State exams

Question 1

You are caring for bill, a 50 year old man who has been hospitalised with a possible
diagnosis of pancreatitis

Which of the following symptoms would you anticipate observing in bill
a) Elevated white blood cell count, ankle oedema and right groin pain
b) Left upper quadrant abdominal pain, nausea, and vomiting
c) Hypoglycaemia, hypertension, and hypochondrial pain
d) Epigastric pain, pyrexia, and elevated white blood cell count

Answer 1

b) Left upper quadrant abdominal pain, nausea, and vomiting

Question 2

You are caring for bill, a 50 year old man who has been hospitalised with a possible
diagnosis of pancreatitis

The initial diagnosis of pancreatitis would be confirmed if bills blood test showed a
significant elevation in serum
a) Amylase
b) Glucose
c) Potassium
d) Trypsin

Answer 2

a) Amylase

Question 3

You are caring for bill, a 50 year old man who has been hospitalised with a possible
diagnosis of pancreatitis

Pain control is an important nursing goal. Which of the following medications would
be the drug of choice
a) Pethidine
b) Cimetidine
c) Morphine
d) Codeine

Answer 3

c) Morphine

Question 4

You are caring for bill, a 50 year old man who has been hospitalised with a possible
diagnosis of pancreatitis

You monitor bills vital signs frequently, observing for the signs of shock. Shock is
extremely difficult to manage in pancreatitis primarily because of the
a) Frequency and severity of gastrointestinal haemorrhage
b) Vasodilating effects of kinin peptides
c) Tendency towards congestive heart failure
d) Frequent incidence of acute tubular necrosis

Answer 4

a) Frequency and severity of gastrointestinal haemorrhage

Question 5

You are caring for bill, a 50 year old man who has been hospitalised with a possible
diagnosis of pancreatitis

While helping bill change position in bed, you note bill has muscle twitching in his
bands and forearms. These symptoms are significant because clients who suffer from
pancreatitis are at risk of
a) Hypermagnisemia
b) Hypoglycaemia
c) Hypocalcaemia
d) Hyponatremia

Answer 5

c) Hypocalcaemia

Question 6

You are caring for bill, a 50 year old man who has been hospitalised with a possible
diagnosis of pancreatitis

Bill does not drink alcohol because of his religious beliefs. When the physician
persists in asking him about his alcohol intake, bill becomes annoyed. You explain the
reasoning behind the questioning by telling bill that
a) There is a strong link between alcohol use and pancreatitis
b) Alcohol intake can interfere with some of the tests used to diagnose pancreatitis
c) Alcoholism is a major health problem and all hospitalised clients are asked about
their alcohol intake
d) The physician must obtain the pertinent facts, and religious beliefs cannot be
considered

Answer 6

c) Alcoholism is a major health problem and all hospitalised clients are asked about
their alcohol intake

Question 7

A home care nurse begins caring for a 25 year old female called Lydia who has just
been diagnosed with human immunodeficiency virus (HIV)

7. Lydia asks the nurse, ‘how could this have happened?” the nurse responds to the
   question based on the most frequent mode of HIV transmission, which is

a) Hugging an HIV positive sexual partner without using barrier precautions
b) Inhaling cocaine or other recreational drugs
c) Sharing a drink bottle with an HIV positive person
d) Sexual intercourse with an HIV positive person without using a condom

Answer 7

d) Sexual intercourse with an HIV positive person without using a condom

Question 8

8. The physician prescribes zidovudine (AZT) a drug that acts to help

a) Destroy the virus
b) Enhance the body’s antibody production
c) Slow replication of the virus
d) Neutralise toxin; produced by the causative organism

Answer 8

c) Slow replication of the virus

Question 9

9. Lydia acquires herpes genitalis and is counselled by the nurse concerning follow up
   care. Women who have this disease are at risk of developing

a) Sterility
b) Cervical cancer
c) Uterine fibroid rumours
d) Irregular menses

Answer 9

d) Irregular menses

Question 10

10. Which of the following nursing diagnosis categories would most likely be a priority
    for a client with herpes genitalis

a) Alteration in sleep; sleep pattern disturbance
b) Nutritional deficit
c) Alteration in comfort pain
d) Alteration in breathing patterns

Answer 10

c) Alteration in comfort pain

Question 11

11. The primary reason that a herpes simplex infection is a serious concern to a client
    with HIV infection is that herpes simplex

a) Is an acquired immunodeficiency virus (AIDS) defining illness
b) Is curable only after 1 year of antiviral therapy
c) Can lead to cervical cancer
d) Causes severe electrolyte imbalances

Answer 11

a) Is an acquired immunodeficiency virus (AIDS) defining illness

Question 12

12. In providing education to Lydia, the nurse should take into account the fact that the
    most effective method known to control the spread to HIV infection is

a) Premarital serologic screening
b) Prophylactic treatment of exposed people
c) Laboratory screening of pregnant women
d) Ongoing sex education about preventive behaviours

Answer 12

d) Ongoing sex education about preventive behaviours

Question 13

13. Lydia becomes depressed about her diagnosis and tells the nurse “I have nothing
    worth living for now.” Which of the following statements would be the best response
    by the nurse

a) There is much to live for; you may not develop AIDS for years
b) You should not be too depressed; we are searching to find a cure for AIDS
c) You are right; it is very depressing to have HIV
d) Tell me more about how you are feeling at being HIV positive

Answer 13

d) Tell me more about how you are feeling at being HIV positive

Question 14

James, a 34 year old man attending a sexual health clinic, is diagnosed with syphilis.

14. The organism responsible for causing syphilis is classified as a

a) Virus
b) Fungus
c) Rickettsia
d) Spirochete

Answer 14

d) Spirochete

Question 15

15. The typical chancre of syphilis appears as

a) A grouping of small, tender pimples
b) An elevated wart
c) A painless moist ulcer
d) An itching, crusted area

Answer 15

c) A painless moist ulcer

Question 16

16. When interviewing James, the nurse should anticipate that the most difficult problem
    is likely to be

a) Motivating the client to undergo treatment
b) Obtaining a list of the clients sexual contacts
c) Increasing the clients knowledge of the disease
d) Assuring the client that records are confidential

Answer 16

b) Obtaining a list of the clients sexual contacts

Question 17

17. Probenecid is prescribed in conjunction with penicillin as treatment for syphilis
    because probenecid helps

a) Delay detoxification of penicillin
b) Inhibit excretion of penicillin
c) Maintain sensitivity of organisms to penicillin
d) Decrease the likelihood of an allergic reaction to penicillin

Answer 17

b) Inhibit excretion of penicillin

Question 18

18. A priority nursing diagnosis for a James would likely be

a) High risk for infection transmission related to lack of knowledge about mode of
spread
b) Pain related to cutaneous skin lesions on palms and soles
c) Altered skin tissue perfusion related to a bleeding chancre
d) Image disturbance related to alopecia

Answer 18

a) High risk for infection transmission related to lack of knowledge about mode of
spread

Question 19

An 18 year old female college student is seen at the university health centre. She
undergoes a pelvic examination and is diagnosed with gonorrhoea

19. Which of the following responses by the nurse would be best when the client says that
    she is nervous about the upcoming pelvic examination

a) can you tell me more about how you’re feeling
b) you’re not alone. Most women feel uncomfortable about this examination
c) do not worry about Dr smith. He’s a specialist in female problems
d) we’ll do everything we can to avoid embarrassing you

Answer 19

a) can you tell me more about how you’re feeling

Question 20

20. in education this client, the nurse should emphasise that in women gonorrhoea

a) is often marked by symptoms of dysuria or vaginal bleeding
b) does not lead to serious complications
c) can be treated but not cured
d) may not cause symptoms until complications occur

Answer 20

d) may not cause symptoms until complications occur

Question 21

21. the client informs the nurse that she has had sexual intercourse with her boyfriend and
    asks the nurse ‘would he have any symptoms?’ the nurse responds that in males,
    symptoms of gonorrhoea include

a) impotence
b) scrotal swelling
c) urine retention
d) dysuria

Answer 21

b) scrotal swelling

Question 22

A 24 year old female client, who is on her honeymoon, comes to an ambulatory care
clinic in moderate distress with a probable diagnosis of acute cystitis

22. Which of the following symptoms would the nurse expect the client to report during
    the assessment

a) fever and chills
b) frequency and burning on urination
c) suprapubic pain and nausea
d) dark, concentrated urine

Answer 22

b) frequency and burning on urination

Question 23

23. The client asks the nurse, ‘how did I get this infection?’ the nurse should explain that
    in most instances, cystitis is caused by

a) congenital strictures in the urethra
b) an infection elsewhere in the body
c) urine stasis in the urinary bladder
d) an ascending infection from the urethra

Answer 23

d) an ascending infection from the urethra

Question 24

24. The physician tells the client that the infection has likely been precipitated by sexual
    intercourse and that an antibiotic will be prescribed. The client becomes upset, and
    tearfully asks the nurse if this means she should abstain from intercourse for the rest
    of her honeymoon. What advice should the nurse offer her

a) avoid intercourse until you’ve completed the antibiotic therapy and then limit
intercourse to once a week
b) limit intercourse to once a day in the early morning after your bladder has rested
c) as long as you’re comfortable you can have intercourse as often as you wish; but
be sure to urinate within 15 minutes after intercourse
d) you and your husband can enjoy intercourse as often as you wish. Just make sure
he wears a condom and uses a spermicide

Answer 24

c) as long as you’re comfortable you can have intercourse as often as you wish; but
be sure to urinate within 15 minutes after intercourse

Question 25

25. The client is given a prescription for co trimoxazole (bactrim) for her infection.
    Which of the following statements would indicate that she understands the principles
    of antibiotic therapy

a) I’ll take the pills until I feel better and keep the rest for recurrences
b) I’ll take all the pills as directed on the label
c) I’ll take the pills until the symptoms pass, then reduce the dose by half
d) I’ll take all the pills and then have the prescription renewed once

Answer 25

b) I’ll take all the pills as directed on the label

Question 26

Winston, a 22 year old man, is brought to the emergency room with an apparent head
injury after being involved in a motor vehicle accident. He is unconscious on arrival and
exhibits signs of increasing intracranial pressure. His fiancée and his older sister
accompany him

26. On Winston’s arrival in the emergency room, which of the following considerations
    should receive the highest priority

a) establishing an airway
b) replacing blood losses
c) stopping bleeding from open wounds
d) determining whether he has a neck fracture

Answer 26

a) establishing an airway

Question 27

27. Which of the following methods would be best, from a legal standpoint, for obtaining
    permission to treat Winston

a) having his sister sign the consent form
b) having two independent doctors agree on the need for treatment
c) obtaining a verbal consent by telephone from his mother
d) obtaining written consent from his fiancée

Answer 27

b) having two independent doctors agree on the need for treatment

Question 28

28. As Winston’s condition worsens, his rising intracranial pressure would be indicated
    by

a) rising blood pressure and falling pulse rate
b) rising pulse rate and falling blood pressure
c) rising blood pressure and rising pulse rate
d) falling pulse rate and falling blood pressure

Answer 28

a) rising blood pressure and falling pulse rate

Question 29

29. the nurse assesses the client frequently for signs of intracranial pressure, including

a) unequal pupil size
b) decreasing systolic blood pressure
c) tachycardia
d) decreasing body temperature

Answer 29

a) unequal pupil size

Question 30

30. which of the following respiratory signs would indicate increasing intracranial
    pressure in the brain stem

a) slow, irregular respirations
b) rapid, shallow respirations
c) asymmetric chest expansion
d) nasal flaring

Answer 30

b) rapid, shallow respirations

Question 31

During the past few months, Elizabeth, a 56 year old woman has felt brief twinges of
chest pain while working, in her garden and has had frequent episodes of indigestion.
She comes to the hospital after experiencing severe anterior chest pain while raking
leaves. Her evaluation confirms a diagnosis of stable angina pectoris

31. Elizabeth states, ‘I really thought I was having a heart attack. How can you tell the
    difference?’ which response by the nurse would provide the client with the most
    accurate information about the difference between the pain of angina and that of
    myocardial infarction

a) The pain associated with a heart attack is much more severe
b) The pain associated with a heart attack radiates into the jaw and down the left arm
c) It is impossible to differentiate angina pain from that of a heart attack without an
ECG
d) The pain of angina is usually relieved by resting or lying down

Answer 31

d) The pain of angina is usually relieved by resting or lying down

Question 32

32. As an initial step in treating elizabeths angina, the physician prescribes nitro-glycerine
    tablets, 0.3 mg given sublingual. This drugs principal effects are produced by

a) Antispasmodic effects on the pericardium
b) Stimulation of a- and 13- receptor sites
c) Vasodilation of peripheral vasculature
d) Improved conductivity in the myocardium

Answer 32

c) Vasodilation of peripheral vasculature

Question 33

33. The nurse teaches Elizabeth that which of the following meals would be best for her
    low cholesterol diet

a) Hamburger, salad, and milkshake
b) Baked liver, green beans, and coffee
c) Spaghetti with tomato sauce, salad, and coffee
d) Fried chicken, green beans, and skim milk

Answer 33

c) Spaghetti with tomato sauce, salad, and coffee

Question 34

34. Which of the following symptoms should the nurse teach Elizabeth to report
    immediately to her physician

a) A change in the pattern of her pain
b) Pain during sexual activity
c) Pain during an argument with her husband
d) During or after an activity such as lawn moving

Answer 34

a) A change in the pattern of her pain

Question 35

35. After stabilisation and treatment, Elizabeth is discharged from the hospital. At her
    follow up appointment, she is discouraged because she is experiencing pain with
    increasing frequency. She states that she visits an invalid friend twice a week and now
    cannot walk up the second flight of steps to the friends apartment without pain. Which
    action can the nurse could suggest that would most likely help the client deal with this
    problem

a) Visit her friend early in the day
b) Rest for at least an hour before climbing the stairs
c) Take a nitro-glycerine tablet before climbing the stairs
d) Lie down once she reaches the friends apartment

Answer 35

c) Take a nitro-glycerine tablet before climbing the stairs

Question 36

36. The nurse teaches Elizabeth that common expected side effects of nitro-glycerine
    include

a) Headache, hypotension, and dizziness
b) Hypertension, flushing and forgetfulness
c) Hypotension, diplopia and shortness of breath
d) Stomach cramps, constipation and urinary frequency

Answer 36

a) Headache, hypotension, and dizziness

Question 37

37. Sublingual nitro-glycerine tablets begin to work within 1 to 2 minutes. How should
    the nurse instruct the client to use the drug when chest pain occurs

a) Take one tablet every 2 to 5 minutes until the pain stops
b) Take one tablet; and rest for 10 minutes. Call the physician if pain persists after 10
minutes
c) Take one tablet, then an additional tablet every 5 minutes for a total of three
tablets. Call the physician if pain persists after 3 tablets
d) Take one tablet; if pain persists after 5 minutes, take two tablets. If pain still
persists 5 minutes later, call the physician

Answer 37

c) Take one tablet, then an additional tablet every 5 minutes for a total of three
tablets. Call the physician if pain persists after 3 tablets

Question 38

38. Which of the following points should the nurse include when instructing the client
    with angina about sublingual nitro-glycerine

a) The drug will cause your urine to turn bright orange
b) Store the tablets in a tight, light resistant container
c) Use the tablets only when the pain is severe
d) The shelf life of nitro-glycerine is up to 2 years

Josie, a 38 year old woman is admitted to the emergency room after being found
unconscious at the wheel of her car in the hospital car park. Josie is comatosed
and does not respond to stimuli. A drug overdose is suspected

Answer 38

b) Store the tablets in a tight, light resistant container

Question 39

39. Which of the following assessment findings would lead the nurse to suspect that the
    coma is a result of a toxic drug overdose

a) Hypertension
b) Hyperpyrexia
c) Dilated pupils
d) Facial asymmetry

Answer 39

c) Dilated pupils

Question 40

40. Blood and urine analysis confirm a diagnosis of salicylate overdose. Josie is treated
    with activated charcoal, which would be administered by

a) Intravenous infusion
b) Nasogastric tube
c) Rectal infusior
d) Oral tablets

Answer 40

b) Nasogastric tube

Question 41

41. What specific potential adverse effect of charcoal administration to josie must the
    nurse be aware and guard against

a) Anaphylaxis
b) Renal failure
c) Aspiration
d) Cardiac arrest

Answer 41

c) Aspiration

Question 42

42. The nurse observes that josie’s right eye does not close totally. Based on this finding,
    which of the following nursing interventions would be most appropriate

a) Making sure josie wears dark glasses to avoid photosensitivity
b) Irrigate her right eye with saline each duty to avoid dryness
c) Instilling neomycin eye drops to prevent conjunctivitis
d) Tape the eyelid down to keep it closed between cares

Answer 42

b) Irrigate her right eye with saline each duty to avoid dryness

Question 43

43. The nursing goal for performing passive range of motion exercises for an unconscious
    client such as josie would be to

a) Preserve muscle mass
b) Prevent bone demineralisation
c) Increase muscle tone
d) Maintain joint mobility

Answer 43

d) Maintain joint mobility

Question 44

44. When the nurse performs oral hygiene for josie, whilst she is still unconscious, which
    of the following actions would be most appropriate

a) Use manual instead of mechanical ventilation
b) Keep suction apparatus available
c) Place josie in a prone position
d) Wear sterile gloves

