اسئلة تمريض شامل

‫مراجعة شاملة‬
‫لمساقات التمريضض‬
‫وحل أسئلة‬
‫المتحانات‬
‫إعداد‬
‫دد معتتصم سععد صلحا‬
‫‪2017‬‬
‫‪Cardiovascular system‬‬
‫‪Dr. Motasem Said Salah‬‬ ‫‪motasem_salah@hotmail.com‬‬

1‫ د‬Which of the following conditions most commonly results in CAD Coronary artery
disease?
a. Atherosclerosis
b. DM
c. MI
d. Renal failure
Atherosclerosis, or plaque formation, is the leading cause of CAD. DM is a ris2k factor
for CAD but isn't the most common cause. Renal failure doesn't cause CAD, but the two
conditions are related. Myocardial infarction is commonly a result of CAD.
2. Atherosclerosis impedes coronary blood flow by which of the following

mechanisms?
a. Plaques obstruct the vein
b. Plaques obstruct the artery
c. Blood clots form outside the vessel wall
d. Hardened vessels dilate to allow the blood to flow through
Arteries, not veins, supply the coronary arteries with oxygen and other nutrients.
Atherosclerosis is a direct result of plaque formation in the artery. Hardened vessels
can't dilate properly and, therefore, constrict blood flow.
3‫ د‬Which of the following risk factors for coronary artery disease cannot be corrected?
a. Cigarette smoking
b. DM
c. Heredity
d. HPN
4‫ د‬Exceeding which of the following serum cholesterol levels significantly increases the
risk of coronary artery disease?
a. 100 mg/dl
b. 150 mg/dl
c. 175 mg/dl
d. 200 mg/dl
They require dietary restriction and perhaps medication. Exercise
5‫ د‬Which of the following actions is the first priority care for a client exhibiting signs
and symptoms of coronary artery disease?
a. Decrease anxiety
b. Enhance myocardial oxygenation
c. Administer sublignual nitroglycerin
d. Educate the client about his symptoms
Enhancing mocardial oxygenation is always the first priority when a client exhibits signs
and symptoms of cardiac compromise. Without adequate oxygen, the myocardium suffers
damage. Sublingual nitorglycerin is administered to treat acute angina, but its
administration isn't the first priority. Although educating the client and decreasing
anxiety are important in care delivery,
6‫ د‬Medical treatment of coronary artery disease includes which of the following
procedures?
a. Cardiac catheterization
b. Coronary artery bypass surgery
c. Oral medication administration
Dr. Motasem Said Salah motasem_salah@hotmail.com
d. Percutaneous transluminal coronary angioplasty
noninvasive, medical treatment for coronary artery disease. Cardiac catheterization isn't
a treatment but a diagnostic tool. Coronary artery bypass surgery and percutaneous
transluminal coronary angioplasty are invasive, surgical treatments.
7‫د‬ Which of the following is the most common symptom of myocardial infarction?
a. Chest pain
b. Dyspnea
c. Edema
d. Palpitations
resulting from deprivation of oxygen to the heart. Dyspnea is the second most common
symptom, related to an increase in the metabolic needs of the body during an MI. Edema
is a later sign of heart failure, often seen after an MI. Palpitations may result from
reduced cardiac output, producing arrhythmias.
8‫ د‬Which of the following systems is the most likely origin of pain the client describes
as knifelike chest pain that increases in intensity with inspiration?
a. Cardiac
b. Gastrointestinal
c. Musculoskeletal
d. Pulmonary
Pulmonary pain is generally described by these symptoms. Musculoskeletal pain only
increase with movement. Cardiac and GI pains don't change with respiration.
9‫ د‬Which of the following blood tests is most indicative of cardiac damage?
a. Lactate dehydrogenase
b. Complete blood count
c. Troponin I
d. Creatine kinase
Troponin I levels rise rapidly and are detectable within 1 hour of myocardial injury.
Lactate dehydrogenase is present in almost all body tissues and not specific to heart
muscle.
CK levels may rise with skeletal muscle injury, CK isoenzymes are required to detect
cardiac injury CK MM,BB, MB
1‫ د‬What is the primary reason for administering morphine to a client with myocardial
infarction?
a. To sedate the client
b. To decrease the client's pain
c. To decrease the client's anxiety
d. To decrease oxygen demand on the client's heart
Morphine is administered because it decreases myocardial oxygen demand. Morphine
will also decrease pain and anxiety while causing sedation, but isn't primarily given for
those reasons.
2‫ د‬Which of the following conditions is most commonly responsible for myocardial

infarction?
a. Aneurysm
b. Heart failure
c. Coronary artery thrombosis
d. Renal failure
3‫ د‬What supplemental medication is most frequently ordered in conjunction with

furosemide (Lasix)?
a. Chloride
b. Digoxin
c. Potassium
d. Sodium
Supplemental potassium is given with furosemide because of the potassium loss that
occurs as a result of this diuretic. Chloride and sodium aren’t loss during diuresis.
Digoxin acts to increase contractility but isn’t given routinely with furosemide.
4‫ د‬Which of the following diagnostic tools is most commonly used to determine the
location of myocardial damage?
a. Cardiac catheterization
b. Cardiac enzymes
c. Echocardiogram
d. Electrocardiogram
The ECG is the quickest, most accurate, and most widely used tool to determine the
location of myocardial infarction. Cardiac enzymes are used to diagnose MI but can’t
determine the location. An echocardiogram is used most widely to view myocardial wall
function after an MI has been diagnosed. Cardiac catheterization is an invasive study for
determining coronary artery disease and may also indicate the location of myocardial
damage, but the study may not be performed immediately.
5‫ د‬What is the first intervention for a client experiencing myocardial infarction?

a. Administer morphine
b. Administer oxygen
c. Administer sublingual nitroglycerin
d. Obtain an electrocardiogram
Administering supplemental oxygen to the client is the first priority of care. The
myocardium is deprived of oxygen during an infarction, so additional oxygen is
administered to assist in oxygenation and prevent further damage. Morphine and
sublingual nitroglycerin are also used to treat MI, but they’re more commonly
administered after the oxygen. An ECG is the most common diagnostic tool used to
evaluate MI.
6‫ د‬Which of the following classes of medications protects the ischemic myocardium by

blocking catecholamines and sympathetic nerve stimulation?
a. Beta-adrenergic blockers b. Calcium channel blockers c. Narcotics d. Nitrates
Beta-adrenergic blockers work by blocking beta receptors in the myocardium, reducing
the response to catecholamines and sympathetic nerve stimulation. They protect the
myocardium, helping to reduce the risk of another infarction by decreasing the workload
of the heart and decreasing myocardial oxygen demand.

Calcium channel blockers reduce the workload of the heart by decreasing the heart rate.
Narcotics reduce myocardial oxygen demand, promote vasodilation, and decreased
anxiety. Nitrates reduce myocardial oxygen consumption by decreasing left ventricular
end-diastolic pressure (preload) and systemic vascular resistance (afterload).
7‫ د‬What is the most common complication of a myocardial infarction?

a. Cardiogenic shock
b. Heart failure
c. Arrhythmias
d. Pericarditis
Arrhythmias, caused by oxygen deprivation to the myocardium, are the most common
complication of an MI.
cardiogenic shock, another complication of MI, is defined as the end stage of left ventricular
dysfunction. The condition occurs in approximately 15% of clients with MI. Because the
pumping function of the heart is compromised by an MI,
heart failure is the second most common complication.
Pericarditis most commonly results from a bacterial of viral infection but may occur after
MI.
8‫د‬ With which of the following disorders is jugular vein distention most prominent?
a. Abdominal aortic aneurysm
b. Heart failure
c. Myocardial infarction
d. Pneumothorax
9‫ د‬Which of the following parameters should be checked before administering digoxin?

a. Apical pulse b. Blood pressure c. Radial pulse d. Respiratory rate
An apical pulse is essential or accurately assessing the client’s heart rate before
administering digoxin. The apical pulse is the most accurate point in the body.
Blood pressure is usually only affected if the heart rate is too low, in which case
the nurse would withhold digoxin. The radial pulse can be affected by cardiac
and vascular disease and therefore, won’t always accurately depict the heart
rate. Digoxin has no effect on respiratory function.
10‫ د‬Which of the following symptoms is most commonly associated with left-sided heart
failure?
a. Crackles b. Arrhythmias c. Hepatic engorgement d. Hypotension
Crackles in the lungs are a classic sign of left-sided heart failure. These sounds are caused
by fluid backing up into the pulmonary system. Arrhythmias can be associated with both
right and left-sided heart failure. Left-sided heart failure causes hypertension secondary to
an increased workload on the system.

11‫ د‬Which of the following symptoms might a client with right-sided heart failure
exhibit?
a. Adequate urine output b. Polyuria c. Oliguria d. Polydipsia
Inadequate deactivation of aldosterone by the liver after right-sided heart failure leads to
fluid retention, which causes oliguria.
12‫ د‬Which of the following conditions is most closely associated with weight gain,
nausea, and a decrease in urine output?
a. Angina pectoris b. Cardiomyopathy c. Left-sided heart failure d. Right-sided heart
failure
13‫ د‬What is the most common cause of abdominal aortic aneurysm?

a. Atherosclerosis b. DM c. HPN d. Syphilis
Atherosclerosis accounts for 75% of all abdominal aortic aneurysms. Plaques build up
on the wall of the vessel and weaken it, causing an aneurysm. Although the other
conditions are related to the development of an aneurysm, none is a direct cause.
14‫ د‬A pulsating abdominal mass usually indicates which of the following conditions?
a. Abdominal aortic aneurysm b. Enlarged spleen c. Gastic distention d. Gastritis
15‫ د‬What is the most common symptom in a client with abdominal aortic aneurysm?
a. Abdominal pain b. Diaphoresis c. Headache d. Upper back pain
Abdominal pain in a client with an abdominal aortic aneurysm results from the
disruption of normal circulation in the abdominal region. Lower back pain, not
upper, is a common symptom, usually signifying expansion and impending
rupture of the aneurysm. Headache and diaphoresis aren’t associated with
abdominal aortic aneurysm.
16‫ د‬What is the definitive test used to diagnose an abdominal aortic aneurysm?
a. Abdominal X-ray b. Arteriogram c. CT scan d. Ultrasound
An arteriogram accurately and directly depicts the vasculature; therefore, it clearly
delineates the vessels and any abnormalities. An abdominal aneurysm would only be
visible on an X-ray if it were calcified. CT scan and ultrasound don’t give a direct view
of the vessels and don’t yield as accurate a diagnosis as the arteriogram.
17‫ د‬Which of the following complications is of greatest concern when caring for a
preoperative abdominal aneurysm client?
a. HPN b. Aneurysm rupture c. Cardiac arrythmias d. Diminished pedal pulses
Rupture of the aneurysm is a life-threatening emergency and is of the greatest concern
for the nurse caring for this type of client. Hypertension should be avoided and
controlled because it can cause the weakened vessel to rupture. Diminished pedal pulses,
a sign of poor circulation to the lower extremities, are associated with an aneurysm but
isn’t life threatening. Cardiac arrhythmias aren’t directly linked to an aneurysm.
18‫ د‬Which of the following blood vessel layers may be damaged in a client with an
aneurysm?
a. Externa b. Interna c. Media d. Interna and Media

The factor common to all types of aneurysms is a damaged media. The media has
more smooth muscle and less elastic fibers, so it’s more capable of
vasoconstriction and vasodilation. The interna and externa are generally no
damaged in an aneurysm.
19‫ د‬What is the term used to describe an enlargement of the heart muscle?
a. Cardiomegaly b. Cardiomyopathy c. Myocarditis d. Pericarditis
Cardiomegaly denotes an enlarged heart muscle. Cardiomyopathy is a heart muscle disease of
unknown origin. Myocarditis refers to inflammation of heart muscle. Pericarditis is an
inflammation of the pericardium, the sac surrounding the heart.
20. A nurse caring for a client with deep vein thrombosis must be especially alert for
complications such as pulmonary embolism‫ د‬Which findings suggest pulmonary embolism?
a. Nonproductive cough and abdominal pain b. Hypertension and lack of fever
c. Bradypnea and bradycardia d. Chest pain and dyspnea
1‫د‬ The pain associated with Myocardial Infarction (MI), is due to?
a. Impending circulatory collapse b. Extracellular electrolyte imbalance
c. Left ventricular overload d. Insufficient oxygen reaching the heart
muscles
1. All of the following may induce angina pectoris EXCEPT:
a. Light meal b. Exposed for cold
c. Stress or emotion upset d. Physical exercise
1‫د‬ Evaluation of the effectiveness of cardiac nitrates is based on:
a. Relief of angina pain b. Decrease in blood pressure
c. Improved cardiac output d. Dilation of superficial blood vessels
1‫د‬ Which of the following is a false statement in relation to ECG?

a. The P wave is represents depolarization of the atrium.
b. The QRS wave is represents repolarization of the ventricle.
c. The T wave follows the S wave and represents ventricular relaxation.
d. The U wave represents repolarization of purkinje fibers.
1‫د‬ A rhythm strip from a patient's ECG shows the following pattern:
2‫د‬ How should the nurse interpret this pattern?

a. Ventricular trigeming b. Ventricular bigeming
c. Ventricular fibrillation d. Ventricular tachycardia
1. All of the following is considered as a clinical manifestation of hypovolemia,

EXCEPT:
a. Decrease skin turgor b. Hypotension
c. Oliquria d. Strong, rapid pulse
1‫د‬ Nursing responsibilities before the thoracentesis should include:

a. Encourage pt. to refrain coughing
b. Making sure that the pt. immobilized during the procedure
c. Seeing that the consent from has been explained and signed
d. All of the above
1‫د‬ In a 75-year-old woman with a diagnosis of a CVA, which of the following nursing
assessments is indicative of a CVA?
a. Facial droop
b. Facial edema
c. Increase in blood pressure
d. Noncompliance with the treatment regimen
1‫د‬ The electrical conduction of the heart usually originates in the SA node‫ د‬Which of
the following sequences completes the conduction?
a. SA node to Bundle of HIS to AV node to Purkinjie fibers
b. SA node to AV node to Purkinjie fibers to Bundle of HIS
c. SA node to bundle of HIS to Purkinjie fibers to AV node
d. SA node to AV node to bundle of HIS to Purkinjie fibers
1‫د‬ A patient is diagnosed as having damage to the layer of the heart responsible for the
pumping action‫ د‬The nurse is aware the damage is in the:
a. Endocardium b. Pericardium
c. Myocardium d. Visceral pericardium
1‫د‬ A nurse finds the patient's systolic pressure as 122 mm Hg and the diastolic pressure
as 75 mm Hg‫ د‬The pulse pressure would be:
a. 57 b. 60
c. 54 d. 47
1‫د‬ An adult patient has damage to the electrical conduction of the ventricles of the
heart‫ د‬The nurse would expect to see changes in the:
a. P wave b. U wave
c. QRS complex d. T wave
1‫د‬ The most appropriate intervention for the nurse to take when a patient develops
chest pain related to angina is:
a. To discontinue the oxygen if in use
b. To have the patient walk to see if pain is relieved with activity
c. To have the patient sit or rest immediately
d. To remove the nitroglycerin patch immediately
1‫د‬ Which of the following defines orthopnea?

a. Difficulty ambulating
b. Difficulty breathing with movement
c. Difficulty breathing while sitting upright
d. Difficulty in breathing when lying flat
1‫د‬ The most reliable sign of cardiac arrest is:
a. Absence of pulse b. Absence of breathing
c. Unconsciousness d. ECG
1‫د‬ The target goal for a patient's blood pressure when being treated for hypertension
is:
a. 140/90 or lower b. 165/90 or lower
c. 130/100 or lower d. 150/80 or lower
1‫د‬ Which of the following symptoms are mainly frequent in pericarditis?

a. Chest pain which respond to nitroglycerine.
b. Chest pain which continues consecutively for one hour.
c. Chest pain which increases with deep breathing and change position.
d. Chest pain which increases when the patient sits up.
1‫ د‬Which of the following assessment findings indicates hypovolemic shock?

a. Pulse less than 60 bpm. B. Respiratory rate more than 20 b/m.
b. C. Pupils unequally dilated. D. Systolic blood pressure less than 90mmHg.
1‫ د‬The underlying pathophysiologic alteration in all types of shock is:

a. Hemorrhage of blood or body fluids. B. Decreased cardiac output.
b. C. Inadequate tissue perfusion. D. Vasodilation of vascular beds.
1‫ د‬In early stage of shock, the nurse would expect the result of (ABG) to indicate:
a. Respiratory alkalosis. B. Respiratory acidosis.
b. C. Metabolic alkalosis. D. Metabolic acidosis.
1‫ د‬If non of the following positions is contraindicated, which position would be

preferred for the client with hypovolemic shock?
a. Supine. B. Semi-Flower's.
b. C. Supine with leg elevated 15 degrees. D. Head elevated 30 to 45 degrees.
1‫ د‬Which of the following would be best indication that fluid replacement for the client
in hypovolemic shock is adequate?
a. Urine output greater than 30 ml/hr. B. Systolic BP above 110 mmHg.
b. C. Diastolic BP above 90 mmHg. D. Urine output of 20 to 30 ml/hr.
1‫ د‬The client receives an intravenous infusion of packed red blood cells‫ د‬A priority for
this client include assessing her for:
a. Hypovolemia . B. Anaphylactic reaction.
b. C. Pain. D. Altered level of consciousness.
1‫ د‬When assessing a client for early septic shock, the nurse should observe for:
a. Cool, clammy skin. B. Warm, flushed skin.
b. C. Decrease systolic blood pressure. D. Hemorrhage.
1‫د‬ Which of the following best describes cardiogenic shock? The client experiences:
a. Decreased cardiac output due to hypovolemia.
b. Shock due to decreased circulating blood volume.
c. Shock due to decreased myocardial contractility.
d. Decreased cardiac output due to infarction.
1‫ د‬MI patient, She is conscious & admitted to the ICU‫ د‬Which nursing goal would have
the highest priority in planning the patient’s care?
A. Maintain normal fluid and electrolyte balance. B. Maintain adequate nutrition.
C. Provide physical and psychological rest. D‫ د‬Prevent invasive infections.
2‫ د‬The pain associated with Angina pectoris, is due to?

