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450 Medical Nursing MCQ Trial Questions [1] - KNUST

1. A serious complication of malaria is

A. Anaemia and haemorrhage

B.  Black water fever

C. Congested lung

D. Impaired peristalsis


2. Which of the following are the common types of chronic pain?

 I.  Pain with obvious on – going peripheral pathology

 II.  Chronic benign pain that may have peripheral or central pathology

 III.  Pain that subsides and gradually disappears

 IV.  Recurrent acute pain

A. I, II and III

B. I, II and IV

C. II, III and IV

D. I, II, III and IV


3. To reduce the symptoms of sprue, the patient should be advised to avoid

A. Broad beans

B. Maize

C. Soya beans

D.  Wheat


4. A patient on  Lasix and Digoxin should be observed for symptoms of electrolytes depletion caused by

A. Continuous dyspepsia

B.  Diuretic therapy

C. Inadequate oral intake

D. Sodium restriction

5. An important nursing responsibility after intravenous pyelogram is to

A. Assess the patient for flank pain

B.  Encourage extra oral  fluid intake

C. Observe urine for remaining contrast material

D. Encourage ambulation 2 to 3 hours after the study

6. The nurse encourages strict diabetic control in the patient prone to diabetic nephropathy knowing that the renal tissue changes that may occur in this condition include

A. Uric acid calculi and nephrolithiasis

B.  Renal  sugar – crystal calculi  and cyst

C. Lipid deposits in the glomeruli and nephrons

D. Thickening of the glomerular basement membrane and glomerulosclerosis 


7. Clinical features of hypokalaemia include

A. Apathy, weakness, abdominal distension

B. Oedema, bounding pulse, confusion

C. Spasms, diarrhoea, irregular pulse rate

D. Sunken eyeballs, Kussmauls breathing, thirst


8. A patient with gastric ulcer is put on antibacterial agents. The nurse should  explain to the patient that these are ordered to

A. Augment the immune response

B. Potentiate the effect of antacids

C. Reduce hydrochloric acid secretion

D.  Treat Helicobacter pylori infection

9. To prevent pulmonary embolus in a patient on bed rest, the nurse sou7ld

A. Encourage deep breathing and coughing exercise

B. Limit the patient’s fluid intake

C. Massage the legs twice daily

D. Teach the patient to move the legs when in bed


10. Conditions that result in decreased serum albumin will result in:

A. Decreased hydrostatic pressure with pressure shift from the interstitium to the vasculature

B. Increased hydrostatic pressure with plasma shift from vasculature to the interstitium

C. Increased oncotic pressure with plasma shift from the interstitium to the vasculature

D. Decreased oncotic pressure with plasma shift from  vasculature to the interstitium


11. The coronary arteries

A. Carry high oxygen content blood to the lungs

B.  Carry blood from the aorta to the myocardium

C. Carry reduced oxygen content blood to the lungs

D. Supply blood to the endocardium


12. An antidiuretic substance important for maintaining fluid balance is released by

A. Adrenal cortex

B. Adrenal medulla

C. Anterior pituitary gland

D.  Posterior pituitary gland




13. The pain associated with coronary thrombosis is caused primarily by

A. Arterial spasm

B. Blocking in the coronary veins

C. Irritation of nerve endings in the cardiac plexus

D.  Ischemia of the heart muscles


14. The ideal fluid replacement for the patient with an Extra – cellular fluid volume deficit is:

A. Isotonic

B.  Hypotonic

C. Hypertonic

D. A plasma expander


15. Without any pathological lesions, a patient’s respiratory centre is stimulated by

A. Calcium

B.  Carbon dioxide

C. Lactic acid

D. Oxygen


16. An ambu bag is used in the intensive care unit when

A. A respiratory arrest occurs

B. A surgical incision with copious drainage is present

C. The patient is in ventricular fibrillation

D. The respiratory output must be monitored


17. Diabetic coma results from an excess accumulation in the blood of

A. Glucose from rapid CHO metabolism causing drowsiness

B. Ketones from rapid fat breakdown, causing acidosis

C. Nitrogen from protein catabolism causing ammonia intoxication

D. Sodium bicarbonate causing alkalosis


18. A common complication of myocardial infarction is

A. Anaphylactic shock

B.  Cardiac arrhythmia

C. Cardiac enlargement

D. Hypokalaemia


19. When assessing a patient with a suspected atelectasis the nursed would expect

A. A dry unproductive cough

B. A normal oral temperature

C. Diminished breath sounds

D. Slow deep respiration


20. Tidal volume can be explained as the amount of air

A. Exhaled forcibly after normal expiration

B.  Exhaled normally after normal inspiration

C. Forcibly inspired over and above normal inspiration

D. Trapped in the alveoli that cannot be extended


21. To assess the effectiveness of vasodilators administered for the management of hypertension, the nurse should take the patient’s pulse and blood pressure

A. After a resting position is maintained for 5 minutes

B. Immediately after the patient gets out of bed

C. Prior to administering the drug

D.  30 minutes after giving the drugs  

22. In a respiratory acidosis, compensation would be accomplished by:

A. Lungs retaining carbon dioxide

B.  Lungs elimination carbon dioxide

C. Kidneys eliminating bicarbonate

D. Kidneys retaining bicarbonate


23. The benefit in using tetanus antitoxin is that it

A. Provides a high titre of antibodies

B.  Provides immediate active immunity

C. Stimulates long – lasting passive immunity

D. Stimulates plasma cells directly


24. When a patient is receiving anticoagulant the nursing care should include observation for

A. Chest pain

B.  Epistaxis

C. Headache

D. Nausea  


25. A patient with diabetes mellitus says “I cannot eat big meals. I prefer eating snacks throughout the day”. The nurse should explain that

A. Large meals can bring about weight problems

B. Regulated food intake is basic to diabetic control

C. Salt and sugar restriction is the main concern

D.  Small frequent meals are better for easy digestion


26. A pacemaker is used in some patients to serve the function normally performed by

A. Accelerate nerves to the heart

B. A V node

C. Bundle of His

D.  S A node


27. In a patient who has a haemorrhage in the posterior chamber of the eye, the nurse knows that blood is accumulating

A. In the aqueous humour

B. Between the cornea and the lens

C. Between the lens and the retina

D. In the space between the iris and the lens


28. A patient who is exposed to Hepatitis A is given gamma globulin to provide passive immunity which

A. Accelerates antigen – antibody union at the hepatic site

B.  Increases the production of short – lived antibodies

C. Provides antibodies that neutralise the antigen

D. Stimulates the lymphatic system to produce antibodies

29. An example of primary prevention activities by the nurse would be

A. Assisting in immunisation programme

B. Correction of dietary deficiencies

C. Establishing goals for rehabilitation

D. Prevention of disabilities


30. When assessing a patient with hyperthyroidism, the nurse should expect the patient to exhibit

A. Increased appetite, slow pulse and dry skin

B. Loss of weight, constipation and restlessness

C. Nervousness, weight loss and increased appetite

D. Protruding eyeballs, slow pulse and sluggishness

31. Increased intraocular pressure may occur as a result of

A.  Oedema of the cornea stoma

B. Blockage of the lacrimal canals and duct

C. Dilation of the retinal arterioles

D. Increased production of aqueous humour by the ciliary process


32. When educating the family of a patient with AIDS who has been discharged, the nurse should tell the family

A. “let the patient eat from paper plates and discard them”

B. “Soak the plates in hot water overnight before washing them”

C. “you need to boil the plates for 30 minutes after use”

D. “wash the plates in hot soapy water as you usually do”


33. It is not important for the nurse to observe a patient with tetanus for

A. Muscular rigidity

B. Respiratory tract spasms

C. Restlessness and irritability

D.  Spastic voluntary muscle contractions


34. When caring for a patient who is HIV positive, the nurse should explain to the patient how to prevent


B. Kaposis sarcoma

C. Other infections

D. Social isolation 


35. To prevent orthostatic hypotension in a patient on Methyldopa (Aldomet), the patient should be taught to

A. Avoid tasks that require high, energy expenditure

B. Lie down for 30 minutes after taking the medication

C. Sit on the edge of the bed a short time before getting up

D. Wear support hose continuously 





36. A patient with rabies will characteristically exhibit

A. Diarrhoea

B. Memory loss

C. Pharyngeal spasm

D. Urinary stasis


37. During physical examination of the patient’s skin, the nurse should

A. Provide a private, well – lighted room

B. Wear gloves during palpation of the skin

C. Focus initially on examination of specific lesions or problem areas

D. Maintain the patient’s privacy by undressing only areas that are abnormal


38. A patient with duodenal ulcer would probably describe the associated pain as

A. A generalised abdominal pain intensified by moving

B.  A gnawing sensation relieved by food

C. An ache radiating to the left side

D. An intermittent colicky abdominal pain


39. When a patient is unconscious, the nurse should expect him to be unable to

A. Control elimination

B. Hear voices

C. Move spontaneously

D. React to painful stimuli


40. A patient has left hemiplegiA. The nurse contributes to the patient’s rehabilitation by

A. Beginning active exercises


B. Making referral to the physiotherapist

C. Not moving the affected arm unnecessarily

D.  Positioning the patient to prevent deformity


41. As a result of inadequate production of erythropoietin in chronic renal failure, patient develops

A. Acidosis

B.  Anaemia

C. Calcium and phosphorus

D. Sodium and water retention  


42. The quickest and most effective method of removing uremic waste products from the body when the kidneys are unable to do so in cases of hyperkalaemia, hypercalcaemia, hepatic coma and uraemia is

A.  Haemodialysis

B. Paracenthesis abdominis

C. Pericardiocenthesis

D. Peritoneal dialysis


43. The nurse should administer nasogastric tube feeding slowly to reduce the hazard of

A. Abdominal distension

B. Flatulence

C. Indigestion

D.  Regurgitation


44. Urinary retention with overflow is evidenced by

A. Continual continence

B. Decreased urinary production

C. Frequent voiding

D. Oliguria and oedema


45. The most indicative symptoms of increased intracranial pressure includes

A. Rapid weak pulse, fall in blood press, hypothermia

B. Slow bounding pulse, fall in blood pressure. Hyperthermia

C. Slow bounding pulse, rising blood pressure. Hyperthermia

D.  Weak, rapid pulse, normal blood pressure, intermittent fever


46. People should be taught to avoid food products in bulged cans because they might contain

A. Clostridia tetani

B.  Clostridia botulinum

C. Escherichia coli

D. Salmonella


47. The gland that manufactures, stores, alters and excretes a large number of substances involved in metabolism in the body is

A. Adrenal

B.  Liver

C. Pancreas

D. Thyroid


48. Prophylaxis for Hepatitis B includes

A. Avoiding expired tin food

B. Observing food hygiene

C. Preventing constipation

D.  Screening of blood donors



49. A patient who has CVA with a right hemiplegia should not have his blood pressure checked using the right arm because circulatory impairment may

A. Cause excessive pressure on the brachial artery

B. Hinder restoration of function

C. Precipitate the formation of thrombus

D.  Produce inaccurate readings 


50. Risk factors associated with apoplexy in the elderly patient may include

A. Continuous nervousness

B. Glaucoma

C. Hypothyroidism

D.  Transient ischaemic attack 


51. The vitamin needed by the liver for the synthesis of prothrombin and some other clotting factors is

A. A

B. D

C. E

D.  K  


52. Before a tuberculosis patient is declared non – infective, the nurse must ensure that

A. No acid fast bacteria are in the sputum

B. The patient no longer has the disease

C. The patient’s temperature is normal

D.  The tuberculin skin test is negative


53. The risk of osteoporosis is increased when an individual

A. Engages in strenuous physical activities

B. Has a history of hypoparathyroidism

C. Receives long – term steroid therapy

D. Takes excessive amounts of oestrogen


54. When teaching a patient with a cardiac problem on reduction of saturated fats in the diet, she should be instructed to avoid

