Mock exam

Question 1

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.

Answer 1

c) can give information of advice on the use of oral contraceptives to people of any age

Question 2

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

Answer 2

B) History of thrombophlebitis

A history of thrombophlebitis (inflammation of a vein with clot formation) is a contraindication to the use of oral contraceptives due to the increased risk of developing blood clots (thromboembolism) with hormonal contraceptives.

Question 3

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

Taking the ECP within 72 hours (3 days) after unprotected intercourse or contraceptive failure is recommended for maximum effectiveness. While taking it earlier (such as within 1-12 hours) may slightly increase effectiveness, taking it within 72 hours still provides a high efficacy rate.

Answer 3

C) Within 72 hours

Take the tablet as soon as possible, preferably within 12 hours, and no later than 72 hours (3 days) after you have had unprotected sex.

Question 4

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c) it delays the release of an egg from your ovary until sperm are no longer active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

Answer 4

c) it delays the release of an egg from your ovary until sperm are no longer active

This statement is incorrect because the ECP primarily works by preventing or delaying ovulation (release of an egg from the ovary) rather than delaying the release of an egg until sperm are no longer active. The ECP may also affect the cervical mucus and the lining of the uterus to prevent fertilization and implantation, but its primary mechanism of action is to prevent ovulation. Therefore, option c) is the correct answer.

Question 5

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

Answer 5

b) The hormones in the pill prevent ovulation (the release of the ovum from the ovaries)

The combined contraceptive pill contains synthetic forms of estrogen and progesterone (progestin). These hormones work together to suppress the release of an egg (ovulation) from the ovary. By preventing ovulation, there is no egg available for fertilization by sperm, thereby preventing pregnancy. Therefore, option b) is the correct answer.

Question 6

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

Answer 6

c) Over the age of 13 years

In New Zealand, the legal age of consent to medical treatment without parental consent is 16 years old. However, the Fraser Guidelines provide guidance that individuals under 16 years old can consent to medical treatment, including contraception, if they are deemed mature enough to understand the nature and implications of the treatment. This typically applies to individuals aged 13 and older, depending on their maturity level and understanding. Therefore, option c) is the correct answer.

Question 7

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

Answer 7

c) Condoms are recommended as a prevention against STI’s

This statement emphasizes a key preventive measure that adolescents can use to protect themselves from sexually transmitted infections. Condoms are highly effective in reducing the risk of STI transmission when used consistently and correctly. Therefore, option c) is the correct answer.

Question 8

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

Answer 8

a) Flow usually lasts 3 to 7 days

This statement accurately reflects the typical duration of menstrual flow, which generally lasts between 3 to 7 days. Therefore, option a) is the correct answer.

Question 9

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

Answer 9

b) Detect abnormal cell changes

Cervical screening is crucial for detecting abnormal cell changes in the cervix, which can indicate early signs of cervical cancer or precancerous conditions. While it can sometimes detect infections, its primary goal is to detect changes in cervical cells that could potentially lead to cancer if left untreated. Therefore, option b) is the correct answer.

Question 10

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

Answer 10

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.

Question 11

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

Answer 11

d) You will be immune to shingles if you’ve had chickenpox in the past

Question 12

The correct name for shingles is:

a) herpes zoster virus

b) herpes simplex type 1

c) herpes simplex type 2

d) fever blisters

Answer 12

a) herpes zoster virus

Question 13

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

Answer 13

a) Advise her child not to share drink bottles at school

Question 14

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

Answer 14

b) Enlarged lymph glands

Question 15

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

Answer 15

b) Rubeola

Question 16

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.

Answer 16

c) It is spread person to person through the air.

Question 17

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.

Answer 17

d) 5 days prior to the appearance of the rash until 5 days after the rash appears.

Question 18

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

Answer 18

a) 12 months and 15 months of age

Question 19

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”

Answer 19

b) “Do you have some questions about this decision?”

Question 20

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.

Answer 20

a) The vaccination causes the person to produce antibodies that will recognise and bind to measles virus particles in the blood.

Question 21

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

Answer 21

a) see an increase in the blood glucose concentration

Question 22

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

Answer 22

a) Give glucose gel

Question 23

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

Answer 23

c) Type 1 diabetes is an autoimmune disease

Question 24

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

Answer 24

d) Inability to speak clearly

Question 25

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

Answer 25

c) Ineffective breathing pattern

Question 26

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

Answer 26

a) Gastric juices digest insulin

Question 27

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

Answer 27

a) They assist the facilitated transport of glucose into skeletal muscle cells

Question 28

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.

Answer 28

c) Kidney tubules cannot resorb the glucose fast enough.

Question 29

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

Answer 29

a) Hyperglycaemia

Question 30

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

Answer 30

d) Glucose in urine assists bacterial reproduction

Question 31

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

Answer 31

b) May be hearing voices

Question 32

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.

Answer 32

d) Reassure him that whilst his thinking is real to him suggest that talking about his feelings might be more beneficial for him.

Question 33

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.

