State exams 3

Question 1

STATE EXAMS 11

1. Mr March sixty year old farmer, was admitted to a private hospital for rehabilitation
   following a cerebro vascular accident which resulted in right sided hemiplegia. When
   cerebro vascular accident causes occlusion of blood supply to one area of the brain,
   loss of voluntary muscle control is usually evident on

a) The same side of the body as the brain damage
b) The opposite side of the body to the brain damage
c) The opposite side of the face
d) Both sides of the body

Answer 1

b) The opposite side of the body to the brain damage

Question 2

Mr March sixty year old farmer, was admitted to a private hospital for rehabilitation
following a cerebro vascular accident which resulted in right sided hemiplegia. When
cerebro vascular accident causes occlusion of blood supply to one area of the brain,
loss of voluntary muscle control is usually evident on

2. Which of the following is most important for Mr. march to succeed in a rehabilitation
   programme

a) Knowledge of the services available to him
b) Families encouragement
c) Personal goals
d) His relationships with the health team

Answer 2

c) Personal goals

Question 3

Mr March sixty year old farmer, was admitted to a private hospital for rehabilitation
following a cerebro vascular accident which resulted in right sided hemiplegia. When
cerebro vascular accident causes occlusion of blood supply to one area of the brain,
loss of voluntary muscle control is usually evident on

3. A rehabilitation programme for Mr. march should begin with

a) Strengthening his weak side
b) Teaching him to walk
c) Utilising the movement he still has
d) Establishing speech

Answer 3

c) Utilising the movement he still has

Question 4

Mr March sixty year old farmer, was admitted to a private hospital for rehabilitation
following a cerebro vascular accident which resulted in right sided hemiplegia. When
cerebro vascular accident causes occlusion of blood supply to one area of the brain,
loss of voluntary muscle control is usually evident on

4. There is evidence that Mr. March suffers a mild degree of expressive aphasia. This
   would be evidenced by which of the following behaviours

a) Mr march has difficulty in understanding what is spoken to him although he can
verbally express his needs appropriately
b) Mr march has difficulty in both understanding what is spoken to him and in
verbally communicating with others
c) Mr march understands what is spoken to him but has difficulty in forming and
expressing words
d) Mr march has difficulty interpreting sensory stimuli causing him to respond
inappropriately

Answer 4

c) Mr march understands what is spoken to him but has difficulty in forming and
expressing words

Question 5

Mr March sixty year old farmer, was admitted to a private hospital for rehabilitation
following a cerebro vascular accident which resulted in right sided hemiplegia. When
cerebro vascular accident causes occlusion of blood supply to one area of the brain,
loss of voluntary muscle control is usually evident on

5. Mr March is enthusiastic about his exercise programme. He exercises should be

a) Frequent and of short duration
b) Twice daily and extensive
c) Carried out in the physiotherapy department
d) Confined to the affected side

Answer 5

a) Frequent and of short duration

Question 6

Mr March sixty year old farmer, was admitted to a private hospital for rehabilitation
following a cerebro vascular accident which resulted in right sided hemiplegia. When
cerebro vascular accident causes occlusion of blood supply to one area of the brain,
loss of voluntary muscle control is usually evident on

6. A rehabilitation programme should promote

a) Client autonomy and independence
b) The best possible level of mobility and ambulation
c) Psychological and social adjustment
d) All of the above

Answer 6

d) All of the above

Question 7

Mr March sixty year old farmer, was admitted to a private hospital for rehabilitation
following a cerebro vascular accident which resulted in right sided hemiplegia. When
cerebro vascular accident causes occlusion of blood supply to one area of the brain,
loss of voluntary muscle control is usually evident on

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

a) Keep the skin area clean, dry and free from urine, faeces and perspiration
b) Place an alternating air pressure or water mattress on the bed
c) Massage the reddened area with lotion or oil to stimulate circulation
d) Turn and reposition the client at least q2h; avoid positioning him on the affected
side if possible

Answer 7

d) Turn and reposition the client at least q2h; avoid positioning him on the affected
side if possible

Question 8

Mr March sixty year old farmer, was admitted to a private hospital for rehabilitation
following a cerebro vascular accident which resulted in right sided hemiplegia. When
cerebro vascular accident causes occlusion of blood supply to one area of the brain,
loss of voluntary muscle control is usually evident on

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

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

Answer 8

a) Flexor muscles are generally stronger than extensors

Question 9

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

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

Answer 9

d) She has diminished sensation in her feet

Question 10

10. Mrs Sweetman’s foot problems result from neuropathic, vascular and infectious
    changes. The most important feature of foot care should be

a) Inspect the feet daily and wash with mild soap and water
b) Maintain adequate blood flow to the lower limbs
c) Rub the feet with alcohol once a week
d) Avoid wearing garters of constricting shoes

Answer 10

a) Inspect the feet daily and wash with mild soap and water

Question 11

11. The first priority in caring for a person whose tissues have insufficient blood supply is
    to

a) Prevent and relieve symptoms
b) Promote the development of collateral circulation
c) Protect the tissues from any injury
d) Relieve the pain associated with vasodilation

Answer 11

c) Protect the tissues from any injury

Question 12

12. Peter aged 10 diagnosed as moderately mentally retarded. He lives in a IHC residence
    and attends a special school. You are employed as a carer at the residence. A major
    strategy in teaching peter is based on behaviour modification principles. An important
    element in peters management then is the use of reinforcement. Which statement best
    defines what a reinforce is for peter.

a) A reinforce is anything you think peter will enjoy
b) A reinforce is anything peter gains enjoyment from even if it appears to an
observer to be producing pain
c) A reinforce is anything which precedes a response which is likely to increase the
probability of that response occurring again
d) A reinforce is anything that follows a response that decreases the probability of
that response occurring again

Answer 12

c) A reinforce is anything which precedes a response which is likely to increase the
probability of that response occurring again

Question 13

13. You wish to teach peter to put on his pants. If the first step in his training programme
    was doing up his belt correctly. This method would best be described as

a) Graduated guidance
b) Forward chaining
c) Backward chaining
d) Prompting

Answer 13

c) Backward chaining

Question 14

14. When teaching peter to pull his pants up a physical prompt by guiding peters hand is
    used. As Peters’ learning increases the physical prompt becomes no more than a
    gentle touch. This is an example of

a) Stimulus control
b) Fading
c) Reinforcing
d) Positive practice

Answer 14

d) Positive practice

Question 15

15. Peter has a temper tantrum during which he lies on the floor at the entrance to the
    hallway. This is making it difficult for other residents. He has been asked to get up but
    continues his tantrum. Using the principles of extinction how would you deal with
    peter

a) Continuing to ask him in a firm voice to get up
b) Ignore him and instruct the other residents to step over him
c) Explain to him that he is blocking the entrance and it is unsafe for him to remain
where he is
d) Let him know that if he doesn’t get up immediately he will be punished

Answer 15

c) Explain to him that he is blocking the entrance and it is unsafe for him to remain
where he is

Question 16

Peter aged 10 diagnosed as moderately mentally retarded. He lives in a IHC residence
and attends a special school. You are employed as a carer at the residence. A major
strategy in teaching peter is based on behaviour modification principles. An important
element in peters management then is the use of reinforcement.

