오답노트

Question 1

To develop self-awareness, a nurse must be willing to be

A. reflective.
B. thorough.
C. uncritical.
D. non-judgemental.

Answer 1

A. reflective.

Question 2

One of the most important principles of the therapeutic relationship when the nurse works with a client with a mental disorder is that

A. the nurse should self-disclose.
B. the client is the primary focus of the interaction.
C. the nurse should have an empathetic relationship with the client.
D. the client’s conversation should be recorded.

Answer 2

B. the client is the primary focus of the interaction.

Question 3

Psychiatric rehabilitation has shifted to the concept of recovery because of:

A. emphasis on the goals of the service and of the staff who work in the service.
B. working more closely with the client’s family and their part in the client’s illness.
C. emphasis on the goals, outcomes and options of the consumer.
D. redirecting rehabilitation towards a community focus.

Answer 3

C. emphasis on the goals, outcomes and options of the consumer.

Question 4

Authorities in Australia and New Zealand are charged with maintaining professional standards. Which task(s) do nurse registration and practice regulation authorities not oversee?

A. Complaints and disciplinary processes
B. Wages
C. Accreditation of educational institutions and nursing programs
D. Registers of individuals licensed to practise nursing

Answer 4

B. Wages

Question 5

One of the main influences on one’s self-concept, life relationships and life experiences is:

A. resilience.
B. personal control.
C. attachment.
D. humanism.

Answer 5

C. attachment.

Question 6

One underlying premise of Allport’s six dimensions of maturity is:

A. acceptance of self and others.
B. autonomy versus shame and doubt.
C. emotional security.
D. definite moral standards

Answer 6

C. emotional security.

Question 7

The major difference, for a child, between an authoritative parent and an authoritarian parent according to Baumrind was that:

A. an authoritative parent was involved and confronting.
B. an authoritarian parent had clear expectations of the child.
C. an authoritarian parent was warm and supportive.
D. an authoritative parent had clear, rational expectations.

Answer 7

D. an authoritative parent had clear, rational expectations.

Question 8

It has been argued that moral development is more complex than simple developmental stage theories indicate. Taking into account underlying critical factors, which of the following family characteristics helps moral development the most?

A. A degree of family adaptability, cohesiveness and communication B. Exploring self-reliance in an individual within a family
C. A degree of support and interactive family communication
D. Warm, non-demanding and non-controlling parents

Answer 8

A. A degree of family adaptability, cohesiveness and communication

Question 9

Good’ outcomes of development proposed by Maslow (1968), Erikson (1963) and Allport (1961) all describe criteria that are normative; that is, they assume that:

A. everyone is the same and if a certain standard is achieved, this can lead to an ideal end-state.
B. everyone is different, but they are in pursuit of ‘the norm’.
C. people define their own criteria for success.
D. there are optimal criteria for achieving mental health.
(Maslow AH 1968 Toward a psychology of being, 2nd edn. Van Nostrand, Princeton, NJ; Erikson EH 1963 Childhood and society, 2nd edn. WW Norton, New York; Allport G 1961 Pattern and growth in personality. Holt, Reinhart & Winston, New York)

Answer 9

A. everyone is the same and if a certain standard is achieved, this can lead to an ideal end-state.

Question 10

Maslow (1968) proposed a set of 15 preconditions for self-actualisation that, if unmet, interfere with development. These were described as:

A. the dimensions of maturity.
B. the characteristics of the self-actualised person.
C. the ‘eight stages of man’.
D. the lifespan approach.
(Maslow AH 1968 Toward a psychology of being, 2nd edn. Van Nostrand, Princeton, NJ)

Answer 10

B. the characteristics of the self-actualised person.

Question 11

According to Erikson, one of the major developmental tasks for older adulthood is:

A. integrity versus despair.
B. identity versus role diffusion.
C. intimacy versus isolation.
D. autonomy versus shame and doubt.

Answer 11

A. integrity versus despair.

Question 12

People typically approach or avoid stressful events. Which of the following is not a characteristic of coping?

A. Problem solving
B. Seeking information
C. Denial
D. Adaptation

Answer 12

C. Denial

Question 13

Nurses need to develop their understanding of trauma-informed care to include knowledge of:

A. Assessment, strengths, therapy, resolution
B. Crisis, assessment, intervention, future planning
C. Crisis, therapy, resolution, prevention
D. Safety, trustworthiness, choice, collaboration and empowerment

Answer 13

D. Safety, trustworthiness, choice, collaboration and empowerment

Question 14

The first step in the progression towards culturally safe practice that involves understanding that there is a difference is referred to as:

A. cultural sensitivity.
B. cultural safety.
C. cultural awareness.
D. cultural competence.

Answer 14

C. cultural awareness.

Question 15

The four phases in the process of family recovery include all of the following except:

A. shock, discovery, denial.
B. recognition and acceptance.
C. bargaining and acceptance.
D. coping and personal and political advocacy.

Answer 15

C. bargaining and acceptance.

Question 16

Janca and Bullen (2003) advise that an Indigenous Australian has a different conception of time from the healthcare professional’s. This can be summarised in the following way:

A. time is an abstract concept.
B. family and community take precedence over time.
C. time does not matter to an Indigenous Australian.
D. time dictates what the Indigenous Australian does and when.
(Janca A, Bullen C 2003 The Aboriginal concept of time and its mental health implications. Australasian Psychiatry 11:40–4)

Answer 16

B. family and community take precedence over time.

Question 17

The Ngaru Ngarunoa model of nursing practice created by Hineroa Hakiaha represents the concept of:

A. shifting tides.
B. supportive partnership with the tangata whaiora.
C. calming restless waves.
D. healing journey.

Answer 17

C. calming restless waves.

Question 18

START (Short-Term Assessment of Risk and Treatability) is a risk assessment tool that:

A. identifies and measures the risk factors of offenders.
B. uses historical involvement in violence to assess risk.
C. is an adaptation of the Level of Service/Case Management Inventory.
D. considers general risks beyond risk to others.

