1. Patient who has had Parkinson’s disease for 7 years has been experiencing aphasia. Which health professional should make a referral to with regards to his aphasia?
Occupational therapist
Community matron
Psychiatrist
Speech and language therapist
2. A newly admitted client has sickle cell crisis. He is complaining of pain in his feet and hands. The nurse’s assessment findings include a pulse oximetry of 92. Assuming that all the following interventions are ordered, which should be done first?
Adjust the room temperature
Give a bolus of IV fluids
Start O2
Administer meperidine (Demerol) 75 mg IV push
3. The night after an exploratory laparotomy, a patient who has a nasogastric tube attached to low suction reports nausea. A nurse should take which of the following actions first?
Administer the prescribed antiemetic to the patient.
Determine the patency of the patient's nasogastric tube.
Instruct the patient to take deep breaths.
Assess the patient for pain
4. What is the preferred position for abdominal Paracenthesis?
Supine with head slightly elevated
Supine with knees bent
Prone
Side-lying
5. What position should you prepare the patient in pre-op for abdominal Paracentesis?
Supine
Supine with head of bed elevated to 40-50cm
Prone
Side-lying
6. A patient was brought to the A&E and manifested several symptoms: loss of intellect and memory; change in personality; loss of balance and co ordination; slurred speech; vision problems and blindness; and abnormal jerking movements. Upon laboratory tests, the patient got tested positive for prions. Which disease is the patient possibly having?
Acute Gastroenteritis
Creutzfeldt-Jakob Disease
HIV/AIDS Fatigue
Urgent bowel
7. Which is not an indication for lumbar tap?
For patients with increased ICP
For diagnostic purposes
Introduction of spinal anaesthesia for surgery
Introduction of contrast medium
8. The nurse is conducting a physical assessment on a client with anemia. Which of the following clinical manifestations would be most indicative of the anemia?
BP 146/88
Respirations 28 shallow
Weight gain of 10 pounds in six months
Pink complexion
9. Which among the following is a cause of Hemorrhoids?
High fibre rich diet
Non- processed food
Straining while passing stools
Unsaturated fats in the diet
10. A patient is admitted to the ward with symptoms of acute diarrhoea. What should your initial management be?
11. After lumbar puncture, the patient experiences shock. What is the etiology behind it?
Increased ICP.
Headache.
Side effect of medications.
CSF leakage
12. The following fruits can be eaten by a person with Crohn’s Disease except:
Mango
Papaya
Strawberries
Cantaloupe
13. A 45-year old patient was diagnosed to have Piles (Haemorrhoids). During your health education with the patient, you informed him of the risk factors of Piles. You would tell him that it is caused by all of the following except:
Straining when passing stool
being overweight
Lack of fibre in the diet
prolonged walking
14. A 33-year-old male is being evaluated for possible acute leukemia. Which of the following findings is most likely related to the diagnosis of leukemia?
The client collects stamps as a hobby.
The client recently lost his job as a postal worker.
The client had radiation for treatment of Hodgkin’s disease as a teenager.
The client’s brother had leukemia as a child.
15. An assessment of the abdomen of a patient with peritonitis you would expect to find
Rebound tenderness and guarding
Hyperactive, high-pitched bowel sounds and a firm abdomen
A soft abdomen with bowel sounds every 2 to 3 seconds
Ascites and increased vascular pattern on the skin
16. A diabetic patient with suspected liver tumor has been prescribed with Trphasic CT scan. Which medication needs to be on hold after the scan?
Furosemide
Metformin
Docusate sodium
Paracetamol
17. The nurse is conducting an admission assessment of a client with vitamin B12 deficiency. Which finding reinforces the diagnosis of B12 deficiency?
Enlarged spleen
Elevated blood pressure
Bradycardia
Beefy tongue
18. Which of the following would be the priority nursing diagnosis for the adult client with acute leukemia?
Oral mucous membrane, altered related to chemotherapy
Risk for injury related to thrombocytopenia
Fatigue related to the disease process
Interrupted family processes related to life-threatening illness of a family member
19. The nurse is instructing a client with iron-deficiency anemia. Which of the following meal plans would the nurse expect the client to select?