a. Impending circulatory collapse. B. Extracellular electrolyte imbalance.
b. C. Left ventricular overload. D. Insufficient oxygen reaching the heart muscles
1‫ د‬Which of the following finding is indicative of MI?

a. Elevated serum cholesterol value. B. Elevated creatinine phosphokinase (CPK).
b. C. Elevated white blood cell count. D. Below normal erythrocyte sedimentation rate.
1‫د‬ Where is the correct placement for lead V4 when doing an ECG?
a. 4th ICS, right sternal border
b. 5th ICS, mid axillary line
c. 4th ICS, left sternal border
d. 5th ICS, mid-clavicular line
1‫ د‬The nurse has noticed that a patients ECG pattern has changed‫ د‬The appearance of
the P waves is similar to Saw toothed shape "series of identical P waves"‫ د‬What does
this changes in pattern indicated?
a. Atrial flutter. B. Ventricular fibrillation.
b. C. Atrial fibrillation. D. Premature Atrial Complexes.
1‫ د‬A rhythm strip from a patient's ECG shows the following pattern:
2‫ د‬How should the nurse interpret this pattern?

a. Normal sinus rhythm. B. Sinus bradycardia.
b. C. Sinus tachycardia. D. Ventricular tachycardia.
1‫ د‬Estimate the heart rate for this Figure:

a. H.R.= 50 - 60 bpm. B. H.R.= 90 – 100 bpm.
b. H.R. = 70 – 80 bpm. D.H.R. = 120 – 130 bpm.
1‫ د‬A rhythm strip from a patient's ECG shows the following pattern:
2‫د‬ How should the nurse interpret this pattern?

a. Ventricular trigeming. B. Ventricular bigeming.
b. C. Ventricular fibrillation. D. Ventricular tachycardia.
1‫د‬ The symptoms of the right side heart failure are?
a. Edema, swelling, weight gain. B. Weakness, palpitation, nausea
b. Fatigue, vertigo, headache D. A feeling distress when breathing
1‫ د‬The major goal of therapy for the client with heart failure would be to:
a. Increase cardiac output. B. Improve respiratory status.
b. Decrease peripheral edema. D. Enhance comfort.
1‫ د‬The nurse expects that a client with mitral stenosis would likely demonstrate
symptoms associated with congestion in the:
a. Aorta. B. Right atrium.
b. C. Pulmonary circulation D. Superior vena cava.
1‫ د‬Dopamine is useful in treating:

a. Hypotension resulting from decreased cardiac output B. Postural hypotension.
b. C. Hypotension secondary to anemia. D. Hypotension secondary to anesthesia.
1‫د‬ Which of the following statements is correct regarding CVP line:

a. A CVP line is a potential source of septicemia.
b. A CVP used for insertion of a pacing wire.
c. Traumatic pneumothorax or hemothorax is a potential complication.
d. All of the above.
1‫ د‬The symptoms of decrease CVP are:

a. Tachycardia, hypertension, oliguria. B. Ascities, hepatomegaly, anuria.
b. C. Tachycardia, hypotension, anuria. D. Bradycardia, dyspnea, ascites.
1‫ د‬Which of the following is a false diagnosis when the CVP increased:

1. Heart failure. B. Cardiac tamponade.

2. C. Hypervolemia. D. Hypovolemia.
1. Exercise will be contraindication in all following cases, Except:

A. Leg ulcer B. Cellulities C. Peripheral arterial insufficiency D. Acute thrombotic
occlusions
2. All of the following consider the most important point for diagnosis of arterial
disorder, Except:
A. Intermittent claudication B. Pulse C. Skin color D. Capillary refill time
3‫ د‬Localized, intermittent arterial vasoocclusion of small arteries of the feet and hands
and it's always associated with underlying systemic disease, is:
A. Buerger’s Disease B. Raynaud's Disease
C. Thromboangiitis Obliterans D. Superficial thrombophlebitis
a. Burgers D = Thromboangiitis Obliterans: Recurring inflammatory process of the
small and intermediate vessels of (usually) the lower extremities; probably an
autoimmune disorder
4‫ دد…… د‬is a bulbous protrusion of one side of the arterial wall‫د‬

a. False aneurysm b. Fusiform aneurysm c. Saccular aneurysm d. Dissecting aneurysm
5‫ د‬All of the following are signs and symptoms of deep vein thrombosis, Except:
a. a. Positive Homans signs b. Heaviness on standing
b. c. Swelling of the leg d. Negative Homans signs
Stress or
6‫ د‬All of the following may Sexual Exposure to
induce angina pectoris Light meal emotional
intercourse cold
Except? upset
Edema, Weakness, Fatigue, A feeling

7‫ د‬The symptoms of the right swelling, palpitation, vertigo, distress when
side heart failure are? weight gain nausea headache breathing
8‫ د‬The most common

vasodilator used to treat Inderal Nitroglycerine Propranolol Pethidine Hcl
anginal pain is?
9‫ د‬Client whose condition is

stable after a myocardial
infarction is gradually
allowed to increase his
activity‫ د‬Of the following Edema Cyanosis Weight loss Dyspnea
criteria, the best one on
which to judge whether the
activity is appropriate is to
note the degree of?
10‫ د‬Patient 60 year old post
coronary artery bypass
graft (CABG) surgery;
participate in education Primary Secondary Tertiary All answer
program to change life prevention prevention prevention are correct
style ; the nurse
understands that this is an
example of what level of
prevention?
11‫ د‬When assessing a client with Extensive

Crushing Dyspnea on Jugular vein
a diagnosis of left peripheral
ventricular failure, the chest pain exertion distention
edema
nurse should expect to find:
12‫د‬ A client who has been admitted

to the cardiac care unit with Lidocaine
myocardial infarction Morphine Nitroglycerin
Oxygen per hydrochlorid
complains of chest pain‫ د‬The sulfate 2 mg e
nursing intervention that would nasal cannula e 50 mg IV
IV sublingually
be most effective in relieving bolus
the client’s pain would be to
administer the ordered:
13‫ د‬The most common

Cardiac
immediate complication for Infection Pneumothorax Thrombosis
central venous line insertion tamponade
is:
Edema, Weakness, Fatigue, A feeling

14‫ د‬The symptoms of the right swelling, palpitation, vertigo, distress when
side heart failure are? weight gain nausea headache breathing
Supine with Head

15‫ د‬Which position would be Semi-
preferred for the client with Supine leg elevated elevated 30
Flower's
hypovolemic shock? 15 degrees to 45 degrees
16‫ د‬Client whose condition is

stable after a myocardial
infarction is gradually
allowed to increase his
activity‫ د‬Of the following Edema Cyanosis Weight loss Dyspnea
criteria, the best one on
which to judge whether the
activity is appropriate is to
note the degree of?
17‫ د‬The most common Infection Pneumothora Cardiac Thrombosis
immediate complication for
central venous line insertion x tamponade
is?
Decreasing Tachycardia
Hypertensio
Pallor , pulse , decreasing
n , increasing
cyanotic lips pressure , blood
18‫ د‬Classic signs of hypovolemic pulse
shock include: and bounding hypertension pressure and
pressure and
pulse , and cool ,
tachypnea
tachycardia monistic skin
19‫ د‬When teaching a 48-year-

old patient about the risk family
factors for hypertension, the weight. gender. age
history.
nurse would identify a
modifiable risk factor as:
20‫ د‬What is the priority nursing
Pupil size
assessment in the first 24 cholesterol Bowel
hours after admission of the and papillary Echocardiogr
level sounds.
patient with thrombotic response am
CVA?
21‫ د‬After the acute phase of
congestive heart failure, the
nurse should expect the Magnesium Sodium Potassium Calcium
dietary management of the
client to include the
restriction of:
severe
flushing of
22‫ د‬which of the following is a itchiness dyspnea and hypertension
sign of anaphylactic shock? face
hypotension
A long term Peripheral

Cardiopulmon A nervous
23‫ د‬Clupping of fingers smoking vascular
indicate: ary disease disorder
history disease

Fluid & Respiratory system
1‫د‬ The most common immediate complication for central venous line insertion is:
A. Infection. B. Pneumothorax.
C. Cardiac tamponade. D. Thrombosis.
1‫د‬ Which of the following is a disadvantage for insertion a femoral line:

A. Infection. B. Pneumothorax.
C. Difficult dressing. D. Uncomfortable for patient.
1‫د‬ A 38-year-old man is admitted to the ICU with a diagnosis of acute pancreatitis‫د‬
When assessing his condition, the nurse notes that he has a positive Trousseau’s sign‫د‬
This sign is associated with what condition?
A. Hyperglycemia B. Hypoglycemia
C. Hypercalcemia D. Hypocalcemia
Hypocalcemia
Positive Chvostek: abnormal spasm of the facial muscle elicited by light taps
Positive Trousseau signs: carpal spasm induced by inflating BP cuff on upper arm
2‫د‬ A patient is admitted to the ICU with a diagnosis of acute upper GI bleeding‫د‬
Which nursing diagnosis would have the highest priority?
A. Deficient fluid volume related to bleeding
B. Impaired tissue integrity related to mucosal damage
C. Disturbed sensory perception (visual) related to increased blood ammonia levels
D. Anxiety related to critical illness
3‫د‬ he physician has ordered for a patient with congestive heart failure (80mg of
lasix) IV twice a day‫ د‬The nurse notes the K level is 3‫د‬0 mEq/L, the nurse should:
A. Administer the lasix 80 mg IV as ordered.
B. Administer half of the dose of lasix (40 mg) IV.
C. Offer the patient potassium rich food and fluid after administering lasix 80 mg IV.
D. Withhold the drug and notify the physician of the serum K level.
1‫د‬ A 38-year-old man is admitted to the ICU with a diagnosis of acute pancreatitis‫د‬
When assessing his condition, the nurse notes that he has a positive Trousseau’s sign‫د‬
This sign is associated with what condition?
A. Hyperkalemia B. Hypokalemia
C‫ د‬Hypocalcemia D. Hypercalcemia
2‫د‬ Your patient’s ECG shows wide flat P wave, wide QRS and Tall T waves‫ د‬You
realize that this indicates:
A. Hypercalcemia B. Hypokalemia
C. Hyperklemia D. Hyperphosphatemia
Hypokalemia: ECG: flattened T waves, prominent U waves, ST depression, prolonged PR

interval.
1‫د‬ Which of the following is correct regarding hypovolemia:

A. Increased HCT B. Decreased Creatinine
C. Decreased specific gravity D. Decreased BUN
1‫د‬ All of the following is used to manage a cases of hypocalcemia, Except:

A. Calcium chlorid B. Decrease magnesium level
C. Calcium gluconate D. Decrease phosphorous level
Most common cause hypocalcemia – depressed function or surgical removal of the

parathyroid gland, Hypomagnesemia, Hyperphosphatemia
1‫د‬ Which of the following isotonic solution used to treatment of a cases with
hypernatremia:
A. Lactated Ringer's B. Normal saline (0.9% NaCl)
C. Half saline (0.45% NaCl) D. Dextrose in water (D5W)
D5W: isotonic solution , NaCl 0.9%, RL
D10%, 3, 5% NaCl: hypertonic
Hypotonic: 0.45 NaCl
1‫د‬ Which of the following is/are complication of fluid therapy:

A. Sepsis B. Circulatory overload
C. Allergic reaction D. All of the above
1‫د‬ All of the following is considered as a causes for hypokalemia, Except:

A. Diarrhea and vomiting B. Tissue trauma
C. Diuretics D. Excessive renal excretion of K
1‫د‬ Patient complaining of Vomiting is at risk for:

a) Respiratory acidosis b) Metabolic acidosis
c) Respiratory alkalosis d) Metabolic alkalosis
1‫د‬ The oxygen delivery device they provide the least O2 concentration is :
a) A Partial rebreather mask b) A nasal cannula
c) A rebreather mask d) A simple mask
2‫ د‬A client ABGs value are: pH: 7‫د‬52, PaO2: 50 mmHg, PaCO2: 28mmHg, HCO3:
24mEq/L: The nurse would interpret these ABG value as indicating:
a. respiratory acidosis
b. respiratory alkalosis
c. metabolic acidosis
d. metabolic alkalosis
1‫ د‬A patient is in the emergency department‫ د‬His pH is 7‫د‬36; PaO2, 88 mm Hg; PaCO2,
62 mm Hg; and HCO3–, 35 mEq/L‫ د‬Which condition is reflected by these values?
a. Respiratory acidosis
b. Full Compensated respiratory acidosis
c. Partially Metabolic alkalosis
d. Full Compensated metabolic alkalosis
1‫ د‬A patient is in the emergency department‫ د‬His pH is 7‫د‬36; PaO2, 88 mm Hg; PaCO2,
62 mm Hg; and HCO3–, 35 mEq/L‫ د‬Which condition is reflected by these values?
a. Respiratory acidosis
b. Full Compensated respiratory acidosis
c. Partially Metabolic alkalosis
d. Full Compensated metabolic alkalosis
1‫ د‬Which one of the following is the most common initial finding in a client with a
pulmonary embolus (PE)?
a. sudden severe dyspnea and chest pain
b. chest pain with unequal chest expansion
c. petechiae over the upper chest and shoulders
d. gradually ascending leg pain
1‫ د‬Which one of the following problems is most likely when a client has a 30- minute
period of hyperventilation?
a. respiratory acidosis
b. respiratory alkalosis
c. compensated respiratory acidosis
d. compensated respiratory alkalosis
1. A 57-year-old client is admitted with a diagnosis of acute myocardial infarction‫د‬

ABG results are pH 7‫د‬30, PaCO2 38, HCO3-17, SaO2 100%‫د‬
a. Well oxygenated with uncompensated respiratory alkalosis.
b. Hypoxemic with compensated respiratory acidosis.
c. Well oxygenated with metabolic acidosis.
d. Hypoxemic with compensated metabolic acidosis.
1. A 68-year-old client is admitted with pneumonia‫ د‬ABG results are pH: 7‫د‬36, PaCO2 -
49, HCO3-30, SaO2 -72‫ د‬The nurse interprets this as:
a. Respiratory acidosis, full compensated
b. Respiratory alkalosis, partially compensated
c. Metabolic alkalosis, uncompensated
d. Metabolic acidosis, full compensated
1. A 71-year-old client develops hypertension, tachycardia, and increased respirations

two days after surgery‫ د‬ABG results are pH 7‫د‬49, PaCO2 40, HCO3-33, SaO2 95%‫د‬
a. Respiratory acidosis, uncompensated
b. Respiratory alkalosis, partially compensated
c. Respiratory alkalosis, partially compensated
d. Metabolic alkalosis, uncompensated
1‫ د‬What action can the nurse take initially when a client becomes anxious and starts to
hyperventilate?
a. Tell the client to stop breathing so fast because he may pass out.
b. Give the client a sedative to decrease anxiety and stop hyperventilation.
c. Give the client a paper bag to breathe into.
d. Notify the physician.
1‫ د‬Which disease, explain the term of blue bloater:
a. Chronic bronchitis.
b. Pulmonary embolism.
c. Pulmonary emphysema.
d. Cystic fibrosis.
Chronic bronchitis: Inflammation of the bronchi and bronchioles caused by chronic exposure
to irritants, especially tobacco smoke
Emphysema: a disease of the airways characterized by destruction of the walls of
overdistended alveoli (pink puffer, Co2 retention)
Cystic fibrosis: Genetic disease affecting many organs, lethally impairing pulmonary
function
PE: obstruction in the pulmonary vessels that obstructs blood flow
ARDS is a disease of the microscopic air sacs of the lungs (alveoli) that leads to decreased
exchange of oxygen and carbon dioxide
1. Chest x-ray show Ground-glass appearance at the end stage of which disease:
d. Acute Respiratory Distress Syndrome.
1‫ د‬The best alternative, to improve the hypoxia for pt‫ د‬with Acute respiratory distress
syndrome:
a. Raising FiO2.
b. Raising PEEP.
c. Raising PEEP and Low FiO2
d. Raising PEEP and High FiO2.
1‫ د‬Which disease, explain the term of pink puffer:
d. Cystic fibrosis.
1‫ د‬Which of the following conditions correlate with the following information: High
pH High HCO3 High BE Neutral pCO2
a. Respiratory alkalosis B. Respiratory acidosis C. Metabolic acidosis
Metabolic alkalosis
2‫ د‬Which of the following conditions correlate with the following information: Low
pH Low HCO3 Low BE Neutral pCO2
a. Respiratory alkalosis B. Respiratory acidosis C. Metabolic acidosis D. Metabolic
alkalosis
3‫د‬ Which of the following is not considered a COPD related disease?

a. Bronchiectasis B. Bronchial asthma C. Bronchitis D. Bronchial hypotension
4‫د‬ The respiratory center is located in the ____ and ______‫د‬