A. Corn oil

B. Fish

C. Soft margarine

D.  Whole milk


55. When emphysema is present, there is decrease oxygen supply because of

A. Infectious obstructions

B.  Loss of aerating surface

C. Pleural effusion

D. Respiratory muscle paralysis 

56. The use of amino – acids from protein for gluconeogenesis results in the formation of...... as by product.

A. Ammonia

B. Fatty acids

C. Ketone bodies

D. Lipoproteins


57. Hydrocortisone is injected into the knee joint of a patient with rheumatoid arthritis in order to

A. Prevent ankylosis of the joint

B. Provide physiotherapy

C. Reduce inflammation

D. Relieve pain


58. A patient’s laboratory report shows acid – fast rods in his sputum. These rods are presumed to be

A. Bordetella pertussis

B. Diphtheria bacillus

C. Influenza virus

D.  Mycobacterium tuberculosis


59. Dietary modification regimen allowed for patients with ascites and hepatic dysfunction is

A. High carbohydrate, low sodium

B. High protein, low carbohydrate

C. High sodium, low protein

D. High sodium, high carbohydrate



60. Symptoms of portal hypertension are chiefly the results of

A. Fatty degeneration of kupffer cells

B. Infection of the liver parenchyma

C. Obstruction of the cystic and hepatic ducts

D.  Obstruction of the portal circulation 


61. One cause of spontaneous pneumothorax in a patient with emphysema is a

A. Pleural friction rub

B. Puncture wound of the chest wall

C. Rupture of subpleura bleb

D. Tracheooesophageal fistula  

62. The nurse encourages the patient to void before paracenthesis abdominis to

A. Encourage patient to sit upright

B. Maintain the sterility of the procedure

C. Minimise bleeding at the puncture site

D.  Minimise the risk of bladder puncture


63. To help a patient obtain a maximum benefit after postural drainage, the nurse should

A. Administer the oxygen PRN

B.  Encouraged the patient to cough deeply

C. Encourage the patient to rest for 30 minutes

D. Place the patient in a sitting position


64. Normal renal function is necessary for the maintenance of

A. Bicarbonate

B. Calcium

C. Potassium

D. Sodium  

65. When caring for a patient with Hepatitis A, the nursed should take special precaution to

A. Prevent droplets spread of the infection

B. Use caution when bringing food to the patient

C. Use gloves when removing the patient’s bedpan

D. Wear mask and gown before entering his room


66. One of the commonest complications of chronic asthma is

A. Atelectasis

B. Emphysema

C. Pneumothorax

D. Pulmonary fibrosis 

67. Paracenthesis is the removal of fluid (ascites) from the

A. Abdominal cavity

B. Pleural cavity

C. Peritoneal cavity

D. Peritoneum

68. Which of the following is not undertaken to assess fluid status?

A. Abdominal girth

B. Daily weight check

C. Elevation of lower extremities

D. Intake and output


69. The nurse should expect a patient with bradycardia to have a

A. Grossly irregular heart beat

B. Heartbeat that has regular skipped beats

C. Heart rate of over 90 per minute

D.  Heart rate of under 60 per minute


70. Oesophageal varices are dilated tortuous veins usually found in the sub mucosa of the

A. Lower oesophagus

B. Mid oesophagus

C. Upper oesophagus

D. Whole of oesophagus


71. Koilonychia is a condition of the nails which occurs in

A. Blood calcium depletion

B. Chronic bronchial asthma

C. Iron deficiency anaemia

D. Osteomyelitis


72. Factors that contribute to haemorrhage in oesophageal varies are the following muscular strain from

I. Carrying heavy objects

II. Coughing

III. Lifting heavy objects

IV.  Sneezing

A. I and II

B. I and III

C. I, II and IV

D.  II, III and IV


73. A patient is to receive 3000mls of IV fluid in 12 hours. The drop factor is 10 gtt/ml. The nurse should regulate the flow to approximately how many drops per minute?

A. 27 to 29

B. 30 to 32

C. 40 to 42

D. 48 to 50


74. A hormone that regulates reabsorption of calcium and phosphorus is

A. Aldosterone

B.  Parathormone

C. Somatostatin

D. Thyroxin

75. A hormone that plays an important role in maintaining a normal fluid balances  is

A. Calcium

B. Parathormone

C. Thyroxin

D.  Vasopressin 

76. The most practical and efficient way to identify losses in renal function is by means of

A. Clearance test

B. Culture and sensitivity test

C. Glucose tolerance test

D. Routine test


77. Pleuritic pain from irritation of the parietal pleura is best described as

A. Catchy

B. Cutting

C. Pinching

D.  Sharp


78. To prevent pulmonary embolism in a patient managed on bed rest, the nurse should

A. Encourage deep breathing and coughing

B. Limit the patient’s fluid intake

C. Teach the patient to move legs when in bed

D. Teach patient to turn in bed from left to right 10 times daily

79. Wheezing is high – pitched musical sound heard mainly on

A. Coughing

B.  Expiration

C. Inspiration

D. Whistling  

80. Cyanosis appears when there is at least.............of unoxygenated blood

A. 5g/dL

B. 8g/dL

C. 10g/dL

D. 15g/dL


81. Patients with severe hepatitis should eat foods containing very little or no protein. This is to prevent

A. Hepatic cirrhosis

B. Hepatic coma

C. Portal hypertension

D. Stone formation in the common bile duct

82. The bluish colouring of the skin in respiratory condition is known as

A. Clubbing

B.  Cyanosis

C. Dyspnoea

D. Haemoptysis


83. A patient with ascites is scheduled for paracenthesis abdominis. Before the procedure, the nurse instruct the patient to

A. Assume the supine position

B. Eat foods low in fats

C. Empty bladder

D. Remain nil per os for 24 hours

84. A patient is diagnosed of mal absorption syndrome. Patient’s condition should improve drastically after the administration of

A. A gluten – free diet

B. Corticotrophin preparations

C. Folic acid

D.  Vitamin B12


85. A negative HIV test means that one

I. Does not have the antibodies in his blood

II. Has not been infected with the virus

III. Has been infected with virus but has not yet produced antibodies

IV.  Is immune to the virus

A. I, II and III

B. I, III and IV

C. II, III and IV

D. I, II, III and IV


86. In acute pharyngitis, a sudden inflammation of the pharynx is more common in patients aged

A. 1 – 4 years

B.  5 – 15 years

C. 25 – 30 years

D. 35 – 40 years


87. Black water fever is characterised by

A. Coffee ground vomiting

B.  Dark red urine

C. Diarrhoea

D. Low grade fever  



88. The following are characteristic of nephritic syndrome EXCEPT

A. Ascites

B.  Hyperalbuminaemia

C. Hypoalbuminaemia

D. Proteinuria


89. One mechanism of action of antiretroviral drugs is

A. Increasing the lifespan of the red blood cells

B. Killing the HIV

C. Neutralising the toxins produced by the HIV

D. Preventing the production of HIV


90. Bruit is a vascular sound that resembles

A. Atrial fibrillation

B. Atrial regurgitation

C. Heart murmur

D. Stridor


91. Acromegaly is produced by an over secretion of

A. Adrenocorticotrophin

B.  Growth hormone

C. Testosterone

D. Thyroid hormone 

92. What blood type is considered the universal donor?

A. A negative

B. B negative

C. AB negative

D.  O negative




93. Antiretroviral therapy is recommended for positive HIV patients

A. Who are manifesting signs and symptoms of AIDS

B. Who have development opportunistic infections

C. Whose C  D4 counts are below 500

D. Whose helper T – cells lymphocytes count are above 800


94. What blood type is considered the universal recipient?

A. A positive

B. B positive

C. AB positive

D. O  positive


95. Oral hypoglycaemic agents may be used for patients with

A. Ketosis

B. Obesity

C. Type 1 diabetes

D.  Type 2 diabetes


96. What urine pH level is considered normal?

A. 4 to 8

B.  4.5 to 8

C. 4 to 7

D. 4.5  to 7

97. A severe incapacitating chest pain is referred to as

A. Intractable or refractory angina

B. Stable angina

C. Unstable angina

D. Variant angina


98. Diabetic coma results from an excess accumulation in the blood of

A. Glucose from rapid carbohydrate metabolism

B. Ketones from rapid fat metabolism causing acidosis

C. Nitrogen from protein catabolism causing ammonia intoxication

D. Sodium bicarbonate causing alkalosis


99. One of the complications of malaria is

A. Bronchopneumonia

B. Conjunctivitis

C. Fever

D.  Splenomegaly 

100. Clinical manifestation of pulmonary congestion include all the following EXCEPT

A. Cough

B. Dyspnoea

C. Nausea

D. Pulmonary crackles


101. Clinical features of pulmonary empyema include

I. Chronic cough

II. Increasing shortness of breath

III. Production of copious purulent sputum

IV.  Wheezing respirations

A. I, II and III

B. I, II and IV

C. II, III and IV

D. I, II, III and IV


102. In right – sided heart failure, patients present with the following EXCEPT

A. Anorexia

B. Ascites

C. Dependent oedema

D.  Dyspnoea

103. In acute heart failure, upright position with the leg dangling over the side of the bed effects the following EXCEPT

A. Decreases venous return

B. Decreases lung congestion

C. Lowers output of the right ventricle

D. Reduces arterial blood pressure

104. Clinical manifestations in Reynaud’s disease includes the following EXCEPT

A. Coldness

B. Pain

C. Pallor of fingertips or toes

D. Ulceration and gangrene


105. The most common cause of diabetic ketoacidosis is

A. Emotional stress

B. Inadequate food intake

C. Increased insulin dose

D. Presence of infection


106. Which of the following electrolytes would be depleted in a patient on furosemide (Lasix)?

A. Calcium

B. Phosphate

C. Potassium

D.  Sodium


107. The factor that determines the needles diameter when preparing an injection is the

A. Efficiency of the medicine

B. Potency of the medicine

C. Patency of the needle

D. Viscosity

108. Before giving a client digoxin, the nurse should obtain the

A. Apical heart rate

B. Difference between the apical and radial pulses

C. Radial pulse in both arms

D. Radial pulse on the left side of the heart


109. A diabetic patient on admission has developed insulin comA. The signs that the nurse is expected to observe include

A. Anorexia, glycosuria

B. Excessive thirst, dry hot skin

C. Fruity odour of breath, acetonuria

D. Pallor, sweating, tremors


110. In giving Aminophyline intravenously to relieve severe asthma, the nurse should observe for

A. Decreased pulse rate

B. Decreased urinary output

C. Hypotension

D. Visual disturbances


111. Oedema in congestive cardiac failure is caused by

A. Decreased plasma protein

B. Decreased venous pressure

C. Increased plasma protein

D. Increased venous pressure



112. Intravenous solution of 0.45% sodium with respect to human blood cells is

A. Hypotonic

B. Hypertonic

C. Isotonic

D. Isomeric  

113. Ascites can be related to

A. Decreased production of potassium

B. Diminished plasma protein

C. Kidney malfunction

D. Portal hypotension


114. The main difference in manifestations of malaria and yellow fever is that in yellow fever the patient has

A. Albuminuria

B. Pain in the limbs

C. Rigor

D. Vomiting


115. A client with pyrexia would demonstrate

A. Dyspnoea

B. Elevated blood pressure

C. Increased  pulse rate

D. Precordial pain


116. In taking the apical pulse, the nurse places the stethoscope

A. Between the sixth and the seventh ribs at the left  medaxillary line

B. Between the third and fourth ribs and to the left of the sternum

C. In the fifth intercostals space along the left midclavicular line

D. Just to the left of the median point of the sternum 


117. Antibodies are produced by

A. Eisubioguds

B. Erythrocytes

C. Lymphocytes

D. Plasma cells

118. A client develops chills and headache during blood transfusion, the nurse’ best action is to

A. Lightly cover the client

B. Notify the physician

C. Stop the transfusion immediately

D. Slow the blood flow to keep the vein open 


119. The most important electrolyte in the extracellular fluid is

A. Calcium

B. Chloride

C. Potassium

D. Sodium


120. Catheterisation is not used routinely in collecting urine for culture because

A. The client feels uncomfortable

B. The doctor has to pass the catheter

C. The danger of causing trauma to the urethra

D. The risk of introducing additional bacterial into the bladder

121. A patient who smokes tells the nurse that she wants to quit smoking. The best response by the nurse is to tell the patient that