Answer 18

D. considers general risks beyond risk to others.

Question 19

Bleuler’s ‘four As’ for identification of symptoms of schizophrenia consisted of:

A. attrition, association disturbance, autism and association looseness.
B. autism, ambivalence, affective disturbance and associative looseness.
C. ambiguousness, affective disturbance, autism and association looseness.
D. autism, affective disturbance, attrition and associative looseness.

Answer 19

B. autism, ambivalence, affective disturbance and associative looseness.

Question 20

Delusional thinking may be described by which of the following definitions?

A. Retreat into an inner fantasy world, socially isolating or withdrawing oneself and losing contact with reality
B. False, fixed belief that is inconsistent with one’s social, cultural and religious beliefs and cannot logically be reasoned with
C. Severe and debilitating illness with disorganised motor behaviour and the inability to relate to external stimuli
D. False, fixed perception that one can see, hear, smell, touch or taste external stimuli, but is losing contact with reality

Answer 20

B. False, fixed belief that is inconsistent with one’s social, cultural and religious beliefs and cannot logically be reasoned with

Question 21

An acute dystonic reaction that is a side effect of some typical antipsychotic medications is:

A. uncontrollable coarse tremor.
B. restless leg syndrome.
C. salivary drooling.
D. oculogyric crisis.

Answer 21

D. oculogyric crisis.

Question 22

The depressed person can undergo many changes in behaviour, cognition, communication and physical functioning. The observable behaviours associated with changes in a person’s mood, such as crying and looking dejected, are called:

A. ruminations.
B. withdrawal.
C. self-awareness.
D. affect.

Answer 22

D. affect.

Question 23

A major depressive disorder is a condition wherein the client experiences significant distress and either a depressed mood or the loss of interest or pleasure in nearly all activities, for at least:

A. 1 week.
B. 2 weeks.
C. 1 month.
D. 2 months.

Answer 23

B. 2 weeks.

Question 24

A person is exhibiting evidence of some paranoid ideation, lacking social networks or friends, expressing odd beliefs and thinking in their speech, and is odd in their appearance. They may be showing signs of which of the following personality disorders?

A. Antisocial personality disorder
B. Avoidant personality disorder
C. Obsessive-compulsive personality disorder
D. Schizotypal personality disorder

Answer 24

D. Schizotypal personality disorder

Question 25

One interactive therapy that helps to actively incorporate social skills training for the client is:

A. pharmacological therapy.
B. therapeutic community.
C. dialectical behaviour therapy.
D. individual therapy.

Answer 25

C. dialectical behaviour therapy.

Question 26

Personality disorders:

A. have their onset in adolescence.
B. fluctuate over time.
C. intensify in adulthood.
D. have their onset in childhood.

Answer 26

A. have their onset in adolescence.

Question 27

Which of the following is a component of cognitive behavioural interventions?

A. ECT.
B. Arousal management.
C. Dialectical therapy.
D. Increased negative reinforcement.

Answer 27

B. Arousal management.

Question 28

A diagnosis of PTSD is not made in the first month of symptoms because what percentage of people fully recover within three months of onset?

A. 90%
B. 10%
C. 35%
D. 50%

Answer 28

D. 50%

Question 29

When a nurse is taking a substance use history, it is important to:

A. undertake an in-depth mental health exam.
B. approach the topic openly and treat substance use as an accepted behaviour.
C. ask why the patient needs to take these substances.
D. involve the family in the discussion about use.

Answer 29

B. approach the topic openly and treat substance use as an accepted behaviour.

Question 30

Harm-reduction strategies aim to:

A. prevent the client from doing any more harm to others.
B. reduce the involvement of the case manager in the reduction of alcohol and other drugs.
C. reduce problems associated with continuing use of alcohol and other drugs.
D. prevent the family from being harmed by a client using alcohol or other drugs.

Answer 30

C. reduce problems associated with continuing use of alcohol and other drugs.

Question 31

Nursing care for clients with a dual diagnosis (of substance use and mental illness) can be complicated by:

A. mandatory admissions.
B. the client’s ‘readiness to change’.
C. the requirement for appropriate medications.
D. confused care pathways.

Answer 31

B. the client’s ‘readiness to change’.

Question 32

A client has been admitted to the hospital with a diagnosis of Wernicke-Korsakoff syndrome. What is administered to treat this condition?

A. Thiamine
B. Vitamin C
C. Riboflavin
D. Vitamin K

Answer 32

A. Thiamine

Question 33

There is no set format for recording a mental state assessment, but the BATOMI mnemonic is a useful for guiding assessment and includes all of the following except:

A. behaviour and appearance.
B. attitude and temperament.
C. affect and mood.
D. cognition and sensorium.

Answer 33

B. attitude and temperament.

Question 34

The mental health nurse who is interviewing a client for the first time should begin the client’s assessment with:

A. delineating common goals.
B. open-ended questions.
C. closed questions.
D. observation of the client’s behaviour.

Answer 34

D. observation of the client’s behaviour.

Question 35

Chapter24: Challenging behaviour, risk and responses
In some instances nurses may experience the ‘fight or flight’ response. Physical symptoms of the ‘fight or flight’ response may include all of the following except:

A. increased blood pressure.
B. deep, rapid respirations.
C. dry mouth and excessive perspiration.
D. increased pulse rate.

Answer 35

B. deep, rapid respirations.

Question 36

When beginning a group counselling session using the open group system, the nurse/therapist should explain to the group members that one advantage of an open group system is that:

A. it can offer the best treatment outcomes.
B. the topics for the group can be controlled.
C. relationships are more easily established in the group.
D. new members can join the group at any time.

Answer 36

D. new members can join the group at any time.

Question 37

Benzodiazepines are a commonly prescribed anti-anxiety drug. They reduce anxiety by facilitating the:

A. action of the neurotransmitter GABA.
B. elevation of CNS depressants.
C. anticonvulsant potentiation.
D. inhibition of CNS.

Answer 37

A. action of the neurotransmitter GABA.

Question 38

In the past, the traditional antipsychotics, particularly haloperidol, have been prescribed as prn medication for acute agitation and disturbed behaviour. New evidence suggests that:

A. mood stabilisers are now more effective than traditional antipsychotics as prn medication.
B. SSRIs can be just as effective as traditional antipsychotic prn medication.
C. antiparkinsonian drugs are more effective than traditional antipsychotics as prn medication.
D. benzodiazepines are just as effective as traditional antipsychotics as prn medication.

