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
A. AIDS
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
B. PRN
C. SOS
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. Negative.ly 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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