Exam

Question 0

A pt with an acute exacerbation of COPD has the following ABG analysis: pH 7.32, PaO2 58 mmHg, paCO2 55 mmHg and sats 86%. You recognize these values as evidence of:

A. Respiratory acidosis
B. Respiratory alkalosis
C. Normal acid base balance with hypoxaemia
D. Normal acid base balance with hypercapnia

Answer 0

A. Respiratory acidosis

Question 1

Following assessment of a pt with pneumonia, you identify a nursing diagnosis of ineffective airway clearance. You base this nursing diagnosis on the findings of:

A. SpO2 of 85%
B. Resp rate of 28 bpm
C. Presence of greenish sputum
D. Crackles in the right and left lower lobes

Answer 1

D. Crackles in R and L lower lobes

Question 2

The most common cause of pulmonary oedema is abnormal _ function ?

A. Kidney
B. Lung
C. Cardiac
D. Alveolar

Answer 2

C. Cardiac

Question 3

A pt has a chest tube following a thoracotomy. Regular intermittent bubbling in the suction chamber of the collection device would alert you that:

A. An air leak may b present
B. The lung has fully expanded
C. The unit is functioning normally
D. A tension pneumothorax is developing

Answer 3

C. The unit is functioning normally

Question 4

A female pt is scheduled for a thoracentesis to obtain pleural fluid. She asks you to explain what causes the fluid in her lung; you explain that:

A. The pleural effusion could be caused by a tumor or other growth
B. A pleural effeson is not a disease but rather a sign of some other disease
C. Pleural effusions occur when there is any inflammation or infection in the lung
D. The cause of pleural effusions is not known but they can be treated by removing the fluid with a needle or tube

Answer 4

B. A pleural effusion is not a disease but rather a sign of some other disease

Question 5

Factors that influence the development of hypertension include all of the following except:

A. Increased sympathetic nervous system activity
B. Increased renal absorption of sodium chloride and water
C. Decreased activity or the renin-angiotensin system
D. Decreased vasodilation

Answer 5

C. Decreased activity of the renin-angiotensin system

Question 6

You teach a pt with hypertension that uncontrolled hypertension may damage organs in the body primarily by:

A. Promoting atherosclerosis and damage of the walls of the arteries
B. Thickening capillary membranes, leading to hypoxia of organ systems
C. Causing direct pressure on organs, resulting in necrosis and replacement of cells with scar tissue
D. Increasing the viscosity of the blood, contributing to intravascular coagulation and necrosis of tissue distal to occlusions

Answer 6

A. Promoting atherosclerosis and damage of the walls of the arteries

Question 7

In analyzing a pt’s ECG rhythm strip, you use the knowledge that the time of the conduction of an impulse from the SA node to the AV node is represented by the:

A. P wave
B. PR interval
C. QT interval
D. QRS complex

Answer 7

B. PR interval

Question 8

Cardiac output is calculated by multiplying:

A. The stroke volume and after load
B. The stroke volume and the pulse rate
C. The stroke volume and impulse rate
D. The after load and the preload

Answer 8

B. The stroke volume and the pulse rate

Question 9

One unit of packed cells is prescribed to be infused over 2hr. The volume of the packed cells 250ml. The infusion set drop factor is 20 d/ml. Which answer below is correct (to the nearest whole number).

A. 42 d/min
B. 84 d/min
C. 21 d/min
D. 125 d/min

Answer 9

A. 42 drops/min

Question 10

A pt with acute coronary syndrome is admitted to ED. Which of the following statements is not true of this diagnosis:
A. His ECG demonstrates ST segment elevation with T wave inversion
B. His chest pain lasts only 2-5 mins
C. His chest pain occurs at rest
D. His cardiac markers are normal

Answer 10

B. Hs chest pain lasts only 2-5mins

Question 11

CK-MB and troponin levels are evaluated for a pt who has experienced chest pain and aching for the last 4days. You expect:

A. Myoglobin levels will be needed to confirm myocardial damage
B. CK-MB will be the most reliable indicator of any myocardial necrosis that is present
C. Any serum cardiac marker will be inconclusive in determining myocardial injury that is several days old
D. The presence of myocardial damage occurring several days earlier can be validated best by troponin level

Answer 11

D. The presence of myocardial damage occurring several days earlier can be validated best by the troponin levels

Question 12

Metabolic syndrome increases the risk of coronary artery disease and consists of insulin resistance and:

A. Smoking/hypertension/obesity
B. Smoking/dysipidaemia/genetics
C. Obesity/smoking/genetics
D. Obesity/dyslipidaemia/hypertension

Answer 12

D. Obesity / dyslipidaemia / hypertension

Question 13

On admitting a pt with bladder Ca you identify a significant risk factor for this diagnosis is:

A. Chronic cystitis
B. Cigarettes smoking
C. High caffeine intake
D. Use if artificial sweeteners

Answer 13

A. Chronic cystitis

Question 14

Following rectal surgery, the pt tells you that he urinates about 10ml of urine every 30-60mins. From the skit below the best action for you to take initially is to:

