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01. The characteristic physiologic changes in peptic ulcer includes:

1. hypermotility
2. ulceration of the gastric mucosa
3. excessive production of secretion
4. secretion of pepsin
a. 1, 2, and 3 b. 2, 3, and 4
c. 1, 3, and 4 d. all of the above are correct

02. Peptic ulcer disease is a psychosomatic disorder in which it is believed that:

a. structural changes have occurred as a result of psychological conflict
b. illness is a defense against psychological conflicts
c. structural changes have occurred as a result of physiologic changes caused by
psychological conflicts
d. all of the above are correct

03. When Aluminum hydroxide gel (Amphojel) is prescribed for patient with peptic ulcer. For
which of the following purposes is it prescribed?
1. to systemically neutralize gastric acidity
2. to chemically neutralize hydrochloric acid of the stomach.
3. to inhibit secretion of hydrochloric acid
4. to exert rapid and prolonged antacid effect
a. 2 only is correct b. 1 and 3
c. 2 and 4 d. all of the above are correct

04. Ahmed 60-years-old, suffering from hesitancy in uniration, diminution in amount and force of
urinary stream, terminal dribbling and nocturia 3 times at night, is probably suffering from:
a. urolethiasis in the urethra
b. chronic nephritis
c. lithiasis of prostate
d. cancer urinary bladder
e. prostatic hyperplasia

05. It was decided to do a perineal prostatectomy to a patient. Which of the following are the
three essential elements of informed consent?
a. capacity, consent, comprehension
b. ability, coercion, risks
c. rationlity, explanation, alternatives
d. capacity, comprehension, voluntariness
+
* Laila, a 40-year-old housewife, is admitted to the hospital with a history of vomiting, tarry stool,
ascites, and long-standing poor nutrition due to excessive alcohol intake. Her admitting
diagnosis is bleeding esophageal varices. (Q06 - 10)

06. The pathophysiologic problem in cirrhosis of the liver causing esophageal varices is:
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a. dilated veins and varicosities

b. portal hypertension
c. ascites and edema
d. loss of regeneration
07. Medical management that may be used to control the hemorrhage includes:
1. pitressin by IV or intra-arterial infusion
2. balloon tamponade
3. gastric suctioning
4. application of cold
a. 1 and 2 b. 2 and 3
c. 1, 2, and 3 d. 1, 2, and 4
e. all of the above are correct

08. In an effort to prevent hepatic coma, it may become necessary to:

1. eliminate protein from diet
2. eliminate carbohydrate from the diet
3. give colonic washouts
4. prepare for emergency surgery
a. 1 and 3 b. 2 and 3
c. 1 and 4 d. all of the above are correct

09. It was decided to insert Sengstaken-Blakemore tube to control esophageal bleeding. All the
following are nursing responsibilities except:
a. keep balloon pressures at required level to control bleeding
b. observe and record vital signs frequently
c. be alert for chest pain
d. keep laila in dorsal recumbent position to diminish nausea and a sensation of gaging
e. irrigate suction tube as prescribed

10. Laila began to develop slurred speech, confusion, drowsiness and a flapping tremor, with
these evidences of impending hepatic coma, her diet was changed to:
a. 020 gm protein, 2000 calories
b. 080 gm protein, 1000 calories
c. 100 gm protein, 2500 calories
d. 150 gm protein, 1200 calories
d. 060 gm protein, 1500 calories

* Maher aged 18-year-old, after an automobile accident in which he sustained a head injury, has
been scheduled for a craniotomy. (Q 11 -13)

11. An indication of increased intracranial pressure that you will observe for is a:
a. pulse rate of 96 beat/minute
b. respiratory rate of 18 and irregular
c. blood pressure of 160/80 mmHg
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d. temperature of 37.7oc orally

e. all of the above are correct

12. Maher's preoperative preparations most probably will include which of the following orders:
a. giving a soapsuds enema
b. hydrating with 3000 cc IV fluid
c. administering steroids
d. inserting a nasogastric tube
e. administering morphin IV

13. When analyzing Maher's immediate postoperative needs, your care plan will include:
a. keeping his temperature below 36.1c to decrease metabolic needs
b. placing him in supine position
c. maintaining fluid and electrolyte balance by administering at least 3000cc
D5 W and lactated Ringer's / 24 hours
d. obtaining serial blood and urine samples

14. The nurse is developing a preoperative teaching plan for a patient who is to undergo a total
hip replacement. The patient should be taught to maintain his affected leg in which position:
a. fully extended with external rotation
b. slight knee-flexion with internal rotation
c. adduction with full extension of the leg
d. abduction with no rotation

15. Sara, aged 86-year-old has a fractured hip and her physician has applied Buck's traction
preoperatively, your assessment to ensure that there is adequate counter-traction will
include:
a. weights hanging freely off the floor and bed
b. ropes knotted to prevent them from moving through the pulleys
c. checking that the client is pulled down on the bed, using the end board as a foot rest
d. checking that the foot of the bed is elevated to provide countertaction

16. One hour Post-op. abdominal surgery, Mr. Nasser's urine is 30cc/hour and he has a CVP
reading of 4-5 cm water, BP is 100/40, pulse 90 and resp. 24 based on this data, your initial
intervention is to:
a. place him in trendlenburg's position
b. administer vasodilator drugs as ordered
c. administer IV fluids as ordered to maintain a CVP reading of 5-9 cm water presure
d. place several blankets over him to increase his body temperature

17. Following surgery, a client is returned to your unit with a T-tube in place, to ensure optimal
functioning, the principle to consider is that the:
a. client is positioned in a prone position to promote bile drainage
b. T-tube is connected to drainage bottle at the level of the bed to prevent bile backflow
c. client is positioned to prevent backflow of the bile into the liver
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d. T-tube is not to be clamped

18. Following surgery and the application of a cast, the nurse's primary concern should be:
a. assessing for pain and discomfort
b. assessing for swelling and bleeding
c. assessing the cast for hot spots
d. assessing the cast for wetness

19. Which of the following skin cancers has the poorest prognosis because, it metastasizes so
rapidly and extensively via the lymph system?
a. basal cell epithelioma
b. squamous cell epithelioma
c. malignant melanoma
d. bronchogenic carcinoma

20. From the following, which would be most likely to contain HIV or the hepatitis B virus?
a. tears b. semen
c. perspiration d. stool
e. all of the above are correct

* Amal, aged 18-year-old, is admitted to the ICU following a car accident, she is unconscious and
has multiple injuries. Her most serious injury is a flail chest, which has resulted in
hypoventilation. (Q 21 -24)

21. If Amal continues to hypoventilate, you will evaluate her for a consequence of:
a. respiratory acidosis b. metabolic alkalosis
c. metabolic acidosis d. respiratory alkalosis

22. Flail chest is usually characterized by the presence of one or more of the following:
1. loss of stability of chest wall
2. dyspnea and increased arterial oxygen tension
3. paradoxical movements of involved chest wall
4. associated with some degree of lung contusion
5. impaired normal breathing mechanism
a. 2, 3, 4, and 5 b. 1, 2, and 4
c. 1, 3, and 5 d. 2, 4, and 5
e. 1, 3, 4, and 5
23. Chest tubes inserted to Amal as one of the treatment lines. An important intervention is to:
1. place her in Fowler's position
2. assess her lung sounds, vital signs, color, an effort of breathing
3. observe the nature and amount of drainage in the collection champer
4. report bright red bleeding or a volume that exceeds 100ml/hour
5. encourage Amal to move about in bed
a.1, 2, and 3 b. 1, 3. 4, and 5
c. 1, 2, 3, and 4 d. all the above are correct
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24. The ABGs of Amal states: PH 7.20 - PCO2 70 - HCO3 27 - PO2 48, these values would lead
you to identify which of the following nursing diagnosis:
a. air way clearance, ineffective
b. respiratory function, alteration in: ineffective breathing patterns
c. cardiac output, alteration in: Decreased
d. respiratory function, alterations in: ineffective gas exchange, impaired

25. to prepare a patient for a bronchoscopy, the nurse should explain to the patient that:
1. the bronchus will be irrigated every hour
2. a local anesthesia will be used
3. gastric washings will be obtained
4. fluids may be taken orally as soon as the procedure is completed
a. 1 and 2 b. 2 and 3
c. only 2 is correct d. only 4 is correct

26. Reviewing the lab. tests of a client scheduled for surgery, you find that the WBC is
9800/cumm. The most appropriate intervention is to:
a. call the operating room and cancel the surgery
b. Notify the surgeon immediately
c. take no action as you recognize that it is a normal value
d. call the lab and have the test repeated

27. As you are administering daily care, the client suddenly coughs and an evisceration of the
wound occurs. Your priority intervention is to:
a. apply butterfly tape to the wound edges
b. apply an abdominal binder to the incision
c. obtain vital signs
d. place the client in a supine position

28. You are eating in a restaurant and someone yells, "Help ! my husband is choking.", the first
suggested action will be:
a. to perform abdominal thrusts
b. to perform chest thrusts
c. to encourage forceful coughing
d. to ask if the victim Can speak
e. to place the victim in a supine position

29. The main-aim of medical treatment in chronic glucoma is:

a. controlling intraoccular pressure
b. dilating the pupil to allow for an increase in the visual field
c. allowing for healing process by resting the eye
d. preventing secondary infections
e. constricting the pupil and increase aqueous flow to the anterior chamber
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30. A systemic drug that may be prescribed to produce diuresis and inhibit formation of aqueous
humor is:
a. acetazolamide (Diamox) b. chlorothiazide (Diuril)
c. furosemide (Lasix) d. methyldopa (Aldomet)

31. A patient with epilepsy questions the nurse regarding the scheduling of her medication. The
nurse informs her that the medications:
a. can usually be stopped one year after absence of seizures
b. need to be taken only in emotional stress periods
c. will probably continue for life
d. will prevent the occurrence of secizures

32. Which of the following characteristics is not related to cancer of the larynx:
a. feeling of a lump in the throat
b. fine high pitched sounds (voice)
c. dyspnea and dysphagia
d. persistant sore throat

33. The most important preparation for a patient for a total laryngectomy includes which of the
following?
a. provide adequate humidity
b. aspirate secretions since cough mechanism is not as effective
c. elevate him to semi-Fowler's or sitting position
d. arrange for him to be visited by a laryngectomee

34. To desensitize a patient means to:

a. give him average amounts of the food to which he is allergic
b. have him abstain from the food to which he is allergic
c. have him abstain from the allergen for one year
d. abstain from the allergen for a period of time and then give one minute doses so that they
cause no reaction in the person
e. abstain from the allergen for several years

35. Gout is a metabolic disorder associated with abnormal:

a. protein metabolism
b. acid production
c. fat metabolism
d. glucose metabolism
e. secretion of gastric juice

36. In the hypersensitive individual the antigen-antibody combination is the event which releases
tissue-damaging materials. All of the following released substances are pharmacologically
active in anaphylaxis except for:
a. histamine
b. slow-reacting substance (SRS)
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c. fast-reacting substance (FRS)

d. serotonin
e. plasma kinins

37. Positive diagnosis of malignant breast cancer can be made by which of the following means?
1. visual inspection of the breast
2. biopsy of breast tumor tissue
3. thermography
4. mammography
a. 1 and 2
b. 2 only
c. 1 and 4
d. all of the above are correct.
38. All of the following characteristics are related to cancer of the breast except:
a. retraction or dimpling of the skin over the mass
b. asymmetry of breasts levels
c. females usually affected more than males
d. pain which is sharp and acute as early symptom

40. Which of the following exams confirms the diagnosis of subarachnoid hemorrhage?
1. skull series
2. computed tomography (CT)
3. cerebral angiography
4. lumber puncture
a. 1, 2, and 3
b. 1 and 4
c. 4 only is correct
d. 3 and 4
41. Those persons who prefer using the word client rather than the word patient, when speaking
of a recipient of health care, mean that the word client more clearly implies that the recipient
is:
a. interested in health maintenance
b. able to adjust to chronic illness
c. actively involved in his own health care
d. Fully committed to seeking care from a variety of health practitioners

42. The primary reason for a profession adopting a code of ethics is to:
a. upgrade the profession's standing in society
b. promote a sense of union among members of the profession
c. safeguard the profession and society from wrongdoing by members of the profession
d. indicate acceptance of the trust and responsibility the consumer places in the profession

43. The major purpose for re-examining the roles and functions of health practitioners is to:
a. reduce the number of health providers to help contain costs
b. replace professionals with paraprofessionals to help contain costs
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c. improve the utilization of available health personnel

d. clarify the functions of various health personnel for the consumer

44. The primary purpose of an oil retention enema to:

a. lubricate and soften the stool
b. increase the fluid in the bowel
c. break up fecal impactions
d. increase peristalsis
45. A technique that has been found to help in improving the patient's satisfaction with his
nursing care is to:
a. involve the patient in his care to the extent possible
b. minimize giving care that the patient dislikes
c. avoid explanations that are likely to cause the patient to become fearful
d. explain that family members are generally not qualified to assist with care

46. The term body image is most often used to describe how a person feels about his:
a. entire self
b. physical attributes
c. sexual orientation
d. ideal self
47. The method of nursing care in which each nurse on a patient unit is assigned to do specific
tasks is known as:
a. primary nursing
b. functional nursing
c. team nursing
d. nurse-managed care

48. A patient responds incorrectly when a nurse asks him the date and day of the week. The best
term to describe the patient's mental state is to say that he is:
a. euphoric
b. ambivalent
c. incohorent
d. disoriented

49. The relationship between the pulse and respiratory rates is represented by which of the
following ratio?
a. one respiration to two or three heart beats
b. one respiration to three or four heart beats
c. one respiration to four or five heart beats
d. one respiration to five or six heart beats

50. A patient's temperature is 37.5C. The Fahrenheit equivalent is:

a. 96.5 F b. 97.5 F
c. 98.5 F d. 99.5 F
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51. A fever broken by periods of normal or subnormal temperature is:

a. constant b. remittent
c. intermittent d. crisis

52. The technique of percussion is most often used to examine:

a. the entire body
b. the abdomen and the back
c. the lung and the back
d. the lung and the abdomen

53. Which of the following statements are most accurately describes a characteristic of pain?
a. pain is objective in nature
b. responses to pain vary widely
c. pain is always associated with bodily damage
d. pain is not a demanding situation

54. The nurse should propose the insertion of a foley catheter only when:
a. the patient complains of bladder discomfort
b. the benefits for the patient outweigh the risks
c. the patient is embarrassed by his incontinence
d. the family needs help in dealing with incontinence

55. The nursing theory that describes man as a biopsychosocial being is:
a. environmental theory
b. basic need theory
c. self care theory
d. adaptation theory

56. Accountability is:

a. the ability to perform an act skillfully
b. the ability to be self directed
c. responsibility for one's acts
d. responsibility for other's acts

57. Nonverbal communication includes all of the following except:

a. facial expression
b. posture and mode of dress
c. grooming and crying
d. speaking in low voice

58. The suitable position for female catheterization is:

a. supine position
b. dorsal recumbent position
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c. prone position
d. lithatomy position

59. The nursing approach for total incontinence is:

a. adequate bowel elimination
b. perform crede's maneuver
c. omit bladder irritants, such as alcohol
d. indwelling catheter

60. If a vial of Gentamycin contains 80 mg. in 2 ml., the physician's order is 12 mg. every 8 hrs.,
the nurse should give every time:
a. 0.1 ml
b. 0.2 ml
c. 0.3 ml
d. 0.4 ml

61. Quadriceps setting is an example of:

a. isotonic exercise
b. aerobic exercise
c. isometric exercise
d. passive exercise

62. When teaching a client how to deep breathe, the nurse should teach him to take a deep
breath and then:
a. forcibly exhale
b. forcibly inhale more air
c. hold his breath for three seconds
d. exhale over a period of five seconds