A. If she is really committed to stopping, that is all that is needed to quit

B. To overcome the nicotine addiction, it is always necessary to join a group of support program

C. Setting a date to stop and then quitting is the most difficult but is associated with fewer relapses

D. The use of nicotine replacement aids with behavioural interventions is the most successful method of stopping


122. The immediate nursing interventions

  To relieve the symptoms of hypoglycaemia include

Administering 5% dextrose solution IV

Giving 100mls of fruit juice

Providing a snack of pie and dry crackers

Withholding a subsequent dose of insulin

123. A nursing measure that should be instituted after a pneumonectomy includes

A. Monitoring chest – tube drainage and functioning

B. Positioning the patient on the unaffected side or back

C. Range – of – motion exercises on the affected upper extremity

D. Auscultating frequently for lung sounds on the affected side

124. In responding to a patient with emphysema who asks about the possibility of a lung transplant, the nurse knows that lung transplantation is contraindicated in patients

A. With cor pulmonale

B. Who currently smoke

C. With end stage renal failure

D. Older than 50 years of age 

125. The body fluids that make up 40% or more of the total body weight are

A. Extracellular

B. Intestinal

C. Intracellular

D. Intravascular


126. A plan of care for the patient with Chronic Obstructive Pulmonary Disease (COPD) would include

A. Chronic corticosteroid therapy

B. Reduction of risk factors for infection

C. High flow rate of oxygen administration

D. Lung exercises that involves inhaling longer than exhaling 

127. One important thing a nurse can teach a patient with emphysema is to

A. Move to a hot, dry climate

B. Perform chest physical therapy

C. Know the early signs of respiratory infection

D. Obtain adequate rest in the supine position  

128. The major advantage of a venturi mask is that it can

A. Deliver up to 80% O2

B. Provide continuous 100% humidity

C. Deliver a precise concentration of O2­

D. Be used while a patient eats and sleeps


129. In evaluating the knowledge of an asthmatic patient about self – care, the nurse identifies additional information needed when the patient says

A. I use my corticosteroid inhaler when I feel short of breath

B. I  get a flu shot every year and see my doctor if I have an upper respiratory infection

C. I use my bronchodilator inhaler before I visit  my aunt who has a cat, but I only visit for a few minutes because of my allergies

D. I walk 30 minutes every day but sometimes I have to use my bronchodilator inhaler before walking to prevent me from getting short of breath 


130. Which of the following is a clinical feature of marasmus?

A. Constantly crying for food

B. Flaky point dermatosis

C. Moon – shaped face due to oedema

D. Reddish brown hair


131. Symptoms of hyperthyroidism include

A. Increased appetite, slow pulse, dry skin

B. Loss of weight, constipation, restlessness

C. Nervousness, weight loss, increased appetite

D. Protruding eyeballs, slow pulse, sluggishness


132. An individual who lives at a high altitude may normally have an increased Red Blood Cell because

A. High altitudes cause vascular fluid loss leading to haemoconcentration

B. Hypoxia caused by decreased atmospheric oxygen stimulates erythropoiesis

C. The function of the spleen in removing old erythrocytes is impaired at high altitudes

D. Impaired production of leucocytes and platelets leads to proportionally higher red blood cell count


133. Disorders such as myeloblastic leukaemia that arise from myeloblast cells in the bone marrow will have the primary effect of causing

A. Increased incidence of cancer

B. Decreased production of antibodies

C. Decreased phagocytosis of bacteria

D. Increased  allergic and inflammatory reaction

134. An anticoagulant such as Warfarin that interferes with the production of prothrombin will alter the clotting mechanism during

A. Platelet aggregation

B. Activation of thrombin

C. The release of tissue thromboplastin

D. Stimulation of factor activation complex

135. In a surgery of an anaemic patient, the nurse would expect to find

A.  Dyspnoea and tachycardia

B. Cyanosis and pulmonary oedema

C. Cardiomegaly and pulmonary fibrosis

D. Ventricular arrhythmias and wheezing  

136. Significant information obtained from the patient health history that relates to the haematologic system includes

A.  Jaundice

B. Bladder surgery

C. Early menopause

D. Multiple pregnancies


137. The nurse will advise a patient with a diagnosis of nephritic syndrome to take food high in

A. Carbohydrates

B. Fats

C. Protein

D. Sodium


138. The primary goal for the patient with Bonchieostasis is that the patient will

A. Have no recurrence of disease

B. Have normal pulmonary function

C. Maintain removal of bronchial secretions

D. Avoid environmental agents that precipitate inflammation

139. A nurse identifies a flail chest  in a trauma patient when

A. Multiple rib fractures are determine by X ray

B. Paradoxical chest movements occurs during respiration

C. There is decreased movement of the involved chest wall

D. A tracheal deviation to the unaffected side is present


140. The nurse notes fluctuation of the water level in the tube submerged in the water – seal chamber in a patient with closed chest tube drainage. The nurse should

A. Continue to monitor this normal findings

B. Check all connections for a leak in the system

C. Lower the drainage collector further from the chest

D. Clamp the tubing at progressively distal points away from the patient until the fluctuations


141. Complications of hyperparathyroidism include

A. Bone destruction

B. Graves’ disease

C. Seizures

D. Tetany


142. Gullian Barrre Syndrome causes respiratory problems primarily by

A. Depressing thee C N S

B. Deforming chest wall muscles

C. Paralysing the diaphragm secondary to trauma

D. Interrupting nerve transmission to respiratory muscle  

143. A diagnosis of pediculosis corporis is made in a pupil at a health centre. An appropriate measure in treating this condition is

e. Topical application of griseofulvin

f.  Washing the body with pyrethrins

g. Administration of systemic antibiotics

h. Moist  compresses applied frequently

144. When creating a therapeutic environment for a patient recovering from myocardial infarction, the nurse should provide for

A. Daily newspapers in the morning

B. Short family visits

C. Telephone communication

D. Television for short periods


145. A patient with COPD asks why the heart is affected by respiratory disease. The nurse’s response to the patient is based on the knowledge that cor pulmonale is characterised by

A. Pulmonary congestion secondary to left ventricular failure

B. Right ventricular hypertrophy secondary to increase pulmonary vascular resistance

C. Excess serous fluid collection in the alveoli caused by retained respiratory secretions

D. Right ventricular failure secondary to compression of the heart by hyperventilated lungs


146. Asthma is best characterised as

A. An inflammatory disease

B. A steady progression of bronchoconstriction

C. A obstructive disease with loss of alveolar walls

D. A chronic obstructive disorder characterised by  mucus production 


147. The effects of cigarette smoking on the respiratory system includes

A. Increased proliferation of ciliated cells

B. Hypertrophy of the alveolar membrane

C. Destruction of all alveolar macrophages

D. Hyperplasia of globet cells and increased production of mucus

148. Mr Amamudu has been admitted to your ward with severe neutropeniA. Which of the following nursing actions would be considered appropriate in his care

A. Perirectal care and platelet administration

B. Oral care and red blood cell administration

C. Monitoring lung sounds and invasive blood pressures

D. Strict hand washing and frequent temperature assessment

149. A patient with a tricuspid  valve disorder will have impaired blood flow between the

A. Vena cava and right atrium

B. Left atrium and left ventricle

C. Right atrium and right ventricle

D. Right ventricle and pulmonary artery  

150. A patient with status epilepticus is given Valium to

A. Dilate the tracheobronchitis structure

B. Induce sleep

C. Relax peripheral muscles

D. Slow down cardiac contraction


151. It has been detected that the Purkinjie system is damaged in a patient. The nurse recognises that the conduction of electrical impulses is most likely impaired through the

A. Atria

B. AV node

C. Bundle of His

D. Ventricles

152. A patient with a MI of the anterior wall of the left ventricle most likely has an occlusion of the

A. Left circumflex

B. Right marginal artery

C. Left anterior descending artery

D. Right anterior descending artery  

153. During the first 24 hours of starvation, the order in which the body obtains substrate for energy is

A. Glycogen, skeletal protein

B. Visceral protein, fat stores, glycogen

C. Fat stores, skeletal protein, visceral protein

D. Liver protein, muscle protein,  visceral protein

154. The most important aspect of hand washing is

A. Friction

B. Soap

C. Time

D. Water  


155. It is necessary to explain to a patient with gastroesophageal reflux disease that this disorder

A. Will require surgical wrapping or repair of the pyloric sphincter to control the symptoms

B. Results in acid erosion and ulceration of the oesophagus through frequent vomiting

C. Is the protrusion of a portion of the stomach into the oesophagus through an opening in the diaphragm

D. Often involves relaxation of the lower oesophageal sphincter allowing stomach contents to back  up into the oesophagus

156. A patient with hiatal hernia in your ward is taught to control the symptoms of the disorder by

A. Drinking a glass of milk at bed time to coat the oesophagus

B. Lie down after  eating to promote relaxation of the GI tract

C. Avoid tight  clotting and bending to decrease intra – abdominal pressure

D. Drink several glasses of liquids with meals to promote stomach  emptying  


157. An elderly man on admission is complaining of hyperplasia of the gums. Which of these drugs that he is taking is responsible for his complaints?

A. Aspirin

B. Digoxin

C. Lasix

D. Phenytoin


158. Dumping syndrome is normally associated with large

A. Hyperosmolar volumes emptying rapidly into the intestine

B. Isotonic volumes stimulating increased GI motility

C. Hypertonic volumes promoting third – spacing in the intestinal cavity

D. Hyposmolar volumes drawing fluid out of the plasma space and into the bowel


159. A basic nursing intervention  for a patient with constipation is

A. Anticholinergic drugs and low fibre diet

B. Antiemetic and high fluid intake

C. Stool softeners and high fibre diet

D. Enemas and high fluid intake

160. A patient is admitted to the hospital with severe renal clinic caused by renal lithiasis. The nurse’s first priority in management  of the patient is to

A. Administration of narcotics as prescribed

B. Obtain supplies for staining all urine

C. Encourage fluid intake of 3 to 4 litres per day

D. Keep the patient on NPO in preparation for surgery

161. A condition which is characterised by hyperuricaemia,  as a result of errors of purine metabolism is

A. Osteoporosis

B. Gout

C. Rheumatoid arthritis

D. Osteomalacia


162. Evaluation of the effectiveness of Nitroglycerine Sublingual is based on

A. A decrease in blood pressure

B. Dilatation of superficial blood vessel

C. Improved cardiac output

D. Relief of angina pain 

163. Weak irregular pulse, confusion, poor muscle tone and irritability are common findings during assessments in the patient with

A. Sodium deficit

B. Calcium deficit

C. Potassium deficit

D. Fluid volume deficit

164. Ascites in congestive cardiac failure is due to

A. Failure of the kidneys to secrete urine

B. Increased intake of fluid

C. Increased venous pressure within the circulatory system

D. Lowered osmotic pressure of blood


165. If symptoms of warfarin overdose are observed in a patient with thrombophlebitis the nurse would expect the doctor to order

