201. A severe form of hyperthyroidism which is usually abrupt in onset and often fatal is known as
A. Exophthalmus
B. Throiditis
C. Thyrotoxicosis
D. Thyroid storm
202.
A patient is taking a digitalis preparation regularly. The medication
is ordinarily instilled and the physician is notified as soon as
possible as the heart rate falls below
A. 80 beats per minute
B. 70 beats per minute
C. 60 beats per minute
D. 50 beats per minute
203.
It has been observed that, under the age of 50 years, approximately
twice as many men as women suffer from atherosclerosis in coronary
vessels walls. It is generally believed that this difference is due to
women having
A. Higher blood levels of oestrogen than men
B. Lifestyles with fewer stresses than men
C. Lifestyles with more activity and exercise than men
D. Diets that results in lower blood cholesterol levels than men
204.
Which one of the following electrolytes helps to release contractile
substances (actin and myosine) that are important for normal cardiac
functioning?
A. Sodium
B. Calcium
C. Chloride
D. Potassium
205. Digoxin has been ordered for a patient with congestive heart failure because the drug helps to
A. Dilate coronary arteries
B. Strengthen the heart beat
C. Decrease arrhythmias in the heart
D. Decrease the electrical conductivity of the myocardium
206.
Which one of the following findings, if noted in this patient during
blood examination is most likely to increase the risk of developing
digoxin toxicity?
A. Low sodium level
B. Low potassium level
C. High glucose level
D. High calcium level
207.
Of the following signs, the one the nurse is most likely to notice
first when the patient is developing digitalis toxicity is a
A. Heart murmur
B. Slow pulse rate
C. Slow respiratory rate
D. Drop in blood pressure
208.
The physician has ordered morphine sulphate subcutaneously shortly
after the admission of the patient with congestive heart failure. In
this situation, the most likely reason for giving the medication is to
reduce
A. Nausea
B. Anxiety
C. Blood pressure
D. Bronchial secretions
209. Most peptic ulcers occurring in the stomach are in the
A. Cardiac sphincter
B. Pyloric sphincter
C. Oesophageal sphincter
D. Body of the stomach
210. The pain in a patient with duodenal ulcer would be described probably as
A. An ache radiating to the left side
B. An intermittent colicky flank pain
C. A gnawing sensation relieved of food
D. A generalised abdominal pain intensified by moving
211. A nurse administering an N G tube feeding must do so slowly to reduce the hazard of
A. Distension
B. Flatulence
C. Indigestion
D. Regurgitation
212.
In a patient suffering from cholelithiasis, the nurse should interpret
his temperature elevation and white blood cell count as probably an
indication of
A. Shock
B. Haemorrhage
C. Inflammation
D. Dehydration
213.
Which of the following in a patient with liver cirrhosis can be
directly related to increased pressure in the portal system?
I. Dyspepsia
II. Gynecomastia
III. Splenomegaly
IV.
Purpura V.Ascites
A. I and II
B. IV and V
C. A, III and V
D. All of the above
214. The nurse should know that the pathophysiology of a patient with cirrhosis of the liver predisposes him to
A. Splenic rupture
B. Umbilical hernia
C. Renal stones
D. Bladder stricture
215.
As a consequence of ascites in a patient with cirrhosis of the liver,
the patient would probably find which position most comfortable for
sleep?
