Brainscape Practice Questions + Richys notes Flashcards
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The Contraception, Sterilisation and Abortion act 1977, as amended in 1990, states that nurses
a) Are not able to give any contraceptives
b) Are able to inform parents of the family planning visit
c) can give information of advice on the use of oral contraceptives to people of any age
d) can give advice on sexual health but not on the use of oral contraceptives.
c) can give information of advice on the use of oral contraceptives to people of any age
The nurse is assessing a client who desires an effective contraceptive method. Which assessment finding would possibly contraindicate the use of an oral contraceptive by the client.
a) Anaemia
b) Age 24
c) Irregular menstrual cycles
d) History of thrombophlebitis
a) Anaemia
The best time frame for taking the Emergency Contraceptive Pill to achieve a 96-99% efficacy rate is:
a) Within 1-12 hours
b) Within 24 hours
c) At 6 hourly intervals
d) Within 72 hours
b) Within 24 hours
Jane asks you about the Emergency Contraceptive pill. Which of these statements is incorrect?
a) It changes the lining of your uterus so a fertilised egg cannot implant and develop
b) it makes the sperm inactive
c) it delays the release of an egg from your ovary until sperm are no longer active
d) there is a 96-99% chance that the pill will be effective.
b) it makes the sperm inactive
How does the combined contraceptive Pill work to prevent pregnancy?
a) The hormones contained in the pill kill the sperm
b) The hormones in the pill prevent ovulation (the release of the ovum from the ovaries)
c) The hormones contained in the pill cause early miscarriage.
d) the hormones contained in the pill reduce sexual drive
b) The hormones in the pill prevent ovulation (the release of the ovum from the ovaries)
At what age can a child obtain contraception without consent from parents/caregivers?
a) Any age
b) Over the age of 16 years
c) Over the age of 13 years
d) Not at all
a) Any age
You are a school nurse who is responsible for teaching adolescents about sexually transmitted infections (STI’s). Which of the following is the best statement you would make regarding prevention of STI’s?
a) HIB is best prevented with the use of condoms and foam
b) Herpes simplex is detected easily and therefore symptom education is very necessary
c) Condoms are recommended as a prevention against STI’s
d) Many STI’s are transmitted to the foetus through the bloodstream from the placenta
c) Condoms are recommended as a prevention against STI’s
Which statement is correct about menstruation?
a) Flow usually lasts 3 to 7 days
b) A normal cycle is 32 days
c) The average amount of flow is 500ml
d) Most girls begin menstruation at 12 or 13 years
a) Flow usually lasts 3 to 7 days
The importance of a cervical screen is to:
a) Detect a sexually transmitted infection
b) Detect abnormal cell changes
c) To prevent infertility
d) all of the above
b) Detect abnormal cell changes
You are a public health nurse at a school and you and your team are planning to vaccinate 12-13 year old girls against human papillomavirus (HPV). You are providing a health education session to parents and teachers. One mother asks you why her daughter needs to be vaccinated against HPB when she knows that her daughter is not sexually active. What would be the most appropriate response?
a) There are increased adverse reactions associated with having the vaccine after puberty.
b) The HPV vaccine is effective in the prevention of HPV infection. For this reason girls need to be vaccinated before they are exposed to HPV through sexual activity.
c) Tell her that her daughter is exempt from having the vaccine and that she should discuss this with their family doctor or nurse.
d) You advise her that she can make an appointment to see their family doctor or nurse when she does become sexually active
b) The HPV vaccine is effective in the prevention of HPV infection. For this reason girls need to be vaccinated before they are exposed to HPV through sexual activity.
While carrying out the education session the Mother also asks you about shingles. She asks you whether she needs to be vaccinated given she has had chicken pox. Which of the following statements is incorrect?
a) You can only get shingles if you’ve had chickenpox in the past
b) The risk of getting shingles is greater in people with a weakened immune system
c) The risk of shingles increases as you get older
d) You will be immune to shingles if you’ve had chickenpox in the past
d) You will be immune to shingles if you’ve had chickenpox in the past
The correct name for shingles is:
a) herpes zoster virus
b) herpes simplex type 1
c) herpes simplex type 2
d) fever blisters
a) herpes zoster virus
Another Mother has heard that several children have been diagnosed with mononucleosis (glandular fever). She asks the nurse what precautions should be taken to prevent this illness occurring in her child. Which of the following would the nurse advise the mother to do?
a) Advise her child not to share drink bottles at school
b) Sterilise the child’s eating utensils before they are reused
c) Wash the child’s linens separately in hot, soapy water
d) Wear a mask when providing direct personal care
a) Advise her child not to share drink bottles at school
A father asks the nurse how he would know if his child had developed mononucleosis. The nurse explains that in addition to fatigue, which of the following would be most common?
a) Liver tenderness
b) Enlarged lymph glands
c) Persistent non-productive cough
d) A blush-like generalised skin rash
b) Enlarged lymph glands
You are asked by a student of a school you are visiting about the measles as they have heard there has been an outbreak in their area. The scientific name for measles is:
a) Herpes Zoster
b) Rubeola
c) Pertussis
d) Varicella
b) Rubeola
The student then asks you how measles is transmitted. The best response is:
a) It is spread person to person by direct contact with body fluids particularly blood products.
b) It is only transmitted in non- vaccinated communities.
c) It is spread person to person through the air.
d) It is only transmitted during the flu season when people sneeze and cough.
c) It is spread person to person through the air.
She asks you what the infectious period for measles is. The correct information about the infectious period is:
a) Once the rash appears until the spots are no longer red and inflamed.
b) 10 days prior to the appearance of the rash until 14 days after the rash appears.
c) During the entire time the rash is evident.
d) 5 days prior to the appearance of the rash until 5 days after the rash appears.
d) 5 days prior to the appearance of the rash until 5 days after the rash appears.
The recommended immunisation schedule for measles is:
a) 12 months and 15 months of age
b) 15 months and 4 years of age
c) 6 weeks, 3 months and 5 months of age
d) 5 months and 4 years of age
a) 12 months and 15 months of age
The student tells you her family doesn’t believe in vaccinations. What is the most appropriate response to this statement?
a) “Are you aware of the serious consequences of not vaccinating”
b) “Do you have some questions about this decision?”
c) “There are articles and pamphlets available about this. Would you like them?”
d) “That seems like an irresponsible decision to make”
b) “Do you have some questions about this decision?”
She asks you how the vaccination works. The correct response to this is:
a) The vaccination causes the person to produce antibodies that will recognise and bind to measles virus particles in the blood.
b) The vaccination introduces antibodies that will inactivate measles virus particles.
c) The vaccination introduces the measles virus so the monocytes can learn to engulf them.
d) The vaccination causes the person to produce antigens that recognise and destroy measles virus particles.
a) The vaccination causes the person to produce antibodies that will recognise and bind to measles virus particles in the blood.
A client with type 1 diabetes mellitus is admitted for treatment of cellulitis in her left leg. Her white cell count is abnormally high. When planning for this client, the nurse should expect to
a) see an increase in the blood glucose concentration
b) see a decrease in the blood glucose concentration
c) Decrease the insulin dosage
d) Withhold all insulin
a) see an increase in the blood glucose concentration
What should you do first if someone has a blood glucose level of 1.5 mmol/L?
a) Give glucose gel
b) Increase insulin by 50%
c) Give a sandwich for lunch
d) Give six jellybeans
a) Give glucose gel
Type 1 diabetes differs from type 2 diabetes in that:
a) Type 2 diabetes only affects the adult population
b) Insulin is never required for type 2 diabetes
c) Type 1 diabetes is an autoimmune disease
d) Type 1 diabetes is only acquired in childhood
c) Type 1 diabetes is an autoimmune disease
A family member asks to look at their relative’s medical records. You should
a) tell them you will get the file for them to view
b) inform them of the policy for viewing medical records
c) ask them to wait while you discuss their request with a senior nurse
d) sit down with them and discuss their relative’s care while referring to the record
b) inform them of the policy for viewing medical records
After a stroke a client develops dysphasia. Which assessment finding most typifies dysphasia?
a) Arm and leg weakness
b) Absence of gag reflex
c) Difficulty with swallowing
d) Inability to speak clearly
d) Inability to speak clearly
On admission your adult client’s vital signs are: temperature 38.8˚C; heart rate 144 beats/minute; respiration rate 26 breaths/minute; and blood pressure 140/87 mmHg. Which nursing diagnosis has the highest priority when planning this client’s care?
a) Decreased cardiac output
b) Ineffective thermoregulation
c) Ineffective breathing pattern
d) Altered renal tissue perfusion
c) Ineffective breathing pattern
Mrs Khan is an 80-year-old female who lives with her son, his wife and their three children. She has had type 2 diabetes for many years, which used to be well-managed using oral hypoglycaemic medications, but now requires exogenous insulin. Her family report that she is requiring more assistance with her personal care.
Why is insulin given as an injection, rather than orally?
a) Gastric juices digest insulin
b) Mucous membranes are sensitive to insulin
c) It is slower acting if administered orally
d) It is easiest to administer by injection
a) Gastric juices digest insulin
Which of the following is a CORRECT statement about one of the ways oral hypoglycaemic medications act?
a) They assist the facilitated transport of glucose into skeletal muscle cells
b) They stimulate glycogenolysis
c) They increase insulin resistance in skeletal muscle and adipose cells
d) They stimulate the release of glucagon to reduce blood glucose concentration
a) They assist the facilitated transport of glucose into skeletal muscle cells
Mrs Khan’s blood glucose concentration is greater than 10 mmol/L, and when you test her urine it is positive for glucose. This is because
a) Kidney tubules secrete excess glucose.
b) Antidiuretic hormone allows glucose to diffuse into the renal collecting ducts.
c) Kidney tubules cannot resorb the glucose fast enough.
d) Glucose diffuses directly from the capillaries’ into the bladder.
c) Kidney tubules cannot resorb the glucose fast enough.
When visiting Mrs Khan at 0800 her son tells you she has been feeling unwell for the last hour, and that she is complaining of blurred vision, and a headache. Her son also states that she has been up to the toilet a number of times this morning.
The potential problem here is:
a) Hyperglycaemia
b) Alcohol intake
c) Hypoglycaemia
d) Hypertension
a) Hyperglycaemia
Why do people with diabetes have an increased risk of getting urinary tract infections?
a) They require increased amounts of fluids
b) The loop of Henle is associated with the production of insulin in the body
c) They have altered urine output
d) Glucose in urine assists bacterial reproduction
d) Glucose in urine assists bacterial reproduction
Billy, aged 22 years is diagnosed with paranoid schizophrenia. He periodically looks intently towards the ceiling and cocks his head to one side while tugging at his ear. In assessing this behaviour, the nurse should consider that Billy:
a) Has peculiar mannerisms
b) May be hearing voices
c) Is avoiding the nurse
d) Is daydreaming
b) May be hearing voices
Which of the following would be the most appropriate action for the nurse to take when a good rapport has been established with Billy and he has voiced his delusions on more than one occasion?
a) Enter into discussion with Billy about his delusions and the negative impact of these on his relationships with other people.
b) Listen patiently and avoid any comment about his delusions.
c) Suggest he ought to discuss his feelings with his doctor and request a medication review.
d) Reassure him that whilst his thinking is real to him suggest that talking about his feelings might be more beneficial for him.
d) Reassure him that whilst his thinking is real to him suggest that talking about his feelings might be more beneficial for him.
Billy is prescribed Clozapine.(Clozaril) this is an atypical antipsychotic medication which acts on
a) positive symptoms related to excess dopamine and decreased GABA.
b) positive symptoms related to decreased dopamine.
c) both positive and negative symptoms related to activity of both serotonin and dopamine.
d) negative symptoms related to excess dopamine and decreased GABA.
c) both positive and negative symptoms related to activity of both serotonin and dopamine.
When you are assessing Billy the following morning, you notice that he appears flushed. With his permission, you assess his vital signs and discover T 37.5, P143, R 20, and BP 100/60. What will you do about his next dose of Clozapine, scheduled for 9am?
a) Withhold the dose and notify the physician
b) Give the medication and monitor vital signs 4 hourly
c) Postpone the dose until her vital signs are normal
d) Recognise these signs as non-important side effects and give the medication
a) Withhold the dose and notify the physician
Freda is admitted to your ward following the death of her mother 12 weeks ago. She is withdrawn and isolates herself in her bedroom, where she sits huddled on her bed and stares at the floor. You suspect that Freda is having suicidal ideation. What would be your best approach?
a) Ask Freda directly about your concern
b) Avoid direct questioning, but observe her carefully
c) Institute suicide precautions and record these in Freda’s notes
d) Record your suspicion in Freda’s notes
a) Ask Freda directly about your concern
On her first night in hospital, Freda states she cannot sleep. Which of the following is the most appropriate action to take?
a) Look up her prescribed medication on the prescription sheet and administer it with a glass of hot milk
b) Ring up the duty medical officer because you feel Freda is suicidal
c) Discuss with Freda what is bothering her, asking what she does at home when she can’t sleep, and use prescribed sedation if necessary
d) Ensure that Freda cannot leave the ward and let her wander about as she likes
c) Discuss with Freda what is bothering her, asking what she does at home when she can’t sleep, and use prescribed sedation if necessary
Which of the following is the nurse’s principal task when caring for Freda during this suicidal risk period?
a) Ensure adequate food and drink
b) Encourage her to participate in interesting activities
c) Maintain continuous unobtrusive observation of her
d) Ensure that she takes and swallows her medication regularly
c) Maintain continuous unobtrusive observation of her
Freda tells you one day, “I feel so miserable I just want to end it all.” What would be the best response?
a) “You’re feeling very negative Freda – let’s go for a walk and get your mind off your problems for a bit”
b) “Your attention seeking behaviour is not going to work today, Freda”
c) “You must be feeling desperate at the moment – have you made any plans as to how you might take your life?”
d) “I think you’d better tell your doctor about this, Freda”
c) “You must be feeling desperate at the moment – have you made any plans as to how you might take your life?”
An attempt to commit suicide is most likely to occur during which of the following phases of hospitalisation?
a) Immediately following hospital admission
b) When depression starts to lift
c) At the point of deepest depression
d) Shortly before hospital discharge
b) When depression starts to lift
Another client in the ward is Mr Rand, currently prescribed haloperidol decanoate shows an inability to sit still, motor restlessness and fidgeting. Which of the following extrapyramidal side effects is he showing?
a) Dystonia
b) Akathisia
c) Parkinsonism
d) Tardive dyskinesia
b) Akathisia
Mr. Rand constantly demands his needs be met and then gets angry when other clients and staff talk with him about his behaviour. At times he threatens clients and challenges staff. Which is the best nursing approach to use with Mr. Rand?
a) Administer PRN medication every time Mr Rand displays threatening behaviour
b) Ignore his behaviour and privately encourage other clients to leave Mr. Rand alone
c) Encourage the other staff to take turns watching Mr. Rand without confronting him
d) Plan limits with Mr. Rand and be consistent in applying unit guidelines
d) Plan limits with Mr. Rand and be consistent in applying unit guidelines
Which one of the following medications can the nurse anticipate the physician will order to treat Mr. Rand’s extrapyramidal side effects?
a) Chlordiazepoxide (librium)
b) Benztropine mesylate (cogentin)
c) Imipramine hydrochloride (tofranil)
d) Thioridazine hydrochloride (melleril)
b) Benztropine mesylate (cogentin)
Before a series of electroconvulsive treatments is begun, which one of the following should be obtained?
a) An electrocardiogram (ECG)
b) A signed consent form
c) A full blood count
d) A mid-stream urine
b) A signed consent form
A client tells you in confidence that he still has suicidal thoughts but doesn’t want anyone to know because he is to be discharged that afternoon. As his nurse, your legal responsibility is to
a) Maintain his right to privacy and confidentiality
b) Encourage him to call his outpatient counsellor before discharge
c) Keep in touch with him after discharge to monitor his progress
d) Inform his health team members
d) Inform his health team members
A client with major depression tells the nurse, “Life’s just not worth living. I can’t stand the pain any longer”. The nurse’s best response would be:
a) “Sometimes when people feel depressed and helpless, they feel like hurting themselves. Do you feel like hurting yourself?”
b) “Perhaps you should discuss this in group therapy today”
c) “I think you may want to use your p.r.n. lorazepam now”
d) “You don’t feel like living?”
d) “You don’t feel like living?”
Which of the following best describes the action of selective serotonin reuptake inhibitors (SSRIs)?
a) Increase the availability of serotonin
b) Block the re-uptake of noradrenaline and serotonin
c) Increase the availability of dopamine
d) Decrease the availability of noradrenaline whilst increasing the availability of serotonin
a) Increase the availability of serotonin
A client with major depression is prescribed the monoamine oxidase (MAO) inhibitor, tranylcypromine sulfate (Parnate). The nurse should teach this client to avoid which food?
a) Free-range poultry
b) Whole-grain bread
c) Aged cheese
d) Fresh fish
c) Aged cheese
Fourteen-year-old Katy, who has a diagnosis of anorexia nervosa, is adhering to the dietary programme with supervision. A nursing student relieving in the ward asks you, “Why do you make Katy eat and put on weight if she doesn’t want to?” What would be your most appropriate response?
a) “Katy’s brain is not functioning well because of her weight loss. She doesn’t know what she is doing, therefore we have to make her eat whether or not she agrees.”
b) “Katy’s weight loss is life threatening. Anorexia nervosa is an illness that can be treated successfully. Dietary therapy is an important part of the treatment.”
c) “Katy’s behaviour is attention seeking. She is being difficult and obstinate. Her condition is life threatening and therefore we have to stop her from further harming herself.”
d) “Katy’s main problem is her manipulative behaviour, and bird eating patterns. The programme is to train her to eat three meals a day.”
b) “Katy’s weight loss is life threatening. Anorexia nervosa is an illness that can be treated successfully. Dietary therapy is an important part of the treatment.”
In the ward, Katy’s refusal to eat would be treated in the first instance by:
a) Force feeding through a tube as she won’t eat
b) A contract to eat a prescribed amount of food agreed to by Katy
c) A contract to reach an agreed weight by a certain date
d) Ignoring the behaviour so as not to reinforce her attention seeking behaviour
b) A contract to eat a prescribed amount of food agreed to by Katy
The nurse should review the haematological test results of a person with a diagnosis of bulimia, looking for evidence of
a) polycythaemia—increased RBCs
b) hypokalaemia—low blood potassium
c) thrombocytopenia—decreased platelets
d) hyponatraemia- low blood sodium
b) hypokalaemia—low blood potassium
While attempting to reach for a biscuit, Tom, a pre-school child, spills a pot of hot tea and burns his right arm and leg. Before bringing him to hospital what First Aid could help?
a) Spraying the burn with an antiseptic spray
b) Applying cold water for ten minutes
c) Applying ice to the burn
d) Breaking the blisters to release the accumulated fluid
b) Applying cold water for ten minutes
The major electrolyte lost in fluid secreted from burns is:
a) Sodium
b) Calcium
c) Potassium
d) Magnesium
A) sodium
Soon after the injury, a third degree or full thickness burn is usually characterised by:
a) Intense pain, blisters, a charred or opaque area
b) Blisters, reduced sensitivity, a charred or opaque area
c) Reduced sensitivity charred or opaque area
d) Intense pain scarring, a charred or opaque area
c) Reduced sensitivity charred or opaque area
Tom is prescribed 4 mg of Morphine IM for pain relief. The vial contains 10 mg Morphine in 1 mL. What is the correct dose to administer?
a) 0.2 mL
b) 0.4 mL
c) 0.5 mL
d) 4 mL
b) 0.4 mL
Tom’s mother exclaims, “I feel sick about what has happened to Tom.” An appropriate response for a nurse to offer would be:
a) “Let me help you discover where you made your mistakes”
b) “Why don’t you buy a book on safety in the home?”
c) “It must have been frightening to see him so distressed”
d) “Why didn’t you call us sooner?”
c) “It must have been frightening to see him so distressed”
During the acute stage of meningitis, a 3 year old child is restless and irritable. Which of the following is most appropriate to do?
a) Limit conversation with the child
b) Keep noise to a minimum
c) Allow the child to play in the bath
d) Perform all treatments quickly
b) Keep noise to a minimum
In order to rehydrate a 12 kg child the doctor has prescribed 600 mL of Normal Saline to be given intravenously. Given that 10 mL/kg is the correct required dose, the prescribed volume should be:
a) 1200 mL
b) 400 mL
c) 60 mL
d) 120 mL
d) 120 mL
Meg a 24-year-old client is receiving intravenous fluids via a giving set with a drip factor of 20 drops/ml. The medication order prescribes 500mls to be delivered over 4 hours. What is the correct drip rate (drops per minute).
a) 38 dpm
b) 40 dpm
c) 42 dpm
d) 43 dpm
c) 42 dpm
The intravenous infusion “tissues”. Your first action is:
a) Call a doctor
b) Stop the infusion
c) Explain to the client what is occurring
d) Tell the child they will need another drip established
b) Stop the infusion
When obtaining a nursing history from parents who are suspected of abusing their child, which of the following characteristics about parents would the nurse typically find?
a) Attentive to the child’s needs
b) Self-blame for the injury to the child
c) Ability to relate to child’s development achievements
d) Evidence of little concern about the extent of the injury
d) Evidence of little concern about the extent of the injury
A 3-year-old child with a history of being abused has blood drawn. The child lies very still and makes no sound during the procedure. Which of the following comments by the nurse would be most appropriate?
a) “It’s ok to cry when something hurts”
b) “That really didn’t hurt did it”
c) “We’re mean to hurt you that way, aren’t we”
d) “You were so good not to cry with the needle”
a) “It’s ok to cry when something hurts”
Which of the following observations by the nurse would strongly suggest that a 15-month old toddler has been abused?
a) The child appears happy when personnel work with him
b) The child plays alongside others contentedly
c) The child is underdeveloped for his age
d) The child sucks his thumb
c) The child is underdeveloped for his age
A 12-year-old child in hospital discloses to you that she is being abused in her home. Your best initial response is to
a) Phone Child, Youth and Family and inform your supervisor
b) Contact the parents and have a discussion
c) Tell the child that they have done the right thing by talking with you
d) Tell the child not to talk to anyone else about those things
c) Tell the child that they have done the right thing by talking with you
What is the most important criterion for the nurse to consider when deciding to report suspected child abuse?
a) Inappropriate parental concern for the degree of injury
b) Absence of caregivers for questioning about the injury
c) Inappropriate response of the child to the injury
d) Incompatibility between the history and the injury
d) Incompatibility between the history and the injury
What are the positive signs of pregnancy?
a) Foetal heartbeat, foetal movement
b) Positive pregnancy test, urinary frequency
c) Breast tenderness
d) Amenorrhea, nausea
a) Foetal heartbeat, foetal movement
You encourage Mrs. Marvin to eat a diet high in complete protein during her pregnancy. Assuming she likes all of the following foods, which of them would you recommend as a source of this for her?
a) Apple sauce or a whole apple
b) A slice of whole grain toast
c) A boiled or fried egg
d) Green leafy vegetables
c) A boiled or fried egg
Mrs. Marvin asks you if she can take an over-the-counter vitamin during pregnancy rather than her prescription prenatal vitamin. A chief ingredient in prenatal vitamins that makes them important for pregnancy nutrition is:
a) Folic acid
b) Vitamin B12
c) Vitamin C
d) Potassium
a) Folic acid
Mrs. Marvin is concerned because she is nauseated every morning. The best measure you would suggest to relieve this would be:
a) Take a teaspoon of baking soda before breakfast
b) Eat before she gets out of bed
c) Delay breakfast until midmorning
d) Take two aspirin on arising
b) Eat before she gets out of bed
If constipation is a problem with Mrs. Marvin, which measure below would be best to recommend?
a) Mineral oil is a non-prescription laxative she could use
b) Increasing fluid intake may be beneficial
c) Reducing her prenatal vitamin to every other day
d) Including more meat in her diet will provide fibre
b) Increasing fluid intake may be beneficial
Mrs. Marvin is a woman with an Rh-negative blood type. Following delivery of an infant, you administer her RHIG (D immune globulin). The purpose of this is to:
a) Promote maternal D antibody formation
b) Prevent maternal D antibody formation
c) Stimulate maternal D immune antigens
d) Prevent foetal Rh blood formation
b) Prevent maternal D antibody formation
Mrs. Marvin is Rh negative and asks you how many children she will be able to have before Rh incompatibility causes them to die in utero. Your best response would be:
a) No more than 3 children
b) As long as she receives anti-Rh immunoglobulin there is no limit
c) Only her next child will be affected
d) She will have to ask her physician
b) As long as she receives anti-Rh immunoglobulin there is no limit
You assess Mrs Dorman’s perineum and notice that her lochial discharge is moderate in amount and red in colour. You would record this as what type of lochia?
a) Lochia rubra
b) Lochia serosa
c) Lochia fireum
d) Lochia alba
a) Lochia rubra
In breastfeeding, what hormone is responsible for the ‘let down’ reflex?
a) Progesterone
b) Oestrogen
c) Prolactin
d) Oxytocin
d) Oxytocin
On the third day postpartum, you discover Mrs Dorman sitting by her bed crying. She states nothing is wrong; she just “feels sad”. Which of the following would be your response to her?
a) “I’ll keep confidential any problem you want to discuss with me”
b) “You have a beautiful boy; you shouldn’t feel sad about that”
c) “Do you wish you’d had a girl instead of a boy?”
d) “Feeling sad when you know you don’t know why must be very confusing”
d) “Feeling sad when you know you don’t know why must be very confusing”
Mrs Dorman points out to you that following three meconium stools, her newborn has had a bright green stool. You would explain to her that:
a) This is a normal finding
b) This is most likely a symptom of diarrhoea
c) Her child may be developing an allergy to breast milk
d) Her child will be isolated until the stool can be cultured
a) This is a normal finding
A newborn is noticeably jaundiced on the third day of life. Which of the following would you explain to his mother?
a) He may have a blood incompatibility developing
b) This is from a normal breakdown of red blood cells
c) He will need an evaluation for bile duct disease
d) No one understands why newborn jaundice occurs
b) This is from a normal breakdown of red blood cells
What are some of the signs or symptoms of postnatal depression?
a) Perception and body image disturbance
b) Persistent low or depressed mood, changes in sleep patterns, feelings of worthlessness or guilt
c) Loose association and flight of ideas
d) Suspicious, guarded and controlling behaviours
b) Persistent low or depressed mood, changes in sleep patterns, feelings of worthlessness or guilt
When teaching the caregiver of a toddler with a congenital heart defect, the nurse should explain all medical treatments. The most important instruction would be:
a) To reduce the caloric intake to decrease cardiac demand
b) To relax discipline and limit setting to prevent crying
c) To avoid contact with small children to reduce over stimulation
d) To try to maintain the usual lifestyle to promote normal development
d) To try to maintain the usual lifestyle to promote normal development
During assessment of the client with severe COPD the nurse notes jugular vein distension and pedal oedema. The nurse recognizes that these findings indicate the development of:
a) Acute respiratory failure
b) Secondary respiratory failure
c) Fluid volume excess secondary to cor pulmonale
d) Pulmonary oedema caused by left sided heart failure
c) Fluid volume excess secondary to cor pulmonale
A client with severe COPD tells the nurse she has been a smoker for many years and realises that smoking contributes to her shortness of breath. She asks how medications could help her stop smoking. Which of the following statements is the best response?
a) Nicotine replacement therapy prevents symptoms of withdrawal
b) People who go ‘cold turkey’ have the best results, medications aren’t necessary
c) Nicotine replacement therapy assists ease symptoms of withdrawal
d) Once you start stop smoking medications you can’t stop
c) Nicotine replacement therapy assists ease symptoms of withdrawal
The nurse evaluates the effectiveness of therapy for a client with an acute exacerbation of asthma. The finding that indicates to the nurse that the client’s respiratory function is improving is:
a) Wheezing becomes louder
b) The cough remains unproductive
c) Vesicular breath sounds decrease
d) Aerosol bronchodilators stimulate coughing
c) Vesicular breath sounds decrease
During assessment of a client with asthma the nurse notes wheezing and dyspnoea, and recognises that these symptoms are related to the pathophysiological feature of:
a) Laryngospasm
b) Pulmonary oedema
c) Narrowing of the airway
d) Over distension of the alveoli
c) Narrowing of the airway
When teaching a client the appropriate use of a peak flow meter, the nurse instructs the client to:
a) Keep a record of the peak flow recordings
b) Increase the doses of their long-term control medications if the peak flow recordings get worse
c) Use the peak flow meter each morning after taking medications
d) Empty the lungs, inhale and then measure how quickly air can be exhaled
d) Empty the lungs, inhale and then measure how quickly air can be exhaled
An 8-year-old boy is admitted for exacerbation of asthma. Which one of the following are early signs of compensated shock in children?
a) Tachycardia, cool extremities, poor capillary refill, weak peripheral pulses compared with central pulses, tachypnoea, normal blood pressure
b) Depressed mental status, decreased urine output, metabolic acidosis, tachypnoea, weak central pulses and hypotension
c) Depressed mental status, decreased urine output, hypertension, tachycardia
d) Poor capillary refill, cyanosis, unresponsive
a) Tachycardia, cool extremities, poor capillary refill, weak peripheral pulses compared with central pulses, tachypnoea, normal blood pressure
Mrs C. has just been diagnosed with multiple sclerosis. Multiple sclerosis is a
a) chronic, progressive degenerative disorder of the central nervous system (CNS)
b) disease that affects the brain in the elderly
c) viral infection of the central nervous system (CNS)
d) condition that affects nerve endings in the hands and feet only
a) chronic, progressive degenerative disorder of the central nervous system (CNS)
Which of the following are typical manifestations of multiple sclerosis?
a) Sudden burst of energy, cough, tremor
b) Double vision, cognitive changes, mood swings
c) Double vision, weakness in the extremities, muscle tremors
d) Weakness in the extremities, muscle tremors, sudden bursts of energy
c) Double vision, weakness in the extremities, muscle tremors
Mrs C. is understandably anxious about her diagnosis. As her nurse, how can you assist with this?
a) Inform her that it is far too soon to be concerned about it all
b) Tell her that the doctor will be back later to explain it to her
c) Talk to her husband so that he can explain it to her
d) Ask Mrs C. what she knows about the condition and spend time answering her questions supported with written information
d) Ask Mrs C. what she knows about the condition and spend time answering her questions supported with written information
Mrs C. is experiencing urinary incontinence, which of the following interventions would you suggest to help with this?
a) Limit fluid intake to 1000 mL per day
b) Insert an indwelling catheter (IDC)
c) Establish a regular toileting schedule
d) Administer prophylactic antibiotics
c) Establish a regular toileting schedule
Which of the following is the best description of the pathophysiological changes that occur with multiple sclerosis?
a) Replacement of parts of the myelin sheath of neurons in the CNS with scar-like tissue
b) Destruction of cell bodies of motor neurons in the grey matter of the spinal cord
c) Degeneration of neuron axons in the CNS
d) Formation of plaques in CNS neurons that prevent the passing of action potentials
a) Replacement of parts of the myelin sheath of neurons in the CNS with scar-like tissue
You are caring for bill, a 50 year old man who has been hospitalised with a possible
diagnosis of pancreatitis
Which of the following symptoms would you anticipate observing in bill
a) Elevated white blood cell count, ankle oedema and right groin pain
b) Left upper quadrant abdominal pain, nausea, and vomiting
c) Hypoglycaemia, hypertension, and hypochondrial pain
d) Epigastric pain, pyrexia, and elevated white blood cell count
b) Left upper quadrant abdominal pain, nausea, and vomiting
You are caring for bill, a 50 year old man who has been hospitalised with a possible
diagnosis of pancreatitis
The initial diagnosis of pancreatitis would be confirmed if bills blood test showed a
significant elevation in serum
a) Amylase
b) Glucose
c) Potassium
d) Trypsin
a) Amylase
You are caring for bill, a 50 year old man who has been hospitalised with a possible
diagnosis of pancreatitis
Pain control is an important nursing goal. Which of the following medications would
be the drug of choice
a) Pethidine
b) Cimetidine
c) Morphine
d) Codeine
c) Morphine
or A) Pethidine??
You are caring for bill, a 50 year old man who has been hospitalised with a possible
diagnosis of pancreatitis
You monitor bills vital signs frequently, observing for the signs of shock. Shock is
extremely difficult to manage in pancreatitis primarily because of the
a) Frequency and severity of gastrointestinal haemorrhage
b) Vasodilating effects of kinin peptides
c) Tendency towards congestive heart failure
d) Frequent incidence of acute tubular necrosis
a) Frequency and severity of gastrointestinal haemorrhage
You are caring for bill, a 50 year old man who has been hospitalised with a possible
diagnosis of pancreatitis
While helping bill change position in bed, you note bill has muscle twitching in his
bands and forearms. These symptoms are significant because clients who suffer from
pancreatitis are at risk of
a) Hypermagnisemia
b) Hypoglycaemia
c) Hypocalcaemia
d) Hyponatremia
c) Hypocalcaemia
You are caring for bill, a 50 year old man who has been hospitalised with a possible
diagnosis of pancreatitis
Bill does not drink alcohol because of his religious beliefs. When the physician
persists in asking him about his alcohol intake, bill becomes annoyed. You explain the
reasoning behind the questioning by telling bill that
a) There is a strong link between alcohol use and pancreatitis
b) Alcohol intake can interfere with some of the tests used to diagnose pancreatitis
c) Alcoholism is a major health problem and all hospitalised clients are asked about
their alcohol intake
d) The physician must obtain the pertinent facts, and religious beliefs cannot be
considered
b) Alcohol intake can interfere with some of the tests used to diagnose pancreatitis
or c) Alcoholism is a major health problem and all hospitalised clients are asked about
their alcohol intake?
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 asks the nurse, ‘how could this have happened?” the nurse responds to the
question based on the most frequent mode of HIV transmission, which is
a) Hugging an HIV positive sexual partner without using barrier precautions
b) Inhaling cocaine or other recreational drugs
c) Sharing a drink bottle with an HIV positive person
d) Sexual intercourse with an HIV positive person without using a condom
d) Sexual intercourse with an HIV positive person without using a condom
The physician prescribes zidovudine (AZT) a drug that acts to help
a) Destroy the virus
b) Enhance the body’s antibody production
c) Slow replication of the virus
d) Neutralise toxin; produced by the causative organism
c) Slow replication of the virus
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
b) Cervical cancer
Which of the following nursing diagnosis categories would most likely be a priority
for a client with herpes genitalis
a) Alteration in sleep; sleep pattern disturbance
b) Nutritional deficit
c) Alteration in comfort pain
d) Alteration in breathing patterns
c) Alteration in comfort pain
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
a) Is an acquired immunodeficiency virus (AIDS) defining illness
In providing education to Lydia, the nurse should take into account the fact that the
most effective method known to control the spread to HIV infection is
a) Premarital serologic screening
b) Prophylactic treatment of exposed people
c) Laboratory screening of pregnant women
d) Ongoing sex education about preventive behaviours
d) Ongoing sex education about preventive behaviours
Lydia becomes depressed about her diagnosis and tells the nurse “I have nothing
worth living for now.” Which of the following statements would be the best response
by the nurse
a) There is much to live for; you may not develop AIDS for years
b) You should not be too depressed; we are searching to find a cure for AIDS
c) You are right; it is very depressing to have HIV
d) Tell me more about how you are feeling at being HIV positive
d) Tell me more about how you are feeling at being HIV positive
James, a 34 year old man attending a sexual health clinic, is diagnosed with syphilis.
The organism responsible for causing syphilis is classified as a
a) Virus
b) Fungus
c) Rickettsia
d) Spirochete
d) Spirochete
The typical chancre of syphilis appears as
a) A grouping of small, tender pimples
b) An elevated wart
c) A painless moist ulcer
d) An itching, crusted area
c) A painless moist ulcer
When interviewing James, the nurse should anticipate that the most difficult problem
is likely to be
a) Motivating the client to undergo treatment
b) Obtaining a list of the clients sexual contacts
c) Increasing the clients knowledge of the disease
d) Assuring the client that records are confidential
b) Obtaining a list of the clients sexual contacts
Probenecid is prescribed in conjunction with penicillin as treatment for syphilis
because probenecid helps
a) Delay detoxification of penicillin
b) Inhibit excretion of penicillin
c) Maintain sensitivity of organisms to penicillin
d) Decrease the likelihood of an allergic reaction to penicillin
b) Inhibit excretion of penicillin
A priority nursing diagnosis for a James would likely be
a) High risk for infection transmission related to lack of knowledge about mode of
spread
b) Pain related to cutaneous skin lesions on palms and soles
c) Altered skin tissue perfusion related to a bleeding chancre
d) Image disturbance related to alopecia
a) High risk for infection transmission related to lack of knowledge about mode of
spread
An 18 year old female college student is seen at the university health centre. She
undergoes a pelvic examination and is diagnosed with gonorrhoea
Which of the following responses by the nurse would be best when the client says that
she is nervous about the upcoming pelvic examination
a) can you tell me more about how you’re feeling
b) you’re not alone. Most women feel uncomfortable about this examination
c) do not worry about Dr smith. He’s a specialist in female problems
d) we’ll do everything we can to avoid embarrassing you
a) can you tell me more about how you’re feeling
in education this client, the nurse should emphasise that in women gonorrhoea
a) is often marked by symptoms of dysuria or vaginal bleeding
b) does not lead to serious complications
c) can be treated but not cured
d) may not cause symptoms until complications occur
d) may not cause symptoms until complications occur
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
D) Dysuria
and b) scrotal swelling
A 24 year old female client, who is on her honeymoon, comes to an ambulatory care
clinic in moderate distress with a probable diagnosis of acute cystitis
Which of the following symptoms would the nurse expect the client to report during
the assessment
a) fever and chills
b) frequency and burning on urination
c) suprapubic pain and nausea
d) dark, concentrated urine
b) frequency and burning on urination
The client asks the nurse, ‘how did I get this infection?’ the nurse should explain that
in most instances, cystitis is caused by
a) congenital strictures in the urethra
b) an infection elsewhere in the body
c) urine stasis in the urinary bladder
d) an ascending infection from the urethra
d) an ascending infection from the urethra
The physician tells the client that the infection has likely been precipitated by sexual
intercourse and that an antibiotic will be prescribed. The client becomes upset, and
tearfully asks the nurse if this means she should abstain from intercourse for the rest
of her honeymoon. What advice should the nurse offer her
a) avoid intercourse until you’ve completed the antibiotic therapy and then limit
intercourse to once a week
b) limit intercourse to once a day in the early morning after your bladder has rested
c) as long as you’re comfortable you can have intercourse as often as you wish; but
be sure to urinate within 15 minutes after intercourse
d) you and your husband can enjoy intercourse as often as you wish. Just make sure
he wears a condom and uses a spermicide
c) as long as you’re comfortable you can have intercourse as often as you wish; but
be sure to urinate within 15 minutes after intercourse
The client is given a prescription for co trimoxazole (bactrim) for her infection.
Which of the following statements would indicate that she understands the principles
of antibiotic therapy
a) I’ll take the pills until I feel better and keep the rest for recurrences
b) I’ll take all the pills as directed on the label
c) I’ll take the pills until the symptoms pass, then reduce the dose by half
d) I’ll take all the pills and then have the prescription renewed once
b) I’ll take all the pills as directed on the label
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 Winston’s arrival in the emergency room, which of the following considerations
should receive the highest priority
a) establishing an airway
b) replacing blood losses
c) stopping bleeding from open wounds
d) determining whether he has a neck fracture
a) establishing an airway
Which of the following methods would be best, from a legal standpoint, for obtaining
permission to treat Winston
a) having his sister sign the consent form
b) having two independent doctors agree on the need for treatment
c) obtaining a verbal consent by telephone from his mother
d) obtaining written consent from his fiancée
b) having two independent doctors agree on the need for treatment
As Winston’s condition worsens, his rising intracranial pressure would be indicated
by
a) rising blood pressure and falling pulse rate
b) rising pulse rate and falling blood pressure
c) rising blood pressure and rising pulse rate
d) falling pulse rate and falling blood pressure
a) rising blood pressure and falling pulse rate
the nurse assesses the client frequently for signs of intracranial pressure, including
a) unequal pupil size
b) decreasing systolic blood pressure
c) tachycardia
d) decreasing body temperature
a) unequal pupil size
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
A) slow, irregular respirations.
During the past few months, Elizabeth, a 56 year old woman has felt brief twinges of
chest pain while working, in her garden and has had frequent episodes of indigestion.
