Question Preparation Exam-1-1
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SONGA AmriQuestion Preparation Exam-1-1
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SONGA Amri㫶143 A student nurse level one is caring a patient with ischemia condition.
He/she asked I charge
nurse the meaning of ischemia. What would be the BEST response from in charge nurse?
ǀౚ⪽ǁ⾨䙎ǂ퇢瓨ǃ䅪ࠝ DŽ㤾䢮
Dž眦dž˨≀LJ㏙Lj흞৹
lj륒༂NJ㖄ᒧNj㸪抸nj埞䉡Ǎ 丠圃
ǎ 艦ᏠǏ Overflow of blood to tissues
ǀౚ⪽ǁ⾨䙎ǂ퇢瓨ǃ䅪ࠝDŽ㤾䢮
Dž眦dž˨≀LJ㏙Lj흞৹
lj륒༂NJ㖄ᒧNj㸪抸nj埞䉡Ǎ丠圃
ǎ艦ᏠǏRestriction of blood supply to tissues
ǀౚ⪽ǁ⾨䙎ǂ퇢瓨ǃ䅪ࠝDŽ㤾䢮
Dž眦dž˨≀LJ㏙Lj흞৹
lj륒༂NJ㖄ᒧNj㸪抸nj埞䉡Ǎ 丠圃
ǎ 艦ᏠǏ Inadequate deoxygenated blood carrying veins
ǀౚ⪽ǁ⾨䙎ǂ퇢瓨ǃ䅪ࠝDŽ㤾䢮
Dž眦dž˨≀LJ㏙Lj흞৹
lj륒༂NJ㖄ᒧNj㸪抸nj埞䉡Ǎ 丠圃
ǎ 艦ᏠǏ The medical term for shortness of breath
㫶144 Which of the following MOSTLY confirming the values meet the diagnostic onset for
diabetes?
ǀౚ⪽ǁ⾨䙎ǂ퇢瓨ǃ䅪ࠝDŽ㤾䢮
Dž眦dž˨≀LJ㏙Lj흞৹
lj륒༂NJ㖄ᒧNj㸪抸nj埞䉡Ǎ 丠圃
ǎ 艦ᏠǏ Fasting blood glucose ≥ 140 mg/dl
ǀౚ⪽ǁ⾨䙎ǂ퇢瓨ǃ䅪ࠝDŽ㤾䢮
Dž眦dž˨≀LJ㏙Lj흞৹
lj륒༂NJ㖄ᒧNj㸪抸nj埞䉡Ǎ 丠圃
ǎ 艦ᏠǏ Random glucose > 160 mg/dl
ǀౚ⪽ǁ⾨䙎ǂ퇢瓨ǃ䅪ࠝDŽ㤾䢮
Dž眦dž˨≀LJ㏙Lj흞৹
lj륒༂NJ㖄ᒧNj㸪抸nj埞䉡Ǎ 丠圃
ǎ 艦ᏠǏ 2 hours post prandial glucose ≥ to 126 mg/dl
ǀౚ⪽ǁ⾨䙎ǂ퇢瓨ǃ䅪ࠝDŽ㤾䢮
Dž眦dž˨≀LJ㏙Lj흞৹
lj륒༂NJ㖄ᒧNj㸪抸nj埞䉡Ǎ丠圃
ǎ艦ᏠǏFasting blood glucose ≥ 126 mg/dl
㫶145 “Ever since my divorce, my 5-year-old has begun to wet the bed”. This is an example of
what defense mechanism?
ǀౚ⪽ǁ⾨䙎ǂ퇢瓨ǃ䅪ࠝDŽ㤾䢮
Dž眦dž˨≀LJ㏙Lj흞৹
lj륒༂NJ㖄ᒧNj㸪抸nj埞䉡Ǎ 丠圃
ǎ 艦ᏠǏ Rationalization
ǀౚ⪽ǁ⾨䙎ǂ퇢瓨ǃ䅪ࠝDŽ㤾䢮
Dž眦dž˨≀LJ㏙Lj흞৹
lj륒༂NJ㖄ᒧNj㸪抸nj埞䉡Ǎ丠圃
ǎ艦ᏠǏRegression
ǀౚ⪽ǁ⾨䙎ǂ퇢瓨ǃ䅪ࠝDŽ㤾䢮
Dž眦dž˨≀LJ㏙Lj흞৹
lj륒༂NJ㖄ᒧNj㸪抸nj埞䉡Ǎ 丠圃
ǎ 艦ᏠǏ Denial
ǀౚ⪽ǁ⾨䙎ǂ퇢瓨ǃ䅪ࠝDŽ㤾䢮
Dž眦dž˨≀LJ㏙Lj흞৹
lj륒༂NJ㖄ᒧNj㸪抸nj埞䉡Ǎ 丠圃
ǎ 艦ᏠǏ Reaction formation
㫶146 Which of the following statements is CORRECT?
ǀౚ⪽ǁ⾨䙎ǂ퇢瓨ǃ䅪ࠝDŽ㤾䢮
Dž眦dž˨≀LJ㏙Lj흞৹
lj륒༂NJ㖄ᒧNj㸪抸nj埞䉡Ǎ 丠圃
ǎ 艦ᏠǏ Insulin suppresses the activity of glycogen synthase
ǀౚ⪽ǁ⾨䙎ǂ퇢瓨ǃ䅪ࠝDŽ㤾䢮
Dž眦dž˨≀LJ㏙Lj흞৹
lj륒༂NJ㖄ᒧNj㸪抸nj埞䉡Ǎ 丠圃
ǎ 艦ᏠǏ Insulin mediates glucose uptake in the brain
ǀౚ⪽ǁ⾨䙎ǂ퇢瓨ǃ䅪ࠝDŽ㤾䢮
Dž眦dž˨≀LJ㏙Lj흞৹
lj륒༂NJ㖄ᒧNj㸪抸nj埞䉡Ǎ丠圃
ǎ艦ᏠǏ"Prediabetes" is a condition characterized by an increased
risk for the future development of type 2 diabetes
ǀౚ⪽ǁ⾨䙎ǂ퇢瓨ǃ䅪ࠝDŽ㤾䢮
Dž眦dž˨≀LJ㏙Lj흞৹
lj륒༂NJ㖄ᒧNj㸪抸nj埞䉡Ǎ 丠圃
ǎ 艦ᏠǏ The rise in insulin concentration after meal ingestion is reduced in
type 1 but not in type 2 diabetes
㫶147 Human digestive system is composed of the following organs. Which of the following organs
is considered as primary absorptive organ?
0 Large intestine
1 Small intestine
2 Stomach
3 Rectum
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5888 Insulin deficiency is associated with:
5888 Reduced lipolysis
5889 Increased ketogenesis
5890 Reduced gluconeogenesis
5891 Reduced proteolysis
5889 The risk factors for type 2 diabetes mellitus include:
5888 Family history
5889 Being overweight
5890 High intake of dietary fat
5891 All of the options listed are correct
5890 Which of the following is NOT one of the Erikson’s stages of psychosocial
development?
5888 Industry vs. Inferiority
5889 Intimacy vs. Isolation
5890 Trust vs. Mistrust
5891 Life vs. Death
5891 The pathogenesis of hyperglycemia in type 2 diabetes includes all the following
mechanisms EXCEPT for:
5888 Increased glucose production by the liver
5889 Impaired insulin secretion
5890 Decreased glucose uptake from the skeletal muscle
5891 All of the options given are correct
5892 Which the following statements BEST describes well the nephron?
5888 It is a basic structural and functional unit of the kidney
5889 It is a part that collects preformed urine together and excrete through
ureters
5890 It is a tube like tunnel that regulates aldosterone
5891 It is supra adrenal gland secreting steroid hormones
5893 Which statement BEST describes the differences between the characteristics of
type 1 and type 2 diabetes?
5888 Persons with type 2 diabetes usually require lower doses of insulin
than person with type 1 diabetes because they have a milder form of diabetes
5889 Persons with type 1 diabetes rapidly develop chronic complications
5890 Autoimmune factors are involved in the pathogenesis of type 1 but
not type 2 diabetes
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0 Persons with type 1 diabetes can increase endogenous insulin production by
taking oral hypoglycemic agents
0 Identify the statements below that are CORRECT:
0 Hallucinations means: Imaginary sensations, such as seeing, hearing, or
smelling things that do not exist in the real world.
1 The "misbehavior" of animals (instinctive idea) shows that some behaviors are
difficult to condition because they interfere with natural appetitive behaviors.
2 A variable ratio schedule is an example of intermittent reinforcement.
3 Term Psychology means” the science of human behavior and mental processes”.
4 Primary reinforcemers do not satisfy a biological need.
Choose the correct sequence
0 1,2,5,4
1 1,2,3,4
2 2,3,4, 5
3 1,2,3,4,5
1 Which of the following is NOT a beneficial effect of exercise in people with diabetes?
0 Reduction of triglycerides
1 Hypoglycemia
2 Increase of insulin sensitivity
3 Controlling hypertension
2 A nurse reviews the arterial blood gas results of a client and notes the following: ph
7.45, Pco2 of 30mmhg, and HCO3- of 22 mEq/L. The nurse analysis these results as
indicating which condition?
0 Metabolic acidosis, compensated
1 Respiratory alkalosis, compensated
2 Metabolic alkalosis, uncompensated
3 Respiratory acidosis, uncompensated
3 A nurse is caring for a client with a nasogastric tube that is attached to low suction. The
nurse monitors the client, knowing the client is at risk for which acid-base disorder?
0 Metabolic acidosis
1 Metabolic alkalosis
2 Respiratory alkalosis
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0 Respiratory acidosis
0 In malaria, where do asexual sporozoites undergo schizogony to form merozoites?
0.0 In the stomach of the female anopheles mosquito
0.1 In liver cells
0.2 In red blood cells
0.3 In macrophages
1 A nurse is caring for a client with diabetic ketoacidosis and documents that the client is
experiencing Kussmaul's respirations. Based on this documentation, which of the
following did the nurse observe?
1.0 Respirations that cease for several seconds.
1.1 Respirations that are regular but abnormally slow.
1.2 Respirations that are labored and increased in depth and rate.
1.3 Respirations that are abnormally deep, regular, and increased in rate.
2 A client who is found unresponsive has arterial blood gases drawn and the results indicate
the following: pH is 7.12, Pco2 is 90 mmHg, and HCO3- is 22 mEq/L. The nurse interprets
the results as indicating which condition?
2.0 Metabolic acidosis, compensated
2.1 Respiratory alkalosis, compensated
2.2 Metabolic alkalosis, uncompensated
2.3 Respiratory acidosis, uncompensated.
3 A nurse plans care for a client with COPD, understanding the client is MOST LIKELY to
experience:
3.0 Metabolic acidosis
3.1 Metabolic alkalosis
3.2 Respiratory acidosis
3.3 Respiratory alkalosis
4 The patient is a 75-year-old man with a history of emphysema. He comes to the emergency
department reporting a productive cough that causes chest pain
and fatigue. "I am having more problems breathing than usual." Which assessment indicates
that this patient has INADEQUATE oxygenation?
4.0 Decreased urine output
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0 Bradycardia
1 Decreased chest expansion
2 Hypotension
0 Which of the following is the rationale for using preoperative checklist on the day of
surgery?
0 To ensure that the patient is correctly identified.
1 To ensure that all preoperative orders and procedures have been carried out and
records are complete.
2 To confirm that the patients’ families have been informed as to where they can
accompany and wait for patients.
3 Preoperative medications are the last procedure before the patient is transported to
the operating room
0 At the end of the surgical procedure, the preoperative nurse evaluates the patient’s
response to the nursing care delivered during the perioperative period. Which of the
following BEST reflects a positive outcome related to the patient’s physical status?
23 The patient’s right to privacy is maintained
24 The patient’s care is consistent with the perioperative plan of care.
25 The patient receives consistent and comparable care regardless of the setting
26 The patient’s respiratory function is consistent with or improved from baseline levels
established preoperatively
23 The patient tells the nurse in the preoperative setting that she has noticed a reaction when
wearing rubber gloves. Which of the following is the MOST appropriate intervention?
0 Notify the surgeon so the case can be cancelled.
1 Ask additional questions to assess for a possible latex allergy.
2 Notify the Operating Room staff immediately so that latex-free supplies can be used.
3 No interventions is needed because the patient’s rubber sensitivity has no bearing on
surgery
0 Which of the following is an advantage of tracheostomy over an endotracheal (ET) tube for
long-term management of an upper airway obstruction?
0 A tracheostomy is safer to perform in an emergency
1 An ET tube has a higher risk of tracheal pressure necrosis.
2 A tracheostomy tube allows for more comfort and mobility.
3 An ET tube is more likely to lead to lower respiratory trach infection.
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0 A patient’s tracheostomy tube becomes dislodged with vigorous coughing. Which of the
following should the nurse’s FIRST action?
0 Attempt to replace the tube.
1 Notify the health care provider.
2 Place the patient in high Fowler position.
3 Ventilate the patient with a manual resuscitation bag until the health care provider arrives.
26. A patient returns to the surgical unit with a nasogastric (NGT) tube to low intermittent
suction, IV fluids, and a drain at the surgical site following an exploratory laparotomy and
repair of a bowel perforation. Four hours after admission, the patient experiences nausea
and vomiting. Which of the following is a PRIORITY nursing intervention for the patient?
0 Assess the abdomen for distention and bowel sounds
1 Inspect the surgical site and drainage in the Jackson-Pratt.
2 Check the amount and character of gastric drainage and the patency of the NG
tube
3 Administer prescribed promethazine to control the nausea and vomiting.
5888 A patient with a gunshot wound to the abdomen complains of increasing
abdominal pain several hours after surgery to repair the bowel. Which of the following
actions should the nurse take FIRST?
5888 Take the patient’s vital signs.
5889 Notify the health care provider
5890 Position the patient with the knees flexed
5891 Determine the patient’s IV intake the end of surgery.
5889 On examining a patient 8 hours after having surgery to create a colostomy, what
should the nurse expect to find?
5888 Hyperactive, high-pitched bowel sounds
5889 A brick-red, puffy stoma that oozes blood
5890 A purplish stoma , shiny and moist with mucus
5891 A small amount of liquid fecal drainage from the stoma
5890 A patient is admitted to the emergency department with a possible cervical spinal
cord injury following an automobile crash. During admission of the patient, what is the
HIGHEST PRIORITY for the nurse?
5888 Maintaining a patent airway
5889 Maintaining immobilization of the cervical spine
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0 Assessing the patient for head and other injuries
1 Assessing the patient’s motor and sensory function
23 All of the following adults are admitted to the surgical unit. Which client should the nurse
prepare for immediate surgery?
23 A 56-year –old woman who is having right scapular pain after eating
24 A 48-year-old woman who has had moderate vaginal bleeding for two weeks
25 A 28-year-old man who has severe right lower quadrant abdominal pain and a
WBC of 14.000/mm
26 A 45-year-old man who has an irreducible inguinal hernia
24 Which of the following methods is the MOST reliable way to assess the severity of a
patient’s pain?
23 Ask patient to describe the pain
24 Observe the patient for physical signs of pain such as moaning or grimacing
25 Ask the patient to rate his or her pain using a valid assessment scale
26 Ask the family member to rate the patient’s pain
25 The nurse is caring for a patient who returned from surgery three (3) hours ago . which of
these findings would the nurse recognize as being the MOST urgent to report to the
surgeon
23 Tachycardia
24 Polyuria
25 Nausea
26 Fever
23 The nurse is caring for a trauma patient who is hemorrhaging from a puncture wound. Which
of the following interventions should the nurse use to control the arterial bleeding?
23 Pressure the puncture site
24 Application of tourniquet
25 Pressure point massage
26 Pressure dressing
24 The nurse would anticipate the potential for inhalation injury in patient who was in a house
fire with which of the following assessment findings?
23 Peripheral edema
24 Burnt nasal hairs
25 Jugular vein distension
26 Increased capillary refill time
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23 In report, the nurse learns that the patient has a transverse colostomy. What should
the nurse expect when providing care for this patient?
23 Semiliquid stools with increased fluid requirements
24 Liquid stools in pouch and increased fluid requirements
25 Formed stools with a pouch, needing irrigation, but no fluid needs
26 Semi-formed stools in a pouch with the need to monitor fluid balance
24 After surgery, a patient returns from the post-anesthesia Care Unit (PACU) with a
nasogastric tube in place following a gall bladder surgery. She continues to complain of
nausea. Which action would the nurse take?
23 Call the physician immediately
24 Administer the prescribed antiemetic
25 Check the patency of the nasogastric tube for any obstruction
26 Immediately give the antiemetic drugs
25 A patient who just returned from surgery after a total gastrectomy begins to vomit
bright red blood. Which of the following is the PRIORITY action for the nurse to take/
23 Increase the IV rate
24 Take a blood pressure
25 Place a patient onto side
26 Administer oxygen
26 When scrubbing at the scrub sink, the nurse should:
23 Scrub from elbows to hands
24 Scrub without mechanical friction
25 Scrub for a minimum of 10 minutes.
26 Hold the hands higher than the elbows
27 During an assessment of a patient who sustained a head injury 24 hours ago, the nurse at
the emergency department notes the development of slurred speech and disorientation to
time and place. The nurse’s initial action is to:
23 Continue the hourly neurologic assessment
24 Inform the neurosurgeon of the patient’s
25 Prepare the patient for emergency surgery status.
26 Recheck the patient’s neurologic status in 15 minutes
28 Which of the following is the BEST way to prevent post-operative wound infection for a
surgical client?
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0 Administer a prescribed antibiotic
1 Wash her hands for two minutes before care.
2 Wear a mask when providing care.
3 Ask the client to cover her mouth when she coughs
0 The client is admitted for an open reduction internal fixation for a fractured hip.
Immediately following surgery, the nurse should give PRIORITY to assessing which of
the following?
0 Collection drain
1 Client’s pain
2 Nutritional status
3 Immobilizer
1 An elderly client with an abdominal surgery is admitted to the unit following surgery. In
anticipation of complication of anesthesia and narcotic administration, the nurse should
take Which of the following actions?
0 Administer oxygen via nasal cannula.
1 Have naloxane available
2 Prepare to administer blood products
3 Prepare to do cardio resuscitation.
2 A 24-year-old female client is scheduled for surgery in the morning. Which of the following
is the primary responsibility of the nurse?
0 Taking the vital signs
1 Obtaining the permit
2 Explaining the procedure
3 Checking the lab work
3 The nurse is working in the emergency room when a client arrives with severe burns of
the left arm, hands, face and neck. Which action should receive PRIORITY?
0 Starting an IV
1 Applying oxygen
2 Obtaining blood gases
3 Medicating the client for pain
4 The nurse is preparing to suction the client with a tracheostomy. The nurse notes a previously
used bottle of normal saline on the client’s bedside table. There is no label to indicate the date or
time of initial use. The nurse should take which of the following actions?
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0 Lip the bottle and use a pack of sterile 4*4 for the dressing
1 Obtain a new bottle and label it with the date and time of first use
2 Ask the ward secretary when the solution was requested
3 Label the existing bottle with the current date and time
0 A 60-year-old woman has pain on motion in her fingers and askes the nurse whether his is just a
result of aging. Which of the following information is the best response by the nurse?
0.0 Joint pain with functional is normal change that affects all people to some extent
0.1 Joint pain that develops with age is usually related to previous trauma or infection of
the joints.
0.2 This is a symptom of a systemic arthritis that eventually affects all joints as the
disease progresses.
0.3 Changes in the cartilage and bones of joints may cause symptoms of pain and loss
of function in some people as the age.
1 The patient asks the nurse the reason why she needs to have surgery for a femoral.
Strangulated hernia. Which of the following is the BEST explanation the nurse can give the
patient?
1.0 The surgery will relieve her constipation
1.1 The abnormal hernia must be replaced into the abdomen
1.2 The surgery is needed to allow intestinal flow and prevent necrosis.
1.3 The hernia is because the umbilical opening did not close after birth as it should have
2 The nurse is collecting data on a patient with an appendicitis that is painful. Where would
the nurse expect the patient’s pain to be located?
2.0 Right upper quadrant
2.1 Right lower quadrant
2.2 Left upper quadrant
2.3 Left lower quadrant
3 The patient comes to the emergency department with intermittent cramp abdominal pain,
nausea, projectile vomiting and dehydration. The nurse suspects a gastro intestinal
obstruction. Which part of the intestine is suspected to be obstructed?
3.0 Large intestine
3.1 Upper small intestine
3.2 Esophageal sphincter
3.3 Lower small intestine
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0 Which of the following interventions is contraindicated in the nonsurgical management of
hemorrhoids?
0 Diets low in fiber and fluids
1 Dibucaine ointment
2 Warm sit baths three or four times a day
3 Cleansing the anal area with moistened cleansing tissue
1 A patient with chronic gastritis is admitted in surgical department. Which of the following
manifestations or conditions is associated with the patient’s diagnosis?
0 Pernicious anemia
1 Gastric hemorrhage
2 Hematemesis
3 Dyspepsia
2 The nurse is caring for a patient with a fractured left leg. Which of the following findings
during a cardiovascular assessment of the lower extremities would the nurse recognize
as PRIORITY to report to the physician?
0 Strong bilateral left leg post tibia pulse
1 Right foot capillary refill less than 2 seconds
2 Bilateral dorsal flexion
3 Pallor of the left leg
3 Which of the following is the most common type of malignant bone tube?
0 Ewing’s sarcoma
1 Chondrosarcoma
2 Fibro sarcoma
3 Osteosarcoma
4 During assessment of the patient with a renal calculus passing down the ureter, what
should the nurse expect the patient to report?
0 A history of chronic Urinary Tract infections
1 Dull, cost vertebral frank pain
2 Severe, colicky back pain radiating to the groin
3 A feeling of bladder fullness with urgency and frequency
5 The following statement are the strategic measures to prevent the kidney stones EXCEPT:
0 Proper hydration
1 Eating spinach, nuts and sweet potatoes
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0 Reduction salt intake
1 Increase calcium intake
0 An adolescent mal of 18 years old comes at the consultation with chief complain of
painless and swelling of the scrotum. After history taking and physical examination, the
physician confirms the medical diagnosis of hydrocele. The patient is asking which
treatment he should receive. Which of the following will be your response to the patient?
0 The aspiration or surgical drainage of the fluid will be performed
1 You will be given antibiotics
2 Surgical removal of the affected testis
3 The fluids will be reabsorbed
1 A patient with shortness of breath is being tested for lung cancer. Which of the
following diagnosis test will be MOST conclusive?
0 Chest X-rays
1 Magnetic Resonance Imaging (MRI)
2 Sputum Culture
3 Biopsy
2 During the early phase of burn injury, there is a drastic increase in capillary permeability.
Based on this physiologic change, the patient is primarily at risk for which of the following?
0 Acute kidney injury
1 Fluid overload
2 Increase cardiac output
3 Hypovolemic shock
3 A patient was admitted for burns of the upper extremities after being trapped in a burning
structure. The patient is also at risk for inadequate oxygenation related to inhalation of
smoke and superheated fumes. Which diagnostic test best monitors this patient’s gas
exchange?
0 Complete blood count
1 Myoglobin level
2 Carboxyhemoglobin level
3 Chest X-Ray
4 Which type of gastric ulcer may occur for a patient with extensive burns?
0 Curling’s ulcer
1 Cushing’s ulcer
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0 Peptic ulcer
1 Ischemic ulcer
0 Which of the following surgical interventions the nurse will prepare for a patient with
compartment syndrome?
0 Fasciotomy
1 Internal fixation
2 Amputation
3 Release of tendons
1 Which of the following descriptions is the MOST characteristics of osteoarthritis (OA) when
compared to rheumatoid arthritis (RA)?
0 Not systemic or symmetric
1 Most commonly occurs in women
2 Rheumatoid factor(RF) positive
3 Morning joint stiffness lasts one to several hours
2 Which of the following statements indicate when the nurse identifies a flail chest in a
trauma patient?
0 The multiple rib fractures are determined by x-ray.
1 Tracheal deviation to the unaffected side is present.
2 Paradoxic chest movement occurs during respiration
3 There is decreased movement of the involved chest wall
3 Progressive enlargement of a multinodular goiter causes tracheal compression. Which of
the following is the preferred management in otherwise good –risk patients?
0 Iodine treatment
1 Thyroid hormone treatment
2 Surgical resection of the abnormal thyroid
3 Radioactive iodine treatment
4 The patient has a thoracic spinal cord lesion and incontinence that occurs equally during
the day and night. Which type of incontinence this patient is experiencing?
0 Reflex incontinence
1 Overflow incontinence
2 Functional incontinence
3 Incontinence after trauma
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0 Which of the following a nurse should assess in order to determine whether a
tension pneumothorax is developing in patient with chest trauma?
Ȁ ⸀Ā Ѐ Ā Ȁ Ā ⸀Ā ᜀĀ ᜀĀ ᜀĀ ᜀĀ ᜀĀ ᜀĀ ᜀĀ Ā Ā Ā Ѐ Ā Ȁ Ā ⸀Ā ᜀĀ ᜀĀ ᜀĀ ᜀĀ ᜀĀ ᜀ0 Dull percussion sounds on the
injured side
Ȁ⸀ĀЀĀȀĀ⸀ĀᜀĀᜀĀᜀĀᜀĀᜀĀᜀĀᜀĀĀĀĀЀĀȀĀ⸀ĀᜀĀᜀĀᜀĀᜀĀᜀĀᜀ1 Severe respiratory
distress and tracheal deviation
Ȁ ⸀Ā Ѐ Ā Ȁ Ā ⸀Ā ᜀĀ ᜀĀ ᜀĀ ᜀĀ ᜀĀ ᜀĀ ᜀĀ Ā Ā Ā Ѐ Ā Ȁ Ā ⸀Ā ᜀĀ ᜀĀ ᜀĀ ᜀĀ ᜀĀ ᜀ2 Muffled and distant heart
sounds with decreasing blood pressure
Ȁ ⸀Ā Ѐ Ā Ȁ Ā ⸀Ā ᜀĀ ᜀĀ ᜀĀ ᜀĀ ᜀĀ ᜀĀ ᜀĀ Ā Ā Ā Ѐ Ā Ȁ Ā ⸀Ā ᜀĀ ᜀĀ ᜀĀ ᜀĀ ᜀĀ ᜀ3 Decreased movement and
diminished breath sounds on the affected side
1 Which of the following statement explains better the gastro-esophageal reflux disease
(GERD)?
Ȁ ⸀Ā Ѐ Ā Ȁ Ā ⸀Ā ᜀĀ ᜀĀ ᜀĀ ᜀĀ ᜀĀ ᜀĀ ᜀĀ Ā Ā Ā Ѐ Ā Ȁ Ā ⸀Ā ᜀĀ ᜀĀ ᜀĀ ᜀĀ ᜀĀ ᜀ0 GERD results in acid erosion
of the esophagus from frequent vomiting.
Ȁ ⸀Ā Ѐ Ā Ȁ Ā ⸀Ā ᜀĀ ᜀĀ ᜀĀ ᜀĀ ᜀĀ ᜀĀ ᜀĀ Ā Ā Ā Ѐ Ā Ȁ Ā ⸀Ā ᜀĀ ᜀĀ ᜀĀ ᜀĀ ᜀĀ ᜀ1 GERD will require surgical
wrapping or repair of the pyloric of the sphincter to control the symptoms
Ȁ ⸀Ā Ѐ Ā Ȁ Ā ⸀Ā ᜀĀ ᜀĀ ᜀĀ ᜀĀ ᜀĀ ᜀĀ ᜀĀ Ā Ā Ā Ѐ Ā Ȁ Ā ⸀Ā ᜀĀ ᜀĀ ᜀĀ ᜀĀ ᜀĀ ᜀ2 GERD is the protrusion
of a portion of the stomach into the esophagus through an opening in the
diaphragm.
Ȁ ⸀Ā Ѐ Ā Ȁ Ā ⸀Ā ᜀĀ ᜀĀ ᜀĀ ᜀĀ ᜀĀ ᜀĀ ᜀĀ Ā Ā Ā Ѐ Ā Ȁ Ā ⸀Ā ᜀĀ ᜀĀ ᜀĀ ᜀĀ ᜀĀ ᜀ3 GERD often involves
relaxation of the lower esophageal sphincter, allowing stomach contents to
back up into the esophagus.
2 The nurse is planning to teach the patient with gastroesophageal reflux disease (GERD)
about foods or beverages that decrease lower esophageal sphincter (LES) pressure. These
foods or beverages should include:
0 Alcohol
1 Leafy greens
2 chocolate
3 Melons
4 Fatty foods
5 Coffee
Choose the best answer
0 i,ii&vi
1 I,iii,iv&vi
2 Ii,&iv
3 I,iii,v&vi
0 Which of the following is the primary difference between healing by primary intention and
healing by secondary intention?
a. Secondary healing requires surgical debridement for healing to occur
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23 Primary healing involves suturing two layers of granulation tissue together.
24 Presence of more granulation tissue in secondary healing results in more scarring
25 Healing by secondary intention takes longer because more steps in the healing process
are necessary
23 The patient has a diagnosis of a biliary obstruction from gallstones. Which type of
jaundice is the patient experiencing and what serum bilirubin results would be expected?
23 Hemolytic jaundice with normal conjugated bilirubin
24 Post hepatic icteris with decreased unconjugated bilirubin
25 Obstructive jaundice with elevated unconjugated and conjugated bilirubin
26 Hepatocellular jaundice with altered conjugated bilirubin in severe disease
24 As a nurse at night duty in the emergency department at Z hospital, you receive a call for
transporting a casualty of 37n years from a scene of road traffic accident. When you
arrive at the scene, you suspect that the casualty has neck injuries. Which of the following
manoeuvre should you use for managing the casualty’s airways?
23 Head tilt-chin lift manoeuvre
24 Jaw-thrust manoeuvre
25 Tun the victim on their side.
26 Use a one –way mouth guard
25 Following a traffic road car accident, a victim has just vomited and now appears to be
coughing up blood. He is breathing very quickly with and fast pulse. What is the most likely
condition is he having?
23 Acute gastric ulcer
24 An internal bleeding
25 A heart attack
26 A diabetic ketoacidosis
26 A nurse, you are called to provide first aid for an emergency situation. Your check of the
scene suggests that a victim has suffered from an electrical shock. Which of the following
is the first thing to do?
23 Cover all burns with a dry loose dressing
24 Make sure the power is turned off, take a dry stick and remove the victim
with away from the site
25 Ask a bystander to help you move the victim
26 Place the victim on one side with the head down
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23 Which of the following patients should be treated first in a disaster situation?
23 A 10-years-old boy with a closed leg fracture that is painful
24 A 32-years-old man with slight bleeding from a hand laceration
25 A 45-years- old man with an open head injury
26 A 62-years-old man reporting chest pain and shortness of breath.
24 Which of the following conditions may result from being bitten by insects?
23 Septic shock
24 Cardiac shock
25 Toxic shock syndrome
26 Anaphylactic shock
25 During CPR to an adult person, where should you place your hands to provide
chest compressions?
23 Just above the nipple line
24 At the center of the victim’s breastbone
25 At the lower half of the victim’s breastbone
26 At upper half of the victim’s breastbone
26 Arriving in the restaurant at 1.00pm, you discover Mr. presenting the signs of chocking
being in the corner of the restaurant. When you try to ask him for coughing and speaking he
is unable to try and the surrounding of him tell you that he has been chocked by meat.
Which of the following interventions will you perform immediately?
23 Attempt to remove the meat with your fingers because you are seeing it?
24 Use the Heimlich manouevre to remove the meat
25 Use chest trust to remove the meat
26 Use back blows to remove the meat.
27 Which of the following is NOT TRUE regarding advantages for making a good triage by
the first aider in saving life of victims?
23 It helps to get care to those who need it and will benefit from it the most
24 It helps in resource allocation
25 It provides an objectives framework for stressful and emotional decisions
26 It provides an option for selecting victims without considering their degree
of suffering
28 What are the three W’s to be stated when making an emergency call?
23 Where, what and why
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23 Who, what, where
24 Why, when and where
25 Who, what and when
23 Among the following colors, which is NOT the right way of describing triage categories
in victims who need first aid?
23 Black color indicates healthily victims without life threatening condition
24 Red color indicates life-threatening with treatable injuries that require rapid
medical attention
25 Green color indicates minor injuries that can wait for longer periods of time for
treatment
26 Yellow color indicates potentially serious injuries, that stable enough to wait a
short while for medical treatment
24 Which of the following medication is NOT among anesthetics?
23 Diazepam
24 Ketamine
25 Xylocaine
26 Nitrous oxide
25 Which of the following medications is known as an inhibiting neurotransmitter that
is involved in pain modulation?
23 Acetylcholine
24 Dopamine
25 Norepinephrine
26 Prostaglandin
26 Which of the following nursing interventions is indicated during the client’s recovery
from general anesthesia in the PACU (post-anesthesia care unit)?
23 Placing the client in a prone position
24 Encouraging deep breathing and coughing
25 Restraining clients during episodes of emergence delirium
26 Withholding analgesics until the client is discharged from PACU
27 Which of the following ways can local anesthesia be administered?
23 Regional, spinal and subdural
24 Injection, topical, intravenous
25 Topical, infiltration and spray
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23 Subcutaneous, infiltration and spray
23 The following are the properties of general anesthesia, EXCEPT:
23 Hypnosis
24 Analgesia
25 Muscle twist
26 Relaxation
24 MRS. AB is scheduled for an abdominal hysterectomy. She is extremely anxious and has a
tendency to hyperventilate when upset. Which of the following anesthetics would be
most appropriate for Mrs. AB?
23 A spinal block
24 An epidural block
25 A general anesthetic
26 A dissociative anesthetic
25 Which of the following techniques is the injection of the local anesthetic into the
tissues through the surgical incision?
23 Local infiltration
24 Nerve block
25 Topical application
26 Regional application
26 Ketamine is one of intravenous anesthetics used in many healthcare facilities. The
characteristics of its effects include the following ,EXCEPT:
23 Products profound analgesia, amnesia, with light sleep
24 Respiration is not depressed and reflexes are not abolished
25 Maintains to low level the heart rate and blood pressure
26 Emergency delirium, hallucinations and involuntary movements occurs in 50%
cases during recovery
27 Where do we locate the carotid pulse
23 On the anterior side of the neck
24 In front of the ears and just above eye level
25 In the antecubital space
26 In the middle of the groin
28 Which of the following blood vessels carries the oxygenated blood to the heart?
23 Aorta
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23 Carotid arteries
24 Inferior vena cava
25 Pulmonary veins
23 Which of the following is an accessory organ of the gastrointestinal system that is responsible
for secreting a hormone that increases the level of carbohydrates in the blood?
23 Adrenal gland
24 Gallbladder
25 Pancreas
26 Liver
24 During inspiration, air enters the thoracic cavity as a result of:
23 Contraction of the accessory abdominal muscles
24 Increased carbon dioxide and decreased oxygen in the blood
25 Stimulation of the respiratory muscles by the chemoreceptors
26 Decreased intrathoracic pressure relative to pressure at airway
25 The majority of the body’s water is contained in which of the following fluids compartment?
23 Interstitial
24 Intracellular
25 Extracellular
26 Intravascular
26 A client has a serum sodium level of 152 mmol/l. What is the normal hormonal response to
this situation?
23 Release of ADH
24 Release of renin
25 Secretion of aldosterone
26 Secretion of corticotropin-releasing hormone
27 How do lungs act as an acid –base buffer
23 By increasing respiratory rate and deep when levels co2 in the blood are high,
reducing acid load
24 By increasing respiratory rate and depth when co2 levels in the blood are
low, reducing base load
25 By decreasing respiratory rate and depth when co2 levels in the blood are high,
reducing load
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23 By decreasing respiratory rate and depth when co2 levels in the blood are low,
increasing acid load
23 You receive a client with the history of diabetes mellitus in a given health center of a rural
district. After laboratory analysis o blood glucose, the results show that the client is
hyperglycemic. In the holistic management of this client, you plan to administer insulin
knowing that insulin has more roles including which of the following?
23 Enhancing the breakdown of adipose tissue for energy
24 Stimulating hepatic glycogenolysis and gluconeogenesis
25 Preventing the transport of triglycerides into adipose tissue
26 Accelerating the transport of amino acids into cells and their synthesis into protein
24 The client who has a hemorrhage in the posterior chamber of the eye, where blood
is accumulated in the following?
23 In the aqueous humor
24 Between the lens and the retina
25 Between the cornea and the lens
26 In the space between the iris and the lens
25 Which of the following signs is NOT characteristics of inflammation?
23 Redness
24 Pain
25 Cold
26 Swelling
26 Which of the following terms should be used by the nurse to document a raised, fluid-
filled lesion smaller than 1 cm?
23 Macule
24 Papule
25 Vesicle
26 Wheal
27 The nurse is caring for a patient who is diagnosed with a refractive error. What would be
the appropriate explanation by the nurse to the patient regarding his conditions?
23 You will lose your vision and become blind
24 You will need corrective lenses in order to see clearly
25 The pressure in your eyes is higher than normal
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23 Your vision is 20/20
23 A patient with early cataracts tells the nurse that he is afraid that cataract surgery may
cause permanent visual damage. Which information should be given by the nurse to this
patient?
23 The cataracts will only worsen with time and should be removed as easrly as possible to
prevent blindness.
24 Cataract surgery is very safe and with the implantation of ab intraocular lens, the
need for glasses will be eliminated
25 Progression of the cataracts can be prevented by avoidance of ultraviolet (UV) light
and good dietary management
26 Vision enhancement techniques may improve vision until surgery becomes an
acceptable option to maintain desired activities
24 You are assigned to provide care to patients with conjunctival infections. Which of the
following would you primarily teach to all these patients?
23 Using artificial tears to moisten and soothe the eyes
24 Wearing dark glasses to prevent the discomfort of photophobia
25 Using warm moist compresses to the eyes to promote drainage and healing,
26 Doing frequent and thorough hand washing to avoid spreading the infection.
25 Which of the following precautions should be taken when administering antibiotic
eardrops?
23 Cool the drops so that they decrease swelling in the canal
24 Avoid placing a cotton wick to assist in administering the drops
25 Be careful to avoid touching the tip of the dropper bottle to the ear.
26 Keep the head tilted 5 to 7 minutes after administration of the drops
26 A patient develops epistaxis upon removal of nasogastric tube. What action should be
taken by nurse?
23 Pinch the soft part of the nose
24 Position the patient on the side
25 Have the patient hyperextend the neck
26 Apply an ice pack to the back of the neck
27 Which of the following will indicate that nursing interventions for impaired gas
exchange related to smoke inhalation have been effective?
23 PaCo2 I greater than 45 mmHg
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23 PaO2 is 88 mmHg
24 SpO2 is less than 90%
25 PH is 7.34
23 Which of the following statements indicate difference between nursing diagnoses mostly
and medical diagnoses?
23 Dependent upon medical diagnoses for the direction of appropriate intervention
24 Primary concerned with caring, while medical diagnoses are primary concerned with
curing.
25 Primary concerned with human response , while medical diagnoses are primary
concerned with pathology
26 Primary concerned with psychosocial parameters, while medical diagnoses are primary
concerned with physiologic parameters.
24 The client arrives in the emergency department after am motor vehicle accident.
Nursing assessment findings include: BP of 80/34 mmHg, Pulse rate of 120 beats per
minute and respirations 20 breath cycles per minute. Which is the client’s MOST
appropriate priority nursing diagnosis
23 Alteration in cerebral tissue perfusion
24 Fluid volume deficit
25 Ineffective airway clearance
26 Alteration in sensory perception
25 A client with psoriasis tells the nurse that she has to quit her job as a receptionist because
she feels her appearance is disgusting to customers. Which of the following nursing
diagnoses BEST describes this client’s response
23 Ineffective coping related to a lack of social support
24 Impaired skin integrity related to presence of lesion
25 Anxiety related to lack of knowledge of the disease process
26 Social isolation related to decreased activities secondary to fear of rejection
Use the following case scenario to answer Questions: 89 and 90
Mr. M, a male aged 21 years with abdominal pain, is admitted to the surgical unit from the
emergency department in one hospital. He lives in student accommodation and had been revising
for his university examinations, which were due to take place in two weeks’ time. He had
experienced several episodes of nausea and vomiting following dull pain in his right iliac fossa
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radiating to the umblical area. Mr. Mhad not eaten for 24 hours. His skin is dry, he is dehydrate and
has the axillary temperature of 37.8 c
23 The following nursing diagnoses direct Mr. M.’s plan of care EXCEPT:
23 Acute pain related to inflammatory process
24 Risk for deficient fluid volume related to vomiting
25 Anxiety related to change in health status
26 Impaired skin integrity related to increased fragility of the skin
24 The following nursing interventions are appropriate to Mr. M.’s condition EXCEPT:
23 Administer I.V. fluids to prevent dehydration
24 Administration of nonsteroidal anti-inflammatory drugs upon patient admission
to reduce pain
25 Don’t administer analgesics until the diagnosis is confirmed
26 Monitor the patient’s vital signs
25 Contraction of the ventricles causes:
23 Closure of the atrioventricular valves.
24 Opening of the mitral valve and closure of the tricuspid valve.
25 Opening of the mitral and tricuspid valves.
26 Opening of the auricular septa.
26 Which of the following pieces of information should NOT be kept confidential?
23 I have been sexually active with three of my boyfriends
24 I sometimes smoke marijuana
25 I want to get pregnant
26 Sometimes I feel like ending my life
27 Upon palpation of the neck of a patient with Graves’ disease, what would the nurse expect
to find?
23 Normal-sized thyroid
24 Small discrete thyroid nodule
25 Multiple discrete thyroid nodules
26 Diffuse thyroid enlargement
28 What are clinical manifestations of hypothyroidism?
23 Intolerance to heat, tachycardia, and weight loss
24 Oligomenorrhea, fatigue, and warm skin
25 Restlessness, increased appetite, and metrorrhagia
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23 Constipation, decreased heat rate, and lethargy
23 What is the MOST COMMON cause of hypoparathyroidism?
23 Pituitary hyposecretion
24 Parathyroid adenoma
25 Parathyroid gland damage
26 Autoimmune parathyroid disease
24 An adult female had a thyroidectomy this morning. She develops muscle spasms, increased
deep tendon reflexes, and laryngeal spasm. What is the MOST COMMON CAUSE of these
findings?