Answer 44

b) Keep suction apparatus available

Question 45

45. When assessing josies respiratory status, which of the following symptoms may be an
    early indicator of hypoxia

a) Cyanosis
b) Decreased respirations
c) Restlessness
d) Hypotension

Answer 45

c) Restlessness

Question 46

A 34 year old Japanese tourist, takayuki hamadi, is admitted to the hospital after
experiencing multiple trauma as a result of an automobile accident. He has three
fractured ribs, a hairline fracture of the pelvis, a compound fracture of his right tibia
and fibula, and soft tissue injuries. He is in severe pain when he arrives on the unit after
emergency surgery

46. Takayuki reports severe pain and requests frequent medication. A nursing assistant
    expresses her surprise, saying, ‘I thought asian people were very stoic about pain.
    ‘ your initial course of action should be

a) Reprimand her immediately and apologise to takayuk’s family
b) Discuss her behaviour with her after you leave the room
c) Do nothing as takayuk’s understanding of English is poor
d) Report her to the charge nurse

Answer 46

b) Discuss her behaviour with her after you leave the room

Question 47

STATE EXAMS 2

1. According to eriksons theory of emotional development, infants will develop a sense
   of trust when

a) They can identify their mother and father
b) They feel a sense of belonging, accepted as part of the family
c) They can predict what is coming and needs are consistently met
d) Nutritional and hygiene needs are provided on a daily basis

Answer 47

c) They can predict what is coming and needs are consistently me

Question 48

2. Baby john was admitted with streptococcal pharyngitis. Upon discharge his mother
   was told to return to the doctors in 2 weeks with a urine specimen. The urine would
   mostly be examined

a) For fat and lipids to see if the kidneys are working
b) For protein to determine if acute glomerulonephritis is developing
c) To determine if the child is developing otitis media
d) To determine if the child should be kept on a liquid diet or progressed to a soft

Answer 48

b) For protein to determine if acute glomerulonephritis is developing

Question 49

3. Reduction of complications of rheumatic fever can be accomplished through which of
   the following interventions

a) Administration of penicillin to children with strep throat or impetigo
b) Beginning speech therapy to reserve damage after antibiotics are completed
c) Pushing children with chorea to perform activities requiring fine motor movement
to strengthen muscles
d) Withholding salicylates to prevent joint haemorrhage

Answer 49

a) Administration of penicillin to children with strep throat or impetigo

Question 50

4. Newborns with heart disease are frequently brought to health professionals initially
   because the infant is having

a) Difficulty sleeping
b) Irritability and restlessness
c) Difficulty feeding
d) Cyanotic spells

Answer 50

c) Difficulty feeding

Question 51

5. In heart defects in which a connection exists between the right and left heart, the
   blood through the connective structure flows most commonly

a) Right to left
b) Left to right
c) Bi directionally
d) Through the mitral and tricuspid valves

Answer 51

b) Left to right

Question 52

6. Amy is 3 months old, with a 2 day history of vomiting. Which of the following is
   NOT indicative of a decreased hydration status

a) Sunken fontanelle
b) Decreased number of wet nappies
c) Skin that is hot to the touch
d) Increased heart rate

Answer 52

c) Skin that is hot to the touch

Question 53

7. Erikson’s theory of human development describes

a) Eight psychosocial crises all people are thought to face
b) Four psychosocial stages and a period of latency
c) The same number of stages as Freud but with different names
d) A stage theory that is not psychoanalytic

Answer 53

a) Eight psychosocial crises all people are thought to face

Question 54

8. According to Piaget, the stage of cognitive development that generally characterises
   pre school children is the

a) Preoperational stage
b) Sensorimotor stage
c) Oral stage
d) Psychosocial stage

Answer 54

a) Preoperational stage

Question 55

9. The cephalo-caudal and proximo-distal patterns of development apply to

a) The upper extremities only
b) Physical growth, but not to motor skills
c) Variations in the timing of motor skills acquisition
d) Motor abilities as well as physical growth

Answer 55

d) Motor abilities as well as physical growth

Question 56

10. An infant who weighs 4kg is prescribed 0.2mg/kg (IV) of morphine sulphate. You
    have an ampoule of 10mg in 1ml. the volume to be administered is

a) 8 mls
b) 0.8 mls
c) 0.08 mls
d) 0.8 mgs

Answer 56

c) 0.08 mls

Question 57

11. Pediculosis is common childhood infestation. It is commonly known as

a) Pin worms
b) Foot eczema
c) Head lice
d) Scabies

Answer 57

c) Head lice

Question 58

12. A child who weighs 20 kgs is prescribed 300 mg of paracetamol. The stock supply is
    120 mg in 5 mls. The volume to be administered is

a) 1.25mls
b) 125mls
c) 125mgs
d) 12.5mls

Answer 58

d) 12.5mls

Question 59

13. Match the following sequence of milligrams to micrograms
    10.0mg, 0.012mg, 0.40mg, 0.08mg

a) 1000.0 micrograms, 120.0 micrograms, 400.0 micrograms, 8.0 micrograms
b) 10000 micrograms, 12.0 micrograms, 40.0 micrograms, 80.0 micrograms
c) 10000 micrograms, 12.0 micrograms, 400 micrograms, 80.0 micrograms
d) 1000 micrograms, 1.2 micrograms, 4.0 micrograms, 0.08 micrograms

Answer 59

c) 10000 micrograms, 12.0 micrograms, 400 micrograms, 80.0 micrograms

Question 60

14. All infants should have their head circumference measured at health visits. This
    measurement is made from

a) Just above the eyebrows through the prominent part of the occiput
b) The center of the forehead to the base of the occiput
c) The hairline in front to the hairline in back
d) The middle of the forehead through the parietal prominence

Answer 60

a) Just above the eyebrows through the prominent part of the occiput

Question 61

15. While caring for a child recovering from viral pneumonia, you examine his lungs for
    evidence of exudate and fluid. Which finding would suggest cause for concern

a) A respiratory rate of 20 heard on auscultation
b) Dullness of his lower lobes heard on percussion
c) A longer inspiratory than expiratory rate noticed on inspection
d) Fine rhonchi heart in the upper lobe on auscultation

Answer 61

b) Dullness of his lower lobes heard on percussion

Question 62

16. To straighten an infant’s ear canal to examine it, you would pull the pinna

a) Down and back
b) Down and forward
c) Up and back
d) Up and forward

Answer 62

a) Down and back

Question 63

17. A child who has an arterial blood gas that depicts respiratory acidosis will show

a) pH is acidic, PaO2 is raised and PaCO2 is raised
b) pH is acidic, PaO2 is raised and PaCO is lowered
c) pH is acidic, PaO2 is lowered and PaCO2 is raised
d) pH is alkalotic, PaO2 is lowered and Pa CO2 is raised

Answer 63

c) pH is acidic, PaO2 is lowered and PaCO2 is raised

Question 64

18. You take an infant’s apical pulse before administering digoxin. What is the usually
    accepted level of pulse rate considered safe for administering digoxin to an 8 month
    old baby

a) 60 bpm
b) 80 bpm
c) 100 bpm
d) 150 bpm

Answer 64

c) 100 bpm

Question 65

19. Which of the following nursing diagnosis would best apply to a child with rheumatic
    fever

a) Ineffective breathing pattern related to cardiomegaly
b) Activity intolerance related to inability of heart to sustain extra workload
c) Sleep pattern disturbance related to hyperexcitability
d) High risk of violence related to development of cerebral anoxia

Answer 65

b) Activity intolerance related to inability of heart to sustain extra workload

Question 66

20. Bronchiolitis is a common __________ infection, which peaks in incidence in
    children aged __________. Symptoms usually peak around day __________

a) Viral, less than two years of age, three to five
b) Viral, less than six months, ten
c) Bacterial, less than two years, three to five
d) Bacterial, less than six months, three to five

Answer 66

a) Viral, less than two years of age, three to five

Question 67

21. Generally, the child most likely to ingest a poison is

a) 10 months to 18 months
b) 1 to 4 years
c) 4 to 5 years
d) 13 to 15 years

Answer 67

b) 1 to 4 years

Question 68

22. The responsibility of the nurse caring for a victim of child abuse in the emergency
    room would include which of the following

a) Prohibiting her parents from visiting with the child until more facts are obtained
b) Asking the parents if they have been abusing their child
c) Suggesting to the medical staff that the child be admitted for observation
d) Asking the child what they were doing that led to abuse

Answer 68

c) Suggesting to the medical staff that the child be admitted for observation

Question 69

23. Which of the following statements is NOT true

a) Health professionals recommend exclusive breast feeding until the age of 4
months
b) Uterine involution is slowed by breast feeding
c) Almost all drugs are excreted to some extent in breast mild
d) Oxytocin is released by breastfeeding

Answer 69

b) Uterine involution is slowed by breast feeding

Question 70

24. Which of the following statements is NOT true of Reyes syndrome

a) Most commonly occurs In young school age children
b) Most commonly occurs after a viral infection
c) Symptoms include severe vomiting, irritability, lethargy and confusion
d) Aspirin is the treatment of choice

Answer 70

d) Aspirin is the treatment of choice

Question 71

25. Which of the following statements is NOT true of bacterial meningitis

a) Bacterial meningitis often presents with flu like symptoms initially
b) A rash may or may not be present
c) There is usually no associated temperature rise
d) A rash, if present, does not blanch under direct pressure

Answer 71

c) There is usually no associated temperature rise

Question 72

26. Fill in the gaps in the following statement
    Type I (insulin dependent) diabetes is characterised by almost no __________
    secretion. This contributes to a build up of __________ in the blood stream. If
    exogenous insulin is not administered __________ and __________ will develop

a) Insulin, glucose, hyperglycaemia and ketoacidosis
b) Glucose, insulin, hyperglycaemia and ketoacidosis
c) Glucose, insulin, hypoglycaemia, and unconsciousness
d) Insulin, hormones, ketoacidosis and unconsciousness

Answer 72

a) Insulin, glucose, hyperglycaemia and ketoacidosis

Question 73

27. The grandmother has brought an infant to the clinic for a check up and has signed the
    consent for immunization administration. Which of the following would the nurse do
    first

a) ask who the infants legal guardian is
b) notify the physician immediately
c) administer the immunizations ordered
d) call the infant’s mother for verbal consent

Answer 73

a) ask who the infants legal guardian is

Question 74

28. Which of the following would the nurse explain to the mother of a child receiving
    digoxin (lanoxin) as the primary reason for giving this drug

a) To relax the walls of the hearts arteries
b) To improve the strength of the heartbeat
c) To prevent irregularities in ventricular contractions
d) To decrease inflammation of the heart wall

Answer 74

b) To improve the strength of the heartbeat

Question 75

29. Paralysis in an individual with a meningomyelocele usually occurs

a) In the motor sphere below the level of the deformity
b) In the motor and sensory spheres below the level of the deformity
c) In the motor sphere above the deformity
d) In the motor and sensory spheres above the deformity

Answer 75

b) In the motor and sensory spheres below the level of the deformity

Question 76

30. During the acute state of meningitis, a 3 year old child is restless and irritable. Which
    of the following would be most appropriate to institute

a) Hemorrhagic skin rash
b) Edema
c) Cyanosis
d) Dyspnea on exertion

Answer 76

a) Hemorrhagic skin rash

Question 77

31. Which of the following would first alert the nurse to suspect that a child with severe
    gastroenteritis who has been receiving intravenous therapy for the past several hours
    may be developing circulatory overload

a) A drop in blood pressure
b) Change to slow, deep respirations
c) Auscultation of moist crackles
d) Marked increase in urine output

Answer 77

c) Auscultation of moist crackles

Question 78

32. The causative organism for rheumatic fever is

a) Haemophilus influenzae
b) Staphylococcus bacteria
c) Syncytial virus
d) Group A streptococcal bacteria

Answer 78

d) Group A streptococcal bacteria

Question 79

33. The most serious complication of rheumatic fever is

a) Endocarditis
b) Pneumonia
c) Arthritis
d) Meningitis

Answer 79

a) Endocarditis

Question 80

34. When preparing the teaching plan for the mother of a child with asthma, which of the
    following would the nurse include as signs to alert the mother that her child is having
    an asthma attack

a) Secretion of this, copious mucous
b) Tight, productive cough
c) Wheezing on expiration
d) Temperature of 37.4oC

Answer 80

c) Wheezing on expiration

Question 81

35. A 10 year old child with a history of asthma uses an inhaled bronchodilator only when
    needed. He takes no other medications routinely. His best peak expiratory flow rate is
    270 L/min. The child’s current peak flow reading is 180 L/min. the nurse interprets
    this reading as indicating which of the following

a) The child’s asthma is under good control, so the routine treatment plan should
continue
b) The child needs to start a short acting inhaled B2 agonist medication
c) This is medical emergency requiring a trip to the emergency department for
treatment
d) The child needs to begin treatment with inhaled cromolyn sodium (intal) for
asthma control

Answer 81

d) The child needs to begin treatment with inhaled cromolyn sodium (intal) for
asthma control

Question 82

36. An 8 year old child with asthma states, I want to play some sports like my friends.
    What can I do. The nurse responds to the child based on the understanding of which
    of the following

a) Physical activities are inappropriate for children with asthma
b) Children with asthma must be excluded from team sports
c) Vigorous physical exercise frequently precipitates an asthmatic episode
d) Most children with asthma can participate in sports if the asthma is controlled

Answer 82

d) Most children with asthma can participate in sports if the asthma is controlled

Question 83

37. After instructing a mother about normal reflexes of term neonates, the nurse
    determines that the mother understands the instructions when she describes the tonic
    neck reflex as occurring when the neonate does which of the following

a) Steps briskly when held upright near a firm, hard surface
b) Pulls both arms and does not move the chin beyond the point of the elbows
c) Turns head to the left, extends left extremities, and flexes right extremities
d) Extends and abducts the arms and legs with the toes fanning open

Answer 83

c) Turns head to the left, extends left extremities, and flexes right extremities

Question 84

38. After talking with the parents of a child with down’s syndrome, which of the
    following would the nurse identify as an appropriate goal for care of the child

a) Encouraging self care skills in the child
b) Teaching the child something new every day
c) Encouraging more lenient behaviour limits for the child
d) Achieving age appropriate social skills

Answer 84

d) Achieving age appropriate social skills

Question 85

39. After teaching a group of school teachers about seizures, the teachers’ role play a
    scenario involving a child experiencing a generalised tonic clonic seizure. Which of
    the following actions, when performed first, indicates that the nurses teaching has
    been successful

a) Asking the other children what happened before the seizure
b) Moving the child to the nurses office for privacy
c) Removing any nearby objects that could harm the child
d) Placing a padded tongue blade between the child’s teeth

Answer 85

c) Removing any nearby objects that could harm the child

Question 86

40. Which of the following statements obtained from the nursing history of a toddler
    would alert the nurse to suspect the child has had a febrile seizure

a) The child has had a low grade fever for several weeks
b) The family history is negative for convulsions
c) The seizure resulted in respiratory arrest
d) The seizure occurred when the child had a respiratory infection

Answer 86

d) The seizure occurred when the child had a respiratory infection

Question 87

41. Which of the following, if described by the parents of a child with cystic fibrosis,
    indicates that the parents understand the underlying problem of the disease

a) An abnormality in the body’s mucus secreting glands
b) Formation of fibrous cysts in various body organs
c) Failure of the pancreatic ducts to develop properly
d) Reaction to the formation of antibodies against streptococcus

Answer 87

a) An abnormality in the body’s mucus secreting glands

Question 88

42. The nurse judges that the mother understands the term cerebral palsy when she
    describes it as a term applied to impaired movement resulting from which of the
    following

a) Injury to the cerebrum caused by viral infection
b) Malformed blood vessels in the ventricles caused by inheritance
c) Non progressive brain damage caused by injury
d) Inflammatory brain disease caused by metabolic imbalances

Answer 88

c) Non progressive brain damage caused by injury

Question 89

43. The mother asks the nurse whether her child with hemiparesis due to spastic cerebral
    palsy will be able to walk normally because he can pull himself to a standing position.
    Which of the following responses by the nurse would be most appropriate

a) Ask the doctor what he thinks at your next appointment
b) Maybe, maybe not. How old were you when you first walked
c) It’s difficult to predict but his ability to bear weight is a positive factor
d) If he really wants to walk, and works hard, he probably will eventually

Answer 89

c) It’s difficult to predict but his ability to bear weight is a positive factor

Question 90

44. A father brings his 3 month old infant to the clinic, reporting that the infant has a cold,
    is having trouble breathing and just doesn’t seem to be acting right. Which of the
    following actions would the nurse do first

a) Check the infants heart rate
b) Weight the infant
c) Assess the infants oxygen saturation
d) Obtain more information from the father

Answer 90

c) Assess the infants oxygen saturation

Question 91

45. In preparation for discharge, the nurse teaches the mother of an infant diagnosed with
    bronchiolitis about the condition and its treatment. Which of the following statements
    by the mother indicates successful teaching

a) I need to be sure to take my child’s temperature everyday
b) I hope I don’t get a cold from my child
c) Next time my child gets a cold I need to listen to the chest
d) I need to wash my hands more often

Answer 91

d) I need to wash my hands more often

Question 92

46. When developing the plan for care for a child with early duchennes muscular
    dystrophy, which of the following would the nurse identify as the primary nursing
    goal for the child

a) Encouraging early wheelchair use
b) Fostering social interactions
c) Maintaining function of unaffected muscles
d) Prevent circulatory impairment

Answer 92

c) Maintaining function of unaffected muscles

Question 93

47. Which of the following would be an important assessment finding for an 8 month old
    infant admitted with severe diarrhoea

a) Absent bowel sounds
b) Pale yellow urine
c) Normal skin elasticity
d) Depressed anterior fontanel

