Title FC MS1 (Mr. Arceo) - SC ✅

1 | Page FINAL COACHING MEDICAL & SURGICAL NURSING I November 2025 Philippine Nurse Licensure Examination Review NAME: DATE: SCORE: _____ “FIRST TAKER AKO, AT LAST TAKE KO NA ‘TO! 1. A nurse is preparing a patient for surgery under general anesthesia. Which assessment finding should be reported immediately to the surgeon and anesthesiologist? A. Blood pressure of 140/88 mmHg B. Blood glucose of 180 mg/dL C. Serum potassium of 2.9 mEq/L D. History of mild seasonal allergies 2. A patient expresses fear of not waking up after anesthesia. What is the best nursing response? A. “Many patients feel that way. You’ll be fine.” B. “Let’s talk to your surgeon so he can reassure you.” C. “Tell me more about your concerns so I can help you.” D. “Anesthesia today is very safe, so you shouldn’t worry.” 3. During the intraoperative phase, the circulating nurse’s primary responsibility is to: A. Maintain a sterile field B. Monitor aseptic technique of surgical instruments C. Document operative activities and patient status D. Hand instruments to the surgeon 4. A postoperative patient suddenly develops restlessness, tachycardia, and decreased oxygen saturation. The nurse suspects hypoxemia. What is the priority intervention? A. Notify the surgeon immediately B. Administer oxygen via face mask C. Increase IV fluid infusion D. Position the patient supine with legs elevated 5. Which nursing action is appropriate during informed consent? A. Explaining the nature of the procedure in detail B. Witnessing the patient’s signature on the consent form C. Deciding for the patient if they appear hesitant D. Obtaining consent if the surgeon is busy 6. In the immediate postoperative period, the most critical nursing assessment is: A. Pain level and comfort B. Airway patency and respiratory function C. Presence of surgical dressing drainage D. IV fluid infusion rate 7. A patient scheduled for surgery states: “I already ate breakfast because no one told me not to.” What is the nurse’s priority action? A. Continue preparation since it may not affect surgery B. Inform the anesthesiologist and surgeon immediately C. Administer preoperative medications as scheduled D. Encourage deep breathing and coughing exercises 8. Which intervention best prevents postoperative deep vein thrombosis (DVT)? A. Restricting movement to avoid pain B. Applying anti-embolic stockings C. Withholding fluids until bowel sounds return D. Encouraging patient to remain in low Fowler’s position 9. Which action demonstrates correct surgical asepsis? A. Reaching across the sterile field to adjust equipment B. Pouring sterile solution onto a sterile field from a height of 6 inches C. Turning back to a sterile field when leaving the room D. Placing sterile gloves below waist level when not in use 10. A postoperative patient is at risk for atelectasis. Which nursing intervention is most effective? A. Encouraging frequent use of the incentive spirometer B. Limiting fluids to prevent pulmonary edema C. Administering opioids to promote rest D. Placing the patient in a high Fowler’s position continuously 11. The nurse is reviewing a surgeon’s prescription sheet for a preop patient that states that the client must be NPO after midnight. The nurse needs to call the surgeon to clarify that which medication would be given to the client and not withheld? A. Prednisone B. Sodium Ascorbate C. Orphenadrine D. Conjugated estrogen 12. A client has undergone laboratory tests prior to surgery, which of the following findings should be reported at once and can cause postponing surgery? A. Hemoglobin 8.0 g/dl B. Sodim 145 meq/L C. Serum creatinine 0.9 mg/dl D. Platelets 200,000/cumm 13. The nurse is monitoring a post op client in the immediate post operative period. Which of the following is the immediate concern of the nurse that could be an early sign of complication? A. Increasing restlessness B. Pulse rate 86/min C. BP 110/70 D. hypoactive bowel sounds in all quadrants 14. The nurse assesses a client’s surgical incision for signs of infection. Which of the following can be interpreted as a normal finding? A. Hard reddened skin B. Serous drainage C. Purulent drainage D. Warm tender skin 16.Which of the following should be included in the plan of care for a patient who had post spinal anesthesia? A. Elevating the patient’s feet to increase blood pressure B. Instructing the patient to remain flat on bed C. Elevating the head of the bed to decrease nausea D. Administering oxygen to reduce hypoxia produced by spinal anesthesia * NLE * NCLEX * CGFNS * HAAD * PROMETRICS * DHA * MIDWIFERY * LET * RAD TECH * CRIMINOLOGY * DENTISTRY * PHARMACY *