16. What would be the most likely effect initially on peters behaviour when commencing
    to apply the principles of extinctions

a) Behaviour shows minimal change
b) Inappropriate behaviour would increase
c) Inappropriate behaviour would rapidly decrease
d) Inappropriate behaviour would slowly decrease

Answer 16

d) Inappropriate behaviour would slowly decrease

Question 17

Peter aged 10 diagnosed as moderately mentally retarded. He lives in a IHC residence
and attends a special school. You are employed as a carer at the residence. A major
strategy in teaching peter is based on behaviour modification principles. An important
element in peters management then is the use of reinforcement

17. Peter has a habit of hugging new staff members and visitors to the residence. In order
    for extinction of this inappropriate social behaviour it would be necessary for him

a) Not to be punished for inappropriate behaviour
b) To be rewarded for inappropriate behaviour
c) To be punished for inappropriate behaviour
d) Not to receive reinforcement for this in appropriate behaviour

Answer 17

d) Not to receive reinforcement for this in appropriate behaviour

Question 18

Peter aged 10 diagnosed as moderately mentally retarded. He lives in a IHC residence
and attends a special school. You are employed as a carer at the residence. A major
strategy in teaching peter is based on behaviour modification principles. An important
element in peters management then is the use of reinforcement

18. If the staff were to apply the principles of response cost in dealing with peters
    inappropriate social behaviour they could do so by

a) Taking away something that peter found reinforcing such as restricting his TV
viewing
b) Taking away from peter something that he found unpleasant such as having to eat
his vegetables
c) Applying an aversive stimuli such as making him stay in his room
d) Ignoring the inappropriate behaviour but reinforcing an appropriate behaviour
such as his willingness to help with the dishes

Answer 18

d) Ignoring the inappropriate behaviour but reinforcing an appropriate behaviour
such as his willingness to help with the dishes

Question 19

Peter aged 10 diagnosed as moderately mentally retarded. He lives in a IHC residence
and attends a special school. You are employed as a carer at the residence. A major
strategy in teaching peter is based on behaviour modification principles. An important
element in peters management then is the use of reinforcement

19. Peter also suffers from epilepsy. During a seizure he falls to the ground is
    unconscious and begins to convulse. The best immediate response would be to

a) Cradle peters head in your lap
b) Place something in peters mouth to prevent him biting his tongue
c) Hold his arms down
d) Move him to a place of safety

Answer 19

d) Move him to a place of safety

Question 20

20. Which of the following tests furnishes the best diagnostic information about seizures

a) Electroencephalogram
b) Cerebral angiogram
c) Cerebral tomography
d) Electrocardiogram

Answer 20

a) Electroencephalogram

Question 21

21. Peter does not regain consciousness after his seizure, but after a brief pause in the
    convulsions the seizure continues. The term for this is called

a) Frequent seizures
b) Febrile seizures
c) Status epilipticus
d) Petit mal seizures

Answer 21

c) Status epilipticus

Question 22

22. Major epilepsy normally follows which of the following sequences

a) Aura, tonic phase, clonic phase, recovery
b) Aura, clonic phase, tonic phase, recovery
c) Aura, tonic phase, recovery
d) Aura, clonic phase, recovery

Answer 22

a) Aura, tonic phase, clonic phase, recovery

Question 23

23. Mr Jones aged 72 years has chronic obstructive respiratory disease (CORD). He is a
    smoker. In the early stages of CORD the most effective way of delaying the disease
    process is to encourage Mr. Jones to

a) Use purse lip breathing and pace physical activity
b) Stop smoking
c) Avoid environmental air pollutants
d) Avoid people with infections

Answer 23

b) Stop smoking

Question 24

24. The safest and most effective way to clear secretions from the respiratory tract is

a) Postural drainage
b) An effective cough
c) Pharyngeal suctioning
d) Endotracheal suctioning

Answer 24

b) An effective cough

Question 25

25. Carl comes to the mental health clinic where you work because of nervousness. He
    tells you I have butterflies in my stomach most of the time. I haven’t missed work but
    it is getting harder to concentrate on things for a long time. What level of anxiety is
    Carl most likely experiencing

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

Answer 25

b) Moderate

Question 26

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

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

Answer 26

c) Have you ever felt this way before

Question 27

27. Which of the following explains the major differences between normal anxiety and
    the syndrome associated with anxiety reactions

a) Normal anxiety is constant; an anxiety reaction is intermittent and rather short
lived
b) Normal anxiety is free floating; in an anxiety reaction there is an impending sense
of doom
c) An anxiety reaction is seldom controllable and usually must run its course
d) Normal anxiety is a fact of life and rarely becomes an anxiety reaction

Answer 27

b) Normal anxiety is free floating; in an anxiety reaction there is an impending sense
of doom

Question 28

28. Signs and symptoms associated with anxiety are

a) Complaints of apprehension, narrowed perception, stomach pains and restlessness
b) Inability to get to sleep, early morning awakening, excessive weight loss and lack
of energy
c) Ideas of reference, grandiose delusion, hallucinations and delusions
d) Spending or giving away large amounts of money

Answer 28

b) Inability to get to sleep, early morning awakening, excessive weight loss and lack
of energy

Question 29

29. Carl complains of severe inner left arm and neck pain during the last few days. This
    pain probably the result of

a) Vasoconstriction because of arterial spasms
b) Myocardial ischemia
c) Fear of death
d) Irritation of nerve endings in the cardiac plexus

Answer 29

a) Vasoconstriction because of arterial spasms

Question 30

30. Carl collapses in a shopping mall as he experiences a cardiac arrest. What would be
    the first action in this situation

a) Call a doctor
b) Establish an airway
c) Start closed chest massage
d) Give a bolus of sodium bicarbonate

Answer 30

b) Establish an airway

Question 31

31. Upon admission to the coronary care unit, oxygen was ordered for Carl. The primary
    purpose of oxygen administration in this situation is to

a) Relieve dyspnoea
b) Relieve cyanosis
c) Increase oxygen concentration in the myocardium
d) Supersaturate the red blood cells

Answer 31

c) Increase oxygen concentration in the myocardium

Question 32

32. The most dangerous period for Carl, following his myocardial infarction is

a) The first 24 to 48 hours
b) The first 73 to 96 hours
c) 4 to 10 days after the myocardial infarction
d) From the onset of symptoms until treatment begins

Answer 32

d) From the onset of symptoms until treatment begins

Question 33

33. Carl is now considerably improved, wants to talk about his sexual activity after he has
    been discharged. What would be the nurses initial approach

a) Give Carl some written material and then answer questions
b) Plan a teaching session with Carl and his wife
c) Answer his questions accurately and directly
d) Provide enough time and privacy so that he can express his concerns fully

Answer 33

d) Provide enough time and privacy so that he can express his concerns fully

Question 34

34. Michael has been brought by the police into the psychiatric unit. He was found curled
    up under a bridge. When asked his name all he would say was nice boy. His father
    informs you that he has not had a psychotic episode for 2 years, and that medication
    has controlled his condition. This episode occurred when Michael refused his
    medication. Which of the following areas should the nurse gather data first

a) Michaels perception of reality
b) Michaels physical condition
c) The observations of Michael, made by the police
d) Michaels speech patterns

Answer 34

c) The observations of Michael, made by the police

Question 35

35. Michael becomes regressed and withdrawn. He appears to be listening to something,
    the nurse hears nothing. What is the most appropriate response

a) Give him an additional dose of his antipsychotic medication
b) Ignore his behaviour
c) Contact his doctor and request a seclusion order
d) Talk to him about what he has experiencing

Answer 35

d) Talk to him about what he has experiencing

Question 36

36. Michael’s doctor prescribes haloperidol, 6mgs IM for three doses. After the third dose
    of the medication, Michael is still severely regressed and also agitated. He also
    appears to be hallucinating. What would the nurse do

a) Call the doctor for further orders
b) Administer another dose of the medication
c) Record the results of the medication
d) Observe the client for an hour