23 Calcium deficit due to reduced parathormone
24 Overuse of radioactive iodine given pre-operatively
25 A history of insufficient dietary intake of iodine
26 An increase in serum phosphorous caused by reduced calcitonin
25 A male patient with diabetic ketoacidosis (DKA) has the following laboratory values:
arterial pH 7.20; serum glucose 500 mg/dl; urine glucose and ketones positive; serum K+ 2
mEq/L; serum Na+ 130 mEq/L. He reports that he has been sick with the “flu” for 1 week.
What relationship do these values have to his insulin deficiency?
23 Increased glucose use causes the shift of fluid from the intravascular to the
intracellular space.
24 Decreased glucose use causes fatty acid use, ketogenesis, metabolic acidosis,
and osmotic diuresis.
25 Increased glucose and fatty acids stimulate renal diuresis, electrolyte loss, and
metabolic alkalosis.
26 Decreased glucose use results in protein catabolism, tissue wasting,
respiratory acidosis, and electrolyte loss.
26 What is a description of diabetes mellitus type 2?
23 There is a resistance to insulin by insulin-sensitive tissues.
24 The patient uses lispro instead of regular insulin.
25 There is an increased glucagon secretion from -cells of the pancreas.
26 There are insulin autoantibodies that destroy ß-cells in the pancreas.
27 According to psychologist Sigmund Freud, fixation at which stage of development is
associated with sarcasm, criticalness, overrating and nail-biting in adults?
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23 Oral
24 Anal
25 Phallic
26 Genital
23 Which type of cancer is associated with HIV disease?
23 Kaposi’s sarcoma
24 Melanoma
25 Lymphoma
26 Renal cell carcinoma
24 Which clinical finding occurs FIRST in metabolic acidosis of the patient with type 1
diabetes mellitus?
23 Ketones in the urine
24 Palpitations, anxiety, and confusion
25 Hyperlipidemia
26 Kussmaul respirations
25 Why does hyperkalemia develop in diabetic ketoacidosis?
23 Because sodium is low, which stimulates aldosterone to retain sodium and
potassium
24 Because hydrogen shifts into the cell in exchange for potassium to
compensate for metabolic acidosis
25 Because phosphorus shifts into the cell in exchange for potassium due to the lack
of insulin
26 Because the blood is concentrated due to the loss of water from polyuria
26 You are nurse working in internal medicine and after transfusing your patient as
prescribed, a nurse student asks you how many hours that the transfused blood should NOT
exceed. What will be your BEST answer?
23 1hour
24 2 hours
25 3 hours
26 4 hours
27 What is a difference in clinical manifestations between diabetic ketoacidosis and
hyperglycemic, hyperosmolar non-ketosis syndrome?
A. Fluid loss
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23 Glycosuria
24 Increased serum glucose
25 Kussmaul respirations
23 What is the first lab test that indicates a patient with type 1 diabetes is developing
nephropathy?
23 Dipstick test for urine ketones
24 Increase in serum creatinine and blood urea nitrogen (BUN)
25 Protein in the urinalysis
26 Cloudy urine on the urinalysis
24 What causes the microvascular complications of clients with diabetes mellitus?
23 The capillaries contain plaques of lipids that obstruct blood flow.
24 There is increased pressure within capillaries as a result of the elevated
glucose attracting water.
25 The capillary basement membranes thicken and there is endothelial cell
hyperplasia.
26 Fibrous plaques form from the proliferation of subendothelial smooth muscle
of arteries.
25 What causes the macrovascular complications of clients with diabetes mellitus?
23 The capillaries contain plaques of lipids that obstruct blood flow.
24 There is increased pressure within capillaries caused by the elevated
glucose attracting water.
25 The capillary basement membranes thicken and there is endothelial cell
hyperplasia.
26 Fibrous plaques form from the proliferation of subendothelial smooth muscle
of arteries.
26 Which chronic complication of diabetes mellitus is caused by microvascular
complications?
23 Nephropathy
24 Coronary artery disease
25 Neuropathy
26 Peripheral vascular disease
27 Hallucinations and delusions are symptoms of :
23 Schizophrenia
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23 Paranoid personality disorder
24 Anxiety disorders
25 Depersonalization disorder
23 Nurses are legally required to document medications that are administered to clients.
The nurse is mandated to document:
23 Medication before administering it
24 Medication after administering it
25 Rationale for administering the medication
26 Prescriber’s rationale for prescribing the medication
24 Why does retinopathy develop in patients with type 2 diabetes?
23 Because there are plaques of lipids within the retinal vessels
24 Because of an increased pressure within the retinal vessels from the increased
osmotic pressure
25 Because ketones cause microaneurysms within the retinal vessels
26 Because of increased retinal capillary permeability and
microaneurysm formation
25 A 76-year-old patient with a 200-pack year smoking history presents with complaints of
chronic cough, dyspnea, fatigue, hemoptysis, and weight loss over the past 2 months. The
physical exam reveals decreased breath sounds and dullness to percussion over the left
lower lung field. The chest X-ray demonstrates shift of the mediastinum and trachea to
the left. These are classic signs of:
23 Lung cancer
24 Tuberculosis
25 Pneumonia
26 COPD
26 Smoke detectors, preventive medicines, insurance, retirements, seat belts, and
sunscreen are all examples of products satisfy consumers’ needs according.
23 Belongingness
24 Self-actualization
25 Safety
26 Esteem
27 Functional classification of the neurons consists of the following EXCEPT:
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23 Sensory (afferent) neurons that transmits sensory information from receptors
of Peripheral Nervous System towards the CNS
24 Motor (efferent) neurons transmit motor information from the Central Nervous
System to effectors (muscles/glands/adipose tissue) in the periphery of the body
25 Association (interneurons) are the most common; transmit information between
neurons within the CNS; analyze inputs, coordinate outputs
26 Conductive neurons that stimulate and transmit impulse from the visceral
parts to their surrounding parts
23 In a situation in which there is insufficient staff to implement competent care, a nurse
should:
23 Refuse the assignment
24 Accept the assignment but make a protest in writing to the administration
25 Organize a strike
26 Inform the clients of the situation
24 A client diagnosed with positive Covid-19 would be isolated immediately for which of the
following reasons?
23 To evaluate his condition
24 To determine his compliance
25 To prevent spread of the disease
26 To determine the need for therapy
25 A student nurse who is employed as a nursing assistant may perform any functions
that:
23 Are expected of a nurse at that level
24 Are identified in the positions job description
25 Have been learned about in school
26 Require technical rather than professional skill – Given
26 If the effect of combination of two drugs is equal to the sum of their individual
effects, the two drugs are exhibiting:
23 Potentiation
24 Synergism
25 Cross tolerance
26 Antagonism
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23 Consider the following levels: (1) chemical; (2) tissue; (3) organ; (4) cellular; (5)
organismal; (6) systemic. Which of the following choices has the levels listed in order of
increasing complexity?
23 1,2,3,4,5,6
24 3,1,2,4,6,5
25 1,4,2,3,6,5
26 4,1,3,2,6,5
24 The nurse in charge identifies a patient's responses to actual or potential health
problems during which step of the nursing process?
23 Assessing
24 Diagnosing
25 Planning
26 Evaluating
25 An older woman was admitted to the medical unit with dehydration. The following
Clinical indications of this problem EXCEPT:
23 Weight loss.
24 Dry oral mucosa.
25 Engorged neck veins.
26 Decreased central venous pressure
26 A 65-year-old stroke patient with limited mobility has a purple area of suspected deep
tissue injury on the left greater trochanter. Which nursing diagnosis is MOST
APPROPRIATE?
23 Acute pain related to tissue damage and inflammation
24 Risk for infection related to tissue injury
25 Impaired tissue integrity related to inadequate circulation secondary to
pressure
26 Risk for infection related to loss of tissue integrity and undernutrition secondary to
stroke
27 Name the gland that is located at the base of the throat, just inferior to the laryngeal
prominence (Adam's apple).
23 Pituitary.
24 Pineal gland.
25 Hypothalamus.
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23 Thyroid.
23 The term homeostasis is BEST described as:
23 The ability to maintain a relatively stable internal state that persists despite
changes in the world outside.
24 The ability to maintain a relative amount of body fluid during bleeding
25 The ability to maintain the body temperature despite changes in the environment
26 The ability to compensate heart beats and cardiac output at a stable state
during stressful situation.
24 Some infectious diseases affect a human and make him to develop immunity. This
immunity developed by a human after being exposed to an infectious disease is called:
23 Naturally acquired active immunity
24 Artificially acquired active immunity
25 Naturally acquired passive immunity
26 Artificially acquired passive immunity
25 When percussing the stomach, which of the following sounds would MOST LIKELY be
heard?
23 Tympany
24 Hyperresonance
25 Dullness
26 Flatness
26 The nurse knows that the analysis of the cerebrospinal fluid (CSF) of a patient with
tubercular meningitis will show :
23 Increased neutrophils in the fluid
24 Increased lymphocytes in the fluid
25 Increased basophils in the fluid
26 Increased eosinophils in the fluid
27 Which of the following assessment measures is used by nurse to assess the size,
consistency, texture, location, and tenderness of an organ or body part?
23 Observation
24 Palpation
25 Percussion
26 Auscultation
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23 A 42 years old man transferred from Ruli District hospital to CHUK was admitted in
internal medicine on 04 January 2021. He is suffering from productive cough and shortness
of breathing. During lungs auscultation, wheezing was noticed by student doing end cycle
practical exam. During history taking, the patient confirmed to have the aforementioned
signs and symptoms periodically. What is his MOST probably medical diagnosis?
23 Tuberculosis
24 Asthma
25 Hypertension
26 Myocardial infarction
24 Which of the following statement about the nursing process is MOST ACCURATE?
23 The nursing process is four steps procedure for identifying and resolving
patient problems.
24 Beginning in Florence Nightingale ‘s days ,nursing students learned and practiced
the nursing process
25 Use of nursing process is optional for nurses since they are many ways
to accomplish the work of nursing
26 The state board of examination for profession nursing practice now use
nursing process rather than medical specialties as an organization concept.
25 A nursing student asks the registered nurse why Dextrose 5% in water (D5W) is
contraindicated when transfusing blood. Which of the following statement is the right
nurse’s response?
23 It cause the hemolysis of blood cells
24 It dilutes the cells
25 It shrinks the blood cells
26 It is in the procedure manual
26 A patient has a surgical site pain 24 hours after a total hip replacement. All the following
medications are ordered. Which would be the MOST appropriate choice for the patient
at this time?
23 Ibuprofen
24 Acetaminophen
25 Morphine
26 Diclofenac
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23 The emergence of resistant strains of microbes to the antibiotics is serious public health
problem. Health care providers can work to prevent the emergence of resistant strains
by:
23 Encouraging the patient to stop the antibiotic as soon as the symptoms are resolved
to prevent overexposure to the drug
24 Encouraging the use of antibiotics when patients feel they will help.
25 Limiting the use of antimicrobial agents to the treatment of specific pathogens
known to be sensitive to the drug being used
26 Using the most recent powerful drug available to treat an infection to
ensure eradication of the microbe.
24 Which one of the following is an example of an anti-infective use as a means of
prophylaxis?
23 Amoxicillin used for tonsillitis
24 Penicillin used to treat an abscess
25 An antibiotic used before dental surgery
26 Norfloxacin used for a bladder infection
25 The laboratory of mal patient with Peptic Ulcer revealed an elevated titer of
Helicobacter pylori. Which of the following statements indicate an understanding of
this data?
23 Treatment will include Ranitidine and Antibiotics
24 No treatment is necessary at this time
25 This result indicates gastric cancer caused by the organism
26 Surgical treatment is necessary
26 Which of the following drugs used to minimize respiratory secretions during
surgical operation
23 Diazepam
24 Propofol
25 Promethazine
26 Atropine
27 A client with osteomyelitis is treated with surgical debridement followed by
continuous irrigation of the affected bone with antibiotics. Which of the following is the
right nurse’s response to the client who asks why oral or IV antibiotics cannot be used
alone?
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23 The irrigation is necessary to washout dead tissue and pus from the infected area
24 The ischemia and bone death associated with osteomyelitis are
frequently impenetrable to most blood bone antibiotics
25 There are no effective oral, IV antibiotics to treat S. aureus, the most common cause of
osteomyelitis
26 An irrigation can penetrate involucrum created by the infection and prevent
bacterial spreading to other tissues
23 A patient has no reaction to a penicillin skin test, so the health care provider orders
benzathine penicillin G intramuscularly. What does the nurse do immediately after the
injection?
23 Ask the patient to give contact information for all sexual partners.
24 Instruct the patient to go home to rest for 2 to 4 hours
25 Observe the patient for 2 hours to detect any allergic reaction
26 Observe the patient for at least 30 minutes to detect an allergic reaction
24 The patient has been on oxygen therapy at 70% for over 2 days. Which of the
following complications must be monitor by the nurse?
23 Oxygen-induced hypoventilation
24 Hypercarbia
25 Oxygen toxicity
26 Absorptive atelectasis
25 Which drug treatment helps to decrease intra-cranial pressure ICP by expanding plasm
and the osmotic effect to move fluid?
23 Oxygen administration
24 Mannitol(osmitrol)(25%)\pentobarbital(Nembutal)
25 Dexamethasone(Decadron)
26 The following component is NOT a dimension of child health wellness:
23 Balanced diet and access to healthy food
24 Updated immunizations
25 Physical environment including safety in the home
26 Managing all childhood illness at referral health setting
23 What is the normal resting pulse for a normal child ˃ 12 years old?
23 80-120
24 40-80
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23 90-140
24 60-100
23 When assessing the fluid and electrolytic balance in an infant, which of the following would
be important to remember?
23 Infant can concentrate urine at an adult level
24 The metabolic rate of infant is slower than in adults
25 Infant have more intracellular water than an adult
26 Infant have greater body surface area than adult
23 A 15 years old child is admitted in pediatrics ward with a respiratory chest infection.
The pediatrician prescribes medication and one drug is a dose of 300 mg of ampicillin
injection 8 hourly for 5 days. The label on the ampoule indicates the following
500mg/2ml. how many milliliters will you draw from the ampoule in order to inject the
complete ordered dose?
23 0.05 milliliters
24 0.5 milliliters
25 1.2 milliliters
26 1.5 milliliters
23 JX, a student in 3rd year General Nursing, prepares an infusion of Ringer Lactate with
infusion set drop factor of 1ml=20 drops. The volume of infusion is 500 ml and the
prescription indicates that the infusion should be administered in 12 hours. Which the
following flow rate is correct?
23 14 drops per minute
24 20 drops per minute
25 25 drops per minute
26 30 drops per minute
23 Which of the following statements is CORRECT about the relationship between
bronchial asthma and obstructive bronchitis?
23 The development of bronchial asthma is usually preceded by obstructive bronchitis
24 Approximately 40% of patients with obstructive bronchitis will develop bronchial asthma
25 The dominant symptom of both diseases is airway obstruction
26 Antihistamines are the most important medications in both diseases
23 A 5 years old child is brought to you in the outpatient department in a hospital. He has
chronic bronchial asthma and he usually comes for nebulization when in asthmatic
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attack. This time the Doctor prescribes combination of short-acting bronchodilator and
corticosteroid because the combination therapeutic effect is greater than the effect of
their individual effect. This effect is called:
23 Drug synergism
24 Drug antagonism
25 The first pass effect
26 Pharmacodynamics
23 When hypernatremic dehydration does develop during the treatment of acute
diarrhea?
23 The amount of fluid received orally is insufficient
24 The sodium concentration of the fluid received orally is 80-90mmol/L
25 The amount of fluid administered orally is insufficient and the patient is oliguric
26 Bacterial toxins, if present, exert a sodium retaining effect
23 A 10 week old infant was brought to the Health Center for immunization. During
assessment, the infant’s temperature registered at 38.10. C. Which is the BEST immediate
action that you will take?
23 Go on with the infants immunization
24 Give paracetamol and wait for his fever to subside
25 Refer the infant to the physician for further assessment
26 Advise the infant’s mother to bring him back for immunization when he is well.
23 After receiving an immunization for diphtheria, tetanus, and pertussis, a child develop
swelling and tenderness at the injection site, a low grade fever, and malaise. Which of the
following is an appropriate information that pediatric nurse provides to the child’s
parents?
23 The reaction is severe enough that they should bring the child to an emergency department
24 They should delay future immunization until the child is seen by an allergist
25 This is a mild reaction, an teaches them how to manage it
26 This is an appropriate reaction, and instructs them to not touch the site of injection.
23 The under 5 years children are supposed to be given mebendazole 500 mg in order to
prevent Ascariasis. How often this prophylactic treatment should be given to these
children?
23 Every 4 months after 6 months of birth
24 Every 3 months after 12 months of birth
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23 Every 5 months after 9 months of birth
24 Every 6 months after 12 months of birth
23 When can Enuresis be classified as primary Enuresis?
23 If a child has good daytime bladder control but has never had a dry night
24 When child who has been dry for at least six months develops symptoms after that period
25 When the cause is idiopathic
26 When a child does not control him when he is stressed
23 Which of the following procedures is reliable in the diagnosis or exclusion of a
foreign body in the airways of an infant?
23 A physical examination
24 A thorough history taking
25 Bronchoscopy
26 Chest trans illumination(Holzkecht’s sign)
23 Based on the growth and development milestones. Which of the following acts can a one
year old child perform?
23 The child can sit down from a standing up position
24 The child can drink from a cup without support
25 The child can speak a word or two with a meaning
26 The child calls for help as it is still young
23 Which of the following therapeutic interventions is prohibited in an asthmatic
crisis?
5888 An increased intake of fluids
5889 Beta receptor agonists
5890 Beta receptor blockers
5891 Theophylline
0 A child S.W hospitalized in pediatric ward at one of Teaching Hospital in Rwanda where
you work as a registered Nurse, he is experiencing the complications of malaria. Which
of the following is a sign of complications of sever malaria and that should be reported
immediately to the Pediatrician?
23 Fever of 400.C
24 Anuria since 2 days and blood in stool
25 Diarrhea
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d. Vomiting
23 A 3 year old female child was brought by her mother in consultation at Health Center for
the following symptoms/signs: history of 2 episodes of convulsions throughout the night,
fever of 39.20C for 3 hours, continuous vomiting, and very lethargic. Which of the following
signs will NOT be the main reason for the transfer to District Hospital?
23 Convulsion
24 fever of 39.20C
25 Lethargic
26 Vomiting everything
23 When assessing a child with Aspirin overdose, which of the following will be
expected?
23 Metabolic alkalosis
24 Respiratory alkalosis
25 Metabolic acidosis
26 Respiratory acidosis
23 How many days does human pregnancy last on average, counting from the first day of the
LMP?
23 260 days
24 270 days
25 280 days
26 290 days
23 Regarding probable signs of pregnancy, at what age of pregnancy Hegar’s sign is
observed?
23 At 4-6 weeks of pregnancy
24 At 6-12 weeks of pregnancy
25 At 8-10 weeks of pregnancy
26 At 8-16 weeks of pregnancy
23 Nausea and vomiting of pregnancy usually stops at what weeks of
gestation? a. 14 weeks
b. 16 weeks
23 18 weeks
24 20 weeks
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23 A mother reports that the first day of her last menstrual period LMP was January 7th 2018.
What should be the expected date of delivery EDD?
23 August 7th 2018
24 September 31st 2018
25 October 14th 2018
26 November 17th 2018
23 The false pelvis is separated from the true pelvis by one of the following plane?
23 Pelvic inlet
24 Pelvic cavity
25 Pelvic outlet
26 Pelvic angle
23 Which of the following measures is NOT necessary in the prevention of infections in the
labor ward?
23 Monitoring of the pregnancy , screening and treatment of any maternal infection
24 Encouraging the mother to empty the bladder
25 Vulva shaving with a razor blade
26 Cleanliness of the personnel
23 A client presents at 42 weeks and 3 days of gestational age, and the cervix is tightly closed.
Which of the following is the BEST method of labor induction?
23 Oxytocin
24 Misoprostol
25 Foley catheter
26 Rupture of membranes
23 Which of the following is NOT TRUE regarding physiological in the breasts during
pregnancy?
23 There is increase in the breasts size which is due to breast-milk
24 There is deep pigmentation of the areola
25 The nipple becomes considerable larger and erectile
26 There is presence of striae gravidarum which is similar to that found on the abdomen
23 In order to prevent anemia related complications, at what time pregnant mothers are
given iron tablets?
23 From the first trimester to term pregnancy
24 From the second trimester to term pregnancy
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23 For the first three months of pregnancy
24 For the last three months of pregnancy
23 Which of the following statements is TRUE in normal obstetrics?
23 Lightening is when the lower uterine segment stretches allowing onset of labour
24 The amount of amniotic fluid is related to the pregnant woman’s intake of fluid.
25 Engagement takes places when the widest diameter of the foetal presenting part has
passed through the pelvic brim
26 Engagement takes place when the widest diameter of the foetal presenting part is in the
pelvic cavity.
23 The cardinal movements of labor occur in which of the following order order?
23 Flexion , extension, internal rotation, external rotation
24 Extension, flexion, external rotation, internal rotation
25 Flexion, internal rotation, extension, external rotation
26 Internal rotation, flexion, external rotation, extension
23 The diagnosis of cephalopelvic disproportion is based on which of the following
elements?
23 The secondary arrest of the descent of the head in the presence of good contractions.
24 A head that can be felt on the side during abdominal examination without contractions
25 Rupture of membranes, early during the labor , before 40 weeks of gestation
26 Cervical dilation is carried to the right of the partogram alert line
23 Which of the following elements is very significant before performing Leopold’s
Monoeuvre?
23 Emptying rectum
24 Emptying the bladder
25 Giving plenty of fluids
26 All answers are correct
23 Which of the following is denominator in normal cephalic presentation?
23 Vertex
24 Occiput
25 Bregma
26 Cephalic
23 The following are TRUE signs of labour, EXCEPT:
a. Shivering and abdominal pains radiating towards the back
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23 ‘show ‘ and cervical dilatation
24 ‘show’, pelvic pain radiating towards the back and dilatation of the cervix
25 Abdominal pains, cervical dilatation and effacement
23 Which of the following is the MOST frequent position of the baby at term
pregnancy?
23 Cephalic with back right posterior
24 Cephalic with back left posterior
25 Cephalic with back left anterior
26 Cephalic with back right anterior
23 During the normal progress of labor, which of the following can explain better the
process that involves cervical effacement?
23 The degree at which the cervix is able to open during labor
24 The degree of cervical thinning during labor
25 The degree of relationship of the presenting part to the cervix during labor
26 The degree of softness of the cervix to during labor
Which of the following period BEST describes the fourth stage of labour?
From dilatation of the cervix to the delivery of the infant
From delivery of the infant to delivery of the placenta
From period extending up to 2 hours after delivery of the placenta
From onset of labor to full cervical dilatation
Active management of labor is package of care which includes all of the following,
EXCEPT:
Controlled cord traction
Wait for the lengthening of the umbilical cord
Administration of oxytocin
Uterine massage
In a normal labor progress, the duration of the first stage of labor for a primigravida should
last between:
13-16 hours
8-12 hours
6-8 hours
4-6 hours
Intrapartum period extends from which of the following?
a. The beginning of contractions to the first 2 hours after delivery of the newborn and placenta
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The beginning of contractions to the expulsion of fetus
The beginning of contractions to the expulsion of the placenta
The beginning of contractions to the first 6 hours after delivery of the newborn and placenta
Madam YY, gravida 1, has been pushing in the second stage of labor for one hour with the
head on the perineum with no progress of the fetal head, though the pelvic was adequate
for a vaginal delivery during the pelvic assessment. Based on the scenario above what
would be your best management plan?
Augmentation of contraction with oxytocin
Call doctor for immediate cesarean section
Assist by applying slight fundal pressure to facilitate the delivery of the fetal head
Perform an episiotomy to facilitate the delivery of the fetal head and avoid laceration of the
perineum.
What is the usual cause of Breast pain and breast tenderness 3 to 5 days after delivery?
Breast trauma
Breast engorgement
Breast infection
Breast tumor
Postpartum uterine contractile pain is greater in breastfeeding women because suckling
releases increased amounts of which of the following hormones?
Progesterone
Prolactin
Oxytocin
Estrogen
Which of the following period is an HIV+ pregnant woman eligible to start anti-retroviral
therapy (ART)?
Anytime when the HIV test is positive
At 10 weeks of gestation age
At 14 weeks of gestation age
At 9th month of gestation
Which of the following is the primary critical observation for Apgar scoring?
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Heart rate
Respiratory rate
Presence of meconium
Evaluation of the Moro reflex
Vitamin K is prescribed for a neonate. A nurse prepares to administer the medication
in which muscle site?
Deltoid
Triceps
Vastus Lateralis
Biceps
When teaching umbilical cord care to a new mother, the nurse would include which of the
following information?
Apply peroxide to the cord with each diaper change
Cover the cord with petroleum jelly after bathing
Keep the cord dry and open to air
Wash the cord with soap and water each day during a tub bath
A woman delivers a 2.260 kg neonate at 38 weeks gestation. The neonate would be
considered as:
Premature
Postmature
Low birthweight
Very low birthweight
A neonate has been diagnosed with caput succedaneum. Which statement is CORRECT
about this condition?
“It usually resolves in 3-6 weeks.”
“It doesn’t cross the cranial suture line.”
“It’s a collection of blood between the skull and periosteum.”
“It involves swelling of tissue over the presenting part of the presenting head.”
Which of the following care plan should be included to help limiting the
development of hyperbilirubinemia in the neonate?
Monitoring for the passage of meconium each shift
Instituting phototherapy for 30 minutes every 6 hours
Substituting breastfeeding for formula during the 2nd day after birth
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d. Supplementing breastfeeding with glucose water the first 24 hours.
Neonates of mothers with diabetes are at risk for which complication following
birth?
Atelectasis
Microcephaly
Macrosomia
Pneumothorax
The most common neonatal sepsis occurring within 24 hours after birth are caused by which
organism?
Candida Albicans
Chlamydia trachomatis
Escheleria Coli
Group B Beta-hemolytis streptococcis
With regard to infants who are small for gestational age (SGA) and intrauterine growth
restriction (IUGR), the nurse should be aware of which information?
In the first trimester, diseases or abnormalities result in asymmetric IUGR.
Infants with asymmetric IUGR have a better prognosis then symmetric IUGR
In asymmetric IUGR: weight is slightly larger than SGA, whereas length and head
circumference are somewhat less than SGA.
Symmetric IUGR is reassuring and occurs in the later stages of pregnancy.
Which of the following is the time window surrounding Ovulation that allows for
fertilization of an ovocyte in human?
3 days
5 days
7 days
9 days
The presence of fragments of endometrial tissue at sites in the pelvis, outside the pelvis or
rarely throughout the body is known as which of the following?
Adenomyosis
Endometriosis
Dyspareunia
Polyps
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Which of the following is the consequence of minor cervical lacerations occurring during
births?
Cervical prolapsed
Cervical ectopy
Cervical ectropion
Cervicitis
Which of the following is the main cause of fallopian tube damage that may lead to infertility?
Birth defects
Child birth
Appendicitis
Infections
Which of the following conditions is commonly occurring after caesarian section,
miscarriage, abortion especially if the products of contraception are retained?
Endometriosis
Endometritis
Bartholinitis
Cervicitis
Which of the following does NOT happen around the menopause period? a. The
negative feedback on pituitary hormone production is increased
b. Luteinizing hormone level rise
Ovaries do not respond to pituitary hormones
Estrogen production diminishes
You have consulted an 89-year-old inpatient in a nursing facility. Your patient has complete
eversion of the vagina. What is another term for this?
Cystocele
Procidentia
Rectocele
Urethrocele
A young Girl 23 year old presented with complaints of abdominal pain associated with
menorrhagia. In 18 weeks ago, a mass arising from hypogastrium was revealed. Which of
the following is MOST LIKELY diagnosis?
a. Endometriosis
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Pelvic inflammatory diseases( PID)
Fibroid Uterus
Ovarian cyst
Which of the following is the characteristic of the second degree uterovaginal prolapse?
Complete protrusion of uterus outside introitus
Descent of genital tract within vagina
Descent of genital tract upto introitus
Descent of genital tract outside the introitus
Which of the following is the MOST effective treatment of pruritus vulvae associated with
atropic vulvitis?
Antihistamines
Hydrocortisone
Topical estrogen therapy
Tranquilizers
Which of the following CORRECTLY describes the usual pathway that sperm take through
the female reproductive tract to the site of fertilization?
Vagina, cervix, fallopian tube, uterus
Vagina, uterus, fallopian tube, cervix
Vagina , cervix, uterus, fallopian tube
Urethra, vagina, fallopian tube, uterus
In the 2015, Rwanda demography health survey reports which of the following fertility
rate?
6.1 births per woman
4.2 births per woman
3.5 births per woman
2 births per woman
According to Rwanda demography Health Survey report (2015), the following are
determinants of fertility among Rwandan population. EXCEPT:
Median age at first marriage among women and men
Polygamy
Marital status
Teenage pregnancies
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Which of the following has typical symptoms including offensive grey-green discharge,
vulval irritation and superficial dyspareunia and it is treated with Metronidazole?
Trichomonas Vaginalis
Human papilloma virus
Neisseria Ghonorrhea
Herpes Simplex Virus
HIV may be transmitted from one individual to another in all of the following ways.
EXCEPT:
Through contact made during oral sex
Through breastmilk from an infected mother and fed to an infant
Perinatally from an infected mother to her fetus
Genetically from parent to child
Which of the following is NOT an absolute contra indication to the combined oral
contraceptive pills?
Pregnancy
History of venous thrombophlebitis
Age ˃ 35 years
Inherited thrombophilia
Which of the following is the main mechanism of action of T380A copper IUD?
Postpone ovulation
Thickening cervical mucus
Thinning endometrial lining
Inhibit sperm motility and viability
Women who become pregnant after undergoing female sterilization are at higher risk for
Which of the following?
Spontaneous abortion
Fetal congenital anomalies
Pelvic inflammatory disease PID
Ectopic pregnancy
Which of the following is typical of vaginal secretion that appear at ovulation?
Thick, cloudy secretions
No observable secretions
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Yellow pale , sticky secretions
Clear, slippery secretions
The following are other non-contraceptive benefits of oral contraceptive , EXCEPT:
Decrease risk of ovarian cancer
Regulate irregular menstrual cycle
Decrease weight gain
Decrease menstrual flow
IUD should NOT be given in which of the following situation?
Breast cancer
Irregular vaginal bleeding
Age above 35 years old
Smoking
The following are the general mechanism of action of most contraceptive method.
EXCEPT:
Thicken cervical mucus blocking sperm from meeting the egg
Rendering endometrium lining improper to nidation
Preventing ovulation
Thickening the myometrium
Which of the following contraceptive methods is the main cause of spotting? a. Depo-
provera
b. Intra uterine device IUD
OCP( oral combined pills)
Microlut
Contraceptive methods that can be used by the breastfeeding woman as early weeks
postpartum include all of the following, EXCEPT:
Lactational amenorrhea method
Progestin only pills
Combined oral contraceptive
Injections and implants
Vasectomy is not immediately effective, thus the World Health Organization recommend that,
after the procedure, the couple use an alternative method contraception for how long
period?
a. Three months
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48 hours
One week
One month
Which of the following is referred as sudden outbreak of any communicable in a population
Epidemic
Endemic
Pandemic
Sporadic
Which of the following is the BEST description of life experience?
The number of the years of people in specific group or population expect to live
The number of years all people in all population expect to live
The minimum number of year’s people in specific group expect to live
The minimum number of year’s people in population expect to live
Community health is a community based practice. Which of the following BEST explain
this statement?
The service is provided in the natural environment of people
The nurse has to conduct community diagnosis to determine nursing needs and
problems
The services are based on the available resources within the community
Priority setting is based on the magnitude of the health problems identified
The process of community diagnosis involves Which of the following stages?
Identifying, data collection, analyzing, dissemination
Initiation, data collection and analyzing ,diagnosing, intervention
Initiation, data collection and analyzing, diagnosing , dissemination
Data collection, analyzing, diagnosing, dissemination
Which of the following is primary goal of community health nursing?
To support and supplement the efforts of the medical profession in the promotion of health
and prevention of
To enhance the capacity of individuals, families and communities to cope with their health
needs
To increase the productivity of the people by providing them with services that will
increase their level of health
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d. To contribute to national development through promotion of family welfare, focusing
particularly on mothers and children
Which of the following is a concern of primary prevention? a.
Preventing illness or disease occurring
b. Treating the existent disease or illness
Maintaining current health status
To delay the existence of current disease or illness
Health equity refers to Which of the following statements?
Disparities in health status among individuals
Discrimination inherent in health care
Statistical differences in health between groups
Right to fair distribution of health care services
An allocation health resource to one geographic area is an example of Which of the following?
Health inequality
Health justice
Health inequity
Health equity
Which of the following statements defines what “Health Policy”?
A program to increase political investment in health
A financial incentive program to encourage health seeking behavior
Strategy for controlling and optimizing the social uses of its health knowledge and
health resources.
Strategy of enabling people to increase control over the determinants of health and
therefore to improve their health.
Which of the following is the meaning of “prevalence of disease”?
Percentage of population who suffer an event
Rate o which an event is experienced in population
Percentage of the population who experience a disorder at a given point or period of
time in specific population
Rate at which an event occurs within a population within a given period of time
During nursing week, nurses in partnership with students conducted a blood pressure
screening in the community, this activity is which level of diseases prevention?
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Focused prevention
Primary prevention
Secondary prevention
Tertiary prevention
The nurse who is teaching about health diet and physical exercises program for weight
control. This activity is an example of Which of the following?
Environmental control program
Information dissemination
Life style behavior change
Health risk appraisal and wellbeing assessment
Which of the following methods is used to raise awareness and educate people by using one
way communication?
Case study
Discussion
Role play
Lecturing and discussion
Health related behavior are both:
Innate and avoidable
Learned and changeable
Acquired and concrete
Flexible and positive
Which of the following statement is TRUE about people with low healthy literacy?
Understand everything health professionals tell them
Are less likely to ask questions of their health to professionals
Have fewer problems with their medicines than others
Patients are able to discuss about their treatment, and are aware another alternative that
may be considered for treatment.
In which city of developing country was the first international conference on health promotion
held?
Bangkok in Thailand
Mexico city in Mexico
Nairobi in Kenya
Jakarta in Indonesia
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Which of the following is the fundamental success factor for the strategy of an
organization?
Development of vision
Development of mission
Development of values
All of the above
Which of the following is the basis of ensuring the alignment of individual and
organizational strategic direction?
Accountability agreement
Balanced score card
Performance review
Financial report
Which of the following is the stage of team development characterized by the increasing
awareness of individuals team memebrs?
Forming
Norming
Performing
Storming
Which of the following management functions is characterized by the design and
development of processes?
Controlling
Leading
Organizing
Planning
The physician prescribed an IV of 5% dextrose at 125ml/h. the available kit provides
10 drops per ml. which of the following is the right flow rate?
10 to 11
12 to 13
20 to 21
22 to 24
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The nurse administers a cleaning enema. The common position for this procedure
is:
Left lateral position
Dorsal position
Right lateral position
Lithotomic position
You are a nurse in medical ward and you suspect that a patient has a distended bladder.
How should you assess for this conditions?
Inspect and palpate in the epigastric region
Auscultate and percuss in the inguinal region
Percuss and palpate the midline area above the suprapubic bone
Percuss and palpate in the lumbar region
The patient is well prepared and the environment is safe to perform physical
examination. You client reports that he has tenderness on the umbilical area and you decide
to perform the abdominal palpation. How are you going to proceed?
Without delaying , ask the patient to locate the pain and palpate that area
Begin your palpation far from the pain location and approach where the pain is at the
last moment
Palpate without selecting where to start because this help the patient not to feel the pain
while palpating
Begin your palpation over the pain location and approach to other areas of abdomen
You are assigned to monitor a patient who immediately finishes receiving intramuscular
penicillin. which of the following would alert you to possible anaphylactic shock?
Sneezing and itching of the nose and eyes
Edema and itching at the injection site.
A wheal and flare reaction at the injection site.
Chest tightness and production of thick sputum
Halfway through the administration of blood, the female client got pain. After stopping the
blood transfusion, the should:
Deeply assess the pain
Increase the flow of Normale saline
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Obtain the vital signs
Notify the blood transfusion center
You are working in the ICU and are assigned to care for a patient with disorder. Which of the
following nursing actions will you implement patient presents seizures?
Assess level of consciousness during and immediately after the action
Turn the patient to the side and protect airway
Administer Diazepan 1 mg IV
Place the patient on a non-rebreather mask will the oxygen 6 L/minute
The nurse should use the bell of a stethoscope for auscultating which sounds?
Abnormal sounds
High frequency sounds
Low frequency sounds
Sounds that are partially audible without a stethoscope
A patient with TB has been admitted to the hospital and is placed in an infection isolation
room. The patient should be educated about prevent spreading the infections.
Expect routine Tuberculin Skin Test (TST) to evaluate infection.
Visitors will not be allowed while in airborne isolation
Take all medications for full length of time to prevent multidrug-restintance TB
Wear a standard isolation mask if leaving the airborne infection in room
Maintain precautions in airborne infection isolation room, for exam coughing into a paper
tissue.
Which of the following should the patient be taught?
3,4,5
1,2,3
2,3,4
2,4,5
The nurse is reviewing the laboratory results for a newly admitted patient in internal
medicine. Which test result should be brought to the attention of the physician
immediately?
Serum K+ of 3.8mEq/L
Hematocrite of 38g/dl
Blood glucose of 90mg/dl
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d. White blood cell count of 1,500/ml
The following statements are TRUE about blood transfusion, EXCEPT:
Before transfusion, a compatibility test should be done and be rechecked on the patient’s
beside
After blood transfusion a nurse should remain with the patient and wait for the first 15
minutes to reassess the vital signs before she/he leave him
The blood can be mixed with any other isotonic liquid for a quick liquid replacement
Once the patient develops the high fever and chill while being transfused, the nurse should
stop the transfusion and provide normal saline.
Which of the following nursing care practices is applied to the management of adult
urinary catheters in hospitalized patients?
Measuring urine output every 1 to 2 hours to ensure patency
Using strict sterile technique during irrigation and obtaining culture
specimens
Turning the patient frequently from side to side to promote drainage
Daily cleaning of the catheter insertion site with soap and water and application of
lotion.
Which of the following is NOT the best way to obtain a urine specimen from patient with a
Foley catheter?
Ideally the best way is to remove the Foley catheter, and replace it with new catheter, and
send urine specimens from the new collection system.
Chronic indwelling Foley catheters nearly always are infected, the specimen should not be
collected from the main collecting urine bag
If the Foley cannot be replaced, then a sterile aspiration of the tube proximal possible
should be done. Cleanse access port with alcohol and insert needless needle and 20cc
syringe in port
Cleanse access port with alcohol and get the sample or clean the access port of
collecting bag and get the sample.
A patient with COPD needs oxygen. Which of the following would deliver the most
accurate ventilation of oxygen?
Nasal cannula
Simple face mask
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Venturi mask
Transtracheal oxygen
A cirrhotic patient vomits bright red blood. He has a systolic blood pressure of 90 mmHg. After
an aggressive fluid resuscitation, 4 units of packed RBC (red blood cells) and gastric
lavage, his pressure is 90 mmHg. What blood product should also be administered?
Transfuse fresh frozen plasma to aid restoring the clotting mechanism
Whole blood transfusion
There is no need for transfusion
There is no need for transfusion, IV solution are necessary to increase the BP
How long should you listen in each abdominal quadrant to confirm the absent of bowel
sounds?
1 second
10- 20 seconds
1 minute
2-3 minutes
What type of solution should be used to irrigate a nasogastric tube? a.
Normal saline 0,9%
b. Normal saline 9%
Ringer Lactate
Glucose 5%
During a nursing round, nurses confirmed that a patient has Cheyne - Stokes respiration.
Which of the following statements would be used to explain to patient the meaning of this
type of breathing?
Alternating periods of bradypnea and light, slow breathing
Alternating period of apnea and dep, rapid breathing
Alternating periods of dyspnea and deep, rapid breathing
Alternating periods of tachypnea and deep, rapid breathing
Which of the following intervention is MOST essential prior to suctioning patient’s
airway?
Hyper-oxygenate a patient
Put sterile gloves
Choose appropriate suction tube
Appropriate position
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What solution may be instilled into a tracheostomy or endotracheal tube to help liquefy
secretions prior to suctioning?
1-2 ml of sterile normal saline
1-2 ml of sterile glucose
1-2 ml of Ringer lactate
1-2 ml of sterile water
The gas used for sterilization is:
Nitrogen
Oxygen
Formaldehyde
Chlorine
What result can occur from using a blood pressure cuff that is too wide? a. A
falsely decreased blood pressure reading may be obtained
b. A falsely increased blood pressure reading may be obtained
A falsely prolonged blood pressure reading may be obtained
A falsely diastolic blood pressure reading may be obtained
Which of the following is the first step in treating all immediate transfusion reaction?
Do not transfuse additional RBC containing components until blood bank has provided
newly cross-matched units
Give antihistamine corticosteroid epinephrine, as ordered
Stop the transfusion
Treatment based the cause
Which of the following is the best method of evaluating whether oxygen therapy is
effective for a patient?
Arterial blood gases(ABGs)
Pulse oximetry
Pulse oximetry and blood pressure
Pulse oximetry and respiration rate
Which of the following is the main reason why a large needle must be uses to administer
whole blood or packed RBCs?
To speed the drops
To avoid RBC hemolysis
To avoid long exposition of RBC to light
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d. To decrease anemia symptoms
Which ABG value indicates that this patient is retaining carbon dioxide?
Paco2 = 40 mm Hg
Paco2 = 60 mm Hg
Bicarbonate = 42mm Hg
Pao2 = 60 mm Hg
The patient's baseline ABG values are: pH 7.36; Paco2 60 mm Hg, Pao2 52 mm Hg,
bicarbonate 42 mEq/L. Which ABG result would MOST LIKELY indicate that he is having a
negative response to the administration of oxygen?
pH 7.35; Paco2 64, Pao2 60, bicarbonate 42 mEq/L
pH 7.36, Paco2 60, Pao2 60, bicarbonate 42 mEq/L
pH 7.36, Paco2 60, Pao2 58, bicarbonate 38 mEq/L
pH 7.33, Paco2 66, Pao2 66, bicarbonate 42 mEq/L
Why do opportunistic diseases develop in an individual with HIV/AIDS?
They are side effects of drug treatment of HIV/AIDS.
They are sexually transmitted to individuals during exposure to HIV.
They are characteristic in individuals with stimulated B and T lymphocytes.
These infections occur in a person with an incompetent immune system.
