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DOH Med Surg (DOH-MedSurg) Practice Tests & Test Prep by Exam Edge - Review


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DOH Medical Surgical Nursing - Reviews


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See why our users from 154 countries love us for their exam prep! Including 100 reviews for the DOH Med Surg exam.

Exam Edge is an industry leader in online test prep. We work with institutional partners to offer a wide array of practice tests that will help you prepare for your big exam. No matter how niche your field of interest might be, we're here to help you prepare for test day.

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DOH Medical Surgical Nursing - Test Reviews Sample Questions

During an assessment with a 52 year old female patient, she tells you that she sometimes leaks a small amount of urine when she laughs or sneezes. Which of the following would be an appropriate diagnosis for this patient?

Correct Answer:
incontinence, stress.


the appropriate diagnosis for a 52-year-old female patient who reports leaking a small amount of urine when she laughs or sneezes is "incontinence, stress." this condition is known as stress urinary incontinence (sui), a common form of incontinence among women, especially in the middle-aged and older age groups.

stress incontinence refers to the involuntary leakage of urine during activities that increase intra-abdominal pressure, such as coughing, sneezing, laughing, or physical exertion. the underlying mechanism involves a weakening of the pelvic floor muscles or a deficiency in the urethral sphincter, which are both crucial in supporting the bladder and maintaining continence. factors contributing to this condition may include childbirth, menopause, and aging, which can all impact the strength and functionality of the pelvic muscles.

it is important to correctly identify this condition as stress incontinence rather than urge incontinence or other types of urinary disorders. urge incontinence, which is different from stress incontinence, involves a sudden, intense urge to urinate followed by an involuntary contraction of the bladder, leading to leakage. the distinction is crucial because the management and treatment strategies for stress incontinence and urge incontinence differ significantly.

for a patient with stress incontinence, treatment options may include pelvic floor muscle training (kegel exercises), lifestyle changes such as weight management and smoking cessation, and possibly surgical interventions if conservative measures are insufficient. it is also helpful to document that this is specifically urinary incontinence, as opposed to bowel incontinence, to ensure clarity in diagnosis and treatment planning.

An elderly patient comes into the ER with symptoms of fever and chills as well as what seems to be an altered state of mind. He has some signs of dehydration and chest pain also, but the charge nurse suspects this patient should be diagnosed with what?

Correct Answer:
pneumonia
the most likely diagnosis for the elderly patient exhibiting symptoms of fever, chills, altered mental state, signs of dehydration, and chest pain is pneumonia. here's an expanded explanation based on the information provided and common medical knowledge:

**symptoms and diagnosis:** elderly patients often present with atypical symptoms of pneumonia, which can make the diagnosis challenging. unlike younger adults who might show clear respiratory symptoms such as a productive cough and pronounced breathing difficulties, elderly individuals might not exhibit such classic signs. instead, they may present with systemic symptoms like fever and chills, which are common to many infections, but the key differentiator here is an altered state of mind. altered mental status in the elderly can be a result of several factors but is particularly concerning in the context of an infection due to its association with poor outcomes.

**why altered mental state occurs:** the altered mental state, often manifesting as confusion or delirium, can be linked to the body's systemic response to infection. in pneumonia, the infection in the lungs can lead to decreased oxygenation and increased carbon dioxide levels in the blood, which affects brain function. furthermore, dehydration, which is evidenced by the patient’s symptoms, can exacerbate confusion. elderly patients are more susceptible to dehydration because they have a lower volume of water in their bodies and often have conditions or take medications that increase fluid loss.

**chest pain:** the complaint of chest pain in this scenario is likely due to pleuritic pain, which is pain derived from inflammation of the pleura (the membrane surrounding the lungs). this is a typical symptom of pneumonia and occurs when the pleura becomes irritated, which happens when the lungs expand during breathing.

**management and importance of early diagnosis:** immediate and accurate diagnosis, followed by appropriate treatment, is crucial in managing pneumonia in elderly patients. this typically involves antibiotics, fluids, and sometimes supplemental oxygen. the reason early diagnosis is particularly critical in elderly patients is due to their generally weaker immune systems and higher susceptibility to complications, which can lead to severe outcomes, including sepsis and respiratory failure.

**conclusion:** considering the symptoms — especially the altered mental state in the context of fever, chills, and dehydration — pneumonia is a likely diagnosis. it's essential for healthcare providers to recognize these atypical presentations in elderly patients to ensure timely and effective treatment. hence, the charge nurse’s suspicion of pneumonia is well-founded based on the symptoms described.