Exam 1

(1) A nurse is caring for a client admitted 2days ago with myocardial infection .upon

assessment the nurse notes a new systolic murmur at the cardiac apex. The nurse

should assess the client for which of the following conditions?

(A) A. Ventricular aneurysm

(B) Acute pericarditis

(C) Papillary muscle dysfunction

(D) Pulmonary embolism

2. Which one of the following is an uncontrollable risk factor that has been linked to

development of coronary artery disease(CAD)

(A) Exercise

(B) obesity

(C) stress

(D) heredity

3. A 21 year old male client is transported by ambulance to the emergency unit. He complains of

severe pain in his right chest where he struck the steering wheel. Which is the primary client

goal at this time?

A. Reduce client’s anxiety

B. Maintain adequate oxygenation

C. Decrease chest pain

D. Maintain adequate circulating volume

4. The following finding is suggestive of a pneumothorax in a patient with chest trauma;

(A) absent breath sounds

(B) inspiratory wheezing

(C) dullness on chest percussion

(D) pronounced crackles

(5) The primary reason for administering digoxin (Lanoxin) to a patient is to,

(A) Relax the walls of the heart’s arteries.

(B) Improve the strength of the heartbeat.

(C) Prevent irregularities in ventricular contractions .

(D) Decrease inflammation of the heart wall.

6) The priority nursing diagnosis for a patient with heart failure and pulmonary oedema is,

(A) Risk for infection related to stasis of alveolar secretions

(B) Impaired skin integrity related to pressure

( C) Activity intolerance related to pump failure

D)Constipation related to immobility

(7) When preparing a patient for colonoscopy procedure the nurse should,

(A) Perform a high colonic washout procedure the night before the procedure

(B) Ensure the patient takes a high roughage diet with a laxative the night before

procedure

(C) Educate the patient to report any “needle prick” sensations within 12 hrs after the

procedure

(D) Advise the patient to take low fiber diet for 1 week before the procedure

8) The characteristics of a “Cushingoid” appearance in Cushing’s disease include,

(A) Hypotension, Kussmauls’ breathing, hunchback & diaphoresis

(B) Moon face, buffalo hump, central obesity & thin musculature

(C) Mood swings, slow wound healing, hypertension & tunnel vision

(D) Flushing, brittle skin, abdominal pain and encephalopathy

(10) The sensitivity part of a culture & sensitivity test is for the purpose of,

(A) Identifying the causative organism for the infection diagnosed

(B) Identifying the most effective antibiotics against the causative organism
(C) Identifying the antibiotics that the patient is resistant to

(D) Testing the concentration of antibiotic required to cure an infection 1

(11) A client with a cataract would most likely complain of,

(A) Halos and rainbows around lights

(B) Eye pain and irritation that worsens at night

(C) Blurred and hazy vision

(D) Eye strain and headache when doing close work

12) The primary rationales for tube feeding for a client post total laryngectomy due to

cancer of larynx is to,

(A) Meet dietary needs and prevent fistula formation

(B) Maintain an open airway and prevent aspiration

(C) Meet fluid & dietary needs and prevent aspiration

(D) Prevent fistula formation and reduce aspiration

13) When a burn occurs in an adult,

(A) Using rule of nine, right arm is calculated as being 18% & right leg 9%.

(B) Capillaries & small vessels dilate, renal blood flow reduces

(C) Fluid shifts from ICF to ECF space/compartment along with potassium.

( D) Permeability of the kidney tubules increases with oliguria

(14) The following technique should be avoided when changing a hemiparalysis clients’

position in bed;

(A) Sliding the client to move her up in bed

(B) Rolling the client onto her side

(C) Lifting the client when moving her up in bed

(D) Having the client lift herself off the bed using a trapeze

15) When a blood pressure (BP) reading is abnormal upon initial assessment, it is best to

check the BP,

(A) a) On the other arm

(B) b) On both arms sitting and standing

(C) c) With the patient standing

(D) d) After a 5 min wait

(16) Swabs, instruments and sharps count during surgery is carried out by,

(A) Circulating and anaesthetic nurses

(B) Anaesthetic and scrub nurses

(C) Circulating and Scrub nurse s

(D) Recovery room and scrub nurses

17) When nursing a patient with chronic obstructive pulmonary disease, the nurse should,

(A) Ensure the patient gets high flow rate oxygen at 100%

(B) Advise the patient to get influenza and pneumococcal vaccines

(C) Avoid administration of prophylactic bronchodilators

(D) Position the patient in dorsal recumbent position to enhance ventilation

(18) After a clients’ nasogastric tube has been removed the nurse should,

(A) Offer the client liquids to drink

(B) Provide the client with oral hygiene

(C) Encourage client to cough and deep breath

(D) Auscultate the client’s bowel sounds

(19) Neurovascular assessment of the lower limb post-cast application involves

observation of,

(A) Color, sensation and pulses

(B) Level of consciousness, limb symmetry and muscular strength

(C) Capillary refill, sensation and muscle power

(D) Color, warmth and muscle power

20) The risk for macrovascular complications in diabetes mellitus may be reduced by,

(A) Lowering BP, avoiding nephrotoxic substances & reducing strenuous exercises.

(B) Weight reduction, reducing fat/triglyceride levels, quitting smoking.

(C) Foot care, early diagnosis of retinal detachment & daily U/Es checkups.

( D) High fibre diet, low fat diet & prompt treatment of systemic infections

(21) The priority indicator of increasing intracranial pressure is,

(A) Unequal pupil size

(B) decreasing systolic pressure

(C) tachycardia

(D) decreasing body temperature

(22) Foods that may predispose a client to megaloblastic anemia if taken exclusively

include,

(A) Meat, eggs and beans

(B) Beans, Peas and rice

(C) Capsicum, Sorghum and Millet

(D) Meat, Maize, Sorghum

23) In pyloric stenosis there is,

(A) a) Projectile vomiting & olive-sized mass in abdomen’s upper right quadrant

(B) b) Blood tinged vomitus and significantly reduced peristaltic waves

(C) c) Severe abdominal pain and irregular opening of the bowels

(D) d) Normal feeding appetite and passing of loose bowel motion

24) The following are risk factors for impaired gas exchange and pulmonary infection :

(A) Immobility, constipation and incontinence

(B) Fluid restriction, immunosuppression and decreased level of consciousness.

(C) Fluid restriction, immobility and ingestion of seasoned foods

(D) Incontinence, chemotherapy and anemia

(25) Buck’s traction is,

(A) a) A form of skin traction and is often used to relieve muscle spasms.

(B) b) A form of skeletal traction for compound fractures.

(C) c) Only used in correction of hip and femur fractures.

(D) d) Always contra-indicated in obese ju patients.

(26) Open angle glaucoma is mainly treated using,

(A) a) Proton pump inhibitors, quinolones and glycosides

(B) b) Antibiotics, osmotic diuretics and haematinics

(C) c) Miotics, Carbonic anhydrase inhibitors and epinephrine

(D) d) Stool softeners, anti-hypertensives and Miotics

27) When nursing a patient on steroids, the nurse should,

(A) a) Observe for oedema, weigh daily, monitor blood counts

(B) b) Maintain infection control, monitor blood sugar, maintain hydration

(C) c) Observe for bone marrow suppression, minimise exposure to heat,encourage

bed rest

(D) d) Encourage increased fluid intake, administer anti-emetics, monitor RBC count

(28) In acute heart failure with pulmonary edema, morphine is administered in small doses

to,

(A) a) Promote excretion of sodium and water by kidneys

(B) b) Relieve hypoxemia and dyspnea

(C) c) Delay release of calcium from intracellular reservoirs

(D) d) Reduce peripheral resistance & venous return3

(29) The common causative organism for pharyngitis is,

(A) a) Group B, beta hemolytic streptococcus

(B) b) Group A, beta hemolytic streptococcus

(C) c) Hemophilus influenza

(D) d) Staphylococcus aureus

30) In pulmonary embolism (PE),

(A) a) There is a clot formation in the pulmonary vein and or its branches

(B) b) There is obstruction of the Pulmonary artery or one of its branches

(C) c) Trauma, pregnancy and Valsava maneuvers are common predisposing factors

(D) d) Old age, heart failure and intestinal obstruction clients are more prone
31) The purpose of monitoring central venous (CVP) for the critically ill patients is to,

(A) a) Help assess the functioning of left side of the heart

(B) b) Monitor fluid replacement therapy

(C) c) Estimate the levels of pulmonary pressures in the critically ill

(D) d) Help assess functioning of the mitral and tricuspid valves

32) The antidote for heparin is,

(A) a) Vitamin K

(B) b) Warfarin (Coumadin)

(C) c) Thrombin

(D) d) Protamine sulphate

33) The frontal lobe of the brain is,

(A) a) The primary receptive area for vision

(B) b) Mainly responsible for auditory sensation and coordination

(C) c) Centre for respiratory and vasomotor activity

(D) d) Responsible for abstract thinking, judgment and emotions

34) Dumping syndrome is as a result of,

(A) a) Rapid emptying of hypertonic food from the stomach into the jejunum

(B) b) Failure of a patient with a peptic ulcer to eat regularly

(C) c) Chronic anemia among the elderly patients

(D) d) Loss of the large intestine functionality following hemicolectomy

35) After cataract surgery, if a patient complains of nausea, the nurse should,

(A) a) Instruct patient to perform deep breaths until the nausea reduces
( B) b) Administer antiemetic to prevent intraocular pressure elevation

(C) c) Ensure a vomiting bowl is placed close to the patient as possible

(D) d) Reassure the patient that it is a common feeling post general Anaesthesia.

(36) Immediately postoperatively a nurse should,

(A) a) Position a patient in recovery position, measure urine output and assess

respirations every 15 minutes

( B) b) Maintain patent airway, measure central venous pressure (CVP) and check

oxygen saturation levels

(C) c) Position patient in recovery position, observe adverse effects of anesthesia and

assess reflexes

(D) d) Check IV site for infiltration, administer clear oral fluids and monitor vital signs

every 15 minutes

(39) The causes of pre-renal failure include,

(A) a) Renal caliculi, benign prostatic hypertrophy and blood clots

(B) b) Tubular necrosis, septic shock and hemolytic blood reaction transfusion

(C) c) Hemorrhage, burns and dehydration

(D) d) Tumours, Trauma and chemical toxicity

(40) For a patient to undergoing a kidney, ureter and bladder X-ray is important for the

nurse to know that,

(A) a) There is no special preparation required.

(B) b) Oral fluids must be withheld the morning of the examination.

(C) c) The patient should have a full bladder before the procedure.

(D) d) An enema should be administered before the procedure

(41) Treatment of megaloblastic anemia includes;

(A) a) Chemotherapy, radiotherapy, hydration

(B) b) Oxygen therapy, hydration and iron supplements

(C) c) Blood transfusion, iron supplements, splenectomy

( D) d) Oxygen therapy, folate supplements, Alcohol restriction

(42) For a patient with cellulitis the nurse should,

(A) A. Apply warm compresses to the site and elevate affected extremity

(B) B. Apply cold compresses to the site and elevate affected extremity

(C) C. Administer topical antibiotics and oral analgesics as prescribed

(D) D. Administer plasma expanders and elevate the affected limb to 90o

43) The vitamin required for normal production of RBCs is;

(A) calcium

(B) vitamin A

(C) folic

(D) vitamin K

(44) Plain insulin has peak action of;

(A) 8- 12hours

(B) 2-3 hours

(C) 12-16hours

(D) 16-30hours

45) Valsava maneuver can result to bradycardia. Which of the following activities will not

stimulate valsalva’s maneuver?

(A) a) Use of stool softeners

(B) b) Enema administration

(C) c) Gaggling while tooth brushing

(D) d) Lifting heavy objects

46) Which of the most relevant knowledge about oxygen administration to a client with
COPD

( A) a) Oxygen at 1-2L/min is given to maintain the hypoxic stimulus for breathing.

(B) b) Hypoxia stimulates the central chemoreceptors in the medulla that makes the

client breath.

(C) c) Oxygen is administered best using non-rebreathing mask.

(D) d) Blood gases are monitored using a pulse oximeter.

47) What is the reason for the nurse in instructing the client to rotate the injection sites for

insulin?

(A) a) lipodystrophy can result and extremity painful

(B) b) Poor rotation technique can cause superficial hemorrhaging

(C) c) lipodystrophic areas can result, causing erratic insulin absorption rates from

these

(D) d) Injection sites can never be reused

48) Which of the following is included in Orem’s theory

(A) a) Maintenance of a sufficient intake of air

(B) b) Self-perception

(C) c) Love and belonging

(D) d) Physiologic needs

(49) The patient with Angina pectoris is being discharged home with nitroglycerine tablets

which of the following instructions does the nurse include in the teaching?

(A) a) ”when the chest begins,place the tablet under the tongue .if it continues take

another tablet in 5 minutes.”

(B) b)”place the tablet under the tongue,if the pain is not relieved in 15 minutes go to

hospital”

(C) c) ccontinue your activity and if the pain does not go away in10 minutes,begin

taking the nitroglycerine tabs for 15 minutes then go and lie”

( D) d) Place the nitroglycerine tab under the tongue every 5 minutes for 3 doses.Go to

hospital if the pain is unrelieved

(50) It is best to describe as a systematic, rational method of planning& providing nursing

care for individuals, families, group and community.

(A) assessment

(B) nursing process

(C) diagnosis

(D) implementation

(51) A client has just undergone spinal fusion after experiencing herniation of a lumbar

disk. The nurse would avoid which intervention to maintain client safety after this

procedure?

(A) Use the overhead trapeze.

(B) Keep the head of the bed flat.

(C) Place pillows under the length of the legs.

(D) Use logrolling technique for repositioning.

(52) Nurse Nyaruai is giving a health education talk to Mothers attending the MCH/FP

clinic at Kapkoros health center. As a knowledgeable nurse, she must know that a mother

who breastfeeds her child passes on which antibody through breast milk?

(A) IgA

(B) IgG

(C) IgM

(D) IgE

(53) Which of the following interventions would be helpful to a breastfeeding mother who

is experiencing engorged breasts?

(A) A. Applying ice

(B) B. Administering bromocriptine

(C) C. Applying a breast binder

(D) D. Teaching how to express her breasts in a warm shower

(54) You are preparing to perform a fundal assessment on a postpartum client. The initial

nursing action in performing this assessment is which of the following?

(A) A. Ask the client to turn on her side

(B) B. Ask the mother to urinate and empty her bladder

(C) C. Massage the fundus gently before determining the level of the fundus.

(D) D. Ask the client to lie flat on her back with the knees and legs flat and straight

55) Which of the following complications is Most likely responsible for a delayed

postpartum hemorrhage?

(A) A. Cervical laceration.

(B) B. Uterine sub involution

(C) C. Perineal laceration

(D) D. Clotting deficiency

56) Following a difficult labor and birth, a primiparous woman refuses to feed her baby

four hours after delivery, she states that she is too tired and just wants to sleep. The nurse

should:

(A) A. Tell the woman she can rest after she feeds her baby

(B) B. Take the baby back to the nursery, reassuring the woman that her rest is a

priority at this time

(C) C. Recognize this as a behavior of the taking-hold stage

(D) D. Record the behavior as ineffective maternal-newborn attachment

57) MrsWangombe is under your care and expresses concern about the weight she gained

during pregnancy and how quickly she can lose it now that the baby is born. In describing

the expected pattern of weight loss, you should begin by telling her that:-

(A) A. Lactation will inhibit weight loss since caloric intake must increase to support
milk production

(B) B. Return to pre pregnant weight is usually achieved by the end of the postpartum

period

(C) Fluid loss from diuresis, diaphoresis, and bleeding accounts for about a 3 pound

weight loss

(D) D. The expected weight loss immediately after birth averages about 11 to 13

pounds

(58) Signs of puerperal sepsis include

(A) A. Pyrexia, tachycardia, whitish lochia

(B) A. Pyrexia, tachycardia, red lochia

(C) A. Pyrexia, tachycardia, pink lochia

(D) A. Pyrexia, tachycardia, offensive lochia

59) Systemic changes during normal puerperium include

(A) A. Involution of the uterus, lochia loss, blood volume returns to normal

(B) B. Rising of the fundus, lochia loss, blood volume decreases

(C) C. Involution of the uterus, lochia loss, blood volume increases

(D) D. Maternal weight gain

(60) About puerperium, the following statement is true

(A) A. The puerperium is a period of 60 days following delivery of the placenta

(B) B. The puerperium is a period of 42 days following delivery of the placenta

(C) C. The puerperium is a period of 21 days following delivery of the placenta

(D) D. The puerperium is a period of 14 days following delivery of the placenta

(61) General nursing care during post-partal period includes assessment of the:

(A) A. Breasts, abdomen, and fundus

(B) B. Breasts, abdomen, and musculoskeletal system

(C) C. Breasts, abdomen, and neurological responses

(D) D. Breasts, abdomen and congenital abnormalities

(62) At the end of labor, the cervix is:

(A) soft and flabby

(B) 2cm dilated

(C) 1cm dilated

(D) a slit

(63) You are taking vital signs observations on a postpartum client who delivered a

healthy newborn 4 hours ago. Her temperature is 100.2° F or 37.9 What is the priority

nursing action?

(A) A. Increase hydration by encouraging oral fluids.

(B) B. Document the findings.

(C) C. Retake the temperature in 15 minutes

(D) D. Notify the doctor

Postpartum fever is defined as a temperature of 38.7 degrees C (101.6 degrees F) or greater for

the first 24 hours or greater than 38.0 degrees C (100.4 degrees F) on any two of the first 10

days postpartum.

(64) .After delivery of a healthy newborn. Which time frame should the nurse relay to the

client regarding the return of bowel function?

(A) A. 7 days postpartum

(B) B. 3 days postpartum

(C) C. Within 2 weeks postpartum

(D) D. On the day of delivery

65) Nurse Dorothy is assessing a client for signs of postpartum depression. Which

observation, if noted in the new mother, would indicate the need for further assessment

related to this form of depression?

(A) A. The mother constantly complains of tiredness and fatigue.

(B) B. The mother is caring for the infant in a loving manner

(C) C. The mother demonstrates an interest in the surroundings.

(D) D. The mother looks forward to visits from the father of the newborn.

(66) Mrs.Nyamasege is a postnatal client who was diagnosed with superficial venous

thrombosis .In developing her care plan, the nurse anticipates that which intervention will

be prescribed?

(A) A. Ambulation eight to ten times daily

( B) B. Administration of anticoagulants

(C) C. Elevation of the affected extremity

(D) D. Application of ice packs to the affected area

67) What is the best position to assess a postpartum woman’s fundus?

(A) A. On her right side.

(B) B. Semi-Fowler position.

(C) C. Supine with knees slightly flexed.

(D) D. In a chair, with feet elevated.

68) A new mother tells you that she is afraid of her baby and that she doubts she will be

able to love the baby. The most appropriate action would be to:

(A) A. Tell the client she will learn fast.

(B) B. Tell the client what a beautiful baby she has

(C) C. Encourage the client to talk about her feelings.

(D) D. Have a psychiatrist visit the client immediately

(69) The main function of oxytocin during puerperium is to stimulate:

(A) A. Estrogen production

(B) B. Progesterone production

(C) C. Contraction of uterine muscle and breast tissues

(D) D. Production of Human Placental Lactogen

(70) Fertilization occurs in one of the following parts of fallopian tube.