Answer 93

d) Depressed anterior fontanel

Question 94

48. When obtaining the initial health history from a 10 year old child with abdominal pain
    and suspected appendicitis, which of the following questions would be most helpful in
    eliciting data to help support the diagnosis

a) Where did the pain start
b) What did you do for the pain
c) How often do you have a bowel movement
d) Is the pain continuous or does it let up

Answer 94

a) Where did the pain start

Question 95

49. Which of the following would first alert the nurse to suspect that a child with severe
    gastroenteritis who has been receiving intravenous therapy for the past several hours
    may be developing circulatory overload

a) A drop in blood pressure
b) Change to slow, deep respirations
c) Auscultation of moist crackles
d) Marked increase in urine output

Answer 95

c) Auscultation of moist crackles

Question 96

50. The stool culture of a child with profuse diarrhoea reveals salmonella bacilli. After
    teaching the mother about the course of salmonella enteritis, which of the following
    statements by the mother indicates effective teaching

a) Some people become carriers and stay infectious for a long time
b) After the acute state passes, the organism is usually not present in the stool
c) Although the organism may be alive indefinitely, in time it will be of no danger to
anyone
d) If my child continues to have the organism in the stool, an antitoxin can help
destroy the organism

Answer 96

a) Some people become carriers and stay infectious for a long time

Question 97

51. A mother of a 1 month old infant state that she is curious as to whether her infant is
    developing normally. Which of the following developmental milestones would the
    nurse expect the infant to perform

a) Smiling and laughing out loud
b) Rolling from side to side
c) Holding a rattle briefly
d) Turning the head from side to side

Answer 97

d) Turning the head from side to side

Question 98

52. A child is to receive Trilafon 24 mg po BD. The medication is available as 16 mg/5ml.
    how may ml will you administer

a) 3.3
b) .75
c) 7.5
d) 0.3

Answer 98

c) 7.5

Question 99

53. Which of the following age groups are most susceptible to meningococcal meningitis

a) Children below 5 years of age
b) Children between 3.6 years (preschool)
c) School age children
d) Adolescents

Answer 99

a) Children below 5 years of age

Question 100

54. A parent asks, can I get head lice too. The nurse indicates that adults can also be
    infested with head lice but that Pediculosis is more common among school children,
    primarily for which of the following reasons

a) An immunity to Pediculosis usually is established by adulthood
b) School aged children tend to be more neglectful of frequent hand washing
c) Pediculosis usually is spread by close contact with infected children
d) The skin of adults is more capable of resisting the invasion of lice

Answer 100

c) Pediculosis usually is spread by close contact with infected children

Question 101

55. When developing the postoperative plan of care for an adolescent who has undergone
    an appendicectomy for a ruptured appendix, in which of the following positions
    would the nurse expect to place the client during the early postoperative period

a) The semi fowlers position
b) Supine
c) Lithotomy position
d) Prone

Answer 101

a) The semi fowlers position

Question 102

STATE EXAMS 3

1. Mental status assessment using the ‘batomi’ formation is a useful nursing assessment
   tool because it tells you

a) Whether or not a client has a mental illness
b) Details about an individual’s feeling state and cognitive functioning
c) Whether a mental illness is organic or functional in origin
d) The history of a clients symptoms and his response to stress

Answer 102

b) Details about an individual’s feeling state and cognitive functioning

Question 103

2. Persons with an acute psychotic illness have most difficulty in

a) Meeting dependency needs
b) Maintaining grooming and personal hygiene
c) Distinguishing between reality and unreality
d) Displaying personal feelings

Answer 103

c) Distinguishing between reality and unreality

Question 104

3. People who have a personality disorder

a) Frequently progress to a psychotic illness
b) Become psychotic under severe stress
c) Are known as borderline personalities
d) Have ongoing difficulties in relating to others

Answer 104

d) Have ongoing difficulties in relating to others

Question 105

4. Neurotic disorders are associated with

a) Inadequacy and poor stress management
b) Maladaptive behaviour related to anxiety
c) Inability to cope with demands and perceived stress
d) Family patterns of inappropriate behaviour

Answer 105

b) Maladaptive behaviour related to anxiety

Question 106

5. Which of the following statements about tardive dyskinesia is true

a) Symptoms are often permanent and do not improve with antiparkinsonian
medication
b) Symptoms will diminish as the client adjusts to long term treatment
c) Clients are seldom concerned about features of tardive dyskinesia
d) Antiparkinsonian medication will suppress the main features of tardive dyskinesia

Answer 106

a) Symptoms are often permanent and do not improve with antiparkinsonian
medication

Question 107

6. Memory loss associated with old age

a) Has a sudden onset and affects both long term and short term memory
b) Has a gradual onset and affects mainly long term memory
c) Has a gradual onset and affects mainly short term memory
d) Has a sudden onset and affects mainly short term memory

Answer 107

c) Has a gradual onset and affects mainly short term memory

Question 108

7. persons who have a neurotic disorder

a) have a minor disorder that will diminish with time and maturity
b) respond well to electro convulsive therapy
c) do not develop psychotic features
d) frequently have insight into their behaviour

Answer 108

d) frequently have insight into their behaviour

Question 109

8. a social factor contributing to the incidence of eating disorders is

a) economic disadvantage
b) educational disadvantage
c) gender stereotyping
d) unemployment

Answer 109

c) gender stereotyping

Question 110

9. the most common features of chronic organic psychosis are

a) fluctuating confusion and disorientation
b) persistent elated mood and hyperactivity
c) thought blocking and concrete thinking
d) social withdrawal and paranoid ideation

Answer 110

d) social withdrawal and paranoid ideation

Question 111

10. phobia is best described as

a) a fear related to an identifiable traumatic event in one’s life
b) an irrational fear of a specific situation or object
c) a series of repetitive behaviours designed to relieve anxiety
d) a general sense of impending doom

Answer 111

b) an irrational fear of a specific situation or object

Question 112

11. the most appropriate treatment for phobias is

a) anxiolytic drugs
b) cognitive restructuring
c) relaxation exercises
d) systematic desensitisation

Answer 112

b) cognitive restructuring

Question 113

12. the best definition of a crisis is

a) any event which causes anxiety
b) a life event which is perceived as a threat to self esteem
c) a traumatic event for which coping behaviours are inadequate
d) a situation which is traumatic and involves a significant loss

Answer 113

b) a life event which is perceived as a threat to self esteem

Question 114

13. forensic psychiatry is the area of mental health care which is concerned with
    individuals who

a) have been committed to hospital because they would not voluntarily accept
treatment
b) are not considered to be capable of caring for themselves in a non custodial
environment
c) have been charged with an offence to undergo a psychiatric examination or
treatment
d) are mentally ill and considered to be a danger to themselves or to the public

Answer 114

c) have been charged with an offence to undergo a psychiatric examination or
treatment

Question 115

14. anxiety is best described as

a) mild form of psychosis
b) disorder of mood
c) response to stress
d) distorted sense of perception

Answer 115

c) response to stress

Question 116

15. Which of the following is common feature of anxiety

a) Paranoid delusions
b) Social withdrawal
c) Impaired concentration
d) Auditory hallucinations

Answer 116

c) Impaired concentration

Question 117

16. A comparison of Maori and non Maori suicide rates shows that

a) Maori are less likely to commit suicide
b) Maori are much more likely to commit suicide
c) There is no difference between Maori and non Maori suicide rates
d) There are differences but they are not statistically significant

Answer 117

?

Question 118

17. A person who is currently acutely depressed expresses an intention to self harm. Your
    initial response would be to

a) Distract the client by talking about less depressing thoughts or ideas
b) Encourage the client to discuss their ideas of suicide to establish potential for self
harm
c) Suggest the client involves themselves with other clients to establish supportive
relationships
d) Ask the client to explain their reasons for contemplating self harm

Answer 118

b) Encourage the client to discuss their ideas of suicide to establish potential for self
harm

Question 119

18. A depressed client is prescribed amitriptyline. This would have the effect of

a) Clarifying his thought processes
b) Helping to raise his mood
c) Eliminating negative ideas
d) Promoting greater self awareness

Answer 119

b) Helping to raise his mood

Question 120

19. While watching television in the lounge a client says quickly and abruptly to the nurse,
    the sun is shining in Virginia. My son is in Virginia. Who’s afraid of Virginia wolf.
    Which of the following is this statement an example of

a) Concrete thinking
b) Flight of ideas
c) Word salad
d) Depersonalisation

Answer 120

b) Flight of ideas

Question 121

20. In planning the care of for the elated client a primary aim is to

a) Encourage interpersonal contact
b) Provide a non stimulating environment
c) Demand that the client follow rules
d) Accept and understand the behaviour

Answer 121

d) Accept and understand the behaviour

Question 122

21. For a client suffering from mania who is unable to sleep the best approach is to

a) Fully involve the client in physical activities and exercise programmes during
daytime
b) Encourage the client to talk about underlying feelings or stressors
c) Nurse in low stimulus environment and administer prescribed antipsychotic
medication
d) Place in seclusion using medication only as a last resort

Answer 122

c) Nurse in low stimulus environment and administer prescribed antipsychotic
medication

Question 123

22. For a client suffering from mania who is expressing delusional ideas the best
    approach is to

a) Explain to the client the distinction between rational and irrational thinking
b) Acknowledge his ideas but distract him by focusing on reality based ideas
c) Ignore him because to do otherwise will only reinforce his ideas
d) Encourage him to stop thinking like that, as it is a symptom of his illness

Answer 123

b) Acknowledge his ideas but distract him by focusing on reality based ideas

Question 124

23. A client who is subject to a community treatment order section 29 of the mental
    health act (1992) must

a) Accept prescribed medication and attend any specified treatment center
b) Report on a weekly basis to a community mental health centre
c) Return to hospital after a period of three months for a psychiatric assessment
d) Name a primary caregiver who will accept responsibility for the clients care and
supervision

Answer 124

a) Accept prescribed medication and attend any specified treatment center

Question 125

24. In preparation for living in the community a client may spend a period of time living
    in a half way house. The main objective of living in a half way house is to

a) Save sufficient money in order to set up a house or flat
b) Spend time looking for a suitable job on leaving hospital
c) Assess whether the client still has any symptoms of mental illness
d) Provide the client with the opportunity to adjust to a more independent lifestyle

Answer 125

d) Provide the client with the opportunity to adjust to a more independent lifestyle

Question 126

25. Following an automobile accident involving a fatality and a subsequent arrest for
    speeding, a client has amnesia for the events surrounding the accident. This is an
    example of the defence mechanism known as

a) Projection
b) Repression
c) Dissociation
d) Suppression

Answer 126

c) Dissociation

Question 127

26. The group most at risk for developing an eating disorder is young women

a) Who are high achievers
b) With a history of disturbed behaviour
c) Who have conflict with their parents
d) With a history of mental illness

Answer 127

d) With a history of mental illness

Question 128

27. Support for a client with an eating disorder involves

a) Avoidance of family conflicts
b) Discussion of health ways of losing weight
c) Encouragement to explore issues of concern
d) Daily checks for changes in weight

Answer 128

c) Encouragement to explore issues of concern

Question 129

28. The personality disorder associated with an inability to make decisions and the need
    for constant reassurance is commonly classified as

a) Obsessive compulsive
b) Dependent
c) Cyclothymic
d) Antisocial

Answer 129

b) Dependent

Question 130

29. People who have a personality disorder

a) Frequently progress to a psychotic illness
b) Become psychotic under severe stress
c) Are known as borderline personalities
d) Have ongoing difficulties in relating to others

Answer 130

d) Have ongoing difficulties in relating to others

Question 131

30. A side effect resulting from long term use of antipsychotic medication is tardive
    dyskinesia. Features of tardive dyskinesia include

a) Involuntary lip smacking and tongue movements
b) Dry mouth and blurred vision
c) Muscular rigidity and shuffling gait
d) Nausea and vomiting

Answer 131

a) Involuntary lip smacking and tongue movements

Question 132

31. A nurse working in a long term ward becomes aware that they are becoming
    institutionalised. Which of the following behaviours would they be most likely to
    have noticed

a) An excessive and unrealistic concern for the welfare of clients
b) A tendency to become involved in new activities
c) A lack of satisfaction with existing methods of work
d) Resistance to new ideas and change

Answer 132

d) Resistance to new ideas and change

Question 133

32. One reason for ordering an individual charged with an offence to have psychiatric
    examination is to determine whether that person

a) Is likely to have committed the offence he is charged with
b) Has a previous personal or family history of psychiatric illness
c) Was suffering from a mental illness at the time of the alleged offence
d) Has a mental illness which would respond to a programmed of treatment

Answer 133

c) Was suffering from a mental illness at the time of the alleged offence

Question 134

33. Cultural considerations in the use of seclusion include

a) Use of seclusion only after consent has been obtained from the appropriate
cultural representatives
b) Listening to advice from staff of the clients culture or form the clients family
c) Having an appropriate cultural representative available each time the seclusion
room is entered
d) Ensuring that only staff from the clients culture participate in caring for any client
in seclusion

Answer 134

a) Use of seclusion only after consent has been obtained from the appropriate
cultural representatives

Question 135

34. Cross cultural studies on mental illness show that

a) The symptoms of mental illness are the same in all cultures
b) The incidence of mental illness the same in all cultures
c) Mental illness has culturally specific characteristics
d) Mental illness is more common amongst cultural minorities

Answer 135

d) Mental illness is more common amongst cultural minorities

Question 136

35. The drug most commonly used in the long term treatment of bi polar disorder is

a) Diazepam
b) Lithium carbonate
c) Clozapine
d) Sodium Amytal

Answer 136

b) Lithium carbonate

Question 137

36. Anticholinergic side effects are common with all the following except

a) Diazepam
b) Benztropine
c) Amitriptyline
d) Thioridazine

Answer 137

d) Thioridazine

Question 138

37. Chlorpromazine is an antipsychotic medication used in the treatment of

a) Anxiety states
b) Schizophrenia
c) Depressive disorders
d) Dementia

Answer 138

b) Schizophrenia

Question 139

38. Which of the following is the main reason for giving depot injections of antipsychotic
    medication

a) They are more effective than oral medication
b) They overcome the problem of non adherence
c) Side effects are not as common
d) They are easier to administer than oral medication

Answer 139

b) They overcome the problem of non adherence

Question 140

39. A client who is committed under the mental health act (1992) is discharged from
    hospital on leave. When visited by the community mental health nurse he refused his
    injection of antipsychotic medication which is due that day. The best initial approach
    to this would be to

a) Explain that this will mean his immediate return to hospital
b) Visit again the next day and attempt to persuade the client to accept his
medication
c) Inform the medical staff so that the clients legal status can be changed
d) Explore with the client alternative forms of treatment to medication

Answer 140

a) Explain that this will mean his immediate return to hospital

Question 141

40. Long term use of benzodiazepine drugs (minor tranquillisers) such as diazepam
    (valium) can lead to

a) Tardive dyskinesia
b) Dependence
c) Renal impairment
d) Akathisia

Answer 141

b) Dependence

Question 142

41. A client expresses the belief that he is the illegitimate son of a famous family. This is
    an example of

a) Paranoid thinking
b) Pressure of speech
c) A delusion of grandeur
d) Ideas of reference

Answer 142

c) A delusion of grandeur

Question 143

42. The best response to this statement (in previous question) is to

a) Involve the client in a group activity
b) Inform the client that he is wrong in his belief
c) Talk to the client without confirming or denying his belief
d) Spend some time with the client in an attempt to meet his need to feel important

Answer 143

c) Talk to the client without confirming or denying his belief

Question 144

43. At an art group a client shows the group the painting he has done. It consists of knives
    and blood, with the words ‘death’ and ‘peace’ written on it. The client tells the group
    that this represents his own death and release from suffering. The best response to this
    is

a) Thank him for his participation and then focus the discussion on another client
b) Acknowledge his contribution and ensure that you discuss this further with him
after the group has finished
c) Request that the client use the opportunity to explore more positive aspects of his
life
d) Insist the client explain this feelings to the group and then point out positive
aspects of his life

Answer 144

b) Acknowledge his contribution and ensure that you discuss this further with him
after the group has finished

Question 145

44. A client who has been admitted for treatment of a depressive illness says he doesn’t
    want to attend group activities. The reason such a client would be encouraged to
    attend is that

a) He is less likely to dwell on depressive ideas while he is involved in a group
activity
b) It is an expectation that all clients attend group activities while in hospital
c) Involvement in group activities is the only way to overcome feelings of depression
d) Attendance at group activities is essential to monitor the effectiveness of
medication

Answer 145

a) He is less likely to dwell on depressive ideas while he is involved in a group
activity

Question 146

45. A client with post traumatic stress disorder says ‘I should have been killed with the
    rest of them. Why am I alive’ this statement is best described as an example of

a) Suicidal thinking
b) Survivor guilt
c) Depressive preoccupation
d) Neurotic conflict

Answer 146

b) Survivor guilt

Question 147

46. The best way to report the clients statement (in previous question) in the nursing notes
    would be

a) Client has no insight into their situation
b) Client is questioning why they are still alive
c) Client is expressing suicidal ideas
d) Client feels responsible for death of others

Answer 147

b) Client is questioning why they are still alive

Question 148

47. Long acting intramuscular antipsychotic medication is used in the treatment of
    schizophrenia because it

a) Has fewer side effects than oral medication
b) Has a greater antipsychotic action
c) Is more rapidly absorbed than oral medication
d) Ensures that clients receive their medication