63. When assisting a patient out of bed after he has been confined on bed rest for a time, the
nurse can best determine the patient's reaction to the activity by:
a. observing the client's skin color
b. obtaining the client's pulse rate
c. measuring the client's blood pressure
d. asking the client to describe how he feels

64. Which of the following are appropriate for walking on stairs with a cane?
1. use stair rail rather than cane
2. going up, take each step with stronger leg first
3. advance cane just before stepping with the weaker leg
4. lean forward
a. 1, 2, and 3 b. a and 3
c. 2 and 4 d. 2, 3, and 4
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65. Goggles and respirator mask are recommended when preparing which of the following
medications for administration?
a. anticoagulant drugs
b. parenteral drugs
c. intravenous drugs
d. antineoplastic drugs

66. The patient who is semiconscious is:

a. confused, does not follow commands
b. confused, not completely oriented, may follow commands
c. poor response to verbal stimuli
d. responed only to deep painful stimuli

67. Factors that promote sleep include:

1. consistent sleep schedules
2. metabolism of alcohol
3. suppression of melatonin
4. sufficient protein intake
5. effortless breathing
a. 1, 3, and 5
b. 2 and 4 only
b. 2, 3, and 5
d. 1, 4, and 5

68. Which one of the following types of orders by the physician, is to be carried out as specified
until it is cancelled by another order?
a. a state order
b. a single order
c. a routine order
d. a standing order

69. Enteric precautions should be practiced for clients who has:

a. rubeola (measles)
b. rubella (german measles)
c. influenza
d. typhoid fever

70. When collecting a urine specimen from a patient with an indwelling catheter, the nurse
should:
a. use a syringe and needle to draw the urine from the collection bag
b. use a syringe and needle to draw the urine from the collection tube
c. use a syringe and needle to draw the urine from the catheter
d. use a syringe and needle to draw from the port on the tube

71. Patients may become weak during a sitz bath because:

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a. they may become tired of sitting in the tub

b. large quantities of blood move to the pelvic region
c. the hot water may make them drowsy and faint
d. the amount of time in the tub causes fatigue

72. "Patient will complete active range-of-motion exercises two times each day by 22/2" is an
example of:
a. a nursing diagnosis
b. a nursing action
c. a goal statement
d. an evaluative statement

73. It is recommended that the feet be separated in the standing position in order to:
a. distribute the body weight evenly
b. provide a wide base of support
c. prevent the strain of locked knees
d. relieve stress on the arches of the feet

74. In order to prevent pressure-sore development in a bedridden client the nurse should do
which of the following?
a. change the client's position at least once during the 8 hour shift
b. limit food intake to minimize the risk of skin breakdown secondary to obesity
c. provide fluids for adequate hydration
d. keep bony prominences moist

75. The common site for giving intramuscular injections into the glutens maximus is the:
a. rectus femoris site
b. vastus lateralis site
c. dorsogluteal site
d. ventrogluteal site
76. The process of removing poisonous substances through gastric intubation is called:
a. gavage b. decompression
c. lavage d. compression

77. Which of the following best describes the nursing kardex?

a. it is a plan that describes the actions to be performed when providing care to a patient
b. it is a short, summarized version of the current basic care plan for a patient
c. it usually has columns for writing the nursing diagnosis, goals and nursing orders
d. it is often used to evaluate the nursing care

78. Gloves are required as barriers in which of the following situations?

a. when direct contact with the source of microorganisms will occur
b. to replace the need for hand-washing when patient care is finished
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c. when microorganisms present on the hands grown and multiply rapidly

d. when the nurse does not want to have contact with the patient

79. For patients with chronic lung conditions, oxygen via nasal cannula is usually prescribed at:
a. 2 to 3 liters per minute b. 2 to 4 liters per minute
c. 3 to 6 liters per minute d. 4 to 7 liters per minute

80. Mrs. Heba's husband has lung cancer and is terminally ill. She tells the nurse," The children
are so good to me but I don't know what I'll do when he's gone. I lie awake at night thinking
about what's going to happen to me. " A likely nursing diagnosis for Mrs. Heba is:
a. dysfunctional grieving evidenced by verbal expression and lying awake, related to
husband's illness
b. anticipatory grieving as evidenced by verbal expressions related to her husband's terminal
illness
c. dysfunctional grieving as evidenced by expressions of care given by children related to
selfishness
d. all of the above are correct
60 - year-old male client is admitted through the emergency department with crushing
substernal chest pain that radiates to the shoulder, jaw, and left arm.
He is attached to a bedside monitor, which indicates sinus tachycardia. The admitting
diagnosis is acute myocardial infarction( MI ). the client is extremely restless and frightened .

81.Immediate admission orders include oxygen by nasal cannula at 4L/min, blood work, a
chest x-ray , a 12-lead electrocardiogram ( EKG ), and 2mg of morphine sulfate IV.Which
intervention is priority and should be accomplished first ?
a. Administer the morphine c. Obtain a 12-lead EKG
b. Obtain the blood work d. Order the chest x-ray

82. An intravenous infusion at a “keep open ” rate would be ordered primarily to:
a. Help keep him well hydrated c. Prevent kidney failure
b. Help keep him well nourished d. Provide a route for emergency drugs

83. After one attack of pain, the client says to the nurse, “ My father died of a heart
attack when he was 60, and 1 suppose 1 will too.” which of the following responses
by the nurse would be the most appropriate?
a. “ Tell me more about what you are feeling
b. “ Are you thinking that you won’t recover from this illness?”
c. “ You have a fine doctor. Everything will be all right soon, I’m sure.”
d. “ Would you agree that this would be very unlikely?”

84. A priority nursing diagnosis during the first 24 hours following an Ml is:
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a. Impaired Gas exchange c. Fluid volume deficit

b. High risk for infection d. Constipation

69-year-0ld female client has a history of congestive heart failure ( CHF).Her physician
Arecently increased her daily digoxin ( Lanoxin ) and furosemide
(lasix) doses as her condition was deteriorating. Ten days ago, the client stopped taking
all her medications,which she blamed for her frequent headaches . She is now admitted to
the emergency department with CHF complicated by pulmonary edema. She is edematous
and cyanotic. In acute respiratory distress, extremely anxious, and complaining of nausea
.

85. The major goal of therapy for this client would be to :

a. Increase cardiac output c. Decrease peripheral edema
b. Improve respiratory status d. Enhance comfort

86. Which of the following would be a priority nursing diagnosis for the client with
CHF and pulmonary edema ?
a. High risk for infection related to stasis of secretions in alveoli
b. Impaired skin integrity related to edema and pressure
c. Activity intolerance related to imbalance between oxygen supply and
demand
d. Constipation related to immobility

87. This client will require careful skin care, primarily because an edematous client is
prone to develop:
a. Itchy skin c. Electrolyte imbalance
b. Decubitus ulcers d. Distention of weakened veins

An elderly female client is scheduled to undergo mitral valve replacement for severely
calcific mitral stenosis and mitral regurgitation . Although the diagnosis was made during
childhood, she had been asymptomatic until 4 of digoxin
( Lanoxin ) and furosemide ( Lasix) .

88. During the initial interview with the client, the nurse would most likely learn that
the client’s childhood health history included :
a. Scarlety fever c. rheumatic fever
b. Poliomyelitis d. Meningitis
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89. The client’s chest tube accidentally disconnects from the drainage tube when she
turns onto her side. Which of the following actions should the nurse take first?
a. Notify the physician c. Raise the level of the drainage bottle
b. Clamp the chest tube d. Reconnect the tube

Over the past few months a middle-aged woman has felt brief twinges of chest pain while
working in her garden and has had frequent episodes of indigestion. She comes to the
hospital after experiencing severe anterior chest pain while raking leaves. Her workup
confirms a diagnosis of stable angina pectoris.

90. Following a myocardial infarction, the hospitalized client is taught to move his legs
about while resting in bed . This type of exercise is recommended primarily to help.
a. Prepare the client for ambulation
b. Promote urinary and intestinal elimination
c. Prevent thrombophlebitis and blood clot formation
d. Decrease the likelihood of decubitus ulcer formation

91. A client whose condition remains stable after a myocardial infarction is gradulally
allowed increased activity Of the following criteria, the best one on which to judge whether
the activity is appropriate is to note the degree of
a. Edema c. Dyspnea
b. Cyanosis d. Weight loss

92. Of the following factors, which appears most closely linked to the development of
coronary artery disease:
a. Diet c. Air pollution
b. Climate d. Excessive exercise

93. A client is discharged from the hospital following a myocardial infarction. The
client is walking and is taught to continue walking gradually progressing distances.
Which vital sign should the client be taught to monitor to determine whether to
increase or decrease progression ?
a. Pulse rate c. Body temperature
b. Blood pressure d. Respiratory rate

94. Which of the following symptoms should cause the nurse to suspect that a
client is experiencing digitalis toxicity ?
a. Skin rash c. Lightheadedness
b. Constipation d. Loss of appetite
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95. The nurse prepares the client for a gastric analysis as part of initial assessment . A
typical laboratory finding of gastric analysis in a client with pernicious anemia is :
a. High bile concentration c. Low bicarbonate concentration
b. Absence of hydrochloric acid d. Immature red blood cells.

96. The client likely will suffer from the symptoms of vitamin B12 deficiency
even though she consumes normal amounts of food containing this vitamin
What is the reason for her vitamin deficiency?
a. Inability to absorb the vitamin because her stomach is not producing
sufficient acid.
b. Inability to absorb the vitamin because the stomach is not producing
sufficient intrinsic factor .
c. Excessive excretion of the vitamin because of kidney dysfunction
d. Increased requirement for the vitamin because of rapid red blood cell
production.

47-year-old male client diagnosed with Hodgkin’s disease is admitted to the hospital for
staging. He is to under go bone marrow biopsy.

97. The nurse assesses the client’s nutritional status to be below adequate.
Which of the following blood examinations would be most helpful in
determining whether the client’s diet contains inadequate protein?
a. Red blood cell count c. Reticulocyte count
b. Bilirobin level d. Albumin level

98. Three different chemotherapeutic agents are administered to the client . The nurse
explains to the client that three drugs are given over an extended
period because:
a. The second and third drugs increase the effectiveness of the first drug
b. The first two drugs destroy the cancer cells, and third drug minimizes
side effects
c. The three drugs can then be given in lower doses
d. The three drugs have a synergistic effect and different actions

99. The chemotherapy is extremely toxic to bone marrow , and the client develops
thromboycytopenia ( low platelet count ) The nurse would recognize
that a priority goal of care would be to take precautions to control.:
a. Bleeding c. Infection
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b. Diarrhea d. Hypotension

100. The recommended parenteral route for administering iron preparations for
anemia is by:
a. Deep gluteal intramuscular injection, using a Z track method
b. Intermittent infusion
c. Intramuscular injection in the deltoid so that muscle contraction can
help dissipate the medication
d. Subcutaneous injection with weekly site rotation

101. Polycythemia vera is characterized by bone marrow overactivity, resulting in

the clinical manifestation(s) of:
a. Angina c. Thrombophlebitis
b. Claudication d. All of the above

102. The common feature of the leukemia is:

a. A compensatory polycythemia stimulated by thrombocytompenia
b. An unregulated accumulation of white cells in the bone marrow, which
replace normal marrow elements
c. Increased blood viscosity, resulting from an overproduction of white cells
d. Reduced plasma volume in response to a reduced production of cellular elements

103. The major cause of death in patients with leukemia is believed to be

a. Anemia c. Embolus
b. Dehydration d. Infection

104. Buerger’s disease is characterized by all of the following EXCEPT:

a. Arterial thrombus formation and occlusion
b. Lipid deposits in the arteries
c. Redness or cyanosis in the limb when it iis dependent
d. Venous inflammation and occlusion

105. Multiple myeloma is characterized by all of the following clinical manifestations

EXCEPT:
a. Anemia and hemorrhagic tendencies
b. Bone pain and pathologic fractures
c. Renal stones and hypercalcemia
d. Increased susceptibility to infection
e. Naturally occurring remissions
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106. The incidence of leukemia appears to be rising for reasons still unknown.
medical researcher have, however, identified all of the following as possible
factors in the development of leukemia EXCEPT:
a. Genetic predisposition c. Ionizing radiation
b. Certain viral infections d. Certain toxic chemicals
e. Smoking

107. The edema associated with varicose with varicose veins is due to which of the
following mechanisms?
a. Increased hydrostatic pressure in the capillaries
b. Increased peripheral resistance in the arterioles
c. Contraction of the leg muscles causing obstruction of the veins
d. Vasospasm in deep and superficial saphenous veins
e. None of the above

108. Factors predisposing to the development of varicose veins include all of the
following EXCEPT :
a. Obesity c. Abdominal tumor
b. Pregnancy d. Hypertension
e. Cirrhosis of the liver

* Hassan, 50 years of age, is hospitalized because of difficulty voiding

109. Mr. Hassan is purposefully dehydrated to help assess kidney function (aurine
concentration test). Which of the following results wound NOT be normal .
a. Color : clear yellow c. Protein : none
b. PH : 5.2 d. Specific gravity : 1.005

110. In preparing Mr. Hassan for a phenoslulfonphthalein (PSP) test, his nurse
should tell him :
a. To remain in bed
b. To omit fluids during the test
c. He may have burning sensation when voiding
d. He may have back pain
e. His urine may turn red
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111. Mr. Hassan is scheduled for cystoscopy and asks his nurse what he may expect .
The nurse should explain that prior to the procedure all of the following steps are likely
to occur EXCEPT :
a. Administrattion of local or general anesthesia
b. Administration of a sedative or narcotic
c. Restriction of all fluid for 12 hours
d. Restriction of all solid foods for 12 hours
e. Cleansing of the bowel .

112. Perforation of the bladder or ureters is possible during cystoscopy. Which of the
following symptoms should alert a nurse to such an occurrence ?
a. Abdominal pain c. Nausea and vomiting
b. Headache d. Pink-tinged urine
e. Peripheral edema

samar, 45 years of age, is hospitalized following several attacks of acute renal colic. Tests
reveal a stone in the upper left ureter, and a ureterolithotomy is performed.
113. Following the procedure, Ms. samar is apt to develop which of the following
complications ?
a. Increased blood urea nitrogen levels b. Hypertension
c. Dependent edema d. Hematemesis
e. Atelectasis

114. Complications that may result directly After ileal conduit surgery include all of the
following EXCEPT :
a. Decreased urinary output
b. Lower abdominal pain
c. Swelling of the stoma
d. Fecal discharge through the ileal conduit
e. Fever .

115. A patient who has the nephrotic syndrome characteristically exhibits which of
the following abnormalities?
a. Proteinuria c. Dysuria
b. Hematuria d. Glycosuria
e. Pyuria
116. The most evident sign of the nephrotic syndrome is :
a. Jaundice c. Dry skin
b. Erythema d. Edema
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e. Pallor .

117. Patients who have a lower urinary tract infection should be given antibiotics and
instructed to :
a. Stay in bed until a febrile for three to four days
b. Clean themselves after each voiding
c. Check their temperature regularly
d. Take all prescribed medication even when asymptomatic
e. Use the same medicine if the infection recurs within the next yrar

118. Chronic renal failure usually occurs gradually over the course of months or years.
The leading cause of chronic renal failure is :
a. Polycystic kidney disease c. Systemic lupus erthematosus
b. Glomerulonephritis d. Hypertension
e. Diabetes mellitus

Said, 20 years of age, is hospitalized with chronic renal failure secondary to chronic
glomerulonephritis. On admission , he appears edematous, weak , and his blood pressure is
190 / 110 mmHg. Laboratory reports reveal: hematocrit, 19 % white blood cells, 16,000/cu
mm; blood urea nitrogen, 165 mg/100ml; serum creatinine, 16 mg/100ml; K + , 7.8 Eq/1; and
urine output, less than 100 ml/24 hours. Nat is restricted to 800 ml of fluid per day and a diet
low in protein , sodium, and potassium .

