathogens associated with prosthetic valve endocarditis. Cardiac, Cardiovascular
Understanding Pneumonia: Causes and Symptoms
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Medical Surgical Question 11: A 55-year-old male patient is admitted to the hospital for elective surgery. On the fourth day post-operation, he develops a fever, tachycardia, and purulent drainage from his surgical wound. What is the most appropriate initial antibiotic therapy for this patient’s suspected surgical site infection?
A) Ciprofloxacin
B) Vancomycin
C) Azithromycin
D) Amoxicillin
E) Trimethoprim-sulfamethoxazole
Explanation: In the context of a post-operative surgical site infection, especially when purulent drainage is present, empiric therapy with vancomycin is appropriate. It provides coverage for methicillin-resistant Staphylococcus aureus (MRSA), which is a common causative pathogen in healthcare-associated surgical infections.
Understanding Pneumonia: Medical-Surgical Nursing Questions
Medical Surgical Question 12: A 70-year-old female patient with a history of indwelling urinary catheterization develops signs and symptoms of urinary tract infection (UTI), including dysuria, urgency, and fever. Urinalysis reveals pyuria. What is the most appropriate initial antibiotic treatment for this healthcare-associated UTI?
A) Ceftriaxone
B) Nitrofurantoin
C) Ciprofloxacin
D) Amoxicillin-clavulanate
E) Trimethoprim-sulfamethoxazole
Explanation: Nitrofurantoin is a suitable initial antibiotic choice for uncomplicated UTIs, including those associated with indwelling urinary catheters. It has a narrow spectrum of activity and is effective against common uropathogens.
Medical Surgical Question 13: A 45-year-old male patient with a history of chronic obstructive pulmonary disease (COPD) is admitted to the hospital for worsening respiratory symptoms. On the second day of hospitalization, he develops fever, increased sputum production, and purulent sputum. What is the most appropriate initial antibiotic therapy for this patient’s healthcare-associated pneumonia?
A) Azithromycin
B) Ciprofloxacin
C) Vancomycin
D) Amoxicillin-clavulanate
E) Ceftriaxone
Explanation: In healthcare-associated pneumonia, especially in patients with underlying lung disease like COPD, empiric antibiotic therapy with amoxicillin-clavulanate is appropriate. It provides coverage for a broad spectrum of potential pathogens, including Haemophilus influenzae and Streptococcus pneumoniae.
Understanding Pneumonia: Medical-Surgical Nursing Questions
Medical Surgical Question 14: A 60-year-old male patient undergoes a cardiac catheterization procedure. Two days later, he develops a high fever, hypotension, and signs of systemic inflammation. Blood cultures reveal the presence of Staphylococcus aureus. What is the most appropriate initial antibiotic therapy for this patient’s healthcare-associated bloodstream infection?
A) Vancomycin and gentamicin
B) Ceftriaxone
C) Azithromycin
D) Amoxicillin
E) Ciprofloxacin
Explanation: In the case of a healthcare-associated bloodstream infection caused by Staphylococcus aureus, empiric therapy with vancomycin and gentamicin is appropriate. This combination provides coverage for both methicillin-resistant Staphylococcus aureus (MRSA) and potential gram-negative pathogens.
Medical Surgical Question 15: A 45-year-old female patient presents with a breast lump that she discovered during a self-breast examination. She has no family history of breast cancer. On physical examination, a firm, non-tender, mobile mass is palpable in her left breast. Which initial diagnostic test is the most appropriate in evaluating this breast lump?
A) Mammography
B) Breast ultrasound
C) Fine-needle aspiration (FNA)
D) Core needle biopsy
E) Breast MRI
Explanation: A breast ultrasound is the initial diagnostic test of choice for evaluating palpable breast lumps. It helps differentiate between solid and cystic masses, providing valuable information about the nature of the lump. Mammography is typically used as a screening tool and may be less informative in younger patients or those with dense breast tissue.
Medical-Surgical Nursing Questions: Pneumonia Questions, Answers and Rationales
Medical Surgical Question 16: A 55-year-old male patient presents with rectal bleeding and changes in bowel habits, including diarrhea and abdominal cramping. His family history includes colorectal cancer in a first-degree relative. What is the most appropriate initial screening test for colorectal cancer in this patient?
A) Stool guaiac test
B) Flexible sigmoidoscopy
C) Colonoscopy
D) Barium enema
E) Computed tomography (CT) colonography
Explanation: Colonoscopy is the most sensitive and specific initial screening test for colorectal cancer, especially in individuals with a family history. It allows for the direct visualization of the entire colon and the removal of precancerous polyps or the biopsy of suspicious lesions.
Medical Surgical Question 17: A 60-year-old female patient presents with persistent cough and hemoptysis. Chest X-ray reveals a suspicious lung mass. Which diagnostic test is most appropriate for confirming a diagnosis of lung cancer and determining its stage? A) Sputum cytology B) Bronchoscopy C) CT-guided lung biopsy D) Pulmonary function tests E) PET-CT scan
Explanation: PET-CT (positron emission tomography-computed tomography) is a valuable diagnostic tool for confirming the presence of lung cancer, assessing its stage, and detecting distant metastases. It combines functional and anatomical information, aiding in the accurate staging of the disease.
Medical Surgical Question 18: A 50-year-old male patient with a history of chronic hepatitis C presents with fatigue, unexplained weight loss, and abdominal discomfort. Laboratory tests reveal elevated liver enzymes, alpha-fetoprotein, and positive hepatitis C antibodies. Which diagnostic test is most appropriate for evaluating the possibility of hepatocellular carcinoma (HCC) in this patient?
A) Abdominal ultrasound
B) Liver biopsy
C) CT scan of the abdomen
D) Serum carcinoembryonic antigen (CEA) level
E) Upper gastrointestinal endoscopy
Explanation: Abdominal ultrasound is a useful initial screening test for hepatocellular carcinoma (HCC) in patients with chronic liver disease. It can detect liver lesions, including HCC, and is often used as a surveillance tool in at-risk individuals due to its availability, safety, and cost-effectiveness.
Medical Surgical Question 19: A 65-year-old female patient presents with bone pain and elevated serum calcium levels. Imaging studies reveal lytic lesions in multiple bones. Laboratory tests show increased serum protein electrophoresis and a monoclonal spike in immunoglobulin G (IgG). Which diagnostic test is most appropriate for confirming a diagnosis of multiple myeloma?
A) Bone marrow biopsy
B) Skeletal survey
C) Serum creatinine D) Urine culture
E) CT scan of the abdomen
Explanation: A bone marrow biopsy is the most definitive diagnostic test for confirming multiple myeloma. It allows for the assessment of plasma cell infiltration and the presence of monoclonal plasma cells, which are characteristic of the disease. Other tests, such as a skeletal survey and serum electrophoresis, may provide supporting evidence, but a bone marrow biopsy is essential for diagnosis.
Medical Surgical Question 20: A 55-year-old female patient is diagnosed with stage III breast cancer and is scheduled to undergo chemotherapy. She is concerned about potential hair loss. Which chemotherapy side effect management strategy can help minimize hair loss in this patient?
A) Scalp cooling (cold cap therapy)
B) Increasing the chemotherapy dose
C) Using a topical antifungal shampoo
D) Avoiding all hair products
E) Starting a high-dose steroid regimen
Explanation: Scalp cooling or cold cap therapy involves using a specialized cap cooled to a low temperature to reduce blood flow to the scalp during chemotherapy administration. This technique can help minimize hair loss by reducing the absorption of chemotherapy by the hair follicles, preserving hair density and quality. It is essential for patients who are concerned about chemotherapy-induced alopecia to discuss this option with their healthcare provider.
Medical Surgical Question 21: A 60-year-old male patient is receiving chemotherapy for colorectal cancer. He develops severe diarrhea, which is affecting his overall quality of life. What medication is commonly used to manage chemotherapy-induced diarrhea?
A) Antibiotics
B) Loperamide (Imodium)
C) Antiemetics
D) Pain relievers
E) Antacids
Explanation: Loperamide, sold under the brand name Imodium, is commonly used to manage chemotherapy-induced diarrhea. It works by slowing down bowel movements, reducing the frequency and severity of diarrhea episodes. However, it is important to consult with a healthcare provider before starting any medication to manage chemotherapy side effects.
Medical Surgical Question 22: A 45-year-old male patient is undergoing chemotherapy for lung cancer. He develops severe neutropenia, increasing his risk of infection. What intervention is essential in managing neutropenia during chemotherapy?
A) Starting a high-protein diet
B) Increasing fluid intake
C) Administering prophylactic antibiotics
D) Encouraging physical activity
E) Reducing pain medication
Explanation: In patients with severe neutropenia during chemotherapy, prophylactic antibiotics may be necessary to prevent potentially life-threatening infections. This intervention can help protect the patient’s weakened immune system. However, antibiotic selection should be guided by the healthcare provider based on the patient’s specific clinical situation and the risk of infection.