Answer 36

a) Call the doctor for further orders

Question 37

37. Michael yells for the nurse. As the nurse enters his room he says do you see there the
    Virgin Mary is appearing. Which of the following is the best nursing response

a) No I don’t see her but I understand she is real to you
b) She is not there. You must be imagining things Michael
c) Show me where in the room she is appearing
d) The virgin Mary is appearing

Answer 37

a) No I don’t see her but I understand she is real to you

Question 38

38. Michael is very withdrawn, he moves slowly and is uncommunicative. The best initial
    goal is which of the following

a) Michael will increase his social skills
b) Michael will be orientated to reality
c) Michael will increase his level of communication
d) Michael will form a trusting relationship with the nurse

Answer 38

c) Michael will increase his level of communication

Question 39

39. Jeff Oakes has cancer of the rectum and has consented to surgery for removal of the
    rectum and the formation of a permanent colostomy. A gastric suction tube is inserted
    before Mr. Oakes goes to surgery in order to

a) Facilitate administration of high caloric, nutritious liquids immediately after
completion of the procedure
b) Prevent accumulation of gas and fluid in the stomach both during and following
surgical action
c) Provide a reliable means of detecting gastrointestinal haemorrhage during the
operative procedure
d) Serve as a stimulus to restore normal peristaltic movement following recovery
from anaesthesia

Answer 39

b) Prevent accumulation of gas and fluid in the stomach both during and following
surgical action

Question 40

40. Sections of colon both above and below the tumour were removed in order to prevent

a) Direct extension and metastatic spread of the tumour
b) Post op paralysis and distension of the bowel
c) Accidental loosening of bowel sutures post operatively
d) Pressure injury to perineal suture line

Answer 40

a) Direct extension and metastatic spread of the tumour

Question 41

41. Mr Oakes will receive tube feedings post operatively. Tube feedings provide adequate
    nutrition for all of the following clients except

a) Those who have difficulty in swallowing
b) Those who are comatose
c) Those who do not have a functioning gastrointestinal tract
d) Those who are anorexic

Answer 41

c) Those who do not have a functioning gastrointestinal tract

Question 42

42. Mr Oakes recovers from surgery. He is scheduled to return to the hospital in a month
    for a course of chemotherapy. Before leaving he says to you I’m not sure I want to
    come back. Maybe I’ll just take my chances. What would be the best response

a) It is your decision and you should do as you feel best
b) What concerns you most about coming back
c) Have you discussed this with your wife and doctor
d) The survival rate with adjuvant chemotherapy is quite high

Answer 42

b) What concerns you most about coming back

Question 43

43. Four year old Sean white was admitted to hospital with burns received while playing
    with matches. His legs and lower abdomen are burned. On assessment of Sean’s
    hydration status, which of the following indicates less than adequate fluid replacement

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

Answer 43

c) Rising hematocrit and decreasing urine volume

Question 44

44. Which signs/symptoms indicate overhydration

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

Answer 44

c) Dyspnea, moist rales

Question 45

45. Sean’s output via his foley catheter is 10mL/hour. What should be the first nursing
    action

a) Check the catheter to see if it is plugged (blocked)
b) Call the doctor immediately
c) Record the information on the chart
d) Increase the intravenous fluids

Answer 45

b) Call the doctor immediately

Question 46

46. The doctor has prescribed 500ml of IV fluid to be given over 10 hours. Using a
    soluset which delivers 60 drops per ml, calculate the rate in drops per min

a) 48
b) 50
c) 52
d) 54

Answer 46

b) 50

Question 47

47. Sean starts oral feeding it is particularly important that his client has a high amount of

a) Fats and carbohydrates
b) Minerals and vitamins
Page 100 of 203
c) Fluids and vitamins
d) Proteins and carbohydrates

Answer 47

b) Minerals and vitamins

Question 48

48. What would be the best diversional activity for Sean while he is in reverse isolation

a) Lace leather wallets
b) Watch television
c) Play with puppets
d) Use computer word games

Answer 48

b) Watch television

Question 49

49. Christine Harvey, aged 21 is to have a bronchoscopy in two hours time under general
    anaesthetic. Why are food or fluids not permitted before this procedure

a) The anaesthetic will not be absorbed
b) Vomiting may occur during the procedure
c) Indigestion may be a problem for Christine
d) Christine may suffer from diarrhoea

Answer 49

b) Vomiting may occur during the procedure

Question 50

50. Christine refuses to remove her wedding ring before she is transferred to theatre.
    Which action should you take in this situation

a) Remind her that you are not responsible for the loss
b) Warn her the ring may slip off during surgery
c) Tell he she should give the ring to her husband
d) Secure the ring to her finger with tape

Answer 50

d) Secure the ring to her finger with tape

Question 51

51. Christine is asked to remove her make up before going to theatre. Why is this
    important

a) The makeup may contaminate the anaesthetic mask
b) The anaesthetist may have difficulty assessing her condition
c) The theatre is a sterile environment and make up carries micro organisms
d) The facemask is more likely to slip if she is wearing makeup

Answer 51

b) The anaesthetist may have difficulty assessing her condition

Question 52

52. Soon after returning to the ward Christine asks for a drink. She should be given water
    first, rather than a milky drink

a) Water is more easily absorbed than milk
b) Water quenches a person’s thirst more rapidly
c) Milk can cause lung infection if the gag reflex has not returned
d) Milk has a more irritating effect on a person’s throat

Answer 52

c) Milk can cause lung infection if the gag reflex has not returned

Question 53

53. Allan martin, is admitted to hospital with acute chest pain. Provisional diagnosis is
    myocardial infarction. When asking about the quality of a clients chest pain you are
    primarily looking for

a) An indication of its severity
b) The patient’s own description
c) A response found on a list of possible descriptions
d) Its cause

Answer 53

b) The patient’s own description

Question 54

54. When a client is anxious and upset about chest pain, it is best to

a) Explain in detail the pathologic changes that may be occurring
b) Provide short, clear explanations of your assessment and treatment interventions
c) Don’t say anything until you are sure of his diagnosis
d) Explain that his doctor can answer his questions better

Answer 54

b) Provide short, clear explanations of your assessment and treatment interventions

Question 55

55. The nurse asks you to check some pain relief for Mr. Martin’s severe chest pain. This
    prescription is for morphine 6mgs every 2 hours. The stock available is morphine
    10mg in 1 ml. calculate the correct amount

a) 0.5ml
b) 0.6ml
c) 1 ml
d) 1.3ml

Answer 55

b) 0.6ml

Question 56

56. The doctor prescribes Frusemide (lasix) intravenously for Mr. Martin. What is the
    action of Frusemide

a) Diuretic
b) Antiemetic
c) Analgesic
d) Bronchodilator

Answer 56

a) Diuretic

Question 57

57. What side effects of Frusemide (lasix) should the nurse be aware of

a) Hypervolaemia
b) Hypovolaemia
c) Hypotension
d) Hypoventilation

Answer 57

c) Hypotension

Question 58

58. The doctor prescribes heparin 7,500 i.u subcutaneous BID. The vial contains heparin
    25,000 units/ml. what volume should be given s.c

a) 0.2ml
b) 0.3ml
c) 0.4ml
d) 0.7ml

Answer 58

b) 0.3ml

Question 59

59. What is the essential nursing action to take when caring for a patient who is having
    heparin

a) Observe for signs of drowsiness
b) Watch for side effects of the drug
c) Record blood pressure and pulse 4 hourly
d) Monitor patient for signs of internal or external haemorrhage