119. After an eight-month course of hemodialysis, said is scheduled for a kidney

transplant. The most important factor in predicting the survival of a
transplanted kidney is :
a. Tissue histo-compatibility
b. Adequacy of antibiotic therapy
c. Adequacy of immunosuppressive therapy
d. The affected patient’s general state of health
e. The affected patient’s attitude

120. Said’s nurses must be especially watchful for signs indicating rejection of the
transplanted kidney. All of the following sings are indices of tissue rejection EXCEPT :
a. Temperature elevation c. Elevated serum creatinine
b. Rising blood pressure d. Decreased urine output
e. Decrease blood urea nitrogen

121. Said is ordered to receive prednisone and azathioprine ( imuran ) the basic
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drugs used in preventing and treating kidney rejection . The dosage of

azathioprine will be determined by Nat’s :
a. Urine output c. Blood pressure
b. Creatinine level d. White blood cell count
e. Prothrombin time

122. The client has asked to be evaluated for a home continuous ambulatory peritoneal
dialysis ( CAPD ) program . The nurse should explain that the major advantage of this
approach to chronic renal failure is that it:
a. Is relatively low in cost
b. Allows the client to be more independent
c. Is faster and more efficient than standard peritoneal dialysis
d. Has fewer potential side effects and complications

123. Common clinical manifestations of uremia include which of the following ?

a. Dry, itchy skin c. Bradycardia
b. Cyanosis d. Hypotension

124. The pathophysiology of hypoparathyroidism is associated with all of the

following EXCEPT a ( N ) :
a. Decrease in serum calcium
b. Elevation of blood phosphate
c. Increase in the renal excretion of phosphate
d. Lowered renal excretion of calcium

125. Nursing management for a hypoparathyroid patient would not include:

a. Maintaining quiet, subdued environment
b. Making certain that calcium gluconate is kept at the bedside
c. Observing the patient for signs of tetany
d. Supplementing the diet with milk and milk products

126. A clinical manifestation not usually associated with hyperthroidism is:

a. Pulse rate below 90 beats per minute
b. An elevated systolic blood pressure
c. Muscular fatigability d. Weight loss

127. Patients with hyperthyroidism are characteristically :

a. Apathetic and anorexic c. Emotionally stable
b. Calm d. Insensitive to heat
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128. Signs of thyroid storm include all of the following EXCEPT:

a. Bradycardia c. Delirium or somnolence
b. Dyspnea and chest pain d. Hyperpyrexia

129. Medical management for thyroid crisis includes :

a. Intravenous dextrose fluids c. Oxygen therapy
b. Hypothermia measures d. All of the above

130. A diagnosis of hyperparathyroidism can be established by all of the following signs

EXCEPT :
a. A negative reading on a sulkowitch test
b. A serum calcium level of 12 mg/dl
c. An elevated level of parathyroid hormone
d. Bone demineralization seen on x-ray film

131. Apheochromocytoma is an adrenal medulla tumor that causes arterial

hypertension by increasing the level of circulating :
a. Catecholamines c. Hormones
b. Enzymes d. Glucocorticoids

132. Laboratory findings suggestive of Addison’s disease include all of the following
EXCEPT:
a. A relative lymphocytosis c. Hypertension
b. Hyperkalemia and hyponatremia d. Hypoglycemia

133. A positive diagnosis of Cushing’s syndrome is associated with :

a. The disappearance of lymphoid tissue
b. A reduction in circulating eosinophils
c. An elevated cortisol level
d. All of the above

134. Clinical manifestations of Cushing’s Syndrome may be modifies with a diet that is :
a. High in protein c. Low in sodium
b. Low in carbohydrates d. All of the above
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135. Nursing assessment for patient who is receiving corticosteroid therapy includes
observation for the unacceptable side effect of :
a. Glaucoma c. Potassium loss
b. Facial mooning d. Weight gain

136. A major symptom of pancreatitis is :

a. Severe abdominal pain c. Jaundice
b. Fever d. Mental agitation

137. The nurse should assess for an important early indicator acute pancreatitis,
which is an increased :
a. Serum amylase level c. White cell count
b. Serum lipase level d. Urine amylase level

138. A clinical manifestation (s) associated with a tumor of the head of the pancreas ( are) :
a. Clay- colored stools c. Jaundice
b. Dark urine d. All of the above

139. The immune system is essentially composed of :

a. Bone marrow c. White blood cells
b. Lymphoid tissue d. All of the above components

140. When teaching a client with diabetes mellitus about foot care, the nurse should
instruct the client to :
a. Avoid going barefoot c. Apply toenail polish
b. Wear hard- soled shoes d. Use bar soap to wash the feet

suha a 35-year old obese mother of four children, is diagnosed as having acute gallbladder
inflammation. She 5 fts in tall and weighs 86 kg. The physician decide to delay surgical
intervention until her acute symptoms subside.

141. Suha’s initial course of treatment would probably consist of :

a. Analgesic and antibiotics c. Intravenous fluids
b. Nasogastric tube d. All of the above

142. After her acute, suha was limited to low fat liquid . As foods are added to her diet,
She needs to know that she should avoid :
a. Cooked fruits b. Lean meats
c. Eggs and cheese d. Rice and potatoes
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143. Postoperative Nursing observation includes assessing for :

a. Obstruction of bile drainage b. Signs of peritonitis
c. Signs of atelectasis d. All of the above

Fatma undergoes a modified radical mastectomy with complete removal of her right breast
and some axillary lymph nods following conformation of breast malignancy

144. Mammography should be done to screen women annually:

a. From 40 to 50 years b. Under age 35
c. Between ages of 35 and 40 d. Over the age 50 years

145. The majority of breast cancers occurs in the :

a. Upper iner quadrent b. Lower inner quadrent
c. Upper outer quadrent d. Lower outer quadrent

146. Radical mastectomy means :

a. Excesion of the breast lump only
b. Excession of the breast lump and clearance of the axilla from lymph nodes
and facia
c. Excesion of breast lump, pectoralis major muscle and clearance of the axilla
d. Excesion of the nipple and areola only besides clearance of the axilla

147. An immediate postoperative goal for the patient who had amodified radical
mastectomy is to :
a. Preventing lymphedema b. Restricting fluid intake
c. Administer preop. medication eg a tropine
d. Promote self steam and self concept
e. All are correct
ali 25 years old man , brought to the emergency department with loss of pain sensation and
weakness of lower extremities for 3 days, The primary diagnosis is Guillain- Barrie syndrome
148. Ali is placed on the neurologic unit to observe the progression of his disease.
The nursing diagnosis of greatest priority would be which of the following ?
a. Impaired skin in-tegrity related to paralysis
b. Knowledge deficit related to disease process
c. Ineffecting coping related to fever of the unknown
d. Impaired gas exchange related to progressive weakness
149. Ali requires mechanical ventillation . The plysician orders suctioning every one
hour , the proper suctioning technique would be:
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a. Endotracheal tube, mouth, nose

b. Nose , mouth, endotracheal tube
c. Endotracheal tube , Nose, mouth
d. Mouth, Endotracheal tube, Nose

150. Which of the following is the most valid indicator that Ali is no longer requires
mechanical ventilation :
a. Ali’s is frequently try to extubate himself
b. Ali’s respiratory rate is 31 br/ minale during weaning
c. Ali’s arterial ph value is with in normal limits at reduced fioz
d. Ali’s assisting ventilation at regular intervals

151. As the first priority of care , a patient with aburn injury will initially needed :
a. An airway established
b. An indwelling catheter is inserted
c. Fluid replacement
d. Pain killing medication administration

152. The most recent consensus for fluid replacement recommends that a balanced
salt soution be administered in the first 24 hours of a burn in the range of 2 ml/kg /%
of burn. A 80 kg man with 30 % burn should receive :
a. 1200 ml in the first 8 hours b. 2400 ml in the first 8 hours
c. 3600 ml in the first 8 hours d. 4800 ml in the first 8 hours

153. A full thickness burn is :

a. Classified by the appearance of blisters
b. Identified by the destruction of the entive dermis
c. Not associated with edema formation
d. Usually very painfull before of exposed nerve endings
A 22-year-old male is brought to the emergency room with an apparent head injury after
being involved in a serious motor vechicle accident .He is unconscious on arrival and exhibits
signs of increasing intracranial pressure . He is accompanied by his fiancée and an adult
friend .
154. When the client arrives in the emergency room, to which of the following
considerations should the nurse give highest priority in his care?
a. Establishing an airway c. Stopping bleeding from open would
b. Replacing blood losses d. Determining whether he has a neck fracture
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155. The nurse assesses the client frequently for signs of increasing intracranial
pressure, including :
a. Unequal pupils c. Tachycardia
b. Decreasing systolic blood pr. d. Decreasing body temperature.

156. Which of the following respiratory signs would indicate increasing

intracranial pressure in the brain stem ?
a. Slow irregular respirations c. Asymmetrical chest excursion
b. Rapid , shallow respirations d. Nasal flaring

157. Which of the following nursing assessments of the client’s eyes would be least
helpful when assessing for signs of increased intracranial pressure?
a. The color of the sclera c. The pupils’ reaction to light
b. The size of the pupils d. The reaction of the corneas to touch

158.Which of the following positions would be most appropriate for client with a head
injury?
a. Head of the bed elevated 30 t0 45 degrees
b. Trendelenburg’s position
c. Left sim’s position
d. Head elevated on two pillows

159. The client receives mannito ( Osmitrol) during surgery to help decrease intracranial
pressure. Which of the following nursing observations would most likely indicate that the
drug is having the desired effect?
a. Urine output increases
b. Pulse rate decreases
c. Blood pressure decreases
d. Mascular relaxation increases

160. Which of the following postoperative care measures would be contraindicated for a
client at risk for increased intracranial pressure ?
a. Deep breathing
b. Turning
c. Coughing
d. Passive range-of-motion exercises

A 38- year-old male is admitted to the emergency room of the shifa hospital after found
unconscious at the wheel of his car in the hospital parking . The client is comatose and does
not respond to stimuli. A drug overdose is suspected .
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161.Which of the following assessment findings would lead the nurse to

suspect that the coma is a result of a toxic drug overdose?
a. Hypertension c. Dilated pupils
b. Fever d. Facial asymmetry

162.Blood and urine analysis confirm a diagnosis of salicylate overdose. the

client is treated with gastric lavage . Which of the following positions would
be most appropriate for the client during this procedure?
a. Lateral c. Trendelenburg’s
b. Supine d. Lithotomy

163.In anticipation of further emergency treatment for the client, which of thefollowing
medications should the nurse have available?
a. Vitamin K ( AquaMEPHYTON) c. Activated charcoal powder
b. Dextrose 50 % d. Sodium thiosulfate

164. The nurse would base the frequency of the client’s turning schedule primarily on an
evaluation of :
a. His weight c. His level of consciousness
b. His skin condition d. His age

165.The client is at risk for developing a decubitus ulcer. The first warning of an
impending decubitus ulcer is when pressure applied to skin turns it:
a. Bluish c. Whitish b. Reddish d. Yellowish

166.The client’s skin care includes frequent massage over bony prominences.
The primary reason for this massage is to help:
a. Relax tense muscles c. Keep the skin dry
b. Improve blood circulation d. Reduce the number of organism on
the skin.

167. The client has been positioned on his side. The nurse would anticipate that
which of the following areas would be a pressure point in this position ?
a. Sacrum c. Ankles b. Occiput d. Heels

168. The client is placed in a right-side-lying position : Which of the following techniques
to position the client is incorrect? The client's:
a. Head is placed on a small pillow
b. Right leg is extended without a pillow support
c. Left arm is rested on the mattress with the elbow flexed
d. Left leg is supported on a pillow with the knee flexed

* Inflammatory bowel diseases includes both ulcerative colitis and crohn’s disease.
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169. Common clinical symptom of crohn’s disease are:

a. Abdominal pain and diarrhea b. Edema and weight gain
c. Nausea and vomiting d. Obstruction and ileus

170. Primary symptom of ulcerative colitis is :

a. Anorexia c. Profuse diarrhea
b. Abdominal cramping d. Bloating

171. Post operative nursing management for patient with a continent ileostomy includes all
of the following EXCEPT:
a. Checking to make certain that the rectal packing in place
b. Irrigating the ileostomy catheter every 3 hours
c. Nasogastric tube feedings 30-50ml every 4 to 6 hours
d. Perineal irrigations after the dressing are removed

172. Hypokalemia may occur rapidly in an elderly person who experience diarrhea, the
nurse should report a critical potassium level of----- to the physician immediately:
a. 3.0 mEq/L c. 4.5 mEq/L
b. 4.0 mEq/L d. 5.0 mEq/L

173. For a patient with inflammatory bowel diseases vitamines are administered
parenterally because :
a. More rapid action result
b. They are ineffective orally
c. They decrease colon irritability
` d. Intestinal absorption may be inadequate

*A 45 years old drug addict is brought to the hospital with a bullet would in his left axilla.
174. He is in profound shock, all of the following are symptoms of hypovolemic shock
EXCEPT :
a. Hypertnsion b. Oliguria
c. Tachycardia d. Tachypnea

175. The principal reason for administering atropine sulfate preoperatively was to:
a. Depress the sensory cortex b. Improve cardiac function
c. Decrease respiratory secretions d. Increase sphincter tone

176. The recovery room nurse should remain with the patient post operatively until she
observes that:
a. He is oriented to his general surroundings
b. His pharyngeal reflexes have return
c. His vital signs have become stabilize
d. He is moving about freely in bed
1. A only . 2. A & B . 3. A,B & C. 4. All the above
177. The most common post operative respiratory complication in elderly patients is :
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a. Pleurisy c. Hypoxemia
b. Pneumonia d. Pulmonary edema

* Sami, a 20 years old college student is admitted to the hospital, he is acutely ill with
Hepatitis A :

178.The nurse would expect Mr. Sami to expect all of the following symptoms EXCEPT:
a. Loss of appetite c. Shortness of breath
b. Yellowing of sclera d. Dark urine

179. Which of the following tests results giving direct care :

a. Glucose tolerance c. Serum amylase
b. Creatinine clearance d. Serum transaminase

180. Plain abdominal x-ray shows air under diaphragm occurs in :

a. Intestinal obstruction c. Volvulous of sigmoid
b. Perforated duodenal ulcer d. None of them

181. The first symptom of acute appendicitis is usually:

a. Nausea c. Constipation
b. Diarrhea d. Periumbilical pain or epigastric pain

Mr. George 63 year old is admitted to the medical depart, diagnosed as a case of congestive
heart failure and pulmonary edema Mr. order the following medication
1 Lasix IV 20 mg and then 10 mg every 8 hours
2- Morphin sulphat 5 mg IV stat order sulphate
3- Metechlopramid IV 10 mg before giving morphin

182. Lasix given for George in order to :

a. Produce hypokalemia because potassium is very high
b. To promote diuresis and reduce fluid volume
c. To alleviate anxiety and promte sleep
d. All of the above

183. Drug mentioned in the question has many side effects , as an old man, the patient
is suspected to have :
a. Fluid and electrolyte imbalances
b. Hyperv olemia and hypokalemia
c. Hyponatremia and hypercalcemia
d. All are correct but (a) is not

184. Metechlopramide ( pramine), ordered for that patient because :

a. Morphine may induce sleep
b. Morphine may cause cardiac dysrhythmia
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c. Morphine may cause vomiting as aside effect

d. Pramine acts as antiemetic drug
e. (c) and (d) are correct.