A. Heparin

B. Imferon

C. Protamine sulphate

D. Vitamin K  


166. Oxygen and carbon dioxide are exchangeable in the lungs by

A. Active transport

B. Diffusion

C. Filtration

D. Osmosis


167. The nurse should assess a patient with psoriasis for

A. Erythematous macules

B. Multiple petechiae

C. Pruritic lesions

D. Shiny scaly lesions


168. Which of the following flies spread onchocerciasis

A.  Sand fly

B. Similium

C. Tsetsefly

D. Tumbufly 

169. Pulmonary embolism may occur as a complication of

A. Aneurysm

B. Coronary artery thrombosis

C. Deep vein thrombosis

D. Pulmonary vein thrombosis  

170. Which organ may be affected in a patient who is losing his balance?

A. Cerebellum

B. Cerebrum

C. Medulla oblongata

D. Pons varoli

171. Which of the following nurses may NOT be allowed to work with patients who have rubella?

A. Breast feeding nurses

B. Pregnant nurses

C. Psychiatric nurses

D. Students nurses


172. A doctor orders 50mg stat of Tabs Valium to reduce anxiety in a patient with myocardial infarction before giving the drug, the nurse should

A. Assess the apical pulse

B. Assess blood pressure

C. Clarify the order with the doctor

D. Encourage patient to verbalise feelings


173. An order for a medication to be given immediately is referred to as

A. Add lib



D. Stat


174. Which of the following is a life - -threatening sign of tetanus infection?

A. Muscular rigidity

B. Respiratory tract spasm

C. Restlessness and irritability

D. Spastic voluntary muscle contraction


175. Causes of haemolytic jaundice include

I. Acute infective hepatitis

II. Incompatible blood transfusion

III. Toxic chemicals and drugs

IV.  Tumour of head of pancreas

A. I, II and III

B. I, II and IV

C. II and III

D. II, III and IV


176. When administration digitalis preparations, the client should be evaluated for

A. Decreased pulse rate

B. Decreased respiration rate

C. Increased pulse rate

D. Increased respiratory rate


177. Oedema in congestive heart failure is due to

A. Lowered arterial pressure

B. Lowered venous pressure

C. Raised arterial pressure

D. Raised venous pressure


178. To perform any nursing care to a patient the nurse must first

A. Establish rapport with the patient’s doctor

B. Recognise personal feelings toward the patient

C. Talk with the patient’s family or significant others

D. Understand the patient’s emotional conflict  


179. The primary aim of giving oxygen is to

A. Encourage deep breathing

B. Maintain tissue cell function

C. Relieve airway obstruction

D. Relieve apprehension and anxiety


180. The primary aim of nursing an unconscious patient is

A. Monitoring of consciousness level

B. Prevention of pressure sores

C. Provision of fluids and nutrients

D. Restoration of  life 


181. Agglutination is likely to occur if blood group

A. A is given to AB

B. AB is given to B

C. O is given A

D. O is given to B


182. An example of tertiary prevention activities by the nurse would be

A. Assisting in immunisation program

B. Correction of dietary deficiencies

C. Establishing goals for rehabilitation

D. Helping to send a sick person to the hospital

183. Which of the following is NOT is true about a patient with HIV or AIDS? The patient

A. May need dietary consultation to maintain adequate nutrition

B. May cope ineffectively because of poor prognosis

C. Needs information about the diseases transmission and safe sex

D. Should be encouraged not to keep pests  


184. Which of the following are associated with skin rash?

I. Chicken pox

II. Plague

III. Rubella

IV.  Typhoid

A. I, II and III

B. I, II and IV

C. I, III and IV

D. I, II, III and IV


185. The pain associated with coronary thrombosis is caused by

A. Arterial spasm

B. Blocking of the coronary veins

C. Irritation of nerve endings  in the cardiac  plexus

D. Ischemia of the heart veins


186. One of the complications of haemolytic streptococcal infection is

A. Cerebrospinal meningitis

B. Hepatitis

C. Rheumatic heart disease

D. Rheumatoid arthritis 


187. One of the signs and symptoms  a nurse should observe when a patient is receiving anticoagulant is

A. Chest pain

B. Epistaxis

C. Headache

D. Nausea


188. The most reliable test in the selection of an antibiotic is the

A. Culture  of the specimen

B. Routine examination of the specimen

C. Sensitivity of the specimen

D. Susceptibility of the patient


189. The generic name for aspirin is

A. Acetylsalicylic acid

B. Salicylic acid

C. Sal soda

D. Sodium salicylic acid


190. In celiac disease there may be an allergic response to

A. Complex carbohydrates

B. Fats

C. Gluten in wheat

D. Simple carbohydrate


191. In planning a diet for a diabetic child, the nurse must

A. Allow for normal growth needs

B. Avoid using cassava

C. Discourage substitution in the menu pattern

D. Limit calories to encourage weight loss


192. A person exposed to hepatitis A is given gamma globulin to provide passive immunity to

A. Accelerate antigen – antibody union at the hepatic sites

B. Increase the production of short – lived antibodies

C. Provide antibodies that neutralise the antigen

D. Stimulate the lymphatic system to produce large number of antibodies


193. Risk factors associated with stroke in the elderly patient may include a history of

A. Continuous nervousness

B. Glaucoma

C. Hypothyroidism

D. Transient ischemia


194. When a doctor prescribes a hypnotics 6 hourly PRN for a patient

A. It should be given only once when necessary

B. The nurse should use her own judgement in giving it every 6 hours

C. The patient should be woken up when it is time to give the drug

D. The patient should be given the drug any time she complains of pains


195. Which of the following is NOT associated with secondary hypertension?

A. Acute glomerulonephritis

B. Adrenocortical hyperfunction

C. Aortic insufficiency

D. Stress or obesity 


196. Which of the following is an important intervention of a patient with glomerulonephritis?

A. Encouraging fluids

B. Monitoring patient’s temperature daily

C. Monitoring patient’s weight daily

D. Teaching patient on personal hygiene  


197. Complications of diabetes mellitus include

 I.  Decreased resistance to infections

 II.  Delayed wound healing

 III.  Peripheral numbness and pain

  IV.  Sodium retention

A. I and II

B. I, II and III

C. II, III and IV

D. I, II, III and IV

198. When assessing an individual with suspected atelectasis, the nurse would expect

A. A dry unproductive cough

B. A diminished breath sounds

C. Normal body temperature

D. Slow deep respirations


199. The following can cause meningitis EXCEPT

A. Mycobacteria

B. Protozoa

C. Streptococci

D. Viruses 

200. The usual stimulant for the respiratory centre is

A. Calcium carbonate

B. Carbon dioxide

C. Nitrous oxide

D. Oxygen


201. A severe form of hyperthyroidism which is usually abrupt in onset and often fatal is known as

A. Exophthalmus

B. Throiditis

C. Thyrotoxicosis

D. Thyroid storm

202. A patient is taking a digitalis preparation regularly. The medication is ordinarily instilled and the physician is notified as soon as possible as the heart rate falls below

A. 80 beats per minute

B. 70 beats per minute

C. 60 beats per minute

D. 50 beats per minute


203. It has been observed that, under the age of 50 years, approximately twice as many men as women suffer from atherosclerosis in coronary vessels walls. It is generally believed that this difference is due to women having

A. Higher blood levels of oestrogen than men

B. Lifestyles with fewer stresses than men

C. Lifestyles with more activity and exercise than men

D. Diets that results in lower blood cholesterol levels than men


204. Which one of the following electrolytes helps to release contractile substances (actin and myosine) that are important for normal cardiac functioning?

A. Sodium

B. Calcium

C. Chloride

D. Potassium


205. Digoxin has been ordered for a patient with congestive heart failure because the drug helps to

A. Dilate coronary arteries

B. Strengthen the heart beat

C. Decrease arrhythmias in the heart

D. Decrease the electrical conductivity of the myocardium


206. Which one of the following findings, if noted in this patient during blood examination is most likely to increase the risk of developing digoxin toxicity?

A. Low sodium level

B. Low potassium level

C. High glucose level

D. High calcium level


207. Of the following signs, the one the nurse is most likely to notice first when the patient is developing digitalis toxicity is a

A. Heart murmur

B. Slow pulse rate

C. Slow respiratory rate

D. Drop in blood pressure


208. The physician has ordered morphine sulphate subcutaneously shortly after the admission of the patient with congestive heart failure. In this situation, the most likely reason for giving the medication is to reduce

A. Nausea

B. Anxiety

C. Blood pressure

D. Bronchial secretions


209. Most peptic ulcers occurring in the stomach are in the

A. Cardiac sphincter

B. Pyloric sphincter

C. Oesophageal sphincter

D. Body of the stomach


210. The pain in a patient with duodenal ulcer would be described probably as

A. An ache radiating to the left side

B. An intermittent colicky flank pain

C. A gnawing sensation relieved of food

D. A generalised abdominal pain intensified by moving

211. A nurse administering an N G tube feeding must do so slowly to reduce the hazard of

A. Distension

B. Flatulence

C. Indigestion

D. Regurgitation


212. In a patient suffering from cholelithiasis, the nurse should interpret his temperature elevation and white blood cell count as probably an indication of

A. Shock

B. Haemorrhage

C. Inflammation

D. Dehydration


213. Which of the following in a patient with liver cirrhosis can be directly related to increased pressure in the portal system?

I. Dyspepsia

II. Gynecomastia

III. Splenomegaly

IV.  Purpura

V.  Ascites

A. I and II

B. IV and V

C. A, III and V

D. All of the above


214. The nurse should know that the pathophysiology of a patient with cirrhosis of the liver predisposes him to

A. Splenic rupture

B. Umbilical hernia

C. Renal stones

D. Bladder stricture


215. As a consequence of ascites in a patient with cirrhosis of the liver, the patient would probably find which position most comfortable for sleep?

A. Supine

B. Side – lying

C. Semi – fowlers

D. Prone


216. Portal cirrhosis is characterised by

A. Catarrhal inflammation of sinusitis

B. Purulent infection of bile ducts

C. Fibrotic replacement of the liver cells

D. Ischemia degeneration of liver capsule


217. The portal hypertension in a patient with cirrhosis of the liver is the result of

A. Acceleration of portal blood floor secondary to severe anaemia

B. Compression of liver substance due to calcification of the liver capsule

C. Sustained contract6ion of vascular muscles in response to emotional stress

D. Twisting and constriction of intralobular and interlobular blood vessels


218. Spider angiomata are thought to be the result of

A. Increased in the systemic blood pressure

B. Failure of the liver to detoxify oestrogens

C. Interference with the normal healing process

D. Increase in permeability of capillaries


219. Which of the following findings in gastric analysis would best support a diagnosis of peptic ulcer

A. Absence of gastric secretions

B. Increased HCL

C. Lack of intrinsic factor

D. Decreased gastric motility


220. The tissue change most characteristic of peptic ulcer is

A. A ragged erosion of surface membrane with purulent exudate

B. A sharp excavation of surface membrane with clean  base

C. A lumping mass of necrotic tissue with surface bleeding

D. An elevated ridge of fibrous tissue with wrinkled margins

221. Increased parasympathetic activity predisposes to peptic ulcer by effecting

I. Hypersecretion

II. Hypertrophy

III. Hypermotility

IV.  Hyperplasia

V.  Hypertonia

A. I and II only

B. III and IV only

C. I, III and V only

D. All of the above


222. Which of the following emotional factors is thought to contribute to the production of a peptic ulcer?

A. Threat of separation from the mother figure

B. Anxiety relating to identification of the sexual role

C. Strong unconscious passive – dependent oral needs

D. Chronic inhibition of strong hostile – aggressive drives


223. Hypochromic anaemia is characterised by red blood cells that differ from normal cells in being

A. Grossly irregular in shape

B. Less filled with haemoglobin

C. Larger in total volume

D. Without nuclear chromatin


224. In a patient undergoing gastric lavage, when the lavage tube is being inserted, the nurse must place the patient in the