Medical Surgical Question 23: A 55-year-old female patient with ovarian cancer is undergoing chemotherapy. She experiences extreme fatigue and a significant decrease in her hemoglobin levels. What is the most appropriate intervention for managing chemotherapy-induced anemia in this patient?
A) Increasing fluid intake
B) Administering prophylactic antibiotics
C) Reducing chemotherapy dose
D) Blood transfusion
E) Encouraging physical activity
Explanation: For patients experiencing severe anemia due to chemotherapy, a blood transfusion may be necessary to restore hemoglobin levels and alleviate symptoms such as fatigue and weakness. The decision to transfuse should be made based on the patient’s clinical condition and hemoglobin levels, as determined by their healthcare provider.
Medical Surgical Question 24: A 65-year-old male patient with pancreatic cancer is receiving chemotherapy. He complains of persistent nausea and vomiting, which is affecting his ability to tolerate food and medications. What is the most appropriate pharmacological intervention for managing chemotherapy-induced nausea and vomiting in this patient?
A) Antibiotics
B) Loperamide (Imodium)
C) Pain relievers
D) Prophylactic antibiotics
E) Antiemetic medications such as ondansetron (Zofran)
Explanation: Antiemetic medications like ondansetron (Zofran) are commonly used to manage chemotherapy-induced nausea and vomiting. These medications work by blocking signals in the brain that trigger nausea and vomiting. They can significantly improve a patient’s quality of life during chemotherapy by preventing or reducing these distressing side effects.
Medical Surgical Question 25: A 40-year-old male patient has a family history of colon cancer, and he’s concerned about his own risk. What is the most effective screening test for the early detection and prevention of colorectal cancer?
A) Mammography
Prostate-specific antigen (PSA) test
C) Colonoscopy
D) Chest X-ray
Explanation: Colonoscopy is the most effective screening test for colorectal cancer prevention. It allows for the direct visualization of the colon, enabling the detection and removal of precancerous polyps, which can reduce the risk of developing colorectal cancer. Other tests, such as mammography and the PSA test, are specific to breast and prostate cancer, respectively, and not suitable for colorectal cancer screening.
Medical Surgical Question 26: A 35-year-old female patient has a strong family history of breast cancer. What is the recommended approach for cancer prevention in this high-risk individual? A) Monthly self-breast examinations B) Annual mammography starting at age 40 C) Annual mammography starting at age 30 D) Prophylactic mastectomy
Explanation: High-risk individuals with a strong family history of breast cancer may benefit from earlier and more frequent mammographic screening. Starting annual mammograms at age 30 allows for the early detection of breast cancer, which can improve outcomes. Prophylactic mastectomy is an option for some high-risk individuals but is a more invasive choice and should be discussed with a healthcare provider.
Medical Surgical Question 27: A 50-year-old male patient is concerned about his risk of developing lung cancer because he has a long history of smoking. What is the most effective method for lung cancer prevention in this patient?
A) Chest X-ray screening
B) Annual physical examinations
C) Smoking cessation
D) High-dose vitamin supplements
Explanation: Smoking cessation is the most effective method for lung cancer prevention in individuals with a history of smoking. Continuing to smoke significantly increases the risk of developing lung cancer. Annual chest X-ray screenings may detect lung cancer at a later stage but do not prevent it. High-dose vitamin supplements have not been proven to prevent lung cancer.
Medical Surgical Question 28: A 45-year-old female patient has a family history of skin cancer, particularly melanoma. What preventive measures should she take to reduce her risk of developing skin cancer?
A) Regular use of tanning beds
B) Sunscreen with a low SPF
C) Avoiding outdoor activities during peak sun hours
D) Frequent skin examinations and self-checks
Explanation: Frequent skin examinations and self-checks are essential for early detection of skin cancer, including melanoma. Avoiding tanning beds, using sunscreen with a high SPF, and taking precautions during peak sun hours (such as wearing protective clothing and hats) are also important measures for skin cancer prevention. Regular use of tanning beds and low SPF sunscreen should be avoided as they increase the risk of skin cancer.
Medical Surgical Question 29: A 60-year-old male patient has a family history of prostate cancer, and he’s concerned about his own risk. What is the recommended approach for prostate cancer prevention and early detection in this patient?
A) Annual prostate-specific antigen (PSA) testing starting at age 40
B) Monthly self-prostate examinations
C) Routine prostate biopsies
D) No specific screening or prevention measures
Explanation: There is ongoing debate regarding prostate cancer screening in asymptomatic individuals. The recommended approach for prostate cancer prevention and early detection varies based on individual risk factors and should be discussed with a healthcare provider. Routine PSA testing is not universally recommended due to concerns about overdiagnosis and overtreatment. Monthly self-prostate examinations and routine prostate biopsies are not established screening methods. The decision should be individualized based on the patient’s age, family history, and other factors.
Medical Surgical Question 30: A 60-year-old male patient undergoes a total knee replacement surgery and is now in the rehabilitation phase. He experiences significant pain, swelling, and stiffness in his operated knee. What is the most appropriate nursing intervention to address these post-operative symptoms effectively?
A) Administering opioid pain medications on a fixed schedule
B) Encouraging the patient to avoid moving the operated knee to prevent discomfort
C) Applying ice to the knee for 20 minutes every hour
D) Elevating the leg on pillows to promote circulation
Explanation: Applying ice (cryotherapy) to the surgical site can help reduce post-operative pain, swelling, and stiffness. This intervention is particularly effective during the early stages of knee replacement rehabilitation. Opioid pain medications should be administered as needed, rather than on a fixed schedule, to minimize the risk of dependency. Encouraging gentle movement and elevation of the leg can also help reduce swelling and improve circulation, but ice application is the most direct way to address the described symptoms.
Medical Surgical Question 31: A 45-year-old female patient has had a stroke that resulted in left-sided hemiplegia. During rehabilitation, she experiences difficulties with mobility and balance. What is the primary goal of rehabilitation for this patient?
A) Maximizing pain relief
B) Promoting complete independence
C) Improving neurological function
D) Preventing further stroke episodes
Explanation: The primary goal of rehabilitation for a patient with stroke-related hemiplegia is to promote complete independence in activities of daily living to the greatest extent possible. While improving neurological function and preventing further stroke episodes are important aspects of care, the ultimate aim is to help the patient regain as much functional independence as possible.
Medical Surgical Question 32: A 55-year-old male patient is recovering from a traumatic brain injury (TBI) and is undergoing rehabilitation. He has difficulty with memory, problem-solving, and executive function. Which cognitive rehabilitation approach is most appropriate for addressing these deficits? A) Passive range of motion exercises B) Occupational therapy C) Physical therapy D) Speech therapy
Explanation: Occupational therapy is the most appropriate rehabilitation approach for addressing cognitive deficits associated with traumatic brain injury (TBI). Occupational therapists work with patients to improve their ability to perform daily activities, including memory, problem-solving, and executive function tasks. While other therapies like physical therapy, passive range of motion exercises, and speech therapy may also be necessary in TBI rehabilitation, occupational therapy focuses on cognitive and functional aspects.
Medical Surgical Question 33: A 70-year-old male patient had a below-the-knee amputation due to peripheral vascular disease. He is in the early stages of rehabilitation. What is the primary nursing intervention during this phase to support the patient’s recovery? A) Teaching the patient to use crutches for ambulation B) Providing emotional support and counseling C) Administering intravenous antibiotics D) Elevating the residual limb to minimize swelling
Explanation: In the early stages of rehabilitation following an amputation, providing emotional support and counseling is a primary nursing intervention. Patients may experience a range of emotions, including grief, depression, and anxiety, as they adapt to their new physical condition. Emotional support is crucial for helping patients cope and engage in the rehabilitation process effectively. Teaching ambulation techniques, administering antibiotics, and elevating the residual limb are important interventions but not the primary focus during this phase.
Medical Surgical Question 34: A 65-year-old female patient is admitted to a rehabilitation unit following a spinal cord injury. She has paraplegia and limited mobility. What is the primary goal of rehabilitation for this patient? A) Pain management B) Restoration of spinal cord function C) Maximizing functional independence D) Prevention of future spinal cord injuries
Explanation: The primary goal of rehabilitation for a patient with paraplegia due to a spinal cord injury is to maximize functional independence. While pain management, restoration of spinal cord function (if possible), and prevention of future injuries are important aspects of care, the primary aim is to help the patient regain as much independence as possible in activities of daily living, mobility, and self-care. This involves physical therapy, occupational therapy, and other multidisciplinary interventions to enhance function and quality of life.