185. Instead of administering 5 mg morphin . The nurse give 50 mg, which of the following
may be noticed on the patient :
a. Sever hypotension b. Respiratory depression
c. Coma d. All of the above

186. To treat the morphine side effects that result from miscalculation, The nurse
should
do which of the following :
a. Maintain air way patent
b. Prepare the antidote ( Noloxon = Narcan)
c. Maintain IV line and Emergency medication ready
d. All must be done

187. Nursing care regarding tetracyclin must include :

a. Should be taken with milk or milk products
b. Administered to children below 4 years diluted
c. To be administered to pregnant women freely
d. Best of be taken with antacids containing calcium
e. Non of the above is correct

188. Nursing cave regarding Non-steroidal antinflammatony drugs must include:

a. To be given on a full stomach or with glass of water
b. Pt. must monitored for fluid retention
c. Kidney function follow up is important
d. Monitor for GIT bleeding
e. All are correct but (c) is not

189. Poisoning with parathion insecticide is best managed by the administration of :

a. Physostigmine b. Pilocarbin
c. Atropine sulfate d. Propranolol e. None

* Abed is a 68-year-old female admitted with diagnosis of fractured left hip :

190. X-ray of Abed’s left femur reveals 40 % demineralization with decreased density
of bone . The nurse should recognize that these findings are indicative of which of
the following bone disorders?
a. Osteoporosis b. Osteoarthritis
c. Osteomalacia d. Ostemyelitis

191. Demineralization of Abed’s bone places her at risk for :

a. Infection b. Ankylosis
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c. Hemorrhage d. Fracture

192. Prior to open reduction and pinning of her fractured femur, Abed is placed
in Buck’s extension traction. The chief purpose of this preoperative treatment is to:
a. Immobilize the extremity to prevent further damage
b. Reduce muscle spasm associated with her fractures
c. Reduce pin in the affected extremity
d. Improve alignment and position of fracture fragments prior to surgery

193. The physician has ordered that Abed receive atropine 0.2 mg preoperatively. The
label reads grain 1/150 = ml. The nurse should administer:
a. 0.2 ml . b. 0.5 ml . c. 1.0 ml . d. 1.5 ml .

194. Following open reduction and pinning of the fracture, the nurse should place
Abed
in which of the following positions postoperatively?
a. Supine with legs adducted
b. Lateral with legs elevated
c. Supine with legs abducted
d. Side-lying with legs internally rotated

195. Sixteen hours postoperatively, Abed complains of pain in the lower extremity.
The nurse should :
a. Reposition the patient and elevate the head of the bed
b. Medicate the patient with the prescribed analgesia
c. Notify the physician of the patient’s status
d. Elevate the affected leg on 2 pillows

* Saleh bas undergone radical neck surgery with placement of a tracheostomy tube :

196. Which of the following should the nurse consider of greatest priority during Saleh
first 24 hours postoperatively ?
a. Monitor temperature for signs of infection
b. Assess for patency of tracheostomy airway
c. Observe quality, rate and rhythm of respirations
d. Monitor blood pressure for indication of bleeding

197. Which of the following steps should Saleh’s nurse take first when preparing to
perform tracheostomy care ?
a. Wash hands thoroughly
b. Open all necessary kits and dressings
c. Apply sterile gloves
d. Pour cleansing solutions into sterile containers
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198. The nurse preparing for tracheostomy care should place Saleh in which of these
positions ?
a. Sims’ b.. Side-lying . c. Semi- Fowler’s. d. Supine

199. Newly applied plaster cast may remain wet for :

a. 24 to 48 hours b. 24 to 36 hours
c. 20 to 30 hours d. 12 to 24 hours

200. The nurse suctioning Saleh trach should take which of the following steps first
a. Suction secretions from inner cannula
b. Instruct saleh to cough and deep breathe
c. Hyperoxygenate saleh per O2 cuff or Ambu bag
d. Remove soiled dressings from around the trach tube

201. Which one of the following characteristics is un true of a theory?

a. a theory can be a fact.
b. a theory can be disproved.
c. a theory can be modified by research.
d. a theory can be used to guide practice.

202. Dorthea E. Orem’s theory of nursing is based primarily on a human’s need for :
a. self care.
b. adaptive behavior.
c. interpersonal relationships.
d. adaptive mechanisms to cope with the environment.

203. If nursing is to attain full status as a profession, nurses must be willing to assume the
primary responsibility that they :
a. are accountable for their practice.
b. support legislation that defines nursing.
c. standardize curricula in schools of nursing.
d. evaluate the ability to give safe care in actual situation before licensure
is granted.

204. Health care that consists of health promotion, disease prevention, detection and treatment
of disease, and rehabilitation is commonly called :
a. Holistic health care.
b. Primary health care.
c. Comprehensive health care.
d. environmental health services.
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205. The step in the nursing process involved with problem identification is:
a. assessment c. diagnosis
b. planning d. implementation

206. The definition “exercises that place little demande on the cardiopulmonary system”
best describes:
a. active exercises. c. aerobic exercises.
b. passive exercises. d. isometric exercises.

207. According to Maslow’s theory of a hierarchy of human needs, which one of the following
needs will ordinarily be met after other needs are fulfilled ?
a. the need for sex. c. the need to be well thought of by others.
b. the need to be creative. d. the need for relating well to other people.

208. Convert 3:30 PM to military time.

a. 1530 c. 3030 b. 1330 d. 0330

209. The sense that appears to be least likely to adapt to repeated stimuli is the sense of :
a. pain. c. smell.
b. sight. d. hearing.

210. The type of data collected while using the nursing process consists of:
a. a plan of care.
b. nursing diagnoses.
c. nursing-intervention measures the patient will require
d. information concerning the patient who is to receive care.

211. The information given below is noted on a patient’s record which information is most
subjective in nature?
a. the patient’s pulse rate is 80.
b. the patient weighs 96 kg.
c. the patient’s blood pressure is 120/80.
d. the patient says he knows his diagnosis.

212. The first step in the process of nursing assessment is to :

a. determine relevant standards for assessing data about the patient.
b. collect information concerning the patient’s health-illness status.
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c. establish priorities in relation to nursing care the patient requires.

d. state the patient’s health problems that are potentially responsive to nursing care.

213. The first step in the process of planning nursing care is to :

a. describe nursing orders. b. prioritize nursing diagnoses.
c. write objectives of nursing care. d. select appropriate nursing measures.

214. The following statement appears on a nursing care plan, the patient will be able to dress and
undress without assistance. This statement is an example of a :
a. nursing order. c. positive assessment.
b. nursing diagnosis. d. behavioral objectives.

215. When the nurse evaluates care she has given a patient, the patient’s responses to care
are compared with the :
a. nursing orders. c. nursing diagnoses.
b. objectives of care. d. positive assessment of the patient.

216. Feedback that occurs when people communicate is best described as being present
when there is a:
a. face-to-face meeting of people.
b. response to a message being received.
c. lack of verbal methods of communicating.
d. lack of non-verbal methods for communicating.

217. Knowledge that many nonverbal communication cues are universal is especially helpful when
a nurse is communicating with a patient who :
a. is blind. c. unexpectedly becomes critically ill.
b. is unconscious. d. speaks a language different from her own.

218. SOB is a commonly used abbreviation that means :

a. stay out of bed. c. sleep on bed board.
b. short of breath. d. stop order of blood.

219. The acronym SOAP is used in problem-oriented records, what does the letter (P) represent ?
a. health problems the patient presents to health practitioners.
b. a plan of action to solve health problems the patient presents.
c. the order of priority in handling the patient’s health problems.
d. the patient’s prognosis as determined by health practitioners caring for the
patient.
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220. A typical characteristic of a problem-oriented record that distinguishes it from a source-

oriented record is that the problem-oriented record :
a. includes progress notes.
b. includes initial information secured from a patient.
c. is organized around a patient’s health problems.
d. is considered to be an acceptable legal document.

221. If Ms. Suad chooses to leave the hospital against her physician’s advice, it is
particularly important that the patient first :
a. sign a special release form.
b. notify the health insurance office.
c. agree to select another physician to care for her.
d. explain her reason for leaving to the hospital administrator.

222. In which one of the following areas of the body are hospital-acquired infections most likely
to occur?
a. the skin. c. the respiratory system.
b. the urinary system. d. the gastrointestinal system.

223. The patient for whom it is safe to insert a clean rather than a sterile tube is one who is to
have a tube placed in his:
a. rectum. c. chest cavity.
b. wound. d. urinary tract.

224. Which one of the following terms is used to describe an infection acquired during
hospitalization ?
a. iatrogenic. c. nosocomial.
b. idiopathic. d. serendipitious.

225. Reverse isolation practices should be observed for the patient who is receiving a medication
that acts in the body to :
a. suppress immune responses.
b. increase blood-clotting time.
c. decease cancer-cell division.
d. promote the development of antibodies.

226. The equivalent centigrade temperature of 102F is :

a. 38.2C. c. 38.8C.
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b. 38.5C. d. 40C.

227. The time during the day when body temperature is normally lowest is:
a. early in the morning. c. late in the afternoon.
b. about noon. d. in the evening.

228. A fever that fluctuates several degrees but does not reach a normal temperature
between fluctuations is :
a. constant fever. c. intermittent fever.
b. remittent fever. d. relapsing fever.

229. . The following manifestations are commonly associated with a fever EXCEPT:
a. pinkish, red skin that is warm to touch.
b. headache.
c. below normal pulse and respiratory rates.
d. convulsions in infants and children.

230. Poor oxygenation of the blood ordinarily will affect the pulse rate and cause it to become :
a. bounding. c. faster than normal.
b. irregular. d. slower than normal.

231. Which of the following factors has the least effect on blood pressure?
a. the blood volume.
b. the elasticity of vessel walls.
c. the level of calcium in the blood.
d. the peripheral resistance in the circulatory system.

232. If a patient’s visual acuity is tested with a snellen chart and reported to be 6/24, the number
24 indicates the :
a. distance at which the patient stood from the chart.
b. distance at which a person with normal vision can read the chart.
c. patient’s vision is 24% less than that of a person with normal vision.
d. patient has four times poorer vision in his right eye than his lift eye.

233. Equipment used to gather data about the ear and hearing include:
a. a tuning fork and an otoscope.
b. a tonometer and an ophthalmoscope.
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c. an otoscope and a sphygmomanometer.

d. a percussion hammer and a stethoscopel.

234. Which of the following sets of terms are frequently used to describe the consistency of a
mass when it is palpated ?
a. ovoid or round. c. fixed or mobile.
b. firm or spongy. d. pulsatile or nonpulsatile.

235. The most common method for assessing the lymph nodes is :
a. palpation. c. inspection.
b. percussion. d. auscultation.

236. When compared with atmospheric pressure, the pressure within the pleural cavity is
normally :
a. lower. c. approximately the same.
b. higher. d. appoximately different.

237. During data gathering, when the nurse checks Ms. Fatma 60-year-old black woman, for
cyanosis, the nurse should examine the patient’s :
a. retina. c. oral mucous membranes.
b. nail beds. d. skin on the inner aspect of the wrists.

238. The nurse judges that Ms. Fatma is dehydrated. To validate this observation, the nurse
should check the patient’s :
a. skin turgor. c. respiratory rate.
b. eye grounds. d. degree of cyanosis.

239. The most frequently recommended may to remove debris from between teeth is by :
a. using a blunt toothpick.
b. flossing between the teeth.
c. pushing toothbrush bristles between the teeth.
d. rinsing forcefully with an antiseptic mouth-wash.

240. In which direction should the nurse stroke when she cleans the perineal area of a female
patient?
a. the stroke should be circular beginning at the vaginal opening.
b. the stroke should move from the anal toward the pubic area.
c. the stroke should move from side to side across the perineal area.
d. the stroke should move from the pubic area toward the anal area.
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* Mrs. Badran a 36-year-old secretary, was admitted to Shifa Hospital complaining of

extreme nervousness, irritability and fatigue, on physical examination the doctor observed
the following : Temp. 39C orally, pulse 100/minute, respiration 24/minute, B.P 130/65
mmHg. The tentative medical diagnosis:
toxic hyperthyroidism with exophthalmus and ordered the following tests:
- protein bound iodine level of the serum
- serum cholesterol level
- chest x-ray
- radio iodine uptake determination (Q 1- 4)

241. Mrs. Badran's diastolic pressure lower than usual is probably a result of:
a. arteriosclerotic changes in the peripheral arteries
b. generalized arteriolor constriction resulting from anxiety
c. vasodilating effect of excessive thyroid hormones
d. decreased blood flow through the renal glomerulus

242. In taking Mrs. Badran's medical history the doctor would be particularly alert to mention
which of the following as possible precipitating factors of her current episode of
thyrotoxicosis?
1. acute infection
2. surgical trauma
3. hay fever.
4. reduction diet
5. psychic trauma
a. 1 and 4 b. 1 and 3
c. 1, 2, and 5 d. all of the above are correct.

243. It was decided to perform subtotal thyroidectomy for Mrs. Badran, the preoperative
instruction for her, should indicate that she is a pt. to receive which of the following
treatments during the immediate postoperative period?
1. intravenous infusion
2. medicated steam inhalations
3. oxygen administration
4. application of an ice collar
a. 1 only is correct b. 2 and 3
c. all but 2 d. all of the above are correct
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244. In giving Mrs. Badran's pre-discharge instructions, the nurse should advice her to consult her
doctor regularly on a long term basis in order to be checked for manifestation of:
a. laryngitis
b. lymphadenitis
c. hypothyroidism
d. carcinoma

* Sixteen year old Salma, is admitted to the hospital for treatment of acute hyperglycemia and
apparent ketoacidosis. (Q 5-7)
245. Which of the following laboratory tests is least associated with ketoacidosis?
1. glucose 580
2. PH 7.51
3. urine ketones large
4. hemoglobin 6.4
a. 1 and 2 b. 4 only is correct
c. 2 and 4 d. 3 and 4 are correct

246. Because of the acute hyperglycemia, Salma appears dehydrated with hot dry, flushed skin
and dry mucous membranes, of the following interventions which should the nurse consider
the first priority?
a. record intake and output
b. measure urine specific gravity
c. insert indwelling catheter
d. initiate IV fluids as ordered

247. Salma recovers and begins attending diabetic classes with his family, the nurse should
explain that all of the following increases the need for insulin except:
a. infectious processes
b. increased activity and exercises
c. increased caloric intake
d. psychic or emotional stress

* Rehab is 66 year old housewife who suffers from deficient production of antidiuretic hormone
(ADH). (Q 8-9)
248. Rehab would have which of the following symptoms secondary to her ADH deficiency?
a. peripheral edema
b. polydipsia
c. anuria
d. taut skin turgor
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249. Which of the following findings would indicate that Rehab's endocrinal disturbance is
improving with treatment?
a. serum sodium is decreasing
b. peripheral edema is decreasing
c. serum glucose is decreasing
d. urinary output is decreasing

* A patient has been diagnosed with addison's disease and is complaining of fatigue and
anorexia. (Q 10-11)
250.The nurse would assess the patient for which other clinical manifestations characteristic of
the disease?
1. hypertension and hyperglycemia
2. hyponatremia and emaciation
3. obesity and hypokalemia
4. hypotension and hypernatremia
5. dark pigmentation of the skin and muscular weakness
a. 1 and 2 b. 4 and 5
c. 2 and 5 d. all of the above are correct

251. A priority nursing diagnostic category for the patient with Addison's disease is:
a. fluid volume deficit
b. fluid volume excess
c. ineffective breathing pattern
d. pain

