NP2/NP3

1. The nurse should FIRST flush the central line with:________

A. Sterile water
B. Normal saline
C. Soap suds
D. Mineral water

2. In the health care delivery system. Maternal deaths increases due to poor
maternal health care services in the country. There are three classified delay in the
delivery of health care services that causes increase in maternal deaths. Among
which of the following is not classified as a delay?
A. Delay in decision to seek care
B. Delay in reaching health care facility
C. Delay in giving appropriate care
D. Delay in receiving appropriate care

3. What is the primary location of prostate cancer?

A. Peripheral zone of prostate gland
B. Neck of the urethra
C. Lower portion of the bowel
D. Prostate capsule

Answer: A
Almost all prostate cancers are adenocarcinomas that develop in the
peripheral zones of the prostate gland. This location increases the risk of spreading
to the prostate capsule. Despite the location of the prostate gland, metastasis to
the bowel is uncommon.

4. Gold standard for Prostate cancer diagnosis is:__________

A. Prostate Specific Antigen (PSA)
B. Prostate Biopsy
C. Digital Rectal Exam (DRE)
D. Gleason Score

Answer: B
The gold standard for diagnosis of prostate carcinoma is histological
assessment obtained by transrectal ultrasound-guided systematic core needle
biopsy.
Prostate-specific antigen (PSA) blood test remain the cornerstone for SCREENING
and multiparametricmagnetic resonance imaging (mpMRI) for local staging.
Prostate biopsy remains the cornerstone of prostate cancer DIAGNOSIS and TRUS-
guided biopsy is widely used in the diagnosis.
The Gleason scoring system is used to show how abnormal or different cancer
tissue is when compared to normal tissue.
The 2 most common patterns of growth seen in the biopsy sample (core biopsy, 9-
10 samples) are added together to give Gleason score.
The greater the different from the normal tissue pattern, the higher the gleason
score, the more aggressive the cancer.
The lowest gleason score of a cancer found on prostate biopsy is 6.

5. The nurse suspects that the client has a pulmonary embolism. Which is the MOST
important nursing action?
A. Monitor the vital signs
B. Elevate the head of the bed
 C. Increase the intravenous flow rate
D. Administer oxygen by face mask, as prescribed

Answer: D
(Because pulmonary circulation is compromised in the presence of an embolus,
cardiorespiratory support is initiated by oxygen administration)

6. A client with hyperaldosteronism has been admitted to the unit. The nurse knows
the client is at risk for impaired gas exchange. Which position should this client be
placed to enhance gas exchange?
A) Fowler's position
B) Prone position
C) Left side-lying position
D) Right Sims position

Answer: A
Explanation: A) The client with prolonged vomiting will likely have severe
metabolic alkalosis with reduced oxygenation. The Fowler's position will facilitate
alveolar ventilation with improved oxygenation. Side-lying and prone positions do
not facilitate needed lung expansion.

7. The nurse is caring for a postpartum client with a diagnosis of thrombophlebitis.

The client suddenly complains of chest pain and dyspnea. The nurse should
INITIALLY check which item?
A. Vital signs
B. Fundal height
C. Presence of calf pain
D. Level of consciousness (LOC)

Answer: A
(Pulmonary embolism is a complication of thrombophlebitis. Changes in the vital
signs are one of the first things to occur with pulmonary embolism, because
pulmonary blood flow is compromised.)

8. The nurse is collecting data from a client who is pregnant with triplets. The client
also has a 3-year-old child who was born at 39 weeks' gestation. The nurse should
document which gravid and para status on this client?
A. Gravida 1, Para 1
B. Gravida 2, Para 1
C. Gravida 2, Para 2
D. Gravida 3, Para 2

Correct answer: B
Rationale: Gravida is a term that refers to a woman who is or who has been
pregnant, regardless of the duration of the pregnancy. Parity is a term that means
the number of births after 20 weeks' gestation; it does not reflect the number of
fetuses or infants. Options A, C, and D are incorrect on the basis of these
definitions.

9. The client who is being prepared for a cesarean delivery is brought to the delivery
room. To maintain the optimal perfusion of oxygenated blood to the fetus, the
nurse should place the client in which position?
A. Prone position
B. Semi-Fowler's position
C. Trendelenburg's position
 D. Semi-Prone position

Answer: D
Rationale: Vena cava and descending aorta compression by the pregnant uterus
impede blood return from the lower trunk and extremities, thereby decreasing
cardiac return, cardiac output, and blood flow to the uterus and subsequently to
the fetus. The best position to prevent this would be side-lying/lateral decubitus
(sims or semiprone position), with the uterus displaced off the abdominal vessels.
Positioning for abdominal surgery necessitates a supine position; however, a
wedge placed under the right hip provides for the displacement of the uterus. A
prone or semi-Fowler's position is not practical for this type of abdominal surgery.
Trendelenburg's position places pressure from the pregnant uterus on the
diaphragm and lungs, thus decreasing respiratory capacity and oxygenation.

10. When taking a culture sample from an infected throat, the nurse should:
1. Don sterile gloves to obtain the sample
2. Depress the tongue with a tongue blade
3. Swab around the back of the throat
4. Swab around the tonsil area
5. Place the swab in the sterile culture tube and seal it
A. 1, 2, 3 & 4
B. 1, 3 & 4
C. 1, 2, 4 & 5
D. 1, 3 & 5

Answer: D
Rationale: When obtaining a culture, the nurse should don sterile gloves to protect
herself and prevent skin bacteria from contaminating the culture specimen; the
culture specimen should be taken from the reddened areas at the back of the
throat; the swab is then placed in a sterile culture tube and the tube is sealed. A
tongue blade may or may not be necessary to depress the tongue to obtain the
culture.

11.