101. Clinical features of pulmonary empyema include
I. Chronic cough
II. Increasing shortness of breath
III. Production of copious purulent sputum
IV.Wheezing respirations
A. I, II and III
B. I, II and IV
C. II, III and IV
D. I, II, III and IV
102. In right – sided heart failure, patients present with the following EXCEPT
A. Anorexia
B. Ascites
C. Dependent oedema
D.Dyspnoea
103. In acute heart failure, upright position with the leg dangling over the side of the bed effects the following EXCEPT
A. Decreases venous return
B. Decreases lung congestion
C. Lowers output of the right ventricle
D. Reduces arterial blood pressure
104. Clinical manifestations in Reynaud’s disease includes the following EXCEPT
A. Coldness
B. Pain
C. Pallor of fingertips or toes
D. Ulceration and gangrene
105. The most common cause of diabetic ketoacidosis is
A. Emotional stress
B. Inadequate food intake
C. Increased insulin dose
D. Presence of infection
106. Which of the following electrolytes would be depleted in a patient on furosemide (Lasix)?
A. Calcium
B. Phosphate
C. Potassium
D.Sodium
107. The factor that determines the needles diameter when preparing an injection is the
A. Efficiency of the medicine
B. Potency of the medicine
C. Patency of the needle
D. Viscosity
108. Before giving a client digoxin, the nurse should obtain the
A. Apical heart rate
B. Difference between the apical and radial pulses
C. Radial pulse in both arms
D. Radial pulse on the left side of the heart
109. A diabetic patient on admission has developed insulin comA. The signs that the nurse is expected to observe include
A. Anorexia, glycosuria
B. Excessive thirst, dry hot skin
C. Fruity odour of breath, acetonuria
D. Pallor, sweating, tremors
110. In giving Aminophyline intravenously to relieve severe asthma, the nurse should observe for
A. Decreased pulse rate
B. Decreased urinary output
C. Hypotension
D. Visual disturbances
111. Oedema in congestive cardiac failure is caused by
A. Decreased plasma protein
B. Decreased venous pressure
C. Increased plasma protein
D. Increased venous pressure
112. Intravenous solution of 0.45% sodium with respect to human blood cells is
A. Hypotonic
B. Hypertonic
C. Isotonic
D. Isomeric
113. Ascites can be related to
A. Decreased production of potassium
B. Diminished plasma protein
C. Kidney malfunction
D. Portal hypotension
114. The main difference in manifestations of malaria and yellow fever is that in yellow fever the patient has
A. Albuminuria
B. Pain in the limbs
C. Rigor
D. Vomiting
115. A client with pyrexia would demonstrate
A. Dyspnoea
B. Elevated blood pressure
C. Increasedpulse rate
D. Precordial pain
116. In taking the apical pulse, the nurse places the stethoscope
A. Between the sixth and the seventh ribs at the leftmedaxillary line
B. Between the third and fourth ribs and to the left of the sternum
C. In the fifth intercostals space along the left midclavicular line
D. Just to the left of the median point of the sternum
117. Antibodies are produced by
A. Eisubioguds
B. Erythrocytes
C. Lymphocytes
D. Plasma cells
118. A client develops chills and headache during blood transfusion, the nurse’ best action is to
A. Lightly cover the client
B. Notify the physician
C. Stop the transfusion immediately
D. Slow the blood flow to keep the vein open
119. The most important electrolyte in the extracellular fluid is
A. Calcium
B. Chloride
C. Potassium
D. Sodium
120. Catheterisation is not used routinely in collecting urine for culture because
A. The client feels uncomfortable
B. The doctor has to pass the catheter
C. The danger of causing trauma to the urethra
D. The risk of introducing additional bacterial into the bladder
121.
A patient who smokes tells the nurse that she wants to quit smoking.
The best response by the nurse is to tell the patient that
A. If she is really committed to stopping, that is all that is needed to quit
B. To overcome the nicotine addiction, it is always necessary to join a group of support program
C. Setting a date to stop and then quitting is the most difficult but is associated with fewer relapses
D. The use of nicotine replacement aids with behavioural interventions is the most successful method of stopping
122. The immediate nursing interventions
To relieve the symptoms of hypoglycaemia include Administering 5% dextrose solution IV
Giving 100mls of fruit juice
Providing a snack of pie and dry crackers
Withholding a subsequent dose of insulin
123. A nursing measure that should be instituted after a pneumonectomy includes
A. Monitoring chest – tube drainage and functioning
B. Positioning the patient on the unaffected side or back
C. Range – of – motion exercises on the affected upper extremity
D. Auscultating frequently for lung sounds on the affected side
124.
