Fundamental Nursing MCQ Quiz - Objective Question with Answer for Fundamental Nursing - Download Free PDF

• Patients with a history of heart disease are often at increased risk of developing bacterial infections, particularly during surgical procedures. To mitigate this risk, prophylactic antibiotics may be prescribed to prevent infections before they occur.
• Prophylactic antibiotics are a preventive measure to reduce the risk of endocarditis, an infection of the inner lining of the heart chambers and valves, which can be particularly dangerous for patients with existing heart conditions.

• Rationale: This option is incorrect because it is a standard practice to prescribe prophylactic antibiotics to patients with a history of heart disease undergoing surgery to prevent potential infections.

• Rationale: This option is incorrect because prophylactic antibiotics are not limited to just open-heart surgeries. They can be prescribed for various surgical procedures where there is a risk of bacterial infection, especially in patients with a history of heart disease.

• Rationale: This option is incorrect because prophylactic antibiotics are given to prevent infections, not just when an active infection is present. The goal is to prevent the onset of infection in high-risk patients.

• Prescribing prophylactic antibiotics for patients with a history of heart disease before surgery is a preventive measure to reduce the risk of severe infections like endocarditis. This practice is not limited to specific types of surgery and is not contingent on the presence of an active infection.

• Paralytic ileus is a condition where there is a lack of intestinal movement, preventing the passage of food and leading to a blockage. This can occur as a complication after surgery due to handling of the intestines, anesthesia, or other factors.
• To assess for paralytic ileus, it is essential to monitor bowel sounds. Bowel sounds are the noises made by the movement of the intestines as they push food through the digestive tract. In the case of paralytic ileus, these sounds may be absent or significantly reduced.
• Auscultating for bowel sounds every 4 hours allows healthcare providers to detect any abnormal patterns early. The presence, absence, or changes in bowel sounds can provide crucial information about the gastrointestinal function of the patient.
• Early detection of paralytic ileus enables timely intervention, which can include measures such as nasogastric decompression, fluid management, and sometimes surgical intervention to relieve the obstruction.

• Rationale: While renal function monitoring is important in postoperative care, it is not directly related to assessing for paralytic ileus. Renal function tests evaluate how well the kidneys are working, which is crucial for overall patient management but not specific to detecting intestinal motility issues.

• Rationale: Administering antibiotics may be necessary for preventing or treating infections, but it does not play a role in the assessment of paralytic ileus. Antibiotics do not influence bowel sounds or intestinal motility directly.

• Rationale: Monitoring heart rate is important for overall patient health and can indicate stress or pain, but it is not specific to assessing for paralytic ileus. Heart rate monitoring does not provide direct information about intestinal function or motility.

• Among the given options, auscultating for bowel sounds every 4 hours is the most relevant and effective method for assessing paralytic ileus. This practice allows healthcare providers to monitor the gastrointestinal activity closely and take appropriate actions if necessary.

• A preoperative assessment is crucial for identifying any potential risks and ensuring patient safety during and after the surgical procedure. It includes evaluating the patient's medical history, physical examination, and necessary laboratory tests.
• While understanding the patient's knowledge about rehabilitation is important for postoperative care and recovery, it is not typically included in the preoperative assessment.

• Rationale: Reviewing the patient's current medications and drug use is essential to identify any potential interactions with anesthesia or surgical medications and to manage any existing health conditions effectively.

• Rationale: Assessing the patient's psychological state is important as it can affect their response to surgery and anesthesia, as well as their ability to recover postoperatively. Anxiety, depression, and other psychological factors need to be managed appropriately.

• Rationale: These demographic details are vital for calculating dosages for anesthesia, determining the risk of complications, and planning postoperative care. Age, weight, and height can significantly influence the outcomes and risks associated with surgery.

• In summary, the preoperative assessment focuses on evaluating the patient's overall health, potential risk factors, and preparedness for surgery. While patient knowledge about rehabilitation is important for postoperative recovery, it is not a primary focus of the preoperative assessment.

• When a patient is being considered for discharge from the Post-Anesthesia Care Unit (PACU), it is crucial to ensure that they have stabilized and are not at risk for complications. One key indicator of stability is the patient's body temperature.
• A temperature greater than 96.8°F (36°C) is necessary to ensure that the patient is not hypothermic. Hypothermia can lead to various complications, including impaired coagulation, increased risk of infection, and prolonged recovery from anesthesia.
• Maintaining a normal body temperature is essential for the patient's metabolic processes and overall well-being during the recovery phase.