A 65-year-old woman with a recent history of cellulitis is admitted to the hospital with fever,
shortness of breath, and hypotension. She has had a 2-day history of diarrhea. Her ABG
reveals a pH of 7.30, Paco2 of 28, Pao2 of 88, and bicarbonate of 17 mEq/L.
Which finding indicates a WORSENING acidic condition?
Increased blood pressure
Anxiety
Decreasing pH
Increased urinary output
Which of the following would cause edema?
Decreased capillary hydrostatic pressure
Increased capillary osmotic pressure
Decreased capillary permeability
Increased capillary permeability
Which of these is the job of the respiratory system?
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Holding up the body and giving it support and shape.
Gas exchange between the external environment and the body's circulatory
system.
Breaking down food for it to be used by the body.
circulating oxygen to the cells for cell function
Diagnostic confirmation of acute leukemia is based on:
Bone marrow aspiration and biopsy
Pancytopenia
Hyperuricemia
All of the above
Which of the following is the MOST common complication of the myelodysplastic
syndromes?
Fatigue
Cardiomyopathy
Falls
Bleeding
A nurse is teaching a patient about anaphylactic shock. Which information should the nurse
include? The onset of anaphylactic shock is usually:
Mild
Immediate and life threatening
Delayed by several hours
Delayed by 24 hours
A nurse is planning care for a patient in shock. Which principle should the nurse
remember? During shock states, glucose uptake is usually:
Enhanced
Normal
Impaired
Energy intensive
A 20-year-old female is being admitted to the hospital with fever and septic shock. Which set
of assessment findings would the nurse expect the patient to exhibit?
Bradycardia, palpitations, confusion, rash
Severe respiratory distress, jugular venous distention, chest pain
Low blood pressure, tachycardia, generalized edema
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Reduced cardiac output, increased systemic vascular resistance, moist cough
When advising a patient about the influenza nasal spray vaccine, the RN considers the
following:
Its use is acceptable during pregnancy.
Its use is limited to children younger than 6 years.
It contains live, attenuated virus.
This is the preferred method of influenza protection in the presence of airway
disease.
Which of the following is the MOST prudent first-line treatment choice for an otherwise well
toddler with acute otitis media (AOM) who requires antimicrobial therapy?
Ceftibuten.
Amoxicillin.
Cefuroxime.
Azithromycin.
For which of the following patients would a comprehensive health history be
appropriate?
A new patient with the chief complaint of “I sprained my ankle”
An established patient with the chief complaint of “I have an upper respiratory
infection”
A new patient with the chief complaint of “I am here to establish care”
A new patient with the chief complaint of “I cut my hand”
Is the following information subjective, objective, diagnosis, or prognosis?
Mr. M. has shortness of breath that has persisted for the past 10 days; it is worse with activity
and relieved by rest.
Subjective
Objective
Diagnosis
Prognosis
The following information is recorded in the health history: “Patient denies chest pain,
palpitations, orthopnea, and paroxysmal nocturnal dyspnea.”
Chief complaint
Present illness
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Personal and social history
Review of systems
A patient presents for evaluation of a sharp, aching chest pain which increases with breathing.
Which anatomic area would you localize the symptom to?
Musculoskeletal
Reproductive
Urinary
Endocrine
A 22-year-old advertising copywriter presents for evaluation of joint pain. The pain is new,
located in the wrists and fingers bilaterally, with some subjective fever. The patient denies
a rash; she also denies recent travel or camping activities. She has a family history
significant for rheumatoid arthritis. Based on this information, which of the following
pathologic processes would be the MOST CORRECT?
Infectious
Inflammatory
Hematologic
Traumatic
A 15-year-old high school sophomore comes to the clinic for evaluation of a 3-week history of
sneezing; itchy, watery eyes; clear nasal discharge; ear pain; and nonproductive cough.
Which is the MOST LIKELY pathologic process?
Infection
Inflammation
Allergic
Vascular
You are seeing an elderly man with multiple complaints. He has chronic arthritis, pain from
an old war injury, and headaches. Today he complains of these pains, as well as dull chest
pain under his sternum. What would the order of priority be for your problem list?
Arthritis, war injury pain, headaches, chest pain
War injury pain, arthritis, headaches, chest pain
Headaches, arthritis, war injury pain, chest pain
Chest pain, headaches, arthritis, war injury pain
How should you determine whether a murmur is systolic or diastolic?
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Palpate the carotid pulse
Palpate the radial pulse
Judge the relative length of systole and diastole by auscultation
Correlate the murmur with a bedside heart monitor
Common or concerning symptoms to inquire about in the General Survey and vital signs
include all of the following EXCEPT _____
Changes in weight
Fatigue and weakness
Cough
Fever and chills
Mrs. Anderson presents with an itchy rash which is raised, and which appears and
disappears in various locations. Each lesion lasts for many minutes. What MOST LIKELY
accounts for this rash?
Insect bite
Urticaria or hives
Psoriasis
Purpura
A nurse is caring for a patient who just has been diagnosed with a peptic ulcer. When teaching
the patient about his new diagnosis, how should the nurse BEST describe a peptic ulcer?
Inflammation of the lining of the stomach
Erosion of the lining of the stomach or intestine
Bleeding from the mucosa in the stomach
Viral invasion of the stomach wall
A patient with a diagnosis of peptic ulcer disease has just been prescribed omeprazole. How
should the nurse BEST describe this medication's therapeutic action?
"This medication will reduce the amount of acid secreted in your stomach."
"This medication will make the lining of your stomach more resistant to damage."
"This medication will specifically address the pain that accompanies peptic ulcer
disease."
"This medication will help your stomach lining to repair itself."
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A nurse is assessing a patient who has peptic ulcer disease. The patient requests more
information about the typical causes of Helicobacter pylori infection. What would it be
APPROPRIATE for the nurse to instruct the patient?
Most affected patients acquired the infection during international travel.
Infection typically occurs due to ingestion of contaminated food and water.
Many people possess genetic factors causing a predisposition to H. pylori infection.
The H. pylori microorganism is endemic in warm, moist climates.
A patient with chronic alcohol abuse is admitted with liver failure. You closely monitor the
patient’s blood pressure because of which change that is associate with the liver failure?
Hypoalbuminemia
Increased capillary permeability
Abnormal peripheral vasodilation
Excess renin release from kidneys
You are assessing the stoma of a patient a health, well healed colostomy. You expect the
stoma to appear:
Pale, pink and moist
Red and moist
Dark or purple colored
Dry and black.
You're performing an abdominal assessment on Peter who is 52 y.o. In which order do you
proceed?
Observation, percussion, palpation, auscultation
Observation, auscultation, percussion, palpation
Percussion, palpation, auscultation, observation
Palpation, percussion, observation, auscultation
What tube is used to collect a Full Blood count (FBC)?
Gray (potassium oxalate)
Red (dry)
Purple (Potassium EDTA)
Green (Sodium or lithium)
The components of the health history include all of the following EXCEPT which
one?
Review of systems
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Thorax and lungs
Present illness
Personal and social items
The following information is recorded in the health history: “I feel really tired.” Which
category does it belong to?
Chief complaint
Present illness
Personal and social history
Review of systems
A patient comes to the emergency room for evaluation of shortness of breath. To which
anatomic region would you assign the symptom?
Reproductive
Urinary
Cardiac
Hematologic
A patient presents for evaluation of a cough. Which of the following anatomic regions
can be responsible for a cough?
Ophthalmologic
Auditory
Endocrine
Cardiac
What is the name of pain affecting of the half of body?
Hepatalgy
Medievalgy
Hemialgy
Coxalgia
A 37-year-old nurse comes for evaluation of colicky right upper quadrant abdominal pain. The
pain is associated with nausea and vomiting and occurs 1 to 2 hours after eating greasy
foods. Which one of the following physical examination descriptions would be MOST
consistent with the diagnosis of cholecystitis?
Abdomen is soft, nontender, and nondistended, without hepatosplenomegaly or
masses.
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Abdomen is soft and tender to palpation in the right lower quadrant, without
rebound or guarding.
Abdomen is soft and tender to palpation in the right upper quadrant with
inspiration, to the point of stopping inspiration, and there is no rebound or
guarding.
Abdomen is soft and tender to palpation in the mid-epigastric area, without rebound or
guarding.
Aortic regurgitation requires medical treatment for early signs of CHF with:
Omeprazole
ACE inhibitors
Insulin rapid
Diazepam
Sigmund Freud is widely considered to be the father of:
Psychology
Behaviorism
Cognitivism
Psychoanalysis
A 60-year-old male undergoes surgery for a bone fracture. Which of the following nursing
measures would be MOST EFFECTIVE for preventing pulmonary embolism (PE) in this
patient?
Ensure that patient uses supplemental oxygen.
Prevent deep vein thrombosis formation.
Check hematocrit and hemoglobin levels frequently during the postoperative
period.
Promote aggressive fluid intake.
Which cardiac structure is responsible for the heart’s pumping action?
Pericardium
Myocardium
Endocardium
Atria
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A nurse prepares a conscious patient for insertion of naso-enteric tube. What is the right
position the nurse will place this patient?
Flat in bed
On his or her right side position
In semi-fowler’s position with head turned to back
In high-Fowler’s position
Which of the following is the mean arterial pressure (MAP) for a patient with blood
pressure of 110/70mmHg?
65
83
73
91
If a patient is an B+ blood type, he may also receive the following blood types:
O+, A+, A-, AB+
A-, AB-, O+, A+
A+, O+, O-, AB-
B+, O+,O-,B+
Mr. G. ha an order for ritonavir (Norvir) 0.2g, PO,B.I.D. The available Norvir is
100mg/capsule. How many capsules Mr.G. will take per day?
1 capsule
2 capsules
3 capsules
4 capsules
A patient is sick and currently not able to control his movement of the tongue. Which of the
following crania nerves is affected?
IX
X
XII
XI
A patient with diabetes asks the nurse the main hormone protecting the human body
against hypoglycemia. Which of the following would be the nurse’s response?
Glucagon
Insulin
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Thyroid hormone
Amylase
Which of the following is NOT a common extra pulmonary TB sites?
Lymph node
Bone
Pericardium
Myocardium
Which of the following changes in chest shape would you expect in someone with
advanced COPD?
An increased anterior-posterior diameter
An increased lateral diameter
Decreased anterior-posterior diameter
Decreased lateral diameter
Which of the following statements is NOT true about cardiac output?
The volume of blood ejected from the heart per minute
It is expressed as liters per minute.
It is equal to the heart rate plus the stroke volume
If there are 70 beats per minute, and 70 ml blood is ejected with each beat of the heart, the
cardiac output is 4,900ml/minute
Which of the following statement is NOT TRUE about capillary refill time?
The amount of time required for color to return to the nai beds after application of slight
pressure which causes blanching , normally less 3 seconds
In patients with low blood pressure or sometimes cold fingers/ skin, this will be delayed
longer than 3 seconds.
The amount of time required for color to return to the skin after application of slight
pressure which causes blanching, normally less 3 seconds
The amount of time required for color to return to the nail beds after application of
slight pressure which causes blanching, is normally less 5 seconds
During CPR in adults, what artery should be used to check the pulse?
Carotid
Femoral
Temporal
Brachial
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A student realizes that IV dopamine is a common vasoactive drug used in ICU and asks the
nurse what nursing assessments are essential during the administration of dopamine.
Among the following are responses by the nurse:
Monitoring respiration rate to avoid respiratory distress
Monitoring blood pressure closely
Monitor the urine output
Monitor the rashes on the skin
Monitor the gravity drip infusion closely and adjust as needed
Assess the patient’s cardiac function by checking the radial pulse
Assess IV site hourly t rule out infiltration
Administer the drug by IV boluses according to the patient’s blood pressure
Which of the following is the BEST response?
2 and 6
1, 3 and 4
8 and 5
2, 4 and 7
A patient is infected with Treponema pallidum. Which of the following antibiotics can be used
for treatment of this patient?
Benzathine penicillin, tetracycline or gentamycin
Benzathine penicillin , Tetracycline or amoxicillin
Benzahine penicillin, gentamycin or erythromycin
Benzathine penicillin, Tetracycline or etrythromycine
When administering large amount of diazepam (Valium). What life-threatening side effect
should the nurse be aware of?
Delirium
Vomiting
Respiratory depression
Cardiac arrest
A patient with stable angina pectoris was told to take nitroglycerin when she suspects a
crisis. One day he asks the nurse how nitroglycerin works to relive her pain. What will be
the BEST response of the nurse to this patient?
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It causes peripheral vasoconstriction, which reduces myocardial oxygen
consumption and workload
It causes peripheral vasodilation, which reduces myocardial oxygen
consumption and workload.
Talk with your physician he might have good response to your question
It increases the heart contraction hence the increase of cardiac output
Why clients are often prescribed at least two drugs for the treatment of tuberculosis?
It helps in reducing the development of side effects
It helps I reducing the development of resistant of strains of disease
It helps to increase the absorption of drugs
If a patient takes one drug, it will take time to complete the regimen
Which of the following is a typical fluid replacement for the patient with a fluid volume
deficit?
10% dextrose
Ringer Lactate
0.45% normal saline
5% dextrose in 0.45% normal saline
Which of the following is the nursing measure to reduce the risk of medication errors?
If you are questioning a drug order, assume that the prescriber is correct?
Be careful about questioning the drug order a board certified surgeon has written for
a patient
Always double check if many drugs with sound alike and look alike names
because of the high risk of errors
Always go with your gut reaction and if you think a drug route has been incorrectly
prescribed use the oral route.
Which of the following is the overall goal for the nursing diagnosis of impaired gas
exchange?
To promote balance of rest and activity
To promote optimal tissue perfusion
To promote optimal respiratory ventilation
To promote deep respiration movements
Which of the following is the priority nursing diagnosis for the patient with an acute
asthma attack?
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Impaired gas exchange related to impaired airway resistance and inflamed lung tissue
secondary to bronchospasm, as evidenced by increased secretions, inability to
breathe and feelings of impending doom
Ineffective airway clearance related to impaired airway resistance and
inflamed lung tissue secondary to bronchospasm, as evidenced by increased
secretions, inability to breathe and feeling of impending doom
Ineffective gas exchange related to impaired airway resistance and inflamed lung tissue
secondary to bronchospasm as evidenced by increased secretions, inability to
breathe and feeling of impending doom
Risk for ineffective airway clearance related to impaired airway resistance and
inflamed lung tissue secondary to bronchospasm, as evidenced by increased
secretions inability.
Which of the following is the primary nursing diagnosis in a patient with a kidney
transplant?
Electrolyte imbalance
Impaired glomerular filtration
Risk for electrolyte imbalance
Increased risk for infection
Which of the following is the primary nursing diagnosis for a patient with angina pectoris?
Risk for infection
Altered cardiopulmonary tissue perfusion
Impaired gas exchange
Ineffective lung clearance
The following are some activities of nursing process:
Analyze data
Collect and organize client information
Develop nursing diagnosis
Identify problems, risk and client strengths
Develop client goals
In respect of order, which of the above activities should be done by the nurse during the diagnosis
phase of the nursing process?
1,2,&3
3, 2, &4
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1, 4, &3
3,4&5
Which of the following is the priority nursing diagnosis for a patient experiencing a
migraine headache?
Risk for side effects related to medical therapy
Acute pain related to biological and chemical factors
Anxiety related to change in or threat to health status
Hopelessness related to deteriorating physiological condition
Which action is example of health promotion?
Assisting a patient in smoking cessation
Inserting an IV catheter
Splinting a patient’s fracture bone
Administering antibiotics to a patient
Which protection items should be removed first when leaving an isolation room?
Gloves and gown
Gloves and mask
Mask and gown
Mask
A patient with a positive TB skin test asks that means. How should you respond?
A positive skin test means that the patient has been exposed to tuberculosis. It does mean the
patient has the active disease.
A positive skin test means that the patient has been exposed to tuberculosis. It does
not mean the patient has the active disease. A chest X-ray and further examination
will be needed to determine active TB
A positive skin test means that the patient has been exposed to tuberculosis. It does mean the
patient has the active disease. A chest X-ray and further examination will be needed to
confirm active TB
A positive skin test does not mean anything, the patient should not be worried and a nurse
should recommend balance diet.
Which of the following is the MOST common symptom that causes patients to see
treatment for gonorrhea in male?
Painful urination and mucopurulent discharge
Hematuria and mucopurulent discharge
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Pollakiuria and mucopurulent discharge
Oliguria and mucopurulent discharge
The following are the steps of the infection cycle to be placed in the order: 1.
Portal of exit
2. Infectious agent
3. Means of transmission
4. Reservoir
5. Portal of entry
Susceptible host
Choose the correct answer
2,4,2 3, 5, 6
2,4, 3, 1, 5, 6
2,1,4,3,5,6
2,1,3,4,5,6
Which of the following may be a sign of a primary syphilis infection?
Painful sore on the back of the neck
A painless sore in the genital area
A heart shaped lesion inside the belly button
A painful sore on the genital area.
A patient comes to the health clinic and requests testing for HIV infection. Which of the
following is the MOST important action for a nurse before administering testing?
Ask the patient to identify all sexual partners
Determine when the patient thinks exposure to HIV occurred
Explain that all test results must be repeated at least twice to be valid
Discuss prevention practices to prevent transmission of the HIV to others.
The following must be given priority by a health worker in case of a first patient suspected with
cholera , EXCEPT:
Give an anti-diarrhea
Give enough fluids
Give an antibiotics
Isolate the patient
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Which of the following are possible etiology of bloody stool?
Rotavirus, shighellosis and amoebiasis
Cholera, E.coli and amebiasis
Ascardiasis, Schistosomiasis and Shighellosis
Schistosomiasis, Shighellosis and amebiasis
Tuberculosis infection is accompanied by an increase of which of the following? a.
Lymphocytes and monocytes.
b. Neutrophils and Eosinophils
Basophiles and platelets
Neutrophils and basophiles
Which of the following disease is caused by bacteria that live in the soil?
Tetanus
Diphtheria
Pertussis cough
Pneumonia
Which of the following virus is responsible for common cold?
Rhinovirus
Rotavirus
Human immunodeficiency virus
Helps zoster virus
NK is a 20 years old lady, teacher in Nursery School. She consulted your health center
reporting to you that she developed fever, pruritic rash all over the body but dense on the
chest, neck and face one week ago. Additionally, she reports that she developed cough 4
days after the mentioned signs. While taking history, she also reveals that some of the
children of her class had previously developed skin eruption and high fever. On your
examination, you notice macule and papules on various stage of development. The chest x-
ray showed bilateral infiltrated in the lungs. Which is the MOST medical diagnosis of this
patient?
Pneumonia due to varicella
Pneumonia due to streptococcus
Pneumonia due to mycoplasma
Pneumonia due to pneumocystis juroveci
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A 43 years old woman has just returned home from a 2 weeks missionary trip in Japan. She is
brought to the emergency service because of abdominal pain, diarrhea and nausea 2 days
ago. The vital signs are: Temperature: 37.70C, Pulse 92 beat/min, RR: 14 breaths/min, BP:
126/84mmHg. The direct stool examination is normal. Which of the following pathogen is
MOSTLY likely to cause these signs and symptoms?
Clostridium perfringens
Escherichia coli
Rotavirus
Staphylococcus Aureus
Which of the following diseases is sexually transmitted?
Hepatitis C
Hepatitis A
Hemophilis influenza C
Urinary tract infection
Positive Kerning and Brudzinski’s signs are typical signs of which of the following
diseases?
Meningitis
Guillain Barre Syndrome
Disseminated Intravascular Coagulation
Tetanus
Typhoid fever and Malaria is have almost similar signs and symptoms. Which of the
following are the particular signs or symptom of typhoid fever?
High temperature is associated with increase of pulse
High temperature is associated with decrease of Pulse
High temperature does not cause any change of pulse
None of the above
Which of the following is the minimum follow-up testing schedule after baseline testing that
should be performed for a health care provider who has had an exposure to known or
suspected HIV positive sources?
At 2 weeks, 4 weeks, 4 and 6 months and 1 year after exposure
At 6 weeks, 12 weeks and at 6 months after exposure
At 6 and 9 weeks, 2 months, 4 months and 6 months after exposure
At 2 months ,4 months and 6 months after exposure
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A withdrawn and isolated patient is most likely suffering from which of the following
stressors on basic human needs?
Physiological needs
Safety and security needs
Self-esteem needs
Love and belonging needs
A terminally ill patient is unresponsive and has cold with clammy skin. The patient’s
husband and two grown children are arguing at the bedside about where the patient’s
funeral should be held. Which of the following should be the first action of the nurse
Ask the family members to leave the room if they are going to argue
Take the family members aside and explain that the patient may be able to
hear them
Tell the family members that this decision is premature because the patient has not yet
died
Remind the family that this should be the patient’s decision and to ask her iif she
regains consciousness.
Which of the following reactions would be considered as anxiety related to psychological
reactions?
Tremors
Sleep disturbances
Expressions of Anger
Removing interactions with others
The patient is telling a nurse that he sometimes hears sounds talking to him. The nurse
responds to patient that those are hallucinations, and that hallucination is a disorder of
which of the following?
Perception
Consciousness
Memory
Thought
Which of the following is the important criterion to diagnose schizophrenia?
A person must claim to hear voices in their head
Blood work must be positive
A person experiences a sudden appearance of psychotic symptoms
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Psychotic or loss of reality symptoms are observed for at least six months.
In internal medicine at District hospital, they had a patient hospitalized since 3 weeks for
weakness, paralysis of leg, because agitated when there is a person near her, she passed a
day with inability to speak and the following day she speaks, vital signs and neurological
exam are normal, the laboratory exams, Computer tomography scan, X-ray,
Electroencephalogram, were done and did not show any abnormalities.
In the morning staff, they present the case for discussion and help staff of internal medicine
to better manage this patient. What do you think is the right management for the patient?
The patient should be ignored, because symptoms are exaggerated when we focus the
attention on her.
The patient should be discharged from internal medicine, because all exams done
didn’t show any abnormalities and be referred in physiotherapy
The patient should be screened for any psychological distress, and be
referred in mental health department for further management and
psychological support
The patient should be referred in neurological department and start physiotherapy
session.
When the nurse takes a surgical consent from to a married woman for a signature after the
surgeon has provided the information about the recommended surgery, the patient
refuses to sign the consent form. What is the BEST response by the nurse?
“Didn’t you understand what the doctor told you about the surgery”?
“Why won’t you sign this form? Do you want to do what the doctor recommended?”
“I’ll have to call the surgeon and have your surgery cancelled until you can make a
decision”.
“Are there others with whom you want to talk before making this decision”.
Mr. GB, a 35 years old male patient was admitted in internal medicine at the day shift and
hospitalized for diabetes Mellitus management. He is also HIV positive and he is on ARVs.
You come at the night duty and during your interview with him, he requests you to never
give him the medications in the presence of Miss KIKI, a 22 years old lady, who
accompanied him. You assured him that it is his right but you asked the reason why of such
decision. With a small voice he says “KIKI is my fiancé, very soon I will marry her and I do
not want her to know that I am HIV positive”. You immediately think that the young lady is
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in danger and you insisted on the benefit of disclosing his HIV status to his fiancé and her
protection but he refuses. In such situation, what kind of ethical issue you are facing?
Ethical distress
Ethical dilemma
Ethical uncertainty
None of the above
373. Which percentage is correct of the skin surface area being burned is found in the pubic
region (sex) of the body?
18%
1%
2%
18%
Which of the following would make the most sense as a more specific
diagnostic test of shock?
The measurement of serum lactate, elevated levels of which are an indicator of
shock.
A CSF (spinal) tap to check for meningitis
A brainstem auditory evoked response test to see if the person can hear ok.
A pupillary light reflex test to check how well the eyes are working.
Which of the following is not a nursing focus during the preoperative period?
patient teaching
patient and family support
diagnostic testing
preparation for discharge
What are characteristics of the irreversible stage of shock?
The worsening of tissue hypo-perfusion and the onset of worsening circulatory and
metabolic imbalances, including acidosis.
Tissue and cell damage are too great tissue and necrosis of the tissue will
occur even if the underlying hemodynamic defect is corrected.
The body tries to initiate compensatory mechanisms.
Nothing can correct the hemodynamic defect.
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Cardiogenic shock occurs as a result of:
Myocardial dysfunction
Excessive vasodilation and possibly increased capillary permeability.
Severe central nervous system trauma that causes a rapid loss in sympathetic
stimulation.
Reduction in intravascular fluid volume
Which characteristic often distinguishes cardiogenic shock from hypovolemic
shock?
Tachycardia.
Narrow pulse pressure.
Increased respiratory rate.
Oliguria.
Nurse Peter is assigned to a telephone triage. A client called who was eating a honey and is
asking for help. The client reports of dizziness, rush, pain and localized swelling but has no
respiratory distress or other symptoms of anaphylactic shock. What is the appropriate
initial action that the nurse Peter should direct the client to perform?
Stop eating
Applying a cold compress
Taking an oral antihistamine
Take upright position
Emergency treatment for a client with impending anaphylaxis and airway symptoms
started secondary to hypersensitivity to a drug should include which of the following
actions first?
Administering oxygen
Inserting an I.V. catheter
Obtaining a complete blood count (CBC)
Taking vital signs
Following the initial care of a client with asthma and impending anaphylaxis from
hypersensitivity to a drug, the nurse should take which of the following steps next?
Administer beta-adrenergic blockers.
Administer bronchodilators.
Obtain serum electrolyte levels.
Have the client lie flat in the bed.
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Anaphylactic shock is associated with which type of hypersensitivity?
Type I hypersensitivity.
Type II hypersensitivity.
Type III sensitivity.
Type IV sensitivity.
What are some conditions that may precipitate anaphylactic shock?
Insects.
Food.
Medicines.
All of the above.
A positive Rovsing’s sign is indicative of appendicitis. The nurse knows to assess for
this indicator by palpating the:
Right lower quadrant.
Left lower quadrant.
Right upper quadrant.
Left upper quadrant.
On physical examination, the nurse should be looking for tenderness on palpation
at McBurney’s point, which is located at the:
Left lower quadrant.
Left upper quadrant.
Right lower quadrant.
Right upper quadrant.
Symptoms suggestive of acute appendicitis include:
A positive Rovsing’s sign.
Increased abdominal pain when coughing.
Tenderness around the umbilicus.
All of the above.
Which of the following complications is thought to be the most common cause of
appendicitis?
A fecalith
Bowel kinking
Internal bowel occlusion
Abdominal bowel swelling
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Which of the following nursing interventions should be implemented to manage a
client with appendicitis?
Assessing for pain
Encouraging oral intake of clear fluids
Providing discharge teaching
Assessing for symptoms of peritonitis
Which of the following definitions best describes gastritis?
Erosion of the gastric mucosa
Inflammation of a diverticulum
Inflammation of the gastric mucosa
Reflux of stomach acid into the esophagus
Which of the following substances is most likely to cause gastritis?
Milk
Bicarbonate of soda, or baking soda
Enteric coated aspirin
Non-steroidal anti-inflammatory drugs
During the first few days of recovery from ostomy surgery for ulcerative colitis,
which of the following aspects should be the first priority of client care?
Body image
Ostomy care
Sexual concerns
Skin care
Which of the following diagnostic tests may be performed to determine if a client has
gastric cancer?
Barium enema
Colonoscopy
Gastroscopy
Serum chemistry levels
A client with gastric cancer can expect to have surgery for resection. Which of the
following should be the nursing management priority for the preoperative client
with gastric cancer?
Discharge planning
Correction of nutritional deficits
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Prevention of DVT
Instruction regarding radiation treatment
Care for the postoperative client after gastric resection should focus on which of the
following problems?
Body image
Nutritional needs
Skin care
Spiritual needs
Which of the following complications of gastric resection should the nurse teach the
client to watch for?
Constipation
Dumping syndrome
Gastric spasm
Intestinal spasms
Which of the following conditions is most likely to directly cause peritonitis?
Cholelithiasis
Gastritis
Perforated ulcer
Incarcerated hernia
Which of the following symptoms would a client in the early stages of
peritonitis exhibit?
Abdominal distention
Abdominal pain and rigidity
Hyperactive bowel sounds
Right upper quadrant pain
Which of the following laboratory results would be expected in a client with
peritonitis?
Partial thromboplastin time above 100 seconds
Hemoglobin level below 10 mg/dL
Sodium level above 135 mEq/L
White blood cell count above 15,000
Which of the following aspects is the priority focus of nursing management for a client
with peritonitis?
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Fluid and electrolyte balance
Gastric irrigation
Pain management
Psychosocial issues
A client presents to the emergency room, reporting that he has been vomiting every 30
to 40 minutes for the past 8 hours. Frequent vomiting puts him at risk for which of
the following?
Metabolic acidosis with hyperkalemia
Metabolic acidosis with hypokalemia
Metabolic alkalosis with hyperkalemia
Metabolic alkalosis with hypokalemia
When teaching an elderly client how to prevent constipation, which of the following
instructions should the nurse include?
“Drink 500 cc of fluid each day.”
“Avoid dietary fiber.”
“Sleep more often a day.”
“Be sure to get regular exercise.”
Critical assessment after placing a cast is:
Gastrointestinal
Compartment syndrome
Respiratory
Depressed fracture
A client has a percutaneous endoscopic gastrostomy tube inserted for tube feedings.
Before starting a continuous feeding, the nurse should place the client in which
position?
Semi-Fowlers
Supine
Reverse Trendelenburg
High Fowler’s
The client being seen in a physician’s office has just been scheduled for a barium
swallow the next day. The nurse writes down which of the following
instructions for the client to follow before the test?
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Fast for 8 hours before the test
Eat a regular supper and breakfast
Continue to take all oral medications as scheduled.
Monitor own bowel movement pattern for constipation
The nurse is preparing a discharge teaching plan for the client who had an umbilical
hernia repair. Which of the following would the nurse include in the plan?
Restricting pain medication
Maintaining bedrest
Avoiding coughing
Irrigating the drain
The nurse is preparing a discharge teaching plan for the client who had an inguinal
hernia repair. Which of the following would the nurse include in the plan?
Restricting pain medication
Maintaining bedrest
Avoiding lift heavy stuffs
Irrigating the drain
The nurse is doing an admission assessment on a client with a history of duodenal
ulcer. To determine whether the problem is currently active, the nurse would
assess the client for which of the following most frequent symptom(s) of
duodenal ulcer?
Pain that is relieved by food intake
Pain that radiated down the right arm
Pain on Right Low quadrant
Weight loss
The client who has undergone creation of a colostomy has which of the following
nursing diagnosis?
Disturbed body image
Hopeless,
Excess fluid volume
Constipation
The nurse is assessing for stoma prolapse in a client with a colostomy. The nurse
would observe which of the following if stoma prolapse occurred?
Sunken and hidden stoma
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Dark- and bluish-colored stoma
Narrowed and flattened stoma
Protruding stoma
When used with hyperacidic disorders of the stomach, antacids are given to elevate
the gastric pH to:
2.0
4.0
6.0
>8.0
The nurse would teach patients that antacids are effective in treatment of
hyperacidity because they:
Neutralize gastric acid
Decrease stomach motility
Decrease gastric pH
Decrease duodenal pH
You’re assessing the stoma of a patient with a healthy, well-healed colostomy. You
expect the stoma to appear:
Pale, pink and moist
Red and moist
Dark or purple colored
Dry and black
You’re caring for a patient with a sigmoid colostomy. The stool from this
colostomy is:
Formed
Semisolid
Semiliquid
Watery
You’re caring for Lewis, a 67 y. o. patient with liver cirrhosis who developed ascites
and requires paracentesis. Relief of which symptom indicated that the
paracentesis was effective?
Pruritus
Dyspnea
Jaundice
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Peripheral Neuropathy
You’re caring for Jane, a 57 y.o. patient with liver cirrhosis who developed ascites
and requires paracentesis. Before her paracentesis, you instruct her to:
Empty her bladder.
Lie supine in bed.
Remain NPO for 4 hours.
Clean her bowels with an enema.
After abdominal surgery, your patient has a severe coughing episode that causes
wound evisceration. In addition to calling the doctor, which intervention is most
appropriate?
Irrigate the wound & organs with Betadine.
Cover the wound with a saline soaked sterile dressing.
Apply a dry sterile dressing & binder.
Push the organs back & cover with moist sterile dressings.
Stephen is a 62 y.o. patient that has had a liver biopsy. Which of the following groups of
signs alert you to a possible pneumothorax?
Dyspnea and reduced or absent breath sounds over the right lung
Tachycardia, hypotension, and cool, clammy skin
Fever, rebound tenderness, and abdominal rigidity
Redness, warmth, and drainage at the biopsy site
Jason, a 22 y.o. accident victim, requires an NG tube for feeding. What should you
immediately do after inserting an NG tube for liquid enteral feedings?
Instill 2-3ml air into the tube while listening over the stomach with a
stethoscope for the sound of air being injected.
Begin feeding slowly to prevent cramping.
Instill 8-10ml air into the tube while listening over the stomach with a
stethoscope for the sound of air being injected.
Clamp off the tube until the feedings begin.
Glenda has cholelithiasis (gallstones). You expect her to complain of:
Pain in the right upper quadrant, radiating to the shoulder.
Pain in the right lower quadrant, with rebound tenderness.
Pain in the left upper quadrant, with shortness of breath.
Pain in the left lower quadrant, with mild cramping.
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Your patient has a GI tract that is functioning, but has the inability to swallow foods.
Which is the preferred method of feeding for your patient?
TPN
PPN
NG feeding
Oral liquid supplements
Anna is 45 y.o. and has a bleeding ulcer. Despite multiple blood transfusions, her HGB is
7.5g/dl and HCT is 27%. Her doctor determines that surgical intervention is
necessary and she undergoes partial gastrectomy. Postoperative nursing care
includes:
Giving pain medication every 6 hours.
Flushing the NG tube with sterile water.
Positioning her in high Fowler’s position.
Keeping her NPO until the return of peristalsis.
Which of the following conditions can cause a hiatal hernia?
Increased intrathoracic pressure
Weakness of the esophageal muscle
Increased esophageal muscle pressure
Weakness of the diaphragmatic muscle
Risk factors for the development of hiatal hernias are those that lead to increased
abdominal pressure. Which of the following complications can cause increased
abdominal pressure?
Obesity
Volvulus
Constipation
Intestinal obstruction
Which of the following symptoms is common with a hiatal hernia?
Left arm pain
Lower back pain
Esophageal reflux
Abdominal cramping
Which of the following tests can be performed to diagnose a hiatal hernia? A.
Colonoscopy
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Lower GI series
Barium swallow
Abdominal x-rays
Which of the following tests can be used to diagnose GI ulcers?
Abdominal x-ray
Barium swallow
Computed tomography (CT) scan
Esophagogastroduodenoscopy (EGD)
The client with a duodenal ulcer may exhibit which of the following findings on
assessment?
Hematemesis
Malnourishment
Melena
Pain with eating
Peptic ulcer disease may be caused by which of the following?
Helicobacter pylori
Clostridium difficile
Candida albicans
Staphylococcus aureus
The degree of neurologic damage that occurs with an ischemic stroke depends
on the:
Location of the lesion.
Size of the area of inadequate perfusion.
Amount of collateral blood flow.
Combination of the above factors.
The primary organs involved in pH regulation are:
Kidneys and lungs.
Heart and intestines.
Lung and endocrine glands.
Skin and kidneys.
The nurse is instructing a 65-year-old female client diagnosed with osteoporosis.
The most important instruction regarding exercise would be to:
Exercise doing weight bearing activities.
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Exercise to reduce weight.
Avoid exercise activities that increase the risk of fracture.
Exercise to strengthen muscles and thereby protect bones.
The nurse knows that a 60-year-old female client’s susceptibility to
osteoporosis is most likely related to:
Lack of exercise.
Hormonal disturbances.
Lack of calcium.
Genetic predisposition.
The most common site for peptic ulcer formation is the:
Duodenum.
Esophagus.
Pylorus.
Stomach
Pain control with peptic ulcer disease includes all of the following except:
Promoting physical and emotional rest.
Identifying stressful situations.
Eating meals when desired.
Administering medications that decrease gastric acidity.
A characteristic associated with peptic ulcer pain is a:
Burning sensation localized in the back or midepigastrium.
Feeling of emptiness that precedes meals from 1 to 3 hours.
Severe gnawing pain that increases in severity as the day progresses.
Combination of all of the above.
The most common complication of peptic ulcer disease that occurs in 10% to
20% of patients is:
Hemorrhage.
Intractable ulcer.
Perforation.
Pyloric obstruction.
The major cause of death from peritonitis is:
Hypovolemia.
Sepsis.
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Shock.
Abscess formation.
The following are results of diagnostic and imaging studies in a patient with
peritonitis except:
Elevated WBC.
Air and fluid levels on abdominal x-ray.
Leukopenia.
Intra-abdominal abscess on MRI.
Peritonitis occurs in which part of the GI system?
Peritoneum.
Appendix.
Duodenum.
Sigmoid colon
The nurse is working in the emergency room when a client arrives with severe burns of
the left arm, hands, face, and neck. Which action should receive priority?
Starting an IV
Applying oxygen
Obtaining blood gases
Medicating the client for pain
A removal of the left lower lobe of the lung is performed on a client with lung cancer.
Which post-operative measure would usually be included in the plan?
Closed chest drainage
A tracheostomy
A mediastenal tube
Percussion vibration and drainage
A client arrives in the emergency room with a possible fractured femur. The nurse should
anticipate an order for:
Trendelenburg position
Ice to the entire extremity
Buck’s traction
An abduction pillow
The nurse is obtaining a history of an 80-year-old client. Which statement made by the client
might indicate a possible fluid and electrolyte imbalance?
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“My skin is always so dry.”
“I often use a laxative for constipation.”
“I have always liked to drink a lot of ice tea.”
“I sometimes have a problem with dribbling urine.”
The nurse recognizes that which of the following would be most appropriate to wear
when providing direct care to a client with a cough?
Mask
Gown
Gloves
Shoe covers
The physician has ordered that the client’s medication be administered intrathecal.
The nurse is aware that medications will be administered by which method?
Intravenously
Rectally
Intramuscularly
Into the cerebrospinal fluid
The nurse employed in the emergency room is responsible for triage of four clients injured in a
motor vehicle accident. Which of the following clients should receive priority in care?
A 10-year-old with lacerations of the face
A 15-year-old with sternal bruises
A 34-year-old with a fractured femur
A 50-year-old with dislocation of the elbow
The nurse is asked by the nurse student, “Are peptic ulcers really caused by stress?”
The nurse would be correct in replying with which of the following:
“Peptic ulcers result from overeating fatty foods.”
“Peptic ulcers are always caused from exposure to continual stress.”
“Peptic ulcers are like all other ulcers, which all result from stress.”
“Peptic ulcers are associated with H. pylori, although there are other
ulcers that are associated with stress.”
Which of the following is the rationale for using preoperative checklist on the day of surgery?
To ensure that the patient is correctly identified.
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To ensure that all preoperative orders and procedures have been carried
out and records are complete.
To confirm that the patients’ families have been informed as to where they can
accompany and wait for patients.
Preoperative medications are the last procedure before the patient is
transported to the operating room
At the end of the surgical procedure, the preoperative nurse evaluates the patient’s response
to the nursing care delivered during the perioperative period. Which of the following
BEST reflects a positive outcome related to the patient’s physical status?
The patient’s right to privacy is maintained
The patient’s care is consistent with the perioperative plan of care.
The patient receives consistent and comparable care regardless of the setting
The patient’s respiratory function is consistent with or improved from
baseline levels established preoperatively
Which of the following is an advantage of tracheostomy over an endotracheal (ET) tube for
long-term management of an upper airway obstruction?
A tracheostomy is safer to perform in an emergency
An ET tube has a higher risk of tracheal pressure necrosis.
A tracheostomy tube allows for more comfort and mobility.
An ET tube is more likely to lead to lower respiratory trach infection.
A patient’s tracheostomy tube becomes dislodged with vigorous coughing. Which of the
following should the nurse’s FIRST action?
Attempt to replace the tube.
Notify the health care provider.
Place the patient in high Fowler position.
Ventilate the patient with a manual resuscitation bag until the health care
provider arrives.
A patient returns to the surgical unit with a nasogastric (NGT) tube to low intermittent
suction, IV fluids, and a drain at the surgical site following an exploratory laparotomy
and repair of a bowel perforation. Four hours after admission, the patient
experiences nausea and vomiting. Which of the following is a PRIORITY nursing
intervention for the patient?
Assess the abdomen for distention and bowel sounds
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Inspect the surgical site and drainage in the Jackson-Pratt.
Check the amount and character of gastric drainage and the patency of the NG
tube
Administer prescribed promethazine to control the nausea and vomiting.
A patient with a gunshot wound to the abdomen complains of increasing abdominal pain
several hours after surgery to repair the bowel. Which of the following actions should the
nurse take FIRST?
Take the patient’s vital signs.
Notify the health care provider
Position the patient with the knees flexed
Determine the patient’s IV intake the end of surgery.
On examining a patient 8 hours after having surgery to create a colostomy, what should the
nurse expect to find?
Hyperactive, high-pitched bowel sounds
A brick-red, puffy stoma that oozes blood
A purplish stoma , shiny and moist with mucus
A small amount of liquid fecal drainage from the stoma
The nurse is caring for a patient who returned from surgery three (3) hours ago. Which of
these findings would the nurse recognize as being the MOST urgent to report to the
surgeon
Tachycardia
Polyuria
Nausea
Fever
The nurse is caring for a patient with a fractured left leg. Which of the following findings
during a cardiovascular assessment of the lower extremities would the nurse
recognize as PRIORITY to report to the physician?
Strong bilateral left leg post tibia pulse
Right foot capillary refill less than 2 seconds
Bilateral dorsal flexion
Pallor of the left leg
The nurse is collecting data on a patient with an appendicitis that is painful. Where would the
nurse expect the patient’s pain to be located?
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Right upper quadrant
Right lower quadrant
Left upper quadrant
Left lower quadrant
The nurse is assisting with data collection on a patient .Which of the following past surgeries
found in the patient’s history would alert the nurse to possible immune system
dysfunction when planning care?
A. Splenectomy
B.Thyroidectomy
C. Pneumonectomy
Parathyroidectomy
ALL BUT ONE of the following is an indication for nasogastric tube insertion. Indicate the
exception:
obtain specimens
relieve distention of the stomach or intestine,
lavage (wash out) the stomach prior to surgery
Severe midface trauma
A patient who has never had any prior surgeries tells the nurse doing the preoperative
assessment about an allergy to bananas and avocados. Which action is most important
for the nurse to take?