Answer 148

c) Is more rapidly absorbed than oral medication

Question 149

48. Which of the following statements related to the treatment, with lithium carbonate, of
    person with bipolar disorder is true

a) Most will need to take lithium carbonate for an extended period of time, perhaps
for life
b) Once the persons mood becomes euthymic, treatment can be discontinued in most
cases
c) Because of the need to maintain constant blood levels, long term injections is the
preferred form of treatment
d) Treatment is most effective in the acute stage of the illness although some people
will need long term treatment

Answer 149

d) Treatment is most effective in the acute stage of the illness although some people
will need long term treatment

Question 150

49. An acutely ill client with the diagnosis of schizophrenia has just been admitted to the
    mental health unit. When working with this client initially the nurses most therapeutic
    action would be to

a) Use diversional activity and involve the client in occupational therapy
b) Build trust and demonstrate acceptance by spending some time with the client
c) Delay one to one interactions until medications reduce the psychotic symptoms
d) Involve the client in multiple small group discussions to distract attention from the
fantasy world

Answer 150

b) Build trust and demonstrate acceptance by spending some time with the client

Question 151

50. You are caring for a client who talks in a regretful way about the past. The best
    response is to

a) Help them find something positive in their past
b) Help them move their thoughts to the future
c) Tell them that focusing on the past is not helpful
d) Acknowledge the clients feelings then focus on the present

Answer 151

d) Acknowledge the clients feelings then focus on the present

Question 152

51. Intervention with an angry client who is threatening violence involves

a) Asking the client to express their feelings verbally
b) Maintaining silence to avoid any escalation of anger
c) Asking the client what has happened to make them so angry
d) Giving brief, clear messages about what you want the client to do

Answer 152

d) Giving brief, clear messages about what you want the client to do

Question 153

52. Mr w is committed under section 11 o the mental health act 1992. He sneaks out at
    night and returns to his former home. He calls the staff and tells them he is not
    coming back. The staffs responsibility is to

a) Make sure he has discharged
b) Tell him to take his medication
c) Ask to have someone else talk to him
d) Notify the police and crisis team

Answer 153

d) Notify the police and crisis team

Question 154

53. The highest priority nursing action relative to alcohol withdrawal delirium would be

a) Orientation to reality
b) Application of restraints
c) Identification and social supports
d) Replacement of fluids and electrolytes

Answer 154

a) Orientation to reality

Question 155

54. The use of silence during an interview is therapeutic if

a) The person is overcome with emotion
b) The person appears uncomfortable with the current discussion
c) The nurse wishes to terminate the communication session
d) The patient wishes to terminate the communication session

Answer 155

b) The person appears uncomfortable with the current discussion

Question 156

55. To facilitate communication the nurse should convey

a) Accurate empathy
b) Authenticity
c) Unconditional positive regard
d) All of the above

Answer 156

d) All of the above

Question 157

56. The parents of a young man experiencing a schizophrenic illness ask if he is likely to
    become violent. The best answer the nurse can make is that the vast majority of
    mentally ill individuals

a) Are more dangerous than normal people
b) Are not more dangerous than other individuals in the population
c) Are unpredictable and therefore more dangerous than normal individuals
d) Are about as violent and unpredictable as more individuals in the population

Answer 157

d) Are about as violent and unpredictable as more individuals in the population

Question 158

57. While interviewing Mr. d, the nurse notes he uses neologisms and has losses
    associations. This would most likely indicate the presence of

a) Mania
b) Depression
c) Defensive coping
d) Schizophrenia or psychosis

Answer 158

c) Defensive coping

Question 159

58. When monoamine oxide inhibitors (MAOIs) are prescribed, the client should be
    cautioned against

a) Prolonged exposure to the sun
b) Ingesting wines and aged cheeses
c) Engaging in active physical exercise
d) The use of medications with an elixir base

Answer 159

a) Prolonged exposure to the sun

Question 160

59. A characteristic feature of the elated client is

a) Retarded speech
b) Increased motor and thought activity
c) Delusions of sin and guilt
d) Depressed mood

Answer 160

b) Increased motor and thought activity

Question 161

60. To give effective nursing care to a client who is using ritualistic behaviour, the nurse
    must first recognize that the client

a) Should be prevented from performing the rituals
b) Needs to realise that the rituals serve no purpose
c) Must immediately be diverted when performing the ritual
d) Does not want to repeat the ritual, but feels compelled to do so

Answer 161

d) Does not want to repeat the ritual, but feels compelled to do so

Question 162

STATE EXAMS 4

1. Culturally safe nursing care can best be achieved when the nurse has

a) An in depth knowledge of the treaty of Waitangi
b) An awareness of Maori perspectives of health
c) An awareness and acceptance of your own limits in meeting someone’s else’s
health and cultural needs
d) A knowledge of Maori protocol

Answer 162

c) An awareness and acceptance of your own limits in meeting someone’s else’s
health and cultural needs

Question 163

2. Imagine a new virus infecting a human population for the first time. Which of the
   following is most likely to lead to a rapid increase in cases worldwide

a) Severe disease with high mortality
b) Lack of hand hygiene
c) Air travel
d) High transmissibility

Answer 163

d) High transmissibility

Question 164

3. The school nurse is caring for a child with haemophilia who is actively bleeding from
   the leg. Which of the following would the nurse apply

a) Direct pressure, checking every few minutes to see if the bleeding has stopped
b) Ice to the injured leg area several times a day
c) Direct pressure to the injured area continuously for 10 minutes
d) Ice bag with elevation of the leg twice a day

Answer 164

c) Direct pressure to the injured area continuously for 10 minutes

Question 165

4. Home health nurses visit a blind diabetic patient who lives alone to monitor the
   patients glucose level and administer the patients daily insulin. Evaluation of outcome
   management for this patient would include

a) An absence of complications of diabetes
b) A reduction in hospitalizations for glycemic control
c) The ability of the patient to learn to use adaptive syringes
d) The patients evaluation of the services provided by the nurses

Answer 165

b) A reduction in hospitalizations for glycemic control

Question 166

5. The nurse consults with the physician to arrange a referral for hospice care for a
   patient with end stage liver disease based on the knowledge that hospice care is
   indicated when

a) Family members can no longer care for dying patients at home
b) Patients and families are having difficulty coping with grief reactions
c) Preparation for death with palliative care and comfort are the goals of care
d) Patients have unmanageable pain and suffering as a result of their condition

Answer 166

c) Preparation for death with palliative care and comfort are the goals of care

Question 167

6. When teaching a patient who smokes about the relationship of smoking to the
   development of cancer, the nurse explains that tobacco smoke is a complete
   carcinogen because

a) Exposure to the smoke always causes cellular changes
b) Tobacco smoke is capable of both initiating and promoting cancer growth
c) Cancer will always develop when people who smoke are exposed to other
carcinogens
d) Tobacco smoke serves as a vehicle for the spread of cancer cells during the
progression stage of cancer

Answer 167

b) Tobacco smoke is capable of both initiating and promoting cancer growth

Question 168

7. In teaching about cancer prevention, the nurse stresses promotion of exercise, normal
   body weight, and low fat diet because

a) General aerobic health is an important defence against cellular mutation
b) Obesity is a factor that promotes cancer growth; if it is reversed, the risk of cancer
can be decreased
c) People who are overweight usually consume large amounts of fat, which is a
chemical carcinogen
d) The development of fatty tumours, such as lipomas, is increased when there is an
abundance of fatty tissue

Answer 168

b) Obesity is a factor that promotes cancer growth; if it is reversed, the risk of cancer
can be decreased

Question 169

8. A 40 year old divorced mother of four school children is hospitalized with metastatic
   cancer of the ovary. The nurse finds the patient crying, and she tells the nurse that she
   does not know what will happen to her children when she dies. The most appropriate
   response by the nurse is

a) Why don’t we talk about the options you have for the care of your children
b) You are going to live for a long time yet, and your children will be just fine
c) I wouldn’t worry about that right now. You need to concentrate on getting well
d) Wont your ex husband take the children when you can’t care for them anymore

Answer 169

a) Why don’t we talk about the options you have for the care of your children

Question 170

9. During the primary assessment of a trauma victim, the nurse determines that the
   patient has a patent airway. The next assessment the nurse makes includes

a) The level of consciousness
b) Observation for external bleeding
c) The status of the patients respiration
d) The rate and character of carotid or femoral pulses

Answer 170

c) The status of the patients respiration

Question 171

10. Which of the following viruses is usually transmitted by airborne droplets

a) Varicella zoster virus
b) Cytomegalovirus
c) Herpes simplex virus
d) Hepatitis a virus

Answer 171

a) Varicella zoster virus

Question 172

11. Which of the following has made the biggest impact on mortality from infectious
    diseases in the 20th century

a) Vaccination
b) Better housing and provision of clean water, sewerage systems
c) Antimicrobials
d) Infection control

Answer 172

d) Infection control

Question 173

12. in addition to providing informational support, which of the following nursing
    activities is an integral part of the role of the nurse advocate

a) maintaining the patient in a dependent role
b) assuming responsibility for directing the patients care
c) assisting the patient to make sound health care decisions
d) persuading the patient to choose exactly what the health care team recommends

Answer 173

c) assisting the patient to make sound health care decisions

Question 174

13. Steve, 15 years old, is admitted with suspected meningitis. Nuchal rigidity will not be
    seen in which of the following

a) intracranial haematoma
b) meningitis
c) cerebral concussion
d) intracranial tumour

Answer 174

c) cerebral concussion

Question 175

14. a positive Mantoux test indicates

a) the client has active tuberculosis
b) the client has been exposed to mycobacterium
c) the client will never have tuberculosis
d) the client has been infected with mycobacterium tuberculosis

Answer 175

b) the client has been exposed to mycobacterium

Question 176

15. Which of the following would the nurse do when suspecting that a child has been
    abused by the mother

a) Continue to collect information until there is no doubt in the nurses mind that
abuse has occurred
b) Ensure that any and all findings are reported to the proper state and legal
authorities
c) Keep the finding confidential, because they represent legal privileged
communication between the nurse and the mother
d) Report the findings to the physician because that falls within the responsibilities of
medical practise

Answer 176

b) Ensure that any and all findings are reported to the proper state and legal
authorities

Question 177

16. Several high school seniors are referred to the school nurse because of suspected
    alcohol misuse. When the nurse assesses the situation, which of the following would
    be most important to determine

a) What they know about the legal implications of drinking
b) The type of alcohol they usually drink
c) The reasons they choose to use alcohol
d) When and with whom they use alcohol

Answer 177

c) The reasons they choose to use alcohol

Question 178

17. When a trauma victim expresses fear that AIDS may develop as a result of a blood
    transfusion, the nurse should explain that

a) Blood is treated with radiation to kill the virus
b) Screening for HIV antibodies has minimised the risk
c) The ability to directly identify HIV has eliminated this concern
d) Consideration should be given to donating own blood for transfusion

Answer 178

b) Screening for HIV antibodies has minimised the risk

Question 179

18. A client asks the nurse, should I tell my husband I have AIDS. The nurses most
    appropriate response would be

a) This is a decision alone you can make
b) Don not tell him anything unless he asks
c) You are having difficulty deciding what to say
d) Tell him you feel you contracted AIDS from him

Answer 179

c) You are having difficulty deciding what to say

Question 180

19. When a disaster occurs, the nurse may have to treat mass hysteria first. The person or
    persons to be cared for immediately would be those in

a) Panic
b) Coma
c) Euphoria
d) Depression

Answer 180

a) Panic

Question 181

20. A child was bitten on the hand by a dog who had recently received a rabies shot. The
    nursing priority for this child would be directed toward ensuring that the

a) Suture line remains red and dry
b) Child does not develop a fear of dogs
c) Rabies antibodies develop within 48 hours
d) Mobility of the injured hand returns to a preinjury state in 1 week

Answer 181

c) Rabies antibodies develop within 48 hours

Question 182

21. The school nurse is invited to attend a meeting with several parents who express
    frustration with the amount of time their adolescents spend in front of the mirror and
    the length of time it takes them to get dressed. The nurse explains that this behaviour
    is indicative of which of the following

a) An abnormal narcissism
b) A method of procrastination
c) A way of testing the parents limit setting
d) A result of developing self concept

Answer 182

d) A result of developing self concept

Question 183

22. A parent asks the nurse about head lice (Pediculosis capitis) infestation during a visit
    to the clinic. Which of the following symptoms would the nurse tell the parent is most
    common in a child infected with head lice

a) Itching of the scalp
b) Scaling of the scalp
c) Serous weeping of the scalp surface
d) Pinpoint hemorrhagic spots on the scalp surface

Answer 183

a) Itching of the scalp

Question 184

23. After teaching the parents about the cause of ringworm of the scalp (tinea capitis),
    which of the following, if stated by the father, indicates successful teaching

a) Over exposure to the sun
b) Infestation with a mite
c) Fungal infection of the scalp
d) An allergic reaction

Answer 184

c) Fungal infection of the scalp

Question 185

24. A mother tells the nurse that one of her children has chicken pox and asks what she
    should do to care for that child. When teaching the mother, which of the following
    would be most important to prevent

a) Acid base imbalance
b) Malnutrition
c) Skin infection
d) Respiratory infection

Answer 185

c) Skin infection

Question 186

25. One litre of intravenous fluid is to be given over 4 hours. The giving set delivers 60
    drops per ml. how many drops per minute should be given

a) 150
b) 250
c) 300
d) 160

Answer 186

b) 250

Question 187

26. The nurse discusses the eating habits of school aged children with their parents,
    explaining that these habits are most influenced by which of the following

a) Food preference of their peers
b) Smell and appearance of foods offered
c) Examples provided by parents at mealtimes
d) Parental encouragement to eat nutritious foods

Answer 187

c) Examples provided by parents at mealtimes

Question 188

27. Which of the following is an offence under the Hydatids act 1959

a) Failure to report stray, unregistered dogs
b) Feeding raw offal to any dogs in your care
c) Tenuicollis worms in lambs at the time of killing
d) Tenuicollis cysts in any purged material from dogs

Answer 188

b) Feeding raw offal to any dogs in your care

Question 189

28. What is the responsibility of the nurse who, for two days, has observed the nurse
    manager putting several syringes into her pocket

a) Report the matter to another nurse manager
b) Discuss the matter with your nursing colleagues
c) Watch the nurse manager to see if it happens again
d) Ignore the incident as a nurse manager is a responsible person

Answer 189

a) Report the matter to another nurse manager

Question 190

29. Neil, a 17 year old, is hit on the head by a cricket ball while playing with a friend at
    home. He fell against the glasshouse, severely lacerating his right wrist. He as
    unconscious for about 5 minutes. The initial first aid treatment for Neil would be to

a) Wrap a handkerchief tightly on the wrist
b) Check for breathing
c) Elevate the wrist
d) Wash the wrist to examine it

Answer 190

a) Wrap a handkerchief tightly on the wrist

Question 191

30. You are taking nails recordings when he appears to have a seizure. What nursing
    intervention would best assist Neil

a) Describing and recording the seizure activity observed
b) Restraining Neil in order to prevent self harm
c) Placing a tongue blade between his teeth
d) Suctioning Neil to prevent aspiration

Answer 191

a) Describing and recording the seizure activity observed

Question 192

31. Following a petit mal seizure a person is likely to be

a) Confused
b) Hostile
c) Hyperactive
d) Euphoric

Answer 192

c) Hyperactive

Question 193

32. On a follow up outpatient. Neil enquires about his anticonvulsant medication. He
    needs to know that following a head injury

a) The medication must be taken for at least 1 year
b) The physician must be seen when the prescription is finished
c) The medication will be discontinued as soon as his seizures are under control
d) The medication will be necessary for the rest of his life

Answer 193

b) The physician must be seen when the prescription is finished

Question 194

33. If you are with someone who has a grand mal seizure, you should

a) Loosen the clothing about their neck and wrist
b) Turn their head to the side to facilitate drainage of secretions
c) Remove nearby objects to protect their extremities from injury
d) All of the above

Answer 194

d) All of the above

Question 195

34. The school nurse is caring for a child with haemophilia who is actively bleeding from
    the leg. Which of the following would the nurse apply

a) Direct pressure, checking every few minutes to see if the bleeding has stopped
b) Ice to the injured leg area several times a day
c) Direct pressure to the injured area continuously for 10 minutes
d) Ice bag with elevation of the leg twice a day

Answer 195

c) Direct pressure to the injured area continuously for 10 minutes

Question 196

35. When performing a cultural assessment with a patient of a different culture, it is
    important for the nurse to first ask about the patients

a) Racial heritage
b) Use of cultural healers
c) Language spoken at home
d) Affiliation with a cultural group

Answer 196

c) Language spoken at home

Question 197

36. After being bitten by an unknown insect, a patient allergic to wasp stings is brought to
    a clinic by a co worker. Upon arrival the patient is anxious and is having difficulty
    breathing. The first action by the nurse is to

a) Administer oxygen
b) Maintain the patients airway
c) Remove the stinger from the site
d) Place the patient in recumbent position with his legs elevated

Answer 197

b) Maintain the patients airway

Question 198

37. During immediate care of a victim of a bite or sting to the hands or fingers, it is most
    important for the nurse to

a) Elevate the affected extremity
b) Scrub the wound with an antibacterial solution
c) Apply ice to the site with ice water or ice packs
d) Remove rings and watches from the affected extremity

Answer 198

d) Remove rings and watches from the affected extremity

Question 199

38. A young man seeks medical care after a friend with whom he shared needles during
    illicit drug use develops hepatitis B. to provide immediate protection from infection,
    the nurse expects to administer

a) Corticosteroids
b) Gamma globulin
c) Hepatitis b vaccine
d) Fresh frozen plasma