A. Supine position

B. Mid – fowlers position

C. High – fowlers position

D. Trendelenburg’s position


225. The maximum height of which the container of fluid should be held when administering a cleansing enema is

A. 30cm

B. 37cm

C. 45cm

D. 66cm


226. Continuous gastrointestinal decompressions is particularly apt to produce

A. Haemorrhage

B. Constipation

C. Hiccoughs

D. Alkalosis


227. Milk is omitted from a clear liquid diet because it

A. Produces gas

B. Contains calories

C. Produce nausea

D. Coats the mucosa


228. Which of the following are possible complications of duodenal ulcer

I. Acute haemorrhage

II. Macrocytic anaemia

III. Pyloric obstruction

IV.  Gallstones

V.  Bowel perforation

A. I and II

B. I, III and V

C. All but V

D. All the above


229. Which of the following is the most accurate definition of bronchiectasis?

A. Encapsulated collection of pus in the lungs

B. Fibrotic obliteration of the terminal bronchi

C. Sac – like or tubular dilatation of the bronchi

D. Traumatic rupture of the bronchiolar wall


230. The pale, boggy nasal mucosa of a patient with bronchiectasis is indicative of

A. Virus infection

B. Heart failure

C. Chronic anaemia

D. Allergic rhinitis


231. An increased anterior – posterior diameter of the chest of a patient with bronchiectasis is suggestive of

A. Osteoarthritis

B. Heart failure

C. Emphysema

D. Mediastinitis


232. A client diagnosed as  having bronchiectasis  and having anorexia; his anorexia can be predominantly result from

A. Disinclination for physical exercise

B. Frequent expectation of foul sputum

C. Decreased basal metabolic rate

D. Increased vertical diameter of the thorax


233. The position for a client with dyspnoea is

A. Sims

B. Supine

C. Orthopnoea

D. Trendelenburg


234. If the nurse explains to a client undergoing respiratory pulmonary function test that during the procedure, he/she should breathe normally then the nurse is helping the therapist to measure

A. Tidal volume

B. Vital capacity

C. Expiratory reserve

D. Inspiratory reserve


235. A client is admitted with pneumothorax and therefore during assessment, the nurse should expect dyspnoea and

A. Hematemesis

B. Unilateraol chest pain

C. Increased chest motion

D. Mediastenal shift toward the involved side


236. Thoracentesis is to empyema as which of the following is to bronchiectasis?

A. Lobectomy

B. Postural drainage

C. Aerosol  penicillin

D. Breathing exercise


237. Which of the following solution is usually placed in the drainage collection bottle in preparing the water – sealed drainage apparatus?

A. Sterile water

B. Ammonium carbonate

C. Hexachlorophene

D. Normal saline


238. Acromegaly is produced by oversecretion of

A. Testosterone

B. Growth hormone

C. Thyroid hormone

D. Adrenocorticotropin


239. The nurse understands that the cause of Cushing’s Syndrome is most commonly

A. Pituitary hypoplasia

B. Insufficient ACTH production

C. Hyperplasia of the adrenal cortex

D. Deprivation of adrenocortical hormone


240. Glucocorticoids and Mineralocorticoids are secreted by the

A. Gonads

B. Pancreas

C. Adrenal gland

D. Anterior pituitary gland

241. In Cushing’s syndrome, excessive amounts of glucocorticoids and mineralocorticoids will increase the client’s

A. Urine output

B. Glucose levels

C. Serum potassium

D. Immune response


242. Thyroid crisis (storm) is caused by

A. Increased iodine in the blood

B. Removal of the parathyroid gland

C. High levels of the hormone triiodothyronine

D.  A rebound increase in metabolism following anaesthesia


243. Which of the following minerals is lost in prolonged diuretic therapy?

A. Sodium

B. calcium

C. Potassium

D. Phosphorus


244. In patients with diabetes insipidus, the specific gravity of urine is

A. High

B. Low

C. Moderate

D. Normal


245. A clinical syndrome in which there are attacks of headache frequently accompanied by visual and gastrointestinal symptoms is referred to as

A. Sinusitis

B. Heart attack

C. Migraine

D. Otitis media


246. Which of the following is not part of the clinical phases of acute renal failure?

A. Oliguria

B. Diuresis

C. Intermittent phase

D. Period of recovery


247. A renal stone in the pelvis of the kidneys will alter the function of the kidney by interfering with

A. The structural support of the kidneys

B.  Regulation of the concentration of urine

C. The entry and exit of blood vessels at the kidney

D. Collection and drainage of urine from the kidney


248. The nurse identifies a risk factor for urinary calculi in a patient who relates a past health history that includes

A. Measles

B. Gastric ulcer

C. Diabetes mellitus

D. Hyperparathyroidism


249. Normal changes associated with aging of the urinary system that the nurse expects to find include

A. Decrease levels of B U N

B. Post voiding urine residual

C. Increased bladder capacity

D. More easily palpable kidneys


250. A patient with renal disease has oliguria and a creatinine clearance of 40ml/min. The nurse identifies that these findings most directly reflect abnormal function of

A. Tubular secretion

B. Capillary permeability

C. Glomerular filtration

D. Concentration of filtrate


251. In teaching a patient with pyelonephritis about the disorder, the nurse informs the patient that the organism that causes pyelonephritis most commonly reach the kidneys through

A. An ascending infection

B. The bloodstream

C. A descending infection

D. The lymphatic system


252. The nurse teaches the female patient who has frequent urinary tract infections that she should

A. Urinate after sexual intercourse

B. Take tub baths with bubble bath

C. Take prophylactic sulphonamides for the rest of her life

D. Restrict fluid intake to prevent the need for frequent voiding


253. The nurse informs the patient with nephritic syndrome that the cause of hiss oedema is as a result of

A. Decreased aldosterone secretion from adrenal insufficiency

B. Increased hydrostatic pressure caused by sodium retention

C. Decreased colloidal osmotic pressure caused by loss of serum albumin

D. Increased fluid retention caused by decreased glomerular filtration


254. A patient is admitted to the hospital with severe renal colicky caused by renal lithiasis. The nurse’s first priority in management of the patient is to

A. Administration of narcotics as prescribed

B. Obtain supplies for staining all urine

C. Encourage fluid intake 3 to 4 litres per day

D. Keep patient N P O in preparation for surgery


255. In  planning nursing interventions to increase bladder control in the patient with urinary incontinence, the nurse includes

A. Using incontinence pads to prevent embarrassment

B. Restricting fluid intake after dinner in the evening

C. Clamping and releasing a catheter to increase bladder tone

D. Teaching the patient about feedback mechanisms to supress the urge to urinate


256. A patient with a ureterolithotomy returns from surgery with a nephrostomy tube in place. Postoperative nursing care of the patient includes

A. Encouraging the patient to drink fruit juices ad milk

B. Forcing fluids of at least 2 t0 3L per day after nausea has subsided

C. Notifying the physician if nephrostomy tube drainage is more than 30ml/hr

D. Irritating the nephrostomy tube with 10mls of normal saline solution as needed


257. The risk factor for kidney and bladder cancer in a patient who relates a history to a nurse could be as a result of

A. Aspirin use

B. Tobacco  use

C. Chronic alcohol abuse

D. Use of artificial sweeteners

258. A patient is admitted to the hospital with chronic renal failure. The nurse understands that this condition is characterised by

A. A rapid decrease in urinary output with azotaemia

B. An increasing creatinine clearance with a decrease in urinary output

C. Progressive irreversible destruction of the kidneys

D. Prostration, somnolence and confusion with coma and imminent death


259. Pre – renal causes of acute renal failure include

A. Prostate cancer and calculi formation

B. Acute glomerular nephritis and neoplasms

C. Septic shock and nephrotoxins injury from drugs

D. Hypovolemia and cardiogenic shock


260. During the oliguric phase of acute renal failure, the nurse monitors the patient for

A. Hypernatraemia and Central Nervous System

B. Kussmaul’s respirations and hypotension

C. Pulmonary oedema and electrical changes in cardiac activity

D. Urine with high specific gravity and low sodium concentration


261. The nurse must monitor which serum electrolyte imbalances in a patient in the diuretic phase of acute renal failure?

A. Hyperkalaemia and hyponatraemia

B. Hyperkalaemia and hypernatraemia

C. Hypokalaemia and hypernatraemia

D. Hypokalaemia and hyponatraemia


262. One of the major disadvantages of peritoneal dialysis is that

A. High glucose concentration of the dialysate necessary for ultrafiltration cause carbohydrate and lipid abnormalities

B. Hypotension is a constant problem because of continuous fluid removal

C. Blood loss can be extensive because of the use of heparin to keep the catheter in patient

D. Solutes are removed more rapidly from the blood than from Central Nervous System, causing disequilibrium syndrome


263. A patient in end stage renal disease on haemodialysis is considering asking a relative to donate a kidney for transplant. In assisting the patient to make a decision about his treatment, the nurse informs the patient that

A. Successful transplantation usually provides better quality of life than that offered by dialysis

B. If rejection of the transplanted kidney occurs no further treatment for the renal failure is available

C. The immunosuppressive therapy that is required following transplantation causes fatal malignancies in many patients

D. Haemodialysis replaces the normal functions of the kidneys and patients do not have to live with the continual fear of rejection


264. Most of the long – term problems that occur in the patient with kidney transplant are as a result of

A. Chronic rejection

B. Immunosuppressive therapy

C. Recurrence of the original renal disease

D. Failure of the patient to follow the prescribed regimen


265.  Following a kidney transplant, the nurse teaches the patient signs of rejection include

A. Fever, weight loss, increased urinary output, increased blood pressure

B. Fever, weight gain, increased urinary output, increased blood pressure

C. Fever, weight gain, decreased urinary output, increased blood pressure

D. Fever, weight loss, increased urinary output, decreased blood pressure


266. A condition which is characterised by hyperuricaemia, pain and swelling of smaller joints and as a result of errors of purine metabolism is

A. Osteoporosis

B. Gout

C. Rheumatoid arthritis

D. Osteomalacia


267. Conditions that result in decreased serum albumin will result in

A. Decreased hydrostatic pressure with pressure shift =s from the interstitium to the vasculature

B. Increased hydrostatic pressure with plasma shifts from the vasculature to the interstitium

C. Increased oncotic pressure with plasma shifts from the interstitium to the vasculature

D. Decreased oncotic pressure with plasma shifts from the vasculature to the interstitium


268. The nurse implements nursing care for the patient with hypernatraemia taking into consideration

A. Fluid restriction

B. Administration of hypotonic fluids

C. Administration of a cation exchange resin

D. Increased water intake for patients on nasogastric suction


269. Weak, irregular pulse, confusion, poor muscle tone and irritability are common finding during assessments in the patient with

A. Sodium deficit

B. Calcium deficit

C. Potassium deficit

D. Fluid volume deficit


270. Which of the following statements is accurate?

A. Hypercalcaemia rarely occurs from increased calcium intake

B. In patients with hypercalcaemia, it is important to restrict fluid intake

C. Any condition that causes decreased parathyroid hormone results in hypercalcaemia

D. Patients who have had thyroid surgery must be closely monitored to hypercalcaemia


271. The ideal fluid replacement for the patient with E C F fluid volume deficit is

A. Isotonic

B. Hypotonic

C. Hypertonic

D. A plasma expander


272. In respiratory acidosis, compensation would be accomplished be

A. Lungs retaining CO2

B. Lungs eliminating CO2

C. Kidneys eliminating bicarbonate

D. Kidneys retaining bicarbonate


273. The primary cation in the fluid compartment that constitute the greatest percentage of total body water is

A. Sodium

B. Chloride

C. Potassium

D. Calcium


274. The characteristics of the operating room environment that facilitates the prevention of infection in the patient is