Notify the dietitian about the food allergies.
Reassure the patient that all allergies are noted on the medical record.
Ask whether the patient uses antihistamines to reduce allergic reactions.
Alert the surgery center about a possible latex allergy.
When performing a microsurgery such as suturing the eyes surgery, which choice of suture size
would be most appropriate?
4-0
11-0
0
5
Over-pressurization of tourniquet cuff may cause:
Compression injuries to blood vessels
Blood in the surgical field
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Muscle spasms
Shock
There are three methods of calculating an area of burned skin. Which method is the MOST
used?
A Broselow tape
Rule of palm
The Lund and Browder chart
Rule of nines
An adult man's entire back is worth what percentage when using the rule of nines?
9%
18%
27%
36%
You have arrived on scene to find a 12-year-old girl who has been burnt by chicken noodle
soup from the stove. She has blisters and redness on her chest. How would you classify this
burn?
It is a first-degree burn.
It is a partial-thickness burn.
It is a superficial burn.
It is a full-thickness burn.
A client is scheduled for surgery in the morning. Preoperative orders have been written. What is
the most important to do before surgery?
Have all consent forms signed
Remove all jewelries or tape wedding ring
Verify that all laboratory work is complete
Inform family or next of kin
The nurse is admitting a patient to the operating room. Which of the following nursing actions
should be given highest priority by the nurse?
Checking the patient’s identification and correct operative permit
Checking the patient’s vital signs
Positioning and performing skin preparation to the patient
Assessing the patient’s level of consciousness
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The nurse is preparing the preoperative client for surgery. The following statements that
indicate the client is knowledgeable about his impending surgery, except:
“The skin prep area is going to be longer and wider than the anticipated incision”
“I cannot have anything to drink or eat after midnight on the night before the
surgery”
“After surgery, I will need to wear the pneumatic compression device while
sitting in the chair”
“To ensure my safety, a ‘time out’ will be conducted in the operating room”
which of the following factors ensure validity of informed written consent, except:
The patient is of legal age with proper mental disposition
If the patient is unable to write, the nurse signs the consent for the patient
If the patient is a child, secure consent from the parents or legal guardian
The consent is secured before administration of preoperative medications
The Consensus (Parkland) formula determines how much fluid a burn patient should
receive:
During the first 12 hours.
During the first hour.
During the first 24 hours
During transport to the hospital.
The nurse is caring for a patient who had undergone exploratory laparotomy. Which of the
following postop findings should the nurse report to the physician?
The patient pushes out the oral airway with his tongue
The patient’s urine output is below 20 ml/hr for the past 2 hours
The patient’s vital signs are as follows: BP = 100/70 mmHg; PR = 95 bpm; RR = 9
minute; T = 36.8°C
The patient’s wound drainage
Burn shock occurs because of the fluid loss across the damaged skin and the volume shifts
within the rest of the body.
False
True
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If you know the identity of the chemical that caused the burn, it preferable to start treatment
with a chemical antidote (eg, applying a weak acid to an alkali burn and vice versa).
True
False
It is important to use only sterile water to flush a chemical burn, lest you
contaminate the burn wound.
True
False
A patient has received burns to the entire anterior chest and to the left upper extremity,
circumferentially. Using the rule of nines, determine the percentage of the body surface
affected
9%
18%
13.5%
27%
A properly executed informed consent for surgery should include the following
Except.
Signature of the patient or patient’s representative
Name of the individual who witnessed the signature
Names of everyone that will be in the OR when the procedure is performed
Specific name of the intervention to be performed.
477. The operating rooms need to be mopped between cases whether there is visible blood
or soiling or not.
True
False
478. The nurse is caring for a first day postoperative surgical client. Prioritize the patient's
desired dietary progression. Arrange in sequence the dietary progression from 1 to 4:
Full liquid;
NPO;
Clear liquid;
Soft
A. 2,3,1,4
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1,2,3,4
2,1,4,3
4,3,2,1
479. Mac Burney tenderness is commonly found in patients experiencing which of the following
conditions:
peritonitis
Appendicitis
Acute pancreatitis
cholecystitis
Which surgical procedure is done for curative purposes?
Rhinoplasty
Breast biopsy
Colostomy
Hysterectomy
Which surgical procedure is done for Cosmetic purposes?
Hysterectomy
Rhinoplasty
Breast biopsy
colostomy
Which surgical procedure is done for Diagnostic purposes?
Hysterectomy
Rhinoplasty
Breast biopsy
colostomy
Which surgical procedure is done for Palliative purposes?
colostomy
Rhinoplasty
Breast biopsy
Hysterectomy
The surgical procedure of removing excess fluid from the peritoneal cavity is known as:
Paracentesis
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Purification
Dialysis.
Thoracentesis
The Medical procedure of removing excess fluid from the thoracic cavity is known as:
Purification
Dialysis.
Paracentesis
Thoracentesis
An 82 kg client has a 45 TBSA (Total Body Surface Area) burn. Using 4mL/kg/percent
,TBSA during the first eight hours after a burn injury, the nurse would anticipate a fluid
replacement of:
3690mL
7380mL
14760mL
9225mL
The client presents with severe abdominal pain, 10 blood stools a day, and hematemesis
dehydration. Because of these symptoms, the nurse should be alert for other problems
associated with what disease?
Chrohn,s disease
Diverticulitis
Peptic ulcer disease(PUD)
Peritonitis
488. The pre-incision TIME OUT should be performed by which member(s) of the
perioperative team?
All perioperative team members except anesthesia professionals
Scrub nurses only
All perioperative team members
Surgeons only
489. Wrong-site surgical errors:
Almost never happen
Are the sole responsibility of the surgeon to prevent
Can result from failure to perform the TIME OUT before surgery
Are usually due to incorrect information provided by the patient
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490. Once you enter into the restricted area, proper attire includes: scrubs, cap, mask, and
shoe covers
True
False
Hand washing is not necessary if gloves are worn.
False
True
492. When performing closed gloving, you must first pull the gown cuffs up and over
your wrists before donning the gloves.
False
True
Only sterile items can be placed on the sterile field.
True
False
494. The edges of a wrapper are considered sterile.
False
True
495. Even if there is no visible sign of a tear, if a glove is thought to have been punctured,
it should be changed.
True
False
496. An open-gloving technique would be used when performing urinary catheterization.
False
True
At the end of a surgical procedure, the gloves are removed before the gown.
True
False
If during surgery a patient is having two or more procedures performed by different
procedure teams, each team must complete time-out.
False
True
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It is okay to wear surgical scrubs anywhere in the hospital unless soiled.
True
False
Preprocedure verification is done at various times in the preprocedure process such as
procedure scheduling, preadmission testing, admission/entry to the hospital, before the
patient enters the procedure room, one the patient has entered the procedure room.
False
True
Site marking is performed after the patient is anesthetized so the patient won’t become
anxious.
True
False
502. The role of the circulating nurse in the OR is to handle the sterile equipment
during surgery?
True
False
503. The preoperative phase ends when the patient is safely transported to the OR and care
is assumed by the OR nurse?
False
True
504. Menopause Women are at risk for osteoporosis
False
True
Criteria of client’s discharge from postanesthesia care unity (PACU) include which of the
following(s)? :
Patient awake
Vital signs stable
No excess bleeding or drainage
All the above are correct
506. Bone injury where bacteria enters through the bloodstream from another part of the
body causing infection of the bone and marrow:
Gout
Bone cancer
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Osteomyelitis
Osteomalacia
The nurse is performing an assessment in a client with a suspected diagnosis of cataract.
The chief clinical manifestation that the nurse would expect to note in the early stages
of cataract formation is:
Blurred vision
Eye pain
Floating spots
Diplopia
During Behavior Change Communication (BCC instead of IEC) teaching plan for good care of the
tooth and oral cavity hygiene. You will include the following EXCEPT:
Brush the teeth at least twice a day
Use of dental floss should be encouraged
Eat balanced diet and make dentist visit at least yearly
Dental hygiene should be applied during working days, not needed more in
day offs
Conditions known to predispose to renal calculi formation include:
Polyuria
dehydration, immobility
glycosuria
presence of an indwelling Foley catheter
How do we measure the tube length for nasogastric tube?
From bridge of nose, to ear lobe , until xiphisternum
From xiphisternum, to ear lobe , until bridge of nose
From ear lobe, to bridge of nose, until xiphisternum
From to bridge of nose, to xiphisternum, until ear lobe
What bed position do you place the client in when inserting a NG tube?
High Flower
Semi-Flower
Brandenburg
Flat
Which anesthesia enters the CSF?
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General
Spinal
Epidural
Inhalation
John, a student in 3rd year General Nursing, prepares an infusion of Ringer Lactate with
infusion set drop factor of 1ml=20 drops. The volume of infusion is 500 ml and the
prescription indicates that the infusion should be administered in 12 hours. Which the
following flow rate is correct?
14 drops per minute
20 drops per minute
25 drops per minute
30 drops per minute
Which of the following methods is the MOST reliable way to assess the severity of a patient’s
pain?
Ask the patient to rate his or her pain using a valid assessment scale
Ask patient to describe the pain
Observe the patient for physical signs of pain such as moaning or grimacing
Ask the family member to rate the patient’s pain
The nurse is assisting with data collection on a patient .Which of the following past surgeries
found in the patient’s history would alert the nurse to possible immune system
dysfunction when planning care?
Splenectomy
Thyroidectomy
Pneumonectomy
Parathyroidectomy
Indications for Foley catheterization include all except
Collection of sterile urine sample
Measuring residual urine volumes
In preparation for a night drinking
Urinary retention
Which of the following is not the correct description of anatomical position?
Body facing forward
Head turned to side
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Feet together
Palms facing forward
The nurse is collecting date on a patient with a ruptured appendix that is painful.
Where would the nurse expect the patient’s pain to be located on abdomen quadrant?
Right upper quadrant
Right lower quadrant
Left upper quadrant
Left lower quadrant
Normal intracranial pressure (ICP) is the pressure exerted the following three
components. what are they among the following:
Blood, Brain , Bone
Cerebral spinal fluid, Blood, Brain
Cerebral spinal fluid, Blood, bone
Cerebral spinal fluid, Brain, Bone
You come upon a person who has lost a significant amount of blood, has very pale skin color
and is confused? What do you suspect the condition to be?
Seizure
Stroke
Low blood sugar
Shock
Name the type of anesthesia that causes loss of sensation without loss of consciousness
and that is induced via infiltration, intracutaneously or subcutaneously.
Regional anesthesia
Local anesthesia
Spinal anesthesia
General anesthesia
Which nervous system controls skeletal muscle?
Sympathetic
Parasympathetic
Somatic
Autonomic
What type of solution should be used to irrigate a nasogastric tube?
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Normal saline 9%
Normal saline 0.9%
Glucose 10%
Glucose 5%
Which value does NOT determine where to give an intramuscular injection?
Age
Body mass
Blood pressure
Amount of medication
Which of the following is not a part of a nursing diagnosis?
Problem
Patient needs
Etiology
Defining characteristics
The following are the signs of choking victim EXCEPT:
Inability to cough or breathe
Inability to speak
Pale or bluish in coloring around the mouth and nail bed.
Blood glucose rise
When administering CPR, the chest should be compressed by?
4-5 cm at a rate of 80-90 per minute
4-5 cm at a rate of 90-110 per minute
5-6 cm at a rate of 100-120 per minute
5-6 cm at a rate of 110-130 per minute
When should the Foley catheter urinary bag be emptied?
Before removal of Foley catheter
After removal of Foley catheter
At the same time a removal of Foley catheter
None of the above
Which of the following does not need to be considered when assessing which suture technique
to use?
Type of wound
Skin type
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Wound location
Wound tension
How often the person providing chest compressions should be changed?
Every minute
Every 2 minutes
Every 3 minutes
Every 4 minutes
How much time should health care workers take to complete the handrub technique
effectively
10-20 seconds
20-30 seconds
40-50 seconds
50-60 seconds
Which of the following is NOT one of the five moments in clinical care requiring hand
hygiene
Before touching a patient
After a clean or aseptic procedure
After touching patient surroundings
After body fluid exposure risk
When confronted with what appears to be a collapsed person, the first thing to do is:
Place the person on his or her back
Talk to the person
Check for danger
Begin chest compressions
As well as high quality basic life support, successful outcome following a cardiac arrest also
relies on prompt access to:
A defibrillator
A nasopharyngeal airway
A pulse oximeter
A sphygmomanometer
Occasional gasps, slow, labored or noisy breathing is known as:
Diaphragmatic breathing
Agonal breathing
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Hyperventilation
Cheyne strokes breathing
536. Mary is 50 years old. During a checkup, a bone scan reveals that portions of her skeleton
show signs of osteoporosis. After reviewing the test results, her physician suggests
hormone therapy. What hormone is prescribed for Mary?
Estrogen
Growth hormone
Calcitonin
Thyroid hormone
537. The forearm consists of the:
Radius and humerus
Radius and ulna
Ulna and humerous
Humerus and carpus
All of the following are groups of vertebrae EXCEPT :
Thoracic
Cervical
Lumbar
Pelvic
Which of the following statement is CORRECT about an open fracture?
Results in multiple pieces of bone
Ruptures a blood vessels
Occurs when a broken bone pierces through the skin
Damage a nerve
Which of the following statement is CORRECT about a greenstick fracture?
The entire bone is broken through and through
Only one side of the bone is broken and the bone is bent
The bone is broken into multiple pieces
None of the above
Which vitamin deficiency is most likely to be a long-term consequence of a full-thickness
burn injury?
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Vitamin A
Vitamin B
Vitamin C
Vitamin D
The burned client is ordered to receive intravenous drugs, an H2 histamine blocking agent,
during the emergent phase. When the client’s family asks why this drug is being given, what
is the nurse’s best response?
“To increase the urine output and prevent kidney damage.”
“To stimulate intestinal movement and prevent abdominal bloating.”
“To decrease hydrochloric acid production in the stomach and prevent Curling
ulcers.”
“To inhibit loss of fluid from the circulatory system and prevent hypovolemic
shock.”
Which type of fluid should the nurse expect to prepare and administer as fluid
resuscitation during the emergent phase of burn recovery?
Colloids
Crystalloids
Fresh-frozen plasma
Packed red blood cells
The client has experienced an electrical injury, with the entrance site on the left hand and the
exit site on the left foot. What are the priority assessment data to obtain from this client on
admission?
Airway patency
Heart rate and rhythm
Orientation to time, place, and person
Current range of motion in all extremities
The burned client’s family ask at what point the client will no longer be at increased risk for
infection. What is the nurse’s best response?
“When fluid remobilization has started.”
“When the burn wounds are closed.”
“When IV fluids are discontinued.”
“When body weight is normal.”
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546. The following are the cause of osteomalacia
Deficient of Vitamin B
Deficient of Vitamin C
Deficient of Vitamin D
Deficient of Vitamin A
547. The Urinary catheter (Foley) is needed before, during and after surgery
To prevent urinary tract infections
To keep the bladder empty and to monitor renal function
To monitor closely vital signs
To keep the bladder full during operation.
Which of these activities is NOT performed in the preoperative area?
Information is confirmed from the patient's history
The patient's name, date of birth, procedure, and procedure site are confirmed
The circulating RN and scrub nurse count instruments, sponges, needles, and other
sharps
The anesthesia plan is confirmed, and consent for anesthesia is obtained
The postoperative period is defined as which of the following?
Admission to the PACU to patient's death
Closure of the incision to admission to the PACU
Discharge from hospital to patient's return home
Admission to the PACU to transfer to a patient care unit
Which activity is NOT recommended to reduce the risk of surgical infections?
Perform a TIME OUT before beginning the procedure
Administer prophylactic antibiotics as directed
Minimize movement and talking during the operative procedure
Perform a thorough skin prep and hand scrub
Which of the following is a role of a registered nurse first assistant (RNFA)?
Clean up the OR after surgery
Assist with the surgical procedure
Concurrently perform the duties of a scrub nurse
Practice at the direction of a RN Circulator
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True statement about burn resuscitation
Colloid preferred in initial 24 hours
Colloid preferred if burnt area is > 15 % of total BSA
Half of the calculated fluid given in initial 8 hrs.
Half of the calculated fluid given in initial 12 hrs.
Superficial burns; true is/are
Always requires skin grafting
Dry & inelastic
Painless
Blister formation
The best guide to adequate tissue perfusion in the fluid management of a patient with
burns, is to ensure a minimum hourly urine output of;
10-30 cc
30-60 cc
50-70 ml
70-100 ml
Which the following microorganisms most causes of osteomyelitis?
Proteus
Pseudomonas
Staphylococcus
E. coli
An adult whose both lower limbs are burned along with genitalia has – – – -burns
18%
19%
36%
37%
In 3’rd degree burns, all are seen except –
Vesicles are absent
Leathery skin
Painful
Reddish
Burns with vesiculation, destruction of the epidermis and upper dermis is –
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1th degree
3rd degree
2nd degree
4th degree
The perioperative period begins when the patient:
Arrives in the holding area and ends in PACU
Arrives in the hospital and ends with discharge
Is informed of the need for surgery and ends with discharge from the hospital
Is informed of the need for surgery and ends with the patient's return to his or her
usual activities.
Intraoperative phase begins when:
The patient arrives at the hospital for surgery
The anesthesia provider induces the patient
The patient enters the operating room
The surgeon makes the initial incision
Initial nursing focus in the postoperative period focuses on:
transferring the patient to the PACU
Preparing the patient for discharge
Supporting the patient's physiological systems
Making arrangements for the patient to return to normal activity
Typical nursing diagnoses for the surgical patient include:
prevention of adverse outcomes and patient teaching
high risk for infection and support of patient and family
knowledge deficit and high risk for infection
maintenance of normothermia and anatomical body alignment
The perioperative nurses begins the patient's care plan:
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prior to the procedure, based on information about the patient from the surgeon
and other healthcare providers
in the holding area based on interview and assessment data
Prior to the procedure based on knowledge of the planned procedure, typical related
nursing diagnoses, and resources required.
when the patient enters the operating room and all attention is focused on
supporting the patient
The intraoperative period begins when the patient:
leaves the preoperative holding area
enters the actual operating room
is transferred to the operating room table
is induced by the anesthesia provider
Three protocols that TJC implements in an effort to prevent wrong-site surgery are:
site marking, time-out, and better documentation
site marking, consent form, and time-out
time-out, better documentation, and consent form
pre procedure verification, site marking, and time-out
What is a Surgical Safety Checklist (SSC)?
List of equipment that will be required during the surgery
A tool to reduce the risk of preventable complications during the
perioperative period
Tool to ensure that all staff in the practice are prepared for an emergency situation
Document listing all the roles of staff members in the operating theatre
The three parts of a Surgical Safety Checklist (SSC )are:
Sign on, Time on, and Sign Out
Sign in, Time out, and Sign out
A Log in, Time on, Exit
A Log in, Time out, and Sign out
In human centered operating theatres, data tells us that the use of SSC has:
Made operating times and waiting lists shorter
Improved communication and reduced preventable incidents in theatre
Helped staff members get to know each other better
Reduced waste in the operating theatre
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Why is it useful to discuss potentially critical events before surgery starts?
It allows staff to prepare for and be more alert to the possibility of such events
It allows staff to inform owners of patients about their concerns
It allows staff to prepare the roster and ask extra staff to stay late
It allows staff to plan how the theatre will be cleaned after the operation
570. What is the correct definition of an incision biopsy?
A small portion of tissue is incised and sent for examination
A fine gauge needle and syringe are used to aspirate the sample
An entire section of tissue is sent for examination
A small portion of the fluid is dawn and sent for examination
During the surgical procedure the fluid management is important because excessive
amounts of fluid could lead to which of the following conditions?
Hyponatremia
Hyperkalemia
Peritonitis
Hypotension
Processes for opening and presenting a variety of sterile items to a sterile field is required at
all time. The following are the steps to follow while you are Opening wrapped sterile
supplies in the proper sequence.
The farthest wrapper flap, each of the side flaps, and the nearest wrapper flap.
The nearest wrapper flap, the farthest wrapper flap, and the farthest wrapper flap.
Each of the side flaps, the nearest wrapper flap, and the farthest wrapper flap.
Each of the side flaps, the farthest wrapper flap, and the farthest wrapper flap.
One of the complications of inguinal hernia is:
strangulation
gas bloat syndrome
hypovolemic shock
Pelvic fracture
574. One of the common priorities nursing diagnoses for preoperative client is:
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Anxiety
Hypothermia
impaired skin integrity
Fluid volume deficit
575. M.K is admitted to the hospital with a possible diagnosis of appendicitis. On physical
examination, the nurse should be looking for tenderness on palpation at McBurney’s
point, which is located in the :
right lower quadrant
left lower quadrant
left upper quadrant
right upper quadrant
576. The client is admitted following cast application for a fractured ulna. Which finding
should be reported to the doctor?
Paresthesia of the fingers
Pain at the site
Warm fingers
Pulses rapid
The nurse is assessing the client with a total knee replacement two hours post-operative.
Which information requires notification of the surgeon?
Hemoglobin of 7gm
Scant bleeding on the dressing
Low-grade temperature
The urinary output has been 120ml during the last hour
Based on your knowledge about Physical trauma (PT), identify one of the following is Not list
of what happen after PT
Diabetes.
Risk of death from shock (caused by massive blood loss),
Infection,
Multiple organ dysfunction syndrome,
Based on your knowledge about Surgical wounds infection, answer the question below Who
is at more at risk for a surgical wound delayed healing?
Person who Takes corticosteroids (for example, prednisone)
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Person who has problems with PUD (Peptic Ulcer Diseases)
Person who takes antacid
Person who live in rural area
Based on your knowledge about assessment of appendicitis, answer the question about meaning
of: Rebound tenderness: patient feels pain when the hand is released.
True
False
Based on your knowledge about primary and secondary causes of peritonitis, choice the
causes we find in secondary.
Postoperative (breakage anastomosis)
Blood-borne organisms
Genital tract organisms
Cirrhosis ascites
Which correct definition of surgical puncture of a joint on below definition?
Arthroplasty
Arthrocentesis
Arthrodesis
Arthritis
Fat embolism is the most serious complication of?
Skull injury
Long bone fracture
Gas gangrene
Neck fractures
Which question asked by the nurse working at district hospital will give the most
information about the patient’s metastatic bone cancer pain?
How long have you had this pain?
How much medication do you take for the pain?
How would you describe your pain?
How many times a day do you take medication for the pain?
The nurse teaches of pharmacology a student nurse about the action of ibuprofen. Which
statement, if made by the student, indicates that teaching was effective?
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The drug decreases pain impulses in the spinal cord.
The drug decreases sensitivity of the brain to painful stimuli.
The drug decreases production of pain-sensitizing chemicals.
The drug decreases the modulating effect of descending nerves.
A patient with second-degree burns has been receiving pain killer (morphine) through
patient-controlled analgesia for a week. The patient wakes up frequently during the night
complaining of pain. What action by the nurse is MOST appropriate?
Administer a dose of morphine every 1 to 2 hours from the patient-controlled
analgesia machine while the patient is sleeping.
Request that the health care provider order a bolus dose of morphine to be given
when the patient awakens with pain.
Consult with the health care provider about using a different treatment
protocol to control the patient’s pain
Teach the patient to push the button every 10 minutes for an hour before going to
sleep, even if the pain is minimal.
The nurse is caring for a 1-day postoperative patient who is receiving morphine through
patient-controlled analgesia. What action by the nurse is a PRIORITY?
Check the respiratory rate.
Assess for nausea after eating.
Inspect the abdomen and auscultate bowel sounds.
Evaluate the sacral and heel areas for signs of redness.
Which patient with pain should the nurse assess first in surgical ward at referral
hospital?
Patient with postoperative pain who received morphine sulfate IV 15 minutes ago
Patient with neuropathic pain who has a dose of diclofenac scheduled now
Patient who received pain killer 1 hour ago and currently has a sedation scale of 2
Patient who returned from the postanesthesia care unit 2 hours ago and has a
respiratory rate of 10
When scrubbing at the scrub sink, the nurse should:
Scrub from elbows to hands
Scrub without mechanical friction
Scrub for a minimum of 10 minutes.
Hold the hands higher than the elbows
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A patient scheduled for an elective hysterectomy tells the nurse, I am afraid that I will die in
surgery like my mother did! Which response by the nurse is MOST APPROPRIATE?
You will receive medications to reduce your anxiety.
Tell me more about what happened to your mother.
You should talk to the doctor again about the surgery.
Surgical techniques have improved a lot in recent years.
A patient arrives at the ambulatory surgery center for a scheduled laparoscopy procedure in
outpatient surgery. Which information is of MOST concern to the nurse?
The patient had a sip of water 4 hours before arriving.
The patient is planning to drive home after surgery.
The patients insurance does not cover outpatient surgery.
The patient has not had surgery using general anesthesia before.
A 38-year-old female is admitted for an elective surgical procedure. Which information
obtained by the nurse during the preoperative assessment is MOST IMPORTANT to report
to the anesthesiologist before surgery?
The patients statement that her last menstrual period was 8 weeks
previously
The patients lack of knowledge about postoperative pain control measures
The patients history of a postoperative infection following a prior
cholecystectomy
The patients concern that she will be unable to care for her children
postoperatively
A patient who is scheduled for a therapeutic abortion tells the nurse, having an abortion is not
right. Which functional health pattern should the nurse further assess?
Value-belief
Cognitive-perceptual
Sexuality-reproductive
Coping-stress tolerance
Which clamp would be most appropriate to control bleeding during an open abdominal
procedure?
Allis
Babcock
Kelly
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D. Koche]
Which of the following is NOT a characteristic that promotes a culture of safety within a
health care organization?
Commitment to safety as the first priority in providing care
Ongoing education of staff members about patient safety
Prompt disciplinary action when errors occur
Trust among healthcare team members
What interventions can the perioperative nurse perform to protect elderly patients?
Select all that apply.
A. Employ deep vein thrombosis prophylactic devices
B. Position the patient for effective air exchange
C. Slide patient onto the OR bed without use of assistive device
D. Use warming devices to maintain the normothermia
During your preoperative assessment of a patient undergoing a laparascopic
chlolecystectomy , which of the following considerations should be important to you, as
the perioperative nurse? Select all that apply.
Patient’s previous abdominal surgery
History of deep vein thrombosis (DVT)
Voiding in the preop area prior to going to the OR
Preventing hyperthermia
The most important reason for maintaining endoscopic instruments at an optimal level of
function is that:
Insulation defects can cause unseen thermal burns
It is easier to maintain the sharpness of their edges
They are expensive to repair or replace if damaged
They are not available in disposable or reposable forms.
Which of the following statements is true concerning use of the AORN Guidelines for
perioperative practice?
Both medical and nursing licensing boards require health care institutions to comply with the
AORN Guidelines.
The AORN Guidelines legally supersede departmental and institutional policies
The AORN Guidelines reflect scientific evidence of how nurse actually practice in
perioperative settings.
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D. Work setting and situation variations may determine the extent to which the AORN
Guideines can be applied.
You are the in perioperative nurse assigned on Monday to OR1.you are preparing to
laparascopic splenectomy. Which of the following would you need to address after
inspecting the surgical environment prior to starting your case? Select all apply.
One of the surgical light is dim
The temperature is 680 F.
The terminal cleaning log is complete for room1
There are no specimen containers available.
The principal elements required for an infection occur are: Select all apply.
A. A method of transmission
B. A source or reservoir
C. A susceptible host with a portal of entry to receive an infection
D. Resistance to antibiotics
When selecting surgical drapes the following are desirable characteristics: Select all
apply.
Antistatic and anti-allergenic
Barrier to restrict passage of microorganisms.
Resistance to tearing, punctures or abrasions
Dull o non-glaring material
Static porous material
Which of the following are recommendations for enhancing the future of nursing include in
the 2011 institute of medicine report? Select all apply.
Nurses should engage in life-long learning
Nurses should practice beyond the full extent of their education and training
Nurses should achieve higher levels of education
Academic institutions should improve their systems to provide seamless academic
progression
An area of painful skin that is abraded, blistered or has shallow crates would be classified
as which stage of ulcer?
Stage 1
Stage 2
Stage 3
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D. Stage4
Which of the following statements about gloving techinique is true? A. Open
glove techinique is used for initial donning of sterile gown and gloves
B. The gown should be fastened in the back before donning gloves
C. When gloving another person , always glove the left hand first
D. Closed gloved technique is used to glove the surgeon or assistant.
The best method of transferring medication to the sterile field is to:
Dispense only what is needed, then recap the container to preserve the sterility of the
unused solution
Remove the stopped from vials and pour solution onto the sterile field
Transfer all intraoperative and postoperative medications to the sterile field prior to start of the
case
Use a sterile transfer device
Documentation of intraoperative surgical specimens includes which of the following:
Select all apply.
Identification of the specimen in the intraoperative record and the pathology
requisition.
No abbreviations
Notation of markers or tags such as clips or sutures, with a statement of what they
represent
The time the pathologist received the specimen.
What is the correct definition of an incision biopsy?
A fine gauge needle and syringe are used to aspirate the sample
An entire section of tissue is sent for examination
A small portion of the fluid is dawn and sent for examination
A small portion of tissue is incised and sent for examination
Perioperative patient and family education is important for which of the following reasons?
Select all apply.
Conveying genuine caring for the patient’s well-being
Increasing patient and family adherence to the plan of care
Increasing the patient’s and family’s satisfaction with the quality of care
Legal, ethical and regulatory mandates
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E. To make sure that the patient returns to your facility for future care.
You have been asked to give a presentation for your unit colleague on preventing surgical
site infection. Which of the following discussion points is NOT recommended in AORN
guidelines?
Wearing a surgical cap or bouffant bonnet to make sure hairs contained
Identifying procedures for pre-operative patient screening for Aureus testing
Using soap and water to perform surgical skin prep.
Practicing the principles of sterile technique
Over-pressurization of tourniquet cuff may cause: E. Blood in
the surgical field
F. Compression injuries to blood vessels
G. Muscle spasms
H. Shock
How can the perioperative nurse directly contribute to financial efficiency in the OR? Select
all apply.
Decrease use of purchased services
Manage the length of cases by having all needed supplies ready
Participate in product evaluation and waste reduction activities
Reducing turnover time
Working to attain on-time starts
Which of the following statements concerning mentors and preceptors are correct?
Select all apply.
Both model professional nursing behaviors
Mentors guide nurses through global professionals activities
Preceptor guide nurse through defined clinical activities
The mentor provides support for fixed and limited period of time
Potential sources of fuel for surgical fires include:
A. Draping materials
B. Fiberoptic cables C.
Lasers
D. Nitrous oxide
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What are the 3 methods used to accomplish hemostasis?
A. Mechanical, chemical and thermal
B. Mechanical, physical and chemical C.
Physical, pharmacology and chemical D.
Thermal, harmonic and ESU
Identify the general guidelines for identifying and labeling specimens. Select all
apply.
Ask the surgeon to identify the specimen
Complete the laboratory or pathology requisition
Label the outside of the specimen container with patient’s name, identification
number, description and source of the specimen and surgeon
Never tag edges and margins of the specimen for orientation
Use abbreviation to identify the specimens
The perioperative nurse’s role in patient and family education should include:
Select all apply.
Explaining what the patient will experience
Obtaining the surgeon’s order for teaching
Providing emotional support to enhance coping
Teaching specific skills that the patient will need to perform postoperatively.
Which of the following questions would you expect to hear In a perioperative interview?
Select all apply.
Could you tell me about any past surgeries?
Has your surgeon reviewed the surgical procedures with you? Do you have any
questions?
What medications do you take on a regular basis?
Why did you choose our hospital for surgery?
You are assigned to relieve a surgical technologist for lunch .you need:
A sterile gown and gloves opened on a table ( other than the main instrument table for
closed gloving)
A pair of surgical gloves opened on the main instrument table for closed gloving
Surgical gloves opened on table (other than the main instrument table) for closed gloving
Two pairs of surgical gloves opened on the main instrument table for initial double gloving.
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Perioperative fluid management is important because excessive amounts of fluid could lead
to which of the following conditions? Select all apply.
Hyperkalemia
Hypervolemia
Hyponatremia
Hypotension
Which of the following statements about proper attire of surgical team members are true?
Select all apply.
Mask may be worn for more than one procedure if not grossly soiled.
Shoe covers are required for every procedure.
Sterile gowns should resist fluid strike-through.
The scrub top must be secured at the waist or tucked into the pants.
The perioperative nurse’s role in preparing and administering medications includes:
Select all apply.
Administering all medications ordered by the surgeon
Assessing the patient’s medication allergies and used of herbal or dietary
Documenting and reading back the surgeon’s oral orders before preparing medications
Verifying the administration of the correct medication, dose and route.
A properly executed informed consent for surgery should include the following:(
Select all apply).
Indication for the proposed intervention
Name of the individual who witnessed the signature
Names of everyone that will be in the OR when the procedure is performed
Signature of the patient or patient’s representative
Specific name of the intervention to be performed.
Which of the following methods listed below may prevent a mishap, event, or fire from
occurring when handling electro surgery equipment? Select all apply.
Allow enough time for alcohol-based skin preparations to completely dry.
Do not use in an oxygen-enriched environment, such as the the trachea when oxygen is
being “blown over” the patient
If the system does not function properly at normal setting, ask the surgeon how much to
increase setting.
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Visually check the integrity and insulation of all cords and coagulation instruments
before use.
Terminal cleaning is performed on daily basis after scheduled cases are completed. This
process includes cleaning of the following: Select all apply.
Anesthesia carts and equipment
Ceiling and walls
Mopping or wet-vacuuming floors
OR beds and positioning devices
Sterile storage areas
Substerile areas
Which of the following components should be included in documentation the placement
of surgical drains?
Expiration date on sterile packaging
Location of drain
Manufacturer
Serial number
The purpose of conducting postoperative phone calls within 24-48 hours for outpatient
procedures is: Select all apply.
Ask about patient satisfaction with care
Assess how the patient did during the 1st month following surgery
Determine if the patient has paid the facility bill.
Direct future hospital performance improvement activities.
Note any surgical complications.
Timely administration of Dantrolene or Ryanodex is critical measure an MH crisis. Which of the
following are also corrective measures that should be implemented? Select all apply.
Cool patient, restart succinylcholineat lower doses
Provide 100% oxygen
Replace potassium lose, continue with safe anesthetic agents
Stop administration of triggering agents
Stop surgery if at all possible
Use iced saline to cool patient
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All of the following are accurate descriptions of “professional accountability “EXCEPT:
Becoming certified in your specialty
Collaborating with peers in selecting the right instruments and right equipment for each
patient
Pursuing a higher academic degree
Relying ONLY on peer evaluation
Staying current with changes in your specialty
PREOPERATIVE documentation should include: Select all apply.
A. Administration of ordered preoperative medications
B. Implants used in the procedure
C. Performance of the Universal protocol for preventing Wrong Site, wrong procedure,
wrong person surgery TM
D. Skin assessment
Identify the conditions listed below that are important considerations in
maintaining the sterility of an item. Select all apply.
The condition of the storage area, that is, cleanliness, temperature, humidity, air
exchanges.
Outside shipping containers are segregated from on shelves
Traffic should be controlled to limit access to those trained in the handling of sterile
supplies.
Sterile supplies are able to be stored in a manner that allows adequate air circulation.
When storing items on the top shelf of a supply cart one does not need to consider the
distance between the top of the item and ceiling.
What the 3 main factors to consider when assessing the patient for allergies? A.
Heredity, age, prior reaction
B. Prior reaction, diet, age
C. Prior reaction, heredity, type of reaction
D. Type of reaction, weight, heredity
In which phase of healing do hemostasis, phagocytosis and edema occur?
Edema
Inflammation
Proliferation
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D. Remodeling
The increase of the vaginal secretions during pregnancy is called leucorrhea and is caused by
increased of:
Metabolic rates caused by Human Chorionic Gonadotropin
Production of estrogen
Functioning of the Bartholin gland
Supply of sodium chloride to the cells of the vagina
Which of the following lists contain the three MAIN causes of bleeding after birth?
Soft uterus, malaria, and dehydration
Retained placenta, malaria, and perineal tearing
Soft uterus, twins, and perineal tearing
Soft uterus, a retained placenta, and perineal tearing
Which of these fetal presentations is the easiest for vaginal birth?
Complete breech
Vertex occiput anterior
Frank breech
Vertex occiput posterior
A female child, age 2, is brought to the emergency department after ingesting an unknown
number of aspirin tablets about 30 minutes earlier. On entering the examination room,
the child is crying and clinging to the mother. Which data should the nurse obtain first?
Heart rate, respiratory rate, and blood pressure
Recent exposure to infectious diseases
Vaccination calendar
Height and weight
A 12 years old has meningitis and is receiving I.V. and oral fluids. The nurse should monitor
fluid intake because fluid overload may cause:
Cerebral edema
Dehydration
Heart failure
Hypovolemic shock
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The respiratory difficult is more pronounced during the expiratory phase because:
The bronchi constrict and shorten during inspiration
The bronchi dilate and shorten during inspiration
The bronchi dilate and shorten during expiration
The bronchi constrict and shorten during expiration
Dr. Emmy prescribes corticosteroids for a child with nephrotic syndrome. What is the
primary purpose of administering corticosteroids to this child?
To increase blood pressure
To reduce inflammation
To decrease proteinuria
To prevent infection
One of the following sign may be among the prodromes of asthma:
Eye discharge
Itching at the front of the neck
Severe headache
Conjunctiva bleeding
Parents bring their infant to the clinic, seeking treatment for vomiting and diarrhea that has
lasted for 2 days. On assessment, the nurse in charge detects dry mucous membranes and
lethargy. What other findings suggests a fluid volume deficit?
Sunken fontanel
Decreased pulse rate
Increased blood pressure
Low urine specific gravity
Tooth eruption is variable primarily because of genetic factors. On average, normal infant
should have:
12 teeth by 6 months
6 teeth by 2 years
6 teeth by 12 months
16 teeth by 18 months
A 6 years old girl is a known case of asthma came with her mother in the clinic yesterday with
severe respiratory distress. In the morning the nurse on the night duty explained to the staff
that at night the child had shortness of breath with the absent breath
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sounds accompanied with the increased of respiratory rate. As a student nurse in
the clinical placement you notice that this is:
An ominous sign for respiratory failure and imminent asphyxia
A compensatory mechanism soon it will resolve itself
Normal, it should be there in a status asthmaticus
Due to drugs, soon it will resolve
Sarah meets you in front of health center asking the vaccines that her young infant of 1 day at
birth is going to receive. One of the following shall be your best answer to Sarah:
Polio and BCG
Only BCG is essential
Polio 1, pentavalent 1, PCV(13)1 and Rotateq 1
Vitamin A to prevent blindness.
The most reason for Isolation of clients with tetanus is:
To minimize contamination of others
To avoid transmission of infection via droplets
To minimize muscle spasms and convulsions
To prevent superinfection
Accreditation refers to one of the following:
Making assessment
Ensuring quality
Meeting predetermined standards
Making care cost effective
The followings are some words used to describe quality EXCEPT:
Meeting standards
Inaccessibility
Healthy
Value for money
DADA is a 3 month old admitted to the hospital with a diagnosis of hydrocephalus. Which of
the following are signs of increased intracranial pressure?
Overriding sutures
Poor sucking
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Hyper reflex
Prominent scalp
After a shunt to relieve intracranial pressure, which of the following would indicate an
infection?
Subcutaneous temperature
Decreased pulse
Marked irritability
Supple neck
Hypertension in children most commonly
Manifests frequent severe symptoms.
Cannot be treated with diet and daily exercise.
Results as a secondary manifestation of another disease
Will resolve before adolescence without treatment if it is primary hypertension.
Which of the following would most likely be noted in a child with acute
glomerulonephritis?
Blood pressure of 90/40
Hypovolemia and signs of dehydration
Hematuria and pulmonary edema
Severe, foul smelling diarrhea
At what age should an infant begin to locate an object hidden under the blanket?
6 months
8 months
10 months
12 months.
A woman who describes finding her partner sexually attractive but is not able to maintain
sufficient sexual excitement and lubrication during sexual activity has:
Hypoactive sexual desire disorder
Sexual arousal disorder
Sexual orgasmic disorder
Vaginismus
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Which of the following lab values would be expected with menopause?
Decreased FSH, increased LH, decreased estradiol
Decreased LH, increased FSH, increased estradiol
Increased FSH, increased LH, decreased estradiol
Increased LH, decreased FSH, increased estradiol
The portion of the uterus that is shed during menstruation is the:
Endometrium
Myometrium
Omentum
Pyometrium
Estrogen is released by the ovary in response to:
GnRH
hCG
LH
FSH
Which phase of the menstrual cycle is the most variable?
Follicular
Luteal
Ovarian
Secretory
Which hormone is dominant during the proliferative phase of the menstrual cycle?
Estrogen
LH
Progesterone
Prolactin
An individual who either has active hepatitis B infection or who is a carrier would have a
positive test for:
Hepatitis B surface antigen
Hepatitis B surface antibody
Hepatitis B e-antigen
Hepatitis B e-antibody
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The anatomical area that contains the urethral, vaginal openings, hymen, Skene’s glands and
Bartholin glands is called the:
Labia majora
Perineum
Vestibule
Vulva
Which of the following structures produces gonadotropin releasing hormone (GnRH)?
Anterior pituitary gland
Hypothalamus
Posterior pituitary gland
Ovaries
The shift in vaginal pH that occurs during
Puberty is influenced by:
Estrogen
FSH
LH
Progesterone
A 21-year-old G0P0 healthy college student presents to Student Health Center, complaining of
severe vulvar puritius. She has a BMI of 24, uses condoms with coitus, and finished her
last menses 4 days prior. Last month she was diagnosed with and successfully treated for
candida vaginitis. She denies any other symptoms including vaginal discharge. What is the
most likely diagnosis?
vaginal trichomoniasis
leukemia
personal hygiene products
secondary syphilis
A 20-year-old patient complains of painful vulvar ulcers present for 72 hours.
Examination reveals three tender, punched-out lesions with a yellow exudate but no
induration. Which of the following is the most likely diagnosis?
Chancroid
Syphylis
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herpes
lymphogranuloma venereum
Which of the following would not be an expected pelvic examination finding in a 70-years old
woman?
Narrow vaginal canal
Palpable ovaries
Small uterus
Thin vaginal walls
Which of the following hormones is responsible for regulating sodium and potassium
by the kidneys?