252. The nurse assesses a patient with cushing's syndrome and recognizes that the clinical
manifestations result from:
1. sodium and water depletion
2. sodium and water retention
3. decreased mineral corticoid secretion
4. decreased glucocorticoid secretion
a. 1 and 3 b. 2 and 4
c. 2 only is correct d. all of the above are correct

253. A priority goal for the patient with cushing's syndrome is:
a. promote regular breathing pattern
b. decrease pain
c. decrease nausea
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d. improve body image

* Roda is a 54-year-old housewife admitted for complaint of chest pain diagnosed as stable
angina pectoris, the frequency and intensity of her angina attacks have increased since her
husband's sudden death 4 months ago, but her recent ECG shows no significant
abnormalities following coronary angiography. She is diagnosed with coronary artery disease
(CAD). (Q 14-20)

254. Which of the following statements Roda in her health history would not correlate with a
diagnosis of stable angina pectoris?
a. "the nitro tablet takes the pain away in a few minutes."
b. "I feel pressure in my chest and it moves down my left arm"
c. "the pain comes on even when I'm lying still and resting"
d. "I sweat a lot during an attack and my hands get all clammy"

255. Roda's anginal pain would likely be managed by any of the following medication except:
a. nitroglycerin b. inderal
c. digoxin d. adalat

256. The nurse teaching Roda about management of anginal pain with nitrate medication should
include which of the following directions to the client in her teaching plan?
a. if the medication causes you to have a headache and to feel dizzy, discontinue
use and notify your physician immediately
b. if chest pain persists, you may take another tablet every 30 minutes after the
first dose
c. place your nitro. tab. under your tongue when your chest pain begins
d. the medication will probably cause your skin to become cool, pale and clammy

257. In addition to the foregoing, which of the following often provoke angina pectoris?
1. strong emotion
2. eating a heavy meal
3. exposure to cold
4. recumbent position
5. exposure to sunlight
a. 1 and 2 b. 1, 2, and 3
c. all but 4 d. all of the above are correct
258. Typically, the pain of coronary occlusion differs from that of angina pectoris in that the
former is:
a. intermittent in nature
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b. more apt. to radiate

c. more responsive to rest
d. less often provoked by exertion

259. Roda should be observed for development of which of the following symptoms which often
follow myocardial infarction?
1. pallor 2. diaphoresis
3. anxiety 4. breathlessness
5. vomiting
a. 1 and 3 b. 2 and 4
c. all but 5 d. all of the above are correct

260. In planning long term care for Roda, the nurse should be aware that which of the following
are possible complication of a myocardial infarction?
1. congestive heart failure
2. hypertensive crisis
3. ventricular fibrillation
4. hemopericardium
5. cardiac arrest
a. 1 and 2 b. 3 and 4
c. all but 2 d. all of the above are correct

* Sara, 45-year-old female with known history of atherosclerotic heart disease, hyper tension and
chronic congestive heart failure (CHF). She has been admitted with recurrence of symptoms
of CHF. (Q 21-25)
261. All of the following would be expected symptoms of CHF except:
a. rapid, shallow, difficult respirations
b. polyuria
c. peripheral edema
d. pulmonary congestion and rales
262. The physician has ordered for Sara to receive 80 mg IV lasix (furosemide) twice
a day. The nurse notes that the patient's K+ level is 3.0, the nurse should:
a. administer the lasix as ordered
b. administer half the dose of lasix IV
c. offer the patient potassium-rich foods and fluids after administering lasix 80mg IV
d. withhold the drug and notify the physician of the serum K+ level

263. Sara has been receiving digoxin 250 mg. IV push daily. Which of the following findings would
indicate that the digoxin has been effective in treating the patient's congestive heart failure?
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a. a pical heart rate is 120 beats/min

b. BP. is 138/86
c. urine output is 3000 cc/24 hrs
d. rales auscultated in the Rt. lower lung lobes

264. A pulmonary capillary wedge pressure of 30 mmHg in a patient with congestive heart failure
indicates:
1. hypertension
2. decreased peripheral vascular resistance
3. reduced cardiac output
4. pulmonary congestion
a. 1 and 2 b. 2 and 3
c. only 4 is correct d. all of the above are correct

265. To assess Sara's fluid balance at home the nurse teaches her to monitor:
a. blood pressure b. daily weight
c. radial pulse rate d. daily urine output

* Mrs. Jaber's valvular heart disease, has responded poorly to medical treatment and she is
becoming increasingly disoriented, and cardiac surgery is indicated:
(Q 266-268)
266. One of the major purposes of the heart-lung machine used during open heart surgery is to:
a. prevent fluid volume overload
b. cool the blood prior to return to the body
c. maintain perfusion of other body organs
d. filter the blood of any toxins

267. Mrs. Jaber expresses many fears before cardiac surgery. What response from the nurse
would be most appropriate?
a. "you have nothing to fear, many patients have had this type of surgery."
b. "why don't I have your doctor explain the surgery to you again."
c. "I'll call your minister, and he can talk to you about your surgery."
d. "tell me about your fears and how do you feel."

268. Preoperative strategies that the nurse implements to improve pulmonary function after
cardiac surgery include:
a. administering antibiotics
b. monitoring for fever
c. practicing using incentive spirometry
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d. maintaining the patient in a volume depleted state

* Mr. Ali 45 years-old admitted to Shifa hospital medical department. The tentative medical
diagnosis was peripheral vascular disease (PVD).

269. The nurse teaches Mr. Ali about the risk factors associated with(PVD) which includes:
a. high protein intake
b. hypotension
c. malnourishment
d. tobacco use

270. When teaching Mr. Ali to perform Buerger-Allen exercises, the nurse instruct him to position
the extremity in:
a. flat position first, elevated position second, and then dependent position
b. flat position first, dependent position second, and then elevated
c. elevated position first, dependent position second, and then flat position
d. dependent position first, followed by elevation

271. When assessing Mr. Ali for the presence of deep vein thrombosis (DVT) the nurse anticipates
which of the following clinical manifestations?
a. absence of a peripheral pulse in the affected extremity
b. swelling of the affected extremity
c. localized swelling around the site of the clot
d. a red, tender induration

272. The most effective measure the nurse can implement to prevent the risk of venous stasis in
an immobilized patient is:
a. active range of motion
b. passive range of motion
c. ambulation as soon as possible
d. repositioning every 2 hours

* A client has received chemotherpeutic agents, suffering from numerous side effects including
leukopenia, thrombocytopenia, anemia, gastro intestinal distress and bleeding. (Q 33-35)
273. The nurse knows that these side effects occurs because:
a. chemotherapeutic agents are toxins
b. both normal and abnormal rapidly dividing cells are destroyed
c. the dosages of chemotherapy are usually high to ensure cure
d. chemotherapeutic agents are lethal to all cells
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274. Nursing interventions for the client suffering from leukopenia secondary to chemotherapy
include:
a. protecting the client from infections
b. avoiding injections
c. providing rest periods
d. administering antiemetic before meals
275.If a client is believed to have gastrointestinal bleeding secondary to chemotherapy, the nurse
should:
a. test all stools and urine for blood
b. administer only cold liquids
c. avoid procedures that could increase blood loss
d. place the client on complete bed rest

* Hoda is a 55-year-old mother of three, admitted with a diagnosis of chronic lymphocytic

leukemia, which has possibly become acute. She is admitted in acute distress and seriously
ill. (Q 36-39)
276. Most leukemias involve changes in the:
a. erythrocytes b. platelets
c. monocytes d. lymphocytes

277. Because Hoda's WBCs is 20,000 mm3 she may demonstrate:

a. enlargement of the lymph nodes
b. lower resistance to infections
c. greater risk of phlebitis
d. increase in clotting activity

278.Thrombocytopenia frequently occurs with leukemia, nursing interventions to prevent

problems associated with this include:
a. using swabs for mouth care
b. encouraging dry meals
c. maintaining strict bed rest
d. avoiding people with infections

279.t seems to the nurse that Hoda is often irritable and difficult to please. This is probably an
indication that:
a. she is very neurotic
b. this is typical behavior for a person her age who has been hospitalized
c. this is a symptom of her illness and outside her control
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d. she has not accepted her illness and needs spiritual help

* Mrs. Salah brought to the hospital, because she was unable to care for herself anymore, Mrs.
Salah was 60 years old and had lived in a furnished room since she had widowed seven years
ago. She had become progressively more weak ,confused and had complained of numbness
and tingling in her legs and feet. A diagnosis was made of pernicious anemia. (Q 280 - 282)
280.Which of the following presumably contributed to Mrs. Salah's poor eating habits in recent
weeks:
1. sore mouth and tongue
2. impairment of taste and smell
3. difficulty in handling a utensils
4. lack of physical activity
a. 1 only is correct b. 1 and 2
c. all but 4 d. all of the above are correct

281. Which of the following is most characteristic of all types of anemia?

a. decreased number of red blood cells
b. decreased amount of hemoglobin per cell
c. decreased volume of circulating blood
d. decreased oxygen-carrying capacity of the blood
282.Which of the following is thought to be the cause of pernicious anemia?
a. insufficient intake of meat, eggs and grain
b. decreased permeability of the intestinal wall
c. failure of the stomach to secrete an intrinsic factor
d. toxic depression of hemopoietic cells in the marrow

* Samy 30 years old, admitted to the hospital complaining from nausea, vomiting , dry mouth,
and enlarged cervical lymph nodes. The patient diagnosed Hodgkin's disease. (Q283 - 286)
283.Diagnostic studies for Mr. Samy reveals that the disease in a single node. During assessment,
the nurse recognizes that the disease is considered to be in what stage?
a. stage I b. stage II
c. stage III d. stage IV

284.To help the patient with Hodgkin's disease, manage anorexia, nausea and dry mouth, the
nurse teaches the patient to:
a. avoid solid and drink primarily liquids
b. eat by themselves to avoid embarrassment
c. eat sweet foods at a cold temperature
d. eat soft, bland food at a mild temperature
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285.Which of the following signs and symptoms are not characteristic of Hodgkin's disease?
a. Fatigue b. night sweats
c. lymph-node enlargement d. hemoptysis
286.Which of the following nursing interventions is most important in the care of Mr. Samy?
a. stool and needle precautions
b. reverse or protective isolation
c. meticulous hand-washing
d. private room

* Sameer is a 21 year-old college student, admitted to the hospital for a bone marrow biopsy. (Q
47 -48)
287.Which of the following are important in preparing Sameer for his biopsy?
a. an explanation of the procedure
b. ensuring Sameer's cooperation
c. assessing Sameer's coagulation studies
d. all of the above are correct

288.Which of the following nursing interventions would be in appropriate after sameer's bone
marrow biopsy?
a. monitoring Sameer's vital signs every hour until stable
b. assessing the biopsy site for bleeding and inflammation
c. encouraging and assisting Sameer to ambulate as much as possible to prevent muscle
stiffness
d. charting the date, time, location and tolerance of the procedure

* Eman 25 year old mother, has developed chronic glomerulonephritis, she has been hospitalized
complaining of proteinuria, hypertension, gastritis and anasarca, she has been treated with
bed rest, aldomet, aluminum hydroxide gel, valium. Renal biopsy revealed local obliteration
of glomerular loops, she was discharged and arrangements were made for her to be
hemodialyzed 3 times a week on an out patient basis. (Q 289-294)
289.During her episodes of acute glomerulonephritis Eman probably demonstrated which of the
following symptoms?
1. headache 2. periorbital edema
3. flank pain 4. oliguria
5. hematuria
a. 1 and 2 b. 1, 2, and 3
c. all but 5 d. all of the above are correct
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290.Which of the following are possible complications of chronic glomerulonephritis?

1. anemia
2. stroke
3. heart failure
4. kidney stones
5. uremia
a. 1 only is correct b. 1 and 2
c. all but 4 d. all of the above are correct

291.Eman's anasarca was primarily the result of:

a. increased hydrostatic capillary pressure
b. increased volume of intravascular fluid
c. decreased plasma colloid osmotic pressure
d. inflammation of capillary endothelium
292.Which of the following is the usual result of excessive concentrations of serum potassium?
a. generalized edema
b. kidney stones
c. bleeding tendencies
d. cardiac stand-still
293.It is the nurse's responsibility to prepare Eman for insertion of the peritoneal dialysis catheter
by:
1. placing her in side-lying position
2. recording her temperature, pulse and blood pressure
3. administering a cleansing enema
4. instructing her to empty her bladder
5. encouraging her to push fluids
a. 1 and 2 b. 2 and 4
c. all but 4 d. all of the above are correct
294.Which of the following psychological reactions are frequently observed in patients
undergoing hemodialysis?
1. anxiety 2. denial
3. depression 4. hysteria
5. euphoria
a. 1 and 2 b. 1, 2, and 3
c. all but 4 d. all of the above are correct

* Mr. Fares had a radical cystectomy and ileal conduit yesterday, to treat his bladder cancer. (Q 55-58)
295.Which of the following symptoms immediately Postop. would be the most critical?
a. lack of urine output for 30 minutes
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b. respiratory rate of 24/minute

c. complaints of severe incisional pain
d. some lower extremity edema
296.Mr. Fares needs to be taught to avoid and/or recognize which of the following problems that
might result from ileal conduit?
a. recurrent bladder infections
b. possible intestinal obstruction
c. kidney infections
d. dilation of the stoma
297.Which of the following is an expected outcome of Mr. Fares's surgery?
a. client does not develop sexual problems
b. client regains normal urinary control
c. client is able to care for own urinary appliance
d. client regains normal bowel function

298.Preoperative physical preparation for the client scheduled for an ileal conduit would not
include which of the following?
a. administering antibiotics such as neomycin
b. giving enemas and laxatives until clear
c. marking the skin for stoma placement
d. inserting an indwelling catheter

* Salama 25 years-old admitted to hospital complaining of fever, generalized rash, cramping,

nausea vomiting, butterfly rash and weight loss, the tentative medical diagnosis: Systemic
Lupus Erythematosus. (Q 59-60)
299.Which of the following would not be considered a complication of lupus?
a. cirrhosis
b. renal failure
c. congestive heart failure
d. peripheral vascular disease

300.Which of the following nursing interventions is appropriate for the client with lupus?
a. administer plaquenil
b. encourage the client to get plenty of sunlight
c. provide for frequent baths
d. provide a low protein, high carbohydrate diet

* You are assigned to treat a 50 year-old paralplegic patient in the medical department, she is
suffering from severe dehydration and mild elevated body temperature. (Q 60 -62)
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301.If planned to give the patient 5% dextrose and Lactated Ringer's 3000 cc IV in 18 hours, the
drop factor of the IV set is 15 drop/cc. you should regulate the IV to run at :
a. 21 drops per minute b. 42 drops per minute
c. 38 drops per minute d. 60 drops per minute

302.The patient is suddenly suffers from SOB, chest pain, dyspnea, cyanosis and coughing blood.
The most likely cause of this problem is:
a. fat embolism
b. myocardial infarction
c. pulmonary oedema
d. massive pneumonia
e. pulmonary embolsim
* Mr. Subhi is admitted to the surgical unit with a diagnosis of cancer of the colon, his doctor
plans for a colon resection with a permenant colostomy. Mr. Subhi is very cooperative in all
preoperative procedures. (Q 63-66)

303.Based on you understanding for cancer colon; which of the following are predisposing
factors:
1. low fiber diet
2. chronic ulcerative colitis
3. familial polyposis
4. excess fat intake
a. 1, 2, and 4 b. 2 and 4
c. 2 and 3 d. 2, 3, and 4
e. all of the above are correct
304.Most colorectal cancers are detected only after symptoms have appeared. Which of the
following is the most common presenting symptoms?
1. changes in bowel habits
2. passage of blood in stool
3. abdominal cramp and pain
4. anemia and weight loss
a. 1 and 3 b. 2, 3, and 4
c. 1, 2, and 3 d. 1 only is correct
305.During the colostomy irrgation, if Mr. Subhi complains of abdominal cramps, the nurse
should:
a. raise the irrigating can, so that it can be completed quickly
b. pinch the tubing so that less fluid enters the colon
c. clamp the tubing and allow Mr. Subhi to rest
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d. reassure Mr. Subhi and continue the irrgation

e. both b and c are correct

306.Mr. Subhi's postoperative diet order reads "diet as tolerated." Principles that should guide
food choices include:
1. a low-residue diet should be followed indefinitely to avoid overstimulating
the intestine
2. a return to a regualr diet as soon as possible gives psychological support
and more rapid physical rehabilitation
3. more rigid dietary rules limiting food choices are needed to provide
security
4. those few foods that caused individual discomfort before the colostomy will
likely continue to do so and can be avoided
a. 1 and 3
b. 1 and 4
c. 2 and 3
d. all of the above are correct
307.For which of the following factors (reasons) is neomycin especially useful prior to colon
surgery?
a. it is effective against many organisms
b. it acts systemically without delay
c. it will not affect the kidneys
d. it's poorly absorbed from the gastrointesinal tract
e. non of the above is correct

* Omar is 68 years-old, is recovering from herniorrhaphy. He also has chronic pulmonary

emphysema. (Q68-71)
308.Emphysema causes a failure in oxygen supply because of:
a. bronchial smooth muscle relaxation
b. respiratory muscle paralysis
c. pleural effusion
d. loss of aerating surfaction
e. bronchial smooth muscle spasm
309.Arterial blood gases measurements that are consistent with a diagnosis of Emphysema are:
a. PH 7.32, PaO2 70mmHg, PaCo2 50mmHg
b. PH 7.37, PaO2 9ommHg, PaCo2 42mmHg
c. PH 7.39, PaO2 80mmHg, PaCo2 35mmHg
d. PH 7.40, PaO2 85mmHg, PaO2 42mmHg
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310.For which of the following factors, inhalation of isoproterenol (Isuprel) PRN, is prescribed?
1. to increase bronchial secretion
2. to decrease blood pressure
3. to produce sedation
4. to relax bronchial smoothe muscle
a. 1 and 4 b. 2 and 4
c. 1, 3, and 4 d. only 4 is correct

311.Complications of pulmonary emphysema, include which of the following disorders?