A. Adjusting lighting

B. Conducive furniture

C. Filters in the ventilation system

D. Explosion – proof electrical plugs


275. The perioperative nurse’s primary responsibility for the care of the patient undergoing surgery is

A. Developing an individualised plan of nursing care for the patient

B. Carrying out specific tasks related of surgical policies and procedures

C. Ensuring that the patient has been assessed for safe administration of anaesthesia

D. Performing a preoperative history and physical assessment to identify patient needs


276. When scrubbing at the scrub sink, the nurse remembers that

A. Scrub from elbows to the hands

B. Scrub without mechanical friction

C. Scrub for a minimum of 10 minutes

D. Hold the hands higher than the elbows


277. Nursing interventions indicated during the patients recovery from general anaesthesia in the recovery ward include

A. Placing the patient in a supine position

B. Encouraging deep breathing and coughing

C. Restraining patients during anaesthesia of emergency delirium

D. Withholding analgesics until the patient is discharged from the recovery ward

278. Following admission of the post – operative patient to the ward, the most immediate attention

A. Oxygen saturation of 85%

B. Respiratory rate of 13 beats per minute

C. Blood pressure of 90/60mmHg

D. Temperature of 34.60C


279. In preparation for discharge after surgery, the nurse should advise the patient regarding

A. A time frame for when physical activities can be resumed

B. The rationale for abstinence from sexual intercourse for 4 – 6 weeks

C. The need to call the hospital or clinical unit to report any abnormal signs or symptoms

D. The necessity of a referral to nutritional centre for management of dietary restriction


280. Increased intraocular pressure may occur as a result of

A. Oedema of the cornea stroma

B. Blockage of the lacrimal canals and duct

C. Dilation of the retinal arterioles

D. Increase production of aqueous humour by the ciliary process


281. The nurse always assess the patient with an ophthalmic problem for

A. Papillary reactions

B. Visual acuity

C. Intraocular pressure

D. Confrontation visual fields


282. The nurse should specifically question patients using eye drops to treat glaucoma about

A. Use of corrective lenses

B. Their usual sleep pattern

C. A history of heart or lung disease

D. Sensitivity to narcotics or depressants


283. While examining a patient, the nurse notes small, raiseD. Solid lesions that merge with one another on the patient’s forearm. The nurse would describe this finding as

A. Diffuse pustular gyrate lesions

B. Generalised pustules with confluence

C. Punctuate, macular satellite lesions

D. Confluent, annular papules forming plaque


284. On observing areas of excoriation on the patient’s arms and legs, the nurse would question the patient regarding

A. Itching

B. Sun exposure

C. Excessive sweating

D. Bleeding disorders


285. Palpation of the skin is the most appropriate technique to assess

A. Skin texture

B. The presence of lesions

C. The vascularity of the skin

D. Presence of intertriginous areas


286. In teaching a patient who is using topical corticosteroids to treat an acute dermatitis, thed nurse should tell the patient that

A. Topical corticosteroids usually do not cause systemic side effects

B. The cream form represents the most efficient system delivery

C. Abruptly discontinuing the use of topical corticosteroids will cause a reappearance of the dermatitis

D. Creams and ointments should be applied with a glove in small amounts to prevent further infection


287. A patient with psoriasis tells the nurse that she has quit her job as a receptionist because she feels her appearance is disgusting to customers. The nursing diagnosis that best describes this patient’s response is

A. Ineffective coping related to lack of social support

B. Impaired skin integrity related to presence of lesions

C. Anxiety related to lack of knowledge of the disease process

D. Social isolation related to decreased activities secondary to fear of rejection


288. A nurse teaches a patient with malignant melanoma about his disorder. The nurse should make the patient know that the prognosis of the condition is most dependent on

A. The thickness of the lesion

B. The degree of colour change in the lesion

C. How much superficial spread the lesion has

D. The amount of ulceration present in the lesion


289. The nurse identifies a nursing diagnosis of Risk for infection transmission as a high priority for the patient with

A. Psoriasis on the palms and soles

B. Candidiasis of the nails

C. Tinea pedis

D. Impetigo on the face


290. A common site for the lesions associated with atopic dermatitis is the

A. Buttocks

B. Temporal areas

C. Antecubital space

D. Palmer surface of the feet


291. Dermatologic symptoms of Cushing’s Syndrome would include

A. Generalised hyperpigmentation

B. Increased sweating

C. Antecubital space

D. Palmer surface of the feet


292. A patient is assessed to be at risk for the development of a pressure ulcer. Based on this information, the nursed should

A. Vigorously massage reddened bony prominences daily

B. Keep head of bed elevated to 900 at all times

C. Implement a 2 hourly turning of patient

D. Have the patient maintain a high fat diet


293. The mechanism that stimulates the release of surfactant is

A. Deep breathing that stretches the alveoli

B. Collapse of the alveoli that activates type I cells

C. Activation of type II cells by fluid accumulation in the alveoli

D. Movement of air from the alveolus through the pores of Kohn


294. During inspiration, air enters the thoracic cavity as a result of

A. Stimulation of the respiratory muscles by the chemoreceptors

B. An increase in CO2 and decrease in O2 in the blood

C. Decrease in intrathoracic pressure relative to pressure at the airway

D. An increased intrathoracic pressure relative to pressure at the airway


295. A diagnostic study that is most likely to be normal in a patient with pneumonia is

A. Oximetry

B. Chest x – ray

C. Sputum C and S

D. Pulmonary angiogram


296. When assessing activity – exercise patterns related to respiratory health, the nurse inquires about

A. Dyspnoea during rest or exercise

B. Recent weight loss or weight gain

C. Willingness to wear oxygen in public

D.  Ability to sleep through the entire night


297. A patient was seen in clinic for an episode of epistaxis, which was controlled by placement of anterior nasal packing. During discharge teaching, the nurse instruct the patient to

A. Use aspirin or aspirin – containing compounds for pain relief

B. Apply ice compresses to the nose every 4 hours for the first 48 hours

C. Avoid vigorous nose blowing and strenuous activity

D. Leave the packing in place for 7 to 10 days until it is removed by the physician


298. In assessing a patient with pneumococcal pneumonia, the nurse recognises that clinical manifestations of this include

A. Fever, chills and a productive cough with rust – coloured sputum

B. A non – productive cough and night sweats that are usually self – limiting

C. A gradual onset of nasal stiffness, sore throat and purulent productive cough

D. An abrupt onset of fever, non – productive cough and formation of lung abscesses


299. A patient with tuberculosis has a nursing diagnosis of non – compliance. The nurse recognises that he most common etiologic factor for this diagnosis in patients with T B is

A.  Fatigue and lack of energy to manage self – care

B. Lack of knowledge about how the disease is transmitted

C. Little or no motivation to adhere to long – term drug regimen

D. Feelings of shame and the response to the social stigma associated with T B


300. A patient is on high doses of corticosteroids and broad – spectrum antibiotics for treatment of serious trauma and infection. The nursed should be aware that this patient is susceptible to

A. Candidiasis

B. Aspergillosis

C. Histoplasmosis

D. Coccidiodomycosis


301. Which of the following can be found in the saliva?

A. Amylase, which digest cellulose

B. Lysosomes, which has a weak antibacterial action

C. Serous fluid which increases primarily by sympathetic stimulation

D. Enzyme which digest protein


302. Which of the following conditions causes inhibition of gastric secretion?

A. Distension of the duodenal wall

B. Fats in the duodenum

C. pH less than 2 in the duodenum

D. pH more than 2 in the duodenum


303. Which of the under listed hormones cause contraction of the gall bladder?

A. Cholecystokinin

B. Gastrin

C. Gastric inhibitory polypeptide

D. Secretin

304. The painful or burning sensation in the chest usually associated with acid reflux in the oesophagus is called

A. Angina

B. A duodenal ulcer

C. Heart burn

D. A peptic ulcer


305. The lymphatic capillaries in the villi of the small intestines are called

A. Crypts of Lieberkuhn

B. Lacteals

C. Microvilli

D. Peyer’s Patches


306. During the function of the heart, the heart valves

A. Cause the heart sound when they open

B. Contract to pump blood through the heart

C. Prevent blood from flowing backward through the heart

D. Separate the left and right sides of the heart


307. The right ventricles of the heart acts as a pump for the

A. Coronary circulation

B. Hepatic portal circulation

C. Pulmonary circulation

D. Systemic circulation


308. The artrioventricular valves open when pressure in the

A. Atria is greater than pressure in the ventricles

B. Arteries is greater than pressure in the ventricles

C. Ventricles is greater than the pressure in the arteries

D. Ventricles is greater than the pressure in the atria




309. Which of the following factors would increase stroke volume?

A. Increased arterial blood pressure

B. Increased end diastolic

C. Increased sympathetic stimulation of the myocardium

D. Increased venous return


310. Which of the under listed is a function of the pleural fluid?

A. Helps fill the pleural cavity

B. Holds the visceral and parietal pleural membranes together

C. Increases diffusion rates in the lungs

D. Prevents the lungs from overinflating


311. Oxygen and carbon dioxide move through the respiratory membrane and into and out of cells by the process of

A. Active transport

B. Cotransport

C. Diffusion

D. Facilitated diffusion


312. Electrolytes are responsible for all the following except

A. Maintaining the osmolality of the body fluid compartment

B. Regulating the balance of acids and bases

C. Aiding in neurologic and neuromuscular conduction

D. Regulating body fluids


313. Major intracellular fluid electrolytes include

A. Sodium

B. Potassium

C. Chloride

D. Bicarbonate

314. Cations are defined as

A. Positively charged ions

B. charged ions

C. Enzyme like substances

D. Precursors of electrolytes


315. The chief cation found in the extracellular fluid is

A. Sodium

B. Potassium

C. Chloride

D. Phosphorus


316. When caring for a patient who has had a small bowel obstruction resection and is 1 day postoperative, the nurse is aware that the patient is at risk  for electrolyte imbalance because of

A. Impaired nutrient intake

B. Impaired exchange between anions and cations

C. Pain

D. Impaired endocrine stimulation


317. Which of the following sources is a normal source of electrolyte intake?

A. Medications

B. Gatorade

C. IV solutions

D. Hyperalimentation


318. Which of the following statements is not true?

A. I C F electrolytes are found within the cell membrane

B. I C F electrolytes are not measureable

C. I C F electrolytes have non variable concentration

D. I C F electrolytes

319. When assessing a patient with hypernatraemia, the nurse would expect to find

A. Serum sodium level of 135mEq/litre

B. Moist mucous membrane

C. Thirst

D. Hypoactive reflexes


320. Patients at high risk for hyponatraemia include all the following except

A. Patients receiving hypertonic total parenteral nutrition

B. Patients on diuretic therapy

C. Burn victims

D. Patients with gastric suctioning


321. When E C F sodium is decreased, the adrenal glands send aldosterone to the kidneys to

A. Increase sodium reabsorption

B. Decrease sodium reabsorption

C. Increase water reabsorption

D. Decrease water reabsorption


322. When caring for a patient with hypernatraemia, the nurse is careful to administer

A. Water

B. Sodium

C. Potassium

D. Chloride


323. When caring for a patient with hyponatraemia, the nurse is careful to restrict

A. Water

B. Sodium

C. Potassium

D. Chloride


324. Which of the following IV solutions would the nurse administer for a patient with hypernatraemia?

A. 3% saline

B. 0.33% saline

C. D5W

D. Ringers Lactate solution


325. The nurse should administer hypertonic IV solutions with caution because these solutions will force

A. Water to leave the E C F

B. Water to leave the I C F

C. Cellular swellings

D. Hydrostatic pressure to drop


326. Aldosterone reabsorption of sodium occurs after stimulation with

A. A C T H

B. Insulin

C. A D H

D. Pitocin


327. When assessing a patient for potassium deficits, the nurse is aware that the normal serum potassium level ranges from