Medical Surgical Question 35: A 50-year-old male patient has been in rehabilitation following a traumatic orthopedic injury involving multiple fractures. He is scheduled to be discharged soon but still experiences significant pain. What nursing intervention is crucial in preparing this patient for discharge from rehabilitation? A) Providing mobility aids, such as a walker or crutches B) Reviewing the patient’s insurance coverage and financial options C) Developing a detailed home exercise program D) Ensuring adequate pain management and medication education
Explanation: Ensuring adequate pain management and medication education is a crucial nursing intervention when preparing a patient for discharge from rehabilitation. This step helps the patient understand and manage pain effectively once they transition back home. While providing mobility aids, reviewing insurance coverage, and developing a home exercise program are important aspects of discharge planning, addressing pain management is a priority to optimize the patient’s post-rehabilitation experience and recovery.
Medical Surgical Question 36: A 45-year-old female patient is in rehabilitation following a traumatic brain injury (TBI). She has difficulty with verbal communication and is often frustrated when trying to express herself. What nursing intervention is essential for helping this patient improve her communication skills? A) Administering pain medication B) Providing physical therapy C) Encouraging expressive writing exercises D) Speech therapy and communication devices
Explanation: The essential nursing intervention to help a patient with communication difficulties following a traumatic brain injury is speech therapy and the use of communication devices. Speech therapists are trained to work with patients to improve verbal communication, language skills, and alternative methods of communication when necessary. While pain management, physical therapy, and expressive writing exercises may be part of the patient’s overall care plan, addressing communication difficulties through speech therapy and communication devices is crucial for improving the patient’s quality of life and functional abilities.
Medical Surgical Question 37: A 55-year-old male patient is undergoing rehabilitation following a spinal cord injury that resulted in quadriplegia. He has difficulty with activities of daily living and mobility. What is the primary nursing goal during rehabilitation for this patient? A) Pain management B) Restoration of spinal cord function C) Maximizing functional independence D) Prevention of future spinal cord injuries
Explanation: The primary goal of rehabilitation for a patient with quadriplegia due to a spinal cord injury is to maximize functional independence. While pain management, restoration of spinal cord function (if possible), and prevention of future injuries are important aspects of care, the primary aim is to help the patient regain as much independence as possible in activities of daily living, mobility, and self-care. This involves physical therapy, occupational therapy, and other multidisciplinary interventions to enhance function and quality of life.
Medical Surgical Question 38: A 65-year-old male patient with diabetes and peripheral vascular disease is being discharged home after a lower extremity amputation. The wound is healing well, but he requires ongoing wound care. What healthcare professional is most appropriate to provide wound care at the patient’s home? A) Home health aide B) Physical therapist C) Nurse practitioner D) Family member
Explanation: Home health aides are trained and qualified to provide wound care and assist with activities of daily living in the patient’s home. They work under the supervision of registered nurses or other healthcare professionals and can help ensure that the patient’s wound heals properly, reducing the risk of complications.
Medical Surgical Question 39: An 80-year-old female patient is being discharged home after a recent hospitalization for heart failure exacerbation. She has a history of medication non-compliance and frequent readmissions. What is a crucial component of her home care plan to prevent readmissions? A) Increasing the number of prescribed medications B) Scheduling frequent in-person follow-up appointments C) Providing written instructions in complex medical terminology D) Medication reconciliation and education on proper medication management
Correct Answer: D) Medication reconciliation and education on proper medication management
Explanation: Medication reconciliation and education on proper medication management are crucial components of the home care plan for preventing readmissions, particularly in patients with a history of medication non-compliance. Ensuring that the patient understands their medications, how to take them, and the importance of adherence can help reduce the risk of exacerbations and readmissions. Cardiac, Cardiovascular
Medical Surgical Question 40: A 70-year-old male patient with advanced cancer is being discharged home with hospice care. He experiences uncontrolled pain and other distressing symptoms. What is the primary focus of hospice care in this patient? A) Curative treatment B) Prolonging life C) Pain and symptom management D) Aggressive medical interventions
Explanation: The primary focus of hospice care is to provide comfort and improve the quality of life for patients with advanced illnesses, like cancer, rather than pursuing curative treatments or aggressive medical interventions. Pain and symptom management, along with emotional and psychosocial support, are central components of hospice care to ensure that the patient’s end-of-life experience is as comfortable and dignified as possible.
Medical Surgical Question 41: A 55-year-old female patient with a recent stroke is being discharged home with home health care services. She requires assistance with activities of daily living and rehabilitation. Which healthcare professional is likely to provide rehabilitation services in the patient’s home? A) Home health aide B) Registered nurse C) Physical therapist D) Primary care physician
Explanation: Physical therapists are trained healthcare professionals who specialize in rehabilitation. They can provide rehabilitation services in the patient’s home to help improve mobility, strength, and overall function following a stroke or other medical conditions. Home health aides and registered nurses may assist with various aspects of care, but physical therapists focus on rehabilitation.
Medical Surgical Question 42: A 45-year-old male patient is discharged home after major surgery and requires wound care and intravenous (IV) antibiotics. What is the most appropriate healthcare provider to coordinate and oversee the patient’s home care in this complex situation? A) Home health aide B) Primary care physician C) Nurse practitioner D) Home healthcare nurse
Explanation: In a situation requiring wound care and IV antibiotics, a home healthcare nurse is the most appropriate healthcare provider to coordinate and oversee the patient’s home care. Home healthcare nurses are skilled in managing complex medical needs, including administering IV medications, monitoring wounds, and providing comprehensive care to patients in their home environments. They work closely with other healthcare professionals, such as nurse practitioners and primary care physicians, to ensure the patient’s needs are met and that they receive appropriate and safe care at home.
Medical Surgical Question 43: A 60-year-old female patient is being discharged home after a hip replacement surgery. She needs assistance with mobility and activities of daily living during her recovery. What is the primary role of a home health aide in the patient’s care plan? A) Administering medications B) Coordinating physical therapy sessions C) Assisting with ambulation and activities of daily living D) Providing wound care and dressing changes
Correct Answer: C) Assisting with ambulation and activities of daily living
Explanation: The primary role of a home health aide in the care plan for a patient recovering from hip replacement surgery is to assist with ambulation (walking) and activities of daily living, such as bathing, dressing, and meal preparation. While they may assist with medication reminders and other tasks as directed, their focus is on helping the patient regain independence in these essential activities to support their recovery and rehabilitation.
Medical Surgical Question 44: A 70-year-old male patient with end-stage heart failure is discharged home with palliative care. He experiences severe shortness of breath and anxiety. What is the primary goal of palliative care in this patient? A) Aggressive disease management B) Prolonging life at all costs C) Symptom management and improving quality of life D) Curative treatments and interventions
Explanation: The primary goal of palliative care for a patient with end-stage heart failure is to provide symptom management and improve the patient’s quality of life. Palliative care focuses on addressing symptoms, such as shortness of breath and anxiety, and providing emotional and psychosocial support to enhance comfort and overall well-being. It does not pursue aggressive disease management, curative treatments, or the goal of prolonging life at all costs, as hospice and palliative care prioritize comfort and dignity at the end of life. Cardiac, Cardiovascular
Medical Surgical Question 45: A 55-year-old female patient with multiple chronic conditions is being discharged home with a complex medication regimen. She has difficulty managing her medications independently. What healthcare professional is most appropriate to ensure proper medication management and reconciliation in the home setting? A) Home health aide B) Physical therapist C) Pharmacist D) Registered nurse
Explanation: A pharmacist is the most appropriate healthcare professional to ensure proper medication management and reconciliation in the home setting for a patient with multiple chronic conditions. Pharmacists can review the patient’s medication regimen, provide education on how to take medications correctly, and identify and address potential drug interactions or issues. While home health aides, physical therapists, and registered nurses may play important roles in the patient’s care, pharmacists have specialized knowledge in medication management and safety.
Medical Surgical Question 46: A 65-year-old male patient is being discharged home after recovering from a severe respiratory infection. He requires oxygen therapy at home to maintain adequate oxygen levels. What is a critical aspect of home care for this patient receiving oxygen therapy? A) Frequent changes in the oxygen flow rate B) Leaving the oxygen tank near an open flame source C) Storing oxygen tanks in a confined, unventilated space D) Ensuring proper oxygen safety measures and storage
Explanation: A critical aspect of home care for a patient receiving oxygen therapy is ensuring proper oxygen safety measures and storage. Oxygen supports combustion, and improper handling can lead to fire hazards. It is essential to educate the patient and their caregivers on safe storage practices, including keeping oxygen away from open flames, ensuring good ventilation, and avoiding smoking while using oxygen. Frequent changes in the oxygen flow rate should be prescribed and monitored by a healthcare provider, and oxygen tanks should never be stored in confined, unventilated spaces to prevent oxygen concentration buildup.