She comes to the hospital after experiencing severe anterior chest pain while raking
leaves. Her evaluation confirms a diagnosis of stable angina pectoris
Elizabeth states, ‘I really thought I was having a heart attack. How can you tell the
difference?’ which response by the nurse would provide the client with the most
accurate information about the difference between the pain of angina and that of
myocardial infarction
a) The pain associated with a heart attack is much more severe
b) The pain associated with a heart attack radiates into the jaw and down the left arm
c) It is impossible to differentiate angina pain from that of a heart attack without an
ECG
d) The pain of angina is usually relieved by resting or lying down
d) The pain of angina is usually relieved by resting or lying down
As an initial step in treating elizabeths angina, the physician prescribes nitro-glycerine
tablets, 0.3 mg given sublingual. This drugs principal effects are produced by
a) Antispasmodic effects on the pericardium
b) Stimulation of a- and 13- receptor sites
c) Vasodilation of peripheral vasculature
d) Improved conductivity in the myocardium
c) Vasodilation of peripheral vasculature
The nurse teaches Elizabeth that which of the following meals would be best for her
low cholesterol diet
a) Hamburger, salad, and milkshake
b) Baked liver, green beans, and coffee
c) Spaghetti with tomato sauce, salad, and coffee
d) Fried chicken, green beans, and skim milk
b) Baked liver, green beans, and coffee
Which of the following symptoms should the nurse teach Elizabeth to report
immediately to her physician
a) A change in the pattern of her pain
b) Pain during sexual activity
c) Pain during an argument with her husband
d) During or after an activity such as lawn moving
a) A change in the pattern of her pain
After stabilisation and treatment, Elizabeth is discharged from the hospital. At her
follow up appointment, she is discouraged because she is experiencing pain with
increasing frequency. She states that she visits an invalid friend twice a week and now
cannot walk up the second flight of steps to the friends apartment without pain. Which
action can the nurse could suggest that would most likely help the client deal with this
problem
a) Visit her friend early in the day
b) Rest for at least an hour before climbing the stairs
c) Take a nitro-glycerine tablet before climbing the stairs
d) Lie down once she reaches the friends apartment
c) Take a nitro-glycerine tablet before climbing the stairs
or d) Lie down once she reaches the friends apartment
The nurse teaches Elizabeth that common expected side effects of nitro-glycerine
include
a) Headache, hypotension, and dizziness
b) Hypertension, flushing and forgetfulness
c) Hypotension, diplopia and shortness of breath
d) Stomach cramps, constipation and urinary frequency
a) Headache, hypotension, and dizziness
Sublingual nitro-glycerine tablets begin to work within 1 to 2 minutes. How should
the nurse instruct the client to use the drug when chest pain occurs
a) Take one tablet every 2 to 5 minutes until the pain stops
b) Take one tablet; and rest for 10 minutes. Call the physician if pain persists after 10
minutes
c) Take one tablet, then an additional tablet every 5 minutes for a total of three
tablets. Call the physician if pain persists after 3 tablets
d) Take one tablet; if pain persists after 5 minutes, take two tablets. If pain still
persists 5 minutes later, call the physician
c) Take one tablet, then an additional tablet every 5 minutes for a total of three
tablets. Call the physician if pain persists after 3 tablets
Which of the following points should the nurse include when instructing the client
with angina about sublingual nitro-glycerine
a) The drug will cause your urine to turn bright orange
b) Store the tablets in a tight, light resistant container
c) Use the tablets only when the pain is severe
d) The shelf life of nitro-glycerine is up to 2 years
d) The shelf life of nitro-glycerine is up to 2 years
Josie, a 38 year old woman is admitted to the emergency room after being found
unconscious at the wheel of her car in the hospital car park. Josie is comatosed
and does not respond to stimuli. A drug overdose is suspected
Which of the following assessment findings would lead the nurse to suspect that the
coma is a result of a toxic drug overdose
a) Hypertension
b) Hyperpyrexia
c) Dilated pupils
d) Facial asymmetry
c) Dilated pupils
Blood and urine analysis confirm a diagnosis of salicylate overdose. Josie is treated
with activated charcoal, which would be administered by
a) Intravenous infusion
b) Nasogastric tube
c) Rectal infusior
d) Oral tablets
b) Nasogastric tube
What specific potential adverse effect of charcoal administration to josie must the
nurse be aware and guard against
a) Anaphylaxis
b) Renal failure
c) Aspiration
d) Cardiac arrest
c) Aspiration
The nurse observes that josie’s right eye does not close totally. Based on this finding,
which of the following nursing interventions would be most appropriate
a) Making sure josie wears dark glasses to avoid photosensitivity
b) Irrigate her right eye with saline each duty to avoid dryness
c) Instilling neomycin eye drops to prevent conjunctivitis
d) Tape the eyelid down to keep it closed between cares
b) Irrigate her right eye with saline each duty to avoid dryness
The nursing goal for performing passive range of motion exercises for an unconscious
client such as josie would be to
a) Preserve muscle mass
b) Prevent bone demineralisation
c) Increase muscle tone
d) Maintain joint mobility
d) Maintain joint mobility
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
b) Keep suction apparatus available
When assessing josies respiratory status, which of the following symptoms may be an
early indicator of hypoxia
a) Cyanosis
b) Decreased respirations
c) Restlessness
d) Hypotension
c) Restlessness
A 34 year old Japanese tourist, takayuki hamadi, is admitted to the hospital after
experiencing multiple trauma as a result of an automobile accident. He has three
fractured ribs, a hairline fracture of the pelvis, a compound fracture of his right tibia
and fibula, and soft tissue injuries. He is in severe pain when he arrives on the unit after
emergency surgery
Takayuki reports severe pain and requests frequent medication. A nursing assistant
expresses her surprise, saying, ‘I thought asian people were very stoic about pain.
‘ your initial course of action should be
a) Reprimand her immediately and apologise to takayuk’s family
b) Discuss her behaviour with her after you leave the room
c) Do nothing as takayuk’s understanding of English is poor
d) Report her to the charge nurse
b) Discuss her behaviour with her after you leave the room
and D) report her to the charge nurse
According to eriksons theory of emotional development, infants will develop a sense
of trust when
a) They can identify their mother and father
b) They feel a sense of belonging, accepted as part of the family
c) They can predict what is coming and needs are consistently met
d) Nutritional and hygiene needs are provided on a daily basis
c) They can predict what is coming and needs are consistently me
Baby john was admitted with streptococcal pharyngitis. Upon discharge his mother
was told to return to the doctors in 2 weeks with a urine specimen. The urine would
mostly be examined
a) For fat and lipids to see if the kidneys are working
b) For protein to determine if acute glomerulonephritis is developing
c) To determine if the child is developing otitis media
d) To determine if the child should be kept on a liquid diet or progressed to a soft
b) For protein to determine if acute glomerulonephritis is developing
Reduction of complications of rheumatic fever can be accomplished through which of
the following interventions
a) Administration of penicillin to children with strep throat or impetigo
b) Beginning speech therapy to reserve damage after antibiotics are completed
c) Pushing children with chorea to perform activities requiring fine motor movement
to strengthen muscles
d) Withholding salicylates to prevent joint haemorrhage
a) Administration of penicillin to children with strep throat or impetigo
Newborns with heart disease are frequently brought to health professionals initially
because the infant is having
a) Difficulty sleeping
b) Irritability and restlessness
c) Difficulty feeding
d) Cyanotic spells
c) Difficulty feeding
In heart defects in which a connection exists between the right and left heart, the
blood through the connective structure flows most commonly
a) Right to left
b) Left to right
c) Bi directionally
d) Through the mitral and tricuspid valves
b) Left to right
Amy is 3 months old, with a 2 day history of vomiting. Which of the following is
NOT indicative of a decreased hydration status
a) Sunken fontanelle
b) Decreased number of wet nappies
c) Skin that is hot to the touch
d) Increased heart rate
c) Skin that is hot to the touch
Erikson’s theory of human development describes
a) Eight psychosocial crises all people are thought to face
b) Four psychosocial stages and a period of latency
c) The same number of stages as Freud but with different names
d) A stage theory that is not psychoanalytic
a) Eight psychosocial crises all people are thought to face
According to Piaget, the stage of cognitive development that generally characterises
pre school children is the
a) Preoperational stage
b) Sensorimotor stage
c) Oral stage
d) Psychosocial stage
a) Preoperational stage
The cephalo-caudal and proximo-distal patterns of development apply to
a) The upper extremities only
b) Physical growth, but not to motor skills
c) Variations in the timing of motor skills acquisition
d) Motor abilities as well as physical growth
d) Motor abilities as well as physical growth
An infant who weighs 4kg is prescribed 0.2mg/kg (IV) of morphine sulphate. You
have an ampoule of 10mg in 1ml. the volume to be administered is
a) 8 mls
b) 0.8 mls
c) 0.08 mls
d) 0.8 mgs
c) 0.08 mls
Pediculosis is common childhood infestation. It is commonly known as
a) Pin worms
b) Foot eczema
c) Head lice
d) Scabies
c) Head lice
A child who weighs 20 kgs is prescribed 300 mg of paracetamol. The stock supply is
120 mg in 5 mls. The volume to be administered is
a) 1.25mls
b) 125mls
c) 125mgs
d) 12.5mls
d) 12.5mls
Match the following sequence of milligrams to micrograms
10.0mg, 0.012mg, 0.40mg, 0.08mg
a) 1000.0 micrograms, 120.0 micrograms, 400.0 micrograms, 8.0 micrograms
b) 10000 micrograms, 12.0 micrograms, 40.0 micrograms, 80.0 micrograms
c) 10000 micrograms, 12.0 micrograms, 400 micrograms, 80.0 micrograms
d) 1000 micrograms, 1.2 micrograms, 4.0 micrograms, 0.08 micrograms
c) 10000 micrograms, 12.0 micrograms, 400 micrograms, 80.0 micrograms
All infants should have their head circumference measured at health visits. This
measurement is made from
a) Just above the eyebrows through the prominent part of the occiput
b) The center of the forehead to the base of the occiput
c) The hairline in front to the hairline in back
d) The middle of the forehead through the parietal prominence
a) Just above the eyebrows through the prominent part of the occiput
While caring for a child recovering from viral pneumonia, you examine his lungs for
evidence of exudate and fluid. Which finding would suggest cause for concern
a) A respiratory rate of 20 heard on auscultation
b) Dullness of his lower lobes heard on percussion
c) A longer inspiratory than expiratory rate noticed on inspection
d) Fine rhonchi heart in the upper lobe on auscultation
b) Dullness of his lower lobes heard on percussion
To straighten an infant’s ear canal to examine it, you would pull the pinna
a) Down and back
b) Down and forward
c) Up and back
d) Up and forward
a) Down and back
A child who has an arterial blood gas that depicts respiratory acidosis will show
a) pH is acidic, PaO2 is raised and PaCO2 is raised
b) pH is acidic, PaO2 is raised and PaCO is lowered
c) pH is acidic, PaO2 is lowered and PaCO2 is raised
d) pH is alkalotic, PaO2 is lowered and Pa CO2 is raised
c) pH is acidic, PaO2 is lowered and PaCO2 is raised
You take an infant’s apical pulse before administering digoxin. What is the usually
accepted level of pulse rate considered safe for administering digoxin to an 8 month
old baby
a) 60 bpm
b) 80 bpm
c) 100 bpm
d) 150 bpm
c) 100 bpm
Which of the following nursing diagnosis would best apply to a child with rheumatic
fever
a) Ineffective breathing pattern related to cardiomegaly
b) Activity intolerance related to inability of heart to sustain extra workload
c) Sleep pattern disturbance related to hyperexcitability
d) High risk of violence related to development of cerebral anoxia
b) Activity intolerance related to inability of heart to sustain extra workload
Bronchiolitis is a common __________ infection, which peaks in incidence in
children aged __________. Symptoms usually peak around day __________
a) Viral, less than two years of age, three to five
b) Viral, less than six months, ten
c) Bacterial, less than two years, three to five
d) Bacterial, less than six months, three to five
a) Viral, less than two years of age, three to five
Generally, the child most likely to ingest a poison is
a) 10 months to 18 months
b) 1 to 4 years
c) 4 to 5 years
d) 13 to 15 years
b) 1 to 4 years
The responsibility of the nurse caring for a victim of child abuse in the emergency
room would include which of the following
a) Prohibiting her parents from visiting with the child until more facts are obtained
b) Asking the parents if they have been abusing their child
c) Suggesting to the medical staff that the child be admitted for observation
d) Asking the child what they were doing that led to abuse
c) Suggesting to the medical staff that the child be admitted for observation
Which of the following statements is NOT true
a) Health professionals recommend exclusive breast feeding until the age of 4
months
b) Uterine involution is slowed by breast feeding
c) Almost all drugs are excreted to some extent in breast mild
d) Oxytocin is released by breastfeeding
b) Uterine involution is slowed by breast feeding
Which of the following statements is NOT true of Reyes syndrome
a) Most commonly occurs In young school age children
b) Most commonly occurs after a viral infection
c) Symptoms include severe vomiting, irritability, lethargy and confusion
d) Aspirin is the treatment of choice
d) Aspirin is the treatment of choice
Which of the following statements is NOT true of bacterial meningitis
a) Bacterial meningitis often presents with flu like symptoms initially
b) A rash may or may not be present
c) There is usually no associated temperature rise
d) A rash, if present, does not blanch under direct pressure
c) There is usually no associated temperature rise
Fill in the gaps in the following statement
Type I (insulin dependent) diabetes is characterised by almost no __________
secretion. This contributes to a build up of __________ in the blood stream. If
exogenous insulin is not administered __________ and __________ will develop
a) Insulin, glucose, hyperglycaemia and ketoacidosis
b) Glucose, insulin, hyperglycaemia and ketoacidosis
c) Glucose, insulin, hypoglycaemia, and unconsciousness
d) Insulin, hormones, ketoacidosis and unconsciousness
a) Insulin, glucose, hyperglycaemia and ketoacidosis
The grandmother has brought an infant to the clinic for a check up and has signed the
consent for immunization administration. Which of the following would the nurse do
first
a) ask who the infants legal guardian is
b) notify the physician immediately
c) administer the immunizations ordered
d) call the infant’s mother for verbal consent
a) ask who the infants legal guardian is
Which of the following would the nurse explain to the mother of a child receiving
digoxin (lanoxin) as the primary reason for giving this drug
a) To relax the walls of the hearts arteries
b) To improve the strength of the heartbeat
c) To prevent irregularities in ventricular contractions
d) To decrease inflammation of the heart wall
b) To improve the strength of the heartbeat
Paralysis in an individual with a meningomyelocele usually occurs
a) In the motor sphere below the level of the deformity
b) In the motor and sensory spheres below the level of the deformity
c) In the motor sphere above the deformity
d) In the motor and sensory spheres above the deformity
b) In the motor and sensory spheres below the level of the deformity
During the acute state of meningitis, a 3 year old child is restless and irritable. Which
of the following would be most appropriate to institute
a) Hemorrhagic skin rash
b) Edema
c) Cyanosis
d) Dyspnea on exertion
a) Hemorrhagic skin rash
Which of the following would first alert the nurse to suspect that a child with severe
gastroenteritis who has been receiving intravenous therapy for the past several hours
may be developing circulatory overload
a) A drop in blood pressure
b) Change to slow, deep respirations
c) Auscultation of moist crackles
d) Marked increase in urine output
c) Auscultation of moist crackles
The causative organism for rheumatic fever is
a) Haemophilus influenzae
b) Staphylococcus bacteria
c) Syncytial virus
d) Group A streptococcal bacteria
d) Group A streptococcal bacteria
The most serious complication of rheumatic fever is
a) Endocarditis
b) Pneumonia
c) Arthritis
d) Meningitis
a) Endocarditis
When preparing the teaching plan for the mother of a child with asthma, which of the
following would the nurse include as signs to alert the mother that her child is having
an asthma attack
a) Secretion of this, copious mucous
b) Tight, productive cough
c) Wheezing on expiration
d) Temperature of 37.4oC
c) Wheezing on expiration
A 10 year old child with a history of asthma uses an inhaled bronchodilator only when
needed. He takes no other medications routinely. His best peak expiratory flow rate is
270 L/min. The child’s current peak flow reading is 180 L/min. the nurse interprets
this reading as indicating which of the following
a) The child’s asthma is under good control, so the routine treatment plan should
continue
b) The child needs to start a short acting inhaled B2 agonist medication
c) This is medical emergency requiring a trip to the emergency department for
treatment
d) The child needs to begin treatment with inhaled cromolyn sodium (intal) for
asthma control
d) The child needs to begin treatment with inhaled cromolyn sodium (intal) for
asthma control
An 8 year old child with asthma states, I want to play some sports like my friends.
What can I do. The nurse responds to the child based on the understanding of which
of the following
a) Physical activities are inappropriate for children with asthma
b) Children with asthma must be excluded from team sports
c) Vigorous physical exercise frequently precipitates an asthmatic episode
d) Most children with asthma can participate in sports if the asthma is controlled
d) Most children with asthma can participate in sports if the asthma is controlled
After instructing a mother about normal reflexes of term neonates, the nurse
determines that the mother understands the instructions when she describes the tonic
neck reflex as occurring when the neonate does which of the following
a) Steps briskly when held upright near a firm, hard surface
b) Pulls both arms and does not move the chin beyond the point of the elbows
c) Turns head to the left, extends left extremities, and flexes right extremities
d) Extends and abducts the arms and legs with the toes fanning open
c) Turns head to the left, extends left extremities, and flexes right extremities
After talking with the parents of a child with down’s syndrome, which of the
following would the nurse identify as an appropriate goal for care of the child
a) Encouraging self care skills in the child
b) Teaching the child something new every day
c) Encouraging more lenient behaviour limits for the child
d) Achieving age appropriate social skills
d) Achieving age appropriate social skills
After teaching a group of school teachers about seizures, the teachers’ role play a
scenario involving a child experiencing a generalised tonic clonic seizure. Which of
the following actions, when performed first, indicates that the nurses teaching has
been successful
a) Asking the other children what happened before the seizure
b) Moving the child to the nurses office for privacy
c) Removing any nearby objects that could harm the child
d) Placing a padded tongue blade between the child’s teeth
c) Removing any nearby objects that could harm the child
Which of the following statements obtained from the nursing history of a toddler
would alert the nurse to suspect the child has had a febrile seizure
a) The child has had a low grade fever for several weeks
b) The family history is negative for convulsions
c) The seizure resulted in respiratory arrest
d) The seizure occurred when the child had a respiratory infection
d) The seizure occurred when the child had a respiratory infection
or a) The child has had a low grade fever for several weeks
Which of the following, if described by the parents of a child with cystic fibrosis,
indicates that the parents understand the underlying problem of the disease
a) An abnormality in the body’s mucus secreting glands
b) Formation of fibrous cysts in various body organs
c) Failure of the pancreatic ducts to develop properly
d) Reaction to the formation of antibodies against streptococcus
a) An abnormality in the body’s mucus secreting glands
The nurse judges that the mother understands the term cerebral palsy when she
describes it as a term applied to impaired movement resulting from which of the
following
a) Injury to the cerebrum caused by viral infection
b) Malformed blood vessels in the ventricles caused by inheritance
c) Non progressive brain damage caused by injury
d) Inflammatory brain disease caused by metabolic imbalances
c) Non progressive brain damage caused by injury
The mother asks the nurse whether her child with hemiparesis due to spastic cerebral
palsy will be able to walk normally because he can pull himself to a standing position.
Which of the following responses by the nurse would be most appropriate
a) Ask the doctor what he thinks at your next appointment
b) Maybe, maybe not. How old were you when you first walked
c) It’s difficult to predict but his ability to bear weight is a positive factor
d) If he really wants to walk, and works hard, he probably will eventually
c) It’s difficult to predict but his ability to bear weight is a positive factor
A father brings his 3 month old infant to the clinic, reporting that the infant has a cold,
is having trouble breathing and just doesn’t seem to be acting right. Which of the
following actions would the nurse do first
a) Check the infants heart rate
b) Weight the infant
c) Assess the infants oxygen saturation
d) Obtain more information from the father
c) Assess the infants oxygen saturation
In preparation for discharge, the nurse teaches the mother of an infant diagnosed with
bronchiolitis about the condition and its treatment. Which of the following statements
by the mother indicates successful teaching
a) I need to be sure to take my child’s temperature everyday
b) I hope I don’t get a cold from my child
c) Next time my child gets a cold I need to listen to the chest
d) I need to wash my hands more often
C) Next time my child gets a cold I need to listen to the chest
or d) I need to wash my hands more often
When developing the plan for care for a child with early duchennes muscular
dystrophy, which of the following would the nurse identify as the primary nursing
goal for the child
a) Encouraging early wheelchair use
b) Fostering social interactions
c) Maintaining function of unaffected muscles
d) Prevent circulatory impairment
c) Maintaining function of unaffected muscles
Which of the following would be an important assessment finding for an 8 month old
infant admitted with severe diarrhoea
a) Absent bowel sounds
b) Pale yellow urine
c) Normal skin elasticity
d) Depressed anterior fontanel
d) Depressed anterior fontanel
When obtaining the initial health history from a 10 year old child with abdominal pain
and suspected appendicitis, which of the following questions would be most helpful in
eliciting data to help support the diagnosis
a) Where did the pain start
b) What did you do for the pain
c) How often do you have a bowel movement
d) Is the pain continuous or does it let up
a) Where did the pain start
Which of the following would first alert the nurse to suspect that a child with severe
gastroenteritis who has been receiving intravenous therapy for the past several hours
may be developing circulatory overload
a) A drop in blood pressure
b) Change to slow, deep respirations
c) Auscultation of moist crackles
d) Marked increase in urine output
c) Auscultation of moist crackles
The stool culture of a child with profuse diarrhoea reveals salmonella bacilli. After
teaching the mother about the course of salmonella enteritis, which of the following
statements by the mother indicates effective teaching
a) Some people become carriers and stay infectious for a long time
b) After the acute state passes, the organism is usually not present in the stool
c) Although the organism may be alive indefinitely, in time it will be of no danger to
anyone
d) If my child continues to have the organism in the stool, an antitoxin can help
destroy the organism
a) Some people become carriers and stay infectious for a long time
A mother of a 1 month old infant state that she is curious as to whether her infant is
developing normally. Which of the following developmental milestones would the
nurse expect the infant to perform
a) Smiling and laughing out loud
b) Rolling from side to side
c) Holding a rattle briefly
d) Turning the head from side to side
d) Turning the head from side to side
A child is to receive Trilafon 24 mg po BD. The medication is available as 16 mg/5ml.
how may ml will you administer
a) 3.3
b) .75
c) 7.5
d) 0.3
c) 7.5
Which of the following age groups are most susceptible to meningococcal meningitis
a) Children below 5 years of age
b) Children between 3.6 years (preschool)
c) School age children
d) Adolescents
a) Children below 5 years of age
A parent asks, can I get head lice too. The nurse indicates that adults can also be
infested with head lice but that Pediculosis is more common among school children,
primarily for which of the following reasons
a) An immunity to Pediculosis usually is established by adulthood
b) School aged children tend to be more neglectful of frequent hand washing
c) Pediculosis usually is spread by close contact with infected children
d) The skin of adults is more capable of resisting the invasion of lice
c) Pediculosis usually is spread by close contact with infected children
When developing the postoperative plan of care for an adolescent who has undergone
an appendicectomy for a ruptured appendix, in which of the following positions
would the nurse expect to place the client during the early postoperative period
a) The semi fowlers position
b) Supine
c) Lithotomy position
d) Prone
a) The semi fowlers position
Mental status assessment using the ‘batomi’ formation is a useful nursing assessment
tool because it tells you
a) Whether or not a client has a mental illness
b) Details about an individual’s feeling state and cognitive functioning
c) Whether a mental illness is organic or functional in origin
d) The history of a clients symptoms and his response to stress
b) Details about an individual’s feeling state and cognitive functioning
Persons with an acute psychotic illness have most difficulty in
a) Meeting dependency needs
b) Maintaining grooming and personal hygiene
c) Distinguishing between reality and unreality
d) Displaying personal feelings
c) Distinguishing between reality and unreality
People who have a personality disorder
a) Frequently progress to a psychotic illness
b) Become psychotic under severe stress
c) Are known as borderline personalities
d) Have ongoing difficulties in relating to others
d) Have ongoing difficulties in relating to others
Neurotic disorders are associated with
a) Inadequacy and poor stress management
b) Maladaptive behaviour related to anxiety
c) Inability to cope with demands and perceived stress
d) Family patterns of inappropriate behaviour
b) Maladaptive behaviour related to anxiety
or c) Inability to cope with demands and perceived stress
Which of the following statements about tardive dyskinesia is true
a) Symptoms are often permanent and do not improve with antiparkinsonian
medication
b) Symptoms will diminish as the client adjusts to long term treatment
c) Clients are seldom concerned about features of tardive dyskinesia
d) Antiparkinsonian medication will suppress the main features of tardive dyskinesia
a) Symptoms are often permanent and do not improve with antiparkinsonian
medication
Memory loss associated with old age
a) Has a sudden onset and affects both long term and short term memory
b) Has a gradual onset and affects mainly long term memory
c) Has a gradual onset and affects mainly short term memory
d) Has a sudden onset and affects mainly short term memory
c) Has a gradual onset and affects mainly short term memory
persons who have a neurotic disorder
a) have a minor disorder that will diminish with time and maturity
b) respond well to electro convulsive therapy
c) do not develop psychotic features
d) frequently have insight into their behaviour
d) frequently have insight into their behaviour
a social factor contributing to the incidence of eating disorders is
a) economic disadvantage
b) educational disadvantage
c) gender stereotyping
d) unemployment
c) gender stereotyping
the most common features of chronic organic psychosis are
a) fluctuating confusion and disorientation
b) persistent elated mood and hyperactivity
c) thought blocking and concrete thinking
d) social withdrawal and paranoid ideation
d) social withdrawal and paranoid ideation
phobia is best described as
a) a fear related to an identifiable traumatic event in one’s life
b) an irrational fear of a specific situation or object
c) a series of repetitive behaviours designed to relieve anxiety
d) a general sense of impending doom
b) an irrational fear of a specific situation or object
the most appropriate treatment for phobias is
a) anxiolytic drugs
b) cognitive restructuring
c) relaxation exercises
d) systematic desensitisation
d) systematic desensitisation
the best definition of a crisis is
a) any event which causes anxiety
b) a life event which is perceived as a threat to self esteem
c) a traumatic event for which coping behaviours are inadequate
d) a situation which is traumatic and involves a significant loss
c) a traumatic event for which coping behaviours are inadequate
forensic psychiatry is the area of mental health care which is concerned with
individuals who
a) have been committed to hospital because they would not voluntarily accept
treatment
b) are not considered to be capable of caring for themselves in a non custodial
environment
c) have been charged with an offence to undergo a psychiatric examination or
treatment
d) are mentally ill and considered to be a danger to themselves or to the public
c) have been charged with an offence to undergo a psychiatric examination or
treatment
anxiety is best described as
a) mild form of psychosis
b) disorder of mood
c) response to stress
d) distorted sense of perception
c) response to stress
Which of the following is common feature of anxiety
a) Paranoid delusions
b) Social withdrawal
c) Impaired concentration
d) Auditory hallucinations
c) Impaired concentration
A person who is currently acutely depressed expresses an intention to self harm. Your
initial response would be to
a) Distract the client by talking about less depressing thoughts or ideas
b) Encourage the client to discuss their ideas of suicide to establish potential for self
harm
c) Suggest the client involves themselves with other clients to establish supportive
relationships
d) Ask the client to explain their reasons for contemplating self harm
b) Encourage the client to discuss their ideas of suicide to establish potential for self
harm
A depressed client is prescribed amitriptyline. This would have the effect of
a) Clarifying his thought processes
b) Helping to raise his mood
c) Eliminating negative ideas
d) Promoting greater self awareness
b) Helping to raise his mood
While watching television in the lounge a client says quickly and abruptly to the nurse,
the sun is shining in Virginia. My son is in Virginia. Who’s afraid of Virginia wolf.
Which of the following is this statement an example of
a) Concrete thinking
b) Flight of ideas
c) Word salad
d) Depersonalisation
b) Flight of ideas
In planning the care of for the elated client a primary aim is to
a) Encourage interpersonal contact
b) Provide a non stimulating environment
c) Demand that the client follow rules
d) Accept and understand the behaviour
B) provide a non stimulating environment.
For a client suffering from mania who is unable to sleep the best approach is to
a) Fully involve the client in physical activities and exercise programmes during
daytime
b) Encourage the client to talk about underlying feelings or stressors
c) Nurse in low stimulus environment and administer prescribed antipsychotic
medication
d) Place in seclusion using medication only as a last resort
c) Nurse in low stimulus environment and administer prescribed antipsychotic
medication
For a client suffering from mania who is expressing delusional ideas the best
approach is to
a) Explain to the client the distinction between rational and irrational thinking
b) Acknowledge his ideas but distract him by focusing on reality based ideas
c) Ignore him because to do otherwise will only reinforce his ideas
d) Encourage him to stop thinking like that, as it is a symptom of his illness
b) Acknowledge his ideas but distract him by focusing on reality based ideas
A client who is subject to a community treatment order section 29 of the mental
health act (1992) must
a) Accept prescribed medication and attend any specified treatment center
b) Report on a weekly basis to a community mental health centre
c) Return to hospital after a period of three months for a psychiatric assessment
d) Name a primary caregiver who will accept responsibility for the clients care and
supervision
a) Accept prescribed medication and attend any specified treatment center
In preparation for living in the community a client may spend a period of time living
in a half way house. The main objective of living in a half way house is to
a) Save sufficient money in order to set up a house or flat
b) Spend time looking for a suitable job on leaving hospital
c) Assess whether the client still has any symptoms of mental illness
d) Provide the client with the opportunity to adjust to a more independent lifestyle
d) Provide the client with the opportunity to adjust to a more independent lifestyle
Following an automobile accident involving a fatality and a subsequent arrest for
speeding, a client has amnesia for the events surrounding the accident. This is an
example of the defence mechanism known as
a) Projection
b) Repression
c) Dissociation
d) Suppression
c) Dissociation
The group most at risk for developing an eating disorder is young women
a) Who are high achievers
b) With a history of disturbed behaviour
c) Who have conflict with their parents
d) With a history of mental illness
d) With a history of mental illness
Support for a client with an eating disorder involves
a) Avoidance of family conflicts
b) Discussion of health ways of losing weight
c) Encouragement to explore issues of concern
d) Daily checks for changes in weight
c) Encouragement to explore issues of concern
The personality disorder associated with an inability to make decisions and the need
for constant reassurance is commonly classified as
a) Obsessive compulsive
b) Dependent
c) Cyclothymic
d) Antisocial
b) Dependent
People who have a personality disorder
a) Frequently progress to a psychotic illness
b) Become psychotic under severe stress
c) Are known as borderline personalities
d) Have ongoing difficulties in relating to others
d) Have ongoing difficulties in relating to others
A side effect resulting from long term use of antipsychotic medication is tardive
dyskinesia. Features of tardive dyskinesia include
a) Involuntary lip smacking and tongue movements
b) Dry mouth and blurred vision
c) Muscular rigidity and shuffling gait
d) Nausea and vomiting
a) Involuntary lip smacking and tongue movements
A nurse working in a long term ward becomes aware that they are becoming
institutionalised. Which of the following behaviours would they be most likely to
have noticed
a) An excessive and unrealistic concern for the welfare of clients
b) A tendency to become involved in new activities
c) A lack of satisfaction with existing methods of work
d) Resistance to new ideas and change
d) Resistance to new ideas and change
One reason for ordering an individual charged with an offence to have psychiatric
examination is to determine whether that person
a) Is likely to have committed the offence he is charged with
b) Has a previous personal or family history of psychiatric illness
c) Was suffering from a mental illness at the time of the alleged offence
d) Has a mental illness which would respond to a programmed of treatment
c) Was suffering from a mental illness at the time of the alleged offence
Cultural considerations in the use of seclusion include
a) Use of seclusion only after consent has been obtained from the appropriate
cultural representatives
b) Listening to advice from staff of the clients culture or form the clients family
c) Having an appropriate cultural representative available each time the seclusion
room is entered
d) Ensuring that only staff from the clients culture participate in caring for any client
in seclusion
a) Use of seclusion only after consent has been obtained from the appropriate
cultural representatives
Cross cultural studies on mental illness show that
a) The symptoms of mental illness are the same in all cultures
b) The incidence of mental illness the same in all cultures
c) Mental illness has culturally specific characteristics
d) Mental illness is more common amongst cultural minorities
d) Mental illness is more common amongst cultural minorities
The drug most commonly used in the long term treatment of bi polar disorder is
a) Diazepam
b) Lithium carbonate
c) Clozapine
d) Sodium Amytal
b) Lithium carbonate
Anticholinergic side effects are common with all the following except
a) Diazepam
b) Benztropine
c) Amitriptyline
d) Thioridazine
A) diazepam
Chlorpromazine is an antipsychotic medication used in the treatment of
a) Anxiety states
b) Schizophrenia
c) Depressive disorders
d) Dementia
b) Schizophrenia
Which of the following is the main reason for giving depot injections of antipsychotic
medication
a) They are more effective than oral medication
b) They overcome the problem of non adherence
c) Side effects are not as common
d) They are easier to administer than oral medication
b) They overcome the problem of non adherence
A client who is committed under the mental health act (1992) is discharged from
hospital on leave. When visited by the community mental health nurse he refused his
injection of antipsychotic medication which is due that day. The best initial approach
to this would be to
a) Explain that this will mean his immediate return to hospital
b) Visit again the next day and attempt to persuade the client to accept his
medication
c) Inform the medical staff so that the clients legal status can be changed
d) Explore with the client alternative forms of treatment to medication
a) Explain that this will mean his immediate return to hospital
Long term use of benzodiazepine drugs (minor tranquillisers) such as diazepam
(valium) can lead to
a) Tardive dyskinesia
b) Dependence
c) Renal impairment
d) Akathisia
b) Dependence
A client expresses the belief that he is the illegitimate son of a famous family. This is
an example of
a) Paranoid thinking
b) Pressure of speech
c) A delusion of grandeur
d) Ideas of reference
c) A delusion of grandeur
The best response to this statement (in previous question) is to
a) Involve the client in a group activity
b) Inform the client that he is wrong in his belief
c) Talk to the client without confirming or denying his belief
d) Spend some time with the client in an attempt to meet his need to feel important
c) Talk to the client without confirming or denying his belief
At an art group a client shows the group the painting he has done. It consists of knives
and blood, with the words ‘death’ and ‘peace’ written on it. The client tells the group
that this represents his own death and release from suffering. The best response to this
is
a) Thank him for his participation and then focus the discussion on another client
b) Acknowledge his contribution and ensure that you discuss this further with him
after the group has finished
c) Request that the client use the opportunity to explore more positive aspects of his
life
d) Insist the client explain this feelings to the group and then point out positive
aspects of his life
b) Acknowledge his contribution and ensure that you discuss this further with him
after the group has finished
A client who has been admitted for treatment of a depressive illness says he doesn’t
want to attend group activities. The reason such a client would be encouraged to
attend is that
a) He is less likely to dwell on depressive ideas while he is involved in a group
activity
b) It is an expectation that all clients attend group activities while in hospital
c) Involvement in group activities is the only way to overcome feelings of depression
d) Attendance at group activities is essential to monitor the effectiveness of
medication
a) He is less likely to dwell on depressive ideas while he is involved in a group
activity
A client with post traumatic stress disorder says ‘I should have been killed with the
rest of them. Why am I alive’ this statement is best described as an example of
a) Suicidal thinking
b) Survivor guilt
c) Depressive preoccupation
d) Neurotic conflict
b) Survivor guilt
The best way to report the clients statement (in previous question) in the nursing notes
would be
a) Client has no insight into their situation
b) Client is questioning why they are still alive
c) Client is expressing suicidal ideas
d) Client feels responsible for death of others
b) Client is questioning why they are still alive
Long acting intramuscular antipsychotic medication is used in the treatment of
schizophrenia because it
a) Has fewer side effects than oral medication
b) Has a greater antipsychotic action
c) Is more rapidly absorbed than oral medication
d) Ensures that clients receive their medication
c) Is more rapidly absorbed than oral medication
or d) Ensures that clients receive their medication
Which of the following statements related to the treatment, with lithium carbonate, of
person with bipolar disorder is true
a) Most will need to take lithium carbonate for an extended period of time, perhaps
for life
b) Once the persons mood becomes euthymic, treatment can be discontinued in most
cases
c) Because of the need to maintain constant blood levels, long term injections is the
preferred form of treatment
d) Treatment is most effective in the acute stage of the illness although some people
will need long term treatment
d) Treatment is most effective in the acute stage of the illness although some people
will need long term treatment
An acutely ill client with the diagnosis of schizophrenia has just been admitted to the
mental health unit. When working with this client initially the nurses most therapeutic
action would be to
a) Use diversional activity and involve the client in occupational therapy
b) Build trust and demonstrate acceptance by spending some time with the client
c) Delay one to one interactions until medications reduce the psychotic symptoms
d) Involve the client in multiple small group discussions to distract attention from the
fantasy world
b) Build trust and demonstrate acceptance by spending some time with the client
You are caring for a client who talks in a regretful way about the past. The best
response is to
a) Help them find something positive in their past
b) Help them move their thoughts to the future
c) Tell them that focusing on the past is not helpful
d) Acknowledge the clients feelings then focus on the present
d) Acknowledge the clients feelings then focus on the present
Intervention with an angry client who is threatening violence involves
a) Asking the client to express their feelings verbally
b) Maintaining silence to avoid any escalation of anger
c) Asking the client what has happened to make them so angry
d) Giving brief, clear messages about what you want the client to do
d) Giving brief, clear messages about what you want the client to do
Mr w is committed under section 11 o the mental health act 1992. He sneaks out at
night and returns to his former home. He calls the staff and tells them he is not
coming back. The staffs responsibility is to
a) Make sure he has discharged
b) Tell him to take his medication
c) Ask to have someone else talk to him
d) Notify the police and crisis team
d) Notify the police and crisis team
The highest priority nursing action relative to alcohol withdrawal delirium would be
a) Orientation to reality
b) Application of restraints
c) Identification and social supports
d) Replacement of fluids and electrolytes
a) Orientation to reality
or d) Replacement of fluids and electrolytes
The use of silence during an interview is therapeutic if
a) The person is overcome with emotion
b) The person appears uncomfortable with the current discussion
c) The nurse wishes to terminate the communication session
d) The patient wishes to terminate the communication session
b) The person appears uncomfortable with the current discussion
To facilitate communication the nurse should convey
a) Accurate empathy
b) Authenticity
c) Unconditional positive regard
d) All of the above
d) All of the above
The parents of a young man experiencing a schizophrenic illness ask if he is likely to
become violent. The best answer the nurse can make is that the vast majority of
mentally ill individuals
a) Are more dangerous than normal people
b) Are not more dangerous than other individuals in the population
c) Are unpredictable and therefore more dangerous than normal individuals
d) Are about as violent and unpredictable as more individuals in the population
d) Are about as violent and unpredictable as more individuals in the population
or
b) Are not more dangerous than other individuals in the population
While interviewing Mr. d, the nurse notes he uses neologisms and has losses
associations. This would most likely indicate the presence of
a) Mania
b) Depression
c) Defensive coping
d) Schizophrenia or psychosis
c) Defensive coping
or
d) Schizophrenia or psychosis
When monoamine oxide inhibitors (MAOIs) are prescribed, the client should be
cautioned against
a) Prolonged exposure to the sun
b) Ingesting wines and aged cheeses
c) Engaging in active physical exercise
d) The use of medications with an elixir base
b) Ingesting wines and aged cheeses
A characteristic feature of the elated client is
a) Retarded speech
b) Increased motor and thought activity
c) Delusions of sin and guilt
d) Depressed mood
b) Increased motor and thought activity
To give effective nursing care to a client who is using ritualistic behaviour, the nurse
must first recognize that the client
a) Should be prevented from performing the rituals
b) Needs to realise that the rituals serve no purpose
c) Must immediately be diverted when performing the ritual
d) Does not want to repeat the ritual, but feels compelled to do so
d) Does not want to repeat the ritual, but feels compelled to do so
Culturally safe nursing care can best be achieved when the nurse has
a) An in depth knowledge of the treaty of Waitangi
b) An awareness of Maori perspectives of health
c) An awareness and acceptance of your own limits in meeting someone’s else’s
health and cultural needs
d) A knowledge of Maori protocol
c) An awareness and acceptance of your own limits in meeting someone’s else’s
health and cultural needs
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
d) High transmissibility
The school nurse is caring for a child with haemophilia who is actively bleeding from
the leg. Which of the following would the nurse apply
a) Direct pressure, checking every few minutes to see if the bleeding has stopped
b) Ice to the injured leg area several times a day
c) Direct pressure to the injured area continuously for 10 minutes
d) Ice bag with elevation of the leg twice a day
c) Direct pressure to the injured area continuously for 10 minutes
Home health nurses visit a blind diabetic patient who lives alone to monitor the
patients glucose level and administer the patients daily insulin. Evaluation of outcome
management for this patient would include
a) An absence of complications of diabetes
b) A reduction in hospitalizations for glycemic control
c) The ability of the patient to learn to use adaptive syringes
d) The patients evaluation of the services provided by the nurses
b) A reduction in hospitalizations for glycemic control
The nurse consults with the physician to arrange a referral for hospice care for a patient with end stage liver disease based on the knowledge that hospice care is indicated when
A) Family members can no longer care for dying patients at home
b) Patients and families are having difficulty coping with grief reactions
c) Preparation for death with palliative care and comfort are the goals of care
d) Patients have unmanageable pain and suffering as a result of their condition
A) Family members can no longer care for dying patients at home
When teaching a patient who smokes about the relationship of smoking to the development of cancer, the nurse explains that tobacco smoke is a complete carcinogen because
a) Exposure to the smoke always causes cellular changes
b) Tobacco smoke is capable of both initiating and promoting cancer growth
c) Cancer will always develop when people who smoke are exposed to other carcinogens
d) Tobacco smoke serves as a vehicle for the spread of cancer cells during the progression stage of cancer
b) Tobacco smoke is capable of both initiating and promoting cancer growth
In teaching about cancer prevention, the nurse stresses promotion of exercise, normal body weight, and low fat diet because
a) General aerobic health is an important defense against cellular mutation
b) Obesity is a factor that promotes cancer growth; if it is reversed, the risk of cancer can be decreased
c) People who are overweight usually consume large amounts of fat, which is a chemical carcinogen
d) The development of fatty tumors, such as lipomas, is increased when there is an abundance of fatty tissue
a) General aerobic health is an important defense against cellular mutation
A 40 year old divorced mother of four school children is hospitalized with metastatic cancer of the ovary. The nurse finds the patient crying, and she tells the nurse that she does not know what will happen to her children when she dies. The most appropriate response by the nurse is
a) Why don’t we talk about the options you have for the care of your children
b) You are going to live for a long time yet, and your children will be just fine
c) I wouldn’t worry about that right now. You need to concentrate on getting well
d) Wont your ex husband take the children when you cant care for them anymore
a) Why don’t we talk about the options you have for the care of your children
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
c) The status of the patients respiration
Which of the following viruses is usually transmitted by airborne droplets
a) Varicella zoster virus
b) Cytomegalovirus
c) Herpes simplex virus
d) Hepatitis a virus
a) Varicella zoster virus
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
a) Vaccination
in addition to providing informational support, which of the following nursing activities is an integral part of the role of the nurse advocate
a) maintaining the patient in a dependent role
b) assuming responsibility for directing the patients care
c) assisting the patient to make sound health care decisions
d) persuading the patient to choose exactly what the health care team recommends
c) assisting the patient to make sound health care decisions
steve, 15 years old, is admitted with suspected meningitis. Nuchal rigidity will not be seen in which of the following
a) intracranial haematoma
b) meningitis
c) cerebral concussion
d) intracranial tumour
c) cerebral concussion
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
b) the client has been exposed to mycobacterium
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
a) Continue to collect information until there is no doubt in the nurses mind that abuse has occurred
Several high school seniors are referred to the school nurse because of suspected alcohol misuse. When the nurse assesses the situation, which of the following would be most important to determine
a) What they know about the legal implications of drinking
b) The type of alcohol they usually drink
c) The reasons they choose to use alcohol
d) When and with whom they use alcohol
c) The reasons they choose to use alcohol
When a trauma victim expresses fear that AIDS may develop as a result of a blood transfusion, the nurse should explain that
a) Blood is treated with radiation to kill the virus
b) Screening for HIV antibodies has minimised the risk
c) The ability to directly identify HIV has eliminated this concern
d) Consideration should be given to donating own blood for transfusion