Answer 59

d) Monitor patient for signs of internal or external haemorrhage

Question 60

60. Mrs Phillips is admitted to your ward in acute respiratory distress following an
    asthmatic attack. In which position should the nurse place Mrs. Phillips to assist her
    breathing

a) High fowlers
b) Semi fowlers
c) Orthopneic
d) Supine with pillows

Answer 60

b) Semi fowlers

Question 61

61. Which signs would indicate your client may have hypoxaemia

a) Anxiety, restless and confusion
b) Cough, strong pulse rate, apprehension
c) Hypotension, alert, tachycardia
d) Hyperventilation, warm peripheries, alert

Answer 61

a) Anxiety, restless and confusion

Question 62

62. Mrs Phillips is prescribed 1 litre of normal saline .9% over 6 hours. This is to be
    delivered via a soluset which has a drop factor of 60. Calculate the correct drops per
    minute

a) 100
b) 125
c) 167
d) 180

Answer 62

c) 167

Question 63

63. Mrs Maring was brought to an acute psychiatric unit by the police. She was found
    wandering around the streets, incoherent, and her behaviour appeared to be
    inappropriate. She was tentatively diagnosed as having schizophrenia. The nurse
    knows that a diagnosis of schizophrenia implies that a patient would manifest which
    of the following behaviours

a) Inability to concentrate
b) Loss of contact with reality
c) Guilt feelings
d) Feelings of worthlessness

Answer 63

b) Loss of contact with reality

Question 64

64. Mrs Maring says that the voices are telling her to do things and she can’t stop
    listening. The best response from the nurse would be

a) Never mind the voices; let’s just concentrate on the game
b) The voices will go away soon
c) I don’t hear any voices. I think the voices are part of your illness. Try to listen to
what I’m saying
d) Everyone hears voices at times

Answer 64

c) I don’t hear any voices. I think the voices are part of your illness. Try to listen to
what I’m saying

Question 65

65. Mrs Maring after a two week stay, appears much better. She is in contact with reality
    and is able to interact with others in an appropriate way. The doctor is sending her
    home with medication. The most common medications given for schizophrenia are

a) ECT
b) Phenothiazines
c) MAO inhibitors
d) Antidepressants

Answer 65

b) Phenothiazines

Question 66

66. A young Maori man dies, as a result of a motor bike accident. The doctor requests his
    kidneys for a transplant. His whanau refuse. What is the most appropriate action of
    the nurse in this situation

a) You accept the wishes of the whanau
b) You pressure the whanau to re consider
c) You seek permission from other whanau members
d) You support the doctor to over ride what the whanau wish to do

Answer 66

a) You accept the wishes of the whanau

Question 67

67. Mr H a 72 year old kaumatua (elder) is admitted to the medical ward with cellulitis of
    his left leg. He is placed on strict bed rest. Because he is whakama (embarrassed) he
    refuses to use a bedpan and demands to walk to the toilet. How should you deal with
    this situation

a) Give him a bed pan anyway
b) Talk over the situation with him
c) Tell him to doctor has ordered bed rest
d) Ask the other patients to leave the room

Answer 67

b) Talk over the situation with him

Question 68

68. While assessing Mr. h you find his daughter answers all your questions for him. The
    most culturally appropriate action is to

a) Question him privately when the daughter leaves
b) Send her out so Mr. h will answer on his own
c) Accept this as appropriate and continue the assessment
d) Ignore her as you need to have the information form Mr. H

Answer 68

c) Accept this as appropriate and continue the assessment

Question 69

69. The tohunga (healer) prescribes a specially prepared solution to be placed on Mr. H
    legs. What is the most appropriate response in this situation

a) Get the doctor to talk to the tohunga
b) Refuse as it may be unhygienic and cause infection
c) Explain to Mr. h that medication from the doctor is more acceptable
d) Ensure both types of treatment may be combined to assist Mr. h

Answer 69

d) Ensure both types of treatment may be combined to assist Mr. h

Question 70

70. Mr T aged 80 has had a right below knee amputation. As a Maori he wishes that his
    amputated foot be returned to him. What is the cultural significance of this request

a) It is the appropriate action to do in Maori society today
b) Maori people prefer to keep all their body parts after surgery
c) Because of the spiritual links between Maori people and the land
d) Because he is worried about what the hospital will do with his foot

Answer 70

c) Because of the spiritual links between Maori people and the land

Question 71

71. Following a cerebral vascular accident (stroke) Mr. M aged 80 is unconscious. Some
    members of the whanau (extended family) wish to take him home. What is the most
    appropriate action to take in this situation

a) Help and support the whanau appropriately
b) Tell them that Mr. h needs hospital care
c) Check to ensure they have enough whanau support
d) Ask if the whanau are capable of nursing him safely

Answer 71

a) Help and support the whanau appropriately

Question 72

72. A Maori manager 26 dies within 24 hours of admission in the A and E clinic in which
    you work. His family wish to take him home immediately to prepare for his tangi. He
    has not been certified dead by a doctor and because of his death within 24 hours, it
    becomes a coroner’s case. Your response to the whanau is

a) Forbid them to leave
b) Allow them to leave
c) Ask them under what circumstances he died
d) Ask them if they understood the process of certification and coroners proceedings

Answer 72

d) Ask them if they understood the process of certification and coroners proceedings

Question 73

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

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

Answer 73

d) Cessation of uterine contractions with walking

Question 74

74. First foetal movements felt by the mother are known as

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

Answer 74

d) Quickening

Question 75

75. Growth is most rapid during the phase of prenatal development known as

a) Implantation
b) First trimester
c) Second trimester
d) Third trimester

Answer 75

b) First trimester

Question 76

76. The chief function of progesterone is the

a) Establishing of secondary male sex characteristics
b) Rupturing of follicles for ovulation to occur
c) Development of female reproductive organs
d) Preparation of the uterus to receive a fertilised ovum

Answer 76

b) Rupturing of follicles for ovulation to occur

Question 77

77. Mrs Green a 22 year old primigravida is attending prenatal clinic. Mrs Green is
    concerned because she has read that nutrition during pregnancy is important for
    proper growth and development of the baby. She wants to know something about the
    foods she should eat. The nurse should

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

Answer 77

b) Assess what she eats by taking a diet history

Question 78

78. Mrs Green states, I’m worried about gaining too much weight because I’ve heard it’s
    bad for me. The nurse should respond

a) Yes, weight gain causes complications during pregnancy
b) Don’t worry about gaining weight. We are more concerned if you don’t gain
enough weight to ensure proper growth of your baby
c) The pattern of your weight gain will be of more importance than the total amount
d) If you gain over 7 kgs you’ll have to follow a low calorie diet

Answer 78

c) The pattern of your weight gain will be of more importance than the total amount

Question 79

79. Immediate critical observation for apgar scoring includes

a) Respiratory rate
b) Heart rate
c) Presence of meconium
d) Evaluation of moro reflex

Answer 79

a) Respiratory rate

Question 80

80. Which part of the hands is most affected in cases of primary irritant dermatitis

a) Between the fingers
b) Flexor aspects of the fingers
c) Medial aspects of the hands
d) Back of the hands

Answer 80

d) Back of the hands

Question 81

81. Why is this particular area of the hands most affected

a) Moisture tends to collect there
b) New cells are generated at a slower rate
c) Skin thickness is relatively thinner
d) Flora are more concentrated

Answer 81

c) Skin thickness is relatively thinner

Question 82

82. The lesions of primary irritant dermatitis appear as tiny fluid filled elevations called

a) Vesicles
b) Macules
c) Papulses
d) Nodules

Answer 82

a) Vesicles

Question 83

83. The major form of treatment in the initial stage of contact dermatitis is the application
    of

a) Wet compresses
b) Dry dressings
c) Topical antibiotics
d) Oil based medications

Answer 83

c) Topical antibiotics

Question 84

STATE EXAMS 12

1. Lucy is charted 5mls of augmentin 125 TDS. You notice the doctor hasn’t signed the
   order form. A senior colleague tells you to give it. You respond by

a) Giving the medication as ordered
b) Contacting the doctor to sign the order
c) Asking Lucy if the doctor told her she would have this
d) Signing the form for the doctor

Answer 84

b) Contacting the doctor to sign the order

Question 85

Lucy is charted 5mls of augmentin 125 TDS. You notice the doctor hasn’t signed the
order form. A senior colleague tells you to give it.