Answer 38

D. benzodiazepines are just as effective as traditional antipsychotics as prn medication.

Question 39

One side effect of traditional or typical antipsychotic medication is an adverse anticholinergic effect such as:

A. dry mouth.
B. hypertension.
C. dizziness.
D. tremors.

Answer 39

A. dry mouth.

Question 40

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

Sterility
Cervical cancer
Uterine fibroid tumours
Irregular menses

Answer 40

Cervical cancer

Question 41

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

Impotence
Scrotal swelling
Urine retention
Dysuria

Answer 41

Dysuria

Question 42

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. On winstons arrival in the emergency room, which of the following considerations should receive the highest priority

Which of the following respiratory signs would indicate increasing intracranial pressure in the brain stem

Slow, irregular respirations
Rapid, shallow respirations
Asymmetric chest expansion
Nasal flaring

Answer 42

Slow, irregular respirations

Question 43

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

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

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

Answer 43

Tape the eyelid down to keep it closed between cares

Question 44

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

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

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

Answer 44

Keep suction apparatus available

Question 45

A 34 year old Japanese tourist, takayuki hanadi is admitted to the hospital after experiencing multiple trauma as a results 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

The nurse finds it difficult to relieve takayukis pain satisfactorily. Which of the following measures should the nurse take into consideration when continuing efforts to promote comfort

Restrict visitors to promote rest
Enlisting the help of the takayukis family
Allowing takayukis to work through his responses to pain
Move takayuki to a room with another client who has pain for mutual support

Answer 45

Enlisting the help of the takayukis family

Question 46

A 34 year old Japanese tourist, takayuki hanadi is admitted to the hospital after experiencing multiple trauma as a results 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

Morphine is prescribed for takayuki as it is an effective pain reliever because of its ability to

Reduce the perception of pain
Decrease the sensitivity of pain receptors
Interfere with pain impulses travelling along sensory nerve fibers
Block the conduction of pain impulses along the central nervous system

Answer 46

Reduce the perception of pain

Question 47

A 34 year old Japanese tourist, takayuki hanadi is admitted to the hospital after experiencing multiple trauma as a results 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

The gate control theory of pain is based on the belief that a regulatory process controls impulses reaching the brain. This regulatory process is believed to be located in the

Brain stem
Cerebellum
Spinal cord
Hypothalamus

Answer 47

Spinal cord

Question 48

An industrial health nurse at a large printing plant finds a 40 year old male employees blood pressure to be elevated on two occasions 1 month apart and refers him to his GP. The employee, called fred, is about 12 kilos overweight and has smoked a pack of cigarettes daily for more than 20 years.
During a nursing assessment, fred says i don’t really know why im here. I feel fine and havnt had any symptoms. The nurse would recognise the importance of explaining to fred that symptoms of hypertension

Are often not present
Signify a high risk of stroke
Occur only with malignant hypertension
Appear after irreversible kidney damage has occurred

Answer 48

Are often not present

Question 49

When genna dies, William cries and expresses his grief, one thing that the nurse should do is

Call the physician to speak with William
Find a place where the nurse and William can talk privately
Leave William alone to work through his emotions in private
Explain that everything possible was done for his wife

Answer 49

Find a place where the nurse and William can talk privately

Question 50

Following a physiotherapists assessment. Nursing assessment data include inability to move the right arm and leg; absence of muscle tone in the right arm and leg; and lack of knowledge about her ability to urn in bed. Based on these data, which of the following would be the most appropriate nursing diagnosis for charlotte

Activity tolerance
Sleep pattern disturbance
Impaired physical mobility
Unilateral neglect

Answer 50

Unilateral neglect

Question 51

A nursing priority in the first 24 hours after admission, for charlotte is assessment of

Risk factors for vascular disease
Pupil size and papillary response
Urinary elimination patterns
Health behaviours before the CVA

Answer 51

Risk factors for vascular disease

Question 52

Initially placing charlotte on a circulating air bed (alternating pressure mattress) is to

Increase mobility
Prevent contractures
Limit orthostatic hypotension
Prevent pressure on peripheral blood vessels

Answer 52

Prevent contractures

Question 53

The nurse is concerned about charlotte possibly developing plantar flexion. Which of the following measures has been found to be the most effective means of preventing plantar flexion in a stroke client

Placing her feet against a firm foot support
Repositioning her every 2 hours
Having her wear ankle high shoes throughout the day
Massaging her feet and ankles regularly

Answer 53

Placing her feet against a firm foot support

Question 54

For the client with dysphagia, which of the following measures would be ineffective in decreasing the risk of aspiration while eating

Maintaining an upright position
Restricting the diet to liquids until swallowing improves
Introducing foods on the unaffected side of the mouth
Keeping distractions to a minimum (this is to do with communication)

Answer 54

Keeping distractions to a minimum (this is to do with communication)

Question 55

The CVA has caused charlotte to experience blindness in half of the visual field. Although all of the following measures might be useful in reducing charlottes visual disability, which measure should the nurse teach her primarily as a safety precaution

Wear a patch over one eye
Place personal items on her sighted side
Lie in bed with the unaffected side toward the door
Turn her head from side to side when walking

Answer 55

Turn her head from side to side when walking

Question 56

Charlotte is experiencing mood swings that include short episodes of crying that are distressing to her family it would be best for the nurse to instruct family members to do which of the following when these crying bouts occur

Sit quietly with charlotte until the episode is over
Ignore the behaviour and continue what they were doing
Attempt to divert charlottes attention
Tell charlotte that this behaviour is unacceptable

Answer 56

Attempt to divert charlottes attention

Question 57

Mary a 47 year old woman has had a gastric ulcer for years. After she started vomiting blood today her neighbour drove her to the emergency room.