Medical Surgical Question 47: A 45-year-old female patient is being discharged home after abdominal surgery. She requires wound care and dressing changes. What healthcare professional is typically responsible for providing wound care and dressing changes in the home setting? A) Home health aide B) Primary care physician C) Pharmacist D) Home healthcare nurse
Explanation: In the home setting, a home healthcare nurse is typically responsible for providing wound care and dressing changes for patients who have recently undergone surgery or have other wound care needs. These nurses are trained to perform these tasks safely and effectively and ensure that the patient’s wounds are healing properly. While other healthcare professionals may have roles in the patient’s care, the home healthcare nurse specializes in hands-on care delivery in the home environment.
Medical Surgical Question 48: A 50-year-old male patient with advanced cancer is discharged home with hospice care. His family members are actively involved in his care. What is a crucial component of hospice care for both the patient and the family? A) Aggressive medical interventions B) Prolonging life at all costs C) Emotional and psychosocial support D) Curative treatments and disease management
Explanation: A crucial component of hospice care for both the patient and their family is the provision of emotional and psychosocial support. Hospice focuses on improving the quality of life, managing symptoms, and enhancing the patient’s and family’s emotional well-being during the end-of-life journey. It does not pursue aggressive medical interventions, curative treatments, or the goal of prolonging life at all costs, as the primary aim is to provide comfort and dignity in the final stages of life.
Medical Surgical Question 49: A 75-year-old female patient with advanced metastatic cancer has opted for hospice care. She is experiencing severe pain that is not well-controlled with her current pain medication. What is the most appropriate nursing intervention to address the patient’s pain effectively? A) Administering additional opioids to the patient B) Reassuring the patient that pain is a natural part of her condition C) Consulting the hospice interdisciplinary team to adjust pain management D) Suggesting alternative therapies such as massage or acupuncture
Explanation: The most appropriate nursing intervention to address the patient’s severe pain in hospice care is to consult the hospice interdisciplinary team, which includes physicians, nurses, and other specialists. Adjustments to pain management, such as changes in medication type or dosage, can be made collaboratively to ensure the patient’s comfort while minimizing side effects and risks. While additional opioids may be necessary, it should be guided by the healthcare team’s assessment and expertise.
Medical Surgical Question 49: A 60-year-old male patient in hospice care due to end-stage heart failure is experiencing profound fatigue and shortness of breath. What nursing intervention is essential to improve the patient’s comfort and quality of life? A) Initiating cardiopulmonary resuscitation (CPR) in case of respiratory distress B) Administering high-dose diuretics to reduce fluid retention C) Providing oxygen therapy at a high flow rate D) Offering emotional support and assistance with symptom management
Correct Answer: D) Offering emotional support and assistance with symptom management
Explanation: In hospice care for a patient with end-stage heart failure, the essential nursing intervention is to offer emotional support and assistance with symptom management. Initiating CPR, administering high-dose diuretics, or providing high-flow oxygen therapy may not align with the goals of hospice care, which prioritize comfort, dignity, and quality of life at the end of life. The focus should be on alleviating symptoms, addressing emotional and psychosocial needs, and ensuring a peaceful and comfortable transition. Cardiac, Cardiovascular
Medical Surgical Question 49: A 55-year-old male patient receiving hospice care due to advanced cancer is experiencing severe nausea and vomiting. What is the most appropriate nursing intervention to manage these symptoms effectively? A) Administering antiemetic medications as prescribed B) Encouraging the patient to eat frequent, small meals C) Advising the patient to drink large amounts of water D) Suggesting alternative therapies like aromatherapy
Correct Answer: A) Administering antiemetic medications as prescribed
Explanation: The most appropriate nursing intervention to manage severe nausea and vomiting in a hospice patient is to administer antiemetic medications as prescribed by the healthcare provider. Antiemetics are effective in controlling nausea and vomiting and can significantly improve the patient’s comfort. Encouraging small meals, hydration, and alternative therapies may be considered but should not replace prescribed medical interventions when symptoms are severe.
Medical Surgical Question 49: A 70-year-old female patient in hospice care is experiencing agitation and restlessness. What nursing intervention can help provide comfort and alleviate these symptoms effectively? A) Administering antipsychotic medications as needed B) Recommending vigorous physical exercise C) Encouraging constant stimulation and activity D) Providing a calm and soothing environment
Correct Answer: D) Providing a calm and soothing environment
Explanation: For a hospice patient experiencing agitation and restlessness, the most appropriate nursing intervention is to provide a calm and soothing environment. Antipsychotic medications should only be considered when other non-pharmacological interventions are ineffective or when the patient’s safety or comfort is at risk. Recommending vigorous physical exercise and constant stimulation may not be suitable for a hospice patient’s condition and comfort, as the focus should be on creating a peaceful and supportive environment.
Medical Surgical Question 49: An 80-year-old male patient in hospice care due to end-stage chronic obstructive pulmonary disease (COPD) is experiencing significant dyspnea (shortness of breath). What nursing intervention is crucial for addressing the patient’s respiratory distress effectively? A) Administering high-flow oxygen therapy B) Encouraging the patient to engage in deep breathing exercises C) Initiating cardiopulmonary resuscitation (CPR) in case of respiratory failure D) Providing oxygen therapy at a comfortable flow rate
Correct Answer: D) Providing oxygen therapy at a comfortable flow rate
Explanation: In hospice care for a patient with end-stage COPD experiencing significant dyspnea, the crucial nursing intervention is to provide oxygen therapy at a comfortable flow rate to alleviate respiratory distress. High-flow oxygen may not always be appropriate as it may not improve the patient’s comfort and could lead to discomfort. Encouraging deep breathing exercises can be helpful, but it should be done at the patient’s pace and comfort level. Initiating CPR is not aligned with the goals of hospice care, which prioritize comfort and quality of life at the end of life.
Medical Surgical Question 53: A 40-year-old female patient presents with fatigue, pale skin, and frequent infections. Laboratory tests reveal a low hemoglobin level and a reduced number of red blood cells. What condition is likely responsible for these symptoms? A) Infectious mononucleosis B) Anemia C) Leukemia D) Lymphoma
Correct Answer: B) Anemia
Explanation: The patient’s symptoms of fatigue, pale skin, frequent infections, low hemoglobin level, and reduced red blood cell count are indicative of anemia. Anemia is a condition characterized by a decreased number of red blood cells or a deficiency in hemoglobin, which can lead to reduced oxygen-carrying capacity and result in symptoms such as fatigue and pallor.
Medical Surgical Question 53: A 55-year-old male patient is diagnosed with lymphoma. Which of the following statements accurately describes lymphoma? A) Lymphoma is a type of anemia. B) Lymphoma is a cancer of the lymphatic system. C) Lymphoma is a bacterial infection of the lymph nodes. D) Lymphoma is a benign growth in the spleen.
Correct Answer: B) Lymphoma is a cancer of the lymphatic system.
Explanation: Lymphoma is a cancer that originates in the lymphatic system, which includes the lymph nodes, lymphatic vessels, spleen, and other lymphoid tissues. It is characterized by the abnormal proliferation of lymphocytes, a type of white blood cell, and can manifest as Hodgkin lymphoma or non-Hodgkin lymphoma.
Medical Surgical Question 53: A 45-year-old female patient presents with painful, swollen lymph nodes in her neck and armpits. She also reports night sweats and unexplained weight loss. What condition should be considered based on these symptoms? A) Anemia B) Lymphoma C) Leukemia D) Infectious mononucleosis
Correct Answer: B) Lymphoma
Explanation: The patient’s symptoms of painful, swollen lymph nodes, night sweats, and unexplained weight loss are suggestive of lymphoma, a cancer of the lymphatic system. These symptoms may be associated with both Hodgkin lymphoma and non-Hodgkin lymphoma. Further evaluation and diagnostic tests would be needed to confirm the diagnosis.
Medical Surgical Question 53: A 50-year-old male patient is diagnosed with infectious mononucleosis (mono). Which virus is primarily responsible for causing mono? A) Epstein-Barr virus (EBV) B) Influenza virus C) Hepatitis C virus (HCV) D) Human immunodeficiency virus (HIV)
Correct Answer: A) Epstein-Barr virus (EBV)
Explanation: Infectious mononucleosis, commonly known as mono, is primarily caused by the Epstein-Barr virus (EBV), a member of the herpesvirus family. This viral infection is characterized by symptoms such as sore throat, fever, swollen lymph nodes, and fatigue.
Medical Surgical Question 53: A 35-year-old female patient is diagnosed with leukemia. Which statement accurately describes leukemia? A) Leukemia is a cancer of the lymphatic system. B) Leukemia is a type of anemia. C) Leukemia is a bacterial infection of the bone marrow. D) Leukemia is a cancer of the blood-forming cells in the bone marrow.
Correct Answer: D) Leukemia is a cancer of the blood-forming cells in the bone marrow.
Explanation: Leukemia is a cancer that originates in the blood-forming cells of the bone marrow. It leads to the abnormal proliferation of immature white blood cells and affects the production of other blood cell types. Leukemia is not a cancer of the lymphatic system, anemia, or a bacterial infection of the bone marrow.