(A) A. Infundibulum

(B) B. Fimbrae

(C) C. Ampulla

(D) D. Isthmus

(71) In the female genital tract the sperms undergo physio-biochemical modification to

allow spermovum interaction. This modification is known as:

(A) A. Capacitation

(B) B. Transformation

(C) C. Reaction

(D) D. Activation

(72) The placenta originates from one of the following parts of the fertilized ovum

(A) A. Inner cell mass

(B) B. York sac

(C) C. Trophoblast

(D) D. Embryoblast

(73) The following structures in fetal circulation joins the umbilical cord to the inferior

vena cava

(A) A. Ductus arteriosus

(B) B. Foramen ovale

(C) C. Ductus venosus

(D) D. Hypogastric arteries

74) Antenatal care of HIV positive client includes:

(A) A. Antiretroviral therapy for life immediately HIV positive status is confirmed

(B) B. Sulfadoxine Pyrimethamine(SP)and cotrimoxazole prophylaxis daily until

delivery
(C) C. Antiretroviral therapy up to postnatal period from the time the CD4 count is

established

(D) D. Delay administration of Sulfadoxine Pyrimethamine until antiretroviral therapy is

started

Maternal and Newborn Health (MNH) Pillars

1. Family planning and pre-pregnancy care – To ensure that individuals and couples

have the

information and services to plan the timing, number and spacing of pregnancies.

2. Focused Antenatal Care – To prevent complications where possible and ensure that

complications

of pregnancy are detected early and treated appropriately.

3. Essential Obstetric Care – To ensure that essential care for the high-risk pregnancies

and

complications is made available to all women who need it.

4. Essential Newborn Care – To ensure that essential care is given to newborns from

the time they

are born up to 28 days in order to prevent complications that may arise after birth.

5. Targeted Postpartum Care – To prevent any complication occurring after childbirth

and ensure that

both mother and baby are healthy and there is no transmission of infection from mother

to child.

6. Post Abortion Care – to provide clinical treatment to all women and girls seeking

care, for

complications of incomplete abortion and miscarriage as well as counselling and

contraceptives.

(75) A client who is pregnant reports nausea and vomiting. The nurse reassures the client
that these symptoms will subside by;

(A) 6-9 WEEKS

(B) 10-13 WEEKS

(C) 14-17 WEEKS

(D) 18- 22 WEEKS

(76) The following type of exercises should be avoided in pregnancy

(A) A. Walking for 30 minutes

(B) B. Sexual intercourse

(C) C. Aerobic exercise

(D) D. Mountain climbing

(77) In class III cardiac disease in pregnancy, patient has:

(A) A. No limitation of physical activity, heart murmur on general examination

(B) B. Slight limitation of physical activity, no symptoms when at rest

(C) C. Marked limitation of physical activity, slight exertion leads to fatigue,

palpitations, dyspnea

(D) D. Inability to carry out any physical activity without discomfort, signs of cardiac

disease and heart failure even at rest

(78) The following statement is true concerning preeclampsia.

(A) A. Oedema is considered as part of the diagnosis of preeclampsia

(B) B. Preeclampsia is primarily hypertension during pregnancy

(C) C. The cardinal signs of preeclampsia include oedema and headache

(D) D. Preeclampsia is gestational hypertension plus proteinuria

79) Effects of gestational diabetes on the fetus include:

(A) A. Congenital malformation, macrosomia,

(B) Fetal hypoglycaemia, congenital anomalies

(C) C. Hypocalcemia, fetal hyperglyceamia

(D) D. Macrosomia, fetal hypoglycaemia

(80) Which of the following sex hormone is produced during throughout the menstrual

cycle

(A) A. Follicle stimulating hormone

(B) B. Luteinizing hormone

(C) C. Estrogen

(D) D. Progesterone

(81) The following hormones are produced by the pituitary gland

( A) A. Follicle stimulating hormone and Luteinizing hormone

(B) B. Estrogen and Progesterone

(C) C. Follicle stimulating hormone and Estrogen

(D) D. Luteinizing hormone and Progesterone

82) Uterovesical pouch is formed when

( A) A. Perimetriumis deflected over the bladder anteriorl y

(B) B. Perimetriumis deflected over the rectum posteriorly

C. Endometrium is deflected over the bladder anteriorly

(D) D. Endometrium Is Deflected Over the rectum posteriorly

(83) The following hormone causes development of new blood vessels to the uterus

(A) A. Eostrogen

(B) Progesterone

(C) C. Luteinizing hormone

(D) D. Follicle stimulating hormone

84) Colostrum can be expressed at:-

( A) A. 6 weeks gestation

(B) B. 12 weeks gestation

(C) C. late pregnancy

(D) D. 16weeks gestation

85) Management of nausea and vomiting among pregnant women include:-

(A) A. Skipping meals

(B) B. Eating small meals frequently

(C) C. Avoiding crackers before getting up in the morning

(D) D. Encouraging highly seasoned foods

(86) The following is caused by deficiency of zinc:-

(A) A. Pre-eclampsia

(B) B. Night blindness

(C) C. Impaired immune system

(D) D. Increased risk of spontaneous abortions

(87) Ptyalism refers to:

(A) A. Excessive nausea and vomiting in pregnancy

(B) B. Lack of appetite

(C) C. An abnormal craving for non-food substances of little or no nutritional value

(D) D. Increased salivation

(88) The normal level of haemoglobin (Hb) on a pregnant woman is:-

(A) 10-15g/dl

(B) 12-14g/dl

(C) 9-14g/dl

(D) 11-12g/dl

(89) The trophoblast cells of the developing zygote form the:-

(A) A. Fetus and amnion.

(B) B. Placenta and fetus.

(C) C. Chorion and amnion

( D) D. Placenta and Chorion

92) In focused antenatal care, the second dose of sulfadoxine pyrimethamine(SP) is

administered at gestation of:

(A) 16-28 weeks

(B) 20-30 weeks

(C) 28-34 weeks

(D) 34-36 weeks

(93) The diastolic pressure is usually not affected by excitement, its increase therefore is

more significant in assessment of pregnant women for pre-eclampsia. The range of

change in mmHg is:

(A) 10-15

(B) 15-20

(C) 15-30

(D) 20-30

(94) The management of placenta praevia type three when the fetus has died in utero

includes:

(A) A. Preparation of women for emergency c-section

(B) B. Induction of labour by use of syntocinon

(C) C. Gentle palpation through vaginal fornices to determine whether posterior or

anterior

(D) D. Complete bed rest and speculum examination on the third day

(95) Fetal axis pressure is a physiological change that is more significant during:

(A) A. Early stages of labor transmitting the force of contraction to the upper pole of

fetus

(B) B. Second stage of labor when membranes are intact

(C) C. Active and second stages of labor when membranes are ruptured

(D) D. Second stage of labour transmitting the force of contraction to the lower pole of
the uterus

(96) If the membranes rupture at cervical dilatation of 8 cm, a vaginal examination

performed rule out:

(A) A. Obstructed labour, cord prolapsed, fetal compromise

(B) B. Cord prolapsed, cord presentation, fetal distress

(C) C. Obstructed labour, cord prolapsed, prolonged labour

(D) D. Maternal distress, prolonged labour, cord presentation

(97) At primary level of anti-retroviral prophylaxis for PMTCT( Prevention of mother to

child transmission), a HIV –positive woman should take:-

(A) A. Nevirapine 300 mgs at onset of labour

(B) B. Nevirapine 200 mgs at onset of labour

(C) C. Zidovudine 300mgs 3 hourly for 12 hours

( D) D. Zidovudine 2mg/kg body weight within 3 days of delivery

(98) After birth, the functional closure of ductus arteriosus takes place within:

(A) 0-1 hour

(B) 2-4hour

(C) 4-6 hours

(D) 8-10 hours

(99) 50. The anti-opiod drug used in resuscitation of the newborn is

(A) A. Konakion 0.5 mg intramuscularly

(B) B. Dexamethasone1-2mg IV

( C) C. Narcan 0.1mg/kg body IV

(D) D. Naloxone 0.5mg IV

Exam 2

1. Duodenal ulcers,

(A) Are more common in people above 50 years

(B) Are more common in females than males

(C) Have a higher risk of malignancy than gastric ulcers

( D) Pain is commonly experienced 3 hours after meals. 2. The following is a mineralocorticoid;

2. The following is a mineralocorticoid

(A) Cortisol

(B) Adrenal corticotropic hormone

(C) Aldosterone

(D) Epinephrine

3. Post intracranial surgery a patient requires strict temperature regulation mainly to;

(A) Detect infection

(B) Prevent increased metabolic demand

(C) Prevent hypothermia

(D) Enhance cerebral perfusion

4. Management of a patient during a seizure include;

(A) Restricting the jerking movements to prevent injury

(B) Inserting an oral airway to protect the tongue

( C) Putting pillows and raising the side rails if the patient is in bed

(D) Removing pillows and raising the side rails if the patient is in bed.

5. A patient with a sprained ankle should be advised to avoid;

(A) Resting the foot

(B) Applying a heating pad

(C) Applying an elastic compression bandage

(D) Elevating the ankle on a pillow while sitting or lying down

6. Risk for osteoporosis is greatest in;

(A) A 36-year-old man who has asthma

(B) A 70-year-old man who consumes alcohol

(C) A sedentary 65-year-old woman who smokes cigarette

(D) A 25-year-old woman who jogs

7. Laboratory findings that are consistent with hyperthyroidism include

(A) Decreased serum triiodothyronine (T3) and thyroxine (T4) levels

(B) Elevated serum thyrotropin releasing hormone (TRH) levels

(C) Decreased radioactive iodine uptake

(D) Increased free triiodothyronine (T3) and thyroxine (T4) levels

8. . A patient newly diagnosed with HIV/AIDS who laments, "I can't believe I got this virus.

I am going to die and everyone will know it was due to my behavior. How could I be so

stupid?" is in the stage of:

(A) Depression

(B) Denial

(C) Acceptance

(D) Bargaining

9. Substances that create colloid osmotic pressure in the capillaries include;

(A) Albumin, globulin

(B) Plasma, potassium

(C) Globulin, sodium

(D) Albumin, potassium

10. Discharge instructions for a client with chronic respiratory acidosis should include

(A) Discussing how to plan for periods of increased activity

(B) Teaching about a low protein, low carbohydrate diet

(C) Demonstrating exercises to increase vital capacity

(D) Encouraging participation in activities such as jogging

11. The predilection of HIV for certain cells in the immune system results in

(A) More T4 lymphocytes and general lymphocytopenia

(B) Fewer activated B-cells and hypogammaglobulinemia

(C) Increased response in cutaneous hypersensitivity

(D) Susceptibility to opportunistic infection and neoplasm

12. The most common preventable cause of valvular heart disease is:

(A) Congenital disease acquired intrauterine

(B) Calcium deposits and thrombus formation

(C) Marfans syndrome

(D) Beta-hemolytic streptococcal infection

13. An anorexic client states that her stomach is "fat" and that all the food she is being forced to

eat is making her obese. The nurse's best reply is:

(A) "Your body is starting to work normally again and is getting stronger and healthier

(B) "You have a bloated stomach because there is too much salt in your food"

(C) "No, it's not, you look much better now than when you were first admitted"

(D) "Maybe we have been feeding you too much and you're gaining weight too fast"

14. The major factors associated with obesity include:-

(A) Genetic, nutritional, level of activity.

(B) Nutritional, level of activity, socio-cultural.

(C) Nutritional, social, genetic.

(D) Level of activity, genetic, psychological.

15. Pelvic inflammatory diseases include:

(A) Salpingitis, cervicitis, candidiasis

(B) Cervicitis, endometritis, oophoritis.

(C) Trichomoniasis, salpingitis, urethritis.

(D) Candidiasis, toxic shock syndrome, endometritis.

16. Cholelithiasis is associated with:-

(A) Abnormal metabolism of cholesterol and bile salts.

(B) Abnormal metabolism of lipids and bile acids.

(C) Chronic pancreatitis.

(D) Hepatitis.

17. Chvostek’s sign is used for diagnosis of:-

(A) Hypercalcemia resulting from hyperparathyroidism.

(B) Hypercalcemia resulting from hyperpituitarism.

(C) Hypocalcemia resulting from hypoparathyroidism.

(D) Hypocalcemia resulting from hypothyroidism.

18. Glomerulonephritis usually follows:-

(A) Staphylococcal infection.

(B) Gonococcal infection.

(C) Gonococcal infection.

(D) Streptococcal infection

19. The teeth that commonly get impacted are the :-

(A) Molars.

(B) Incisors.

(C) Canine.

(D) Wisdom.

20. Body mechanics usually prescribed for clients with low pain include:-

(A) Bending at knee and hips, standing straight, carrying objects close to the body.

(B) Bending at the waist carrying objects close to the body, standing straight.

(C) Sleeping on the side carrying objects farther from the body, bending at the knees and hips.

(D) Bending at the waist, sleeping on the side, standing straight.

21. When a nurse is monitoring a patient for cerebrospinal fluid (CSF) leak he/she should

observe for:-

(A) Halo sign.

(B) Babinski reflex.

(C) Iliopsoas sign.

(D) Blumberg sign.

22. The commonest cause of toxic goitre (Grave’s disease) is: -

(A) Pituitary tumours

(B) Benign thyroid

(C) Lack of iodine in the diet

(D) Immunoglobulins reaction

23. Parathyroid hormone maintains fluid and electrolyte balance by

(A) Promoting absorption of calcium from the intestines

(B) Inhibiting release of calcium from the bone

(C) Increasing the excretion of phosphate ions by the kidneys

(D) Acting on the renal tubules to retain water and to decrease urinary output

24. The Na+ K+ ATPase pump: -

(A) Extrudes potassium ions from the cell and takes two sodium ions into the cell

(B) Extrudes three sodium ions from the cell and takes two potassium ions into the cell

(C) Has a coupling ratio of 2:1

(D) Is found mainly in the intravascular fluid compartment

25. Conductive hearing loss can be caused by: -

(A) Ototoxic medication, otitis externa

(B) Presbycusis, ototoxic medication

(C) Meniere’s disease, otosclerosis

(D) Otosclerosis, tympanic membrane retraction

26. During thoracentesis

(A) Fluid is aspirated from the peritoneal space

(B) Consent is not necessary

( C) Medications can be instilled into the pleural space

(D) Local anaesthesia is not advisable

27. The carcinogenic risk factors for laryngeal cancers include:

(A) a. Tar products, mustard gas, chronic laryngitis

(B) b. Asbestos, chronic laryngitis, voice straining

(C) c. Voice straining, high fibre diet, tobacco

(D) d. Asbestos, tobacco, tar products

28. Sympathetic stimulation of the cardiovascular system causes: -

(A) a. Increased heart rate and constriction of coronary arteries

(B) b. Constriction of GIT secretory gland vessels with increased flow of digestive juices.

(C) c. Increased peripheral resistance and dilatation of coronary arteries

(D) d. Increased force of heart contraction & reduced peripheral resistance.

29. A deteriorating condition for a patient with head injury will be indicated by;

(A) Widening pulse pressure and irregular respiratory pattern.

(B) Narrowing pulse pressure and escalation of discomfort.

(C) Bradycardia and Kussmaul breathing

(D) Oliguria and narrow pulse pressure.

30. In Fallot’s tetralogy there is

(A) Pulmonary artery stenosis, ventricular septal defect, aortic misplacement & right ventricular

hypertrophy.

(B) Coarctation of the aorta, patent ductus arteriosus, aortic stenosis and ventricular septal

defect.

(C) Ventricular hypertrophy, coarctation of the aorta, atrial septal defect and Blue babies’

syndrome

(D) Atrial-ventricular hypertrophy, coarctation of the aorta, ventricular septal defect and

pulmonary artery stenosis.

31. An individual considered overweight has a basal metabolic rate (BMI) of:

(A) a. 21-25

(B) b. 25-29

(C) c. 30-39

(D) d. Above 40

32. The STI that particularly increases transmission and acquisition of HIV include:

(A) Gonorrhoea, chancroid

(B) Candidiasis, gonorrhoea

(C) Chancroid, Chlamydia

(D) Syphilis, genital herpes

33. The position an unconscious patient should be nursed in is:

(A) Recumbent

(B) Lithotomy

(C) Prone

(D) Semi-prone

34. Parklands’ formula is used to calculate

(A) Total burnt surface area

(B) Fluid replacement

(C) Thickness of the burn

(D) Hemo-concentration

35. The body’s internal environment which is tightly controlled and kept within normal limit is:

(A) Control feedback mechanism

(B) Compensatory mechanism

(C) Homeostasis

(D) Equilibrium

36. Before barium meal is performed, the nurse should:

(A) Position the patient in supine position

(B) Perform a head to toe examination

( C) Take history and ask for history of allergic reactions to barium

(D) Alert the doctor if the patient had severe vomiting

37. The vascular coat of eye ball that lies between the sclera and retina is

(A) Uvea

(B) Iris

(C) Ciliary body

(D) Choroid

38. Following thyroidectomy, the nurse suspects damage or removal of parathyroid gland when

the patient develops:

(A) Muscle weakness and weight loss

(B) Hyperthermia and severe tachycardia

(C) Hypertension and difficulty in swallowing

(D) Laryngeal stridor and tingling in the hands and feet

39. increased concentration of red blood cells due to excessive production of erythropoietin is

referred to as:

(A) primary polycythemia

(B) leukopenia

(C) secondary polycythemia

(D) agranulocytosis

40. The following observations are noted on the patient on underwater seal drainage:

(A) a. Vital signs, patent connections, colour of drainage

(B) b. Vital signs, colour of drainage, amount of drainage

(C) c. Vital signs, patient understanding of the procedure, amount of drainage

(D) d. Vital signs, patient understanding of the procedure, cyanosis

41. Fractures of the base of the skull will manifest with

(A) Hemorrhage from the nose, the pharynx or the ears

(B) Cerebrospinal fluid leakage from the ears

(C) Bloody spinal fluid

(D) Persistent localized pain on swelling

42. Which cranial nerve is involved when the patient presents with facial pain, diminished

corneal reflex and chewing dysfunction:

(A) III

(B) IV

(C) V

(D) VI

43. The main long-term complication following radical mastectomy is

(A) Phantom pain

(B) Tingling and numbness

(C) Lymphoedema

(D) Paralysis

44. Reverse barrier nursing is aimed at:

(A) Nursing a patient in a corner bed with a sink

(B) Taking precautions to protect the patient

(C) Taking precautions to protect other patients

(D) Nursing the patient who has a highly infectious disease

45. Steroid nasal sprays are used in management of sinusitis to:

(A) Moisten secretions

(B) Prevent nasal crusting

(C) Reduce mucosal inflammation

(D) Thin the nasal secretions

46. Restoration of bone fragments to the original position following a fracture is called:

( A) Reduction

(B) Immobilization

(C) Rehabilitation

(D) Restoration of function

47. Haemophilia A results from deficiency of factor:

(A) VII

(B) IX

(C) III

(D) V

48. The accumulation of thick, purulent fluid within the pleural space with fibrin development is

characteristic of:

(A) Empyema

(B) Effusion

(C) Pleurisy

(D) Emphysema

49. The Nursing council of Kenya (NCK) is established under the Nurses Act Cap.

(A) 274

(B) 247

(C) 257

(D) 254

50. The nursing diagnosis that best describes a patient with psoriasis who has quit her job as a

receptionist because she feels her appearance is disgusting to customers is:

(A) Ineffective coping related to loss of skin integrity

(B) Social isolation related to loss of skin integrity

(C) Impaired skin integrity related to presence of lesions

(D) Anxiety related to lack of knowledge of the disease process

51. The anterior posterior fontanelles normally closes at the age of:

(A) 6weeks and 18 weeks respectively

(B) 18 weeks and 6 weeks respectively

(C) 18 months and 6 weeks respectively

(D) 6 months and 18 months respectively

52. The trophoblast cells of the developing zygote from the:-

(A) Fetus and amnion

(B) Placenta and fetus

(C) Chorion and amnion

(D) Placenta and chorion

53. When performing Leopold's maneuver, the purpose of the first maneuver is to determine

(A) Fetal part lying in the fundus and presentation

(B) Location of fetal back and position

(C) Engagement of the presenting part

(D) The degree of flexion of fetal head

54. If Mrs. Cola’s menstrual period was on 27.7.08, her expected date of delivery will be:

(A) 3.4.09

(B) 4.5.09

(C) 3.5.09

(D) 4.4.09

55. The most important benefit of vestibular stimulation in the normal newborn is improvement

of

(A) Sucking capability

(B) Tactile sensitivity

(C) Motor coordination

(D) Attention span

56. In focused antenatal care, the second dose of sulfadoxine pyrimethamine (sp) is

administered at gestation of:-

(A) 16-28 weeks(First dose)

(B) 20-30 weeks.