Aldosterone
Androstenedione
Cortisol
DHEA
A couple presented in OPD with infertility since last two years. Husband semen analysis was
advised, what is WHO criterion for minimum sperm count in normal semen
10 million
20 million
30 million
40 million
16.the second degree of uterovagina prolapse is characterized by:
Complete protrusion of uterus outside introitus
Descent of genital tract within vagina
Descent of genital tract up to introitus
Descent of cervix below the ischeal spines
A 55 years old women present in consultation room complaining, thin, gray, white vaginal
discharge with foul smelling fishy vaginal odor and history of vaginal itching and burning
sensation during urination. What is the most likely diagnosis:
Bacterial vaginosis
Tricomoniasis
Candidiasis
Malignant
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A women of 50 years old presents with postcoital bleeding, her last smear was 8 years ago
and was normal. She is otherwise well. On examination she has an ulcerated lesion on
her cervix which bleed on contact. The vulva, vagina and uterus all feel normal. Wich of
the following should be undertaken to investigate the cause of her postcoital bleeding?
CT scan of abdomen and pelvis
Liver function test
Biopsy of her cervix
Hysteroscopy and curettage
The most cause of rectovaginal fistula is:
Obstetrical
Irradiation of the pelvis
Endometriosis
Adenomyosis
A large cyst ovarian tumour is detected in a women on routine antenatal checkup. The most
common complication she can encounter is:
Rupture
Torsion
Haemorrhage
Degeneration
Studying the future and arranging the means for dealing with it is part of the process of;
Organising
Commanding
Controlling
Planning
Who is the person you have to give importance under the company’s checklist before
making call to the consultant.
Managers
Employees
Customer
All of the above
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In management process, the most misinterpreted word is;
Organizing
Delegating
Controlling
Planning
Bureaucracy theory means ;
The development of management functions and administrative principles
A scientific study of work
A shared responsibility of authority and delegation
A hierarch of command based on rational legal authority structure
A person who is motivated by the enjoyment of performing a task is high in:
Self -esteem
Need for achievement
Extrinsic motivation
Intrinsic motivation
Which of these methods of sterilization is permanent?
Monthly injectable
Progestin only injectable
Tubal sterilization
CuT380A
Before a patient’s elective foot surgery, they recommend that patient should stop taking the
Oral contraceptive pills. What is the reason for this among the following?
Stopping the OCP will increase her Hgb preop
You will want to evaluate symptoms without the OCP masking them.
There is an increased risk of DVT with OCP use
Estrogen works as a blood thinner and should be stopped preoperative
681. A client in the family planning clinic asks the nurse about the most likely time for her to
conceive. The nurse explains that conception is most likely to occur when:
Estrogen levels are low
The endometrial lining is thin
Lutenizing hormone is high
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D. The progesterone level is low
682. Depo –provera is the important injectable Family planning method and is available in
public. Choose the duration of protection of this method:
12moths
12years
12 weeks
5years
683. NORISTERAT is the other available injection contraceptive method used in Rwanda what
is the period of birth control protection for this method.
12 moths
5years
8 weeks
12weeks
684. During the home visit, a client with AIDS tells the nurse that he has been exposed to
measles. Which action taken by the nurse is the most appropriate?
Administer an antibiotic.
Administer an antiviral.
Contact the physician for an order of immune globulin.
Tell the client that he should remain in isolation for two Weeks
685. Which among the following statement is appropriate about CD4 cell counts and
viral load Tests?
Amount of ARVs in blood, how body interact with ARVs drugs, side effects of ARVs
Shows other infections
Person’s CD4 cell count shows the strength or weakness of the immune
system. Viral load is the amount of HIV in a person’s blood.
Higher viral load indicate the incubation period of HIV
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Which of the following procedures reflects best practice for transferring medication from a
medication vial to the sterile field?
Clean the stopper with alcohol and hold the vial steady while the scrub person draws up the
medication.
Draw up the medication with a needle and syringe and dispense it into a sterile medicine
cup on the field.
Remove the stopper from the vial and pour the medication into a sterile medicine cup on the
field.
Use a sterile transfer device.
What factors increase the risk for skin injury? Select all apply. A.
Adequate tissue perfusion
B. Allergy to betadine
C. Diabetes
D. Prolonged length of surgery
E. Unusual positions or positioning devices
What are the requirements for hospital disinfectants? Select all apply.
A. Labeled as an EPA registered germicide
B. Meets the required indications of use
C. Has passed the potency test against three representative microorganisms
D. Selected according to cost constraints
What responsibilities do OR staff members have in maintaining a safe OR
environment? Select all apply.
Adhering to facility policies related to safety
Consistency applying OR-specific safety practices
Developing an emergency plan in case of electrical power outage
Monitor, identify and report safety hazards
In preparing for a regulatory survey, your quality consultant questions you about the restricted
zone in your OR suite. The following statements are true: Select all apply.
Airflow in the OR rooms should be cleaned by by HEPA filters.
Air is kept at negative pressure with minimum of 25 air exchange per hour.
Masks are required when open sterile supplies are present
Relative humidity is maintained between 60 and 75% to prevent static electricity.
Temperature is maintained between 68and 75 F
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What special care procedures are required for microsurgical instruments? Select all
apply.
All microsurgical instrument must be cleaned by the ultrasonic method
Keep stainless steel and titanium instruments separated
Use anon-fibrous sponge wipe to clean the instrument tip if recommended
Use tip cover or protective sleeves when instruments are not being used.
Which PNDS outcome is the most important when draping the surgical patient?
A. The patient is free from signs and symptoms of infection. B.
The patient is free of s and s of injury from extraneous objects.
C. The patient maintains normothermia during the perioperative phase of care
D. The patient’s care is consistent with the perioperative plan of care
Which of the following are advantages of disposable drapes? Select all apply. A.
Disposable drapes are lint-free.
B. Disposable drapes can be reprocessed to decrease waste to landfills.
C. The chemically-treated cotton of disposable drapes makes them completely flame resistant.
D. Using disposable drapes can minimize strike-through because of their moisture
repellent quality.
Which of the following statements about immediate use steam sterilization is the
recommended practice?
After immediate use steam sterilization, an item may be packaged and stored for future use.
Because the instrument is needed quickly, the cleaning process may be omitted
Instruments may be immediate use steam sterilized when there is inadequate inventory.
Instruments may be immediate use steam sterilized only when there is insufficient
time to process by preferred wrapped or container method.
The joint Commission Universal Protocol consists of: Select all apply.
A. Perioperative verification
B. Surgical site marking
C. Time out
D. Transfer de-briefing
During which phase of wound healing does contraction occur?
Epithelialization
Inflammation
Proliferation
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D. Remodeling
Guidelines for safe use of an endoscopic light source include: A.
Following surgeon preferences when setting parameters.
B. Placing the light on the sterile field when not in use.
C. Placing the light in standby mode when not in use.
D. Turning the light source on before connecting the cable to the telescope.
The following steps can be used to reduce personnel exposure to and risk of fire for specimen
fixatives such as formalin. Select all apply.
Avoid splashing while pouring
Store in any location that provides convenient access
When pouring wear gloves, mask and goggles
Use absorbent material and then triple-rinse with water any area or surface where
accidental formalin spillage occurs
Store fixatives securely so they are inaccessible to persons unfamiliar with their use.
The following information is important in the management of forensic specimens.
Select all apply.
Forensic specimens include but are not limited to hair, fibers, debris, body fluids, and
foreign bodies.
Forensic specimens require special handling when the surgeon is using metal
instruments
Hospitals need to have policies to give guidance to the perioperative nurse about the
management of forensic specimens
The chain of custody is not a consideration when managing forensic specimens
When applying the concept of a surgical conscience which of the following
statements should be considered? Select all apply.
It involves mental discipline and the ability to speak out.
It is essential to the delivery of optimal care and prevent of harm.
It is limited to application to one’s own individual practice.
Surgical conscience allows for no compromise in the principles of aseptic technique.
In addition to giving Dantrolene, which of the following treatment options for MH should the
nurse anticipate and prepare for?
Cool patient, restart succinylcholine at lower doses
Provide 100% oxygen, use iced saline to cool patent.
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Replace potassium loss, continue with safe anesthetic b agents
Avoid patient shivering , contact blood bank for platelets
When documenting medications, which of the following elements should be include?
Select all apply.
Contact information for provider from which verbal orders are obtained
Drug name, concentration, rout of administration, dose and time it was administered
Only medications that were administered by circulating RN
Verbal orders
Which of the following practice is recommended for damp dusting in the OR damp Dusting
should?
Be completed after the last case of the day.
Be done with a disposable cloth moistened with isopropyl alcohol.
Be performed by environmental services personnel.
Begin with higher surface and finish with the lowest levels.
Based on your understanding of chemical safety issues, identify the best strategy to reduce the
risk associated with ignition of prep solution vapor.
Allow the prep solution to dry before draping to allow the vapors to dissipate
Insert blotting towels before performing skin prep so that prep solution does not pool on the
patient’s skin.
Reduce the amount of prep solution applied when you know an ignition source will be used
Use a suction device to remove the vapors during the procedure.
Interventions to help prevent a surgical site infection (SSI) in the patient undergoing a
laparascopic appendectomy include: Select all apply.
Performing the surgical skin prep beginning at the planned incision site and moving
outward toward the periphery in all directions
Removing hair around the surgical site using a razor
Confirming that antibiotic are administered as ordered before the start of the case
Documenting the wound classification as clean.
The first step in sterilization process of surgical instruments that have been used in a case is:
Cleaning
Assembly
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Disinfection
Transport to sterilizer
Which of the following is NOT routinely included in the verbal team agreement during the
performance of the Time Out for patient safety?
Patient identification using two patient identifiers
Procedure to be performed
Site of the procedure, including rig/left distinction.
Type of suture material to be used
Which of the following practices are examples of the Guidelines –A sterile field should be
maintained and monitored constantly. Select all apply.
A sterile field that has been set up for more 1 hour before the procedure begins should be
broken down and a new set-up prepared.
If a delay occurs after a sterile field is set up, it may be covered with sterile drapes
until the delay is resolved.
If a delay occurs after a sterile field is set up, personnel may leave the room as long as
someone remains in the room to maintain continuous visual observation of the
sterile field.
The sterile field should be prepared as close as possible to the time of use.
Which of the following statements about the gowning procedure are correct?
As the gown unfolds, slide your hands through the cuffs to allow access for closed gloving
Hold your hands at chest level and slip both arms into the armholes one at a time
Open your gown on to the back table prior to performing your surgical scrub.
Step back from the table into an unobstructed area to let the gown unfold.
Which elements are required to create an environment where the culture of safety is
embrannced? Select all apply.
A sense of trust among all team members
Development of a proactive approach instead of a reactive approach
Emphasis on worker safety over patient safety.
Sincere commitment to affirming safety as the first priority
Verification of receipt of information at all levels of the organization
To follow the AORN Guidelines for positioning the patient ,the perioperative nurse
should:
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Depend on the patient’s nature defense mechanisms to indicate the need for positioning
alterations.
Rely on the surgeon’s and anesthesia provider’s assessment to guide positioning
Use a consistent method of procedure-specific positioning for each patient
Use additional precautions as appropriate based on unique patient considerations.
Which of the following principles of asepsis is most directly related to the concept of surgical
conscience?
A sterile field is contaminated whenever a sterile barrier is permeated
Consider items of doubtful sterility contaminated.
Tables are sterile at table level.
Use only sterile items within the sterile field
Which of the following is a disadvantage of using clips? A. They
should not be used when infection is present
B. They are time-consuming to apply
C. They often cause more scarring than other skin closure method
D. They are prone to corrosion.
The Aldrete scale, used to determine readiness for discharge, measures all of the following
EXCEPT:
Circulation
Level of pain
Patient mobility
Pulse oximetry
Respiratory status
To place a patient safety in TRENDELENBURG position, which of the following practices
is indicated?
Apply graduated compression stockings to encourage venous return
Position the knees over the break in the procedure bed to allow for knee flexion.
Rapidly return the patient to the supine position at the end of the procedure
Use shoulder braces to prevent the patient’s sliding toward the head of the bed.
Safety precautions when handling and caring for powered instruments include:
Select all apply.
A. Handling the powered instrument to the surgeon with the safety mechanism on
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Having irrigation ready to use with the dill or saw
Turning the safety mechanism off to clean the hand piece
Using the instrument with the blade guard or drill guard in place.
According to the guideline on positioning, which is the best intervention to prevent
intraoperative pressure ulcer development on the patient’s heels:
Elevate heels off of the bed
Place 2” of foam under the patient’s heels
Apply prophylactic dressing to heels
Wrap the feet in a blanket and secure with tape
Which type of human factor is responsible for an error that occurs when a
perioperative nurse is trying to attend to several tasks at once?
Device user error
Knowledge
Situational
Skill-based
The perioperative nurse’s documentation of the skin prep procedure should include:
Select all apply.
Body area prepped
Name of the person performing the prep
Preoperative assessment of the skin at the operative site
Skin prep agent used
Type of razor used for hair removal
The dispersive electrode should: A. Be applied
before the patient is positioned B. Be applied
distal to any tourniquet in use
C. Be placed as closed to the operative site as possible
D. Cover as small an area as possible.
You have completed your case and must now transport your patient to PACU. To give report to the
PACU nurse, your facility requires the use of SBAR format, which includes:
Safety, Background, Actions, Recovery expectations
Safety concerns, Background, Assessment, Responsibility
Situation, Background, Assessment, recommendation
Surgeon, Background, Assessment, Recovery time
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When performing a plastic surgery skin close, which choice of suture size would be most
appropriate?
15-0
2-0
5-0
0
Barriers to effective patient and family education in perioperative setting include:
Select all apply.
Anxiety about an uncertain outcome
Discomfort or pain
Fear of the unknown
Limited time for assessment and teaching
Patient satisfaction with care
The surgeon’s preference for the preoperative skin prep includes the application of an alcohol
and Chlorhexidine gluconate (GHG) solution. The primary reason for allowing this prep to
dry prior draping is because:
Alcohol has a persistent chemical effect when dry
Fumes trapped underneath the drapes could ignite
Many patients develop allergies to CHG if it is allowed to pool on the skin
The patient could become hypothermic if there is wet perp solution left under the drapes
A 72-year-old man is scheduled for a procedure to repair his right hip fracture. He has a
history of smoking and diabetes, and is currently taking prednisone for his rheumatoid
arthritis. Based on this history, you would be concerned about which of the following:
Delayed wound healing
Postop pain control
Return to normothermia
Development of surgical site infection
What statement by the client indicates the need for further discussion regarding the outcome
of skin grafting (allografting) procedures?
“For the first few days after surgery, the donor sites will be painful.”
“Because the graft is my own skin, there is no chance it won’t ‘take’.”
“I will have some scarring in the area when the skin is removed for grafting.”
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“Once all grafting is completed, my risk for infection is the same as it was before I
was burned.”
Each of the three components of the Glasgow Coma Scale have a number of steps. Which of
these are the correct combinations?
Eyes 5 Verbal 4 Motor 6
Eyes 4 Verbal 5 Motor 5
Eyes 4 Verbal 5 Motor 6
Eyes 5 Verbal 6 Motor 4
A 45 year old man called Innocent is admitted to the Emergency Department on Friday 1
January 2021 after being assaulted. When you ask the patient to tell you his name, where he
is and what the date is, he answers, Innocent, Hospital, and December. How would you
record this finding?
Orientated
Confused
Moans
Words
A patient who opens his eyes in response to pain, makes no verbal response, but withdraws
from pain has a Glasgow Coma Score. Choose the best Glasgow Coma Score
3
5
7
11
Which of the following statement is TRUE about Salbutamol?
Is a beta-1 selective adrenoreceptor agonist
Acts on the lung only when given by the inhalational route
Reduces the forced expiratory volume in asthmatics
Produces vasodilatation
After bandaging, John's fingers became cold and tingling. He also complained of pain upon
moving his fingers. You should now:
loosen the bandage
massage the fingers
warm the hand with hot water bottle
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give pain killers like morphine
After applying a dressing and bandage, you should check for:
Vomiting
Circulation
packing sterility
the opposite limb
How much medication can the nurse safely administer into the deltoid muscle?
5 ml
6 ml
1-2 ml
4-8 ml
Medications are in pre-filled needle and syringe units for certain types of injections - most
commonly for:
A intradermal injections
subcutaneous injections
intramuscular injections
Subcutaneous injections are used for:
A systemic delivery of medications
local delivery of medications
large, quick-action doses
none of the above
Needles must be disposed of in:
A general clinical waste bins,
clinical sharps disposal containers,
domestic waste bins
confidential waste bins
When collecting the arterial blood gas (ABG) sample, you should use a specific syringe,
which also contains:
A coagulase
potassium
heparin
Normal saline 0.9%
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Human body is made of and supported by skeleton composed of 206 bones and
cartilages. The following are types of bones except:
Irregular bones
Long bones
Flat bones
Ligament bones
The following is the most important purpose of documentation?except
To Communication
To provide comfort
To Reimbursement
To Quality assurance
740. The best description of critical thinking indicators is the following:
Evidence based description of behaviors that demonstrates the knowledge that
promotes critical thinking in clinical practice
Evidence based description of behaviors that demonstrates the knowledge and skills
that promotes critical thinking in clinical practice
Evidence based description of behaviors that demonstrates the knowledge,
characteristics and skills that promotes critical thinking in clinical practice
To have good idea for patient feeding
The nurse performs an assessment of a newly admitted patient. The nurse understands that this
admission assessment is conducted primarily to:
Diagnose if the patient is at risk for falls.
Ensure that the patient's skin is intact
Establish a therapeutic relationship
Identify important data
The nurse is caring for a patient admitted with a right hip fracture. Based on the diagnosis,
the nurse realizes that the priority nursing diagnosis for this patient is:
Risk for peripheral neurovascular dysfunction.
Risk for fluid volume deficit.
Decreased cardiac output.
Anxiety
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A patient is brought to the emergency department with a diagnosis of traumatic head injury
following a motorcycle accident. Upon admission, vital signs are within normal limits,
pupils are equal but react sluggishly, Glasgow Coma score = 6, and (ICP) intracranial
pressure is 35 mm Hg. Based upon this initial assessment, which priority intervention
should be planned by the nurse:
Administer medications to reduce the increased (ICP) intracranial pressure.
Start two large bore IVs at 100 mL per hour.
Monitor and record vital signs and pupillary responses.
Maintain a patent airway and administer oxygen.
The nurse must be knowledgeable in patient’ needs assessment .Types of Data to be collected
by the nurse are:
Subjective data and objective data
Raw data
Statistical data
Medical data
Human digestive system is composed of the following organs. One of the following organs is
considered as primary absorptive organ
Large intestine
Small intestine
Stomach
Rectum
John who was diagnosed with brain tumor was scheduled for craniotomy. In preventing the
development of cerebral edema after surgery, the nurse should expect the use of:
Anticonvulsants
Steroids
Diuretics
Antihypertensive
Most diuretics medications act in the body to cause:
Loss of calcium.
Loss of sodium.
Retention of potassium.
Retention of chloride
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Which of the following drugs is used for candidiasis treatment:
Heparin
Nitrofungin
Myconazol
Ibuprofen
Which of the following is the function of white blood cells?
Transport oxygen.
Maintain homeostasis.
Defend against infection.
Produce haemoglobin.
An infant’s Apgar score is 9 at 5 minutes. The nurse is aware that the most likely cause for
the deduction of one point is:
The baby is cold.
The baby is experiencing bradycardia.
The baby’s hands and feet are blue.
The baby is lethargic.
The physician has ordered an injection of RhoGam for a client with blood type A negative.
The nurse understands that RhoGam is given to:
Provide immunity against Rh isoenzymes
Prevent the formation of Rh antibodies
Eliminate circulating Rh antibodies
Convert the Rh factor from negative to positive
While assessing the postpartal client, the nurse notes that the fundus is displaced to the right.
Based on this finding, the nurse should:
Ask the client to void
Assess the blood pressure for hypotension
Administer oxytocin
Check for vaginal bleeding
The nurse is responsible for performing a neonatal assessment on a full-term infant. At 1
minute, the nurse could expect to find:
An apical pulse of 100
An absence of tonus
Cyanosis of the feet and hands
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Jaundice of the skin and sclera
A primigravida, age 42, is 6 weeks pregnant. Based on the client’s age, her infant is at risk for:
Down syndrome
Respiratory distress syndrome
Turner’s syndrome
Pathological jaundice
A client is admitted to the labor and delivery unit. The nurse performs a vaginal exam and
determines that the client’s cervix is 5cm dilated with 75% effacement. Based on the
nurse’s assessment the client is in which phase of labor?
Active
Latent
Transition
Early
The nurse is measuring the duration of the client’s contractions. Which statement is true
regarding the measurement of the duration of contractions?
Duration is measured by timing from the beginning of one contraction to the
beginning of the next contraction.
Duration is measured by timing from the end of one contraction to the beginning of the
next contraction.
Duration is measured by timing from the beginning of one contraction to the
end of the same contraction.
Duration is measured by timing from the peak of one contraction to the end of the
same contraction.
After the physician performs an amniotomy, the nurse’s first action should be to assess the:
Degree of cervical dilation
Fetal heart tones
Client’s vital signs
Client’s level of discomfort
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The physician has ordered an injection of RhoGam for the postpartum client whose blood type
is A negative but whose baby is O positive. To provide postpartum prophylaxis,RhoGam
should be administered:
Within 72 hours of delivery
Within 1 week of delivery
Within 2 weeks of delivery
Within 1 month of delivery
A client telephones the emergency room stating that she thinks that she is in labor. The nurse
should tell the client that labor has probably begun when:
Her contractions are 2 minutes apart.
She has back pain and a bloody discharge.
She experiences abdominal pain and frequent urination.
Her contractions are 5 minutes apart.
The nurse is caring for a neonate whose mother is diabetic. The nurse will expect the
neonate to be:
Hypoglycemic, small for gestational age
Hyperglycemic, large for gestational age
Hypoglycemic, large for gestational age
Hyperglycemic, small for gestational age
A client tells the doctor that she is about 20 weeks pregnant. The most definitive sign of
pregnancy is:
Elevated human chorionic gonadotropin
The presence of fetal heart tones
Uterine enlargement
Breast enlargement and tenderness
The client is having fetal heart rates of 90–110bpm during the contractions. The first action the
nurse should take is:
Reposition the monitor
Turn the client to her left side
Ask the client to ambulate
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Prepare the client for delivery
A client with a diagnosis of HPV is at risk for which of the following?
Hodgkin’s lymphoma
Cervical cancer
Multiple myeloma
Ovarian cancer
A 10 weeks-old is brought to the well-baby Ruli HC on Monday 19th October 2019 for
immunization. In addition to the oral polio vaccine(OPV,Diphteria, Tetanus, Pertussis,
HepatitisB and Hemophilus Influenza (DTP-HeB-Hib) and Pneumococcal vaccine(PCV13)
vaccines, the baby should receive:
Bacillus Calmette-Guerin (BCG)
Mumps vaccine
Measles
Rotavirus(Rotarix)
When assessing the newborn’s umbilical cord, what should the nurse expect to find?
One smaller vein and two larger arteries
One smaller artery and two larger veins
Two smaller veins and one larger artery
Two smaller arteries and one larger vein
A 3 years old child is brought to Ruli health center with a history of vomiting and diarrhea for
the past 2 days. Which of the following signs and symptoms is the nurse MOST likely to
see?
Shortness of breath
Slow heart rate
Sunken eyes
Tremors
What would happen to red blood cells if the haem group were removed from
haemoglobin?
Red blood cells would not be able to bind oxygen.
Red blood cells would not be able to reproduce.
White blood cells would not be able to reproduce.
Blood clot formation would be inhibited.
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The formation of a blood clot is known as which of the following?
Chemotaxis
Erythropoiesis
Coagulation,
Bone marrow
A 59 year old male patient has full thickness burns on both of the legs on the back, front and back of
the trunk, both arms on the front and back, and front and back of the head and neck. The
patient weighs 85kg. Use the Rule of Nine, what will be the BSA percentage?
38
71
48
81
The goals of patient and family education include all of the following EXCEPT:
Achieve long-lasting improvements in patient health status
Improve patient satisfaction
Provide information/knowledge to the patient and family
Improve the overall community rating for the facility
Which of the following is a method for preventing blood-borne pathogen exposure?
A. Changing gloves during regular intervals during a procedure
B. Using surgical gowns made from material that allow air and fluid to move freely in order to
minimize thermal discomfort of the team during the case
C. Wearing exam gloves under surgical gloves as an additional barrier
D. Wearing reading glasses to improve sight accuracy during the procedure
Which of the following best describes capacitive coupling?
Patient injury caused by an electrosurgical device that occurs away from the dispersive
electrode side
Radio-frequency coagulation from an electrosurgical generator that is capable of delivering
monopolar current through a flow of ionized gas.
The transfer of electrical current from the active electrode through intact insulation to
adjacent conductive items such as tissue or trocars.
The contact of an energized active electrode tip with another mental instrument or object
within the surgical field.
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What precaution should be taken when microfibrillar collagen is used as hemostatic agent
intraoperatively?
Antibiotics must be administrated concurrently because of increased risk of wound
infection.
Be aware of the possibility of an allergic reaction.
Avoid using it with an autologous blood salvage unit
Protamine sulfate should be available as reversal agent.
Which of the following statements reflect the concept of critical thinking? Select all
apply.
Memorization
Rote tasks
Informed practice
Holistic thinking
Unbiased thinking
Reasoned application of step by step process
Recommended sponge count procedures include all of the following EXCEPT: A.
Counting all sponge at the beginning of the case.
B. Counting silently so it doesn’t distract other personnel
C. Separating sponges as they are counted
D. Simultaneous counting by two people, including an RN circulator.
The open-assisted gloving technique should be used: Select all apply.
During initial gowning and gloving
Every time gloves are changed during the case
When closed-assisted gloving is not possible
When the surgeon requests this specific technique
Which of the following statements about regional anesthesia is correct?
A Bier Block, employing a double tourniquet, is most often used for surgery of the lower
extremity.
Continuous nerve stimulation helps ensure proper needle placement during
peripheral nerve blocks.
Epidural anesthesia involves injecting the anesthetic into the spinal canal.
Nurses should be aware of the potential for sudden hypertension after spinal anesthesia
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According to the CDC, which surgical wound classification should be documented for patient
who underwent a laparoscopic appendectomy with the diagnosis of perforated
appendicitis?
Class 1(clean)
Class 2(clean-contaminated)
Class 3(contaminated)
Class 4(dirty/infected)
By using a high radio frequency electrical current, surgeon routinely use electro surgery
to……………….the tissue.
Cauterize
Cut
Cut and coagulate
coagulate
You are the circulating RN for a patient having an operative hysteroscopy. Actions you
should take to achieve correct fluid management for the patient include all of the
following EXCEPT:
Assessing the patient’s NPO status, weight, medications, and allergies
Monitoring overload of IV and irrigation fluids to avoid hyponatremia and hypervolemia.
Providing Ringer’s Lactate as a distention media because the surgeon will be using
monopolar electrosurgery.
Monitoring the amount of irrigation fluids dispensed and returned during the surgical
procedure.
Which of the following statements correctly describes recommendations for
preoperative patient skin antisepsis?
Dirty areas are prepped before clean areas
Hair should be removed with a razor immediately before prepping.
In determining the area to be prepped, expose the smallest area possible to protect the
patient’s privacy.
Prep should start at the site of the incision and move outwards.
A patient is scheduled for reconstruction of her external ear following a dog bite injury.
Which of the following skin prep agents is contraindicated for use in this case?
Alcohol
Cationic phenolic mixture
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Chlorhexidine gluconate
Povidone-iodine
Which of the following strategies are recommended to reduce the occurrence of retained
surgical items? Select all apply.
Avoid distractions during the counting process.
Count items including radiopaque soft goods, sharps, and other miscellaneous items
and instruments.
Maintain an organized, uncluttered environment by removing trash and linen bags as they
become filled.
Use a standardized approach each time a count is conducted.
A psychosocial assessment may include the patient’s: Select all apply.
A. Cultural beliefs and practice
B. Expressed level of anxiety or stress
C. Spiritual or religious beliefs
D. Understanding of the surgical procedure
E. Vital signs including height and weight
Upon hearing that he has acute pericarditis, the patient asks how he could have gotten the
disease. The best response is:
It is a genetic condition that you received from your father.
The upper respiratory viral infection that you experienced a couple of weeks ago
could have led to acute pericarditis.
It is a genetic condition that you received from your mother.
It is the weakening of the left side of your heart.
The patient asks you why she is being administered so many arterial blood gas tests. The best
response is:
This test determines how well your tissues are oxygenated.
This test determines if your liver and kidneys are functioning properly.
This test determines if you have a sufficient WBC to fight infection.
This test determines if you are hyperglycemic, which a side effect of your medication is.
The patient is admitted to rule out cardiac disease and is scheduled for a chest x-ray. He asks
you how a chest x-ray would help the physician examine his heart. The best response is:
a. A chest x-ray is used to rule out that a fractured rib caused your pain.
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A chest x-ray is used to detect the size and position of the heart.
The chest x-ray is an error. I’ll cancel the order.
All patients who are admitted must have a chest x-ray.
A patient diagnosed with congestive heart failure asks you why fluid accumulates in his lungs.
The best response is:
The left side of his heart is weak and is losing the capability to pump blood to his
lungs.
Because of the excessive volume of IV fluid that is being administered.
The right side of his heart is weak and is losing the capability to pump blood to his lungs.
He stands too long at work.
What does the nursing responsibility in the management of the patient with
hypertensive urgency often include?
Monitoring hourly urine output for drug effectiveness
Instructing the patient to follow up with a health care professional within 24 hours
after outpatient treatment
Treating IV drug dosages based on BP measurements every 2 to 3 minutes
Providing continuous electrocardiographic (ECG) monitoring to detect side effects of the
drugs
Secondary hypertension is not associated with: a. obesity
or genetic
b. acute renal disease
hormonals dysfunction
cardiovascular disease
Which of the following does not occur in ECF volume deficit?
thirst
neck vein distention and hypertension
decreased urine output and constipation
poor skin turgor and dry mouth and tongue
What is the top-priority nursing diagnosis category for the patient with
pneumothorax?
anxiety
ineffective airway clearance
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Impaired related to mucus
Impaired gas exchange
The following statement are not nursing intervention for a patient with dyspnea
except:
to give him/her drugs which increase respiratory rate as prescribed by physician
tell the patient that you are a Registered Nurse
start a conversation with patient for 2 hours
Place patient in high Fowler’s or semi-Fowler’s position to ease respiratory effort
How is secondary hypertension differentiated from primary hypertension?
Has a more gradual onset than primary hypertension
Does not cause the target organ damage that occurs with primary hypertension
Is caused by age-related changes in BP regulatory mechanisms in people over 65 years of
age
Has a specific cause, such as renal disease, that often can be treated by medicine or
surgery
What is the patient with primary hypertension likely to report?
Cardiac palpitations
Dyspnea on exertion
Dizziness and vertigo
No symptoms
What are modifiable risk factors for primary hypertension?
Age
Ethnicity
Genetic link and Gender
Obesity
What is included in the correct technique for BP measurements?
Always take the BP in both arms.
Position the patient supine for all readings.
Place the cuff loosely around the upper arm.
Take readings at least two times at least 1 minute apart.
While obtaining patient histories, which patient does the nurse identify as having the
highest risk for CAD?
A white woman, age 68, with a BP of 172/100 mm Hg and who is physically inactive
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A white man, age 54, who is a smoker and has a stressful lifestyle
An Asian woman, age 45, with a cholesterol level of 240 mg/dL and a BP of 130/74 mm Hg
An obese African American man, age 65, with a cholesterol level of 195 mg/dL and a BP of
128/76 mm Hg
Priority Decision: While teaching women about the risks and incidence of CAD, what does
the nurse emphasize?
CAD is the leading cause of death in women, with a higher mortality rate after MI
than in men.
Smoking is not as significant a risk factor for CAD in women as it is in men.
Women seek treatment sooner than men when they have symptoms of CAD.
Estrogen replacement therapy in postmenopausal women decreases the risk for
CAD.
A 52-year-old man is admitted to the emergency department with severe chest pain. On what
basis would the nurse suspect an MI?
He reports he has had no relief of the pain with rest or position change.
He has pale, cool, clammy skin.
He reports nausea and vomited once at home.
He says he is anxious and has a feeling of impending doom.
A 20-year-old patient has acute infective endocarditis. While obtaining a nursing history,
what should the nurse ask the patient about (select all that apply)?
Renal dialysis
IV drug abuse
Recent dental work
Cardiac catheterization and Recent urinary tract infection
A patient has an admitting diagnosis of acute left-sided infective endocarditis. What is the best
test to confirm this diagnosis?
Blood cultures
Complete blood count
Cardiac catheterization
Transesophageal echocardiogram
The patient with acute pericarditis is having a pericardiocentesis. Postoperatively
what complication should the nurse monitor the patient for?
a. Pneumonia
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Pneumothorax
Myocardial infarction (MI)
Cerebrovascular accident (CVA)
When obtaining a nursing history for a patient with myocarditis, what should the nurse
specifically question the patient about?
Prior use of digoxin for treatment of cardiac problems
Recent symptoms of a viral illness, such as fever and malaise
A history of coronary artery disease (CAD) with or without an MI
A recent streptococcal infection requiring treatment with penicillin
What accurately describes mitral valve prolapse?
Rapid onset prevents left chamber dilation
Ballooning of valve into left atrium during ventricular systole
May be caused by pulmonary hypertension
Rapid development of pulmonary edema and cardiogenic shock
What is an effect of valvular regurgitation?
It causes a pressure gradient difference across an open valve.
There is a backward flow of blood and volume overload in the preceding
chamber.
A pericardial friction rub is heard on the right sternal border of the chest.
It leads to decreased flow of blood and hypertrophy of the preceding chamber.
When instructing a patient with endocarditis how to prevent recurrence of the infection,
what should the nurse teach the patient?
Start on antibiotic therapy when exposed to persons with infections.
d. Obtain prophylactic antibiotic therapy before certain invasive medical or dental
procedures (e.g., dental cleaning).
Take one aspirin a day to prevent vegetative lesions from forming around the valves.
Always maintain continuous antibiotic therapy to prevent the development of any systemic
infection.
Place the most common pathophysiologic stages of pneumonia in order. Number the first
stage with 1 and the last stage with 4.
Macrophages lyse the debris and normal lung tissue and function is restored.
Mucus production increases and can obstruct airflow and further decrease gas exchange.
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c. Increased capillary permeability contributes to alveolar filling with organisms
and neutrophils interrupt normal oxygen transportation
d. Inflammatory response in the lungs with neutrophils is activated to engulf and kill
the offending organism..
A patient with pneumonia has a nursing diagnosis of ineffective airway clearance related to pain,
fatigue, and thick secretions. What is an expected outcome for this patient?
SpO2 is 90%
Lungs clear to auscultation
Patient tolerates walking in hallway
Patient takes three or four shallow breaths before coughing to minimize pain
How do microorganisms reach the lungs and cause pneumonia (select all that
apply)?
Lymphatic spread
Aspiration
Inhalation of microbes in the air
Hematogenous spread from infections elsewhere in the body
When obtaining a health history from a patient suspected of having early TB, what
manifestations should the nurse ask the patient about?
Chest pain, hemoptysis, and weight loss
Fatigue, low-grade fever, and night sweats
Cough with purulent mucus and fever with chills
Pleuritic pain, nonproductive cough, and temperature elevation at night
While assisting a patient with asthma to identify specific triggers of asthma, what should the
nurse explain?
Food and drug allergies do not manifest in respiratory symptoms.
Viral upper respiratory infections are a common precipitating factor in acute
asthma attacks.
Exercise-induced asthma is seen only in individuals with sensitivity to cold air.
Asthma attacks are psychogenic in origin and can be controlled with relaxation
techniques.
Priority Decision: A patient is admitted to the emergency department with an acute asthma
attack. Which patient assessment is of greatest concern to the nurse?
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The presence of a pulsus paradoxus
Use of accessory muscles of respiration and a feeling of suffocation
A respiratory rate of 34 and increased pulse and blood pressure
Markedly diminished breath sounds with no wheezing
The nurse recognizes that additional teaching is needed when the patient with asthma
says
“I should exercise every day if my symptoms are controlled.”
“I should inform my spouse about my medications and how to get help if I have a
severe asthma attack.”
“A diary to record my medication use, symptoms, peak expiratory flow rates, and
activity levels will help in adjusting my therapy.”
“I may use over-the-counter bronchodilator drugs occasionally if I develop
chest tightness.”
The husband of a patient with severe COPD tells the nurse that he and his wife have not had
any sexual activity since she was diagnosed with COPD because she becomes too short of
breath. What is the nurse’s best response?
“You need to discuss your feelings and needs with your wife so she knows what you
expect of her.”
“There are other ways to maintain intimacy besides sexual intercourse that will not
make her short of breath.”
“You should explore other ways to meet your sexual needs since your wife is no
longer capable of sexual activity.”
“Would you like for me to talk to you and your wife about some modifications
that can be made to maintain sexual activity?”
To help the patient with COPD maintain a clear airway, the nurse should perform which
intervention:
limit fluid to 2 liters per day
encourage absolute bed rest
give pain killer regularly and in large amounts to prevent anxiety
teach controlled coughing
What is the highest priority nursing diagnosis for patient with COPD?
activity intolerance related to fatigue
anxiety related to actual threat to health status
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semi-setting related to breathiness
impaired gas exchange related to airflow obstruction
The normal sodium level in the body is:
3 to 5 milliequivalents.
135 to 145 microequivalents.
3 to 5 microequivalents.
135 to 145 milliequivalents.
Which position will you place your patient in when they are demonstrating the signs and
symptoms of hypovolemic shock?
The supine position
The left lateral position
The right lateral position
The Trendelenberg position
A patient who has been vomiting for several days from an unknown cause is admitted to the
hospital. What should the nurse anticipate will be included in collaborative care?
Oral administration of broth and tea
Administration of parenteral antiemetics
Insertion of a nasogastric (NG) tube for suction
IV replacement of fluid and electrolytes
Which laboratory findings should the nurse expect in the patient with persistent vomiting?
a.
b.
c.
d.
Priority Decision: A patient is admitted to the emergency department with acute abdominal
pain. What nursing intervention should the nurse implement first?
Measurement of vital signs
Administration of prescribed analgesics
Assessment of the onset, location, intensity, duration, and character of the pain
Physical assessment of the abdomen for distention, bowel sounds, and pigmentation
changes
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The patient has persistent and continuous pain at McBurney’s point. The nursing assessment
reveals rebound tenderness and muscle guarding with the patient preferring to lie still
with the right leg flexed. What should the nursing interventions for this patient include?
NPO status in preparation for possible appendectomy
Laxatives to move the constipated bowel
Parenteral fluids and antibiotic therapy for 6 hours before surgery
NG tube inserted to decompress the stomach and prevent aspiration
TB medical treatment for adult new case in Rwanda is
2 (RHZE)7 / 4 (RH)7
4 (RHZE)7 / 2 (RH)7
2 (RHZE) / 4 (RH)
2 (RHZ)7 / 4 (REH)7
What does the nursing responsibility in the management of the patient with
hypertensive urgency often include?
Instructing the patient to follow up with a health care professional within 24 hours
after outpatient treatment
Monitoring hourly urine output for drug effectiveness
Treating IV drug dosages based on BP measurements every 2 to 3 minutes
Providing continuous electrocardiographic (ECG) monitoring to detect side effects of the
drugs
Transfusions in emergent situations do not allow time for a complete crossmatch. Under
these circumstances, the fastest choice blood to use is:
type O, Rh-negative
type O, Rh-positive
type AB, Rh-negative
type A , Rh-negative
Derek has recently converted his outdoor garage to a gym. He has been exercising frequently in his
new gym due to the convenience, even in the extreme heat. He has started taking salt tablets.
You think his current symptoms may be due to hypernatremia. You
recognize these as:
a. cardiac arrhythmias, palpitations, and sinus arrest.
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weakness, dizziness, abdominal distention, nausea, vomiting, and diarrhea.
weight gain, irritability, muscle twitching, and decreased myocardial contractility.
muscle cramps, malaise, constipation, rhabdomyolysis, and pupillary constriction.
You are monitoring intravenous fluids for Tom who is currently being treated for metabolic
acidosis. You monitor his signs and symptoms typical of metabolic acidosis which include:
elevated blood pressure, bradycardia, elevated respiratory rate, and muscle twitching.
hypertension, tachycardia, slowed respiratory rate, and muscle spasms.
hypotension, altered heart rate, elevated respiratory rate, and muscle weakness.
hypotension, hypoxia, irritability, and paresthesia.
You are caring for a client who has diabetes complicated by kidney disease. You will need to
make a detailed assessment when administering medications because this client may
experience problems with:
Absorption
Biotransformation
Distribution
Excretion
The nurse is giving a medication that has a high first-pass effect. The physician has changed
the route from IV to PO. The nurse expects the oral dose to be:
Higher because of the first-pass effect.
Lower because of the first-pass effect.
The same as the IV dose.
Unchanged.
Answer:A
A patient is complaining of severe pain and has orders for morphine sulfate. The nurse
knows that the route that would give the slowest pain relief would be which route?
IV
IM
SC
PO
Answer:D
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Much of the biotransformation that occurs when the drug is taken occurs as a part of
The protein binding effect of the drug
The functioning of the renal system
The first pass effect through the liver
The distribution of the drug
Receptor sites
Are a normal part of enzyme substrate
Are protein areas on cell membranes that react with specific chemicals to cause an
effect within the cell
Can usually be stimulated by many different chemicals
Are responsible for all drug effects in the body
A postoperative client is receiving morphine sulphate via a PCA. The nurse assesses that the
client’s respirations are depressed. The effects of the morphine sulphate can be classified
as:
Allergic
Idiosyncratic
Therapeutic
Toxic
Nurses are legally required to document medications that are administered to clients.
The nurse is mandated to document:
Medication before administering it
Medication after administering it
Rationale for administering the medication
Prescriber’s rationale for prescribing the medication
Answer:B
If a nurse experiences a problem reading a physician’s medication order, the most
appropriate action will be to:
a. Call the physician to verify the order.
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Call the pharmacist to verify the order.
Consult with other nursing staff to verify the order.
Withhold the medication until the physician makes rounds.