b) Screening for HIV antibodies has minimised the risk
A client asks the nurse, should I tell my husband I have AIDS. The nurses most appropriate response would be
a) This is a decision alone you can make
b) Do not tell him anything unless he asks
c) You are having difficulty deciding what to say
d) Tell him you feel you contracted AIDS from him
c) You are having difficulty deciding what to say
When a disaster occurs, the nurse may have to treat mass hysteria first. The person or persons to be cared for immediately would be those in
a) Panic
b) Coma
c) Euphoria
d) Depression
a) Panic
A child was bitten on the hand by a dog who had recently received a rabies shot. The nursing priority for this child would be directed toward ensuring that the
a) Suture line remains red and dry
b) Child does not develop a fear of dogs
c) Rabies antibodies develop within 48 hours
d) Mobility of the injured hand returns to a pre injury state in 1 week
d) Mobility of the injured hand returns to a pre injury state in 1 week
The school nurse is invited to attend a meeting with several parents who express frustration with the amount of time their adolescents spend in front of the mirror and the length of time it takes them to get dressed. The nurse explains that this behaviour is indicative of which of the following
a) An abnormal narcissism
b) A method of procrastination
c) A way of testing the parents limit setting
d) A result of developing self concept
d) A result of developing self concept
A parent asks the nurse about head lice (pediculosis capitis) infestation during a visit to the clinic. Which of the following symptoms would the nurse tell the parent is most common in a child infected with head lice
A) Itching of the scalp
b) Scaling of the scalp
c) Serous weeping of the scalp surface
d) Pinpoint hemorrhagic spots on the scalp surface
A) Itching of the scalp
After teaching the parents about the cause of ringworm of the scalp (tinea capitis), which of the following, if stated by the father, indicates successful teaching
a) Over exposure to the sun
b) Infestation with a mite
c) Fungal infection of the scalp
d) An allergic reaction
c) Fungal infection of the scalp
A mother tells the nurse that one of her children has chicken pox and asks what she should do to care for that child. When teaching the mother, which of the following would be most important to prevent
a) Acid base imbalance
b) Malnutrition
c) Skin infection
d) Respiratory infection
c) Skin infection
One litre of intravenous fluid is to be given over 4 hours. The giving set delivers 60 drops per mL. how many drops per minute should be given
a) 150
b) 250
c) 300
d) 160
b) 250
The nurse discusses the eating habits of school aged children with their parents, explaining that these habits are most influenced by which of the following
a) Food preference of their peers
b) Smell and appearance of foods offered
c) Examples provided by parents at mealtimes
d) Parental encouragement to eat nutritious foods
a) Food preference of their peers
Which of the following is an offence under the hydatids act 1959
a) Failure to report stray, unregistered dogs
b) Feeding raw offal to any dogs in your care
c) Tenuicollis worms in lambs at the time of killing
d) Tenuicollis cysts in any purged material from dogs
b) Feeding raw offal to any dogs in your care
What is the responsibility of the nurse who, for two days, has observed the nurse manager putting several syringes into her pocket
A) Report the matter to another nurse manager
b) Discuss the matter with your nursing colleagues
c) Watch the nurse manager to see if it happens again
d) Ignore the incident as a nurse manager is a responsible person
A) Report the matter to another nurse manager
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
a) Wrap a handkerchief tightly on the wrist
You are taking neils recordings when he appears to have a seizure. What nursing intervention would best assist neil
a) Describing and recording the seizure activity observed
b) Restraining neil in order to prevent self harm
c) Placing a tongue blade between his teeth
d) Suctioning neil to prevent aspiration
a) Describing and recording the seizure activity observed
Following a petit mal seizure a person is likely to be
a) Confused
b) Hostile
c) Hyperactive
d) Euphoric
a) Confused
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
b) The physician must be seen when the prescription is finished
If you are with someone who has a grand mal seizure, you should
a) Loosen the clothing about their neck and wrist
b) Turn their head to the side to facilitate drainage of secretions
c) Remove nearby objects to protect their extremities from injury
d) All of the above
d) All of the above
The school nurse is caring for a child with haemophilia who is actively bleeding from the leg. Which of the following would the nurse apply
a) Direct pressure, checking every few minutes to see if the bleeding has stopped
b) Ice to the injured leg area several times a day
c) Direct pressure to the injured area continuously for 10 minutes
d) Ice bag with elevation of the leg twice a day
c) Direct pressure to the injured area continuously for 10 minutes
When performing a cultural assessment with a patient of a different culture, it is important for the nurse to first ask about the patients
a) Racial heritage
b) Use of cultural healers
c) Language spoken at home
d) Affiliation with a cultural group
d) Affiliation with a cultural group
After being bitten by an unknown insect, a patient allergic to wasp stings is brought to a clinic by a co worker. Upon arrival the patient is anxious and is having difficulty breathing. The first action by the nurse is to
A) Administer oxygen
b) Maintain the patients airway
c) Remove the stinger from the site
d) Place the patient in recumbent position with his legs elevated
b) Maintain the patients airway
During immediate care of a victim of a bite or sting to the hands or fingers, it is most important for the nurse to
a) Elevate the affected extremity
b) Scrub the wound with an antibacterial solution
c) Apply ice to the site with ice water or ice packs
d) Remove rings and watches from the affected extremity
d) Remove rings and watches from the affected extremity
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
b) Gamma globulin
A 63 year old man has terminal cancer of the liver and is cared for by his wife at home. His abdominal pain ahs become increasingly severe, and he now says it is intense most of the time. The nurse recognizes that teaching regarding pain management has been effective when the patient
a) Limits the use of opiate analgesics to prevent addiction
b) Resigns himself to the fact that pain is an inevitable consequence of cancer
c) Uses pain medication only when the pain becomes more than he can tolerate
d) Takes analgesics around the clock on a regular schedule, using additional doses for the breakthrough pain
d) Takes analgesics around the clock on a regular schedule, using additional doses for the breakthrough pain
A patient is treated at a clinic with an injection of long acting penicillin for a streptococcal throat infection. Her history reveals that she has received penicillin before with no allergic responses. When the penicillin injection is administered, the nurse should inform the patient that
a) She must wait in the clinic area for 20 minutes before she is discharged
b) Since she has taken penicillin before without problems, she can safely take it now
c) She would have immediate symptoms if she had developed an allergy to penicillin
d) She should monitor for fever and skin rash typical of serum sickness after taking penicillin
d) She should monitor for fever and skin rash typical of serum sickness after taking penicillin
A parent asks why it is recommended that the second dose of the measles, mumps, rubella (MMR) vaccine be given by 12 years of age. The nurse responds based on which of the following as the most important reason
a) The risks to a foetus are high if a girl receiving the vaccine becomes pregnant
b) The chance of contracting the disease is much lower after puberty than before it
c) The dangers associated with a strong reaction to the vaccine are increased after puberty
d) The changes that occur in the immunologic system may affect the rhythm of the menstrual cycle
a) The risks to a foetus are high if a girl receiving the vaccine becomes pregnant
Mrs simmon states she is not feeling well, that she cannot breathe and asks you to please do something. Your initial response to the client is
a) You will be alright, just calm down
b) Don’t worry, the doctors have everything under control
c) I will ring the doctor to come and see you
d) I will take your recordings and ring the doctor to see you
d) I will take your recordings and ring the doctor to see you
For the nursing council to find a registered nurse guilty of negligence, it would have to prove that the nurse
a) Failed to do what another careful registered nurse would have done in a similar situation
b) Did not give competent care as defined by colleagues with the same level of experience
c) Did not give an appropriate level of care as defined by the NZNO standards for nursing practice
d) Did not give an appropriate level of care as defined by the NZNO code of practice for nurses
c) Did not give an appropriate level of care as defined by the NZNO standards for nursing practice
Ageism is an important concept for the nurse to understand because it
a) May damage the self esteem of the elderly
b) Increases social awareness of the needs of the elderly
c) Provides statistical information regarding the elderly population
d) Promotes consideration of the diversity of the elderly population
b) Increases social awareness of the needs of the elderly
A middle aged woman enjoys orienting new young women and men at work. She enjoys being a teacher and mentor and feels she should pass down her legacy of knowledge and skills to the younger generation. The nurse recognizes that the woman is involved in the behaviour described by Erikson as
a) Generativity
b) Ego integrity
c) Identification
d) Valuing wisdom
a) Generativity
For the nursing council to find a registered nurse guilt of malpractice following an assault on a client, it would have to prove that the nurse
a) Intended to cause bodily harm to the client
b) Actually assaulted the client
c) Did not establish a therapeutic relationship with the client
d) Committed a felony against the client
a) Intended to cause bodily harm to the client
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
b) Immobilization of the cervical spine
An employee spilled industrial acids on his arms and legs at work. The appropriate action by the occupational nurse at the facility is to
a) Apply cool compresses to the area of exposure
b) Apply an alkaline solution to the affected area
c) Cover the affected area with dry, sterile dressings
d) Flush the substance with large amounts of tap water
d) Flush the substance with large amounts of tap water
According to the privacy act 1993, when collecting health information from a client the nurse must
a) Ensure the client is aware that health information is being collected
b) Tell the client why health information is being collected
c) Inform the client about their rights of access and correction
d) All of the above
d) All of the above
An example of the use of primary prevention for family violence is
a) Working to eliminate the glamorisation of violence on television
b) Counselling a woman living in an abusive relationship about available shelter programs
c) Calling child protective services regarding a school age child who has reported sexual attacks by her stepfather
d) Carefully examining the skin of an elder who has just returned to an extended care facility following a weekend with his children
a) Working to eliminate the glamorisation of violence on television
With a patient who is homosexual, the nurses most appropriate initial action during the preinteraction phase of the relationship should be to
a) Assist the patient in changing sexual values
b) Examine own feelings and anxieties with regard to the patient
c) Review the literature pertaining to the human sexual response
d) Attempt to identify the underlying reasons for the patients values
b) Examine own feelings and anxieties with regard to the patient
The nurse judges that the mother understands the term cerebral palsy when she describes it as a term applied to impaired movement resulting from which of the following
a) Injury to the cerebrum caused by viral infection
b) Malformed blood vessels in the ventricles caused by inheritance
c) Non progressive brain damage caused by injury
d) Inflammatory brain disease caused by metabolic imbalances
c) Non progressive brain damage caused by injury
The first symptom of gonorrhoea is usually
a) Lower abdominal pain
b) A sore or ulcer on the genitals
c) Purulent vaginal discharge in the female
d) Urethral discharge in the male
c) Purulent vaginal discharge in the female
or
d) Urethral discharge in the male
The first symptom of syphilis is
a) A generalised rash all over the body
b) A sore or ulcer on the genitals
c) Abdominal pain in the male
d) Purulent vaginal discharge
b) A sore or ulcer on the genitals
When obtaining a nursing history from parents who are suspected of abusing their child, which of the following characteristics about the parents would the nurse typically find
a) Attentiveness to the childs needs
b) Self blame for the injury to the child
c) Ability to relate childs developmental achievements
d) Evidence of little concern over the extent of the injury
a) Attentiveness to the childs needs
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
c) The right to health is guaranteed to maori under article two of the treaty of Waitangi
The long term consequences of Chlamydia is most likely to be
a) Menorrhagia
b) Chronic vaginitis
c) Chronic cervicitis
d) Sterility
d) Sterility
When describing the effects of insulin on the body to a patient newly diagnosed with diabetes mellitus, the best explanation by the nurse is
A) Insulin promotes the breakdown of fatty tissue into triglycerides, which can be used for energy
b) When proteins are taken into the body, insulin promotes their breakdown and conversion to fats
c) Insulin stimulates the conversion of stored sugars into blood glucose and the conversion of proteins into glucose
d) When carbohydrates, fats, and proteins are eaten, insulin promotes cellular transport and storage of all these nutrients
d) When carbohydrates, fats, and proteins are eaten, insulin promotes cellular transport and storage of all these nutrients
A serious complication of acute malaria is
a) Congested lungs
b) Impaired peristalsis
c) Aaemia and cachexia
d) Fluid and electrolyte imbalance
d) Fluid and electrolyte imbalance
A registered nurse stops to assist at the scene of an accident but the injured man dies before the ambulance arrives. The nurse should understand that she
a) Should leave the scene before the ambulance arrives
b) Will be covered by her actions by the good Samaritan laws
c) Has a legal duty of care to perform at a competent level as a registered nurse
d) Should pronounce the person dead at the scene
c) Has a legal duty of care to perform at a competent level as a registered nurse
John is admitted with neutropenia, what does the nurse assess in determining his risk for infection
a) Length of time neutropenia has existed
b) Health status before neutropenia
c) Body build and weight
d) Resistance to infection in childhood
a) Length of time neutropenia has existed
What nursing action would be important in preventing cross contamination
a) Change gloves immediately after use
b) Stand two feet from the patient
c) Speak minimally when in the room
d) Wear long sleeved shirts
a) Change gloves immediately after use
What would you teach john and his family to avoid
a) Using suppositories or enemias
b) Using a high efficiency particulate air filter mask
c) Performing perineal care after every bowel movement
d) Performing oral care after every meal
a) Using suppositories or enemias
24 hours after john has a bone marrow aspiration, the nurse evaluates which of the following as an appropriate client outcome
a) The client maintains bed rest
b) There is redness and swelling at the aspiration site
c) The client requests morphine sulphate 2mg IM every 2 hours
d) There is no bleeding at aspiration site
d) There is no bleeding at aspiration site
During the induction stage for treatment of leukaemia, the nurse should remove which items that the family has brought into the room
a) A bible
b) A picture
c) A sachet of lavender
d) A hairbrush
c) A sachet of lavender
The goal of nursing care for a client with acute myeloid leukaemia is to prevent
a) Cardiac arrhythmias
b) Liver failure
c) Renal failure
d) Haemorrhage
d) Haemorrhage
The nurse is evaluating the clients learning about combination chemotherapy. Which of the following statements about reasons for using combination chemotherapy indicates the need for further explanation
a) Combination chemotherapy is used to interrupt cell growth cycle at different points
b) Combination chemo is used to destroy cancer cells and treat side effects simultaneously
c) Combination chemo is used to decrease resistance
d) Combination chemo is used to minimise the toxicity from using high doses of single agent
b) Combination chemo is used to destroy cancer cells and treat side effects simultaneously
In providing care to the client with leukaemia who has developed thrombocytopenia, the nurse assessed the most common sites for bleeding. Which of the following is not a common site
a) Biliary system
b) Gastrointestinal tract
c) Brain and meninges
d) Pulmonary system
c) Brain and meninges
The nurses best explanation for why the severely neutropenic client is place in reverse isolation is that reverse isolation helps prevent the spread of organisms
a) To the client from sources outside the clients environment
b) From the client to health care personnel, visitors and other clients
c) By using special techniques to dispose of contaminated material
d) By using special techniques to hand the clients linens and personal items
a) To the client from sources outside the clients environment
A client has received 25ml of packed red blood cells when she began to experience low back pain and mild itching. After stopping the transfusion the nurse should
a) Administer prescribed aspirin and antihistamines
b) Collect blood and urine samples to be sent to the laboratory
c) Administer prescribed diuretics, oxygen and morphine
d) Administer prescribed vasopressors
b) Collect blood and urine samples to be sent to the laboratory
the nurse in the preoperative period is preparing a female client for surgery and notices that the client looks sad. The client says, ‘im scared of having cancer. Its so horrible and I brought it on myself. I should have quit smoking years ago’. What would be the nurses best response to the client
a) Its okay to be scared. What is it about cancer that you’re afraid of
b) Its normal to be scared. I would be too. Well help you through it
c) Don’t be hard on yourself. You don’t know if your smoking caused the cancer
d) Do you feel guilty because you smoked
a) Its okay to be scared. What is it about cancer that you’re afraid of
Following mastectomy the client is now due to have radiation therapy. She should be taught to care for the skin at the therapy site by
a) Washing the area with water
b) Exposing the area to dry heat
c) Applying an ointment to the area
d) Using talcum powder on the area
c) Applying an ointment to the area
A 42 year old woman is interested in making dietary changes to reduce her risk of colon cancer. What dietary selections would the nurse suggest
a) Croissant, peanut butter, sandwiches, whole milk
b) Bran muffin, skim milk, sir fried broccoli
c) Bagel with cream cheese, cauliflower salad
d)Oatmeal, baked potato, turkey sandwich
b) Bran muffin, skim milk, sir fried broccoli
The nurse is teaching a 19 year old client and the clients family about what to expect with high dose chemotherapy and the effects of neutropenia. What should the nurse teach as the most reliable early indicator of infection in a neutropenic client
a) Fever
b) Chills
c) Tachycardia
d) Dyspnoea
a) Fever
The client is being discharged with oral chemotherapy, in teaching the client and family how to manage nausea and vomiting at home, which of the following should be discussed
a) Eating frequent, small meals throughout the day
b) Eating three normal meals a day
c) Eating only cold food but no salads
d) Limiting the amount of fluid intake
a) Eating frequent, small meals throughout the day
In setting up a syringe driver to administer analgesia which of the following factors would be most important for the nurse to consider when determining the angle at which to insert the needle
a) Size of the syringe
b) Tissue turgor
c) Length of the needle
d) Amount of subcutaneous tissue
d) Amount of subcutaneous tissue
A client is diagnosed with metastatic bone cancer. Which of the following abnormal laboratory values would the nurse expect to see
a) Hypocalcemia
b) Elevated serum alkaline phosphatase
c) Hypokalemia
d) Hypoglycaemia
b) Elevated serum alkaline phosphatase
Mrs Johnson has had a recurrence of breast cancer and has been managed at home with support from the palliative care nurse specialist. This morning when visiting her, the nurse noted she was experiencing severe low back pain especially when lying down. Which of the following assessments would be the priority
A) Bowel and bladder
b) Respiratory
c) Neurological
d) Skin and pressure sore risk
d) Skin and pressure sore risk
The nurse would teach the client that a normal local tissue response to radiation is
a) Atrophy of the skin
b) Scattered pustule formation
c) Redness of the surface tissue
d) Sloughing of two layers of skin
c) Redness of the surface tissue
The husband of a client with cervical cancer says to the nurse, ‘the doctor told my wife that her cancer is curable. Is he just trying to make us feel better.’ Which would be the nurses most accurate response
a) When cervical cancer is detected early and treated aggressively, the cure rate is almost 100%
b) The 5 year survival rate is about 75%, which makes the odds pretty good
c) Saying a cancer is curable means that 50% of all women with cancer survive at least 5 years
d) Cancers of the female reproductive tract tend to be slow growing and respond well to treatment
a) When cervical cancer is detected early and treated aggressively, the cure rate is almost 100%
A priority nursing diagnosis for a client with cervical cancer who has an internal radium implant would be
a) Pain related to cervical tumour
b) Anxiety related to self care deficit from imposed immobility during radiation
c) Impaired health maintenance related to surgery
d) Disturbed sleep pattern related to interruptions by health care personnel
b) Anxiety related to self care deficit from imposed immobility during radiation
The nurse should carefully observe a client with internal radium implants for typical side effects associated with radiation therapy to the cervix. These effects include
a) Severe vaginal itching
b) Confusion
c) High fever in the afternoon or evening
d) Nausea and a foul vaginal discharge
d) Nausea and a foul vaginal discharge
A terminally ill clients husband tells the nurse, ‘I wish we had taken that trip to europe last year. We just kept putting it off, and now im furious that we didn’t go.’ The nurse interprets that husbands statement as indicating which of the following stages of adapt ion to dying
a) Anger
b) Denial
c) Bargaining
d) Depression
a) Anger
A client is newly diagnosed with cancer and is beginning a treatment plan. Which of the following nursing interventions will be most effective in helping the client cope
a) Assume decision making for the client
b) Encourage strict compliance with all treatment regimens
c) Inform the client of all possible adverse treatment effects
d) Identify available resources
d) Identify available resources
Mr green has been admitted terminally ill and in need of pain management. He has now been commenced on oral morphine. What would you also ensure the doctor prescribe at this time
a) Antiemetics
b) Subcutaneous fluids
c) Aperients
d) Sedatives
a) Antiemetics
A client sustained an open fracture of the femur from an automobile accident. For which of the following types of shock should the client be assessed
a) Cardiogenic
b) Neurogenic
c) Hypovolaemic
d) Anaphylactic
c) Hypovolaemic
What is the primary goal for the care of a client who is in shock
a) Preserve renal function
b) Prevent hypostatic pneumonia
c) Maintain adequate vascular tone
d) Achieve adequate tissue perfusion
d) Achieve adequate tissue perfusion
Which of the following findings would the nurse most likely note in the client who is in the compensatory stage of shock
a) Decreased urinary output
b) Significant hypotension
c) Mental confusion
d) Tachycardia
d) Tachycardia
Two days after the fracture of his femur, a client suddenly complains of chest pain and dyspnea. The nurse also notes some confusion and an elevated temperature. Based on these assessment findings, the nurse suspects which of the following complications
a) Osteomyelitis
b) Fat embolism syndrome
c) Venous thrombosis
d) Compartment syndrome
b) Fat embolism syndrome
When the nurse asked her client and partner what type of birth control they were planning to use, they stated that since she is breast feeding, they don’t need to have to worry about birth control. The nurse should tell them that
a) They can decide on a method when cindy stops breast feeding
b) No birth control is necessary until after the first menstrual period
c) Ovulation can occur when a woman is breast feeding
d) Since cindy has become pregnant once, it will be much easier for her to become pregnant now
c) Ovulation can occur when a woman is breast feeding
During the post partum period many women experience mood swings which are referred to as
a) Psychosis
b) Post partum blues
c) Detachment from infant
d) Attachment to the infant
b) Post partum blues
According to erikson, an infant is in the psychosocial stage that is characterised by the conflict of
a) Trust vs mistrust
b) Initiative vs guilt
c) Intimacy vs isolation
d) Autonomy vs shame and doubt
a) Trust vs mistrust
Mrs cindy Jackson, para 1, gravid 1, had a vaginal delivery of a full term baby yesterday. Because of the soreness of her perineum, cindy states that she is afraid to have a bowel movement. The nurse should encourage cindy to
a) Ambulate frequently, eat fresh fruits and vegetables, and drink 6 – 8 glasses water per day
b) Ask her doctor to prescribe a laxative to stimulate defecation
c) Drink 2 glasses of warm water after every meal, then try to defecate
d) Do kegel exercises twice a day, eat a low roughage diet, and drink ten glasses of water per day
a) Ambulate frequently, eat fresh fruits and vegetables, and drink 6 – 8 glasses water per day
Mrs fredericks is scheduled for exploratory and palliative surgery the next day. Results of blood tests show that she has a microcytic anaemia
Likely causes of microcytic anaemia is
A diet low in iron
A diet low in vitamin C
Chronic blood loss
Acute blood loss
Haemolytic streptococcal infection
a) 1, 3 and 5
b) 1, 2 and 5
c) 1, 2 and 4
d) 1, 2 and 5
c) 1, 2 and 4
Mrs fredericks is to have a blood transfusion of two units of packed cells, prior to surgery. She is charted 350 mls over three hours through a blood giving set with a drip factor of 15
How many drops per minute will you run the blood at
a) 20
b) 25
c) 30
d) 35
c) 30
If mrs fredericks were to receive blood with which she is incompatiable, the signs and symptoms we would see, would include
Restlessness and anxiety
Generalised tingling sensations
Nausea and vomiting
Elevated temperature
Decreased blood pressure
a) 1, 2 and 3
b) 1, 4 and 5
c) 2, 3 and 5
d) All of the above
d) All of the above
If a client who suffers from cancer of the colon, the most common site of metastases is the
a) Bladder
b) Liver
c) Spleen
d) Pancreas
b) Liver
hich of the following post operative complications may be avoided by pre operative teaching
a) Wound infection
b) Wound dehiscence
c) Hypostatic pneumonia
d) Hypovolaemic shock
c) Hypostatic pneumonia
Haemorrhage during the first 12 hours post operatively is termed
a) Primary
b) Secondary
c) Intermediary
d) Reactionary
d) Reactionary
Mary aged 45 years is admitted to the ward for planned surgery. Mary smokes 20 cigarettes a day and drinks three glasses of wine every evening
The significance of this information for you is so that you
a) May teach deep breathing and coughing and relaxation techniques in preparation for surgery
b) Be aware of a potentially addictive personality when planning her pain relief post operatively
c) Can assist her to break her smoking and drinking habits when in hospital
d) May plan to include cigarettes and alcohol in her post operative regime
a) May teach deep breathing and coughing and relaxation techniques in preparation for surgery
Two days later, mary has a cholecystectomy performed, successfully. On her return to the ward, mary has an upper abdominal wound with a redivac, a T tube, A naso gastric tube and an inbtravenous infusion in situ
when carrying out marys post operative exercise regime, which aspect should receive the highest priority
a) Ensuring mary has privacy and freedom from interruption
b) That mary knows hwo to breathe and cough and why it is important
c) That she knows how to support her wound and that her pain is under control
d) That there be no interruption by marys family and friends when they visit
c) That she knows how to support her wound and that her pain is under control
Mr evere, a 69 year old retired musician was admitted to he intensive care unit with a diagnosis of adams stokes syndrome
The nurse notes m reveres pulse pressure is decreasing. Pulse pressure is the
a) Difference between the apical and radial rates
b) Force exerted against an arterial wall
c) Degree of ventricular contraction in relation to output
d) Difference between systolic and diastolic readings
d) Difference between systolic and diastolic readings
The physician suspects cardiogenic shock. Shock is
a) A failure of peripheral circulation
b) An irreversible phenomenon
c) Always caused by decreased blood volume
d) A fleeting reaction to tissue injury
a) A failure of peripheral circulation
The physical law explaining the greatly increased venous return accompanying mild vasoconstriction underlies the use of
a) Adrenaline in treating shock
b) Rotating tourniquets in pulmonary oedema
c) Sympathetomy in treating hypertension
d) Digoxin to increase cardiac output
a) Adrenaline in treating shock
Culturally safe nursing care can best be achieved when the nurse has
a) An in depth knowledge of the treaty of Waitangi
b) An awareness of maori perspectives of health
c) An awareness and acceptance of your own limits in meeting someone else’s health and cultural needs
d) A knowledge of maori protocol
c) An awareness and acceptance of your own limits in meeting someone else’s health and cultural needs
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
d) High transmissibility
The school nurse is caring for a child with haemophilia who is actively bleeding from the leg. Which of the following would the nurse apply
a) Direct pressure, checking every few minutes to see if the bleeding has stopped
b) Ice to the injured leg area several times a day
c) Direct pressure to the injured area continuously for 10 minutes
d) Ice bag with elevation of the leg twice a day
c) Direct pressure to the injured area continuously for 10 minutes
Home health nurses visit a blind diabetic patient who lives along to monitor the patients glucose level and administer the patients daily insulin. Evaluation of outcome management for this patient would include
a) An absence of complications of diabetes
b) A reduction in hospitalizations for glycemic control
c) The ability of the patient to learn to use adaptive syringes
d) The patients evaluation of the services provided by the nurses
a) An absence of complications of diabetes
Or
b) A reduction in hospitalizations for glycemic control
The nurse consults with the physician to arrange a referral for hospice care for a patient with end stage liver disease based on the knowledge that hospice care is indicated when
a) Family members can no longer care for dying patients at home
b) Patients and families are having difficulty coping with grief reactions
c) Preparation for death with palliative care and comfort are the goals of care
d) Patients have unmanageable pain and suffering as a result of their condition
c) Preparation for death with palliative care and comfort are the goals of care
Or
D
To better understand fluid balance the nurse needs to recognise that
a) Glomerular filtration occurs in the glomerular which are small arteries in the kidneys
b) The volume of urine secreted is regulated mainly by mechanisms that control the glomerular filtration rate
c) An increase in the hydrostatic pressure in bowman’s capsule tends to increase the glomerular filtration rate
d) A decrease in blood protein concentration tends to increase the glomerular filtration rate
c) An increase in the hydrostatic pressure in bowman’s capsule tends to increase the glomerular filtration rate
The client with unresolved oedema is most likely to develop
a) Thrombus formation
b) Tissue ischaemia
c) Proteinaemia
d) Contractures
C) Proteinaemia
Women are more susceptible to urinary tract infection because of
a) Poor hygienic practices
b) Length of urethra
c) Continuity of the mucous membrane
d) Inadequate fluid intakes
b) Length of urethra
The most important electrolyte of intracellular fluid is
a) Calcium
b) Sodium
c) Potassium
d) Chloride
c) Potassium
In encouraging hospitalised clients to void the most basic methods for the nurse to employ is
a) Having the client listen to running water
b) Warming a bedpan
c) Placing the clients hand in warm water
d) Providing privacy
d) Providing privacy
Since mr saul has right hemiplegia the nurse contributes to his rehabilitation by
a) Making a referral to the physio therapist
b) Not moving the affected arm and leg unless necessary
c) Beginning active exercise
d) Positioning mr saul to prevent deformity and decubiti
d) Positioning mr saul to prevent deformity and decubiti
Mr sauls emotions responses to his illness would probably be determined by
a) His premobid personality
b) The location of his lesion
c) The care he is receiving
d) His ability to understand his illness
d) His ability to understand his illness
Mrs olin, a retired school teacher with rheumatoid arthritis, is admitted to hospital with severe pain and swelling of the joints in both hands
Mrs olin’s condition would indicate that a primary consideration of her care is
a) Motivation
b) Education
c) Control of pain
d) Surgery
c) Control of pain
While taking a nursing history from mrs olin, the nurse promotes communication by
a) Asking questions that can be answered by a simple ‘yes’ or ‘no’
b) Telling mrs olin there’s no cause for alarm
c) Asking ‘why’ and ‘how’ questions’
d) Using broad, open ended statements
c) Asking ‘why’ and ‘how’ questions’
Mr and mrs B were emotionally upset when their baby girl, sue, was born with a cleft palate and double cleft lip
The nurse, in order to give the most support to he parents, should
a) Discourage them from talking about the baby
b) Encourage them to express their worries and fears
c) Tell them not to worry because the defect can be repaired
d) Show them post operative photographs of babies who had similar defects
b) Encourage them to express their worries and fears
The most critical factor in the immediate care of sue, after repair of the lip is
a) Maintenance of airway
b) Administration of drugs to reduce secretions
c) Administration of fluids
d) Preventing of vomiting
a) Maintenance of airway
Additional nursing care for sue after the original lip repair would include
a) Placing the baby in a semi sitting position
b) Keeping the infant from crying
c) Spoon feeding for the first two days after surgery
d) Keeping the baby nil per mouth
c) Spoon feeding for the first two days after surgery
Seven year old Johnny has been admitted for a tonsillectomy. The nurse suspects haemorrhage post operatively when Johnny
a) Snores noisily
b) Becomes pale
c) Complains of thirst
d) Swallows frequently
d) Swallows frequently
Pitting oedema in the lower extremities occurs with this problem because of the
a) Increase in tissue colloid osmotic pressure
b) Increase in the tissue hydrostatic pressure at the arterial end of the capillary bed
c) Decrease in the plasma colloid osmotic pressure
d) Increase in the plasma hydrostatic pressure at the venous end of the capillary beds
d) Increase in the plasma hydrostatic pressure at the venous end of the capillary beds
The nurse can best assess the degree of oedema in an extremity by
a) Checking for pitting
b) Weighing the client
c) Measuring the affected area
d) Observing intake and output
a) Checking for pitting
Mrs smith is hosptialised with coronary heart disease. She is receiving IV fluids, her vital signs are checked 4 hourly. She is on bed rest. She was also prescribed digoxin. She does not seem to be acutely sick but her prognosis is guarded. Mrs smith asks what the coronary arteries have to do with her angina. In determining the answer, the nurse should take into consideration that coronary arteries
a) Carry reduced oxygen content blood to the lungs
b) Carry blood from aorta to the myocardium
c) Supply blood to the endocardium
d) Carry high oxygen blood from the lungs towards the heart
b) Carry blood from aorta to the myocardium
After activity mrs smith states she has angina pain. The nurse should realise that angina pectoris is a sign of
a) Myocardial ischemia
b) Myocardial infarction
c) Coronary thrombosis
d) Mitral insufficiency
a) Myocardial ischemia
During therapy with salbutamol (venolin) mr peters complains of palpitation, chest pain, and a throbbing headache. In view of these symptoms which of the following statements represent the most appropriate nursing action
a Reassure mr peters that these effects are temporary and will subside as he becomes accustomed to the drug
b) Withhold the drug until additional orders are obtained from the physician
c) Tell him not to worry, he is experiencing expected side effects of medicine
d) Ask him to relax, then instruct him to breath slowly for several minutes
d) Ask him to relax, then instruct him to breath slowly for several minutes
Mr peters pulmonary function studies are abnormal. The nurse should realise that one of the most common complication of chronic asthma is
a) Athelectasis
b) Emphysema
c) Pneumothorax
d) Pulmonary fibrosis
d) Pulmonary fibrosis
Emphysema causes a failure in oxygen supply because of
a) Infectious obstructions
b) Respiratory muscle paralysis?
c) Pleural effusion
d) Loss of aerating surface
d) Loss of aerating surface
When the alveoli loose normal elasticity, the nurse teaches mr peters exercises that lead to effective use of the diaphragm because
a) Mr peters has an increase in the vital capacity of the lungs
b) The residual capacity of the lungs has been increased
c) Inspiration has been markedly prolonged and difficult
d) Abdominal breathing is an effective compensatory mechanism that is spontaneously initiated
b) The residual capacity of the lungs has been increased
Mr hurt has developed acute renal failure and uranemia. Metabolic acidosis develops in renal failure as a result of
a) depression of respiratory rate by metabolic wastes causing carbon dioxide retention
b) inability of renal tubules to secrete hydrogen ions and conserve bicarbonate
c) inability of renal tubules to reabsorb water to achieve dilution of acid contents of the blood
d) impaired glomerular filteration causing retention of sodium and metabolic waste products
b) inability of renal tubules to secrete hydrogen ions and conserve bicarbonate
of the following, which is most important in maintaining the fluid and electrolyte balance of the body
a) urinary system
b) respiratory system
c) antidiuretic hormone (ADH)
d) aldosterone
d) aldosterone
to prevent laryngeal spasms and respiratory arrest in a patient who is at risk for hypocalcemia, an early sign of hypocalcemia the nurse should assess for is
a) tetany
b) confusion
c) constipation
d) numbness and tingling around the lips or in the fingers
a) tetany
a 36 year old woman has been admitted to the hospital for knee surgery. Information obtained by the nurse during the preoperative assessment that should be reported to the surgeon before surgery is performed includes the patients
a) lack of knowledge about postoperative pain control
b) knowledge of the possibility of an early, unplanned pregnancy
c) history of a postoperative infection following a prior cholecystectomy
d) concern that she will be physically limited in caring for her children for a period postoperatively
b) knowledge of the possibility of an early, unplanned pregnancy
In is especially important for the nurse to determine the patients current use of medications during the preoperative assessment because
a) these medications may alter the patients perceptions about surgery
b) anaesthetics alter renal and hepatic function, causing toxicity by other drugs
c) other medications may cause interactions with anaesthetics, altering the potency and effect of the drugs
d) routine medications are usually withheld the day of surgery, requiring dosage and schedule adjustments
c) other medications may cause interactions with anaesthetics, altering the potency and effect of the drugs
A client with type 1 diabetes mellitus is scheduled to have surgery. The client has been nil per mouth since midnight in preparation for the surgery. In the morning before sending the client to the operating room, the nurse notices that the clients daily insulin has not been ordered. Which of the following interventions would be most appropriate for the nurse at this time
a) obtain the clients blood glucose values and evaluate the clients need for insulin
b) contact the physician for further orders regarding insulin administration
c) give the clients usual morning dose of insulin
d) notify the recovery room staff to obtain an order for insulin after the surgery
a) obtain the clients blood glucose values and evaluate the clients need for insulin
the nurse monitors a patient receiving high doses of broad spectrum antibiotics for treatment of endocarditis for the development of
a) erysipelas
b) candidiasis
c) tinea corporis
d) verruca vulgaris
b) candidiasis
the nurse is evaluating the effectiveness of fluid resuscitation during the emergent period of burn management. Which of the following indicates that adequate fluid replacement has been achieved in the client
a) an increase in body weight
b) fluid intake is less than urinary output
c) urinary output greater than 35 ml/hr
d) blood pressure of 90/60 mm Hg
c) urinary output greater than 35 ml/hr
cimetidine (tagamet) is prescribed for a patient with major burns. In teaching the patient about the drug, the nurse explains that it is used to prevent the development of
a) diarrhoea
b) constipation
c) adynamic ileus
d) curlings ulcer
d) curlings ulcer
A client who has had a transurethral resection of the prostate (TURP) 1 day earlier has a three way foley catheter inserted for continuous bladder irrigation. Which of the following statements best explains why continuous irrigation is used after a TURP
a) to control bleeding in the bladder
b) to instil antibiotics into the bladder
c) to keep the catheter free from clot obstruction
d) to prevent bladder distention
c) to keep the catheter free from clot obstruction
a patient in severe respiratory distress is admitted to the medical unit at the hospital. During the admission assessment of the patient, the nurse should
a) perform a comprehensive health history with the patient to determine the extent of prior respiratory problems
b) complete a full physical examination to determine the effect of the respiratory distress on other body functions
c) delay any physical assessment of the patient and ask family members about the patients history of respiratory problems
d) perform a physical assessment of the respiratory system and ask specific questions related to this episode of respiratory distress
d) perform a physical assessment of the respiratory system and ask specific questions related to this episode of respiratory distress
spinal anaesthesia effects all of the following systems except
a) the sympathetic nervous system
b) the sensory system
c) the parasympathetic nervous system
d) the motor system
c) the parasympathetic nervous system
following assessment of a patient with pneumonia, the nurse identifies a nursing diagnosis of ineffective airway clearance. The nurse bases this nursing diagnosis on the finding of
a) SpO2 of 85%
b) Respiratory rate of 28
c) Presence of greenish sputum
d) Crackles in the right and left lower lobes
d) Crackles in the right and left lower lobes
To protect susceptible patients in the hospital from aspiration pneumonia, the nurse
a) Turns and repositions immobile patients every 2 hours
b) Positions patients with altered consciousness in lateral positions
c) Monitors for respiratory symptoms in those patients who are immunosuppressed
d) Plans room assignments to prevent patients with infections from being placed with surgical or chronically ill patients
b) Positions patients with altered consciousness in lateral positions
A patient experiences a flail chest as a result of an automobile accident. Which finding during a respiratory assessment would the nurse expect
a) Bloody sputum
b) Laryngeal stridor
c) Deep, irregular respirations
d) Paradoxic chest movement
d) Paradoxic chest movement
A client is admitted to the emergency room with crushing chest injuries sustained in a car accident. Which of the following signs would indicate a possible pneumothorax
a) Cheyne stokes breathing
b) Increased noisy breath sounds
c) Diminished or absent breath sounds on the affected side
d) A decreased sensation on the affected side
c) Diminished or absent breath sounds on the affected side
Joan murray, aged 40 years, discovers a lump in the upper and outer quadrant of her left breast when she is showering one morning. One week later, after being seen by a surgeon, she is admitted to the ward for a biopsy of the lump and possible left radical mastectomy. In establishing a relationship with joan, what is the most important factor for the nurse to consider. That
a) The diagnosis has not yet been established and the breast lump is not necessarily malignant
b) Joan will have many questions about the possible effects of a mastectomy on her sexual identity
c) At this time of uncertainty, joan will need a lot of time to be alone to consider her choices
d) Joan will be full of fear about the mass and its possible effects on her being
d) Joan will be full of fear about the mass and its possible effects on her being
Part of joans pre operative preparation is practising arm and shoulder exercises. The reason for these exercises are
a) She can be assured of maximum function of her arm and shoulder if these exercises are carried out properly
b) That they help reduce the pain and the swelling in the area, after surgery
c) To assist peripheral venous return and thus reduce the potential for pulmonary embolus
d) By being involved in activities related to her care, joan is less likely to worry
c) To assist peripheral venous return and thus reduce the potential for pulmonary embolus
The reason we position joans affected arm with her elbow at the level of the right atrium and her hand higher than her elbow is to
a) Minimise the development of oedema
b) Assist venous return
c) Reduce her pain and discomfort
d) Ensure that the area is supported
a) Minimise the development of oedema
The primary ossification center of long bone is located in which of the following structures
a) Ephipysis
b) Epiphyseal plate
c) Diaphysis
d) Endosteum
c) Diaphysis
The body tissue affected by rheumatoid arthritis is
a) Adipose
b) Muscular
c) Connective
d) Epithelial
c) Connective
The pattern of rheumatoid arthritis is best describe by its
a) Chronicity
b) Remissions and exacerbations
c) Little relief from aches and pains
d) A progressive increase in disability
b) Remissions and exacerbations
Rheumatoid arthritis is characterized by
a) Bone pain
b) Sharp tingling sensations
c) Inflammation of the joints
d) Pain and swelling of joints
d) Pain and swelling of joints
Synovial joints are characterized by
a) articular cartilage
b) fibrous capsule
c) joint cavity
d) all of these
d) all of these
The major support that the muscular system gets from the cardiovascular system
a) a direct response by controlling the heart rate and the respiratory rate
b) constriction of blood vessels and decrease in heart rate for thermoregulatory control
c) nutrient and oxygen delivery and carbon dioxide removal
d) decreased volume of blood and rate of flow for maximal muscle contraction
c) nutrient and oxygen delivery and carbon dioxide removal
as the nurse assesses jack for increased intracranial pressure, she would be concerned if she observed
a) change in level of consciousness
b) anorexia and thirst
c) increased pulse and respiration rates
d) blurred vision and halos around lights
c) increased pulse and respiration rates
a person has just been involved in an accident that affected the medulla oblongata. The body process most directly affected by this would be
a) slight
b) hearing
c) muscular coordination
d) respiration
d) respiration
if you are dealing with a person whose phrenic nerve has been damaged, what would you expect to observe
a) reduced diaphragm function
b) less mucous secreted by the goblet cells
c) decreased elasticity of the lung tissue
d) increased coughing
a) reduced diaphragm function
the spinal cord extends through the vertebral canal from the foramen magnum to the
a) 7th cervical vertebra
b) 12th thoracic vertebra
c) 2nd lumbar vertebra
d) 1st sacral vertebra
c) 2nd lumbar vertebra
Synaptic conduction of a nerve impulse can be affected by
a) Certain diseases
b) Drugs
c) Changes in Ph
d) All of these
d) All of these
Lack of muscle coordination is called
a) Monoplegia
b) Ataxia
c) TIA
d) None of these
b) Ataxia
Inability of chew might result from damage to which cranial nerve
a) Facial
b) Trigeminal
c) Abducens
d) Vagus
b) Trigeminal
In most people, the left cerebral hemisphere is more important for which of the following
A) Spoken and written language
b) Space and pattern perception
c) Musical and artistic awareness
d) Imagination
A) Spoken and written language
Which of the following is true concerning the limbic system
a) It is comprised of parts of the cerebrum and diencephalon
b) It assumes a primary function in emotions
c) Both a and b
d) Neither a nor b
c) Both a and b
Coordination of muscular activity is a function of the
a) Cerebral peduncles
b) Cerebellum
c) Thalamus
d) Medulla oblongata
b) Cerebellum
Which of the following statements is correct
a) Appetite control is a function of the thalamus
b) The midbrain is a conduction pathway and reflex center
c) The cerebellum has sensory centers for thirst and speech
d) Respiratory centers are located in the basal ganglia
b) The midbrain is a conduction pathway and reflex center
The structure that connects the cerebral hemispheres and facilitates the sharing of cerebral information is the
a) Corpus callosum
b) Cingulated sulcus
c) Fourth ventricle
d) Aqueduct of sylvius
a) Corpus callosum
The portion of bone laid down first in bone formation is the
a) Matrix
b) Calcium salts
c) Trabeculae
d) Marrow
a) Matrix
The area of the greatest degree of flexibility along with the vertebral column is found from
a) C3 – C7
b) T1 – T6
c) T7 – T12
d) L1 – L5
a) C3 – C7
The only ankle bone that articulates with the tibia and the fibula is the
a) Calcaneus
b) Talus
c) Navicular
d) Cuboid
b) Talus
Severe fractures of the femoral neck have the highest complication rate of any fracture because
a) Primary limits are imposed by the surrounding muscles
b) Of the restrictions imposed by ligaments and capsular fibers
c) Of the thickenss and length of the bone
d) The blood supply to the region is relatively delicate
c) Of the thickenss and length of the bone
The purpose of myoglobin in skeletal muscle cells is
a) Assist anaerobic reactions
b) Store oxygen for use during vigorous exercise
c) Catabolise pyruvic acid
d) All of these
b) Store oxygen for use during vigorous exercise
With a milk product free diet, which of the following supplements would you need
a) Vitamin C and iron
b) Iron and phosphorous
c) Calcium and manganese
d) Vitamin c and riboflavin
c) Calcium and manganese
Protein should be eaten as it
a) Reduces the risk of anaemia
b) Ensures an adequate supply of energy
c) Assists the body to produce new tissues
d) Maintains the bodys protein stores
c) Assists the body to produce new tissues
Risk factors of CVA that cannot be altered are
a) Sex, race, and raised blood cholesterol levels
b) High BP, previous TIA
c) Race, prior stroke and overweight
d) High BP, previous TIA and increased blood cholesterol levels
a) Sex, race, and raised blood cholesterol levels
A person who has experienced a right CVA may present with
a) Receptive or expressive aphasia
b) Right hemiplegia
c) Left hemiplegia
d) Deficit of new language information
c) Left hemiplegia
Where and what is the circle of willis
a) A capillary meshwork found in bowmans capsule of the nephron
b) A vascular network at the base of the brain
c) A roundabout at the top of bank st (LOL!)