1. corpulmonale
2. respiratory alkalosis
3. spontaneous pneumothorax
4. recurrent respiratory infections
a. 1, 2, and 3
b. 1 and 3
c. 1, 3, and 4
d. 1 and 2
* A 28 year old female patient, is admitted to the emergency room with second-degree burns,
over 40 % of her body and face, which she received, when her nightgown caught fire. (Q72-
76)
312.Which of the following would not be a problem during the first few hours after the incident?
a. edema of the larynx and trachea
b. maintenance of blood volume
c. rapid decrease in leukocyte count
d. pain

313.Intravenous fluids replacement therapy is important to the patient with burns. Which of the
following would be expected in the first 24 hours ?
a. intake 08,000 ml output 0,480 ml
b. intake 12,000 ml output 4,500 ml
c. intake 03,000 ml output 2,400 ml
d. intake 06,000 ml output 1,200 ml

314.n the immediate shock period, nutritional care centered on replacement therapy by IV fluids.
These initial fluid replacement included:
1. colloid (protein) through blood or plasma transfusion or by use of plasma
expanders such as dextran
2. electrolytes sodium and chloride by use of a saline solution such as
lactated Ringer's solution
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3. potassium added to replace losses

4. water (dextrose solution) to cover additional insensible losses
a. 1, 2, and 4
b. 2, 3, and 4
c. all of the above are correct
d. 1, 2, and 3
315.In the secondary feeding period, after recovery from shock and balance of circulating fluids
and electrolytes, vigorous nutritional therapy is mandatory because:
1. tissue destruction by the burn has caused large losses of protein and
electrolytes
2. tissue catabolism followed, with continuing nitrogen loss
3. energy needs requires extra protein and vitamin D
4. infection and fever may require reduction in calories
5. tissue regeneration in the healing process requires extra-protein and
vitamin C
a. 1, 2, and 5
b. 3, 4, and 5
c. 1, 2, and 3
d. 2, 3, and 4

316.To prevent tetanus development. If it is impossible to determine whether the patient has
been immunized against tetanus, which of the following preparations would produce passive
immunization for several weeks with minimal danger of allergic reactions?
a. tetanus antitoxin
b. tetanus toxoid
c. tetanus immune-globulin
d. DPT vaccine

* Mr. Eisa 50-years-old, recently came from Syria to visit relatives, while here, he was admitted to
the hospital complaining of anorexia, loss of weight, abdominal distention, and passage of
abnormal stools. The tentative diagnosis was cancer of esophagus or malabsorption
syndrome. (Q77-78)
317.To determine the correct diagnosis, extensive diagnostic studies were performed. Tests in
connection with cancer of esophagus includes:
1. x-ray examination
2. biopsy
3. esophagoscopy
4. bronchoscopy
a. 1 and 2
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b. 1 and 3
c. 1, 2, and 3
d. all of the above are correct
318.Since Mr. Eisa's nutritional status is poor, the nurse should:
1. maintain IV therapy as ordered
2. encourage the patient to take whatever food and/or fluids he will take
3. keep an accurate record of intake and output
4. keep the patient NPO since he has diarrhea
a. 1 and 2
b. 1, 2, and 3
c. 1 and 3
d. 1, 3, and 4
319.Sodium bicarbonate is effective in the treatment of hyperkalemia because it:
a. antagonizes hyperkalemia-induced cardiotoxicity
b. shifts potassium into the cells
c. increases renal excretion of potassium
d. binds chemically with serum potassium molecules and forms an innocuous substance
320.To differentiate between a gastric ulcer and gastric carcinoma, which of the following
diagnostic tests may be performed?
a. gastrointestinal series
b. gastroscopy
c. stool examiantion
d. gastric analysis

321.Maternal mortality rate may be defined as:

a. the No. of maternal deaths resulting from labor
b. the No. of maternal deaths resulting from postpartum only
c. the No. of maternal deaths resulting from pregnancy
d. all of the above are correct

322.The risk of maternal death for all mothers is lowest at ages of:
a. 15 - 18
b. 20 - 24
c. 40 - 44
d. 45 - 55

323.The normal position of the uterus is:

a. anteversion - anteflexion
b. retroversion - retroflexion
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c. complete prolaps
d. firmly fixed in the pelvic cavity

324.Which of the following is the correct figures concerning the normal uterus Nullipara?
a. wt. 60 grams, 5.5 cm to 8 cm in length
b. wt. 900 gram, 10 cm in length
c. wt. 20 gram, 7 cm in length
d. wt 120 gram, 6 cm in length

* A primipara and her husband voice an interest in the childbirth preparation classes offered in
the community. They have their physician's support for delivery in a birthing center. The
client is at approximately 6 weeks gestation.

325.The couple asks the nurse when they will first be able to hear the baby's heart beat. What is
the nurse's best response?
a. "the baby's heart beat can be heard with a doppler early in the third trimester."
b. "using a stethoscope, the heart beat can be heard as early as 6 weeks."
c. "I think you should be worrying about other things right now."
d. "the heart beat can be heard as early as 8 to 10 weeks with a doppler."

326.The couple asks when they should begin the preparation for childbirth classes that discuss
nutrition during pregnancy and infant feeding. The best response by the nurse would be to
suggest that the couple start attending:
a. as soon as the client experiences quickening
b. after the client has read pamphlets on the anatomy and physiology of reproduction
c. during the first trimester of pregnancy
d. in the late second or early third trimester

327.The client asks the nurse how to prepare her breasts for breast-feeding. The nurse's best
response is to instruct her to:
a. wear a supportive but loose-fitting brassiere
b. tug and roll the nipples between the thumb and forefinger
c. rub the nipples with a terrychloth towel when drying them after bathing
d. pat the nipples once a day with a gauze sponge moistened with alchohol

* Ms. Fatma is having her first baby and is at term, she is having uterine contractions when
admitted to the hospital:
328.Which of the following questions that the nurse asks Ms. Fatma upon admission is least
pertinent?
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a. "when did you last eat?"

b. "have you ever had an enema?"
c. "have your membranes ruptured?"
d. "when did your contractions start?"
329.The nurse should check the fetal heart rate during the time when Ms. Fatma has a
contraction and again:
a. midway between contractions
b. immediately after the contractions
c. immediately before the next contraction
d. as near to the end of the contraction as possible

330.Alpha - fetoprotein levels in amniotic fluid may be increased greatly if a fetus has:
a. renal agenesis
b. trisomy 21
c. esophageal atresia
d. meningomyelocele
e. pyloric stenosis
* A 24-year-old multigravida, schedules an appointment at the prenatal clinic because she has
missed two menstrual periods.
331.From the initial interview the nurse learns that the first day of the client's last menstrual
period was March 20. According to Naegele's Rule, the nurse determines that the clients
estimated due date is:
a. June, 27
b. October, 6
c. November, 6
d. December, 27
332.While the nurse is preparing the client for a pelvic examination, the client says "I am afraid of
this examiantion." What is the nurse's best response?
a. "I'll be with your to explain everything the nurse practitioner is doing."
b. "nearly all new mothers have some fears about this type of examination."
c. "please tell me more about what you mean when you say you're afraid."
d. "the examination won't take too long, you'll be draped to ensure privacy."
333.The nurse plans to perform leopold's maneuvers to examine the clients abdomen. To help
make the client feel more comfortable and make the results more accurate, the nurse should
have the client:
a. empty her bladder
b. lie on her left side
c. hyperventilate for 2 minutes
d. avoid eating immediately before the procedure
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334.The nurse is planning a 2-hour childbirth preparation class focused on labor and delivery.
Included in the plan will be the normal sequence of maneuvers the fetus goes through during
labor and delivery if the head is the presenting part. Which of the following should the nurse
plan to include in the instructions?
a. engagement, external rotation, flexion and expulsion
b. internal rotation, descent, engagement, expulsion and external rotation
c. descent, flexion, external rotation, internal rotation, extension and expulsion
d. descent, flexion, internal roation, extension, external rotation and expulsion

335.The nurse plans to discuss various diagnostic tests to determine fetal well-being, which of the
following should be included in the teaching plan?
a. fetal biophysical profile involves assessing breathing movements, body movements, tone,
amniotic fluid volume and fetal heart rate reactivity
b. a reactive nonstress test is an aminous sign and requires further evaluation with fetal
echocardiography
c. contraction stress testing is performed on most pregnant women and can be initiated as
early as 20 weeks gestation
d. Amniocentesis for lung maturity studies requires admission to the hospital and a full
bladder
e. non of the above is correct

* A primigravida is admitted to the hospital at 11 weeks gestation. She has abdominal cramping
and bright red vaginal spotting. Her cervix is not dilated.

336.Based on the client's symptoms, the nurse determines that the client is most likely experiencing
a:
a. missed abortion
b. threatened abortion
c. inevitable abortion
d. incomplete abortion

337.The client is discharged when her symptoms subside, although she is still having slight vaginal
spotting occasionally. Before discharge, the nurse should instruct the client to:
a. weigh herself daily
b. follow a salt-free diet temprarily
c. have intercourse no more often than once a week
d. save her perineal pads for inspection
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338.After the client passes some of the products of conception, she returns to the hospital for a
dilatation and curettage (D & C). The nurse determines that the client is most likely
experiencing which type of abortion?
a. missed
b. induced
c. incomplete
d. threatened

339.Postoperatively, the nurse finds the client crying. Which of the following comments by the
nurse would be best in this situation?
a. Why are you crying?
b. will a pill help your pain?
c. I'am sorry you lost your baby?
d. you can always try again to get pregnant?
* A 34-year-lold multigravida, at 36 weeks gestation is admitted to the hospital, the client has
experienced two stillbirths.
340.On admission to the antenatal unit, the nurse determines that the fetal heart rate is 140
beats per minute. The nurse should:
a. notify the attending physician
b. document this as an abnormal reading
c. check the fetal heart rate again in 5 minutes
d. continue to monitor the client and fetus

341.An ultrasound is scheduled for the client before an amniocentesis. After teaching the client
about the purpose of the ultrasound, the nurse determines that the client needs further
instructions when she says that ultrasound is done to:
a. locate the placenta
b. measure the biparietal diameter
c. determine where to insert the needle
d. identify a pool of amniotic fluid

* A 30-year-old multigravida at 10 weeks gestation is receiving prenatal care in a high risk clinic,
she is an insulin dependent diabetic.
342.The nurse discusses the importance of keeping blood glucose levels near normal throughout
the pregnancy. The nurse explains to the client that as pregnancy progresses, her insulin
needs will:
a. increase
b. decrease
c. remain constant
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d. cannot be predicted
e. stop and take oral hypoglycemia

343.After explaining the complications of pregnancy that occur with diabetes, the nurse
determines that the client needs further instructions when she says that one complication is:
a. infection
b. ketoacidosis
c. oligohydramnios
d. pregnancy-induced hypertention

344.When planning to teach the client how to monitor glucose control and insulin dosage at
home, the nurse should explain that most accurate method for glucose assessment is:
a. urine testing
b. blood glucose testing
c. 50 g I-hour screen
d. 3 - hour glucose tolerance testing

345.The client reports that she participated in strenuous aerobic exercise before becoming
pregnant, she asks the nurse if she can continue exercising. What is the nurse's best
response?
a. you probably should discontinue exercising for a while
b. you need to ask your doctor if this type of exercise will affect the fetus
c. you can continue exercising as before, but you should eat a carbohydrate or protein
snack before exercising
d. it's probably not a good idea, this type of exercise could injure the developing fetus

346.Symptoms of placenta previa would include:

a. sharp pains in the absence of bleeding
b. spotting in the early months of pregnancy
c. painless bleeding in the last months of pregnancy
d. watery discharge prior to birth

347.Which of the following is a typical manifestation of the third stage of labor?

1. uterus assumes globular shape
2. blood gushes from uterus
3. perineum bulges
4. fundus rises
a. 1, 3, and 4 b. 1, 2, and 3
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c. 3 and 4 d. 1, 2, and 4

348.The majority of ectopic pregnancy are:

a. tubal
b. ovarian
c. abdominal
d. cervical

349.Station may best be defined as the:

a. ratio of the degree of cervical dilation accomplished to the total possible dilations
b. relationship of the long axis of fetus to that of the mother
c. positional relationship of the further most part of the fetus to the maternal ischial
spines
d. degree to which the uterine fundus has contracted and descend below the umbilicus

350.The cervix is considered to be completely dilated when the diameter of the os is:
a. 08 cms
b. 10 cms
c. 12 cms
d. 14 cms

351.The 2nd stage of labor ends with:

a. complete cervical dilation
b. bulging of the perineum
c. delivery of the baby
d. removal of the placenta

352.All of the following are risk factors for developing postpartum infections related to general
infection except:
a. anemia
b. lack of prenatal care
c. poor nutrition, obesity
d. sexual intercourse before rupture of membrane

353.Acute phase of Toxic Shock syndrome lasts about :

a. 02 days
b 05 days
c. 10 days
d. 14 days
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* Mrs. Samira, 6 months pregnant, is admitted with complaints of painful urination, flank
tenderness and hematuria.
354.A diagnosis of pyelonephritis is made, an important nursing intervention for Mrs. Samira
during this attack is:
a. limiting fluid intake
b. observing for signs of premature labor
c. examining the urine for albumin
d. maintaining her on a law - salt diet

355.Which of the following is an indication for the use of oxytocin for your client in labor?
a. prolapse of the cord
b. history of previous cesarean section more than five years ago
c. cervical dilation less than 3 cms
d. hypotonic uterine contractions

356.Part of your initial assessment on a client admitted in labor is to perform leopold's maneuver
to determine:
a. contractions
b. fetal psition
c. fetal heart rate
d. presence of fetal distress

* A 30-year-old primigravida, delivers a viable male infant more than 2 weeks post-term.
357.At 5 minutes after birth, the nurse evaluates the neonate using the Apgar Scoring Chart.
After assessing heart rate, respiratory effort, muscle tone, and reflex irritability, the nurse
should next assess the neonates:
a. eyes
b. color
c. suck reflex
d. urethral patency

358.Because the neonate is post-mature, the nurse assesses carefully for sytmptoms of:
a. hyperglycemia
b. hypoglycemia
c. anemia
d. elevated temperature
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359.A client who has just delivered expresses anxiety to the post-partum nurse over the fact that
her brother has Down Syndrome. After teaching the client about Down Syndrome, the nurse
determines that the client needs further instructions when she says:
a. Down Syndrome is an abnormality that can result from an extra chromosome
b. Down Syndrome is a form of mental retardation
c. there is no method available to determine if my baby has Down Syndrome
d. babies born to older mothers are more likely to have Down Syndrome

* A multigravida at 28 weeks gestation, is arrived to a perinatal center, accompanied by her

husband, crying , with contractions of moderate intensity occuring every 3 to 4 minutes. She
has previously delivered two nonviable fetuses.