A. 1.5 – 3.5mEq/litre

B. 2.5 – 4.5mEq/litre

C. 3.5 – 5.0mEq/litre

D. 4.0 – 7.5mEq/litre


328. Which of the following symptoms is not associated with hypokalaemia

A. Muscle cramps

B. U waves on E C K

C. Paraesthesia

D. Hyperreflexia


329. When assessing a patient for hyperkalaemia, the nurse would not assess

A. U waves on E C G

B. Paraesthesia

C. Muscle cramps

D. Tented T waves on E C G


330. Before administering a medication containing potassium, an important nursing intervention is to check the patient’s

A. E C G

B. Pulse

C. Blood pressure

D. Urine output


331. When caring for a patient with hypercalcaemia, the nurse should plan to administer which of the following drugs?

A. Inderal

B. Bicarbonate

C. Lasix

D. Mannitol


332. The most dangerous sequel of hypercalcaemia is

A. Constipation

B. Muscle weakness

C. Dyspnoea

D. Dysrhythmias

333. Which of the following metabolic conditions places a patient at high risk for hypercalcaemia?

A. Myxoedema

B. Exercise

C. Hyperphosphotaemia

D. Hyperparathyroidism


334. When educating a patient about foods high in calcium, the nurse would be recommended

A. Canned fish

B. Coffee

C. Dry beans

D. Meat


335. Normal calcium levels are

A. 800mg

B. 1200mg

C. 8.5 – 10.5mg/dl

D. 2.5 – 4.5mg/dl


336. Serum calcium levels rise with metastatic done because of

A. Hyperphosphotaemia

B. Osteoporosis

C. Chemotherapy

D. Accelerated bone metabolism


337. A client with pyrexia would demonstrate

A. Dyspnoea

B. Elevated blood pressure

C. Increased pulse rate

D. Precordial pain


338. Red blood cell production is controlled by

A. Kidney

B. Liver

C. Pancreas

D. Spleen


339. Pleuritic pain from irritation of the parietal pleura is best described as

A. Catchy

B. Sharp

C. Cutting

D. Pinching


340. Wheezing is a high pitched musical sound heard mainly on

A. Coughing

B. Inspiration

C. Expiration

D. Whistling


341. The bluish colouring of the skin in respiratory condition is known as

A. Clubbing

B. Dyspnoea

C. Haemoptysis

D. Cyanosis


342. Clubbing of the fingers is a sign of

A. Anaemia

B. Cyanosis

C. Dehydration

D. Chronic lung diseases


343. The closure or collapse of the alveoli is known as

A. Atelectasis

B. Arteriosclerosis

C. Epistaxis

D. Sleep anoea


344. Community pneumonia occurs with the first……………….of hospitalisation

A. 24 hours

B. Week

C. 48 hours

D. Two weeks


345. When reviewing laboratory results of an 83 year old patient with an infection, the nurse expects to find

A. Minimal leucocytes

B. Decreased platelet count

C. Increased haemoglobin and haematocrit levels

D. Decrease erythrocyte sedimentation rate


346. Immediately following a bone marrow biopsy and aspiration, the nurse should instruct the patient to

A. Expect to receive a blood transfusion

B.  Lie still with a sterile pressure dressing intact

C. Lie with knees slightly bent and head elevated

D. Cleanse the site immediately with povidone iodine


347. When providing care for a patient with thrombocytopenia, the nurse must avoid administering aspirin or aspirin containing products because they

A. Interfere with platelet aggregation

B. May contribute to the destruction of thrombocytes

C. May mask the fever that occurs with thrombocytopenia

D. Alter blood flow to the homeostatic mechanisms in the brain


348. The nurse would expect that a patient with Von Willebrand’s disease undergoing surgery would be treated with administration of V W F and

A. Factor VI

B. Factor VII

C. Factor VIII

D. Thrombin


349. Disseminated intravascular coagulation (D I C) is a disorder in which

A. The coagulation pathway is genetically altered leading to thrombus formation in all major blood vessels

B. An underlying disease depletes haemolytic factors in the blood leading diffuse thrombotic episodes and infarcts

C. A disease process stimulates coagulation processes with resultant depletion of clotting factors leading to diffuse haemorrhage

D. An inherited predisposition causes deficiency of clotting factors that leads to overstimulation of coagulation processes in the vasculature


350. When obtaining assessment data from a patient with microcytic normocytic anaemia, the nurse would question the patient about

A. Folic acid intake

B. Dietary intake of iron

C. A history of gastric surgery

D.  A history of sickle cell anaemia


351. A nursing intervention for a patient with severe anaemia of chronic disease includes

A. Monitoring stools for guaiac

B.  Instructions on high iron intake

C. Monitoring urine intake and output

D. Teaching self – injection of erythropoietin


352. A patient with anaemia secondary to heavy menstrual blood loss describes her dietary intake to the nurse. For breakfast the nurse recommends that whole grain cereal be substituted for

A. Scrambled eggs

B. Sausage and toast

C. Fresh fruit and yoghurt

D. Granola bar with raisins


353. The nursing management of a patient in sickle cell crisis includes

A. Bed rest and heparin therapy

B.  Blood transfusions and iron replacement

C. Aggressive analgesics and oxygen therapy

D. Platelet administration and monitoring


354. A complication of hyperviscosity of polycythaemia is

A. Thrombosis

B. Cardiomyopathy

C. Pulmonary oedema

D. Disseminated intravascular coagulation (D I C)


355. Myelodysplastic syndromes are thought to arise from the pluripotent haemotopoietic stemcell in the bone marrow. A nurse should therefore expect a laboratory results which contain

A. An excess of platelets

B. An excess of T cell

C. A deficiency of granulocytes

D. A deficiency of all cellular blood components


356. A doctor has ordered multiple drug combinations as the  first line treatment of leukaemia and lymphoma because

A. There are fewer toxic and side effects

B. The chance that one drug will be effective is increased

C. They can interrupt cell growth at multiple points in the cell cycle

D. They are more effective without having exacerbation side effects


357. A patient in your ward with multiple myeloma complains of confusion and lethargy. The nurse would expect that these clinical features or manifestations may be explained by diagnostic result that indicate

A. Hyperkalaemia

B. Hyperuricaemia

C. Hypercalcaemia

D. Central Nervous System


358. When checking the capillary filling time of a patient, the nurse recognises that the colour of the nail bed returns in 10 seconds, the finding is an indicative of


A. A normal response

B. Thrombus formation in the veins

C. Lymphatic obstruction of venous return

D.  Impaired arterial flow to the extremities


359. A nurse assesses a patient and notes a palpable precordial thrill. Her findings may be caused by

A. Gallop rhythm

B. Heart murmurs

C. Pulmonary oedema

D. Right ventricular hypertrophy


360.  A patient in your ward has been scheduled for an invasive cardiovascular diagnostic study. An important nursing responsibility for the patient is

A. Checking the peripheral pulses and percutaneous sites

B.  Instructing the patient about radioactive isotope injection

C. Informing the patient that general anaesthesia will be given

D. Assisting the patient to do a surgical scrub of the insertion site


361. Mr Lazarazu has undergone E C G because the doctor suspects myocardial infarction after taking his history. As a senior nurse, a P wave on the E C G represents an impulse

A. Arising at the S A node and repolarising the atria

B. Arising at the S A node and depolarising the atria

C. Arising at the A V node and depolarising the atria

D. Arising at the A V node and spreading to the bundle of His




362. The nurses identifies a need for dietary teaching for the patient whose daily intake of food groups consists of

A. 2 – 4 servings of the fruit group

B. 2 – 3 servings of milk, yoghurt and cheese group

C. 4 – 5 servings of the bread, cereal, rice and pasta group

D. 2 – 3 servings of meat, poultry, fish, beans, eggs and nut group


363. In general, nutrient or food interactions with medications can result in all of the following except

A. Enhancing drug absorption

B. Retarding drug bioavailability

C. Increasing a nutrient requirement

D. All the above can happen


364. A successful goal of treatment that a nurse may recognise in a patient with anorexia nervosa is when the patient

A. Demonstrate a rapid weight gain

B. Consumes the required daily intake of nutrients

C. Commits a long – term individual and family counselling

D. Verbalises feelings regarding self – image and fears of becoming obese


365. A patient with Vincent’s infection should be taught that his/her treatment will include

A. Smallpox vaccination

B. Viscous lidocaine rinses

C. Amphotericin B suspension

D. Topical application of antibiotics


366. The most appropriate nursing intervention to provide oral care for a patient unable to do this for himself involves

A. Applying a fluoride solution to the surface of the teeth

B. Using oral antimicrobial agents to reduce local bacterial counts

C. Brushing and flossing the patient’s teeth

D. Swabbing the patient’s mouth with soft foam applications soaked with mouth wash


367. In assessing a patient with oesophageal achalasia the nurse would expect the patient to say or report

A. A history to say or report

B. A sore throat and hoarseness

C. Dysphagia, especially with liquids

D. Relief of pyrosis with the use of antacids


368. Mrs Julles, aged 85 is reported of nausea all day and has vomited twice. From your assessment data, you instruct that she be given

A. Antispasmodic drugs and observe skin turgor

B. Mouth sips of water and elevate the head of her bed to prevent aspiration

C. Offer her large quantities of sodium containing drinks since elderly people are at risk for sodium depletion

D. Offer her high protein liquid supplement to drink to maintain her nutritional needs


369. The pernicious anaemia that may accompany gastritis may be due to

A. Chronic autoimmune destruction of cobalamine stores in the body

B.  Progressive gastric atrophy from chronic breakage in the mucosal barrier and blood loss

C. A lack of intrinsic factor normally produced by acid – secreting cells of the gastric mucosa

D. Hyperchlorhydria resulting from an increase in acid secreting parietal cells and degrading of R B Cs


370. Discharge teachings for a patient with acute episodes of G I bleeding will include information concerning the importance of

A. Taking only medications prescribed by the physician

B. Avoiding taking aspirin with acidic beverages such as orange juice

C. Taking all medications 1 hour before meal time to prevent further bleeding

D. Reading all O T C medications labels to avoid medications containing stearic acid and calcium


371. You are teaching your patient and her family about possible causes of peptic ulcers. You explain that ulcer formation is

A. Inherited within families and reinforce by bacterial spread of staphylococcus aureus in childhood

B. Promoted by factors that tend to cause over secretion of acid, such as excess dietary fats, smoking and B pylori

C. Caused by a stressful lifestyle and other acid – producing factors such as B pylori

D. Promoted by a combination of possible factors that may result in erosion of the gastric mucosa including certain medications and alcohol


372. Several patients are hit by symptoms of nausea, vomiting and diarrhoea that started after attending a family reunion pot luck dinner. The nurse question the patients specifically about foods they ingested containing

A. Beef

B. Meat and milk

C. Poultry and eggs

D. Home preserved vegetables


373. The nurse notifies the physician, suspecting a possible ruptured appendix when the patient has

A. A low grade fever with a leucocytosis

B. A distended, rigid abdomen and muscle

C. Right lower quadrant pain on palpation of the left lower quadrant

D. Localised abdominal pain hallway between the umbilicus and the right iliac


374. When the vascular volume is depleted, the nurse can expect the sign of

A. Decreased urine output, postural hypotension and tachycardia

B. Increased urine output, postural hypotension and tachycardia

C. Tachycardia, hypertension and decreased urine output

D. Tachycardia, hypertension and increased urine output


375. A flat x – ray could reveal which of the following about the kidneys?

A. Decreased glomerular function

B. Enlargement due to hydronephrosis

C. Renal calculi

D. Hypoperfusion of the kidneys


376. With acid retention respiratory compensation is manifested as

A. A cheyne – stroke respiratory pattern

B. An increased depth breathing

C. Decreased respiratory rate and depth

D. Increased arterial carbon dioxide levels


377. A client in uraemia will have all the following except

A. Uremic halitosis or stomatitis

B. Hiccups and anorexia

C. Spider haemangioma

D. Nausea and vomiting


378. Which of the following is a result of kidney failure? Excessive hydrogen ions

A. Cannot be excreted

B. Are counteracted by ammonia

C. Anteroposterior lung sounds

D. Weight gain with even muscle development


379. Which of the following is a classical indication of chronic hypoxaemia?

A. Increased combustion

B. Oxygen induced hyperventilation

C. Oxygen toxicity

D. Absorption atelectasis

380. Which of the following is not a complication related to tracheal suctioning?

A. Hypoxia

B. Tissue trauma

C. Infection

D. Bronchodilation


381. A client with chronic bronchitis often shows signs of hypoxiA. The nurse would observe for which of the following clinical manifestations of this problem?