Medical Surgical Question 68: A 30-year-old male patient presents with persistent sore throat, enlarged tonsils, and swollen lymph nodes in the neck. Upon examination, the healthcare provider suspects a viral infection. Which of the following viruses is commonly associated with this clinical presentation? A) Influenza virus B) Epstein-Barr virus (EBV) C) Human immunodeficiency virus (HIV) D) Hepatitis C virus (HCV)
Correct Answer: B) Epstein-Barr virus (EBV)
Explanation: The clinical presentation of a persistent sore throat, enlarged tonsils, and swollen lymph nodes in the neck is often associated with infectious mononucleosis, which is primarily caused by the Epstein-Barr virus (EBV). EBV is a member of the herpesvirus family and commonly leads to these symptoms, especially in young adults.
Medical Surgical Question 69: A 55-year-old female patient is diagnosed with Hodgkin lymphoma. Which of the following is a characteristic feature of Hodgkin lymphoma? A) Presence of Reed-Sternberg cells B) Excessive production of erythrocytes C) Abnormal proliferation of plasma cells D) Infiltration of leukocytes in bone marrow
Correct Answer: A) Presence of Reed-Sternberg cells
Explanation: Hodgkin lymphoma is characterized by the presence of Reed-Sternberg cells within the lymph nodes. These large, abnormal lymphocytes are a hallmark of Hodgkin lymphoma and are essential for its diagnosis. Excessive production of erythrocytes is not a characteristic feature of Hodgkin lymphoma. Abnormal proliferation of plasma cells is seen in conditions like multiple myeloma, and infiltration of leukocytes in the bone marrow may occur in various disorders, but it is not specific to Hodgkin lymphoma.
Medical Surgical Question 70: A 40-year-old male patient presents with unexplained fatigue, frequent infections, and easy bruising. Laboratory tests reveal a low platelet count and an increased number of blast cells in the peripheral blood. What condition is likely responsible for these symptoms? A) Infectious mononucleosis B) Leukemia C) Lymphoma D) Anemia
Correct Answer: B) Leukemia
Explanation: The patient’s symptoms of fatigue, frequent infections, easy bruising, low platelet count, and an increased number of blast cells in the peripheral blood are indicative of leukemia. Leukemia is a group of blood cancers characterized by the uncontrolled proliferation of immature white blood cells (blast cells) in the bone marrow and peripheral blood.
Medical Surgical Question 71: A 45-year-old female patient is diagnosed with non-Hodgkin lymphoma. Which of the following statements accurately describes non-Hodgkin lymphoma? A) Non-Hodgkin lymphoma typically involves the presence of Reed-Sternberg cells. B) Non-Hodgkin lymphoma is a cancer of the lymphatic system. C) Non-Hodgkin lymphoma is a benign lymph node enlargement. D) Non-Hodgkin lymphoma often follows a predictable pattern of spread.
Correct Answer: B) Non-Hodgkin lymphoma is a cancer of the lymphatic system.
Explanation: Non-Hodgkin lymphoma is a cancer that originates in the lymphatic system, which includes the lymph nodes, lymphatic vessels, spleen, and other lymphoid tissues. Unlike Hodgkin lymphoma, non-Hodgkin lymphoma does not typically involve the presence of Reed-Sternberg cells. It is not a benign lymph node enlargement, and its pattern of spread can vary widely among different subtypes.
Medical Surgical Question 72: A 35-year-old male patient with a history of chronic lymphocytic leukemia (CLL) presents with night sweats, fatigue, and a noticeable increase in lymph node size. What term is commonly used to describe this clinical scenario in CLL patients? A) Remission B) Relapse C) Regression D) Rebound
Correct Answer: B) Relapse
Explanation: In the context of chronic lymphocytic leukemia (CLL), a relapse refers to the return or worsening of symptoms and signs of the disease after a period of improvement or remission. In CLL, patients may experience periods of remission, during which their symptoms improve or disappear, followed by relapses where the disease becomes active again, leading to symptoms like night sweats, fatigue, and lymph node enlargement.
Medical Surgical Question 73: A 28-year-old female patient presents with joint pain, swelling, and stiffness in her hands and wrists. She also reports feeling fatigued and notices a rash on her cheeks. Laboratory tests reveal the presence of antinuclear antibodies (ANAs) and anti-double-stranded DNA (anti-dsDNA) antibodies. What autoimmune disease is most likely responsible for these symptoms? A) Rheumatoid arthritis B) Systemic lupus erythematosus (SLE) C) Sjögren’s syndrome D) Psoriatic arthritis
Correct Answer: B) Systemic lupus erythematosus (SLE)
Explanation: The patient’s symptoms of joint pain, swelling, stiffness, fatigue, and a rash on the cheeks, along with the presence of antinuclear antibodies (ANAs) and anti-double-stranded DNA (anti-dsDNA) antibodies, are indicative of systemic lupus erythematosus (SLE). SLE is a chronic autoimmune disease that can affect multiple organ systems and is characterized by the production of autoantibodies against various cellular components, including DNA.
Medical Surgical Question 74: A 35-year-old male patient is experiencing muscle weakness, especially in his proximal muscles, along with difficulty in climbing stairs and raising his arms. Laboratory tests reveal elevated levels of creatine kinase (CK) and the presence of anti-acetylcholine receptor antibodies. What autoimmune neuromuscular disorder is most likely responsible for these symptoms? A) Myasthenia gravis B) Polymyositis C) Guillain-Barré syndrome D) Multiple sclerosis
Correct Answer: A) Myasthenia gravis
Explanation: The patient’s symptoms of muscle weakness, especially in the proximal muscles, along with elevated creatine kinase (CK) levels and the presence of anti-acetylcholine receptor antibodies, are indicative of myasthenia gravis. Myasthenia gravis is an autoimmune neuromuscular disorder characterized by muscle weakness and fatigue, often worsened with exertion, and is caused by the body’s immune system attacking the acetylcholine receptors at the neuromuscular junction.
Medical Surgical Question 75: A 42-year-old female patient presents with dry eyes and a dry mouth, along with joint pain and fatigue. She also reports difficulty in swallowing dry foods. What autoimmune disease is associated with these symptoms? A) Rheumatoid arthritis B) Systemic lupus erythematosus (SLE) C) Sjögren’s syndrome D) Hashimoto’s thyroiditis
Correct Answer: C) Sjögren’s syndrome
Explanation: The patient’s symptoms of dry eyes, dry mouth, joint pain, fatigue, and difficulty in swallowing dry foods are characteristic of Sjögren’s syndrome, an autoimmune disease that primarily affects the exocrine glands, leading to reduced tear and saliva production. This condition often occurs in association with other autoimmune diseases such as rheumatoid arthritis and systemic lupus erythematosus (SLE).
Medical Surgical Question 76: A 50-year-old male patient presents with recurrent episodes of skin rash, joint pain, and abdominal discomfort. The skin rash is characterized by raised, red, and scaly patches, and he experiences fatigue. Laboratory tests reveal the presence of anti-cyclic citrullinated peptide (anti-CCP) antibodies. What autoimmune disease is most likely responsible for these symptoms? A) Systemic lupus erythematosus (SLE) B) Rheumatoid arthritis C) Psoriatic arthritis D) Crohn’s disease
Correct Answer: C) Psoriatic arthritis
Explanation: The patient’s symptoms of recurrent skin rash, joint pain, abdominal discomfort, fatigue, and the presence of anti-cyclic citrullinated peptide (anti-CCP) antibodies are indicative of psoriatic arthritis. Psoriatic arthritis is an autoimmune disease that can affect individuals with psoriasis and is characterized by joint inflammation and skin involvement, such as raised, red, and scaly skin patches.
Medical Surgical Question 77: A 36-year-old female patient presents with muscle pain, weakness, and tenderness, particularly in her thighs and upper arms. She also reports difficulty in rising from a seated position and combing her hair. Laboratory tests reveal elevated levels of muscle enzymes, including creatine kinase (CK). What autoimmune disorder primarily affects the muscles and is responsible for these symptoms? A) Polymyositis B) Myasthenia gravis C) Guillain-Barré syndrome D) Multiple sclerosis
Correct Answer: A) Polymyositis
Explanation: The patient’s symptoms of muscle pain, weakness, tenderness, and difficulty in rising from a seated position are indicative of polymyositis, an autoimmune disorder primarily affecting the muscles. Elevated levels of muscle enzymes, such as creatine kinase (CK), are often seen in polymyositis due to muscle damage. This condition results from inflammation in the muscle tissue, leading to muscle weakness and discomfort.