d) The capsule membrane of a malignant growth
b) A vascular network at the base of the brain
List the 3 main causes of stroke
a) Cerebral haemorrhage, thrombosis, embolism
b) Cerebral thrombosis, infarction, aneurysm
c) Cerebral embolism, metastatic lesions, coagulopathy
d) Cerebral ischemia, vascular spasms, hypoxia
a) Cerebral haemorrhage, thrombosis, embolism
Angina symptoms include
a) Radiating pain, decreased BP and increased pulse
b) Shortness of breath, loss of consciousness and these effects may last indefinitely
c) Ringing in the ears, anxiety and cramping in the extremities
d) Shortness of breath, sweating, nausea and tiredness
d) Shortness of breath, sweating, nausea and tiredness
Emphysema is
a) An alveolar disease
b) Due to hypertrophy and hyperplasia of bronchial glands
c) Persistent episodes of productive cough
d) An airway disease
a) An alveolar disease
The nurses act is administered by the
a) New Zealand nurses organisation
b) Nursing council of new Zealand
c) Division of nursing (department of health)
d) All of the above
b) Nursing council of new Zealand
The registrar of nurses is employed in the
a) Department of health
b) Nursing council
c) Nurses organisation
d) Hospital boards association
b) Nursing council
The nursing council is
a) A bureau in the department of health
b) A subcommittee of the nurses organisation
c) An incorporated society
d) A statutory body
d) A statutory body
The nursing council does all of the following except
a) Administer the nurses act
b) Administer the hospitals act
c) Approve schools of nursing
d) Issue practising certificates
b) Administer the hospitals act
The act which provides for the nursing council to have disciplinary jurisdiction over the conduct of registered and enrolled nurses is
a) The nurses act of 1977
b) The nurses regulation act of 1977
c) The hospital act of 1951
d) The area health board act of 1989
a) The nurses act of 1977
Nurses employed in any setting can have formal complaints made against them. By law to whom should these complaints be addressed
a) The medical superintendant
b) The registrar of the nursing council
c) The medical officer of health
d) The executive director of the nurses organisation
b) The registrar of the nursing council
The maintenance of standards, discipline, examinations and registration are administered by the nursing council under which act of parliament
a) Crimes act 1961
b) Nurses act 1977
c) Accident rehabilitation and compensation insurance act 1992
d) Official information act 1982
b) Nurses act 1977
As you prepare a client for surgery she states that although she has signed her consent form she doesn’t really understand what the doctor told her. She asks what sort of operation is she to have. You respond with
a) I’ll just give you your premedication and soon you’ll feel alright
b) You seem worried about your operation, would you like me to stay
c) I can see you are upset. I’ll get the doctor to explain the operation again to clarify if for you
d) You don’t have to worry, the doctors do this operation all the time
c) I can see you are upset. I’ll get the doctor to explain the operation again to clarify if for you
If a client is admitted and dies within 24 hours following surgery who must be notified by law
a) Significant others
b) Doctor
c) Medical superintendent
d) Coroner
d) Coroner
All of the following are a coroners case except
a) An unexpected death of client 24 hours after admission
b) Death of a client with an infectious disease
c) An unexpected death 24 hours after surgery
d) No established cause of death
b) Death of a client with an infectious disease
One of the relevant parts of the abortion act of 1977 is authorization for the performance of an abortion. Which statement is true
a) No abortion can be done unless authorized by 2 certifying consultants
b) Abortions can be performed anywhere where there are consultants
c) A woman who decides to have an abortion can ask a general practitioner
d) Only consultants can perform an abortion
a) No abortion can be done unless authorized by 2 certifying consultants
Which statement is true regarding consent for an abortion
a) A female of any age can consent to or refuse an abortion
b) A guardian or parent can consent to or refuse an abortion if a child is not of legal age
c) Only females under 16 years of age can give consent to an abortion
d) Only females over 16 years of age can give consent to an abortion
a) A female of any age can consent to or refuse an abortion
You note that a child you are caring for was given a double dose of Panadol. Your responsibility would be to
a) Ensure adequate airway and breathing
b) Fill out an incident form and inform the doctor
c) Inform the nurse who gave the medication
d) Keep it to yourself as no damage was apparent
b) Fill out an incident form and inform the doctor
Richard a 25 year old mildly retarded person was admitted to accident and emergency due to multiple fractures after a motor vehicle accident. Richard is to have an emergency laparotomy due to internal bleeding. The crimes act states that consent in the above case is
a) Implied from the circumstances surrounding the case and the need to take immediate action for the welfare of the individual
b) Written and must be freely given and fully understood if major surgery was to be performed
c) Mentally ill and demented clients must have a consent of a parent or a guardian or significant others representing them
d) Valid only if the client is 16 years and over or if married
a) Implied from the circumstances surrounding the case and the need to take immediate action for the welfare of the individual
Whilst in theatre a friend who knew Richard very well, rings to inquire about the client’s condition. You are the staff nurse on duty. The official secrets act of 1951 allows you to
A) Give the full information as he is a very close friend of the client
b) Give him the information as he is a member of the health profession
c) Give him information in general terms concerning the condition of the client
d) None of the above
c) Give him information in general terms concerning the condition of the client
After surgery Richard is taken to the intensive care unit but dies shortly thereafter. A legal responsibility in cases of unexplained death up to 24 hours after surgery is to
a) Lay the body out so that the family and friends can see the client
b) Send a coroners referral for investigation
c) Make sure the clients name and address and the circumstances surrounding the death are written in the 24 hours census book
d) Ensure that personal belonging are inspected and signed for by the family
b) Send a coroners referral for investigation
Debbie a 16 year old student is admitted in a semi conscious state with a history of a 58 pound weight loss in 3 months. Preliminary diagnosis is acute anorexia nervosa. Which of the following admission lab values should the nurse caring for Debbie consider to most critical
a) Glucose 80
b) Potassium 3.0
c) Sodium 144
d) Haemoglobin 10
d) Haemoglobin 10
Which vital sign would provide the most essential information in light of Debbie’s current lab values
a) Temperature
b) Pulse
c) Respirations
d) blood pressure
d) blood pressure
Nutritional assessments of Debbie during this acute stage should include all of the following except
a) Urine output
b) Level of consciousness
c) Skin turgor
d) Urine dextrostix
b) Level of consciousness
The nursing diagnosis of highest priority for Debbie in her acute anorexic episode would be
a) Alteration in nutrition: less than body requirements
b) Alteration in health maintenance
c) Fluid volume deficit
d) Disturbance in self concept
a) Alteration in nutrition: less than body requirements
Or c) fluid volume deficit
All of the following are common characteristics of anorexia nervosa except
a) Preoccupation with food
b) Fear of developing sexuality
c) Independence from parental and peer pressures
d) Distorted body image
b) Fear of developing sexuality
The nurse recognises that anorexic behaviour often stems from the clients desire
a) For self abuse or self mutilation
b) To punish herself for past behaviour through starvation
c) To gain control over an aspect of her life
d) To express hatred towards her parents
c) To gain control over an aspect of her life
The nurse should recognise that Debbie has recovered from her psychological conflicts associated with anorexia when she
a) Demonstrates an increase in weight
b) Demonstrates ser4um electrolytes within normal parameters
c) Reduces her exercise regimen to only once a day
d) Makes a date with a companion for dinner
d) Makes a date with a companion for dinner
Claire aged 30 and single, is brought to the mental health unit by her brother, who tells the nurse that she has become increasingly overactive and out of control over the past 2 months. She begins tasks but doesn’t complete them, takes little time to eat and sleep and spends large amounts of money and is now in debt. Which approach would be most therapeutic in working with Claire?
a) Teaching the patient about banking procedures, then extending this approach to everyday issues
b) Confronting the patient about all her inappropriate behaviour
c) kindly but firmly guiding the patient into such activities as bathing and eating
d) showing the patient that she is in a controlled environment so that no difficulties arise later
c) kindly but firmly guiding the patient into such activities as bathing and eating
Claire lost 15 lb (6.8kg) last week and now weighs 100 lb (45.4 kg). The nurse formulates a nursing diagnosis based on the diagnostic category altered nutrition: less than body requirements. Which goal is most appropriate initially
a) The patient will consume an adequate diet
b) The patient will maintain her current weight of 100lb
c) The patient will gain 1 lb (0.5 kg) per week
d) The patient will remain adequately hydrated
b) The patient will maintain her current weight of 100lb
The best approach to meeting claires hydration and nutrition needs would be to
a) Leave finger foods and liquids in her room and let her eat and drink as she moves about
b) Bring her to the dining room and encourage her to sit and eat with calm, quiet companions
c) Explain mealtime routines and allow her to make her own decisions about eating
d) Provide essential nutrition through high calorie gavage (naso gastric) feedings
d) Provide essential nutrition through high calorie gavage (naso gastric) feedings
The physician decides to start Claire on lithium therapy. Which of the following best describes her dietary requirements while she is receiving this medication
a) A high calorie diet with reduced sodium and adequate fluid intake
b) A regular diet with normal sodium and adequate fluid intake
c) A low calorie diet with reduced sodium and increased fluid intake
d) A regular diet with reduced sodium and adequate fluid intake
b) A regular diet with normal sodium and adequate fluid intake
A few days later, Claire tells the nurse, I’m so ashamed of myself. I don’t deserve to be here and be taken care of. Which action best demonstrates the nurses understanding of the patients needs
a) Expressing relief that Claire has recognised the foolishness of her behaviour
b) Calling a team meeting to increase protection against possible self destructive behaviour
c) Reporting to staff members that Claire appears to be developing insight into her behaviour
d) Telling Claire that she has done nothing that she should regret
b) Calling a team meeting to increase protection against possible self destructive behaviour
Claire would benefit most from which activity during the manic phase of her illness
a) Playing a game of badminton
b) Attending the units weekly bingo game
c) Putting together an intricate puzzle
d) Drawing or painting in her room
d) Drawing or painting in her room
Early signs of lithium toxicity include
a) Tremors nausea vomiting and diarrhoea
b) Ataxia, confusion and seizures
c) Elevated white blood cell count and orthostatic hypotension
d) Restlessness, shuffling gait and involuntary muscle movements
a) Tremors nausea vomiting and diarrhoea
The over activity observed in mania is believed to be a defence against underlying feelings of depression. Which of the following defence mechanisms best identifies this process
a) Displacement
b) Reaction formation
c) Projection
d) Denial
b) Reaction formation
Michelle aged 25 is found sitting on the floor of the bathroom in the treatment clinic with moderate lacerations to both wrists. Surrounded by broken glass, she sits staring blankly at her bleeding wrists while staff members call for an ambulance. How should the nurse approach Michelle initially
a) Enter the room quietly and move beside Michelle to assess her injuries
b) Call for staff backup before entering the room and restraining Michelle XZ
c) Move as much glass away from Michelle as possible and quietly sit next to her
d) Approach Michelle slowly while speaking in a calm voice, calling her name and telling her that the nurse is here to help her
d) Approach Michelle slowly while speaking in a calm voice, calling her name and telling her that the nurse is here to help her
Michelle is taken to the hospital and admitted on an emergency basis for 5 days compulsory assessment and treatment. Michelle says to the admitting nurse, im not staying here. I was a little upset and did a stupid thing. I want to leave. Which response is most appropriate
a) Unfortunately you have no right to leave at this time. You must be evaluated further
b) Cutting your wrists certainly was a stupid thing to do. What were you trying to accomplish anyway
c) You have been admitted on an emergency basis and can be held. You have the right to consult a lawyer about your admission
d) I can see you’re upset. Why don’t you try to relax? You can explain to the doctor what upset you. If what you say is true, you’ll be released sooner.
c) You have been admitted on an emergency basis and can be held. You have the right to consult a lawyer about your admission
Determining Michelle suicide potential during the mental status examination, involves assessing several factors, the most significant of which is her
a) History of previous suicide attempts
b) Suicide plan
c) Emotional state
d) Self esteem
b) Suicide plan
Michelle is placed on suicide precautions, which include constant observation. When the nurse accompanies her to the bathroom, Michelle complains, I can’t believe this. I can’t even go to the bathroom without being watched. How would you like to have me watching you go the toilet? Which response by the nurse is best
a) I’m sure i wouldn’t like it very much, but then i didn’t try to hurt myself
b) I’m sorry but these are the rules. Someone must be with you at all times
c) If it’s more comfortable for you, i can stand right outside as long as the door is open. Would you agree to that
d) I would probably feel uncomfortable too, but ensuring your safety is my first priority. I must stay in the room with you
d) I would probably feel uncomfortable too, but ensuring your safety is my first priority. I must stay in the room with you
After 5 days hospitalisation, Michelle is to be discharged and treated on an outpatient basis at the day treatment clinic. During the discharge planning, the nurse should set as a priority short term goal that Michelle will
a) Identify support systems to help manage stress
b) Verbalise feelings of shame regarding her suicide attempt
c) Demonstrate an uplifted mood and optimism about the future
d) Admit that her wrist slashing was an attention seeking behaviour and not a true suicide attempt
a) Identify support systems to help manage stress
Megan aged 26 enters the emergency room for treatment of an acute overdose of amitriptyline. Megan is very lethargic but rousable on admission. Gastric lavage is performed, and vital signs are stable when she is transferred to ICU for close observation. Of greatest concern during the next 48 hours would be
a) WBC of 6000
b) ECG changes
c) K+ value of 3.6
d) Slightly elevated TPR
b) ECG changes
Megan tells the ICU nurse, I’m sorry i didn’t die. Life is useless. Why did you have to save me? The best response of the nurse would be
a) You know you don’t mean that
b) It’s our job Megan. Nothing is ever that bad
c) I know you’re feeling hopeless. Tell me what’s happening
d) Let’s concentrate on getting well. In a few days you’ll feel differently
c) I know you’re feeling hopeless. Tell me what’s happening
Further history indicates Megan has been seeing a psychiatrist for depressive symptoms and has been diagnosed as having borderline personality disorder. The nurse would be most surprised to learn that this patient
a) Believes she has been chosen by god to be his special messenger on earth
b) Has a history of episodic substance abuse
c) Has made other suicide attempts
d) Has a pattern of unstable, intense relationships with others
a) Believes she has been chosen by god to be his special messenger on earth
Upon transfer to the psychiatric unit, Megan is informed by the admitting nurse that it will be necessary to check her belongings for any unsafe or banned items. She begins to scream angrily, what’s the matter with you. I’m upset. Get away from me. The nurse would first
a) Administer emergency tranquillizers as ordered
b) Place Megan in seclusion and restraints
c) Eliminate the belongings search so as to avoid upsetting her
d) Set verbal limits on her behaviour
d) Set verbal limits on her behaviour
Megan requests a weekend pass two days after transfer to the psychiatric unit. Her primary nurse, informs her following the treatment team meeting that the pass has not been approved. Megan responds angrily, they all hate me, they’re so mean. I know you’d have let me go. You’re the only decent nurse here. The nurses best response is
a) I would have approved it, but you’re right. I’m only one voice
b) I don’t think the others realise how hard you’ve been trying
c) Megan, you’ll never get a pass behaving this way
d) This was the team’s decision. Let’s talk about why we feel it’s not appropriate now
d) This was the team’s decision. Let’s talk about why we feel it’s not appropriate now
Megan’s behaviour in this situation illustrates the use of which defence mechanism
a) Splitting
b) Reaction formation
c) Conversion
d) Repression
a) Splitting
Megan’s doctor resumes her regular dosage of amitriptyline. Which affect of this medication might the staff and patient expect to see first
a) Elevated mood
b) Improved reality testing
c) Improved sleep pattern
d) Fewer hallucinations and delusions
a) Elevated mood
Mary is admitted under section 11 of the mental health assessment and treatment act (1992). The definition of mental disorder under the act includes all of the following except
a) A seriously diminished ability to care for oneself
b) Mental handicap and substance abuse
c) An abnormal state of mind
d) A serious danger to self or others
b) Mental handicap and substance abuse
Marys rights under the act include, the right
a) To information about her status, to respect of her cultural identity, to seek legal representation
b) To respect as a human being, to respect of her cultural values, to receive visitors and make phone calls
c) To information about her status, to receive treatment and health care, to change her treatment at her request
d) To receive visitors and make telephone calls, to refuse seclusion on cultural grounds, to seek a judicial inquiry
a) To information about her status, to respect of her cultural identity, to seek legal representation
When it is time for Mary to take medication, she says to you, you can’t make me take this; I’m only on an assessment section. Choose the best reply
a) This must seem confusing to you Mary, but under the act we can require you to take treatment
b) Under the act we can make you take medication and if you don’t we will have to give you an injection
c) I can see this must be confusing Mary, but you are right you are not required to take treatment on section 11
d) Section 11 is an assessment section but you can be required to take medication
a) This must seem confusing to you Mary, but under the act we can require you to take treatment
Mary asks for a review of her legal status. Your action would be
a) Explain that her status will be reviewed by the responsible clinician before the end of five days
b) Reassure her that you understand how frustrating it must be to be in hospital against her will
c) Offer to phone the client advocate on Marys behalf
d) Explain section 16 to Mary and allow her to phone the district inspector
d) Explain section 16 to Mary and allow her to phone the district inspector
A nurse finds john crouched in the corner of his room with a curtain covering him. His roommate is sitting on the bed laughing and saying ‘this guy is really a nut. He should be in a padded cell. How should the nurse respond to the roommate
a) Say I’m sure john’s behaviour is frightening to you. I understand that you are trying to cover up how you really feel by laughing
b) Say, ‘I’d appreciate it if you’d step outside for awhile. I’d like to talk with you after I help john’
c) Say nothing and attend to john
d) Say, in a neutral tone, ‘i think your laughing is making john feel worse. How would you feel if you were john’
b) Say, ‘I’d appreciate it if you’d step outside for awhile. I’d like to talk with you after I help john’
What is the least threatening approach to john while he sits huddled under the curtain
a) Sit next to him on the floor without speaking, and wait for him to acknowledge the nurse
b) Gently remove the curtain and say, ‘john, this is the nurse. What happened
c) Approach john slowly and say, ‘john this is the nurse. You appear to be very frightened. Can you tell me what you are experiencing
d) Call for assistance and do not approach john until at least two other staff members are present
c) Approach john slowly and say, ‘john this is the nurse. You appear to be very frightened. Can you tell me what you are experiencing
Because john has previously responded well to treatment with haloperidol (serenace), the doctor orders haloperidol 10mg orally twice a day. Which adverse effect is most common with this medication
a) Extrapyramidal symptoms
b) Hypotension
c) Drowsiness
d) Tardive dyskinesia
c) Drowsiness
During the next several days, john is observed laughing, yelling and talking to himself. His behaviour is characteristic of
a) Delusions
b) Looseness of association
c) Illusion
d) Hallucination
d) Hallucination
John tells the nurse, ‘the earth is doomed, you know. The ozone layer is being destroyed by hair spray. You should get away before you die.’ John appears frightened as he say this. The most helpful response is to
a) Say, ‘john i think you are overreacting. I know there is some concern about the earth’s ozone layer, but there is no immediate danger to anyone’
b) Say, ‘I’ve heard about the destruction of the ozone layer and its effect on the earth. Why don’t you tell me more about it’
c) Ignore john’s statement and redirect his attention to some activity on the unit
d) Say, ‘john is you saying you feel as though something bad will happen to you. I don’t believe we are in danger right now’
d) Say, ‘john is you saying you feel as though something bad will happen to you. I don’t believe we are in danger right now’
After a half hour, john continues to ramble about the ozone layer and being doomed to die. He paces in an increasingly agitated manner, and he begins to speak more loudly. At this time, the nurse should
a) Check to see whether the doctor ordered haloperidol PRN
b) Allow john to continue pacing but observe him closely
c) Try to involve john in a current events discussion group that is about to start
d) Tell john to go to his room for a while
c) Try to involve john in a current events discussion group that is about to start
After several months, john improves, and the doctor decides to change the medication to haloperidol decanoate (Haldol Decanoate). Why is this change made
a) Haloperidol decanoate is more effective
b) Haloperidol decanoate has fewer side effects
c) A change in medication produces a better response
d) Haloperidol decanoate can be given monthly instead of daily
d) Haloperidol decanoate can be given monthly instead of daily
Henry is brought to the mental health unit by his wife who states that for the past week her husband has refused all meals and accused her of poisoning him; he has become withdrawn, forgetful and inattentive and has frequent mood swings. Henry appears suspicious. His speech, which is only partly comprehensible, reveals that his thoughts are controlled by delusions of possession by the devil. He claims that the devil told him that people around him are trying to destroy him. The doctor diagnoses paranoid schizophrenia. Schizophrenia is best described as a disorder characterized by
a) Disturbed relationships related to an inability to communicate and think clearly
b) Severe mood swings and periods of low to high activity
c) Multiple personalities, one of which is more destructive than the others
d) Auditory and visual hallucinations
d) Auditory and visual hallucinations
The nursing assessment of Henry should include careful observation
a) Thinking, perceiving and decision making skills
b) Verbal and nonverbal communication processes
c) Affect and behaviour
d) Psychomotor activity
a) Thinking, perceiving and decision making skills
When communicating with Henry the nurse should initially
a) Remain silent and wait for Henry to speak first
b) Talk with Henry as one would talk with a healthy person
c) Allow Henry to do all the talking
d) Speak to Henry using simple, concrete language
d) Speak to Henry using simple, concrete language
The patients thought content can be evaluated on the basis of which assessment area
a) Presence or absence of delusions
b) Unbiased information from the patients psychiatric history
c) degree of orientation to person, place and time
d) Ability to think abstractly
a) Presence or absence of delusions
Henry mentions that voices are telling him that he is in danger and that he will be safe only if he stays in his room and avoids ‘zoids’ how should the nurse respond
a) I understand that these voices are real to you, but I want you to know that I do not here them
b) Don’t worry. I won’t let anything happen to you here.
c) What else can you tell me about the voices
d) Many patients hear voices when they come here. The voices will go away when you get better
c) What else can you tell me about the voices
The innermost layer of the eye is
a) Sclera
b) Retina
c) Choroid
d) Conjunctiva
b) Retina
The nurse observes henry pacing in his room. He is alone but talking in an angry tone. When asked what he was experiencing, he replies ‘the devil is yelling in my ear. He say people here want to hurt me’. The nurses best response is
a) Can you tell me more about what the devil is saying to you
b) How do you feel when the devil says such things to you
c) I don’t hear any voice, henry. Are you feeling afraid right now
d) Henry the devil cannot talk to you
c) I don’t hear any voice, henry. Are you feeling afraid right now
Henry has been hearing voices for many years. An approach that has proven effective is for the hallucinating patient to
a) Practice saying ‘go away’ or ‘stop’ when he hears voices
b) Take an as-needed dose of his psychotropic medication when ever hears voices
c) Sing loudly to drown out the voices and to distract himself
d) Go to his room until the voices go away
a) Practice saying ‘go away’ or ‘stop’ when he hears voices
Henry requests that his room be changed. He states that his roommate is homosexual and has been making advances to him. He wants to be in a private room. How should the nurse reply
a) Remind henry that he is in a hospital and not a hotel and tell him that patients are assigned to rooms on the basis of need
b) Tell henry that his request will be discussed that morning and if a room is available he will be moved
c) Inform henry that his roommate is not homosexual and that he should get to know him better
d) Ask henry if he is physically attracted to his roommate
a) Remind henry that he is in a hospital and not a hotel and tell him that patients are assigned to rooms on the basis of need
Physical activity is an important part of the schizophrenic patients treatment plan. Assuming henry is capable of the following activities which one is most appropriate for him
a) Taking a daily brisk walk with a staff member
b) Playing a basketball game
c) Participating in touch rugby
d) Playing tennis with another patient and a staff member
a) Taking a daily brisk walk with a staff member
Plans are being made for henrys discharge. His wife expresses concern over whether her husband will continue to take his prescribed medication. The nurse should inform her that
a) Her concern is valid but henry is an adult and has the right to make his own decisions
b) She can easily mix the medication in henrys food if he stops taking it
c) Henry can be given a long acting medication that is administered every 1 to 4 weeks
d) Henry knows that he must take his medications as prescribed to avoid future hospitalizations
c) Henry can be given a long acting medication that is administered every 1 to 4 weeks
The generic name for stelazine is
a) Chlorpromazine
b) Diazepam
c) Trifluoperazine
d) prochloperazine
c) Trifluoperazine
Circulatory shock can best be described as a condition in which there is
a) A state of hypotension
b) Loss of blood
c) Loss of consciousness due to blood loss
d) Inadequate blood flow to meet the metabolic needs of the body tissues
d) Inadequate blood flow to meet the metabolic needs of the body tissues
Causes of hypovolemic shock include
a) Vomiting and los of body fluids
b) Allergic reactions to drugs
c) Cardiac failure
d) Hypoglycaemia
a) Vomiting and los of body fluids
Early signs of hypovolemic shock include
a) Restlessness, thirst, and increased heart rate
b) Decreased blood pressure and apathy
c) Increase in heart rate and increased pulse pressure
d) Decreased blood pressure and unconsciousness
a) Restlessness, thirst, and increased heart rate
In shock, one of the best indicators of blood flow to viral organs is
a) Rate of blood and fluid administration
b) Blood pressure
c) The colour and temperature
d) Urine output
b) Blood pressure
A person admitted to the emergency room with trauma and an estimated blood loss of 1200 to 1400 mls has a blood pressure of 110/70 mmHg and a heart rate of 120 beats per minute. The best explanation for these observations would be that
a) The persons actual blood loss was less than the originally estimated loss
b) The person was normally hypertensive and hence did not have as great a drop in blood pressure as a normotensive person
c) The cause of the bleeding is now under control and the increased heart rate is due to anxiety
d) An increase in heart rate is compensating for the loss of blood volume
d) An increase in heart rate is compensating for the loss of blood volume
The pale, cool, clammy skin that is often observed in an individual with shock, can be explained in terms of
a) Loss of red blood cells
b) Bodys attempt to shunt blood to vital organs by constricting skin vessels
c) Decreased metabolic needs that accompany shock
d) Bodys attempt to conserve heat loss
b) Bodys attempt to shunt blood to vital organs by constricting skin vessels
____________________ is generally relieved by sitting up in a forward leaning position
a) Hyperpnoea
b) Orthopnoea
c) Apnoea
d) Dyspnoea on exertion
b) Orthopnoea
In a client with emphysema, hypoventilation could initially cause
a) Respiratory alkalosis
b) Respiratory acidosis
c) Metabolic acidosis
d) Metabolic alkalosis
b) Respiratory acidosis
A client is anxious and is hyperventilating. In order to prevent respiratory alkalosis the nurse will
a) Administer oxygen
b) Instruct the client to pant
c) Have the client breathe deeply and slowly
d) Have the client breathe into a paper bag
c) Have the client breathe deeply and slowly
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
b) Enlargement of the right ventricle
Tony buffer, 54 years old, has a long history of smoking. He decides to have lung and blood studies done because he is very tired, is short of breath, and just does not feel good. His blood gases reveal the following findings: pH 7.3; HCO3 27; CO2 58. Tonys condition may be
a) Respiratory alkalosis
b) Metabolic acidosis
c) Respiratory acidosis
d) Metabolic alkalosis
c) Respiratory acidosis
Approximately 1000ml (1L0 of oxygen is transported to cells each minute. Most of the oxygen is transported
a) Dissolved in his plasma
b) Loosely bound to his haemoglobin
c) In the form of CO2
d) As a free floating molecule
b) Loosely bound to his haemoglobin
Mary a 46 year old woman, is admitted to your ward with a chest infection due to an exacerbation of chronic obstructive pulmonary disease. A person with emphysema is susceptible to respiratory infections primarily because
a) Failure of his bone marrow to produce phagocytic white blood cells
b) Retention of tracheobronchial secretions
c) Decreased detoxification of body fluids by compressed liver cells
d) Persistent mouth breathing associated with dyspnoea
b) Retention of tracheobronchial secretions
Emphysema differs from chronic bronchitis in that
a) Emphysema obstruction results from mucous production and inflammation
b) Emphysema obstruction results from changes in lung tissues
c) Chronic bronchitis obstruction results from changes in lung tissue
d) There are no visual difference between the two conditions
b) Emphysema obstruction results from changes in lung tissues
The tissue change most characteristic of emphysema is
a) Accumulation of pus in the pleural space
b) Constriction of capillaries by fibrous tissue
c) Filling of air passages by inflammatory coagulum
d) Over distension, in elasticity, and rupture of alveoli
d) Over distension, in elasticity, and rupture of alveoli
Which of the following results of emphysema is primarily responsible for cardiomegaly
a) Hypertrophy of muscles encircling the bronchi
b) Increased pressure in the pulmonary circulation
c) Decreased number of circulating red blood cells
d) Secretion of excessive amounts of pericardial fluids
b) Increased pressure in the pulmonary circulation
A 48 year old complains of chest pain. Signs and symptoms that would support a diagnosis of myocardial infarction would include
a) Jugular vein distension and hypatomegaly
b) Fever and petechiae over the chest area
c) Nausea and vomiting and cool, clammy pale skin
d) Pericardial friction rub and absent apical pulse
c) Nausea and vomiting and cool, clammy pale skin
Teaching for the client taking GT or glycerol with nitrate for angina would include
a) Instructing the client to take the nitroglycerin regularly
b) Explain to the client that a subsequent headache indicates ineffective medication
c) Instructing the client to put the tablet on the tongue and swallow after the tablet dissolves
d) Teaching the client to take a tablet every 5 minutes (3x) when chest pain occurs
d) Teaching the client to take a tablet every 5 minutes (3x) when chest pain occurs
A female client is diagnosed with unstable angina. The nurse finds her crying because she fears she will become a burden to her husband. Which of the following nursing diagnosis would be most appropriate
a) Impaired verbal communication
b) Ineffective family coping
c) Relationship difficulties
d) Fear due to knowledge deficit
d) Fear due to knowledge deficit
Which of the following steps should a client with periodic angina pain take first when pain occurs at home
a) Take sublingual nitroglycerin and lie down
b) Do mild breathing exercises
c) Take an extra long lasting nitrate tablet
d) Sit down and relax
a) Take sublingual nitroglycerin and lie down
The nurse detects premature ventricular contractions and (PVC’s) on the ECG of a client who had a mitral valve replacement 2 days ago. PVC’s may be dangerous because they
a) Significantly increase cardiac workload
b) May lead to ventricular tachycardia or fibrillation
c) Are the most common cause of myocardial infarction
d) Decreased heart rate and blood pressure
b) May lead to ventricular tachycardia or fibrillation
A client is admitted to ED following a car accident. He complains of abdominal discomfort. The nurse encourages the client to lie down. The reason for this action is
a) To decrease abdominal pain
b) To decrease the risk of dislodging an intra abdominal clot
c) To facilitate peristalsis
d) To decrease the risk of peritoneal infection
b) To decrease the risk of dislodging an intra abdominal clot
A client sustained moderate concussion. He has a Glasgow coma scale score of 7. Which of the following interventions would you include in your care plan
a) Decrease stimuli, monitor vital signs and neurological status nurse him flat on his back
b) Gradually increase stimuli, monitor vital signs and neurological status, elevate the head of the bed 60 degrees
c) Encourage family involvement, reduce monitoring at night to allow client to rest, elevate the head of the bed 60 degrees
d) Decrease stimuli, monitor vital signs and neurological status elevate the head of the bed 30 degrees, positioning the client on his side
d) Decrease stimuli, monitor vital signs and neurological status elevate the head of the bed 30 degrees, positioning the client on his side
James has sustained a fracture of his left lower leg in a car accident. Classical signs of a fracture may include
a) Intermittent pain, flushing of surrounding tissues and vascular spasm
b) Local bone tenderness, soft tissue swelling and inability to use extremity
c) Neural compromise, sharp stabbing pain and obvious ischaemia of he extremity
d) Blanching, hyperextension and parasthesia
b) Local bone tenderness, soft tissue swelling and inability to use extremity
Monitoring for compartment syndrome is done by checking for
a) Active movement of the limb
b) Colour, warmth, sensation and movement of the extremity
c) Pulse and blood pressure changes
d) The tightness of the plaster cast
b) Colour, warmth, sensation and movement of the extremity
On assessment the nurse suspects that james is developing compartment syndrome because he complains of
a) Severe pain, motor compromise and a ‘pins and needles’ sensation
b) A radiating pain and loss of two point discrimination
c) Swelling, muscle atrophy and intermittent parasthesia
d) Dull aching, spasms and lack of fine co ordination
a) Severe pain, motor compromise and a ‘pins and needles’ sensation
A comminuted fracture is characterised by
a) A partial break in bone continuity
b) Injury in which two bones are crushed together
c) An injury in which the bone is broken into two or more pieces
d) An injury in which the bone fragments have broken through the skin
c) An injury in which the bone is broken into two or more pieces
Type 2 diabetics
a) Need insulin to maintain homeostasis
b) May develop ketoacidosis easily
c) May go undetected for years
d) Are usually very slim and malnourished
c) May go undetected for years
Hyperglycemia
a) Is alright only once in a while
b) Due to an over medication of insulin
c) If left uncontrolled, this can lead to DKA in type 1 or HNK in type 2
d) Also called insulin shock reaction
c) If left uncontrolled, this can lead to DKA in type 1 or HNK in type 2
Macrovascular complications of diabetes
a) Occur shortly after the onset of the disease
b) Affects coronary, peripheral and cerebral circulation
c) Affects the eyes and the kidneys
d) Affects sensorimotor and autonomic nerves
c) Affects the eyes and the kidneys
For relief of angina, the client may
a) Call 111
b) Take a dose of glyceryl trinitrate up to 3 times, 5 minutes apart until the pain subsides
c) Slowly exercise to the individuals tolerance level
d) Take only one dose of glyceryl trinitrate, if this has no effect, call 111
b) Take a dose of glyceryl trinitrate up to 3 times, 5 minutes apart until the pain subsides
Ways to minimise precipitating effects of angina are
a) Avoid over exertion
b) Reduce stress
c) Avoid overeating
d) All above
d) All above
Angina
a) May be referred to as angina majoralis
b) Not relieved by rest
c) Include chest pain which may radiate down the arms, neck, jaw and back
d) Needs immediate medical attention
c) Include chest pain which may radiate down the arms, neck, jaw and back
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
b) Mental confusion or restlessness
Following an application of a full arm cast a client complains of deep throbbing elbow pain. You note diminished capillary refill in the fingers. You should
a) Notify the doctor immediately and prepare to bivalve the cast
b) Cut a window in the cast over the elbow area and check for infection
c) Elevate the arm, apply ice packs and assess hourly
d) Administer prescribed analgesics and notify the doctor
a) Notify the doctor immediately and prepare to bivalve the cast
When assessing a patient at risk for increased intracranial pressure, the first thing you would check is
a) Reaction to pain stimuli
b) Papillary function
c) Level of consciousness
d) Motor function
c) Level of consciousness
Papillary dilation occurs when herniating brain tissue
a) Compresses the occulomotor nerve
b) Chokes the optic disks
c) Stretches the optic nerve
d) Paralyses the occulare muscles
a) Compresses the occulomotor nerve
Changes in vital signs with increasing intracranial pressure would include
a) Hypotension and tachycardia
b) Narrowing pulse pressure and tachypnea
c) Hypotension and a pulse deficit
d) Widening pulse pressure and bradycardia
d) Widening pulse pressure and bradycardia
Bleeding within the skull results in increased intracranial pressure because
a) Arteries bleed rapidly and profusely
b) Bleeding from veins goes undetected
c) Spinal fluid is produced more rapidly
d) The cranium is a closed, rigid vault
d) The cranium is a closed, rigid vault
What is the most common cause of heart failure (HF)
a) Smoking
b) Diabetes
c) Coronary artery disease
d) Family history
c) Coronary artery disease
The action of ACE inhibitors (angiotensin converting enzyme) is
a) Increased urinary output, therefore decreased blood pressure
b) Relax blood vessels, therefore decreased vascular resistance
c) Strengthens cardiac contraction, therefore increase cardiac output?