Answer:A
Clinical pharmacology is the study of
The biological effects of the chemicals
Drugs used to treat, prevent or diagnose disease
Plant components that can be used as medicines
Binders and other vehicles for delivering medication
Answer:B
The generic name is
The name assigned to the drug by the pharmaceutical company developing it
The chemical name of the drug based on its chemical structure
The original name assigned to the drug at the beginning of the evaluation process
Often used in advertising campaigns
The FDA pregnancy categories
Indicate the drug’s potential or actual teratogenic effect, offering guidelines for use of
particular drug in pregnancy
Are used for research purposes only
List the drugs that are more likely to have addicting properties
Are tightly regulated by the DEA(Drug Enforcement Agency)
Answer:A
Receptor sites
Are normal part of enzyme substrates
Are protein areas on cell membranes that react with specific chemicals to cause an
effect within the cell
Can usually be stimulated by many different chemicals
Are responsible for all drug effects in the body
Answer:B
Selective toxicity is
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The ability of the drug to seek out a specific bacterial species or microorganism
The ability of a drug to cause only specific adverse effects
The ability of a drug to cause fetal damage
The ability of a drug to attack only those systems in foreign or abnormal cells
Answer:D
The absorption of a drug taken orally can be affected by
The blood flow to the muscle beds
The acidity of gastric juices, often influenced by the presence of food
The weight and age of the patient
The temperature of peripheral environment
Much of the biotransformation that occurs when a drug is taken occurs as a part of
The protein binding effect of the drug
The functioning of the renal system
The first -pass effect through the liver
The distribution of the drug to the reactive tissues
The half- life of a drug
Is determined by a balance of all of the factors working on that drug- absorption,
distribution, biotransformation and excretion
Is a constant factor for all drugs taken by a patient
Is influenced by the fat distribution of the patient
Can be calculated with the use a body surface nomogram
Answer:A
An analgesic is a drug that
Reduces fever
Reduces swelling
Reduces redness
Reduces pain
Answer:D
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Antipyretic is a drug that can
Block pain
Block swelling
Block fever
Block inflammation
Answer:C
Salicylates are very popular anti-inflammatory agents for all of the following reasons
except
They have antipyretic properties
They have analgesic properties
They are available without prescription
They must be given parenterally
Answer:D
The NSAIDs affect the COX-1 and COX-2 enzymes. By blocking COX-2 enzymes, the NSAIDs
block the inflammation and the signs and symptoms of inflammation at the site of injury
or trauma. By blocking COX-1 enzymes these drugs block
Fever regulation
Prostaglandins that protect stomach lining
Swelling in the periphery
Liver function
Your patient has been receiving ibuprofen for many years to relieve the pain of
osteoarthritis. The assessment of the patient should include
An electrocardiogram
CBC with differential
Respiratory auscultation
Renal evaluation
Opioid receptors are found throughout the body
Only in people who have become addicted to opiates
Increasing numbers with chronic pain conditions
And incorporate pain perception and blocking
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And cause endorphin release
Answer:C
Most narcotics are controlled substances because
They are very expensive
They can cause respiratory depression
They can be addicted
They can be used only in a hospital setting
Answer:C
Proper administration of an ordered narcotic
Can lead to addiction
Should be done promptly to prevent increased pain and the need for larger doses
Would include the holding the drug as long as possible until the patient really needs it
Should rely on the patient’s request for medication
Answer:B
The generic name of a drug is:
the name assigned to the drug by the pharmaceutical company developing it.
the chemical name of the drug based on its chemical structure.
the original name assigned to the drug at the beginning of the evaluation process.
the name that is often used in advertising campaigns.
Answer:
The fraction of a dose reaching the systemic circulation as unchanged drug (i.e., intact) is
defined as:
Theoretical dose
C (max)
Bioavailability
Ideal dose
Answer:C
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A pregnant adolescent patient asks the nurse whether she should continue to take her
prescription for tetracycline to clear up her acne. Which response by the nurse is correct?
“Tetracycline can be harmful to the baby’s teeth and should be avoided.”
“Tetracycline is safe to take during pregnancy.”
“Tetracycline may cause allergic reactions in pregnant women.”
“Tetracycline will prevent asymptomatic urinary tract infections.”
Answer:A
Clinical pharmacology is the study of
the biological effects of chemicals.
drugs used to treat, prevent, or diagnose disease.
plant components that can be used as medicines.
binders and other vehicles for delivering medication.
Answer:B
A nurse is preparing to administer a drug to a client for the first time. What questions
should the nurse consider before actually administering the drug?
Is this the right patient and right nurse?
Is this the right drug and clinical nurse?
Is this the right route for this patient?
Is this the 5 rights: drug, dose, client, route and time?
Answer:D
A bacteriostatic substance is one that
directly kills any bacteria it comes in contact with.
directly kills any bacteria that are sensitive to the substance.
prevents the growth of any bacteria.
prevents the growth of specific bacteria that are sensitive to the substance.
Answer:C
A drug could be classified as an analgesic if it
a. reduces fever.
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reduces swelling.
reduces redness.
reduces pain.
Answer:D
An antipyretic is a drug that can
block pain.
block swelling.
block fever.
block inflammation.
Answer:C
Treatment for overdose of Acetaminophen is:
Acetylcysteine
Cefotaxime
Paracetamol
Ibuprofen
Answer:A
Which statement is false?
Adverse drug reaction and adverse drug events are same
Side effects occur in the therapeutic dose
Side effects at one time may be used for the therapy at other situations
Overdose of the drugs produce toxic effects
Answer:C
Teratogenicity is
Effect of drug on the foetus when drug is given to pregnant mother
According to potential to cause teratogenicity, drugs are divided in to five categories
Category A drugs are the safest for pregnant mother
All of the above
Most drugs and drug molecules are excreted by the:
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liver
kidneys
gall bladder
lungs
Answer:B
The ability of the kidneys to excrete drugs is called:
renal excretion
renal fi ltration
renal secretion
renal clearance
Answer:D
The time taken for the concentration of a drug to fall to half its original level is
called:
half- life
steady state
elimination
clearance
Answer:A
Pharmacokinetics is:
The study of biological and therapeutic effects of drugs
The study of absorption, distribution, metabolism and excretion of drugs
The study of mechanisms of drug action
The study of methods of new drug development
Answer:B
What does “pharmacokinetics” include?
Complications of drug therapy
Drug biotransformation in the organism
Influence of drugs on metabolism processes
Influence of drugs on genes
What does “pharmacokinetics” include?
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Absorption of drugs in the body
Pharmacological effects of drugs
Chemical structure of a medicinal agent
Unwanted effects of drugs
Answer:A
What does “pharmacokinetics” include?
Pharmacological effects of drugs
Distribution of drugs in the organism
Chemical structure of a medicinal agent
Unwanted effects of drugs
What does “pharmacokinetics” include?
Localization of drug action
Mechanisms of drug action
Metabolism of drugs
Interaction of substances
Answer:C
What does “pharmacokinetics” include?
Localization of drug action
Mechanisms of drug action
Interaction of substances
Excretion (Elimination) of substances
Answer:D
Which route of drug administration is most likely to lead to the first-pass effect?
Sublingual
Oral
Intravenous
Intramuscular
Answer:B
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Intravenous injections are more suitable for Table solutions:
True
False
PO are more suitable for Table drugs:
a. True
b. False
Parenteral drugs are more suitable for Table solutions:
True
False
Intravenous injections are more suitable for Table solutions:
True
False
IM injection are more suitable for Table drugs
True
False
Intravenous injections are more suitable for Table drugs:
True
False
Brand name also is called a trade name.
True
False
Trade name or Registered name:. Several trade names can exist for a same
drug.
True
False
OTC drugs are available without prescription for the self-treatment of various
complaints.
True
False
Pharmacodynamics—the study of the way the body deals with drugs—includes
absorption, distribution, biotransformation, and excretion of drugs.
True
False
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Side effects of drugs is the synonyms of negative effects or undesirable reaction
True
False
Antibiotics work by disrupting protein or enzyme systems within a bacterium, causing cell
death (bactericidal) or preventing multiplication (bacteriostatic).
True
False
To be approved for marketing, a drug must pass through animal testing,before being test to
human living.
True
False
The nurse is in a unique position regarding drug therapy because nursing responsibilities
include the following: Administering drugs and Assessing drug effects
True
False
Drugs can come from plants, foods, animals, salts of inorganic compounds, or synthetic
sources.
True
False
Essential drugs’ are:
Life saving drugs
Drugs that meet the priority health care needs of the population
Drugs that must be present in the emergency bag of a doctor
Drugs that are listed in the pharmacopoia of a country
ANSWER:
An 'orphan drug' is:
A very cheap drug
A drug which has no therapeutic use
A drug needed for treatment or prevention of a are disesase
Drug which acts on Orphanin receptors
ANSWER:C
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Transdermal drug delivery systems offer the following advantages except:
They produce high peak plasma concentration of the drug
They produce smooth and nonfluctuating plasma concentration of the drug
They minimise interindividual variations in the achieved plasma drug concentration
They avoid hepatic first-pass metabolism of the drug
ANSWER:A
In addition to slow intravenous infusion, which of the following routes of
administration allows for titration of the dose of a drug with the response:
Sublingual
Transdermal
Inhalational
Nasal insufflation
ANSWER:C
Compare to subcutaneous injection, the intramuscular injection of drug:
is more painful
produces faster response
is unsuitable for depot preparations
Carries greater risk of anaphylactic reaction
ANSWER:B
Select the route of administration which carries the highest risk of adversely affecting vital
functions:
Intra arterial injection
Intrathecal injection
Intravenous injection
Intramuscular injection
ANSWER:C
Alkalinization of urine hastens the excretion of:
Weakly basic drugs
Weakly acidic drugs
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C. Strong electrolytes
D. Nonpolar drugs
ANSWER:B
68.Majority of drugs cross biological membranes primarily by:
Passive diffusion
Facilitated diffusion
Active transport
Pinocytosis
ANSWER:A
69.Diffusion of drugs across cell membrane:
Is dependent upon metabolic activity of the cell
Is competitively inhibited by chemically related drugs
Is affected by extent of ionization of drug molecules
Exhibits saturation kinetics
ANSWER:C
WHICH OF THE following drugs is most likely to be absorbed from the stomach:
Morphine sulfate
Diclofenac sodium
Hyoscine hydrobromide
Quinine dihydrochloride
ANSWER:B
71.The most important factor which governs diffusion of drugs across capillaries other than those
in the brain is:
Blood flow through the capillary
Lipid solubility of the drug
pKa value of the drug
pH of the medium
ANSWER:A
Active transport of a substance across biological membranes has the following
characteristics except:
It is specific
It is pH dependent
It is saturable
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D. It requires metabolic energy
ANSWER:B
Bioavailabilityof drug refers to:
Percentage of administered dose that reaches systemic circulation in the unchanged form
Ratio of oral to parenteral dose
Ratio of orally administered drug to that excreted in the faeces
Ratio of drug excreted unchanged in urine to that excreted as metabolites
ANSWER:A
Bioavailability differences among oral formulations of a drug are most likely to occur if the drug:
Is freely water soluble
Is completely absorbed
Is incompletely absorbed
Undergoes little first-pass metabolism
ANSWER:C
The most important factor governing absorption of a drug from intact skin is:
Molecular weight of the drug
Site of application
Lipid solubility of the drug
Nature of the base used in the formulation
ANSWER:C
If the total amount of a drug present in the body at a given moment is 2.0 g and its plasma
concentration is 25 μg/ml, its volume of distribution is:
100 L
80 L
60 L
50 L
ANSWER:B
The following attribute of a drug tends to reduce its volume of distribution: A. High
lipid solubility
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B. Low ionisation at physiological pH values
C. High plasma protein binding
D. High tissue binding
ANSWER:C
Marked redistribution is a feature of:
Highly lipid soluble drugs
Poorly lipid soluble drugs
Depot preparations
Highly plasma protein bound drugs
ANSWER:A
907. .A nonvolatile, highly lipid soluble drug is metabolized at a rate of 15% per hour. On
intravenous injection it produces general anaesthesia for 10 min. Which process is
responsible for termination of its action:
A. Metabolism in liver
B. Plasma protein binding
C. Excretion by kidney
Redistribution
ANSWER:D
79.The blood-brain barrier, which restricts entry of many drugs into brain, is
constituted by:
P-glycoprotein efflux carriers in brain capillary cells
Tight junctions between endothelial cells of brain capillaries
Enzymes present in brain capillary walls
All of the above
ANSWER:D
Which of the following is not true of the blood-brain barrier:
It is constituted by tight junctions between the endothelial cells of brain capillaries and the glial
tissue
It allows passage of lipid soluble drugs into the brain
It limits entry of highly ionized drugs into the brain
It regulates passage of substances from brain into blood
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ANSWER:D
WEAKLY acidic drugs:
Are bound primarily to α1 acid glycoprotein in plasma
Are excreted faster in alkaline urine
Are highly ionized in the gastric juice
Do not cross blood-brain barrier
ANSWER:B
High plasma protein binding:
Increases volume of distribution of the drug
Facilitates glomerular filtration of the drug
Minimises drug interactions
Generally makes the drug long acting
ANSWER:D
The plasma protein bound fraction of a drug:
Contributes to the response at the given moment
Remains constant irrespective of the total drug concentration
Remains constant irrespective of the disease state
Is not available for metabolism unless actively extracted by the liver
ANSWER:D
Biotransformation of drugs is primarily directed to:
A. Activate the drug
B. Inactivate the drug
C. Convert lipid soluble drugs into nonlipid soluble metabolites
D. Convert nonlipid soluble drugs into lipid soluble
metabolites
ANSWER:C
A prodrug IS:
A.The prototype member of a class of drugs
B. The oldest member of a class of drugs
C. An inactive drug that is transformed in the body to an active metabolite
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D. A drug that is stored in body tissues and is then gradually released in the circulation
ANSWER:C
Which of the following cytochrome P450 isoenzymes Is involved in the metabolism of largest
number of drugs in human beings and has been implicated in some dangerous drug
interactions:
CYP 3A4
CYP 2C9
CYP 2E1
CYP 1A2
ANSWER:A
Drugs which undergo high degree of first-pass metabolism in liver:
Have low oral bioavailability
Are excreted primarily in bile
Are contraindicated in liver disease
Exhibit zero order kinetics of elimination
ANSWER:A
Glomerular filtration of a drug is affected by its:
Lipid solubility
Plasma protein binding
Degree of ionization
Rate of tubular secretion
ANSWER:B
If a drug is excreted in urine at the rate of 10 mg/hr at a steady-state plasma
concentration of 5 mg/L, then its renal clearance is:
0.5 L/hr
2.0 L/hr
5.0 L/hr
20 L/hr
ANSWER:B
Which of the following is not a primary/fundamental, but a derived pharmacokinetic
parameter:
Bioavailability
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B. Volume of distribution
Clearance
Plasma half life
ANSWER:D
If a drug has a constant bioavailability and first order elimination, its maintenance dose rate
will be directly proportional to its:
Volume of distribution
Plasma protein binding
Lipid solubility
Total body clearance
ANSWER:D
The loading dose of a drug is governed by its:
Renal clearance
Plasma half life
Volume of distribution
Elimination rate constant (
ANSWER:C
What is true in relation to drug receptors:
All drugs act through specific receptors
All drug receptors are located on the surface of the target cells
Agonists induce a conformational change in the receptor
Partial agonists have low affinity for the receptor
ANSWER:C
Drugs acting through receptors exhibit the following features except:
Structural specificity
High potency
Competitive antagonism
Dependence of action on lipophilicity
ANSWER:D
Receptors agonists possess:
Affinity but no intrinsic activity
Intrinsic activity but no affinity
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C. Affinity and intrinsic activity with a + sign
D. Affinity and intrinsic activity with a – sign
ANSWER:C
Agonists affect the receptor molecule in the following manner:
Alter its amino acid sequence
Denature the receptor protein
Alter its folding or alignment of subunits
Induce covalent bond formation
ANSWER:C
The following statement is not true of ‘potency’ of a drug:
Refers to the dose of the drug needed to produce a certain degree of response
Can be related to that of its congeners by the relative position of its dose-response curve on the
dose axis
It is often not a major consideration in the choice of a drug
It reflects the capacity of the drug to produce a drastic response
ANSWER:D
Drug efficacy’ refers to:
The range of diseases in which the drug is beneficial
The maximal intensity of response that can be produced by the drug
The dose of the drug needed to produce half maximal effect
The dose of the drug needed to produce therapeutic effect
ANSWER:B
Which of the following is always true:
A more potent drug is more efficacious
A more potent drug is safer
A more potent drug is clinically superior
A more potent drug can produce the same response at lower doses
ANSWER:D
Higher efficacy of a drug necessarily confers:
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A. Greater safety
B. Therapeutic superiority
C. Capacity to produce more intense response
D. Cost saving
ANSWER:C
The therapeutic index of a drug is a measure of its:
Safety
Potency
Efficacy
Dose variability
ANSWER:A
If the effect of combination of two drugs is equal to the sum of their individual effects, the two
drugs are exhibiting:
Potentiation
Synergism
Cross tolerance
Antagonism
ANSWER:B
THE antagonism between adrenaline and histamine is called ‘physiological
antagonism’ because:
Both are physiologically present in the body
They act on physiological receptors
Both affect many physiological processes
They have opposite physiological effects
ANSWER:D
The antidotal action of sodium nitrite in cyanide poisoning is based on:
Physical antagonism
Chemical antagonism
Physiological antagonism
Noncompetitive antagonism
ANSWER:B
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A drug ‘R’ producing no response by itself causes the log dose-response curve of another drug
‘S’ to shift to the right in a parallel manner without decreasing the maximal response:
Drug ‘R’ is a:
Partial agonist
Inverse agonist
Competitive antagonist
Noncompetitive antagonist
ANSWER:C
A drug which does not produce any action by itself but decreases the slope of the log dose-
response curve and suppresses the maximal response to another drug is a:
Physiological antagonist
Competitive antagonist
Noncompetitive antagonist
Partial agonist
ANSWER:C
The following is not a feature of competitive antagonists:
Chemical resemblance with the agonist
Parallel rightward shift of the agonist log doseresponse curve
Suppression of maximal agonist response
Apparent reduction in agonist affinity for the receptor
ANSWER:C
The pharmacokinetics of drugs in the neonate differs from that in adults, because
their:
Intestinal transit is fast
Drug metabolizing enzymes are overactive
Tubular transport mechanisms are not well developed
Glomerular filtration rate is high
ANSWER:C
WHICH OF The following is true of ‘placebos’:
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A. Placebo is a dummy medication
B. Placebo is the inert material added to the drug
for making tablets
C. Placebos do not produce any effect
D. All patients respond to placebos
ANSWER:A
In patients of hepatic cirrhosis:
The extent of change in pharmacokinetics of drugs can be predicted from the values of liver
function tests
High doses of furosemide can be safely used
Metformin is the preferred oral hypoglycaemic
Disposition of atenolol is not significantly affected
ANSWER:D
Tolerance is generally not acquired to:
Antisecretory action of atropine
Sedative action of chlorpromazine
Emetic action of levodopa
Vasodilator action of nitrates
ANSWER:A
Significant tolerance does not develop to the following action of morphine:
Analgesia
Euphoria
Sedation
Miosis
ANSWER:D
An undesirable effect of a drug that occurs at therapeutic doses and can be predicted from its
pharmacological actions is called:
Side effect
Toxic effect
Allergic reaction
Idiosyncrasy
ANSWER:A
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Which of the following is a type B (unpredictable) adverse drug reaction:
Side effect
Toxic effect
Idiosyncrasy
Physical dependence
ANSWER:C
The side effect of a drug which has been used as a therapeutic effect in another condition
is:
Constipation caused by codeine
Cough caused by captopril
Uterine stimulation caused by quinine
Diarrhoea caused by ampicillin
ANSWER:A
A ‘toxic effect’ differs from a ‘side effect’ in that:
It is not a pharmacological effect of the drug
It is a more intense pharmacological effect that occurs at high dose or after prolonged medication
It must involve drug induced cellular injury
It involves host defence mechanisms
ANSWER:B
THE FOLLOWING statement is true in relation to ‘drug toxicity’ and ‘poisoning’:
The two terms are synonymous
When a toxic effect requires specific treatment, it is called poisoning
A toxic effect which endangers life by markedly affecting vital functions is called poisoning
Toxicity is caused by drugs while poisoning is caused by other harmful chemicals
ANSWER:C
The essential feature in drug addiction is:
A. Physical dependence
B. Psychological dependence
C. Both physical and psychological dependence
D. Psychiatric abnormality
ANSWER:B
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Adaptive neurophysiological changes produced by repeated administration of a drug, which
result in the appearance of characteristic withdrawal syndrome on discontinuation of the
drug is called:
Drug addiction
Drug abuse
Psychological dependence
Physical dependence
ANSWER:D
Which of the following constitutes ‘drug abuse’:
Physician prescribed use of penicillin G for the cure of viral fever
Self administration of aspirin to relieve headache
Repeated self administration of morphine to derive euphoria
All of the above
ANSWER:C
Addiction AND habituation’:
Are fundamentally different phenomena
Are produced by different set of drugs/substances
Differ from one another by the presence or absence of physical dependence
Differ from each other in the degree of attendant psychological dependence
ANSWER:D
Choose the antimicrobial which acts by interfering with DNA function in the bacteria:
Chloramphenicol
Ciprofloxacin
Streptomycin
Vancomycin
ANSWER:B
Which antibiotic is primarily bacteriostatic but becomes bactericidal at higher
concentrations:
Erythromycin
Tetracycline
Chloramphenicol
Ampicillin
ANSWER:A
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Select the antibiotic that has a high therapeutic index:
Streptomycin
Doxycycline
Cephalexin
Vancomycin
ANSWER:C
Widespread and prolonged use of an antibiotic leads to emergence of drug resistant strains
because antibiotics:
Induce mutation in the bacteria
Promote conjugation among bacteria
Allow resistant strains to propagate preferentially
All of the above
ANSWER:C
The most important mechanism of concurrent acquisition of multidrug resistance among
bacteria is:
Mutation
Conjugation
Transduction
Transformation
ANSWER:B
SUPERINFECTION ARE more common with:
Use of narrow spectrum antibiotics
Short courses of antibiotics
Use of antibiotics that are completely absorbed from the small intestines
Use of antibiotic combinations covering both gram positive and gram negative bacteria
ANSWER:D
Antimicrobial drug combinations are aimed at achieving the following except:
Faster and more complete elimination of the infecting organism
Treat infection when nature and sensitivity of the infecting organism is not definite
Prevent emergence of resistant strains
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D. Prevent superinfection
ANSWER:D
WHICH TYPE OF antimicrobial drug combination is most likely to exhibit antagonism:
Bactericidal + Bactericidal
Bactericidal + Bacteriostatic for a highly sensitive organism
Bactericidal + Bacteriostatic for a marginallysensitive organism
Bacteriostatic + Bacteriostatic
ANSWER:B
SURGICAL started just before operation should be continued for:
One day
Three days
Five days
Seven days
ANSWER:A
THE CHARACTERISTICS feature(s) of penicillin G is/are:
It is unstable in aqueous solution
Its antibacterial action is unaffected by pus and tissue fluids
It is equally active against resting and multiplying bacteria
Both ‘A’ and ‘B’ are correct
ANSWER:D
Which of the following is NOT part of the etymology of the word pharmacology?
Medicine
Drug
Herb
Poison
Study
ANSWER:C
Which of the following describes an agonist?
Any substance that brings about a change in biologic function through its chemical action
A specific regulatory molecule in the biologic system where a drug interacts
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A drug that binds to a receptor and stimulates cellular activity
A drug that binds to a receptor and inhibits or opposes cellular activity
A drug directed at parasites infecting the patient
ANSWER:C
Pharmacokinetics is the effect of the ____ and pharmacodynamics is the effect of the
____.
Drug on a drug; Body on the drug
Body on the drug; Drug on a drug
Drug on the body; Body on the drug
Body on the drug; Drug on the body
Drug on a drug; Drug on a drug
ANSWER:D
Which of the following is NOT an action of the body on a drug?
Absorption
Distribution
Metabolism
Excretion
Side effects
ANSWER:E
If a drug is 80% bound to blood elements or plasma proteins, what part is
considered the free form?
20%
40%
50%
80%
100%
ANSWER:A
Which of the following describes minimal effective concentration (MEC)?
The minimal drug plasma concentration that can be detected
The minimal drug plasma concentration to enter tissues
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The minimal drug plasma concentration to interact with receptors
The minimal drug plasma concentration to produce effect
e) The minimal drug plasma concentration to reach therapeutic levels
ANSWER:D
If a patient misses three doses of their daily drug, which of the following (in general) is the best
solution?
Take a 4x dose at the next dose time
Wait 3 more days (week total) then return to normal regimen
Do nothing and continue normal regimen
Setup an appointment to have the patient evaluated
Prescribe a higher dosage pill so missed doses will have less effect
ANSWER:C
Which of the following is the amount of a drug absorbed per the amount
administered?
Bioavailability
Bioequivalence
Drug absorption
Bioinequivalence
Dosage
ANSWER:A
Which of the following is NOT needed for drug bioequivalence?
Same active ingredients
Same strength or concentration
Same dosage form
Same route of administration
Same side effects
ANSWER:E
For intravenous (IV) dosages, what is the bioavailability assumed to be?
0%
25%
50%
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75%
100%
ANSWER:E
Which of the following is NOT a pharmacokinetic process?
Alteration of the drug by liver enzymes
Drug metabolites are removed in the urine
Movement of drug from the gut into general circulation
The drug causes dilation of coronary vessels
The drug is readily deposited in fat tissue
ANSWER:D
Which of the following can produce a therapeutic response? A drug that is:
Bound to plasma albumin
Concentrated in the bile
Concentrated in the urine
Not absorbed from the GI tract
Unbound to plasma proteins
ANSWER:E
Most drugs are either ____ acids or ____ bases.
Strong; Strong
Strong; Weak
Weak; Weak
Weak; Strong
ANSWER:C
Bioavailability (F) is the fraction or percentage of administered drug that reaches the
systemic circulation via a given route as compared to what route?
Oral
IV (intravenous)
IO (intraosseous)
CSF (cerebrospinal fluid)
Whatever route attains the target drug concentration in plasma (CT)
ANSWER:B
What organ is responsible for metabolism in the “first pass effect”?
Brain
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Heart
Kidney
Liver
Spleen
ANSWER: D
A patient is in the hospital and is stable on digoxin 0.175 mg IV qd (daily). How much
digoxin in mg. would you need to give your patient orally, given that the
bioavailability for oral digoxin tablets is 0.7?
(0.175 * 0.7) / (1.0) = 0.1225 mg
(0.175 * 1) / (0.7) = 0.25 mg
(0.175 + 0.7) / (1.0) = 0.875 mg
(0.175 + 1) / (0.7) = 1.67 mg
No change is necessary
ANSWER:B
Given a graph of plasma drug concentration versus time, what part of the graph would be
used to calculate bioavailability for a PO (oral) drug administration?
Maximum concentration
Steady concentration
Derivative of the curve (slope)
Integral of the curve (area underneath)
The curve is not used to calculate bioavailability
ANSWER:D
Which of the following routes of administration has a bioavailability of about 80-100%, is
usually very slow absorbing, and has prolonged duration of action?
IV (intravenous)
IM (intramuscular)
SQ (subcutaneous)
Rectal
Transdermal
ANSWER:E
Which of the following routers of administration is the most convenient, although may have
a bioavailability anywhere from 5-100%?
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PO (oral)
IV (intravenous)
IM (intramuscular)
SQ (subcutaneous)
Transdermal
ANSWER:A
Which of the following enteral administration routes has the largest first-pass
effect?
SL (sublingual)
Buccal
Rectal
Oral
ANSWER:D
Which of the following metabolically active tissues is the principle organ for drug
metabolism?
Skin
Kidneys
Lungs
Liver
GI Tract
ANSWER:D
One liter contains 1,000 mg of a drug. After one hour, 900 mg of the drug remains. What is
the clearance?
100 mL
100 mL/hr
1 mg/ml
100 mg
1 mg/sec
ANSWER:B
To maintain a drug concentration at steady state, the dosing rate should equal the
elimination rate. Which of the following is true? (CL = Drug Clearance)
Dosing rate = CL + target concentration
Dosing rate = CL - target concentration
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Dosing rate = CL * target concentration
Dosing rate = CL / target concentration
ANSWER:C
Which of the following is most useful in determining the rate of elimination of a drug, in
general?
Drug concentration in urine (renal elimination)
Drug concentration in stool (bilary elimination)
Drug concentration in blood
Drug concentration in brain
Drug oxidation rate
ANSWER:C
For first-order drug elimination, half-life t(1/2) is ____ at two places on the curve and a constant
____ is lost per unit time.
Equal; Amount
Equal; Percentage
Not equal; Amount
Not equal; Percentage
ANSWER:B
If a drug with a 2-hour half life is given with an initial dose of 8 mcg/ml, assuming first-order
kinetics, how much drug will be left at 6 hours?
8 mcg/ml
4 mcg/ml
2 mcg/ml
1 mcg/ml
0.5 mcg/ml
ANSWER:D
What are the units for steady-state concentration (Css), or infusion rate over clearance?
mg/min
ml/min
mg/ml
ml/mg
min/mg
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ANSWER:C
Which of the following statements concerning the anti-inflammatory effect of NSAIDs
are TRUE?
a)Anti-inflammatory effect of NSAIDs results from inhibition of cyclooxygenase b)Anti-
inflammatory effect of NSAIDs results from inhibition of phospholipase A2 andreducing
prostaglandin and leukotriene synthesis
c)Anti-inflammatory effect of NSAIDs results from induction of cyclooxygenase IIexpression which
results in reducing the amount of an enzyme available to produceprostoglandins d)All of the
above
ANSWER: A
Which of the following NSAIDs is a selective COX-2 inhibitor?
a)Piroxicam
b)Indomethacin
c)Celecoxib
d)Diclofenac
ANSWER:C
Which of the following NSAIDs is a nonselective COX inhibitor
a)Piroxicam
b)Rofecoxib
c)Celecoxib d)All
of the above
ANSWER:A
The following statements concerning aspirin are true, EXCEPT: a)In
contrast to most other NSAIDs, aspirin irreversibly inhibits COX
b)Aspirin interferes with the chemical mediators of the kallikrein
system c)Aspirin inhibits phospholipase A2
d)Aspirin inhibits tromboxane A2 formation
ANSWER:C
Indication for aspirin administration are the following, EXCEPT:
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a)Inflammatory conditions
b)Decreasing the incidence of transient ischemic attack, unstable angina, coronary
arterythrombosis with myocardial infarction, and thrombosis after coronary artery by passgrafting
c)Relieving severe visceral pain( myocardial infarction, cancer pain condition, renal orbiliary
colic ) d)Reducing elevated body temperature
ANSWER:C
Identify the term used for the study of drugs and their effect on the body : A.
Pharmacy
B. Pharmaceutical
Pharmacology [True]
Physiotherapy
The correct answer is C. Pharmacology is concerned with the study of drugs, covering
absorption, metabolism and excretion of drugs from the body along with the effect that the drug
has on the body.
Identify the route of administration for ear drops : A. Oral
administration
Parenteral administration
Topical administration [True]
Identify the term used to describe an injection that is given just under the skin of an animal :
Subcutaneous [True]
Intramuscular
Intravenous
Epidural
The correct answer is A. Subcutaneous injections are given just under the skin of the animal.
Identify the term used to describe an injection that is given into the vein of an animal :
A. Subcutaneous
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Intramuscular
Intravenous [True]
Epidural
The correct answer is C. Intravenous injections are given into the vein of an animal.
Identify the category of drug which acts to prevent blood from clotting : A.
Analgesic
B. Antibiotic
C. Anticoagulant [True]
D. Antidiuretic
Identify the category of drug which acts to relieve pain : A.
Analgesic [True]
B. Antibiotic
Anticoagulant
Antidiuretic
Identify the category of drug which acts to remove intestinal worms :
Antibiotic
Anthelmintic [True]
Diuretic
Emetic
The correct answer is B. Anthelmintics work to destroy intestinal worms.
1000. Which of the following statements about Aspirin is TRUE?
Aspirin has no ototoxic characteristics
Aspirin should generally be avoided for 1 to 2 weeks before and after surgery
Aspirin is least likely to cause gastric irritation.
enteric-coated Aspirin (Ecospirin) should be chewed or crushed before swallowing.
ANSWER:2
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1001. Drugs that increase effects of indomethacin are all, EXCEPT:
Antacids
Corticosteroids
Heparin
Salicylates
ANSWER:1
1002. Aspirin, NSAIDs and acetaminophen act by
Competitively blocking the neuronal terminal
Inhibiting impulses to brain.
Releasing endorphin
Inhibiting the synthesis of prostaglandins.
ANSWER:1
1003. The enzyme involved in the therapeutic action of NSAIDs is
Monoamine oxidase
Cytochrome
Lipocortin-1
Cyclo-oxygenase
ANSWER:4
1004. Salicylate intoxication (salicylism) is characterized by the following symptoms,
except
Fluid and electrolyte deficiencies
Tinnitus, decreased hearing, visual changes
Hypoventilation
Nausea, vomiting, fever
ANSWER:3
1005. Which of the following statements is WRONG about NSAIDs?
NSAIDs decrease effects of ACE inhibitors.
NSAIDs decrease the serum lithium levels
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NSAIDs increase the risk of bleeding by prolonging the prothrombin time.
NSAIDs decrease antihypertensive effects
ANSWER:2
1006. Intravenous (IV) indomethacin is approved for treatment of:
Trigeminal neuralgia
Pain associated with gastritis
Patent ductus arteriosus in premature infants
Cardiogenic pain
ANSWER:3
1007. Which of the following drugs on overdose is known to cause liver failure;
Ketorelac
Piroxicam
Acetaminophen
Ibuprofen
ANSWER:3
1008. A commonly used NSAID, Ibuprofen belongs to the subclass of
Prpionic acid derivatives
Oxicam derivatives
Pyrazolone derivatives
Salicylates
1009. What is Albendazole?
Albendazole is a medication that is used to treat different tap worm infections.
Albendazole is a medication that is used to treat different parasitic worm infestations.
Albendazole is a medication that is used to treat different virus infections.
Albendazole is a medication that is used to treat different non-parasitic worm infestations.
1010. What is the rout of ampicillin?
• A. IV
• B. IM
• C. PO
D.ALL ABOVE
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1011. patient coming in the hospital has pain in joint then after consultation the nurse
administrate the client to take diclofenac.which of the following disease that patient has?
a.maralia
b.menegitis
c. osteoarthritis
D.cholera
1012. After he doctor Consultation the pregnant woman doctor refuse to administrate the
client to use diclofenac.?
a. because diclofenac used for the abdominal pain only
b. because those drug used to treatment fever
Because those drug is contraindicated for the pregnant category c
1013. A pharmacist receives a patient who has bacterial infection while asking
paracetamol, the pharmacist refuse and decide to give her metronidazole because it is
a. Contrast product
Vaccine
Antibiotic
all above
none above
1014. a nurse check patient prescription document and found that he will take injectable
metronidazole, firstly the nurse must understand that he will give that dose through
Oral route
The vaginal
Topical route
The all above
The none above
1015. aspirin inhibits activity of which enzymes
cyclooxygenase (COX-1 and COX-2)
amylase
lipase
peptidase
1016. Which of the following best describes the human body's defense mechanism against
environmental bacteria?
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A. Hair in the nose
B. Mucous membranes
C. Osteoblasts
D. Saliva and Tears
Which of the following terms describes the body's ability to maintain its normal
1017.
state?
Anabolism
Catabolism
Homeostasis
Metabolism
1018. The patient asks you why she is being administered so many arterial blood gas tests.
The best response is:
This test determines how well your tissues are oxygenated.
This test determines if your liver and kidneys are functioning properly.
This test determines if you have a sufficient WBC to fight infection.
This test determines if you are hyperglycemic, which a side effect of your
medication is.
1019. The pressure the ventricle must generate to overcome the higher pressure in the
aorta refers to
Stroke volume.
Contractility.
Preload.
Afterload.
1020. The layer of the heart responsible for contraction is the
Myocardium.
Endocardium.
Pericardium.
epicardium.
1021. When assessing a patient for jugular vein distension, you should position him
Sitting upright.
Lying flat on his back.
Lying on his back, with the head of his bed elevated 30 to 45 degrees.
Lying on his left side.
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1022. A patient diagnosed with congestive heart failure asks you why fluid accumulates in his
lungs. The best response is:
The left side of his heart is weak and is losing the capability to pump blood to his
lungs.
Because of the excessive volume of IV fluid that is being administered.
The right side of his heart is weak and is losing the capability to pump blood to his
lungs.
He stands too long at work.
1023. Capillary refill time is normally
15 seconds.
7 to 10 seconds.
4 to 6 seconds.
1 to 3 seconds.
1024. For a patient with symptomatic bradycardia, appropriate nursing interventions
include establishing I.V. access to administer
Atropine.
Anticoagulants.
A calcium channel blocker.
Digoxin.
1025. What does the nursing responsibility in the management of the patient with
hypertensive urgency often include?
Monitoring hourly urine output for drug effectiveness
Instructing the patient to follow up with a health care professional within 24
hours after outpatient treatment
Treating IV drug dosages based on BP measurements every 2 to 3 minutes
Providing continuous electrocardiographic (ECG) monitoring to detect side effects
of the drugs
1026. Which cells in the blood do not have a nucleus?
Lymphocyte
Erythrocyte
Basophil
Neutrophil
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1027. Which of the following is flexible connective tissue that is attached to bones at the
joints?
Adipose
Cartilage
Epithelial
Muscle
1028. A patient with a history of congestive heart failure arrives at the clinic
complaining of dyspnea. Which of the following actions is the first the nurse
should perform?
Ask the patient to lie down on the exam table.
Draw blood for chemistry panel and arterial blood gas (ABG).
Send the patient for a chest x-ray.
Check blood pressure
1029. Which of the following allows air to pass into the lungs?
Aorta
Heart
Pancreas
Trachea
1030. How is secondary hypertension differentiated from primary hypertension?
Has a more gradual onset than primary hypertension
Does not cause the target organ damage that occurs with primary hypertension
Is caused by age-related changes in BP regulatory mechanisms in people over 65
years of age
Has a specific cause, such as renal disease, that often can be treated by
medicine or surgery
1031. Which of the following closes and seals off the lower airway during swallowing?
Alveoli
Epiglottis
Larynx
Uvula
1032. Which of the following is located beneath the diaphragm in the left upper quadrant of
the abdominal cavity?
Appendix
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Duodenum
Gallbladder
Spleen
1033. For a client with hepatic cirrhosis who has altered clotting mechanisms, which
intervention would be most important?
Allowing complete independence of mobility.
Applying pressure to injection sites.
Administering antibiotics as prescribed.
Increasing nutritional intake.
1034. Which of the following controls body temperature, sleep, and appetite?
Adrenal glands
Hypothalamus
Pancreas
Thalamus
1035. One among the following highlight the characteristic of gonococcal urethritis .choose
the correct answer:
Presence of secretions (pus) from anterior urethral accompanied by burning
urethral discomfort when passing urine and the most common is Vulvo-
vaginitis due to Candidiasis.
Presence of secretions (Malodorous yellow green discharge ) from anterior urethral
accompanied by burning urethral discomfort when passing urine and the most
common is Vulvo-vaginitis due to Candidiasis (refer to fungal infections
Presence of secretions (pus) from anterior urethral accompanied by burning
urethral discomfort when passing urine.
It runs through 3 stages and characterized by urethral discharge
1036. Which of the following is the proper pharmacological treatment of early syphilis
(primary, secondary)?
Aqueous benzyl penicillin (Peni G), 2-4 million IU by IV injection every 4 hours for 14 days
Erythromycin 500mg orally 6 hourly for 7 days
Benzathine benzylpenicillin (Extecilline), 2.4 million IU, by intramuscular injection,
at single session per week for 3 weeks
Cefotriaxone 2 g BID for 7 days
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1037. The first choice treatment of Chlamydia Infections is:
Doxycycline 200 mg orally daily for 10 days
Clindamycin 360mg 2 times for 7days
Azithromycin 1g orally as single dose
Erythromycin 500mg 4 times per day for 7 days
1038. A client visiting a family planning clinic is suspected of having an STI. The best
diagnostic test for treponema pallidum is:
Rapid plasma reagin (RPR) & (VDRL)
Fluorescent treponemal antibody (FTA)
Complete blood count
Thayer-Martin culture (TMC)
1039. The most important risk factor for MTCT ( Maternal To Child Transmission) is the:
Viral,
Maternal,
Obstetrical,
Amount of HIV in the mother's blood
1040. Disintegration of the endometrium during a menstrual cycle is the result of:
Decline in the level of estrogen
Decline in progesterone level at end of luteal phase
Decline in estrogen level and progesterone at end of luteal phase
The discharge of LH from the pituitary gland which is excised by the high level of
estrogen
1041. A patient calls to tell you that she has missed her pill yesterday. Upon further
questioning, she has not had intercourse in the past week. What must be her BEST action
among the following?
Take two pills today
Take two pills today and use a barrier method for seven days
Disregard the missed pill and continue taking the rest in order. Use a barrier
method for the next seven days.
Disregard the missed pill and continue taking the rest in order
1042. Gonorrhea is treated with antibiotics. What problem has occurred recently in
treatment?
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Antibiotics have been in short supply
The bacteria that cause gonorrhea have become resistant to certain antibiotic
People have developed an allergic reaction to certain antibiotics
Only ceftriaxone have become resistant
1043. Emergency contraceptive (morning after) pill can be taken up to how long after
intercourse? Choose One
24 hours.
36 hours.
72 hours.
120 hour.
1044. A client with an IUD has pelvic pain, with severe purulent discharge and fever. What can
you do?
You withdraw an IUD
you give her an antibiotic treatment and proposal an appointment ( RV) in 48
hours for IUD removal if no improvement
you remove the IUD and prescribe another method of contraception
you immediately give aspirin
1045. The temperature technique in self-observation methods of FP is based on the rise in the
basal temperature due to:
to the secretion of progesteron
the secretion of estrogen
to the secretion of progesterone and estrogen
to the secretion of LH
1046. What is the average lifetime of the unfertilized ovary (egg)?
2 days
2 hours
24 hours
12 to 14 days
1047. The observable signs of fertility in all women are:
A. Cervical mucus, increase in basal temperature and changes in the cervix
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Immoral mood only
Presence of many buttons in the face and dry skin.
Dry month and immoral mood
1048. A 24 years old G2P1A0 had last menstrual period 9 weeks ago. She presents with
bleeding and passage of tissues pervaginum. Bleeding is associated with lower
abdominal pain. The MOST LIKELY diagnosis is:
Threatened abortion.
Inevitable abortion.
Incomplete abortion.