A. Palpate for a distended bladder
B. Have the pt drink only small amounts of fluid throughout the day
C. Show the pt how to apply pressure on his bladder during urination
D. Monitor the pt’s fluid intake and output over an 8hr period to determine whether urine output is adequate

Answer 14

A. Palpate for distended bladder

Question 15

You are searching the literature for the highest level of evidence for the effectiveness of low glycaemic index (GI) diets on the reduction of blood sugar levels. You would therefore look for:

A. Case studiesn
B. Systematic reviews
C. Randomized double blind controlled trials
D. Prospective cohort studies

Answer 15

C. Randomized double blind controlled trials

Question 16

You explain to the pt that type 2 diabetes differs from type 1 primarily in that type 2 diabetes:

A. The pt is totally dependent on an outside source of insulin
B. There is decreased insulin secretion and/or increased cellular resistance to insulin that is produced
C. There are islet cell antibodies and insulin autoantibodies that destroy beta cells in the pancreas
D. The C-peptide chain of proinsulin secreted by the pancreas cannot be removed by the liver, resulting pin a lack of active insulin

Answer 16

B. There is decreased insulin secretions and /or increased cellular resistance to insulin that is produced

Question 17

A pt recovering from diabetic ketoacidosis asks you how acidosis occurs. Your best response is:

A. Excess glucose in the blood is metabolized by the liver into acetone, which is acidic in nature
B. An insulin deficit promotes metabolism of fat stores, which produce large amounts of acidic ketones
C. Insufficient insulin leads to cellular starvation and, as cells rupture, they release organic acids into the blood
D. When an insulin deficit causes hyperglycemia, then proteins are deaminated by the liver, causing acidic by-products

Answer 17

B. An insulin deficit promotes metabolism of fat stores, which produces large amounts of acidic ketones

Question 18

You are studying research that investigates the effectiveness of alginate dressings on the rate of wound healing. The rate of wound healing is known as the:

A. Control variables
B. Extraneous variables
C. Independent variables
D. Dependent variables

Answer 18

D. Dependent variables

Question 19

In a study where TED stockings and a calf stimulator were found to be significantly more effective in preventing post operative DVTs (deep vein thrombosis) that TEDs alone, the significance level would be:

A. Less than .05
B. Less than .5
C. Greater than .5
D. Greater than 1

Answer 19

C. Greater than .5

Question 20

A pt with hypovolaemic shock has a unrinary output of 30 ml/hr. You understand that the compensatory physiological mechanism that leads to altered urinary output is:

A. Release of aldosterone, which increases serum osmolarity, causing release of antidiuretic hormone (ADH)
B. Movement of interstitial fluid to the intravascular space, increasing renal blood flow
C. Activation of the sympathetic nervous system, causing vasodilation of the renal arteries
D. Beta-adrenergic recpetor stimulation that causes increased cardiac output as a result of increased heart rate and myocardial contractility

Answer 20

C. Activation of the sympathetic nervous system, causing vasodilation of the renal arteries

Question 21

The major contributing factor to the development of esophageal varsities is:

A. Portal hypertension
B. Water retention
C. Lymphodema
D. Increased serum bilirubin levels

Answer 21

A. Portal hypertension

Question 22

Hep A is transmitted primarily through the :

A. Sharing of needles
B. Faecal-oral route
C. Unsafe sex
D. Abuse of alcohol

Answer 22

B. Faecal-oral route

Question 23

You are caring for a pt with hepatic encephalopathy due to severe liver disease. What clinical manifestations specific to this disease should you be alert to when caring for this patient?

A. Intermittent severe right upper quadrant pain
B. Impaired peripheral circulation
C. Asterixis
D. Urinary retention

Answer 23

A. Intermittent severe right upper quadrant pain

Question 24

A reliable means of determining a pt’s total fluid status is to conduct:

A. 4hrly BP
B. Daily weights
C. Strict FBC
D. Diuretic challenges

Answer 24

B. Daily weights

Question 25

The primary functions of the thyroid gland are to:

A. Control cellular metabolic activity
B. Maintain body metabolism
C. Control normal growth
D. All of the above

Answer 25

D. All of the above

Question 26

Corticosteroid dosage must be gradually tapered off to avoid:

A. Thyroid storm
B. Addisonian crisis
C. Urinary retention
D. Adrenal insufficiency

Answer 26

D. Adrenal insufficiency

Question 27

Cushing’s syndrome has several classic signs, including facial hair, buffalo hump and:

A. Moon face
B. Pendulous breasts
C. Greatly enlarged ear lobes
D. Urinary retention

Answer 27

A. Moon face

Question 28

The most immediate life threatening of the fluid and electrolyte canes that occur in pt’s with acute renal failure is:

A. Hyponatremia
B. Hyperkalaemia
C. Hypocalcaemia
D. Hyperphospatemia

Answer 28

B. Hyperkalaemia

Question 29

The preferred method of permanent access for haemodialysis is:

A. Arteriovenous graft
B. PIC line
C. Peritoneal access device
D. Arteriovenous fistula

Answer 29

D. Arteriovenous fistula