401. What should be included in your initial assessment of your patients respiratory status?

a) Review the patients notes and charts, to obtain the patients history.

b) Review the results of routine investigations.

c) Observe the patients breathing for ease and comfort, rate and pattern.

d) Perform a systematic examination and ask the relatives for the patient’s history.

402. What should be included in your initial assessment of your patient’s respiratory status?

A. Review the patient’s notes and charts, to obtain the patient’s history.

B. Review the results of routine investigations.

C. Observe the patient’s breathing for ease and comfort, rate and pattern.

D.check for any drains

E all of the above

403. Position to make breathing effective?

a) left lateral

b) Supine

c) Right Lateral

d) High sidelying

404. A client breathes shallowly and looks upward when listening to the nurse. Which sensory mode should the nurse plan

to use with this client?

a) Touch

b) Auditory

c) Kinesthetic

d) Visual

405. While assisting a client from bed to chair, the nurse observes that the client looks pale and is beginning to perspire heavily.

The nurse would then do which of the following activities as a reassessment?

a) Help client into the chair but more quickly

b) Document client’s vital signs taken just prior to moving the client

c) Help client back to bed immediately

d) Observe clients skin color and take another set of vital signs

406. A patient under u developed shortness of breath while climbing stairs. U inform this to the doctor. This response

is interpreted ass:

a) Breaching of patients confidentiality

b) Essential, as it is the matter of patient’s health

407. Which of the following is NOT a cause of Type 1 (hypoxaemic) respiratory failure?

A) Asthma

B) Pulmonary oedema

C) Drug overdose

D) Granulomatous lung disease

408. Respiratory protective equipment include:

A. gloves

B. mask

C. apron

D. paper towels

409. What should be included in a prescription for oxygen therapy?

A) You don’t need a prescription for oxygen unless in an emergency.

B) The date it should commence, the doctor’s signature and bleep number.

C) The type of oxygen delivery system, inspired oxygen percentage and duration of the therapy.

D) You only need a prescription if the patient is going to have home oxygen

410. Patient is in for oxygen therapy

A) A prescription is required including route, method and how long

B) No prescription is required unless he will use it at home.

C) Prescription not required for oxygen therapy

411. Why is it essential to humidify oxygen used during respiratory therapy?

A) Oxygen is a very hot gas so if humidification isnt used, the oxygen will burn the respiratory tract and cause considerable pain for

the patient when they breathe.

B) Oxygen is a dry gas which can cause evaporation of water from the respiratory tract and lead to thickened mucus in the

airways, reduction of the movement of cilia and increased susceptibility to respiratory infection.

C) Humidification cleans the oxygen as it is administered to ensure it is free from any aerobic pathogens before it is inhaled by

the patient.

412. When using nasal cannulae, the maximum oxygen flow rate that should be used is 6 litres/min. Why?

A) Nasal cannulae are only capable of delivering an inspired oxygen concentration between 24% and 40%.

B) For any given flow rate, the inspired oxygen concentration will vary between breaths, as it depends upon the rate and depth of the

patients breath and the inspiratory flow rate.

C) Higher rates can cause nasal mucosal drying and may lead to epistaxis.

D) If oxygen is administered at greater than 40% it should be humidified. You cannot humidify oxygen via nasal cannulae

413. If a patient is prescribed nebulizers, what is the minimum flow rate in litres per minute required?

a) 2 – 4

b) 4 – 6

c) 6 – 8

d) 8 – 10

414. Which of the following oxygen masks is able to deliver between 60-90% of oxygen when delivered at a flow rate of 10 –


a) Simple semi rigid plastic masks

b) Nasal cannulas

c) Venture high flow mask

d) Non-rebreathing masks

415. Prior to sending a patient home on oxygen, healthcare providers must ensure the patient and family understand

the dangers of smoking in an oxygen-rich environment. Why is this necessary?

a) It is especially dangerous to the patient’s health to smoke while using oxygen

b) Oxygen is highly flammable and there is a risk of fire

c) Oxygen and cigarette smoke can combine to produce a poisonous mixture

d) Oxygen can lead to an increased consumption of cigarette

416. What do you need to consider when helping a patient with shortness of breath sit out in a chair?

a) They should not sit out on a chair; lying flat is the only position for someone with shortness of breath so that there are no negative

effects of gravity putting pressure in lungs

b) Sitting in a reclining position with legs elevated to reduce the use of postural muscle oxygen requirements, increasing lung

volumes and optimizing perfusion for the best V/Q ratio. The patient should also be kept in an environment that is quiet so they

don’t expend any unnecessary energy

c) The patient needs to be able to sit in a forward leaning position supported by pillows. They may also need access to a nebulizer

and humidified oxygen so they must be in a position where this is a ccessible without being a risk to others.

d) There are two possible positions, either sitting upright or side lying. Which is used and is determined by the age of the patient. It

is also important to remember that they will always need a nebulizer and oxygen and the air temperature must be below20

degree Celsius

417. What do you expect patients with COPD to manifest?

A) Inc Pco2, dec O2

B) Dec Pco2, inc o2

C) Inc pco2, inc o2

D) Dec pco2, dec o2

418. Which of the following indicates signs of severe Chronic Obstructive Pulmonary disease (COPD)?

A) high p02 and high pC02

B) Low p02 and low pC02

C) low p02 and high pC02

D) high p02 and low pC02

419. A COPD patient is in home care. When you visit the patient, he is dyspnoeic, anxious and frightened. He is already on 2

lit oxygen with nasal cannula.What will be your action

A. Call the emergency service.

B. GiveOramorph 5mg medications as prescribed.

C. Ask the patient to calm down.

D. Increase the flow of oxygen to 5 L

420. A COPD patient is about to be discharged from the hospital. What is the best health teaching to provide this patient?

A. Increase fluid intake

B. Do not use home oxygen

C. Quit smoking

D. nebulize as needed

421. As a nurse, what health teachings will you give to a COPD patient?

A) Encourage to stop smoking

B) Administer oxygen inhalation as prescribed

C) Enroll in a pulmonary rehabilitation programme

D) All the above

You are caring for a patient with a history of COAD who is requiring 70% humidified oxygen via a facemask. You are monitoring

his response to therapy by observing his colour, degree of respiratory distress and respiratory rate. The patient’s oxygen

saturations have been between 95% and 98%. In addition, the doctor has been taking arterial blood gases. What is the reason for


A. Oximeters may be unreliable under certain circumstances, e.g. if tissue

perfusion is poor, if the environment is cold and if the patient’s nails are covered

with nail polish.

B. Arterial blood gases should be sampled if the patient is receiving >60%

oxygen. C. Pulse oximeters provide excellent evidence of oxygenation, but they

do not measure the adequacy of ventilation.

D. Arterial blood gases measure both oxygen and carbon dioxide levels

and therefore give an indication ofboth ventilation and oxygenation

422. Joy, a COPD patient is to be discharged in the community. As her nurse, which of the following interventions will

you encourage him to do to prevent progression of disease.

A) Oxygen therapy

B) Breathing exercise

C) Cessation of smoking

D) coughing exercise

423. You are caring for a 17 year old woman who has been admitted with acute exacerbation of asthma. Her peak flow readings

are deteriorating and she is becoming wheezy. What would you do?

A. Sit her upright, listen to her chest and refer to the chest physiotherapist.

B. Suggest that the patient takes her Ventolin inhaler and continue to monitor the patient.

C. Undertake a full set of observations to include oxygen saturations and respiratory rate. Administer humidified

oxygen, bronchodilators, corticosteroids and antimicrobial therapy as prescribed.