2. The augmentin is given to Lucy. She is found to be allergic when she exhibits

a) Tinnitus and vertigo
b) Wheezing and urticaria
c) Abdominal cramps and diarrhoea
d) Blurred vision and ataxia

Answer 85

b) Wheezing and urticaria

Question 86

3. Jack is 15 years old. He is admitted to the hospital after briefly losing consciousness
   when tackled during a rugby game. Which of the following is an indication increasing
   intracranial pressure

a) Change in his level of consciousness
b) Anorexia and thirst
c) Increased pulse and respiration rates
d) Blurred vision and halos around lights

Answer 86

d) Blurred vision and halos around lights

Question 87

Jack is 15 years old. He is admitted to the hospital after briefly losing consciousness
when tackled during a rugby game.

4. Jack has had two seizures while hospitalised. These have been controlled by
   anticonvulsant medications. Jack and his family must understand

a) The medication must be taken for at least one year
b) The doctor should be seen when the prescription has finished
c) The medication will be discontinued on discharge
d) The medication will be necessary for the rest of his life

Answer 87

b) The doctor should be seen when the prescription has finished

Question 88

Jack is 15 years old. He is admitted to the hospital after briefly losing consciousness
when tackled during a rugby game.

5. Jack is prescribed rivotril 8 mgs daily. He weighs 68 kgs. The initial doses for 2-3
   days should not exceed 0.01 mgs/kg/day. Your nursing responsibility is to

a) Observe for any side effects after giving the drug
b) Contact the doctor to reassess the dose prescribed
c) Consider his weight loss and administer the dose prescribed
d) Check with the charge nurse prior to administration

Answer 88

b) Contact the doctor to reassess the dose prescribed

Question 89

6. Lucy Rogers, 5 years old, has had a recent upper respiratory tract infection. Now she
   is febrile and complains of a painful left ear. Acute otitis media is diagnosed. The
   typical appearance of the tympanic membrane in acute otitis media is

a) Red and bulging
b) Grey and concave
c) Yellow and retracted
d) Red and concave

Answer 89

a) Red and bulging

Question 90

Lucy Rogers, 5 years old, has had a recent upper respiratory tract infection. Now she
is febrile and complains of a painful left ear. Acute otitis media is diagnosed

7. Lucy’s symptoms may be relieved most effectively by

a) Warm compresses
b) Paracetamol elixir
c) Ice packs
d) Warm olive oil drops

Answer 90

b) Paracetamol elixir

Question 91

8. Children are more likely to develop acute otitis media from an upper respiratory
   infection than adults because of their

a) Inadequate resistance to infection
b) Eustachian tubes size and shape
c) Lack of acquired immunity to the causative organism
d) Increased susceptibility to colds

Answer 91

b) Eustachian tubes size and shape

Question 92

9. The organism most commonly responsible for acute otitis media is

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

Answer 92

c) Haemophilus influenza

Question 93

10. Kevin aged 19 is admitted with an acute attack of asthma. During an asthmatic attack,
    the reaction to excessive histamine release would be
11. Bronchospasm
12. Bronchodilation
13. Excessive mucous production
14. Production of I.G.E antibodies

a) 1,3 and 4
b) 1,3 and 5
c) 1,4 and 5
d) 2,3 and 4

Answer 93

a) 1,3 and 4

Question 94

11. The hypersensitive reaction in asthma is due to the

a) Antigen – antibody response
b) Antigen – histamine release
c) Inhalation of pollens
d) Release of histamine

Answer 94

a) Antigen – antibody response

Question 95

12. Which of the following signs would a person admitted to hospital with an acute attack
    of asthma present with

a) Dyspnea, tachycardia, anxiety
b) Dyspnea, bradycardia, frothy sputum
c) Tachycardia, chest pain, pallor
d) Increased anxiety, sweating, chest pain

Answer 95

a) Dyspnea, tachycardia, anxiety

Question 96

13. A primiparous woman, one day postpartum, calls the nurse into her room the woman
    explains that while breastfeeding, she experienced uterine cramps and a heavy gush
    that soaked through her pad to the bed. The nurse should

a) Palpate the woman’s fundus
b) Tell the woman that this often happens when breastfeeding
c) Administer PRN ergometrine medication
d) Assist the woman with perineal care and changing her pad

Answer 96

a) Palpate the woman’s fundus

Question 97

14. The lochia of the postpartum woman second day after birth should exhibit each of the
    following except

a) Deep red and thick blood
b) A few large clots
c) Fleshy odour
d) Moderate amount – 15cm on pad after 1 hour

Answer 97

a) Deep red and thick blood

Question 98

15. The risk for constipation in the postpartum period is related to all except

a) Tenderness of the episiotomy
b) Decreasing levels of oestrogen
c) Decreased abdominal muscle tone
d) Fear of pain and of ripping sutures during a bowel movement

Answer 98

b) Decreasing levels of oestrogen

Question 99

16. Primary sites for postpartum infections would include all of the following except

a) Respiratory tract
b) Endometrium
c) Urinary tract
d) Breasts

Answer 99

a) Respiratory tract

Question 100

17. When caring for a postpartum woman with a uterine infection the nurse should

a) Administer an antipyretic when the temperature rises above 37.5oC
b) Provide at least 2000mls of fluid a day
c) Obtain specimens for cultures before initiating antibiotic treatment
d) Reassure the woman that future reproduction will not be affected

Answer 100

b) Provide at least 2000mls of fluid a day

Question 101

18. A definition of cor pulmonale is

a) L) sided heart failure secondary to disease of the lungs
b) L) sided heart failure secondary to R) sided heart failure
c) R) sided heart failure secondary to severe lung disease
d) Disease of the lungs secondary to R) sided heart failure

Answer 101

c) R) sided heart failure secondary to severe lung disease

Question 102

19. The main function of alveoli is

a) Bacterial filtration
b) Exchange of gases
c) Conduction of gases
d) Pleural attachment

Answer 102

b) Exchange of gases

Question 103

20. The patency of the trachea is maintained by

a) Incomplete rings of cartilage
b) Circular smooth muscle fibres
c) Thickly layered pseudo stratified epithelium
d) Elastic connective tissue

Answer 103

a) Incomplete rings of cartilage

Question 104

21. Human milk is preferably to cow’s milk because

a) Human milk is a non laxative effect
b) Human milk has more calories per ml
c) Human milk is great mineral content
d) Human milk offers greater immunologic benefits

Answer 104

d) Human milk offers greater immunologic benefits

Question 105

22. Which of the following neonates will most likely need additional respiratory support
    at birth

a) The infant born by normal vaginal delivery
b) The infant born by caesarean birth
c) The infant born vaginally after 12 hours of labour
d) The infant born with high levels of surfactant