(C) 28-34 weeks. (Second dose)

(D) 34-36 weeks.

57. The diastolic pressure is usually not affected by excitement, its increase is therefore more

significant in assessment of pregnant women for pre-eclampsia. The range of change in mmHg

is:-

(A) 10-15

(B) 15-20

(C) 15-30

(D) 20-30

58. The management of placenta previa type three when the fetus has died in utero includes:-

(A) Preparation of woman for emergency caesarian section.

(B) Induction of labour by use of syntocinon.

(C) Gentle palpation through vaginal forncles to determine whether posterior or anterior.

(D) Complete bed rest and speculum examination on third day.

59.The hormonal factor responsible for uterine contractions at onset of labour are:-

(A) Increase release of oxytocin progesterone from deciduas at term.

(B) Formation of oxytocin and estrogen in the fetal circulation

(C) Rise of oxytocin and estrogen in the fetal circulation.

(D) Optimum levels of estrogen and rise of prostaglandins in maternal circulation.

60. Fetal axis pressure is a physical change that is more significant durin

(A) Early stages of labour transmitting the force of contraction to the upper pole of fetus.
(B) Second stage of labour when membranes are intact.

(C) Active and second stages of labour when membranes are ruptured.

(D) Second stage of labour transmitting the force of contraction to the lower pole of the uterus.

61. If membranes rupture at cervical dilation of 8 centimeters, a vaginal examination performed

should rule out:-

(A) Obstructed labour, cord prolapse, fetal compromise.

(B) Cord prolapse, cord presentation, fetal distress.

(C) Obstructed labour, cord prolapse, prolonged labour.

(D) Maternal distress, prolonged labour, cord presentation.

62. The partograph is an effective tool in management of women in labour, a good progress in

the active phase will be:-

(A) Cervical dilatation plotted progressively on alert line within 7 hours.

(B) Uterine contractions increase in strength from 20-25 seconds within 8 hours.

(C) Cervical dilation plotted on the action line and progressive descent.

(D) Cervical dilatation plotted the right of the action line.

63. At primary level of ant-retroviral prophylaxis for PMTCT (prevention of mother to child

transmission), a HIV-positive woman should take:-

(A) Nevirapine 300 mgs at onset of labour

(B) Nevirapine 200 mgs at onset of labour

(C) Zidovudine 300 mgs 3 hourly for 12 hours.

(D) Zidovudine 2mg/ kilogram body weight within three days of delivery

64. The initial characteristics of rigid cervix in cervical dystocia include:-

( A) Thin, tight, unyielding.

(B) Thick, tight, edematous.

(C) Long, thick, edematous

(D) Thick, edematous, unyielding

65. Perineal trauma is common in delivery of face to pubis due to:-

(A) Irregular shape of the face as a presenting part.

(B) Persistent occipito-posterior position when occiput becomes the leading part.

(C) Large presenting mentovertical diameter

(D) Large presenting occipito-frontal and biparietal diameters.

66. After birth, the functional closure of ductus arteriosus takes place within:-

(A) 1-2hours.

(B) 2-4 hours

(C) 4-6 hours

(D) 8-15 hours

67. The anti-opioid drug used in resuscitation of the newborn is:-

(A) Konakion 0.5 mg intramuscularly.

(B) Dexamethasone 1-2mg Intravenously.

(C) Narcan 0.1 mg/kilogram body weight intravenously

(D) Naloxone 0.5 mg intravenously.

68. Injury to the fetal scalp due to pressure by girdle of contact is known as:-

(A) Cephalhematoma.

(B) Pericranial hematoma.

(C) Subdural oedema.

(D) Caput succedaneum.

69. The peak action syntocinon administered to prevent postpartum hemorrhage is felt in:-

(A) 2 ½ minutes

(B) 2 minutes

(C) 2 seconds

(D) 2 ½ seconds

70. The exogenous causative organisms to puerperal infection include:-

(A) Escherichia coli, clostridium welchii.

(B) Streptococcus faecalis, haemolytic streptococcus

(C) Staphylococcus aureus, Escherichia coli.

(D) Haemolytic streptococcus aureus

71. Mrs Dodo para 6+ 0 comes to the postnatal clinic at six weeks and demands for

bilateral tubal ligation, the midwife should:-

(A) Reassure and encourage her to continue with lactational amenorrhea method.

(B) Schedule for return date in order to prepare for the procedure.

(C) Check whether the pregnancy test is negative then provide the demanded method

accordingly.

( D) Take in-depth medico-social history and encourage partner participation.

72. Fetal causes of early pregnancy loss include:-

(A) Structural abnormalities of the genital tract

(B) Bicornulate uterus and fibroids

(C) Chromosomal abnormalities of the conceptus

(D) Infections such as rubella, listeria and Chlamydia

73. The outcome of labor is not dependent on:-

(A) Effectiveness of uterine contractions

(B) Maternal size

(C) The “give” of the pelvic joints

(D) The degree of moulding of the fetal head

74. In monitoring fetal well being using the fetal kick chart, you will tell the client to

notify you if she counts:-

(A) More than 10 movements in 3hours

(B) Less than 10 movements in 3hours

(C) More than 10 movements per hour

(D) Less than 10 movements per hour

75. During discharge, an important advice for the breastfeeding mother is to:-

(A) Routinely avoid onions, cabbage and chocolate

(B) Keep her calcium intake the same as during pregnancy

(C) Increase her calories over her pregnancy requirements

(D) Return to her pre-pregnancy intake for proteins but not calories

76. The part of the uterus in which a contraction begins is:-

(A) Cornua

(B) Fundus

(C) Isthmus

(D) The body or corpus

77. The follicle stimulating hormone and luteinizing hormone are secreted by the:-

(A) Ovaries and testes

(B) Posterior pituitary

(C) Anterior pituitary gland

(D) Hypothalamus

78. Uterine contractions are controlled by the:-

(A) Central nervous system

(B) Sympathetic nervous system

(C) Peripheral nervous system

( D) Autonomic nervous system

79. The volume of amniotic fluid at 40 weeks gestation is:-

(A) 500 to 1000 ml

(B) 350 to 500 ml

( C) 500 to 800 ml

(D) 1000 to 1500 ml

80. The ectoderm differentiates to form the:-

(A) Cardiovascular system

(B) Peripheral nervous system

(C) Respiratory tract

(D) Connective tissues

81. The hormone that maintains endometrium and stimulates maternal metabolism and

development of breast alveoli during pregnancy is:-

(A) Human chorionic gonadotropin

(B) Human placental lactogen

(C) Oestrogen

(D) Progesterone

82. The anteroposterior diameter of the pelvic outlet measures:-

(A) 12CM

(B) 13CM

(C) 11CM

(D) 10CM

83. During pregnancy, the glomerular filtration rate

(A) Only changes when pathological conditions are present

(B) Is directly influenced by the woman’s posture

(C) Increases significantly above pre-pregnant levels

(D) Makes the most dramatic changes near birth

84. Signs of cardiac decompensation in a pregnant woman with cardiac disease are

likely to appear at

(A) 28-32 weeks gestation

(B) 36-40 weeks gestation

(C) 12-16 weeks gestation

(D) 20-24 weeks gestation

85. The mechanism of labor that allows the fetal head to present itself to fit the widest

anteroposterior diameter of the pelvic cavity is:-

(A) Flexion

(B) Internal rotation

(C) Descent

(D) Extension

86. Closure of the newborns foramen ovale occurs when:-

(A) Blood flows from the pulmonary artery to the aorta

(B) PO2 is increased causing constriction to occur

(C) The umbilical cord is severed

(D) Left atrial pressure exceeds right atrial pressure

87. The newborn with post maturity syndrome is at high risk for cold stress due to:-

(A) Absence of vernix

(B) Decreased subcutaneous fat

(C) Parchment like skin

(D) Extended posture

88.Presence of Meconium in the newborn’s lungs:-

(A) Leads to respiratory alkalosis

(B) Prevents air leaks

(C) Traps inspired air in the alveoli

(D) Prevents air from entering the airway

89. Symptoms of superficial thrombophlebitis include:-

(A) Local redness and tenderness in a portion of the vein

(B) Edema of the ankle and lower leg

(C) Pain in the affected leg and foot

(D) Positive Homan’s sign

90. Direct causes of placenta abruption include:-

(A) Abnormally short umbilical cord, sudden loss of uterine volume

(B) Defective vascularization of the deciduas, previous uterine surgery

(C) Injury to the abdomen from fall or accident, multiple pregnancy

(D) Advanced maternal age, injury to the abdomen from fall or accident

91. Persistence of moro reflex beyond the age of 6months is usually suggestive of:

(A) Immaturity

(B) Brain damage

(C) Mental retardation

(D) Brachial plexus palsy

92. Babies born with intrauterine growth retardation are usually prone to;

(A) Congenital abnormalities, hyperglycemia

(B) Neonatal hyperglcemia, asphyxia

(C) Neonatal asphyxia, birth defects

(D) Neonatal tetanus, asphyxia

93. Mrs. Ug, presents in the maternity ward with pulsating prolapsed umbilical cord. The

recommended nursing position would be;

( A) Knee-chest position, exaggerated Sim's position

(B) Fowler's position, McRoberts manoeuvre position

(C) Sim's position, trendelenburg position

(D) Prone position, knee-chest position

94.Lochia serosa is composed of:

(A) Decidua, vernix, leucocytes

(B) Leucocytes, cervical mucus, decidua

(C) Cervical mucus, cholestrin crystals, lanugo

(D) Leucocytes, cervical mucus, erythrocytes

95. During second stage of labour, the diameter that distends the vaginal orifice in face

presentation is:

(A) Occipito frontal

(B) Submento-vertical

(C) Submento-bregmatic

(D) Mentovertical

96. The right time for diagnosing HIV infection using antibody tests among children

born to HIV positive mother is at or after;

(A) 12 months of age

(B) 16 months off age

(C) 18 months of age

(D) D. 6 months of age

97. During management of severe eclampsia

(A) Anticonvulsant therapy should be given once daily

(B) Ketamine is the drug of choice in performing a caesarean delivery

( C) Nifedipine can be used to lower the blood pressure

(D) Blood pressure should be monitored 6hourly

98. Benefits of breastfeeding to the infant include:

(A) Increased cognitive development, less chances of developing diabetes type 2, less

risk of extreme obesity

(B) Lowered risk of infection, less likely to become overweight, protection against

malignancies

(C) Strengthens bonding, protection against malignancies, decreased risk of

cardiovascular diseases

(D) Reduced risk of metabolic syndrome, lowered risk of developing necrotizing

enterocolitis, protection against diabetes type 1

99. The common age of onset for gonococcal ophthalmia neonatorum is:

(A) Between 21-28 days after birth

(B) Between 0-7 days after birth

(C) Between 7-14 days after birth

(D) At 28 days of age

100. Perinatal mortality refers to fetal and infants deaths including still births occurring

from 28 weeks of gestation to within the first:

(A) One week of life per 1000 live births

(B) Two weeks of life per 1000 live births

(C) Four weeks of life per 1000 live births

(D) Six weeks of life per 1000 live births

Type 3

1. Which of the following respiratory patterns indicate increased intracranial pressure in

the brain stem?

(A) Slow, irregular respirations

(B) Rapid, shallow respirations’

C) Asymmetric chest excursion

(D) Nasal flaring

(2) A client has signs of increased intracranial pressure (ICP). Which of the following is

an early indicator of deterioration in the client’s condition?

(A) Widening pulse pressure

(B) Decrease in pulse rate

(C) Dilated fixed pupils

(D) Decrease in level of consciousness

(3) The nurse administers mannitol to the client with increased intracranial pressure.
Which parameter needs close monitoring

(A) Muscle relaxation

(B) Intake and output

(C) Widening of the pulse pressure

(D) Pupil dilation

(4) Which activity should the nurse encourage the client to avoid when there is a risk for

increased intracranial pressure (ICP)?

(A) Deep breathing

(B) Coughing

(C) Turning

(D) Passive range of motion (ROM) exercises

(5) For a client who is experiencing expressive aphasia, which nursing intervention is

most helpful in promoting communication?

(A) Speaking loudly

(B) Using a picture board

(C) Writing directions so client can read them

(D) Speaking in short sentence

● (6) The nurse is assessing the motor and sensory function of an unconscious

client. The nurse should use which technique to test the client’s peripheral

response to pain?

(A) Sternal rub

(B) Nail bed pressure

(C) Pressure on the orbital rim - (localizing pain)

(D) Squeezing of the sternocleidomastoid muscle

(7) The nurse is evaluating the neurological signs of a client in spinal shock following

spinal cord injury. Which observation indicates that spinal shock persists?
(A) Hyperreflexia

(B) Positive reflexes

(C) Flaccid paralysis

(D) D. Reflex emptying of the bladder

(8) The nurse has instructed the family of a client with stroke (brain attack) who has

homonymous hemianopsia about measures to help the client overcome the deficit.

Which statement suggests that the family understands the measures to use when

caring for the client?

(A) “We need to discourage him from wearing eyeglasses.”

(B) “We need to place objects in his impaired field of vision.”

(C) “We need to approach him from the impaired field of vision.”

(D) “We need to remind him to turn his head to scan the lost visual field.”

(9) The nurse is teaching a client with myasthenia gravis about the prevention of

myasthenic and cholinergic crisis. Which client activity suggests that teaching is most

effective?

(A) Taking medications as scheduled

(B) Eating large, well-balanced meals

(C) Doing muscle-strengthening exercises

(D) Doing all chores early in the day while less fatigue

(10) The nurse has given suggestions to a client with trigeminal neuralgia about

strategies to minimize episodes of pain. The nurse determines that the client needs

further teaching if the client makes which statement?

(A) “I will wash my face with cotton pads.”

(B) “I’ll have to start chewing on my unaffected side.”

(C) “I should not rinse my mouth if toothbrushing is painful.”

( D) “I should rinse my mouth if toothbrushing is painful.”

(11) The client is admitted to the hospital with a diagnosis of Guillain-Barre syndrome.

Which past medical history finding makes the client most at risk for this disease?

(A) Meningitis or encephalitis during the last 5 years

(B) Seizures or trauma to the brain within the last year

(C) Back injury or trauma to the spinal cord during the last 2 years

(D) Respiratory or gastrointestinal infection during the previous month

(12) A client has a neurological deficit involving the limbic system. On assessment,

which finding is specific to this type of deficit?

(A) Is disoriented to person, place, and time

(B) Affect is flat, with periods of emotional lability

(C) Cannot recall what was eaten for breakfast today

(D) Demonstrates inability to add and subtract; does not know who is the president of

the United States

(13) The nurse is evaluating the status of a client who had a craniotomy 3 days ago.

Which assessment finding would indicate that the client is developing meningitis as a

complication of surgery?

(A) A negative Kernig’s sign

(B) Absence of nuchal rigidity

(C) A positive Brudzinski’s sign

(D) A Glasgow Coma Scale score of 15

(14) The nurse is admitting a client with Guillain-Barre syndrome to the nursing unit. The

client has ascending paralysis to the level of the waist. Knowing the complications of

the disorder, the nurse should bring which most essential items into the client’s room?

(A) Nebulizer and pulse oximeter

(B) Blood pressure cuff and flashlight

(C) Flashlight and incentive spirometer

(D) Electrocardiographic monitoring electrodes and intubation tray

(15) A client with myasthenia gravis has become increasingly weaker. The health care

provider prepares to identify whether the client is reacting to an overdose of the

medication (cholinergic crisis) or an increasing severity of the disease (myasthenic

crisis). An injection of edrophonium is administered. Which finding would indicate that

the client is in a cholinergic crisis?

(A) No change in the condition

(B) Complaints of muscle spasms

(C) An improvement of the weakness

(D) A temporary worsening of the condition

(16) A male client is having a lumbar puncture performed. The nurse would plan to

place the client in which position?

(A) Side lying with pillow under the hip

(B) Prone, with a pillow under the abdomen

(C) Prone , in slight Trendelenburg position

( D) Side-lying with legs pulled up and bent down onto chest

(17) The nurse is positioning the female client with increased intracranial pressure.

Which of the following positions would the nurse avoid?

(A) Head midline

(B) Head turned to the side

(C) Neck in neutral position

(D) Head of bed elevated 30 to 45 degrees

(18) 18. The nurse is caring for the male client who begins to experience seizure activity

while in bed. Which of the following actions by the nurse would be contraindicated?

(A) Loosening restrictive clothing

(B) Restraining the client’s limbs

(C) Removing the pillow and raising padded side rails

(D) Positioning the client to side, if possible , with the head flexed forward

(19) The nurse is assigned to care for a female client with complete right-sided

hemiparesis. The nurse plans care knowing that this condition:

(A) the client has complete bilateral paralysis of arms and legs

( B) the client has weakness on the right side of the body including the face and tongue

(C) the client has lost the ability to move the right arm but is able walk independently

(D) the client has lost the ability to move the left arm but is able to walk independently

(20) A female client has experienced an episode of myasthenic crisis. The nurse would

assess whether the client has precipitating factors such as:

(A) getting too little exercise

(B) taking excess medication - (will cause cholinergic crisis instead)

(C) omitting doses of medication

(D) increasing intake of fatty foods

(21) A male client has an impairment of cranial nerve II. Specific to this impairment, the

nurse would plan to do which of the following to ensure clients to ensure client safety?

(A) Speak loudly to the client

(B) Test the temperature of the shower water

(C) Check the temperature of the food on the delivery tray

(D) Provide a clear path for ambulation without obstacles

(22) A male client is having a tonic-clonic seizures. What should the nurse do first?

(A) Elevate the head of the bed

(B) Restrain the client’s arms and legs

(C) Place a tongue blade in the client’s mouth

(D) Take measures to prevent injury

(23) The nurse is teaching the female client with myasthenia gravis about the
prevention of myasthenic and cholinergic crises. The nurse tells the client that this is

most effectively done by:

(A) Eating large, well-balanced meals

(B) Doing muscle -strengthening exercises

(C) Doing all chores early in the day while less fatigued

(D) Taking medications on time to maintain therapeutic blood levels

(24) Which of the following neurotransmitters is known to be associated with sleep,

mood and appetite?