A. Midbrain and pons B. Pons and Medulla oblongata
1. Midbrain and Medulla oblongata D. Pons and Hypothalamus
1. A male client with Guillain-Barré syndrome develops respiratory acidosis as a result

of reduced alveolar ventilation‫ د‬Which combination of arterial blood gas (ABG)
values confirms respiratory acidosis?
a. pH, 5.0; PaCO2 30 mm Hg
b. pH, 7.40; PaCO2 35 mm Hg
c. pH, 7.35; PaCO2 40 mm Hg
d. pH, 7.25; PaCO2 50 mm Hg
Answer D.
2. A male client is admitted to the health care facility for treatment of chronic
obstructive pulmonary disease‫ د‬Which nursing diagnosis is most important for this
client?
a. Activity intolerance related to fatigue
b. Anxiety related to actual threat to health status
c. Risk for infection related to retained secretions
d. Impaired gas exchange related to airflow obstruction
Answer D. A patent airway and an adequate breathing pattern are the top priority for any
client, making impaired gas exchange related to airflow obstruction the most important
nursing diagnosis. The other options also may apply to this client but are less important.
3. A male client abruptly sits up in bed, reports having difficulty breathing and has an
arterial oxygen saturation of 88%‫ د‬Which mode of oxygen delivery would most
likely reverse the manifestations?
a. Simple mask
b. Non-rebreather mask
c. Face tent
d. Nasal cannula
Answer B. A non-rebreather mask can deliver levels of the fraction of inspired oxygen
(FIO2) as high as 100%. Other modes — simple mask, face tent and nasal cannula —
deliver lower levels of FIO2.
4. A male adult client with cystic fibrosis is admitted to an acute care facility with an
acute respiratory infection‫ د‬Prescribed respiratory treatment includes chest
physiotherapy‫ د‬When should the nurse perform this procedure?
a. Immediately before a meal
b. At least 2 hours after a meal
c. When bronchospasms occur
d. When secretions have mobilized
Answer B. The nurse should perform chest physiotherapy at least 2 hours after a meal to
reduce the risk of vomiting and aspiration. Performing it immediately before a meal may
tire the client and impair the ability to eat. Percussion and vibration, components of chest
physiotherapy, may worsen bronchospasms; therefore, the procedure is contraindicated in
clients with bronchospasms. Secretions that have mobilized (especially when suction
equipment isn’t available) are a contraindication for postural drainage, another
component of chest physiotherapy.
5. The nurse is caring for a male client who recently underwent a tracheostomy‫ د‬The
first priority when caring for a client with a tracheostomy is:
a. helping him communicate.
b. keeping his airway patent.
c. encouraging him to perform activities of daily living.
d. preventing him from developing an infection.
Answer B. Maintaining a patent airway is the most basic and critical human need. All
other interventions are important to the client’s well-being but not as important as having
sufficient oxygen to breathe.
6. For a male client with chronic obstructive pulmonary disease, which nursing
intervention would help maintain a patent airway?
a. Restricting fluid intake to 1,000 ml/day
b. Enforcing absolute bed rest
c. Teaching the client how to perform controlled coughing
d. Administering prescribed sedatives regularly and in large amounts

Answer C. Controlled coughing helps maintain a patent airway by helping to mobilize
and remove secretions. A moderate fluid intake (usually 2 L or more daily) and moderate
activity help liquefy and mobilize secretions. Bed rest and sedatives may limit the client’s
ability to maintain a patent airway, causing a high risk of infection from pooled
secretions.
7. Before weaning a male client from a ventilator, which assessment parameter is most
important for the nurse to review?
a. Fluid intake for the last 24 hours
b. Baseline arterial blood gas (ABG) levels
c. Prior outcomes of weaning
d. Electrocardiogram (ECG) results
Answer B. Before weaning a client from mechanical ventilation, it’s most important to
have baseline ABG levels. During the weaning process, ABG levels will be checked to
assess how the client is tolerating the procedure. Other assessment parameters are less
critical. Measuring fluid volume intake and output is always important when a client is
being mechanically ventilated. Prior attempts at weaning and ECG results are
documented on the client’s record, and the nurse can refer to them before the weaning
process begins.
8. Which of the following would be most appropriate for a male client with an arterial
blood gas (ABG) of pH 7‫د‬5, PaCO2 26 mm Hg, O2 saturation 96%, HCO3 24 mEq/
L, and PaO2 94 mm Hg?
a. Administer a prescribed decongestant.
b. Instruct the client to breathe into a paper bag.
c. Offer the client fluids frequently.
d. Administer prescribed supplemental oxygen.
Answer B. The ABG results reveal respiratory alkalosis. The best intervention to raise the
PaCO2 level would be to have the client breathe into a paper bag. All of the other options
— such as administering a decongestant, offering fluids frequently, and administering
supplemental oxygen — wouldn’t raise the lowered PaCO2 level.
9. Before seeing a newly assigned female client with respiratory alkalosis, the nurse
quickly reviews the client’s medical history‫ د‬Which condition is a predisposing
factor for respiratory alkalosis?
a. Myasthenia gravis
b. Type 1 diabetes mellitus
c. Extreme anxiety
d. Narcotic overdose
Answer C. Extreme anxiety may lead to respiratory alkalosis by causing hyperventilation,

which results in excessive carbon dioxide (CO2) loss. Other conditions that may set the
stage for respiratory alkalosis include fever, heart failure, and injury to the brain’s
respiratory center, overventilation with a mechanical ventilator, pulmonary embolism,
and early salicylate intoxication. Type 1 diabetes mellitus may lead to diabetic
ketoacidosis; the deep, rapid respirations occurring in this disorder (Kussmaul’s
respirations) don’t cause excessive CO2 loss. Myasthenia gravis and narcotic overdose
suppress the respiratory drive, causing CO2 retention, not CO2 loss; this may lead to
respiratory acidosis, not alkalosis.
10. Pulmonary disease (COPD), which nursing action best promotes adequate gas
exchange?
a. Encouraging the client to drink three glasses of fluid daily
b. Keeping the client in semi-Fowler’s position
c. Using a high-flow Venturi mask to deliver oxygen as prescribed
d. Administering a sedative as prescribed
Answer C. The client with COPD retains carbon dioxide, which inhibits stimulation of
breathing by the medullary center in the brain. As a result, low oxygen levels in the blood
stimulate respiration, and administering unspecified, unmonitored amounts of oxygen
may depress ventilation. To promote adequate gas exchange, the nurse should use a
Venturi mask to deliver a specified, controlled amount of oxygen consistently and
accurately. Drinking three glasses of fluid daily wouldn’t affect gas exchange or be
sufficient to liquefy secretions, which are common in COPD. Clients with COPD and
respiratory distress should be placed in high Fowler’s position and shouldn’t receive
sedatives or other drugs that may further depress the respiratory center.
11. A nurse is suctioning fluids from a female client through an endotracheal tube‫د‬
During the suctioning procedure, the nurse notes on the monitor that the heart rate
is decreasing‫ د‬Which if the following is the appropriate nursing intervention?
a. Continue to suction
b. Notify the physician immediately
c. Stop the procedure and reoxygenate the client
d. Ensure that the suction is limited to 15 seconds
Answer C. During suctioning, the nurse should monitor the client closely for side
effects, including hypoxemia, cardiac irregularities such as a decrease in heart rate
resulting from vagal stimulation, mucosal trauma, hypotension, and paroxysmal
coughing. If side effects develop, especially cardiac irregularities, the procedure is
stopped and the client is reoxygenated.
12. A male adult client is suspected of having a pulmonary embolus‫ د‬A nurse assesses
the client, knowing that which of the following is a common clinical manifestation of
pulmonary embolism?
a. Dyspnea
b. Bradypnea
c. Bradycardia
d. Decreased respirations
Answer A. The common clinical manifestations of pulmonary embolism are
tachypnea, tachycardia, dyspnea, and chest pain.
13. The nurse is teaching a male client with chronic bronchitis about breathing
exercises‫ د‬Which of the following should the nurse include in the teaching?
a. Make inhalation longer than exhalation.
b. Exhale through an open mouth.
c. Use diaphragmatic breathing.
d. Use chest breathing.
Answer C. In chronic bronchitis the diaphragm is flat and weak. Diaphragmatic breathing
helps to strengthen the diaphragm and maximizes ventilation. Exhalation should be
longer than inhalation to prevent collapse of the bronchioles. The client with chronic
bronchitis should exhale through pursed lips to prolong exhalation, keep the bronchioles
from collapsing, and prevent air trapping. Diaphragmatic breathing — not chest breathing
— increases lung expansion.
14. For a male client with an endotracheal (ET) tube, which nursing action is most
essential?
a. Auscultating the lungs for bilateral breath sounds
b. Turning the client from side to side every 2 hours
c. Monitoring serial blood gas values every 4 hours
d. Providing frequent oral hygiene
Answer A. For a client with an ET tube, the most important nursing action is
auscultating the lungs regularly for bilateral breath sounds to ensure proper tube
placement and effective oxygen delivery. Although the other options are
appropriate for this client, they’re secondary to ensuring adequate oxygenation.
15. A male client with chronic obstructive pulmonary disease (COPD) is recovering
from a myocardial infarction‫ د‬Because the client is extremely weak and can’t
produce an effective cough, the nurse should monitor closely for:
a. Pleural effusion.
b. Pulmonary edema.
c. Atelectasis.
d. Oxygen toxicity.
Answer C. In a client with COPD, an ineffective cough impedes secretion removal.

This, in turn, causes mucus plugging, which leads to localized airway obstruction
— a known cause of atelectasis. An ineffective cough doesn’t cause pleural
effusion (fluid accumulation in the pleural space). Pulmonary edema usually
results from left-sided heart failure, not an ineffective cough. Although many
noncardiac conditions may cause pulmonary edema, an ineffective cough isn’t
one of them. Oxygen toxicity results from prolonged administration of high
oxygen concentrations, not an ineffective cough.
16. To prevent respiratory suction every 4 to administer pain teach the reposition the
complications resulting 6 hours. medications as patient the patient and
from immobility, the best frequently as technique of encourage him
nursing interventions possible. pursed lip or her to cough
would be to: breathing. and deep-
breathe at least
every 2 hours.
17. The process of removing Intubation Extubation Air way Suction
the patient from placement
mechanical ventilation
therapy is?
18. Which of the following Head of the bed Trendelenburg’s Left sim’s Head elevated
positions would be most elevated 30 to 45 position position on one pillow
appropriate for client with degrees
dyspnea?
19. Using Maslow’s hierarchy Anxiety related to Ineffective Risk of injury Impaired verbal
of basic human needs, impending breathing pattern related to communication
which of the following surgery, as related to pain, autoimmune related to
nursing diagnosis has the evidenced by as evidenced by dysfunction tracheostomy, as
highest priority? insomnia shortness of evidenced by
breath inability to
speak
20. When suctioning a client's Insert the suction Oxygenate the Use a bolus of Use clean gloves
tracheostomy tube, the catheter about 2 client before sterile water to during the
nurse should incorporate inches into the suctioning stimulate procedure
which of the following cannula cough
steps into the procedure?
21. The nurse is preparing a Sitting forward Prone position Supine with Sims' position
client for a thoracentesis. with arms without a pillow arms over
How should the nurse supported on head
position the client for the bedside table
procedure?
22. A nurse caring for a client Nonproductive Hypertension Bradypnea Chest pain and
with deep vein thrombosis cough and and abnormal and dyspnea
must be especially alert for abdominal pain body bradycardia
complications such as temperature
pulmonary embolism.
Which findings suggest
pulmonary embolism?
23. In assessing for major stasis of low body weight. episodes of delayed antigen-
sources of infection in a respiratory postural antibody
COPD patient, the nurse secretions. hypotension. response.
focuses on:
24. An emergency treatment Increase BP Decrease Relax the Decrease

for an acute asthmatic mucosal swelling bronchial bronchial
attack is Adrenaline given smooth secretions.
hypodermically. This is muscle
given to:
25. if oxygen is given to Mr. Irritability of the Decrease Overinflation Hyperventilation
khaled, it should be nervous system stimulation of of the alveoli
administered at a low flow medulla
liter with caution. The
nurse understands that the
use of oxygen can be
dangerous in client with
high carbon dioxide levels.
Oxygen may result in :
26. Which one is atypical Expiratory Inspiratory Expiratory inspiratory
breathing pattern in wheezing wheezing stridor crackles
ashtma?
Pneumonia Upper airway
obs.
27. A client with respiratory PH, 7.0; PaCO2 30 PH, 7.40; PaCO2 PH, 7.35; PH, 7.25;
acidosis as a result of mm Hg 35 mm Hg PaCO2 40 mm PaCO2 50 mm
reduced alveolar Hg Hg
ventilation. Which
combination of arterial
blood gas (ABG) values
confirms respiratory
acidosis?
28. To evaluate a patient for Red blood cell Sputum culture Arterial blood Total
hypoxia, the physician is count gas (ABG) hemoglobin
most likely to order which analysis
laboratory test?
PNEUMONIA – inflammation of lung parenchyma leading to pulmonary consolidation as
alveoli is filled with exudates.
Etiologic agents:
1. Streptococcus pneumoniae (pnemococcal pneumonia)
S/Sx:
1. Productive cough – pathognomonic: greenish to rusty sputum
2. Dyspnea with prolonged respiratory grunt
Sputum exam – could confirm presence of TB & pneumonia
PULMONARY TUBERCULOSIS (KOCH DSE) - Inflammation of lung tissue caused by

invasion of mycobacterium TB
COPD – Chronic Obstructive Pulmonary Disease

1. Chronic bronchitis
2. Bronchial asthma
3. Bronchiectasis
4. Pulmonary emphysema – terminal stage

CHRONIC BRONCHITIS - called BLUE BLOATERS inflammation of bronchus due to
hypertrophy or hyperplasia of goblet mucus producing cells leading to narrowing of smaller
airways.
Predisposing factors:
1. Smoking – all COPD types
2. Air pollution
S/Sx:
1. Prod cough
2. Dyspnea on exertion
BRONCHIAL ASTHMA- reversible inflammation lung condition due to hyerpsensitivity

leading to narrowing of smaller airway.
BRONCHIECTASIS – abnormal permanent dilation of bronchus resulting to destruction of

muscular & elastic tissues of alveoli.
Bronchoscopy – direct visualization of bronchus using fiberscope.

Nsg Mgt: before bronchoscopy
1. Consent, explain procedure – MD/ lab explain RN
2. NPO
3. Monitor VS
PULMONARY EMPHYSEMA – irreversible terminal stage of COPD

- Characterized by inelasticity of alveolar wall leading to air trapping, leading to maldistribution
of gases.
- Body will compensate over distension of thoracic cavity
- Barrel chest
S/Sx:
1. Productive cough
2. Dyspnea at rest – due terminal
3. Purse lip breathing – to eliminated PCO2
PNEUMOTHORAX – partial / or complete collapse of lungs due to entry or air in pleural

space.
GIT System
1. A client is undergoing an extensive diagnostic workup for a suspected GI problem‫د‬
The nurse discovers that the client has a family history of ulcer disease‫ د‬Which blood type
also is a risk factor for duodenal ulcers?
a) Type A b) Type B
c) Type AB d) Type O
Hereditary link
1‫د‬ After patient return from barium swallow the nursing action include:
a) Increase fluid in take b) Keep pt. N.P.O until pass stool
c) Complete bed rest d) Assess the level of consciousness
1‫د‬ One of the functions of the gallbladder is:

a) Storage and production of bile b) To store white blood cells
c) To produce vitamin D d) To reabsorb bile salts
1‫د‬ In a typical patient with cholecysitis, beside localized pain, in what other area might
the patient report feeling pain?
a) Left upper arm b) Neck or jaw
c) Lower abdomen d) Right shoulder
RUQ: Liver, Gall bladder, Duodenum, Head of pancreas
LUQ: Stomach, Spleen, Left lobe of liver, Body of pancreas, Left kidney and adrenal gland,
Parts of transverse and descending colon
RLQ: Cecum, Appendix, Ascending Colon, Right ovary and Fallopian tube, Right ureter
1‫د‬ The patient has a gallstone blocking the bile duct‫ د‬with what symptoms will the
patient report feeling pain?
a) Increased bilirubin levels in the blood
b) Increase in appetite
c) Weight gain
d) Constipation
1‫د‬ Usually the first symptom associated with esophageal disease is:
a) Dysphagia b) Pain
c) Malnutrition d) Regurgition
1‫د‬ On physical examination the nurse should be looking for tenderness on palpation at
Mc Burney's point, which :
a) Left lower quadrant b) Right lower quadrant
c) Left upper quadrant d) Right upper quadrant
1‫د‬ A symptom or symptoms suggestive of acute appendicitis is(are):
a) Appositive rovsing
b) Increase abdominal pain with coughing
c) Tenderness around the umbilicus
d) All of the above
1‫د‬ Before a gastroscopy the nurses should inform the patient that:
a) He must fast for 6 to 8 hours before the exam
b) After gastroscopy, he will not be given anything to eat or drink until his gag reflex results
c) His throat will be sprayed with a local anesthetic
d) All of the above will be necessary

1‫د‬ The purpose of the cilia is to:
a) Produce mucus b) Contract smooth muscle
c) Phagocyte bacteria d) Move the mucous
1‫د‬ Clinical manifestation of tonsillitis included:

a) Hypertrophy of tonsils
b) Repeated attacks of otitis media
c) Suspected hearing loss
d) All of the above
1‫د‬ Rapid movement of intestinal contents that results in many watery stools per day is called:
a) Hemorrhoids. b) Constipation
c) Peristalsis. d) Diarrhea.
2‫ د‬The condition in which there is absent or ineffective peristalsis of the distal esophagus is
known as:
a. Achalasia
b. Gastroesophageal reflex
c. Diffuse spasm
d. Hiatal hernia
Diffuse spasm: motor disorder of the esophagus.
Gastroesophageal reflex: Excessive back flow of gastric or duodenal contents into the esophagus.
Hiatal hernia: The esophagus enters the abdomen through an opening in the diaphragm, and
upper part of the stomach move up into the thorax.
1‫د‬ Based on awareness that the primary symptoms of a sliding hiatal hernia are
associated with reflux, the nurse should particularly assess the client for:
a. Heartburn, regurgitation and dysphagia
b. Jaundice, ascities and edema
c. Abdominal distention, diarrhea and anorexia
d. Vomiting, stomatitis and board-like abdominal rigidity
1‫د‬ Which of the following dietary measures would be useful in preventing

esophageal reflux?
a. Eating small, frequent meals, avoiding over eating
b. Blenching (shrinking) frequently to reduce abdominal distention
c. Avoiding air swallowing with meals
d. Reducing the size of the evening meals and adding a bedtime snack
1‫د‬ As a part of the client's outpatient teaching plan, the nurse would instruct him
to take which of the medications below after the barium enema?
a. A laxative
b. An emetic
c. An antacid
d. A digestant