Answer 199

c) Hepatitis b vaccine

Question 200

39. A 63 year old man has terminal cancer of the liver and is cared for by his wife at
    home. His abdominal pain has become increasingly severe, and he now says it is
    intense most of the time. The nurse recognizes that teaching regarding pain
    management has been effective when the patient

a) Limits the use of opiate analgesics to prevent addiction
b) Resigns himself to the fact that pain is an inevitable consequence of cancer
c) Uses pain medication only when the pain becomes more than he can tolerate
d) Takes analgesics around the clock on a regular schedule, using additional doses
for the breakthrough pain

Answer 200

d) Takes analgesics around the clock on a regular schedule, using additional doses
for the breakthrough pain

Question 201

40. A patient is treated at a clinic with an injection of long acting penicillin for a
    streptococcal throat infection. Her history reveals that she has received penicillin
    before with no allergic responses. When the penicillin injection is administered, the
    nurse should inform the patient that

a) She must wait in the clinic area for 20 minutes before she is discharged
b) Since she has taken penicillin before without problems, she can safely take it now
c) She would have immediate symptoms if she had developed an allergy to penicillin
d) She should monitor for fever and skin rash typical of serum sickness after taking
penicillin

Answer 201

a) She must wait in the clinic area for 20 minutes before she is discharged

Question 202

41. A parent asks why it is recommended that the second dose of the measles, mumps,
    rubella (MMR) vaccine be given by 12 years of age. The nurse responds based on
    which of the following as the most important reason

a) The risks to a foetus are high if a girl receiving the vaccine becomes pregnant
b) The chance of contracting the disease is much lower after puberty than before it
c) The dangers associated with a strong reaction to the vaccine are increased after
puberty
d) The changes that occur in the immunologic system may affect the rhythm of the
menstrual cycle

Answer 202

a) The risks to a foetus are high if a girl receiving the vaccine becomes pregnant

Question 203

42. Mrs Simmon states she is not feeling well, that she cannot breathe and asks you to
    please do something. Your initial response to the client is

a) You will be alright, just calm down
b) Don’t worry, the doctors have everything under control
c) I will ring the doctor to come and see you
d) I will take your recordings and ring the doctor to see you

Answer 203

d) I will take your recordings and ring the doctor to see you

Question 204

43. For the nursing council to find a registered nurse guilty of negligence, it would have
    to prove that the nurse

a) Failed to do what another careful registered nurse would have done in a similar
situation
b) Did not give competent care as defined by colleagues with the same level of
experience
c) Did not give an appropriate level of care as defined by the NZNO standards for
nursing practice
d) Did not give an appropriate level of care as defined by the NZNO code of practice
for nurses

Answer 204

c) Did not give an appropriate level of care as defined by the NZNO standards for
nursing practice

Question 205

44. Ageism is an important concept for the nurse to understand because it

a) May damage the self esteem of the elderly
b) Increases social awareness of the needs of the elderly
c) Provides statistical information regarding the elderly population
d) Promotes consideration of the diversity of the elderly population

Answer 205

a) May damage the self esteem of the elderly

Question 206

45. A middle aged woman enjoys orienting new young women and men at work. She
    enjoys being a teacher and mentor and feels she should pass down her legacy of
    knowledge and skills to the younger generation. The nurse recognizes that the woman
    is involved in the behaviour described by Erikson as

a) Generativity
b) Ego integrity
c) Identification
d) Valuing wisdom

Answer 206

a) Generativity

Question 207

46. For the nursing council to find a registered nurse guilt of malpractice following an
    assault on a client, it would have to prove that the nurse

a) Intended to cause bodily harm to the client
b) Actually assaulted the client
c) Did not establish a therapeutic relationship with the client
d) Committed a felony against the client

Answer 207

a) Intended to cause bodily harm to the client

Question 208

47. Emergency interventions for a victim with upper torso injuries or face, head, or neck
    trauma include

a) Suctioning to clear the airway
b) Immobilization of the cervical spine
c) Administration of supplemental oxygen
d) Ensuring venous access with at least two large bore IV lines

Answer 208

b) Immobilization of the cervical spine

Question 209

48. An employee spilled industrial acids on his arms and legs at work. The appropriate
    action by the occupational nurse at the facility is to

a) Apply cool compresses to the area of exposure
b) Apply an alkaline solution to the affected area
c) Cover the affected area with dry, sterile dressings
d) Flush the substance with large amounts of tap water

Answer 209

d) Flush the substance with large amounts of tap water

Question 210

49. According to the privacy act 1993, when collecting health information from a client
    the nurse must

a) Ensure the client is aware that health information is being collected
b) Tell the client why health information is being collected
c) Inform the client about their rights of access and correction
d) All of the above

Answer 210

d) All of the above

Question 211

50. An example of the use of primary prevention for family violence is

a) Working to eliminate the glamorisation of violence on television
b) Counselling a woman living in an abusive relationship about available shelter
programs
c) Calling child protective services regarding a school age child who has reported
sexual attacks by her stepfather
d) Carefully examining the skin of an elder who has just returned to an extended care
facility following a weekend with his children

Answer 211

a) Working to eliminate the glamorisation of violence on television

Question 212

51. With a patient who is homosexual, the nurses most appropriate initial action during
    the preinteraction phase of the relationship should be to

a) Assist the patient in changing sexual values
b) Examine own feelings and anxieties with regard to the patient
c) Review the literature pertaining to the human sexual response
d) Attempt to identify the underlying reasons for the patients values

Answer 212

b) Examine own feelings and anxieties with regard to the patient

Question 213

52. The nurse judges that the mother understands the term cerebral palsy when she
    describes it as a term applied to impaired movement resulting from which of the
    following

a) Injury to the cerebrum caused by viral infection
b) Malformed blood vessels in the ventricles caused by inheritance
c) Non progressive brain damage caused by injury
d) Inflammatory brain disease caused by metabolic imbalances

Answer 213

c) Non progressive brain damage caused by injury

Question 214

53. The first symptom of gonorrhoea is usually

a) Lower abdominal pain
b) A sore or ulcer on the genitals
c) Purulent vaginal discharge in the female
d) Urethral discharge in the male

Answer 214

d) Urethral discharge in the male

Question 215

54. The first symptom of syphilis is

a) A generalised rash all over the body
b) A sore or ulcer on the genitals
c) Abdominal pain in the male
d) Purulent vaginal discharge

Answer 215

b) A sore or ulcer on the genitals

Question 216

55. When obtaining a nursing history from parents who are suspected of abusing their
    child, which of the following characteristics about the parents would the nurse
    typically find

a) Attentiveness to the child’s needs
b) Self blame for the injury to the child
c) Ability to relate child’s developmental achievements
d) Evidence of little concern over the extent of the injury

Answer 216

d) Evidence of little concern over the extent of the injury

Question 217

56. A colleague comments: what is the relevance of the treaty of Waitangi to Maori health

a) Maori people view the treaty of Waitangi as a health document
b) Nursing practice in new Zealand is congruent with the treaty of Waitangi
c) The right to health is guaranteed to Maori under article two of the treaty of
Waitangi
d) The right to Maori involvement in health is guaranteed

Answer 217

b) Nursing practice in new Zealand is congruent with the treaty of Waitangi

Question 218

57. The long term consequences of Chlamydia is most likely to be

a) Menorrhagia
b) Chronic vaginitis
c) Chronic cervicitis
d) Sterility

Answer 218

c) Chronic cervicitis

Question 219

58. When describing the effects of insulin on the body to a patient newly diagnosed with
    diabetes mellitus, the best explanation by the nurse is

a) Insulin promotes the breakdown of fatty tissue into triglycerides, which can be
used for energy
b) When proteins are taken into the body, insulin promotes their breakdown and
conversion to fats
c) Insulin stimulates the conversion of stored sugars into blood glucose and the
conversion of proteins into glucose
d) When carbohydrates, fats, and proteins are eaten, insulin promotes cellular
transport and storage of all these nutrients

Answer 219

d) When carbohydrates, fats, and proteins are eaten, insulin promotes cellular
transport and storage of all these nutrients

Question 220

59. A serious complication of acute malaria is

a) Congested lungs
b) Impaired peristalsis
c) Anaemia and cachexia
d) Fluid and electrolyte imbalance

Answer 220

c) Anaemia and cachexia

Question 221

60. A registered nurse stops to assist at the scene of an accident but the injured man dies
    before the ambulance arrives. The nurse should understand that she

a) Should leave the scene before the ambulance arrives
b) Will be covered by her actions by the good Samaritan laws
c) Has a legal duty of care to perform at a competent level as a registered nurse
d) Should pronounce the person dead at the scene

Answer 221

c) Has a legal duty of care to perform at a competent level as a registered nurse

Question 222

STATE EXAMS 5

1. John is admitted with neutropenia, what does the nurse assess in determining his risk
   for infection

a) Length of time neutropenia has existed
b) Health status before neutropenia
c) Body build and weight
d) Resistance to infection in childhood

Answer 222

b) Health status before neutropenia

Question 223

2. What nursing action would be important in preventing cross contamination

a) Change gloves immediately after use
b) Stand two feet from the patient
c) Speak minimally when in the room
d) Wear long sleeved shirts

Answer 223

a) Change gloves immediately after use

Question 224

3. What would you teach john and his family to avoid

a) Using suppositories or enemas
b) Using a high efficiency particulate air filter mask
c) Performing perineal care after every bowel movement
d) Performing oral care after every meal

Answer 224

a) Using suppositories or enemas

Question 225

4. 24 hours after john has a bone marrow aspiration, the nurse evaluates which of the
   following as an appropriate client outcome

a) The client maintains bed rest
b) There is redness and swelling at the aspiration site
c) The client requests morphine sulphate 2mg IM every 2 hours
d) There is no bleeding at aspiration site

Answer 225

d) There is no bleeding at aspiration site

Question 226

5. During the induction stage for treatment of leukaemia, the nurse should remove which
   items that the family has brought into the room

a) A bible
b) A picture
c) A sachet of lavender
d) A hairbrush

Answer 226

c) A sachet of lavender

Question 227

6. The goal of nursing care for a client with acute myeloid leukaemia is to prevent

a) Cardiac arrhythmias
b) Liver failure
c) Renal failure
d) Haemorrhage

Answer 227

d) Haemorrhage

Question 228

7. The nurse is evaluating the clients learning about combination chemotherapy. Which
   of the following statements about reasons for using combination chemotherapy
   indicates the need for further explanation

a) Combination chemotherapy is used to interrupt cell growth cycle at different
points
b) Combination chemo is used to destroy cancer cells and treat side effects
simultaneously
c) Combination chemo is used to decrease resistance
d) Combination chemo is used to minimise the toxicity from using high doses of
single agent

Answer 228

a) Combination chemotherapy is used to interrupt cell growth cycle at different
points

Question 229

8. In providing care to the client with leukaemia who has developed thrombocytopenia,
   the nurse assessed the most common sites for bleeding. Which of the following is not
   a common site

a) Biliary system
b) Gastrointestinal tract
c) Brain and meninges
d) Pulmonary system

Answer 229

a) Biliary system

Question 230

9. The nurses best explanation for why the severely neutropenic client is place in reverse
   isolation is that reverse isolation helps prevent the spread of organisms

a) To the client from sources outside the clients environment
b) From the client to health care personnel, visitors and other clients
c) By using special techniques to dispose of contaminated material
d) By using special techniques to hand the clients linens and personal items

Answer 230

a) To the client from sources outside the clients environment

Question 231

10. A client has received 25ml of packed red blood cells when she began to experience
    low back pain and mild itching. After stopping the transfusion the nurse should

a) Administer prescribed aspirin and antihistamines
b) Collect blood and urine samples to be sent to the laboratory
c) Administer prescribed diuretics, oxygen and morphine
d) Administer prescribed vasopressors

Answer 231

a) Administer prescribed aspirin and antihistamines

Question 232

11.
The nurse in the preoperative period is preparing a female client for surgery and
notices that the client looks sad. The client says, ‘I’m scared of having cancer. It’s so
horrible and I brought it on myself. I should have quit smoking years ago’. What
would be the nurses best response to the client

a) It’s okay to be scared. What is it about cancer that you’re afraid of
b) It’s normal to be scared. I would be too. Well help you through it
c) Don’t be hard on yourself. You don’t know if your smoking caused the cancer
d) Do you feel guilty because you smoked

Answer 232

a) It’s okay to be scared. What is it about cancer that you’re afraid of

Question 233

12. Following mastectomy the client is now due to have radiation therapy. She should be
    taught to care for the skin at the therapy site by

a) Washing the area with water
b) Exposing the area to dry heat
c) Applying an ointment to the area
d) Using talcum powder on the area

Answer 233

a) Washing the area with water

Question 234

13. A 42 year old woman is interested in making dietary changes to reduce her risk of
    colon cancer. What dietary selections would the nurse suggest

a) Croissant, peanut butter, sandwiches, whole milk
b) Bran muffin, skim milk, sir fried broccoli
c) Bagel with cream cheese, cauliflower salad
d) Oatmeal, baked potato, turkey sandwich

Answer 234

b) Bran muffin, skim milk, sir fried broccoli

Question 235

14. The nurse is teaching a 19 year old client and the client’s family about what to expect
    with high dose chemotherapy and the effects of neutropenia. What should the nurse
    teach as the most reliable early indicator of infection in a neutropenic client

a) Fever
b) Chills
c) Tachycardia
d) Dyspnoea

Answer 235

a) Fever

Question 236

15. The client is being discharged with oral chemotherapy, in teaching the client and
    family how to manage nausea and vomiting at home, which of the following should
    be discussed

a) Eating frequent, small meals throughout the day
b) Eating three normal meals a day
c) Eating only cold food but no salads
d) Limiting the amount of fluid intake

Answer 236

a) Eating frequent, small meals throughout the day

Question 237

16. In setting up a syringe driver to administer analgesia which of the following factors
    would be most important for the nurse to consider when determining the angle at
    which to insert the needle

a) Size of the syringe
b) Tissue turgor
c) Length of the needle
d) Amount of subcutaneous tissue

Answer 237

d) Amount of subcutaneous tissue

Question 238

17. A client is diagnosed with metastatic bone cancer. Which of the following abnormal
    laboratory values would the nurse expect to see

a) Hypocalcaemia
b) Elevated serum alkaline phosphatase
c) Hypokalemia
d) Hypoglycaemia

Answer 238

b) Elevated serum alkaline phosphatase

Question 239

18. Mrs Johnson has had a recurrence of breast cancer and has been managed at home
    with support from the palliative care nurse specialist. This morning when visiting her,
    the nurse noted she was experiencing severe low back pain especially when lying
    down. Which of the following assessments would be the priority

a) Bowel and bladder
b) Respiratory
c) Neurological
d) Skin and pressure sore risk

Answer 239

d) Skin and pressure sore risk

Question 240

19. The nurse would teach the client that a normal local tissue response to radiation is

a) Atrophy of the skin
b) Scattered pustule formation
c) Redness of the surface tissue
d) Sloughing of two layers of skin

Answer 240

c) Redness of the surface tissue

Question 241

20. The husband of a client with cervical cancer says to the nurse, ‘the doctor told my
    wife that her cancer is curable. Is he just trying to make us feel better.’ Which would
    be the nurses most accurate response

a) When cervical cancer is detected early and treated aggressively, the cure rate is
almost 100%
b) The 5 year survival rate is about 75%, which makes the odds pretty good
c) Saying a cancer is curable means that 50% of all women with cancer survive at
least 5 years
d) Cancers of the female reproductive tract tend to be slow growing and respond well
to treatment

Answer 241

a) When cervical cancer is detected early and treated aggressively, the cure rate is
almost 100%

Question 242

21. A priority nursing diagnosis for a client with cervical cancer who has an internal
    radium implant would be

a) Pain related to cervical tumour
b) Anxiety related to self care deficit from imposed immobility during radiation
c) Impaired health maintenance related to surgery
d) Disturbed sleep pattern related to interruptions by health care personnel

Answer 242

b) Anxiety related to self care deficit from imposed immobility during radiation

Question 243

22. The nurse should carefully observe a client with internal radium implants for typical
    side effects associated with radiation therapy to the cervix. These effects include

a) Severe vaginal itching
b) Confusion
c) High fever in the afternoon or evening
d) Nausea and a foul vaginal discharge

Answer 243

d) Nausea and a foul vaginal discharge

Question 244

23. A terminally ill client’s husband tells the nurse, ‘I wish we had taken that trip to
    Europe last year. We just kept putting it off, and now I’m furious that we didn’t go.’
    The nurse interprets that husbands statement as indicating which of the following
    stages of adapt ion to dying

a) Anger
b) Denial
c) Bargaining
d) Depression

Answer 244

a) Anger

Question 245

24. A client is newly diagnosed with cancer and is beginning a treatment plan. Which of
    the following nursing interventions will be most effective in helping the client cope

a) Assume decision making for the client
b) Encourage strict compliance with all treatment regimens
c) Inform the client of all possible adverse treatment effects
d) Identify available resources

Answer 245

d) Identify available resources

Question 246

25. Mr Green has been admitted terminally ill and in need of pain management. He has
    now been commenced on oral morphine. What would you also ensure the doctor
    prescribe at this time

a) Antiemetics
b) Subcutaneous fluids
c) Aperients
d) Sedatives

Answer 246

a) Antiemetics

Question 247

STATE EXAMS 6

1. A client sustained an open fracture of the femur from an automobile accident. For
   which of the following types of shock should the client be assessed

a) Cardiogenic
b) Neurogenic
c) Hypovolaemic
d) Anaphylactic

Answer 247

c) Hypovolaemic

Question 248

2. What is the primary goal for the care of a client who is in shock

a) Preserve renal function
b) Prevent hypostatic pneumonia
c) Maintain adequate vascular tone
d) Achieve adequate tissue perfusion