D. Reassure the patient: you know from reading her notes that stress and anxiety often trigger her asthma.

424. Lisa, a working mother of 3, has approached you during a recent attendance of her daughter in Accident and

Emergency because of an acute asthma attack about smoking cessation. What is your most appropriate response to her?

A. Smoking cessation will help prevent further asthma attack

B. Referral can be made to the local NHS Stop smoking service

C. Discuss with her the NICE recommendations on smoking cessation

D. It is not common for people like her to stop smoking

425. Reason for dyspnoea in patients who diagnosed with Glomerulonephritis patients?

a) Albumin loss increase oncotic pressure causes water retention in cells

b) Albumin loss causes decrease in oncotic pressure causes water retention causing fluid retention I alveoli

c) Albumin loss has no effect on oncotic pressure

426. Your patient has bronchitis and has difficulty in clearing his chest. What position would help to maximize the drainage

of secretions?

a) Lying on his side with the area to be drained uppermost after the patient has had humidified air

b) Lying flat on his back while using a nebulizer

c) Sitting up leaning on pillows and inhaling humidified oxygen

d) Standing up in fresh air taking deep breaths

427. A client diagnosed of cancer visits the OPD and after consulting the doctor breaks down in the corridor and begins to

cry. What would the nurses best action?

a) Ignore the client and let her cry in the hallway

b) Inform the client about the preparing to come forth next appointment for further discussion on the treatment planned

c) Take her to a room and try to understand her worries and do the needful and assist her with further information if required

d) Explain her about the list of cancer treatments to survive

428. When an oropharyngeal airway is inserted properly, what is the sign

a) Airway obstruction

b) Retching and vomiting

c) Bradycardia

d) Tachycardia

429. Which of the following is a potential complication of putting an oropharyngeal airway adjunct:

A) Retching, vomiting

B) Bradycardia

C) Obstruction

D) Nasal injury

430. What are the principles of gaining informed consent prior to a planned surgery?

A) Gaining permission for an imminent procedure by providing information in medical terms, ensuring a patient knows the potential risks

and intended benefits.

B) Gaining permission from a patient who is competent to give it, by providing information, both verbally and with written material,

relating to the planned procedure, for them to read on the day of planned surgery.

C) Gaining permission from a patient who is competent to give it, by informing them about the procedure and highlighting risks if the

procedure is not carried out.

D) Gaining permission from a patient who is competent to give it, by providing information in understandable terms prior to surgery,

allowing time for answering questions, and inviting voluntary participation.

431. When do you gain consent from a patient and consider it valid?

a) Only if a patient has the mental capacity to give consent

b) Only before a clinical procedure

c) None of the above

432. A patient is assessed as lacking capacity to give consent if they are unable to:

A) Understand information about the decision and remember that information

B) Use that information to make a decision

C) Communicate their decision by talking, using sign language or by any other means

D) All the above

433. The following must be considered in procuring a consent, except:

a) respect and support people’s rights to accept or decline treatment or care

b) withhold people’s rights to be fully involved in decisions about their care

c) be aware of the legislation regarding mental capacity

d) gain consent before treatment or care starts

434. What do you have to consider if you are obtaining a consent from the patient?

a) Understanding

b) Capacity

c) Intellect

d) Patient’s condition

435. An adult has been medicated for her surgery. The operating room (OR) nurse, when going through the client’s chart,

realizes that the consent form has not been signed. Which of the following is the best action for the nurse to take?

a) Assume it is emergency surgery & the consent is implied

b) Get the consent form & have the client sign it

c) Tell the physician that the consent form is not signed

d) Have a family member sign the consent form

436. A patient doesn’t sign the consent for mastectomy. But bystanders strongly feel that she needs surgery.

A) Allow family members to take decision on behalf of patient

B) Doc can proceed with surgery, since it is in line with the best interest and outcome

C) Respect patients decision. She has the right to accept or deny

437. A client is brought to the emergency room by the emergency medical services after being hit by car. The name of the client

is not known. The client has sustained a severe head injury, multiple fractures and is unconscious. An emergency craniotomy

is required, regarding informed consent for the surgical procedure, which of the following is the best action?

a) Call the police to identify the client and locate the family

b) Obtain a court order for the surgical procedure

c) Ask the emergency medical services team to sign the informed consent

d) Transport the victim to the operating room for surgery

438. What does assessing for no refusal means?

A) That the person has not already refused treatment

B) That the person cannot or is unable to refuse treatment

C) That the person does not already have an advanced decision

D) The person is already detained/ being treated under the mental health act.

439. Barbara, a 75-year old patient from a nursing home was admitted on your ward because of fractured neck of femur after

a trip. She will require an open-reduction and internal fixation (ORIF) procedure to correct the injury. Which of the following

statements will help her understand the procedure?

a) You are going to have an ORIF done to correct your fracture.

b) Some metal screws and pins will be attached to your hip to help with the healing of your broken bone.

c) The operation will require a metal fixator implanted to your femur and adjacent bones to keep it secured

d) The ORIF procedure will be done under general anaesthesia by an orthopaedic surgeon

440. What is right in case of consent among children under 18.

a) Only children between 16-18 are competent to give it.

b) Parents are responsible to give consent with children

c) Children who are intellectually developed and understand matters can give consent

441. Recommended preoperative fasting times are:

a) 2-4 hours

b) 6-12 hours

c) 12-14 hours

442. A patient is being prepared for a surgery and was placed on NPO. What is the purpose of NPO?

A. Prevention of aspiration pneumonia

B. To facilitate induction of pre-op meds

C. For abdominal procedures

D. To decrease production of fluids

443. Which is the safest and most appropriate method to remove hair pre-operatively?

a) Shaving

b) Clipping

c) Chemical removal

d) Washing

444. Who should mark the skin with an indelible pen ahead of surgery?

A) The nurse should mark the skin in consultation with the patient

B) A senior nurse should be asked to mark the patient’s skin

C) The surgeon should mark the skin

D) It is best not to mark the patient’s skin for fear of distressing the patient.

445. A patient is scheduled to undergo an Elective Surgery. What is the least thing that should be done?

A. Assess/Obtain the patient’s understanding of, and consent to, the procedure, and

a share in the decision making process.

B. Ensure pre-operative fasting, the proposed pain relief method, and expected

sequelae are carried out anddiscussed.

C. Discuss the risk of operation if it won’t push through.

D. The documentation of details of any discussion in the anaesthetic record.

446. Safe moving and handling of an anaesthetized patient is imperative to reduce harm to both the patient and staff. What is the

minimum number of staff required to provide safe manual handling of a patient in theatre?

A) 3 (1 either side, 1 at head).

B) 5 (2 each side, 1 at head).

C) 4 (1 each side, 1 at head, 1 at feet).

D) 6 (2 each side, 1 at head, 1 at feet).

447. You are the nurse assigned in recovery room or post anaesthetic care unit. The main priority of care in such area is:

a) Keeping airway intact

b) keeping patient pain free

c) keeping neurological condition stable

d) keeping relatives informed of patient’s condition

448. As a registered nurse in a unit what would consider as a priority to a patient immediately post operatively?

A) pain relief

B) blood loss

C) airway patency

449. Gurgling sound from airway in a postoperative client indicates what

a) Complete obstruction of lower airway

b) Partial obstruction of upper airway

c) Common sign of a post-operative patient

450. Accurate postoperative observations are key to assessing a patient’s deterioration or recovery. The Modified Early

Warning Score (MEWS) is a scoring system that supports that aim. What is the primary purpose of MEWS?

a) Identifies patients at risk of deterioration.

b) Identifies potential respiratory distress.

c) improves communication between nursing staff and doctors.

d) Assesses the impact of pre-existing conditions on postoperative recovery

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451. What serious condition is a possibility for patients positioned in the Lloyd Davies position during surgery?