Answer 33

c) both positive and negative symptoms related to activity of both serotonin and dopamine.

Question 34

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

Answer 34

a) Withhold the dose and notify the physician

Question 35

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

Answer 35

a) Ask Freda directly about your concern

Question 36

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

Answer 36

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

Question 37

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

Answer 37

c) Maintain continuous unobtrusive observation of her

Question 38

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”

Answer 38

c) “You must be feeling desperate at the moment – have you made any plans as to how you might take your life?”

Question 39

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

Answer 39

b) When depression starts to lift

Question 40

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

Answer 40

b) Akathisia

Question 41

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

Answer 41

d) Plan limits with Mr. Rand and be consistent in applying unit guidelines

Question 42

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)

Answer 42

b) Benztropine mesylate (cogentin)

Question 43

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

Answer 43

b) A signed consent form

Question 44

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

Answer 44

d) Inform his health team members

Question 45

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?”

Answer 45

d) “You don’t feel like living?”

Question 46

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

Answer 46

a) Increase the availability of serotonin

Question 47

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.”

Answer 47

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.”

Question 48

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

Answer 48

b) A contract to eat a prescribed amount of food agreed to by Katy

Question 49

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

Answer 49

b) hypokalaemia—low blood potassium

Question 50

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

Answer 50

b) Applying cold water for ten minutes

Question 51

The major electrolyte lost in fluid secreted from burns is: a) Sodium b) Calcium c) Potassium d) Magnesium

Answer 51

a) Sodium

Question 52

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

Answer 52

c) Reduced sensitivity charred or opaque area

Question 53

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

Answer 53

b) 0.4 mL

Question 54

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?”

Answer 54

c) “It must have been frightening to see him so distressed”

Question 55

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

Answer 55

b) Keep noise to a minimum

Question 56

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

Answer 56

d) 120 mL

Question 57

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

Answer 57

c) 42 dpm

Question 58

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

Answer 58

b) Stop the infusion

Question 59

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

Answer 59

d) Evidence of little concern about the extent of the injury

Question 60

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”

Answer 60

a) “It’s ok to cry when something hurts”

Question 61

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

Answer 61

c) The child is underdeveloped for his age

Question 62

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

Answer 62

c) Tell the child that they have done the right thing by talking with you

Question 63

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

Answer 63

d) Incompatibility between the history and the injury

Question 64

What are the positive signs of pregnancy? a) Foetal heartbeat, foetal movement b) Positive pregnancy test, urinary frequency c) Breast tenderness d) Amenorrhea, nausea

Answer 64

a) Foetal heartbeat, foetal movement

Question 65

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

Answer 65

c) A boiled or fried egg

Question 66

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

Answer 66

a) Folic acid

Question 67

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

Answer 67

b) Eat before she gets out of bed

Question 68

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

Answer 68

b) Increasing fluid intake may be beneficial

Question 69

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

Answer 69

b) Prevent maternal D antibody formation

Question 70

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

Answer 70

b) As long as she receives anti-Rh immunoglobulin there is no limit

Question 71

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

Answer 71

a) Lochia rubra

Question 72

In breastfeeding, what hormone is responsible for the ‘let down’ reflex? a) Progesterone b) Oestrogen c) Prolactin d) Oxytocin

Answer 72

d) Oxytocin

Question 73

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”

Answer 73

d) “Feeling sad when you know you don’t know why must be very confusing”

Question 74

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

Answer 74

a) This is a normal finding

Question 75

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

Answer 75

b) This is from a normal breakdown of red blood cells

Question 76

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

Answer 76

d) To try to maintain the usual lifestyle to promote normal developmen

Question 77

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

Answer 77

c) Fluid volume excess secondary to cor pulmonale

Question 78

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

Answer 78

c) Nicotine replacement therapy assists ease symptoms of withdrawal

Question 79

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

Answer 79

c) Vesicular breath sounds decrease

Question 80

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

Answer 80

c) Narrowing of the airway

Question 81

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

Answer 81

d) Empty the lungs, inhale and then measure how quickly air can be exhaled

Question 82

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

Answer 82

a) Tachycardia, cool extremities, poor capillary refill, weak peripheral pulses compared with central pulses, tachypnoea, normal blood pressure

Question 83

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

Answer 83

a) chronic, progressive degenerative disorder of the central nervous system (CNS)

Question 84

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

Answer 84

c) Double vision, weakness in the extremities, muscle tremors

Question 85

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

Answer 85

d) Ask Mrs C. what she knows about the condition and spend time answering her questions supported with written information

Question 86

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

Answer 86

c) Establish a regular toileting schedule

Question 87

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

Answer 87

a) Replacement of parts of the myelin sheath of neurons in the CNS with scar-like tissue

Question 88

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

Answer 88

b) Persistent low or depressed mood, changes in sleep patterns, feelings of worthlessness or guilt

Question 89

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

Answer 89

c) Aged cheese

Question 90

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

Answer 90

b) inform them of the policy for viewing medical records