Mary receives a blood transfusion and the nurse assesses for the signs of an adverse reaction; the early signs include

Tachycardia and pyrexia
Bradycardia and hypotension
Hyperventilation and pallor
Shock and loss of consciousness

Answer 57

Bradycardia and hypotension

Question 58

3. Which of the following is NOT TRUE with respect to an un-stimulates neuron?

a) Na+ and Ca+ are usually found extracellular
b) The inside of the neuron is more negative that the outside giving a polarised state
c) Neurotransmitter’s are produced elsewhere enter the neurons when they are stimulated.
d) Each neuron is designed to produce its own neurotransmitter in its soma for transmission to a postsynaptic neuron or effector cell.

Answer 58

c) Neurotransmitter’s are produced elsewhere enter the neurons when they are stimulated.

Question 59

4. Which of the following is INCORRECT with respect to neurotransmitters?

a) Dopamine, epinephrine and norepinephrine are all catecholamine
b) Schizophrenia is usually due to excessive dopamine while depression is due to low levels of serotonin.
c) Both GABA and glutamate are inhibitory
d) Both dopamine and serotonin use amino acids as precursor molecules

Answer 59

c) Both GABA and glutamate are inhibitory

Question 60

8. The most effective approach to deal with denial in a client who abuses substance is

a) Discussing the addictive personality
b) Confronting the client regarding his or her hopeless life situation
c) Having the client identify the effect of substance abuse on his or her life
d) Describing the physiologic effects of substance abuse

Answer 60

c) Having the client identify the effect of substance abuse on his or her life

Question 61

13. What is the modern view of mental health recovery?

a) This involves the treatment of symptoms, and the ability to resolve any psychiatric problems
b) This involves the stabilising of symptoms, with or without the need to adhere to a regimen of antipsychotic medication, where the individual feels well enough to re-engage with their community.
c) This involves regular admissions to hospital under the care of different mental health professionals.
d) This involves involuntary admissions to hospital without opportunity to re-engage in the community.

Answer 61

b) This involves the stabilising of symptoms, with or without the need to adhere to a regimen of antipsychotic medication, where the individual feels well enough to re-engage with their community.

Question 62

14. Which of the following statement is relevant to DSM-V and ICD-10?

a) ICD – 10 is produced by a global health agency with a constitutional public health mission, while the DSM-V is produced by a single national professional association.
b) ICD-10 is produced by a British company , while DSM is done by USA government
c) ICD- 10 has now replaced DSM-V in clinical setting for making diagnosis
d) ICD-10 and DSM0-V are compulsory admission tools for to mental health hospitals

Answer 62

a) ICD – 10 is produced by a global health agency with a constitutional public health mission, while the DSM-V is produced by a single national professional association.

Question 63

19. Detoxification is a process of systematic and supervised withdrawal from substance use that is either manages in a residential setting or on an outpatient basis. How can drug used during detoxification affect that person?

a) It helps to monitor psychosocial behaviours
b) It prevents relapse
c) It weans-off a user onto a weaker substance
d) All the Above

Answer 63

c) It weans-off a user onto a weaker substance

Question 64

21. Recurrent episode of Bulimia are characterised by one of the following:

a) Eating food in a separate period of time (e.g. within any two-hour period), which is larger than most people would eat during a similar period.
b) A sense of control over your eating during the episode (e.g. control what or how many calories are in your food)
c) Fear of gaining weight or becoming overweight, by eating a small regular meal.
d) Eat more than 4 meals a day.

Answer 64

d) Eat more than 4 meals a day.

Question 65

22. What health complication is often seen with bulimia nervosa

a) Loss of weight
b) Hearing loss
c) Loss of smell
d) Dental erosion

Answer 65

d) Dental erosion

Question 66

24. Tom is taking Risperidone for a few days and develops muscular rigidity, altered consciousness, a temperature of 39 degrees Celsius and trouble breathing. Which of the following is the likely problem?

a) Neuroleptic malignant syndrome
b) Tardive dyskinesia
c) Extrapyramidal side effects
d) Risperidone induced parkinsonism

Answer 66

a) Neuroleptic malignant syndrome

Question 67

26. Which one of the following is TRUE of recovery model

a) Someone with mental health recovers completely from the illness
b) Recovery is characterised by seeking no pharmacological treatment’s
c) Take control of one’s lives and treatment may or may not include medication
d) Recovery model involves adherence to medication and treatment.

Answer 67

c) Take control of one’s lives and treatment may or may not include medication

Question 68

27. How does the process of caring differ between general and mental health nurses?

a) Mental health nurses emphasise the psychiatric aspects of care and general nurse focus physical care
b) General nurse focus on holistic care and mental health nurses focus only on psychological care
c) There is no difference in the process of care between a general and mental health nurses
d) Mental health nurse must care for patients compelled to accept professional care under Mental Health Act

Answer 68

c) There is no difference in the process of care between a general and mental health nurses

Question 69

30. An acute stress reaction is an acute response to a catastrophic experience that diminishes in a matter of days. Choose one example of this :

a) Road accidents or criminals assaults
b) Fear developing a phobia when in a foreign country and eating in a public place
c) Seeing your dentist for routine treatment
d) Leaving job to join another company

Answer 69

d) Leaving job to join another company

Question 70

32. Which of the following are the essential features of post-traumatic disorder?

a) Disaster, violence and loss
b) Fear, helplessness and horror
c) Depression, anger and helplessness
d) Memory loss, connection and anxiety

Answer 70

a) Disaster, violence and loss

Question 71

33. What is specific phobia

a) Anxiety about being in place /situation where escape may be difficult or embarrassing or help might not be available if a panic attack was to occur
b) A marked and persistent fear that is irrational and cured by the presence or anticipation of an object or event
c) A marked and persistent fear on one or more social or performance situations in which the person is exposed to unfamiliar people or possible scrutiny by others. The person feels they will act in a way that humiliates or embarrasses them
d) Recurrent and unexpected panic attacks

Answer 71

c) A marked and persistent fear on one or more social or performance situations in which the person is exposed to unfamiliar people or possible scrutiny by others. The person feels they will act in a way that humiliates or embarrasses them

Question 72

35. Dysthymia involves the presence of a depressed mood for:

a) Symptoms that are less than a year
b) A 2 year period in an adult’s life plus fewer than five symptoms of a major depression
c) The duration of part of the winter months only
d) At least a 3 months period in adults and had five symptoms of a major depressive episode

Answer 72

b) A 2 year period in an adult’s life plus fewer than five symptoms of a major depression

Question 73

37. Which of the following statement is associated with schizophrenia?

a) The presence of depression symptoms over a long period of time
b) It is as a distinct entity, distinguishing it from bipolar disorder psychosis and naming it dementia praecox – dementia of early life
c) It involves regular admissions to hospital under the care of mental health professionals
d) It involves voluntary admissions to hospital when people start hearing voices.