(A) A. Acetylcholine

(B) B. Dopamine

(C) C. Serotonin

(D) D. GABA

(25) 25. The neurons of the motor pathway control:

(A) A. Stress reaction

(B) B. Organs and glands

(C) C. Involuntary muscles

(D) D. Voluntary muscles

(26) 26. The area of the brain which is involved in the understanding of meaning is:

(A) A. Broca’s area

(B) B. association areas

(C) C. Wernicke area

(D) D. Motor speech area

(27) 27. Parkinson’s disease , is caused by the degeneration of neurons in an area of the

brain called the:

(A) A. Substantia nigra

(B) B. Basal ganglia

(C) C. Cerebellum

(D) D. Corpus callosum

(28) 28. The division of the nervous system which controls the involuntary muscles,

organs, and glands is:

(A) A. Somatic nervous system

(B) B. Autonomic nervous system

(C) C. Central nervous system

(D) D. The motor pathway of the CNS

(29) 29. Parasympathetic system is also called

(A) A. Fight or flight system

( B) B. Eat-drink and rest system

(C) C. Autonomic nervous system

(D) D. Somatic nervous system

(30) 30. A condition, causing the affected person to be unable to understand or

comprehend the language ( poor comprehension) with intact repetition (fluent output) is

termed as:

(A) A. Broca’s aphasia

(B) B. Global aphasia

( C) C. Wernicke’s aphasia

(D) D. Conduction aphasia

(31) A client is unconscious following a tonic-clonic seizure. What should the nurse do

FIRST?

(A) A. Place the client in a side-lying position

(B) B. Check the pulse

(C) C. Administer Valium

(D) D. Place a tongue blade in the mouth (Never do this! Places client in danger!)
(32) 32. The nurse enters the room as the client is beginning to have a tonic-clonic

seizure. What action should the nurse implement first?

(A) A. Determine if the client is incontinent of urine or stool.

(B) B. Provide the client with privacy during the seizure.

(C) C. Note the first thing the client does in the seizure.

(D) D. Assess the size of the client’s pupils.

(33) 33. The nurse is teaching a class on the prevention of cerebrovascular accidents.

Which of the following risk factors should the nurse identify as the most important

factor contributing to a stroke?

(A) A. Sedentary lifestyle

(B) B. Smoking

(C) C. Obesity

(D) D. Hypertension

(34) 35. The nurse is assessing a 37-year-old client diagnosed with multiple sclerosis.

Which of the following symptoms would the nurse expect to find?

(A) A. Flaccid muscles

(B) B. Tremors at rest

(C) C. Absent deep tendon reflexes

(D) D. Vision changes

(35) 36. If a male client experienced a cerebrovascular accident (CVA) that damaged

the hypothalamus, the nurse would anticipate that the client has problems with:

(A) A. Thinking and reasoning

(B) B. Body temperature control

(C) C. Balance and equilibrium

(D) D. Visual acuity

(36) 37. During recovery from a cerebrovascular accident (CVA), a female client is given
nothing by mouth, to help prevent aspiration. To determine when the client is ready for a

liquid diet, the nurse assesses the client’s swallowing ability once each shift. This

assessment evaluates

(A) A. Cranial nerves III and V

(B) B. Cranial nerves IX and X

(C) C. Cranial nerves I and II

(D) D. Cranial nerves VI and VIII

(37) After striking his head on a tree while falling from a ladder, a young man age 18 is

admitted to the emergency department. He’s unconscious and his pupils are

nonreactive. Which intervention would be the most dangerous for the client?

( A) A. Perform lumbar puncture

(B) B. Elevate the head of his bed

(C) C. Give him a barbiturate

(D) D. Place him on mechanical ventilation

(38) A male client is admitted with a cervical spine injury sustained during a diving

accident. When planning this client’s care, the nurse should assign highest priority to

which nursing diagnosis?

(A) A. Disturbed sensory perception (tactile)

(B) B. Self-care deficit: dressing /grooming

(C) C. Impaired physical mobility

(D) D. Ineffective breathing pattern

(39) Demyelination is defined as;

(A) A. Loss of an axon in a neuron

(B) B. Loss of dendrites in a neuron

(C) C. Loss of protective sheath surrounding neurons

(D) D. Loss of connective tissue between neurons

(40) Failure of muscle coordination , including unsteady movements and staggering

walk, due to disorders in the cerebellum is called?

(A) A. Anoxia

(B) B. Dyslexia

(C) C. Paraplegia

(D) D. Ataxia

(41) Which part of the brain regulates heartbeat, breathing and other vital functions?

(A) A. Grey matter

(B) B. Brain stem

(C) C. Occipital lobe

(D) D. White matter

(42) Common complications of spinal cord injury include each of the following

EXCEPT?

(A) A. Pressure sores

(B) B. Deep vein thrombosis

(C) C. Diarrhoea

(D) D. Urinary Tract infections

(43) 45. Broca’s area is located in the

(A) A. Brain stem

(B) B. Frontal lobe

(C) C. Parietal lobe

(D) D. Temporal lobe

(44) Wernicke area is located in the

(A) A. Brain stem

(B) B. Parietal lobe

(C) C. Temporal lobe

(D) D. Frontal lobe

(46) The presence of ptosis suggests damage to cranial nerve:

(A) a. IV

(B) b. V

(C) c. III

(D) d. VII

(47) A 55-year-old man complaints that he sometimes has sudden pain on one side oof

his face. It lasts up to 2 minutes. The pain is excruciating and feels like an “electric

shock”. He states it happens when he shaves and sometimes when he is chewing food.

Upon physical exam, you notice the area of the face he points to is the area of

distribution of 5th cranial nerve. He is otherwise healthy and does not take any

medications. You ask him if he has ever had shingles and says no. The most likely

diagnosis is

(A) A. Temporomandibular joint dysfunction

(B) B. Cluster headache

(C) C. Bells palsy - cranial nerve 7

( D) D. Tic dolourex

(48) A 60-year-old man complains of extremely severe, sharp, shooting pain in his face.

Hee describes the episodes as being “like a bolt of electricity”that is brought about by

touching a specific area. Lasta about 60 seconds, and occur many times during the day.

Neurologic examination is completely normal but it is noted that part of his face is

unshaven because he fears to touch that area. Which on the following is the most

appropriate initial treatment?

(A) A. Anticonvulsants

(B) B. Aspirin

(C) C. NSAIDS
(D) D. Vasoconstrictors

(49) Which of the following function is controlled by parasympathetic system?

(A) A. Pupil constriction

(B) B. Acceleration of heart beat

(C) C. Stimulation of sweat glands

(D) D. Contraction of hair muscles

(50) . Which one of the following is NOT a probable sign of the second stage of labour?

(A) A. uterine contractions

(B) B. No cervix felt on vaginal examination

(C) C. Rupture of membranes

(D) D. Bulging of the perineum

(51) You are caring for a woman in the second stage of labor. The client is experiencing

uterine contractions every 2 minutes and cries out in pain with each contraction. This

behaviour is best described as:

(A) A. Exhaustion

(B) B. Fear of losing control

(C) C. Involuntary grunting

(D) D. Valsalva's maneuver

(52) Ms. D is admitted to the labour ward in early active labour. The priority intervention

on admission of this woman would be:

(A) A. Auscultating the fetal heart

(B) B. Taking an obstetric history

(C) C. Asking the client when she last ate

(D) D. Ascertaining whether the membranes were ruptured

(53) 4. A woman who is gravida 1, para 0 is admitted in active labour. Her cervix is 100%

effaced, and she is dilated to 3 cm. The presenting part is at +1 station. The midwife is
aware that the fetus' head is:

(A) A. Not yet engaged

(B) B. Entering the pelvic inlet

(C) C. Below the ischial spines

(D) D. Visible at the vaginal opening

(54) In order to ascertain the frequency of the woman's contractions, the midwife times

from the beginning of one contraction:

( A) A. Until the time it is completely over

(B) B. To the end of a second contraction

(C) C. To the beginning of the next contraction

(D) D. Until the time that the uterus becomes very firm

(55) 6. A woman in labour receives a pudendal block. The midwife plans to tell the her

that once the block is working she:

( A) A. Will not feel the episiotomy

(B) B. May lose bladder sensation

(C) C. May lose the ability to push

(D) D. Will no longer feel contractions

(56) Which one of the following foetal positions is most favourable for birth?

(A) A. Vertex presentation

(B) B. Transverse lie

(C) C. Frank breech presentation

(D) D. Posterior position of the fetal head

(57) Which one of the following assessment data can be determined by examining the

fetal heart rate strip produced by the external electronic fetal monitor?

(A) A. Gender of the fetus

( B) B. Fetal position
(C) C. Foetal heart rate in relation to contractions

(D) D. Oxygenation

(58) Mrs. Peters is experiencing contractions every 2 minutes. She is in which stage of

birth?

(A) A. First

(B) B. Second

(C) C. Third

(D) D. Fourth

(59) 10. In which one of the following stages is the placenta delivered?

(A) A. Stage 1, latent phase

(B) B. Stage 1, active phase

(C) C. Stage2

(D) D. Stage 3

(60) Endogenous oxytocin is released from the:

(A) A. anterior pituitary gland

(B) B. cervix

(C) C. posterior pituitary gland

(D) D. uterus

(61) 12. The midwife is caring for a woman in labour. She determines that the woman is

beginning the 2nd stage of labour when which of the following signs is noted?

(A) A. The woman begins to expel clear vaginal fluid

(B) B. The contractions are regular

(C) C. The membranes have ruptured

(D) D. The cervix is dilated completely

(62) 13. The midwife is caring for a client in labor and prepares to auscultate the foetal

heart rate by using a Doppler ultrasound device. The midwife most accurately
determines that the foetal heart sounds are heard by

(A) A. Noting if the heart rate is greater than 140 BPM

(B) B. Placing the diaphragm of the Doppler on the mother abdomen

( C) C. Performing Leopold's maneuvers first to determine the location of the fetal heart

(D) D. Palpating the maternal radial pulse while listening to the fetal heart rate

(63) Which of the following is true about congenital abnormalities?

(A) A. It refers to defects in the body structure at birth

(B) B. It is always occult at birth making it difficult to detect

(C) C. Congenital abnormalities are all inherited from the family

(D) D. It results from unknown fetal developments that are always difficult to predict

(64) When resuscitating a neonate who has neonatal asphyxia after how long should

the midwife use ambubag

(A) A. After 30 seconds of oxygen by face mask

(B) B. When the baby remains apnoeic after 30 minutes of facemask oxygen therapy.

(C) C. When the neonate is no longer cyanosed

(D) D. When the neonate P02 level has increased

(65) When should a midwife put an asphyxiated neonate on intubation and ventilation?

(A) A. When the heart beat is more than 100 beats per minute

(B) B. When the heart beat is less than 100 beats per minute

(C) C. When the heart rate has improved

(D) D. When resuscitation measures are performed without medical assistance

(66) Which neonate from the listed below is at risk of developing severe jaundice?

(A) A. Breast feed neonates

(B) B. Conjoined twins

(C) C. Neonates with haemorrhagic conditionsions

(D) D. Term neonates

(67) Which of the following is the most appropriate feature seen in symmetric growth

retarded infant?

(A) A. Weight is depressed more than length or head circumference.

(B) B. Fetal growth retardation probably has occurred in the last trimester of pregnancy.

(C) C. Weight, length and head circumference are below normal and babies look like

miniature normal babies.

(D) D. It is mostly linked with cigarette smoking.

(68) 21. A new born infant was delivered in your maternity unit an hour ago. The skin of

this infant appears to be red, wrinkly with ribs visible under the skin. When was the

infant probably born?

(A) A. Before 24 and 27 weeks

(B) B. Before 30 and 32 weeks

(C) C. Before 29 and 32 weeks

(D) D. Around 35 weeks

(69) Which statement is true about meconium?

(A) A. Meconium is 1st found in the foetal ileum between the 20th and 26th weeks of

gestation

(B) B. Meconium passage is uncommon before 36 weeks but its common in

pregnancies beyond 42 weeks

(C) C. In utero passage of meconium is common because the anal sphincter tone is

poor

(D) D. All of the above

(70) Which of the following is NOT diagnostic of twin to twin transfusion?

(A) A. Both are of same sex

(B) B. It results from venous communication of both foetuses

(C) C. Both are of different growth

(D) D. Both are of different amniotic fluid.

(71) 24. Which of the following is true about twin to twin transfusion syndrome?

(A) A. The smaller twin has the greatest risk of cardiac compromise

(B) B. The larger twin is often stuck to the uterine wall

(C) C. Serial amnia reduction improves perinatal survival

(D) D. Fetoscopic laser ablation of the placental vessels increases survival for both

(72) What would be the result of fail splitting a single fertilized ovum between 8 to 12

days after fertilization?

(A) A. Conjoined twin

(B) B. Monochorionic monoamniotic twin

(C) C. Dichorionic diamniotic twin

(D) D. Monochorionic diamniotic twin

(73) A twin pregnancy is identified at 12 weeks gestation on antenatal ultrasound. One

placenta and one amnion sac are identified. What would be the probable cause?

(A) A. ICSI with single embryo transfer

(B) B. Ovulation induction

(C) C. Maternal age over 35 years

(D) D. Family history of multiple pregnancies

(74) Which of the following best describes large for gestational age?

(A) A. Large for gestational age is weight, length, or circumference that lies above the

90th percentile for that gestational age.

(B) B. Large for gestational age is defined as birth weight more than 2 standard

deviations above the mean.

(C) C. Large for gestational age is an indication of high prenatal growth.

(D) D. Large for gestational age is weight of 3500g at birth despite gestational age.

(75) Which ONE of the following is a clinical feature clinical chorio-amnionitis?

(A) A. Foul smelling vaginal discharge

(B) B. Non tender uterus on palpation

(C) C. Maternal temperature of 37.4 degrees Celsius

(D) D. Maternal pulse of 110 beats per minute

(76) Which ONE of the following CANNOT predispose the foetus to chorio-amnionitis?

(A) A. Malnutrition

(B) B. Infection in maternal blood

(C) C. Amniocentesis

( D) D. Abdominal ultrasound

(77) 30. Which ONE of the following is NOT a complication of preterm prelabour rupture

of membranes?

(A) A. Preterm birth

(B) B. Oligohydramnios

(C ) C. Polyhydramnios

(D) D. Infectious morbidity

(78) Which of the following BEST describes a third degree perinea! tear?

(A) A. Injury to perineum involving perineal muscles

(B) B. Injury to perineal! skin, includes the fourchette, the hymen, labia and

vaginalmucosa

(C) C. Injury to perineum involving anal sphincter complex and anal epithelium

(D) D. Injury to perineum involving the anal sphincter complex

(79) What is the greatest risk of retained products of conception in the immediate post

partum period?

(A) A. Uterine atony

(B) B. Uterine inversion

(C) C. Uterine rupture

(D) D. Uterine tenderness

(80) Which of the following is NOT an outcome for an occipito posterior position?

(A) A. Brow delivery

(B) B. Deep transverse arrest

(C) C. Persistent occipito posterior position

(D) D. Occipito anterior delivery

(81) When assessing the progress of labour, the midwife should assess for the 4 Ps.

Which ONE of the following represents the 4 Ps?

(A) A. Power, parity, passenger and passage

(B) B. Passenger, power, patient and passage

(C) C. Parity, progress, power and passenger

(D) D. Passenger, power, progress and passage

(82) What is 3rd degree moulding?

(A) A. Change of the shape of the foetal skull that occurs during labour

(B) B. Sutures of the foetal skull are overridden, but are easily separable

(C) C. Sutures of the foetal skull are in close contact

(D) D. Sutures of the foetal skull are overridden and inseparable

(83) Before performing an episiotomy, the nurse midwife needs to infiltrate the

perineum. In the ward, lignocaine 1% is available. How should the midwife dilute the

lignocaine before using it?

(A) A. Dilute 2 parts lignocaine 1% and 1 part sterile water/ normal saline

( B) B. Dilute 1 part of lignocaine 1% and 1 part of sterile water/ normal saline

(C) C. Dilute 1 part of lignocaine 1% and 3 parts of sterile water/ normal saline

(D) D. Dilute 3 parts of lignocaine 1% and 1 part of sterile water/ normal saline

(84) Which ONE of the following is NOT an indication for an episiotomy?

( A) A. Shoulder presentation
(B) B. Foetal distress

(C) C. Tight perineum

(D) D. Assisted vaginal delivery

(85) Which practice in labour would increase the chance of Mother to Child

Transmission of HIV in HIV positive women?

(A) A. Performing an ultrasound to rule out placental localisation

(B) B. Monitoring of maternal condition

(C) C. Foetal heart monitoring using a cardiotocograph

( D) D. Rupture of membranes 4 hours prior to child birth

(86) In a brow presentation, what is the engaging diameter of the foetus into the

maternal pelvis?

(A) A. Sub-mento vertical diameter

(B) B. Occipito-frontal diameter

(C) C. Mento-vertical diameter

(D) D. Sub-mento bregmatic diameter

(87) Which statement BEST describes a complete breech presentation?

(A) A. Both hips are flexed and both knees are extended

(B) B. Both hips and both knees are flexed

(C) C. One or both hips are extended with the knees extended

(D) D. One or both hips are extended with the knees or knee flexed

(88) 41. Which of the following are the engaging diameters in a face presentation?

(A) A. Sub-occipitofrontal and biparietal

(B) B. Occipito-frontal and biparietal

(C) C. Mentovertical and biparietal

(D) D. Sub-mentobregmatic and biparietal

(89) Which ONE of the following IS NOT a precaution for tocolytics?

(A) A. Measure blood pressure hourly

(B) B. Give one tocolytic agent at a time

(C) C. Do not give tocolytics to women with heart rate greater than or equal to 120 beats

per minute

(D) D. Auscultate the mother's lungs every 2 hours

(90) 43. Thembi is primigravida at 39 weeks gestational age. She requested induction of

labour because she is a student in one of the universities, in preparation for her

examination. On examination:Presentation- cephalic, Fundal height- 40cm, foetal heart

rate 148 beats per minute. Before induction, the obstetrician examines her and the

findings are as follows: cervix-mid position; firm; station-3; length-2cm; and cervical

dilatation: 1-2 cm. What is Thembi's Bishop Score?

(A) 2

(B) 3

(C) 4

(D) 5

Your Answer :

Correct Answer :

(91) Which statement is FALSE concerning augmentation of labour?

( A) A. The uterus always responds effectively to oxytocin used as administration

(B) B. Augmentation is required if labour contractions are weak and ineffective in the

absence of cephalo pelvic disproportion

(C) C. Augmentation must be gradually increased and when strong uterine contractions

occurring 3 in 10 minutes have been achieved, augmentation should be stopped

(D) D. Augmentation requires close monitoring because of the risk of uterine

hyperstimulation 45. What is cervical dystocia?

(92) What is cervical dystocia?

(A) A. When the cervix dilates at the normal expected rate during labour

(B) B. When the cervix fails to dilate in the absence of malpresentation and

cephalopelvic disproportion

(C) C. When the cervix dilates more rapidly than the expected rate

( D) D. Failure of the cervix to dilate despite adequate uterine contractions

(93) Which of the following is NOT a contra-indication for a trial of scar?