360.The client is a candidate for therapy with ritodrine (Yutopar), which of the following would be
most important for the nurse to assess before beginning ritodrine therapy?
a. level of consciousness
b. fatigue level
c. estimated fetal size
d. cervical dilation

361. While administering intravenous ritodrine the nurse assesses the client for which common
side effect?
a. obesity
b. seizure activity
c. itching
d. tachycardia

362. The nurse monitors the client's laboratory studies during ritodrine therapy. The nurse
explains to the client that an increase in blood plasma volume is confirmed by:
a. decreased hemoglobin level
b. protein in the urine
c. decreased blood glucose levels
d. increased serum calcium levels

363. The clients contractions are monitored with an external electronic monitor. The nurse
places the toko-dynamometer disc:
a. over the body of the fetus
b. on the left side of the abdomen
c. over the top of the fundus
d. at the side of discomfort during a contraction
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364. The position of choice for a client undergoing a vaginal examination is the:
a. sim's position
b. lithotomy position
c. genupectoral position
d. dorsal recumbent position

365. A priority nursing diagnosis for a client with cervical cancer and an internal radium implant
would be:
a. pain related to cervical tumor
b. anxiety related to self-care deficit from imposed immobility during radiation
c. altered health maintenance related to surgery
d. sleep pattern disturbance related to interruptions of sleep by health care personnel

366. The Anti-D is given within 72 hours to Rh-ve women after:

a. labor
b. abortion
c. both
d. neither

367. Which of the following are causes of bleeding in the first trimester of pregnancy?
1. abortion
2. abrupto placenta
3. placenta previa
4. ectopic pregnancy
a. 1 and 2
b. 1 and 4
c. 1 and 3
d. 1, 2, and 3

368. The most common complication due to epidural anesthesia during labor is:
a. respiratory suppression
b. hypotension
c. paralysis
d. all of the above are correct

369. Contraindication for administering contraceptive Pills are all of the following, except:
a. hypertension.
b. active liver disease.
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c. uncontrolled diabetes.
d. age of woman 30-32 years.

370. What are the possible causes of intra-uterine growth retardation?

a. hypertension, diabetes, systemic diseases of the mother and idiopathic
b. placental insufficiency, placenta previa and a real knot in the umbilical cord
c. placen accreta and pressure on the umbilical cord
d. abruptio placenta, malnutition of the mother and short umbilical cord

371. Misperceptions occuring as a patient is walking up for which, there is no basis in reality is:
a. hallucinations
b. hypnopompic hallucinations
c. hypnagogic hallucinations
d. phobia

372. Excessive feeling of emotional and physical well-being inappropriate for actual
environmental stimuli is:
a. ambivalence
b. elation
c. flat affct
d. euphoria

373. Extreme (panic) anxiety-characterized by all the following except :

a. unrealistic perception of situation
b. inability to speak
c. vomiting, feeling of personality disintegration
d. increased ability to concentrate on problem situation

374. To meet basic needs while reducing pervasive feelings of worthlessness, hopelessness, and
helplessness, the following are true nurse's responses except:
a. "I understand, you feel worthless.
b. avoid making moral judgement regarding what patient should or should not do.
c. confront irrational demands.
d. it's good to isolate him for a short time.
375. When caring for a patient with Schizophrenia the nurse is supposed to do all of the following
except:
a. keep patient in a small unit or private room
b. don't laugh infront of the patient
c. confront irrational delusions
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d. keep your promise

376. When caring for patient with mania, nurse supposed to do which of the following:
1. keep client in a quiet room
2. focus on things, the patient can do positively
3. induce sleep to keep patient calm
4. don't make compititions with the patient
5. Send patient to occupational therapy
a. 1 and 2 are correct
b. 1, 2, and 3 are correct
c. 1, 2, and 4 are correct
d. 1, 2, 3, and 4 are correct
e. all of the answers are correct

377. Which of the following signs or symptoms must be present to make a diagnosis of
Schizophrenia?
1. characteristic psychotic symptoms such as delusions or prominent
hallucinations
2. Markedly impaired social functioning during the course of the disturbance.
3. signs of disturbance for at least 6 months
4. onset before age 45
a. 1, 2, and 3 are correct
b. 1 and 3 are correct
c. 2 and 4 are correct
d. only 4 is correct
e. all of the above are correct

378. Vegetative signs in depression includes all of the following except:

a. weight loss
b. abnormal menses
c. obsessive rumination
d. decreased libido
e. fatiguability

379. Therapy for phobias may include:

1. flooding
2. propranolol (Inderal)
3. systematic desensitization
4. Phenelzine (Nardil)
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a. 1, 2, and 3 are correct

b. 1 and 3 are correct
c. only 2 & 4 are correct
d. only 4 is correct
e. all of the above are correct

380. Obsessive-compulsive disorders (OCD) involves the use of which of the following defense
mechanisms?
1. isolation
2. reaction formation
3. undoing
4. projection
a. 1, 2, & 3 are correct
b. 1 & 3 are correct
c. 2 & 4 are correct
d. only 4 is correct
e. all of the above are correct

381.In phobia, the major defense mechanism utilized is:

1. identification.
2. reaction formation.
3. projection.
4. displacement.
a. 1,2, and 3 are correct
b. 1 and 3 are correct
c. 2 and 4 are correct
d. only 4 is correct
e. all of the above are correct

382. On the mental status examiantion of a patient diagnosed as bipolar, manic phase, which
of the following symptoms might be present?
1. mood-congruent halluciantions
2. neologisms
3. clang associations
4. mood-incongruent delusions
a. 1,2, and 3 are correct
b. 1 and 3 are correct
c. 2 and 4 are correct
d. only 4 is correct
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e. all of the above are correct

383. Features associated with post-traumatic stress disorder include:

1. re-experiencing of the trauma through dreams
2. emotional numbing
3. autonomic instability
4. cognitive difficulties
a. 1, 2, & 3 are correct
b. 1 and 3 are correct
c. 2 and 4 are correct
d. only 4 is correct
e. all of the above are correct

384. According to Freud, neuroses develop when:

1. there is a conflict between the id and the ego
2. the ego's defense against instinctual impulses is unsuccessful
3. the drives that seek discharge are repressed from consciousness
4. anxiety becomes manifest
a. 1, 2, & 3 are correct
b. 1 and 3 are correct
c. 2 and 4 are correct
d. only 4 is correct
e. all of the above are correct

385. Thoughts, feelings, and actions are controlled by an external force is an example of:
a. nihilistic delusion
b. delusion of reference
c. delusion of control
d. somatic delusion
e. pseudologia fantastica

386. Narcolepsy is associated with:

1. cataplexy
2. hypnagogic hallucinations
3. sleep paralysis
4. brief awakening during the night
a. 1, 2, & 3 are correct
b. 1 and 3 are correct
c. 2 & 4 are correct
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d. only 4 is correct
e. all of the above are correct

387. Withdrawal from alchohol often causes delirium tremors. Which of the following symptoms
are characteristic of delirium tremors?
a. hyperthermia, catatonia, convulsions, tremors
b. hypotension, increased agitation, hallucinations
c. hypertension, diaphoresis, tachycardia, delusions
d. hypotension, visual hallucinations, tremors

* Zaki, aged 55, has been admitted to the hospital. Since five years , he was admitted for a
similar problem. During the past month, he has become increasingly agitated and
hyperexcitable, with an increase in verbal and physical activity. He is also suffering from
insomnia and has rapid speech patterns.
Before his current admission, he went on a buying spree, but gave all his purchases away.
388. Considering all of Mr. Zaki's symptoms, which of the following best describes his condition?
a. panic attacks
b. paranoid behavior
c. schizophrenia
d. manic episode

389. When Mr. Zaki is admitted, he is extremely agitated, which of the following is a useful
nursing intervention during this time?
a. place him in a quiet area, separate from others
b. encourage him to organize some physical activity
c. establish firm, set limits on his behavior
d. include him in the group's activies

390. Mr. Zaki is started on lithium, which of the following should be included as part of your
nursing care when a client is on lithium?
a. place him on a high sodium diet to increase the effect of lithium
b. check the client's BP every morning for symptoms of hypotension
c. withhold the medication for 12 hours before drawing blood levels
d. withhold the medication at intervals to prevent client dependency

391. The nurse must be aware of the potential of lithium toxicity. Which of the following
symptoms are characteristic of lithium toxicity?
a. paradoxical exictement, a kasthesia, rash
b. confusion, ataxia, GI symptoms
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c. photosensitivity, contact dermatitis

d. tremor, thirst, weight gain

* Ms. Su'ad is a secretary in a physician's office who has been calling in sick frequently. She
complains of fatigue, sleeplessness, and loss of appetitie that has resulted in 6.75 kg. weight
loss. She was told by her employer that she might lose her job. She recently called her family
and said good-bye. Her family, worried about her, brought her to the hospital.
392. Ms. Su'ad has been expressing suicidal ideas. Which of the following would you use to help
her deal with these ideas?
a. help her to see that she is not the only one with problems
b. keep a careful record of all of her behavior
c. reassure her that you will not let her kill herself
d. encourage her to talk to you about her suicidal ideas

393. Which of the followign medications would help treat Ms. Su'ad symptoms?
a. chlordiazepoxide (Librium)
b. amitriptyline (Elavil)
c. lithium carbonate
d. chlorpromazine (Thorazine)

394. Which of the following would most help Ms. Su'ad become more involved with her own
care?
a. tell her to stop feeling sorry for herself
b. ask her what she wants to eat
c. tell her you want her to brush her teeth right now
d. ask her if she wants her bath now

395.If a client is started on MAO inhibitors, which of the following would you include in you
nursing care?
a. stress the avoidance of any CNS depressants
b. teach the client to avoid foods containing tyramine
c. ensure that the drugs are taken only intermittently
d. help the client to set treatment goals

396. Nurses caring for a hallucinating patient should do which of the following?
a. determine what the hallucinatory process means to the patient
b. be alert to verbal and nonverbal cues and respond to any perception that is real
c. affirm reality by pointing out that they are not experiencing the hallucinations
d. provide protection for the patient as needed
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e. all the above are correct

397. A feeling of unreality regarding the self or one's environment is called:
a. neurosis
b. schizophrenia
c. depersonalization
d. introjection
e. projection

398. All the following phobias are accureately defined except :

a. zoophobia : fear of animals
b. acrophobia : fear of heights
c. agoraphobia : fear of closed spaces
d. phonophobia : fear of sounds
e. xenophobia : fear of strangers

399. Diagnosed as obsessive-compulsive, Mona washes and disinfects everything in sight at every
opportunity. The initial nursing intervention for this patient should include:
a. removal of all soaps and disinfectants from patient room
b. an explanation of extensive cleaning procedures in the hospital
c. provision of rubber gloves and cleaning supplies
d. encouragement to udnertake activities that interfere with her compulsive ritual

400. Which of the following disorders occurs most frequently in a dolescent girls and is
characterized by a menorrhea, constipation, slowed pulse and respirations, subnormal
temperature, weight loss and vomiting?
a. hysterical neurosis
b. anorexia nervosa
c. colitis
d. phobia
e. obsessive-compulsive neurosis.

* Reem a 2 year-old-girl is admitted to the pediatric unit with respiratory wheezing,

dyspnea, and cyanosis, the tentative diagnosis is cystic fibrosis. (Q01-04)
401. Cystic fibrosis can predispose Reem to bronchitis mainly because of:
a. tenacious (viscous) secretion, that obstructs the bronchioles and respiratory tract and
provide a favorable medium for growth of bacteria
b. increased salt content in saliva, can irritate and necrose mucus membranes in
nasopharynx
c. neuromuscular irritability causes spasm and infection of bronchi
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d. the associated heart defects of cystic fibrosis causes congestive heart failure and
respiratory depression

402. Reem is small and under developed for her age primarily because she:
a. ingested little food for several months because of poor appetite
b. was unable to absorb nutrients because of lack of pancreatic enzymes
c. secreted less than normal amounts of pituitary growth hormone
d. developed muscular and bony atrophy from lack of motor activity

403. The foul-smelling, frothy characteristics of the stool in cystic fibrosis results from the
presence of large amounts of:
a. sodium and chloride
b. semidigested carbohydrate
c. undigested fat
d. lipase, trypsine and amylase

404. Medications that will probably be used for Reem in her therapeutic regimen includes:
a. steroids and antimetabolilte
b. antibiotics and cough suppressants
c. aerosol mists and decongestants
d. pancreatic enzymes and antibiotics

405. Which of the following respiratory problems has an etiology of allergic history:
a. bronchiolitis
b. cystic fibrosis
c. bronchial asthma
d. respiratory distress syndrome

406. A Child has celiac disease, his diet should be:

1. wheat free
2. rice free
3. barely free
4. corn free
a. 1and 2 are correct b. 2 and 3 are correct
c. 1 and 3 are correct d. 2 and 4 are correct

407. If oxygen therapy is used inappropriately to a premature, he may develop:

a. glucoma
b. cataracts
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c. ophthalmia neonatorum
d. retrolental fibroplasia

408. All the following nursing measures may be done for a premature baby under
phototherapy related to hyperbilirubinemia except:
a. changing position frequently every two hours
b. unsheilded gonads and eyes
c. monitoring body termperature
d. follow up for serum bilirubin levels

409. The characteristic symptoms of nephrosis in children is:

a. dyspnea, albuminuria and weight loss
b. hematuria, hyperlipedemia and proteinuria
c. albuminuria, hypoproteinemia and edema
d. hypertension, hematuria and malnutrition

410. The best drug used to prevent hemosiderosis in children with thalassemia is:
a. folic acid tablets
b. iron injections
c. vit. B12 injections
d. desferral injections

411. A 1-week-old infant has had a cleft lip repair, following this, the most important
nursing intervention would be:
a. place him prone to allow secretions to drain
b. avoid washing suture line to prevent disturbing sutures
c. carry or cuddle him to keep him from crying
d. omit burping him to decrease handling

412. A newborn who has been diagnosed as having a tracheoesophageal fistula is

awaiting transport to a regional hospital for care, until transport, the best position to
keep him in would be:
a. prone
b. supine
c. on his left side
d. upright
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413. Which of the following would be an important intervention for an infant receiving total
parenteral nutrition (TPN)?
a. begin baby cereal to maintain bowel function
b. provide "talk time" and holding daily to substitute for usual feeding
interaction
c. give the infant two bottles of water daily to maintain kidney function
d. change the dressing covering the catheter insertion site every 4 hours

414. Which of the following statements reflects one of the various characteristics of abusing
families?
a. "my son has a low-key temperament"
b. "my son is different from the other children"
c. "we're looking forward to playing little league ball"
d. "we're having considerable financial difficulties"

415. Zaki 3-years old, has down syndrome, his parents are concerned about Zaki's weight "He is
so much smaller than other children in his age". The nurses response should be based on the
knowledge that:
a. Zaki's growth will "catch up" in a few years
b. Zaki's parents should discuss their concern with his pediatrician
c. The height and weight of children with down syndrome is usually below
chronological norms
d. Zaki needs more fluids and calories than the average 3-year old.