3 | Page 38. Which of the following is the most common clinical manifestations of pulmonary embolism? A. Positive Homan’s sign B. Crushing chest pain and diaphoresis C. Bilateral crackles and cough D. Sudden onset of chest pain and dyspnea 39. The student nurse is assessing a bed ridden patient for possible presence of venous thromboembolism, the student nurse notices a positive homan’s sign on the left leg, which of the following is an appropriate action of the student’s nurse? A. Let the clinical instructor confirm the test. B. Refer and immobilize the legs C. Administer analgesic as ordered D. All of the above 40. To prevent VTE in a paralyzed patient, it is most important for the nurse to do the following except A. do passive range of motion exercises B. elevated the legs C. massage the legs D. no exception 41. When assessing a client with chest trauma. Which of the following indicates a possible pneumothorax? A.Adventitious sound and dyspnea B.Unequal lung expansion and diminished breath sound. C.Frothy bloody sputum and consolidation. D.Flat sound on percussion, absent breath sound and dyspnea 42. Flail chest develop in a client after trauma, will show which of the following assessment finding? A.Paradoxical breathing B.Asymmetrical chest expansion C.Severe pain D.All of the above 43. Management of flail chest include the following except A.Narcotics as ordered B.Mechanical ventilation C.Support lung function D.No exception 44. The nurse is monitoring a client who has a right sided chest tube inserted two hours ago. Which of the following should be implemented if the nurse notices that the water seal chamber has no fluctuation? A.Assess for leakage B.Increase the amount of wall suction. C.Check the tubing for kinks or clots. D.Monitor the client’s pulse oximeter reading. 45. The nurse receives an order that the chest tubes will be removed in 30 minutes. Which of the following should be done first? A.Prepare the needed equipment B.Administer analgesic as ordered C.Inform the X ray department D.Position the client 46.Which expected outcome should be given priority in the nursing care plan for a patient with adult respiratory distress syndrome: A.systolic BP blood pressure greater than 90 mmHg B.oxygen saturation greater than 95% C.respiration rate less than 20/min D.heart rate lees than 100/min 47. The client diagnosed with ARDS is transferred to the intensive care department and placed on a ventilator. Which intervention should the nurse implement first? A.Confirm that the ventilator settings are correct. B.Verify that the ventilator alarms are functioning properly. C.Assess the respiratory status and pulse oximeter reading. D.Monitor the client’s arterial blood gas results. 48. Which of the following assessment data would make the nurse suspect of developing ARDS? A.Low arterial oxygen when administering high concentration of oxygen. B.The client is in severe respiratory distress C.Breath sounds are clear but pulse oximeter reading is low D.The client has distended neck veins and cough 49. A client with ARDS is hooked to a mechanical ventilator, which assessment finding would the nurse suspect that the client develops complication secondary to ventilator? A.Urine output is 100 ml in 2 hours B.The cardiac monitor is showing sinus rhythm C.Diminished breath sound on one lung D.Pulse oximeter greater than 95% 50. COPD can cause pulmonary hypertension. Pulmonary hypertension is best defined as A. Elevated pulmonary arterial pressure of greater than 25 mmHg at rest B. Elevated pulmonary arterial pressure of greater than 30 mmHg with secondary exercise C. A and B with secondary right ventricular failure D. A and B only 51. Which of the following is correct regarding Ventilator Associated Pneumonia (VAP). It is the pneumonia that develops in A. the client has been endotracheally intubated for 48 hours B. it is a type of hospital acquired pneumonia (HAP) C. VAP occurring within 96 hours of the onset of mechanical ventilation is usually due to antibiotic sensitive bacteria that colonize the patient before hospital admission D. All are correct 52. The patient with severe Covid 19 pneumonia will have the following except A. SpO2 < 93% B. tachypnea C. “ground- glass” opacities in Chest x ray D. All of the above 53. Transfusion – Related Acute Lung Injury (TRALI) is potentially fatal, idiosyncratic reaction that is defined as the development of acute lung injury occurring within 6 hours after the blood transfusion. Which of the following is/are the most prominent clinical manifestations? A. Shortness of breath, hypertension B. Hypothermia, dyspnea, pulmonary edema C. Shortness of breath, dyspnea, hypotension D. all of the above 54. Clinical manifestations of heat stroke include the following A.Confusion, tachycardia, headache and hypertension B.Dry skin, tachycardia, tachypnea and hypotension C.Bizarre behaviour, anhidrosis, bradycardia D. All of the above 55. Which of the following methods maybe used to decrease core body temperature of a client with heat stroke? A.Cool sheets and towels or continuous sponging with cool water B.Apply ice to the neck, groin , chest, and axilla while applying tepid water C.Cooling blanket or immersion of patient in a cold water bath D.All of the above 56. Which of the following is a complication of heat stroke? A.Acute renal failure B.Seizure C.Myocardial injury D.All of the above 57. The nurse knows that the possible cause of angina pectoris is A.Dysrhythmias triggered by stress B.Coronary vasospasm C.Minute emboli through the narrowed lumen of the coronary vessels D.Spasms of the vessel walls owing to excessive secretion of epinephrine