(A) A. Multiple pregnancy

(B) B. History of sepsis following the previous caesarean section

(C) C. Previous caesarean section for cord prolapse

(D) D. Breech presentation

(94) Which ONE of the following statements best defines perinatal mortality?

(A) A. Death of a newborn in the first week of life

(B) B. Death of a newborn within the first month of life

(C) C. Stillbirth and death of a neonate in the first month of life

( D) D. Stillbirth and death of a neonate in the first week of life

(95) Which ONE of the following drugs should be used first to a non hypertensive

woman presenting with post partum haemorrhage occurring due to uterine atony?

(A) A. Syntometrine

(B) B. Oxytocin

(C) C. Misoprostol

(D) D. Ergometrine

(96) 49. A woman presents to a clinic 7 days after normal childbirth with a fever of 37.9

Degrees Celsius and an offensive vaginal discharge. According to the Emergency

Obstetrics and Neonatal Care signal functions, where should the woman be managed?
(A) A. Clinic

(B) B. Health Centre

(C) C. Hospital

(D) D. Intensive Care Unit (ICU)

(97) Which ONE of the following statements best defines a Direct Obstetric Case

Fatality Rate?

(A ) A. The percent of women admitted with major direct obstetric complications, or who

develop such complications after admission, and die before discharge

(B) B. The percent of women admitted with direct obstetric complications, or who

develop such complications after admission, and die after discharge

(C) C. The percent of women admitted with major direct obstetric complications who

die before discharge

(D) D. The percent of women admitted with direct obstetric complications who die after

discharge

(98) Subtle neonatal seizure is recognized by:-

(A) A. Sustained eye opening or fixation, drooling, sustained posturing of a limb.

(B) B. Migrating jerks of limbs, localized clonic jerking, tonic horizontal deviation of

eyes.

(C) C. Migrating jerks of limbs, tonic horizontal deviation of eyes, lip smacking.

(D) D. Tonic horizontal deviation of eyes, apnoeic spells, lips smacking.

(99) Causes of primary amenorrhea include:-

(A) A. Gonadal dysgenesis, premature ovarian failure, asherman’s syndrome.

(B) B. Sheehan’s syndrome, gonadal dysgenesis, imperforate hymen.

(C) C. Androgen insensitivity, gonadal dysgenesis, imperforate hymen.

(D) D. Polycystic ovarian syndrome, sheehan’s syndrome, gonadal dysgenesis.

(100) The following are anterior pituitary gland hormones except

(A) Prolactin

(B) Antidiuretic hormone

(C) Follicle stimulating hormone

(D) Luteinizing hormone

Type 4

1. Wernicke area is in the;

(A) A. Occipital lobe

(B) B. Frontal lobe

(C) C. Parietal lobe

(D) D. Temporal lobe

(2) 2. The sensitivity part of culture and sensitivity test is for the purpose of,

(A) A. Identifying the causative organism for the infection diagnosed

(B) B. Testing the concentration of antibiotic required to cure an infection

(C) C. Identifying the most effective antibiotics against the causative agent

(D) D. Identifying the antibiotics that the patient is resistant to.

(3) 3. After a clients’ nasogastric tube has been removed the nurse should,

(A) A. Provide the client with oral hygiene

(B) B. Encourage the client to cough and deep breath

(C) C. Auscultate the client’s bowel sounds

(D) D. Offer the client liquids to drink.

(4) 4. Cardiac output is equal to;

(A) A. Heart rate × patients body weight

(B) B. Venous return× Peripheral resistance

(C) C. Peripheral resistance × stroke volume

(D) D. Stroke volume ×heart rate

(5) 5. Bell’s palsy involves the following cranial nerve

(A) A. VIII

(B) B. VII

(C) C. V

(D) D. II

(6) 6. Management of scaled lesion in psoriasis include;

(A) A. Shaving the scales using a clean razor

(B) B. Applying moisturizers to soften the scales

(C) C. Covering the lesions with occlusive dressings to remove scales

(D) D. Keeping the lesions dry to enhance dropping off the scales

(7) 7. The main causes of Diabetic keto-acidosis are;

(A) A. Infection, physical trauma, self-medication

( B) B. Decreased dose of insulin, an illness, missed dose of insulin

(C) C. Sepsis, renal disease, liver failure

(D) D. Increased dose of insulin, starvation, use of expired insulin

(8) 8. The following is true regarding Hashimoto thyroiditis

(A) A. Is an autoimmune disease, causes primary hypothyroidism

(B) B. Is an autoimmune disease, causes primary hyperthyroidism

(C) C. Results in goiter, causes exophthalmos

(D) D. More common in women, there is an increase in TH levels.

(9) 9. All the following nursing diagnoses are appropriate for a client with acute asthma

attack, which is of the highest priority?

(A) A. Anxiety related to difficulty in breathing

( B) B. Ineffective airway clearance related to bronchoconstriction and increased mucus

production

(C) C. Ineffective breathing pattern related to discomfort during breathing

(D) D. Ineffective health maintenance related to lack of knowledge about attack triggers
and appropriate use of medication

(10) 10. Russell’s traction is indicated in a;

(A) A. Femur, knee and hip fractures

(B) B. Femur, acetabulum and lower leg fractures

(C) C. Minor fractures of lower spine, sciatica, muscle spasms

(D) D. Degenerative disc disease of the cervical spine, shoulder dislocation, muscle

spasms

(11) 11. Characteristics of 2nd degree burns include;

(A) A. Waxy white dry, leathery, charred, oedema

(B) B. Fluid-filled blisters, weeping of fluid, bright pink

(C) C. Red to gray, may have local edema

(D) D. severe pain, weeping of fluid, may have local edema, leathery charred

(12) 12. When estimating the size of burns, the palm of the patient’s hand represents

body surface area of;

(A) A. 3%

(B) B. 1%

(C) C. 4.5%

(D) D. 9%

(13) The early signs of cancer of the posterior nasal space include;

(A) A. Proptosis, hearing loss

(B) B. Hearing loss, double vision

(C) C. Purulent nasal discharge, aphonia

(D) D. Anosmia, proptosis

(14) A client complains of decreasing peripheral vision and halos around lights. These

manifestations are characteristics of;

(A) A. Retinal detachment

(B) B. Open-angle glaucoma

(C) C. Cataract

(D) D. Macular degeneration

(15) 15. Malena can be caused by;

(A) A. Small bowel obstruction, abdominal aortic aneurysm, internal hemorrhoids

(B) B. Perforated gastric ulcers, neoplasms in the transverse colon

(C) C. Bleeding esophageal varices, perforated gastric ulcer

(D) D. Abdominal aortic aneurysm, splenic neoplasm, esophageal varices

(16) 16. Which sign and symptoms should a nurse expect to find in a client diagnosed

with ulcerative colitis?

(A) A. Twenty bloody stools a day

(B) B. Chronic constipation

(C) C. Oral temperature of 39o c

(D) D. Hard rigid abdomen

(17) 17. Early miscarriage refers to;

(A) A. loss of pregnancy spontaneously in between 16-24 weeks

(B) B. spontaneous loss of pregnancy from between 16-30 weeks gestation

(C) C. spontaneous loss of pregnancy from between 0 to 16 weeks gestation

(D) D. loss of pregnancy between 24 to 30weeks

(18) 18. The patient was brought to the outpatient department with a cut wound, which

is the most appropriate intervention for a triage nurse;

(A) A. Wash the site with soap and water

(B) B. Squeeze the site to enhance bleeding

(C) C. Apply a tourniquet proximal to the site

(D) D. Apply a tourniquet distal to the site

(19) 19. Bacterial growth phase where cellular division seems to have stopped or

ceases for a period of time:

(A) A. The Lag Phase

(B) B. The Log Phase

( C) C. The Stationary Phase

(D) D. The Death Phase

20) 20. A nurse is showing a patient how to use crutches at home and instructing his

mother about how to change his bandages. At this time, the nurse is primarily acting as:

(A) A. Patient advocate

(B) B. Manager of care

(C) C. Teacher

(D) D. Decision maker

(21) 22. While caring for a patient with a diagnosis of emphysema, the healthcare

provider instructs the patient on positioning that will assist the patient’s ability to

breathe when experiencing dyspnea. Which of the following positions will the healthcare

provider instruct the patient about?

(A) A. Lie supine with your feet on a blanket roll.

(B) B. Sit upright and lean forward on a supportive surface

(C) C. Sit in a recliner chair at a 120-degree angle

(D) D. Assume a side-lying position

(22) 23. During chest auscultation of a patient, which findings will indicate that the

patient has cardiac condition and cannot be felt in a normal person

(A) A. S1, S3 , Murmurs

(B) B. S1, S2, Negative Murmurs,

(C) C. S3, S4, Murmurs

(D) D. S3, S1,S2

(23) 24. Nurse Lei caring for a client with a pneumothorax and who has had a chest tube

inserted notes continues gentle bubbling in the suction control chamber. What action is

appropriate?

(A) A. Do nothing, because this is an expected findng

(B) B. Immediately clamp the chest tube and notify the physician

(C) C. Check for an air leak because the bubbling should be intermittent

(D) D. Increase the suction pressure so that the bubbling becomes vigorous

(24) 25. You assess a client with newly diagnosed hypothyroidism as having an

enlarged thyroid gland (goiter). What pathologic process causes this enlargement?

(A) A. An excess of TH stimulates thyroid follicles

(B) B. An increased dietary iodine intake

(C) C. A compensatory effort to produce more TH

(D) D. Tissue hypertrophy in response to increased TH

(25) 26. An elderly client has severe xerosis. What topic should be included in your

teaching plan?

(A) A. Maintain a warm environment

(B) B. Take a hot bath everyday

(C) C . Apply skin lotions after a bath

(D) D. Use fabric softeners when laundering clothing

(26) 27. Which of the following clients would be most at risk for the development of

type 2 diabetes?

(A) A. Middle-age man who maintains normal weight

(B) B. Young adult who is a professional basketball player

(C) C. Middle-aged woman who is the sole caretaker of her parents

(D) D. Woman over the age 70 who is overweight and sedentary

(27) 28. A client received a liver transplant a day ago. If a client were to develop an
acute transplant rejection episode, when should the nurse expect to see the

manifestations?

(A ) A. Approximately 4days to 3 months later

(B) B. Approximately 2 days later

(C) C. Within the first 24 hours

(D) D. Within the first 8 hours

(28) Ms. Smith complains of nausea and vomiting following her daily chemotherapy

treatment. The most appropriate nursing intervention would be to;

(A) A. Keep NPO until her daily chemotherapy is completed

(B) B. Provide antiemetic medication 30 to 40 minutes prior to each treatment

(C) C. Provide clear liquids until the chemotherapy is completed

(D) D. Schedule chemotherapy administration to bed time

(29) 21. The nurse in charge identifies a patient’s responses to actual or potential health

problems during which step of the nursing process?

(A ) A. Assessment

(B) B. Diagnosis

(C) C. Planning

(D) D. Evaluating

(30) 30. Which of the following clients is a greater risk for burn shock?

(A) A. One with 90% superficial burns from a tanning bed

(B) B. One with 10% TBSA from gasoline explosion

(C) C. One with radiation burns following treatment for cancer

(D) D. One with >50% TBSA from a high-voltage electric accident

(31) 31. Which one of the following topics should be included in a health message on

burn prevention?

(A) A. Use a solar powered night light

(B) B. Check smoke detectors annually

(C) C. Do not use oven for cooking

(D) D. Set water heater no longer than 48°C

(32) While providing care to an old woman with a cast on her lower arm (from below the

elbow the elbow to above the fingers) you perform a neurovascular assessment. What

is the possible complication?

(A) A. Slightly edematous fingers

(B) B. Warm, pink skin above the cast

(C) C. Pale, cold fingers

(D) D. Pain rating of 2 on a 1 to 10 scale

(33) 33. A patient becomes restless and tells you she has a headache and feels

nauseous during hemodialysis. Which complication do you suspect?

(A) A. Infection

(B) B. Disequilibrium syndrome

(C) C. Air embolism

(D) D. Acute hemolysis

Your Answer :

(34) 34. A patient Kante, 16 years old is brought to the Emergency department with

history of sodium hypochloride/JIK spill on the left eye 5 minutes ago. The first most

appropriate Nurse action would be?

(A) A. Immediately refer to an ophthalmologist for review

(B) B. Administer topical antibiotics and analgesics

(C) C. Test for Visual Acuity to check extent of damage

(D) D. Patch the eye after irrigation with clean water

(35) 35. A classification of ringworm that infect the finger nails is:-

(A) A. Tinea coporis

(B) B. Tinea unguium

(C) C. Tinea cruris

(D) D. Tinea pedis

(36) 36. Following gastrectomy, dumping syndrome occurs as a results of:-

(A) A. Reduced gastric motility resulting from Vagus nerve stimulation

(B) B. Removal of acid producing cells thus resulting in reduced absorption of Vit B12

(C) C. Rapid gastric emptying of hyperosmolar fluid and substances into the duodenum

(D) D. Damage of Vagus nerve and cardiac sphincter

(37) 37. The intracranial; hemorrhage with the worst prognosis is :-

(A) A. Cephalohematoma

(B) B. Epidural hemorrhage

(C) C. Intracerebral hemorrhage

(D) D. Subarachnoid hemorrhage

(38) 38. Signs of hypothyroidism include:-

(A ) A. Muscle weakness, depression

(B) B. Tachycardia, irritability

(C) C. Decreased appetite, tachycardia

(D) D. Hypertension, somnolence

(39) 39. A patient with potassium levels in excess of 5.0 mEq/L is considered to be in a

state of :-

(A) A. Hypernatremia

(B) B. Hypercalcemia

(C) C. Hypervolemia

(D) D . Hyperkalemia

(40) 40. The health message given to a patient following tympanoplasty is:-

(A) A. Drink fluids using a straw

(B) B. Avoid blowing the nose and sneeze through the mouth

(C) C. Administered saline water into the ear to aid healing

(D) D. Avoid noisy places upto two weeks post operatively

(41) 41. Which of the following indicates a normal finding on percussion of the lungs

(A) A. Tympani over the right upper lobe

(B) B. Resonance over the left upper lobe

(C) C . Hyper resonance over the left lower lobe

(D) D. Dullness above the left 10th intercostal space

(42) 42. What are the causes of ischaemic stroke

(A) A. Saccualar aneurysm, artery thrombosis, large artery thrombosis

(B) B. Cardiogenic embolism, small artery thrombosis, cryptogenic

(C) C. small artery thrombosis, cryptogenic, intracerebral hemmorage

(D) D. Arterio-venous malformation, Cardiogenic embolism, small artery thrombosis

(43) 43. Which one of the following is correct regarding the control of glucose levels?

(A) A. Both insulin and glucagon are necessary to maintain high blood glucose levels.

(B) B. Glucagon is responsible for switching off gluconeogenesis.

(C) C. Insulin is responsible for switching on glycogenolysis.

(D) D. Glucagon is responsible for switching on gluconeogenesis

(44) 44. What type of stool can a nurse expect from a client who has a colostomy of the

lower descending colon?

(A) A. Liquid

(B) B. Bloody

(C) C. Black

(D) D. Formed

(45) 45. An adult patient weighing 120 kg has a 20% total body surface area burn. Using

the modified parkland formula, how much total intravenous fluid should he receive in
the first 8 hours:-

(A) A. 2400 mL

(B) B. 4800mL

(C) C. 9600 mL

(D) D. 10,800 ml

4ml x 20 x 120kg = 9600 ml Total to be given in 24hrs

First half, 4800 ml given in the first 8hrs

Second half given in next 16hrs

(46) 46. Antihistamines are indicated in the management of vertigo because they:

(A) A. Sedate the client

(B) B. Activate the vestibular system

(C) C. Suppress the vestibular system

(D) D. Suppress the cochlear system

(47) 47. Clinical features of hydatidiform mole include;

(A) A. Positive pregnancy test of urine diluted to 1:100 after4 weeks of amenorrhea,

ultrasound shows features of fetus.

(B) B. Amenorrhea followed by vomiting, breast changes.

(C) C. Uterus larger than dates ,chronic gonadotropin hormone in urine increase

(D) D. Amenorrhea followed by intermittent bleeding, fetus demonstrated in x-ray.

(48) 48. Glomerulonephritis usually follows;

(A) A. Staphylococcal infection

(B) B. Gonococcal infection

(C) C. Hemophilus infection

( D) D. Streptococcal infection

(49) 49. The aorta divides at the level of the 4th lumbar vertebra into;

(A) A. external &internal iliac arteries

(B) B. superior & inferior mesenteric arteries

(C) C. common iliac arteries

(D) D. lumbar arteries

(50) 50. Corneal infections are difficult to treat due to the fact that;

(A) A. The surface area of cornea is small

(B) B. Causative organisms cannot be recovered

(C) C. Corneal infections are not easily diagnosed

(D) D. The cornea is avascular organ

(51) 51. The most appropriate intervention for a client with a diagnosis of ineffective

airway clearance is:

(A) A. Withholding pain medications

(B) B. Administering cough suppressants every 4-6 hours

(C) C. Administering antibiotics as prescribed

(D) D. Maintaining adequate hydration and providing increased humidity.

(52) 52. Chvostek’s sign is used for diagnosis of:-

(A) A. Hypercalcemia resulting from hyperpituitariism

(B) B. Hypocalcemia resulting from hypoparathyroidism

(C ) C. Hypocalcemia resulting from hypothyroidism

(D) D. Hypocalcemia resulting from hypothyroidism

(53) 53. Which is a symptom of atopic dermatitis?

(A) A. A blister on the palms of hands and soles of feet.

(B) B. Itchy, inflamed skin.

(C) C. Scaly patches of skin on the scalp.

(D) D. Coin-shaped patches of irritated skin on the arms and lower legs.

(54) 54. A primary defect in osteomalacia is a deficiency in which vitamin?

(A) A. B12
(B) B. D

(C) C. E

(D) D. C

(55) 55. Obesity is a risk factor for all of the following types of cancer except:-

(A) A. Renal

(B) B. Pancreas.

(C) C. Endometrial.

( D) D. Lung cancer.

(56) 56. A child on long term use of corticosteroids is at risk of;

(A) A. Growth retardation.

(B) B. Peripheral neuropathy.

(C) C. Muscular degeneration.

(D) D. Hyperkalemia.

(57) 57. Pleural effusion is a complication of;

(A) A. Heart failure, nephritic syndrome, pulmonary tuberculosis

(B) B. Pneumonia,upper respiratory infections, post thoracotomy

(C) C. Penetrating chest trauma,bronchitis,haematogenous infection of the pleural

space

(D) D. Pulmonary embolism, lung cancer, post thoracentesis

(58) When measuring central venous pressure (CVP) the nurse should;

(A) A. Mark the location of the right atrium.

(B) B. Identify the location of the left atrium.

(C) C. Always ensure the patient lies in supine position.

(D) D. Allow Normal saline to drip rapidly into the client for 5 min before taking CVP

reading

(59) 60. Furuncles (boils) are commonly caused by;

(A) A. Streptococcus pyogenes

(B) B. Clostridium tetani

(C) C. Staphylococcus aureus

(D) D. Bacillus aureus

(60) 61. The appropriate health message to a patient who develops stomatitis

secondary to radiotherapy is ;

(A) A. Gurgle with mouthwash and rinse thoroughly after each meal.