1‫د‬ A symptom that distinguishes a chronic gastric ulcer from chronic duodenal
ulcer is the :
a. Absence of any correlation between the presence of the ulcer and a malignancy.
b. Hematemsis more common than melena
c. Relief of pain after food ingestion
d. Uncommon incidence of vomiting
1‫د‬ Which of the following statements indicates that the client understands the
dietary modifications he will need to follow at home for duodenal ulcer patient:
a. "I should eat a bland (nice) , soft diet"
b. "It is important to eat six small meals a day"
c. "I should drink several glasses of milk a day"
d. "I should avoid alcohol and caffeine"
1‫د‬ The client is scheduled to undergo a subtotal gastrectomy (Billorth II procedure),

when providing preoperative client teaching, the nurse should explain that the surgical
procedure will allow stomach contents to bypass the:
a. Jejunum
b. Ileum
c. Cardiac sphincter
d. Funds of the stomach
Billorth I : I-Gastroduodenostomy
Billorth II : Gastrojejunostomy
1‫د‬ As a result of his gastric resection the client is at risk for developing dumping
syndrome, the nurse would develop a plan of care for this client based on knowledge
that this problem primarily stems from:
a. Excess secretion of digestive enzymes in the intestine
b. Rapid emptying of stomach content into the small intestine
c. Excess glycogen production by the liver
d. Excess HCL production by pancreas
1‫د‬ A colostomy irrigation is ordered for the client on the fifth post operative days‫د‬
If abdominal cramping occurs during irrigation, you should:
a. Stop the flow of solution temporarily
b. Have the client sit up in bed
c. Remove the irrigating tube
d. Insert the tube further into the colon
1‫د‬ On physical examination the nurse should be looking for tenderness on

palpation at Mc Burney’s point, which is located in the :
a. Left lower quadrant

b. Left upper quadrant
c. Right lower quadrant
d. Right upper quadrant
1‫د‬ The nurse assesses the clients bowel elimination pattern‫ د‬Which of the following
signs are most typical of ulcerative colitis?
a. Constipation
b. Bloody, diarrheal stools
c. Steatorrhea
d. Alternating periods of constipation and diarrhea
1‫د‬ Which of the following factors in the clients nursing history most likely would
be a primary cause of her hemorrhoids?
a. Her age
b. Three pregnancies with vaginal deliveries
c. Her job as a schoolteacher
d. A varicosities in her legs
1. During preparation for bowel surgery, a male client receives an antibiotic to reduce
intestinal bacteria‫ د‬Antibiotic therapy may interfere with synthesis of which vitamin
and may lead to hypoprothrombinemia?
a. vitamin A
b. vitamin D
c. vitamin E
d. vitamin K
Answer D. Intestinal bacteria synthesize such nutritional substances as vitamin K,

thiamine, riboflavin, vitamin B12, folic acid, biotin, and nicotinic acid. Therefore,
antibiotic therapy may interfere with synthesis of these substances, including vitamin K.
Intestinal bacteria don’t synthesize vitamins A, D, or E.
2. When evaluating a male client for complications of acute pancreatitis, the nurse would
observe for:
a. increased intracranial pressure.
b. decreased urine output
c. bradycardia.
d. hypertension.
Answer B. Acute pancreatitis can cause decreased urine output, which results from the
renal failure that sometimes accompanies this condition. Intracranial pressure neither
increases nor decreases in a client with pancreatitis. Tachycardia, not bradycardia, usually
is associated with pulmonary or hypovolemic complications of pancreatitis. Hypotension
can be caused by a hypovolemic complication, but hypertension usually isn’t related to
acute pancreatitis.
3. A male client with a recent history of rectal bleeding is being prepared for a
colonoscopy‫ د‬How should the nurse position the client for this test initially?
a. Lying on the right side with legs straight
b. Lying on the left side with knees bent
c. Prone with the torso (upper part of body) elevated
d. Bent over with hands touching the floor
Answer B. For a colonoscopy, the nurse initially should position the client on the left side with
knees bent. Placing the client on the right side with legs straight, prone with the torso elevated, or
bent over with hands touching the floor wouldn’t allow proper visualization of the large
intestine.
4. The nurse is caring for a male client with cirrhosis‫ د‬Which assessment findings indicate
that the client has deficient vitamin K absorption caused by this hepatic disease?
a. Dyspnea and fatigue
b. Ascites and orthopnea
c. Purpura and petechiae
d. Gynecomastia and testicular atrophy
Answer C. A hepatic disorder, such as cirrhosis, may disrupt the liver’s normal use of vitamin K
to produce prothrombin (a clotting factor). Consequently, the nurse should monitor the client for
signs of bleeding, including purpura and petechiae. Dyspnea and fatigue suggest anemia. Ascites
and orthopnea are unrelated to vitamin K absorption. Gynecomastia and testicular atrophy result
from decreased estrogen metabolism by the diseased liver.
5. While a female client is being prepared for discharge, the nasogastric (NG) feeding tube
becomes clogged‫ د‬To remedy this problem and teach the client’s family how to deal with
it at home, what should the nurse do?
a. Irrigate the tube.
b. Advance the tube into the intestine.
c. Apply intermittent suction to the tube.
d. Withdraw the obstruction with a 30-ml syringe.
6. Which diagnostic test would be used first to evaluate a client with upper GI bleeding?
a. Endoscopy
b. Upper GI series or barium study
c. Hemoglobin (Hb) levels and hematocrit (HCT)
d. Arteriography
Answer A. Endoscopy permits direct evaluation of the upper GI tract and can detect 90% of
bleeding lesions. An upper GI series, or barium study, usually isn’t the diagnostic method of
choice, especially in a client with acute active bleeding who’s vomiting and unstable. An
upper GI series is also less accurate than endoscopy. Although an upper GI series might
confirm the presence of a lesion, it wouldn’t necessarily reveal whether the lesion is bleeding.
Hb levels and HCT, which indicate loss of blood volume, aren’t always reliable indicators of
GI bleeding because a decrease in these values may not be seen for several hours.
Arteriography is an invasive study associated with life-threatening complications and
wouldn’t be used for an initial evaluation.
7. The nurse caring for a client with small-bowel obstruction would plan to implement
which nursing intervention first?
a. Administering pain medication
b. Obtaining a blood sample for laboratory studies
c. Preparing to insert a nasogastric (NG) tube
d. Administering I.V. fluids
Answer D. I.V. infusions containing normal saline solution and potassium should be
given first to maintain fluid and electrolyte balance. For the client’s comfort and to assist
in bowel decompression, the nurse should prepare to insert an NG tube next. A blood
sample is then obtained for laboratory studies to aid in the diagnosis of bowel obstruction
and guide treatment. Blood studies usually include a complete blood count, serum
electrolyte levels, and blood urea nitrogen level. Pain medication often is withheld until
obstruction is diagnosed because analgesics can decrease intestinal motility.
8. A male client undergoes total gastrectomy‫ د‬Several hours after surgery, the nurse notes
that the client’s nasogastric (NG) tube has stopped draining‫ د‬How should the nurse
respond?
a. Notify the physician
b. Reposition the tube
c. Irrigate the tube
d. Increase the suction level
Answer A. An NG tube that fails to drain during the postoperative period should be reported to
the physician immediately. It may be clogged, which could increase pressure on the suture site
because fluid isn’t draining adequately. Repositioning or irrigating an NG tube in a client who
has undergone gastric surgery can disrupt the anastomosis. Increasing the level of suction may
cause trauma to GI mucosa or the suture line.
9. What laboratory finding is the primary diagnostic indicator for pancreatitis?

a. Elevated blood urea nitrogen (BUN)
b. Elevated serum lipase
c. Elevated aspartate aminotransferase (AST)
d. Increased lactate dehydrogenase (LD)
Answer B. Elevation of serum lipase is the most reliable indicator of pancreatitis because
this enzyme is produced only by the pancreas. A client’s BUN is typically elevated in
relation to renal dysfunction; the AST, in relation to liver dysfunction; and LD, in relation
to damaged cardiac muscle.
10. A male client with cholelithiasis has a gallstone lodged in the common bile duct‫ د‬When
assessing this client, the nurse expects to note:
a. yellow sclerae.
b. light amber urine.
c. circumoral pallor.
d. black, tarry stools.
Answer A. Yellow sclerae may be the first sign of jaundice, which occurs when the
common bile duct is obstructed. Urine normally is light amber. Circumoral pallor and
black, tarry stools don’t occur in common bile duct obstruction; they are signs of hypoxia
and GI bleeding, respectively.
11. A male client is recovering from an ileostomy that was performed to treat inflammatory
bowel disease‫ د‬During discharge teaching, the nurse should stress the importance of:
a. increasing fluid intake to prevent dehydration.
b. wearing an appliance pouch only at bedtime.
c. consuming a low-protein, high-fiber diet.
d. taking only enteric-coated medications.
Answer A. Because stool forms in the large intestine, an ileostomy typically drains liquid
waste. To avoid fluid loss through ileostomy drainage, the nurse should instruct the client
to increase fluid intake. The nurse should teach the client to wear a collection appliance at
all times because ileostomy drainage is incontinent, to avoid high-fiber foods because
they may irritate the intestines, and to avoid enteric-coated medications because the body
can’t absorb them after an ileostomy
12. A male client has just been diagnosed with hepatitis A‫ د‬On assessment, the nurse expects
to note:
a. severe abdominal pain radiating to the shoulder.
b. anorexia, nausea, and vomiting.
c. eructation and constipation.
d. abdominal ascites.
Answer B. Hallmark signs and symptoms of hepatitis A include anorexia, nausea,

vomiting, fatigue, and weakness. Abdominal pain may occur but doesn’t radiate to the
shoulder. Eructation and constipation are common in gallbladder disease, not hepatitis A.
Abdominal ascites is a sign of advanced hepatic disease, not an early sign of hepatitis
13. Which of the following factors can cause hepatitis A?

a. Contact with infected blood
b. Blood transfusions with infected blood
c. Eating contaminated shellfish
d. Sexual contact with an infected person
Answer C. Hepatitis A can be caused by consuming contaminated water, milk, or food —

especially shellfish from contaminated water. Hepatitis B is caused by blood and sexual contact
with an infected person. Hepatitis C is usually caused by contact with infected blood, including
receiving blood transfusions

14. The nurse is caring for a male client with a diagnosis of chronic gastritis‫ د‬The nurse
monitors the client knowing that this client is at risk for which vitamin deficiency?
a. Vitamin A
b. Vitamin B12
c. Vitamin C
d. Vitamin E
Answer B. Chronic gastritis causes deterioration and atrophy of the lining of the stomach,
leading to the loss of the function of the parietal cells. The source of the intrinsic factor is lost,
which results in the inability to absorb vitamin B12. This leads to the development of pernicious
anemia. The client is not at risk for vitamin A, C, or E deficiency.
15. The nurse is assessing a male client 24 hours following a cholecystectomy‫ د‬The nurse
noted that the T tube has drained 750 mL of green-brown drainage since the surgery‫د‬
Which nursing intervention is appropriate?
a. Clamp the T tube
b. Irrigate the T tube
c. Notify the physician
d. Document the findings
Answer D. Following cholecystectomy, drainage from the T tube is initially bloody and then
turns to a greenish-brown color. The drainage is measured as output. The amount of expected
drainage will range from 500 to 1000 mL/day. The nurse would document the output.
16. The nurse is monitoring a female client with a diagnosis of peptic ulcer‫ د‬Which
assessment findings would most likely indicate perforation of the ulcer?
a. Bradycardia
b. Numbness in the legs
c. Nausea and vomiting
d. A rigid, board-like abdomen
Answer D. Perforation of an ulcer is a surgical emergency and is characterized by sudden, sharp,

intolerable severe pain beginning in the midepigastric area and spreading over the abdomen,
which becomes rigid and board-like. Nausea and vomiting may occur. Tachycardia may occur as
hypovolemic shock develops. Numbness in the legs is not an associated finding.
17. A male client with a peptic ulcer is scheduled for a vagotomy and the client asks the
nurse about the purpose of this procedure‫ د‬Which response by the nurse best describes
the purpose of a vagotomy?
a. Halts stress reactions
b. Heals the gastric mucosa
c. Reduces the stimulus to acid secretions
d. Decreases food absorption in the stomach
Answer C. A vagotomy, or cutting of the vagus nerve, is done to eliminate parasympathetic
stimulation of gastric secretion. Options A, B, and D are incorrect descriptions of a vagotomy.

18. The nurse is caring for a female client following a Billroth II procedure‫ د‬Which
postoperative order should the nurse question and verify?
a. Leg exercises
b. Early ambulation
c. Irrigating the nasogastric tube
d. Coughing and deep-breathing exercises
Answer C. In a Billroth II procedure, the proximal remnant of the stomach is anastomosed to the
proximal jejunum. Patency of the nasogastric tube is critical for preventing the retention of
gastric secretions. The nurse should never irrigate or reposition the gastric tube after gastric
surgery, unless specifically ordered by the physician. In this situation, the nurse should clarify
the order. Options A, B, and D are appropriate postoperative interventions
19. The nurse is providing discharge instructions to a male client following gastrectomy and
instructs the client to take which measure to assist in preventing dumping syndrome?
a. Ambulate following a meal
b. Eat high carbohydrate foods
c. Limit the fluid taken with meal
d. Sit in a high-Fowler’s position during meals
Answer C. Dumping syndrome is a term that refers to a constellation of vasomotor symptoms

that occurs after eating, especially following a Billroth II procedure. Early manifestations usually
occur within 30 minutes of eating and include vertigo, tachycardia, syncope, sweating, pallor,
palpitations, and the desire to lie down. The nurse should instruct the client to decrease the
amount of fluid taken at meals and to avoid high-carbohydrate foods, including fluids such as
fruit nectars; to assume a low-Fowler’s position during meals; to lie down for 30 minutes after
eating to delay gastric emptying; and to take antispasmodics as prescribed
20. The nurse is monitoring a female client for the early signs and symptoms of dumping
syndrome. Which of the following indicate this occurrence?
a. Sweating and pallor
b. Bradycardia and indigestion
c. Double vision and chest pain
d. Abdominal cramping and pain
Answer A. Early manifestations of dumping syndrome occur 5 to 30 minutes after eating. Symptoms
include vertigo, tachycardia, syncope, sweating, pallor, palpitations, and the desire to lie down.
21. The nurse is preparing a discharge teaching plan for the male client who had umbilical
hernia repair‫ د‬What should the nurse include in the plan?
a. Irrigating the drain
b. Avoiding coughing
c. Maintaining bed rest
d. Restricting pain medication
Answer B. Coughing is avoided following umbilical hernia repair to prevent disruption of tissue
integrity, which can occur because of the location of this surgical procedure. Bed rest is not
required following this surgical procedure. The client should take analgesics as needed and as

prescribed to control pain. A drain is not used in this surgical procedure, although the client may
be instructed in simple dressing changes.
22. The nurse is instructing the male client who has an inguinal hernia repair how to
reduce postoperative swelling following the procedure‫ د‬What should the nurse tell the
client?
a. Limit oral fluid
b. Elevate the scrotum
c. Apply heat to the abdomen
d. Remain in a low-fiber diet
Answer B. Following inguinal hernia repair, the client should be instructed to elevate the
scrotum and apply ice packs while in bed to decrease pain and swelling. The nurse also should
instruct the client to apply a scrotal support when out of bed. Heat will increase swelling.
Limiting oral fluids and a low-fiber diet can cause constipation.
23. The nurse is caring for a hospitalized female client with a diagnosis of ulcerative colitis‫د‬
Which finding, if noted on assessment of the client, would the nurse report to the
physician?
a. Hypotension
b. Bloody diarrhea
c. Rebound tenderness
d. A hemoglobin level of 12 mg/dL
Answer C. Rebound tenderness may indicate peritonitis. Bloody diarrhea is expected to occur in
ulcerative colitis. Because of the blood loss, the client may be hypotensive and the hemoglobin
level may be lower than normal. Signs of peritonitis must be reported to the physician.
 ulcerative colitis : Its chronic inflammatory disease of the mucosal layer of the colon &
rectum. It characterized by multiple ulcerations.
1. The nurse is caring for a male client postoperatively following creation of a colostomy‫د‬
Which nursing diagnosis should the nurse include in the plan of care?
a. Sexual dysfunction
b. Body image, disturbed
c. Fear related to poor prognosis
d. Nutrition: more than body requirements, imbalanced
Answer B. Body image, disturbed relates to loss of bowel control, the presence of a stoma, the
release of fecal material onto the abdomen, the passage of flatus, odor, and the need for an
appliance (external pouch). No data in the question support options A and C. Nutrition: less than
body requirements, imbalanced is the more likely nursing diagnosis.
2. The nurse is reviewing the record of a female client with Crohn’s disease‫ د‬Which stool
characteristics should the nurse expect to note documented in the client’s record?
a. Diarrhea
b. Chronic constipation
c. Constipation alternating with diarrhea

d. Stools constantly oozing form the rectum
Answer A. Crohn’s disease is characterized by nonbloody diarrhea of usually not more than four
to five stools daily. Over time, the diarrhea episodes increase in frequency, duration, and
severity. Options B, C, and D are not characteristics of Crohn’s disease.
 Crohn's disease, also known as regional enteritis is an inflammatory disease of the
intestines that may affect any part of the gastrointestinal tract from mouth to anus causing
a wide variety of symptoms.
1. The nurse is teaching a female client how to perform a colostomy irrigation‫ د‬To enhance
the effectiveness of the irrigation and fecal returns, what measure should the nurse
instruct the client to do?
a. Increase fluid intake
b. Place heat on the abdomen
c. Perform the irrigation in the evening
d. Reduce the amount of irrigation solution
Answer A. To enhance effectiveness of the irrigation and fecal returns, the client is instructed to
increase fluid intake and to take other measures to prevent constipation. Options B, C and D will
not enhance the effectiveness of this procedure
2‫ د‬The condition in which there is absent or ineffective peristalsis of the distal esophagus is
known as:
a. Achalasia b. Gastroesophageal reflex c. Diffuse spasm d. Hiatal hernia
1‫ د‬The most common site for diverticulum in the esophagus is the :