In responding to a patient with emphysema who asks about the
possibility of a lung transplant, the nurse knows that lung
transplantation is contraindicated in patients
A. With cor pulmonale
B. Who currently smoke
C. With end stage renal failure
D. Older than 50 years of age
125. The body fluids that make up 40% or more of the total body weight are
A. Extracellular
B. Intestinal
C. Intracellular
D. Intravascular
126. A plan of care for the patient with Chronic Obstructive Pulmonary Disease (COPD) would include
A. Chronic corticosteroid therapy
B. Reduction of risk factors for infection
C. High flow rate of oxygen administration
D. Lung exercises that involves inhaling longer than exhaling
127. One important thing a nurse can teach a patient with emphysema is to
A. Move to a hot, dry climate
B. Perform chest physical therapy
C. Know the early signs of respiratory infection
D. Obtain adequate rest in the supine position
128. The major advantage of a venturi mask is that it can
A. Deliver up to 80% O2
B. Provide continuous 100% humidity
C. Deliver a precise concentration of O2
D. Be used while a patient eats and sleeps
129.
In evaluating the knowledge of an asthmatic patient about self – care,
the nurse identifies additional information needed when the patient says
A. I use my corticosteroid inhaler when I feel short of breath
B. Iget a flu shot every year and see my doctor if I have an upper respiratory infection
C.
I use my bronchodilator inhaler before I visitmy aunt who has a cat,
but I only visit for a few minutes because of my allergies
D. I
walk 30 minutes every day but sometimes I have to use my bronchodilator
inhaler before walking to prevent me from getting short of breath
130. Which of the following is a clinical feature of marasmus?
A. Constantly crying for food
B. Flaky point dermatosis
C. Moon – shaped face due to oedema
D. Reddish brown hair
131. Symptoms of hyperthyroidism include
A. Increased appetite, slow pulse, dry skin
B. Loss of weight, constipation, restlessness
C. Nervousness, weight loss, increased appetite
D. Protruding eyeballs, slow pulse, sluggishness
132. An individual who lives at a high altitude may normally have an increased Red Blood Cell because
A. High altitudes cause vascular fluid loss leading to haemoconcentration
B. Hypoxia caused by decreased atmospheric oxygen stimulates erythropoiesis
C. The function of the spleen in removing old erythrocytes is impaired at high altitudes
D. Impaired production of leucocytes and platelets leads to proportionally higher red blood cell count
133.
Disorders such as myeloblastic leukaemia that arise from myeloblast
cells in the bone marrow will have the primary effect of causing
A. Increased incidence of cancer
B. Decreased production of antibodies
C. Decreased phagocytosis of bacteria
D. Increasedallergic and inflammatory reaction
134.
An anticoagulant such as Warfarin that interferes with the production
of prothrombin will alter the clotting mechanism during
A. Platelet aggregation
B. Activation of thrombin
C. The release of tissue thromboplastin
D. Stimulation of factor activation complex
135. In a surgery of an anaemic patient, the nurse would expect to find
A.
Dyspnoea and tachycardia B. Cyanosis and pulmonary oedema
C. Cardiomegaly and pulmonary fibrosis
D. Ventricular arrhythmias and wheezing
136. Significant information obtained from the patient health history that relates to the haematologic system includes
A.
Jaundice B. Bladder surgery
C. Early menopause
D. Multiple pregnancies
137. The nurse will advise a patient with a diagnosis of nephritic syndrome to take food high in
A. Carbohydrates
B. Fats
C. Protein
D. Sodium
138. The primary goal for the patient with Bonchieostasis is that the patient will
A. Have no recurrence of disease
B. Have normal pulmonary function
C. Maintain removal of bronchial secretions
D. Avoid environmental agents that precipitate inflammation
139. A nurse identifies a flail chestin a trauma patient when
A. Multiple rib fractures are determine by X ray
B. Paradoxical chest movements occurs during respiration
C. There is decreased movement of the involved chest wall
D. A tracheal deviation to the unaffected side is present
140.
The nurse notes fluctuation of the water level in the tube submerged in
the water – seal chamber in a patient with closed chest tube drainage.