(B) B. Use ice cold liquids such as tea or cola to relieve discomfort.

(C) C. Use a toothbrush soaked in saline to clean the mouth.

(D) D. Drink citrus juices

(61) 62. Sympathetic stimulation of the cardiovascular system causes;-

(A) A. Increased heart rate and constriction of coronary arteries.

(B) B. Constriction of GIT secretory gland vessels with increased flow of digestive

juices.

( C) C. Increased peripheral resistance and dilatation of coronary arteries .

(D) D. Increased force of heart contraction & reduced peripheral resistance.

(62) 63. The immediate effects of burns on body fluids and electrolytes include ;-

(A) A. Hypokalemia & Hyponatremia.

(B) B. Reduced circulatory blood volume and hypernatremia.

(C) C. Hyponatremia and Hyperkalemia.

(D) D. Reduced urine output and hypokalemia

(63) 64. Early complication of fractures include;

(A) A. Shock, vascular necrosis.

(B) B. Reaction to internal fixation device, deep venous thrombosis

(C) C. Compartment syndrome, fat embolism.

(D) D. Complex regional pain syndrome, infection.

(64) 65. When suctioning a laryngeal tube;-

(A) A. It should take about 10 seconds.

(B) B. A clean and not asceptic technique should be used.

(C) C. Suction is applied while inserting the catheter into the tube.

(D) D. Suctioning should be done continuously till secretions clear.

Your Answer :

Correct Answer :

(65) 67. Angiotensin-converting enzyme (ACE)inhibitors;

(A) A. Inhibit conversion of angitensinogen to angiotensin I.

(B) B. Block receptors from binding angiotensin II.

(C) C. Inhibit conversion of angiotensin I to angiotensin II.

(D) D. Block angiotensin I receptor sites.

Your Answer :

Correct Answer :

(66) 68. In myocardial infarction, Nitroglycerin is administered to;-

(A) A. Dilate arteries in small doses.

(B) B. Decrease ischemia by reducing myocardial oxygen consumption.

(C) C. Increase the preload.

(D) D. Enable the patient achieve muscle relaxation.

Your Answer :

Correct Answer :
A

(67) 69. After a barium enema a nurse should,

(A) A. Keep the patient NPO for 8 hours to rest the bowel

(B) B. Advise the patient that his/her stool will be radioactive

(C) C. Encourage the patient to increase his fluid intake

(D) D. Advise the patient to avoid abdominal exercises for at least 1 week

Your Answer :

Correct Answer :

(68) 70. Passive range of motion exercises;

(A) A. Are performed to prevent nosocomial infections.

(B) B. Helps to prevent joints rigidity and contractures.

(C) C. Is a collaborative intervention that requires a surgeon and a nurse.

(D) D. Are repeated 5-6 times a day to enhance quick recovery.

Your Answer :

Correct Answer :

(69) 71. Appropriate nursing interventions for a patient with “Risk for infection related to

altered immunity response” include;

(A) A. Barrier nursing, avoiding invasive procedures and inspection of entry port sites for

pathogens

(B) B. Reverse barrier nursing, monitor SPO2 hourly and serve high protein diet

(C) C. Isolation nursing, obtaining cultures & sensitivities daily and administration of

antibiotics
(D) D. Reverse barrier nursing, avoiding invasive procedures & daily assessment of

intravenous sites

Your Answer :

Correct Answer :

(70) 72. The Korotkoff sounds heard while measuring blood pressure present in the

order of,

(A) A. Tapping, Swishing, Knocking, muffling and silence

(B) B. Swishing, Tapping, Silence, muffling and knocking

(C) C. Knocking, Tapping, Swishing, muffling, silence

(D) D. Silence, Tapping, Knocking, Swishing and Muffling

Your Answer :

Correct Answer :

(71) 73. In sickle cell anaemia patients,

(A) A. The structure of haemoglobin molecule is not affected.

(B) B. Prophylactic administration of folic acid and pneumococcal vaccine is

recommended

(C) C. Administration of IV fluids & immediate blood transfusion are encouraged during

sickle cell crisis situations

(D) D. The treatment of choice includes administration of penicillins & NSAIDs

Your Answer :

Correct Answer :
C

(72) 74. Hyperkalemia commonly occurs in the following,

(A) A. Burns, pneumonia and congestive cardiac failure.

(B) B. Renal failure, crush injuries and burns.

(C) C. Digitalis toxicity, DKA and hyperthyroidism.

(D) D. Overuse of potassium sparing diuretics, CCF and liver cirrhosis

Your Answer :

Correct Answer :

(73) 75. The route that achieves the quickest absorption and effects of a drug is the,

(A) A. Subcutaneous

(B) B. Intradermal

(C) C. Intramuscular

(D) D. Oral

Your Answer :

Correct Answer :

(74) 76. In simple mastectomy:-

(A) A. Pectoralis major muscle and the entire breast is excised

(B) B. Axillary lymph nodes and pectoralis major muscles are left intact

(C) C. Underlying chest muscles and chaniin of internal mammary lymph nodes are

removed

(D) D. Entire breast and axillary lymph nodes are removed

Your Answer :
B

Correct Answer :

(75) 77. Reed Sternberg cell is a pathologic hallmark essential in diagnosis of:-

(A) A. Hodgkin’s disease

(B) B. Acute myeloid leukemia

(C) C. Chronic lymphocytic leukemia

(D) D. Non-hodgkin disease

(76) 78. Characteristics of 1st degree burns include:-

(A) A. Erythema and pain

(B) B. Chilling and dry wounds

(C) C. Healing by scaling, painless wounds

(D) D. Black appearance, painless wounds

(77) 79. In rheumatoid arthritis, inflammation of the jounts begins in the:-

(A) A. Hip, ankle,elbow

(B) B. Feet, wrist, toes

(C) C. Shoulder, fingers, wrist

(D) D. Clavicle, hands, fingers

Your Answer :

Correct Answer :

(78) 80. The main aim of escharotomy in treatment of full thickness burns is to:-

(A) A. Improve oxygenation of the burnt tissues

(B) B. Remove the dead tissues

(C) C. Allow underlying viable tissues to expand

(D) D. Reduce pain

Your Answer :

Correct Answer :

(79) 81. Risk factors of osteoporosis include:-

(A) A. Lack of Vitamin D in diet, high estrogen levels in women

(B) B. Too much exposure to the sun, low testosterone levels in men

(C) C. Increase in age, late menopause

(D) D. Excessive alcohol consumption, early menopause

Your Answer :

Correct Answer :

(80) 82. Rhesus factor is found in the cell membrane of the:-

(A) A. Lymphocytes

(B) B. Granulocytes

(C) C. Erythrocytes

(D) D. Globulins

Your Answer :

Correct Answer :

(81) 83. The immediate action in a patient with sickle cell anaemia who develops

priapism is:-

(A) A. Caution the patient against passing urine till the priapism resolves

(B) B. Make the patient to lie still on bed

(C) C. Have the patient take a warm bath

( D) D. Administer morphine at the onset of the attack

Your Answer :

Correct Answer :

(82) 84. Atherosclerosis impedes coronary blood flow by the following mechanisms

(A) A. Plaques obstructs the vein

(B) B. Plaques obstruct the artery

(C) C. Blood clots from outside the vessel wall

(D) D. Hardened vessels dilate to allow the blood to flow through

Your Answer :

Correct Answer :

(83) 85. The hypogastric region of the abdominopelvic cavity is;

(A) a. Inferior to the umbilical region, medial to the right iliac region

(B) b. Lateral to the left iliac region, superior to the umbilical region

(C) c. Medial to the right iliac region, lateral to the umbilical region

(D) d. Superior to the umbilical region, medial to the right iliac region

Your Answer :

Correct Answer :

(84) 86. The most appropriate nursing action when a client begins to cough and has

difficulty breathing during nasogastric tube insertion is;

(A) A. Inserting the tube quickly

(B) B. Notifying the physician immediately

(C) C. Removing the tube and reinserting when the respiratory distress subsides

(D) Pulling the tube back a little and wait until the respiratory distress subsides

Your Answer :

Correct Answer :

(85) 87. Turbid urine is an indication of;

(A) a. Dehydration and urinary tract infection.

(B) b. Presence of prostatic fluid and WBC.

(C) c. Anuria and presence of RBCs.

(D) d. Perineal injury and prolonged use of diuretics

Your Answer :

Correct Answer :

(86) 88. An 11-month-old infant with dehydration and metabolic acidosis is likely to

present with;

(A) a. A decreased platelet count

(B) b. Shallow respirations

(C) c. Tachypnea

(D) d. A reduced white blood cell count

Your Answer :

Correct Answer :
C

(87) 89. A child with Wilms’ tumor presents with;

(A) a. Gross hematuria

(B) b. Dysuria

(C) c. Nausea and vomiting

(D) d. An abdominal mass

Your Answer :

Correct Answer :

(88) 90. The expected outcomes for a patient who has “potential for impaired gas

exchange related to fluid overload” is;

(A) a. No shortness of breath, scaphoid abdomen.

(B) b. Chest X-ray normal, improved gas exchange.

(C) c. Respiratory rate less than 20breaths/min, skin colour normal.

(D) d. Heart rate less than 100 beats/min, increased urine output

Your Answer :

Correct Answer :

(89) 91. During Lumbar puncture, a needle is inserted in the space between;-

(A) a. Fifth and sixth thoracic vertebrae.

(B) b. Fourth and fifth thoracic vertebrae

(C) c. Third and fourth lumbar vertebrae.

(D) d. First and second lumbar vertebrae

Your Answer :
C

Correct Answer :

(90) 92. A deteriorating condition for a patient with head injury will be indicated by;-

(A) a. Widening pulse pressure and irregular respiratory pattern.

(B) b. Narrowing pulse pressure and escalation of discomfort.

(C) c. Bradycardia and Kussmaul breathing.

(D) d. Oliguria and narrow pulse pressure

Your Answer :

Correct Answer :

(91) 93. In chronic bronchitis;-

(A) a. There is cough and sputum production for at least 3 months in 2 consecutive

years.

(B) b. There is destruction of alveoli walls due to severe infection and increased

secretion.

(C) c. There is increased ciliary function in the airway.

(D) d. There is flow limitation and is not fully reversible

(92) 94. The condition in which the eyeballs are not properly aligned with each other is

referred to as;

(A) a. Astigmatism

(B) b. Strabismus

(C) c. Presbyopia

(D) d. Amblyopia

(93) 95. A patient with diabetic ketoacidosis presents with hyperventilation because;
(A) A. The respiratory centre in the brain is damaged

(B) B . The body PH is low

(C) C. There is high rate of oxygen consumption

(D) D. There is reduced excretion of waste through the renal system

(94) 96. When assessing a client with possible Cushing’s syndrome you would expect to

find;

(A) A. Hypotension

(B) B. Thick coarse skin

(C) C. Deposits of adipose tissue in the trunk

(D) D. Weight loss

(95) 97. When administering an enema;

(A) A. The client should lie in the right lateral position.

(B) B. The enema tube should be inserted 8 inches into the clients’ rectum.

(C) C. The client should be advised to retain the enema for 30 minutes.

(D) D. The nurse should position the client in left lateral position

(96) 98. The primary causes of acute otitis media are;-

(A) A. Escherichia coli and proteus spp.

(B) B. Streptococcus pneumoniae and Haemophilus influenzae.

(C) C. Staphylococcus aureus and haemophilus influenzae.

(D) D. Proteus spp. and Streptococcus pneumoniae.

(97) 99. Triple therapy is indicated in treatment of;

(A) A. Osteomyelitis.

(B) B. Helicobacter pylori.

(C) C. Neisseria meningitidis.

(D) D. Oncocerca volvulus

(98) 100. The early signs of cancer of the posterior-nasal space include;
(A) A. Proptosis, hearing loss.

(B) B. Hearing loss, double vision.

(C) Purulent nasal discharge, aphonia .

(D) D. Anosmia, proptosis

(99) during the early postoperative period after a subtotal thyroidectomy, the concern

that has the priority is

(A) hemorrhage

(B) thyrotoxic crisis

(C) airway obstruction

(D) hypocalcemic tetany

(100) immediately after esophageal surgery the priority nursing assessment concerns

the client's

(A) incision

(B) respiration

(C) level of pain

(D) nasogastric tube

Type 5 : Paper 1 trial exam

1. The client presents to the clinic with a serum cholesterol of 275 mg/dL and is placed

on rosuvastatin (Crestor). Which instruction should be given to the client?

A. Report muscle weakness to the physician.

B. Allow six months for the drug to take effect.

C. Take the medication with fruit juice.

D. Ask the doctor to perform a complete blood count before starting the medication.

2. The client is admitted to the hospital with hypertensive crises. Diazoxide (Hyperstat)

is ordered. During administration, the nurse should:

A. Utilize an infusion pump

B. Check the blood glucose level

C. Place the client in Trendelenburg position

D. Cover the solution with foil

3. The 6-month-old client with a ventral septal defect is receiving Digitalis for regulation

of his heart rate. Which finding should be reported to the doctor?

A. Blood pressure of 126/80

B. Blood glucose of 110 mg/dL

C. Heart rate of 60 bpm

D. Respiratory rate of 30 per minute

4. The client admitted with angina is given a prescription for nitroglycerin. The client

should be instructed to:

A. Replenish his supply every 3 months

B. Take one every 15 minutes if pain occurs

C. Leave the medication in the brown bottle

D. Crush the medication and take with water

5. The client is instructed regarding foods that are low in fat and cholesterol. Which diet

selection is lowest in saturated fats?

A. Macaroni and cheese

B. Shrimp with rice

C. Turkey breast

D. Spaghetti

6. The client is admitted with left-sided congestive heart failure. In assessing the client

for edema, the nurse should check the:

A. Feet

B. Neck

C. Hands
D. Sacrum

7. The nurse is checking the client’s central venous pressure. The nurse should place

the zero of the manometer at the:

A. Phlebostatic axis

B. PMI

C. Erb’s point

D. Tail of Spence

8. The physician orders lisinopril (Zestril) and furosemide (Lasix) to be administered

concomitantly to the client with hypertension. The nurse should:

A. Question the order

B. Administer the medications

C. Administer separately

D. Contact the pharmacy

9. The best method of evaluating the amount of peripheral edema is:

A. Weighing the client daily

B. Measuring the extremity

C. Measuring the intake and output

D. Checking for pitting

10. A client with vaginal cancer is being treated with a radioactive vaginal implant. The

client’s husband asks the nurse if he can spend the night with his wife. The nurse

should explain that:

A. Overnight stays by family members is against hospital policy.

B. There is no need for him to stay because staffing is adequate.

C. His wife will rest much better knowing that he is at home.

D. Visitation is limited to 30 minutes when the implant is in place.

11. The nurse is caring for a client hospitalized with a facial stroke. Which diet selection
would be suited to the client?

A. Roast beef sandwich, potato chips, pickle spear, iced tea

B. Split pea soup, mashed potatoes, pudding, milk

C. Tomato soup, cheese toast, Jello, coffee

D. Hamburger, baked beans, fruit cup, iced tea

12. The physician has prescribed Novolog insulin for a client with diabetes mellitus.

Which statement indicates that the client knows when the peak action of the insulin

occurs?

A. “I will make sure I eat breakfast within 10 minutes of taking my insulin.”

B. “I will need to carry candy or some form of sugar with me all the time.”

C. “I will eat a snack around three o’clock each afternoon.”

D. “I can save my dessert from supper for a bedtime snack.”

13. The nurse is teaching basic infant care to a group of first-time parents. The nurse

should explain that a sponge bath is recommended for the first 2 weeks of life because:

A. New parents need time to learn how to hold the baby.

B. The umbilical cord needs time to separate.

C. Newborn skin is easily traumatized by washing.

D. The chance of chilling the baby outweighs the benefits of bathing.

14. A client with leukemia is receiving Trimetrexate. After reviewing the client’s chart,

the physician orders Wellcovorin (leucovorin calcium). The rationale for administering

leucovorin calcium to a client receiving Trimetrexate is to:

A. Treat iron-deficiency anemia caused by chemotherapeutic agents

B. Create a synergistic effect that shortens treatment time

C. Increase the number of circulating neutrophils

D. Reverse drug toxicity and prevent tissue damag e

15. A 4-month-old is brought to the well-baby clinic for immunization. In addition to the
DPT and polio vaccines, the baby should receive:

A. HibTITER

B. Mumps vaccine

C. Hepatitis B vaccine

D. MMR

16. The physician has prescribed Nexium (esomeprazole) for a client with erosive

gastritis. The nurse should administer the medication:

A. 30 minutes before meals

B. With each meal

C. In a single dose at bedtime

D. 30 minutes after meals

17. A client on the psychiatric unit is in an uncontrolled rage and is threatening other

clients and staff. What is the most appropriate action for the nurse to take?

A. Call security for assistance and prepare to sedate the client.

B. Tell the client to calm down and ask him if he would like to play cards.

C. Tell the client that if he continues his behavior he will be punished.

D. Leave the client alone until he calms down.

If the client is a threat to the staff and to other clients the nurse should call for help and

18. When the nurse checks the fundus of a client on the first postpartum day, she notes

that the fundus is firm, is at the level of the umbilicus, and is displaced to the right. The

next action the nurse should take is to:

A. Check the client for bladder distention

B. Assess the blood pressure for hypotension

C. Determine whether an oxytocic drug was given

D. Check for the expulsion of small clots

19. A client is admitted to the hospital with a temperature of 99.8°F, complaints of

blood-tinged hemoptysis, fatigue, and night sweats. The client’s symptoms are

consistent with a diagnosis of:

A. Pneumonia

B. Reaction to antiviral medication

C. Tuberculosis

D. Superinfection due to low CD4 count

20. The client is seen in the clinic for treatment of migraine headaches. The drug Imitrex

(sumatriptan succinate) is prescribed for the client. Which of the following in the client’s

history should be reported to the doctor?

A. Diabetes

B. Prinzmetal’s angina

C. Cancer

D. Cluster headaches

21. The client with suspected meningitis is admitted to the unit. The doctor is

performing an assessment to determine meningeal irritation and spinal nerve root

inflammation. A positive Kernig’s sign is charted if the nurse notes:

A. Pain on flexion of the hip and knee

B. Nuchal rigidity on flexion of the neck

C. Pain when the head is turned to the left side

D. Dizziness when changing positions

22. The client with Alzheimer’s disease is being assisted with activities of daily living

when the nurse notes that the client uses her toothbrush to brush her hair. The nurse is

aware that the client is exhibiting:

A. Agnosia

B. Apraxia

C. Anomia
D. Aphasia

23. The client with dementia is experiencing confusion late in the afternoon and before

bedtime. The nurse is aware that the client is experiencing what is known as:

A. Chronic fatigue syndrome

B. Normal aging

C. Sundowning

D. Delusions

24. The client with confusion says to the nurse, “I haven’t had anything to eat all day

long. When are they going to bring breakfast?” The nurse saw the client in the day room

eating breakfast with other clients 30 minutes before this conversation. Which response

would be best for the nurse to make?

A. “You know you had breakfast 30 minutes ago.”

B. “I am so sorry that they didn’t get you breakfast. I’ll report it to the charge nurse.”

C. “I’ll get you some juice and toast. Would you like something else?”

D. “You will have to wait a while; lunch will be here in a little while.”

25. The doctor has prescribed Exelon (rivastigmine) for the client with Alzheimer’s

disease. Which side effect is most often associated with this drug?