a. Zenker’s diverticulum b. Midesophageal diverticulum
c. Lower part esophagus d. Epiphrenic diverticulum
Upper part of the esophagus [pharyngoesophageal diverticulum
1‫ د‬The most common site for diverticulitis is the :

a. Duodenum b. Ileum c. Sigmoid d. Jejunum
Diverticulum: sac formed at weak points in any area long the gastrointestinal tract.
Diverticulitis: inflammation of diverticulum caused by infection
1‫ د‬Which diagnostic tool is used in patients with peptic ulcer disease and provides direct
visualization of the gastrointestinal tract and bleeding site?
a. Endoscopy. b. Angiography. c. Stool analysis. d. Barium enema
1‫د‬ The most common site for peptic ulcer formation is :

a. Esophagus b. Pylorus c. Duodenum d. Stomach

1‫د‬ The nurse prepares the client for a gastric analysis as a part of the initial
assessment‫ د‬A typical laboratory finding of gastric analysis in a client with pernicious
anemia is:
a. High bile concentration b. Absence of intrinsic factor
c. Immature red blood cells d. Low bicarbonate concentration
1‫د‬ A patient is admitted to the hospital with the diagnosis of peptic ulcer disease‫د‬
The patient develops a sudden, sharp pain in the midepigastric region of the abdomen‫د‬
The abdomen is rigid and boardlike‫ د‬The clinical manifestation most likely indicates:
a. The ulcer has perforated. b. Additional ulcers gave formed.
c. The patient has hemorrhagic shock. d. An intestinal obstruction has developed.
1‫د‬ The nurse is completing dietary teaching for the patient recovering from an
episode of gastrointestinal bleeding‫ د‬The nurse explains to the patient that he or she
will be able to eat:
a. High protein, low fat foods. b. Any foods that are tolerated.
c. Low calories, low fat food. d. High fiber foods.
1‫د‬ The client asks the nurse what causes an ulcer to develop‫ د‬The nurse responds
that recent research indicates that many peptic ulcers are the result of:
a. Work related stress b. Helicobacter pylori infection
c. Diets high in fat and spicy foods d. A genetic defect in the gastric mucosa
1‫د‬ After a subtotal gastrectomy, care of the clients nasogastric tube and drainage
system should include which of the following nursing intervention:
a. Irrigate the tube with 30 ml of sterile water every hours, if needed
b. If the tube is not draining well, reposition it
c. Monitor the client for nausea, vomiting, and abdominal distention
d. If the drainage is sluggish on low suction, turn the machine to high suction
1‫د‬ Today, the most common way to detect cancer of the colon in the asymptomatic
population aged over 55 years is:
a. Flexible sigmoidoscopy b. Colonoscopy
c. Barium Enema d. Examination of stools for the presence of blood
1‫د‬ Duke’s classified rectal and colon cancer into four stages, class A,B,C & D‫د‬
Class (B) is:
a. Invasion into regional draining lymph system C
b. Penetration through bowel wall
c. Tumor limited to mucosa and submucosa A
d. Advanced and widespread regional metastasis D
1‫د‬ Which of the following sentences with the nurse use when instructing a patient
who is receiving radiation therapy?
a. To stop swimming because it may destroy the skin.
b. To remember that he is more susceptible to fracture in this period.

c. To keep away from people who are suffering from viral and bacterial infections.
d. To eat foods that have a high concentration of fat in order to prevent him from
losing weight.
1. Which of the following postoperative nursing care would not correlate for a
patient with a partial gastric resection:
a. Administering 30ml of fluid through the nasogastric tube every hour to maintain
the patency of the tube and help to prevent dehydration
b. Auscultation of the abdomen for the presence of bowel sounds
c. Maintaining the patient in a modified fowler’s position to promote drainage from
the stomach
d. Withholding fluids by mouth until peristalsis has returned
1‫د‬ As a result of his gastric resection the client is at risk for developing dumping
syndrome, the nurse would develop a plan of care for this client based on knowledge
that this problem primarily stems from:
a. Excess secretion of digestive enzymes in the intestine
b. Excess HCL production by pancreas
c. Rapid emptying of stomach content into the small intestine
d. Excess glycogen production by the liver
1‫د‬ Of the following symptoms of bowel obstruction, which is related primarily to

small bowel obstruction rather than to large bowel obstruction?
a. Profuse vomiting b. Cramping abdominal pain
c. Abdominal distention d. High pitched bowel sounds above the obstruction
1‫د‬ A nurse suspects a diagnosis of Regional Enteritis when she assesses the
symptoms of :
a. Crampy abdominal pain especially after meal b. Fever and leukocytosis
c. Intermittent pain associated with diarrhea d. All of the above
1‫د‬ The nurse assesses the clients bowel elimination pattern‫ د‬Which of the following
signs are most typical of ulcerative colitis?
a. Constipation b. Bloody, diarrheal stools
c. Steatorrhea d. Alternating periods of constipation and diarrhea
1. All the following are contributing factors in producing constipation, Except:

a. Hemorrhoids & fissure b. Lack of fiber in diet
b. Lack of exercise d. Malabsorptive disorders such as ulcerative colitis
1‫د‬ Your patient asks what caused of hemorrhoid problem, your answer, it results
from:
a. Eating spicy foods b. Poor bowel control c. Hypertension d. Constipation
Hemorrhoid: Are dilated portions of veins in the anal canal common by the age of 50.
1‫د‬ Which of the following factors is believed to be linked to Chron’s disease?

a. Diet b. Constipation c. Heredity d. Lack of exercise

2‫د‬ Treatment of intusseception usually starts in the first 24 hours by
a) Hydrostatic barium enema b) Resection and anastomosis
c) Surgery d) All of these
In case of parathion poisoning, one of Giving Giving Giving hepari
the important treatments is: hydrocortisone adrenaline injection
The primary purpose of an oil lubricate and increase the fluid break up fecal
retention enema is to? soften the stool in the bowel impactions
The pathophysiologic problem in dilated veins and portal ascites and
cirrhosis of the liver causing varicosities hypertension edema
esophageal varices is?
The nurse is teaching a group of A sedentary A history of Alcohol abuse
middle-aged men about peptic lifestyle and hemorrhoids and and a history o
ulcers‫ د‬When discussing risk factors smoking smoking acute renal
for peptic ulcers, the nurse should failure
mention?
Which outcome indicates effective The client The client The client lim
client teaching to prevent verbalizes maintains a water intake t
constipation? consumption of sedentary three glasses p
high-fiber foods. lifestyle day
The nurse is assigned to monitor the Vitamin E Vitamin B12 Vitamin A
client with a diagnosis of chronic
gastritis‫ د‬The nurse is aware that
this client is at risk for which of the
following vitamin deficiencies?
The nurse must observe for which of Hypernatremia Hyperkalemia Metabolic
the following imbalances to occur alkalosis
with prolonged nasogastric
suctioning?
The complication that the nurse headache. muscle cramps. bleeding.

would monitor for after a liver
biopsy is:
A female patient has an acute Constipation Hypertension Ascites
pancreatitis‫ د‬Which of the following
signs and symptoms the nurse would
expect to see?
10‫ د‬The nurse assesses the client's bowel Constipation Bloody, Steatorrhe
elimination pattern‫ د‬Which of the diarrheal stools
following signs are most typical of
ulcerative colitis?
11‫ د‬What is the main route of Sputum Feces Blood
transmission of hepatitis B virus?
12‫ د‬After a cholecystectomy, the nurse Stimulate gastric Prevent post Prevent
encourages the patient to cough and drainage. operative atelectasis.
deep breathing in order to: vomiting and
distension.
Hematology

1‫د‬ The sickling process of RBCs occurs in the condition of
a) Hemodilution b) Hypoxia
c) Thrombocytopenia d) Hypocalcaemia
Sickle cell anemia: It is a hereditary blood diseases characterized by the production of abnormal
Hb in the RBCs, lead to decrease in the ability of red blood cells to carry oxygen throughout the
body
1‫د‬ Which of the following may cause Megaloblastic anemia:

a. Vitamin B12 deficiency
b. Deficiency the folic acid
c. disorder is in the G-6-PD gene
d. A&B
Megaloblastic anemia: caused by deficiencies of vitamin B12 or folic acid

deficiencies of vitamin B12 (pernicious anemia):
Partial or complete gastrectomy, malabsoprtion due to inability of gastric mucosa to secrete
intrinsic factor. Intrinsic factor important to absorb Vit 12
Schilling test: test used to assess patient capacity to absorb vitamin B12 from the bowel
S & S pernicious anemia: Difficulty maintaining their balance because of damage to the spinal
cord [degeneration of nervous system]
Folic acid deficiency: The same as vitamin B12 deficiency except neurological manifestations of
vitamin B12 deficiency do not occur with folic acid deficiency.
1‫د‬ Which of the following laboratory findings would best help the physician to
confirm the diagnosis of Hodgkin's disease?
a. Elevated lymphocyte count
b. Low platelet count
c. C in lymph nodes
d. Elevated serum enzyme levels
Hodgkin’s disease: Malignant disease originates in the lymphatic system and involve
predominantly the lymph node
1‫د‬ Nursing intervention for the patient suffering from Leukopenia secondary to
chemotherapy include:
a. Protecting the patient from infections
b. Avoiding injections
c. Providing periods of rest
d. Administering antiemetics before meals
1‫د‬ The primary approach to consider when treating a patient with DIC is:
a. Correct the condition, and treat the underlying precipitating mechanism.
b. Start heparin therapy.
c. Begin blood products.
d. Administer excessive IV fluids.
1‫د‬ In your ward there is a patient suffering from multiple myeloma who is being
treated with chemotherapy and radiation‫ د‬What will be the additional instructions for
this patient treatment‫د‬
a. Complete bed rest.
b. Hydration or lots of fluid and analgesic.
c. Antibiotic treatment.
d. Don't give aspirin or IM injection.
Multiple Myeloma: It's malignant disease of the plasma cells that infiltrate bone, lymph nodes,
liver, spleen and kidney.
Signs and symptoms (CRAB)
C = Calcium (elevated),
R = Renal failure, Renal damage due precipitating of protein in the renal tubules.
A = Anemia, normochromic, normocytic anemia
B = Bone lesions, Patient complain of bone pain and may develop pathological fractures.
Dx: Bence jones proteins [protein found in the urine because malignant plasma cell produce
large quantities of abnormal globulins.
Management:
 Radiation to reduce the size of plasma cell tumor.
 Hydration to prevent renal damage .
 Analgesics for pain.
6‫د‬ The chief characteristic of aplastic anemia are:

a. Destruction of the red blood cells
b. Increase production of young immature cells
c. Decrease in production of cells in bone marrow
d. All of the above
 Sever form of anemia, in which the bone marrow fails to produce new blood cells it
can be caused by ↓ in precursor cells in bone marrow.
 Aplastic anemia is caused by a decrease in or damage to marrow stem cells, and
replacement of the marrow with fat. It results in bone marrow aplasia (markedly
reduced hematopoiesis).
6‫د‬ The clinical appearance and lab‫ د‬findings in case of acute leukemia:
a. Liability to develop anemia, infection, and bleeding
b. Enlargement of liver, spleen and lymph nodes
c. Large number of young WBC in the blood or bone marrow
d. All of the answers are correct.
6‫د‬ In what kind of anemia do we find neurological manifestation:

a. Anemia due to absence of iron b. Anemia of chronic disorders
c. Anemia due to absence of vitamin B12 d. All of the above
6‫د‬ Which of the following laboratory findings would best help the physician to
confirm the diagnosis of Hodgkin's disease?
a. Elevated lymphocyte count b. Low platelet count
c. Reed Sternburge cells in lymph nodes d. Elevated serum enzyme levels
6‫د‬ The major cause of death in patient with leukemia is believed to be :

a. Anemia b. Dehydration c. Infection d. Hemorrhage
6‫د‬ The Schilling test is used to diagnose:

a. Aplastic anemia b. Iron deficiency anemia c. Megaloblastic anemia d. Prenicious anemia
6‫د‬ Before initiating the blood transfusion the nurse needs to check:
a. For the abnormal presence of gas bubbles and cloudiness in the blood bag
b. That the blood has been typed and cross matched
c. That the recipients blood numbers match the donors blood numbers
d. All of the above
6‫د‬ Thalassemia major (Cooley’s anemia) characterized by:

a. Ineffective production of erythrocytes b. Severe anemia
b. Organ dysfunction due to Iron overload d. All of the above
Defi.: defective Hgb chain synthesis, Organ dysfunction due to Iron overload occurs
results from the excessive amounts of iron obtained through the RBC transfusions
Rx: Deferoxamine SC) has reduced the complications of iron overload and prolonged the
life of these patients
6‫د‬ Your patients post-platelet transfusion count increases 200 cells/mm3 per unit
of platelet transfused‫ د‬The advanced practice nurse states the patient has developed
antibodies against human leukocyte antigens‫ د‬This is called:
a. Leukocytosis. b. Alloimmunization. c. Autoregulation. d. Red cell lysis syndrome.
Hemolytic anemias can result from exposure of the RBC to antibodies.

Alloantibodies (ie, antibodies against the host, or “self”) result from the immunization of an
individual with foreign antigens The most common type of alloimmune hemolytic anemia in
adults results from a hemolytic transfusion reaction.
Autoantibodies are developed by an individual for varying reasons.
Coombs test: test used in the diagnosis of hemolytic anemia, means detecting antibodies on the
surface of red blood cells.
6‫ د‬The diagnosis of multiple myeloma is established by:

a. Bone marrow aspiration or biopsy b. Urine for Bence Jones Proteins
c. Level of globulins in the blood d. All of the above

6‫ د‬The client is given radioactive B12 in water for a shilling test‫ د‬The primary purpose of this
test is to measure the clients ability to:
a. Store vitamin B12 b. Digest vitamin B12 c. Absorb vitamin B12 d. Produce vitamin B12
6‫ د‬An early sign of Hodgkin's disease is:

a. Difficulty swallowing b. Swollen cervical lymph nodes
c. Difficult breathing d. A feeling of fullness over the liver
6‫د‬ You are reviewing the complete blood count (CBC) for a client who has been
admitted for knee arthroscopy‫ د‬Which value is most important to report to the
physician prior to surgery?
a. White blood cell count 16,000/mm3 b. Hematocrit 33%
c. Platelet count 426,000/ mm3 d. Hemoglobin 10.9 g/dL
1) Erythrocytes [Red blood cells, normally 5 million per mm3 of blood]

2] Leukocytes [White blood cells, normally 5.000 to 10.000 per mm3 of blood]
3] Platelets [normally 150.000 to 450.000 per mm3 of blood].
Hematocrit: M: 40–52%, F: 36–48%
7‫د‬ A 32-year-old client with a history of sickle cell anemia is admitted to the
hospital during a sickle cell crisis‫ د‬The physician orders all of these interventions‫د‬
Which order will you implement first?
a. Give morphine sulfate 4-8 mg IV every hour as needed.
b. Start a large-gauge IV line and infuse normal saline at 200 mL/hour.
c. Immunize with Pneumovax and Haemophilus influenzae vaccines.
d. Administer oxygen immediately.
20‫ د‬Which of the following sentences with the nurse use when instructing a patient who
is receiving radiation therapy?
a. To stop swimming because it may destroy the skin.
b. To remember that he is more susceptible to fracture in this period.
c. To keep away from people who are suffering from viral and bacterial infections.
d. To eat foods that have a high concentration of fat in order to prevent him from
losing weight.
20‫ د‬Nursing intervention for the patient suffering from Leukopenia secondary to
chemotherapy include:
a. Protecting the patient from infections
b. Avoiding injections
c. Providing periods of rest
d. Administering antiemetics before meals
20‫ د‬The major cause of death in patient with leukemia is believed to be :

a. Anemia
b. Dehydration
c. Infection
d. Hemorrhage
20‫ د‬The Schilling test is used to diagnose:
a. Aplastic anemia
b. Iron deficiency anemia
c. Megaloblastic anemia
d. Prenicious anemia
20‫ د‬Sickle shaped erythrocytes cause:

a. Cellular blockage in small vessels
b. Decrease organ perfusion
c. Tissue ischemia and infarction
d. All of the above
20‫ د‬Macrocytic Hyperchromic anemia may appear during all of the following condition
Except:
a. Chronic hemorrhage from digestive tract
b. Prenicious anemia
c. Intestinal disease with disorder in absorption of folic acid
d. Intestinal disease with disorder in absorption of vitamin B12
20‫ د‬Micorcytic Hypochromic anemia is liable to develop on background of:
a. Lack of iron
b. Malabsorption of iron
c. Loss of iron in digestive process
d. All of the above
Total body iron is decreased below normal level and iron is important for the synthesis of
Hemoglobin and consider the most common type of anemia in all age groups.
20. Which of the following is essential for the hemoglobin synthesis during RBC
production?
a. Folic Acid
b. Iron
c. Vitamin B12
d. All of these
Answer B. Keyword: HEMOGLOBIN SYNTHESIS. Rationale: Dietary elements are essential

for RBC production. The following are needed by the red marrow to produce erythrocytes:
• Iron – for hemoglobin synthesis
• Folic Acid – for DNA synthesis
• Vitamin B12 – for DNA synthesis

21. Decreased number of platelets is called:
a. Thrombectomy
b. Thrombocytopenia
c. Thrombocytopathy
d. Thrombocytosis
Answer B. Keyword: DECREASED NUMBER OF PLATELETS. Rationale: thrombocytopenia

is a decreased number of platelets. Thrombocytosis is an excess in the number of platelets.
Thrombocytopathy is a platelet dysfunction. Thrombectomy is the surgical removal of a
thrombus.
22. A patient is diagnosed with a systematic lupus erythematous (SLE)‫ د‬SLE primarily
attacks which tissues?
a. Heart
b. Lung
c. Nerve
d. Connective
Answer D. Keyword: PRIMARILY. Rationale: SLE is a chronic, inflammatory, autoimmune

disorder affecting primarily the connective tissues. It also affects the skin and kidneys and may
affect the pulmonary, cardiac, neural and renal systems.
23‫د‬ A client with systematic lupus erythematosus (SLE) has the classic rash of lesions on the
cheeks and bridge of the nose‫ د‬Which term dose the nurse use to describe this characteristic
pattern?
a. Papular rash
b. Pustular rash
c. Bull's eye rash
d. Butterfly rash
31‫ د‬A classic sign of SLE is:

a. Rashes over the cheeks and nose
b. Weight loss
c. Vomiting
d. Difficulty urinating
Answer A. Keyword: CLASSIC SIGN. Rationale: Although all these symptoms can be signs of
SLE, the classic sign is the butterfly rash over the cheeks and nose.
24‫د‬ The
chemotherapy is
extremely toxic to bone Diarrhea Hypotension Bleeding Hypoglycemia
marrow , and the client
may experience?
25‫د‬ The major cause
of death in patients with
Anemia Embolus Infection Dehydration
leukemia is believed to
be?
26‫د‬ A condition in
which the white cells are
Polycythemia Leukopenia Leukaemia None of these
fewer in number than
normal is termed?
Swollen A feeling of
27‫د‬ An early sign of Difficulty Difficult
cervical lymph fullness over the
Hodgkin's disease is: swallowing breathing
nodes liver
28‫د‬ The nurse is
assisting in planning care
for a client with a
diagnosis of immune
Identifying
deficiency‫ د‬The nurse providing
Protecting the Encouraging factors that
would incorporate which emotional
client from discussion about decreased the
of the following‫ د‬as a support to
infection lifestyle changes immune
priority in the plan of decrease fear
function.
care?
29‫د‬ Erythropoietin is
elevated lipid
a hormone produced by diminished anemia because of hypertension
levels in the
the kidney‫ د‬When the immunologic the diminished because of the
bloodstream,
patient is in chronic function with number of red increased,
contributing to
renal failure, loss of this fewer white blood cells being concentrated
accelerated
hormone will result in: blood cells. produce blood volume.
atherosclerosis.
30‫د‬ Which of the
Excessive Vasoconstriction
following will contribute
Thrombocytosis platelet Thrombocytopenia of the damaged
to increased bleeding
aggregation blood vessels
time ?