Twin pregnancy
1049. 35 years old woman who is now in her 5th pregnancy with 4 alive children presented
inthe antenatal clinic and in diagnosed as a case of anaemia. Cause of anaemia in her case
is:
Iron deficiency.
Sickle cell anaemia.
Pernicious anaemia.
Thalassaemia.
1050. Organogenesis is complete at:
2 weeks after ovulation.
6 weeks after ovulation.
8 weeks after ovulation.
20 weeks after ovulation.
1051. 19 years old primigravida comes in emergency at 32 weeks of gestation. She is
complaining of blurring of vision, edema. On examination her B.P is 170/115mm Hg,
preteunuria ++. What is the most likely diagnosis:
Chronic Hypertension.
Renal disease.
Eclampsia.
Severe Preeclampsia.
1052. Diabetic control is important before conception to reduce the incidence of:
Maternal nephropathy.
Congenital anomalies.
Maternal retinopathy.
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D. C-section.
1053. Currently the Rwandan Community based health insurance is:
RAMA
RSSB
Mutuelle de Santé
UAP
1054. A 25 years old P2 comes to emergency, after home delivery with heavy bleeding per
vaginum. After evaluation and emergency resuscitation she is diagnosed as a case of uterine
atony. What is the appropriate medicine in the management of this case:
Oxytocin.
Salbutamol.
Magnesium sulphate.
Hydralazine.
1055. Vaginal examination is contraindicated in pregnancy in which situation:
Carcinoma of cervix.
Gonorrhoea.
Placenta previa.
Active labour.
1056.Total bishops score is:
6.
8.
10.
13.
1057. During nursing week, nurses in partnership with students conducted a blood
pressure screening in the community, this activity is which level of diseases prevention?
Secondary prevention
Focused prevention
Primary prevention
Tertiary prevention
1058. The nurse who is teaching about health diet and physical exercises program for
weight control. This activity is an example of which of the following?
Life style behavior change
Environmental control program
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Information dissemination
Health risk appraisal and wellbeing assessment
1059. During a prenatal visit a patient tells you her last menstrual period was May 21,
2016. Based on the Naegele's Rule, when is the estimated due date of her baby?
February 27, 2016
March 19. 2017
February 28, 2017
April 16, 2016
1060. All Are the components of The Partogram EXCEPT:
Measuring Fetal Well Being during Labor
Fetal heart rates and pattern
Degree of molding, caput
Color of amniotic fluid
1061. A child is diagnosed with Wilms’ tumor. During assessment, the nurse in charge
expects to detect:
Gross hematuria
Dysuria
Nausea and vomiting
An abdominal mass
1062. Heartburn and flatulence, common in the second trimester, are most likely the
result of which of the following?
Increased plasma HCG levels
Decreased intestinal motility
Decreased gastric acidity
Elevated estrogen levels
1063. Appropriate insertion urinary catheterization follows aseptic technique, which
includes the use of which of the following?
Sterile gloves
Sterile drapes
Sterile skin antiseptic
All of the above
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1064. Which of the following is referred as sudden outbreak of any communicable in a
population
Epidemic
Endemic
Pandemic
Sporadic
1065. Which of the following anatomical regions of abdomen lies just distal to the
sternum?
Epigastric
Hypochondriac
Hypogastric
Lumbar
1066. Which of the following cavities are separated by the diaphragm?
Abdominal and pelvic
Cranial and spinal
Pericardial and pleural
Thoracic and abdominal
1067. A patient has a fracture in which the radius is bent but not displaced, and the skin is
intact. This type of fracture is known as which of the following?
Closed, greenstick
Complex, comminuted
Compound, transverse
Open, spiral
1068. What are modifiable risk factors for primary hypertension?
Age
Ethnicity
Genetic link and Gender
Obesity
1069. The physician directs the medical assistant to complete a request form for an X-ray
study of the fibula. The procedure will be performed on which of the following structures?
Heel
Lower leg
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Toes
Thigh
1070. An important nursing duty related to pain is to:
Leave the patient alone to rest.
Help the patient appear to not be in pain.
Believe what the patient says about the pain.
Assume responsibility for eliminating the patient’s pain.
1071. A nurse believes that patients with the same type of tissue injury should have the
same amount of pain. This statement reflects:
A belief that will contribute to appropriate pain management.
An accurate statement about pain mechanisms and an expected goal of pain therapy.
A belief that will have no effect on the type of care provided to people in pain.
A lack of knowledge about pain mechanisms, which is likely to contribute to
poor pain management.
1072. Appropriate nonopioid analgesics for mild pain include :
Oxycodone.
Ibuprofen (Advil).
Lorazepam (Ativan).
Acetaminophen (Tylenol).
1073. An 80-year-old female patient is receiving palliative care for heart failure. Primary
purpose(s) of her receiving palliative care is to:
Improve her quality of life.
Assess her coping ability with disease.
Have time to teach patient and family about disease.
Focus on reducing the severity of disease symptoms.
1074. A father who has an X-linked recessive disorder and a wife with a normal genotype
will:
Pass the carrier state to his male children.
Pass the carrier state to all of his children.
Pass the carrier state to his female children.
Not pass on the genetic mutation to any of his children.
1075. Immunization with antigen gives which of the following acquired immunity?
A. Active Acquired Immunity
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Passive Acquired Immunity
Innate Immunity.
Active and passive acquired Immunity
1076. A patient has an admitting diagnosis of acute left-sided infective endocarditis. What is
the best test to confirm this diagnosis?
Blood cultures
Complete blood count
Cardiac catheterization
Transesophageal echocardiogram
1077. Screening for HIV infection generally involves:
Laboratory analysis of blood to detect HIV antigen.
Electrophoretic analysis for HIV antigen in plasma.
Laboratory analysis of blood to detect HIV antibodies.
Analysis of lymph tissues for the presence of HIV RNA.
1078. Which of the following statement describe the pathogenesis of HIV infection?
The virus replicates mainly in B-cells before spreading to CD4+ T cells.
Infection of monocytes may occur, but antibodies quickly destroy these cells.
The immune system is impaired predominantly by the eventual widespread
destruction of CD4+ T cells.
A long period of dormancy develops during which HIV cannot be found in the blood
and there is little viral replication.
1079. The nurse counsels the patient receiving radiation therapy or chemotherapy that:
Effective birth control methods should be used for the rest of the patient’s life.
If nausea and vomiting occur during treatment, the treatment plan will be modified.
After successful treatment, a return to the person’s previous functional level
can be expected.
The cycle of fatigue-depression-fatigue that may occur during treatment can be
reduced by restricting activity.
1080. Which of the following is the disease of the myelin sheath?
Alzheimer disease
Multiple sclerosis
Leprosy
Polio
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1081. Mental health is defined as:
A constant feeling of contentment
Striking a balance in all aspects of your life - social, physical, spiritual,
economic, mental
Achieving a period of 12-18 months without a psychotic episode
A mental illness with symptoms that include hallucinations, delusions, social
withdrawal and thought disorders
1082. The nurse should be alert for which manifestations in a patient receiving a loop
diuretic?
Restlessness and agitation
Paresthesias and irritability
Weak, irregular pulse and poor muscle tone
Increased blood pressure and muscle spasms
1083. An older woman was admitted to the medical unit with dehydration. Clinical
indications of this problem are:
Weight loss, dry oral mucosa, decreased central venous pressure
Dry oral mucosa, full bounding pulse and weight loss
Weight loss, dry oral mucosa, and engorged neck veins.
Decreased central venous pressure, weight loss and full bounding pulse.
1084.The type of delusion most commonly seen in manic patient is:
Delusion of grandeur
Delusion of persecution
Delusion of guilt
Nihilistic delusion
1085.The lungs act as an acid-base buffer by:
Increasing respiratory rate and depth when CO2 levels in the blood are high,
reducing acid load.
Increasing respiratory rate and depth when CO2 levels in the blood are low,
reducing base load.
Decreasing respiratory rate and depth when CO2 levels in the blood are high,
reducing acid load.
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D. Decreasing respiratory rate and depth when CO2 levels in the blood are low,
increasing acid load.
1086. A student nurse asks the RN what can be measured by arterial blood gases (ABGs).
The RN tells the student that the ABGs can measure the following except:
Acid-base balance.
Oxygenation status.
Glucose bound to hemoglobin.
Bicarbonate (HCO3−) in arterial blood.
1087. A patient was seen in the clinic for an episode of epistaxis, which was controlled by
placement of anterior nasal packing. During discharge teaching, the nurse instructs
the patient to:
Use aspirin for pain relief.
Remove the packing later that day.
Skip the next dose of antihypertensive medication.
Avoid vigorous nose blowing and strenuous activity.
1088. An appropriate nursing intervention for a patient with pneumonia with the nursing
diagnosis of ineffective airway clearance related to thick secretions and fatigue would be to:
Perform postural drainage every hour.
Provide analgesics as ordered to promote patient comfort.
Administer O2 as prescribed to maintain optimal oxygen levels.
Teach the patient how to cough effectively to bring secretions to the mouth.
1089.The following patients with pneumonia the nurse would suspect aspiration as the
likely cause of pneumonia except:
Patient with seizures
Patient with head injury
Patient who had a myocardial infarction
Patient who is receiving nasogastric tube feeding
1090.The effects of cigarette smoking on the respiratory system include:
Hypertrophy of capillaries causing hemoptysis.
Hyperplasia of goblet cells and increased production of mucus.
Increased proliferation of cilia and decreased clearance of mucus.
Proliferation of alveolar macrophages to decrease the risk for infection.
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1091. Significant information obtained from the patient’s health history that relates to the
hematologic system includes:
Jaundice.
Bladder surgery.
Early menopause.
Multiple pregnancies.
1092. You are taking care of a male patient who has the following laboratory values from his
CBC: WBC 3.5 × 103/μL, Hgb 13.4 g/dL, Hct 40%, platelets 50 × 103/μL. What are you
most concerned about?
Your patient is neutropenic.
Your patient has an infection.
Your patient is at risk for bleeding.
Your patient is at fall risk due to his anemia.
1093. In a severely anemic patient, the nurse would expect to find:
Dyspnea and tachycardia.
Cyanosis and pulmonary edema.
Cardiomegaly and pulmonary fibrosis.
Ventricular dysrhythmias and wheezing.
1094. The nurse is aware that a major difference between Hodgkin’s lymphoma and non-
Hodgkin’s lymphoma is that:
Hodgkin’s lymphoma occurs only in young adults.
Hodgkin’s lymphoma is considered potentially curable.
Non-Hodgkin’s lymphoma can manifest in multiple organs.
Hodgkin’s lymphoma occurs only in young adults.
1095. A patient with a tricuspid valve disorder will have impaired blood flow between the:
Vena cava and right atrium.
Left atrium and left ventricle.
Right atrium and right ventricle.
Right ventricle and pulmonary artery.
1096. A 32-year-old mother of three is brought to the clinic. Her pulse is 52, there is a
weight gain of 30 pounds in 4 months, and the client is wearing two sweaters. The
client is diagnosed with hypothyroidism. Which of the following nursing diagnoses is
of highest priority?
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Impaired physical mobility related to decreased endurance
Hypothermia r/t decreased metabolic rate
Disturbed thought processes r/t interstitial edema
Decreased cardiac output r/t bradycardia
1097. A client with Addison’s disease has been admitted with a history of nausea and
vomiting for the past 3 days. The client is receiving IV glucocorticoids. Which of the
following interventions would the nurse implement?
Glucometer readings as ordered
Intake/output measurements
Sodium and potassium levels monitored
Daily weights
1098. The client with a history of diabetes insipidus is admitted with polyuria,
polydipsia, and mental confusion. The priority intervention for this client is:
Measure the urinary output
Check the vital signs
Encourage increased fluid intake
Weigh the client
1099. In applying the principles of pain treatment, what is the first consideration?
Treatment is based on client goals
A multidisciplinary approach is needed.
The client must be believed about perceptions of own pain.
Drug side effects must be prevented and managed.
1100. The home health nurse is visiting a client with autoimmune thrombocytopenic
purpura (ATP). The client’s platelet count currently is 80, It will be most important to
teach the client and family about:
Bleeding precautions
Prevention of falls
Oxygen therapy
Conservation of energy
1101. A client appears upset and tearful, but denies pain and refuses pain medication,
because “my sibling is a drug addict and has ruined out lives.” What is the priority
intervention for this client?
Encourage expression of fears on past experiences
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Provide accurate information about use of pain medication
Explain that addiction is unlikely among acute care clients
Seek family assistance in resolving this problem
1102. The most common cause of secondary immunodeficiencies is:
Drugs.
Stress
Malnutrition
Human immunodeficiency virus.
1103. A patient in state of ineffective coughing a nurse in care plan she will know that she has
to prevent which the following complication?
Pulmonary embolism
Bronchial edema
Pulmonary edema
Aspiration pneumonia
1104. Myocardial Ischemia is temporarily deprivation of blood supply in myocardium. For
better understand pathophysiology of this condition a nurse will know that the following
vessel is obstructed:
Inferior vein cava
coronary artery
carotid artery
superior vein cava
1105. In valvular stenosis the workload of the cardiac chamber in front of the diseased
valve will be:
Normal
Decreased
Increased
No correct response
1106. The auscultatory area in the left midclavicular line at the level of the fifth ICS is the best
location to hear sounds from which heart valve?
Aortic
Mitral
Tricuspid
Pulmonic
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1107. While obtaining subjective assessment data from a patient with
hypertension, the nurse recognizes that a modifiable risk factor for the
development of hypertension is:
A low-calcium diet.
Excessive alcohol consumption.
A family history of hypertension.
Consumption of a high-protein diet.
1108. In teaching a patient with hypertension about controlling the condition, the nurse
recognizes that:
All patients with elevated BP require medication.
Obese persons must achieve a normal weight to lower BP.
It is not necessary to limit salt in the diet if taking a diuretic.
Lifestyle modifications are indicated for all persons with elevated BP.
1109. A patient with newly discovered high BP has an average reading of 158/98 mm Hg
after 3 months of exercise and diet modifications. Which management strategy will be a
priority for this patient?
Medication will be required because the BP is still not at goal.
BP monitoring should continue for another 3 months to confirm a diagnosis of
hypertension.
Lifestyle changes are less important, since they were not effective, and medications
will be started.
More vigorous changes in the patient’s lifestyle are needed for a longer time before
starting medications.
1110. Basing on pathophysiology of hypertension the following is the basic explanation of
hypertension:
Increased cardiac output plus increased stroke volume
Increased cardiac output plus decreased peripheral vascular resistance
Increased stroke volume, heart rate and increased vascular resistance
Increased stroke volume and increased vascular resistance
1111. When teaching a patient about the long-term consequences of rheumatic fever, the nurse
should discuss the possibility of:
Valvular heart disease.
Pulmonary hypertension.
Superior vena cava syndrome.
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D. Hypertrophy of the right ventricle.
1112. Which is a priority nursing intervention for a patient during the acute phase of
rheumatic fever?
Administration of antibiotics as ordered
Management of pain with opioid analgesics
Encouragement of fluid intake for hydration
Performance of frequent active range-of-motion exercises
1113. Patients with which of the following diseases are treated with injections of vitamin B-
12?
Bell's palsy
Crohn's disease
Diabetes mellitus
Pernicious anemia
1114. Which of these is the job of the respiratory system?
Holding up the body and giving it support and shape.
Gas exchange between the external environment and the body's circulatory
system.
Breaking down food for it to be used by the body.
circulating oxygen to the cells for cell function
1115. When the patient is suffering from Asthma which of these respiratory system
organs is impaired?
Lungs
Pleura
Trachea
Bronchi
1116. While patient is diagnosed Asthma, the following should be the best nursing
diagnosis
Impaired gas exchange related to bronchospasm as evidenced by dyspnea and
crackles
Ineffective airway clearance related to bronchospasm evidenced by dyspnea and
crackles
Impaired gas exchange related to bronchospasm as evidenced by dyspnea and
wheezing
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Ineffective airway clearance related to bronchospasm evidenced by dyspnea and
wheezing
1117. When the patient is suffering from pneumonia the problem is located in which of the
following respiratory organs:
Bronchioles
Pulmonary parenchyma
Pleural cavity
alveoli
1118. While patient is diagnosed for pneumonia, the following should be the best nursing
diagnosis
Impaired gas exchange related to lung infection as evidenced by dyspnea and
crackles
Ineffective airway clearance related to lung infection evidenced by dyspnea and
crackles
Impaired gas exchange related to lung infection as evidenced by dyspnea and
wheezing
Ineffective airway clearance related to lung infection evidenced by dyspnea and
wheezing
1119. During pulmonary embolism which the following is the cause of embolism?
Blockage of coronary artery by thrombus
Blockage of aorta artery by thrombus
Blockage of pulmonary vein by thrombus
Blockage of pulmonary artery by thrombus 1120.
The following are the signs of pulmonary embolism
Sudden onset of dyspnea, bradpnea, tachycardia and unexplained anxiety
Sudden onset of dyspnea, bradcardia, tachpnea and unexplained anxiety
Sudden onset of dyspnea, tachypnea and, tachpnea and unexplained anxiety
Sudden onset of dyspnea, tachypnea, tachycardia and unxeplaine anxiety
1121. Which of the following is true definition of acute respiratory distress syndrome
(ARDS)
A clinical syndrome of severe dyspnea of rapid onset, hypoxemia, and diffuse
pulmonary infiltrates leading to respiratory failure.
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A clinical syndrome of severe dyspnea of rapid onset, hyperxemia, and diffuse
pulmonary infiltrates leading to respiratory failure
A clinical syndrome of chronic severe dyspnea, hypoxemia, and diffuse
pulmonary infiltrates leading to respiratory failure
A clinical syndrome of chronic severe dyspnea , hypoxemia, and diffuse
pulmonary infiltrates leading to respiratory failure.
1122. When obtaining a nursing history for a patient with myocarditis, what should the
nurse specifically question the patient about?
Prior use of digoxin for treatment of cardiac problems
Recent symptoms of a viral illness, such as fever and malaise
A history of coronary artery disease (CAD) with or without an MI
A recent streptococcal infection requiring treatment with penicillin
1123. Which of the following is definition of Pneumothorax
The presence of fluid in the pleural space.
The collection of air in the pleura space, causing the lungs to collapse
The collection of the fluid and air in the pleural space
Obstruction of bronchioles
1124. Which of the following mechanism is responsible for acute gatstritis
Excessive Alcohol cause the gastric mucosa injury
Infection especially H.pyrorus is responsible for acute gastritis
Taking more spices induce destruction of gastric mucosa
imbalance between the aggressive and the defensive factors that maintain the
integrity of the gastric lining
1125. Which of the following chemicals responsible for maintaining mechanisms that
result in the protection of the mucosa from the injurious effects of the gastric acid.
Histamines
Cytokines
Prostaglandines
Hcl secreted by gastric mucosa gland
1126. The nurse recognizes that additional teaching is needed when the patient with
asthma says
“I should exercise every day if my symptoms are controlled.”
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“I should inform my spouse about my medications and how to get help if I have a
severe asthma attack.”
“A diary to record my medication use, symptoms, peak expiratory flow rates, and
activity levels will help in adjusting my therapy.”
“I may use over-the-counter bronchodilator drugs occasionally if I develop
chest tightness.”
1127. The husband of a patient with severe COPD tells the nurse that he and his wife have not
had any sexual activity since she was diagnosed with COPD because she becomes too short
of breath. What is the nurse’s best response?
“You need to discuss your feelings and needs with your wife so she knows what you
expect of her.”
“There are other ways to maintain intimacy besides sexual intercourse that will not
make her short of breath.”
“You should explore other ways to meet your sexual needs since your wife is no
longer capable of sexual activity.”
“Would you like for me to talk to you and your wife about some modifications
that can be made to maintain sexual activity?”
1128. To help the patient with COPD maintain a clear airway, the nurse should perform
which intervention:
limit fluid to 2 liters per day
encourage absolute bed rest
give pain killer regularly and in large amounts to prevent anxiety
teach controlled coughing
1129. What is the highest priority nursing diagnosis for patient with COPD?
activity intolerance related to fatigue
anxiety related to actual threat to health status
semi-setting related to breathiness
impaired gas exchange related to airflow obstruction
1130. Which of the following is considered as good treatment for patient complaining
heartburn and epigastric pain starting 2to3 hours after eating
Amoxycillin, metronidazole and anti acid “ Al (OH)3,”
Amoxycillin, metronidazole and antiproton pump “omeprazole”
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Amoxycilline, anti-acid “ Al (OH)3,” and antiproton pump “omeprazole”
Any of the above is good treatment for the patient
1131. What accurately describes mitral valve prolapse?
Rapid onset prevents left chamber dilation
Ballooning of valve into left atrium during ventricular systole
May be caused by pulmonary hypertension
Rapid development of pulmonary edema and cardiogenic shock
1132.What is an effect of valvular regurgitation?
It causes a pressure gradient difference across an open valve.
There is a backward flow of blood and volume overload in the preceding
chamber.
A pericardial friction rub is heard on the right sternal border of the chest.
It leads to decreased flow of blood and hypertrophy of the preceding chamber.
1133. The portal hypertension is related to which of the following condition?
Accumulation of the fluid in peritoneal cavity
Hyper function of hepatocytes
Inflammation and fibrosis of hepatocytes
Taking more than 2 l of alchohol a day.
1134. Hepatic encephalopathy is a condition related to which of the following?
Presence of ammonia in blood that reaches the brain.
Presence of amino acid in blood that reaches the brain.
Presence of CO toxic in blood that reaches the brain
Presence of carbohydrate catabolic residue in blood that reaches the brain
1135.Hallucinations and delusions are symptoms of :
schizophrenia
paranoid personality disorder
anxiety disorders
depersonalization disorder
1136. A patient is being discharged home after hospitalization of left ventricular systolic
dysfunction. As the nurse providing discharge teaching to the patient, which statement is
NOT a correct statement about this condition?
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Signs and symptoms of this type of heart failure can include: dyspnea, persistent
cough, difficulty breathing while lying down, and weight gain.
It is important to monitor your daily weights, fluid and salt intake."
Left-sided heart failure can lead to right-sided heart failure, if left untreated."
This type of heart failure can build up pressure in the hepatic veins and cause them
to become congested with fluid which leads to peripheral edema."
1137. What type of heart failure does this statement describe? The ventricle is unable to
properly fill with blood because it is too stiff. Therefore, blood backs up into the lungs
causing the patient to experience shortness of breath.
Left ventricular systolic dysfunction
Left ventricular ride-sided dysfunction
Right ventricular diastolic dysfunction
Left ventricular diastolic dysfunction
1138. When obtaining a health history from a patient suspected of having early TB, what
manifestations should the nurse ask the patient about?
Chest pain, hemoptysis, and weight loss
Fatigue, low-grade fever, and night sweats
Cough with purulent mucus and fever with chills
Pleuritic pain, nonproductive cough, and temperature elevation at night
1139. A patient with left-sided heart failure is having difficulty breathing. Which of the
following is the most appropriate nursing intervention?
Encourage the patient to cough and deep breathe.
Place the patient in Semi-Fowler's position.
Assist the patient into High Fowler's position.
Perform chest percussion therapy.
1140. Which of the following underlying emotions is commonly seen in a passive-
aggressive personality disorder?
Fear
Depression
Anger
Guilt
1141. Which laboratory findings should the nurse expect in the patient with persistent
vomiting?
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Decrease pH, increase sodium, decrease hematocrit
Increase pH, decrease chloride, decrease hematocrit
Decrease pH, decrease potassium, increase hematocrit
Increase pH, decrease potassium, increase hematocrit
1142. Which types of hepatitis are orally transmitted?
A&B
B&D
D&A
A&E
1143. Clinical phase I drug studies involve
The use of laboratory animals to test chemicals.
Patients with the disease the drug is designed to treat.
Mass marketing surveys of drug effects in large numbers of people.
Healthy human volunteers who are often paid for their participation.
1144. An order is written for 700 mg of ampicillin PO. The drug is supplied in liquid form as 1
g/3.5 mL. How much of the liquid should be given?
5 mL
2.5 mL
6.2 Ml
2.45 mL
1145. Self-deception used to reduce anxiety that would come from awareness of our own
unconscious wishes, memories and thoughts are called:
defense mechanisms
psychodynamic adaptations
hypnotic defenses
rationalizations
1146. The following are the indications for external fixation for fracture EXCEPT:
Open fracture
Complex fractures
Greenstick fracture
Joint fractures
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1147. In which phase of wound healing do hemostasis, phagocytosis and edema occur?
Edema
Inflammation
Proliferation
Remodeling
1148. A registered nurse (RN) asked the students in clinical placement the purposes of the
drains for surgical patients. Which of the following answers indicating that students needed
further teaching about purpose of drains for surgical patients?
The drains is used to withdraw fluids from surgical site
The drain is used for apposition of tissues to remove a potential space by suction
The drain is used to monitor fluid output
The drain is used to minimize the surgical site infection
1149. A break in sterile technique occurs during surgery when the scrub nurse touches:
The mask with sterile gloved hands.
The sterile gloved hands to the gown at chest level.
The drape at the incision site with sterile gloved hands.
The lower arm to the instruments on the instrument tray.
1150. Which patient is ready for discharge from Phase I Post Anesthesia Care Unit (PACU) care
to the clinical unit?
Arouses easily, pulse is 112 bpm, respiratory rate is 24, dressing is saturated, SaO2 is
88%
Difficult to arouse, pulse is 52, respiratory rate is 22, dressing is dry and intact, SaO2 is
91%
Awake, vital signs stable, dressing is dry and intact, no respiratory depression, SaO2 is
92%
Arouses, blood pressure (BP) higher than preoperative and respiratory rate is 10, no
excess bleeding, SaO2 is 90%
1151. In report, the nurse learns that the patient has a transverse colostomy. What should the
nurse expect when providing care for this patient?
A. Semiliquid stools with increased fluid requirements
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Liquid stools in a pouch and increased fluid requirements
Formed stools with a pouch, needing irrigation, but no fluid needs
Semi formed stools in a pouch with the need to monitor fluid balance
1152. During discharge instructions for a patient following a laparoscopic
cholecystectomy, what should the nurse include in the teaching?
Keep the incision areas clean and dry for at least a week.
Report the need to take pain medication for shoulder pain.
Report any bile-colored or purulent drainage from the incisions.
Expect some postoperative nausea and vomiting for a few days
1153. Which of the following suffixes that indicates the removal of part of or an entire
organ or structure?
Ectomy
Ostomy
Otomy
Plasty
1154. A patient is admitted with an open fracture of the tibia following a bicycle accident.
During assessment of the patient, what specifically should the nurse question the patient
about in order to prevent microbial infection?
Any previous injuries to the leg
The status of tetanus immunization
The use of antibiotics in the last month
Whether the injury was exposed to dirt or gravel
1155.Which of the following is the cause of osteomalacia? A.
Deficient of Vitamin B
Deficient of Vitamin C
Deficient of Vitamin D
Deficient of Vitamin A
1156. What is a Surgical Safety Checklist (SSC)?
A. List of equipment that will be required during the surgery
B. A tool to reduce the risk of preventable complications during the
perioperative period
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C. Tool to ensure that all staff in the practice are prepared for an emergency
situation D. Document listing all the roles of staff members in the operating theatre
1157. What is an explanation that the nurse should give to the male patient at health
sitting who asks what his diagnosis of paraphimosis means?
Painful, prolonged erection
Inflammation of the epididymis
Foreskin is too tight to be pulled back over the head of the penis (glans)
Retracted tight foreskin preventing return over the glans
1158. Julie is admitted to the hospital with a possible diagnosis of appendicitis. On
physical examination, the nurse should be looking for tenderness on palpation at
McBurney’s point, which is located in the :
right lower quadrant
left lower quadrant
left upper quadrant
right upper quadrant
1159. Which of the following may develop as a result of fractured ribs the patient?
Scoliosis
Pneumothorax
Obstructive lung disease
Herniation of the diaphragm
1160. When is a fat embolism most likely to occur?
24 to 48 hours following a fractured tibia
36 to 72 hours following a skull fracture
4 to 5 days following a fractured femur
5 to 6 days following a pelvic fracture
1161. The patient asks the nurse why she needs to have surgery for a femoral,
strangulated hernia. What is the best explanation the nurse can give the patient?
The surgery will relieve her constipation.
The abnormal hernia must be replaced into the abdomen.
The surgery is needed to allow intestinal flow and prevent necrosis.
The hernia is because the umbilical opening did not close after birth as it should
have
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1162. Which of the following is a major complication that can occur with a flame burn in an
enclosed space?
A wound infection
Inhalation injury
Hypovolemic shock
Contractures
1163. A patient is brought to hospital and the patient is diagnosed with gas gangrene. A
nurse takes this case as an emergency because of which of the following reasons?
Gas gangrene is usually caused by clostridium perfringens bacteria.
The infection spreads rapidly as the gases produced by the bacteria
expand and infiltrate the healthy tissue in the vicinity.
Gas gangrene can cause necrosis and sepsis.
The gas gangrene is caused by saprogenic microorganisms which
cause tissue to swell and emit fetid smell.
1164. Which of the following microorganisms is the causative agents of the most abscess?
Streptococcus species
Staphylococcus aureus
Klebsiella
E. coli
1165. The term “hemorrhoid” refers to well-vascularized subcutaneous tissues that
cushion the anal lining during defecation. What factors predisposes to development of
pathology in these structures?
Repetitive straining and increased intra-abdominal pressure
Increased intra-abdominal pressure and infection
Infection and Repetitive straining
Constipation and frequent use of stool softeners
1166. Which is of the following sutures is the thickest?
1-O
2-0
3-0
4-0
1167. What is an absorbable suture?
Suture that is not broken down by the body
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Suture that is completely broken down by the body
Synthetic suture
Biological suture
1168. When a nurse is suturing a wound, she/he is advised to not pull sutures too tight in
order to prevent which of the following surgical complication?
Surgical site infection
Post-operative bleeding
Ischemia
Poor wound healing
1169. How long before surgery should warfarin be discontinued?
4 to 6 hours before surgery
4 to 8 hours before surgery
3 to 5 days before surgery
7 to 10 days before surgery
1170. A postoperative patient has received an IV morphine sulfate. The patient’s
respiratory rate decreases to 8 breaths per minute, and he has a decreased level of
consciousness. Which medication would the nurse anticipate administering?
Naloxone
Acetylcysteine
Methylprednisolone
Pethidine
1171. A physician orders 3 liters of lactated Ringers for 24hours for a patient with severe
dehydration. A nurse calculated drop rate of infusion before the administration of the fluid
using intravenous set of drop factor of 20 drops/ml. Which of the following drop rate is
correct?
6.25 drops/min
42 drops/ml
42 drops/min
125 drops/min
1172. A nurse preparing to administer intravenous gentamicin to a patient notes that the
dose is half the usual dose for an adult. Which one of the following conditions that may
justify the decease of the usual dose for an adult patient?
A. Antibiotic resistance.
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Interpatient variation.
Liver disease.
Renal disease.
1173. Which of the following factors does not influence the choice of anesthesia?
Age of the patient
Sex of the patient
Length of surgery
Surgical procedure
1174. Which of the following is the most common complication of spinal anesthesia?
Hypotension
Post-dural puncture headache
Back pain
Paralysis
1175. Which of the following conditions can cause a hiatal hernia?
Increased intrathoracic pressure
Weakness of the esophageal muscle
Increased esophageal muscle pressure
Weakness of the diaphragmatic muscle
1176. You find an adolescent of 12 years old with nasal bleeding. What steps would you
take to control the bleeding?
Sit casualty down, lean forward and pinch soft part of nose.
Sit casualty down, lean backward and pinch soft part of nose.
Lie casualty down and pinch soft part of nose.
Lie casualty down and pinch top of nose.
1177. You want to rescue a 20 years old unconscious male patient. Which is the correct ratio
of chest compressions to rescue breaths in cardiopulmonary resuscitation (CPR) for this
casualty?
2 compressions: 30 rescue breaths.
5 compressions: 1 rescue breath.
15 compressions: 2 rescue breaths.
30 compressions: 2 rescue breaths.
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1178. After assessing the client, the nurse formulates the following nursing diagnoses.
Place them in order of priority, with the MOST important (classified as high) listed FIRST:
Constipation
Anticipated grieving
Ineffective airway clearance
Ineffective tissue perfusion.
3,4,2,1
4,3,2,1
1,3,2,4
3,4,1,2
1179. The planning step of the nursing process includes which of the following activities?
Assessing and diagnosis
Evaluating goal achievement
Performing nursing actions and documenting them
Setting goals and selecting interventions
1180. A nurse is collecting data about client’s health. Which of the following data does a
nurse classify as objective data?
Chest pain.
Complaint of dizziness.
Blood pressure values
None of the above
1181. A registered nurse at clinical placement asks a nurse student to localize organs in the
abdominal regions. A student will localize an organ that lies just distal to the sternum in
which of the following abdominal regions?
Epigastric
Hypochondriac
Hypogastric
Umbilical
1182. Nurse Peter is assigned to a telephone triage. A client called who was eating a honey and
is asking for help. The client reports of dizziness, rush, pain and localized swelling but has
no respiratory distress or other symptoms of anaphylactic shock. What is the appropriate
initial action that the nurse Peter should direct the client to perform?
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Stop eating
Applying a cold compress
Taking an oral antihistamine
Take upright position
1183. Which characteristic often distinguishes cardiogenic shock from hypovolemic
shock?
Tachycardia.
Narrow pulse pressure.
Increased respiratory rate.
Oliguria.
1184. A positive Rovsing’s sign is indicative of appendicitis. The nurse knows to
assess for this indicator by palpating the:
Right lower quadrant.
Left lower quadrant.
Right upper quadrant.
Left upper quadrant.
1185. Which of the following substances is most likely to cause gastritis?
Milk
Bicarbonate of soda, or baking soda
Enteric coated aspirin
Non-steroidal anti-inflammatory drugs
1186. Which of the following diagnostic tests may be performed to determine if a
client has gastric cancer?
Barium enema
Colonoscopy
Gastroscopy
Serum chemistry levels
1187. Care for the postoperative client after gastric resection should focus on which of
the following problems?
Body image
Nutritional needs
Skin care
Spiritual needs
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1188. Which of the following laboratory results would be expected in a client with
peritonitis?
Partial thromboplastin time above 100 seconds
Hemoglobin level below 10 mg/dL
Sodium level above 135 mEq/L
White blood cell count above 15,000
1189. A client presents to the emergency room, reporting that he has been vomiting
every 30 to 40 minutes for the past 8 hours. Frequent vomiting puts him at risk for
which of the following?
Metabolic acidosis with hyperkalemia
Metabolic acidosis with hypokalemia
Metabolic alkalosis with hyperkalemia
Metabolic alkalosis with hypokalemia
1190.Critical assessment after placing a cast is:
Gastrointestinal
Compartment syndrome
Respiratory
Depressed fracture
1191. The client who has undergone creation of a colostomy has which of the
following nursing diagnosis?
Disturbed body image
Hopeless,
Excess fluid volume
Constipation
1192. The nurse is assessing for stoma prolapse in a client with a colostomy. The
nurse would observe which of the following if stoma prolapse occurred?
Sunken and hidden stoma
Dark- and bluish-colored stoma
Narrowed and flattened stoma
Protruding stoma
1193. You’re caring for Lewis, a 67 y. o. patient with liver cirrhosis who developed
ascites and requires paracentesis. Relief of which symptom indicated that the
paracentesis was effective?
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Pruritus
Dyspnea
Jaundice
Peripheral Neuropathy
1194. Anna is 45 y.o. and has a bleeding ulcer. Despite multiple blood transfusions, her
HGB is 7.5g/dl and HCT is 27%. Her doctor determines that surgical intervention is
necessary and she undergoes partial gastrectomy. Postoperative nursing care
includes:
Giving pain medication every 6 hours.
Flushing the NG tube with sterile water.
Positioning her in high Fowler’s position.
Keeping her NPO until the return of peristalsis.
1195. The primary organs involved in pH regulation are:
Kidneys and lungs.
Heart and intestines.
Lung and endocrine glands.
Skin and kidneys.
1196. The major cause of death from peritonitis is:
Hypovolemia.
Sepsis.
Shock.
Abscess formation.
1197. A removal of the left lower lobe of the lung is performed on a client with lung
cancer. Which post-operative measure would usually be included in the plan?
Closed chest drainage
A tracheostomy
A mediastenal tube
Percussion vibration and drainage
1198. A client arrives in the emergency room with a possible fractured femur. The nurse
should anticipate an order for:
Trendelenburg position
Ice to the entire extremity
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Buck’s traction
An abduction pillow
1199. The nurse is caring for a patient with a fractured left leg. Which of the following
findings during a cardiovascular assessment of the lower extremities would the nurse
recognize as PRIORITY to report to the physician?
Strong bilateral left leg post tibia pulse
Right foot capillary refill less than 2 seconds
Bilateral dorsal flexion
Pallor of the left leg
1200. The nurse is assisting with data collection on a patient .Which of the following past
surgeries found in the patient’s history would alert the nurse to possible immune system
dysfunction when planning care?
E. Splenectomy
Thyroidectomy
G.Pneumonectomy H.
Parathyroidectomy
1201. A properly executed informed consent for surgery should include the following
Except.
Signature of the patient or patient’s representative
Name of the individual who witnessed the signature
Names of everyone that will be in the OR when the procedure is performed
Specific name of the intervention to be performed.
1202. Which surgical procedure is done for Cosmetic purposes?
Hysterectomy
Rhinoplasty
Breast biopsy
colostomy
1203. A patient with severe burns has crystalloid fluid replacement ordered using the
Parkland formula. The initial volume of fluid to be administered in the first 24 hours is
30,000 mL. The initial rate of administration is 1875 mL/hr. After the first 8 hours, what
rate should the nurse infuse the IV fluids? a. 350 mL/hour b. 523 mL/hour c. 938
mL/hour d. 1250 mL/hour ANS: C Half of the fluid replacement using the Parkland
formula is administered in the first 8 hours and the other half over the next 16 hours.
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1204. The client presents with severe abdominal pain, 10 blood stools a day, and
hematemesis dehydration. Because of these symptoms, the nurse should be alert for other
problems associated with what disease?
Chrohn,s disease
Diverticulitis
Peptic ulcer disease(PUD)
Peritonitis
1205. The pre-incision TIME OUT should be performed by which member(s) of the
perioperative team?
All perioperative team members except anesthesia professionals
Scrub nurses only
All perioperative team members
Surgeons only
1206. Bone injury where bacteria enters through the bloodstream from another part of the
body causing infection of the bone and marrow:
Gout
Bone cancer
Osteomyelitis
Osteomalacia
1207. The best guide to adequate tissue perfusion in the fluid management of a patient
with burns, is to ensure a minimum hourly urine output of;
10-30 cc
30-60 cc
50-70 ml
70-100 ml
1208. The three parts of a Surgical Safety Checklist (SSC )are:
Sign on, Time on, and Sign Out
Sign in, Time out, and Sign out
A Log in, Time on, Exit
A Log in, Time out, and Sign out
1209. What is the correct definition of an incision biopsy?
A small portion of tissue is incised and sent for examination
A fine gauge needle and syringe are used to aspirate the sample
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G. An entire section of tissue is sent for examination
H. A small portion of the fluid is dawn and sent for examination
Based on your knowledge about Surgical wounds infection, answer the question
1210.
below
Who is at more at risk for a surgical wound delayed healing?
Person who Takes corticosteroids (for example, prednisone)
Person who has problems with PUD (Peptic Ulcer Diseases)
Person who takes antacid
Person who live in rural area
1211. A patient who is scheduled for a therapeutic abortion tells the nurse, having an abortion
is not right. Which functional health pattern should the nurse further assess?
Value-belief
Cognitive-perceptual
Sexuality-reproductive
Coping-stress tolerance
1212. A nurse is discharging a man from the emergency department after treatment for
priapism. Which statement by the patient shows understanding of instructions?
I should use hot packs three times a day for the next three days
I should be seen immediately If I have another erection lasting more than two
hours
The Viagra I took may have caused this problem
I should avoid having sex for one month
1213. The nurse is caring for a patient immediately after a below knee amputation. Which of
these assessments should the nurse consider a priority?
Sacral edema
Mobility
Stump dressings
Blood sugar level
1214. A patient who experienced an open fracture of the humerus 2 weeks ago is having
increased pain at the fracture site. To identify a possible causative agent of osteomyelitis at
the site, what should the nurse expect testing to include?
A. X-rays
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CT scan
Specimen culture
WBC count and erythrocyte sedimentation rate (ESR)
1215. The nurse is caring for a patient with macular degeneration. During data collection,
which symptom would the nurse anticipate the patient to report?
Loss of peripheral vision
Sudden darkness
Dull ache in the eyes
Loss of central vision
1216. What information is most important for the nurse to teach patients about avoiding
malignant skin lesion?
Shower or bat daily
Avoid contact with allergens and irritants
Avoid exposure to ultra-Violet
Avoid with other malignant lesions
1217. A patient is admitted to the emergency department with flame burns to the entire
chest, abdomen, back, and upper extremities. Using the rule of Nines, What approximate
percentage of burns should the nurse document?
36%
45%
54%
64%
1218. A client has an order to receive a one unit of packed RBC's. The nurse make sure which
of the following intravenous solutions to hang with the blood product at the client's
bedside?
0.9% sodium chloride.
5% dextrose in 0.9% sodium chloride.
Balanced Multiple Maintenance Solution with 5% Dextrose.
5% dextrose in 0.45% sodium chloride.
1219. An assessment finding consistent with decreased cardiac output in the first 24hours
after burn injury is:
An increased urine out put
Bounding peripheral pulse
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Normal capillary refill
Decreased blood pressure
1220. As soon as the patient enters the post anaesthetic care unit, the priority
assessment by the nurse is:
Airway patency and respiratory status
Urinary output
ECG monitoring
Level of consciousness
1221. The nurse is administering an intramuscular (IM) injection to a client. When the nurse
aspirates, there is a blood return. What is the most appropriate action for the nurse to
take?
Continue to administer the medication
Withdraw the needle and administer in another site
Withdraw the needle, discard the medication, and start over
Change the needle before administering the medication in another site
1222. All of the following adults are admitted to the surgical unit. Which client should the
nurse prepare for immediate surgery?
A 56-year-old woman who is having right scapular pain after eating
A 48-year-old woman who has had moderate vaginal bleeding for two weeks
A 28-year-old man who has severe right lower quadrant abdominal pain and a WBC of
14,000/mm
A 45-year-old man who has a reducible inguinal hernia
1223. In the human cardiovascular system, what is the largest artery in the body?
Vena cava
Pulmonary
The atrium
The aorta
1224. Which nursing intervention takes highest priority when caring for a newly admitted
client who's receiving a blood transfusion?