Answer 73

b) It is as a distinct entity, distinguishing it from bipolar disorder psychosis and naming it dementia praecox – dementia of early life

Question 74

38. Which of the following indicated adverse effects of a typical antipsychotic?

a) Akathisia, blunted affect, dehydration and weight gain
b) Blunted affect, weight gain, hysteria, and neuroleptic malignant syndrome
c) Dehydration, Akathisia, mood swing, and weight gain
d) Weight gain, parkinsonian effects, Akathisia, dystonia

Answer 74

d) Weight gain, parkinsonian effects, Akathisia, dystonia

Question 75

39. Which of the following are negative symptoms of schizophrenia?

a) Anhedonia, apathy and blunted affect
b) Periodic excitability and lack of concentration
c) Bizarre behaviour and delusion and infidelity
d) Apathy and hallucinations

Answer 75

a) Anhedonia, apathy and blunted affect

Question 76

41. Electro-convulsive therapy is a useful treatment for treating schizophrenia when:

a) The patient has been experiencing side effects with the oral antipsychotic
b) The patient is non-concordant with an antidepressant
c) The patient is a risk of considerable harm to self or others
d) The patient is experiencing auditory hallucinations

Answer 76

c) The patient is a risk of considerable harm to self or others

Question 77

43. Evidence had shown that some situation can lead to biological alteration of the brain development. Which of the following may not be considered as a biological cause of the mental illness from childhood?

a) Swine flu infection of pregnant women
b) Inheritance of a gene that can code for a protein which inhibits neuronal network connections
c) Premature delivery which can lead compromise foetal oxygen supply
d) Breakdown of relationship, e.g., divorce

Answer 77

d) Breakdown of relationship, e.g., divorce

Question 78

44. What is the most important piece of information you must give to someone when they discharge on Clozapine from a psychiatric unit:

a) Have a flu vaccination as soon as possible
b) Ensure no doses of Clozapine are missed
c) Don’t take Clozapine with vegemite and cheese
d) Visit you GP regularly

Answer 78

a) Have a flu vaccination as soon as possible

Question 79

45. Which of the following is relevant to someone on Mental Health Act 1992?

a) Patients right to be treated in a single room
b) Patients right to have adequate food and drink
c) Patients right to refuse long acting intra medication
d) Patients right to independent lawyer for the tribunal

Answer 79

d) Patients right to independent lawyer for the tribunal

Question 80

47. Which of the following indicates the possible problem with ECT

a) Seizures
b) Incontinence
c) Dehydration
d) Headache

Answer 80

b) Incontinence

Question 81

● 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 81

c) Air travel

Question 82

● 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

● 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 82

c) The status of the patients respiration

Question 83

● 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 83

d) Infection control

Question 84

● 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 84

b) the client has been exposed to mycobacterium

Question 85

● 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 85

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

Question 86

● 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 86

b) Check for breathing

Question 87

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

Following a petit mal seizure a person is likely to be

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

Answer 87

a) Confused

Question 88

● 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

● 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 a 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 88

d) The medication will be necessary for the rest of his life

Question 89

● 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 89

b) Gamma globulin

Question 90

● 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 90

a) Suctioning to clear the airway

Question 91

● 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 91

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

Question 92

• Mrs todds nurse has a paronychia (infected finger). What action should the nurse take

a) Take sick leave
b) Go to work as usual
c) Work with the paronychia covered
d) Go to work and only care for mrs todd
e) Inform the nurse in charge and ask for ‘dry duties’

Answer 92

c) Work with the paronychia covered

Question 93

• Mrs todd is found to have a haemoglobin of 68g% and is ordered a blood transfusion. She says to the nurse who is checking the blood, ‘I don’t really want this, but the doctor says I have to’. What should the nurse do

a) Discuss the matter with the doctor and give the blood if she confirms the need
b) Not give the blood until the doctor has discussed it with the patient
c) Start the blood as charted and inform the doctor of the patients concern
d) Encourage the patient to have the blood and give it when she consents
e) Not give the blood if the patient remains unsure and notify the doctor of this decision

Answer 93

b) Not give the blood until the doctor has discussed it with the patient

Question 94

• While mr march is hospitalised, the nurse is concerned with preventing the complications of prolonged bed rest. Mr march already has a reddened area over the sacrum and coccyx. The nurse knows that the most important action to prevent a decubitus ulcer is to

a) Keep the skin area clean, dry and free from urine, faeces and perspiration
b) Place an alternating air pressure or water mattress on the bed
c) Massage the reddened area with lotion or oil to stimulate circulation
d) Turn and reposition the client at least q2hrly; avoid positioning him on the affected side if possible

Answer 94

d) Turn and reposition the client at least q2hrly; avoid positioning him on the affected side if possible

Question 95

• Which of the following is the most correct statement about positioning the stroke client

a) Flexor muscles are generally stronger than extensors
b) Extensor muscles are generally stronger than flexor
c) The fingers should be flexed tightly
d) The footboard should be flush with the mattress

Answer 95

b) Extensor muscles are generally stronger than flexor

Question 96

• Mrs sweetman, aged sixty two years, has non insulin dependent diabetes mellitus. She recently returned home from hospital where she received treatment for an infection of her left big toe. Mrs sweetmans toe infection resulted from an injury of which she was unaware. The most likely reason for this would be that

a) Her vision is impaired
b) She did not regularly wash her feet
c) She finds it difficult to flex her knees and hips
d) She has diminished sensation in her feet

Answer 96

d) She has diminished sensation in her feet

Question 97

• Carl comes to the mental health clinic where you work because of nerviousness. He tells you ‘I have butterflies in my stomach most of the time. I havnt missed work but it is getting harder to concentrate on things for a long time. What level of anxiety is carl most likely experiencing

a) Mild
b) Moderate
c) Severe
d) Panic

Answer 97

a) Mild

Question 98

• Which of the following questions would be the best way to begin taking carls history

a) Could you tell me about your family
b) What are you feeling now
c) Have you ever felt this way before
d) Does anyone else in your family experience these feelings

Answer 98

c) Have you ever felt this way before

Question 99

• Four year old sean white was admitted to hospital with burns received while playing with matches. His legs and lower abdomen are burned. On assessment of seans hydrated status, which of the following indicates

a) Decreasing hematocrit and increasing urine volume
b) Falling hematocrit and decreasing urine volume
c) Rising hematocrit and decreasing urine volume
d) Stable hematocrit and increasing urine volume

Answer 99

b) Falling hematocrit and decreasing urine volume

Question 100

• Which signs/symptoms indicate overhydration

a) Dieresis
b) Drowsiness and lethargy
c) Dyspnea, moist rales
d) Warmth and redness around intravenous site

Answer 100

b) Drowsiness and lethargy

Question 101

• True labour can be differentiated from prodromal or false labour in that in true labour there is a

a) Strengthening of uterine contractions with walking
b) Failure of presenting part to descend
c) Lack of cervical effacement or dilation
d) Cessation of uterine contractions with walking

Answer 101

c) Lack of cervical effacement or dilation

Question 102

• First fetal movements felt by the mother are known as

a) Ballottement
b) Engagement
c) Lightening
d) Quickening

Answer 102

d) Quickening

Question 103

• Mrs greene, a 22 year old primigravida is attending prenatal clinic

a) Give her a list of foods so she can better plan her meals
b) Assess what she eats by taking a diet history
c) Emphasise the importance of limiting salt and highly seasoned foods
d) Instruct her to continue eating a normal diet

Answer 103

c) Emphasise the importance of limiting salt and highly seasoned foods

Question 104

• The nurse evaluates mr quangs mantoux test as positive by the presence of

a) A small red swelling less than 7mm in diameter
b) An erythematious area greater than 7mm
c) Swelling and erythema together measuring between 7mm and 9mm
d) A lump greater than 7mm in diameter

Answer 104

b) An erythematious area greater than 7mm

Question 105

• On mr quangs chest x ray film a lesion is observed in an upper lobe. Why is this area of the lung most commonly affected in tuberculosis

a) There is a slightly higher oxygen concentration in the upper lobes
b) Sputum collects more readily in upper lobes than in lower lobes
c) Upper lobes are less easily ventilated than are lower lobes
d) Tubercule bacilli are less dense than air and therefore remain in the upper lobes

Answer 105

d) Tubercule bacilli are less dense than air and therefore remain in the upper lobes

Question 106

• For how long will mr quang need treatment

a) Until he leaves the hospital
b) For 18 months
c) Until all tests are negative
d) For two years

Answer 106

b) For 18 months

Question 107

• Chris says she wants to discharge herself and go home. Which of the following is the best nursing response

a) I will ask the doctor to talk with you
b) It would be very unsafe for you to leave hospital without proper medical treatment
c) Can we talk about what is worrying you
d) If that’s what you have decided I will get a self discharge form

Answer 107

c) Can we talk about what is worrying you

Question 108

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

● 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 108

b) Cervical cancer

Question 109

● 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 109

c) Can lead to cervical cancer

Question 110

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

● 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 110

b) scrotal swelling

Question 111

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.

● 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 111

a) slow, irregular respirations

Cushing reflex or Cushing’s Law, is a physiological nervous system response to increased intracranial pressure (ICP) that results in Cushing’s triad of increased blood pressure, irregular breathing, and bradycardia. It is usually seen in the terminal stages of acute head injury and may indicate imminent brain herniation. It can also be seen after the intravenous administration of epinephrine and similar drugs. It was first described in detail by American neurosurgeon Harvey Cushing in 1901.

Question 112

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 comatose and does not respond to stimuli. A drug overdose is suspected.

● 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 112

b) Keep suction apparatus available

Question 113

● 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 113

c) Air travel

Question 114

Which reflex can be stimulated in breastfeeding?

a) Moro reflex
b) Rooting reflex
C) Grasping reflex
D) Tonic neck reflex

Answer 114

b) Rooting reflex

Question 115

A client states that anginal pain increases after activity. The nurse should realise that angina pectoris is a sign of

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

Answer 115

b) Myocardial ischemia

Question 116

A client with pyrexia will most likely demonstrate

a) Dyspnoea
b) Precordial pain
c) Increased pulse rate
d) Elevate blood pressure

Answer 116

c) Increased pulse rate

Question 117

Cholesterol, frequently discussed in relation to atherosclerosis, is a substance that

a) May be controlled entirely by eliminating food sources.
b) Is found in many foods, both in plant and animal sources.
c) All persons would be better off without because it cases the disease process
d) Circulates in the blood, the level of which responds usually to dietary substitutions of unsaturated fats for saturated fats.

Answer 117

d) Circulates in the blood, the level of which responds usually to dietary substitutions of unsaturated fats for saturated fats.

Question 118

Early symptoms of morphine overdose include

a) slow pulse, slow respirations, sedation
b) slow respirations, dilated pupils, and restlessness
c) profuse sweating, pinpoint pupils and deep sleep
d) slow respirations, constricted pupils and deep sleep

Answer 118

d) slow respirations, constricted pupils and deep sleep

Question 119

When formulating nursing care plans for elderly clients, the nurse should include special measures to accommodate for age-relate sensory losses such as

a) Difficulty in swallowing.
b) Increased sensitivity to heat.
c) Diminished sensation of pain.
d) Heightened response to stimuli.

Answer 119

c) Diminished sensation of pain

Question 120

183) A client has collapsed has no carotid pulse or respirations. The nurse should:

a) Call for help
b) Check for a radial pulse.
c) Give four full lung inflations.
d) Compress the lower sternum 15 times.

Answer 120

a) Call for help

Question 121

179) When helping a client with a cerebral vascular accident to develop independence, the
nurse should:

a) Establish long-range goals for the client.
b) Reinforce success in tasks accomplished.
c) Point out errors in performance on which to focus.
d) Demonstrate ways the client can regain independence in activities.

