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c) it delays the release of an egg from your ovary until sperm are no longer active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