Warming the blood prior transfusion.
Informing the client that the transfusion usually takes 4 to 6 hours.
Documenting blood administration in the client chart.
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Instructing the client to report any itching, chest pain, or dyspnea.
1225. A client is receiving a first-time blood transfusion of packed RBC. How long should the
nurse stay and monitor the client to ensure a transfusion reaction will not happen?
15 minutes.
30 minutes.
45 minutes.
60 minutes.
1226. What is the time duration for soap water hand washing WHEN VISIBLY
SOILED?
20-30 sec
2 minutes
40-60 sec
10-20 sec
1227. How many moment are in the for hand hygiene procedure?
8 moments
7 moments
6 moments
5 moments
1228. What is the most efficient method to prevent the spread of infection in
hospitalized patients?
Wearing gloves
Have the patient use antibiotic soap
Hand washing
Wear gowns
1229. The injection of medications into the circulatory system, that often provides the
most rapid drug delivery and absorption, is a description of the:
Enteral drug route and per os.
Parenteral drug route.
Percutaneous route.
Endotracheal route.
1230. Which of the following event happened when Ventricular is in state of “rest" and/or
ventricular filling of blood?
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S2 Sound
Diastole
S4 Sound
Systole
1231. Based on the knowledge you have in Health assessment, indicate the location of
auscultation of Aortic sound
Aortic is located at 2nd intercostal space and left sternal border
Aortic is located at 2nd intercostal space and right sternal border
Aortic is located at 3rd intercostal space and right sternal border
Aortic is located at 3rd intercostal space and left sternal border
1232.Color, size, shape, position and symmetry can be assessed using:
Palpation
Auscultation
Inspection
Percussion
1233. While examining a client with impaired vision, the nurse notices the clouding of the lens.
This client is having which eye disorder among the following?
Cholestatoma
Orbital cellulitis
Cataract
Glaucoma
1234. What is the term that indicates the probability of recovery or likelihood of other
health outcomes?
Prognosis
Diagnosis
Synopsis
Apoptosis
1235. Blistering of the epidermal layer of the skin is an indication of a:
First degree burn.
Second degree burn.
Third degree burn.
Fourth degree burn.
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1236. Which of the following precautions should be taken when administering antibiotic
eardrops?
Cool the drops so that they decrease swelling in the canal
Avoid placing a cotton wick to assist in administering the drops
Be careful to avoid touching the tip of the dropper bottle to the ear.
Keep the head tilted 5 to 7 minutes after administration of the drops
1237. A nurse is using the Glasgow coma scale to assess a client who had a head injury.
During assessment, the following is observed: Eyes open to speech, motor response
appropriate, client obeys commands, and conversation is confused. The client should
receive a score of:
3-5
6-10
11-13
14-15
1238. Which of the following is the best method of evaluating whether oxygen therapy is
effective for a patient?
Arterial blood gases(ABGs)
Pulse oximetry
Pulse oximetry and blood pressure
Pulse oximetry and respiration rate
1239. The MOST important sign in the evaluation of a head-injured patient is:
A) tachycardia
B) blood pressure
C) tachypnea
D) level of consciousness
1240. Early signs and symptoms of hypoperfusion include
A) cool, clammy skin
B) bradycardia
C) hypertension
D) constricted pupils.
1241. Pale, sweaty skin, a rapid thready pulse and a delayed capillary refill time indicate:
ICP
hypoperfusion
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a nervous intern
over exertion
1242. Stephen Douglas has been in an automobile accident. The most effective IV solution for
a patient having hypovolemic shock would be:
A. hypertonic.
B. isotonic.
C. hypotonic.
D. colloids.
1243. Justin Mack, 20, was critically injured in a motorcycle accident and is not expected to
survive. His parents, after arriving at the hospital from several hundred miles away, are
asked to give important information about Justin, including:
A. his childhood immunization schedule.
B. whether Justin wanted to be an organ donor.
C. the number of siblings Justin had.
D. previous hospitalizations and surgeries.
1244. A client had a hemicolectomy performed two days ago. Today, the nurse assessed the
incision and discovered a small part of the abdominal viscera protruding through the
incision. This complication of wound healing is known as:
excoriation.
dehiscence.
decortication.
evisceration.
1245. Which of the following terms describes the body's ability to maintain its normal
state?
(A) Anabolism
Catabolism
Tolerance
Homeostasis
Metabolism
1246. Which of the following structures is part of the small intestine?
F. (A) Ascending colon
Cecum
Ileum
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Sigmoid colon
Transverse colon
1247. Which of the following best describes the location where the carotid pulse can be
found?
(A) In front of the ears and just above eye level
In the antecubital space
In the middle of the groin
On the anterior side of the neck
On the medial aspect of the wrist
Questions 986 and 987 apply to the following patient:
A 23-year-old woman (gravida 1) at about 12 weeks’ gestation develops persistent nausea and
vomiting that progresses from an occasional episode to a constant retching. She has no fever
or diarrhea but appears dehydrated.
1248. What is your diagnosis?
anorexia nervosa
morning sickness
hyperemesis gravidarum
gastroenteritis
1249. Which of the following is the best choice of therapy for this patient?
Phenothiazines
Hypnosis
IV hydration
outpatient antiemetic therapy
1250. You estimate that the pelvic outlet is adequate, but there may be a problem in the
midpelvis. The interspinous diameter of a normal pelvis should be at least how many
centimeters?
5-6
6–8
9–11
12-14
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1251. In a cephalic presentation, the position is determined by the relationship of what
fetal part to the mother’s pelvis?
Mentum
Sacrum
Acromion
Occiput
1252. In the normal labor, the pressure produced by uterine contractions is greatest at
which of the following times?
latent phase
second stage
third stage
when Braxton Hicks’ sign is evident
1253. Engagement is best defined as which of the following?
when the presenting part is level with the ischial spines
when the greatest biparietal diameter of the fetal head passes the pelvic inlet
when the greatest biparietal diameter of the head is level with the ischial spines
when the greatest diameter of the fetal presenting part passes through the
narrowest and lowest part of the maternal pelvis
1254. When educating a patient about the possible signs of labor you mention “bloody
show.” This is which of the following?
a result of small placental abruptions
a consequence of effacement and dilatation of the cervix
associated with the passage of meconium
problematic in Rh-negative mothers if not given RhoGAM within 72 hours
1255.Total bishop score is:
10
8
13
6
1256. 19-year-old G0 woman presents with lower abdominal cramping. The pain started
with her menses and has persisted, despite resolution of the bleeding. She thinks she may
have a fever, but has not taken her temperature. No urinary frequency or dysuria are
present. Her bowel habits are regular. She denies vomiting, but has mild nausea. A yellow
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blood-tinged vaginal discharge preceded her menses. No pruritus or odor was noted. She is
sexually active, uses oral contraceptives and states that her partner does not like condoms.
On examination: temperature is 37.9°C; pulse 90 beat/ min; blood pressure 110/60
mmHg. She is well-developed and nourished and in mild distress. No flank pain is elicited.
Her abdomen has normal bowel sounds, but is very tender with guarding in the lower
quadrants. No rebound is present. Pelvic examination reveals a moderate amount of thick
yellow discharge. The cervix is friable with yellow mucoid discharge at the os. Cervical
motion tenderness is present. Uterus and the adnexa are tender without masses. Urine dip
is negative for nitrates. Urine pregnancy test is negative. What is the most likely diagnosis?
Vulvovaginal candidiasis
Acute salpingitis
Trichomonas vaginitis
Bacterial vaginosis
1257. A nurse is describing the process of fetal circulation to a client during a prenatal
visit. The nurse accurately tells the client that fetal circulation consists of:
Two umbilical veins and one umbilical artery
Arteries carrying oxygenated blood to the fetus
Veins carrying deoxygenated blood to the fetus
Two umbilical arteries and one umbilical vein
1258. A nurse is reviewing the record of a client who has just been told that a pregnancy test
is positive. The physician has documented the presence of a Goodell’s sign. The nurse
determines this sign indicates:
A soft blowing sound that corresponds to the maternal pulse during
auscultation of the uterus.
The presence of HCG in the urine
Softening of the cervix
The presence of fetal movement
1259. Which of the following statements indicates an understanding of Quickening
It is the irregular, painless contractions that occur throughout pregnancy.
It is the soft blowing sound that can be heard when the uterus is
auscultated.
It is the fetal movement that is felt by the mother.
It is the thinning of the lower uterine segment.
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1260. The antagonist for magnesium sulfate should be readily available to any client
receiving IV magnesium. Which of the following drugs is the antidote for magnesium
toxicity?
Calcium gluconate
Hydralazine
Albendazole
RhoGAM
1261. Which of the following is MOST hospitable the environment for sperm passage?
Preovulation
Ovulation
post ovulation
menstruation
1262. In a lecture on sexual functioning, the nurse plans to include the fact that ovulation
occurs when the:
Oxytocin is too high
Blood level of LH is too high
Progesterone level is high
Endometrial wall is sloughed off.
1263. After releasing an egg, the follicle, under stimulation of luteinizing hormone, turns into
a glandular mass of cells called the: __________
corpus cavernosum
corpus spongiosum
corpus glandula
corpus luteum
1264. In the 10th weeks of gestation, a client completely expels the products of conception.
Because the client is Rh negative, the nurse must:
Administer RhoGAM within 72 hours
Make certain she receives RhoGAM on her first clinic visit
Not give RhoGAM, since it is not used with the birth of a stillborn
Make certain the client does not receive RhoGAM, since the gestation only
lasted 10 weeks.
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1265. The endometrium grows and thickens during:
menstruation
the follicular phase
the luteal phase
ovulation
1266. The increase of the vaginal secretions during pregnancy is called leukorrhea and is
caused by increased:
Metabolic rates
Production of estrogen
Functioning of the Bartholin glands
Supply of sodium chloride to the cells of the vagina
1267. A 39 years old women para 6 has presented with complaint of post coital bleeding for
the past three months. Your first investigation should be:
Dilatation and curettage
Biopsy of cervix.
Pap smear.
Colposcopy
1268. Which action best explains the main role of surfactant in the neonate?
Assists with ciliary body maturation in the upper airways
Helps maintain a rhythmic breathing pattern
Promotes clearing mucus from the respiratory tract
Helps the lungs remain expanded after the initiation of breathing 1269. If
the testes are both removed before puberty, will secondary sex characteristics
develop in the male?
It is impossible to tell.
No, they won't develop and the man will be sterile.
Yes, they will develop, but the man will be sterile.
Yes, they will develop and the man can produce children
1270. While assessing a 2-hour old neonate, the nurse observes the neonate to have
acrocyanosis. Which of the following nursing actions should be performed initially?
Activate the code blue or emergency system
Do nothing because acrocyanosis is normal in the neonate
Immediately take the newborn’s temperature according to hospital policy.
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D. Notify the physician of the need for a cardiac consult
1271. A 40-year-old woman is admitted in labor with high blood pressure, edema, and
proteinuria. She is started on magnesium sulfate. The nurse caring for her should be sure
to keep which drug at the bedside?
Naloxone
Calcium gluconate
Phenytoin
Glucose
1272. Neonates of mothers with diabetes are at risk for which complication following
birth?
Atelectasis
Microcephaly
Pneumothorax
Macrosomia
1273. Which is the most correct sequence of sperm flow in the male duct system?
Seminiferous tubules, epididymis, vas deferens, ampulla, ejaculatory
duct, urethra
Testes, ductus deferens, seminal vesicle, urethra,
Seminiferous tubules, vas deferens, ejaculatory duct, ampulla, urethra
Seminiferous tubules, prostatic urethra, vas deferens, ejaculatory duct,
urethra
1274. By keeping the nursery temperature warm and wrapping the neonate in blankets, the
nurse is preventing which type of heat loss?
Conduction
Convection
Evaporation
Radiation
1275. The most common cause of rectovaginal fistula is:
Carcinoma
Obstetrical
Endometriosis
Crohn’s disease
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1276. When we perform an assessment of a newborn infant; the nurse is preparing to
measure the head circumference of the infant. The nurse would most appropriately:
Wrap the tape measure around the infant’s head (occiput) and
measure just above the eyebrows.
Place the tape measure under the infants head at the base of the skull and
wrap around to the front just above the eyes
Place the tape measure under the infants head, wrap around the occiput ,
and measure just above the eyes
Place the tape measure at the back of the infant’s head, wrap around across
the ears, and measure across the infant’s mouth.
1277. Normal duration of menstrual cycle is:
1-3 days
1-4 days
2- 7 days
7-10 days
1278. When teaching umbilical cord care to a new mother, the nurse would include which
information?
Apply peroxide to the cord with each diaper change
Cover the cord with petroleum jelly after bathing
Keep the cord dry and open to air
Wash the cord with soap and water each day during a tub bath 1279.
A newly married girl comes to Gynae OPD with history of dysuria, burning,
micturition and sore perineum. What is your likely diagnosis?
Trichomonas vaginalis
Honey moon cystitis
Candida infection
General herpes
1280.A postpartum nurse is providing instructions to the mother of a newborn infant with
hyperbilirubinemia who is being breastfed. The nurse provides which most
appropriate instructions to the mother?
Switch to bottle feeding the baby for 2 weeks
Stop the breast feedings and switch to bottle-feeding permanently
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Feed the newborn infant less frequently
Continue to breastfeed every 2-4 hours
1281. Which of the following is used as an emergency contraceptives?
Combined oral contraceptive pills
Levonorgestril
Progesterone only pills
Depo provera combined with Oxytocin
1282. A nurse prepares to administer a vitamin K injection to a newborn infant. The mother
asks the nurse why her newborn infant needs the injection. The best response by the
nurse would be:
You infant needs vitamin K to develop immunity.”
The vitamin K will protect your infant from being jaundiced.”
“Newborn infants are deficient in vitamin K, and this injection prevents
your infant from abnormal bleeding.”
“Newborn infants have sterile bowels, and vitamin K promotes the growth of
bacteria in the bowel.”
1283. A 20 years old school students wants to use oral contraceptive pills for
contraception. She is asking about mechanism of action of oral contraceptive pills
Inhibiting prolactin
Inducing endometrial atrophy
Inhibiting ovulation by suppression of serum FSH
Killing the spermatozoid by inhibiting to enter in uterus
1284. 33 years old woman who is now in her 5th pregnancy with 4 alive children presented
in the antenatal health center and in diagnosed as case of anemia. What are the cause of
anemia for this case?
Sickle cell anemia
Iron deficiency
Thalassemia
Pernicious anemia
1285. When performing nursing care for a neonate after a birth, which intervention has the
highest nursing priority?
A. Give the initial bath
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Give the vitamin K injection
Cover the neonates head with a cap
Taking the Vital Signs
1286. 24 years old primigravida comes in obstetric emergency at 32 weeks of gestation. She
is complaining of blurring of vision, gross edema. On examination her B.P is 170/115
mmHg. What is the MOST likely diagnosis?
Hypertension
Renal disease
Preeclampsia
Eclampsia
1287. The active management of third stage of labor involves all of the following EXCEPT:
Delay in cutting the cord, observe gushing out of blood from the
vagina.
Prophylactic Uterotonic Drug ( Oxytocin)
Uterine Massage
Controlled Cord Traction (CCT).
1288. A 30 years old P2 comes to hospital, after home delivery with heavy bleeding in vagina.
After evaluation and emergency resuscitation she is diagnosed as a case of uterine atony.
What is the appropriate drug in the management of this case:
Beta blockers
Magnesium sulphate
Oxytocin
Hydralazine
1289. On a second day of postpartum day you elicited HOMAN's sign. A positive finding
means:
Thrombophlebitis
Puerperal sepsis
Mastitis
Pelvic cellulitis
1290. Vaginal examination is contraindicated in pregnancy in which situation?
Carcinoma of cervix
Gonorrhea
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Active labour
Placenta previa
1291. The average blood loss during vaginal birth is approximately to:
300ml
500ml
700ml
200ml
1292. Of the following method, the safest, most precise and simplest for placental
localization is:
Auscultation
Ultrasonography
Radiography
Abdominal palpation
1293. During a patient history a women tells you she has been pregnant 7 times.
She had 3 vaginal deliveries, 2 spontaneous abortions in the first trimester of pregnancy
and 1 cesarean birth. She currently has 4living children. You would refer to this woman
as a:
G6 P2
G7P7
G7 P4
G5 P6
1294. A laboring client is in the first stage of labor and has progressed from 4 to 7 cm in
cervical dilation. In which of the following phases of the first stage does cervical dilation
occur most rapidly?
Active phase
Preparatory phase
Latent phase
Transition phase
1295. The following component is NOT a dimension of child health wellness:
Balanced diet and access to healthy food
Updated immunizations
Physical environment including safety in the home
Managing all childhood illness at referral health setting
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1296. What is the normal resting pulse for a normal child ˃ 12 years old?
80-120
40-80
90-140
60-100
1297. In a women with a 31 day menstrual cycle, you would expect her to ovulate on
approximately which day of her cycle?
17
14
21
28
1298. When assessing the fluid and electrolytic balance in an infant, which of the following
would be important to remember?
Infant can concentrate urine at an adult level
The metabolic rate of infant is slower than in adults
Infant have more intracellular water than an adult
Infant have greater body surface area than adult
1299. The correct Estimated Due Date (EDD) of a woman with a Last Menstrual Period
(LMP) of 13/6/2012 would be?
20/3/2013
20/12/2012
13/3/2013
3/12/2013
1300. Fetal presentation refers to:
The long axis of the fetus to that of the mother
The relation of the fetal presenting part to the right or left transverse side birth
canal
The relationship of the fetal head to that of the maternal pelvis.
The part of the fetus that is presents at the pelvic brim.
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1301. A 10 week old infant was brought to the Health Center for immunization. During
assessment, the infant’s temperature registered at 38.1 0. C. Which is the BEST immediate
action that you will take?
Go on with the infants immunization
Give paracetamol and wait for his fever to subside
Refer the infant to the physician for further assessment
Advise the infant’s mother to bring him back for immunization when he is well.
1302. After receiving an immunization for diphtheria, tetanus, and pertussis, a child develop
swelling and tenderness at the injection site, a low grade fever, and malaise. Which of the
following is an appropriate information that pediatric nurse provides to the child’s
parents?
The reaction is severe enough that they should bring the child to an
emergency department
They should delay future immunization until the child is seen by an allergist
This is a mild reaction, an teaches them how to manage it
This is an appropriate reaction, and instructs them to not touch the site of
injection.
1303. The under 5 year’s children are supposed to be given Mebendazole 500 mg in order to
prevent Ascariasis. How often this prophylactic treatment should be given to these
children?
Every 4 months after 6 months of birth
Every 3 months after 12 months of birth
Every 5 months after 9 months of birth
Every 6 months after 12 months of birth
1304. When can Enuresis be classified as primary Enuresis?
If a child has good daytime bladder control but has never had a dry
night
When child who has been dry for at least six months develops symptoms
after that period
When the cause is idiopathic
When a child does not control him when he is stressed
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1305. A child S.W hospitalized in pediatric ward at one of Teaching Hospital in Rwanda
where you work as a registered Nurse, he is experiencing the complications of malaria.
Which of the following is a sign of complications of sever malaria and that should be
reported immediately to the Pediatrician?
Fever of 400.C
Anuria since 2 days and blood in stool
Diarrhea
Vomiting
1306. Pelvic inflammatory disease (PID) occurs in women because of which of the
following characteristics of the fallopian tube?
It is a conduit from the peritoneal space to the uterine cavity.
It is found in the utero-ovarian ligament.
It has five separate parts.
It is entirely extraperitoneal.
1307. During the menstrual cycle, the histologic appearance of the endometrium will change
significantly. During the first half of the menstrual cycle, the endometrium becomes
thicker and rebuilds largely in response to which of the following?
Progesterone
follicle-stimulating hormone (FSH)
estrogen
gonadotropin-releasing hormone (GnRH)
1308. A 16-year-old G1P0 patient is brought for an examination due to a probable
pregnancy. The patient says that she became sexually active approximately 5 months
ago. To estimate her gestational age, you palpate the abdomen. At approximately 20
weeks’ estimated gestational age, which of the following best describes the uterus in a
normal pregnancy?
not palpable abdominally
palpable at the level of the umbilicus
palpable at the level of the xiphoid
palpable just over the symphysis pubis
1309. A patient presents for her routine prenatal visit at 34 weeks’ estimated gestational age
(EGA). She is complaining to the nurse of back pain. Her pulse and temperature are
normal as well as her urine dip. After the examination you determine that it is due to
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exaggerate posture caused by her weight (BMI 35) and her pregnancy. Which of
the following is a characteristic posture of pregnancy?
Hyperextension
scoliosis
Kyphosis
Lordosis
1310. Most obstetrical providers screen pregnant women for gestational diabetes around 28
weeks’ gestation. The increased risk of developing diabetes in pregnancy is due to which of
the following?
decreased fetal glucose requirements
shorter insulin half life
decreased free fatty acids in maternal circulation
increased maternal glucose requirements
1311. Hydramnios is characterized by which of the following?
amniotic fluid volumes greater than 2,000 cc
negligible increase in perinatal morbidity
a lack of symptoms, depending on rapidity of onset
marked increase in intrauterine pressure
1312. A 3 year old female child was brought by her mother in consultation at Health Center
for the following symptoms/signs: history of 2 episodes of convulsions throughout the
night, fever of 39.20C for 3 hours, continuous vomiting, and very lethargic. Which of the
following signs will NOT be the main reason for the transfer to District Hospital?
Convulsion
fever of 39.20C
Lethargic
Vomiting everything
1313. The false pelvis is separated from the true pelvis by one of the following plane?
Pelvic inlet
Pelvic cavity
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Pelvic outlet
Pelvic angle
1314. A client presents at 42 weeks and 3 days of gestational age, and the cervix is tightly
closed. Which of the following is the BEST method of labor induction?
Oxytocin
Misoprostol
Foley catheter
Rupture of membranes
1315. Which of the following statements is TRUE in normal obstetrics?
Lightening is when the lower uterine segment stretches allowing onset of labour
The amount of amniotic fluid is related to the pregnant woman’s intake of fluid.
Engagement takes places when the widest diameter of the foetal
presenting part has passed through the pelvic brim
Engagement takes place when the widest diameter of the foetal presenting part is
in the pelvic cavity.
1316. The following are TRUE signs of labour, EXCEPT:
Shivering and abdominal pains radiating towards the back
‘show ‘ and cervical dilatation
‘show’, pelvic pain radiating towards the back and dilatation of the cervix
Abdominal pains, cervical dilatation and effacement
1317. During the normal progress of labor, which of the following can explain better the
process that involves cervical effacement?
The degree at which the cervix is able to open during labor
The degree of cervical thinning during labor
The degree of relationship of the presenting part to the cervix during labor
The degree of softness of the cervix to during labor
1318. Which of the following period BEST describes the fourth stage of labour?
From dilatation of the cervix to the delivery of the infant
From delivery of the infant to delivery of the placenta
From period extending up to 2 hours after delivery of the placenta
From onset of labor to full cervical dilatation
1319. In a normal labor progress, the duration of the first stage of labor for a primigravida
should last between:
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13-16 hours
8-12 hours
6-8 hours
4-6 hours
1320. Intrapartum period extends from which of the following?
The beginning of contractions to the first 2 hours after delivery of the newborn
and placenta
The beginning of contractions to the expulsion of fetus
The beginning of contractions to the expulsion of the placenta
The beginning of contractions to the first 6 hours after delivery of the newborn
and placenta
1321. What is the usual cause of Breast pain and breast tenderness 3 to 5 days after
delivery?
Breast trauma
Breast engorgement
Breast infection
Breast tumor
1322. Which of the following period is an HIV+ pregnant woman eligible to start anti-
retroviral therapy (ART)?
At 10 weeks of gestation age
At 14 weeks of gestation age
At 9th month of gestation
Anytime when the HIV test is positive
1323. When teaching umbilical cord care to a new mother, the nurse would include which of
the following information?
Apply peroxide to the cord with each diaper change
Cover the cord with petroleum jelly after bathing
Keep the cord dry and open to air
Wash the cord with soap and water each day during a tub bath
1324. A woman delivers a 2.260 kg neonate at 38 weeks gestation. The neonate would be
considered as:
A. Premature
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Postmature
Low birthweight
Very low birthweight
1325. A neonate has been diagnosed with caput succedaneum. Which statement is
CORRECT about this condition?
“It usually resolves in 3-6 weeks.”
“It doesn’t cross the cranial suture line.”
“It’s a collection of blood between the skull and periosteum.”
“It involves swelling of tissue over the presenting part of the presenting
head.”
1326. Which of the following care plan should be included to help limiting the
development of hyperbilirubinemia in the neonate?
Monitoring for the passage of meconium each shift
Instituting phototherapy for 30 minutes every 6 hours
Substituting breastfeeding for formula during the 2nd day after birth
Supplementing breastfeeding with glucose water the first 24 hours.
1327. With regard to infants who are small for gestational age (SGA) and intrauterine
growth restriction (IUGR), the nurse should be aware of which information?
In the first trimester, diseases or abnormalities result in asymmetric IUGR.
Infants with asymmetric IUGR have a better prognosis then symmetric IUGR
In asymmetric IUGR: weight is slightly larger than SGA, whereas length and
head circumference are somewhat less than SGA.
Symmetric IUGR is reassuring and occurs in the later stages of pregnancy.
1328. Which of the following does NOT happen around the menopause period?
The negative feedback on pituitary hormone production is increased
Luteinizing hormone level rise
Ovaries do not respond to pituitary hormones
Estrogen production diminishes
1329.A young Girl 23 year old presented with complaints of abdominal pain associated with
menorrhagia. In 18 weeks ago, a mass arising from hypogastrium was revealed. Which of
the following is MOST LIKELY diagnosis?
Endometriosis
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Pelvic inflammatory diseases( PID)
Fibroid Uterus
Ovarian cyst
1330. Which of the following CORRECTLY describes the usual pathway that sperm take
through the female reproductive tract to the site of fertilization?
Vagina, cervix, fallopian tube, uterus
Vagina, uterus, fallopian tube, cervix
Vagina , cervix, uterus, fallopian tube
Urethra, vagina, fallopian tube, uterus
1331. HIV may be transmitted from one individual to another in all of the following ways.
EXCEPT:
Through contact made during oral sex
Through breastmilk from an infected mother and fed to an infant
Perinatally from an infected mother to her fetus
Genetically from parent to child
1332. Which of the following is typical of vaginal secretion that appear at ovulation?
Thick, cloudy secretions
No observable secretions
Yellow pale , sticky secretions
Clear, slippery secretions
1333. Contraceptive methods that can be used by the breastfeeding woman as early weeks
postpartum include all of the following, EXCEPT:
Lactational amenorrhea method
Progestin only pills
Combined oral contraceptive
Injections and implants
1334. Vasectomy is not immediately effective, thus the World Health Organization
recommend that, after the procedure, the couple use an alternative method
contraception for how long period?
Three months
48 hours
One week
One month
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1335. Which of the following is referred as sudden outbreak of any communicable in a
population
Epidemic
Endemic
Pandemic
Sporadic
1336. Which of the following is the BEST description of life experience?
The number of the years of people in specific group or population expect to
live
The number of years all people in all population expect to live
The minimum number of year’s people in specific group expect to live
The minimum number of year’s people in population expect to live
1337. Community health is a community based practice. Which of the following BEST
explain this statement?
The service is provided in the natural environment of people
The nurse has to conduct community diagnosis to determine nursing
needs and problems
The services are based on the available resources within the community
Priority setting is based on the magnitude of the health problems identified
1338. The process of community diagnosis involves which of the following stages?
Identifying, data collection, analyzing, dissemination
Initiation, data collection and analyzing ,diagnosing, intervention
Initiation, data collection and analyzing, diagnosing , dissemination
Data collection, analyzing, diagnosing, dissemination
1339. Which of the following is a concern of primary prevention?
Preventing illness or disease occurring
Treating the existent disease or illness
Maintaining current health status
Treat chronic diseases
1340.An allocation health resource to one geographic area is an example of Which of the
following?
Health inequality
Health justice
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263
Health inequity
Health equity
1341. Which of the following statements defines what “Health Policy”?
A program to increase political investment in health
A financial incentive program to encourage health seeking behavior
Strategy for controlling and optimizing the social uses of its health
knowledge and health resources.
Strategy of enabling people to increase control over the determinants of health
and therefore to improve their health.
1342. Which of the following is the meaning of “prevalence of disease”?
Percentage of population who suffer an event
Rate o which an event is experienced in population
Percentage of the population who experience a disorder at a given point or
period of time in specific population
Rate at which an event occurs within a population within a given period of time
1343. During nursing week, nurses in partnership with students conducted a blood
pressure screening in the community, this activity is which level of diseases prevention?
Focused prevention
Primary prevention
Secondary prevention
Tertiary prevention
1344. The nurse who is teaching about health diet and physical exercises program for
weight control. This activity is an example of which of the following?
Environmental control program
Information dissemination
Life style behavior change
Health risk appraisal and wellbeing assessment
1345. Which of the following methods is used to raise awareness and educate people by
using one way communication?
Case study
Discussion
Role play
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264
D. Lecturing and discussion
1346. Which of the following are qualities or traits that good leaders have?
Control, power, authority
Creativity, understanding, laissez-faire style
Vision, creativity, awareness, initiative, supportive
Authoritarian, rule-makers, control
1347. Which hormone prevents the monthly occurrence of menstruation when in
pregnancy has taken place
FSH
prolactin
adrenaline
progesterone
1348. Which of the following is the MOST basic type of health promotion program a nurse
educator should use in planning a smoking cessation program?
Conducting health risk surveys
Providing counseling for lifestyle and behavior change
Utilizing a variety of media for information dissemination
Facilitating environmental control programs
1349. The health educator offering weight control and exercise programs is an example of
:
Information dissemination
Health risk appraisal and wellness assessment
Lifestyle and behavior change
Environmental control program
1350. Primary health Care deals with, EXCEPT:
Essential medicines
Accessible health facilities
Affordable health care cost
Acceptable and scientific methods
1351. The public health nurse who does Blood Pressure screening and related health
education is conducting activities in the level of :
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265
A. Primary prevention D. Stage IV
B. Secondary prevention C.
Tertiary prevention D.
Focused prevention
1352.
Which of the following is the BEST goal of patient and family about health education in
district hospital in Rwanda?
A. Lessen financial burden
B. Assumption of responsibility for
care
C. Improvement of patient outcomes D.
Decrease amount of healthcare services
1353. Which of the following is a concern of primary prevention?
A. Preventing illness or disease occurring B.
Treating the existent disease or illness C.
Maintaining current health status
D. To delay the existence of current disease or illness Health
1354. equity refers to which of the following statements?
A. Right to fair distribution of health care services
B. Disparities in health status among individuals
C. Discrimination inherent in health care
D. Statistical differences in health between groups
1355.
Which of the following statements about planning health education activities are
true?
A. Planning should be
rigid.
B. Planning will create duplication of effort and
activities.
C. Planning should be based on the local situation.
D. We should not worry about the availability of resources when we plan our
health education activities.
1356.
The patient is transferring from another facility with the description of a sore on her
sacrum that is deep enough to see the muscle. What stage of pressure ulcer does the
nurse expect to see on admission?
A. Stage I
B. Stage II
C. Stage III
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1357. What is a Surgical Safety Checklist (SSC)?
A. List of equipment that will be required during the surgery
B. A tool to reduce the risk of preventable complications during the
perioperative period
C. Tool to ensure that all staff in the practice are prepared for an emergency
situation D. Document listing all the roles of staff members in the operating theatre
1358. A patient’s documentation indicates he has a stage III pressure ulcer on his right hip.
What should the nurse expect to find on assessment of the patient’s right hip?
Exposed bone, tendon, or muscle
An abrasion, blister, or shallow crater
Deep crater through subcutaneous tissue to fascia
Persistent redness (or bluish color in darker skin tones)
1359. What is an explanation that the nurse should give to the patient who asks what his
diagnosis of paraphimosis means?
Painful, prolonged erection
Inflammation of the epididymis
Foreskin is too tight to be pulled back over the head of the penis (glans)
Retracted tight foreskin preventing return over the glans
1360. A patient presents with a skin infection caused by STREPTOCOCCUS PYOGENES. The
patient's lower leg is infected from the deep dermis to the subcutaneous fat. What skin
disorder does this describe?
Cellulitis
Erysipelas
Psoriasis
Impetigo
1361. The otitis media is the condition to be treated promptly. Which of the following can be
the most prevalent complication of untreated otitis media?
Fluctuating or persistent hearing loss
Perforation of the tympanic membrane
Development of cholesteatomas
Chronic infection of the middle ear
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1362. A nurse wants to prescribe regimen for a child diagnosed for acute otitis media.
Which ONE of the following drugs is the choice for initial treatment of acute otitis
media?
Ciprofloxacin
Amoxicillin
Erythromycin
Azithromycin
1363. During discharge teaching for a patient treated for dental carries, which of the following
vitamins you will encourage the patient to take for preventing enamel defects and
increased risk of dental caries?
Vitamin A
Folic acid
Vitamin C
Vitamin D
1364. At which area a patient is most likely to experience pain due to infection of the
ethmoidal air cells sinus?
At the base of the skull
On the forehead
In the cheeks
Between the eyes
1365. A 59 year old male patient has full thickness burns on both of the legs on the back, front
and back of the trunk, both arms on the front and back, and front and back of the head and
neck. The patient weighs 85kg. Use the Parkland Burn Formula: You've already infused
fluids during the first 8 hours. Now what will you set the flow rate during the next 16 hours
(mL/hr) based on the total you calculated?
563 mL/hr
854 mL/hr
289 mL/hr
861 mL/hr
1366. A 60-year-old male undergoes surgery for a bone fracture. Which of the following
nursing measures would be most effective for preventing pulmonary embolism (PE) in this
patient?
Ensure that patient uses supplemental oxygen.
Prevent deep vein thrombosis formation.
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268
Check hematocrit and hemoglobin levels frequently during the postoperative
period.
Promote aggressive fluid intake.
1367. The components of the health history include all of the following except which one?
Review of systems
Thorax and lungs
Present illness
Personal and social items
1368. You are assessing the stoma of a patient a health, well healed colostomy. You expect the
stoma to appear:
Pale, pink and moist
Red and moist
Dark or purple colored
Dry and black
1369. Damage to the VII cranial nerve results in:
Facial disturbance
Absence of ability to smell
Absence of movement
Leg disturbance
1370. A nurse is assessing a patient who has peptic ulcer disease. The patient requests more
information about the typical causes of Helicobacter pylori infection. What would it be
appropriate for the nurse to instruct the patient?
Most affected patients acquired the infection during international travel.
Infection typically occurs due to ingestion of contaminated food and water.
Many people possess genetic factors causing a predisposition to H. pylori infection.
The H. pylori microorganism is endemic in warm, moist climates.
1371. A nurse in the postanesthesia care unit admits a patient following resection of a
gastric tumor. Following immediate recovery, the patient should be placed in
which position to facilitate patient comfort and gastric emptying?
Fowler's
Supine
Left lateral
Left Sim's
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1372. A nurse is caring for a patient who just has been diagnosed with a peptic ulcer. When
teaching the patient about his new diagnosis, how should the nurse best describe a
peptic ulcer?
Inflammation of the lining of the stomach
Erosion of the lining of the stomach or intestine
Bleeding from the mucosa in the stomach
Viral invasion of the stomach wall
1373. You are seeing an elderly man with multiple complaints. He has chronic arthritis, pain
from an old war injury, and headaches. Today he complains of these pains, as well as dull
chest pain under his sternum. What would the order of priority be for your problem list?
Arthritis, war injury pain, headaches, chest pain
War injury pain, arthritis, headaches, chest pain
Headaches, arthritis, war injury pain, chest pain
Chest pain, headaches, arthritis, war injury pain
1374. A patient has a spinal cord injury at T4. Vital signs include falling blood pressure
with bradycardia. The nurse recognizes that the patient is experiencing
A relative hypervolemia.
An absolute hypovolemia.
Cardiogenic shock.
Neurogenic shock from massive vasodilation
1375. The most accurate assessment parameters for the nurse to use to determine
adequate tissue perfusion in the patient with Multiple Organ Dysfunction Syndrome
(MODS) are
Blood prssure, pulse, and respirations.
Breath sounds, blood pressure, and body temperature.
Pulse pressure, level of consciousness, and pupillary response.
Level of consciousness, urine output, and skin color and temperature.
1376.An older man arrives in triage disoriented and tachypnea. His skin is hot and dry. His
wife states that he was fine earlier today. The nurse’s next priority would be to
Obtain a detailed medical history from his wife.
Assess his vital signs, including a temperature.
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270
Determine the kind of insurance he has before treating him.
Start supplemental oxygen and have the Emergency Department physician see him.
1377.The most common early clinical manifestations of ARDS that the nurse may observe
are:
Dyspnea and tachypnea.
Cyanosis and apprehension.
Hypotension and tachycardia.
Respiratory distress and frothy sputum.
1378. A patient has been diagnosed with osteosarcoma of the humerus. He shows an
understanding of his treatment options when he states
“I accept that I have to lose my arm with surgery.”
“The chemotherapy before surgery will shrink the tumor.”
“This tumor is related to the melanoma I had 3 years ago.”
“I’m glad they can take out the cancer with such a small scar.”
1379. A patient with a comminuted fracture of the tibia is to have an open
reduction with internal fixation (ORIF) of the fracture. The nurse explains that
ORIF is indicated when
The patient is unable to tolerate prolonged immobilization.
The patient cannot tolerate the surgery of a closed reduction.
A temporary cast would be too unstable to provide normal mobility.
Adequate alignment cannot be obtained by other nonsurgical methods.
1380.The client arrives in the emergency department after a motor vehicle accident. Nursing
assessment findings include BP 80/34, pulse rate 120, and respirations 20. Which is the
client’s most appropriate priority nursing diagnosis?
Alteration in cerebral tissue perfusion
Fluid volume deficit
Ineffective airway clearance
Alteration in sensory perception
1381. The client is admitted following repair of a fractured tibia and cast application.
Which nursing assessment should be reported to the doctor?
Pain beneath the cast
Warm toes
Pedal pulses weak and rapid
Paresthesia of the toes
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1382. The nurse is observing several healthcare workers providing care. Which action by the
healthcare worker indicates a need for further teaching?
The nursing assistant wears gloves while giving the client a bath.
The nurse wears goggles while drawing blood from the client.
The doctor washes his hands before examining the client.
The nurse did not wash hand before to take the client’s vital signs.
1383.The nurse is planning room assignments for the day. Which client should be
assigned to an isolation room for if only one is available?
The client with diabetes
The client with acromegaly
The client with covid-19
The client with myxedema
1384.A priority nursing diagnosis for a child being admitted from surgery following a
tonsillectomy is:
Body image disturbance
Impaired verbal communication
Risk for aspiration
Pain
1385. A 25-year-old client with Grave’s disease is admitted to the unit. What would the
nurse expect the admitting assessment to reveal?
Bradycardia
Decreased appetite
Exophthalmos
Weight gain
1386. The nurse is aware that the best way to prevent postoperative wound infection in the
surgical client is to:
Administer a prescribed antibiotic
Wash hands before care
Wear a mask when providing care
Ask the client to cover her mouth when she coughs
1387. The nurse knows that a 60-year-old female client’s susceptibility to osteoporosis is
most likely related to:
A. Lack of exercise
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Hormonal disturbances
Lack of calcium
Genetic predisposition
1388. A client with a fractured tibia has a plaster-of-Paris cast applied to immobilize the
fracture. Which action by the nurse indicates understanding of a plaster-of-Paris cast?
The nurse:
Handles the cast with the fingertips
Petals the cast
Dries the cast with a dryer
Allows 24 hours before bearing weight
1389. A client is receiving morphine for a severe pain. The client should be taught that the
medication may:
Cause diarrhea
Cause constipation
Cause mental confusion
Cause changes in taste
1390. The nurse should visit which of the following clients first?
The client with diabetes with a blood glucose of 95mg/dL
The client with hypertension being maintained on captopril
The client with chest pain and a history of angina
The client with Grave’s disease
1391. Cataracts result in opacity of the crystalline lens. Which of the following best
explains the functions of the lens?
The lens controls stimulation of the retina.
The lens orchestrates eye movement.
The lens focuses light rays on the retina.
The lens magnifies small objects.
1392. The nurse is caring for a client admitted with multiple trauma. Fractures
include the pelvis, femur, and ulna. Which finding should be reported to the
physician immediately?
Hematuria
Muscle spasms
Dizziness
Nausea
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1393. A client with blood glucose disorder has an order to continue insulin rapid injections
after discharge. The nurse should teach the client that insulin rapid injections should:
Be injected into the deltoid muscle only
Be injected into the abdomen only
Be injected into the veins
Be injected into the subcutaneous
1394. It has been determined that the client with hepatitis has contracted the infection
from contaminated food. What type of hepatitis is this client most likely experiencing?
Hepatitis A
Hepatitis B
Hepatitis C
Hepatitis D
1395. What is the cataract of the eyes?
Opacity of the cornea
Clouding of the aqueous humor
Opacity of the lens
Papilledema
1396. A client returns to the clinic for follow-up treatment following a skin biopsy of a
suspicious lesion performed one (1) week ago. The biopsy report indicates that the lesion is
a melanoma. The nurse understands that which of the following describes a characteristic of
this type of a lesion?
Melanoma is characterized by local invasion.
Melanoma is malignant and highly metastatic.
Metastasis is rare.
Melanoma is encapsulated.
1397. Among the following, which one is not included in paranasal sinuses:
Maxillary
Mandibular
Sphenoid
Ethmoid
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1398. A nursing instructor asks a nursing student to demonstrate the procedure for
performing an otoscopic examination on an adult client. Which observation, if made by the
instructor, indicates the correct procedure?
The nursing student pulls the pinna up and back to assist in inserting the
speculum
The nursing student obtains a small speculum to decrease the discomfort of the
examination
The nursing student pulls the earlobe down and back to assist in inserting the
speculum
The nursing student tilts the client’s head forward and down before inserting the
speculum
1399. A patient with allergic rhinitis reports severe nasal congestion; sneezing; and watery,
itchy eyes and nose at various times year. To teach the patient to control these symptoms,
the nurse advises the patient to.
Avoid all intranasal sprays and oral antihistamines.
Limit the use of nasal decongestant spray to 10 days.
Oral decongestants at bedtime the night.
keep a diary of when the allergic reaction occurs and what precipitates it
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