Answer 105

b) The infant born by caesarean birth

Question 106

23. During the transition from foetal to neonatal circulation, the newborn cardiovascular
    system accomplishes which of the following anatomic and physiologic alterations
24. Closure of the ductus venosus
25. Closure of the foramen ovale
26. Closure of the ductus arteriosis
27. Increased systemic pressure and decreased pulmonary artery
    pressure

a) 1,2,3 and 4
b) 1,2 and 3
c) 2,3 and 4
d) 1,3 and 4

Answer 106

a) 1,2,3 and 4

Question 107

24. A woman diagnosed with marginal placenta praevia gave birth vaginally 15 minutes
    ago. She is at greatest risk for

a) Haemorrhage
b) Infection
c) Urinary retention
d) Thrombophlebitis

Answer 107

a) Haemorrhage

Question 108

25. The primary nursing focus of the fourth stage of labour would be to

a) Prevent infection
b) Facilitate newborn – parent interaction
c) Enhance maternal comfort and rest
d) Prevent haemorrhage and shock

Answer 108

d) Prevent haemorrhage and shock

Question 109

26. Which of the following results of emphysema is primarily responsible for
    cardiomegaly

a) Hypertrophy of muscles encircling the bronchi
b) Increased pressure in the pulmonary circulation
c) Decreased number of circulating red blood cells
d) Secretion of excessive amounts of pericardial fluids

Answer 109

b) Increased pressure in the pulmonary circulation

Question 110

27. The tissue change most characteristic of emphysema is

a) Accumulation of pus in the pleural space
b) Constriction of capillaries by fibrous tissue
c) Filling of air passages by inflammatory coagulum
d) Over-distention, inelasticity and rupture of alveoli

Answer 110

d) Over-distention, inelasticity and rupture of alveoli

Question 111

28. Which of the following positions is most comfortable for a person with emphysema

a) Lying flat in bed
b) Reclining on his/her left side
c) Sitting of the edge of the bed
d) Lying flat on their back (supine)

Answer 111

c) Sitting of the edge of the bed

Question 112

29. A person of the following factors commonly predisposes to emphysematous lung
    changes

a) Chemical irritation of bronchiolar and alveolar linings
b) Sudden increase in intrapulmonary pressure coincident with hypertension
c) Obstruction of air passages by spasms of bronchiolar muscles
d) Senile degenerative changes in the vertebral bodies and intervertebral discs

Answer 112

a) Chemical irritation of bronchiolar and alveolar linings

Question 113

30. Oxygen therapy is administered at low concentrations (below 35%), for people with
    chronically elevated pCO2 levels, as for some people with chronic obstructive
    respiratory disease, in order to prevent

a) Depression of the respiratory centre
b) Decrease in red blood cell formation
c) Rupture of emphysematous bullae
d) Excessive drying of respiratory mucosa

Answer 113

a) Depression of the respiratory centre

Question 114

31. A newborns birth weight is 3400krms. The maximum expected weight loss for this
    newborn would be

a) 170 grms
b) 340 grms
c) 510 grms
d) 680 grms

Answer 114

b) 340 grms

Question 115

32. The birth weight of a breast feed newborn was 3600 grms. On the third day the
    newborns weight was 3350 grms. The nurse should

a) Encourage the mother to continue breast feeding as her baby’s nutrient and fluid
needs are being met
b) Suggest that the mother switch to bottle feeding as breastfeeding is ineffective in
meeting her baby’s needs
c) Notify the doctor as the baby has lost too much weight
d) Refer the mother to a lactation consultant to improve her breastfeeding technique

Answer 115

a) Encourage the mother to continue breast feeding as her baby’s nutrient and fluid
needs are being met

Question 116

33. Which of the following would be an unexpected sign of dehydration in the newborn

a) Weight loss
b) Reduced turgor
c) Concentrated urine
d) Decreased frequency and amount of urine

Answer 116

a) Weight loss

Question 117

34. The nurse would recognise that a new mother understood breastfeeding instructions
    when she explains

a) I feed my baby every two hours around the clock
b) I always start feeding on my right breast, as my baby feeds best on that breast
c) I use both the football and the traditional positions for feeding
d) I let my baby continue to suck for a while on the second breast once its empty

Answer 117

d) I let my baby continue to suck for a while on the second breast once its empty

Question 118

35. Which of the following actions of a breastfeeding mother indicate the need for further
    instruction

a) Holds breast with four fingers along the bottom and thumb at the top
b) Leans forward to bring breast towards the baby
c) Stimulates the rooting reflex than inserts nipple and areola into newborns open
mouth
d) Puts her finger into newborns mouth before removing breast

Answer 118

b) Leans forward to bring breast towards the baby

Question 119

36. Characteristically, respirations of the client in diabetic acidosis are

a) Shallow and irregular
b) Uneven in rate and depth
c) Deep, rapid, with acetone breath, (kussmaul)
d) Rapid and shallow

Answer 119

c) Deep, rapid, with acetone breath, (kussmaul)

Question 120

37. The most important feature of foot care for a diabetic would be to

a) Cut nails straight across
b) Maintain adequate blood flow to the lower limbs
c) Wear sandals at all times
d) Avoid wearing garters

Answer 120

d) Avoid wearing garters

Question 121

38. Excessive thirst for people with diabetes mellitus is a result of

a) Need for increased amounts of water to hydrolyse food during digestion
b) Loss of excessive body water due to increased daily urine volume
c) Reflex adaption to a sustained elevation of body temperature
d) Compensatory adjustment to decreased production of posterior pituitary hormone

Answer 121

b) Loss of excessive body water due to increased daily urine volume

Question 122

39. For people with diabetes mellitus polyuria is the result of

a) Increased glomerular permeability due to generalized vascular damage
b) Increased glomerular filtration due to decreased serum albumin concentration
c) Increased volume of glomerular filtrate due to elevated blood pressure
d) Decreased water resorption due to high tubular osmotic pressure

Answer 122

d) Decreased water resorption due to high tubular osmotic pressure

Question 123

40. A normal CBG (capillary blood glucose) reading is within the range of

a) 1-5 mmol/L
b) 4-7 mmol/L
c) 6-12 mmol/L
d) 3-10 mmol/L

Answer 123

b) 4-7 mmol/L

Question 124

41. The foetal presenting part is described as vertex when the

a) Face enters the pelvis first
b) Buttocks emerge with legs extended over the abdomen
c) Flexed head enters pelvis first
d) Foetal lie is longitudinal

Answer 124

c) Flexed head enters pelvis first

Question 125

42. When examining the umbilical cord immediately after birth the nurse should expect to
    observe

a) One artery
b) Two veins
c) Whitish grey colouration
d) Slight odour

Answer 125

c) Whitish grey colouration

Question 126

43. Vitamin K is given to the newborn to

a) Reduce bilirubin levels
b) Increase the production of red blood cells
c) Stimulate the formation of surfactant
d) Enhance the ability of the blood to clot

Answer 126

d) Enhance the ability of the blood to clot

Question 127

44. The nurse is performing a 5 minute apgar on a newborn. Which of the following
    observations is included in the apgar score

a) Blood pressure
b) Temperature
c) Muscle tone
d) Weight

Answer 127

c) Muscle tone

Question 128

45. At birth the major cause of heat loss is by

a) Evaporation
b) Radiation
c) Conduction
d) Convection

Answer 128

a) Evaporation

Question 129

46. The newborn would respond most effectively to feeding in which state

a) Drowsy
b) Quiet alert
c) Active alert
d) Crying

Answer 129

d) Crying

Question 130

47. A pregnant woman at 30 weeks gestation exhibits a rise in her baseline systolic blood
    pressure of 32mmHg, a weight gain of 4 kgs since last week and difficulty removing
    rings she normally wears. This is suggestive of

a) Gestational hypertension
b) Pre eclampsia
c) Eclampsia
d) Elevated liver enzymes