A. Supine
B. Side – lying
C. Semi – fowlers
D. Prone
216. Portal cirrhosis is characterised by
A. Catarrhal inflammation of sinusitis
B. Purulent infection of bile ducts
C. Fibrotic replacement of the liver cells
D. Ischemia degeneration of liver capsule
217. The portal hypertension in a patient with cirrhosis of the liver is the result of
A. Acceleration of portal blood floor secondary to severe anaemia
B. Compression of liver substance due to calcification of the liver capsule
C. Sustained contract6ion of vascular muscles in response to emotional stress
D. Twisting and constriction of intralobular and interlobular blood vessels
218. Spider angiomata are thought to be the result of
A. Increased in the systemic blood pressure
B. Failure of the liver to detoxify oestrogens
C. Interference with the normal healing process
D. Increase in permeability of capillaries
219. Which of the following findings in gastric analysis would best support a diagnosis of peptic ulcer
A. Absence of gastric secretions
B. Increased HCL
C. Lack of intrinsic factor
D. Decreased gastric motility
220. The tissue change most characteristic of peptic ulcer is
A. A ragged erosion of surface membrane with purulent exudate
B. A sharp excavation of surface membrane with cleanbase
C. A lumping mass of necrotic tissue with surface bleeding
D. An elevated ridge of fibrous tissue with wrinkled margins
221. Increased parasympathetic activity predisposes to peptic ulcer by effecting
I. Hypersecretion
II. Hypertrophy
III. Hypermotility
IV.Hyperplasia
V.Hypertonia
A. I and II only
B. III and IV only
C. I, III and V only
D. All of the above
222. Which of the following emotional factors is thought to contribute to the production of a peptic ulcer?
A. Threat of separation from the mother figure
B. Anxiety relating to identification of the sexual role
C. Strong unconscious passive – dependent oral needs
D. Chronic inhibition of strong hostile – aggressive drives
223. Hypochromic anaemia is characterised by red blood cells that differ from normal cells in being
A. Grossly irregular in shape
B. Less filled with haemoglobin
C. Larger in total volume
D. Without nuclear chromatin
224. In a patient undergoing gastric lavage, when the lavage tube is being inserted, the nurse must place the patient in the
A. Supine position
B. Mid – fowlers position
C. High – fowlers position
D. Trendelenburg’s position
225. The maximum height of which the container of fluid should be held when administering a cleansing enema is
A. 30cm
B. 37cm
C. 45cm
D. 66cm
226. Continuous gastrointestinal decompressions is particularly apt to produce
A. Haemorrhage
B. Constipation
C. Hiccoughs
D. Alkalosis
227. Milk is omitted from a clear liquid diet because it
A. Produces gas
B. Contains calories
C. Produce nausea
D. Coats the mucosa
228. Which of the following are possible complications of duodenal ulcer
I. Acute haemorrhage
II. Macrocytic anaemia
III. Pyloric obstruction
IV.Gallstones
V.Bowel perforation
A. I and II
B. I, III and V
C. All but V
D. All the above
229. Which of the following is the most accurate definition of bronchiectasis?
A. Encapsulated collection of pus in the lungs
B. Fibrotic obliteration of the terminal bronchi
C. Sac – like or tubular dilatation of the bronchi
D. Traumatic rupture of the bronchiolar wall
230. The pale, boggy nasal mucosa of a patient with bronchiectasis is indicative of
A. Virus infection
B. Heart failure
C. Chronic anaemia
D. Allergic rhinitis
231. An increased anterior – posterior diameter of the chest of a patient with bronchiectasis is suggestive of
A. Osteoarthritis
B. Heart failure
C. Emphysema
D. Mediastinitis
232. A client diagnosed ashaving bronchiectasisand having anorexia; his anorexia can be predominantly result from
A. Disinclination for physical exercise
B. Frequent expectation of foul sputum
C. Decreased basal metabolic rate
D. Increased vertical diameter of the thorax
233. The position for a client with dyspnoea is
A. Sims
B. Supine
C. Orthopnoea
D. Trendelenburg
234.
If the nurse explains to a client undergoing respiratory pulmonary
function test that during the procedure, he/she should breathe normally
then the nurse is helping the therapist to measure
A. Tidal volume
B. Vital capacity
C. Expiratory reserve
D. Inspiratory reserve
235. A client is admitted with pneumothorax and therefore during assessment, the nurse should expect dyspnoea and
A. Hematemesis
B. Unilateraol chest pain
C. Increased chest motion
D. Mediastenal shift toward the involved side
236. Thoracentesis is to empyema as which of the following is to bronchiectasis?
A. Lobectomy
B. Postural drainage
C. Aerosolpenicillin
D. Breathing exercise
237.
Which of the following solution is usually placed in the drainage
collection bottle in preparing the water – sealed drainage apparatus?