Medical Surgical Question 78: A 45-year-old male patient presents to the emergency department with sudden-onset severe chest pain that worsens with deep breaths. He also experiences shortness of breath and coughs up bloody sputum. On physical examination, he has decreased breath sounds on the left side of the chest. What is the most likely diagnosis? A) Pulmonary embolism B) Pleural effusion C) Pneumothorax D) Acute bronchitis
Correct Answer: C) Pneumothorax
Explanation: The patient’s sudden-onset severe chest pain, worsened by deep breaths, along with decreased breath sounds on one side of the chest, is highly suggestive of a pneumothorax. A pneumothorax occurs when air accumulates in the pleural space, leading to lung collapse. This condition can cause chest pain, shortness of breath, and other symptoms described.
Medical Surgical Question 79: A 55-year-old female patient with a history of smoking presents with chronic cough, sputum production, and wheezing. She also reports shortness of breath that has worsened over the years. On examination, she has decreased breath sounds and prolonged expiration. What respiratory disorder is most likely responsible for these symptoms? A) Pneumonia B) Pulmonary embolism C) Chronic obstructive pulmonary disease (COPD) D) Asthma
Correct Answer: C) Chronic obstructive pulmonary disease (COPD)
Explanation: The patient’s chronic cough, sputum production, wheezing, shortness of breath, decreased breath sounds, and prolonged expiration are indicative of chronic obstructive pulmonary disease (COPD), a progressive lung condition often caused by smoking. COPD is characterized by airflow limitation and persistent respiratory symptoms.
Medical Surgical Question 80: A 60-year-old male patient with a history of heart failure presents with sudden-onset dyspnea, chest pain, and hemoptysis (coughing up blood). His vital signs show tachycardia and hypotension. What is the most likely diagnosis in this critical situation? A) Acute bronchitis B) Pneumothorax C) Pulmonary embolism D) Pleural effusion
Correct Answer: C) Pulmonary embolism
Explanation: The patient’s sudden-onset dyspnea, chest pain, hemoptysis, tachycardia, hypotension, and history of heart failure raise concern for a pulmonary embolism. Pulmonary embolism occurs when a blood clot (typically from deep vein thrombosis) travels to the pulmonary arteries, obstructing blood flow to the lungs. This is a life-threatening condition requiring immediate medical attention. Cardiac, Cardiovascular
Medical Surgical Question 81: A 30-year-old female patient presents with a productive cough, fever, and pleuritic chest pain. On physical examination, there are coarse crackles and decreased breath sounds over the right lower lung field. What respiratory disorder is most likely responsible for these findings? A) Tuberculosis B) Pneumothorax C) Pneumonia D) Bronchitis
Correct Answer: C) Pneumonia
Explanation: The patient’s symptoms of productive cough, fever, pleuritic chest pain, coarse crackles, and decreased breath sounds are consistent with pneumonia, which is an inflammatory lung condition typically caused by infection. In pneumonia, the airspaces in the lung become filled with pus and other inflammatory materials, leading to respiratory symptoms and abnormal lung sounds on examination.
Medical Surgical Question 78: A 45-year-old male patient presents to the emergency department with sudden-onset severe chest pain that worsens with deep breaths. He also experiences shortness of breath and coughs up bloody sputum. On physical examination, he has decreased breath sounds on the left side of the chest. What is the most likely diagnosis? A) Pulmonary embolism B) Pleural effusion C) Pneumothorax D) Acute bronchitis
Correct Answer: C) Pneumothorax
Explanation: The patient’s sudden-onset severe chest pain, worsened by deep breaths, along with decreased breath sounds on one side of the chest, is highly suggestive of a pneumothorax. A pneumothorax occurs when air accumulates in the pleural space, leading to lung collapse. This condition can cause chest pain, shortness of breath, and other symptoms described.
Medical Surgical Question 79: A 55-year-old female patient with a history of smoking presents with chronic cough, sputum production, and wheezing. She also reports shortness of breath that has worsened over the years. On examination, she has decreased breath sounds and prolonged expiration. What respiratory disorder is most likely responsible for these symptoms? A) Pneumonia B) Pulmonary embolism C) Chronic obstructive pulmonary disease (COPD) D) Asthma
Correct Answer: C) Chronic obstructive pulmonary disease (COPD)
Explanation: The patient’s chronic cough, sputum production, wheezing, shortness of breath, decreased breath sounds, and prolonged expiration are indicative of chronic obstructive pulmonary disease (COPD), a progressive lung condition often caused by smoking. COPD is characterized by airflow limitation and persistent respiratory symptoms.
Medical Surgical Question 80: A 60-year-old male patient with a history of heart failure presents with sudden-onset dyspnea, chest pain, and hemoptysis (coughing up blood). His vital signs show tachycardia and hypotension. What is the most likely diagnosis in this critical situation? A) Acute bronchitis B) Pneumothorax C) Pulmonary embolism D) Pleural effusion
Correct Answer: C) Pulmonary embolism
Explanation: The patient’s sudden-onset dyspnea, chest pain, hemoptysis, tachycardia, hypotension, and history of heart failure raise concern for a pulmonary embolism. Pulmonary embolism occurs when a blood clot (typically from deep vein thrombosis) travels to the pulmonary arteries, obstructing blood flow to the lungs. This is a life-threatening condition requiring immediate medical attention. Cardiac, Cardiovascular
Medical Surgical Question 81: A 30-year-old female patient presents with a productive cough, fever, and pleuritic chest pain. On physical examination, there are coarse crackles and decreased breath sounds over the right lower lung field. What respiratory disorder is most likely responsible for these findings? A) Tuberculosis B) Pneumothorax C) Pneumonia D) Bronchitis
Correct Answer: C) Pneumonia
Explanation: The patient’s symptoms of productive cough, fever, pleuritic chest pain, coarse crackles, and decreased breath sounds are consistent with pneumonia, which is an inflammatory lung condition typically caused by infection. In pneumonia, the airspaces in the lung become filled with pus and other inflammatory materials, leading to respiratory symptoms and abnormal lung sounds on examination.
Medical Surgical Question 85: A 55-year-old male patient with a history of chronic obstructive pulmonary disease (COPD) presents to the emergency department with severe dyspnea and increased sputum production. He is using accessory muscles to breathe, and his oxygen saturation is below 90%. What is the initial treatment priority for this patient? A) Administering a bronchodilator B) Providing supplemental oxygen C) Initiating mechanical ventilation D) Administering intravenous antibiotics
Correct Answer: B) Providing supplemental oxygen
Explanation: The initial treatment priority for a patient with severe dyspnea and oxygen saturation below 90% is to provide supplemental oxygen to improve oxygenation and relieve respiratory distress. While bronchodilators, antibiotics, and mechanical ventilation may be necessary depending on the underlying cause, ensuring adequate oxygenation is essential in the initial management of respiratory distress.
Medical Surgical Question 86: A 40-year-old female patient is admitted with a diagnosis of community-acquired pneumonia. Which of the following interventions is a key component of the treatment plan for this patient? A) Administering anticoagulants B) Initiating corticosteroid therapy C) Providing nebulized bronchodilators D) Administering broad-spectrum antibiotics
Correct Answer: D) Administering broad-spectrum antibiotics
Explanation: In the treatment of community-acquired pneumonia, the key component is the administration of broad-spectrum antibiotics to target the underlying bacterial infection. Anticoagulants, corticosteroids, and nebulized bronchodilators may have roles in specific cases, but the primary treatment approach is to address the infection with appropriate antibiotics.
Medical Surgical Question 87: A 60-year-old male patient with a history of congestive heart failure presents with paroxysmal nocturnal dyspnea, orthopnea, and increased peripheral edema. Which medication is commonly used in the management of acute exacerbations of congestive heart failure?
A) Proton pump inhibitor (PPI)
B) Intravenous (IV) diuretics
C) Inhaled corticosteroids
D) Antihypertensive medication
Correct Answer: B) Intravenous (IV) diuretics
Explanation: In the management of acute exacerbations of congestive heart failure (CHF), intravenous diuretics are commonly used to reduce fluid overload, alleviate symptoms like paroxysmal nocturnal dyspnea, orthopnea, and peripheral edema, and improve cardiac function by reducing preload. Proton pump inhibitors (PPIs), inhaled corticosteroids, and antihypertensive medications are not the primary treatment modalities for acute CHF exacerbations. Cardiac, Cardiovascular
Medical Surgical Question 88: A 35-year-old female patient with asthma is experiencing worsening symptoms, including increased shortness of breath and wheezing. She reports using her rescue inhaler more frequently but without relief. What is the next appropriate step in the management of her asthma exacerbation? A) Initiating oral corticosteroid therapy B) Administering a long-acting bronchodilator C) Recommending avoidance of allergens D) Administering a rescue inhaler again
Correct Answer: A) Initiating oral corticosteroid therapy
Explanation: In the management of an asthma exacerbation not responding to rescue inhaler use, the next appropriate step is to initiate oral corticosteroid therapy to reduce airway inflammation and improve symptoms. Long-acting bronchodilators may be used as part of the long-term asthma management plan but are not typically used in the acute exacerbation setting. Avoidance of allergens is part of asthma management but may not provide immediate relief. Repeated use of the rescue inhaler without improvement necessitates a different approach.