Answer 130

b) Pre eclampsia

Question 131

48. The primary pathophysiologic basis for the clinical manifestations of pregnancy
    induced hypertension (PIH) is

a) Fluid retention related to excessive salt intake
b) Ineffective excretion of fluid by the kidneys
c) Cardiac decompensation
d) Ineffective dilatation of the vascular network to accommodate the expanding
blood volume of pregnancy

Answer 131

a) Fluid retention related to excessive salt intake

Question 132

49. Which measure would be least effective in relieving the signs and symptoms of mild
    pre eclampsia

a) Low salt diet
b) Period of bed rest
c) Balanced diet with protein
d) Relaxation techniques

Answer 132

d) Relaxation techniques

Question 133

50. A woman with severe pre eclampsia is being monitored for assessment findings
    indicative of cerebral oedema and venospasm. Which of the following would you not
    expect to find

a) Hypotonic deep tendon reflexes
b) Headache
c) Vision changes including blurring and spots before the eyes
d) Insomnia

Answer 133

a) Hypotonic deep tendon reflexes

Question 134

51. Newly expectant parents, ask the nurse how they can prepare their 3yr old preschool
    daughter for the new baby. All of the following would be useful except

a) Tell the child about the pregnancy as soon as mother begins to look pregnant
b) Arrange for a few sleep overs with the person who will care for the child at the
time of the birth
c) Transfer their child to her new room and bed just before the expected birth of the
baby
d) Introduce their child to preschool as soon as possible

Answer 134

c) Transfer their child to her new room and bed just before the expected birth of the
baby

Question 135

52. A patient with a diagnosis of schizophrenia says to the nurse ‘I’m like a fallen star.
    But I won’t go to the bar… it would be mar on my family, on the tar’. This is an
    example of

a) A loose association
b) A delusion
c) Word salad
d) Clang association

Answer 135

d) Clang association

Question 136

53. A person diagnosed with schizophrenia tells the nurse that ‘the voices have told me
    I’m in danger’. He stays in his room, wears the same clothes, and avoids cracks on the
    floor. The nurses best initial response to this information is

a) I know that these voices are real to you, but I don’t hear them
b) Don’t worry, you’re safe here. I won’t let anything happen to you
c) You need to get out of your room and get your mind occupied
d) Would you like some p.r.n medication

Answer 136

a) I know that these voices are real to you, but I don’t hear them

Question 137

54. Mr P a new client on the ward, allows himself to be escorted to the day room.
    However he does not speak in response to you. The most therapeutic nursing
    intervention is to

a) Ignore his silence and talk about superficial topics such as the weather
b) Involve him in group psychotherapy so other patients can encourage him to talk
c) Point out that he is making others uncomfortable with his silences
d) Plan time to spend with him, in silence, if that is his choice

Answer 137

b) Involve him in group psychotherapy so other patients can encourage him to talk

Question 138

55. In communicating with a client experiencing delusions, what is it best to do

a) Logically explain the delusions
b) Tell the client that they aren’t real
c) Acknowledge his belief, but state your own understanding
d) Ignore this topic when it is brought up

Answer 138

c) Acknowledge his belief, but state your own understanding

Question 139

56. Mr P is prescribed Clozapine tablets, initially at 50mg mane and 100 mg nocte. What
    is the most likely side effect that will be first noted

a) Neutropenia
b) Akathesia
c) Sedation
d) Agranulycytocis

Answer 139

c) Sedation

Question 140

Mr P is prescribed Clozapine tablets, initially at 50mg mane and 100 mg nocte.

57. On discharge what is the most important piece of information you must give to Mr. p

a) Report any flu like symptoms immediately
b) Ensure no doses of clozapine are missed
c) Don’t take clozapine with alcohol
d) Visit your GP regularly

Answer 140

b) Ensure no doses of clozapine are missed

Question 141

58. Which of the following represents a positive change of pregnancy

a) Morning sickness
b) Quickening
c) Positive pregnancy test
d) Foetal heart beat auscultated with Doppler

Answer 141

d) Foetal heart beat auscultated with Doppler

Question 142

59. Which of the following statements can be used as a guideline for planning diets
    during pregnancy

a) A increase of 300 calories per day beginning in the first trimester
b) A ten percent increase in protein above daily requirements
c) Iron supplementation is recommended for women whose diets are lacking in iron
d) The requirement for folic acid is increased by 50 percent

Answer 142

c) Iron supplementation is recommended for women whose diets are lacking in iron

Question 143

60. In order to percent infection of hepatitis B virus, the pregnant woman should

a) Receive gamma globulin during the first trimester
b) Carefully wash hands before eating or preparing food
c) Receive the hepatitis B vaccine
d) Take AZT during the second and third trimester

Answer 143

c) Receive the hepatitis B vaccine

Question 144

61. Which of the following represents a recommended weight gain during pregnancy

a) 6-11 kgs
b) 11-16 kgs
c) 13-18 kgs
d) 18-20 kgs

Answer 144

b) 11-16 kgs

Question 145

62. John’s behaviour are increasingly annoying to other patients. The best nursing
    approach is to

a) Explain that he must try to conserve his energy
b) Set limits on his behaviours and be consistent in approach
c) Tell him he is annoying to others and ask him to stay in his room
d) Ask him to walk to town to burn off energy

Answer 145

b) Set limits on his behaviours and be consistent in approach

Question 146

63. John also has been described as having flight of ideas. These would be likely present
    when john

a) Asks for a cup of tea, but tells you later he doesn’t want it
b) Takes a long time to make his point in conversation
c) Rapidly changes topic in conversation, sometimes without apparent connection
d) Speaks in a staccato voice and says words you don’t understand

Answer 146

c) Rapidly changes topic in conversation, sometimes without apparent connection

Question 147

64. John has been prescribed chlorpromazine (largactil) tablets 150mg nocte since being
    on the ward. The most likely reason for this is to

a) Cause a deep dreamless sleep
b) To reduce agitation, anxiety and tension
c) To reduce external stimuli
d) To prevent long term mood swings

Answer 147

b) To reduce agitation, anxiety and tension

Question 148

65. John tells you he feels faint when he first gets out of bed, since taking the largactil.
    Which response would best assist john

a) Tell him not to get until the nurse is present
b) Suggest he does not get up until he has taken the medication
c) Tell him to discuss this with the doctor
d) Explain he should sit on the bed for a time before standing

Answer 148

d) Explain he should sit on the bed for a time before standing

Question 149

66. John has also taking lithium carbonate capsules. Creatinine clearance tests ordered
    during lithium carbonate therapy determines the functioning of the

a) Liver
b) Pancreas
c) Renal system
d) Thyroid gland

Answer 149

c) Renal system

Question 150

67. Mihi means traditional greetings and is normally extended to
68. The land
69. The meeting house
70. The dead
71. The people present
72. The reason for the hui

a) 1,2 and 5
b) 1,3 and 4
c) 2,3 and 4
d) All of the above

Answer 150

d) All of the above

Question 151

68. The internal migration of Maori people from rural to urban life since the mid 1940s
    has adversely affected Maori health. What is the most likely reason for this

a) Overcrowding within urban communities
b) Increased exposure to infectious diseases
c) Dietary changes from naturally produced to processed food
d) Loss of cultural, social, and spiritual ties