A. Sterile water
B. Ammonium carbonate
C. Hexachlorophene
D. Normal saline
238. Acromegaly is produced by oversecretion of
A. Testosterone
B. Growth hormone
C. Thyroid hormone
D. Adrenocorticotropin
239. The nurse understands that the cause of Cushing’s Syndrome is most commonly
A. Pituitary hypoplasia
B. Insufficient ACTH production
C. Hyperplasia of the adrenal cortex
D. Deprivation of adrenocortical hormone
240. Glucocorticoids and Mineralocorticoids are secreted by the
A. Gonads
B. Pancreas
C. Adrenal gland
D. Anterior pituitary gland
241. In Cushing’s syndrome, excessive amounts of glucocorticoids and mineralocorticoids will increase the client’s
A. Urine output
B. Glucose levels
C. Serum potassium
D. Immune response
242. Thyroid crisis (storm) is caused by
A. Increased iodine in the blood
B. Removal of the parathyroid gland
C. High levels of the hormone triiodothyronine
D.
A rebound increase in metabolism following anaesthesia 243. Which of the following minerals is lost in prolonged diuretic therapy?
A. Sodium
B. calcium
C. Potassium
D. Phosphorus
244. In patients with diabetes insipidus, the specific gravity of urine is
A. High
B. Low
C. Moderate
D. Normal
245.
A clinical syndrome in which there are attacks of headache frequently
accompanied by visual and gastrointestinal symptoms is referred to as
A. Sinusitis
B. Heart attack
C. Migraine
D. Otitis media
246. Which of the following is not part of the clinical phases of acute renal failure?
A. Oliguria
B. Diuresis
C. Intermittent phase
D. Period of recovery
247. A renal stone in the pelvis of the kidneys will alter the function of the kidney by interfering with
A. The structural support of the kidneys
B.
Regulation of the concentration of urine C. The entry and exit of blood vessels at the kidney
D. Collection and drainage of urine from the kidney
248. The nurse identifies a risk factor for urinary calculi in a patient who relates a past health history that includes
A. Measles
B. Gastric ulcer
C. Diabetes mellitus
D. Hyperparathyroidism
249. Normal changes associated with aging of the urinary system that the nurse expects to find include
A. Decrease levels of B U N
B. Post voiding urine residual
C. Increased bladder capacity
D. More easily palpable kidneys
250.
A patient with renal disease has oliguria and a creatinine clearance of
40ml/min. The nurse identifies that these findings most directly
reflect abnormal function of
A. Tubular secretion
B. Capillary permeability
C. Glomerular filtration
D. Concentration of filtrate
251.
In teaching a patient with pyelonephritis about the disorder, the nurse
informs the patient that the organism that causes pyelonephritis most
commonly reach the kidneys through
A. An ascending infection
B. The bloodstream
C. A descending infection
D. The lymphatic system
252. The nurse teaches the female patient who has frequent urinary tract infections that she should
A. Urinate after sexual intercourse
B. Take tub baths with bubble bath
C. Take prophylactic sulphonamides for the rest of her life
D. Restrict fluid intake to prevent the need for frequent voiding
253. The nurse informs the patient with nephritic syndrome that the cause of hiss oedema is as a result of
A. Decreased aldosterone secretion from adrenal insufficiency
B. Increased hydrostatic pressure caused by sodium retention
C. Decreased colloidal osmotic pressure caused by loss of serum albumin
D. Increased fluid retention caused by decreased glomerular filtration
254.
A patient is admitted to the hospital with severe renal colicky caused
by renal lithiasis. The nurse’s first priority in management of the
patient is to
A. Administration of narcotics as prescribed
B. Obtain supplies for staining all urine
C. Encourage fluid intake 3 to 4 litres per day
D. Keep patient N P O in preparation for surgery
255. Inplanning nursing interventions to increase bladder control in the patient with urinary incontinence, the nurse includes
A. Using incontinence pads to prevent embarrassment
B. Restricting fluid intake after dinner in the evening
C. Clamping and releasing a catheter to increase bladder tone
D. Teaching the patient about feedback mechanisms to supress the urge to urinate
256.