Skin and Burn
1‫د‬ Estimate the burn size using the rule of nines, if the client burned at anterior
chest, abdomen and left arm:
a) 27% b) 36%
c) 9% d) 18%
Rule of nines:
1‫د‬ Earliest sings of excessive pressure in the back is:

a) Pale appearance of the skin.
b) Ulcer formation of the cell.
c) Dark or cyanotic color in skin
d) Reddened appearance of the skin.
1‫د‬ The newly admitted client has a large burned area on the right arm‫ د‬The burned
area appears red, has blisters, and is very painful‫ د‬How should this injury be categorized?
A. Superficial
B. Partial-thickness superficial
C. Partial-thickness deep
D. Full thickness
ANS: B The characteristics of the wound meet the criteria for a superficial partial thickness
injury (color that is pink or red; blisters; pain present and high).

Superficial (1st-degree) Epidermis Red without blisters[1
Superficial partial thickness (2nd- Extends into superficial

Redness with clear blister.
degree) dermis
Deep partial thickness (Second- Yellow or white. May be

Extends into deep dermis
degree) blistering.
Extends through entire

Full thickness (3rd-degree) Stiff and white/brown
dermis
2‫د‬ Which client factors should alert the nurse to potential increased complications
with a burn injury?
A. The client is a 26-year-old male.
B. The client has had a burn injury in the past.
C. The burned areas include the hands and perineum.
D. The burn took place in an open field and inflamed the client's clothing.
ANS: C Burns of the perineum increase the risk for sepsis. Burns of the hands require special
attention to ensure the best functional outcome.
3‫د‬ At what point after a burn injury should the nurse be most alert for the
complication of hypokalemia?
A. Immediately following the injury
B. During the fluid shift
C. During fluid remobilization
D. During the late acute phase
ANS: C
Hypokalemia is most likely to occur during the fluid remobilization period as a result of dilution,
potassium movement back into the cells, and increased potassium excreted into the urine with
the greatly increased urine output.
Fluid remobilization phase called diuretics stage, after 48 hrs burn, fluid shift back to the
vascular compartment , decrease edema, blood flow to kidney increase, hypokalemia occur: shift
of fluid from extracellular back to cell this is occur in 4 -5 day
Fluid accumulation phase: fluid shift from the vascular compartment to the interstitial space
(third space shift) lead to edema, maximum within 8 hrs after burn lead to fluid and electrolyte
imbalance, less fluid available to dilute the blood (hemoconentrated) lead to hypotension ,shock,
decrease cardiac output
Parkland Formula: RL: over 24 hrs

= 4 ml * wt * % of burn

68 Kg, Burn 27%
4* 68 *27 = 7334 ml
One half of the amount over the first 8 hrs, the reminder over the 16 hrs
a. Initial 24 hours: RL 4 ml/kg/% burn (adults)
b. Next 24 hours: 0.3–1 ml/kg/% burn/16 per hour
1‫د‬ What clinical manifestation should alert the nurse to possible carbon monoxide
poisoning in a client who experienced a burn injury during a house fire?
A. Pulse oximetry reading of 80%
B. Expiratory stridor and nasal flaring
C. Cherry red color to the mucous membranes
D. Presence of carbonaceous particles in the sputum
ANS: C
The saturation of hemoglobin molecules with carbon monoxide and the subsequent vasodilation
induces a “cherry red ‫ ”الكرز الحامر‬color of the mucous membranes in these clients. The other
manifestations are associated with inhalation injury, but not specifically carbon monoxide
poisoning.
10‫ د‬What clinical manifestation indicates that an escharotomy is needed on a

circumferential extremity burn?
A. The burn is full thickness rather than partial thickness.
B. The client is unable to fully pronate and supinate the extremity.
C. Capillary refill is slow in the digits and the distal pulse is absent.
D. The client cannot distinguish the sensation of sharp versus dull in the extremity.
ANS: C Circumferential eschar can act as a tourniquet when edema forms from the fluid shift,
increasing tissue pressure and preventing blood flow to the distal extremities and increasing the
risk for tissue necrosis. This problem is an emergency and, without intervention, can lead to loss
of the distal limb. This problem can be reduced or corrected with an escharotomy.
11‫ د‬Which type of fluid should the nurse expect to prepare and administer as fluid
resuscitation during the emergent phase of burn recovery?
A. Colloids
B. Crystalloids
C. Fresh-frozen plasma
D. Packed red blood cells
ANS: B Although not universally true, most fluid resuscitation for burn injuries starts with
crystalloid solutions, such as normal saline and Ringer’s lactate. The burn client rarely requires
blood during the emergent phase unless the burn is complicated by another injury that involved
hemorrhage. Colloids and plasma are not generally used during the fluid shift phase
12‫ د‬The client with a dressing covering the neck is experiencing some respiratory difficulty‫د‬
What is the nurse’s best first action?
A. Administer oxygen.
B. Loosen the dressing.
C. Notify the emergency team.
D. Document the observation as the only action.
ANS: B Respiratory difficulty can arise from external pressure. The first action in this situation
would be to loosen the dressing and then reassess the client's respiratory status.
13‫ د‬On admission to the emergency department the burned client's blood pressure is 90/60, with
an apical pulse rate of 122‫ د‬These findings are an expected result of what thermal injury–
related response?
A. Fluid shift
B. Intense pain
C. Hemorrhage
D. Carbon monoxide poisoning
ANS: A Intense pain and carbon monoxide poisoning increase blood pressure. Hemorrhage is
unusual in a burn injury. The physiologic effect of histamine release in injured tissues is a loss of
vascular volume to the interstitial space, with a resulting decrease in blood pressure.
14‫ د‬The client has experienced an electrical injury, with the entrance site on the left hand
and the exit site on the left foot‫ د‬What are the priority assessment data to obtain from this
client on admission?
A. Airway patency
B. Heart rate and rhythm
C. Orientation to time, place, and person
D. Current range of motion in all extremities
ANS: B The airway is not at any particular risk with this injury. Electric current travels through
the body from the entrance site to the exit site and can seriously damage all tissues between the
two sites. Early cardiac damage from electrical injury includes irregular heart rate, rhythm, and
ECG changes.
15‫ د‬All of the following may present with a child complaining of Right congenital
dislocation Hip EXCEPT
a) Shortening of right leg b) Asymmetry of gluteal folds
c) Lengthening of right leg d) Resistance in abducting the right leg
16‫د‬ A client presents with blistering wounds caused from an unknown chemical agent‫د‬
How should the nurse intervene?
a- Do nothing until the chemical agent is identified.
b- Irrigate the wounds with water.
c- Wash the wounds with soap and water and apply a barrier cream.
d- Insert a 20-gauge I.V. catheter and infuse normal saline solution at 150 ml/hour.
16‫د‬ What makes up the largest portion of the skin?

a) Rete ridges b) Epidermis
c) Dermis d) Subcutaneous tissue
Rete ridges = epidermis

16‫د‬ A client received burns of his entire back and left arm‫ د‬Using the Rule of Nine, the
nurse can calculate that he has sustained burns on what percentage of his body?
17. 9%
18. 18%
19. 27%
20. 36%
19‫ د‬You delegate taking vital signs to an experienced nursing assistant‫ د‬The patient has
been diagnosed with osteomyelitis‫ د‬Which vital sign do you want the nursing assistant to
report immediately?
a. Temperature 39 F b. Blood pressure 136/80 c. Heart rate 96/minute d. Respiratory rate
24/minute
Answer A: An elevated temperature indicates infection and inflammation. This patient needs IV
antibiotic therapy. The other vital signs are normal or high normal results.
20‫ د‬The patient suffered a fractured femur‫ د‬Which of the following would you tell the
nursing assistant to report immediately?
a. The patient complains of pain.
b. The patient appears confused.
c. The patient’s blood pressure is 136/88.
d. The patient voided using the bedpan.
Answer B: Fat embolism syndrome is a serious complication that is often the result of fractures
of long bones. The earliest manifestation of this is altered mental status caused by low arterial
oxygen level. The nurse would want to know about and treat the pain, but it is not life
threatening. The nurse would also want to know about the blood pressure and that the patient
voided; however, neither of these pieces of information is urgent.
embolism syndrome presents with tachycardia, tachypnea, elevated

temperature, hypoxemia, hypercapnia, thrombocytopenia, and occasionally mild neurological
symptoms.
Complications from a fat embolism tend to be serious:

1. Pulmonary fat embolism. Widespread obstruction causes sudden death.
2. Systemic fat embolism. These may get lodged in capillaries of organs
like brain, kidney, skin etc
21‫ د‬A patient with a fractured fibula is receiving skeletal traction and has skeletal pins in
place‫ د‬You instruct the nursing assistant to immediately report which of the following?
a. The patient wants to change position in bed.
b. There is a small amount of clear fluid on the pin sites.
c. The traction weights are resting on the floor.
d. The patient is complaining of pain and muscle spasm.
16. ANSWER C – When the weights are resting on the floor, they are not exerting pulling force
to provide reduction and alignment, or to prevent muscle spasm. The weights should always

hang freely. Attending to the weights may reduce the patient’s pain and spasm. With skeletal
pins, a small amount of clear fluid drainage is expected. It is important to inspect the traction
system after a patient changes position because position changes may alter the traction.
22‫ د‬The charge nurse assigns the nursing care of a patient who is 1 day post-operative after
a left below-the-knee amputation to an experienced LPN/LVN, what will you describe as
the major focus for care today?
a. To attain pain control for phantom ‫وهمي‬pain.
b. To monitor for signs of sufficient tissue perfusion.
c. To assist the patient to ambulate as soon as possible.
d. To elevate the residual limb when the patient is supine.
ANSWER B – Monitoring for sufficient tissue perfusion is the priority at this time. Phantom
pain is a concern, but is more common is patients with above-the-knee amputations. Early
ambulation is a goal, but at this time, the patient is more likely to be engaged in muscle-
strengthening exercises. Elevation of the residual limb on a pillow is controversial because it
may promote knee flexion contracture.
23‫د‬ Wh Antibiotic Fluid Continuous Closed

ich of the following is an should be given. replacement monitoring for dressing
immediate action in care laryngeal
of burn at face and neck? edema
24‫د‬ Esti 18% 36% 37% 19%
mate the burn size using
the rule of nines, if the
client burned at one leg
and perineum area?
25‫د‬ Foll assessing for assessing for assessing the assessing
owing surgery and the pain and swelling and cast for hot the cast for
application of a cast, the discomfort bleeding spots wetness
nurse's primary &
priority concern should be
for?
26‫د‬ The Relax Improve blood Keep the skin Reduce the
client’s skin care includes tense circulation dry number of
frequent massage over muscles organism on
bony prominences? the skin
27‫د‬ For Decrease your Decrease your Eat more fruits Eat more
a client with osteoporosis, intake of red intake of to increase your dairy
the nurse should provide meat popcorn, nuts, potassium products to
which dietary instruction? and seeds intake increase
your
calcium
intake
28‫د‬ Wh Complaints of Moderate to Urine output Hoarseness
en assessing a 70 kg body intense thirst severe pain of 20 ml in the of the voice
weight client with partial 1st hour
thickness burns over 60%
of the body, which
findings should the nurse
report immediately?
29‫د‬ Esti 37% 36% 45% 40%
mate the burn size using
the rule of nines, if the
client burned at 2 legs and
anterior part of abdomen:
30‫د‬ The presence of dislocation of degeneration of body’s

nurse explains to a 51- antibodies in the patella over articular autoimmun
year-old man who is the synovial the tibi cartilage. e response.
diagnosed with flui
osteoarthritis that the
disease is best understood
as the:
31‫د‬ The cloudiness in the an increase in failed eye retinal tears.
nurse considers in lens. intraocular surgery.
planning care for a patient pressure.
with glaucoma that this
disorder is caused by:
32‫د‬ The Hardnes is absorbed Acts against increase
physician orders Silvadene s eschar, more rapidly both gram granulocyte
as atopical antibiotic allowing than other negative and formation
treatment for a client with a faster topical agents gram positive for efficient
burn wounds ‫ د‬An recovery microorganism wound
advantage of this period s healing
treatment is which of the
following ?
33‫د‬ The correct water Allow the GI Provide Ensure

client with major burn and electrolyte tract to rest supplemental adequate
injury receives total imbalance minerals and caloric and
parenteral nutrition vitamins protein
(TPN)‫ د‬The primary intake
reason for this therapy for
this client is to help:

Neurologic System
1‫د‬ Which of the following clinical manifestation would be an early and most
sensitive indicator of deterioration in the client's neurologic status?
a) Widening pulse pressure b) Decrease in the pulse pressure
c) Otorrhea and rihnorrehea d) Decrease in level of consciousness
2‫د‬ When the client arrives in the emergency room, which of the following
considerations should receive the highest priority?
A. Establishing an airway. B. Determining whether he has a neck fracture
C. Replacing blood losses. D. Stopping bleeding from open wounds.
2‫د‬ The nurse assesses the client frequently for signs of increasing intracranial
pressure, including:
A. Tachycardia. B. Decrease systolic blood pressure.
C. Unequal pupil size. D. Decreasing body temperature.
2‫د‬ Which of the following respiratory signs would indicate increasing intracranial
pressure in the brain stem?
A. Slow, irregular respirations. B. Rapid, shallow respirations.
C. Asymmetric chest excursion. D. Nasal flaring.
2‫د‬ Which of the following positions would be most appropriate for a client with a
head injury?
A. Left Sim,s position. B. Trendelenburg's position.
C. Head of the bed elevated 30 to 45 degrees. D. Head elevated on two pillows.
2‫د‬ Which of the following postoperative care measures would be contraindicated

for a client at risk for increased intracranial pressure?
A. Deep breathing. B. Coughing.
C. Turning. D. Passive range of motion exercises.