Roast beef, gelatin salad, green beans, and peach pie
Chicken salad sandwich, coleslaw, French fries, ice cream
Egg salad on wheat bread, carrot sticks, lettuce salad, raisin pie
Pork chop, creamed potatoes, corn, and coconut cake
20. Patient had undergone post lumbar tap and is exhibiting increase HR, decrease BP, and alteration in consciousness and dilated pupils. What is the patient likely experiencing?
Headache
Shock
Brain herniation
Hypotension
21. Patients with gastrointestinal bleeding may experience acute or chronic blood loss. Your patient is experiencing hematochezia. You recognise this by:
Red or maroon-coloured stool rectally
Coffee ground emesis
Black, tarry stool
Vomiting of bright red or maroon blood
22. Correct position for abdominal paracentesis.
Lie the patient supine in bed with the head raised 45-50 cm with a backrest
Sitting upright at 45 to 60
Sitting upright at 60 to 75°
Sitting upright at 75 to 90°
23. Patients with gastric ulcers typically exhibit the following symptoms:
Epigastric pain worsens before meals, pain awakening patient from sleep an melena
Decreased bowel sounds, rigid abdomen, rebound tenderness, and fever
Boring epigastric pain radiating to back and left shoulder, bluish-grey discoloration of periumbilical area and ascites
Epigastric pains worsens after eating and weight loss
24. A 30 year old male from Haiti is brought to the emergency department in sickle cell crisis. What is the best position for this client?
Side-lying with knees flexed
Knee chest
High fowlers with knees flexed
Semi flowlers with legs extended on the bed
25. If a patient feels a cramping sensation in their abdomen after a colonoscopy, it is advisable that they should do/have which of the following?
Eat and drink as soon as sedation has worn off.
Drink 500 ml of fluid immediately to flush out any gas retained in the abdomen.
Have half hourly blood pressure performed for 12 hours.
Be nursed flat and kept in bed for 12 hours.
26. A patient was recommended to undergo lumbar puncture. As the nurse caring for this patient, what should you not expect as its complications:
Swelling and bruising
Headache
Back pain
Infection
27. Taking a nursing history prior to the physical examination allows a nurse to establish a rapport with the patient and family. Elements of the history include all of the following except:
the client’s health status
the course of the present illness
social history
Cultural beliefs and practices
28. How to position patient for abdominal tap
Supine
Prone
Supine with HOB 40-50 degree elevated
Sitting
29. What would be your main objectives in providing stoma education when preparing a patient with a stoma for discharge home?
That the patient can independently manage their stoma, and can get supplies.
That the patient has had their appliance changed regularly, and knows their community stoma nurse.
That the patient knows the community stoma nurse, and has a prescription.
That the patient has a referral to the District Nurses for stoma care.
30. A patient was diagnosed to have Chron’s disease. What would the patient be manifesting?
Blood and mucous in the faeces
Fatigue
Loss of appetite
Urgent bowel
31. Which of the following statements made by client diagnosed with hepatitis A needs further understanding of the disease.
Washing hands before cooking food
Refraining from sexual intimacy and kissing while symptoms still present
Towels and flannels can be shared with children
32. The term gavage indicates
Administration of a liquid feeding into the stomach
Visual examination of the stomach
Irrigation of the stomach with solution
A surgical opening through the abdomen to stomach
33. A 43 year old African male is admitted with sickle cell anemia. The nurse plans to assess the circulation in the lower extremities every two hours. Which of the following outcome criteria would the nurse use?
Body temperature of 99°F or less
Toes moved in active range of motion
Sensation reported when soles of feet are touched
Capillary refill of < 3 seconds
34. Clients with sickle cell anemia are taught to avoid activities that cause hypoxia and hypoxemia. Which of the following activities would the nurse recommend?