A patient with a ureterolithotomy returns from surgery with a
nephrostomy tube in place. Postoperative nursing care of the patient
includes
A. Encouraging the patient to drink fruit juices ad milk
B. Forcing fluids of at least 2 t0 3L per day after nausea has subsided
C. Notifying the physician if nephrostomy tube drainage is more than 30ml/hr
D. Irritating the nephrostomy tube with 10mls of normal saline solution as needed
257. The risk factor for kidney and bladder cancer in a patient who relates a history to a nurse could be as a result of
A. Aspirin use
B. Tobaccouse
C. Chronic alcohol abuse
D. Use of artificial sweeteners
258.
A patient is admitted to the hospital with chronic renal failure. The
nurse understands that this condition is characterised by
A. A rapid decrease in urinary output with azotaemia
B. An increasing creatinine clearance with a decrease in urinary output
C. Progressive irreversible destruction of the kidneys
D. Prostration, somnolence and confusion with coma and imminent death
259. Pre – renal causes of acute renal failure include
A. Prostate cancer and calculi formation
B. Acute glomerular nephritis and neoplasms
C. Septic shock and nephrotoxins injury from drugs
D. Hypovolemia and cardiogenic shock
260. During the oliguric phase of acute renal failure, the nurse monitors the patient for
A. Hypernatraemia and Central Nervous System
B. Kussmaul’s respirations and hypotension
C. Pulmonary oedema and electrical changes in cardiac activity
D. Urine with high specific gravity and low sodium concentration
261. The nurse must monitor which serum electrolyte imbalances in a patient in the diuretic phase of acute renal failure?
A. Hyperkalaemia and hyponatraemia
B. Hyperkalaemia and hypernatraemia
C. Hypokalaemia and hypernatraemia
D. Hypokalaemia and hyponatraemia
262. One of the major disadvantages of peritoneal dialysis is that
A. High glucose concentration of the dialysate necessary for ultrafiltration cause carbohydrate and lipid abnormalities
B. Hypotension is a constant problem because of continuous fluid removal
C. Blood loss can be extensive because of the use of heparin to keep the catheter in patient
D. Solutes are removed more rapidly from the blood than from Central Nervous System, causing disequilibrium syndrome
263.
A patient in end stage renal disease on haemodialysis is considering
asking a relative to donate a kidney for transplant. In assisting the
patient to make a decision about his treatment, the nurse informs the
patient that
A. Successful transplantation usually provides better quality of life than that offered by dialysis
B. If rejection of the transplanted kidney occurs no further treatment for the renal failure is available
C. The immunosuppressive therapy that is required following transplantation causes fatal malignancies in many patients
D.
Haemodialysis replaces the normal functions of the kidneys and patients
do not have to live with the continual fear of rejection
264. Most of the long – term problems that occur in the patient with kidney transplant are as a result of
A. Chronic rejection
B. Immunosuppressive therapy
C. Recurrence of the original renal disease
D. Failure of the patient to follow the prescribed regimen
265.
Following a kidney transplant, the nurse teaches the patient signs of rejection include A. Fever, weight loss, increased urinary output, increased blood pressure
B. Fever, weight gain, increased urinary output, increased blood pressure
C. Fever, weight gain, decreased urinary output, increased blood pressure
D. Fever, weight loss, increased urinary output, decreased blood pressure
266.
A condition which is characterised by hyperuricaemia, pain and swelling
of smaller joints and as a result of errors of purine metabolism is
A. Osteoporosis
B. Gout
C. Rheumatoid arthritis
D. Osteomalacia
267. Conditions that result in decreased serum albumin will result in
A. Decreased hydrostatic pressure with pressure shift =s from the interstitium to the vasculature
B. Increased hydrostatic pressure with plasma shifts from the vasculature to the interstitium
C. Increased oncotic pressure with plasma shifts from the interstitium to the vasculature
D. Decreased oncotic pressure with plasma shifts from the vasculature to the interstitium
268. The nurse implements nursing care for the patient with hypernatraemia taking into consideration
A. Fluid restriction
B. Administration of hypotonic fluids
C. Administration of a cation exchange resin
D. Increased water intake for patients on nasogastric suction
269.
Weak, irregular pulse, confusion, poor muscle tone and irritability are
common finding during assessments in the patient with
A. Sodium deficit
B. Calcium deficit
C. Potassium deficit
D. Fluid volume deficit
270. Which of the following statements is accurate?
A. Hypercalcaemia rarely occurs from increased calcium intake
B. In patients with hypercalcaemia, it is important to restrict fluid intake
C. Any condition that causes decreased parathyroid hormone results in hypercalcaemia
D. Patients who have had thyroid surgery must be closely monitored to hypercalcaemia
271. The ideal fluid replacement for the patient with E C F fluid volume deficit is
A. Isotonic
B. Hypotonic
C. Hypertonic
D. A plasma expander
272. In respiratory acidosis, compensation would be accomplished be
A. Lungs retaining CO2
B. Lungs eliminating CO2
C. Kidneys eliminating bicarbonate
D. Kidneys retaining bicarbonate
273. The primary cation in the fluid compartment that constitute the greatest percentage of total body water is
A. Sodium
B. Chloride
C. Potassium
D. Calcium
274. The characteristics of the operating room environment that facilitates the prevention of infection in the patient is
A. Adjusting lighting
B. Conducive furniture
C. Filters in the ventilation system
D. Explosion – proof electrical plugs
275. The perioperative nurse’s primary responsibility for the care of the patient undergoing surgery is
A. Developing an individualised plan of nursing care for the patient
B. Carrying out specific tasks related of surgical policies and procedures
C. Ensuring that the patient has been assessed for safe administration of anaesthesia
D. Performing a preoperative history and physical assessment to identify patient needs
276. When scrubbing at the scrub sink, the nurse remembers that
A. Scrub from elbows to the hands
B. Scrub without mechanical friction
C. Scrub for a minimum of 10 minutes
D. Hold the hands higher than the elbows
277. Nursing interventions indicated during the patients recovery from general anaesthesia in the recovery ward include
A. Placing the patient in a supine position
B. Encouraging deep breathing and coughing
C. Restraining patients during anaesthesia of emergency delirium
D. Withholding analgesics until the patient is discharged from the recovery ward
278. Following admission of the post – operative patient to the ward, the most immediate attention
A. Oxygen saturation of 85%
B. Respiratory rate of 13 beats per minute
C. Blood pressure of 90/60mmHg
D. Temperature of 34.60C
279. In preparation for discharge after surgery, the nurse should advise the patient regarding
A. A time frame for when physical activities can be resumed
B. The rationale for abstinence from sexual intercourse for 4 – 6 weeks
C. The need to call the hospital or clinical unit to report any abnormal signs or symptoms
D. The necessity of a referral to nutritional centre for management of dietary restriction
280. Increased intraocular pressure may occur as a result of
A. Oedema of the cornea stroma
B. Blockage of the lacrimal canals and duct
C. Dilation of the retinal arterioles
D. Increase production of aqueous humour by the ciliary process
281. The nurse always assess the patient with an ophthalmic problem for
A. Papillary reactions
B. Visual acuity
C. Intraocular pressure
D. Confrontation visual fields
282. The nurse should specifically question patients using eye drops to treat glaucoma about
A. Use of corrective lenses
B. Their usual sleep pattern
C. A history of heart or lung disease
D. Sensitivity to narcotics or depressants
283.
While examining a patient, the nurse notes small, raiseD. Solid lesions
that merge with one another on the patient’s forearm. The nurse would
describe this finding as
A. Diffuse pustular gyrate lesions
B. Generalised pustules with confluence
C. Punctuate, macular satellite lesions
D. Confluent, annular papules forming plaque
284. On observing areas of excoriation on the patient’s arms and legs, the nurse would question the patient regarding
A. Itching
B. Sun exposure
C. Excessive sweating
D. Bleeding disorders
285. Palpation of the skin is the most appropriate technique to assess
A. Skin texture
B. The presence of lesions
C. The vascularity of the skin
D. Presence of intertriginous areas
286.
In teaching a patient who is using topical corticosteroids to treat an
acute dermatitis, thed nurse should tell the patient that
A. Topical corticosteroids usually do not cause systemic side effects
B. The cream form represents the most efficient system delivery
C. Abruptly discontinuing the use of topical corticosteroids will cause a reappearance of the dermatitis
D. Creams and ointments should be applied with a glove in small amounts to prevent further infection
287.