Answer 248

d) Achieve adequate tissue perfusion

Question 249

3. Which of the following findings would the nurse most likely note in the client who is
   in the compensatory stage of shock

a) Decreased urinary output
b) Significant hypotension
c) Mental confusion
d) Tachycardia

Answer 249

d) Tachycardia

Question 250

4. Two days after the fracture of his femur, a client suddenly complains of chest pain
   and dyspnoea. The nurse also notes some confusion and an elevated temperature.
   Based on these assessment findings, the nurse suspects which of the following
   complications

a) Osteomyelitis
b) Fat embolism syndrome
c) Venous thrombosis
d) Compartment syndrome

Answer 250

b) Fat embolism syndrome

Question 251

5. When the nurse asked her client and partner what type of birth control they were
   planning to use, they stated that since she is breast feeding, they don’t need to have to
   worry about birth control. The nurse should tell them that

a) They can decide on a method when Cindy stops breast feeding
b) No birth control is necessary until after the first menstrual period
c) Ovulation can occur when a woman is breast feeding
d) Since Cindy has become pregnant once, it will be much easier for her to become
pregnant now

Answer 251

c) Ovulation can occur when a woman is breast feeding

Question 252

6. During the post partum period many women experience mood swings which are
   referred to as

a) Psychosis
b) Post partum blues
c) Detachment from infant
d) Attachment to the infant

Answer 252

b) Post partum blues

Question 253

7. According to Erikson, an infant is in the psychosocial stage that is characterised by
   the conflict of

a) Trust vs mistrust
b) Initiative vs guilt
c) Intimacy vs isolation
d) Autonomy vs shame and doubt

Answer 253

a) Trust vs mistrust

Question 254

8. Mrs Cindy Jackson, para 1, gravid 1, had a vaginal delivery of a full term baby
   yesterday. Because of the soreness of her perineum, Cindy states that she is afraid to
   have a bowel movement. The nurse should encourage Cindy to

a) Ambulate frequently, eat fresh fruits and vegetables, and drink 6 – 8 glasses water
per day
b) Ask her doctor to prescribe a laxative to stimulate defecation
c) Drink 2 glasses of warm water after every meal, then try to defecate
d) Do kegel exercises twice a day, eat a low roughage diet, and drink ten glasses of
water per day

Answer 254

a) Ambulate frequently, eat fresh fruits and vegetables, and drink 6 – 8 glasses water
per day

Question 255

9. Mrs Frederick is scheduled for exploratory and palliative surgery the next day.
   Results of blood tests show that she has a microcytic anaemia
   Likely causes of microcytic anaemia is
10. A diet low in iron
11. A diet low in vitamin C
12. Chronic blood loss
13. Acute blood loss
14. Haemolytic streptococcal infection

a) 1, 3 and 5
b) 1, 2 and 5
c) 1, 2 and 4
d) 1, 2 and 5

Answer 255

c) 1, 2 and 4

Question 256

10. Mrs Frederick is to have a blood transfusion of two units of packed cells, prior to
    surgery. She is charted 350 mls over three hours through a blood giving set with a
    drip factor of 15
    How many drops per minute will you run the blood at

a) 20
b) 25
c) 30
d) 35

Answer 256

c) 30

Question 257

11. If Mrs. Frederick were to receive blood with which she is incompatible, the signs and
    symptoms we would see, would include
12. Restlessness and anxiety
13. Generalised tingling sensations
14. Nausea and vomiting
15. Elevated temperature
16. Decreased blood pressure

a) 1, 2 and 3
b) 1, 4 and 5
c) 2, 3 and 5
d) All of the above

Answer 257

b) 1, 4 and 5

Question 258

12. If a client who suffers from cancer of the colon, the most common site of metastases
    is the

a) Bladder
b) Liver
c) Spleen
d) Pancreas

Answer 258

b) Liver

Question 259

13. Which of the following post operative complications may be avoided by pre operative
    teaching

a) Wound infection
b) Wound dehiscence
c) Hypostatic pneumonia
d) Hypovolaemic shock

Answer 259

c) Hypostatic pneumonia

Question 260

14. Haemorrhage during the first 12 hours post operatively is termed

a) Primary
b) Secondary
c) Intermediary
d) Reactionary

Answer 260

c) Intermediary

Question 261

15. Mary aged 45 years is admitted to the ward for planned surgery. Mary smokes 20
    cigarettes a day and drinks three glasses of wine every evening
    The significance of this information for you is so that you

a) May teach deep breathing and coughing and relaxation techniques in preparation
for surgery
b) Be aware of a potentially addictive personality when planning her pain relief post
operatively
c) Can assist her to break her smoking and drinking habits when in hospital
d) May plan to include cigarettes and alcohol in her post operative regime

Answer 261

c) Can assist her to break her smoking and drinking habits when in hospital

Question 262

16. Two days later, Mary has a cholecystectomy performed, successfully. On her return to
    the ward, Mary has an upper abdominal wound with a redivac, a T tube, A naso
    gastric tube and an intravenous infusion in situ
    When carrying out Marys post operative exercise regime, which aspect should receive
    the highest priority

a) Ensuring Mary has privacy and freedom from interruption
b) That Mary knows how to breathe and cough and why it is important
c) That she knows how to support her wound and that her pain is under control
d) That there be no interruption by Marys family and friends when they visit

Answer 262

c) That she knows how to support her wound and that her pain is under control

Question 263

17. Mr Evere, a 69 year old retired musician was admitted to the intensive care unit with a
    diagnosis of Adams stokes syndrome
    The nurse notes mr everes pulse pressure is decreasing. Pulse pressure is the

a) Difference between the apical and radial rates
b) Force exerted against an arterial wall
c) Degree of ventricular contraction in relation to output
d) Difference between systolic and diastolic readings

Answer 263

d) Difference between systolic and diastolic readings

Question 264

18. The physician suspects cardiogenic shock. Shock is

a) A failure of peripheral circulation
b) An irreversible phenomenon
c) Always caused by decreased blood volume
d) A fleeting reaction to tissue injury

Answer 264

a) A failure of peripheral circulation

Question 265

19. The physical law explaining the greatly increased venous return accompanying mild
    vasoconstriction underlies the use of

a) Adrenaline in treating shock
b) Rotating tourniquets in pulmonary oedema
c) Sympathetomy in treating hypertension
d) Digoxin to increase cardiac output

Answer 265

a) Adrenaline in treating shock

Question 266

20. Culturally safe nursing care can best be achieved when the nurse has

a) An in depth knowledge of the treaty of Waitangi
b) An awareness of Maori perspectives of health
c) An awareness and acceptance of your own limits in meeting someone else’s health
and cultural needs
d) A knowledge of Maori protocol

Answer 266

c) An awareness and acceptance of your own limits in meeting someone else’s health
and cultural needs

Question 267

21. Imagine a new virus infecting a human population for the first time. Which of the
    following is most likely to lead to a rapid increase in cases worldwide

a) Severe disease with high mortality
b) Lack of hand hygiene
c) Air travel
d) High transmissibility

Answer 267

d) High transmissibility

Question 268

22. The school nurse is caring for a child with haemophilia who is actively bleeding from
    the leg. Which of the following would the nurse apply

a) Direct pressure, checking every few minutes to see if the bleeding has stopped
b) Ice to the injured leg area several times a day
c) Direct pressure to the injured area continuously for 10 minutes
d) Ice bag with elevation of the leg twice a day

Answer 268

c) Direct pressure to the injured area continuously for 10 minutes

Question 269

23. Home health nurses visit a blind diabetic patient who lives along to monitor the
    patient’s glucose level and administer the patient’s daily insulin. Evaluation of
    outcome management for this patient would include

a) An absence of complications of diabetes
b) A reduction in hospitalizations for glycemic control
c) The ability of the patient to learn to use adaptive syringes
d) The patients evaluation of the services provided by the nurses

Answer 269

b) A reduction in hospitalizations for glycemic control

Question 270

24. The nurse consults with the physician to arrange a referral for hospice care for a
    patient with end stage liver disease based on the knowledge that hospice care is
    indicated when

a) Family members can no longer care for dying patients at home
b) Patients and families are having difficulty coping with grief reactions
c) Preparation for death with palliative care and comfort are the goals of care
d) Patients have unmanageable pain and suffering as a result of their condition

Answer 270

c) Preparation for death with palliative care and comfort are the goals of care

Question 271

25. To better understand fluid balance the nurse needs to recognise that

a) Glomerular filtration occurs in the glomerular which are small arteries in the
kidneys
b) The volume of urine secreted is regulated mainly by mechanisms that control the
glomerular filtration rate
c) An increase in the hydrostatic pressure in bowman’s capsule tends to increase the
glomerular filtration rate
d) A decrease in blood protein concentration tends to increase the glomerular
filtration rate

Answer 271

c) An increase in the hydrostatic pressure in bowman’s capsule tends to increase the
glomerular filtration rate

Question 272

26. The client with unresolved oedema is most likely to develop

a) Thrombus formation
b) Tissue ischaemia
c) Proteinaemia
d) Contractures

Answer 272

b) Tissue ischaemia

Question 273

27. Women are more susceptible to urinary tract infection because of

a) Poor hygienic practices
b) Length of urethra
c) Continuity of the mucous membrane
d) Inadequate fluid intakes

Answer 273

b) Length of urethra

Question 274

28. The most important electrolyte of intracellular fluid is
    a) Calcium
    b) Sodium
    c) Potassium
    d) Chloride

Answer 274

c) Potassium

Question 275

29. In encouraging hospitalised clients to void the most basic methods for the nurse to
    employ is

a) Having the client listen to running water
b) Warming a bedpan
c) Placing the clients hand in warm water
d) Providing privacy

Answer 275

d) Providing privacy

Question 276

30. Since Mr. Saul has right hemiplegia the nurse contributes to his rehabilitation by

a) Making a referral to the physio therapist
b) Not moving the affected arm and leg unless necessary
c) Beginning active exercise
d) Positioning Mr. Saul to prevent deformity and decubiti

Answer 276

d) Positioning Mr. Saul to prevent deformity and decubiti

Question 277

31. Mr Saul’s emotions responses to his illness would probably be determined by

a) His premobid personality
b) The location of his lesion
c) The care he is receiving
d) His ability to understand his illness

Answer 277

d) His ability to understand his illness

Question 278

32. Mrs Olin, a retired school teacher with rheumatoid arthritis, is admitted to hospital
    with severe pain and swelling of the joints in both hands
    Mrs Olin’s condition would indicate that a primary consideration of her care is

a) Motivation
b) Education
c) Control of pain
d) Surgery

Answer 278

c) Control of pain

Question 279

33. While taking a nursing history from Mrs. Olin, the nurse promotes communication by

a) Asking questions that can be answered by a simple ‘yes’ or ‘no’
b) Telling Mrs. Olin there’s no cause for alarm
c) Asking ‘why’ and ‘how’ questions’
d) Using broad, open ended statements

Answer 279

d) Using broad, open ended statements

Question 280

34. Mr and Mrs. B were emotionally upset when their baby girl, sue, was born with a cleft
    palate and double cleft lip
    The nurse, in order to give the most support to the parents, should

a) Discourage them from talking about the baby
b) Encourage them to express their worries and fears
c) Tell them not to worry because the defect can be repaired
d) Show them post operative photographs of babies who had similar defects

Answer 280

b) Encourage them to express their worries and fears

Question 281

35. The most critical factor in the immediate care of sue, after repair of the lip is

a) Maintenance of airway
b) Administration of drugs to reduce secretions
c) Administration of fluids
d) Preventing of vomiting

Answer 281

a) Maintenance of airway

Question 282

36. Additional nursing care for sue after the original lip repair would include

a) Placing the baby in a semi sitting position
b) Keeping the infant from crying
c) Spoon feeding for the first two days after surgery
d) Keeping the baby nil per mouth

Answer 282

a) Placing the baby in a semi sitting position

Question 283

37. Seven year old Johnny has been admitted for a tonsillectomy. The nurse suspects
    haemorrhage post operatively when Johnny

a) Snores noisily
b) Becomes pale
c) Complains of thirst
d) Swallows frequently

Answer 283

d) Swallows frequently

Question 284

38. Pitting oedema in the lower extremities occurs with this problem because of the

a) Increase in tissue colloid osmotic pressure
b) Increase in the tissue hydrostatic pressure at the arterial end of the capillary bed
c) Decrease in the plasma colloid osmotic pressure
d) Increase in the plasma hydrostatic pressure at the venous end of the capillary beds

Answer 284

d) Increase in the plasma hydrostatic pressure at the venous end of the capillary beds

Question 285

39. The nurse can best assess the degree of oedema in an extremity by

a) Checking for pitting
b) Weighing the client
c) Measuring the affected area
d) Observing intake and output

Answer 285

a) Checking for pitting

Question 286

40. Mrs Smith is hospitalised with coronary heart disease. She is receiving IV fluids, her
    vital signs are checked 4 hourly. She is on bed rest. She was also prescribed digoxin.
    She does not seem to be acutely sick but her prognosis is guarded. Mrs Smith asks
    what the coronary arteries have to do with her angina. In determining the answer, the
    nurse should take into consideration that coronary arteries

a) Carry reduced oxygen content blood to the lungs
b) Carry blood from aorta to the myocardium
c) Supply blood to the endocardium
d) Carry high oxygen blood from the lungs towards the heart

Answer 286

b) Carry blood from aorta to the myocardium

Question 287

41. After activity Mrs. Smith states she has angina pain. The nurse should realise that
    angina pectoris is a sign of

a) Myocardial ischemia
b) Myocardial infarction
c) Coronary thrombosis
d) Mitral insufficiency

Answer 287

a) Myocardial ischemia

Question 288

STATE EXAMS 7

1. During therapy with salbutamol (venolin) Mr. Peters complains of palpitation, chest
   pain, and a throbbing headache. In view of these symptoms which of the following
   statements represent the most appropriate nursing action

a) Reassure Mr. peters that these effects are temporary and will subside as he
becomes accustomed to the drug
b) Withhold the drug until additional orders are obtained from the physician
c) Tell him not to worry, he is experiencing expected side effects of medicine
d) Ask him to relax, then instruct him to breath slowly for several minutes

Answer 288

b) Withhold the drug until additional orders are obtained from the physician

Question 289

2. Mr Peters pulmonary function studies are abnormal. The nurse should realise that one
   of the most common complication of chronic asthma is

A) Athelectasis
B) Emphysema
C) Pneumothorax
D) Pulmonary fibrosis

Answer 289

C) Pneumothorax

Question 290

3. Emphysema causes a failure in oxygen supply because of

a) Infectious obstructions
b) Respiratory muscle paralysis
c) Pleural effusion
d) Loss of aerating surface

Answer 290

b) Respiratory muscle paralysis

Question 291

4. When the alveoli loose normal elasticity, the nurse teaches Mr. peters exercises that
   lead to effective use of the diaphragm because

a) Mr peters has an increase in the vital capacity of the lungs
b) The residual capacity of the lungs has been increased
c) Inspiration has been markedly prolonged and difficult
d) Abdominal breathing is an effective compensatory mechanism that is
spontaneously initiated

Answer 291

d) Abdominal breathing is an effective compensatory mechanism that is
spontaneously initiated

Question 292

5. Mr hurt has developed acute renal failure and uraemia. Metabolic acidosis develops in
   renal failure as a result of

a) depression of respiratory rate by metabolic wastes causing carbon dioxide
retention
b) inability of renal tubules to secrete hydrogen ions and conserve bicarbonate
c) inability of renal tubules to reabsorb water to achieve dilution of acid contents of
the blood
d) impaired glomerular filtration causing retention of sodium and metabolic waste
products

Answer 292

c) inability of renal tubules to reabsorb water to achieve dilution of acid contents of
the blood

Question 293

6. of the following, which is most important in maintaining the fluid and electrolyte
   balance of the body

a) urinary system
b) respiratory system
c) antidiuretic hormone (ADH)
d) aldosterone

Answer 293

a) urinary system

Question 294

7. to prevent laryngeal spasms and respiratory arrest in a patient who is at risk for
   hypocalcaemia, an early sign of hypocalcaemia the nurse should assess for is

a) tetany
b) confusion
c) constipation
d) numbness and tingling around the lips or in the fingers

Answer 294

d) numbness and tingling around the lips or in the fingers

Question 295

8. A 36 year old woman has been admitted to the hospital for knee surgery. Information
   obtained by the nurse during the preoperative assessment that should be reported to
   the surgeon before surgery is performed includes the patients

a) lack of knowledge about postoperative pain control
b) knowledge of the possibility of an early, unplanned pregnancy
c) history of a postoperative infection following a prior cholecystectomy
d) concern that she will be physically limited in caring for her children for a period
postoperatively

Answer 295

b) knowledge of the possibility of an early, unplanned pregnancy

Question 296

9. in is especially important for the nurse to determine the patients current use of
   medications during the preoperative assessment because

a) these medications may alter the patients perceptions about surgery
b) anaesthetics alter renal and hepatic function, causing toxicity by other drugs
c) other medications may cause interactions with anaesthetics, altering the potency
and effect of the drugs
d) routine medications are usually withheld the day of surgery, requiring dosage and
schedule adjustments

Answer 296

c) other medications may cause interactions with anaesthetics, altering the potency
and effect of the drugs

Question 297

10. A client with type 1 diabetes mellitus is scheduled to have surgery. The client has
    been nil per mouth since midnight in preparation for the surgery. In the morning
    before sending the client to the operating room, the nurse notices that the client’s
    daily insulin has not been ordered. Which of the following interventions would be
    most appropriate for the nurse at this time

a) obtain the clients blood glucose values and evaluate the clients need for insulin
b) contact the physician for further orders regarding insulin administration
c) give the clients usual morning dose of insulin
d) notify the recovery room staff to obtain an order for insulin after the surgery

Answer 297

b) contact the physician for further orders regarding insulin administration

Question 298

11. the nurse monitors a patient receiving high doses of broad spectrum antibiotics for
    treatment of endocarditis for the development of

a) erysipelas
b) candidiasis
c) tinea corporis
d) verruca vulgaris

Answer 298

b) candidiasis

Question 299

12. The nurse is evaluating the effectiveness of fluid resuscitation during the emergent
    period of burn management. Which of the following indicates that adequate fluid
    replacement has been achieved in the client

a) an increase in body weight
b) fluid intake is less than urinary output
c) urinary output greater than 35 ml/hr
d) blood pressure of 90/60 mm Hg

Answer 299

c) urinary output greater than 35 ml/hr

Question 300

13. Cimetidine (tagamet) is prescribed for a patient with major burns. In teaching the
    patient about the drug, the nurse explains that it is used to prevent the development of

a) diarrhoea
b) constipation
c) adynamic ileus
d) curling’s ulcer

Answer 300

d) curling’s ulcer

Question 301

14. A client who has had a transurethral resection of the prostate (TURP) 1 day earlier has
    a three way foley catheter inserted for continuous bladder irrigation. Which of the
    following statements best explains why continuous irrigation is used after a TURP

a) to control bleeding in the bladder
b) to instil antibiotics into the bladder
c) to keep the catheter free from clot obstruction
d) to prevent bladder distention

Answer 301

c) to keep the catheter free from clot obstruction

Question 302

15. A patient in severe respiratory distress is admitted to the medical unit at the hospital.
    During the admission assessment of the patient, the nurse should

a) perform a comprehensive health history with the patient to determine the extent of
prior respiratory problems
b) complete a full physical examination to determine the effect of the respiratory
distress on other body functions
c) delay any physical assessment of the patient and ask family members about the
patients history of respiratory problems
d) perform a physical assessment of the respiratory system and ask specific questions
related to this episode of respiratory distress

Answer 302

d) perform a physical assessment of the respiratory system and ask specific questions
related to this episode of respiratory distress

Question 303

16. spinal anaesthesia effects all of the following systems except

a) the sympathetic nervous system
b) the sensory system
c) the parasympathetic nervous system
d) the motor system

Answer 303

c) the parasympathetic nervous system

Question 304

17. Following assessment of a patient with pneumonia, the nurse identifies a nursing
    diagnosis of ineffective airway clearance. The nurse bases this nursing diagnosis on
    the finding of

a) SpO2 of 85%
b) Respiratory rate of 28
c) Presence of greenish sputum
d) Crackles in the right and left lower lobes

Answer 304

d) Crackles in the right and left lower lobes

Question 305

18. To protect susceptible patients in the hospital from aspiration pneumonia, the nurse

a) Turns and repositions immobile patients every 2 hours
b) Positions patients with altered consciousness in lateral positions
c) Monitors for respiratory symptoms in those patients who are immunosuppressed
d) Plans room assignments to prevent patients with infections from being placed with
surgical or chronically ill patients

Answer 305

b) Positions patients with altered consciousness in lateral positions

Question 306

19. A patient experiences a flail chest as a result of an automobile accident. Which
    finding during a respiratory assessment would the nurse expect

a) Bloody sputum
b) Laryngeal stridor
c) Deep, irregular respirations
d) Paradoxic chest movement

Answer 306

d) Paradoxic chest movement

Question 307

20. A client is admitted to the emergency room with crushing chest injuries sustained in a
    car accident. Which of the following signs would indicate a possible pneumothorax

a) Cheyne stokes breathing
b) Increased noisy breath sounds
c) Diminished or absent breath sounds on the affected side
d) A decreased sensation on the affected side

Answer 307

c) Diminished or absent breath sounds on the affected side

Question 308

21. Joan Murray, aged 40 years, discovers a lump in the upper and outer quadrant of her
    left breast when she is showering one morning. One week later, after being seen by a
    surgeon, she is admitted to the ward for a biopsy of the lump and possible left radical
    mastectomy. In establishing a relationship with Joan, what is the most important
    factor for the nurse to consider. That

a) The diagnosis has not yet been established and the breast lump is not necessarily
malignant
b) Joan will have many questions about the possible effects of a mastectomy on her
sexual identity
c) At this time of uncertainty, Joan will need a lot of time to be alone to consider her
choices
d) Joan will be full of fear about the mass and its possible effects on her being

Answer 308

b) Joan will have many questions about the possible effects of a mastectomy on her
sexual identity

Question 309

22. Part of Joan’s pre operative preparation is practising arm and shoulder exercises. The
    reason for these exercises are

a) She can be assured of maximum function of her arm and shoulder if these
exercises are carried out properly
b) That they help reduce the pain and the swelling in the area, after surgery
c) To assist peripheral venous return and thus reduce the potential for pulmonary
embolus
d) By being involved in activities related to her care, Joan is less likely to worry

Answer 309

c) To assist peripheral venous return and thus reduce the potential for pulmonary
embolus

Question 310

23. The reason we position Joan’s affected arm with her elbow at the level of the right
    atrium and her hand higher than her elbow is to

a) Minimise the development of oedema
b) Assist venous return
c) Reduce her pain and discomfort
d) Ensure that the area is supported

Answer 310

b) Assist venous return

Question 311

24. The primary ossification center of long bone is located in which of the following
    structures

a) Epiphysis
b) Epiphyseal plate
c) Diaphysis
d) Endosteum

Answer 311

c) Diaphysis

Question 312

25. The body tissue affected by rheumatoid arthritis is

a) Adipose
b) Muscular
c) Connective
d) Epithelial

Answer 312

c) Connective

Question 313

26. The pattern of rheumatoid arthritis is best describe by its

a) Chronicity
b) Remissions and exacerbations
c) Little relief from aches and pains
d) A progressive increase in disability

Answer 313

b) Remissions and exacerbations

Question 314

27. Rheumatoid arthritis is characterized by

a) Bone pain
b) Sharp tingling sensations
c) Inflammation of the joints
d) Pain and swelling of joints

Answer 314

c) Inflammation of the joints

Question 315

28. Synovial joints are characterized by

a) articular cartilage
b) fibrous capsule
c) joint cavity
d) all of these

Answer 315

d) all of these

Question 316

29. the major support that the muscular system gets from the cardiovascular system

a) a direct response by controlling the heart rate and the respiratory rate
b) constriction of blood vessels and decrease in heart rate for thermoregulatory
control
c) nutrient and oxygen delivery and carbon dioxide removal
d) decreased volume of blood and rate of flow for maximal muscle contraction

Answer 316

c) nutrient and oxygen delivery and carbon dioxide remova

Question 317

30. as the nurse assesses jack for increased intracranial pressure, she would be concerned
    if she observed

a) change in level of consciousness
b) anorexia and thirst
c) increased pulse and respiration rates
d) blurred vision and halos around lights

Answer 317

a) change in level of consciousness

Question 318

31. A person has just been involved in an accident that affected the medulla oblongata.
    The body process most directly affected by this would be

a) slight
b) hearing
c) muscular coordination
d) respiration

Answer 318

d) respiration

Question 319

32. if you are dealing with a person whose phrenic nerve has been damaged, what would
    you expect to observe

a) reduced diaphragm function
b) less mucous secreted by the goblet cells
c) decreased elasticity of the lung tissue
d) increased coughing

Answer 319

a) reduced diaphragm function

Question 320

33. the spinal cord extends through the vertebral canal from the foramen magnum to the

a) 7th cervical vertebra
b) 12th thoracic vertebra
c) 2nd lumbar vertebra
d) 1st sacral vertebra

Answer 320

c) 2nd lumbar vertebra

Question 321

34. Synaptic conduction of a nerve impulse can be affected by

a) Certain diseases
b) Drugs
c) Changes in Ph
d) All of these

Answer 321

d) All of these

Question 322

35. Lack of muscle coordination is called

a) Monoplegia
b) Ataxia
c) TIA
d) None of these

Answer 322

b) Ataxia

Question 323

36. Inability of chew might result from damage to which cranial nerve

a) Facial
b) Trigeminal
c) Abducens
d) Vagus

Answer 323

b) Trigeminal

Question 324

37. In most people, the left cerebral hemisphere is more important for which of the
    following

a) Spoken and written language
b) Space and pattern perception
c) Musical and artistic awareness
d) Imagination

Answer 324

a) Spoken and written language

Question 325

38. Which of the following is true concerning the limbic system

a) It is comprised of parts of the cerebrum and diencephalon
b) It assumes a primary function in emotions
c) Both a and b
d) Neither a nor b

Answer 325

c) Both a and b

Question 326

39. Coordination of muscular activity is a function of the

a) Cerebral peduncles
b) Cerebellum
c) Thalamus
d) Medulla oblongata

Answer 326

b) Cerebellum

Question 327

40. Which of the following statements is correct

a) Appetite control is a function of the thalamus
b) The midbrain is a conduction pathway and reflex center
c) The cerebellum has sensory centres for thirst and speech
d) Respiratory centres are located in the basal ganglia

Answer 327

b) The midbrain is a conduction pathway and reflex center

Question 328

41. The structure that connects the cerebral hemispheres and facilitates the sharing of
    cerebral information is the

a) Corpus callosum
b) Cingulated sulcus
c) Fourth ventricle
d) Aqueduct of sylvius

Answer 328

a) Corpus callosum

Question 329

42. The portion of bone laid down first in bone formation is the

a) Matrix
b) Calcium salts
c) Trabeculae
d) Marrow

Answer 329

b) Calcium salts

Question 330

43. The area of the greatest degree of flexibility along with the vertebral column is found
    from

a) C3 – C7
b) T1 – T6
c) T7 – T12
d) L1 – L5

Answer 330

a) C3 – C7

Question 331

44. The only ankle bone that articulates with the tibia and the fibula is the

a) Calcaneus
b) Talus
c) Navicular
d) Cuboid

Answer 331

b) Talus

Question 332

45. Severe fractures of the femoral neck have the highest complication rate of any
    fracture because

a) Primary limits are imposed by the surrounding muscles
b) Of the restrictions imposed by ligaments and capsular fibers
c) Of the thickness and length of the bone
d) The blood supply to the region is relatively delicate

Answer 332

d) The blood supply to the region is relatively delicate

Question 333

46. The purpose of myoglobin in skeletal muscle cells is

a) Assist anaerobic reactions
b) Store oxygen for use during vigorous exercise
c) Catabolise pyruvic acid
d) All of these

Answer 333

b) Store oxygen for use during vigorous exercise

Question 334

47. With a milk product free diet, which of the following supplements would you need

a) Vitamin C and iron
b) Iron and phosphorous
c) Calcium and manganese
d) Vitamin c and riboflavin

Answer 334

c) Calcium and manganese

Question 335

48. Protein should be eaten as it

a) Reduces the risk of anaemia
b) Ensures an adequate supply of energy
c) Assists the body to produce new tissues
d) Maintains the body’s protein stores

Answer 335

c) Assists the body to produce new tissues

Question 336

49. Risk factors of CVA that cannot be altered are

a) Sex, race, and raised blood cholesterol levels
b) High BP, previous TIA
c) Race, prior stroke and overweight
d) High BP, previous TIA and increased blood cholesterol levels

Answer 336

a) Sex, race, and raised blood cholesterol levels

Question 337

50. A person who has experienced a right CVA may present with

a) Receptive or expressive aphasia
b) Right hemiplegia
c) Left hemiplegia
d) Deficit of new language information

Answer 337

c) Left hemiplegia

Question 338

51. Where and what is the circle of Willis

a) A capillary meshwork found in bowman’s capsule of the nephron
b) A vascular network at the base of the brain
c) A roundabout at the top of bank st
d) The capsule membrane of a malignant growth

Answer 338

b) A vascular network at the base of the brain

Question 339

52. List the 3 main causes of stroke

a) Cerebral haemorrhage, thrombosis, embolism
b) Cerebral thrombosis, infarction, aneurysm
c) Cerebral embolism, metastatic lesions, coagulopathy
d) Cerebral ischemia, vascular spasms, hypoxia

Answer 339

b) Cerebral thrombosis, infarction, aneurysm

Question 340

53. Angina symptoms include

a) Radiating pain, decreased BP and increased pulse
b) Shortness of breath, loss of consciousness and these effects may last indefinitely
c) Ringing in the ears, anxiety and cramping in the extremities
d) Shortness of breath, sweating, nausea and tiredness

Answer 340

d) Shortness of breath, sweating, nausea and tiredness

Question 341

54. Emphysema is

a) An alveolar disease
b) Due to hypertrophy and hyperplasia of bronchial glands
c) Persistent episodes of productive cough
d) An airway disease

Answer 341

a) An alveolar disease

Question 342

STATE EXAMS 8

1. Circulatory shock can best be described as a condition in which there is

a) A state of hypotension
b) Loss of blood
c) Loss of consciousness due to blood loss
d) Inadequate blood flow to meet the metabolic needs of the body tissues

Answer 342

d) Inadequate blood flow to meet the metabolic needs of the body tissues

Question 343

2. Causes of hypovolemic shock include

a) Vomiting and los of body fluids
b) Allergic reactions to drugs
c) Cardiac failure
d) Hypoglycaemia

Answer 343

a) Vomiting and los of body fluids

Question 344

3. Early signs of hypovolemic shock include

a) Restlessness, thirst, and increased heart rate
b) Decreased blood pressure and apathy
c) Increase in heart rate and increased pulse pressure
d) Decreased blood pressure and unconsciousness

Answer 344

a) Restlessness, thirst, and increased heart rate

Question 345

4. In shock, one of the best indicators of blood flow to vital organs is

a) Rate of blood and fluid administration
b) Blood pressure
c) The colour and temperature
d) Urine output

Answer 345

d) Urine output

Question 346

5. Oliguria, an early sign of shock, occurs for what reason

a) Cessation of glomerular filtration
b) Acute tubular necrosis
c) Metabolic acidosis
d) Sympathetic stimulation

Answer 346

b) Acute tubular necrosis

Question 347

6. A person admitted to the emergency room with trauma and an estimated blood loss of
   1200 to 1400 mls has a blood pressure of 110/70 mmHg and a heart rate of 120 beats
   per minute. The best explanation for these observations would be that

a) The persons actual blood loss was less than the originally estimated loss
b) The person was normally hypertensive and hence did not have as great a drop in
blood pressure as a normotensive person
c) The cause of the bleeding is now under control and the increased heart rate is due
to anxiety
d) An increase in heart rate is compensating for the loss of blood volume

Answer 347

d) An increase in heart rate is compensating for the loss of blood volume

Question 348

7. The pale, cool, clammy skin that is often observed in an individual with shock, can be
   explained in terms of

a) Loss of red blood cells
b) Body’s attempt to shunt blood to vital organs by constricting skin vessels
c) Decreased metabolic needs that accompany shock
d) Body’s attempt to conserve heat loss

Answer 348

b) Body’s attempt to shunt blood to vital organs by constricting skin vessels

Question 349

8. ____________________ is generally relieved by sitting up in a forward leaning
   position

a) Hyperpnoea
b) Orthopnoea
c) Apnoea
d) Dyspnoea on exertion

Answer 349

b) Orthopnoea

Question 350

9. In a client with emphysema, hypoventilation could initially cause

a) Respiratory alkalosis
b) Respiratory acidosis
c) Metabolic acidosis
d) Metabolic alkalosis

Answer 350

b) Respiratory acidosis

Question 351

10. A client is anxious and is hyperventilating. In order to prevent respiratory alkalosis
    the nurse will

a) Administer oxygen
b) Instruct the client to pant
c) Have the client breathe deeply and slowly
d) Have the client breathe into a paper bag

Answer 351

d) Have the client breathe into a paper bag

Question 352

11. A district nurse is sent to assess a new client with cor pulmonale. This term refers to

a) Enlargement of the pulmonary artery
b) Enlargement of the right ventricle
c) Atrophy of the right ventricle
d) Giant bullae growth on the lung

Answer 352

b) Enlargement of the right ventricle

Question 353

12. Tony buffer, 54 years old, has a long history of smoking. He decides to have lung and
    blood studies done because he is very tired, is short of breath, and just does not feel
    good. His blood gases reveal the following findings: pH 7.3; HCO3 27; CO2 58.
    Tony’s condition may be

a) Respiratory alkalosis
b) Metabolic acidosis
c) Respiratory acidosis
d) Metabolic alkalosis

Answer 353

c) Respiratory acidosis

Question 354

13. Approximately 1000ml (1L) of oxygen is transported to cells each minute. Most of
    the oxygen is transported

a) Dissolved in his plasma
b) Loosely bound to his haemoglobin
c) In the form of CO2
d) As a free floating molecule