• Rationale: While normal breathing is important for recovery, it is not the sole criterion for discharge from the PACU. The patient's respiratory function must be assessed alongside other vital signs and overall stability.

• Rationale: Absence of bleeding or swelling is crucial for patient safety, especially after surgery. However, it is just one of several factors that need to be evaluated before discharge. It does not singularly determine the readiness for discharge from the PACU.

• Rationale: An oxygen saturation level of at least 90% is important to ensure adequate oxygenation and prevent hypoxia. However, this parameter alone does not cover all aspects of patient stability and readiness for discharge from the PACU.

• For safe discharge from the PACU, patients must meet multiple criteria indicating overall stability. A temperature greater than 96.8°F is essential to ensure the patient is not hypothermic, which is critical for their recovery and to prevent complications.

• Spinal anesthesia involves the injection of anesthetic medication into the spinal fluid, which can impact various physiological systems in the body, including renal function.
• Monitoring renal function is important because anesthetic agents and the stress of surgery can affect kidney perfusion and function, potentially leading to acute kidney injury (AKI).
• Ensuring proper renal function helps in maintaining fluid and electrolyte balance, which is crucial for patient recovery.

• Rationale: While monitoring oxygen levels is always important during any surgical procedure, it is not specifically required for spinal anesthesia. Oxygen saturation is usually monitored as part of routine anesthesia care.

• Rationale: Hypertension (high blood pressure) is not a primary concern with spinal anesthesia. However, blood pressure monitoring is necessary since spinal anesthesia can sometimes lead to hypotension (low blood pressure).

• Rationale: Monitoring brain activity, such as with an EEG, is not typically required for spinal anesthesia. This type of monitoring is more relevant for procedures involving general anesthesia or surgeries that directly affect brain function.

• Among the given options, renal function monitoring is the most critical in the context of spinal anesthesia. This is due to the potential effects of anesthesia and surgery on kidney function, which requires careful observation to prevent complications.

'Halitosis' commonly known as Bad breath.

• Halitosis (bad breath) is mostly caused by sulphur-producing bacteria that normally live on the surface of the tongue and in the throat.
• It is used to describe any disagreeable bad or unpleasant odor emanating from the mouth air and breath.
• Halitosis is a latin word which derived from halitus (breathed air) and the osis (pathologic alteration).
• Bad breath is typically caused by bacteria present on the teeth and debris on the tongue.
• Most cases of halitosis are associated with poor oral hygiene, gum diseases such as gingivitis and periodontitis, and dry mouth.
• Dry mouth is a condition in which the salivary glands cannot make enough saliva to keep your mouth moist. 
• Halitosis is not infectious.
• High Blood Pressure may be referred to as Hypertension and Low Blood Pressure may be referred to as Hypotension.
• A headache is called cephalgia in medical terminology.
• Influenza is commonly referred to as Flu.

ECG is the process of recording the electrical activity of the heart over a period of time using electrodes placed on the skin.

Explanation:

5 Moments for Hand Hygiene according to WHO.

Confusion Points

• There is a difference between “Moments of Hand Hygiene” and Steps of Hand Hygiene.
• The 5 Moments for Hand Hygiene defines the key Incidences or situations when health care workers must demonstrate hand hygiene.
• The key to hand washing with 7 Steps of Hand Washing is to ensure that you thoroughly clean all surfaces and areas of your hands, fingers, and wrists.

Concept:

• Rectal examination is a diagnostic method used to inspect :-
  • Disorder of lower gastrointestinal GI tract
  • Prostatic disorders like benign prostatic hyperplasia
  • Active unexplained gastrointestinal bleed
  • Examining women for vaginal wall prolapse.
  • Sometimes prior to a colonoscopy or proctoscopy
• In sims position the person will be placed in side lying position with one leg flexed because of which the anus is clearly visualized and can facilitate the anal related procedures
• Sims' position, named after the gynaecologist -> J. Marion Sims, 

Additional Information

• Lithotomy position is a position where both the legs are flexed at knees and the vagina is clearly visualized for labor and other gynaecological examinations this position is used 
• Dorsal recumbent or supine position is the most common position used to observe the face and chest
• Prone position is when the face is placed downwards, in this position the back is clearly visible 

• The last preoperative assessment is crucial to ensure the patient’s stability and readiness for anesthesia and surgery. Checking vital signs is essential as it provides immediate data on the patient’s physiological status.
• Vital signs include measurements of heart rate, blood pressure, respiratory rate, and temperature, which are critical indicators of a patient’s current health state.
• This final check confirms the patient is in a stable condition to proceed with the operation, ensuring that any immediate issues can be addressed promptly.