Medical Surgical Question 89: A 50-year-old male patient with chronic obstructive pulmonary disease (COPD) is prescribed home oxygen therapy. What is a crucial aspect of patient education regarding oxygen therapy at home? A) Using oxygen while smoking B) Increasing oxygen flow rate as needed C) Storing oxygen cylinders in a confined space D) Avoiding the use of electric appliances near oxygen
Correct Answer: D) Avoiding the use of electric appliances near oxygen
Explanation: A crucial aspect of patient education regarding home oxygen therapy is to emphasize the importance of avoiding the use of electric appliances near oxygen sources, as oxygen supports combustion and can increase the risk of fires. Patients should also be educated about the hazards of smoking while using oxygen, should not adjust the oxygen flow rate without healthcare provider guidance, and should store oxygen cylinders in well-ventilated areas.
Medical Surgical Question 90: A 65-year-old female patient with chronic bronchitis and recurrent exacerbations of chronic obstructive pulmonary disease (COPD) presents to the clinic. She has a history of frequent antibiotic use during exacerbations. What non-pharmacological intervention should be emphasized in the management of her condition to reduce the risk of exacerbations? A) Initiating long-term corticosteroid therapy B) Administering prophylactic bronchodilators C) Encouraging smoking cessation D) Recommending regular vaccinations
Correct Answer: D) Recommending regular vaccinations
Explanation: In the management of patients with chronic bronchitis and COPD, regular vaccinations, including influenza and pneumococcal vaccines, are crucial to reduce the risk of exacerbations. Smoking cessation is also vital to slow disease progression. Long-term corticosteroid therapy is typically reserved for severe cases, and prophylactic bronchodilators are not the primary preventive measure for exacerbations.
Medical Surgical Question 91: A 55-year-old male patient with a history of obstructive sleep apnea (OSA) presents with complaints of excessive daytime sleepiness, loud snoring, and restless sleep. He has been using continuous positive airway pressure (CPAP) therapy but continues to experience symptoms. What additional intervention can be considered to improve his OSA management? A) Increasing CPAP pressure B) Administering sedative medications C) Initiating oxygen therapy D) Recommending positional therapy
Correct Answer: D) Recommending positional therapy
Explanation: In patients with OSA, positional therapy can be considered as an additional intervention to improve management. Positional therapy involves encouraging patients to sleep in positions that minimize airway obstruction, such as avoiding sleeping on the back. Increasing CPAP pressure may be necessary in some cases, but it should be adjusted under medical supervision. Sedative medications are generally avoided in OSA management due to the risk of exacerbating airway obstruction, and oxygen therapy is not typically indicated as a primary treatment for OSA.
Medical Surgical Question 92: A 60-year-old male patient with a history of chronic obstructive pulmonary disease (COPD) is admitted to the hospital with worsening dyspnea, increased sputum production, and fever. Chest X-ray reveals a consolidation in the right lower lobe of the lung. What is the most appropriate initial antibiotic choice for the treatment of this patient’s community-acquired pneumonia? A) Azithromycin B) Amoxicillin/clavulanic acid C) Ciprofloxacin D) Vancomycin
Correct Answer: B) Amoxicillin/clavulanic acid
Explanation: In the treatment of community-acquired pneumonia, amoxicillin/clavulanic acid is a suitable initial antibiotic choice, especially for patients with COPD who are at risk of infection with both typical and atypical pathogens. Azithromycin may be an alternative choice for atypical coverage, while ciprofloxacin may be considered in specific cases. Vancomycin is typically reserved for cases involving suspected or confirmed methicillin-resistant Staphylococcus aureus (MRSA) infections.
Medical Surgical Question 93: A 45-year-old female patient with a history of asthma presents to the clinic with recurrent exacerbations. She reports using her rescue inhaler frequently and wakes up at night with worsening symptoms. Which long-term controller medication is most appropriate to add to her asthma management? A) Montelukast (Singulair) B) Albuterol (Proventil) inhaler C) Ipratropium (Atrovent) inhaler D) Prednisone (Deltasone) tablets
Correct Answer: A) Montelukast (Singulair)
Explanation: In the management of asthma, the addition of a long-term controller medication is indicated for patients experiencing frequent exacerbations. Montelukast, a leukotriene receptor antagonist, can help improve asthma control by reducing inflammation and bronchoconstriction. Albuterol is a rescue inhaler used for acute symptom relief, ipratropium is typically used in chronic obstructive pulmonary disease (COPD), and prednisone is a short-term corticosteroid treatment for exacerbations.
Medical Surgical Question 94: A 50-year-old male patient with chronic obstructive pulmonary disease (COPD) presents with worsening dyspnea and increased sputum production. He is currently taking an inhaled corticosteroid (ICS) and a long-acting beta-agonist (LABA). What additional medication class is recommended to further improve his COPD management? A) Anticholinergic (LAMA) inhaler B) Oral corticosteroids C) Mast cell stabilizer inhaler D) Inhaled leukotriene modifiers
Correct Answer: A) Anticholinergic (LAMA) inhaler
Explanation: In the management of COPD, the addition of an anticholinergic inhaler (LAMA) is recommended for patients who experience persistent symptoms despite treatment with an ICS and LABA combination. LAMAs help improve bronchodilation and reduce symptoms. Oral corticosteroids are typically reserved for exacerbations, and mast cell stabilizer inhalers and inhaled leukotriene modifiers are not typically primary treatments for COPD.
Medical Surgical Question 95: A 65-year-old male patient with chronic obstructive pulmonary disease (COPD) is experiencing frequent exacerbations despite optimal therapy. What intervention may be considered to reduce the risk of exacerbations and hospital admissions in this patient? A) Home oxygen therapy B) Pneumococcal vaccination C) Continuous positive airway pressure (CPAP) therapy D) Pulmonary rehabilitation program
Correct Answer: D) Pulmonary rehabilitation program
Explanation: For patients with COPD experiencing frequent exacerbations, a pulmonary rehabilitation program may be considered to reduce the risk of exacerbations and hospital admissions. Pulmonary rehabilitation includes exercise training, education, and psychosocial support to improve overall lung function and quality of life. Home oxygen therapy, pneumococcal vaccination, and continuous positive airway pressure (CPAP) therapy may have their roles but may not directly address the reduction of exacerbations as effectively as pulmonary rehabilitation.
Medical Surgical Question 96: A 55-year-old female patient presents with chronic cough, sputum production, and wheezing. She reports a history of smoking for several years. To assess her lung function and diagnose any underlying respiratory conditions, which diagnostic test is most appropriate? A) Electrocardiogram (ECG) B) Chest X-ray C) Pulmonary function tests (PFTs) D) Complete blood count (CBC)
Correct Answer: C) Pulmonary function tests (PFTs)
Explanation: Pulmonary function tests (PFTs) are the most appropriate diagnostic test to assess lung function and diagnose respiratory conditions in this patient. PFTs can measure lung volume, capacity, and airflow, helping to diagnose conditions like chronic obstructive pulmonary disease (COPD) and asthma. An electrocardiogram (ECG) assesses cardiac function, while a chest X-ray primarily provides information about lung structure. A complete blood count (CBC) may show signs of inflammation but is not specific for diagnosing respiratory conditions.
Medical Surgical Question 97: A 40-year-old male patient presents with a history of tuberculosis (TB) exposure and persistent cough. To confirm or rule out active TB infection, which diagnostic test is the most appropriate initial step? A) Sputum culture and acid-fast bacilli (AFB) smear B) Chest X-ray C) Tuberculin skin test (TST) D) Blood culture
Correct Answer: A) Sputum culture and acid-fast bacilli (AFB) smear
Explanation: In a patient with suspected active tuberculosis (TB) infection, the most appropriate initial diagnostic step is to perform sputum culture and acid-fast bacilli (AFB) smear. These tests help confirm the presence of Mycobacterium tuberculosis in respiratory secretions. Chest X-ray is often used as a complementary test to assess lung involvement. Tuberculin skin tests (TSTs) are more commonly used for TB screening and do not confirm active infection. Blood cultures are not typically used for TB diagnosis.
Medical Surgical Question 98: A 60-year-old male patient with a history of lung cancer presents with chest pain, cough, and hemoptysis (coughing up blood). To evaluate the extent and staging of the lung cancer, which diagnostic test is most appropriate? A) Bronchoscopy B) Computed tomography (CT) scan C) Pulmonary function tests (PFTs) D) Electrocardiogram (ECG)
Correct Answer: B) Computed tomography (CT) scan
Explanation: For evaluating the extent and staging of lung cancer, a computed tomography (CT) scan is the most appropriate diagnostic test. It provides detailed imaging of the chest and surrounding structures, allowing healthcare providers to determine the size and extent of the tumor, as well as any involvement of lymph nodes or distant metastases. Bronchoscopy may be used to obtain tissue samples for histological diagnosis, while pulmonary function tests (PFTs) assess lung function. An electrocardiogram (ECG) assesses cardiac function and is not specific to lung cancer staging.