The nurse should
A. Continue to monitor this normal findings
B. Check all connections for a leak in the system
C. Lower the drainage collector further from the chest
D. Clamp the tubing at progressively distal points away from the patient until the fluctuations
141. Complications of hyperparathyroidism include
A. Bone destruction
B. Graves’ disease
C. Seizures
D. Tetany
142. Gullian Barrre Syndrome causes respiratory problems primarily by
A. Depressing thee C N S
B. Deforming chest wall muscles
C. Paralysing the diaphragm secondary to trauma
D. Interrupting nerve transmission to respiratory muscle
143.
A diagnosis of pediculosis corporis is made in a pupil at a health
centre. An appropriate measure in treating this condition is
e. Topical application of griseofulvin
f.
Washing the body with pyrethrins g. Administration of systemic antibiotics
h. Moistcompresses applied frequently
144. When creating a therapeutic environment for a patient recovering from myocardial infarction, the nurse should provide for
A. Daily newspapers in the morning
B. Short family visits
C. Telephone communication
D. Television for short periods
145.
A patient with COPD asks why the heart is affected by respiratory
disease. The nurse’s response to the patient is based on the knowledge
that cor pulmonale is characterised by
A. Pulmonary congestion secondary to left ventricular failure
B. Right ventricular hypertrophy secondary to increase pulmonary vascular resistance
C. Excess serous fluid collection in the alveoli caused by retained respiratory secretions
D. Right ventricular failure secondary to compression of the heart by hyperventilated lungs
146. Asthma is best characterised as
A. An inflammatory disease
B. A steady progression of bronchoconstriction
C. A obstructive disease with loss of alveolar walls
D. A chronic obstructive disorder characterised bymucus production
147. The effects of cigarette smoking on the respiratory system includes
A. Increased proliferation of ciliated cells
B. Hypertrophy of the alveolar membrane
C. Destruction of all alveolar macrophages
D. Hyperplasia of globet cells and increased production of mucus
148.
Mr Amamudu has been admitted to your ward with severe neutropeniA.
Which of the following nursing actions would be considered appropriate
in his care
A. Perirectal care and platelet administration
B. Oral care and red blood cell administration
C. Monitoring lung sounds and invasive blood pressures
D. Strict hand washing and frequent temperature assessment
149. A patient with a tricuspidvalve disorder will have impaired blood flow between the
A. Vena cava and right atrium
B. Left atrium and left ventricle
C. Right atrium and right ventricle
D. Right ventricle and pulmonary artery
150. A patient with status epilepticus is given Valium to
A. Dilate the tracheobronchitis structure
B. Induce sleep
C. Relax peripheral muscles
D. Slow down cardiac contraction
151.
It has been detected that the Purkinjie system is damaged in a patient.
The nurse recognises that the conduction of electrical impulses is most
likely impaired through the
A. Atria
B. AV node
C. Bundle of His
D. Ventricles
152. A patient with a MI of the anterior wall of the left ventricle most likely has an occlusion of the
A. Left circumflex
B. Right marginal artery
C. Left anterior descending artery
D. Right anterior descending artery
153. During the first 24 hours of starvation, the order in which the body obtains substrate for energy is
A. Glycogen, skeletal protein
B. Visceral protein, fat stores, glycogen
C. Fat stores, skeletal protein, visceral protein
D. Liver protein, muscle protein,visceral protein
154. The most important aspect of hand washing is
A. Friction
B. Soap
C. Time
D. Water
155. It is necessary to explain to a patient with gastroesophageal reflux disease that this disorder
A. Will require surgical wrapping or repair of the pyloric sphincter to control the symptoms
B. Results in acid erosion and ulceration of the oesophagus through frequent vomiting
C. Is the protrusion of a portion of the stomach into the oesophagus through an opening in the diaphragm
D. Often involves relaxation of the lower oesophageal sphincter allowing stomach contents to backup into the oesophagus
156. A patient with hiatal hernia in your ward is taught to control the symptoms of the disorder by
A. Drinking a glass of milk at bed time to coat the oesophagus
B. Lie down aftereating to promote relaxation of the GI tract
C. Avoid tightclotting and bending to decrease intra – abdominal pressure
D. Drink several glasses of liquids with meals to promote stomachemptying
157.
An elderly man on admission is complaining of hyperplasia of the gums.