• Rationale: A name band is used for patient identification, ensuring that the correct individual receives the correct procedure. While this is vital for preventing medical errors, it is generally verified earlier in the preparation process.

• Rationale: Obtaining signed consent is essential for legal and ethical reasons, ensuring that the patient understands the procedure and agrees to undergo it. This step is completed well before the final stages of preoperative assessment.

• Rationale: Having an empty bladder is important to reduce discomfort during and after surgery and to prevent potential complications. However, this is usually instructed and checked before moving the patient to the operating room area.

• Among the given options, checking vital signs is the final assessment prior to an elective splenectomy. This ensures the patient’s physiological parameters are within safe limits for anesthesia and surgery, thus confirming readiness and overall safety just before the procedure begins.

Explanation:

Oximeter

• Pulse oximetry is a non-invasive test that measures the oxygen saturation level of your blood.
• It can rapidly detect even small changes in Oxygen levels, Pulse, Oxygen saturation level (SpO2%).
• The pulse oximeter is a small, clip-like device that attaches to a body part, most commonly to a finger.
• Medical professionals often use it in emergency rooms or hospitals. 

Concept:

• Chemical burn -> Caused due to exposure to a corrosive chemical.
• Concentrated acids like sulphuric acid and hydrochloric acid can cause chemical burns.
• Immediate medical care must be provided to reduce the impact of the burn.

Explanation:

• Initial care for chemical burn -> Excessive flushing with water for 20-30 minutes.
• Remove the remnants of the chemical from the surface of the body.
• Other steps of chemical burn management -> Removal of dressing -> Done later on.
• Based on the type of burn -> Treatment is provided to the patient.

Additional Information

• Immediately cover the burn area -> Not the first step.
• Remove all the dressings -> Not the initial step.
• Provide the calm environment -> It is done later to help the patient relax.

Concept:

• Nurse should wait for 20 to 30 minutes before you take a temperature by mouth to normalize the body temperature and to prevent from the wrong result
• When the patient drinks some cold drinks there are changes in temperature of buccal cavity cold drinks take down temperature to an extent that false reading on thermometer is evident.
• This greatly affect on health records of patient and also possibly alter the care plan
• However after drinking hot drinks it might take a little long time to return baseline temperature of buccal cavity

Additional Information

Sites of measuring body temperature:-

• Oral
• Tympanic
• Axillary
• Rectal
• Temporal artery temperature

Temperature reading relations

• A normal axillary temperature is between 96.6° (35.9° C) and 98° F (36.7° C). The normal axillary temperature is usually a degree lower than the oral (by mouth) temperature. The axillary temperature may be as much as two degrees lower than the rectal temperature.
• A <- O -> R
• -1     1    +1

Concept:

• The nosocomial infection is an infection which a person can get from the the hospital after 48 hours of the admission. It's also called a hospital-acquired infection or a health-care associated infection. Hence option 1 is the Correct Answer.

​Types

• Bacterial infections are mainly caused by the bacteria which are tiny living things that are too small to see. Most aren’t harmful indeed, but some can cause serious illness. Bacteria are the most common source of nosocomial infections. Common bacteria include E. coli and staph.
• Fungal infections are caused by the fungi a living things, like mushrooms, mold, and yeast. Some fungi can cause harmful contagious infections sometimes. The most common fungi that cause nosocomial infections are Candida (thrush) and Aspergillus.‌
• Viral infections are mainly caused by the Viruses which are are tiny germs that spread through the body by imitating your natural genetic code. They trick your body into making copies of them, just like the body makes copies of other cells. Viruses can cause severe sickness. 

Additional Information

• Idiopathic disease is basically any disease with an unknown cause or mechanism of apparent spontaneous origin.
• Primary infection is the type of infection when first time  people are exposed to and infected by a pathogen. During a primary infection, body has no innate defenses against the organism, such as antibodies.
• Iatrogenic infection is defined as an infection after medical or surgical management, whether or not the patient was hospitalized.

Concept:

• Pain is considered to be the fifth vital sign.
• The four vital signs are:
  • Temperature
  • Respiration
  • Blood pressure
  • Heart rate or pulse
• The assessment of the vital signs provides baseline data of the patient.
• They provide initial information at the time of admission.
• A patient may be in distress, vital signs help to assess the condition.

Explanation:

• Pain is another sign signifying any bodily distress.
• Therefore, health care staff should always assess for any pain at the time of vital assessment.
• Pain can also alter the vital signs.
• For example, it can lead to an increase in blood pressure.
• Therefore, it should be a priority.