A) Stroke

B) Cardiac arrest

C) Compartment syndrome

D) There are no drawbacks to the Lloyd Davies position

452. A patient has just returned from theatre following surgery on their left arm. They have a PCA infusion connected and

from the admission, you remember that they have poor dexterity with their right hand. They are currently pain free. What

actions would you take?

A) Educate the patient’s family to push the button when the patient asks for it. Encourage them to tell the nursing staff when they

leave the ward so that staff can take over.

B) Routinely offer the patient a bolus and document this clearly.

C) Contact the pain team/anaesthetist to discuss the situation and suggest that the means of delivery are changed.

D) The patient has paracetamol q.d.s. written up, so this should be adequate pain relief

453. The night after an exploratory laparotomy, a patient who has a nasogastric tube attached to low suction reports nausea. A

nurse should take which of the following actions first?

A) Administer the prescribed antiemetic to the patient.

B) Determine the patency of the patient’s nasogastric tube.

C) Instruct the patient to take deep breaths.

Assess the patient for pain

454. You are looking after a postoperative patient and when carrying out their observations, you discover that they

are tachycardic and anxious, with an increased respiratory rate. What could be happening? What would you do?

a) The patient is showing symptoms of hypovolaemic shock. Investigate source of fluid loss, administer fluid replacement and

get medical support.

b) The patient is demonstrating symptoms of atelectasis. Administer a nebulizer, refer to physiotherapist for assessment.

c) The patient is demonstrating symptoms of uncontrolled pain. Administer prescribed analgesia, seek assistance from medical team.

d) The patient is demonstrating symptoms of hyperventilation. Offer reassurance, administer oxygen

455. Patient is post of repair of tibia and fibula possible signs of compartment syndrome include

A) Numbness and tingling

B) Cool dusky toes

C) Pain

D) Toes swelling

E) All of the above

456. Now the medical team encourages early ambulation in the post-operative period. which complication is least prevented by


A) Tissue wasting

B) Thrombophlebitis

C) Wound infection

D) Pneumonia

457. if a client is experiencing hypotension post operatively, the head is not tilted in which of the following surgeries

a) Chest surgery

b) Abdominal surgery

c) Gynaecological surgery

d) Lower limb surgery

458. You went back to see Mr Derby who is 1 day post-herniorraphy. As you approach him he complained of difficulty of

breathing with respiration rate of 23 breaths per minute and oxygen saturation 92% in room air. What is your next action

to help him?

a) give him oxygen

b) give him pain relief

c) give him antibiotics

d) give him nebulisers

459. Barbara was screaming in pain later in the day despite the PCA in-situ. You refer back to your nurse in charge for a

stronger pain killer. She refused to call the doctor because her pain relief was reassessed earlier. What will you do next?

A. Continue to refer back to her until she calls the doctor

B. Encourage Barbara to continuously use the PCA

C. Give Barbara some sedatives to keep her calm

D. Wait until her pain stops

460. How soon after surgery is the patient expected to pass urine?

A) 1-2 hours

B) 2-4 hours

C) 4-6 hours

D) 6-8 hours

461. A patient has just returned to the unit from surgery. The nurse transferred him to his bed but did not put up the side

rails. The patient fell and was injured. What kind of liability does the nurse have?

a) None

b) Negligence

c) Intentional tort

d) Assault and battery

462. Which of these is not a symptom of an ectopic pregnancy?

A. Pain

B. Bleeding

C. Vomiting

D. Diarrhoea

463. A young woman gets admitted with abdominal pain & vaginal bleeding. Nurse should consider an ectopic

pregnancy. Which among the following is not a symptom of ectopic pregnancy?

a) Pain at the shoulder tip

b) Dysuria

c) Positive pregnancy test

464. The signs and symptoms of ectopic pregnancy except:

a) Vaginal bleeding

b) Positive pregnancy test

c) Shoulder tip pain

d) Protein excretion exceeds 2 g/day

465. Which of the following is NOT a risk factor for ectopic pregnancy?

a) Alcohol abuse

b) Smoking

c) Tubal or pelvic surgery

d) previous ectopic pregnancy

466. What is not a sign of meconium aspiration

a) Floppy in appearance

b) Apnoea

c) Crying

467. An 18 year old 26 week pregnant woman who uses illicit drugs frequently, the factors in risk for which one of the following:

a) Spina bifida

b) Meconium aspiration

c) Pneumonia

d) Teratogenicity

468. Common minor disorder in pregnancy?

a) abdominal pain

b) heart burn

c) headache

469. An unmarried young female admitted with ectopic pregnancy with her friend to hospital with complaints of abdominal pain. Her

friend assisted a procedure and became aware of her pregnancy and when the family arrives to hospital, she reveals the truth. The

family reacts negatively. What could the nurse have done to protect the confidentiality of the patient information?

a. should tell the family that they don’t have any rights to know the patient information b.

that the friend was mistaken and the doctor will confirm the patient’s condition

c. should insist friend on confidentiality

d. should have asked another staff nurse to be a chaperone while assisting a procedure

470. Jenny was admitted to your ward with severe bleeding after 48 hours following her labour. What stage of post

partum haemorrhage is she experiencing?

a) Primary

b) Secondary

c) Tertiary

d) Emergency

471. Postpartum haemorrhage: A patient gave birth via NSD. After 48 hours, patient came back due to bleeding, bleeding

after birth is called post partum haemorrhage. What type?

A. primary postpartum haemorrhage

B. secondary postpartum haemorrhage

C. tertiary postpartum haemorrhage

D. lochia

472. A young mother who delivered 48hrs ago comes back to the emergency department with post partum haemorrhage.

What type of PPH is it?

a) primary post partum haemorrhage

b) secondary post partum haemorrhage

c) tertiary post partum haemorrhage.

473. A new mother is admitted to the acute psychiatric unit with severe postpartum depression. She is tearful and states, “I

don’t know why this happened to me I was so excited for my baby to come, but now I don’t know!” Which of the following

responses by the nurse is MOST therapeutic?

a) Maybe you weren’t ready for a child after all.”

b) Having a new baby is stressful, and the tiredness and different hormone levels don’t help. It happens to many new mothers and

is very treatable.

c) What happened once you brought the baby home? Did you feel nervous?

d) Has your husband been helping you with the housework at all?”

474. In a G.P clinic when you assessing a pregnant lady you observe some bruises on her hand. When you asked her about

this she remains silent. What is your action?

a) Call her husband to know what is happening

b) Tell her that you are concerned of her welfare and you may need to share this information appropriately with the people who

offer help

c) Do nothing as she does not want to speak anything

d) Call the police

475. A client is admitted to the labour and delivery unit. The nurse performs a vaginal exam and determines that the client’s

cervix is 5cm dilated with 75% effacement. Based on the nurse’s assessment the client is in which phase of labour?

A. Active

B. Latent

C. Transition

D. Early

476. After the physician performs an amniotomy, the nurse’s first action should be to assess the:

A. Degree of cervical dilation

B. Fetal heart tones

C. Client’s vital signs

D. Client’s level of discomfort

477. The physician has ordered an injection of RhoGam for the postpartum client whose blood type is A negative but whose baby is

O positive. To provide postpartum prophylaxis, RhoGam should be administered:

A. Within 72 hours of delivery

B. Within one week of delivery

C. Within two weeks of delivery

D. Within one month of delivery

478. The nurse is teaching a group of prenatal clients about the effects of cigarette smoke on fetal development.

Which characteristic is associated with babies born to mothers who smoked during pregnancy?

A. Low birth weight

B. Large for gestational age

C. Preterm birth, but appropriate size for gestation

D. Growth retardation in weight and length

479. A client telephones the emergency room stating that she thinks that she is in labour. The nurse should tell the client

that labour has probably begun when:

A. Her contractions are two minutes apart.

B. She has back pain and a bloody discharge.

C. She experiences abdominal pain and frequent urination.

D. Her contractions are five minutes apart.

480. A client is admitted to the labour and delivery unit complaining of vaginal bleeding with very little discomfort. The

nurse’s first action should be to:

A. Assess the fetal heart tones.

B. Check for cervical dilation.

C. Check for firmness of the uterus.

D. Obtain a detailed history

481. The nurse is discussing breastfeeding with a postpartum client. Breastfeeding is contraindicated in the postpartum client with:

A. Diabetes


C. Hypertension

D. Thyroid disease

482. The nurse is caring for a neonate whose mother is diabetic. The nurse will expect the neonate to be:

A. Hypoglycemic, small for gestational age

B. Hyperglycemic, large for gestational age

C. Hypoglycemic, la rge for gestational age

D. Hyperglycemic, small for gestational age

483. A client tells the doctor that she is about 20 weeks pregnant. The most definitive sign of pregnancy is:

A. Elevated human chorionic gonadatropin

B. The presence of fetal heart tones

C. Uterine enlargement

D. Breast enlargement and tenderness

484. The nurse is teaching a pregnant client about nutritional needs during pregnancy. Which menu selection will best meet

the nutritional needs of the pregnant client?

A. Hamburger patty, green beans, French fries, and iced tea

B. Roast beef sandwich, potato chips, baked beans, and cola

C. Baked chicken, fruit cup, potato salad, coleslaw, yogurt, and iced tea

D. Fish sandwich, gelatin with fruit, and coffee

485. The doctor suspects that the client has an ectopic pregnancy. Which symptom is consistent with a diagnosis of a

ruptured ectopic pregnancy?

A. Painless vaginal bleeding

B. Abdominal cramping

C. Throbbing pain in the upper quadrant

D. Sudden, stabbing pain in the lower quadrant

486. Which of the following is a characteristic of an ominous periodic change in the fetal heart rate?

A. A fetal heart rate of 120–130bpm

B. A baseline variability of 6–10bpm

C. Accelerations in FHR with fetal movement

D. A recurrent rate of 90–100bpm at the end of the contractions

487. The nurse notes variable decelerations on the fetal monitor strip. The most appropriate initial action would be to:

A. Notify her doctor.

B. Start an IV.

C. Reposition the client.

D. Readjust the monitor.

488. As the client reaches 6cm dilation, the nurse notes late decelerations on the fetal monitor. What is the most likely

explanation of this pattern?

A. The baby is sleeping.

B. The umbilical cord is compressed.

C. There is head compression.

D. There is uteroplacental insufficiency.

489. The following are all nursing diagnoses appropriate for a gravida 1 para 0 in labour. Which one would be most appropriate

for the primagravida as she completes the early phase of labour?

A. Impaired gas exchange related to hyperventilation

B. Alteration in placental perfusion related to maternal position

C. Impaired physical mobility related to fetal-monitoring equipment

D. Potential fluid volume deficit related to decreased fluid intake

490. A vaginal exam reveals that the cervix is 4cm dilated, with intact membranes and a fetal heart tone rate of 160–170bpm. The

nurse decides to apply an external fetal monitor. The rationale for this implementation is:

A. The cervix is closed.

B. The membranes are still intact.

C. The fetal heart tones are within normal limits.

D. The contractions are intense enough for insertion of an internal monitor.

491. A vaginal exam reveals a footling breech presentation. The nurse should take which of the following actions at this time?

A. Anticipate the need for a Caesarean section.

B. Apply an internal fetal monitor.

C. Place the client in Genu Pectoral position.

D. Perform an ultrasound.

492. The obstetric client’s fetal heart rate is 80–90 during the contractions. The first action the nurse should take is:

A. Reposition the monitor.

B. Turn the client to her left side.

C. Ask the client to ambulate.. The client’s T-cell count is extremely low.

D. Prepare the client for delivery

493. Which observation would the nurse expect to make after an amniotomy?

A. Dark yellow amniotic fluid

B. Clear amniotic fluid

C. Greenish amniotic fluid

D. Red amniotic fluid

494. The client with pre-eclampsia is admitted to the unit with an order for magnesium sulfate. Which action by the

nurse indicates the understanding of magnesium toxicity?

A. The nurse performs a vaginal exam every 30 minutes.

B. The nurse places a padded tongue blade at the bedside.

C. The nurse inserts a Foley catheter.

D. The nurse darkens the room.

495. Which selection would provide the most calcium for the client who is four months pregnant?

A. A granola bar

B. A bran muffin

C. A cup of yogurt

D. A glass of fruit juice

496. The nurse is monitoring a client with a history of stillborn infant. The nurse is aware that nonstress test can be ordered

for the client to:

a) Determine lung maturity

b) Measure the fetal activity

c) Show the effect of contractions on fetal heart rate

d) Measure the well-being of the fetus

497. The nurse is teaching basic infant care to a group of first-time parents. The nurse should explain that a sponge bath

is recommended for the first two weeks of life because:

A. New parents need time to learn how to hold the baby.

B. The umbilical cord needs time to separate.

C. Newborn skin is easily traumatized by washing.

D. The chance of chilling the baby outweighs the benefits of bathing.

498. When the nurse checks the fundus of a client on the first postpartum day, she notes that the fundus is firm, is at the level

of the umbilicus, and is displaced to the right. The next action the nurse should take is to:

A. Check t he client for bladder distention.

B. Assess the blood pressure for hypotension.

C. Determine whether an oxytocic drug was given.

D. Check for the expulsion of small clots.

499. A client is admitted to the labour and delivery unit in active labour. During examination, the nurse notes a papular lesion on

the perineum. Which initial action is most appropriate?

A. Document the finding.

B. Report the finding to the doctor.

C. Prepare the client for a C-section.

D. Continue primary care as prescribed.

500. A 15-year-old primigravida is admitted with a tentative diagnosis of HELLP syndrome. Which laboratory finding is

associated with HELLP syndrome?

A. Elevated blood glucose

B. Elevated platelet count

C. Elevated creatinine clearance

D. Elevated hepatic enzymes

501. The nurse is assessing the deep tendon reflexes of a client with pre-eclampsia. Which method is used to elicit the

biceps reflex?

A. The nurse places her thumb on the muscle inset in the antecubital space and taps the thumb briskly with the reflex hammer.

B. The nurse loosely suspends the client’s arm in an open hand while tapping the back of the client’s elbow.

C. The nurse instructs the client to dangle her legs as the nurse strikes the area below the patella with the blunt side of the reflex hammer.

D. The nurse instructs the client to place her arms loosely at her side as the nurse strikes the muscle insert just above the wrist.

502. Which observation in the newborn of a diabetic mother would require immediate nursing intervention?

A. Crying

B. Wakefulness

C. Jitteriness

D. Yawning

503. The nurse caring for a client receiving intravenous magnesium sulfate must closely observe for side effects associated with

drug therapy. An expected side effect of magnesium sulfate is:

A. Decreased urinary output

B. Hypersomnolence

C. Absence of knee jerk reflex

D. Decreased respiratory rate

504. A newborn with narcotic abstinence syndrome is admitted to the nursery. Nursing care of the newborn should include:

A. Teaching the mother to provide tactile stimulation

B. Wrapping the newborn snugly in a blanket

C. Placing the newborn in the infant seat

D. Initiating an early infant-stimulation program

505. A client elects to have epidural anesthesia to relieve the discomfort of labour. Following the initiation of epidural

anesthesia, the nurse should give priority to:

A. Checking for cervical dilation

B. Placing the client in a supine position

C. Checking the client’s blood pressure

D. Obtaining a fetal heart rate

506. When assessing a labouring client, the nurse finds a prolapsed cord. The nurse should:

A. Attempt to replace the cord.

B. Place the client on her left side.

C. Elevate the client’s hips.

507. A client who delivered this morning tells the nurse that she plans to breastfeed her baby. The nurse is aware

that successful breastfeeding is most dependent on the:

A. Mother’s educational level

B. Infant’s birth weight

C. Size of the mother’s breast

D. Mother’s desire to breastfeed

508. The nurse is monitoring the progress of a client in labour. Which finding should be reported to the physician immediately?

A. The presence of scant bloody discharge

B. Frequent urination

C. The presence of green-tinged amniotic fluid

D. Moderate uterine contractions

509. The nurse is measuring the duration of the client’s contractions. Which statement is true regarding the measurement of the

duration of contractions?

A. Duration is measured by timing from the beginning of one contraction to

the beginning of the next contraction.

B. Duration is measured by timing from the end of one contraction to

the beginning of the next contraction.

C. Duration is measured by timing from the beginning of one contraction to

the end of the same contraction.

D. Duration is measured by timing from the peak of one contraction to the end

of the same contraction.

510. The physician has ordered an intravenous infusion of Pitocin for the induction of labour. When caring for the obstetric

client receiving intravenous Pitocin, the nurse should monitor for:

A. Maternal hypoglycemia

B. Fetal bradycardia

C. Maternal hyperreflexia

D. Fetal movement

511. A client with diabetes visits the prenatal clinic at 28 weeks gestation. Which statement is true regarding insulin

needs during pregnancy?

A. Insulin requirements moderate as the pregnancy progresses.

B. A decreased need for insulin occurs during the second trimester.

C. Elevations in human chorionic gonadotrophin decrease the need for insulin.

D. Fetal development depends on adequate insulin regulation.

512. A client in the prenatal clinic is assessed to have a blood pressure of 180/96. The nurse should give priority to:

A. Providing a calm environment

B. Obtaining a diet history

C. Administering an analgesic

D. Assessing fetal heart tones

513. A primigravida, age 42, is six weeks pregnant. Based on the client’s age, her infant is at risk for:

A. Down syndrome

B. Respiratory distress syndrome

C. Turner’s syndrome

D. Pathological jaundice

514. A client with a missed abortion at 29 weeks gestation is admitted to the hospital. The client will most likely be treated with:

A. Magnesium sulfate

B. Calcium gluconate

C. Dinoprostone (Prostin E.)

D. Bromocrystine (Parlodel)..

515. Which statement made by the nurse describes the inheritance pattern of autosomal recessive disorders?

A. An affected newborn has unaffected parents.

B. An affected newborn has one affected parent.

C. Affected parents have a one in four chance of passing on the defective gene.

D. Affected parents have unaffected children who are carriers.

516. A pregnant client, age 32, asks the nurse why her doctor has recommended a serum alpha fetoprotein. The nurse

should explain that the doctor has recommended the test:

A. Because it is a state law

B. To detect cardiovascular defects

C. Because of her age

D. To detect neurological defects

517. A client with hypothyroidism asks the nurse if she will still need to take thyroid medication during the pregnancy.

The nurse’s response is based on the knowledge that:

A. There is no need to take thyroid medication because the fetus’s

thyroid produces a thyroid-stimulating hormone.

B. Regulation of thyroid medication is more difficult because the thyroid gland

increases in size during pregnancy.

C. It is more difficult to maintain thyroid regulation during pregnancy due to

a slowing of metabolism.

D. Fetal growth is arrested if thyroid medication is continued during pregnancy.

518. The nurse is responsible for performing a neonatal assessment on a full-terminfant. At one minute, the nurse could

expect to find:

A. An apical pulse of 100

B. An absence of tonus

C. Cyanosis of the feet and hands

D. Jaundice of the skin and sclera

519. A client with sickle cell anaemia is admitted to the labour and delivery unit during the first phase of labour. The

nurse should anticipate the client’s need for:

A. Supplemental oxygen

B. Fluid restriction

C. Blood transfusion

D. Delivery by Caesarean section

520. An infant who weighs 8 pounds at birth would be expected to weigh how many pounds at one year?

A. 14 pounds

B. 16 pounds

C. 18 pounds

D. 24 pounds

521. A pregnant client with a history of alcohol addiction is scheduled for a nonstress test. The nonstress test:

A. Determines the lung maturity of the fetus

B. Measures the activity of the fetus

C. Shows the effect of contractions o n the fetal heart rate

D. Measures the neurological well-being of the fetus

A full-term male has hypospadias. Which statement describes hypospadias?

A. The urethral opening is absent

B. The urethra opens on the top side of the penis

C. The urethral opening is enlarged

D. The urethra opens on the under side of the penis

A gravida III para II is admitted to the labor unit. Vaginal exam reveals that the client’s cervix is 8cm dilated, with

complete effacement. The priority nursing diagnosis at this time is:

A. Alteration in coping related to pain

B. Potential for injury related to precipitate delivery

C. Alteration in elimination related to anesthesia

D. Potential for fluid volume deficit related to NPO status

During the assessment of a labouring client, the nurse notes that the FHT are loudest in the upper-right quadrant. The infant is

most likely in which position?

A. Right breech presentation

B. Right occipital anterior presentation

C. Left sacral anterior presentation

D. Left occipital transverse presentation

The nurse is providing postpartum teaching for a mother planning to breastfeed her infant. Which of the client’s

statements indicates the need for additional teaching?

A. “I’m wearing a support bra.”

B. “I’m expressing milk from my breast.”

C. “I’m drinking four glasses of fluid during a 24-hour period.”

D. “While I’m in the shower, I’ll allow the water to run over my breasts.”

While assessing the postpartal client, the nurse notes that the fundus is displaced to the right. Based on this finding, the

nurse should:

A. Ask the client to void.

B. Assess the blood pressure for hypotension.

C. Administer oxytocin.

D. Check for vaginal bleeding.

The nurse is performing an initial assessment of a newborn Caucasian male delivered at 32 weeks gestation. The nurse

can expect to find the presence of:

A. Mongolian spots

B. Scrotal rugae

C. Head lag

D. Polyhydramnios

The nurse is monitoring a client with a history of stillborn infants. The nurse is aware that a nonstress test can be ordered

for this client to:

A. Determine lung maturity

B. Measure the fetal activity

C. Show the effect of contractions on fetal heart rate

D. Measure the well-being of the fetus

An infant’s Apgar score is 9 at five minutes. The nurse is aware that the most likely cause for the deduction of one point is:

A. The baby is hypothermic.

B. The baby is experiencing bradycardia.

C. The baby’s hands and feet are blue.

D. The baby is lethargic.

An adolescent primigravida who is 10 weeks pregnant attends the antepartal clinic for a first check-up. To develop a teaching

plan, the nurse should initially assess:

A. The client’s knowledge of the signs of preterm labor

B. The client’s feelings about the pregnancy

C. Whether the client was using a method of birth control

D. The client’s thought about future children

A diabetic multigravida is scheduled for an amniocentesis at 32 weeks gestation to determine the L/S ratio and phosphatidyl

glycerol level. The L/S ratio is 1:1 and the presence of phosphatidylglycerol is noted. The nurse’s assessment of this data is:

A. The infant is at low risk for congenital anomalies.

B. The infant is at high risk for intrauterine growth retardation.

C. The infant is at high risk for respiratory distress syndrome.

D. The infant is at high risk for birth trauma.

522. Which of the following best describes the Contingency Theory of Leadership?

a) Leaders behaviour influence team members

b) Leaders grasp the whole picture and their respective roles

c) The plan is influenced by the outside force

d) The leader sees the kind of situation, the setting, and their roles

523. Which of the steps is NOT involved in Tuckman’s group formation theory?

a) Accepting

b) Norming

c) Storming

d) Forming

524. Which is not a stage in the Tuckman Theory of contingency?

a) Forming

b) Storming

c) Norming

d) Analysing

525. Which of the following nursing theorists developed a conceptual model based on the belief that all persons should strive

to achieve self-care?

a) Martha Rogers

b) Dorothea Orem

c) Florence Nightingale

d) Cister Callista Roy

526. The contingency theory of management moves the manager away from which of the following approaches?

a) No perfect solution

b) One size fits all

c) Interaction of the system with the environment

d) a method of combination of methods that will be most effective in a given situation.

527. Which nursing delivery model is based on a production and efficiency model and stresses a task-orientated approach?

a) Case management

b) Primary nursing

c) Differentiated practice

d) Functional method

528. C Clostridium difficile (C- diff) infections can be prevented by:

a) using hand gels

b) washing your hands with soap and water

c) using repellent gowns

d) limit visiting times

529. Causes of diarrhoea in Clostridium Difficile are:

a) Ulcerative colitis – Ulcerative Colitis is a condition that causes inflammation and ulceration of the inner lining of the rectum and colon

b) Hashimotos disease – Hashimoto’s disease, also called chronic lymphocytic thyroiditis or autoimmune thyroiditis, is an

autoimmune disease

c) Pseudomembranous colitis -pseudomembranous colitis (PMC) is an acute, exudative colitis usually caused by Clostridium

difficile. PMC can rarely be caused by other bacteria,

d) Crohn’s disease – Crohn’s Disease is one of the two main forms of Inflammatory Bowel Disease, so may also be called ‘IBD’. The

other main form of IBD is a condition known as Ulcerative Colitis

530. Barrier Nursing for C.diff patient what should you not do?

a) Use of hand gel/ alcohol rub

b) Use gloves

c) Patient has his own set of washers

d) Strict disinfection of pt’s room after isolation

531. Leonor, 72 years old patient is being treated with antibiotics for her UTI. After three days of taking them, she

developed diarrhoea with blood stains. What is the most possible reason for this?

a) Antibiotics causes chronic inflammation of the intestine

b) An anaphylactic reaction

c) Antibiotic alters her GI flora which made Clostridium-difficile to multiply

d) she is not taking the antibiotics with food

532. You are caring for a patient in isolation with suspected Clostridium difficile. What are the essential key actions to

prevent the spread of infection?

a) Regular hand hygiene and the promotion of the infection prevention link nurse role.

b) Encourage the doctors to wear gloves and aprons, to be bare below the elbow and to wash hands with alcohol hand rub. Ask

for cleaning to be increased with soap-based products.

c) seek the infection prevention team to review the patient’s medication chart and provide regular teaching sessions on the 5 moments

of hand hygiene. Provide the patient and family with adequate information.

d) Review antimicrobials daily, wash hands with soap and water before and after each contact with the patient, ask for

enhanced cleaning with chlorine-based products and use gloves and aprons when disposing of body fluids.

533. When treating patients with clostridium difficile, how should you clean your hands?

a) Use alcohol hand rubs

b) Use soap & water

c) Use hand wipes

d) All of the above

534. What infection control steps should not be taken in a patient with diarrhoea caused by Clostridium Difficile?

a) Isolation of the patient

b) All staff must wear aprons and gloves while attending the patient

c) All staff will be required to wash their hands before and after contact with the patient, their bed linen and soiled items

d) Oral administration of metronidazole, vancomycin, fidaxomicin may be required

e) None of the above

535. Patient with clostridium deficile has stools with blood and mucus. due to which condition?

a) Ulcerative colitis

b) Chrons disease

c) Inflammatory bowel disease

536. Which of the following is NOT a stage in the life cycle of viruses?

a) Attachment

b) Uncoating

c) Replication

d) Dispersal

538. Which of the following is NOT a typical characteristic of bacteria?

a) Cell wall

b) Eukaryocyte

c) Spherical

d) Spores

539. For which of the following modes of transmission is good hand hygiene a key preventative measure?

a) Airborne

b) Direct & indirect contact

c) Droplet

d) All of the above

540. 5 moments of hand hygiene include all of the following except:

a) Before Patient Contact

b) Before a clean / aseptic procedure

c) Before Body Fluid Exposure Risk

d) After Patient contact

e) After Contact with Patient’s surrounding

541. If you were asked to take ‘standard precautions’ what would you expect to be doing?

A. Wearing gloves, aprons and mask when caring for someone in protective isolation

B. Taking precautions when handling blood and ‘high risk’ body fluids so as not to pass on any infection to the patient

C. Using appropriate hand hygiene, wearing gloves and aprons where necessary, disposing of used sharp instruments safely

and providing care in a suitably clean environment to protect yourself and the patients

D. Asking relatives to wash their hands when visiting patients in the clinical setting

542. Define standard precaution:

a) The precautions that are taken with all blood and ‘high-risk’ body fluids.

b) The actions that should be taken in every care situation to protect patients and others from infection, regardless of what is known of

the patient’s status with respect to infection.

c) It is meant to reduce the risk of transmission of blood bourne and other pathogens from both recognized and unrecognized sources.

d) The practice of avoiding contact with bodily fluids, by means of wearing of nonporous articles such as gloves, goggles, and

face shields.

543. Except which procedure must all individuals providing nursing care must be competent at?

a) Hand hygiene

b) Use of protective equipment

c) Disposal of waste

d) Aseptic technique

544. Which client has the highest risk for a bacteraemia?

A. Client with a peripherally inserted central catheter (PICC)

line B. Client with a central venous catheter (CVC)

C. Client with an implanted infusion port

D. Client with a peripherally inserted intravenous line

545. In infection control, what is a pathogen?

A) A micro-organism that is capable of causing infection, especially in vulnerable individuals, but not normally in healthy ones.

B) Micro-organisms that are present on or in a person but not causing them any harm.

C) Indigenous microbiota regularly found at an anatomical site.

D) Antibodies recruited by the immune system to identify and neutralize foreign objects like bacteria and viruses.

546. When disposing of waste, what colour bag should be used to dispose of offensive/ hygiene waste?

a) Orange

b) Yellow

c) Yellow and black stripe

d) Black

547. Before giving direct care to the patient, u should

A) Wear mask, aprons

B) Wash hands with alchohol rub

C) Handwashing using 6 steps

D) Take all standard precautions

548. What infection is thought to be caused by prions?

a) Leprosy

b) Pneumocystis jirovecii

c) Norovirus

d) Creutzfeldt Jakob disease

e) None of the above

549. For which of the following modes of transmission is good hand hygiene a key preventative measure?

A. Airborne

B. Direct contact

C. Indirect contact

D. All of the above

550. If a patient requires protective isolation, which of the following should you advise them to drink?

a) Filtered water only

b) Fresh fruit juice and filtered water

c) Bottled water and tap water

d) Tap water only

e) long-life fruit juice and filtered water

Read Also :

551. Examples of offensive/hygiene waste which may be sent for energy recovery at energy from waste facilities can include:

a) Stoma or catheter bags – The Management of Waste from health, social and personal care -RCN

b) Unused non-cytotoxic/cytostatic medicines in original packaging

c) Used sharps from treatment using cytotoxic or cytostatic medicines

d) Empty medicine bottles

552. The use of an alcohol-based hand rub for decontamination of hands before and after direct patient contact and clinical

care is recommended when:

a) Hands are visibly soiled

b) Caring for patients with vomiting or diarrhoeal illness, regardless of whether or not gloves have been worn

c) Immediately after contact with body fluids, mucous membranes and non-intact skin

553. You are told a patient is in “source isolation”. What would you do & why?

a) Isolating a patient so that they don’t catch any infections

b) Nursing an individual who is regarded as being particularly vulnerable to infection in such a way as to minimize the transmission

of potential pathogens to that person.

c) Nursing a patient who is carrying an infectious agent that may be risk to others in such a way as to minimize the risk of the infection

spreading elsewhere in their body.

d) Nurse the patient in isolation, ensure that you wear apprpriate personal protective equipment (PPE) & adhere to strict hygiene ,for

the purpose of preventing the spread of organism from that patient to others.

554. If you were told by a nurse at handover to take “standard precautions” what would you expect to be doing?

a) Taking precautions when handling blood & ‘high risk’ body fluids so that you don’t pass on any infection to the patient.

b) Wearing gloves, aprons & mask when caring for someone in protective isolation to protect yourself from infection

c) Asking relatives to wash their hands when visiting patients in the clinical setting

d) Using appropriate hand hygiene, wearing gloves & aprons when necessary, disposing of used sharp instruments safely &

providing care in a suitably clean environment to protect yourself & the patients

555. Under the Yellow Card Scheme you must report the following: ( Select x 2 correct answers)

a) Faulty brakes on a wheelchair

b) Suspected side effects to blood factor, except immunoglobulin products

c) Counterfeit or fake medicines or medical devices

556. Where will you put infectious linen?

a) red plastic bag designed to disintegrate when exposed to heat

b) red linen bag designed to hold its integrity even when exposed to heat

c) yellow plastic bag for disposal

557. What would make you suspect that a patient in your care had a urinary tract infection?

a) The doctor has requested a midstream urine specimen.

b) The patient has a urinary catheter in situ, and the patients wife states that he seems more forgetful than usual.

c) The patient has spiked a temperature, has a raised white cell count (WCC), has new-onset confusion and the urine in his

catheter bag is cloudy.

d) The patient has complained of frequency of faecal elimination and hasn’t been drinking enough.

558. Which of the following would indicate an infection?

a) Hot, sweaty, a temperature of 36.5°C, and bradycardic.

b) Temperature of 38.5°C, shivering, tachycardia and hypertensive.

c) Raised WBC, elevated blood glucose and temperature of 36.0°C.

d) Hypotensive, cold and clammy, and bradycardic.

559. A client was diagnosed to have infection. What is not a sign or symptom of infection?

a) A temperature of more than 38°C

b) warm skin

c) Chills and sweats

d) Aching muscles

560. Mrs. Smith is receiving blood transfusion after a total hip replacement operation. After 15 minutes, you went back to

check her vital signs and she complained of high temperature and loin pain. This may indicate:

a) Renal Colic

b) Urine Infection

c) Common adverse reaction

d) Serious adverse reaction

561. As an infection prevention and control protocol, linens soiled with infectious bodily fluids should be disposed of in

what means?

a) Placed in yellow plastic bag to be disposed of

b) Placed in dissolvable red linen bag and washed at high temperature

c) Placed in yellow linen bag, and washed at high temperature

d) Placed in red plastic bag to be incinerated at high temperature

562. What percentage of patients in hospital in England, at the time of the 2011 National Prevalence survey, had an infection?

a) 4.6%

b) 6.4%

c) 14%

d) 16%

563. How to take an infected sheet for washing according to UK standard

a) Take infected linen in yellow bag for disposal

b) Take in red plastic bag, that disintegrates in high temperature

c) Use red linen bag that allows washing in high temperatures

d) Use a white bag

564. There has been an outbreak of the Norovirus in your clinical area. Majority of your staff have rang in sick. Which of

the following is incorrect?

a.) Do not allow visitors to come in until after 48h of the last episode

b.) Tally the episodes of diarrhoea and vomiting

c.) Staff who has the virus can only report to work 48h after last episode

d.) Ask one of the staff who is off-sick to do an afternoon shift on same day

565. One of your patients in bay 1 having episodes of vomiting in the last 2 days now. The Norovirus alert has been

enforced. The other patients look concerned that he may spread infection. What is your next action in the situation?

a) Seek the infection control nurse’s advice regarding isolation

b) Give the patient antiemetic to control the vomiting

c) Offer the patient a lot of drinks to rehydrated

d) Tell the other patients that vomiting will not cause infection to others

566. Infected linen should be placed in:

a) Red plastic bag that disintegrates at high temperature

b) Red linen bag that can withstand high temperatures

c) White linen bag that can withstand high temperatures

d) Yellow plastic bag that cannot withstand high temperatures.

567. When do you wear clean gloves?

a) Assisting with bathing

b) Feeding a client

c) When there is broken skin on hand

d) Any activity which includes physical touch of a client

568. The nurse needs to validate which of the following statements pertaining to an assigned client?

a) The client has a hard, raised, red lesion on his right hand.

b) A weight of 185 lbs. is recorded in the chart

C. The client reported an infected toe

D. The client’s blood pressure is 124/70. It was 118/68 yesterday.

569. Which bag do you place infected linen?

a) water-soluble alginate polythene bag before being placed in the appropriate linen bag, no more than ¾ full

b) orange waste bag, before being placed in the appropriate linen bag, no more than ¾ full

c) white linen bag, after sorting, no more than ¾ full

570. Under the Yellow Card Scheme you must report the following: ( Select x 2 correct answers)

A. Faulty brakes on a wheelchair

B. Suspected side effects to blood factor, except immunoglobulin products

C. Counterfeit or fake medicines or medical devices

D. Ascites and increased vascular pattern on the skin

571. For which type of waste should orange bags be used?

a) Waste that requires disposal by incineration

b) Offensive/hygiene waste

c) Waste which may be ‘treated

d) Offensive waste

572. Jenny, a nursing assistant working with you in an Elderly Care Ward is showing signs of norovirus infection. Which of

the following will you ask her to do next?

A. Go home and avoid direct contact with other people and preparing food for others until at least 48 hours after her symptoms have


B. Disinfect any surfaces or objects that could be contaminated with the virus

C. Flush away any infected faeces or vomit in the toilet and clean the surrounding toilet

area D. Avoid eating raw oysters

573. Mrs X had developed Steven-Johnson syndrome whilst on Carbamazepine. She is now being transferred for the ITU to

a bay in the Medical ward. Which patient can Mrs X share a baby with?

a) a patient with MRSA

b) a patient with diarrhoea

c) a patient with a fever of unknown origin

d) a patient with Stephen Johnson Syndrome

574. Which of the following are not signs of a speed shock?

a) Flushed face

b) Headache and dizziness

c) Tachycardia and fall in blood pressure

d) Peripheral oedema

575. Which is not a sign or symptom of speed shock?

a) Headache

b) A tight feeling in the chest

c) Irregular pulse

d) Cyanosis

576. While giving an IV infusion your patient develops speed shock. What is not a sign and symptom of this?

A. Circulatory collapse

B. Peripheral oedema

C. Facial flushing

D. Headache

577. Signs of hypovolemic shock would include all except:

a) restlessness, anxiety or confusion

c) shallow respiratory rate, becoming weak

d) rising pulse rate

e) low urine output of <0.5 mL/kg/h E. pallor (pale, cyanotic skin) and later sweating

578. What are the signs and symptoms of shock during early stage (stage 1-3)?

a) hypoxemia

b) tachycardia and hyperventilation

c) hypotension

d) acidosis

579. All but one are signs of anaphylaxis:

a) itchy skin or a raised, red skin rash

b) swollen eyes, lips, hands and feet

c) hypertension and tachycardia

d) abdominal pain, nausea and vomiting

580. Which of the following are signs of anaphylaxis?

a) swelling of tongue and rashes

b) dyspnoea, hypotension and tachycardia

c) hypertension and hyperthermia

d) cold and clammy skin

581. You were asked by the nursing assistant to see Claudia whom you have recently given trimetophrim 200 mgs PO because

of urine infection. When you arrived at her bedside, she was short of breath, wheezy and some red patches evident over her

face. Which of the following actions will you do if you are suspecting anaphylaxis?

a) call for help and give oxygen

b) give oxygen and salbutamol nebs if prescribed and call for help

c) give oxygen, administer adrenaline 500 mcg IM, give salbutamol nebs if prescribed and call for help

d) call for help, give oxygen, administer adrenaline 500 mcg IM, give salbutamol nebs if prescribed.

582. A patient has collapsed with an anaphylactic reaction. What symptoms would you expect to see?

a) The patient will have a low blood pressure (hypotensive) and will have a fast heart rate (tachycardia) usually associated with skin and

mucosal changes.

b) The patient will have a high blood pressure (hypertensive) and will have a fast heart rate (tachycardia).

c) The patient will quickly find breathing very difficult because of compromise to their airway or circulation. This is accompanied by skin

and mucosal changes

d) The patient will experience a sense of impending doom, hyperventilate and be itchy all over

583. What are the signs and symptoms of shock during early stage (stage 1-3)? (CHOOSE 3 ANSWERS)

A. hypoxemia

B. tachycardia and hyperventilation

C. hypotension

D. Acidosis

584. After lumbar puncture, the patient experienced shock. What is the etiology behind it?

a) Increased ICP

b) Headache

c) Side effect of medications

d) CSF leakage

585. A patient has collapsed with an anaphylactic reaction. What symptoms would you expect to see?

a) The patient will have a low blood pressure (hypotensive) & will have a fast heart rate (tachycardia) usually associated with skin &

mucosal changes

b) The patient will have a high blood pressure (hypertensive) & will have a fast heart rate (tachycardia)

c) The patient will quickly find breathing very difficult because of compromise to their airway or circulation. This is accompanied by skin

& mucosal changes

d) The patient will experience a sense of impending doom, hyperventilate & be itchy all over

586. Leonor, 72 years old patient is being treated with antibiotics for her UTI. After three days of taking them, she

developed diarrhoea with blood stains. What is the most possible reason for this?

a) Antibiotics causes chronic inflammation of the intestine

b) An anaphylactic reaction

c) Antibiotic alters her GI flora which made Clostridium-difficile to multiply

d) she is not taking the antibiotics with food

587. The following are signs & symptoms of hypovolemic shock, except:

a) Confusion

b) Rapid heart rate

c) Strong pulse

d) Decrease Blood Pressure

588. Signs and symptoms of septic shock?

a) Tachycardia, hypertension, normal WBC, non pyrexial

b) Tachycardia, hypotension, increased WBC, pyrexial

c) Tachycardia, , increased WBC, normotension, non pyrexial

d) Decreased heart rate, decreased blood pressure, normal WBC and pyrexial

589. Which of the following is not a criteria for anaphylactic reaction:

a) Sudden onset and rapid progression of symptoms

b) life threatening airway and/ or breathing and/or circulation problems

c) skin and/or mucosal changes ( flushing, urticaria and angioedema)

d) skin and mucosal changes only

e) A and B only

f) all of the above

e) A, B and C

590. Mrs X was taken to the Accident and Emergency Unit due to anaphylactic shock. The treatment for Mrs X will depend on

the following except:

a.) Location

b.) Number of Responders

c.) Equipment and Drugs available

d.) Triage system in the A&E

591. Mark, 48 years old, has been exhibiting signs and symptoms of anaphylactic reaction. You want to make sure that he is in

a comfortable position. Which of the following should you consider?

a) Mark should be sat up if he is experiencing airway and breathing problems.

b) Mark should be lying on his back if he is assessed to be breathing and unconscious.

c) Mark should be sat up if his blood pressure is too low.

d) Mark should be encouraged to stand up if he feels faint.

592. The following are ways to remove factors that trigger anaphylactic reaction except for one.

a) It is not recommended to make the patient should not be forced to vomit after food-induced anaphylaxis.

b) Definitive treatment should not be delayed if removing a trigger is not feasible.

c) Any drug suspected of causing an anaphylactic reaction should be stopped.

d) After a bee sting, do not touch the stinger for about a maximum of 3 hours.

593. Mrs Smith has been assessed to have a cardiac arrest after anaphylactic reaction to a medication. Cardiopulmonary

Resuscitation (CPR) was started immediately. According to the Resuscitation Council UK, which of the following statements

is true?

a.) Intramuscular route administration of adrenaline is always recommended during cardiac arrest after anaphylactic reaction.

b.) Intramuscular route for adrenaline is not recommended during cardiac arrest after anaphylactic reaction.

c.) Adrenaline can be administered intradermally during cardiac arrest after anaphylactic reaction.

d.) None of the Above

594. An Eight year old girl with learning disabilities is admitted for a minor surgery, she is very restless and agitated and wants

her mother to stay with her, what will you do?

A. Advice the mother to stay till she settles.

b. Act according to company policy

c. Tell her you will take care of the child

d. Inform the Doctor

595. What is meant by ‘Gillick competent’?

A. Children under the age of 12 who are believed to have enough intelligence, competence and understanding to fully

appreciate what’s involved in their treatment.

B. Children under the age of 16 who are believed to have enough intelligence, competence and understanding to fully

appreciate what’s involved in their treatment

C. Children under the age of 18 who are believed not to have enough intelligence, competence and understanding to fully appreciate

what’s involved in their treatment.

D. Children under the lawful age of consent who are believed not to have enough intelligence, competence and understanding to

596. When communicating with children, what most important factor should the nurse take into consideration?

a) Developmental level

b) Physical development

c) Nonverbal cues

d) Parental involvement

597. Normal heart rate for 1 to 2 years old?

a) 80 – 140 beats per minute

b) 80 – 110 beats per minute

c) 75 – 115 beats per minute

598. Which of the following is an average heart rate of a 1-2 year old child?

a) 110-120 bpm

b) 60-100 bpm

c) 140-160 bpm

d) 80-120 bpm

599. You are assisting a doctor who is trying to assess and collect information from a child who does not seem to understand

all that the doctor is telling and is restless. What will be your best response?

a) Stay quiet and remain with the doctor

b) Interrupt the doctor and ask the child the questions

c) Remain with the doctor and try to gain the confidence of the child and politely assess the child’s level of understanding and

help the doctor with the information he is looking for

d) Make the child quiet & ask his mother to stay with him

600. Recognition of the unwell child is crucial. The following are all signs and symptoms of respiratory distress in children


a) Lying supine

b) Nasal flaring

c) Intercostal and sternal recession

d) adopting an upright position

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