A. Urinary incontinence

B. Headaches

C. Confusion

D. Nausea

26. A client is admitted to the labor and delivery unit in active labor. During examination,

the nurse notes a papular lesion on the perineum. Which initial action is most

appropriate?

A. Document the finding

B. Report the finding to the doctor

C. Prepare the client for a C-section

D. Continue primary care as prescribed

27. A client with a diagnosis of HPV is at risk for which of the following?

A. Hodgkin’s lymphoma

B. Cervical cancer

C. Multiple myeloma

D. Ovarian cancer

28. During the initial interview, the client reports that she has a lesion on the perineum.

Further investigation reveals a small blister on the vulva that is painful to touch. The

nurse is aware that the most likely source of the lesion is:

A. Syphilis

B. Herpes

C. Gonorrhea

D. Condylomata

29. A client visiting a family planning clinic is suspected of having an STI. The best

diagnostic test for treponema pallidum is:

A. Venereal Disease Research Lab (VDRL)

B. Rapid plasma reagin (RPR)

C. Fluorescent treponemal antibody (FTA)

D. Thayer-Martin culture (TMC)

30. A 15-year-old primigravida is admitted with a tentative diagnosis of HELLP

syndrome. Which laboratory finding is associated with HELLP syndrome?

A. Elevated blood glucose

B. Elevated platelet count

C. Elevated creatinine clearance

D. Elevated hepatic enzymes

31. The nurse is assessing the deep tendon reflexes of a client with preeclampsia.

Which method is used to elicit the biceps reflex?

A. The nurse places her thumb on the muscle inset in the antecubital space and taps

the thumb briskly with the reflex hammer.

B. The nurse loosely suspends the client’s arm in an open hand while tapping the back

of the client’s elbow.

C. The nurse instructs the client to dangle her legs as the nurse strikes the area below

the patella with the blunt side of the reflex hammer.

D. The nurse instructs the client to place her arms loosely at her side as the nurse

strikes the muscle insert just above the wrist.

32. A primigravida with diabetes is admitted to the labor and delivery unit at 34 weeks

gestation. Which doctor’s order should the nurse question?

A. Magnesium sulfate 4gm (25%) IV

B. Brethine 10 mcg IV

C. Stadol 1 mg IV push every 4 hours as needed prn for pain

D. Ancef 2gm IVPB every 6 hours

33. A diabetic multigravida is scheduled for an amniocentesis at 32 weeks gestation to

determine the L/S ratio and phosphatidylglycerol level. The L/S ratio is 1:1 and the

presence of phosphatidylglycerol is noted. The nurse’s assessment of this data is:

A. The infant is at low risk for congenital anomalies.

B. The infant is at high risk for intrauterine growth retardation.

C. The infant is at high risk for respiratory distress syndrome.

D. The infant is at high risk for birth trauma.

34. Which observation in the newborn of a diabetic mother would require immediate

nursing intervention?
A. Crying

B. Wakefulness

C. Jitteriness

D. Yawning

35. The nurse caring for a client receiving intravenous magnesium sulfate must closely

observe for side effects associated with drug therapy. An expected side effect of

magnesium sulfate is:

A. Decreased urinary output

B. Hypersomnolence

C. Absence of knee jerk reflex

D. Decreased respiratory rate

36. The client has elected to have epidural anesthesia to relieve labor pain. If the client

experiences hypotension, the nurse would:

A. Place her in Trendelenburg position

B. Decrease the rate of IV infusion

C. Administer oxygen per nasal cannula

D. Increase the rate of the IV infusion

37. A client has cancer of the pancreas. The nurse should be most concerned about

which nursing diagnosis?

A. Alteration in nutrition

B. Alteration in bowel elimination

C. Alteration in skin integrity

D. Ineffective individual coping

38. The nurse is caring for a client with ascites. Which is the best method to use for

determining early ascites?

A. Inspection of the abdomen for enlargement

B. Bimanual palpation for hepatomegaly

C. Daily measurement of abdominal girth

D. Assessment for a fluid wave

39. The client arrives in the emergency department after a motor vehicle accident.

Nursing assessment findings include BP 80/34, pulse rate 120, and respirations 20.

Which is the client’s most appropriate priority nursing diagnosis?

A. Alteration in cerebral tissue perfusion

B. Fluid volume deficit

C. Ineffective airway clearance

D. Alteration in sensory perception

40. The home health nurse is visiting an 18-year-old with osteogenesis imperfecta.

Which information obtained on the visit would cause the most concern? The client:

A. Likes to play football

B. Drinks several carbonated drinks per day

C. Has two sisters with sickle cell tract

D. Is taking acetaminophen to control pain

41. The nurse working the organ transplant unit is caring for a client with a white blood

cell count of 450. During evening visitation, a visitor brings a basket of fruit. What action

should the nurse take?

A. Allow the client to keep the fruit

B. Place the fruit next to the bed for easy access by the client

C. Offer to wash the fruit for the client

D. Tell the family members to take the fruit home

42. The nurse is caring for the client following a laryngectomy when suddenly the client

becomes unresponsive and pale, with a BP of 90/40 systolic. The initial nurse’s action

should be to:
A. Place the client in Trendelenburg position

B . Increase the infusion of Dextrose in normal saline

C. Administer atropine intravenously

D. Move the emergency cart to the bedside

43. The client admitted 2 days earlier that a lung resection accidentally pulls out the

chest tube. Which action by the nurse indicates understanding of the management of

chest tubes?

A. Order a chest x-ray

B. Reinsert the tube

C. Cover the insertion site with a Vaseline gauze

D. Call the doctor

44. A client being treated with sodium warfarin has a Protime of 120 seconds. Which

intervention would be most important to include in the nursing care plan?

A. Assess for signs of abnormal bleeding

B. Anticipate an increase in the Coumadin dosage

C. Instruct the client regarding the drug therapy

D. Increase the frequency of neurological assessments

45. Which selection would provide the most calcium for the client who is 4 months

pregnant?

A. A granola bar

B. A bran muffin

C. A cup of yogurt

D. A glass of fruit juice

46. The client with preeclampsia is admitted to the unit with an order for magnesium

sulfate. Which action by the nurse indicates understanding of the possible side effects

of magnesium sulfate?
A. The nurse places a sign over the bed not to check blood pressure in the right arm.

B. The nurse places a padded tongue blade at the bedside.

C. The nurse inserts a Foley catheter.

D. The nurse darkens the room.

47. A 6-year-old client is admitted to the unit with a hemoglobin of 6g/dL. The physician

has written an order to transfuse 2 units of whole blood. When discussing the

treatment, the child’s mother tells the nurse that she does not believe in having blood

transfusions and that she will not allow her child to have the treatment. What nursing

action is most appropriate?

A. Ask the mother to leave while the blood transfusion is in progress

B. Encourage the mother to reconsider

C. Explain the consequences without treatment

D. Notify the physician of the mother’s refusal

48. A client is admitted to the unit 2 hours after an explosion causes burns to the face.

The nurse would be most concerned with the client developing which of the following?

A. Hypovolemia

B . Laryngeal edema

C. Hypernatremia

D. Hyperkalemia

49. The nurse is evaluating nutritional outcomes for a with anorexia nervosa. Which

data best indicates that the plan of care is effective?

A. The client selects a balanced diet from the menu.

B. The client’s hemoglobin and hematocrit improve.

C. The client’s tissue turgor improves.

D. The client gains weight.

50. The client is admitted following repair of a fractured tibia and cast application.
Which nursing assessment should be reported to the doctor?

A. Pain beneath the cast

B. Warm toes

C. Pedal pulses weak and rapid

D. Paresthesia of the toes

51. A 43-year-old African American male is admitted with sickle cell anemia. The nurse

plans to assess circulation in the lower extremities every 2 hours. Which of the

following outcome criteria would the nurse use?

A. Body temperature of 37.2 celsius or less

B. Toes moved in active range of motion

C. Sensation reported when soles of feet are touched

D. Capillary refill of < 3 seconds

52. A 30-year-old male from Haiti is brought to the emergency department in sickle

cell crisis. What is the best position for this client?

A. Side-lying with knees flexed

B. Knee-chest

C. High Fowler's with knees flexed

D. Semi-Fowler's with legs extended on the bed

53. A 25-year-old male is admitted in sickle cell crisis. Which of the following

interventions would be of highest priority for this client?

A. Taking hourly blood pressures with mechanical cuff

B. Encouraging fluid intake of at least 200mL per hour

C. Position in high Fowler's with knee gatch raised

D. Administering Tylenol as ordered

54. Which of the following foods would the nurse encourage the client in sickle cell

crisis to eat?
A. Peaches

B. Cottage cheese

C. Popsicle

D. Lima beans

55. A newly admitted client has sickle cell crisis. The nurse is planning care based on

assessment of the client. The client is complaining of severe pain in his feet and

hands. The pulse oximetry is 92. Which of the following interventions would be

implemented first? Assume that there are orders for each intervention.

A. Adjust the room temperature

B. Give a bolus of IV fluids

C. Start O2

D. Administer meperidine (Demerol) 75mg IV push

56. The nurse is instructing a client with iron-deficiency anemia. Which of the following

meal plans would the nurse expect the client to select?

A. Roast beef, gelatin salad, green beans, and peach pie

B. Chicken salad sandwich, coleslaw, French fries, ice cream

C. Egg salad on wheat bread, carrot sticks, lettuce salad, raisin pie

D. Pork chop, creamed potatoes, corn, and coconut cake

57. Clients with sickle cell anemia are taught to avoid activities that cause hypoxia and

hypoxemia. Which of the following activities would the nurse recommend?

A. A family vacation in the Rocky Mountains

B. Chaperoning the local boys club on a snow-skiing trip

C. Traveling by airplane for business trips

D. A bus trip to the Museum of Natural History

58. The nurse is conducting an admission assessment of a client with vitamin B12

deficiency. Which of the following would the nurse include in the physical assessment?
A. Palpate the spleen

B. Take the blood pressure

C. Examine the feet for petechiae

D. Examine the tongue

59. An African American female comes to the outpatient clinic. The physician suspects

vitamin B12 deficiency anemia. Because jaundice is often a clinical manifestation of

this type of anemia, what body part would be the best indicator?

A. Conjunctiva of the eye

B. Soles of the feet

C. Roof of the mouth

D. Shins

60. The nurse is conducting a physical assessment on a client with anemia. Which of

the following clinical manifestations would be most indicative of the anemia?

A. BP 146/88

B. Respirations 28 shallow

C. Weight gain of 10 pounds in 6 months

D. Pink complexion

61. The nurse is teaching the client with polycythemia vera about prevention of

complications of the disease. Which of the following statements by the client indicates

a need for further teaching?

"I will drink 500mL of fluid or less each day."

"I will wear support hose when I am up."

"I will use an electric razor for shaving."

"I will eat foods low in iron."

62. A 33-year-old male is being evaluated for possible acute leukemia. Which of the

following would the nurse inquire about as a part of the assessment?

A. The client collects stamps as a hobby.

B. The client recently lost his job as a postal worker.

C. The client had radiation for treatment of Hodgkin's disease as a teenager.

D. The client's brother had leukemia as a child.

63. An African American client is admitted with acute leukemia. The nurse is

assessing for signs and symptoms of bleeding. Where is the best site for examining

for the presence of petechiae?

A. The abdomen

B. The thorax

C. The earlobes

D. The soles of the feet

64. A client with acute leukemia is admitted to the oncology unit. Which of the

following would be most important for the nurse to inquire?

A. "Have you noticed a change in sleeping habits recently?"

B. "Have you had a respiratory infection in the last 6 months?"

C. "Have you lost weight recently?"

D. "Have you noticed changes in your alertness?"

65 . Which of the following would be the priority nursing diagnosis for the adult client

with acute leukemia?

A. Oral mucous membrane, altered related to chemotherapy

B. Risk for injury related to thrombocytopenia

C. Fatigue related to the disease process

D. Interrupted family processes related to life-threatening illness of a family

member

66. A 21-year-old male with Hodgkin's lymphoma is a senior at the local university. He

is engaged to be married and is to begin a new job upon graduation. Which of the
following diagnoses would be a priority for this client?

A. Sexual dysfunction related to radiation therapy

B. Anticipatory grieving related to terminal illness

C. Tissue integrity related to prolonged bed rest

D. Fatigue related to chemotherapy

67. A client has autoimmune thrombocytopenic purpura. To determine the client's

response to treatment, the nurse would monitor:

A. Platelet count

B. White blood cell count

C. Potassium levels

D. Partial prothrombin time (PTT)

68.The home health nurse is visiting a client with autoimmune thrombocytopenic

purpura (ATP). The client's platelet count currently is 80, It will be most important to

teach the client and family about:

A. Bleeding precautions

B. Prevention of falls

C. Oxygen therapy

D. Conservation of energy

69. A client with a pituitary tumor has had a transsphenoidal hypophysectomy. Which

of the following interventions would be appropriate for this client?

A. Place the client in Trendelenburg position for postural drainage

B. Encourage coughing and deep breathing every 2 hours

C. Elevate the head of the bed 30°

D. Encourage the Valsalva maneuver for bowel movements

70. The client with a history of diabetes insipidus is admitted with polyuria, polydipsia,

and mental confusion. The priority intervention for this client is:
A. Measure the urinary output

B. Check the vital signs

C. Encourage increased fluid intake

D. Weigh the client

71. A client with hemophilia has a nosebleed. Which nursing action is most

appropriate to control the bleeding?

A. Place the client in a sitting position with the head hyperextended

B. Pack the nares tightly with gauze to apply pressure to the source of

bleeding

C. Pinch the soft lower part of the nose for a minimum of 5 minutes

D. Apply ice packs to the forehead and back of the neck

72. A client has had a unilateral adrenalectomy to remove a tumor. To prevent

complications, the most important measurement in the immediate postoperative period

for the nurse to take is:

A. Blood pressure

B. Temperature

C. Output

D. Specific gravity

73. A client with Addison's disease has been admitted with a history of nausea and

vomiting for the past 3 days. The client is receiving IV glucocorticoids (Solu-Medrol).

Which of the following interventions would the nurse implement?

A. Glucometer readings as ordered

B. Intake/output measurements

C. Sodium and potassium levels monitored

D. Daily weights

74. A client had a total thyroidectomy yesterday. The client is complaining of tingling
around the mouth and in the fingers and toes. What would the nurses' next action be?

A. Obtain a crash cart

B. Check the calcium level

C. Assess the dressing for drainage

D. Assess the blood pressure for hypertension

75.A 32-year-old mother of three is brought to the clinic. Her pulse is 52, there is a

weight gain of 30 pounds in 4 months, and the client is wearing two sweaters. The

client is diagnosed with hypothyroidism. Which of the following nursing diagnoses is of

highest priority?

A. Impaired physical mobility related to decreased endurance

B. Hypothermia r/t decreased metabolic rate

C. Disturbed thought processes r/t interstitial edema

D. Decreased cardiac output r/t bradycardia

76. The nurse is caring for a client hospitalized with a facial stroke. Which diet

selection would be suited to the client?

A. Roast beef sandwich, potato chips, pickle spear, iced tea

B. Split pea soup, mashed potatoes, pudding, milk

C. Tomato soup, cheese toast, Jello, coffee

D. Hamburger, baked beans, fruit cup, iced tea

77. A primigravida, age 42, is 6 weeks pregnant. Based on the client's age, her infant

is at risk for:

A. Down syndrome

B. Respiratory distress syndrome

C. Turner's syndrome

D. Pathological jaundice

78. A client with a missed abortion at 29 weeks gestation is admitted to the hospital.
The client will most likely be treated with:

A. Magnesium sulfate

B. Calcium gluconate

C. Dinoprostone (Prostin E.)

D. Bromocriptine (Pardel)

79. A client with preeclampsia has been receiving an infusion containing magnesium

sulfate for a blood pressure that is 160/80; deep tendon reflexes are 1 plus, and the

urinary output for the past hour is 100mL. The nurse should:

A. Continue the infusion of magnesium sulfate while monitoring the client's blood

pressure

B. Stop the infusion of magnesium sulfate and contact the physician

C. Slow the infusion rate and turn the client on her left side

D. Administer calcium gluconate IV push and continue to monitor the blood

pressure

80. Which statement made by the nurse describes the inheritance pattern of

autosomal recessive disorders?

A. An affected newborn has unaffected parents.

B. An affected newborn has one affected parent.

C. Affected parents have a one in four chance of passing on the defective

gene.

D. Affected parents have unaffected children who are carriers.

81. A pregnant client, age 32, asks the nurse why her doctor has recommended a

serum alpha fetoprotein. The nurse should explain that the doctor has recommended

the test:

A. Because it is a state law

B. To detect cardiovascular defects

C. Because of her age

D. To detect neurological defects

82. A client with hypothyroidism asks the nurse if she will still need to take thyroid

medication during the pregnancy. The nurse's response is based on the knowledge

that:

A. There is no need to take thyroid medication because the fetus's thyroid

produces a thyroid-stimulating hormone.

B. Regulation of thyroid medication is more difficult because the thyroid

gland increases in size during pregnancy.

C. It is more difficult to maintain thyroid regulation during pregnancy due to

a slowing of metabolism.

D. Fetal growth is arrested if thyroid medication is continued during

pregnancy.

83. The nurse is responsible for performing a neonatal assessment on a full-term

infant. At 1 minute, the nurse would expect to find:

A. An apical pulse of 100

B. An absence of tonus

C. Cyanosis of the feet and hands

D. Jaundice of the skin and sclera

84. A client with sickle cell anemia is admitted to the labor and delivery unit during the

first phase of labor. The nurse should anticipate the client's need for:

A. Supplemental oxygen

B. Fluid restriction

C. Blood transfusion

D. Delivery by Caesarean section

85. A client with diabetes has an order for ultrasonography. Preparation for an
ultrasound includes:

A. Increasing fluid intake

B. Limiting ambulation

C. Administering an enema

D. Withholding food for 8 hours

86. An infant who weighs 8 pounds at birth would be expected to weigh how many

pounds at 1 year?

A. 14 pounds

B. 16 pounds

C. 18 pounds

D. 24 pounds

87. A pregnant client with a history of alcohol addiction is scheduled for a nonstress

test. The nonstress test:

A. Determines the lung maturity of the fetus

B. Measures the activity of the fetus

C. Shows the effect of contractions on the fetal heart rate

D. Measures the neurological well-being of the fetus

88. A full-term male has hypospadias. Which statement describes hypospadias?

A. The urethral opening is absent.

B. The urethra opens on the dorsal side of the penis.

C. The penis is shorter than usual.

D. The urethra opens on the ventral side of the penis.

89. A gravida III, para II is admitted to the labor unit. Vaginal exam reveals that the

client's cervix is 8cm dilated, with complete effacement. The priority nursing diagnosis

at this time is:

A. Alteration in coping related to pain

B. Potential for injury related to precipitate delivery

C. Alteration in elimination related to anesthesia

D. Potential for fluid volume deficit related to NPO status

90. The client with varicella will most likely have an order for which category of

medication?

A. Antibiotics

B. Antipyretics

C. Antivirals

D. Anticoagulants

91. A client is admitted complaining of chest pain. Which of the following drug orders

should the nurse question?