d) Relax cardiac muscle therefore decrease heart rate
b) Relax blood vessels, therefore decreased vascular resistance
Hyperkalemia is
a) Increased serum potassium levels
b) Increased serum calcium levels
c) Increased red blood cell count
d) Increased serum chloride levels
a) Increased serum potassium levels
Manifestations of heart failure are
a) Heaptomeglia, pitted dependant edema
b) Increased serum glucose levels
c) Increased appetite and weight gain
d) Decreased respiration and dyspnea
a) Heaptomeglia, pitted dependant edema
Nursing interventions associated with your clients taking loop diuretics such as frusimide are
a) Blood sugar levels, dietary fibre
b) Monitoring of weight and K+ levels
c) Blood pressure and urinary output
d) Make sure your client eats ½ hour following administration
b) Monitoring of weight and K+ levels
Loop diuretics act by
a) Increasing the blood flow to the glomerular network
b) Decreasing the blood flow to the kidneys therefore decreased urinary output
c) Increased H2O reabsorption in the distal convoluted tubules of the nephron
d) Inhibition complex active pump mechanism therefore increase excretion of electrolytes
d) Inhibition complex active pump mechanism therefore increase excretion of electrolytes
Blood pressure control is carried out by regulation of smooth muscles via
a) Parasympathetic stimulation
b) Parasympathetic and sympathetic stimulation
c) Sympathetic stimulation
d) None of these
b) Parasympathetic and sympathetic stimulation
The areas of the body that sense blood pressure are known as
a) Baroreceptors
b) Chemoreceptors
c) Viscoreceptors
d) None of these
a) Baroreceptors
When taking a blood pressure, the first sound picked up by the stethoscope as blood pulses through the artery is the
a) Mean arterial pressure
b) Pulse pressure
c) Diastolic pressure
d) Peak systolic pressure
d) Peak systolic pressure
At any given moment, the systemic circulation contains about _________________ of the total blood volume
a) 10%
b) 51%
c) 71%
d) 91%
d) 91%
The nurse gets the arterial blood gases report and it shows that a person has hypercapnia. This means that
a) There is an increased blood carbon dioxide
b) The blood oxygen level is reduced
c) Carbon dioxide has been lost
d) There is respiratory alkalosis
a) There is an increased blood carbon dioxide
Gregory, aged 70, was admitted with congestive heart failure. Which of these changes in physiology is present in congestive heart failure
a) Heart muscle degeneration due to old age
b) A decrease of blood flow through the heart
c) An abnormality in the structure of the heart
d) A blood clot forms in one of the heart chambers
b) A decrease of blood flow through the heart
Manifestations of right sided heart failure are
a) Fatigue, cyanosis, blood tinged sputum
b) Anorexia, complaints of gastrointestinal distress, fatigue and pitted edema
c) Dyspnea, orthopnea and cyanosis
d) Fatigue dependant edema and cough
b) Anorexia, complaints of gastrointestinal distress, fatigue and pitted edema
Nursing intervention necessary prior to the administration of digoxin is
a) Palpation of arterial pulse less than 60 bpm
b) Palpation of venous pulse less than 60 bpm
c) Palpation of arterial pulse greater than 60 bpm
d) Palpation of pedal pulse less than 60 bpm
c) Palpation of arterial pulse greater than 60 bpm
Left sided heart failure affects directly the
a) Liver and extremities
b) Lungs
c) Levels of consciousness
d) Lungs and extremities
b) Lungs
Basic nursing objectives in the treatment of HF are
a) Start heparinization immediately
b) Nursing the client in trendlenberg position
c) Promote rest therefore decrease workload on heart and decrease H20 accumulation
d) Assess levels of consciousness and give 02 61/min via Hudson mask
c) Promote rest therefore decrease workload on heart and decrease H20 accumulation
Define a cerebral vascular accident (CVA)
a) Sudden loss of consciousness due to a decreased contractility of the cardia
b) Loss of brain function due to disruption of blood supply to the brain
c) Intermittent spasms of blood vessels interrupting blood flow to the brain
d) Neurologic dysfunction due to diminished blood flow to the cranium
b) Loss of brain function due to disruption of blood supply to the brain
Cerebral thrombosis is
a) Most common cause of a stroke
b) Originates from a large vessel and lodges in the brain
c) May be caused by an arterial spasm in the brain
d) Usually occurs during strenuous exercise
b) Originates from a large vessel and lodges in the brain
The term blue bloater refers to
a) Decreased erythropoietin production therefore decreased 02 carrying capability of the RBC
b) Polycythemia and cyanosis from right ventricular failure
c) Cyanosis due to decreased RBC production
d) Increased BP due to high blood volume or fluid overload
a) Decreased erythropoietin production therefore decreased 02 carrying capability of the RBC
Bronchitis is
a) Results from a breakdown in the normal lung defence mechanisms
b) Destruction of alveolar
c) Due to enlarged terminal non respiratory bronchioles and alveolar walls
d) History of daily productive cough that last at least 3 months, for 2 years
a) Results from a breakdown in the normal lung defence mechanisms
Emphysema is characterised by
a) Fat people due to decreased activity tolerance
b) Unproductive cough and pursed lip breathing
c) Pursed lip breathing and productive cough
d) Blue bloater, normal skin colour and rapid respirations
c) Pursed lip breathing and productive cough
Nursing interventions for the CORD patient include everyone of these except
a) Improve ventilation
b) Remove secretions
c) Prevent complications
d) Promote cooperation and understanding
e) Encourage exercise to test tolerance levels
e) Encourage exercise to test tolerance levels
Bronchodilators
a) Aid the movement of secretions
b) Liquefy the sputum therefore increase expectoration
c) Include aminophylline for the acute exacerbation
d) Are only used in emergency cases
c) Include aminophylline for the acute exacerbation
Corticosteroids are used
a) Prophylactically in most cases
b) To aid in vitamin D synthesis
c) To aid the liquefaction and expectoration of sputum
d) Used during the acute exacerbation of CORD
a) Prophylactically in most cases
Pursed lip and diaphragmatic breathing
a) Calms the anxious client
b) Speed up slow respirations and used to promote effective coughing
c) Prevents bronehiolar collapse and air trapping
d) Encourages longer inhalation and faster exhalation
c) Prevents bronehiolar collapse and air trapping
Percussion, vibration and postural drainage
a) Is effective management of nursing frustrations
b) Promotes loosening secretions and movement out of airway
c) Increases blood supply to area therefore increased expectoration
d) Should be done prior to all meals
b) Promotes loosening secretions and movement out of airway
A normal blood sugar level (BSL) is
a) 7.35 – 7.45
b) 120 – 160 mm dL
c) 4 - 7 mmol/l
d) +/- 2 mmEq
c) 4 - 7 mmol/l
Diabetes is
a) An exocrine disorder
b) Decreased production of insulin by the liver
c) An endocrine disorder
d) Decreased secretion of insulin by the alpha cells in the pancreas
c) An endocrine disorder
Type I diabetics are characterised by
a) Non insulin dependence
b) Majority of the diabetic population
c) Require hypoglycaemic agents to maintain glucose levels
d) Need insulin to maintain normal BSL
d) Need insulin to maintain normal BSL
Angina is
a) Caused by a sudden blockage of one of the coronary arteries
b) Caused by anaerobic metabolism exciting pain receptors
c) Causes cardiac tissue necrosis and scaring
d) Interferes with cardiac contractility
b) Caused by anaerobic metabolism exciting pain receptors
Myocardial infarction (MI)
a) Causes irreversible tissue damage
b) The final extent of the damage depends on the ability of the surrounding tissue to recruit collateral circulation
c) 15% of all MIs are silent
d) All the above
d) All the above
MIs may be caused by
a) A formation of a thrombus in a coronary artery
b) Sudden progression of atherosclerotic changes
c) Prolong constriction of the arteries
d) All of the above
d) All of the above
Manifestations of an MI are
a) Bradycardia
b) Necrosis of a portion of the myocardium
c) Treated only by bypass surgery
d) Not seen on an ECG for 24 hours
b) Necrosis of a portion of the myocardium
Medications which are of the utmost importance for a patient following an MI are
a) 02
b) Stool softeners
c) Morphine
d) All of the above
a) 02
ACE inhibitors include
a) Catopril, enalapril
b) Propranolol, atenolol
c) Niphedipine, dittiazem
d) Frusemide
a) Catopril, enalapril
all “pril”
Antidiuretic hormone is
a) Secreted by the posterior pituitary
b) Increases glomerular filtration rate
c) Increases urinary output
d) Secreted by the hypothalamus
a) Secreted by the posterior pituitary
The renal system maintains homeostasis by
a) Maintaining electrolyte balances
b) Maintenance of blood volume
c) Conversion of vitamin D for calcium reabsorption
d) All of the above
d) All of the above
Prerenal failure may be caused by
a) Burns
b) Nephrotoxic drugs
c) Multiple transfusions
d) Renal calculi
b) Nephrotoxic drugs
Acute renal failure (ARF) is
a) Incurable
b) Only curable by kidney transplantation
c) Occurs suddenly and may be reversible
d) Characterised by polyuria
c) Occurs suddenly and may be reversible
Chronic renal failure (CRF)
a) Occurs suddenly and is reversible
b) Occurs over a long period of time and is reversible
c) Occurs over a long period of time and is irreversible
d) Is a nuisance by not fatal
c) Occurs over a long period of time and is irreversible
Chronic renal failure may be characterised by
a) Lethargy, mental confusion
b) Headaches, GI symptoms
c) General weakness and bleeding tendencies
d) All of the above
d) All of the above
Problems associated with CRF are
a) Polycythemia
b) Metabolic alkalosis
c) Accentuated sex drive
d) Reduced healing, susceptibility to infections
b) Metabolic alkalosis
Nursing interventions with a client with renal failure includes
a) Increase dietary protein
b) Increase fluid intake
c) Increase potassium intake – passed via urine
d) Maintain adequate nutritional status and decrease the metabolic demands
d) Maintain adequate nutritional status and decrease the metabolic demands
Malignant tumours have
a) Irregular shapes with poorly defined borders
b) Cells similar to their parent cells
c) Expansive growth
d) Fibrous capsule
a) Irregular shapes with poorly defined borders
Which of the following are not malignant
a) Sarcoma
b) Metastases
c) Neoplasm
d) Benign
d) Benign
Side effects of radiotherapy include
a) Burns, lethargy
b) Alopecia
c) Increased rate of cell division
d) Increased WBC production
a) Burns, lethargy
Cytotoxic therapy
a) Is used only as a last resort – a palliative care
b) May be used in conjunction with radiotherapy
c) Not to be given if radiotherapy is anticipated
d) Is used if surgery is impossible
b) May be used in conjunction with radiotherapy
Chemotherapy acts by
a) Attacking existing malignant cells and kills tumours
b) Decreases the blood supply to the tumour
c) Interferes with the cell division
d) Increases the clients feelings of wellness therefore giving a boost to cancer patients
a) Attacking existing malignant cells and kills tumours
Cancer clients pain is assessed by
a) The doctor
b) The health care team
c) The client
d) The family
c) The client
If paracetamol is no longer effective in the treatment of malignant pain
a) Strong opioids are prescribed
b) The end is near
c) Weak opioids and/or NSAIDS may be prescribed
d) The client needs hospitalisation for pain control
c) Weak opioids and/or NSAIDS may be prescribed
Important components of pain assessment include
a) Site of pain
b) Onset and patterns
c) Current therapy and effect
d) All of the above
d) All of the above
The world health organisations (WHO) analgesia ladder is
a) A systematic tool used for the identification of medications to prescribe for patients with cancer pain
b) Initial treatment includes simple analgesics, to progression of mild opioids to strong opioids
c) Opioids may be used in conjunction with anticonvulsant and antidepressant drugs to promote effectiveness
d) All of the above
d) All of the above
If your client is experiencing break through pain
a) They are not administering their medications correctly
b) Morphine should only be taken when pain is experienced
c) They may require a quick release morphine titrated to alleviate their pain
d) Start an IV and double the dose of morphine
c) They may require a quick release morphine titrated to alleviate their pain
Potential side effects of morphine administration for he alleviation of malignant pain are
a) Addiction
b) Constipation, nausea and vomiting
c) Antisocial behaviour
d) Once the maximum dose of morphine is reached, the pain may no longer be controlled
b) Constipation, nausea and vomiting
When an arterial blood gas (ABG) sample is taken, the initial nursing intervention should be
a) Assessing the movement of the extremity
b) Applying pressure to prevent an arterial bleed
c) Calming and educating the client to alleviate anxiety
d) All the above
b) Applying pressure to prevent an arterial bleed
Normal oxygen saturation values are
a) 80-100% saturation
b) 70-90% saturation
c) 90-100% saturation
d) 100% saturation
c) 90-100% saturation
Which patient is at highest risk for pulmonary embolus
a) A 25 year old man with a history of alcohol abuse recuperating from a gastric ulcer
b) A 36 year old woman on a liquid diet beginning an exercise programme
c) A 40 year old, obese, pregnant woman place on bed rest
d) A 90 year old man with no identified health problems
c) A 40 year old, obese, pregnant woman place on bed rest
James has sustained a fracture of his left lower leg in a car accident. Classical signs of a fracture may include
a) Intermittent pain, flushing of surrounding tissues and vascular spasm
b) Local bone tenderness, soft tissue swelling and inability to use extremity
c) Neural compromise, sharp stabbing pain and obvious ischaemia of the extremity
d) Blanching, hyperextension and parasthesia
b) Local bone tenderness, soft tissue swelling and inability to use extremity
Monitoring for compartment syndrome is done by checking for
a) Active movement of the limb
b) Colour, warmth, sensation and movement of the extremity
c) Pulse and blood pressure changes
d) The rightness of the plaster cast
b) Colour, warmth, sensation and movement of the extremity
On assessment, th nurse suspects that james is developing compartment syndrome because he complains of
a) Severe pain, motor compromise and a ‘pins and needles’ sensation
b) A radiating pain and loss of two point discrimination
c) Swelling, muscle atrophy and intermittent parasthesia
d) Dull aching, spasms and lack of fine co ordination
a) Severe pain, motor compromise and a ‘pins and needles’ sensation
Uraemia is a clinical syndrome associated with
a) Retention of urea and other nitrogenous wastes
b) The presence of urine in the blood
c) The presence of blood in the urine
d) High ammonia excretion
b) The presence of urine in the blood
Spinal anaesthesia is inserted into the
a) Intravenous space
b) Sacral canal
c) Dural membrane
d) Subarachnoid space
d) Subarachnoid space
The fluid outside the vascular system, which surrounds tissue cells, and which includes lymph is called
a) Interstitial fluid
b) Extracellular fluid
c) Intravascular fluid
d) Intracellular fluid
a) Interstitial fluid
When there is a decrease in blood volume (as in dehydration or blood loss), the body reacts by retaining sodium and thus water. This occurs mainly as a result of adrenal gland secretion of
a) Aldosterone
b) Antidiuretic hormone (ADH)
c) Cortisol
d) Parathyroid hormone
a) Aldosterone
To monitor abdominal distension, you would
a) Assess bowel sounds every shift
b) Measure abdominal girth at the umbilicus every 24 hours
c) Measure abdominal girth every shift, using two fixed points
d) Weigh the patient every shift
c) Measure abdominal girth every shift, using two fixed points ????
Which of the following is a defining characteristic for a nursing diagnosis of ‘fluid volume deficit’
a) Distended neck veins
b) Weak, rapid pulse
c) Moist rales in lungs
d) Bounding, full pulse
b) Weak, rapid pulse
The nurse should assess carefully for hypervolaemia, (fluid volume excess) when working with the client with
a) Nausea and vomiting
b) Kidney failure
c) Decreased fluid intake
d) Blood loss
b) Kidney failure
Which is probably the most accurate indication of a clients fluid balance status
a) Intake and output record
b) Skin turgor
c) Daily weight
d) Complete blood count
c) Daily weight
When you check the time tape on your clients IV bag, you note that the proper amount has not been infused. The prescribed rate is 200 ml/hour, but in the past hour only 100 mls have infused. Your first action should be to
a) Call the physician for a new order
b) Adjust the roller clamp and increase the rate to 300 ml/hour to ‘catch up’
c) Restart the IV at a different site
d) Count the drops per minute to be sure it is running at a rate of 200 ml/hour
d) Count the drops per minute to be sure it is running at a rate of 200 ml/hour
In evaluating for complications of IV therapy, which of the following are evidence that the IV has infiltrated
a) In the past hour, only 50 ml of fluid have infused
b) The insertion site is red, hot and swollen
c) The clients temperature has gone up to 38.oC
d) The site is pale, cool, swollen and painful
d) The site is pale, cool, swollen and painful
Swelling and paleness of the skin at the venipuncture site could be indicative of
a) Infiltration
b) Phlebitis
c) Infection
d) Air embolism
a) Infiltration
Mr smith is to have one litre of normal saline IV over 6 hours. The giving set has a drop factor of 10. The correct flow rate would be
a) 14 dpm
b) 28 dpm
c) 140 dpm
d) 280 dpm
b) 28 dpm
John has been prescribed dextrose/saline 125 mls per hour IV. The giving set has a drop factor of 60. The correct flow rate would be
a) 125 dpm
b) 120 dpm
c) 60 dpm
d) 65 dpm
a) 125 dpm
Hone has been prescribed plasmolyte 500 mls over 2 hours IV. The giving set has a drop factor of 10. The correct flow rate would be
a) 24 dpm
b) 42 dpm
c) 84 dpm
d) 48 dpm
b) 42 dpm
The optimal position for the comatose patient is
a) Prone
b) Supine
c) Semi fowlers
d) Side lying
c) Semi fowlers
Which of the following would a nurse be testing if she asked a 65 year old patient questions like, ‘what day is it’, ‘what time is it’, ‘what month is it’
a) Intelligence
b) Perception
c) Orientation
d) Personality
c) Orientation
When a person experiences loss or decreased sensation of pain, temperature and touch, the major nursing concern will be meetin their need for
a) Communication
b) Nutrition
c) Safety
d) Belonging
c) Safety
When caring for a patient with aphasia, you should
a) Talk loudly so she can hear you
b) Refrain from giving explanations about procedures
c) Provide as much environmental stimuli as possible to prevent feelings of isolation
d) Consider the type that the person has and adapt communications methods accordingly
d) Consider the type that the person has and adapt communications methods accordingly
Narcotics are given as preanaesthetic medications to
a) Decrease oral secretions
b) Reduce the risk of intra operation DUT
c) Decrease postoperative pain
d) Reduce postoperative nausea and vomiting
a) Decrease oral secretions
Clinical manifestations of hypovolaemic shock include all except
a) A fall in blood pressure
b) A decreased urinary output
c) A weak, rapid, thread pulse
d) Warm, moist skin
d) Warm, moist skin
You clients physician writes an order for antibiotics stat that you feel is too high a dosage for that client. What should your reaction to this order be
a) Administer the drug as prescribed since the physician is legally responsible for any mistakes in the order
b) Check with the prescribing physician before administering the drug
c) Administer the drug first since it is a stat drug, and then check with the physician
d) Check with the client about dosages administered to him in the past and compare this response to the ordered dosage
b) Check with the prescribing physician before administering the drug
Miss blake has suddenly had a cardiac arrest. What is the critical time period that the nurse must keep in mind before irreversible brain damage occurs
a) 1-3 minutes
b) 8-10 minutes
c) 2-4 minutes
d) 4-6 minutes
a) 1-3 minutes
David white is in the hospital with a medical diagnosis of viral pneumonia. He is getting oxygen via a simple face mask. Why must it fit snugly over the clients face
a) Prevents mask movement and consequent skin breakdown
b) Helps the client feel secure
c) Maintains carbon dioxide retention
d) Aids in maintaining expected oxygen delivery
d) Aids in maintaining expected oxygen delivery
The Heimlich manoeuvre is described in which of the following statements
a) Arms encircling persons waist from behind with firm abdominal thrusts
b) Quick, forceful blow with fist on clients sternum
c) Sweeping out foreign objects from clients mouth with fingers
d) Sharp blow on centre of clients back
a) Arms encircling persons waist from behind with firm abdominal thrusts
In teaching a patient about foods that affect his fluid balance, the nurse will keep in mind that the electrolyte which primarily controls water distribution throughout the body is
a) Sodium
b) Potassium
c) Calcium
d) Magnesium
a) Sodium
Mrs zikes is receiving frequent medication. Which of the following would be the correct identification procedure
a) Check the identification bracelet and call mrs zikes by name
b) Check the name on the foot of the bed, and check the identification bracelet
c) Call mrs zikes by name, this is all that is needed
d) Ask mrs zikes her name, and check her identification bracelet
d) Ask mrs zikes her name, and check her identification bracelet
When you answer the clients call light, you note that he has suffered a wound evisceration. Your response will be to
a) Call the physician immediately for offers. Do not touch the wound
b) Cover the wound with sterile dressing, call the lab to do a culture and then call the physician
c) Cover the wound with sterile, saline soaked towels and immediately notify the physician
d) Take the clients vital signs, cover the wound with a sterile towel and call the physician
c) Cover the wound with sterile, saline soaked towels and immediately notify the physician
Which surgical consent would NOT be considered legal
a) Consent signed by a 36 year old lady one hour after receiving her preoperative medication of morphine
b) Consent signed by 21 year old man who has fractured leg due to an auto accident
c) Telephone consent from the father to perform an emergency surgery on a 17 year old girl
d) Consent signed by a 60 year old man the evening prior to surgery and prior to his evening sedative
a) Consent signed by a 36 year old lady one hour after receiving her preoperative medication of morphine
Which statement by the nurse would be most therapeutic when the client says ‘ my friend has a terrible scar from her surgery’
a) Don’t worry, your surgeon is very good
b) You need the surgery, and a little scarring is okay
C) Are you concerned about how your surgical scar will look
d) I wouldn’t worry about that right now, all people are different
C) Are you concerned about how your surgical scar will look
Several screening tests are performed on clients preoperatively. Which test demonstrates the presence of bleeding or anaemia
a) An elevated white blood cell count
b) Decreased haemoglobin and hematocrit
c) Elevated blood urea nitrogen
d) Hypokalemia
b) Decreased haemoglobin and hematocrit
Leg exercises are taught to clients in order to increase venous return and prevent thrombophylebitis. Which step of this procedure is incorrect
a) Alternately dorsiflex and plantar flex toes
b) Flex and extend the knee
c) Raise and lower each leg
d) Repeat exercise every one to two hours
b) Flex and extend the knee
Two days post surgery ms D continues to complain of pain. There are a number of interventions available for pain relief. Which comfort measure has the potential of increasing ms Daniels risk for cardiovascular complications
a) Turn ms D every two hours
b) Place pillows under ms Ds knees
c) Splint ms Ds abdomen when she coughs
d) Encourage ambulation as tolerated
d) Encourage ambulation as tolerated
our client develops a fever and complaints of calf pain over an area that is red and swollen. Nursing interventions for thrombophlebitis will include all except
a) Elevate the affected leg to heart level
b) Maintain bedrest as ordered
c) Measure bilateral calf circumference every shift
d) Massage the affected calf
d) Massage the affected calf
Which of the following is an autonomic nervous system response to acute pain
a) Decreased heart rate
b) Decreased depth of respiration
c) Pupil constriction
d) Increased blood pressure
d) Increased blood pressure
Which of the following is a natural opiate of the brain involved in the analgesic system
a) Endorphins
b) Histamine
c) Colalgenase
d) Neurotensin
a) Endorphins
Judgement and caution must be used when nonpharmacologic interventions are applied in the treatment of acute pain because
a) No proof exists that they work
b) They are very expensive to implement
c) They are outside the scope of nursing practice
d) They do not guarantee pain relief
d) They do not guarantee pain relief
If morphine is given intravenously, regularly as post operative analgesia for 10 days to a multiple trauma patient, what is the possibility that this patient would become addicted to the narcotic
a) Almost never
b) Sometimes
c) Often
d) Almost always
c) Often
A malignant neoplasm
a) Grows very slowly
b) Is usually surrounded by a well defined capsule
c) Consists of cells that only form tissues in a very disorganised manner
d) Is composed of goblet cells
c) Consists of cells that only form tissues in a very disorganised manner
Which of the following characteristics generally differentiate malignant tumours from benign tumours
1 lack of a capsule
2 more rapid growth
3 infiltrates normal tissues
4 respects other cells boundaries
a) 1, 2 and 3
b) 1, 2 and 4
c) 1, 3 and 4
d) 2, 3 and 4
a) 1, 2 and 3
Malignant tumors and leukaemias may be treated with chemotherapy. The primary aims of this therapy is to
1 attack newly developing cancer cells
2 reduce the size of a tumour
3 build up a persons defence system
4 reduce the oxygen bearing capacity of the blood
5 destroy cancer cells and leave normal cells
a) 1, 2 and 3
b) 1, 2 and 5
c) 2, 3 and 4
d) 2, 3 and 5
b) 1, 2 and 5
During chemotherapy, soreness of the mouth and anus may develop because
a) The effects of the chemotherapeutic agents concentrate in these body areas
b) These tissues normally divide rapidly and are damaged by chemotherapeutic agents
c) The entire GI tract is involved because of the direct irritating effects of chemotherapy
d) The tissues have become damaged from prolonged vomiting and diarrhoea
b) These tissues normally divide rapidly and are damaged by chemotherapeutic agents
Which of the following should be considered in order to avoid skin reactions following radiotherapy
1 not to apply ointments or lotions
2 not to vigorously dry the skin
3 to apply powder p.r.n
4 to keep the skin area dry and open to air
5 to avoid exposure to sunlight
a) 1, 2 and 3
b) 2, 3 and 5
c) 3, 4 and 5
d) 1, 2, 4 and 5
e) 2, 3, 4 and 5
e) 2, 3, 4 and 5
A common problem after open cholecystectomy is shallow breathing. This is mainly due to
a) The site of the incision making breathing painful
b) Damage to the phrenic nerves during surgery
c) The obese state of most patients pre operatively
d) Inadequate pre operative instruction
a) The site of the incision making breathing painful
Chest problems may best be prevented after cholecystectomy by
1 giving the patient oxygen
2 regular deep breathing and coughing
3 keeping the patients pain minimised
4 prophylactic antibiotic therapy
5 keeping the patient rested and warm
a) 1 and 3
b) 1 and 4
c) 2 and 3
d) 2 and 4
c) 2 and 3
Your client suffers from nausea and vomiting in the early post operative period. Vomiting at this time is most likely due to
a) Volvulus
b) Phrenic irritation
c) Effect of anaesthetic
d) Paralytic ileus
c) Effect of anaesthetic
Mrs S is scheduled for a cholecystectomy and asks you how she will manage without a gallbladder. Your best reply is
a) Dilute bile will still pass into your digestive tract but will be less efficient at digesting fat
b) Your liver will no longer produce bile now so you must stay strictly off fatty foods
c) Your gallbladder was not a very important organ and you will not miss it
d) You can take a bile supplement in your diet to compensate
a) Dilute bile will still pass into your digestive tract but will be less efficient at digesting fat
An intravenous infusion of 500 ml dextrose/saline through a metriset infusion set (60 drops per ml) is ordered to run over 6 hours. Calculate the drops per minute
a) 137
b) 36
c) 60
d) 83
d) 83
An injection of morphine 7.5 mg is required – on hand are ampoules containing 10 mg per ml. Calculate the volume to be drawn up
a) 0.5 ml
b) 0.6 ml
c) 0.65 ml
d) 0.7 ml
e) 0.75 ml
e) 0.75 ml
Your patient is charted 1 L normal saline 12 hourly via an IV line (drop factor 10). Calculate the correct drops per minute (d.p.m)
a) 8
b) 12
c) 14
d) 20
e) 24
c) 14
If the drop factor is 15, how fast should an infusion of 1000 ml normal saline run over 10 hours
a) 15 dpm
b) 20 dpm
c) 25 dpm
d) 40 dpm
c) 25 dpm
Mrs graham is an active, retired 62 year old. She has been admitted for investigation of possible renal calcili. Which of the following investigations would be most useful in confirming Mrs G’s provisional diagnosis of renal calculi
a) Cystoscopy
b) Intravenous pyelogram
c) Renal biopsy
d) Urinary electrolytes
b) Intravenous pyelogram
Mrs S, aged 56, has undergone elective abdominal surgery. In the evening of the day of surgery she feels that she wants to pass urine but is unable to do so. The nurse could best assist her to micturate by
1 applying manual pressure to the suprapubic region
2 assisting her to sit at the edge of the bed and use a pan – couldn’t sit on bedside of day of operation??
3 encouraging her to increase her fluid intake
4 changing her position, ensuring comfort and giving pain relief
5 emptying her bladder to give relief by use of a urinary catheter
a) 1 and 3
b) 1 and 4
c) 2 and 3
d) 2 and 4
d) 2 and 4
Nji - Nasojejunal insertion?
a) Intellectual
b) Interpersonal
c) Technical
d) Mechanical
c) Technical
Which of the following peripheral pulses is the most common site for obtaining a pulse in an emergency
a) Carotid artery
b) Radial artery
c) Brachial artery
d) Temporal artery
a) Carotid artery
Culturally safe nursing practice involves
a) Relating to all clients in a neutral manner regardless of their cultural heritage
b) Asking clients about knowledge of their own cultural heritage
c) Ensuring clients are nursed by nurses from their own culture
d) Using appropriate resources to meet clients identified needs
d) Using appropriate resources to meet clients identified needs
The nurse notifies the physician when it is determined that an adult male clients pulse is 52 beats per minute because the client is experiencing
a) Cardiovascular collapse
b) Bradycardia
c) Tachycardia
d) Dysrhythmia
b) Bradycardia
Potential sources of client data useful to the nurse for a comprehensive assessment include
a) client
b) family
c) medical records
d) all of the above
d) all of the above
vital signs are measured to order to
a) regulate the clients condition within a narrow range
b) provide clues to the physiologic functioning of the body
c) comply with the doctors order for vital signs to be taken at prescribed intervals
d) assess the psychological status of the client
b) provide clues to the physiologic functioning of the body
in effective communication, the course sends a message to the receiver. Which of the following describes the process by which reception and comprehension of the message are verified
a) noise
b) feedback
c) channel
d) decoder
b) feedback
the frequency of assessing vital signs depends upon the
a) doctors orders
b) nurses discretion
c) availability of personnel
d) patients condition
d) patients condition
where should the stethoscope be placed upon the apical pulse?
a) fifth intercostals space at left midclavicular line
b) the epigastric area at the tip of the sternum
c) third intercostals space over the right ventricle
d) between the aortic and tricuspid areas
a) fifth intercostals space at left midclavicular line
which of the following best indicates good blood circulation to the extremities
a) blood pressure in normal range
b) dorsalis pedis pulses strong and equal bilaterally
c) mucous membranes pink and moist
d) venous patterns readily identifiable
b) dorsalis pedis pulses strong and equal bilaterally
measuring the clients response to nursing interventions and the clients progress toward achieving goals is done during which phase of the nursing process
a) planning
b) nursing diagnosis
c) evaluation
d) assessment
c) evaluation
the primary source of data for evaluation is the
a) physician
b) client
C) nurse
d) medical record
b) client
the criteria for determining the effectiveness of nursing actions are based on the
a) nursing diagnosis
b) expected outcome
c) clients satisfaction
d) nursing interventions
b) expected outcome
the planning step of the nursing process includes which of the following activities
a) assessing and diagnosing
b) evaluating goal achievement
c) performing nursing actions and documenting them
d) setting goals and selecting interventions
d) setting goals and selecting interventions
the nursing care plan is
a) a written guideline for implementation and evaluation
b) a documentation of client care
c) a projection of potential alterations in client behaviours
d) a tool to set goals and project outcomes
a) a written guideline for implementation and evaluation
the nurses act is administered by the
a) new Zealand nurses organisation
b) nursing council of new Zealand
c) division of nursing (department of health)
d) all of the above
b) nursing council of new Zealand
the nursing council does all of the following except
a) administer the nurses act
b) administer the hospitals act
c) approve schools of nursing
d) issue practising certificates
b) administer the hospitals act
the act which provides for the nursing council to have disciplinary jurisdiction over the conduct of registered and enrolled nurses is
a) the nurses act of 1977
b) the nurses regulation act of 1977
c) the hospital act of 1951
d) the area health board act of 1989
a) the nurses act of 1977
nurses employed in any setting can be formal complaint is made against them. By law to whom should these complaints be addressed
a) the medical superintendent
b) the registrar of the nursing council
c) the medical officer of health
d) the executive director of the nurses organisation
b) the registrar of the nursing council
the maintenance of standards, discipline, examinations are administered by the nursing council under which act of parliament
a) crimes act 1961
b) nurses act 1977
c) accident rehabilitation and compensation insurance act
d) official information act 1982
b) nurses act 1977
as you prepare a client for surgery she states that although she has signed her consent form she doesn’t really understand what the doctor told her. She asks what sort of operation is she to have. You respond with
a) ill just give you your pre medication and soon youll be alright
b) you seem worried about your operation, would you like to stay
c) I can see you are upset. Ill get the doctor to explain the operation again to clarify if for you
d) You don’t have to worry, the doctors do this operation all time
c) I can see you are upset. Ill get the doctor to explain the operation again to clarify if for you
All of the following are a coroners case except
a) An unexpected death of client 24 hours after admission
b) Death of a client with an infectious disease
c) An unexpected death 24 hours after surgery
d) No established cause of death
b) Death of a client with an infectious disease
Richard a 25 year old mildly retarded person was admitted to accident and emergency due to multiple fractures after a motor bike accident. Richard is to have an emergency laparotomy due to internal bleeding. The crimes act states that consent in the above case is
a) Implied from the circumstances surrounding the case and the need to take immediate action for the welfare of the individual
b) Written and must be freely given and fully understood if major surgery was to be performed
c) Mentally ill and demented clients must have a consent of a parent or a guardian or significant others representing them
d) Valid only if the client is 16 years and over or if married
a) Implied from the circumstances surrounding the case and the need to take immediate action for the welfare of the individual
Whilst in theatre, a friend who knew Richard very well, rings to inquire about the clients condition. You are the staff nurse on duty. The official secrets act of 1951 allows you to
a) Give the full information as he is a very close friend of the client
b) Give him the information as he is a member of the health profession
c) Give him information in general terms concerning the condition of the client
d) None of the above
d) None of the above
After surgery Richard is taken to the intensive care unit but dies shortly thereafter. A legal responsibility in cases of unexplained death up to 24 hours after surgery is to
a) Lay the body out so that the family and friends can see the client
b) Send a coroners referral for investigation
c) Make sure the clients name and address and the circumstances surrounding the death are written in the 24 hours census book
d) Ensure that personal belonging are inspected and signed for by the family
b) Send a coroners referral for investigation
Debbie a 16 year old student, is admitted in a semi conscious state with a history of a 58 pound weight loss in 3 months. Preliminary diagnosis is acute anorexia nervosa. Which of the following admissions lab values should the nurse caring for Debbie consider to most critical
a) Glucose 80
b) Potassium 3.0
c) Sodium 144
d) Haemoglobin 10
d) Haemoglobin 10
Which vital sign would provide the most essential information in light of debbies current lab values
a) Temperature
b) Pulse
c) Respirations
d) Blood pressure
d) Blood pressure
Which approach would be most therapeutic in working with Claire
a) Teaching the patient about banking procedures, then extending this approach to everyday issues
b) Confronting the patient about all her inappropriate behaviour
c) Kindly but firmly guiding the patient into such activities such as bathing and eating
d) Showing the patient that she is in a controlled environment so that no difficulties arise later
c) Kindly but firmly guiding the patient into such activities such as bathing and eating
Claire lost 15lb last week and now weights 100lb. the nurse formulates a nursing diagnosis based on the diagnostic category altered nutrition: less than body requirements. Which goal is most appropriate initially
a) The patient will consume an adequate diet
b) The patient will maintain her current weight of 100lb
c) The patient will gain 1lb per week
d) The patient will remain adequately hydrated
d) The patient will remain adequately hydrated
The best approach to meeting claires hydration and nutrition needs would be to
a) Leave finger foods and liquids in her room and let her eat and drink as she moves about
b) Bring her to the dining room and encourage her to sit and eat with calm, quiet companions
c) Explain meal time routines and allow her to make own decisions about eating
d) Provide essential nutrition through high calorie gavage (naso gastric) feedings
d) Provide essential nutrition through high calorie gavage (naso gastric) feedings
The physician decides to start Claire on lithium therapy. Which of the following best describes her dietary requirements while she is receiving this medication
a) A high calorie diet with reduced sodium and adequate fluid intake
b) A regular diet with normal sodium and fluid adequate intake
c) A low calorie diet with reduced sodium and increased fluid intake
d) A regular diet with reduced sodium and adequate fluid intake
b) A regular diet with normal sodium and fluid adequate intake
Michelle aged 25 is found sitting on the floor of the bathroom in treatment clinic with moderate lacerations to both wrists. Accompanied with broken glass she sits staring blankly at her bleeding wrists while staff members call for an ambulance. How should the nurse approach michelle initially
a) Enter the room quietly and move beside michelle to assess her injuries
b) Call for staff backup before entering the room and restraining michelle
c) Move as much glass away from michelle as possible and quietly sit next to her
d) Approach michelle slowly while speaking in a calm voice, calling her mane and telling her that the nurse is here to help her
d) Approach michelle slowly while speaking in a calm voice, calling her mane and telling her that the nurse is here to help her
Michelle is taken to the hospital and admitted on an emergency basis for 5 days compulsory assessment and treatment. Michelle says to the admitting nurse. Im not staying here. I was a little upset and did a stupid thing. I want to leave. Which response is most appropriate
a) Unfortunately, you have no right to leave at this time. You must be evaluated further
b) Cutting your wrists certainly was a stupid thing to do. What were you trying to accomplish anyway
c) You have been admitted on an emergency basis and can be held you have the right to consult a lawyer about your admission
d) I can see youre upset. Why don’t you try to relax. You can explain to the doctor what upset you. If what you say is true, youll be released sooner.
c) You have been admitted on an emergency basis and can be held you have the right to consult a lawyer about your admission
Determining micelles suicide potential during the mental status examination,
involves assessing several factors, the most significant of which is her
a) History of previous suicide attempts
b) Suicide plan
c) Emotional state
d) Self esteem
b) Suicide plan
Michelle is placed on suicide precautions, which include constant observation. When the nurse accompanies her to the bathroom. Michelle complains, I cant believe this. I cant even go to the bathroom without being watched. How would you like to have me watching you go to the toilet. Which response by the nurse is best
a) Im sure I wouldn’t like it very much, but then I didn’t try to hurt myself
b) Im sorry but these are the rules. Someone must be with you at all times
c) If its more comfortable for you, I can stand right outside as long as the door is open. Would you agree to that
d) I would probably feel uncomfortable too, but ensuring your safety is my first priority. I must stay in the room with you
d) I would probably feel uncomfortable too, but ensuring your safety is my first priority. I must stay in the room with you
5 days of hospitalization. Michelle is to be discharged and an outpatient basis at the day of treatment clinic. During discharge planning, the nurse should set as a priority short term goals michelle will
a) Identify support systems to help manage stress
b) Verbalise feelings of shame regarding her suicide attempt
c) Demonstrate an uplifted mood and optimism about the future
d) Admit that her wrist slashing was an attention seeking behaviour and not a true suicide attempt
a) Identify support systems to help manage stress
Upon transfer to the psychiatric unit megan is informed by the admitting nurse that it will be necessary to check her belongings for any unsafe or banned items. She begins to scream angrily. Whats the matter with you. Im upset. Get away from me. The nurse should first
a) Administer emergency tranquillizers as ordered
b) Place megan in seclusion and restraints
c) Eliminate the belongings search so as to avoid upsetting her
d) Set verbal limits on her behaviour
d) Set verbal limits on her behaviour
Megan requests a weekend pass two days after transfer to the psychiatric unit. Her primary nurse informs her following the treatment team meeting that the pass has not been approved. Megan responds angrily. They all hate me, theyre so mean. I know youd have let me go. Youre the only decent nurse here. The nurses best response is
a) I would have approved it, but youre right im only one voice
b) I don’t think the others realise how hard you’ve been trying
c) Megan youll never get a pass behaving this way
d) This was the teams decision. Lets talk about why we feel its not appropriate now
d) This was the teams decision. Lets talk about why we feel its not appropriate now
Wilfred a 42 year old executive, is admitted for treatment of his alcoholism. The most important factor in wilfreds rehabilitation is
a) His emotional or motivational readiness
b) The qualitative level of his physical state
c) His familys accepting attitude
d) The availability of community resources
a) His emotional or motivational readiness
Which one of the following remarks of Wilfred, made prior to discharge from hospital would show the most realistic assessment of his situation in relation to avoiding future drinking problems
a) I promise ill never get drunk again
b) I will cut down my drinking so I drink only socially
c) I can stop drinking providing my wife keeps off my back
d) Im going to try hard to stay away from that first drink
d) Im going to try hard to stay away from that first drink
John is a 32 year old man with a 5 year history of psychiatric admissions. He is escorted to the mental health unit by the police. He is dishevelled, confused and his records state that he has been diagnosed as chronic undifferentiated schizophrenic. The nurse observes john sitting in th hall looking frightened. He is curled up in a corner of the bench with his arms over his head and covering his face. How should the nurse approach the patient
a) Walk over to the bench, sit beside him quietly, and place an arm around his shoulders, then say im the nurse and wait for a response
b) Allow him to remain alone on the bench, where he can observe the unit for a half hour or so until he is more comfortable
c) Greet him warmly saying hi im the nurse. This is a very nice unit. I think youll like it here. Let me show you around
d) Sit about 3 or 4 feet from him on the bench and say hello john im a nurse on this unit. You appear frightened then wait for a response
d) Sit about 3 or 4 feet from him on the bench and say hello john im a nurse on this unit. You appear frightened then wait for a response
John responds to the nurse by curling up on the bench even tighter. His arms still cover his head and his hands are clasped tightly over his ears. The nurse should
a) Show acceptance of johns behaviour by remaining with him and reassuring him, gently stroking his arms and shoulders
b) Tell john that she will leave him for a while and will return later when he feels more relaxed
c) Say gently john ill just sit here quietly with you for a while then remain seated nearby
d) Say john, most people feel uncomfortable in hospitals. You shouldn’t be afraid. Im here to help you
c) Say gently john ill just sit here quietly with you for a while then remain seated nearby
Later that evening, the nurse finds john crouched in the corner of his room, with a curtain covering him. His reoomate is sitting on the bed laughing and saying this guy is really a nut. He should be in a padded cell. How should the nurse respond to the roommate
a) Say im sure johns behaviour is frightening to you. I understand that you are trying to cover up how you really feel by laughing
b) Say id appreciate it if youd step outside for awhile. Id like to talk with you after I help john
c) Say nothing and attend to john
d) Say in a neutral tone. I think your laughing is making john feel worse. How would you feel if your were john
b) Say id appreciate it if youd step outside for awhile. Id like to talk with you after I help john
What is the least threatening approach to john while he sits huddled under the curtain
a) Sit next to him on the floor without speaking, and wait for him to acknowledge the nurse
b) Gently remove the curtain and say, john this is the nurse. What happened
c) Approach john slowly and say. John this is the nurse. You appear to be very frightened. Can you tell me what you are experiencing
d) Call for assistance and do not approach john until at least two other staff members are present
c) Approach john slowly and say. John this is the nurse. You appear to be very frightened. Can you tell me what you are experiencing
Because john has previously responded well to treatment with haloperidol (serenace), the doctor orders haloperidol 10mg orally twice a day. Which adverse effect is most common with this medication
a) Extrapyramidal symptoms
b) Hypotension
c) Drowsiness
d) Tardive dyskinesia
c) Drowsiness
During the next several days, john is observed laughing, yelling and talking to himself. His behaviour is characteristic of
a) Delusion
b) Looseness of association
c) Illusion
d) Hallucination
d) Hallucination
John tells the nurse, the earth is doomed, you know. The ozone is being destroyed by hair spray. You should get away before you die. John appears frightened as he say this. The most helpful response is to
a) Say john I think you are overreacting. I know that some concern about the earths ozone layer, but there is no immediate danger to anyone
b) Say ive heard about the destruction of the ozone and its effect on the earth. Why don’t you tell me more about it
c) Ignore johns statement and redirect his attention to activity on the unit
d) Say john are you saying you feel as thought sometimes wil happen to you. I don’t believe we are in danger right now
d) Say john are you saying you feel as thought sometimes wil happen to you. I don’t believe we are in danger right now
After a half hour, john continues to ramble about the ozone layer being doomed to die. He paces in an increasingly agitated mood he begins to speak more loudly. At this time, the nurse should
a) Check to see whether the doctor ordered haloperidol
b) Allow john to continue pacing but observe him closely
c) Try to involve john in a current events discussion group that is about to start
d) Tell john to go to his room for a while
… unsure??