Which of these drugs that he is taking is responsible for his
complaints?
A. Aspirin
B. Digoxin
C. Lasix
D. Phenytoin
158. Dumping syndrome is normally associated with large
A. Hyperosmolar volumes emptying rapidly into the intestine
B. Isotonic volumes stimulating increased GI motility
C. Hypertonic volumes promoting third – spacing in the intestinal cavity
D. Hyposmolar volumes drawing fluid out of the plasma space and into the bowel
159. A basic nursing interventionfor a patient with constipation is
A. Anticholinergic drugs and low fibre diet
B. Antiemetic and high fluid intake
C. Stool softeners and high fibre diet
D. Enemas and high fluid intake
160.
A patient is admitted to the hospital with severe renal clinic caused
by renal lithiasis. The nurse’s first priority in managementof the
patient is to
A. Administration of narcotics as prescribed
B. Obtain supplies for staining all urine
C. Encourage fluid intake of 3 to 4 litres per day
D. Keep the patient on NPO in preparation for surgery
161. A condition which is characterised by hyperuricaemia,as a result of errors of purine metabolism is
A. Osteoporosis
B. Gout
C. Rheumatoid arthritis
D. Osteomalacia
162. Evaluation of the effectiveness of Nitroglycerine Sublingual is based on
A. A decrease in blood pressure
B. Dilatation of superficial blood vessel
C. Improved cardiac output
D. Relief of angina pain
163.
Weak irregular pulse, confusion, poor muscle tone and irritability are
common findings during assessments in the patient with
A. Sodium deficit
B. Calcium deficit
C. Potassium deficit
D. Fluid volume deficit
164. Ascites in congestive cardiac failure is due to
A. Failure of the kidneys to secrete urine
B. Increased intake of fluid
C. Increased venous pressure within the circulatory system
D. Lowered osmotic pressure of blood
165. If symptoms of warfarin overdose are observed in a patient with thrombophlebitis the nurse would expect the doctor to order
A. Heparin
B. Imferon
C. Protamine sulphate
D. Vitamin K
166. Oxygen and carbon dioxide are exchangeable in the lungs by
A. Active transport
B. Diffusion
C. Filtration
D. Osmosis
167. The nurse should assess a patient with psoriasis for
A. Erythematous macules
B. Multiple petechiae
C. Pruritic lesions
D. Shiny scaly lesions
168. Which of the following flies spread onchocerciasis
A.
Sand fly B. Similium
C. Tsetsefly
D. Tumbufly
169. Pulmonary embolism may occur as a complication of
A. Aneurysm
B. Coronary artery thrombosis
C. Deep vein thrombosis
D. Pulmonary vein thrombosis
170. Which organ may be affected in a patient who is losing his balance?
A. Cerebellum
B. Cerebrum
C. Medulla oblongata
D. Pons varoli
171. Which of the following nurses may NOT be allowed to work with patients who have rubella?
A. Breast feeding nurses
B. Pregnant nurses
C. Psychiatric nurses
D. Students nurses
172.