A. Nitroglycerin

B. Ampicillin

C. Propranolol

D. Verapamil

92. Which of the following instructions should be included in the teaching for the client

with rheumatoid arthritis?

A. Avoid exercise because it fatigues the joints.

B. Take prescribed anti-inflammatory medications with meals.

C. Alternate hot and cold packs to affected joints.

D. Avoid weight-bearing activity.

93. A client with acute pancreatitis is experiencing severe abdominal pain. Which of

the following orders should be questioned by the nurse?

A. Meperidine 100mg IM q 4 hours PRN pain

B. Mylanta 30 ccs q 4 hours via NG

C. Cimetidine 300mg PO q.i.d.

D. Morphine 8mg IM q 4 hours PRN pain

94. The client is admitted to the chemical dependence unit with an order for

continuous observation. The nurse is aware that the doctor has ordered continuous

observation because:

A. Hallucinogenic drugs create both stimulant and depressant effects.

B. Hallucinogenic drugs induce a state of altered perception.

C. Hallucinogenic drugs produce severe respiratory depression.

D. Hallucinogenic drugs induce rapid physical dependence.

95. A client with a history of abusing barbiturates abruptly stops taking the medication.

The nurse should give priority to assessing the client for:

A. Depression and suicidal ideation

B. Tachycardia and diarrhea

C. Muscle cramping and abdominal pain

D. Tachycardia and euphoric mood

96. During the assessment of a laboring client, the nurse notes that the FHT are

loudest in the upper-right quadrant. The infant is most likely in which position?

A. Right breech presentation

B. Right occipital anterior presentation

C. Left sacral anterior presentation

D. Left occipital transverse presentation

97. The primary physiological alteration in the development of asthma is:

A. Bronchiolar inflammation and dyspnea

B. Hypersecretion of abnormally viscous mucus

C. Infectious processes causing mucosal edema

D. Spasm of bronchial smooth muscle

98. A client with mania is unable to finish her dinner. To help her maintain sufficient
nourishment, the nurse should:

A. Serve high-calorie foods she can carry with her

B. Encourage her appetite by sending out for her favorite foods

C. Serve her small, attractively arranged portions

D. Allow her in the unit kitchen for extra food whenever she pleases

99. To maintain Bryant's traction, the nurse must make certain that the child's:

A. Hips are resting on the bed, with the legs suspended at a right angle to

the bed

B. Hips are slightly elevated above the bed and the legs are suspended at a

right angle to the bed

C. Hips are elevated above the level of the body on a pillow and the legs

are suspended parallel to the bed

D. Hips and legs are flat on the bed, with the traction positioned at the foot

of the bed

100. Which action by the nurse indicates understanding of herpes zoster?

A. The nurse covers the lesions with a sterile dressing.

B. The nurse wears gloves when providing care.

C. The nurse administers a prescribed antibiotic.

D. The nurse administers oxygen.

101. The client has an order for a trough to be drawn on the client receiving

Vancomycin. The nurse is aware that the nurse should contact the lab for them to

collect the blood:

A. 15 minutes after the infusion

B. 30 minutes before the infusion

C. 1 hour after the infusion

D. 2 hours after the infusion

102. The client using a diaphragm should be instructed to:

A. Refrain from keeping the diaphragm in longer than 4 hours

B. Keep the diaphragm in a cool location

C. Have the diaphragm resized if she gains 5 pounds

D. Have the diaphragm resized if she has any surgery

103. The nurse is providing postpartum teaching for a mother planning to breastfeed

her infant. Which of the client's statements indicates the need for additional teaching?

A. "I'm wearing a support bra."

B. "I'm expressing milk from my breast."

C. "I'm drinking four glasses of fluid during a 24-hour period."

D. "While I'm in the shower, I'll allow the water to run over my breasts."

104. Damage to the VII cranial nerve results in:

A. Facial pain

B. Absence of ability to smell

C. Absence of eye movement

D. Tinnitus

105. A client is receiving Pyridium (phenazopyridine hydrochloride) for a urinary tract

infection. The client should be taught that the medication may:

A. Cause diarrhea

B. Change the color of her urine

C. Cause mental confusion

D. Cause changes in taste

106. Which of the following tests should be performed before beginning a prescription

of Accutane?

A. Check the calcium level

B. Perform a pregnancy test

C. Monitor apical pulse

D. Obtain a creatinine level

107. A client with AIDS is taking Zovirax (acyclovir). Which nursing intervention is most

critical during the administration of acyclovir?

A. Limit the client's activity

B. Encourage a high-carbohydrate diet

C. Utilize an incentive spirometer to improve respiratory function

D. Encourage fluids

108. A client is admitted for an MRI. The nurse should question the client regarding:

A. Pregnancy

B. A titanium hip replacement

C. Allergies to antibiotics

D. Inability to move his feet

109. The nurse is caring for the client receiving Amphotericin B. Which of the following

indicates that the client has experienced toxicity to this drug?

A. Changes in vision

B. Nausea

C. Urinary frequency

D. Changes in skin color

110. The nurse should visit which of the following clients first?

A. The client with diabetes with a blood glucose of 95mg/dL

B. The client with hypertension being maintained on Lisinopril

C. The client with chest pain and a history of angina

D. The client with Raynaud's disease

111. A client with cystic fibrosis is taking pancreatic enzymes. The nurse should

administer this medication:

A. Once per day in the morning

B. Three times per day with meals

C. Once per day at bedtime

D. Four times per day

112. Cataracts result in opacity of the crystalline lens. Which of the following best

explains the functions of the lens?

A. The lens controls stimulation of the retina.

B. The lens orchestrates eye movement.

C. The lens focuses light rays on the retina.

D. The lens magnifies small objects.

113. A client who has glaucoma is to have miotic eye drops instilled in both eyes. The

nurse knows that the purpose of the medication is to:

A. Anesthetize the cornea

B. Dilate the pupils

C. Constrict the pupils

D. Paralyze the muscles of accommodation

114. A client with a severe corneal ulcer has an order for Gentamicin gtt. q 4 hours

and Neomycin 1 gtt q 4 hours. Which of the following schedules should be used when

administering the drops?

A. Allow 5 minutes between the two medications.

B. The medications may be used together.

C. The medications should be separated by a cycloplegic drug.

D. The medications should not be used in the same client.

115. The client with color blindness will most likely have problems distinguishing which

of the following colors?

A. Orange
B. Violet

C. Red

D. White

116.The client with a pacemaker should be taught to:

A. Report ankle edema

B. Check his blood pressure daily

C. Refrain from using a microwave oven

D. Monitor his pulse rate

117.The client with enuresis is being taught regarding bladder retraining. The nurse

should advise the client to refrain from drinking after:

A. 1900

B. 1200

C. 1000

D. 0700

118. Which of the following diet instructions should be given to the client with recurring

urinary tract infections?

A. Increase intake of meats.

B. Avoid citrus fruits.

C. Perform pericare with hydrogen peroxide.

D. Drink a glass of cranberry juice every day.

119.The physician has prescribed NPH insulin for a client with diabetes mellitus.

Which statement indicates that the client knows when the peak action of the insulin

occurs?

A. "I will make sure I eat breakfast within 2 hours of taking my insulin."

B. "I will need to carry candy or some form of sugar with me all the time."

C. "I will eat a snack around three o'clock each afternoon."

D. "I can save my dessert from supper for a bedtime snack."

120. A client with pneumocystis carinii pneumonia is receiving trimetrexate. The

rationale for administering leucovorin calcium to a client receiving Methotrexate is to:

A. Treat anemia.

B. Create a synergistic effect.

C. Increase the number of white blood cells.

D. Reverse drug toxicity.

121. A client tells the nurse that she is allergic to eggs, dogs, rabbits, and chicken

feathers. Which order should the nurse question?

A. TB skin test

B. Rubella vaccine

C. ELISA test

D. Chest x-ray

122.The physician has prescribed ranitidine (Zantac) for a client with erosive gastritis.

The nurse should administer the medication:

A. 30 minutes before meals

B. With each meal

C. In a single dose at bedtime

D. 60 minutes after meals

123. A temporary colostomy is performed on the client with colon cancer. The nurse is

aware that the proximal end of a double barrel colostomy:

A. Is the opening on the client's left side

B. Is the opening on the distal end on the client's left side

C. Is the opening on the client's right side

D. Is the opening on the distal right side

124. While assessing the postpartal client, the nurse notes that the fundus is displaced
to the right. Based on this finding, the nurse should:

A. Ask the client to void

B. Assess the blood pressure for hypotension

C. Administer oxytocin

D. Check for vaginal bleeding

125. The physician has ordered an MRI for a client with an orthopedic ailment. An MRI

should not be done if the client has:

A. The need for oxygen therapy

B. A history of claustrophobia

C. A permanent pacemaker

D. Sensory deafness

126. A 6-month-old client is placed on strict bed rest following a hernia repair. Which

toy is best suited to the client?

A. Colorful crib mobile

B. Hand-held electronic games

C. Cars in a plastic container

D. 30-piece jigsaw puzzle

127. The nurse is preparing to discharge a client with a long history of polio. The nurse

should tell the client that:

A. Taking a hot bath will decrease stiffness and spasticity.

B. A schedule of strenuous exercise will improve muscle strength.

C. Rest periods should be scheduled throughout the day.

D. Visual disturbances can be corrected with prescription glasses.

128. A client on the postpartum unit has a proctoepisiotomy. The nurse should

anticipate administering which medication?

A. Dulcolax suppository
B. Docusate sodium (Colace)

C. Methyergonovine maleate (Methergine)

D. Bromocriptine sulfate (Parlodel)

129. A client with pancreatic cancer has an infusion of TPN (Total Parenteral

Nutrition). The doctor has ordered for sliding-scale insulin. The most likely explanation

for this order is:

A. Total Parenteral Nutrition leads to negative nitrogen balance and

elevated glucose levels.

B. Total Parenteral Nutrition cannot be managed with oral hypoglycemics.

C. Total Parenteral Nutrition is a high-glucose solution that often elevates

the blood glucose levels.

D. Total Parenteral Nutrition leads to further pancreatic disease.

130. An adolescent primigravida who is 10 weeks pregnant attends the antepartal

clinic for a first check-up. To develop a teaching plan, the nurse should initially assess:

A. The client's knowledge of the signs of preterm labor

B. The client's feelings about the pregnancy

C. Whether the client was using a method of birth control

D. The client's thought about future children

131.An obstetric client is admitted with dehydration. Which IV fluid would be most

appropriate for the client?

A. 0.45 normal saline

B. Dextrose 1% in water

C. Lactated Ringer's

D. Dextrose 5% in 0.45 normal saline

132. The physician has ordered a thyroid scan to confirm the diagnosis. Before the

procedure, the nurse should:

A. Assess the client for allergies

B. Bolus the client with IV fluid

C. Tell the client he will be asleep

D. Insert a urinary catheter

133. The physician has ordered an injection of RhoGam for a client with blood type A

negative. The nurse understands that RhoGam is given to:

A. Provide immunity against Rh isoenzymes

B. Prevent the formation of Rh antibodies

C. Eliminate circulating Rh antibodies

D. Convert the Rh factor from negative to positive

134. The nurse is caring for a client admitted to the emergency room after a fall.

X-rays reveal that the client has several fractured bones in the foot. Which treatment

should the nurse anticipate for the fractured foot?

A. Application of a short inclusive spica cast

B. Stabilization with a plaster-of-Paris cast

C. Surgery with Kirschner wire implantation

D. A gauze dressing only

135. A client with bladder cancer is being treated with iridium seed implants. The

nurse's discharge teaching should include telling the client to:

A. Strain his urine

B. Increase his fluid intake

C. Report urinary frequency

D. Avoid prolonged sitting

136. Following a heart transplant, a client is started on medication to prevent organ

rejection. Which category of medication prevents the formation of antibodies against

the new organ?

A. Antivirals

B. Antibiotics

C. Immunosuppressants

D. Analgesics

137. The nurse is preparing a client for cataract surgery. The nurse is aware that the

procedure will use:

A. Mydriatics to facilitate removal

B. Miotic medications such as Timoptic

C. A laser to smooth and reshape the lens

D. Silicone oil injections into the eyeball

138. A client with Alzheimer's disease is awaiting placement in a skilled nursing

facility. Which long-term plans would be most therapeutic for the client?

A. Placing mirrors in several locations in the home

B. Placing a picture of herself in her bedroom

C. Placing simple signs to indicate the location of the bedroom, bathroom,

and so on

D. Alternating healthcare workers to prevent boredom

139. A client with an abdominal cholecystectomy returns from surgery with a

Jackson-Pratt drain. The chief purpose of the Jackson-Pratt drain is to:

A. Prevent the need for dressing changes

B. Reduce edema at the incision

C. Provide for wound drainage

D. Keep the common bile duct open

140. The nurse is performing an initial assessment of a newborn Caucasian male

delivered at 32 weeks gestation. The nurse can expect to find the presence of:

A. Mongolian spots
B. Scrotal rugae

C. Head lag

D. Vernix caseosa

141. The nurse is caring for a client admitted with multiple trauma. Fractures include

the pelvis, femur, and ulna. Which finding should be reported to the physician

immediately?

A. Hematuria

B. Muscle spasms

C. Dizziness

D. Nausea

142. A client is brought to the emergency room by the police. He is combative and

yells, "I have to get out of here. They are trying to kill me." Which assessment is most

likely correct in relation to this statement?

A. The client is experiencing an auditory hallucination.

B. The client is having a delusion of grandeur.

C. The client is experiencing paranoid delusions.

D. The client is intoxicated.

143. The nurse is preparing to suction the client with a tracheotomy. The nurse notes

a previously used bottle of normal saline on the client's bedside table. There is no

label to indicate the date or time of initial use. The nurse should:

A. Lip the bottle and use a pack of sterile 4x4 for the dressing

B. Obtain a new bottle and label it with the date and time of first use

C. Ask the ward secretary when the solution was requested

D. Label the existing bottle with the current date and time

144. An infant's Apgar score is 9 at 5 minutes. The nurse is aware that the most likely

cause for the deduction of one point is:

a. The baby is cold.

b. The baby is experiencing bradycardia.

c. The baby's hands and feet are blue.

d. The baby is lethargic.

145. The primary reason for rapid continuous rewarming of the area affected by

frostbite is to:

A. Lessen the amount of cellular damage

B. Prevent the formation of blisters

C. Promote movement

D. Prevent pain and discomfort

146. A client recently started on hemodialysis wants to know how the dialysis will take

the place of his kidneys. The nurse's response is based on the knowledge that

hemodialysis works by:

A. Passing water through a dialyzing membrane

B. Eliminating plasma proteins from the blood

C. Lowering the pH by removing nonvolatile acids

D. Filtering waste through a dialyzing membrane

147. During a home visit, a client with AIDS tells the nurse that he has been exposed

to measles. Which action by the nurse is most appropriate?

a. Administer an antibiotic

b. Contact the physician for an order for immune globulin

c. Administer an antiviral

d. Tell the client that he should remain in isolation for 2 weeks

150. A client hospitalized with MRSA (methicillin-resistant staph aureus) is placed on

contact precautions. Which statement is true regarding precautions for infections

spread by contact?
A. The client should be placed in a room with negative pressure.

B. Infection requires close contact; therefore, the door may remain open.

C. Transmission is highly likely, so the client should wear a mask at all

times.

D. Infection requires skin-to-skin contact and is prevented by hand washing,

gloves, and a gown.

151. A client who is admitted with an above-the-knee amputation tells the nurse that

his foot hurts and itches. Which response by the nurse indicates understanding of

phantom limb pain?

A. "The pain will go away in a few days."

B. "The pain is due to peripheral nervous system interruptions. I will get you

some pain medication."

C. "The pain is psychological because your foot is no longer there."

D. "The pain and itching are due to the infection you had before the

surgery."

152. A client with cancer of the pancreas has undergone a Whipple procedure. The

nurse is aware that during the Whipple procedure, the doctor will remove the:

A. Head of the pancreas

B. Proximal third section of the small intestines

C. Stomach and duodenum

D. Esophagus and jejunum

153. The physician has ordered a minimal-bacteria diet for a client with neutropenia.

The client should be taught to avoid eating:

A. Fruits

B. Salt

C. Pepper
D. Ketchup

154. A client is discharged home with a prescription for Coumadin (sodium warfarin).

The client should be instructed to:

A. Have a Protime done monthly

B. Eat more fruits and vegetables

C. Drink more liquids

D. Avoid crowds

155. The nurse is assisting the physician with removal of a central venous catheter. To

facilitate removal, the nurse should instruct the client to:

A. Perform the Valsalva maneuver as the catheter is advanced

B. Turn his head to the left side and hyperextend the neck

C. Take slow, deep breaths as the catheter is removed

D. Turn his head to the right while maintaining a sniffing position

156. A client has an order for streptokinase. Before administering the medication, the

nurse should assess the client for:

A. Allergies to pineapples and bananas

B. A history of streptococcal infections

C. Prior therapy with phenytoin

D. A history of alcohol abuse

157. The nurse is providing discharge teaching for the client with leukemia. The client

should be told to avoid:

A. Using oil- or cream-based soaps

B. Flossing between the teeth

C. The intake of salt

D. Using an electric razor

158. The nurse is changing the ties of the client with a tracheotomy. The safest
method of changing the tracheostomy ties is to:

A. Apply the new tie before removing the old one.

B. Have a helper present.

C. Hold the tracheotomy with the nondominant hand while removing the old

tie.

D. Ask the doctor to suture the tracheostomy in place.

159. The nurse is monitoring a client following a lung resection. The hourly output from

the chest tube was 300mL. The nurse should give priority to:

A. Turning the client to the left side

B. Milking the tube to ensure patency

C. Slowing the intravenous infusion

D. Notifying the physician

160. The infant is admitted to the unit with tetralogy of fallot. The nurse would

anticipate an order for which medication?

a. Digoxin

b. Epinephrine

c. Aminophylline

d. Atropine

161. The toddler is admitted with a cardiac anomaly. The nurse is aware that the infant

with a ventricular septal defect will:

A. Tire easily

B. Grow normally

C. Need more calories

D. Be more susceptible to viral infections

162. The nurse is monitoring a client with a history of stillborn infants. The nurse is

aware that a nonstress test can be ordered for this client to:
A. Determine lung maturity

B. Measure the fetal activity

C. Show the effect of contractions on fetal heart rate

D. Measure the well-being of the fetus

163. A client with clotting disorder has an order to continue Lovenox (enoxaparin)

injections after discharge. The nurse should teach the client that Lovenox injections

should:

A. Be injected into the deltoid muscle

B. Be injected into the abdomen

C. Aspirate after the injection

D. Clear the air from the syringe before injections

164. The nurse has a preop order to administer Valium (diazepam) 10mg and

Phenergan (promethazine) 25mg. The correct method of administering these

medications is to:

A. Administer the medications together in one syringe

B. Administer the medication separately

C. Administer the Valium, wait 5 minutes, and then inject the Phenergan

D. Question the order because they cannot be given at the same time

165. The client has recently returned from having a thyroidectomy. The nurse should

keep which of the following at the bedside?

A. A tracheotomy set

B. A padded tongue blade

C. An endotracheal tube

D. An airway

166. The physician has ordered a histoplasmosis test for the elderly client. The nurse

is aware that histoplasmosis is transmitted to humans by:

A. Cats

B. Dogs

C. Turtles

D. Birds