After reviewing your NCLEX materials, it is crucial to practice and answer some NCLEX questions.
Some of the trickiest questions on the NCLEX are the medical-surgical ones, which is why focusing on them during your NCLEX prep is essential if you want to succeed on your first try.
And if you’re not sure where to start, then you’re in luck, because you’ve come to the right place!
In this week’s episode of NCLEX Ready, I’ll be sharing with you the answers to four must-know med-surg questions (and the logic I used to get to those answers).
Are you ready to learn more?
Then tune in now!
Med-Surg Question #1:
“Nurse Jojo is providing care for a sixty-three year old male who was diagnosed with Addison’s disease. What type of treatment should she expect a patient to have?
- Dialysis
- Insulin and glucose
- Blood transfusion and oxygen
- Hormone replacement therapy and fluids for shock”
The answer: Hormone replacement therapy and fluids for shock.
Let’s go over the rationale for this correct answer together:
Hormone replacement therapy and fluids for shock are treatments for Addison’s disease. This is because Addison’s disease affects the adrenal glands, causing them not to produce enough cortisol and aldosterone. An example of hormone replacement therapy for Addison’s disease is hydrocortisone, which replaces the missing cortisol.
The first step here is understanding how Addison’s disease affects the adrenal glands. The second step is understanding why hormone replacement therapy is necessary for Addison’s disease. If there aren’t enough cortisol and aldosterone being produced, then the treatment would be hormone replacement therapy. If the patient experiences Addison’s crisis, fluids for shock would be required.
A patient with Addison’s disease can also experience dehydration, which is why fluids may be needed. A patient diagnosed with Addison’s disease would also have increased thirst and would urinate frequently. Knowing the signs and symptoms can help you understand that you need to add fluids for someone with Addison’s disease.
NCLEX quick tip: A great way to remember the treatment for Addison’s disease is that one must add hormones if one has Addison’s disease.
Med-Surg Question #2:
“Which of the following inflammatory bowel disorders causes inflammation in the colon and rectum?
- Diverticulitis
- Ulcerative colitis
- Gastroesophageal Reflux Disease (GERD)
- Gastric ulcer”
The answer: Ulcerative colitis.
Let’s go over the rationale for this correct answer together:
Ulcerative colitis starts at the rectum and ascends towards the colon, causing inflammation. Systemic complications can occur, which contributes to the increasing mortality rate with ulcerative colitis.
Rectal bleeding, blood in diarrhea, weight loss, and abdominal cramping are all signs and symptoms you can see in ulcerative colitis. This chronic inflammatory bowel disorder can affect the patient for years or even a lifetime.
If someone is experiencing rectal bleeding and bloody diarrhea, then you can associate those symptoms with abdominal cramping. Someone who is experiencing diarrhea may be experiencing weight loss as well due to the loss of fluid.
NCLEX quick tip: To remember that ulcerative colitis affects the rectum and colon, know that letters “R, E, C” are in the word “rectum” and in ulcerative, but backwards. The letters “C, O, L” are in the word COLon and COLitis.
Med-Surg Question #3:
“Nurse Jojo is assessing a sixty-five year old patient who is receiving meperidine, also known as Demerol, via patient-controlled analgesia (PCA), to relieve pain after a total knee replacement. Which of the following assessment findings should be reported to the physician?
- Respiratory rate of ten breaths per minute
- Pain score of eight over ten
- Pulse rate of a hundred and ten beats per minute
- Respiratory rate of twenty-two breaths per minute”
The answer: Respiratory rate of ten breaths per minute.
Let’s go over the rationale for this correct answer together:
A respiratory rate of ten breaths per minute is an assessment finding that should be reported to the physician if the patient is taking meperidine. The normal breath rate should be between twelve to twenty breaths per minute.
A respiratory rate of twenty-two breaths per minute is a little higher than normal, but would not be considered an assessment finding that needs to be reported to the physician.
Meperidine is a controlled substance that is used to treat moderate to severe pain. This pain relieving medication has a high risk for respiratory distress and can cause death when the dose is too high.
NCLEX quick tip: If two of the answers are the exact opposite, one of the two is most likely the correct one!
Med-Surg Question #4:
“Myopia, astigmatism, and hyperopia are examples of what type of eye disorders?
- Intraocular disorders
- Traumatic injury
- Retinal disorders
- Refractive errors”
The answer: Refractive errors.
Let’s go over the rationale for this correct answer together:
Myopia, astigmatism, and hyperopia are all examples of refractive errors, which occur when the eye is not able to bend light correctly due to its shape. Blurry vision and headaches are common complaints associated with refractive errors.
Myopia is nearsightedness: Objects that are nearby are clear and objects that are far away are blurry. Concave lenses correct this type of refractive error.
Hyperopia is farsightedness: Objects that are far away are clear and objects that are nearby are blurry. Convex lenses correct this type of refractive error.
Astigmatism causes blurry vision at both near and far distances. The light rays refract unequally due to the uneven surface of the cornea. If the cornea is not completely round, vision is affected at all distances.
I discuss all of this in more depth in the episode