Medical Surgical Question 99: A 45-year-old female patient with a history of asthma presents with worsening dyspnea and wheezing. To assess her current lung function and response to bronchodilator therapy, which diagnostic test is the most appropriate? A) Chest X-ray B) Sputum culture C) Arterial blood gas (ABG) analysis D) Peak expiratory flow rate (PEFR)
Correct Answer: D) Peak expiratory flow rate (PEFR)
Explanation: To assess current lung function and response to bronchodilator therapy in a patient with asthma, the most appropriate diagnostic test is measuring the peak expiratory flow rate (PEFR). PEFR is a simple and effective tool for monitoring airflow obstruction and evaluating treatment response in asthma. A chest X-ray may provide information about lung structure but is not specific for asthma diagnosis or monitoring. Sputum culture and arterial blood gas (ABG) analysis are not typically used for routine asthma assessment.
Medical Surgical Question 100: A 50-year-old male patient with a history of chronic obstructive pulmonary disease (COPD) presents with worsening dyspnea and increased sputum production. To assess his current lung function and oxygenation, which diagnostic test is the most appropriate? A) Complete blood count (CBC) B) Pulmonary function tests (PFTs) C) Electrocardiogram (ECG) D) Arterial blood gas (ABG) analysis
Correct Answer: D) Arterial blood gas (ABG) analysis
Explanation: To assess the current lung function and oxygenation status of a patient with worsening dyspnea and increased sputum production, the most appropriate diagnostic test is arterial blood gas (ABG) analysis. ABG analysis provides critical information about oxygen and carbon dioxide levels in the blood, helping to assess respiratory function and guide treatment decisions in patients with respiratory distress. Complete blood counts (CBCs) are not specific for respiratory function assessment and are typically used for evaluating overall health. Pulmonary function tests (PFTs) provide information about lung capacity and airflow but may not offer real-time oxygenation data. Electrocardiograms (ECGs) assess cardiac function and are not the primary diagnostic test for evaluating lung function or oxygenation status.
Medical Surgical Question 101: A 65-year-old male patient with a history of asbestos exposure presents with chest pain and dyspnea. To assess for the presence of pleural effusion and guide further evaluation, which diagnostic test is the most appropriate initial step? A) Bronchoscopy B) Chest X-ray C) Computed tomography (CT) scan D) Magnetic resonance imaging (MRI)
Correct Answer: B) Chest X-ray
Explanation: In a patient presenting with chest pain and dyspnea suggestive of pleural effusion, the most appropriate initial diagnostic test is a chest X-ray. A chest X-ray can provide an initial assessment of pleural fluid accumulation and guide further evaluation. While computed tomography (CT) scans and magnetic resonance imaging (MRI) may offer more detailed information, a chest X-ray is often the first step in evaluating pleural effusion. Bronchoscopy is typically used to examine the airways and is not the primary diagnostic test for pleural effusion.
Medical Surgical Question 102: A 40-year-old female patient with a history of rheumatoid arthritis presents with pleuritic chest pain and difficulty breathing. To evaluate the presence of pleurisy (inflammation of the pleura) and its potential underlying causes, which diagnostic test is the most appropriate? A) Echocardiogram B) Arthrocentesis C) Tuberculin skin test (TST) D) Chest ultrasound
Correct Answer: D) Chest ultrasound
Explanation: To evaluate pleurisy and its underlying causes, a chest ultrasound is the most appropriate diagnostic test. Chest ultrasound can visualize the pleura and any associated abnormalities, such as pleural effusion, pleural thickening, or pleural masses. An echocardiogram is used to assess cardiac function and is not specific for pleural evaluation. Arthrocentesis is a joint aspiration procedure and is unrelated to pleurisy. Tuberculin skin tests (TSTs) are used for tuberculosis screening and are not the primary diagnostic test for pleurisy.
Medical Surgical Question 103: A 50-year-old male patient with a history of exposure to asbestos presents with persistent cough and chest pain. To assess for potential asbestos-related lung disease and evaluate lung tissue, which diagnostic test is the most appropriate? A) Pulmonary function tests (PFTs) B) Bronchoscopy C) High-resolution computed tomography (HRCT) D) Spirometry
Correct Answer: C) High-resolution computed tomography (HRCT)
Explanation: In a patient with a history of asbestos exposure and symptoms suggestive of asbestos-related lung disease, high-resolution computed tomography (HRCT) is the most appropriate diagnostic test. HRCT can provide detailed imaging of lung tissue and is particularly useful for detecting asbestos-related lung diseases such as asbestosis and pleural plaques. Pulmonary function tests (PFTs) and spirometry assess lung function but may not provide specific information about lung tissue abnormalities. Bronchoscopy is typically used to examine the airways and may not be the primary diagnostic test for asbestos-related lung disease.
Medical Surgical Question 104: A 45-year-old male patient with a history of exposure to occupational dust and a persistent cough presents to the clinic. To assess potential occupational lung disease and determine if lung function is affected, which diagnostic test is the most appropriate? A) Electrocardiogram (ECG) B) Pulmonary function tests (PFTs) C) Chest X-ray D) Complete blood count (CBC)
Correct Answer: B) Pulmonary function tests (PFTs)
Explanation: In a patient with a history of occupational dust exposure and respiratory symptoms, the most appropriate diagnostic test to assess lung function and potential occupational lung disease is pulmonary function tests (PFTs). PFTs provide information about lung capacity, airflow, and gas exchange, helping to identify any obstructive or restrictive patterns. Electrocardiograms (ECGs) assess cardiac function, chest X-rays may show structural abnormalities but are not specific for lung function evaluation, and complete blood counts (CBCs) assess overall health but do not provide lung function data.
Medical Surgical Question 105: A 55-year-old female patient with a history of sarcoidosis presents with fatigue, cough, and shortness of breath. To assess for sarcoidosis activity and organ involvement, which diagnostic test is the most appropriate? A) Tuberculin skin test (TST) B) Serum angiotensin-converting enzyme (ACE) level C) Computed tomography (CT) scan of the head D) Complete blood count (CBC)
Correct Answer: B) Serum angiotensin-converting enzyme (ACE) level
Explanation: To assess for sarcoidosis activity and organ involvement, the most appropriate diagnostic test is measuring the serum angiotensin-converting enzyme (ACE) level. Elevated ACE levels are commonly seen in sarcoidosis and can provide valuable information for diagnosis and disease monitoring. Tuberculin skin tests (TSTs) are unrelated to sarcoidosis assessment. Computed tomography (CT) scans of the head may be performed in specific cases of neurosarcoidosis but are not typically used for initial evaluation. Complete blood counts (CBCs) assess overall health but are not specific for sarcoidosis diagnosis or monitoring.
Medical Surgical Question 106: A 60-year-old male patient with a history of chronic cough and exposure to occupational toxins presents for evaluation. To assess potential occupational lung disease and determine the presence of lung abnormalities, which diagnostic test is the most appropriate initial step? A) Bronchoscopy B) High-resolution computed tomography (HRCT) C) Spirometry D) Complete blood count (CBC)Correct Answer: B) High-resolution computed tomography (HRCT)
Explanation: In a patient with a history of chronic cough, exposure to occupational toxins, and suspected occupational lung disease, the most appropriate initial diagnostic step is a high-resolution computed tomography (HRCT) scan. HRCT can provide detailed imaging of lung tissue, detecting abnormalities and lung disease associated with occupational exposures. Bronchoscopy may be used for further evaluation but is not typically the initial step. Spirometry assesses lung function but does not provide detailed imaging. A complete blood count (CBC) assesses overall health but is not specific for lung disease diagnosis.
Medical Surgical Question 107: A 45-year-old female patient with a history of asbestos exposure presents with chest discomfort and shortness of breath. To evaluate potential asbestos-related lung disease and assess pleural involvement, which diagnostic test is the most appropriate? A) Tuberculin skin test (TST) B) Pulmonary function tests (PFTs) C) Chest X-ray D) High-resolution computed tomography (HRCT)
Correct Answer: D) High-resolution computed tomography (HRCT)
Explanation: In a patient with a history of asbestos exposure and respiratory symptoms, the most appropriate diagnostic test to evaluate potential asbestos-related lung disease and assess pleural involvement is a high-resolution computed tomography (HRCT) scan. HRCT can provide detailed imaging of lung tissue and the pleura, helping to detect abnormalities such as asbestosis and pleural plaques. Tuberculin skin tests (TSTs) are unrelated to asbestos-related lung disease. Pulmonary function tests (PFTs) assess lung function but may not provide specific information about asbestos-related diseases. Chest X-rays may show structural abnormalities but are less sensitive than HRCT for detecting asbestos-related lung disease.