A. Increased capillary refill

B. Clubbing of fingers

C. Pink mucous membrane

D. Overall pale appearance


382. A client has been diagnosed with a chronic airflow limitation problem. Which of the following is not a disease of chronic airflow limitation?

A. Bronchiectasis

B. Bronchial asthma

C. Chronic bronchitis

D. Pulmonary emphysema


383. A body structure primarily affected by pneumonia is which of the following?

A. Bronchi

B. Pharynx

C. Alveoli

D. Trachea



384. An assessment of which of the following would most likely follow or accompany rhinitis?

A. Pharyngitis

B. Tonsillitis

C. Laryngitis

D. Sinusitis


385. When prescribing a drug for treatment of rhinitis and sinusitis, which of the following classes of drugs would not be included?

A. Antihistamines

B. Antipyretics

C. Decongestants

D. Mucolytics


386. Which two of the following valve disorders would not cause paroxysmal nocturnal dyspnoea?

A. Mitral stenosis

B. Mitral prolapse

C. Mitral insufficiency

D. Aortic insuffic9iency


387. The diagnostic test most often performed to assess valvular heart disease is

A. Echocardiogram

B. Electrocardiography

C. Exercise testing

D. Thallium scanning


388. Pitting oedema is a sign for which type of valvular disease

A. Mitral valve stenosis and insufficiency

B. Aortic valve stenosis and insufficiency

C. Both aortic and mitral valve insufficiency

D. Mitral valve prolapsed


389. The main cause of heart failure is related to which of the following conditions?

A. Renal failure

B. Myocardial infarction/coronary artery disease

C. High fat diet

D. Hypertension


390. Drug therapy for heart failure include

A. Inotropic agents to increase heart rate

B. Sympathomimemtics to decrease contractility

C. Diuresis to increase the cardiac period

D. Vasodilators to decrease systemic resistance


391. Assessment findings of a client with right sided heart failure is most likely to include

A. Dependent oedema

B. Weight loss

C. Hypotension

D. Angina


392. A client with congestive heart failure is suspected of having pulmonary oedemA. To diagnose pulmonary oedema, the test that is most useful is

A. Pulmonary artery catheterisation

B. Thallium scan

C. Arterial Blood Gas

D. Lung scan




393. Leukaemia is classified as which of the flowing type of disease?

A. Nutritional

B. Infectious

C. Neoplastic

D. Allergic


394. The sites commonly used for bone marrow biopsies are

A. Sternum and iliac crest

B. Sternum and femur

C. Skull and femur

D. Radius and skull


395. A patient with leukaemia having an elevated temperature may be due to

A. Dehydration

B. Brain damage

C. Penicillin hypersensitivity

D. Hypermetabolism


396. Which of the following symptoms should be observed for in patient with coronary heart disease?

I. Pallor

II. Diaphoresis

III. Anxiety

IV.  Breathlessness

V.  Vomiting

A. I and II

B. II and IV

C. All but V

D. All the above


397. Excessive alcoholism is a predisposing cause of all underlisted diseases except

A. Cancer of lungs

B. Liver cirrhosis

C. Mental illness

D. Peptic ulcer


398. In blood transfusion reaction, the nurse

A. Informs the doctor

B. Give antihistamine

C. Clip off the transfusion

D. Give diuretics


399. Haemolytic anaemia is characterised by

A. An increased in red and white blood cells count

B. Abnormality of red blood cells

C. Decreased in red blood cells count

D.  Over destruction of red blood cells


400. Mr Asuming will be given digitalis. The effect of digitalis is to

A. Increase the heart rate and weaken contractions

B. Slow the  heart rate and strengthen contractions

C. Decrease cardiac output

D. Decrease renal blood flow


401. The observations to be made on a patient with cardiac failure include

I. Blood pressure

II. Weight

III. Intake and output

IV.  Bowel movement

A. I and III only

B. I, III and IV only

C. I, II and III only

D. I, II and IV only


402. The cause of elephantiasis may be

A. Filarial

B. Bacterial

C. Fungal

D. Idiopathic


403. The flaring of the alae nasi in an individual with bronchial asthma is probably a manifestation of

A. Acute anxiety

B.  Inspiration difficulty

C. Physical exhaustion

D. Respiratory acidosis


404. The main intracellular cation is

A. Na+

B. Ca+

C. Mg+

D.  K+

405. Which of the following organs play a major role in regulating fluid and electrolyte balance?

A. Kidneys

B. Adrenal gland

C. Liver

D. Skin



406. When the solutions on both sides of a permeable membrane have established equilibrium or are equal in concentration, they are said to be

A.  Hypertonic

B.  Isotonic

C. Hypotonic

D. Normotonic




407. When a solution contains a lower concentration of salt than the other solutions, it is

A. Hypertonic

B. Isotonic

C. Hypotonic

D. Normotonic


408. Extracellular fluid basically contains

A. Transcellular and interstitial

B. Third space and interstitial

C. Plasma and interstitial

D. Intracellular and transcellular


409. The force of fluid pressing outward against some surfaces is known as

A. Filtration force

B.  Hydrostatic force

C. Osmotic force

D. Diffusion


410. A nurse is caring for a client with suspected diagnosis of hypocalcaemiA. Which of the following signs would not be an indication of this diagnosis?

A. Hypotonicity of the muscles

B. Twitching

C. Hyperactice bowel sounds

D. Positive Trousseau’s sign




411. Which of the following food items contains the least amount of calcium

A. Butter

B. Milk

C. Spinach

D. Broccoli


412. Which of the following is a hypotonic intravenous solution

A. 0,45% saline

B. 5% dextrose

C. 10% dextrose

D. 5% dextrose in 0.9% saline


413.  What is the tonicity of intravenous Ringer’s Lactate solution?

A. Normotonic

B.  Isotonic

C. Hypotonic

D. Hypertonic


414. A physician documents approximately 500mls of insensible fluid loss per day in a patient progress notes. The nurse understands that this type of fluid loss can occur through

A. G I tract

B.  Urinary output

C. Wound drainage

D. The skin


415. Community pneumonia occurs within the first…………… of hospitalisation

A. 24 hours

B. Week

C. 48 hours

D. Two weeks


416. The closure or collapse of the alveoli is known as

A. Atelectasis

B. Arteriosclerosis

C. Epistaxis

D. Sleep apnoea


417. The bluish colouration of the skin in respiratory condition is known as

A. Clubbing

B. Dyspnoea

C. Haemoptysis

D.  Cyanosis


418. Red blood cell production is controlled by

A. Kidney

B. Liver

C. Pancreas

D. Spleen


419. A client with pyrexia would demonstrate

A. Dyspnoea

B. Elevated blood pressure

C. Increased pulse rate

D. Precordial pain


420. Which of the following is not undertaken to assess fluid status?

A. Abdominal girth

B. Daily weight

C. Intake and output

D.  Elevation of lower extremities


421. Paracentesis is the removal of fluid (ascites) from the

A. Abdominal cavity

B.  Peritoneal cavity

C. Peritoneum

D. Pleural cavity


422. The following are functions of liver except

A. Conversion of glucose to glycogen

B. Deamination of amino acid

C. Storage of vitamin B6

D.  Synthesis of vitamin A


423. Normal renal function is necessary for the maintenance of

A. Bicarbonates

B. Calcium

C. Potassium

D. Sodium


424. Assessment of pain in a patient involves the following except

A. Determining whether the pain is severe

B. Identifying the factors that influence the pain and the patient’s response

C. Observing the patient’s behavioural response

D.  Determining whether the pain is acute or chronic





425. Which of the following conditions is often referred to as a “silent killer”?

A. Cerebrovascular accident

B.  Congestive heart failure

C. Hypertension

D. Chronic renal failure


426. Which of the following enzymes is present in the small intestines?

A. Chemotrypsinogen

B.  Enterokinase

C. Peptides

D. Erepsin


427. Which of the following cannot be digested by humans?

A. Glycogen

B. Starch

C. Cellulose

D. Collagen


428. Hyperthyroidism is characterised by

A. Increased bone ressorption

B.  Elevated serum phosphate

C. Increased neuromuscular activity

D. A and C


429. Adrenal insufficiency is the same as

A. Myxoedema

B. Cushing’s syndrome

C. Phaechromocytoma

D.  Addison’s disease


430. Hypothyroidism is characterised by

A. Sweating

B. Fluid retention

C. High respiratory rate

D. Pulse rate increased


431. Signs and symptoms of myxoedema include

A. Intolerance of heat

B.  Dry skin

C. Sweating

D. Hair loss


432. Simple goitre can be prevented through dietary intake of

A. Fresh water fish

B. Cabbage

C. Iodised salt

D. Antithyroid agents


433. The major clinical feature that brings clients with acute pancreatitis to the hospital is

A. Severe abdominal pain

B. Severe headache

C. Nausea and vomiting

D. Oedema


434. Chronic pancreatitis is usually due to

I. Alcohol consumption

II. Increased consumption of protein

III. Malnutrition

IV.  Narcotic use


A. I and II

B.  I and III

C. II and IV

D. III and IV


435. In planning a diet for a patient with diabetes mellitus, the percentage of fat required is

A. 12 – 20%

B.  Less than 30%

C. 50 – 60%

D. More than 60%


436. The following are all complications of diabetes mellitus except

A. Retinopathy

B. Nephropathy

C. Diabetic ketoacidosis

D.  Myxoedema coma


437. Which of the following is a manifestation of tetany?

A. Hypercalcaemia

B.  Hypocalcaemia

C. Hyponatraemia

D. Hypernatraemia


438. In diabetes insipidus, polyuria is as a result of

A. Deficiency in vasopressin secretion

B. Excessive antidiuretic hormone

C. Excessive fluid intake

D. Increased appetite


439. The nurse assists the patient with dietary management of diabetes mellitus with the knowledge that diabetic diet is designed

A. To be used only for type 1 diabetes

B. For use during periods of high stress

C. To normalise blood glucose through a balanced diet

D. To normalise blood glucose by elimination of sugar


440. An important nursing intervention when caring for a client with Cushing’s Syndrome is to

A. Restrict protein intake

B. Observe for signs of hypotension

C. Protect the patient from exposure to infections

D. Administer corticosteroids in equal doses


441. In developing a plan of care for a patient with Grave’s disease, a nurse would include in the plan of care

A. Provision of three small meals per day

B. Provide patient with extra blanket

C. Provide a restful environment

D. Provide high fibre diet


442. The skin perform the following functions except

A. Protects the internal organs

B.  Permits microorganisms through it

C. Maintains a stable normal environment

D. Prevents excessive loos of heat


443. Where are the nerves controlling the respiratory centre situated?

A. Cerebrum

B. Cerebellum

C. Medulla oblongata

D. Pons varoli


444. Which of the following cartilages is the most prominent part of the larynx?

A. Arytenoids cartilage

B. Cricoid cartilage

C. Epiglottis

D. Thyroid cartilage


445. Pepsin starts the digestion of which of the following in the stomach?

A. Carbohydrates

B.  Proteins

C. Fats

D. Mineral salt


446. The liver receives blood from the hepatic artery and the

A. Aorta

B. Inferior vena cava

C. Portal vein

D. Hepatic duct


447. Micturition occurs as a result of

I. Decrease pressure in the pelvic

II. Contractions of muscular wall of the bladder

III. Reflex relaxation of the internal sphincter

IV.  Voluntary relaxation of the external sphincter

A. I and II only

B. II and III only

C. I, II and IV only

D.  II, III and IV only


448. Interchange of gases in the lungs takes place in the

A. Alveoli

B. Bronchioles

C. Lobe

D. Lobule


449. Which of the following is not part of the root of the teeth?

A. Dentine

B.  Cement

C. Pulp

D. Enamel


450. The processes involved in the formation of urine include the following Except

A. Secretion

B. Selective absorption

C. Micturition

D. Filtration

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