416. Which of the following childhood problems posses the most serious threat to Zaki's health
(down syndrome):
a. conjunctivitis
b. milk allergy
c. chicken pox
d. bronchitis

417. A newborn begins vomiting bile-stained emesis 4 hours after birth, which would be
your best action in regard to this?
a. report this to her physician, as bile-stained emesis is never normal in a newborn

b. continue to evaluate the infant, as this could be normal if labour was

prolonged
c. assure the mother that this is not a problem, as the baby was born breech
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d. continue to observe the infant until she has had at least two bottle
feedings

418. A child has surgery for pyloric stenosis, you offer him his first feeding post operatively,
following this it would be best to position him:
a. supine, to prevent sudden infant death syndrome
b. trendelenburg, to prevent pressure on the suture line
c. on his right side to encourage flow through the pylorus
d. prone, to encourage maximum digestion of milk curds

419. A child is admitted to the hospital because of dehydration, and an electrolyte solution of 5%
glucose in normal saline with added potassium is prescribed for him, before beginning this
fluid, an important assessment you would want to make would be:
a. skin turgor, to assess the degree of dehydration
b. blood serum, for the glucose level
c. blood serum for the potassium level
d. if he is voiding

420. A 2-year-old toddler, is seen in out patient clinic with the suspected diagnosis of
Hirschsprugn's Disease, you notice that his abdomen is distended and hard. Which pertinent
assessment technique will probably be done at this visit?
a. asking if the mother took an antibiotic during pregnancy
b. a rectal examination to palpate for constipated stool
c. an x-ray to determine if the bowel has herniated
d. an intra-abdominal biopsy to determine bowel integrity

421. The emergency room is very busy and an abused 3-year old father grows impatient with the
delay in receiving care, which action by the child in this instance would most likely add to a
suspicion of abuse?
a. lying on the examining table and falling asleep
b. sitting on the examining table holding absolutely still
c. crying continuously because his arm hurts
d. telling his father he is all right and not to worry

422. Assessing reflexes of a 6 week-old infant, you would expect to find which of the
following reflexes present?
a. babinski's sign, neck righting reflex
b. maro's reflex, rooting reflex
c. sucking reflex, walking reflex
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d. kernig's reflex, moro's reflex

423. Suzan had a fairly long and difficult labor but finally delivered a 3.4kg. baby girl. On the first
postpartum day, Suzan asks you to bathe and change the baby, your best response is:
a. "I'd be glad to".
b. "don't you remember how from your last baby?"
c. "how does it feel to have a new baby to care for?"
d. "It's better if you care for the baby"

* A 4-year-old black girl, lives in America, arrived to clinic with her parents, the initial
medical diagnosis of sickle cell anemia was made. (Q 24 -25)
424. The girl experiences her first thrombic crisis, based on knowledge of this disease, a thrombic
crisis is the result of:
a. pooling of the blood in spleen
b. occlusion of small blood vessels
c. hemoarthrosis
d. injury to the joints

425. While the girl is hospitalized, her mother learns that she is pregnant, when the mother
comes to visit the girl. She asks you if her new baby will also get sickle cell anemia. The best
answer is:
a. "no, since only you have the trait and not your husband, the chances are
fifty-fifty that the new baby will not have the disease"
b. "it depends upon wether both you and your husband have the disease
c. "it is possible, because if the girl to have the disease, both of you must at least carry
the trait"
d. "yes, since you have one child with the disease, all of your children will have sickle
cell anemia"

* Samia, an obese 14 years-old, is admitted to the adolescent unit with a tentative diagnosis
of type  diabetes mellitus. (Q 26 -27)
426. In preparing a care plan for Samia, you know that her admission to the hospital may cause
her to experience fear of:
a. being displaced
b. separation
c. loss of independence
d. unknown

427. While planning therapeutic care for Samia, you would expect her treatment plan to include:
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a. oral hypoglycemic agents

b. more physical exercises only
c. dietary regimen only
d. insulin injection

428. Blood gases and electrolytes studies are ordered immediately to premature infants to
assess their:
a. leukocyte count
b. oxygen, carbon dioxide, and PH levels
c. antibody titer for RH
d. blood glucose level

429. Which of the following statements best explains why premature infants are more likely to
develop hyperbilirubinemia?
a. liver enzymes are immature
b. antibody formation is immature
c. premature infants receive few antibodies from mother
d. white blood cells are immature

430. Ali is 10 months, can stand alone, but has not taken any steps, her mother is upset because
she has been told by a friend that many babies walk by 10 months of age, you can respond by
saying:
a. "your friend is exaggerating"
b. "children never walk before one year"
c. "Perhaps Ali hasn't had enough experience crawling"
d. "each child develops at his or her own rate"

431. Samy is 18 months old, you counsel his mother that the best procedure to follow, if her
child swallows something poisonous first to:
a. telephone the local poison control center
b. bring the child to emergency room
c. give the child milk to drink to induce vomiting
d. ascertain what substance the child swallowed

432. Which of the following is a characteristic in a child with acute lymphocytic leukemia:
a. fatigability
b. persistant fever of unknown cause
c. tendency to bruise easily
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d. all of the above are correct

433. In bacterial meningitis all the following may be observed during CSF analysis results except:
a. high cells count
b. high sugar
c. high protein
d. turbidity

434. In willm's tumour child, a nurse may do all the following procedures except:
a. taking vital signs
b. assess abdominal girth
c. palpating abdomen
d. preparing child for diagnostic tests

435. Which of the following actions should receive priority in the care of a premature infant in
the delivery room:
a. weighing the infant
b. preventing heat loss
c. drawing blood for a hemoglobin level
d. measuring the anterior fontanelle

436. What is the main action of surfactant, when caring for a premature infant?
a. it provides antibiotic protection
b. it acts as a corticosteroid to reduce inflammation
c. It reduces the surface tension in the alveoli
d. it prevents the bronchi from collapsing
437. You are assessing a baby for congenital dislocation of hip, to do this, you would:
a. lie him prone and inspect to see if her foot creases are symmetric
b. lie him supine and attempt to flex and abduct his hips
c. lie him supine and attempt to extend and adduct his hips
d. stand him upright and watch if his dancing reflex is symmetric

438. Ali 13 years-old, has hemophilia, has been hospitalized for hemoarthrosis of his left elbow
and complaining from severe elbow pain, in addition to placing him on bed rest, the nurse
should:
a. elevate and immobilize Ali's elbow
b. give Ali aspirin per os.
c. gently perform passive range of motion exercises to Ali's elbow
d. apply heating pads to Ali's left elbow
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439. When a female carrier of hemophilia marries a male who is free of the disease, the risk to
their offspring for each pregnancy is what:
a. all female children will be carriers of hemophilia
b. half the male children will have the hemophilia
c. all male children will have the disease
d. half the female children will have hemophilia

440. Nadia 7 years old, had acute post streptococcal nephritis. The nurse monitors Nadia's
response to treatment, which of the following is necessary for the nurse to include when
evaluating Nadia?
a. auscultation of breath sounds
b. urine test for glucose and acetone
c. BP measurement
d. abdominal circumference measurement

441. Regarding prognosis of nephritis Nadia will most likely:

a. return to normal renal functioning
b. develop acute renal failure, requring dialysis
c. develop chronic renal failure, necessiating a kidney transplant
d. have numerous recurrences of the disease

442. Which of the following is true concerning rheumatic fever:

a. it is usually associated with glomerulonephritis
b. symptoms disappear shortly after the fever abate and the temperature returns to
normal
c. the child should resume normal activities as soon as she feels well
d. it usually follows a streptococcal infection

443. Which of the following blood tests results is the most indicative of an improvement in
rheumatic fever child?
a. WBCs 11,000
b. decrease ESR
c. Elevated ASOT
d. Hemoglobin 10 gm/dl.
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444. A newborn has a meningomyelocele, the nurse should place him in which position:
a. semi-Fowler's
b. supine
c. prone
d. non of the above is correct

445. While caring for the newborn (meningomyelocele) post-operatively, which nursing action
should receive the highest priority?
a. maintain his leg in abduction
b. provide tactile stimulation and verbal stimulation
c. change his position frequently
d. measure his head circumference
446. A newborn is receiving ampicillin 75 mg IVevery 6 hours, when reconstituted with sterile
saline, the vial contain 125 mg/1.2 ml, the nurse should administer what amount of the
solution in the drip chamber?
a. 0.60 ml.
b. 0.72 ml.
c. 0.84 ml.
d. 1.00 ml.
447. Regurgitation is common in the newborn primarily because the newborn:
a. tends to overeat
b. swallows air while nursing
c. has an immature cardiac sphincter
d. has a disproportionately long gastrointestinal track

448. During data collection, a nurse noted that a baby weighed 3 kg. at birth and 7 kg. at the age
of one year, which one of the following statements offers the nurse the best guide by which
to assess his information?
a. the weight of a baby at one year of age is influenced primarily by hereditary factors.
b. the average infant trebles his birth weight by one year.
c. there is considerable difference in weight at one year of age between girl and boy
babies
d. the weight at one year of age, depends on maturation of the process of fluid
balance

449. A physiological task that would be unrealistic for most infants to achieve between 12 and
14 months of age is being able to:
a. help feeding himself
b. walk with assistance
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c. handle building blocks

d. control the anal sphincter

450. Infant who cries when a nurse takes him to obtain a blood specimen is most probably fearful
of:
a. having his body mutilated
b. being separated from his mother
c. losing control of his environment
d. experiencing pain during the procedure

451. A community is commonly defined as an aggregate of people living in the same area and:
a. sharing common values and beliefs
b. having the same racial and ethnic background
c. speaking the same language
d. professing a common religion

452. Which one of the activities listed below illustrates that a community believes in a mother's
right to work?
a. providing day care facilities
b. providing family planning services
c. supporting right to work legislation
d. supporting aid to dependent children
453. Which one of the following types of health problems is least often found in communities
whose members are in high socioeconomic situation?
a. chronic diseases b. preventable diseases
c. hereditary diseases d. communicable diseases

454. The incidence of preventable diseases in a community is most closely related to the:
a. number of wroking mothers
b. availability of health care services
c. median age of community members
d. number of schools in the community

455. The finding that the occurrence of most industrial accidents is related to normal circadian
rhythms has prompted industry to observe practices that:
a. provide rest breaks
b. increase overhead lighting
c. install soothing music
d. shorten working hours
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456. Ms. Fatma wishes to assess for the cohesiveness of the community. One appropriate
standard for making a judgement is that community cohesiveness tends to be greater when:
a. families are smaller than the national average
b. various modes of transportation are limited
c. average income is slightly higher than the national average
d. most studies in the community attend schools away from home

* Community health nurse is in a unique position to do community assessment and

planning.
457. The nurse knows that assessment of the community requires:
a. assessment of vital statistics
b. diagnosis rate problems
c. setting up a community conferences
d. all of the above are correct

458. The community health nurse plans nursing outcomes within the frame-work of:
a. primary prevention
b. secondary prevention
c. tertiary prevention
d. all of the above are correct

459. There are 250 cases of chicken pox in a town of 12,500 people, what is the incidence of
this disease?
a. 020 cases per 1000 population
b. 002 cases per 1000 population
c. 020 cases per 0500 population
d. 200 cases per 30,0000 population

460. Primary, secondary, and tertiary prevention are solely used to describe:
a. means of preventing the infection of a person
b. a system of factors influencing formation of causality
c. a system of care during a disease process
d. all of the above are correct
461. When investigating a new disease which of the following is the first step?
a. determining risk factors
b. establishing a case definition
c. determining prevalence of the disease
d. conducting prophylactic trials
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462. One reason women are perceived to seek out health care more than men is that:
a. men take better care of themselves than women do
b. the sick role is more acceptable to women than to men
c. women have more time to spend on themselves than men do
d. women's health care is cheaper than men's

463. The infant mortality rate indicates the number of deaths:

a. within the first 28 days of life
b. after the first 28 days of life
c. during the first year of life
d. during the first 3 years of life

464. A parent consults a Community Health nurse about a child who had nightmares after
seeing a horror movie. The nurse should advise the parent to:
a. talk to the child about the movie and to screen movies for violence
b. ignore the nightmares, they will go away
c. talk to the child and tell him or her that the movie is a story
d. stop taking the child to the movies, since movies are a source of fear

465. While, following up a case, the nurse knows that iron deficiency anemia in a child is resolved
when:
a. the child eats red meats
b. the child no longer falls asleep in class
c. the child is growing based on height/weight charts
d. the child is ready to eat vegetables and fruits

466. Women's cancer screening (i.e. pap smear) is considered to be a part of:
a. primary prevention
b. secondary prevention
c. tertiary prevention
d. prepubertal care

467. The nurse notes that Fatma, age 87, is having difficulty in following conversations:
How should the nurse intervene?
a. refer her to a geriatric specialist for senility
b. send her to the audiologist for a hearing test
c. ask her if she has hearing problem
d. call her daughter and inform her of the trouble
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468. Ergonomics is described as the field of study dealing with individuals and their:
a. health and health practices
b. religious and cultural beliefs
c. work and working environment
d. community and social relationships

469. Which of the following is not an example of a situational crisis?

a. death of a family member
b. birth of a child
c. accidental injury
d. loss of a job

470. Which of the following is common to all definitions of family?

a. a group whose members are related by blood
b. a group composed of at least two adults
c. a group composed of at least one adult
d. a sociologic structure maintained by legal bonds

471. When you are reporting to the authorities about a family in which a child abuse
is suspected, which information is essential for the nurse to report?
a. the name of the perpetrator
b. the place where the abuse occured
c. the duration of the abuse
d. the nature and extent of injuries

472. Active artificial immunity from disease comes from:

a. the mother through pregnancy
b. immunization
c. exposure to the disease
d. all of the above are correct

473. Families are often involved with the care of chronically ill persons, the care help
through all of the following except:
a. involvement with planning/intervention
b. financial support
c. promoting dependence
d. encouraging self reliance
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474. Professionals involved in home health care include:

a. physicians
b. nurses
c. physical therapist
d. a and c are correct
e. all of the above are correct
475. The target population of occupational health nursing is:
a. the worker
b. the worker's family
c. the employer
d. a and b are correct
476. Abu Rami's family has a three school aged children. First grader Zakia, has been a
frequent visitor to the nurse's office with numerous vague complaints. The first step the
school nurse should take in formulating a plan of care is to:
a. consult the pupil service team
b. make a home visit
c. contact the parents by phone
d. contact the classroom teacher
477. In which case of these a prospective investigation should be performed:
a. food poisoning
b. viral hepatitis
c. the influence of a high carbohydrate diet on hypertension
d. meningitis

478.The mother of a 10-year-old boy, expresses her concerns that her boy is
overweight, when developing a plan of care with the mother, the nurse should
encourage her to:
a. limit the child activity between-meal snacks
b. prohibit the child from playing outside, if he eats sweets
c. limit the child's daily caloric intake to 1,200
d. include the child in meal planning and preparation

479. Exposure to excessive noise and radiation is a potential _______ hazard:

a. physical
b. ergonomic
c. chemical
d. biological
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