A doctor orders 50mg stat of Tabs Valium to reduce anxiety in a patient
with myocardial infarction before giving the drug, the nurse should
A. Assess the apical pulse
B. Assess blood pressure
C. Clarify the order with the doctor
D. Encourage patient to verbalise feelings
173. An order for a medication to be given immediately is referred to as
A. Add lib
B. PRN
C. SOS
D. Stat
174. Which of the following is a life - -threatening sign of tetanus infection?
A. Muscular rigidity
B. Respiratory tract spasm
C. Restlessness and irritability
D. Spastic voluntary muscle contraction
175. Causes of haemolytic jaundice include
I. Acute infective hepatitis
II. Incompatible blood transfusion
III. Toxic chemicals and drugs
IV.Tumour of head of pancreas
A. I, II and III
B. I, II and IV
C. II and III
D. II, III and IV
176. When administration digitalis preparations, the client should be evaluated for
A. Decreased pulse rate
B. Decreased respiration rate
C. Increased pulse rate
D. Increased respiratory rate
177. Oedema in congestive heart failure is due to
A. Lowered arterial pressure
B. Lowered venous pressure
C. Raised arterial pressure
D. Raised venous pressure
178. To perform any nursing care to a patient the nurse must first
A. Establish rapport with the patient’s doctor
B. Recognise personal feelings toward the patient
C. Talk with the patient’s family or significant others
D. Understand the patient’s emotional conflict
179. The primary aim of giving oxygen is to
A. Encourage deep breathing
B. Maintain tissue cell function
C. Relieve airway obstruction
D. Relieve apprehension and anxiety
180. The primary aim of nursing an unconscious patient is
A. Monitoring of consciousness level
B. Prevention of pressure sores
C. Provision of fluids and nutrients
D. Restoration oflife
181. Agglutination is likely to occur if blood group
A. A is given to AB
B. AB is given to B
C. O is given A
D. O is given to B
182. An example of tertiary prevention activities by the nurse would be
A. Assisting in immunisation program
B. Correction of dietary deficiencies
C. Establishing goals for rehabilitation
D. Helping to send a sick person to the hospital
183. Which of the following is NOT is true about a patient with HIV or AIDS? The patient
A. May need dietary consultation to maintain adequate nutrition
B. May cope ineffectively because of poor prognosis
C. Needs information about the diseases transmission and safe sex
D. Should be encouraged not to keep pests
184. Which of the following are associated with skin rash?
I. Chicken pox
II. Plague
III. Rubella
IV.Typhoid
A. I, II and III
B. I, II and IV
C. I, III and IV
D. I, II, III and IV
185. The pain associated with coronary thrombosis is caused by
A. Arterial spasm
B. Blocking of the coronary veins
C. Irritation of nerve endingsin the cardiacplexus
D. Ischemia of the heart veins
186. One of the complications of haemolytic streptococcal infection is
A. Cerebrospinal meningitis
B. Hepatitis
C. Rheumatic heart disease
D. Rheumatoid arthritis
187. One of the signs and symptomsa nurse should observe when a patient is receiving anticoagulant is
A. Chest pain
B. Epistaxis
C. Headache
D. Nausea
188. The most reliable test in the selection of an antibiotic is the
A. Cultureof the specimen
B. Routine examination of the specimen
C. Sensitivity of the specimen
D. Susceptibility of the patient
189. The generic name for aspirin is
A. Acetylsalicylic acid
B. Salicylic acid
C. Sal soda
D. Sodium salicylic acid
190. In celiac disease there may be an allergic response to
A. Complex carbohydrates
B. Fats
C. Gluten in wheat
D. Simple carbohydrate
191. In planning a diet for a diabetic child, the nurse must
A. Allow for normal growth needs
B. Avoid using cassava
C. Discourage substitution in the menu pattern
D. Limit calories to encourage weight loss
192. A person exposed to hepatitis A is given gamma globulin to provide passive immunity to
A. Accelerate antigen – antibody union at the hepatic sites
B. Increase the production of short – lived antibodies
C. Provide antibodies that neutralise the antigen
D. Stimulate the lymphatic system to produce large number of antibodies
193. Risk factors associated with stroke in the elderly patient may include a history of
A. Continuous nervousness
B. Glaucoma
C. Hypothyroidism
D. Transient ischemia
194. When a doctor prescribes a hypnotics 6 hourly PRN for a patient
A. It should be given only once when necessary
B. The nurse should use her own judgement in giving it every 6 hours
C. The patient should be woken up when it is time to give the drug
D. The patient should be given the drug any time she complains of pains
195. Which of the following is NOT associated with secondary hypertension?
A. Acute glomerulonephritis
B. Adrenocortical hyperfunction
C. Aortic insufficiency
D. Stress or obesity
196. Which of the following is an important intervention of a patient with glomerulonephritis?
A. Encouraging fluids
B. Monitoring patient’s temperature daily
C. Monitoring patient’s weight daily
D. Teaching patient on personal hygiene
197. Complications of diabetes mellitus include
I. Decreased resistance to infections II. Delayed wound healing III. Peripheral numbness and pain IV. Sodium retention A. I and II
B. I, II and III
C. II, III and IV
D. I, II, III and IV
198. When assessing an individual with suspected atelectasis, the nurse would expect
A. A dry unproductive cough
B. A diminished breath sounds
C. Normal body temperature
D. Slow deep respirations
199. The following can cause meningitis EXCEPT
A. Mycobacteria
B. Protozoa
C. Streptococci
D. Viruses
200. The usual stimulant for the respiratory centre is
A. Calcium carbonate
B. Carbon dioxide
C. Nitrous oxide
D. Oxygen
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