2. During assessment, the patient does not open his eyes to painful stimuli
anymore, his speech is now inappropriate word and withdraws from pain, What is his
Glasgow coma score now?
A. G.C.S.= 9. B. G.C.S.= 7.
C. G.C.S.= 10. D. G.C.S= 8.
Eye opening: Spontaneous 4, On comands 3, On Pain 2, Nil 1
Verbal response: Oriented 5, Disoriented 4, Inappropriate words 3,
Incomprehensive sound 2, Nil 1
Best Motor response: Obey 6, localize pain 5, Flexion withdrawal 4,
Flexion abnormal 3, Extension 2, Nil 1
2‫د‬ The nurse assessing for signs of increase intracranial pressure, which include:
A. Tachycardia, bradypnea, hypertension
B. Bradycardia, bradypnea, hypertension
C. Bradycardia, Tachypnea, hypotension
D. Tachycardia, bradypnea, hypotension
2‫د‬ The nurse is caring for a client with a cerebral injury that impaired his speech
and hearing‫ د‬Most likely, the client has experienced damage to:
A. Frontal lobe. B. Parietal lobe.
C. Occipital lobe. D. Temporal lobe.
2. The patient with multiple sclerosis tells the nursing assistant that after physical
therapy she is too tired to take a bath‫ د‬What is your priority nursing diagnosis at this
time?
a. Fatigue related to disease state
b. Activity Intolerance due to generalized weakness
c. Impaired Physical Mobility related to neuromuscular impairment
d. Self-care Deficit related to fatigue and neuromuscular weakness
16. ANSWER D – At this time, based on the patient’s statement, the priority is Self-Care Deficit
related to fatigue after physical therapy. The other three nursing diagnoses are appropriate to a
patient with MS, but they are not related to the patient’s statement.
11‫ د‬While working in the ICU, you are assigned to care for a patient with a seizure
disorder‫ د‬Which of these nursing actions will you implement first if the patient has a
seizure?
a. Place the patient on a non-rebreather mask will the oxygen at 15 L/minute.
b. Administer lorazepam (Ativan) 1 mg IV.
c. Turn the patient to the side and protect airway.
d. Assess level of consciousness during and immediately after the seizure.
26. ANSWER C – The priority action during a generalized tonic-clonic seizure is to protect the
airway. Administration of lorazepam should be the next action, since it will act rapidly to control
the seizure. Although oxygen may be useful during the postictal phase, the hypoxemia during

tonic-clonic seizures is caused by apnea. Checking the level of consciousness is not appropriate
during the seizure
Lorazepam: benzodiazepines and is used to treat anxiety disorders
Endocrine system
1‫د‬ In type II non-insulin diabetes mellitus (NIDDM), the patient demonstrates the
following characteristics:
a) A need for insulin for life
b) Usually obesity at diagnosis
c) Islet cell antibodies
d) Decrease in insulin resistance
Beta cell produce Insulin

Increase insulin resistance
1‫د‬ The nurse teaches the newly diagnosed patient with diabetes mellitus that which of
the following guidelines will decrease the body's need for insulin?
a) Sleep b) Exercise
d) Low-fat diet
c) Stress
Which of the following symptoms are characteristic of Addison's disease?
a) Truncal obesity b) Hypertension
c) Muscle weakness d) “Moon” face
Addison disease (adrenocortical insufficiency): A syndrome due to inadequate secretion of

corticosteroid hormones by the adrenal gland. Muscle weakness, anorexia, GI symptoms, fatigue,
dark pigmentation of skin and mucosa, hypotension, low blood glucose, low serum sodium, high
serum potassium, mental changes
Cushing syndrome: The condition resulting from excess amounts of corticosteroid hormones in
the body (Wight gain, promotes fat deposition in the face (moon face ), in shoulder and cause
(buffalo hump) and in the abdomen, ↑ BP, ↑ BS)
1‫د‬ Nursing care for the patient with hypothyroidism would include which action as a
priority?
a) Encourage the patient to participate in activities as tolerated .
b) Keep the patient's room temperature cool
c) Provide frequent high-calorie meals
d) Teach about alcohol and stimulants

• Hypothyroidism results from suboptimal levels of thyroid hormone. Thyroid deficiency
can affect all body functions.
• S&S: Hair loss, brittle nails and dry skin, Numbness & hoarseness of voice, subnormal
pulse and temperature, apathetic.
• Myxedema coma: sever stage of hypothyrodism in which the patient is hypothermic,
lethargy, stupor and coma
• Encourage the patient to participate in activity to prevent complication of immobility
(because the pt. experiences ↓ energy).
• The most common cause of hypothyroidism in adults is autoimmune thyroiditis
(Hashimoto’s disease), in which the immune system attacks the thyroid gland (formation
of auto antibodies against normal thyroid tissue)
3‫ د‬Which nursing diagnosis takes highest priority for a female client with
hyperthyroidism?
a. Risk for imbalanced nutrition: More than body requirements related to thyroid
hormone excess
b. Risk for impaired skin integrity related to edema, skin fragility, and poor wound
healing
c. Body image disturbance related to weight gain and edema
d. Imbalanced nutrition: Less than body requirements related to thyroid hormone excess
• Answer D. In the client with hyperthyroidism, excessive thyroid hormone production

leads to hypermetabolism and increased nutrient metabolism. These conditions may
result in a negative nitrogen balance, increased protein synthesis and breakdown,
decreased glucose tolerance, and fat mobilization and depletion. This puts the client at
risk for marked nutrient and calorie deficiency, making Imbalanced nutrition: Less than
body requirements the most important nursing diagnosis. Options B and C may be
appropriate for a client with hypothyroidism, which slows the metabolic rate.
4‫ د‬A patient is admitted to the medical unit with possible Graves’ disease
(hyperthyroidism)‫ د‬Which assessment finding supports this diagnosis?
a. Periorbital edema b. Bradycardia c. Exophthalmos d. Hoarse voice
1. ANSWER C – Exophthalmos (abnormal protrusion of the eye) is characteristic of patients
with hyperthyroidism due to Graves’ disease. Periorbital edema, bradycardia, and hoarse voice
are all characteristics of patients with hypothyroidism. Focus: Prioritization
5‫ د‬Which change in vital signs would you instruct a nursing assistant to report immediately
for a patient with hyperthyroidism?
a. Increased and rapid heart rate
b. Decrease systolic blood pressure
c. Increased respiratory rate
d. Decreased oral temperature
2. ANSWER A – The cardiac problems associated with hyperthyroidism include tachycardia,
increased systolic blood pressure, and decreased diastolic blood pressure. Patients with
hyperthyroidism also may have increased body temperature related to increased metabolic rate.

6‫ د‬For the patient with hyperthyroidism, what intervention should you delegate to the
experienced certified nursing assistant?
a. Instruct the patient to report palpitations, dyspnea, vertigo, pr chest pain.
b. Check the apical pulse, blood pressure, and temperature every 4 hours.
c. Draw blood for thyroid-stimulating hormone, T3, and T4 levels.
d. Explain the side effects of propylthiouracil (PTU) to the patient.
ANSWER B – Monitoring and recording vital signs are within the education scope of nursing
assistants. An experienced nursing assistant should have been taught how to monitor the apical
pulse. However, the nurse should observe the nursing assistant to be sure that she has mastered
this skill.
7‫ د‬You assess a patient with Cushing’s disease‫ د‬For which finding will you notify the
physician immediately?
a. Purple striae (line) present on abdomen and thighs
b. Weight gain of 1 pound since the previous day
c. +1 dependent edema in ankles and calves
d. Crackles bilaterally in lower lobes of lungs
ANSWER D – The presence of crackles in the patient’s lungs indicate excess fluid volume doe
to excess water and sodium reabsorption and may be a symptom of pulmonary edema, which
must be treated rapidly. Striae (stretch marks), weight gain, and dependent edema are common
findings in patients Cushing’s disease. These findings should be monitored, but are not urgent.
8. When instructing the female client diagnosed with hyperparathyroidism about

diet, nurse X should stress the importance of which of the following?
a. Restricting fluids
b. Restricting sodium
c. Forcing fluids
d. Restricting potassium
Answer C. The client should be encouraged to force fluids to prevent renal calculi formation.
Sodium should be encouraged to replace losses in urine. Restricting potassium isn’t necessary in
hyperparathyroidism.
Parathyroid hormone (regulates calcium & phosphorus metabolism
9‫د‬ The nurse teaches the patient who is prescribed corticosteroid therapy that:
a) Her diet should be low protein with ample fat
b) There will be no change in appearance
c) She is at an increased risk for developing infection
d) She is at a decreased risk for development of thrombophlebitis and thromboembolism
10‫ د‬Nurse X is assessing a client with possible Cushing’s syndrome‫ د‬In a client with
Cushing’s syndrome, the nurse would expect to find:
a. Hypotension.
b. Thick, coarse skin.
c. Deposits of adipose tissue in the trunk and dorsocervical area.
d. Weight gain in arms and legs.
Answer C. Because of changes in fat distribution, adipose tissue accumulates in the trunk, face
(moonface), and dorsocervical areas (buffalo hump‫)سنام الجاموس‬. Hypertension is caused by fluid
retention. Skin becomes thin and bruises easily because of a loss of collagen. Muscle wasting
causes muscle atrophy and thin extremities.
11‫ د‬Nurse X is aware that a positive Chvostek’s sign indicate?
a. Hypocalcemia
b. Hyponatremia
c. Hypokalemia
d. Hypermagnesemia
Answer A. Chvostek’s sign is elicited by tapping the client’s face lightly over the facial nerve,
just below the temple. If the client’s facial muscles twitch, it indicates hypocalcemia.
Hyponatremia is indicated by weight loss, abdominal cramping, muscle weakness, headache, and
postural hypotension. Hypokalemia causes paralytic ileus and muscle weakness. Clients with
hypermagnesemia exhibit a loss of deep tendon reflexes, coma, or cardiac arrest.
12‫ د‬Nurse X is assessing a client after a thyroidectomy‫ د‬The assessment reveals muscle twitching
and tingling, along with numbness in the fingers, toes, and mouth area‫ د‬The nurse should suspect
which complication?
a. Tetany
b. Hemorrhage
c. Thyroid storm
d. Laryngeal nerve damage
Answer A. Tetany may result if the parathyroid glands are excised or damaged during thyroid
surgery. Hemorrhage is a potential complication after thyroid surgery but is characterized by
tachycardia, hypotension, frequent swallowing, feelings of fullness at the incision site, choking,
and bleeding. Thyroid storm is another term for severe hyperthyroidism — not a complication of
thyroidectomy. Laryngeal nerve damage may occur postoperatively, but its signs include a
hoarse voice and, possibly, acute airway obstruction.
13‫ د‬Which of these signs suggests that a male client with the syndrome of inappropriate
antidiuretic hormone (SIADH) secretion is experiencing complications?
a. Tetanic contractions
b. Neck vein distention
c. Weight loss
d. Polyuria
Answer B. SIADH secretion causes antidiuretic hormone overproduction, which leads to fluid
retention. Severe SIADH can cause such complications as vascular fluid overload, signaled by
neck vein distention. This syndrome isn’t associated with tetanic contractions. It may cause
weight gain and fluid retention (secondary to oliguria).
14‫ د‬A male client with a history of hypertension is diagnosed with primary
hyperaldosteronism‫ د‬This diagnosis indicates that the client’s hypertension is caused by
excessive hormone secretion from which of the following glands?
a. Adrenal cortex b. Pancreas c. Adrenal medulla d. Parathyroid

Answer A. Excessive secretion of aldosterone in the adrenal cortex is responsible for the client’s
hypertension. This hormone acts on the renal tubule, where it promotes reabsorption of
sodium and excretion of potassium and hydrogen ions‫ د‬The pancreas mainly secretes
hormones involved in fuel metabolism. The adrenal medulla secretes the catecholamines —
epinephrine and norepinephrine. The parathyroids secrete parathyroid hormone.
1)Pituitary gland:
 Anterior
 Posterior
2) Thyroid gland: thyroid hormone,
 Tetraiodothyronine (T4)
 Triiodothyronine (T3)
3) Parathyroid glands :
 Parathyroid hormone (regulates calcium & phosphorus metabolism)
4) Adrenal gland:
A‫ د‬Cortex:
 Mineralocorticoids (aldosterone)
 Glucocorticoids (Cortisol)
B‫ د‬Medulla:
 Epinephrine, Nor epinephrine
5) Pancreas:
A. Endocrine:
• Insulin (decrease blood glucose)
• Glucagon: (Increase blood glucose)
• Somatostatin: (Exerts hypoglycemic effect)
B‫ د‬Exocrine (Pancreas):
 Amylase: aid in digestion of CHO
 Trypsin: aid in digestion of protein
 Lipase: help in digestion of fat
15‫ د‬Nurse X is aware that the most appropriate for a client with Addison’s disease?
a. Risk for infection
b. Excessive fluid volume
c. Urinary retention
d. Hypothermia
Answer A. Addison’s disease decreases the production of all adrenal hormones, compromising
the body’s normal stress response and increasing the risk of infection. Other appropriate nursing
diagnoses for a client with Addison’s disease include Deficient fluid volume and Hyperthermia.
Urinary retention isn’t appropriate because Addison’s disease causes polyuria.
16. Nurse X is caring for a female client with type 1 diabetes mellitus who exhibits
confusion, light-headedness, and abnormal behavior‫ د‬The client is still conscious‫ د‬The
nurse should first administer:
a. I.M. or subcutaneous glucagon. b. I.V. bolus of dextrose 50%.
c. 15 to 20 g of a fast-acting carbohydrate such as orange juice.
d. 10 U of fast-acting insulin.

Answer C. This client is having a hypoglycemic episode. Because the client is conscious, the
nurse should first administer a fast-acting carbohydrate, such as orange juice, hard candy, or
honey. If the client has lost consciousness, the nurse should administer either I.M. or
subcutaneous glucagon or an I.V. bolus of dextrose 50%. The nurse shouldn’t administer insulin
to a client who’s hypoglycemic; this action will further compromise the client’s condition
17‫ د‬For the first 72 hours after thyroidectomy surgery, nurse Jamie would assess the female
client for Chvostek’s sign and Trousseau’s sign because they indicate which of the
following?
a. Hypocalcemia
b. Hypercalcemia
c. Hypokalemia
d. Hyperkalemia
Answer A. The client who has undergone a thyroidectomy is at risk for developing hypocalcemia
from inadvertent removal or damage to the parathyroid gland. The client with hypocalcemia will
exhibit a positive Chvostek’s sign (facial muscle contraction when the facial nerve in front of the
ear is tapped) and a positive Trousseau’s sign (carpal spasm when a blood pressure cuff is
inflated for a few minutes). These signs aren’t present with hypercalcemia, hypokalemia, or
hyperkalemia.
18. A 67-year-old male client has been complaining of sleeping more, increased urination,
anorexia, weakness, irritability, depression, and bone pain that interferes with her going
outdoors. Based on these assessment findings, nurse X would suspect which of the following
disorders?
a. Diabetes mellitus
b. Diabetes insipidus
c. Hypoparathyroidism
d. Hyperparathyroidism
Answer D. Hyperparathyroidism is most common in older women and is characterized by bone

pain and weakness from excess parathyroid hormone (PTH). While clients with diabetes mellitus
and diabetes insipidus also have polyuria, they don’t have bone pain and increased sleeping.
Hypoparathyroidism is characterized by urinary frequency rather than polyuria.
Hyperparathyroidism
Caused by overproduction of parathyroid hormone by the parathyroid gland and it
characterized by the development of renal stones containing calcium.
S & S : Fatigue, muscle weakness, N & V, cardias dysrhythmias. Formation of stones in
one or both kidneys. Renal failure.
Management: Hydration: fluid intake to 2ooo ml to prevent calculus formation.
Mobility: encourage as much as possible because bed rest ↑ risk to develop renal calculi.
Diet & medications: patient should avoid diet with restricted or excess calcium.
19‫ د‬When caring for a male client with diabetes insipidus, nurse X expects to administer:
a. vasopressin (Pitressin Synthetic).

b. furosemide (Lasix).
c. regular insulin.
d. 10% dextrose.
Diabetes Insipidus: Disorder of the posterior lobe of the pituitary gland due to a
deficiency of vasopressin (ADH).
Answer A. Because diabetes insipidus results from decreased antidiuretic hormone (vasopressin)
production, the nurse should expect to administer synthetic vasopressin for hormone replacement
therapy. Furosemide, a diuretic, is contraindicated because a client with diabetes insipidus
experiences polyuria. Insulin and dextrose are used to treat diabetes mellitus and its
complications, not diabetes insipidus.
20‫د‬You are providing care for a patient who underwent thyroidectomy 2 days ago‫ د‬Which
laboratory value requires close monitoring?
a. Calcium b. Sodium c. Potassium d. White blood cells
ANSWER A – The parathyroid glands are located on the back of the thyroid gland. The
parathyroids are important in maintaining calcium and phosphorus balance. The nurse should be
attentive to all patient laboratory values, but calcium and phosphorus are important to monitor
after thyroidectomy.
21‫ د‬Which of the following complications may be least observed in diabetic clients?
a. Nephropathy b. Encephalopathy c. Retinopathy d. Neuropathy
22‫ د‬All of the following symptoms are characteristics of diabetes mellitus EXCEPT?
a. Polyuria b. Polyarthritis c. Polydypsia d. Polyphagia
Renal System
8. All of the following considered as the most common life threatening complication
for a patient with renal failure EXCEPT:

a) Acute pulmonary edema b) Hyperkalemia
c) Metabolic alkalosis d) Cardiac arrhythmia
8‫د‬ The functional units of the kidneys are the:

a) Nephrons b) Renal capsules
c) Renal pyramids d) Convoluted tubules
8‫د‬ An important function of the kidneys is:

a) Ammonia retention b) Phosphate retention
c) Glucose elimination d) Acid elimination
8‫د‬ A 73-year-old male patient has a urethral obstruction related to prostatic

enlargement‫ د‬The nurse is aware this may result in:
a) Urinary tract infection b) Enuresis
c) Polyuria d) Proteinuria
8‫د‬ A patient has asked the nurse what test the physician has ordered to measure the
effectiveness of his or her renal function‫ د‬Which is the appropriate response?
a) Urine-specific gravity b) Urine osmolality
c) Serum creatinine d) Blood urea nitrogen to creatinine
ratio
8‫د‬ A male patient has a catheter, and the nurse suspects he has a bladder infection‫د‬
What may be the most likely cause of bladder infection in a patient with a catheter?
a) Irrigation of the catheter
b) Maintenance of the closed drainage system
c) Emptying the Foley bag
d) Emptying the Foley bag without applying gloves
8‫د‬ Acute glomerulonephritis usually

a) Occurs after urinary tract infection
b) Occurs after a previous streptococcal infection
c) Associated with vascular disorder
d) Associated with congenital anomalies of the urinary tract
8‫د‬ The clinical manifestations of nephrotic syndrome include

a) Hematuria, proteinuria, weight b) Hematuria, albuminuria, fever
gain
c) Hypertension,proteinuria, weight d) Proteinuria,hypoalbuminemia,
loss edema
8‫د‬ The client has continuous bladder irrigation after a transurethral resection, a major
goal related to the irrigation is to :
a. maintain catheter patency. b. reduce incisional bleeding.
b. recognize sign s of prostate cancer d. perform activity of daily living.
Transurethral resection (TUR) of the bladder is a surgical procedure that is used both to
diagnose bladder cancer and to remove cancerous tissue from the bladder.