Answer 354

b) Loosely bound to his haemoglobin

Question 355

14. Mary a 46 year old woman, is admitted to your ward with a chest infection due to an
    exacerbation of chronic obstructive pulmonary disease. A person with emphysema is
    susceptible to respiratory infections primarily because

a) Failure of his bone marrow to produce phagocytic white blood cells
b) Retention of tracheobronchial secretions
c) Decreased detoxification of body fluids by compressed liver cells
d) Persistent mouth breathing associated with dyspnoea

Answer 355

b) Retention of tracheobronchial secretions

Question 356

15. Emphysema differs from chronic bronchitis in that

a) Emphysema obstruction results from mucous production and inflammation
b) Emphysema obstruction results from changes in lung tissues
c) Chronic bronchitis obstruction results from changes in lung tissue
d) There are no visual difference between the two conditions

Answer 356

b) Emphysema obstruction results from changes in lung tissues

Question 357

16. The tissue change most characteristic of emphysema is

a) Accumulation of pus in the pleural space
b) Constriction of capillaries by fibrous tissue
c) Filling of air passages by inflammatory coagulum
d) Over distension, in elasticity, and rupture of alveoli

Answer 357

c) Filling of air passages by inflammatory coagulum

Question 358

17. Which of the following results of emphysema is primarily responsible for
    cardiomegaly

a) Hypertrophy of muscles encircling the bronchi
b) Increased pressure in the pulmonary circulation
c) Decreased number of circulating red blood cells
d) Secretion of excessive amounts of pericardial fluids

Answer 358

b) Increased pressure in the pulmonary circulation

Question 359

18. A 48 year old complains of chest pain. Signs and symptoms that would support a
    diagnosis of myocardial infarction would include

a) Jugular vein distension and hypatomegaly
b) Fever and petechiae over the chest area
c) Nausea and vomiting and cool, clammy pale skin
d) Pericardial friction rub and absent apical pulse

Answer 359

c) Nausea and vomiting and cool, clammy pale skin

Question 360

19. Teaching for the client taking GT or glycerol with nitrate for angina would include

a) Instructing the client to take the nitro-glycerine regularly
b) Explain to the client that a subsequent headache indicates ineffective medication
c) Instructing the client to put the tablet on the tongue and swallow after the tablet
dissolves
d) Teaching the client to take a tablet every 5 minutes (3x) when chest pain occurs

Answer 360

d) Teaching the client to take a tablet every 5 minutes (3x) when chest pain occurs

Question 361

20. A female client is diagnosed with unstable angina. The nurse finds her crying because
    she fears she will become a burden to her husband. Which of the following nursing
    diagnosis would be most appropriate

a) Impaired verbal communication
b) Ineffective family coping
c) Relationship difficulties
d) Fear due to knowledge deficit

Answer 361

d) Fear due to knowledge deficit

Question 362

21. Which of the following steps should a client with periodic angina pain take first when
    pain occurs at home

a) Take sublingual nitro-glycerine and lie down
b) Do mild breathing exercises
c) Take an extra long lasting nitrate tablet
d) Sit down and relax

Answer 362

a) Take sublingual nitro-glycerine and lie down

Question 363

22. The nurse detects premature ventricular contractions and (PVC’s) on the ECG of a
    client who had a mitral valve replacement 2 days ago. PVC’s may be dangerous
    because they

a) Significantly increase cardiac workload
b) May lead to ventricular tachycardia or fibrillation
c) Are the most common cause of myocardial infarction
d) Decreased heart rate and blood pressure

Answer 363

b) May lead to ventricular tachycardia or fibrillation

Question 364

23. A client is admitted to ED following a car accident. He complains of abdominal
    discomfort. The nurse encourages the client to lie down. The reason for this action is

a) To decrease abdominal pain
b) To decrease the risk of dislodging an intra abdominal clot
c) To facilitate peristalsis
d) To decrease the risk of peritoneal infection

Answer 364

a) To decrease abdominal pain

Question 365

24. A client sustained moderate concussion. He has a Glasgow coma scale score of 7.
    Which of the following interventions would you include in your care plan

a) Decrease stimuli, monitor vital signs and neurological status nurse him flat on his
back
b) Gradually increase stimuli, monitor vital signs and neurological status, elevate the
head of the bed 60 degrees
c) Encourage family involvement, reduce monitoring at night to allow client to rest,
elevate the head of the bed 60 degrees
d) Decrease stimuli, monitor vital signs and neurological status elevate the head of
the bed 30 degrees, positioning the client on his side

Answer 365

d) Decrease stimuli, monitor vital signs and neurological status elevate the head of
the bed 30 degrees, positioning the client on his side

Question 366

25. James has sustained a fracture of his left lower leg in a car accident. Classical signs of
    a fracture may include

a) Intermittent pain, flushing of surrounding tissues and vascular spasm
b) Local bone tenderness, soft tissue swelling and inability to use extremity
c) Neural compromise, sharp stabbing pain and obvious ischaemia of the extremity
d) Blanching, hyperextension and parasthesia

Answer 366

b) Local bone tenderness, soft tissue swelling and inability to use extremity

Question 367

26. Monitoring for compartment syndrome is done by checking for

a) Active movement of the limb
b) Colour, warmth, sensation and movement of the extremity
c) Pulse and blood pressure changes
d) The tightness of the plaster cast

Answer 367

b) Colour, warmth, sensation and movement of the extremity

Question 368

27. On assessment the nurse suspects that James is developing compartment syndrome
    because he complains of

a) Severe pain, motor compromise and a ‘pins and needles’ sensation
b) A radiating pain and loss of two point discrimination
c) Swelling, muscle atrophy and intermittent parasthesia
d) Dull aching, spasms and lack of fine co ordination

Answer 368

a) Severe pain, motor compromise and a ‘pins and needles’ sensation

Question 369

28. A comminuted fracture is characterised by

a) A partial break in bone continuity
b) Injury in which two bones are crushed together
c) An injury in which the bone is broken into two or more pieces
d) An injury in which the bone fragments have broken through the skin

Answer 369

c) An injury in which the bone is broken into two or more pieces

Question 370

29. Type 2 diabetics

a) Need insulin to maintain homeostasis
b) May develop ketoacidosis easily
c) May go undetected for years
d) Are usually very slim and malnourished

Answer 370

c) May go undetected for years

Question 371

30. Hyperglycemia

a) Is alright only once in a while
b) Due to an over medication of insulin
c) If left uncontrolled, this can lead to DKA in type 1 or HNK in type 2
d) Also called insulin shock reaction

Answer 371

c) If left uncontrolled, this can lead to DKA in type 1 or HNK in type 2

Question 372

31. Macrovascular complications of diabetes

a) Occur shortly after the onset of the disease
b) Affects coronary, peripheral and cerebral circulation
c) Affects the eyes and the kidneys
d) Affects sensorimotor and autonomic nerves

Answer 372

b) Affects coronary, peripheral and cerebral circulation

Question 373

32. For relief of angina, the client may

a) Call 111
b) Take a dose of glyceryl trinitrate up to 3 times, 5 minutes apart until the pain
subsides
c) Slowly exercise to the individuals tolerance level
d) Take only one dose of glyceryl trinitrate, if this has no effect, call 111

Answer 373

b) Take a dose of glyceryl trinitrate up to 3 times, 5 minutes apart until the pain
subsides

Question 374

33. Ways to minimise precipitating effects of angina are

a) Avoid over exertion
b) Reduce stress
c) Avoid overeating
d) All above

Answer 374

d) All above

Question 375

34. Angina

a) May be referred to as angina majoralis
b) Not relieved by rest
c) Include chest pain which may radiate down the arms, neck, jaw and back
d) Needs immediate medical attention

Answer 375

d) Needs immediate medical attention

Question 376

35. A client with multiple fractures is at risk for a fat embolism. What early sign should
    you monitor for

a) Haematuria
b) Mental confusion or restlessness
c) Sudden temperature elevation
d) Pallor and discoloration at the fracture site

Answer 376

b) Mental confusion or restlessness

Question 377

36. Following an application of a full arm cast a client complains of deep throbbing elbow
    pain. You note diminished capillary refill in the fingers. You should

a) Notify the doctor immediately and prepare to bivalve the cast
b) Cut a window in the cast over the elbow area and check for infection
c) Elevate the arm, apply ice packs and assess hourly
d) Administer prescribed analgesics and notify the doctor

Answer 377

a) Notify the doctor immediately and prepare to bivalve the cast

Question 378

37. When assessing a patient at risk for increased intracranial pressure, the first thing you
    would check is

a) Reaction to pain stimuli
b) Papillary function
c) Level of consciousness
d) Motor function

Answer 378

c) Level of consciousness

Question 379

38. Pupillary dilation occurs when herniating brain tissue

a) Compresses the occulomotor nerve
b) Chokes the optic disks
c) Stretches the optic nerve
d) Paralyses the ocular muscles

Answer 379

a) Compresses the occulomotor nerve

Question 380

39. Changes in vital signs with increasing intracranial pressure would include

a) Hypotension and tachycardia
b) Narrowing pulse pressure and tachypnea
c) Hypotension and a pulse deficit
d) Widening pulse pressure and bradycardia

Answer 380

d) Widening pulse pressure and bradycardia

Question 381

40. Bleeding within the skull results in increased intracranial pressure because

a) Arteries bleed rapidly and profusely
b) Bleeding from veins goes undetected
c) Spinal fluid is produced more rapidly
d) The cranium is a closed, rigid vault

Answer 381

d) The cranium is a closed, rigid vault

Question 382

41. What is the most common cause of heart failure (HF)

a) Smoking
b) Diabetes
c) Coronary artery disease
d) Family history

Answer 382

c) Coronary artery disease

Question 383

42. The action of ACE inhibitors (angiotensin converting enzyme) is

a) Increased urinary output, therefore decreased blood pressure
b) Relax blood vessels, therefore decreased vascular resistance
c) Strengthens cardiac contraction, therefore increase cardiac output
d) Relax cardiac muscle therefore decrease heart rate

Answer 383

a) Increased urinary output, therefore decreased blood pressure

Question 384

43. Hyperkalemia is

a) Increased serum potassium levels
b) Increased serum calcium levels
c) Increased red blood cell count
d) Increased serum chloride levels

Answer 384

a) Increased serum potassium levels

Question 385

44. Manifestations of heart failure are

a) Hepatomeglia, pitted dependant edema
b) Increased serum glucose levels
c) Increased appetite and weight gain
d) Decreased respiration and dyspnoea

Answer 385

d) Decreased respiration and dyspnoea

Question 386

45. Nursing interventions associated with your clients taking loop diuretics such as
    frusemide are

a) Blood sugar levels, dietary fibre
b) Monitoring of weight and K+ levels
c) Blood pressure and urinary output
d) Make sure your client eats ½ hour following administration

Answer 386

c) Blood pressure and urinary output

Question 387

46. Loop diuretics act by

a) Increasing the blood flow to the glomerular network
b) Decreasing the blood flow to the kidneys therefore decreased urinary output
c) Increased H2O reabsorption in the distal convoluted tubules of the nephron
d) Inhibition complex active pump mechanism therefore increase excretion of
electrolytes

Answer 387

d) Inhibition complex active pump mechanism therefore increase excretion of
electrolytes

Question 388

47. Blood pressure control is carried out by regulation of smooth muscles via

a) Parasympathetic stimulation
b) Parasympathetic and sympathetic stimulation
c) Sympathetic stimulation
d) None of these

Answer 388

b) Parasympathetic and sympathetic stimulation

Question 389

48. The areas of the body that sense blood pressure are known as

a) Baroreceptors
b) Chemoreceptors
c) Viscoreceptors
d) None of these

Answer 389

a) Baroreceptors

Question 390

49. When taking a blood pressure, the first sound picked up by the stethoscope as blood
    pulses through the artery is the

a) Mean arterial pressure
b) Pulse pressure
c) Diastolic pressure
d) Peak systolic pressure

Answer 390

d) Peak systolic pressure

Question 391

50. At any given moment, the systemic circulation contains about _________________ of
    the total blood volume

a) 10%
b) 51%
c) 71%
d) 91%

Answer 391

c) 71%

Question 392

51. The nurse gets the arterial blood gases report and it shows that a person has
    hypercapnia. This means that

a) There is an increased blood carbon dioxide
b) The blood oxygen level is reduced
c) Carbon dioxide has been lost
d) There is respiratory alkalosis

Answer 392

a) There is an increased blood carbon dioxide

Question 393

52. Gregory, aged 70, was admitted with congestive heart failure. Which of these changes
    in physiology is present in congestive heart failure

a) Heart muscle degeneration due to old age
b) A decrease of blood flow through the heart
c) An abnormality in the structure of the heart
d) A blood clot forms in one of the heart chambers

Answer 393

b) A decrease of blood flow through the heart

Question 394

53. Manifestations of right sided heart failure are

a) Fatigue, cyanosis, blood tinged sputum
b) Anorexia, complaints of gastrointestinal distress, fatigue and pitted edema
c) Dyspnea, Orthopnoea and cyanosis
d) Fatigue dependant edema and cough

Answer 394

d) Fatigue dependant edema and cough

Question 395

54. Nursing intervention necessary prior to the administration of digoxin is

a) Palpation of arterial pulse less than 60 bpm
b) Palpation of venous pulse less than 60 bpm
c) Palpation of arterial pulse greater than 60 bpm
d) Palpation of pedal pulse less than 60 bpm

Answer 395

c) Palpation of arterial pulse greater than 60 bpm

Question 396

55. Left sided heart failure affects directly the

a) Liver and extremities
b) Lungs
c) Levels of consciousness
d) Lungs and extremities

Answer 396

b) Lungs

Question 397

56. Basic nursing objectives in the treatment of HF are

a) Start heparinization immediately
b) Nursing the client in trendlenberg position
c) Promote rest therefore decrease workload on heart and decrease H20
accumulation
d) Assess levels of consciousness and give 02 61/min via Hudson mask

Answer 397

c) Promote rest therefore decrease workload on heart and decrease H20
accumulation

Question 398

57. Define a cerebral vascular accident (CVA)

a) Sudden loss of consciousness due to a decreased contractility of the cardia
b) Loss of brain function due to disruption of blood supply to the brain
c) Intermittent spasms of blood vessels interrupting blood flow to the brain
d) Neurologic dysfunction due to diminished blood flow to the cranium

Answer 398

b) Loss of brain function due to disruption of blood supply to the brain

Question 399

58. Cerebral thrombosis is

a) Most common cause of a stroke
b) Originates from a large vessel and lodges in the brain
c) May be caused by an arterial spasm in the brain
d) Usually occurs during strenuous exercise

Answer 399

a) Most common cause of a stroke

Question 400

59. The term blue bloater refers to

a) Decreased erythropoietin production therefore decreased 02 carrying capability of
the RBC
b) Polycythemia and cyanosis from right ventricular failure
c) Cyanosis due to decreased RBC production
d) Increased BP due to high blood volume or fluid overload

Answer 400

b) Polycythemia and cyanosis from right ventricular failure

Question 401

60. Bronchitis is

a) Results from a breakdown in the normal lung defence mechanisms
b) Destruction of alveolar
c) Due to enlarged terminal non respiratory bronchioles and alveolar walls
d) History of daily productive cough that last at least 3 months, for 2 years

Answer 401

a) Results from a breakdown in the normal lung defence mechanisms

Question 402

61. Emphysema is characterised by

a) Fat people due to decreased activity tolerance
b) Unproductive cough and pursed lip breathing
c) Pursed lip breathing and productive cough
d) Blue bloater, normal skin colour and rapid respirations

Answer 402

b) Unproductive cough and pursed lip breathing

Question 403

62. Nursing interventions for the CORD patient include everyone of these except

a) Improve ventilation
b) Remove secretions
c) Prevent complications
d) Promote cooperation and understanding
e) Encourage exercise to test tolerance levels

Answer 403

e) Encourage exercise to test tolerance levels

Question 404

63. Bronchodilators

a) Aid the movement of secretions
b) Liquefy the sputum therefore increase expectoration
c) Include aminophylline for the acute exacerbation
d) Are only used in emergency cases

Answer 404

c) Include aminophylline for the acute exacerbation

Question 405

64. Corticosteroids are used

a) Prophylactically in most cases
b) To aid in vitamin D synthesis
c) To aid the liquefaction and expectoration of sputum
d) Used during the acute exacerbation of CORD

Answer 405

d) Used during the acute exacerbation of CORD

Question 406

65. Pursed lip and diaphragmatic breathing

a) Calms the anxious client
b) Speed up slow respirations and used to promote effective coughing
c) Prevents bronchiolar collapse and air trapping
d) Encourages longer inhalation and faster exhalation

Answer 406

c) Prevents bronchiolar collapse and air trapping

Question 407

66. Percussion, vibration and postural drainage

a) Is effective management of nursing frustrations
b) Promotes loosening secretions and movement out of airway
c) Increases blood supply to area therefore increased expectoration
d) Should be done prior to all meals

Answer 407

b) Promotes loosening secretions and movement out of airway

Question 408

67. A normal blood sugar level (BSL) is

a) 7.35 – 7.45
b) 120 – 160 mm dL
c) 4 - 7 mmol/l
d) +/- 2 mmEq

Answer 408

c) 4 - 7 mmol/l

Question 409

68. Diabetes is

a) An exocrine disorder
b) Decreased production of insulin by the liver
c) An endocrine disorder
d) Decreased secretion of insulin by the alpha cells in the pancreas

Answer 409

c) An endocrine disorder

Question 410

69. Type I diabetics are characterised by

a) Non insulin dependence
b) Majority of the diabetic population
c) Require hypoglycaemic agents to maintain glucose levels
d) Need insulin to maintain normal BSL

Answer 410

d) Need insulin to maintain normal BSL