Med-surg: GI, perioperative & oncology worksheet with answers

Why is nail varnish or a gel nail often removed from at least one finger before surgery?

1. ASo pulse oximetry readings and nail colour can be assessed accurately
2. BBecause varnish raises the patient's blood pressure
3. CBecause it is a checklist rule with no clinical reason
4. DBecause the varnish can make the anaesthetic gas less effective

What is a parastomal hernia?

1. AA sore, red area of skin under the stoma bag from leaking output
2. BA narrowing of the stoma opening
3. CA bulge of bowel through the abdominal wall next to a stoma
4. DA stoma that has sunk below the level of the skin

Why is a feeding tube flushed with water before and after giving medicines?

1. ATo keep it clear and stop drugs mixing with feed
2. BTo clean the stomach before the next meal
3. CTo check that the patient is not thirsty
4. DTo warm the tube so it is more comfortable

Which finding means a patient is usually ready to leave recovery for the ward?

1. AAwake, with a clear airway, stable observations and controlled pain
2. BStill drowsy and needing a jaw thrust to breathe
3. CSystolic BP falling steadily over the last hour, with a rising pulse rate
4. DPain score 9/10 and vomiting repeatedly

What is tumour lysis syndrome?

1. AAn allergic reaction to a chemotherapy infusion
2. BA slow-growing tumour that presses on the nerves
3. CA skin reaction in an area recently treated with radiotherapy
4. DA metabolic emergency from rapid breakdown of cancer cells

Why are antimotility drugs such as loperamide avoided in C. difficile infection?

1. AThey cause serious liver failure in most patients who take them
2. BThey kill the normal bowel bacteria
3. CThey make the stool sample test positive falsely
4. DThey may keep toxin in the bowel and risk toxic megacolon

A patient has sharp, tearing pain on passing stool, "like passing glass", with a streak of fresh blood. Which condition is most likely?

1. AAnal fissure
2. BColorectal cancer
3. CUpper GI bleeding
4. DCrohn's disease of the ileum

Which group of signs suggests that a patient is entering the last days of life?

1. AClearer thinking and increased movement
2. BReduced intake, mottled skin and changes in breathing
3. CHigh blood pressure and very fast weight gain
4. DRising appetite, more energy and normal skin colour and warmth