a) Check to see whether the doctor ordered haloperidol or d) Tell john to go to his room for a while
Henry is brought to the mental health unit by his wife who states for the past week her husband has refused all meals and accused her of poisoning him, he has become withdrawn, forgetful and inattentive and has frequent mood swings. Henry appears suspicious. His speech which is only partly comprehensible reveals that his thoughts are controlled by delusions of possession by the devil. He claims the devil told him that people around him are trying to destroy him. The doctor diagnoses paranoid schizophrenia. Schizophrenia is best described as a disorder characterised by
a) Disturbed relationships related to an inability to communicate and think clearly
b) Severe mood swings and periods of low to high activity
c) Multiple personalities, one of which is more destructive than the others
d) Auditory and visual hallucinations
d) Auditory and visual hallucinations
The nursing assessment of henry should include careful observation of his
a) Thinking, perceiving and decisions making skills
b) Verbal and nonverbal communication processes
c) Affect and behaviour
d) Psychomotor activity
c) Affect and behaviour
When communicating with henry the nurse should initially
a) Remain silent and wait for henry to speak first
b) Talk with henry as one would talk with a healthy person
c) Allow henry to do all the talking
d) Speak to henry using simple, concrete language
d) Speak to henry using simple, concrete language
The patients thought content can be evaluated on the basis of which assessment area
a) Presence or absence of delusions
b) Unbiased information from the patients psychiatric history
c) Degree of orientation to person, place and time
d) Ability to think abstractly
a) Presence or absence of delusions
Henry mentions that voices are telling him that he is in danger and that he will be safe only if he stays in his room and avoids ‘zoids’. How should the nurse respond
a) I understand that these voices are real to you, but I want you to know that I do not here them
b) Don’t worry. I wont let anything happen to you here
c) What else can you tell me about the voices
d) Many patients hear voices when they come here. The voices will go away when you get better
a) I understand that these voices are real to you, but I want you to know that I do not here them
The innermost layer of the eye is
a) Sclera
b) Retina
c) Choroid
d) Conjunctive
b) Retina
The nurse observes henry pacing in his room. He is alone but in an angry tone. When asked what he was experiencing he replys the devil is yelling in my ear. He say people here want to live. The nurses best response is
a) Can you tell me more about what the devil is saying
b) How do you feel when the devil says such things to you
c) I don’t hear any voice. Henry are you feeling afraid now
d) Henry the devil cannot talk to you
c) I don’t hear any voice. Henry are you feeling afraid now
Mary is admitted under section 11 of the mental health (compulsory assessment and treatment act 1992). The definition of mental disorder under the act includes all of the following except
a) A seriously diminished ability to care for yourself
b) Mental handicap and substance abuse
c) An abnormal state of mind
d) A serious danger to self or others
b) Mental handicap and substance abuse
Mary asks for review of her legal status. Your action would be
a) Explain that her status will be reviewed by the responsible clinician before the end of five days
b) Reassure her that you understand how frustrating it must to be in hospital against her will
c) Offer to phone the client advocate on marys behalf
d) Explain section 16 to mary and allow her to phone the district inspector
d) Explain section 16 to mary and allow her to phone the district inspector
Under section 30 of the mental health act (1992), the inpatient treatment order lasts for
a) 2 months
b) 4 months
c) 6 months
d) 12 months
c) 6 months
Under section 111 of the mental health act (1992) a person admitted to hospital, not already subject to any assessment and treatment can be detained, for how long, if considered mentally disordered
a) 24 hours
b) 12 hours
c) 6 hours
d) 3 hours
c) 6 hours
Lisa tell the nurse that she has gained 2kg in a month and plans to diet by skipping lunches. Which of the following responses would be the most appropriate
a) Have you noticed that your hands and feet have become swollen
b) You should cut down on high calorie foods like cake and candy, but you shouldn’t skip lunch
c) Your weight gain is just right for you for this period of your pregnancy. You are doing fine
d) Yourre supposed to gain a lot of weight its good for the baby. Youll lose it after the baby is born
c) Your weight gain is just right for you for this period of your pregnancy. You are doing fine
50mg is equal to
a) 0.5 gram
b) 5 grams
c) 5000 micrograms
d) 50,000 micrograms
d) 50,000 micrograms
The drugs used to treat parkinsons disease act by
a) Increasing cholinergic activity and increasing dopamine
b) Reducing cholinergic activity and increasing dopamine
c) Increasing cholinergic activity and reducing dopamine
d) Reducing cholinergic activity and reducing dopamine
b) Reducing cholinergic activity and increasing dopamine
Recent research indicates that arthritis may be an autoimmune disease. Which of the following statements most accurately describes the process of autoimmunity
a) A rare complication of vaccination when the body reacts to the vaccine by producing symptoms of the disease
b) An inherent factor in the blood which renders the person susceptible to certain diseases
c) Lack of antitoxins in the blood which render the person susceptible to the certain diseases
d) Formation of antibodies in the blood which destroy certain healthy cells in the individual
d) Formation of antibodies in the blood which destroy certain healthy cells in the individual
Patients with rheumatoid arthritis commonly have a raised ESR (erythrocyte sedimentation rate). This is because
a) Arthritic patients usually have a degree of anaemia
b) Rheumatoid factor decreases the viscosity of the cells
c) Protein changes result in the erythrocytes becoming heavier
d) There is an increase in leucocyte numbers
d) There is an increase in leucocyte numbers
Before administering a dose of digoxin the patients pulse (apex beat) should be taken. Which is the correct action for the nurse to take if the pulse is found to be under 60 beats per minute
a) Give the drug and take the pulse again an hour later
b) Give the drug and notify the staff nurse that the pulse is slow
c) Do not give the drug and report the slow pulse to the doctor
d) Omit the drug and make a note on the nursing care plan
c) Do not give the drug and report the slow pulse to the doctor
Which of the following can be causes of anaemia in the elderly
Apathy and depression
Ill fitting dentures
A physiological inability to utilize food properly
a) 3 only
b) 1 and 2
c) 1 and 3
d) 1, 2 and 3
c) 1 and 3
Old people are inevitably a burden on the community (assertion) because old people cannot work because they are slow and cannot be relied on (reason). With reference to the above statement which of the following is true
a) Both assertion and reason are true statements but the reason is not a correct explanation of assertion
b) The assertion is true but the reason is a false statement
c) The assertion is false but the reason is a true statement
d) Both the assertion and reason are false statements
d) Both the assertion and reason are false statements
A common problem with the elderly is their reluctance to drink adequate amounts of fluid. The most probable reason for this is that they are
a) Frightened of being incontinent
b) More likely to sweat than younger people
c) Unable to afford adequate fluids
d) Afraid of developing diarrhoea
a) Frightened of being incontinent
Haemorrhage into the anterior chamber of the eye following a cataract extraction is called
a) Hyaemia
b) Hyphaema
c) Hyfever
d) Hyena
b) Hyphaema
Mrs adams suffers from dementia and requires a dressing to a shin wound. The nurse suspects the wound is the result of a non accidental injury. What is the main cause of non accidental injury in an elderly person suffering from dementia
a) A dependent person being more prone to injury
b) A long standing pattern of domestic violence
c) The home not being a suitable place for a dependent person
d) The increased stress in caring for a dependent person at home
d) The increased stress in caring for a dependent person at home
When dressing the shin wound the nurses most appropriate remark is
a) How did you scrape your shin mrs adams
b) How did you scrape your wifes shin mr admas
c) This shin must hurt. Was it really an accident
d) A shin is easy to hurt. How did this injury happen
d) A shin is easy to hurt. How did this injury happen
The most appropriate way to help mr and mrs adams at the first visit is to
a) Express professional concern at the cause of the injury
b) Conceal feelings about the possible cause of the injury
c) Reassure mrs adams that this injury will not occur again
d) Acknowledge the stress of mr adams in caring for his wife
a) Express professional concern at the cause of the injury
An increased incidence of vaginal infections occurs when contraceptive pills are taken because there is
a) A shift in the vaginal pH
b) Drying of the vagina mucosa
c) An increase in vaginal fluids
d) A reduction in white cell numbers
a) A shift in the vaginal pH
What action should the nurse take when on three home visits the mother of a nine months old baby prevents him from being seen as ‘he is sleeping’
a) Notify the social welfare of the situation
b) Notify the family doctor in writing of this occurrence
c) Insist on seeing the child and refuse to leave the home
d) Respect the patients right to accept or refuse treatment
a) Notify the social welfare of the situation
Which is the major pathophysiological abnormality occurring in asthma
a) Cardiac arrhythmias
b) Bronchiole dysplasia
c) Spasm of the smooth muscles of the bronchi
d) Inflammation of the alveoli
c) Spasm of the smooth muscles of the bronchi
Which of the following sings/symptoms would indicate mumps
a) Swelling of the lymph nodes
b) Tenderness of the parotid gland
c) Enlargement of the prostate gland
d) Ulceration of vesicular stomatitis
b) Tenderness of the parotid gland
Which option is important for the nurse to know with regard to prevention of the spread of mumps
a) Safe disposal of all bodily excretions
b) No specific isolation measures are needed
c) Control of all food stuffs prepared for sale
d) Isolation for ten days after the last notified case
a) Safe disposal of all bodily excretions
Which of the following is the best description of a vaccine
a) Dead modified bacilli
b) Live attenuated virus
c) Dead virus given orally
d) Antibodies suspended in serum
b) Live attenuated virus
Mrs shaw brings her 8 year old daughter jane to the clinic. Jane has eczema. Janes eczema is most likely the result of
a) Inadequate skin care and hygiene
b) Excretion of acids through sweat pores
c) An inherited predisposition to skin infections
d) Sensitivity to a substance in her external environment
d) Sensitivity to a substance in her external environment
Eczema is the term used to describe a (n)
a) Acute, contagious inflammation of the skin
b) Non contagious inflammatory response of the skin
c) Fungal infection more commonly seen in childhood
d) Condition marked by the appearance of erythematous wheals
b) Non contagious inflammatory response of the skin
Which statement best describes ‘vesicle’
a) Reddened, pinprick like rash
b) Small round area of discolouration
c) Small area of swelling on the skin
d) Small blister filled with serous fluid
d) Small blister filled with serous fluid
You are employed as a practice nurse. A friend telephones and asks if her boyfriend has been to see the doctor this week. Your most appropriate response is
a) I don’t know
b) Ill have to ask the doctor
c) I am not able to tell you that
d) Just a moment, ill check the files
c) I am not able to tell you that
Aminophylline 350mg is prescribed. Each ampoule contains 250mg in 10ml. how much should be added to the intravenous solution
a) 12ml
b) 14ml
c) 16ml
d) 35ml
b) 14ml
A client is charted nitrazepam (mogadon) tablets to sleep. She refuses to take them at 9pm. She tells you that the other nurses always leave the tablets on the locker and she takes them when she is ready. What should you do
a) Put them back in the container
b) Give her the tablets and let her take them later
c) Tell the patient to ring when she is ready for them
d) Tell her if she doesn’t take them now she may not get them later
c) Tell the patient to ring when she is ready for them
Hyperventilation may initially cause
a) Metabolic acidosis
b) Metabolic alkalosis
c) Respiratory acidosis
d) Respiratory alkalosis
d) Respiratory alkalosis
Your neurologic assessment indicates increased ICP (intracranial pressure), so you raise the head of the bed 15 to 30 degrees in order to
a) Improve arterial flow to the brain
b) Promote venous drainage from the brain
c) Improve respirations
d) Increase cardiac output
b) Promote venous drainage from the brain
Mr march sixty year old farmer, was admitted to a private hospital for rehabilitation following a cerebro vascular accident which resulted in right sided hermiplegia. When cerebro vascular accident causes occlusion of blood supply to one area of the brain, loss of voluntary muscle control is usually evident on
a) The same side of the body as the brain damage
b) The opposite side of the body to the brain damage
c) The opposite side of the face
d) Both sides of the body
b) The opposite side of the body to the brain damage
- Which of the following is most important for mr march to succeed in a rehabilitation programme
a) Knowledge of the services available to him
b) Familys encouragement
c) Personal goals
d) His relationships with the health team
c) Personal goals
- A rehabilitation programme for mr march should begin with
a) Strengthening his weak side
b) Teaching him to walk
c) Utilising the movement he still has
d) Establishing speech
c) Utilising the movement he still has
- There is evidence that mr march suffers a mild degree of expressive aphasia. This would be evidenced by which of the following behaviours
a) Mr march has difficulty in understanding what is spoken to him although he can verbally express his needs appropriately
b) Mr march has difficulty in both understanding what is spoken to him and in verbally communicating with others
c) Mr march understands what is spoken to him but has difficulty in forming and expressing words
d) Mr march has difficulty interpreting sensory stimuli causing him to respond inappropriately
c) Mr march understands what is spoken to him but has difficulty in forming and expressing words
- Mr march is enthusiastic about his excersie programme. He exercises should be
a) Frequent and of short duration
b) Twice daily and extensive
c) Carried out in the physiotherapy department
d) Confined to the affected side
a) Frequent and of short duration
- A rehabilitation programme should promote
a) Client autonomy and independence
b) The best possible level of mobility and ambulation
c) Psychological and social adjustment
d) All of the above
d) All of the above
- 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 q2h; avoid positioning him on the affected side if possible
d) Turn and reposition the client at least q2h; avoid positioning him on the affected side if possible
- 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
a) Flexor muscles are generally stronger than extensors
- Mrs sweetman, aged sixty two years has non insulin dependent diabetes mellitus. She recently returned home from hospital where she received treatment for any 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
d) She has diminished sensation in her feet
- Mrs sweetmans foot problems result from neuropathic, vascular and infectious changes. The most important feature of foot care should be
a) Inspect the feet daily and wash with mild soap and water
b) Maintain adequate blood flow to the lower limbs
c) Rub the feet with alcohol once a week
d) Avoid wearing garters of constricting shoes
a) Inspect the feet daily and wash with mild soap and water
Or
B
- Peter aged 10 diagnosed as moderately mentally retarded. He lives in a IHC residence and attends a special school. You are employed as a carer at the residence. A major strategy in teaching peter is based on behaviour modification principles. An important element in peters management then is the use of reinforcement. Which statement best defines what a reinforce is for peter.
a) A reinforce is anything you think peter will enjoy
b) A reinforce is anything peter gains enjoyment from even if it appears to an observer to be producing pain
c) A reinforce is anything which precedes a response which is likely to increase the probability of that response occurring again
d) A reinforce is anything that follows a response that decreases the probability of that response occurring again
d) A reinforce is anything that follows a response that decreases the probability of that response occurring again
- You wish to teach peter to put on his pants. If the first step in his training programme was doing up his belt correctly. This method would best be described as
a) Graduated guidance
b) Forward chaining
c) Backward chaining
d) Prompting
c) Backward chaining
- When teaching peter to pull his pants up a physical prompt by guiding peters hand is used. As peters learning increases the physical prompt becomes no more than a gentle touch. This is an example of
a) Stimulus control
b) Fading
c) Reinforcing
d) Positive practice
a) Stimulus control
- Peter has a temper tantrum during which he lies on the floor at the entrance to the hallway. This is making it difficult for other residents. He has been asked to get up but continues his tantrum. Using the principles of extinction how would you deal with peter
a) Continuing to ask him in a firm voice to get up
b) Ignore him and instruct the other residents to step over him
c) Explain to him that he is blocking the entrance and it is unsafe for him to remain where he is
d) Let him know that if he doesn’t get up immediately he will be punished
b) Ignore him and instruct the other residents to step over him
- What would be the most likely effect initially on peters behaviour when commencing to apply the principles of extinctions
a) Behaviour shows minimal change
b) Inappropriate behaviour would increase
c) Inappropriate behaviour would rapidly decrease
d) Inappropriate behaviour would slowly decrease
b) Inappropriate behaviour would increase
- Peter has a habit of hugging new staff members and visitors to the residence. In order for extinction of this inappropriate social behaviour it would be necessary for him
a) Not to be punished for inappropriate behaviour
b) To be rewarded for inappropriate behaviour
c) To be punished for inappropriate behaviour
d) Not to receive reinformcement for this in appropriate behaviour
d) Not to receive reinformcement for this in appropriate behaviour
- If the staff were to apply the principles of response cost in dealing with peters inappropriate social behaviour they could do so by
a) Taking away something that peter found reinforcing such as restricting his TV viewing
b) Taking away from peter something that he found unpleasant such as having to eat his vegetables
c) Applying an aversive stimuli such as making him stay in his room
d) Ignoring the inappropriate behaviour but reinformcing an appropriate behaviour such as his willingness to help with the dishes
a) Taking away something that peter found reinforcing such as restricting his TV viewing
- Peter also suffers from epilepsy. During a seizure he falls to the ground is unconscious and begins to convulse. The best immediate response would be to
a) Cradle peters head in your lap
b) Place something in peters mouth to prevent him biting his tongue
c) Hold his arms down
d) Move him to a place of safety
d) Move him to a place of safety
- Which of the following tests furnishes the best diagnostic information about seizures
a) Electroencephalogram
b) Cerebral angiogram
c) Cerebral tomography
d) Electrocardiogram
a) Electroencephalogram
- Peter does not regain consciousness after his seizure, but after a brief pause in the convulsions the seizure continues. The term for this is called
a) Frequent seizures
b) Febrile seizures
c) Status epilipticus
d) Petit mal seizures
c) Status epilipticus
- Major epilepsy normally follows which of the following sequences
a) Aura, tonic phase, clonic phase, recovery
b) Aura, clonic phase, tonic phase, recovery
c) Aura, tonic phase, recovery
d) Aura, clonic phase, recovery
a) Aura, tonic phase, clonic phase, recovery
- Mr jones aged 72 years has chronic obstructive respiratory disease (CORD). He is a smoker. In the early stages of CORD the most effective way of delaying the disease process is to encourage mr jones to
a) Use purse lip breathing and pace physical activity
b) Stop smoking
c) Avoid environmental air pollutants
d) Avoid people with infections
a) Use purse lip breathing and pace physical activity
or
b) Stop smoking
- The safest and most effective way to clear secretions from the respiratory tract is
a) Postural drainage
b) An effective cough
c) Pharyngeal suctioning
d) Endotracheal suctioning
b) An effective cough
- Carl comes to the mental health clinic where you work because of nervousness. He tells you I have butterflies in my stomach most of the time. I haven’t 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
a) Mild
- 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
c) Have you ever felt this way before
- Which of the following explains the major differences between normal anxiety and the syndrome associated with anxiety reactions
a) Normal anxiety is constant; an anxiety reaction is intermittent and rather short lived
b) Normal anxiety is free floating; in an anxiety reaction there is an impending sense of doom
c) An anxiety reaction is seldom controllable and usually must run its course
d) Normal anxiety is a fact of life and rarely becomes an anxiety reaction
b) Normal anxiety is free floating; in an anxiety reaction there is an impending sense of doom
- Signs and symptoms associated with anxiety are
a) Complaints of apprehension, narrowed perception, stomach pains and restlessness
b) Inability to get to sleep, early morning awakening, excessive weight loss and lack of energy
c) Ideas of reference, grandiose delusion, hallucinations and delusions
d) Spending or giving away large amounts of money
a) Complaints of apprehension, narrowed perception, stomach pains and restlessness
- Carl compains of severe inner left arm and neck pain during the last few days. This pain probably the result of
a) Vasoconstriction because of arterial spasms
b) Myocardial ischemia
c) Fear of death
d) Irritation of nerve endings in the cardiac plexus
b) Myocardial ischemia
- Carl collapses in a shopping mall as he experiences a cardiac arrest. What would be the first action in this situation
a) Call a doctor
b) Establish an airway
c) Start closed chest massage
d) Give a bolus of sodium bicarbonate
b) Establish an airway
- Upon admission to the coronary care unit, oxygen was ordered for carl. The primary purpose of oxygen administration in this situation is to
a) Relieve dyspnea
b) Relieve cyanosis
c) Increase oxygen concentration in the myocardium
d) Supersaturate the red blood cells
c) Increase oxygen concentration in the myocardium
- The most dangerous period for carl, following his myocardial infarction is
a) The first 24 to 48 hours
b) The first 73 to 96 hours
c) 4 to 10 days after the myocardial infarction
d) From the onset of symptoms until treatment begins
a) The first 24 to 48 hours
- Carl now considerably improved, wants to talk about his sexual activity after he has been discharged. What would be the nurses initial approach
a) Give carl some written material and then answer questions
b) Plan a teaching session with carl and his wife
c) Answer his questions accurately and directly
d) Provide enough time and privacy so that he can express his concerns fully
d) Provide enough time and privacy so that he can express his concerns fully
- Michael has been brought by the police into the psychiatric unit. He was found curled up under a bridge. When asked his name all he would say was nice boy. His father informs you that he has not had a psychotic episode for 2 years, and that medication has controlled his condition. This episode occurred when Michael refused his medication. Which of the following areas should the nurse gather data first
a) Michaels perception of reality
b) Michaels physical condition
c) The observations of Michael, made by the police
d) Michaels speech patterns
a) Michaels perception of reality
- Michael becomes regressed and withdrawn. He appears to be listening to something, the nurse hears nothing. What is the most appropriate response
a) Give him an additional dose of his antipsychotic medication
b) Ignore his behaviour
c) Contact his doctor and request a seclusion order
d) Talk to him about what hes experiencing
d) Talk to him about what hes experiencing
- Michaels doctor prescribes haloperidol, 6mgs IM for three doses. After the third dose of the medication, Michael is still severly regressed and also agitated. He also appears to be hallucinating. What would the nurse do
a) Call the doctor for further orders
b) Administer another dose of the medication
c) Record the results of the medication
d) Observe the client for an hour
c) Record the results of the medication
- Michael yells for the nurse. As the nurse enters his room he says do you see there the virgin mary is appearing. Which of the following is the best nursing response
a) No I don’t see her but I understand she is real to you
b) She is not there. You must be imagining things Michael
c) Show me where in the room she is appearing
d) The virgin mary is appearing
a) No I don’t see her but I understand she is real to you
- Michael is very withdrawn, he moves slowly and is uncommunicative. The best initial goal is which of the following
a) Michael will increase his social skills
b) Michael will be orientated to reality
c) Michael will increase his level of communication
d) Michael will form a trusting relationship with the nurse
d) Michael will form a trusting relationship with the nurse
- Jeff oakes has cancer of the rectum and has consented to surgery for removal of the rectum and the formation of a permanent colostomy. A gastric suction tube is inserted before mr oakes goes to surgery in order to
a) Facilitate administration of high caloric, nutritious liquids immediately after completion of the procedure
b) Prevent accumulation of gas and fluid in the stomach both during and following surgical action
c) Provide a reliable means of detecting gastrointestinal haemorrhage during the operative procedure
d) Serve as a stimulus to restore normal peristaltic movement following recovery from anaesthesia
b) Prevent accumulation of gas and fluid in the stomach both during and following surgical action
- Sections of colon both above and below the tumour were removed in order to prevent
a) Direct extension and metastatic spread of the tumour
b) Post op paralysis and distension fo the bowel
c) Accidental loosening of bowel sutures post operatively
d) Pressure injury to perineal suture line
a) Direct extension and metastatic spread of the tumour
- Mr oakes will receive tube feedings post operatively. Tube feedings provide adequate nutrition for all of the following clients except
a) Those who have difficulty in swallowing
b) Those who are comatose
c) Those who do not have a functioning gastrointestinal tract
d) Those who are anorexic
c) Those who do not have a functioning gastrointestinal tract
- Mr oakes recovers from surgery. He is scheduled to return to the hospital in a month for a course of chemotherapy. Before leaving he says to you im not sure I want to come back. Maybe ill just take my chances. What would be the best response
a) It is your decision and you should do as you feel best
b) What concerns you most about coming back
c) Have you discussed this with your wife and doctor
d) The survival rate with adjuvant chemotherapy is quite high
b) What concerns you most about coming back
- 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 hydration status, which of the following indicates less than adequate fluid replacement
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
c) Rising hematocrit and decreasing urine volume
- Which signs/symptoms indicate overhydration
a) Dieresis
b) Drowsiness and lethargy
c) Dyspnea, moist rales
d) Warmth and redness around intravenous site
c) Dyspnea, moist rales
- Seans output via his foley catheter is 10mL/hour. What should be the first nursing action
a) Check the catheter to see if it is plugged (blocked)
b) Call the doctor immediately
c) Record the information on the chart
d) Increase the intravenous fluids
c) Record the information on the chart
- The doctor has prescribed 500ml of IV fluid to be given over 10 hours. Using a soluset which delivers 60 drops per ml, calculate the rate in drops per min
a) 48
b) 50
c) 52
d) 54
b) 50
- What important sean starts oral feeding it is particularly important that his client has a high amount of
a) Fats and carbohydrates
b) Minerals and vitamins
c) Fluids and vitamins
d) Proteins and carbohydrates
b) Minerals and vitamins
- What would be the best diversional activity for sean while he is in reverse isolation
a) Lace leather wallets
b) Watch television
c) Play with puppets
d) Use computer word games
b) Watch television
- Christine Harvey, aged 21 is to have a bronchoscopy in two hours time under general anaesthetic. Why are food or fluids not permitted before this procedure
a) The anaesthetic will not be absorbed
b) Vomiting may occur during the procedure
c) Indigestion may be a problem for Christine
d) Christine may suffer from diarrhoea
b) Vomiting may occur during the procedure
- Christine refuses to remove her wedding ring before she is transferred to theatre. Which action should you take in this situation
a) Remind her that you are not responsible for the loss
b) Warn her the ring may slip off during surgery
c) Tell he she should give the ring to her husband
d) Secure the ring to her finger with tape
d) Secure the ring to her finger with tape
Christine is asked to remove her make up before going to theatre. Why is this important
a) The make up may contaminate the anaesthetic mask
b) The anaesthetist may have difficulty assessing her condition
c) The theatre is a sterile environment and make up carries micro organisms
d) The facemask is more likely to slip if she is wearing makeup
b) The anaesthetist may have difficulty assessing her condition
- Soon after returning to the ward Christine asks for a drink. She should be given water first, rather than a milky drink
a) Water is more easily absorbed than milk
b) Water quenches a persons thirst more rapidly
c) Milk can cause lung infection if the gag reflex has not returned
d) Milk has a more irritating effect on a persons throat
d) Milk has a more irritating effect on a persons throat
- Allan martin, is admitted to hospital with acute chest pain. Provisional diagnosis is myocardial infarction. When asking about the quality of a clients chest pain you are primarily looking for
a) An indication of its severity
b) The patients own description
c) A response found on a list of possible descriptions
d) Its cause
a) An indication of its severity
- When a client is anxious and upset about chest pain, it is best to
a) Explain in detail the pathologic changes that may be occurring
b) Provide short, clear explanations of your assessment and treatment interventions
c) Don’t say anything until you are sure of his diagnosis
d) Explain that his doctor can answer his questions better
b) Provide short, clear explanations of your assessment and treatment interventions
- The nurse asks you to check some pain relief for mr martins severe chest pain. This prescription is for morphine 6mgs every 2 hours. The stock available is morphine 10mg in 1 ml. calculate the correct amount
a) 0.5ml
b) 0.6ml
c) 1 ml
d) 1.3ml
b) 0.6ml
- The doctor prescribes frusemide (lasix) intravenously for mr martin. What is the action of frusemide
a) Diuretic
b) Antiemetic
c) Analgesic
d) Bronchodilator
a) Diuretic
- What side effects of frusemide (lasix) should the nurse be aware of
a) Hypervolaemia
b) Hypovolaemia
c) Hypotension
d) Hypoventilation
b) Hypovolaemia
- The doctor prescribes heparin 7,500 i.u subcutaneous BID. The vial contains heparin 25,000 units/ml. what volume should be given s.c
a) 0.2ml
b) 0.3ml
c) 0.4ml
d) 0.7ml
b) 0.3ml
- What is the essential nursing action to take when caring for a patient who is having heparin
a) Observe for signs of drowsiness
b) Watch for side effects of the drug
c) Record blood pressure and pulse 4 hourly
d) Monitor patient for signs of internal or external haemorrhage
d) Monitor patient for signs of internal or external haemorrhage
- Mrs Phillips is admitted to your ward in acute respiratory distress following an asthmatic attack. In which position should the nurse place mrs Phillips to assist her breathing
a) High fowlers
b) Semi fowlers
c) Orthopneic
d) Supine with pillows
c) Orthopneic
- Which signs would indicate your client may have hypoxaemia
a) Anxiety, restless and confusion
b) Cough, strong pulse rate, apprehension
c) Hypotension, alert, tachycardia
d) Hyperventilation, warm peripheries, alert
d) Hyperventilation, warm peripheries, alert
- Mrs Phillips is prescribed 1 litre of normal saline .9% over 6 hours. This is to be delivered via a soluset which has a drop factor of 60. Calculate the correct drops per minute
a) 100
b) 125
c) 167
d) 180
c) 167
- Mrs maring was brought to an acute psychiatric unit by the police. She was found wandering around the streets, incoherent, and her behaviour appeared to be inappropriate. She was tentatively diagnosed as having schizophrenia. The nurse knows that a diagnosis of schizophrenia implies that a patient would manifest which of the following behaviours
a) Inability to concentrate
b) Loss of contact with reality
c) Guilt feelings
d) Feelings of worthlessness
b) Loss of contact with reality
- Mrs maring says that the voices are telling her to do things and she cant stop listening. The best response from the nurse would be
a) Never mind the voices; lets just concentrate on the game
b) The voices will go away soon
c) I don’t hear any voices. I think the voices are part of your illness. Try to listen to what im saying
d) Everyone hears voices at times
c) I don’t hear any voices. I think the voices are part of your illness. Try to listen to what im saying
- Mrs maring after a two week stay, appears much better. She is in contact with reality and is able to interact with others in an appropriate way. The doctor is sending her home with medication. The most common medications given for schizophrenia are
a) ECT
b) Phenothiazines
c) MAO inhibitors
d) Antidepressants
b) Phenothiazines
- A young maori man dies, as a result of a motor bike accident. The doctor requests his kidneys for a transplant. His whanau refuse. What is the most appropriate action of the nurse in this situation
a) You accept the wishes of the whanau
b) You pressure the whanau to re consider
c) You seek permission form other whanau members
d) You support the doctor to over ride what the whanau wish to do
a) You accept the wishes of the whanau
- Mr H a 72 year old kaumatua (elder) is admitted to the medical ward with cellulitis of his left leg. He is placed on strict bed rest. Because he is whakama (embarrassed) he refuses to use a bedpan and demands to walk to the toilet. How should you deal with this situation
a) Give him a bed pan anyway
b) Talk over the situation with him
c) Tell him to doctor has ordered bed rest
d) Ask the other patients to leave the room
b) Talk over the situation with him
- While assessing mr h you find his daughter answers all your questions for him. The most culturally appropriate action is to
a) Question him privately when the daughter leaves
b) Send her out so mr h will answer on his own
c) Accept this as appropriate and continue the assessment
d) Ignore her as you need to have the information form mr H
a) Question him privately when the daughter leaves
- The tohunga (healer) prescribes a specially prepared solution to be placed on mr H legs. What is the most appropriate response in this situation
a) Get the doctor to talk to the tohunga
b) Refuse as it may be unhygienic and cause infection
c) Explain to mr h that medication from the doctor is more acceptable
d) Ensure both types of treatment may be combined to assist mr h
d) Ensure both types of treatment may be combined to assist mr h
- Mr t aged 80 has had a right below knee amputation. As a maori he wishes that his amputated foot be returned to him. What is the cultural significance of this request
a) It is the appropriate action to do in maori society today
b) Maori people prefer to keep all their body parts after surgery
c) Because of the spiritual links between maori people and the land
d) Because he is worried about what the hospital will do with his foot
c) Because of the spiritual links between maori people and the land
- Following a cerebral vascular accident (stroke) mr m aged 80 is unconscious. Some members of the whanau (extended family) wish to take him home. What is the most appropriate action to take in this situation
a) Help and support the whanau appropriately
b) Tell them that mr h needs hospital care
c) Check to ensure they have enough whanau support
d) Ask if the whanau are capable of nursing him safely
a) Help and support the whanau appropriately
- A maori man aged 26 dies within 24 hours of admission in the A and E clinic in which you work. His family wish to take him home immediately to prepare for his tangi. He has not been certified dead by a doctor and because of his death within 24 hours, it becomes a coroners case. Your response to the whanau is
a) Forbid them to leave
b) Allow them to leave
c) Ask them under what circumstances he died
d) Ask them if they understood the process of certification and coroners proceedings
d) Ask them if they understood the process of certification and coroners proceedings
- 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
a) Strengthening of uterine contractions with walking
- First fetal movements felt by the mother are known as
a) Ballottement
b) Engagement
c) Lightening
d) Quickening
d) Quickening
- Growth is most rapid during the phase of prenatal development known as
a) Implantation
b) First trimester
c) Second trimester
d) Third trimester
b) First trimester
- The chief function of progesterone is the
a) Establishing of secondary male sex characteristics
b) Rupturing of follicles for ovulation to occur
c) Development of female reproductive organs
d) Preparation of the uterus to receive a fertilised ovum
d) Preparation of the uterus to receive a fertilised ovum
- Mrs green a 22 year old primigravida is attending prenatal clinic. Mrs greene is concerned because she has read that nutrition during pregnancy is important for proper growth and development of the baby. She wants to know something about he foods she should eat. The nurse should
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
b) Assess what she eats by taking a diet history
- Mrs greene states, im worried about gaining too much weight because ive heard its bad for me. The nurse should respond
a) Yes, weight gain causes complications during pregnancy
b) Don’t worry about gaining weight. We are more concerned if you don’t gain enough weight to ensure proper growth of your baby
c) The pattern of your weight gain will be of more importance than the total amount
d) If you gain over 7 kgs youll have to follow a low calorie diet
c) The pattern of your weight gain will be of more importance than the total amount
- Immediate critical observation for apgar scoring includes
a) Respiratory rate
b) Heart rate
c) Presence of meconium
d) Evaluation of moro reflex
a) Respiratory rate
- Which part of the hands is most affected in cases of primary irritant dermatitis
a) Between the fingers
b) Flexor aspects of the fingers
c) Medial aspects of the hands
d) Back of the hands
a) Between the fingers
- Why is this particular area of the hands most affected
a) Moisture tends to collect there
b) New cells are generated at a slower rate
c) Skin thickness is relatively thinner
d) Flora are more concentrated
a) Moisture tends to collect there
- The lesions of primary irritant dermatitis appear as tiny fluid filled elevations called
a) Vesicles
b) Macules
c) Papulses
d) Nodules
a) Vesicles
- The major form of treatment in the initial stage of contact dermatitis is the application of
a) Wet compresses
b) Dry dressings
c) Topical antibiotics
d) Oil based medications
d) Oil based medications
Lucy is charted 5mls of augmentin 125 TDS. You notice the doctor hasn’t signed the order form. A senior colleague tells you to give it. You respond by
a) Giving the medication as ordered
b) Contacting the doctor to sign the order
c) Asking lucy if the doctor told her she would have this
d) Signing the form for the doctor
b) Contacting the doctor to sign the order
- The augmentin is given to lucy. She is found to be allergic when she exhibits
a) Tinnitus and vertigo
b) Wheezing and urticaria
c) Abdominal cramps and diarrhoea
d) Blurred vision and ataxia
c) Abdominal cramps and diarrhoea
- Jack is 15 years old. He is admitted to the hospital after briefly losing consciousness when tackled during a rugby game. Which of the following is an indication increasing intracranial pressure
a) Change in his level of consciousness
b) Anorexia and thirst
c) Increased pulse and respiration rates
d) Blurred vision and halos around lights
a) Change in his level of consciousness
- Jack has had two seizures while hospitalised. These have been controlled by anticonvulsant medications. Jack and his family must understand
a) The medication must be taken for at least one year
b) The doctor should be seen when the prescription has finished
c) The medication will be discontinued on discharge
d) The medication will be necessary for the rest of his life
b) The doctor should be seen when the prescription has finished
- Jack is prescribed rivotril 8 mgs daily. He weighs 68 kgs. The initial doses for 2-3 days should not exceed 0.01 mgs/kg/day. Your nursing responsibility is to
a) Observe for any side effects after giving the drug
b) Contact the doctor to reassess the dose prescribed
c) Consider his weight loss and administer the dose prescribed
d) Check with the charge nurse prior to administration
b) Contact the doctor to reassess the dose prescribed
- Lucy rogers, 5 years old, has had a recent upper respiratory tract infection. Now she is febrile and complains of a painful left ear. Acute otitis media is diagnosed. The typical appearance of the tympanic membrane in acute otitis media is
a) Red and bulging
b) Grey and concave
c) Yellow and retracted
d) Red and concave
a) Red and bulging
- Lucys symptoms may be relieved most effectively by
a) Warm compresses
b) Paracetamol elixir
c) Ice packs
d) Warm olive oil drops
b) Paracetamol elixir
- Children are more likely to develop acute otitis media from an upper respiratory infection than adults because of their
a) Inadequate resistance to infection
b) Eustachian tubes size and shape
c) Lack of acquired immunity to the causative organism
d) Increased susceptibility to colds
b) Eustachian tubes size and shape
- The organism most commonly responsible for acute otitis media is
a) Streptococcus pyogenes
b) Staphylococcus albus
c) Haemophilus influenza
d) Escherichia coli
c) Haemophilus influenza
- Kevin aged 19 is admitted with an acute attack of asthma. During an asthmatic attack, the reaction to excessive histamine release would be
1. Bronchospasm
2. Bronchodilation
3. Excessive mucous production
4. Production of I.G.E antibodies
a) 1,3 and 4
b) 1,3 and 5
c) 1,4 and 5
d) 2,3 and 4
a) 1,3 and 4
- The hypersensitive reaction in asthma is due to the
a) Antigen – antibody response
b) Antigen – histamine release
c) Inhalation of pollens
d) Release of histamine
d) Release of histamine
- Which of the following signs would a person admitted to hospital with an acute attack of asthma present with
a) Dyspnea, tachycardia, anxiety
b) Dyspnea, bradycardia, frothy sputum
c) Tachycardia, chest pain, pallor
d) Increased anxiety, sweating, chest pain
a) Dyspnea, tachycardia, anxiety
- A primiparous woman, one day postpartum, calls the nurse into her room the woman explains that while breastfeeding, she experienced uterine cramps and a heavy gush that soaked through her pad to the bed. The nurse should
a) Palpate the womans fundus
b) Tell the woman that this often happens when breastfeeding
c) Administer PRN ergometrine medication
d) Assist the woman with perineal care and changing her pad
b) Tell the woman that this often happens when breastfeeding
- The lochia of the postpartum woman second day after birth should exhibit each of the following except
a) Deep red and thick blood
b) A few large clots
c) Fleshy odour
d) Moderate amount – 15cm on pad after 1 hour
c) Fleshy odour
- The risk for constipation in the postpartum period is related to all except
a) Tenderness of the episiotomy
b) Decreasing levels of oestrogen
c) Decreased abdominal muscle tone
d) Fear of pain and of ripping sutures during a bowel movement
b) Decreasing levels of oestrogen
- Primary sites for postpartum infections would include all of the following except
a) Respiratory tract
b) Endometrium
c) Urinary tract
d) Breasts
a) Respiratory tract
- When caring for a postpartum woman with a uterine infection the nurse should
a) Administer an antipyretic when the temperature rises above 37.5oC
b) Provide at least 2000mls of fluid a day
c) Obtain specimens for cultures before initiating antibiotic treatment
d) Reassure the woman that future reproduction will not be affected
c) Obtain specimens for cultures before initiating antibiotic treatment
- A definition of cor pulmonalae is
a) L) sided heart failure secondary to disease of the lungs
b) L) sided heart failure secondary to R) sided heart failure
c) R) sided heart failure secondary to severe lung disease
d) Disease of the lungs secondary to R) sided heart failure
c) R) sided heart failure secondary to severe lung disease
- The main function of alveoli is
a) Bacterial filtration
b) Exchange of gases
c) Conduction of gases
d) Pleural attachment
b) Exchange of gases
- The patency of the trachea is maintained by
a) Incomplete rings of cartilage
b) Circular smooth muscle fibres
c) Thickly layered pseudostratified epithelium
d) Elastic connective tissue
a) Incomplete rings of cartilage
- Human milk is preferably to cows milk because
a) Human milk is a non laxative effect
b) Human milk has more calories per ml
c) Human milk is great mineral content
d) Human milk offers greater immunologic benefits
d) Human milk offers greater immunologic benefits
- Which of the following neonates will most likely need additional respiratory support at birth
a) The infant born by normal vaginal delivery
b) The infant born by caesarean birth
c) The infant born vaginally after 12 hours of labour
d) The infant born with high levels of surfactant
b) The infant born by caesarean birth
- During the transition from foetal to neonatal circulation, the newborn cardiovascular system accomplishes which of the following anatomic and physiologic alterations
1. Closure of the ductus venosus
2. Closure of the foramen ovale
3. Closure of the doctus arteriosis
4. Increased systemic pressure and decreased pulmonary artery pressure
a) 1,2,3 and 4
b) 1,2 and 3
c) 2,3 and 4
d) 1,3 and 4
c) 2,3 and 4
- A woman diagnosed with marginal placenta praevia gave birth vaginally 15 minutes ago. She is at greatest risk for
a) Haemorrhage
b) Infection
c) Urinary retention
d) Thrombophlebitis
a) Haemorrhage
- The primary nursing focus of the fourth stage of labour would be to
a) Prevent infection
b) Facilitate newborn – parent interaction
c) Enhance maternal comfort and rest
d) Prevent haemorrhage and shock
d) Prevent haemorrhage and shock
- Which of the following results of emphysema is primarily responsible for cardiomegaly
a) Hypertrophy of muscles encircling the bronchi
b) Increased pressure in the pulmonary circulation
c) Decreased number of circulating red blood cells
d) Secretion of excessive amounts of pericardial fluids
b) Increased pressure in the pulmonary circulation
- The tissue change most characteristic of emphysema is
a) Accumulation of pus in the pleural space
b) Constriction of capillaries by fibrous tissue
c) Filling of air passages by inflammatory coagulum
d) Overdistention, inelasticity and rupture of alveoli
d) Overdistention, inelasticity and rupture of alveoli
- Which of the following positions is most comfortable for a person with emphysema
a) Lying flat in bed
b) Reclining on his/her left side
c) Sitting of the edge of the bed
d) Lying flat on their back (supine)
c) Sitting of the edge of the bed
- A person of the following factors commonly predisposes to emphysematous lung changes
a) Chemical irritation of bronchiolar and alveolar linings
b) Sudden increase in intrapulmonary pressure coincident with hypertension
c) Obstruction of air passages by spasms of bronchiolar muscles
d) Senile degenerative changes in the vertebral bodies and intervertebral discs
a) Chemical irritation of bronchiolar and alveolar linings
- Oxygen therapy is administered at low concentrations (below 35%), for people with chronically elevated pCO2 levels, as for some people with chronic obstructive respiratory disease, in order to prevent
a) Depression of the respiratory centre
b) Decrease in red blood cell formation
c) Rupture of emphysematous bullae
d) Excessive drying of respiratory mucosa
d) Excessive drying of respiratory mucosa
- A newborns birth weight is 3400krms. The maximum expected weight loss for this newborn would be
a) 170 grms
b) 340 grms
c) 510 grms
d) 680 grms
b) 340 grms
- The birth weight of a breast feed newborn was 3600 grms. On the third day the newborns weight was 3350 grms. The nurse should
a) Encourage the mother to continue breast feeding as her babys nutrient and fluid needs are being met
b) Suggest that the mother switch to bottle feeding as breastfeeding is ineffective in meeting her babys needs
c) Notify the doctor as the baby has lost too much weight
d) Refer the mother to a lactation consultant to improve her breastfeeding technique
a) Encourage the mother to continue breast feeding as her babys nutrient and fluid needs are being met
- Which of the following would be an unexpected sign of dehydration in the newborn
a) Weight loss
b) Reduced turgor
c) Concentrated urine
d) Decreased frequency and amount of urine
a) Weight loss
- The nurse would recognise that a new mother understood breastfeeding instructions when she explains
a) I feed my baby every two hours around the clock
b) I always start feeding on my right breast, as my baby feeds best on that breast
c) I use both the football and the traditional positions for feeding
d) I let my baby continue to suck for a while on the second breast once its empty
c) I use both the football and the traditional positions for feeding
- Which of the following actions of a breastfeeding mother indicate the need for further instruction
a) Holds breast with four fingers along the bottom and thumb at the top
b) Leans forward to bring breast towards the baby
c) Stimulates the rooting reflex than inserts nipple and areola into newborns open mouth
d) Puts her finger into newborns mouth before removing breast
d) Puts her finger into newborns mouth before removing breast
- Characteristically, respirations of the client in diabetic acidosis are
a) Shallow and irregular
b) Uneven in rate and depth
c) Deep, rapid, with acetone breath, (kussmaul)
d) Rapid and shallow
c) Deep, rapid, with acetone breath, (kussmaul)
- The most important feature of foot care for a diabetic would be to
a) Cut nails straight across
b) Maintain adequate blood flow to the lower limbs
c) Wear sandals at all times
d) Avoid wearing garters
a) Cut nails straight across
- Excessive thirst for people with diabetes mellitus is a result of
a) Need for increased amounts of water to hydrolyse food during digestion
b) Loss of excessive body water due to increased daily urine volume
c) Reflex adaption to a sustained elevation of body temperature
d) Compensatory adjustment to decreased production of posterior pituitary hormone
b) Loss of excessive body water due to increased daily urine volume
- For people with diabetes mellitus polyuria is the result of
a) Increased glomerular permeability due to generalized vascular damage
b) Increased glomerular filtration due to decreased serum albumin concentration
c) Increased volume of glomerular filtrate due to elevated blood pressure
d) Decreased water resorption due to high tubular osmotic pressure
d) Decreased water resorption due to high tubular osmotic pressure
- A normal CBG (capillary blood glucose) reading is within the range of
a) 1-5 mmol/L
b) 4-7 mmol/L
c) 6-12 mmol/L
d) 3-10 mmol/L
b) 4-7 mmol/L
- The foetal presenting part is described as vertex when the
a) Face enters the pelvis first
b) Buttocks emerge with legs extended over the abdomen
c) Flexed head enters pelvis first
d) Foetal lie is longitudinal
c) Flexed head enters pelvis first