Answer 121

b) Reinforce success in tasks accomplished.

Question 122

In order to get an Annual Practicing Certificate a Registered Nurse must:

a) Be employed as a Registered Nurse.
b) Have completed 60 days nursing practice and 60 hours professional development in the last 3 yeas.
c) Be a participant in an approved professional development programme.
d) Have completed 100 hours nursing practice and 100 hours professional
development over the last 5 years.
e) Have completed a first year of practice programme.

Answer 122

b) Have completed 60 days nursing practice and 60 hours professional development in the last 3 yeas.

Question 123

Maria, aged 24 years, is a 3-month primagravida, visiting ante-na.tal clinic for the first
time.
(The following four questions relate to the above passage.)

8) Maria is experiencing frequency of micturition. You should be aware that pregnancy
predisposes women to urinary tract infections, because:

a) There is a drop in her white blood cell count.
b) Hormonal changes cause dilated ureters and urinary stasis.
c) Intrauterine infections spread to the bladder.
d) There is increased frequency of urination caused by uterine pressure.

Answer 123

b) Hormonal changes cause dilated ureters and urinary stasis.

Question 124

Maria, aged 24 years, is a 3-month primagravida, visiting ante-na.tal clinic for the first
time.
(The following four questions relate to the above passage.)

9) On a later visit to the clinic, you notice that the rings on Maria’s fingers are becoming
very tight. The routine urine test shows protein 2+. What further information is
required?

a) Blood pressure and haemoglobin.
b) Assessment for visual disturbances and epigastric pain.
and stretch reflexes.
c) Haemoglobin and stretch reflexes.
d) Weight and blood pressure.

Answer 124

d) Weight and blood pressure.

Question 125

Maria, aged 24 years, is a 3-month primagravida, visiting ante-na.tal clinic for the first
time.
(The following four questions relate to the above passage.)

10) Maria is admitted to an antenatal ward with gestational hypertension and
proteinuria. Mother and baby are likely to have:

a) hypoglycaemia
b) ischaemia
c) immunosuppression
d) anaemia

Answer 125

b) ischaemia

Question 126

13) 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 126

b) Mental confusion or restlessness.

Question 127

20) On your next visit to Sally’s residence you notice that Sally’s husband often answers for
his wife. You can see that her tremor is becoming more pronounced and she is no longer
attempting to participate in the conversation. What is the BEST action to take in this
situation?

a) Continue to speak directly to Sally.
b) Ask Sally’s husband not to respond for his wife.
c) Suggest Sally take medication to reduce the tremor.
d) Address all your questions to Sally’s husband.

Answer 127

b) Ask Sally’s husband not to respond for his wife.

Question 128

Allen is stabbed in the right anterior chest.
28) Allen is admitted to the Emergency Department with a haemothorax. Blood is
accumulating in his:

a. Chest wall.
b. Bronchial tree.
c. Pleural space.
d. Thoracic cavity.

Answer 128

c. Pleural space.

Question 129

29) A chest drain is inserted. The nurse recognises that this treatment is effective primarily
because it:

a. Re-establishes a negative pressure in the pleural space.
b. Promotes haemostasis and coagulation of retained blood.
c. Collapses the unaffected lung and allows for greater expansion of functional
lung tissue.
d. Permits the accumulation of free air in the chest

Answer 129

a. Re-establishes a negative pressure in the pleural space.

Question 130

30) Which of the following explains the presence of a crackling sensation under Allen’s skin?

a. Pleural effusion.
b. Pulmonary contusion.
c. Percutaneous hyperoxaemia.
d. Subcutaneous emphysema.

Answer 130

d. Subcutaneous emphysema.

Question 131

33) The nurse monitors Allen for the signs of mediastinal shift. The nurse should watch
particularly for which of the following?

a. Decreasing cyanosis.
b. Dyspnoea and stridor.
c. Tachycardia and hypertension.
d. Tracheal deviation.

Answer 131

d. Tracheal deviation.

Question 132

34) Allen becomes hypotensive, apprehensive and has a feeling of tightness in his chest. The
nurse should anticipate which of the following treatments?

a. Insertion of a large needle into the pleural space.
b. Emergency thoracotomy.
c. Diagnostic electrocardiograph.
d. Intubation and controlled mechanical ventilation.

Answer 132

a. Insertion of a large needle into the pleural space.

Question 133

Rosemary is being prepared for a craniotomy, due to an extradural haemorrhage.

37) The doctor prescribes the following drugs for Rosemary preoperatively. Which
medication should the nurse question prior to administration?

a. Atropine.
b. Corticosteriods.
c. Mannitol.
d. Morphine

Answer 133

d. Morphine

Question 134

Rosemary is being prepared for a craniotomy, due to an extradural haemorrhage.

38) Rosemary is placed in the lateral position during surgery. Which specific postoperative
observation would you now make?

a. Observe the knees for flexion contractures.
b. Check the shoulders for decubiti.
c. Monitor for postural hypotension.
d. Evaluate chest expansion.

Answer 134

b. Check the shoulders for decubiti.

Question 135

40} If increased intracranial pressure was suspected in the postoperative period, in which
position would Rosemary be placed?

a. Flat with feet elevated.
b. Head of the bed elevated 30 degrees.
c. Side-lying.
d. Prone.

Answer 135

b. Head of the bed elevated 30 degrees.

Question 136

Cane, a 68 year old is scheduled for abdominal surgery.

46) If respiratory depression is noted in Cane, the nurse should prepare to administer which
of the following drugs?

a) Aminophylline.
b) Lasix.
c) Naloxone.
d) Numorphan.

Answer 136

c) Naloxone.

Question 137

Cane, a 68 year old is scheduled for abdominal surgery.

47) You are monitoring Cane’s vital signs every 15 min post-surgery. Which of the following
changes should be reported immediately?

a) A systolic blood pressure that drops 30 mm Hg.
b) Dry, cool skin.
c) A pulse rate that increases and decreases with respirations.
d) A diastolic pressure at 70 mm Hg.

Answer 137

a) A systolic blood pressure that drops 30 mm Hg.