A patient with psoriasis tells the nurse that she has quit her job as a
receptionist because she feels her appearance is disgusting to
customers. The nursing diagnosis that best describes this patient’s
response is
A. Ineffective coping related to lack of social support
B. Impaired skin integrity related to presence of lesions
C. Anxiety related to lack of knowledge of the disease process
D. Social isolation related to decreased activities secondary to fear of rejection
288.
A nurse teaches a patient with malignant melanoma about his disorder.
The nurse should make the patient know that the prognosis of the
condition is most dependent on
A. The thickness of the lesion
B. The degree of colour change in the lesion
C. How much superficial spread the lesion has
D. The amount of ulceration present in the lesion
289. The nurse identifies a nursing diagnosis of Risk for infection transmission as a high priority for the patient with
A. Psoriasis on the palms and soles
B. Candidiasis of the nails
C. Tinea pedis
D. Impetigo on the face
290. A common site for the lesions associated with atopic dermatitis is the
A. Buttocks
B. Temporal areas
C. Antecubital space
D. Palmer surface of the feet
291. Dermatologic symptoms of Cushing’s Syndrome would include
A. Generalised hyperpigmentation
B. Increased sweating
C. Antecubital space
D. Palmer surface of the feet
292. A patient is assessed to be at risk for the development of a pressure ulcer. Based on this information, the nursed should
A. Vigorously massage reddened bony prominences daily
B. Keep head of bed elevated to 900 at all times
C. Implement a 2 hourly turning of patient
D. Have the patient maintain a high fat diet
293. The mechanism that stimulates the release of surfactant is
A. Deep breathing that stretches the alveoli
B. Collapse of the alveoli that activates type I cells
C. Activation of type II cells by fluid accumulation in the alveoli
D. Movement of air from the alveolus through the pores of Kohn
294. During inspiration, air enters the thoracic cavity as a result of
A. Stimulation of the respiratory muscles by the chemoreceptors
B. An increase in CO2 and decrease in O2 in the blood
C. Decrease in intrathoracic pressure relative to pressure at the airway
D. An increased intrathoracic pressure relative to pressure at the airway
295. A diagnostic study that is most likely to be normal in a patient with pneumonia is
A. Oximetry
B. Chest x – ray
C. Sputum C and S
D. Pulmonary angiogram
296. When assessing activity – exercise patterns related to respiratory health, the nurse inquires about
A. Dyspnoea during rest or exercise
B. Recent weight loss or weight gain
C. Willingness to wear oxygen in public
D.
Ability to sleep through the entire night 297.
A patient was seen in clinic for an episode of epistaxis, which was
controlled by placement of anterior nasal packing. During discharge
teaching, the nurse instruct the patient to
A. Use aspirin or aspirin – containing compounds for pain relief
B. Apply ice compresses to the nose every 4 hours for the first 48 hours
C. Avoid vigorous nose blowing and strenuous activity
D. Leave the packing in place for 7 to 10 days until it is removed by the physician
298. In assessing a patient with pneumococcal pneumonia, the nurse recognises that clinical manifestations of this include
A. Fever, chills and a productive cough with rust – coloured sputum
B. A non – productive cough and night sweats that are usually self – limiting
C. A gradual onset of nasal stiffness, sore throat and purulent productive cough
D. An abrupt onset of fever, non – productive cough and formation of lung abscesses
299.
A patient with tuberculosis has a nursing diagnosis of non –
compliance. The nurse recognises that he most common etiologic factor
for this diagnosis in patients with T B is
A.
Fatigue and lack of energy to manage self – care B. Lack of knowledge about how the disease is transmitted
C. Little or no motivation to adhere to long – term drug regimen
D. Feelings of shame and the response to the social stigma associated with T B
300.
A patient is on high doses of corticosteroids and broad – spectrum
antibiotics for treatment of serious trauma and infection. The nursed
should be aware that this patient is susceptible to
A. Candidiasis
B. Aspergillosis
C. Histoplasmosis
D. Coccidiodomycosis
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