- When examining the umbilical cord immediately after birth the nurse should expect to observe
a) One artery
b) Two veins
c) Whitish grey colouration
d) Slight odour
c) Whitish grey colouration
- Vitamin K is given to the newborn to
a) Reduce bilirubin levels
b) Increase the production of red blood cells
c) Stimulate the formation of surfactant
d) Enhance the ability of the blood to clot
d) Enhance the ability of the blood to clot
- The nurse is performing a 5 minute apgar on a newborn. Which of the following observations is included in the apgar score
a) Blood pressure
b) Temperature
c) Muscle tone
d) Weight
c) Muscle tone
- At birth the major cause of heat loss is by
a) Evaporation
b) Radiation
c) Conduction
d) Convection
a) Evaporation
- The newborn would respond most effectively to feeding in which state
a) Drowsy
b) Quiet alert
c) Active alert
d) Crying
b) Quiet alert
- A pregnant woman at 30 weeks gestation exhibits a rise in her baseline systolic blood pressure of 32mmHg, a weight gain of 4 kgs since last week and difficulty removing rings she normally wears. This is suggestive of
a) Gestational hypertension
b) Pre eclampsia
c) Eclampsia
d) Elevated liver enzymes
a) Gestational hypertension
- The primary pathophysiologic basis for the clinical manifestations of pregnancy induced hypertension (PIH) is
a) Fluid retention related to excessive salt intake
b) Ineffective excretion of fluid by the kidneys
c) Cardiac decompensation
d) Ineffective dilatation of the vascular network to accommodate the expanding blood volume of pregnancy
d) Ineffective dilatation of the vascular network to accommodate the expanding blood volume of pregnancy
- Which measure would be least effective in relieving the signs and symptoms of mild pre eclampsia
a) Low salt diet
b) Period of bed rest
c) Balanced diet with protein
d) Relaxation techniques
d) Relaxation techniques
- A woman with severe pre eclampsia is being monitored for assessment findings indicative
of cerebral oedema and venospasm. Which of the following would you not expect to find
a) Hypotonic deep tendon reflexes
b) Headache
c) Vision changes including blurring and spots before the eyes
d) Insomnia
d) Insomnia
- Newly expectant parents, ask the nurse how they can prepare their 3yr old preschool daughter for the new baby. All of the following would be useful except
a) Tell the child about the pregnancy as soon as mother begins to look pregnant
b) Arrange for a few sleep overs with the person who will care for the child at the time of the birth
c) Transfer their child to her new room and bed just before the expected birth of the baby
d) Introduce their child to preschool as soon as possible
c) Transfer their child to her new room and bed just before the expected birth of the baby
- A patient with a diagnosis of schizophrenia says to the nurse ‘im like a fallen star. But I wont go to the bar… it would be mar on my family, on the tar’. This is an example of
a) A loose association
b) A delusion
c) Word salad
d) Clang association
d) Clang association
- A person diagnosed with schizophrenia tells the nurse that ‘the voices have told me im in danger’. He stays in his room, wears the same clothes, and avoids cracks on the floor. The nurses best initial response to this information is
a) I know that these voices ar real to you, but I don’t hear them
b) Don’t worry, youre safe here. I wont let anything happen to you
c) You need to get out of your room and get your mind occupied
d) Would you like some prn medication
b) Don’t worry, youre safe here. I wont let anything happen to you
- Mr p a new client on the ward, allows himself to be escorted to the day room. However he does not speak in response to you. The most therapeutic nursing intervention is to
a) Ignore his silence and talk about superficial topics such as the weather
b) Involve him in group psychotherapy so other patients can encourage him to talk
c) Point out that he is making others uncomfortable with his silences
d) Plan time to spend with him, in silence, if that is his choice
d) Plan time to spend with him, in silence, if that is his choice
- In communicating with a client experiencing delusions, what is it best to do
a) Logically explain the delusions
b) Tell the client that they aren’t real
c) Acknowledge his belief, but state your own understanding
d) Ignore this topic when it is brought up
c) Acknowledge his belief, but state your own understanding
- Mr p is prescribed cloazpine tablets, initially at 50mg mane and 100 mg nocte. What is the most likely side effect that will be first noted
a) Neutropenia
b) Akathesia
c) Sedation
d) Agranulycytocis
c) Sedation
- On discharge what is the most important piece of information you must give to mr p
a) Report any flu like symptoms immediately
b) Ensure no doses of clozapine are missed
c) Don’t take clozapine with alcohol
d) Visit your GP regularly
a) Report any flu like symptoms immediately
- Which of the following represents a positive change of pregnancy
a) Morning sickness
b) Quickening
c) Positive pregnancy test
d) Foetal heart beat auscultated with Doppler
b) Quickening
- Which of the following statements can be used as a guideline for planning diets during pregnancy
a) A increase of 300 calories per day beginning in the first trimester
b) A ten percent increase in protein above daily requirements
c) Iron supplementation is recommended for women whose diets are lacking in iron
d) The requirement for folic acid is increased by 50 percent
c) Iron supplementation is recommended for women whose diets are lacking in iron
- In order to percent infection of hepatitis B virus, the pregnant woman should
a) Receive gamma globulin during the first trimester
b) Carefully wash hands before eating or preparing food
c) Receive the hepatitis B vaccine
d) Take AZT during the second and third trimester
c) Receive the hepatitis B vaccine
- Which of the following represents a recommended weight gain during pregnancy
a) 6-11 kgs
b) 11-16 kgs
c) 13-18 kgs
d) 18-20 kgs
b) 11-16 kgs
- Johns behaviour are increasingly annoying to other patients. The best nursing approach is to
a) Explain that he must try to conserve his energy
b) Set limits on his behaviours and be consistent in approach
c) Tell him he is annoying to others and ask him to stay in his room
d) Ask him to walk to town to burn off energy
b) Set limits on his behaviours and be consistent in approach
- John also has been described as having flight of ideas. These would be likely present when john
a) Asks for a cup of tea, but tells you later he doesn’t want it
b) Takes a long time to make his point in conversation
c) Rapidly changes topic in conversation, sometimes without apparent connection
d) Speaks in a staccato voice and says words you don’t understand
c) Rapidly changes topic in conversation, sometimes without apparent connection
- John has been prescribed chlorpromazine (largactil) tablets 150mg nocte since being on the ward. The most likely reason for this is to
a) Cause a deep dreamless sleep
b) To reduce agitation, anxiety and tension
c) To reduce external stimuli
d) To prevent long term mood swings
b) To reduce agitation, anxiety and tension
- John tells you he feels faint when he first gets out of bed, since taking the largactil. Which response would best assist john
a) Tell him not to get until the nurse is present
b) Suggest he does not get up until he has taken the medication
c) Tell him to discuss this with the doctor
d) Explain he should sit on the bed for a time before standing
d) Explain he should sit on the bed for a time before standing
- John has also taking lithium carbonate capsules. Creatinine clearance tests ordered during lithium carbonate therapy determines the functioning of the
a) Liver
b) Pancreas
c) Renal system
d) Thyroid gland
c) Renal system
- Mihi means traditional greetings and is normally extended to
1. The land
2. The meeting house
3. The dead
4. The people present
5. The reason for the hui
a) 1,2 and 5
b) 1,3 and 4
c) 2,3 and 4
d) All of the above
d) All of the above
- The internal migration of maori people from rural to urban life since the mid 1940s has adversely affected maori health. What is the most likely reason for this
a) Over crowding within urban communities
b) Increased exposure to infectious diseases
c) Dietary changes from naturally produced to processed food
d) Loss of cultural, social, and spiritual ties
d) Loss of cultural, social, and spiritual ties
- Which of the following interventions would be most helpful for david in dealing with his impending death
a) Distract him by initiating conversation that does not deal with his disease
b) Encourage him to reach out and spend more time with his wife and children
c) Listen and encourage david to reminisce about his life
d) Help him to spend much of his time sleeping
c) Listen and encourage david to reminisce about his life
- David tells the nurse, that he does not want his wife and children to know that his is dying. What would be the most helpful response
a) They would not want you to upset yourself by worrying about them
b) You are concerned that they will be distressed
c) I think we should talk about something less stressful for you
d) Sit quietly and say nothing
b) You are concerned that they will be distressed
- Which of the following interventions is the most effective in helping davids wife and children deal with davids impending death
a) Try to keep all the family at the same stage in the grieving process
b) Encourage the family to verbalise their grief to the nurse
c) Encourage the family to spend as much time as possible with david
d) Encourage the family to cry but not in the presence of david
c) Encourage the family to spend as much time as possible with david
- Your client has cancer, nobody can tell him until his surgeon arrives from 5 days away. However in the meantime his anxiety is increasing. What should you do
a) Contact a social worker/chaplain to spend time with him
b) Give him relaxation tapes to listen to
c) Tell him his results are not back yet
d) Speak with the doctor who is acting in the surgeons place
d) Speak with the doctor who is acting in the surgeons place
- Your patient, who is a voluntary admission to a mental health unit, leaves the following day without telling anyone. Legally, what is required to staff
a) Provide care for him at home
b) Re admit him under a compulsory order
c) Get police to bring him in to sign a statement
d) Do nothing, the patient has rights to leave health care at any time
d) Do nothing, the patient has rights to leave health care at any time
- Pepe a 26 year old, developmentally delayed maori man, who at aged two years contracted meningitis. He has been cared for in an insititution, and is now to be moved to the community. Pepe is able to live in the community. What action should be taken now
a) Ring his whanau to advise them of his discharge
b) Ask the social worker to tell the family pepe is to be discharged
c) Arrange for pepe to visit with his whanau
d) Organise a conference with the whanau
d) Organise a conference with the whanau
- What statement would best describe your next action
a) Organise regular meetings between nursing staff and whanau prior to discharge
b) Support pepes whanau in being able to visit and to be involved in his discharge planning
c) Invite the whanau in to explain what will be required of them in caring for pepe
d) Make sure the whanau understand pepe limitations in self care
b) Support pepes whanau in being able to visit and to be involved in his discharge planning
- Pape has been discharged to a marae based community house. How would you ensure his continued well being
a) Set up regular appointments to monitor pepes well being
b) Explain to the community workers pepes requirements
c) Arrange for pepe to attend the local sheltered workshop
d) Ensure pepe and his whanau have on going support and access to resources
d) Ensure pepe and his whanau have on going support and access to resources
- Blake a 65 year old kaumatua (elder) is admitted with urinary retention. He is quiet and appears withdrawn. Blakes whanau arrived. A female doctor tells them he needs a urinary catheter inserted. Blakes son refuses to have a young woman doctor catheterise his father. What is your most appropriate response
a) Let us talk about this together
b) I will contact the maori support person for you
c) I will inform the doctor of your decision
d) Tell him that this is the only doctor available
b) I will contact the maori support person for you
- Blake falls in the shower sustaining a laceration to his right elbow. His family are angry and upset. What is the most appropriate action to take in this situation
a) Enquire of the whanau if blake has had previous falls
b) Offer for them to take to the doctor
c) Acknowledge their anger and discuss ways to prevent further falls
d) Acknowledge their anger and ensure the whanau it will not happen again
c) Acknowledge their anger and discuss ways to prevent further falls
- Charlie a 62 year old who identifies as maori is admitted to your ward with shortness of breath. He is very anxious and has no family with him. What is the most appropriate initial action to take
a) Introduce Charlie to others in the room
b) Telephone his whanau to come and visit
c) Carry out a physical assessment on Charlie
d) Acknowledge charlies anxiety and ask how you can help
d) Acknowledge charlies anxiety and ask how you can help
- Iris condition deteriorates and she dies. What is the most appropriate nursing action to help the whanau
a) Ensure privacy for the family to have karakia (prayers)
b) Allow a spokesperson to contact the rest of the family
c) Move iris body to a side room
d) Offer the whanau to go to a quiet room for a cup of tea
a) Ensure privacy for the family to have karakia (prayers)
- The doctor asks the whanau for the corneas of iris for transplantation. The whanau cannot make a decision right now. What is the most appropriate action you should take in support of the whanau
a) Tell the doctor that this is not culturally appropriate
b) Listen to them and support them in their decision
c) Explain to the whanau why corneas are transplanted
d) Suggest the whanau talk to the hospital chaplain
b) Listen to them and support them in their decision
- Stanley progresses well. His chest tube is removed. He still does not have much of an appetite and is concerned about his diet. Which of these responses would be of help
a) Eat three large meals a day that are high in carbohydrates
b) Eat three large meals a day that are high in protein
c) Eat six small meals a day that are high in carbohydrates
d) Eat six small meals a day that are high in protein
d) Eat six small meals a day that are high in protein
- Select the most appropriate nursing intervention to assist. Stanley to mobilise without becoming breathless
1. Gradually increase mobility
2. Assess respiratory function related to mobility
3. Administer oxygen prior to mobilising
4. Increase time up by 10 minutes per day
5. Continually assess respiratory function
a) 1 and 5
b) 4 and 5
c) 1 and 2
d) 3 and 5
a) 1 and 5
- Tom a 38 year old businessman, voluntarily admits himself to a detoxification unit. He admits to drinking one large bottle of vodka each day. Which of the following ego defense mechanisms is a top and continuing priory in dealing with alcoholic clients
a) Dependency
b) Denial
c) Paranoia
d) Projection
b) Denial
- Of the following approaches to the treatment of alcoholism, which has been found to be the most effective to date
a) Membership in alcoholics anonymous
b) Family systems approach
c) Treatment alcoholism as a chronic disease
d) Individual psychotherapy
c) Treatment alcoholism as a chronic disease
- Mr quang duc pho 65 years old is admitted to hospital after arriving with a group of boat people from Vietnam. On the basis of the results of a manitous test, chest x ray examination, and sputum cultures a diagnosis of acive pulmonary tuberculosis is made. The most appropriate area in which to nurse mr quang on admission is
a) A single room, isolated from all other patients
b) The general male ward
c) Among other patients with infectious disease
d) With other male Vietnamese refugees
a) A single room, isolated from all other patients
- 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
a) A small red swelling less than 7mm in diameter
- 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 an 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
b) Sputum collects more readily in upper lobes than in lower lobes
- Which of the following precautions must the nurse take when attending routinely to mr quang
a) Put on a gown, mask and gloves
b) Wash hands thoroughly after handling contaminated articles
c) Wear a mask when in close proximity to him
d) Insist that he wear a mask when care is given
c) Wear a mask when in close proximity to him
- Mr quang tuberculosis is considered to be under control when
a) He becomes mantoux negative
b) His chest x ray film is free of any lesion
c) He has three consecutive negative sputum cultures
d) His symptoms of tuberculosis have subsided
d) His symptoms of tuberculosis have subsided
- Quangs chemotherapy regime includes the drugs ethambutol, riampicin. What is the rationale for prescribing triple therapy for mr quang
a) The combination of three drugs is necessary to destroy the tubercule bacillus
b) If there is resistance to one drug, effective double therapy is assured
c) High serum levels of the drugs are achieved early in the treatment
d) The asian strain oftuberculosis is particularly resistant the chemotherapy
b) If there is resistance to one drug, effective double therapy is assured
- Mr quangs daily ethambutol dosage is based on 25mg per kg of body weight. Given that he weighs 48kg and ethambutol is dispensed in 400mg tables, how many tablets should the nurse administer
a) Two
b) Three
c) Four
d) Five
b) Three
- Which of the following symptoms are associated with ethambutol toxicity
a) Nausea and vomiting
b) Vertigo and ataxia
c) Blurred vision and colour blindness
d) Tinnitus and hearing loss
c) Blurred vision and colour blindness
- Mr quangs is concerned because his urine has changed to an organge red colour. The most appropriate response is
a) This is a usual side effect of one of your tablets
b) Ill test your urine to see if there is blood present
c) This is a desired effect of your treatment
d) The drug which is causing this will be discontinued
b) Ill test your urine to see if there is blood present
- You are working on a ward where several staff members complain about carrying another nurse. As a colleague, you have professional responsibility to
a) Tell them to do their own work and not be concerned with others
b) Suggest they speak to the nurse concerned in order to negotiate the workload
c) Talk to the nurse and encourage her to try some other form of work
d) Tell them to sort it out between themselves without involving other people
b) Suggest they speak to the nurse concerned in order to negotiate the workload
- The NZNA standards for nursing practice were developed to
a) Provide outcome criteria for the evaluation of nursing practice
b) Provide a framework for standardised nursing care
c) Promote the development of a theory for nursing
d) Define the scope of nursing practice
b) Provide a framework for standardised nursing care
- Mrs fitzpatick, a client in a ward opposite chris, asks the nurse ‘what is wrong with that person opposite me’? what should the nurse say
a) I do not know
b) Oh nothing, she just wanted to talk about some problems she is having
c) Ill get the doctor to talk to you
d) Im sorry I cannot disclose that information
d) Im sorry I cannot disclose that information
- Chris says he 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 walk about what is worrying you
d) If that’s what you have decided I will get a self discharge form
b) It would be very unsafe for you to leave hospital without proper medical treatment
- Larry and mary smith had planned their first pregnancy for sometime, but when it is confirmed, mary feels conflicting emotions. She comes to the clinic for her first prenatal (antenatal) visit at ten weeks gestation. Mary shares her mixed feelings about the pregnancy with the midwife. The midwifes best response would be to
a) Encourage her to consider abortion counselling
b) Encourage her to seek support from larry
c) Reassure her that when she feels the baby move, her mixed feelings will disappear completely
d) Reassure her that most women experience some mixed feelings in early pregnancy, even when their pregnancies are planned
b) Encourage her to seek support from larry
- Marys last menstrual period was 11 april. Her EDD (expected date of delivery) would be
a) 4 january
b) 18 january
c) 25 january
d) 4 february
b) 18 january
- During a subsequent visit, mary states she has begun to feel foetal movement. Foetal movement is usually felt by the pregnant woman when the fetus is approximately
a) 12 weeks gestation
b) 16 weeks gestation
c) 22 weeks gestation
d) 26 weeks gestation
d) 26 weeks gestation
- Tui k is 22 years old and has missed two of her regular menstrual periods. Her doctor confirms she is pregnant. This is her first pregnancy. Tui can expect to experience all the following signs in the early stages of her pregnancy except
a) Chadwicks sign
b) Goodells sign
c) Humans sign
d) Frequency of micturition
c) Humans sign
- During tuis sixth week of pregnancy she experienced a small episode of vaginal bleeding. You should suspect
a) Placenta previa
b) Urinary tract infection
c) Threatened abortion
d) Abruption placenta
c) Threatened abortion
- Tui asks for advice on diet. Which of the following is the best approach
a) Give her a list of the five basic food groups and tell her to include them in her daily intake
b) Tell her to increase her caloric intake so she gains about 12 kg during the pregnancy
c) Take a diet history that includes socio economic status, previous nutritional status and food preferences
d) Take a diet history, analyse it and say what foods she must now omit
c) Take a diet history that includes socio economic status, previous nutritional status and food preferences
- Tui and her partner hawea, attend antenatal classes together. One of the topics discussed are danger signs of pregnancy. Which of the following is normal and not a danger sign
a) Regular contractions occurring before the due date
b) Vaginal changes, including leucorrhoea
c) A sudden change in fetal activity patterns
d) Any bleeding from the vagina
a) Regular contractions occurring before the due date
- At 34 weeks gestation, mary is hospitalised with severe HOP (hypertension, oedema, proteinuria) syndrome. Which of the following represents an unusual finding for this condition
a) Blood pressure 150/100
b) Large amount of protein in the urine
c) Convulsions
d) Generalised oedema
c) Convulsions
- Candice meeker is expecting her first baby. Candice is interested in having an independent midwife deliver her baby. The certified midwife is licensed to
a) Manage the care of women throughout the clildbearing cycle
b) Manage the care of women only durine the intrapartal period
c) Manage the care of women throughout the childbearing cycle under direct supervision of a GP
d) Contract with a GP to do their prenatal care
a) Manage the care of women throughout the clildbearing cycle
- John is timing the frequency of candices contractions. This means he is timing
a) From the end of one contraction to the beginning of the next
b) From the beginning of one contraction to the beginning of the next
c) From the beginning of one contraction until it begins to go away
d) From the beginning of one contraction until it is completely over
b) From the beginning of one contraction to the beginning of the next
- Neil grant, six months old, is admitted to the childrens ward with severe dehydration due to vomiting and diarrhoea, IV fluids are commenced. One of the dangers of IV therapy is overhydration. This could lead to
a) Infiltration
b) Kidney failure
c) Rupture of the bladder
d) Pulmonary oedema
d) Pulmonary oedema
- Neils blood pressure is very low. You realise that a low blood pressure is expected because
a) Neil has been vomiting
b) He has been receiving IV therapy
c) He has an elevated temperature
d) His circulating blood volume is low
d) His circulating blood volume is low
- Patty ray 6 years old, is admitted to the childrens ward with a diagnosis of cystic fibrosis. Postural drainage is ordered for patty. Postural drainage consists of
a) Chest percussion, and vibration
b) Retraining techniques, allowing patty to be more active
c) Chest percussion and positioning to drain and remove secretions from pattys lungs
d) Providing patty with exercises that will assist her to control breathing and prevent dyspnoea
c) Chest percussion and positioning to drain and remove secretions from pattys lungs
- The most important nursing intervention in giving daily care to patty is
a) Forcing her to eat because she is malnourished
b) Seeing she receives the appropriate dietary regime
c) Frequent skin care to remove excessive salt deposits from increased perspiration
d) Having her repress her feelings of anger
c) Frequent skin care to remove excessive salt deposits from increased perspiration
- Patty spends a lot of time in the play room. What does make believe play in hospital provide for a child
a) Ability to accept a parent substitute
b) opportunity to learn to know other children more quickly
c) opportunity to reject the reality of the hospital
d) opportunity to express fears
d) opportunity to express fears
- you are teaching pattys parents how to care for her at home. Which of the following do you include
a) regular medication dosage according to urine testing
b) use cough suppressant only at bedtime
c) do postural drainage three times a day
d) restrict her activities
c) do postural drainage three times a day
- while working in the childrens ward, the staff nurse asks you the following questions relating to legal issues. How would you reply. When may a child be treated without parental consent
a) if they require treatment
b) if they need a blood transfusion
c) in the emergency care situation
d) in the absence of a parent or guardian
c) in the emergency care situation
- under what circumstances must permission from the court be sought to treat a minor
a) when the parent or guardian refuses treatment
b) in the case of parental absence, abandonment or incompetence
c) when the minor is seriously injured
d) in the case of parental separation
a) when the parent or guardian refuses treatment
- you are working with the public health nurse in a rural area. A mother attends the childrens clinic asking for information regarding an outbreak of chicken pox in the area. You advise
a) that the effects of chicken pox on the child are minimal and the childs schooling will not be affected
b) that an immunisation is available for chicken pox for all children at 18 months of age
c) that chicken pox is a notifiable disease and the child must be seen by a general practitioner if you suspect this condition
d) that chicken pox is a contagious viral disease which can be transmitted by direct contact with skin lesions
d) that chicken pox is a contagious viral disease which can be transmitted by direct contact with skin lesions
- later that morning, joan smith phones to tell you that her 18 month old son, jared, has been diagnosed with whooping cough. Joan asks you what she can do for jared. You suggest
a) regular fluids and increased food intake
b) continue as normal and encourage activity
c) humidified air, regular fluids and rest
d) isolate from other adults and rest
c) humidified air, regular fluids and rest
- matthew, is nursed at rest with the head of the bed elevated to 30 degrees as directed. The purpose of this is to
a) prevent Mathew developing skin abrasions from shifting and turning in the bed
b) prevent Mathew from developing complications such as a DVT and chest infection
c) assisting Mathew to see and have conversations with the other patients in his cubicle
d) assisting in reducing any cerebral oedema Mathew may have and improving venous drainage from his head
d) assisting in reducing any cerebral oedema Mathew may have and improving venous drainage from his head
- your assessment of matthew shows a widening pulse pressure. The term pulse pressure refers to
a) the difference between a bounding and or thread pulse
b) the difference between a bounding and thread pulse rate
c) the difference between diastolic and systolic blood pressure
d) the difference between diastolic blood pressure and pulse rate
c) the difference between diastolic and systolic blood pressure
- jacksons fracture is immobilised by open reduction and internal fixation. A nurse, new to the orthopaedic area asks you to explain what is meant by open reduction and internal fixation. You reply
a) bringing both bone ends into alignment by surgical intervention and holding them in position with a metal plate and screws
b) bringing bone ends into alignment by external manipulation and holding them in position with a stienman pin and traction
c) bringing bone ends into alignment by external manipulation and holding them in position by an external fixating device
d) bringing bone ends into alignment by surgical intervention and holding them in position by a tight back slab and firm bandage
a) bringing both bone ends into alignment by surgical intervention and holding them in position with a metal plate and screws
- you are on duty in the surgical ward of a small rural hospital when james dickey aged 30 is admitted with a crush injury to his right arm. On arrival james arm is wrapped in a blood soaked towel, but he hasn’t received any other first aid. As you do your initial assessment you note james has extensive soft tissue damage which includes a 15cm laceration, a large haemotoma and severe bruising. James becomes very agitated at the sight of the haemotoma and asks you to explain it. You reply
a) it was caused by splintering of underlying bone at the time of injury
b) it was caused by muscle spasm occurring at the time of injury
c) it was caused by blood vessels bleeding into the soft tissue at the time of injury
d) it was caused by the tearing of subcutaneous tissue at the time of injury
c) it was caused by blood vessels bleeding into the soft tissue at the time of injury
- while treating james wound the doctor becomes aware that it will require extensive debridment before good healing will occur. The term debridment means to
a) irrigate the wound to remove blood clots
b) cauterize all bleeding points and wash out blood clots
c) tie off blood vessels and nerves deep in the wound
d) cut away all damage and necrotic tissue and remove and foreign material
d) cut away all damage and necrotic tissue and remove and foreign material
- due to the nature of james wound prophylactic IV antibiotics and intravenous therapy is to be commenced. The doctor prescribes a litre of dexterose/saline over 8 hours. The giving set you use has a drop factor of 60 drops/ml. Which of the following flow rates will ensure james receives the IV fluid within the correct time frame
a) 115
b) 125
c) 135
d) 145
b) 125
- As james waits to be transferred to theatre you note his bleeding is increasing and you monitor him more closely. What changes to his vital signs would you expect to see if his blood loss becomes excessive
a) Slowing of pulse rate, increasing blood pressure, elevated temperature
b) Increasing pulse rate, stable blood pressure, elevated temperature
c) Stable pulse rate, dropping blood pressure, normal temperature
d) Increasing pulse rate, dropping blood pressure, normal temperature
d) Increasing pulse rate, dropping blood pressure, normal temperature
- James is becoming shocked in this instance. What type of shock will this be
a) Neurogenic shock
b) Hypovolemic shock
c) Septic shock
d) Cardiogenic shock
b) Hypovolemic shock
- Physiological compensation by the body in this type of shock will include all of the following except
a) Vasoconstriction of the capillary beds
b) Increased pumping efficiency of the heart
c) Fluid shift extra cellular to intravascular
d) Increased sodium excretion of sodium by the kidneys
d) Increased sodium excretion of sodium by the kidneys
- Henare is a 25 year old man admitted for emergency surgery, he has a left inquinal hernia which is nonreducible. This means that he has
a) A weakness in the abdominal wall opening through which the spermatic cord emerges
b) A hernia sac which does not return to the abdominal cavity as a result of swelling
c) Abdominal content, usually omentum or intestine descending into the groin or scrotum creating a mass
d) A direct inguinal hernia resulting from bowel and bladder content passing through the posterior inguinal wall
c) Abdominal content, usually omentum or intestine descending into the groin or scrotum creating a mass
- Pat is a 20 year old woman with a diagnosis of PID (pelvic inflammatory disease). Her nursing assessment includes temperature 38.4c, moderate lower abdominal pain, and an offensive vaginal discharge. Nursing interventions for pats care would include
a) Bed and chair rest with legs elevated
b) Monitor temperature and pulse twice daily
c) Nurse at rest in a semi fowlers position
d) Monitor blood pressure three times a day
b) Monitor temperature and pulse twice daily
- Pat asks you is it true that some STDs can cause cervical cancer. Your answer would be
a) Recent research strongly, suggests that both genital warts and genital herpes may cause cervical cancer
b) Yes all the STDs are capable of causing cervical cancer
c) Any woman who has multiple partners has a high risk of developing cervical cancer
d) Yes but only those who have the genital herpes virus
c) Any woman who has multiple partners has a high risk of developing cervical cancer
- Nina is 33 years old, she has had rheumatoid arthritis for the last five years, and is currently suffering from an exacerbation of her disease. You are visiting nina with the district nurse. Although nina is troubled with pain, she is most worried about caring for her 8 month old son and her home. Nina and the nurse establish a plan to manage ninas pain which is related to joint inflammation. Which of the following strategies will provide relief for her
a) Applying warm, moist compresses 30 minutes before doing house hold activities requiring hand and finger movements
b) Taking salicylates after activity to decrease the inflammation caused by activity
c) Loosing 5 kg to limit stress placed on joints
d) Applying cold compresses after activities to numb the pain if it does occur
a) Applying warm, moist compresses 30 minutes before doing house hold activities requiring hand and finger movements
- Which is the correct statement about rheumatoid arthritis. This disease
a) Affects both men and women equally
b) Mainly affects the larger weight bearing joints
c) Is a systemic disease with multiple joint involvement
d) Never occurs in children
c) Is a systemic disease with multiple joint involvement
- Mrs mary brown, aged 34 years, has had abdominal surgery. 24 hours later she complains of pain in her left calf. Your first action should be to
a) Palpate the calf to note tenderness or pain
b) Check mrs browns pedal pulses
c) Ask mrs brown to extend her leg and dorsi flex her foot and note if this causes pain
d) Measure the circumference of the right and left calves and note the difference
d) Measure the circumference of the right and left calves and note the difference
- Compartment syndrome is a possible complication of fractures. Which assessment data should the nurse report immediately
a) Increasing pain out of proportion to the sustained injury
b) Capillary refill which takes two seconds
c) Parathesia which decreases with movement of the affected part
d) Mild oedema of the affected limb
c) Parathesia which decreases with movement of the affected part
- Mrs skinner has a blood transfusion in progress following hip replacement .her blood group is a. This means that in an emergency she could receive blood from
a) Any other group
b) Any group except b
c) Group A only
d) Group A and O only
d) Group A and O only
- Twelve hours after the operation mrs skinner started shivering and complaining of pain in her back. Her pulse was very rapid. In these circumstances which one of the following should the nurse do first
a) Take her temperature
b) Give her an extra blanket
c) Send for medical aid
d) Stop the blood transfusion
d) Stop the blood transfusion
- The most probable explanation for mrs skinners symptoms is
a) Infection of the urinary tract
b) Reaction to the anaesthetic
c) An allergic reaction to the blood transfusion
d) An allergic reaction to the metal prosthesis
c) An allergic reaction to the blood transfusion
- John an 18 year old student, has been assigned to your care. He is jaundiced and his clinical appearance suggests that he has hepatitis a. Hepatitis a is an inflammatory condition of the liver caused by
a) Auto immune processes following a viral infection
b) a virus which infects the person via the GI system
c) a virus which is only transmitted via contaminated blood products
d) a virus which is mainly transmitted by sharing needles
d) a virus which is mainly transmitted by sharing needles
- following a bout of hepatitis A most people can expect
a) to become a carrier
b) frequent relapses
c) lifelong immunity to hepatitis A
d) increased risk of liver cancer
a) to become a carrier
- the jaundice in hepatitis a is best described a
a) haemolytic
b) bilio static
c) obstructive
d) hepato cellular
d) hepato cellular
- the incubation period is
a) less than 10 days
b) 5-15 days
c) 15-50 days
d) 40-60 days
c) 15-50 days
- Smoking is bad for people with chronic respiratory disorders because cigarette smoke
a) Destroys the cilia which cleanse debris from the airways
b) Inhibit s the inspiratory centres in the central nervous system
c) Inhibit nerves involved in the reflex pathways involved in coughing
d) Prevents the vocal cords closing tightly together when swallowing
a) Destroys the cilia which cleanse debris from the airways
- One reason why smokers with chronic respiratory problems should not be given medications that inhibit the cough reflex, as
a) These medications dry up mucous and make secretions difficult to expel
b) The hypoxic drive is inhibited causing a slow in breathing rate
c) Coughing is their only means of preventing mucous accumulating in the lungs
d) In people with chronic problems these medications have no effect anyway
c) Coughing is their only means of preventing mucous accumulating in the lungs
- Asthma is a disorder primarily characterised by
a) Hyperinflation and over expansion of lung tissue
b) Spastic constriction of the respiratory airways
c) A breakdown in the walls of alveolar tissue
d) Chronic dilation and expansion of the airways
b) Spastic constriction of the respiratory airways
- During acute asthmatic attacks theophylline medications are given because they
a) Stimulate the inspiratory centre
b) Raise the blood PO2 levels
c) Hyperinflate the lung
d) Dilate the bronchioles
d) Dilate the bronchioles
- Aminophylline comes in ampoules of 250mgs in 10mls. How much in mls, would you draw up to obtain 300mgs
a) 8.3
b) 12.0
c) 83.0
d) 120.0
b) 12.0
- In the early stages of obstruction to urine flow, symptoms which a client with an enlarged prostate gland might experience include
a) Difficulty in emptying his bladder and hematuria
b) Foul smelling urine with a high bacteria count
c) Complete retention of urine and dribbling
d) Frequency, urgency, a poor stream and nocturia
d) Frequency, urgency, a poor stream and nocturia
- A client is prescribed 1 litre of dextrose/saline to be given over 3 hours. If the IV giving set has a drop factor of 15 drops per ml, which of the following, in drops per minute, gives the correct rate
a) 17
b) 33
c) 67
d) 83
d) 83
- Your client states that she is most unhappy with the care she is receiving from her doctor and wishes to change doctors. You respond
a) Would you like to talk to me about why you are unhappy with your care – i may be able to help
b) Okay should be no problem, its your choice after all
c) I don’t think thats a good idea – it can glad to the doctor becoming annoyed
d) Hospital policy does not allow for you to make a choice of doctor but would you like to talk to me about your concerns
a) Would you like to talk to me about why you are unhappy with your care – i may be able to help
- Jenny is 22 years old and has been admitted under section 8 of the mental health act (1992). This period of assessment of jenny is for
a) 14 days
b) 6 months
c) 7 days
d) 5 days
d) 5 days
- Jenny feels frightened and is obviously psychotic. She feels persecuted and has paranoid delusions that we will harm her. Delusions, like this are
a) False ideas that are entrenched and permanent
b) Fixed, false beliefs that do not respond to reasoning
c) Transitory fantasies which diminish with medication
d) Illogical ideas which can be reasoned and explained to her
d) Illogical ideas which can be reasoned and explained to her
- Jennys family tell you that they feel frightened when she talks about people who are going to harm her. They ask you what they should say. A therapeutic response to the family would be
a) Talk about something else and distract jennys attention
b) Identify that you know she is really going to be harmed
c) Identify with how she is feeling and state what you see as reality
d) Tell them to ignore the comments and respond positively to jenny
c) Identify with how she is feeling and state what you see as reality
- Jenny has been commenced on chlorpromazine medication and has been sitting outdoors. She complains of sunburn and you note how reddened her skin seems. As a nurse you are aware that his is due to
a) Ultraviolet light and the fairness of jennys skin
b) A skin reaction to the medication jenny commenced
c) Increased photosensitivity to ultraviolet light from the chlorpromazine
d) Allergic reaction to the medication and subsequent redness of skin
c) Increased photosensitivity to ultraviolet light from the chlorpromazine
- Jenny approaches you, clasping your hands and telling you she needs help. You note that her eyes appear to have rolled backwards and that her neck is rigid. Your nursing diagnosis is
a) Attention seeking behaviour with manipulative overtones
b) Parkinsons disease and high level of anxiety
c) Oculogyric crisis due to extra pyramidal side effects
d) Akathisia due to side effects from the medication
c) Oculogyric crisis due to extra pyramidal side effects
- In an acute presentation, such as jenny, the need to administer medication so as to address the situation is important. The most likely choice of drug would be
a) Trifluoperazine
b) Thioridiazine
c) Haloperidol decanoate
d) Benzotropine mesylate
d) Benzotropine mesylate
- When administering this medication what is the dosage and upper limit or ceiling in a twenty four hour period
a) 2mgs, up to 6mgs/24hrs
b) 6mgs, up to 12mgs/24hrs
c) 20mgs, up to 60mgs/24hrs
d) 4mgs, up to 12mgs/24hrs
b) 6mgs, up to 12mgs/24hrs
- Tom has a diagnosis of bipolar affective disorder and his family ask you to talk with them about it. They ask you what an affective disorder is. A therapeutic response would be
a) An abnormality in the mood or feeling state of a person
b) A dysfunctional emotive illness exacerbated intermittently
c) A chronic and progressive deterioration in the emotion of a person
d) A strange feeling which is abnormal in origin
a) An abnormality in the mood or feeling state of a person
- Tom is due for a test today and the lab technicians arrive to do the blood test.
- Tom asks you what the level needed in his blood is. A correct response is
a) 1.5-2meg
b) 0.1-0.3meg
c) 0.5-1.3meg
d) 1.0-1.9meg
c) 0.5-1.3meg
- Toms level comes back from the lab who ring you to tell you that his level is very high. The immediate nursing actions would involve
a) A check to see if a.m. dose was given, discontinue meds and notify doctor
b) Commencement on fluid balance chart and vital recordings
c) Encourage fluid intake and continue meds and document observations
d) Inform tom he is toxic, place on bedrest and notify next of kin
a) A check to see if a.m. dose was given, discontinue meds and notify doctor
- Tom is assessed and has lithium toxicity. The symptoms we would expect to see as nurses are
a) Palpitations, skin rash and headache
b) Photophobia, bradycardia and dyspnoea
c) Coarse tremor, diarrhoea, vomiting and sluggishness
d) Thirst, nausea, skin rash and pain on dorsal flexion
c) Coarse tremor, diarrhoea, vomiting and sluggishness
- You are a domicillary nurse and have been visiting liz in the community. Liz is receiving an antipsychotic in infectable form. Which medication is not an injectable antipsychotic
a) Pipothiazine
b) Thiroidiazine
c) Haldol deconoate
d) Flupenthixol
b) Thiroidiazine
- Before liz was commenced on her medication you asked that she be charted a test dose. This lower dose is
a) Given then reviewed after 5 days before regular charting begins
b) Given fortnightly for a period of six months
c) Administered and then followed immediately by a regular dose if no reaction is noted
d) Administered once and then repeated weekly for four weeks
a) Given then reviewed after 5 days before regular charting begins
- Liz continues to request that her injection site be in her buttock and refuses to have it in the thigh. You have permission to do this. You assure the accurate site by
a) Locating the upper, outer quadrant of the buttock
b) Locating the lower, outer quadrant of the buttock
c) Locating the iliac crest and administering the injection
d) Locating the midline and injecting 3cms to the side of it
a) Locating the upper, outer quadrant of the buttock
- In regularly dispensing injectable medication you are aware as a nurse that the medication is locally irritating. You therefore
a) Administer it in one area only
b) Rub the area gently following administration
c) Rotate sites and do not rub/massage the area
d) Apply heat and massage the area
c) Rotate sites and do not rub/massage the area
- Jan is a first line manager responsible for the care of a group of patients. She is concerned because for the last three weeks the physiotherapist has been late to see the patients and sometimes has not come at all. She has called the physiotherapist but the situation has not improved. Jans next action should be to
a) Write a memo to the physiotherapy department
b) Contact a nursing clinical advisor
c) Notify the physician of the situation
d) Consult her nurse manager
b) Contact a nursing clinical advisor
- In organisations the primary management function is to
a) Assess and establish goals
b) Establish a framework in which to function
c) Plan for results
d) Control all operations
b) Establish a framework in which to function
- Cohesiveness is important to all teams. This means
a) The process a group goes through in deciding what to do
b) A mutual attraction which holds a group together
c) A decision made by a knowledgeable leader for the group
d) A strong organisational support system of the group
b) A mutual attraction which holds a group together
- Part of jans position requires her to manage the budget. This is
a) A statement of future expenditures
b) A list of current expenditure
c) A plan for meeting expenses
d) A recording of past expenditure
c) A plan for meeting expenses
- Jan is aware that nursing tasks and quality of nursing practice are compared with which pivotal question
a) Does the performance match standards and objectives
b) Does the performance reflect interest and enthusiasm for the job
c) Does performance indicate knowledge and expertise
d) Does performance leave the patients comfortable
a) Does the performance match standards and objectives
- Elanore brown aged 20, is a passenger who is thrown clear when the car she is travelling in hits a lamp post. Eleanor exhibits internal bleeding later diagnosed a ruptured spleen. First aid care for Eleanor includes elevating her limbs. This is done to
a) Decrease her venous return
b) Lower her blood pressure
c) Increase her venous return
d) Assist her to breathe
c) Increase her venous return
- Eleanor is admitted to the accident and emergency department in advanced stage two shock. When taking her base line observations you would expect to find
a) Elevated BP, elevated pulse rate and elevated respiratory rate
b) Decreased BP, decreased pulse rate and decreased respiratory rate
c) Decreased BP, increased pulse rate and increased respiratory rate
d) Decreased BP, decreased pulse rate and increased respiratory rate
c) Decreased BP, increased pulse rate and increased respiratory rate
- Eleanor is catherterised and her urine output is monitored hourly. This is done to
a) Provide an indication of her renal perfusion
b) Ensure she does not go into fluid overload
c) Ensure she is receiving adequate hydration
d) Monitor the concentration of serum electrolytes
a) Provide an indication of her renal perfusion
- Eleanor also requires additional nursing observations. Which of the following is the most appropriate
a) Mental status exam and urinary electrolytes
b) Level of consciousness and abdominal girth
c) Papillary reaction to light and limb movement
d) Swallowing reflex and orientation to time and place
b) Level of consciousness and abdominal girth
- A sample of eleanors blood is sent to the laboratory for cross matching. When eleanors blood group has been identified the best treatment for her is to transfuse her with
a) Packed cells
b) Whole blood
c) Lactated ringers
d) Plasma
b) Whole blood
- John smith aged 50 receives 30% burns to his face, neck, arms and upper
- thorax when he pours petrol onto his barbecue. The most appropriate
- immediate first aid treatment for mr smith is to
a) Roll him in a damp rug to extinguish the flames
b) Remove his burning clothes as fast as possible
c) Quickly throw him into the swimming pool
d) Quickly roll him in a wet sheet and apply ice to his burns
a) Roll him in a damp rug to extinguish the flames
- Smoke inhalation can complicate burn injuries. While waiting the ambulance the most appropriate position for conscious victims of smoke inhalation is
a) Sitting in the semi fowlers position
b) Laying down with neck hyperextended
c) Lying supine with the legs elevated
d) Lying in the recovery position
a) Sitting in the semi fowlers position
- Which of the following is correct with regard to burn injuries
a) Partial thickness burns are not painful as the nerve endings are destroyed
b) Full thickness burns are often very painful as the nerve endings are irritated
c) Full thickness burns are often not painful as the nerve endings are destroyed
d) Blistering and redness often occur very quickly following a full thickness burn
c) Full thickness burns are often not painful as the nerve endings are destroyed
- Factors determining the severity of the burn injury include
a) Depth of burn and percentage of body surface area burnt
b) Location of the burn on the body and age of the victim
c) Size of the burn and previous medical history of the victim
d) All of the above
d) All of the above
- You consider joe to be quite disturbed and communicate this to joes doctor. Eventually joe is hospitalised for assessment and treatment. Joe continues to have delusions. Reality for joe will be reinforced by
1. Listening to him carefully
2. Calling him by name
3. Calling him at mealtimes
4. Reminding him to change his clothes
a) 1, 2 and 3
b) 2 only
c) 1, 2 and 4
d) All of the above
b) 2 only
- In view of his age and stage of development, and given his disorder thinking, joe will most likely need all except
a) Reminding to wash his body
b) Reminding to change his clothes
c) Reminding to attend group
d) Reminding to eat and drink
d) Reminding to eat and drink
- Therapeutically, doing what you say you will is important in establishing
a) Patterns of reliability
b) Trust in a relationship
c) Self respect
d) Patterns of predictability
a) Patterns of reliability
- At the next team meeting it is decided to commence joe on medication in an attempt to impose a control on his disorder thoughts. Of the following, which will contribute most to the teams choice of the mode of administration of the drug
a) Joes attitude to medication generally
b) The amount of insight about his situation
c) Joes trust in the medical staff
d) Joes trust in his primary nurse
d) Joes trust in his primary nurse
- Of the following which is likely to contribute to the choice selecting a depot medication for a patient
a) The patient requesting the medication be given by injection
b) Convenience for the community psychiatric nurse
c) Likelihood of the client defaulting with oral medications
d) Convenience for the clients family
c) Likelihood of the client defaulting with oral medications
- In any situation where restraint is necessary, which of the following is not true
a) Questions asked by the patient are answered by one staff member
b) One staff member per limb is the minimum safe requirement
c) Medication will always be given to effect control
d) The patient is most safely restrained lying down
c) Medication will always be given to effect control
- When caring for potentially suicidal patients, the nurse should
1. Respect their right to privacy foremost
2. Know their where3abouts at all times
3. Remove dangerous objects from their rooms
4. Allow weekend leave to boost morale
a) 1 and 2
b) 2 and 3
c) 3 and 4
d) 1 and 3
b) 2 and 3
- Mr white is a depressed patient who has said ‘im fed up.