Question 138

Cane, a 68 year old is scheduled for abdominal surgery

48) Which nursing action would best help to prevent post-operative thrombophlebitis in
Cane?

a) Encouraging pre-operative ambulation.
b) Assisting Cane to sit up in bed after surgery.
c) Keeping Cane Nil by Mouth.
d) Reminding Cane to move his feet.

Answer 138

d) Reminding Cane to move his feet.

Question 139

Kate, aged 40, is admitted to the hospital after several episodes of right upper quadrant
abdominal pain and intolerance to fatty and gas-forming foods. A diagnosis of biliary colic is
made.

49) The ingestion of fatty foods will precipitate the pain of biliary colic because:

a) Increased fat in the stomach increases peristalsis.
b) Fat in the duodenum initiates contraction of the gallbladder.
c) Fat in the duodenum increases abdominal distention.
d) Increased fat intake may result in a gallbladder obstruction.

Answer 139

b) Fat in the duodenum initiates contraction of the gallbladder.

Question 140

Kate, aged 40, is admitted to the hospital after several episodes of right upper quadrant
abdominal pain and intolerance to fatty and gas-forming foods. A diagnosis of biliary colic is
made.

58) To prevent the most common complication following a cholecystectomy, it would be
most important for Kate to:

a) Have the abdominal dressing changed prn for heavy drainage.
b) Increase fluid intake and decrease fat intake.
c) Receive prn pain medication at intervals ordered.
d) Cough and deep breathe every 2 hrs and fully expand her lungs.

Answer 140

d) Cough and deep breathe every 2 hrs and fully expand her lungs.

Question 141

61) The initiation of inspiration originates with discharge of inspiratory neurons in the:

a) Diaphragm.
b) Medulla.
c) Pons.
d) Lungs.

Answer 141

b) Medulla.

Question 142

63) Decreased amounts of CO2 concentration in the bronchioles cause:

a) An increase in bronchiolar dilation.
b) A decrease in bronchiolar constriction.
c) An increase in bronchiolar constriction.
d) None of these.

Answer 142

c) An increase in bronchiolar constriction.

Question 143

65) The maximum amount of air moved in and out during a single breath is:

a) Tidal volume.
b) Vital capacity.
c) Alveolar ventilation.
d) Residual volume.

Answer 143

a) Tidal volume.

Question 144

66) If a person is breathing 12 times per minute and the tidal volume is 500 ml what is the
alveolar ventilation?

a) 0ml/min.
b) 5200ml/min.
c) 6000ml/min.
d) 4200ml/min.

Answer 144

d) 4200ml/min.

Question 145

71) One of the early symptoms of emphysema is:

a) A reduced expiratory volume.
b) The lung becomes solid and airless.
c) The lungs becomes inflamed.
d) The vital capacity is reduced.

Answer 145

a) A reduced expiratory volume.

Question 146

72) The substance administered during an asthmatic attack to decrease resistance via
airway dilation is:

a) Histamine.
b) Epinephrine.
c) Norepinephrine.
d) Angiotensin.

Answer 146

b) Epinephrine.

Question 147

75) Mavis is anxious but refuses to discuss her condition with you. She always listens
intently during the doctor’s round but never asks questions. The best action to take to
help relieve Mavis anxiety is to:

a) Sit with Mavis and listen to her worries.
b) Interpret for her what the doctor is saying.
c) Discuss Mavis anxiety with the doctor.
d) Encourage the doctor to spend more time with her

Answer 147

a) Sit with Mavis and listen to her worries.

Question 148

74) Mavis, aged 69, is admitted to hospital with severe chronic obstructive respiratory
disease. Oxygen is charted at 28%. Why is it important to limit the amount of oxygen
Mavis receives?

a) To prevent her from becoming dependent on oxygen.
b) Avoid depressing her central nervous system.
c) To ensure she initiates her own respirations.
d) To maximise gaseous exchange in the lungs.

Answer 148

c) To ensure she initiates her own respirations.

Question 149

77) __________ is generally relieved by sitting up in a forward leaning
position:

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

Answer 149

b) Orthopnoea.

Question 150

78) In a client with emphysema, hypoventilation could initially cause:

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

Answer 150

a) Respiratory acidosis.

Question 151

79) 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 151

b) Enlargement of the right ventricle.

Question 152

A 40-year-old divorced mother of four school-age children is hospitalised with
metastatic cancer of the ovary.

88) 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 patient’s respiration.
d) The rate and character of carotid or femoral pulses.

Answer 152

c) The status of the patient’s respiration.

Question 153

90) 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 and systems.
c) Antimicrobials.
d) Infection control.

Answer 153

b) Better housing and provision of clean water, sewerage and systems.

Question 154

95) An older adult with a diagnosis of dementia of the Alzheimer’s type likes to talk about
olden days and at times has a tendency to confabulate. The nurse should recognise that
confabulation serves to:

a) Prevent regression.
b) Prevent embarrassment.
c) Attract the attention of others.
d) Reminisce about achievements.

Answer 154

b) Prevent embarrassment.

Question 155

97) Which of the following is a critical factor in response to a crisis in the older adult?

a) Translocation.
b) Self-destructive behaviour.
c) Perception of the event.
d) Ineffective coping.

Answer 155

c) Perception of the event.

Question 156

99) Pathological signs of grieving include:

a) Crying.
b) Failure to acknowledge and accept losses.
c) Grieving lasting at least 3 months.
d) Diminished social activities and church attendance.

Answer 156

b) Failure to acknowledge and accept losses.

Question 157

02} Immunity that results from the natural exposure to an antigen in the environment is
called:

a} Active immunity
b} Natural passive immunity.
c} Autoimmunity.
d} Passive immunisation.

Answer 157

a} Active immunity

Question 158

104} Autoimmune disease occurs when

a} Antibodies fail to recognise own tissue as an antigen.
b} Antigens fail to stimulate antibody response.
c} Antibodies identify own tissue as an antigen.
d} Antibody production ceases.

Answer 158

c} Antibodies identify own tissue as an antigen.

Question 159

107) The organism most commonly responsible for acute otitis media is:

a) Streptococcus pyogenes.
b) Staphylococcus albus.
c) Haemophilus influenza.
d) Escherichia coli.

Answer 159

c) Haemophilus influenza.