A family vacation in the Rocky Mountains
Chaperoning the local boys club on a snow-skiing trip
Traveling by airplane for business trips
A bus trip to the Museum of Natural History
35. Which statement is not true about acute illness?
A disease with a rapid onset and/or a short course one.
It will eventually resolve without any medical supervision.
36. When explaining about travellers’ diarrhoea which of the following is correct?
Travellers diarrhoea is mostly caused by Rotavirus
Antimotility drugs like loperamide is ineffective management
Oral rehydration in adults and children is not useful
Adsorbents such as kaolin is ineffective and not advised
37. Reason for dyspnoea in patients who diagnosed with Glomerulonephritis patients?
Albumin loss increase oncotic pressure causes water retention in cells
Albumin loss causes decrease in oncotic pressure causes water retention causing fluid retention I alveoli
Albumin loss has no effect on oncotic pressure
38. A client immediately following LP developed deterioration of consciousness, bradycardia, increased systolic BP. What is this:
normal reaction
client has brain stem herniation
spinal headache
39. The client is being evaluated for possible acute leukemia. Which inquiry by the nurse is most important?
“Have you noticed a change in sleeping habits recently?”
“Have you had a respiratory infection in the last six months?”
“Have you lost weight recently?”
“Have you noticed changes in your alertness?”
40. Which is not an expected side effect of lumbar tap?
Headache
Back pain
Swelling and bruising
Nausea and vomiting
41. A 25 year old male is admitted in sickle cell crisis. Which of the following interventions would be of highest priority for this client?
Taking hourly blood pressures with mechanical cuff
Encouraging fluid intake of at least 200ml per hour
Position in high folwlers with knee gatch raised
Administering Tylenol as orderd
42. A young adult is being treated for second and third degree burns over 25% of his body and is now read for discharge. The nurse evaluates his understanding of discharge instructions relating to wound care and is satisfaction that he is prepared for home care when he makes which statement?
I will need to take sponge baths at home to avoid exposing the wound’s to unsterile bath water
If any healed areas break open I should first cover them with sterile dressing and then report it
I must wear my Jobst elastic garment all day and an only remove it when I’m going to bed
I can expect occasional periods of low-grade fever and can take Tylenol every 4 hours
43. What type of diet would you recommend to your patient who has a newly formed stoma?
Encourage high fibre foods to avoid constipation.
Encourage lots of vegetables and fruit to avoid constipation.
Encourage a varied diet as people can react differently
Avoid spicy foods because they can cause erratic function
44. Which condition is not a cause of diarrhea?
Ulcerative colitis
Intestinal obstruction
Hashimotos disease
Food allergy
45. The body part that would most likely display jaundice in the dark-skinned individual is the:
Conjunctiva of the eye
Soles of the feet
Roof of the mouth
Shins
46. A 27- year old adult male is admitted for treatment of Crohn’s disease. Which information is most significant when the nurse assesses his nutritional health?
Anthropometric measurements
Bleeding gums
Dry skin
Facial rubor
47. Which of the following foods would the nurse encourage the client in sickle cell crisis to eat?
Steak
Cottage cheese
Popsicle
Lima beans
48. A patient in your care is about to go for a liver biopsy. What are the most likely potential complications related to this procedure?
Inadvertent puncture of the pleura, a blood vessel or bile duct
Inadvertent puncture of the heart, oesophagus or spleen.
Cardiac arrest requiring resuscitation.
Inadvertent puncture of the kidney and cardiac arrest
49. When selecting a stoma appliance for a patient who has undergone a formation of a loop colostomy, what factors would you consider?
Patient dexterity, consistency of effluent, type of stoma
Patient preference, type of stoma, consistency of effluent, state of peristomal skin, dexterity of the patient
Patient preference, lifestyle, position of stoma, consistency of effluent, state of peristomal skin, patient dexterity, type of stoma
Cognitive ability, lifestyle, patient dexterity, position of stoma, state of peristomal skin, type of stoma, consistency of effluent, patient preference
50. It is unsafe for a spinal tap to be undertaken if the patient: