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1
A pregnant woman asks about conditions which might affect her growing baby. What is true about listereria. it;
can be prevented through appropriate vaccination procedures
is transmitted through contact with infected cat faeces
causes vomiting diarrhoea and flu-like symptoms in pregnant women
may be present in seafood and milk products
2
Which of the following examples of behaviour could be considered to be professional misconduct?
Having values, beliefs or opinions that differ from a client
Smoking cigarettes while in uniform,
Declining gifts from a client or an ex-client
Having an intimate relationship with a client or an ex-client
3
A hallucination is a disorder of:
Memory
Affect
Perception
Orientation
4
Pt:anxious, dyspnoeic & in severe pain. left chest wall moves in during inspiration and balloons on exhale. symptoms of?
atelectasis
flail chest
pleural effusion
haemothorax
5
What effect does exercise have on the food intake needs of a personwith well controlled Type 1 diabetes mellitus?
Decreases the need for food
Increases the person’s blood sugar levels.
Has little effect on the need for food
Increases the need for food
6
Child is bought to doctors. At what age is it appropriate for the nurse to question a child about presenting symptoms
7 years
9 years
5 years
3 years
7
The most effective nursing approach to deal with denial in a person with substance abuse is:
Confronting the client regarding the hopelessness of their situation
Describing the physiological effects of alcohol on the body
Having the client discuss the effects of alcohol on his/her life
Discussing the addictive personality
8
pt has hx of alc dependancy, separated from wife and has problems managing life, appropriate nursing diagnosis for pt:
Ineffective denial
Risk for loneliness
Powerlessness
Ineffective individual coping
9
signs and symptoms indicating pt has developed pneumothorax would be
Dull percussion sounds on the injured side
Muffled and distant heart sounds with decreasing blood pressure
Severe respiratory distress and tracheal deviation
Decreased movement and diminished breath sounds on the affected side
10
pt experiencing angina. The pain calledangina pectoris most likely occurs with myocardial ischaemia as a result of:
Cardiac arrhythmias caused by cellular irritability
Death of myocardial tissue
Lactic acid accumulation during anaerobic metabolism
Elevated pressure in the ventricles and pulmonary vessels.
11
newborn undergoes several respiratory adaptations at birth to ensure it can breathe effectively. All are true EXCEPT:
Surfactant is a substance found in the lungs of a newborn to help expanding
When the cord is cut acidosis stimulates the respiratory centre
Crying helps the small air sacs (alveoli) to open in the lungs
The blood is to be shunted from the lungs through the ductus arteriosis
12
Parents of a newborn are concerned about Sudden Unexplained Death of Infant (SUDI). best way to reduce this risk is
sleep baby on a sheepskin rug, keep at a constant temperature & breast feed
lay baby on back, breast feed and maintain a smoke free environment
monitor the baby on an apnoea mattress, maintain the environment smoke free
keep baby with you at all times, breast feed and lay baby on side
13
pregnant woman’s diet consists of breads, cereals, fruits and vegetables. nurse would be most concerned of her intake of
calcium
protein
folic acid
vitamin b12
14
A mother attends the children’s clinic asking for information regarding outbreak of chicken pox in the area. You advise
effects of chicken pox are minimal & child’s schooling will not be affected
An immunisation is available for chicken pox for all children at 3 mnths
The child must be seen by GP if you suspect the chickenpox
Chicken pox is viral contagious&can be transmitted w skin contact of lesion
15
On assessment of Timothy’s hydration status, which of the following indicates less than adequate fluid replacement?
Stable haematocrit and increasing urine volume
Falling haematocrit and decreasing urine volume
Decreasing haematocrit and increasing urine volume
Rising haematocrit and decreasing urine volume
16
A mother of 6 week old asks you about hepB virus(HBV). U inform her that all of the following are true about HBV EXCEPT:
HBV is spread by exposure to infected food and water
HBV virus can be reduced by avoiding the sharing of needles and syringes
HBV is spread by contact with infected semen or other body fluid
HBV is effectively prevented by vaccination is a preventable disease
17
pt has been admitted with a diagnosis of major depression. The nurse would expect to assess which personality types?
Narcissistic
Dependent
Eccentric
Egocentric
18
Your nursing priority during the process of gaining consent is to:
check that the consent form identifies the correct procedure and date
ensure that pt husband is involved in the process.
check that the consent form has been witnessed
ensure pt understands the procedure
19
Timothy is susceptible to infection for the following reasons except
The frequency of invasive procedures performed during his hospital stay
Loss of skin impairs his ability to protect his underlying tissues
Longer length of stay in hospital predisposed him to nosocomial infections
He is likely to develop antibiotic resistance from prolonged use
20
Mr H, has recently been diagnosed ashaving Type I diabetes. The major signs of untreated diabetes are:
Decrease in urine output and increase in thirst
Fatigue, weight loss and decrease in urinary output
Increased thirst, increased urinary output and increased appetite.
Weight gain, decrease in appetite and fatigue
21
Which of the following is an unacceptable professional role activity? Choose one answer
Utilising effective interviewing counselling skills with with clients
Being welcoming to a patient
Caring for a patient
Being a personal friend to a client
22
Liz has been advised that the best time of the month to perform breast self-examination is
During menstruation
After the menstruation period
Before going to bed at night.
Before menstruation starts
23
pt returned from ot following bowel resection, has an NG tube on freedrainage. whats the purpose of NG in this situation
To administer medications
To provide enteral nutrition
To monitor bleeding post-operatively
To drain the contents of the stomach
24
What organs does alcohol primarily affect?
Liver only & nothing else
GI Tract causing malabsorption
Liver and brain
Pancreas
25
Which food would the nurse encourage a woman to consume more to increase her calcium intake
Canned sardines
Canned baked beans
Fresh apricots
Spaghetti with meat sauce
26
The frontal lobe of the brain is thought to be responsible for:
Judgement and orientation
Sense of time and space
Vocabulary
Speech
27
the most common effect of radiation therapy on the area exposed is:
developing freckles on the affected skin
redness of the surface area
pain and blistering of the skin
macular papular rash on the skin
28
Which option should the nurse incorporate in the nursing care plan of a client with dementia to aid in memory retention?
Daily activity schedules
Simple word games
Discussion groups
Large motor activities
29
Maternity carer asks a first time pregnant woman if she has felt any quickening. The term ‘quickening’ is us
the first time fetal parts are felt by the mother
the first fetal movements felt by the mother
the first time the mother feels contractions
the first fetal movements felt by the lead maternity carer
30
The following information should be given to parents seeking information about Gardasil vaccine for (HPV).
The vaccine means women will not need regular cervical smear tests
Cervical cancer is a cancer which has low mortality rates in NZ
There is a $10 charge for each individual girl who gets the vaccine
Most effective time to have vaccine is before girls start sexual activity
31
post masectomy pt develops lymphoedema following radiation. what 3 points will you give to minimise & manage lymphoedema
Minimise arm trauma, exercises, and diuretics
Diuretics, compression bandaging, ultraviolet light therapy
Compression bandaging, exercises, minimise arm trauma
Minimise arm trauma, compression bandaging, ultra violet light therapy
32
Which would be the most suitable to cover pt's burnt legs whilst being transported to the nearest health care facility
Wrap clean plastic cling film (if available) around both legs
Apply cooking oil liberally (if available) and keep legs exposed
Apply a thick layer of sunscreen and wrap with beach towel
Apply ice from chilly bin and wrap both legs in clean beach towel(s)
33
When attempting to elicit an accurate substance abuse history, the nurse should:
Progress from the most acceptable chemical of abuse to the most prohibited
Wait for the client to disclose abuse
Avoid the drug history question and question the spouse later
Progress from the most prohibited chemical of abuse to the most acceptable
34
1/2 hr after blood transfusion is commenced pt has temp of 39, shaking & feels cold. what immediate action should u take
Contact medical staff
Reassure pt
Give pt a tepid sponge
Stop the blood transfusion
35
Timothy’s urine output via his foley catheter is 10ml/hr. What should you do first?
Check Timothy’s catheter to see if it is blocked
Increase his intravenous fluids
Notify medical staff immediately
Record the information on his fluid balance chart
36
Which of the following statements is true about breastfeeding changes in early postpartum period?
Oestrogen& progesterone lvls drop with the increase in prolactin secretion
breasts become larger so newborn can recieve sufficient milk
Colostrum is present by 1-2 daus postpartum & eventually changes to milk
Oestrogen & progesterone levels increase rapidly to enable milk production
37
Which of the following is a priority assessment for the client with a major depression:
Suicidal ideation
Mood and affect
Fluid and electrolyte balance
Nutritional status
38
As a result of his Type I diabetes Mr H could go into a diabetic coma. This results from:
Cerebral depression by ketones.
A sudden reduction in blood glucose level
Decreased tissue perfusion
Excessive acetylcholinesterase
39
Which of the following is the most common complication immediatelyfollowing a myocardial infarction?
Cardiac arrhythmias
. Deep vein thrombosis.
Heart Failure
Angina
40
post masectomy pt is encouraged to exercise left arm and shoulder through a ROM's. What is the rationale for this?
To build up her pectoral muscles and maintain chest firmness and contour
To prevent oedema forming post-operatively in her left arm
To maintain a full range of motion in her left shoulder and arm
To encourage her to actively participate in her rehabilitation
41
nurse explains to mum of 1yr old that the child is more likely to have otitis media than her 13 yr old brother because:
her hands are often contaminated when she crawls on the floor
she is not old enough to have learned how to “clear” her nasal passages.
she is still “cutting” new teeth
the angle of the child’s Eustachian tube is straighter than her brother’s
42
pt is tachycardic and hypotensive. Hourly drainage from his wound drain has increased and urine output is decreasing.
internal bleeding from intra-peritoneal trauma and surgery
septic shock associated with contaminated chest and peritoneal wounds
vaso-dilation associated with opioid patient-controlled analgesia
anaphylaxis relating to opioid patient-controlled analgesia
43
pt is in bed and you notice a small amount of haemo-serous ooze on his abdominal wound dressing. How should you respond
Remove the dressing, collect a wound swab and inform medical staff
Document on wound assessment chart and observe for changes.
Reinforce the dressing, leaving the original dressing undisturbed
Remove and replace the dressing immediately
44
why is it important to administer blood over several hours
To prevent palpitations
To prevent hypertension
To prevent fluid overload
To prevent anaphylaxis
45
A potential effect of physical and emotional stress on diabetes mellitus control may include:
The secretion of stress hormones that cause a decrease in blood sugar level
The secretion of stress hormones that cause an elevation in BGL's
The secretion of stress hormones that reduce the amount of insulin required
Secretion of stress hormone which increase the store of glucagon in liver
46
The risk of a suicide attempt is highest in a person experiencing depression when they are:
Responding to treatment but still depressed
Profoundly depressed and severely retarded
About to be discharged from hospital
Less depressed, but still retarded
47
Assessing suicidal potential of clients involves all except:
Previous suicide attempts
Whether they have a plan
Social status
Method of lethality
48
Pt mother asks for advice on food to bring in for his burn healing. what would you advise her.
Food that is high in protein such as milkshakes, cheese and eggs
Potato chips and high-salt foods to replace sodium lost with burns
Soft food and fluids only because he will have difficulty swallowing
His favourite ‘comfort’ food as he is so upset
49
You have identified that a women is experiencing violence. Supportive action you now take could be to:
Validate that she is not responsible for the abuse
Ask her details of all the abuse she has suffered
Explain that her children may also be in danger
Tell the women she should leave her relationship
50
breastfeeding woman baby is 3 days old and concerned the baby is having difficulty latching onto the area, youd advise:
Give the baby a bottle of infant formula
Limit the time the baby has on her breasts
Gently massage her breasts and assist the baby to latch on
Apply hot packs to her breasts before feeding
51
pt exhibits disruptive behaviour on ward & is being annoying to the other clients. One approach by the nurse might be
Set limits on her behaviour and be consistent in approach
ignore her behaviour, realising it is consistent with her illness
Tell pt she is annoying others and confine her to her room
Make a rigid structured plan that Mrs A. will have to follow
52
Pt sustained burns to legs following beach bbq, pt went in sea afterward. what is true about this first aid treatment
Not acceptable because of the risk of chilling and shock
Strongly recommended as sea water is healing
Risky because of the contaminants in sea water
Advisable to reduce the heat of the flames
53
Timothy quickly develops oedema in both of his legs. What is the greatest risk of circumferential burns?
Obstruction of blood flow and consequent ischaemia
Increased susceptibility to infection because of loss of skin cover
Loss of skin cover and therefore loss of body fluids & electrolytes
Excessive pain that limits mobility, increasing risk of DVT
54
pt admitted for alcoholism relapsing upon d/c, minimises problems w/ alcohol. an outcome of hospital stay will be
Remain compliant with the protocol for alcohol detoxification
Remain abstinent
Develop more effective coping skills
Verbalise that he is powerless over alcohol
55
The safe level of alcohol use for women is what?
21 units per week
14 units per week
60 units per week
50 units per week
56
Anginal pain can best be differentiated from the pain of a myocardial infarction in that angina:
Attacks usually occur when the person is at rest.
Is usually not relieved by nitroglycerine tablets or sublingual spray
Is usually relieved by the client bending forward
Subsides when precipitating factors are removed
57
Tachycardia in response to ischaemic cardiac chest pain isdetrimental because it increases oxygen demand and also:
Causes reflex hypotension
Decreases cardiac output
Causes palpitations.
Impairs perfusion of the coronary arteries
58
Under the Mental Health Act 1992 Section 111 “Powers of a Nurse” it states that a nurse can detain:
The Client for exam until the crisis team has made an assessment
The client for assessment if they have a mental disorder
The client for exam no longer than 6hrs from first calling for a med prac
The Client if they believe them to be a danger to self or others
59
Which of the following are considered the positive signs of schizophrenia?
Disordered thinking, anhedonia, illusions
Delusions, anhedonia, ambivalence
Hallucinations, illusions, ambivalence
Delusions, hallucinations, disordered thinking
60
Pregnant woman states, “I usually drink 4 cans of beer and 2 glasses of wine with dinner”. Your best reply would be;
You should limit your alcohol consumption to 1 glass of wine in the evening
You should not to exceed 3.2% alcohol, per day
“It is preferable that you dont drink alcoholic beverages during pregnancy”
“You should limit your alcohol consumption to 1 drink per week”
61
When a mother feeds her infant colostrum it contains immunoglobulins. This gives the infant:
Passive short term immunity
Adaptive short term immunity
Active short term immunity
Dynamic long term immunity
62
Mr H asks you why it is necessary for him to have insulin injections. You explain that:
It stimulates the liver to excrete more glucose for the body to utilise
It increases the rate of metabolism, therefore lowering BGLs
it is absorbed rapidly and increases the body’s resistance to infection
It lowers the blood sugar by increasing utilisation of carbohydrates.
63
you are the charge nurse, two uniformed police officers arrive on ward and request an interview with pt, what do u do
Refuse access to the patient in order to protect their confidentiality.
Give the police officers the patient’s medical notes
Show the police officers to the patient’s bedside, if the patient agrees
Show the police officers to the patient’s bedside immediately
64
All of the following breast signs and symptoms may indicate the presence of breast cancer except
asymmetrical left and right breast
retraction of the nipple
puckering of the skin around the nipple
discharge from the nipple.
65
Three days later her temperature is 39 . Which of the following actions should you take immediately?
Give her a tepid sponge
Check her urine and sputum
Administer Panadol 1 Gram
Check her wound and drain sites
66
Pt wound ooze has increased next day and his temperature has risen to 38.5 Your most appropriate response would be to
Renew wound dressing and encourage Sam to drink more fluids
Replace with hydrocolloid wound dressing and inform medical staff.
Record vital signs and administer Paracetamol 1Gm
Assess and redress wound, obtain a wound swab and inform medical staff
67
Mr H is experiencing a hypoglycaemic reaction. Your most appropriate action is to get him to:
Drink half a cup of orange juice with 2 teaspoons sugar
Eat 4 crackers with butter or margarine
Drink one cup of regular lemonade or take 3 glucose tablets
Ring 111 and ask for an ambulance.
68
pt experiencing paranoid delusions states “they’re after me night and day.” A therapeutic response would be;
"Must be frightening feeling that, but it doesn’t seem, this is being done"
“They are out to get you; they are conspiring against you?”
“Why do you feel they are pursuing you?”
You think this cause your mentally ill, when your well you will see it isnt
69
Asking a depressed client/consumer about suicidal ideation is:
Best avoided to allow concentration on more positive ideas
Potentially dangerous as it might put the idea into their heads
An unnecessary intrusion into someone’s privacy
An unnecessary part of assessment of a depressed client/consumer
70
post op pt is using PCA freq. Feels itchy and becomes very sedated over the shift with RR falling to 6 breaths,what now?
Stop patient-control-analgesia and notify medical staff
Sit pt up, check vital signs and get him to deep breath and cough
Nothing. He is more relaxed and comfortable with better pain control
Change to a different type of patient-controlled analgesia
71
A pregnant woman says she isnt immune to rubella and asks if she should be vaccinated now. best response would be
It is too late now that you are pregnant
you must arrange for your Lead Maternity Carer to vaccinate you ASAP
You must wait until after the baby is born
it is not urgent- arrange it at your next Lead Maternity Carer’s visit
72
pt is suppose to be NBM but you discover his family have given small drink of water. what do you do?
Inform medical staff that Sam has just had a small drink of water
Reprimand the family for delaying surgery by giving Sam the water to drink
advise operating theatre staff when you hand him over
Nothing because the amount was less than 100 ml and therefore insignificant
73
The Human Papillomavirus:
Does not normally infect healthy men and women
Can be prevented completely by using condoms for protection
Is a common virus causing up to 70% of cervical cancers and genital warts
Is not a sexually transmitted disease because it is spread by droplets
74
A breastfeeding woman is concerned that she is producing colostrum not milk on her 1st day PP. You should tell her that:
She must feed the baby two hourly to stimulate milk production
This is normal and milk production is not present for at least three days
Lactation does not become established until oestrogen is produced
She should express more frequently to stimulate milk production
75
A father is concerned that his one week old newborn son is sleeping too much. The nurse’s initial response should be:
"You sound concerned. Let’s examine how many hours he’s actually sleeping”
“You need to discuss this with his paediatrician”
“Don’t worry, most newborns sleep a lot”
“Your baby has to sleep at least 20 hours a day”
76
pt is 85 with dementia & has impaired ADL's. lives at home and hasnt bathed for a month. what is an appropriate outcome
pt will bathe daily
pt will bathe 3x a week
pt will remain free of skin disease
nurse will maintain pt's hygiene
77
5 nurses are given $50 from pt. 3 keep money & 2 refuse. appropriate response from nurses in this situation would be?
Put the money in collective fund for staff xmas party
Not to accept monetary gifts, politely returning the money to the patient
Every nurse should accept the money
Accept gifts as long as the patient can afford it
78
Which of the following best defines the term “myocardial infarction”?
Necrosis of a portion of the myocardium
A sudden irregularity of cardiac contraction
A diminished blood supply to the myocardium
79
At the onset of a concurrent illness, a person with Type 1 diabetes mellitus should:
Drink a glass of water with each meal and test urine for ketones
Test blood glucose more frequently than usual and try to eat regularly
Dial 111 and request and ambulance.
Take usual insulin even if not eating and test blood glucose frequently
80
You teach Mr H that the early signs of hypoglycaemia are:
Dry skin, vomiting and irritability
Drowsiness, dry mouth and nystagmus
Nervousness, sweating and weakness
Palpitations, nausea and drooling
81
Partner abuse screening should occur:
Only when you have a strong suspicion
As part of any routine health history
Only when a women brings up the subject herself
Only when a women presents with unexplained injuries
82
Which of the following are recommended as the preferred site(s) foron-going subcutaneous insulin administration?
Upper outer thigh and upper arm
Abdomen
Anywhere in the body as long as the injection is given subcutaneously
Abdomen and upper thigh
83
A woman asks you if aspirin is safe to take during pregnancy. Your best response would be:
Not safe because it is a teratogen which interferes with blood production
This is a nonsteroidal anti-inflammatory drug (NSAID) so it is safe
It is much safer than paracetamol because it is excreted rapidly
It is not a safe medication because it can interfere with blood clotting
84
Client tells you that 18mnth son was diagnosed with whooping cough
Isolate from other adults and rest
Continue as normal and encourage activity
Regular fluids and increased food intake
Humidified air, regular fluids and rest
85
4 yr old pt is upset and does not want to get skin grafts to badly burnt areas of his legs. what should you do?
Ask his mother to leave and talk to Timothy alone
Work with pt and his mother to help him overcome his fears
Ask his mother to persuade Timothy that he must have the operation
Tell pt that the doctor says that he needs to have the skin grafts
86
Once Mr H has received a dose of rapid acting insulin he must have food within:
Three hours
One hour
Four hours
. Two hours
87
Pt+partner in room. Reasons pt gives for injury do not make sense. you suspect it is partner abuse, what action to take?
Dont discuss concerns with the women unless you can talk to her in private
Ask her partner if he has an anger problem
Given the women and her partner information about violence prevention
Do nothing because this women is not telling the truth
88
What kind of substance is insulin?
A protein produced in the pancreas and stored in the liver
A carbohydrate produced by the Islets of Langerhan
A hormone produced by the Isles of Langerhans
An electrolyte produced by the pancreas.
89
Mr H’s Hb1Ac on admission is 9.2%. This probably indicates that:
His blood glucose level is at the lower end of normal range
. His blood glucose has been very poorly controlled for a long time
His blood glucose has been under good control recently.
His blood glucose has been slightly high for at least three months
90
Determinants of success for a substance abuser completing a rehabilitation programme are based on:
Willingness to recognise denial
Ability to maintain employment
Number of drug free days
Lack of symptoms of complications
91
Liz undergoes a left mastectomy for breast cancer. What is the priority for nurses receiving her in (PACU) post-op
Relieve her pain
Ensure her airway is patent
Obtain vital signs
Administer IV fluids
92
you overhear pt asking nurse if whanau can say a prayer. The nurse says, “Prayers won’t do you any good " what do you do
Ignore the incident completely and continue on with your own work
Arrange for family prayer without informing the nurse or pt to please pt
Inform charge nurse, explaining what you overheard so she can deal to it
Take the nurse aside and explain to her about the importance of pt's needs
93
When the client who is under Compulsory Assessment and Treatment, is no longer ‘mentally disordered’ what must occur?
Review to Section 29
Review and immediately release client from Act
Review of status
Review of client’s rights
94
You are trying to activate a client who is hallucinating, withdrawn & negativistic Your approach to the client might be:
Demand that the client join a group activity
Explain the benefits of activity
“I need a partner for this game”
Mention that his/her “voices” would want him/her to participate
95
pt in same room overheard conversation of consent and asks what type of operation the other pt is having. what do u say
"Oh nothing. She just wanted to talk about some problems she is having.”
Not sure, Ask them yourself
"I’ll get the doctor to talk to you. I can’t tell you.”
I’m sorry, I cannot disclose that information.”
96
Recent weight loss experienced by Mr H over the last few months is probably due to:
Dehydration resulting from his increased urinary output
Increased body metabolism associated with his Type I diabetes.
Depletion of his body stores of fats and protein
Renal impairment associated with his condition
97
What should the nurse do first when preparing to do a physical assessment on a sleeping 8 month old baby?
wake the baby
check the eyes for the red reflex
measure the occipital –frontal head circumference
auscultate the heart and lungs
98
All of the following are true about newborn infant’s temperature EXCEPT:
Infants use more oxygen if they are hypothermic
Cold stress may result in the infant using its glycogen stores in the liver
Infants lose heat while placed on the mother’s chest for skintoskin contact
Infants may become hypothermic quickly due to their large body surface
99
pt is going to OT for laparotomy. what is purpose of them being NBM pre op
To prevent fluid overload pre-operatively
To reduce bowel motility in case he has perforated his bowel
To dry his mucous membranes and prevent vomiting
To prevent aspiration during anaesthesia
100
It is common for people undergoing chemotherapy to experience:
nausea and headaches
jaundice and mouth ulceration
jaundice and diarrhea
nausea and hair loss