I don’t intend to go on like this’ the nurse should
a) Ask him directly if he is considering suicide
b) Ignore the statement and continue the conversation
c) Change the subject but report incident to charge nurses
d) Comment that others are worse off than he is
a) Ask him directly if he is considering suicide
- Disulfiram (antabuse) is given to people suffering from alcoholism
a) To ease their anxiety
b) To discourage them from drinking
c) To help them with depression
d) During detoxification
b) To discourage them from drinking
- Which of the following is a temporary form of amnesia, usually occurring at higher levels of intoxication
a) An alcohol psychosis
b) A hypersensitive reaction
c) A blackout
d) A hangover
c) A blackout
- Which of the following is not a progressive stage of addiction
a) Experimentation
b) Compulsive involvement
c) Infrequent involvement
d) Harmful involvement
d) Harmful involvement
- When a person tries to make up for weaknesses in one area by playing up strengths in another, it is termed
a) Displacement
b) Compensation
c) Projection
d) Rationalisation
b) Compensation
- The act specifically excludes a number of diagnostic groups from compulsory assessment and treatment. These include
a) Substance abuse, intellectual handicap and personality disorder
b) Manic depressive psychoses and schizophrenia
c) Hebephrenia, schizo affective illness and drug induced psychoses
d) Paranoid schizophrenia, bi polar affective disorder and psychoses
a) Substance abuse, intellectual handicap and personality disorder
- Mr elias who is a 19 year old, pakeha male, who has been admitted to ED following a motorbike accident. Mr elias had been drinking heavily in isolation prior to the accident and his flatmates had discovered a suicide note in his room. In the admitting room doctors have made a provisional diagnosis of head injury, right pneumothorax and a compound fracture of his right tibia and fibula. Emergency nursing in this situation is concerned with focussing on your patients immediate needs and setting priority of care. Therefore your first nursing action is to
a) Suction his airway and administer oxygen by mask
b) Do a rapid assessment for baseline blood pressure and pulse
c) Assess for clear airway and presence of respirations
d) Assess levels of consciousness and papillary reaction
c) Assess for clear airway and presence of respirations
- The Glasgow coma scale is used to establish the level of consciousness. All of the following are used except
a) Papillary response to light
b) Eye opening on request
c) Verbal response on request
d) Motor response on request
a) Papillary response to light
- Changes in the patients condition which would indicate increasing intracranial pressure are
a) Stable level of consciousness, increasing pulse rate, widening pulse pressure
b) Stable level of consciousness, increasing pulse rate, stable pulse pressure
c) Increasing level of consciousness, decreasing pulse rate, narrow pulse pressure
d) Decreasing level of consciousness, decreasing pulse rate, widening pulse pressure
d) Decreasing level of consciousness, decreasing pulse rate, widening pulse pressure
- Mr elias general condition deteriorates with hypovolaemic shock. The cardinal signs of which are
a) Slowing of pulse rate, increasing blood pressure, elevated temperature
b) Increasing pulse rate, stable blood pressure, elevated temperature
c) Increasing pulse rate, dropping blood pressure, normal temperature
d) Stable pulse rate, dropping blood pressure, normal temperature
c) Increasing pulse rate, dropping blood pressure, normal temperature
- To evaluate the effectiveness of fluid replacement for the patient in hypovolaemic shock, you would first look for return to normal range of
a) Haemoglobin
b) Pulse rate
c) Temperature
d) Blood pressure
d) Blood pressure
- Mr elias compound fracture of the tibia and fibula is immobilised by open reduction and internal fixation. A nurse, new to the orthopaedic area asks you to explain what is meant by open reduction and internal fixation. You reply
a) Bring both bone ends into alignment by surgical intervention and holding them in position with a metal plate and screws
b) Bringing bone ends into alignment by external manipulation and holding them in position with a Steinmann pin and traction
c) Bringing bone ends into alignment by external manipulation and holding them in position by an external fixing device
d) Bringing both bone ends into alignment by surgical intervention and holding them in position by a tight back slab and firm bandage
a) Bring both bone ends into alignment by surgical intervention and holding them in position with a metal plate and screws
- Mr evans is a twenty year old patient admitted with hepatitis B to a medical ward you are working on. Jaundice has developed because
a) The liver is unable to absorb vitamin B
b) Prothrombin time is prolonged
c) Of the damaged livers inability to metabolise bilirubin
d) Liver enzymes are released and liver function decreases
c) Of the damaged livers inability to metabolise bilirubin
- For which of the following reasons would a patient with jaundice develop the nursing diagnosis of high risk for impaired skin integrity
a) Jaundice is associated with decubitus formation
b) Jaundice impairs urea formation
c) Jaundice produces pruritus due to impaired bile excretion
d) Jaundice leads to decreased tissue perfusion
d) Jaundice leads to decreased tissue perfusion
- Henare is a 25 year old man admitted for emergency surgery, he has a left inquinal hernia which is nonreducible. This means that he has
a) A weakness in the abdominal wall opening through which the spermatic cord emerges
b) A hernia sac which does not return to the abdominal cavity a result of swelling
c) Abdominal content, usually omentum or intestine descending into the groin, or scrotum creating a mass
d) A direct inguinal hernia resulting from bowel and bladder content passing through the posterior inguinal wall
c) Abdominal content, usually omentum or intestine descending into the groin, or scrotum creating a mass
- Pat asks you ‘is it true that some STDs can cause cervical cancer’ your answer would be
a) Recent research strongly, suggest that both genital warts and genital herpes may cause cervical cancer
b) Yes all the STDs are capable of causing cervical cancer
c) Any woman who has multiple partners has a high risk of developing cervical cancer
d) Yes but only those who have the genital herpes virus
c) Any woman who has multiple partners has a high risk of developing cervical cancer
- Four purposes of chromosomal studies, amniocentesis is most commonly performed
a) Anytime in early pregnancy
b) Usually not until after the 12th week
c) Usually not until after the 20th week
d) Anytime during pregnancy
b) Usually not until after the 12th week
- Tina, a midwife, tells an antenatal class that progesterone is considered the hormone most responsible for maintaining pregnancy. Where is the primary source of progesterone found throughout most of the pregnancy
a) The placenta
b) The corpus luteum
c) The ovary
d) The pituitary gland
a) The placenta
- Larry and mary smith had planned their first pregnancy for sometime, but when it is confirmed, mary feels conflicting emotions. She comes to the clinic for her first prenatal (antenatal) visit at ten weeks gestation. Mary shares her mixed feelings about the pregnancy with the midwife. The midwifes best response would be to
a) Encourage her to consider abortion counselling
b) Encourage her to seek support from larry
c) Reassure her that when she feels the baby move, her mixed feelings will disappear completely
d) Reassure her that most women experience some mixed feelings in early pregnancy, even when their pregnancies are planned
b) Encourage her to seek support from larry
- During a subsequent visit, mary states she has begun to feel fetal movement. Fetal movement is usually felt by the pregnancy woman when the foetus is approximately
a) 12 weeks gestation
b) 16 weeks gestation
c) 22 weeks gestation
d) 26 weeks gestation
d) 26 weeks gestation
- Mary and larry are proud parents of a baby girl weighing 3050 gms. The apgar is nine at one minute. With an above apgar score the babys
a) Heart beat is absent
b) Body is pink but extremities are blue
c) Muscle tone is flaccid
d) Reflex irritability is absent
b) Body is pink but extremities are blue
- You assess marys fundas and find the fundus to be firm and off centre. You would suspect
a) A retained palcenta
b) A full bladder
c) The fundus is not well contracted
d) There are clots in the fundus
b) A full bladder
- On day five mary, and her baby are ready for discharge. You tell mary that should her vaginal bleeding increase excessively (secondary postpartum hemorrhage), she should notify her primary care given immediately. The most likely cause will be
a) Uterine fibroids
b) Lacerations during delivery
c) Retained placental fragments
d) Low haemoglobin levels
b) Lacerations during delivery
- Mary is breast feeding for the first time. She may require assistance. What is the most important factor to ensure successful breast feeding
a) Ensure comfortable position for mother
b) Ensure baby is attached to breast properly
c) Ensure babys suction is broken before detaching from breast
d) A support person is with her while feeding
b) Ensure baby is attached to breast properly
- Another mother tui also chooses to breastfeed. You are aware that breastfeeding is a natural form of contraception in that it is 98 effective, providing that
a) The baby is less than six months old and taking most of the nourishment from breast milk
b) The mothers menses have not returned and the baby is less than six months old
c) The baby is less than nine months old and feeding six to eight times per day
d) The baby is less than nine months old and has been fully breastfeed
b) The mothers menses have not returned and the baby is less than six months old
- During the discussion tui and henare ask what the Guthrie test is for you reply it is a test that
a) Assesses haemoglobin levels in the new born
b) Assesses the babies serum bilirubin levels
c) Identifies congenital disorders of metabolism
d) Identifies the hepatitis B virus
c) Identifies congenital disorders of metabolism
- Meningitis is a life threatening illness and it poses a grave concern for hughs parents. As hughs nurse you help to reduce their anxiety by the following
1. Educate them about the illness so they can understand its effects on hugh
2. Explain procedures so they can understand and help with highs care
3. Explain that hughs irritability is part of the illness
4. Give them time to discuss their concerns
a) 1 and 3
b) 2 and 4
c) 1, 3 and 4
d) All of the above
d) All of the above
- Benjamin Johnson, aged 4 falls off his bike when playing. You are working in the emergency department when he is admitted. Using the Glasgow coma scale you assess all of the following except
a) His temperature and pulse
b) His best motor response
c) His best verbal response
d) His ability to open his eyes
a) His temperature and pulse
- You also observe Benjamin for signs of increased intracranial pressure which include
a) Increase in pulse rate, drop in blood pressure
b) Increase in pulse rate, rise in blood pressure
c) Decrease in pulse rate, rise in blood pressure
d) Decrease in pulse rate, drop in blood pressure
c) Decrease in pulse rate, rise in blood pressure
- You are working with the public health nurse in a large urban area. You visit a day care centre at the request of the staff to visit joel hinton, aged 3 years. The staff are concerned because joel is becoming disruptive, has poor concentration, and has visible bruising. He has walked with a limp for the past week. On arrival at the day care centre, you would
a) Observe joel at play with other children
b) Ring joels family to ask them what is wrong with joel
c) talk to the staff about joel
d) assess the situation and meet with joel
a) Observe joel at play with other children
- you are going to report your suspicions regarding joel to the appropriate authority. The appropriate authority in this situation is
a) department of health
b) joels teacher at school or principal
c) joels general practitioner or practice nurse
d) the police, or department of social welfare
d) the police, or department of social welfare
- sarah miles has brought her six week old daughter sophie in to see the public health nurse you are working with .she wants to talk about the immunisation schedule as she is not sure if she should have sophie immunised. She expresses concern that sophie may react to the vaccine. The public health nurses best response would be
a) yes, this can happen but the research is inconclusive
b) this is very rare, however you and sophie should stay for 20 minutes after the vaccine
c) don’t worry as the chance of sophie having a reaction is minimal
d) don’t worry as this is only of concern if another member of your family has reacted to a vaccination
b) this is very rare, however you and sophie should stay for 20 minutes after the vaccine
- sarah asks how immunisations work. You explain the differences between active and passive immunisation. Which of the following is not associated with passive immunisation
a) protection is immediate
b) human globulin is given containing antibodies
c) it provides lifelong immunity
d) this type of immunity is provided through breastfeeding
c) it provides lifelong immunity
- the following day, Louisa whiti attends the clinic with her son jayden, aged 3 years. Louisa has noted jaydens behaviour is more disruptive than usual, and he does not respond to her calling him. Your initial nursing assessment would include which of the following
a) referral to a psychologist
b) telling Louisa about the possibility of sibling rivalry
c) reassuring Louisa this is normal behaviour for a 3 year old
d) inspection of both ears and a hearing test
d) inspection of both ears and a hearing test
- later that afternoon, susan jones aged 4 years comes to the clinic with her father anu. Susan has had recurrent bilateral otitis media with effusion for 6 months. She is booked for a myringotomy next week. Anu asks what this means. A myringotomy is
a) a surgical incision of the mastoid
b) a surgical incision of the tympanic membrane
c) a surgical incision of the Eustachian tube
d) the surgical removal of the adenoids
b) a surgical incision of the tympanic membrane
- john is unit manager in a local hospital. John is trying to build a climate of accountability in this unit. This means
a) nurses should involve patients and families in decisions and offer explanations for actions
b) registered nurses should report back to the unit manager regularly through the day
c) the unit manager is ultimately responsible for all the registered nurses actions
d) all of the above are true of accountability
b) registered nurses should report back to the unit manager regularly through the day
- john realises however that as a nurse manager he is accountable for his decisions. He takes this to mean that
a) he is able to make decisions in accordance with his beliefs and values
b) what is best for the patient overrides all other considerations
c) he is responsible for his actions and the consequence of his decisions
d) as nurse manager he is able to pass on to others praise or blame for outcomes of decisions
c) he is responsible for his actions and the consequence of his decisions
- accountability in the maintenance of quality nursing practice influenced most by
a) individual ideas regarding ethics, competence, commitment integrity
b) knowledge of professional standards and institutional and professional philosophy
c) knowledge of the nurses act and nursing councils role as well as malpractice decisions
d) all of the above have an influence
d) all of the above have an influence
- john is unit manager at a large aged care centre unit. Because increased competition in all areas of health care john is keen to see quality maintained on the unit. Appropriate quality indicators he could used could be
a) repetition of work and adverse events
b) inappropriate placements and waiting times
c) cancelled services and patient withdrawals
d) all of the above would be useful indicators
d) all of the above would be useful indicators
- john wants the staff to understand quality assurance and the difference from quality control. He tells them that quality assurance means
a) staff must monitor their own practice and take responsibility
b) at the end of each week staff will reflect on ways to improve
c) that specific check points will be put in place to monitor progress
d) random audits will be done of nursing care to spot check
a) staff must monitor their own practice and take responsibility
- one way of improving quality is to set standards. These
a) are broad aims or goals of the organisation
b) form the basis of an organisations mission statement
c) must be a specific statement about every aspect of care
d) describe what constitutes good care and state criteria to measure performance
d) describe what constitutes good care and state criteria to measure performance
- current literature identifies serious difficulties faced by the novice entering the workforce. New graduates often experience reality shock. This could be described as
a) having to suddenly drop one set of values and adapt to a new subculture
b) a situation where one feels unhappy in the new job and decide to move on
c) surprise and disequilibrium experienced on moving from a familiar to a new culture
d) the challenge of becoming competent and effective in the new culture
d) the challenge of becoming competent and effective in the new culture
- the first phase of reality shock is often known as the honeymoon phase, graduates would be wise to
a) explain their values and beliefs at the onset so that co-workers understand them
b) be as helpful as possible to co workers and build up a support system
c) do their own work to the best of their ability and keep to themselves
d) share their new enthusiasm and try to motivate other staff to new ways
b) be as helpful as possible to co workers and build up a support system
- gradually graduates move into the ‘recovery’ phase; this is a time to
a) re evaluate values, keep worthwhile values and transfer them to work setting
b) drop all the professional values learnt in school and adapt to unit values
c) subjugate both school values and work values and decide not to cause problems
d) start to watch all advertisements and look for a better job
a) re evaluate values, keep worthwhile values and transfer them to work setting
- mrs skinner has a blood transfusion in progress following hip replacement. Her blood group is a. This means that in an emergency she could receive blood from
a) any other group
b) any group except B
c) group A only
d) group A and O only
d) group A and O only
- twelve hours after the operation mrs skinner started shivering and complaining of pain in her back. Her pulse was very rapid. In these circumstances which one of the following should the nurse do first
a) take her temperature
b) give her an extra blanket
c) send for medical aid
d) stop the blood transfusion
d) stop the blood transfusion
- the most probable explanation for mrs skinners symptoms is
a) infection of the urinary tract
b) reaction to the anaesthetic
c) an allergic reaction to the blood transfusion
d) an allergic reaction to the metal prosthesis
c) an allergic reaction to the blood transfusion
- john an 18 year old student, has been assigned to your care. He is jaundiced and his clinical appearance suggests that he has hepatitis A. Hepatitis A is an inflammatory condition of the liver caused by
a) auto immune processes following a viral infection
b) a virus which infects the person via the GI system
c) a virus which is only transmitted via contaminated blood products
d) a virus which is mainly transmitted by sharing needles
d) a virus which is mainly transmitted by sharing needles
- following a bout of hepatitis a most people can expect
a) to become a carrier
b) frequent relapses
c) lifelong immunity to hepatitis a
d) increased risk of liver cancer
b) frequent relapses
- the jaundice in hepatitis A is best described as
a) haemolytic
b) bilio static
c) obstructive
d) hepato cellular
d) hepato cellular
- the incubation period is
a) less than 10 days
b) 5-15 days
c) 15-50 days
d) 40-60 days
c) 15-50 days
- Which of the following is not a typical sign of early hepatitis
a) Ascites
b) Slightly yellowing of the sclera
c) Clay stools
d) Anorexia
a) Ascites
- During the infectious stage, a person with hepatitis A is excreting the virus mainly in
a) Faeces
b) Urine
c) Saliva
d) All body fluids
d) All body fluids
- When a person is in the infectious stage of hepatitis A, special precautions are taken when you
a) Take a food tray to the person
b) Administer medications
c) Gave an antiemetic injection
d) Remove a used bedpan
d) Remove a used bedpan
- A client has been back from surgery for several hours and has not asked for pain medication. The client and nurse are from different cultural groups. Being aware of cultural influences on health behaviours, the nurse will
a) Realize the client probably does not feel as much pain as some people
b) Wait for the client to ask before bringing pain medication
c) Look for non verbal signs of pain, such as holding the incision or lying still
d) Tell the client to be sure to call her if he/she is in pain
c) Look for non verbal signs of pain, such as holding the incision or lying still
- Although the home health nurse has taught the client the importance of taking his antibiotic exactly every six hours, he still cannot seem to take it on schedule. In evaluating the effects of her teaching, the holistic nurse should consider that the client (who is from a different culture) possibly
a) Is relating to time differently than she
b) Has not understood what she taught
c) Does not believe the medicine will help
d) All of above
d) All of above
- Smoking is bad for people with chronic respiratory disorders because cigarette smoke
a) Destroys the cilia which cleanse debris from the airways
b) Inhibits the inspiratory centres in the central nervous system
c) Inhibit nerves involved in the reflex pathways involved in coughing
d) Prevents the vocal cords closing tightly together when swallowing
a) Destroys the cilia which cleanse debris from the airways
- One reason why smokers with chronic respiratory problems should not be given medications that inhibit the cough reflex is
a) These medication dry up mucous and make secretions difficult to expel
b) The hypoxic drive is inhibited causing a slowing in breathing rate
c) Coughing is their only means of preventing mucous accumulating in the lungs
d) In people with chronic problems these medications have no effect anyway
c) Coughing is their only means of preventing mucous accumulating in the lungs
- Asthma is a disorder primarily characterised by
a) Hyperinflation and over expansion of lung tissue
b) Spastic constriction of the respiratory airways
c) A breakdown in the walls of alveolar tissue
d) Chronic dilation and expansion of the airways
b) Spastic constriction of the respiratory airways
- During acute asthmatic attacks theophylline medications are given because they
a) Stimulate the inspiratory centre
b) Raise the blood PO2 levels
c) Hyperinflate the lung
d) Dilate the bronchioles
d) Dilate the bronchioles
- Aminophylline comes in ampoules of 250mgs in 10mls. How much in mls, would you draw up to obtain 300mgs
a) 8.3
b) 12.0
c) 83.0
d) 120.0
b) 12.0
- In the early stages of obstruction to urine flow, symptoms which a client with an enlarged prostate gland might experience include
a) Difficulty in emptying his bladder and hematuria
b) Foul smelling urine with a high bacteria count
c) Complete retention of urine and dribbling
d) Frequency, urgency, a poor stream and nocturia
d) Frequency, urgency, a poor stream and nocturia
- A client is prescribed 1 litre of dextrose/saline to be given over 3 hours. If the IV giving set has a drop factor of 15 drops per ml, which of the following in drops per minute, gives the correct rate
a) 17
b) 33
c) 67
d) 83
d) 83
- Your client states that she is most unhappy with the care she is receiving from her doctor and wishes to change doctors. You respond
a) Would you like to talk to me about why you are unhappy with your care i may be able to help
b) Okay should be no problem, its your choice after all
c) I don’t think thats a good idea it can lead to the doctor becoming annoyed
d) Hospital policy does not allow for you to make a choice of doctor but would you like to talk to me about your concerns
a) Would you like to talk to me about why you are unhappy with your care i may be able to help
- Mr tawhai, a 23 year old shearer presents in ED acutely ill with peritonitis. He says that he has had abdominal pain over the last 2 weeks but has been reluctant to seek help as he needs to continue working to support his large extended whanau. In your assessment your best response would be one of the following
a) Voice your disapproval of his non compliance. Tell him the consequences of his actions
b) Explain to him that its responsibility to seek treatment early
c) Empathise with the many factors in his life that make it difficult to seek early treatment
d) Blame his acute condition on his reluctance to seek earlier treatment
c) Empathise with the many factors in his life that make it difficult to seek early treatment
- Mrs netane, 68 year old is admitted with septicaemia following below knee amputation. She says to you that she has been treated by the maori healer and she wants them to keep treating her. Your reply would be
a) To encourage her choice to have the maori healer participate in her care
b) To tell mrs netane that you will pass her request on to medical staff
c) To tell mrs netane that its not part of hospital policy but she could seek a maori healer on discharge
d) To tell mrs netane that western medicine is more advanced and the maori healer hasn’t fixed her condition so far
a) To encourage her choice to have the maori healer participate in her care
- Mr smith a deeply religious 75 year old is about to have a blood sample taken when the maori minister appears to take prayers with him. The technician is in a hurry to do her rounds. You
a) Tell the maori minister to wait until after the blood sample has been taken
b) Tell the technician to come back at a later time
c) Offer to take prayers with mr smith if he has the blood test first
d) Seek medical advice
b) Tell the technician to come back at a later time
- Mrs jones, a closed brethren in B block is on a restricted diet. Her family and church members regularly bring in food for her. You
a) Take the food and put it in the kitchen for the nurses supper
b) Tell the family and the church members sternly not to bring in any more food because she is on a restricted diet
c) Tells mrs jones not to let the family and church members feed her any longer
d) Tell mrs jones, her family and church members the consequences of her eating the wrong diet
d) Tell mrs jones, her family and church members the consequences of her eating the wrong diet
or
b) Tell the family and the church members sternly not to bring in any more food because she is on a restricted diet
- Mr lance is a 22 year old homosexual whose partner died last year from aids. He presents at your GP practice without an appointment. He is coughing uncontrollably and sweating profusely in the waiting room which is full. You
a) Tell him to leave as he doesn’t have an appointment and hes upsetting the other patients
b) Take him to the treatment room and ask the GP to examine him when he has a chance
c) Quietly tell the receptionist that he probably has the aids virus and to be careful when she serves him
d) Take him to the treatment room so he doesn’t infect those in the waiting room
b) Take him to the treatment room and ask the GP to examine him when he has a chance
- Mr Prasad, a sixth is admitted to ICPU in an acute psychotic episode. You are told to remove his head dress so that he doesn’t hand himself. He begs you to leave it on. You
a) Order sedation for him and remove the head dress when he has quieted down
b) Use ‘calming and restraint’ with two other nurses and remove his head dress
c) Empathise with his pleading and leave the head dress on
d) Ring the sikh translator on the hospital phone list and ask him to come and tell mr Prasad that its ok to have his head dress removed
d) Ring the sikh translator on the hospital phone list and ask him to come and tell mr Prasad that its ok to have his head dress removed
- Mary maher is a primigravids, who has diabetes and required insulin for the last year. She has been told her insulin needs will increase during pregnancy. This statement is based on the fact that
a) The placenta produces a hormone that decreases maternal glucose levels
b) The placenta produces a hormone that decreases the effectiveness of maternal insulin
c) Her diabetic condition is becoming more severe
d) None of the above
b) The placenta produces a hormone that decreases the effectiveness of maternal insulin
- Mary is scheduled to have an aminocentesis. She is concerned that the placenta will be punctured and her baby will lose its adequate source of oxygen. The nurse assures mary that it is unlikely the placenta will be punctured because
a) The placenta is implanted in the fundus and insertion of the needs for aminocentesis is in the lower region of the uterus
b) The membrane covering the placenta is almost impossible to penetrate with a needle prior to term
c) Ultrasound is used just prior to amniocentesis to locate the placenta and prevent such a risk
d) Amioscopy is performed just prior to amniocentesis to locate the placenta and prevent such a risk
c) Ultrasound is used just prior to amniocentesis to locate the placenta and prevent such a risk
- Following an amniocentesis, mary should be advised to
a) Be on bedrest for at least the next 24-48 hours
b) Report any uterine contractions or abdominal pain
c) Record her temperature 4 hourly for the next 24 hours
d) Observe for blood in her urine
a) Be on bedrest for at least the next 24-48 hours
- Mary states at her next ante natal visit to her midwife that she has begun to feel foetal movement. Foetal movement is usually felt by the pregnant woman when the foetus is approximately
a) 12 weeks gestation
b) 16-20 weeks gestation
c) 22-24 weeks gestation
d) 26-28 weeks gestation
b) 16-20 weeks gestation
- Marys pregnancy progresses well and she goes into spontaneous labour at 38 weeks gestation. Her diabetes has been well controlled by insulin. Mary is now in active labour. On vaginal examination, her midwife finds that the foetal head is at -1 station. This means that the foetal head is
a) 1cm below the ischial spines
b) 1cm above the ischial spines
c) 1cm below the iliac spines
d) 1cm above the iliac spines
b) 1cm above the ischial spines
- You assisting the midwife who tells you mary is now in the transitional phase of the first stage of labour. In the transitional phase the cervix is
a) 0-3cm dilated
b) 3-5cm dilated
c) 5-7cm dilated
d) 7-10cm dilated
d) 7-10cm dilated
- Marys husband sean is timing the frequency of her contractions. This means he is timing from the
a) Beginning of one contraction to the beginning of the next
b) End of one contraction to the beginning of the next
c) Beginning of one contraction until it begins to go away
d) Beginning of one contraction until it is completely over
a) Beginning of one contraction to the beginning of the next
- The midwife takes marys blood pressure between contractions. The chief purpose underlying this action is because
a) It is more comfortable for mary
b) Diastolic blood pressure lowers between contractions
c) Maternal blood pressure does not change with contractions
d) Systolic blood pressure increases during uterine contractions
d) Systolic blood pressure increases during uterine contractions
- When mary and seans baby girl yara is born ,she does not cry immediately, but at one minute she is crying lustily and her baby is pink with blueness of extremities. Her heart rate is 156. The baby has an apgar score of
a) 7
b) 8
c) 9
d) 10
c) 9
- Johanna brown, 18 months old is admitted to the children ward with a diagnosis of bonchiolitis. Erikson has referred this age as a period of
a) Industry
b) Self actualisation
c) Trust
d) Autonomy
d) Autonomy
- On admission, Johanna is clinging to her mother and refuses to stay in the cot. Denise, johannas mother is upset. You would state
a) Put her in the cot and leave her for half and hour
b) It is normal for Johanna to want to stay with you
c) Give her some toys and she’ll be alright
d) She’ll soon get over it
b) It is normal for Johanna to want to stay with you
- Bronchiolitis is most commonly caused by which of the following microorganisms
a) Respiratory syncytial virus
b) Chlamydia bacteria
c) Parainfluenza virus
d) Enterovirus
a) Respiratory syncytial virus
- When doing johannas physical assessment you notice her respiratory function is diminished. This is because johannas
a) Alveoli are destroyed
b) Temperature is elevated
c) Bronchioles are inflamed
d) Heart rate is increased
c) Bronchioles are inflamed
- Johanna is scheduled for regular nebulizer treatment for the purpose of
a) Administering bronchodilators
b) Providing a dry mist to ease breathing
c) Reversing respiratory acidosis
d) Administering oxygen
a) Administering bronchodilators
- On taking johannas vital signs, you notice her temperature is 39.5 degrees. You would
a) Check her temperature again in half an hour
b) Give aspirin as prescribed and tepid sponge
c) Wrap her in a blanket to prevent chills, and administer paracetamol as prescribed
d) Tepid sponge her and administer paracetamol as prescribed
d) Tepid sponge her and administer paracetamol as prescribed
- As well as ensuring johannas respiratory status is stable, a further priority in your nursing intervention is
a) Giving her toys to play with
b) Spending time with Johanna to establish a rapport
c) Encouraging fluids and observing hydration status
d) Continuing with normal activities to reduce separation anxiety
c) Encouraging fluids and observing hydration status
- Johanna has recovered from the acute stage of her illness. In planning for her discharge, denise is encouraged to
a) Allow Johanna to rest and play as she feels able
b) Keep Johanna in bed as much as possible
c) Offer her small toys to occupy her
d) Discourage interaction with other children
a) Allow Johanna to rest and play as she feels able
- Dominic black, six months old, is admitted to the childrens ward with severe dehydration due to vomiting and diarrhoea. Iv fluids are commenced, one of the dangers of IV therapy is overhydration. This could lead to
a) Infiltration
b) Kidney failure
c) Rupture of the bladder
d) Pulmonary oedema
d) Pulmonary oedema
- Dominics blood pressure is very low. You realize a low blood pressure is expected because
a) Dominic has been vomiting
b) His circulation blood volume is low
c) He has been receiving iv therapy
d) He has an elevated temperature
b) His circulation blood volume is low
- Jo is a third year comprehensive student nurse who has just completed her elective clinical experience. Whilst on clinical jo was able to observe the management role. Jo noticed that the charge nurse managed to control all the activities in the ward really well. Controlling refers to actions taken to
a) Increase job satisfaction and motivation among employees
b) Increase productivity, innovation and quality outcomes
c) Ensure that actual outcomes are consistent with those planned and anticipated
d) Determine success or failure with tasks
b) Increase productivity, innovation and quality outcomes
- Quality control refers to activities which
a) Set standards and determine criteria
b) Determine whether standards have been met
c) Educate staff about corrective actions required
d) Evaluate, monitor or regulate services rendered to customers
d) Evaluate, monitor or regulate services rendered to customers
- One of the reasons the charge nurse controls well is that she has set standards for performance. A standard is
a) An agreed upon base line condition or level of excellence
b) An evaluation instrument tool used by all
c) A set of behaviours that are common and understood by all
d) A set of behaviours that are defined by others for a profession
a) An agreed upon base line condition or level of excellence
- While jo was on the ward a nursing audit was done. The nursing audit is a tool designed to evaluate
a) The nurses clinical practice
b) The nursing care clients receive
c) The charge nurses managerial skill
d) The cost of nursing care of clients
a) The nurses clinical practice
- Jo is keen to develop her own leadership and management skills. She knows as a newly registered nurse she will need to
a) Be able to organise herself well
b) Communicate with others effectively
c) Manage time effectively
d) All of the above
d) All of the above
- A conflict situation arose on the ward while jo was there. It is important in resolving conflict for a manager to
a) Make sure the better side wins
b) Tell each side what they need to do
c) Leave each side with their self esteem intact
d) Make sure the conflict is resolved immediately
d) Make sure the conflict is resolved immediately
- Constructive conflict can
a) Keep everyone on their toes
b) Encourage growth
c) Improve relationships on the ward
d) All of the above
d) All of the above
- There was always plenty of equipment in jos ward and one of the staff told her that the charge nurse ‘has great budgeting skills’. She probably meant that
a) The budget was used as a master plan for annual operation of the ward
b) The budget was used as a tool to evaluate the wards performance over the year
c) The budget allowed maxiumum utilization of resources to meet short and long term needs
d) All of the above would be correct about budgets
c) The budget allowed maxiumum utilization of resources to meet short and long term needs
- Jos elective experience brought home to her the fact that nurse often have to make decisions of an ethical nature. An ethical dilemma exists for the nurse when
a) Two nurses cannot agree on a course of action
b) The doctor and nurse are in conflict
c) A conflict exists between the nurses personal values and professional ethics
d) A conflict exists between the nurse and doctors personal values
c) A conflict exists between the nurses personal values and professional ethics
- Mr smyth has been admitted to the surgical ward with a provisional diagnosis of peritonitis. Mr smyth is examined by the surgeon who asks for him to be prepared for theatre. This preparation will probably include
1. Commencing IV fluids
2. Gastric aspiration
3. A bowel washout
4. Gastric lavage
a) 1 and 2
b) 2 and 3
c) 1 and 4
d) 3 and 4
a) 1 and 2
- It is possible that intraperitoneal inflammation can be localised. It is surrounded and sealed off by
a) Mesentery
b) Omentum
c) Peritoneum
d) Granulation tissue
b) Omentum
- Post surgery mr smyth has IV therapy – 1 litre of dextrose saline 8 hourly with potassium 30 mmols in each litre. It is necessary to augment IV therapy with potassium in this instance because
a) It is routine following this type of surgery
b) Excessive sodium is retained when potassium is not given
c) Potassium loss is excessive following this type of surgery
d) Nil by mouth reduces potassium absorption
c) Potassium loss is excessive following this type of surgery
- Mr smyth has a naso gastric tube in situ on free drainage. The function of the naso gastric tube in this instance is to
a) Prevent gastric reflux
b) Allow the gut to rest and heal
c) Allow for return of peristalsis
d) Maintain long term nil by mouth
a) Prevent gastric reflux
- For pregnancy confirmation what instructions regarding a specimen urine would you give
a) Give a voided specimen during her first visit
b) Instruct her on how to give a sterile specimen
c) Bring in the first voided specimen in the morning
d) A catheterised specimen will be required
c) Bring in the first voided specimen in the morning
- Which of the following is a complication of gestational proteinuria hypertension (GPH/HOP) syndrome
a) Hydrops fetalis
b) Placenta praevia
c) Ictirus neonatorum
d) Placental abruption
d) Placental abruption
- An acute communicable disease that can cause severe deformities in the fetus if contracted during pregnancy is
a) Syphilis
b) Morbilli
c) Gonorrhoea
d) Tuberculosis
a) Syphilis
- Pregnancy predisposes a woman to urinary tract infection because
a) There is a decrease in leucocytes in pregnancy
b) Urinary stasis results from dilated ureters
c) Vaginal flora becomes easily infected
d) Of an altered pH (acidity) of urine
d) Of an altered pH (acidity) of urine
- For an initial prenatal visit to the doctor, which of the following tests will be done
a) Blood pressure, urinalysis, ultrasound, blood pressure
b) Weight, blood pressure, family history, blood group
c) Urinalysis, weight, blood pressure, blood group
d) Blood group, weight, blood pressure, oestriols
c) Urinalysis, weight, blood pressure, blood group
- Dietary counselling for a pregnant client would include
a) Referral to the dietician
b) Discussing the importance of limiting salt to prevent gestational proteinuria hypertension (GPH) syndrome
c) Asking her what she eats at each meal
d) Telling her that proteins are essential for fetal development
c) Asking her what she eats at each meal
- A 36 weeks primigravidia, complains that her fingers are swelling. The nurse should
a) Tell her to take her rings off
b) Say that further bedrest will resolve this problem
c) Advise her to drink less fluid
d) Take her blood pressure
d) Take her blood pressure
- To prevent or ease varicose veins during pregnancy, women should be advised to
a) Elevate the legs when sitting
b) Sit in an upright chair with feet flat on the floor
c) Avoid excessive walking
d) Put on firm stockings after getting up
a) Elevate the legs when sitting
- Fetal distress during labour may be indicated by
1. Marked change in fetal heart rate
2. Irregularity of fetal heart rate
3. Meconium stained liquor
4. Hyperactivity of the fetus
a) 1 and 2
b) 3 and 4
c) 2, 3 and 4
d) 1, 2, 3 and 4
d) 1, 2, 3 and 4
- Which of the following can be described as a sign of true labour
a) A show of blood and mucous
b) Contractions increasing in frequency
c) Progressive cervical dilation
d) Rupture of the membranes
c) Progressive cervical dilation
- In the mechanism of labour for a right occipito posterior (R.O.P) position, external rotation of the head follows
a) Extension of the sinciput and face
b) Internal rotation of the shoulders
c) Crowning of the occiput
d) Restitution of the head
a) Extension of the sinciput and face
- Which mechanism of labour is responsible for the delivery of the fetal head
a) Extension
b) External rotation
c) Expulsion
d) Effacement
a) Extension
- Crowning occurs when
a) The largest diameters of the babys head have passed through the pelvic inlet
b) The largest diameters of the babys head have passed through the pelvic outlet
c) The largest diameters of the babys head are encircled by the vaginal opening
d) None of the above
c) The largest diameters of the babys head are encircled by the vaginal opening
- Presentation of the fetus refers to the
a) Level of fetal head in the pelvis
b) Part of the fetus lying in the lower pole of the uterus
c) Part of the fetus lying over the os during labour
d) Relationship of the denominator to the maternal pelvis
b) Part of the fetus lying in the lower pole of the uterus
- Position of the fetus refers to
a) The relationship of the fetal parts to each other
b) That part of the fetus that engages in the maternal pelvis
c) The relationship of the long axis of the fetus to the long axis of the mother
d) The relationship of the denominator to the maternal pelvis
c) The relationship of the long axis of the fetus to the long axis of the mother
- In caring for pre term infants, which of the following precautions should be taken against retrolental fibroplasias
1. Oxygen administration should be discontinued as soon as feasible
2. Oxygen concentration should be monitored
3. Daily tests should assess serum bilirubin levels
4. Eye covering should be applied to infants during phototherapy
a) 1 and 2
b) 2 and 4
c) 3 and 4
d) 1, 3 and 4
a) 1 and 2
- Neonatal hypoxia may be due to
a) Persistent effects of intra uterine hypoxia
b) Congenital abnormalities
c) Intracranial bleeding
d) All of these
d) All of these
- The neonates body temperature during the first several days is
1. Dependent upon the environment
2. Stable between 36.6 to 37.2 C
3. Dependent upon caloric intake
4. Immune to environmental changes
5. Dependent upon babys physiological state
a) 2, 4 and 5
b) 1, 2 and 5
c) 1, 3 and 5
d) All of these
c) 1, 3 and 5
- The skin of a newborn infant may be covered with a yellowish cheese like substance called
a) Lanugo
b) Milia
c) Mongolian spot
d) Vernex caseosa
d) Vernex caseosa
- A baby just born who has a spontaneous cry and breathing is established within 30 seconds. The apgar rating will probably be
a) 10
b) 9
c) 8
d). 7
a) 10
- The fetal heart rate per minute is normally between
a) 900-120
b) 100-150
c) 120-160
d) 130-170
c) 120-160
- The approximate daily fluid requirement for a 7 day old baby who is healthy and weighs 3.5 kilograms, will be
a) 110ml
b) 210ml
c) 330ml
d) 525ml
d) 525ml
- For a healthy full term baby, the earliest the Guthrie test is reliable is
a) Immediately following birth
b) 24 hours following birth
c) 48 hours following birth
d) 5 days following birth
c) 48 hours following birth
- You are asked about the likely outcome of treatment of (P>K>U>) phenylketonuria. Your answer should include
a) Normal development is assured if treatment is adhered to
b) Treatment by diet is necessary until adulthood.
c) Treatment by diet is designed to reverse the process of brain damage
d) Treatment by diet is essential for the prevention of mental deficiency
d) Treatment by diet is essential for the prevention of mental deficiency
- After birth the closure of the foramen ovale occurs because
a) Clamping of the umbilical vein reduces pressure in the right atrium
b) Expansion of the lungs and increased pulmonary circulation increases pressure in the left atrium
c) With its first cry the infant increases blood flow to the right side of its heart
d) A and b
b) Expansion of the lungs and increased pulmonary circulation increases pressure in the left atrium
- Fetal blood bypasses the lung by means of the
a) Formen ovale
b) Ductus venosis
c) Ductus arteriosis
d) Both a and c
d) Both a and c
- Retraction of uterine muscles during the first stage of labour causes
a) Reduction of the uterine capacity
b) Thinning of the uterine wall
c) Lengthening of teh muscle fibres
d) Placental separation
b) Thinning of the uterine wall
- The most important factor in preventing post partum haemorrhage from the placental site is
a) Complete separation of the placenta and membranes
b) Spasm of the muscular walls of the uterine arteries
c) Prevention of trauma of the uterus and birth canal
d) Contraction of the middle layer of the myometrium
a) Complete separation of the placenta and membranes
- A post partum haemorrhage is any blood loss exceeding
a) 200 millilitre
b) 300 millilitre
c) 500 millilitre
d) 1000 millilitre
c) 500 millilitre
- Persistent red lochia is
a) A normal phenomenon
b) Associated with cardiac disease
c) A prime cause of anaemia
d) A sign of possible infection
d) A sign of possible infection
- If a mother has placental abruption, the major sign she will exhibit is
a) Painful bleeding
b) Painless bleeding
c) Hypertension
d) Nausea and vomiting
a) Painful bleeding