Answer 151

d) Loss of cultural, social, and spiritual ties

Question 152

69. Maori communities are encouraging Maori to be involved in health research with their
    own people. What is the most likely reason for this

a) That ownership of the information will remain with Maori
b) Previously there has been little feedback which has been useful to Maori
c) Non Maori promote themselves on Maori research
d) Non Maori researchers are unaware of Maori values

Answer 152

a) That ownership of the information will remain with Maori

Question 153

70. Which of the following interventions would be most helpful for David in dealing with
    his impending death

a) Distract him by initiating conversation that does not deal with his disease
b) Encourage him to reach out and spend more time with his wife and children
c) Listen and encourage David to reminisce about his life
d) Help him to spend much of his time sleeping

Answer 153

b) Encourage him to reach out and spend more time with his wife and children

Question 154

71. David tells the nurse, that he does not want his wife and children to know that his is
    dying. What would be the most helpful response

a) They would not want you to upset yourself by worrying about them
b) You are concerned that they will be distressed
c) I think we should talk about something less stressful for you
d) Sit quietly and say nothing

Answer 154

b) You are concerned that they will be distressed

Question 155

72. Which of the following interventions is the most effective in helping David’s wife and
    children deal with David’s impending death

a) Try to keep all the family at the same stage in the grieving process
b) Encourage the family to verbalise their grief to the nurse
c) Encourage the family to spend as much time as possible with David
d) Encourage the family to cry but not in the presence of David

Answer 155

c) Encourage the family to spend as much time as possible with David

Question 156

73. Your client has cancer, nobody can tell him until his surgeon arrives from 5 days
    away. However in the meantime his anxiety is increasing. What should you do

a) Contact a social worker/chaplain to spend time with him
b) Give him relaxation tapes to listen to
c) Tell him his results are not back yet
d) Speak with the doctor who is acting in the surgeons place

Answer 156

d) Speak with the doctor who is acting in the surgeons place

Question 157

74. Your patient, who is a voluntary admission to a mental health unit, leaves the
    following day without telling anyone. Legally, what is required to staff

a) Provide care for him at home
b) Re admit him under a compulsory order
c) Get police to bring him in to sign a statement
d) Do nothing, the patient has rights to leave health care at any time

Answer 157

a) Provide care for him at home

Question 158

75. Pepe a 26 year old, developmentally delayed Maori man, who at aged two years
    contracted meningitis. He has been cared for in an institution, and is now to be moved
    to the community. Pepe is able to live in the community. What action should be taken
    now

a) Ring his whanau to advise them of his discharge
b) Ask the social worker to tell the family Pepe is to be discharged
c) Arrange for Pepe to visit with his whanau
d) Organise a conference with the whanau

Answer 158

d) Organise a conference with the whanau

Question 159

Pepe a 26 year old, developmentally delayed Maori man, who at aged two years
contracted meningitis. He has been cared for in an institution, and is now to be moved
to the community. Pepe is able to live in the community

76. What statement would best describe your next action

a) Organise regular meetings between nursing staff and whanau prior to discharge
b) Support Pepe’s whanau in being able to visit and to be involved in his discharge
planning
c) Invite the whanau in to explain what will be required of them in caring for Pepe
d) Make sure the whanau understand Pepe limitations in self care

Answer 159

b) Support Pepe’s whanau in being able to visit and to be involved in his discharge
planning

Question 160

77. Pepe has been discharged to a marae based community house. How would you ensure
    his continued well being

a) Set up regular appointments to monitor Pepe’s well being
b) Explain to the community workers Pepe’s requirements
c) Arrange for Pepe to attend the local sheltered workshop
d) Ensure Pepe and his whanau have ongoing support and access to resources

Answer 160

d) Ensure Pepe and his whanau have ongoing support and access to resources

Question 161

78. Blake a 65 year old kaumatua (elder) is admitted with urinary retention. He is quiet
    and appears withdrawn. Blake’s whanau arrived. A female doctor tells them he needs
    a urinary catheter inserted. Blake’s son refuses to have a young woman doctor
    catheterise his father. What is your most appropriate response

a) Let us talk about this together
b) I will contact the Maori support person for you
c) I will inform the doctor of your decision
d) Tell him that this is the only doctor available

Answer 161

a) Let us talk about this together

Question 162

Blake a 65 year old kaumatua (elder) is admitted with urinary retention. He is quiet
and appears withdrawn. Blake’s whanau arrived. A female doctor tells them he needs
a urinary catheter inserted. Blake’s son refuses to have a young woman doctor
catheterise his father.

79. Blake falls in the shower sustaining a laceration to his right elbow. His family are
    angry and upset. What is the most appropriate action to take in this situation

a) Enquire of the whanau if Blake has had previous falls
b) Offer for them to take to the doctor
c) Acknowledge their anger and discuss ways to prevent further falls
d) Acknowledge their anger and ensure the whanau it will not happen again

Answer 162

c) Acknowledge their anger and discuss ways to prevent further falls

Question 163

80. Charlie a 62 year old who identifies as Maori is admitted to your ward with shortness
    of breath. He is very anxious and has no family with him. What is the most
    appropriate initial action to take

a) Introduce Charlie to others in the room
b) Telephone his whanau to come and visit
c) Carry out a physical assessment on Charlie
d) Acknowledge Charlie’s anxiety and ask how you can help

Answer 163

d) Acknowledge Charlie’s anxiety and ask how you can help

Question 164

81. Iris condition deteriorates and she dies. What is the most appropriate nursing action to
    help the whanau

a) Ensure privacy for the family to have karakia (prayers)
b) Allow a spokesperson to contact the rest of the family
c) Move iris body to a side room
d) Offer the whanau to go to a quiet room for a cup of tea

Answer 164

a) Ensure privacy for the family to have karakia (prayers)

Question 165

82. The doctor asks the whanau for the corneas of iris for transplantation. The whanau
    cannot make a decision right now. What is the most appropriate action you should
    take in support of the whanau

a) Tell the doctor that this is not culturally appropriate
b) Listen to them and support them in their decision
c) Explain to the whanau why corneas are transplanted
d) Suggest the whanau talk to the hospital chaplain

Answer 165

b) Listen to them and support them in their decision

Question 166

83. Stanley progresses well. His chest tube is removed. He still does not have much of an
    appetite and is concerned about his diet. Which of these responses would be of help

a) Eat three large meals a day that are high in carbohydrates
b) Eat three large meals a day that are high in protein
c) Eat six small meals a day that are high in carbohydrates
d) Eat six small meals a day that are high in protein

Answer 166

c) Eat six small meals a day that are high in carbohydrates

Question 167

Stanley progresses well. His chest tube is removed. He still does not have much of an
appetite and is concerned about his diet.

84. Select the most appropriate nursing intervention to assist. Stanley to mobilise without
    becoming breathless
85. Gradually increase mobility
86. Assess respiratory function related to mobility
87. Administer oxygen prior to mobilising
88. Increase time up by 10 minutes per day
89. Continually assess respiratory function

a) 1 and 5
b) 4 and 5
c) 1 and 2
d) 3 and 5

Answer 167

a) 1 and 5

Question 168

85. Tom a 38 year old businessman, voluntarily admits himself to a detoxification unit.
    He admits to drinking one large bottle of vodka each day. Which of the following ego
    defence mechanisms is a top and continuing priory in dealing with alcoholic clients

a) Dependency
b) Denial
c) Paranoia
d) Projection

Answer 168

b) Denial

Question 169

86. Of the following approaches to the treatment of alcoholism, which has been found to
    be the most effective to date

a) Membership in alcoholics anonymous
b) Family systems approach
c) Treatment alcoholism as a chronic disease
d) Individual psychotherapy

Answer 169

b) Family systems approach