The most common symptoms
Back pain Dysuria Painless hematuria Infection
of bladder cancer?
A client with fever and
urinary urgency is asked to
provide a urine specimen for
First stream of Middle stream of No matter to
culture and sensitivity‫ د‬The last stream of urine
urine urine time
nurse should instruct the
client to collect the specimen
from the?
All of the following may
present with Acute
Bacteruria Hematuria Proteinuria Oliguria
glomerulonephritis
EXCEPT?
A patient has asked the nurse
what test the physician has To keep the
ordered to measure the catheter free Blood urea nitrogen Serum
Urine osmolality
effectiveness of his or her from clot to creatinine ratio creatinine
renal function‫ د‬Which is the obstruction.
appropriate response?
elevated lipid
Erythropoietin is a hormone diminished anemia because of hypertension
levels in the
produced by the kidney‫د‬ immunologic the diminished because of the
bloodstream,
When the patient is in function with number of red increased,
contributing to
chronic renal failure, loss of fewer white blood cells being concentrated
accelerated
this hormone will result in: blood cells. produce blood volume.
atherosclerosis.
Occurs after a Associated with
Occurs after
Acute glomerulonephritis previous Associated with congintal
urinary tract
usually streptococcal vascular disorder anomalies of the
infection
infection urinary tract.
The nurse working in
hemodialysis unit runs a high Hepatitis A Hepatitis B Hepatitis C Hepatitis D
risk of developing:
Fundamental of Nursing
20‫د‬ A medication scheduled for T‫د‬I‫د‬D should be given
a. Every two hours b. Every 6 hours
c. Every 8 hours d. Every 12 hours
T.I.D. : three time a day

Q.I.D.: 4 time a day
q/6hr: each 6 hours
20‫د‬ Rapid movement of intestinal contents that results in many watery stools per day is called:
a) Hemorrhoids. b) Constipation
c) Peristalsis. d) Diarrhea.
Constipation: refers to bowel movements that are infrequent or hard to pass
Hemorrhoids: the vascular structures in the anal canal are swollen or inflamed.
Peristalsis: is a radially symmetrical contraction and relaxation of muscles
21‫د‬ Diarrhea is best described by its:

a) Amount b) Consistency
c) Frequency d) Odor
20‫د‬ Earliest sings of excessive pressure in the back is:

a) Pale appearance of the skin.
b) Ulcer formation of the cell.
c) Dark or cyanotic color in skin
d) Reddened appearance of the skin.
Earliest
20. All of the following from pre op‫ د‬requirements Except:

a) Signed consent form b) Vital signs.
c) C.B.C d) Skull x- ray.
21‫د‬ Post operative care first observation is:

a) Breathing b) level of consciousness
c) Take Blood Pressure c) Inspect the dressing
22‫د‬ A pre-operative check list form that should be completed before surgery, it should
be including which of the following?
a) The surgical consent form b) All laboratory test
c) Vital Signs d) All of above
20‫ د‬To avoid lipohypertrophy of skin resulted from recurrent injection at a site, the
nurse mostly must:
a)Use a small needles and syringes.
b)Massage the site well after injection.
c)Rotate the site of injection.
d)Use lubricant after injection.
20‫ د‬When otic application instilled, the ear first manipulated to straighten the auditory
canal of young child, the nurse should:
a)Pull the ear down and back
b) Pull the ear down and forward
c)Pull the ear up and back
d) Pull the ear up and forward
20‫د‬ To examine the ear canal of the child, this is done by:
a) Pull the ear down and back
b) Pull the ear up and back
c) Pull the ear only back
d) Do not pull the ear, direct examine the ear by otoscope
20. The nurse should apply all of the following principles when administering
medications Except:
a) Never administer medication prepared by another one
b) Never leave the medication unattended.
c) The ordered medication must be given even the patient refuse
d) Applying the five rights
20‫د‬ Discharge planning for hospitalized patient begins:

a) When the treating Dr. gives discharge order
b) When all of the specific needs of the patient have been identified
c) When the patient begins to ask about his discharge plans
d) From the first day of admission
20. Instrument which is used to examine the eye structure is called:

a) Ophthalmoscope b) Laryngoscope
c) Otoscope d) Bronchoscope
Otoscope: ear, laryngoscope: Bronchoscope:
20‫د‬ Abnormal skin color which indicates yellowish color is called:

a) Erythema b) Ecchymosis
c) Jaundice d) Pallor
Pallor
Ecchymosis: extravasation of blood
Erythema: redness of the skin or mucous membranes (infection, inflammation)
20‫د‬ A pattern in which the nursing personnel divide the patient into groups and
complete their care together is called:
a) Primary method b) Team nursing
c) Nursing managed care case method d) Case method
Primary: Case, Functional, Team method
20‫د‬ Which of the following is considered as subjective data?
a) Anxiety b) Skin color
c) Height d) Temperature
20‫د‬ The physician has ordered an indwelling urinary catheter inserted in a hospitalized
patient, the nurse is aware that:
a) The procedure requires surgical asepsis
b) Lubricant not needed for catheter insertion
c) Smaller catheters are used for male catheter
d) Normally a clean technique is required for catheter insertion
Clean & surgical asepsis
20‫د‬ The normal color of urine is:

a) Dark amber b) Reddish brown
c) Cloudy d) Light yellow

20‫د‬ When a person has a fever or diaphoresis, the urine output will be which of the
following:
a) Increased and diluted b) Increased and concentrated
c) Decreased and highly diluted d) Decreased and highly concentrated
Concentrated and diluted, increase and decrease
20‫د‬ Medication is instilled between the skin & the muscle and used to administer
Heparin‫د‬
a) Intravenous b) Intramuscular
c) Intradermal d) Subcutaneous
IV, IM, Intradermal
20‫د‬ The angle of the syringe and needle for intramuscular injections is:
a) 90 degrees b) 45 degrees
c) 15 degrees d) 10 degrees
20‫د‬ A primary concern when giving heparin subcutaneously to prevent bleeding is:
a) Don’t make massage on the injection site
b) To make massage on the injection site
c) Use the smallest gauge needle that is appropriate
d) Use Z technique
20‫د‬ When administering medication via nasogastric tubing, clamp the tube for at least:
a) One half hour prior to medication administration to prevent complication
b) One half hours after instilling medication to allow for absorption
c) One hour prior to medication administration to prevent complication
d) One and one half hours after instilling medication to allow for absorption
20‫د‬ To ensure that medications are prepared and administered correctly, the nurse
should:
a) Give the medication without question
b) Use the patient's rights
c) Give the medication only when requested
d) Use the FIVE rights
20‫د‬ The nurse chooses to inject a prescribed intramuscular medication into the
ventrogluteal site‫ د‬If the nurse selects the site correctly, the injection is administered into
the‫د‬
a) Hip b) Arm
c) Thigh d) Buttock
20‫د‬ The doctor order is 300 cc of normal saline solution, to be finished within 4 hours,
how many drop/min you will regulate this IV (drop factor is 20 drop/minute)‫د‬
a) 10 drop/min b) 15 drop/min
c) 25 drop/min d) 35 drop/min
Volume * drop factor / minutes*60 = 300*20/4*60 = 25
20‫د‬ If a vial of Gentamycin contains 80 mg in 2 ml, the physician order is 16 mg every 8

hr‫د‬, the nurse should give every time:
a) 0.1 ml b) 0.2 ml
c) 0.3 ml d) 0.4 ml
20‫د‬ All of the following is used Central Venous Catheter, EXCEPT:

a) Clients require long term IV medication
b) IV medications are irritating to peripheral veins
c) Clients require short term IV medication
d) Difficult to insert peripheral catheter
20‫د‬ One of your patients complains of difficulty of breathing, all of the following
measurement which help improve breathing EXCEPT:
a) Put your patient in semi- fowler's position
b) Teach patient breathing techniques
c) Put the patient in prone position
d) Give oxygen therapy
20‫د‬ The process of removing poisonous substance through gastric intubation is called:
a) Gastric Lavage b) Gastric Gavage
c) Gastric Decompression d) Gastric Tamponade
Lavage and Gavage
20‫د‬ To prevent the formation of thrombi in the postoperative patient, the nurse should
a) Teach foot and leg exercises
b) Have the patient lie still
c) Place pillows under the knee
d) Lie in lateral position
20‫د‬ Paracentesis is best described as:
a) The removal of fluid from the lung
b) The removal of fluid or air from pleural cavity
c) The removal of body fluid from the abdominal cavity
d) The removal of secretion from the stomach
B: Pneumothorax
20‫د‬ Which of the following is used to determine the activity of the brain:
a) Electrocardiography b) Electromyography
c) Electroencephalography d) Echocardiography
B: EMG is a diagnostic procedure to assess the health of muscles and the nerve cells that control
them (motor neurons)
D: Doppler ultrasound to create images of the heart
20. All of the following are modification necessary to prevent bruising in the area of heparin
injection Except:
a) Rotation of the site
b) Never aspirate the plunger once the needle in place
c) Change the needle before injection
d) Massage the site of injection
20‫د‬ An infection that the patient acquires in the hospital is called:

a) A local infection b) An endogenous infection
c) A nosocomial infection d) A secondary infection
B: bacteria that naturally reside in a closed system X exogenous infection
20‫د‬ The nursing activity most likely to prevent the clogging of a nasogastric feeding tube
is:
a) Attaching the tubing to suction after each feeding
b) Clamping the tubing after formula feeding
c) Flushing the tubing with water and clamping it after each feeding
d) Aspirate as much as possible from the tubing using a 50 ml syringe
20‫د‬ If a nasogastric tube has been misplaced in the trachea during preparation to obtain
a gastric specimen, the nurse should anticipate that the patient will:
a) Have difficult breathing b) Swallow every few seconds
c) Gage without relief d) Complain of feeling nauseated
20‫د‬ When planning Mr‫ د‬Ahmed care (50 years) who demonstrates difficulty in
breathing‫ د‬Which of the following positions is most appropriate?
a) On either side b) Flat on his back
c) On his abdomen d) Mid-Flower's position
20‫د‬ The following manifestations are commonly associated with a fever, EXCEPT:
a) Headache b) Pinkish and red skin color
c) Bradycardia d) Convulsions in infants and child
20‫د‬ Dorsal recumbent position is used when performing the following procedures
EXCEPT:
a) Suppository insertion b) Cystoscopic examination
c) Urinary catheter insertion d) Vaginal examination
Back, leg supported and knee flex
cystoscopic: is a procedure used to see inside your urinary bladder and urethra
20‫د‬ All of the following would be expected symptoms of CHF EXCEPT:

a) Rapid, shallow, difficult breathing b) Pyuria
c) Peripheral edema d) Pulmonary congestion
20‫د‬ Blood and urine analysis confirm a diagnosis of salicylate overdose‫ د‬The client is
treated with gastric lavage‫ د‬Which of the following positions would be most appropriate for
the client during this procedure?
a) Lateral b) Trednelenburgs
c) Supine d) Lithotomy
20‫د‬ Is the term used to administered undiluted medication quickly into a vein:
a) Bolus b) Secondary infusion
c) Intermittent d) Continuous
20‫د‬ A primary concern when giving heparin subcutaneously to prevent bleeding is:
a. Don’t make massage on the injection site
b. To make massage on the injection site
c. Use the smallest gauge needle that is appropriate
d. Use Z technique
20‫د‬ When administering medication via nasogastric tubing, clamp the tube for at least:
a. One half hour prior to medication administration to prevent complication
b. One half hours after instilling medication to allow for absorption
c. One hour prior to medication administration to prevent complication
d. One and one half hours after instilling medication to allow for absorption
20‫ د‬As a part of the client's outpatient teaching plan, the nurse would instruct him to
take which of the medications below after the barium enema?
a. A laxative
b. An emetic
c. An antacid
d. A digestant
20‫د‬ To prevent the formation of thrombi in the postoperative patient, the nurse should
a. Teach foot and leg exercises
b. Have the patient lie still
c. Place pillows under the knee
d. Lie in lateral position
20‫د‬ Paracentesis is best described as:

a. The removal of fluid from the lung
b. The removal of fluid or air from pleural cavity
c. The removal of body fluid from the abdominal cavity
d. The removal of secretion from the stomach
20‫د‬ An infection that the patient acquires in the hospital is called:

a. A local infection b. An endogenous infection
c. A nosocomial infection d. A secondary infection
20‫د‬ The nursing activity most likely to prevent the clogging of a nasogastric feeding tube
is:
a. Attaching the tubing to suction after each feeding
b. Clamping the tubing after formula feeding
c. Flushing the tubing with water and clamping it after each feeding
d. Aspirate as much as possible from the tubing using a 50 ml syringe
20‫د‬ If a nasogastric tube has been misplaced in the trachea during preparation to obtain
a gastric specimen, the nurse should anticipate that the patient will:
a. Have difficult breathing b. Swallow every few seconds
c. Gage without relief d. Complain of feeling nauseated
20‫د‬ The following manifestations are commonly associated with a fever, EXCEPT:
a. Headache b. Pinkish and red skin color
c. Bradycardia d. Convulsions in infants and child
20‫د‬ Dorsal recumbent position is used when performing the following procedures
EXCEPT:
a. Suppository insertion b. Cystoscopic examination
c. Urinary catheter insertion d. Vaginal examination
20‫د‬ All of the following would be expected symptoms of CHF EXCEPT:
a. Rapid, shallow, difficult breathing b. Pyuria
c. Peripheral edema d. Pulmonary congestion
20‫د‬ Blood and urine analysis confirm a diagnosis of salicylate overdose‫ د‬The client is
treated with gastric lavage‫ د‬Which of the following positions would be most appropriate for
the client during this procedure?
a. Lateral b. Trednelenburgs
c. Supine d. Lithotomy
20‫د‬ The nurse is changing a dressing and providing wound care‫ د‬Which activity should she
perform first?
a. Assessing the drainage in the dressing.
b. Slowly remove the soiled dressing.
c. Wash her hands thoroughly.
d. Put on latex gloves.
20‫د‬ Which of the following defines orthopnea?

a) Difficulty ambulating
b) Difficulty breathing with movement
c) Difficulty breathing while sitting upright
d) Difficulty in breathing when lying flat
20‫د‬ Nursing responsibilities before the thoracentesis should include:

a) Encourage pt. to refrain coughing
b) Making sure that the pt. immobilized during the procedure
c) Seeing that the consent from has been explained and signed
d) All of the above
20‫ د‬The patient is in the recovery room following chest surgery and complains of severe
nausea‫ د‬The nurse should first:
a) Administer an analgesic.
b) Apply a cool cloth to the patient's forehead.
c) Offer the patient a small amount of ice chips.
d) Turn the patient completely to one side.
20‫ د‬What is the first assessment the recovery room nurse makes on a newly admitted
patient?
a. Heart rate
b. Nail perfusion
c. Core temperature
d. Patency of the airway
20‫د‬ The oxygen delivery device they provide the least O2 concentration is :
a) A Partial rebreather mask b) A nasal cannula
c) A rebreather mask d) A simple mask

21‫ د‬A 78-year-old patient is scheduled for a total hip replacement‫ د‬Which of the factors
should be considered during the preparation in the operating room?
a. The patient should be placed in Trendelenburg position.
b. The patient must be firmly restrained at all times.
c. Pressure points should be assessed and well padded.
d. The preoperative shave should be done by the circulating nurse
20‫ د‬An elderly patient is scheduled for surgery under a general anesthetic‫ د‬The nurse
should monitor the patient for which side effect of the surgery and anesthesia that is
common in elderly patients?
a. Hypothermia
b. Pulmonary edema
c. Cerebral ischemia
d. Increased ability to resist stress
20‫ د‬What is the purpose of teaching a patient leg exercises prior to surgery?
a. Leg exercises increase the patient's appetite postoperatively.
b. Leg exercises improve circulation and prevent blood clots.
c. Leg exercises help to prevent pressure sores to the sacrum.
d. Leg exercise help increase the patient's level of consciousness after surgery.
20‫ د‬What is a potential risk for a patient who has had a difficult intubation?
a. Hyperthermia
b. Tachycardia
c. Hypovolemia
d. Broken teeth
20‫ د‬The patient is having understanding teeth removed‫ د‬The patient will be intubated
during the surgery‫ د‬Which statement best provides rationale for intubation during
a surgical procedure?
a. The tube provides an airway for ventilation.
b. The tube protects the esophagus.
c. The patient may receive an anti-emetic through the tube.
d. The patient's heart rate can be monitored with the tube.
20. The common site for giving intramuscular injections for infants is:
a. dorsogluteal b. ventrogluteal c. vastus lateralis d. rectus femoris
20‫ د‬before you send the is the patient Did he sign the Did he shaved the All of them
patient to the fasting? consent form? site of operation?
operation room, you
must check:
21‫ د‬For the client Speaking loudly Using short Writing all Correcting all
experiencing sentences directions so the of the client’s
expressive aphasia, client can read speech errors
which of the them
following nursing
actions would be
most helpful in
promoting
communication?
22‫ د‬Nonverbal facial expression Body gesture Crying speaking in

communication low voice
includes all of the
following except?
23‫ د‬The purpose of urine Determine the Identify the Determine the Identify the
culture & sensitivity duration of a organism causing a severity of a organism and
is to? urinary infection urinary infection urinary infection. its sensitivity
to antibiotics
24‫ د‬You are eating in a to perform to perform chest to encourage to place the
restaurant and abdominal thrusts thrusts forceful coughing victim in a
someone shouts, supine
"Help ! my husband position
is choking‫"د‬, the first
suggested action will
be?
25‫ د‬The client’s chest Notify the Clamp the chest Raise the level of Reconnect the
tube accidentally physician tube the drainage bottle tube
disconnected from
the drainage tube‫د‬
Which of the
following actions the
nurse take first?
26‫ د‬The recommended Subcutaneous Intramuscular Intermittent Deep gluteal

parenteral route for injection with injection in the infusion intramuscular
administering iron weekly site deltoid muscle injection,
preparations is? rotation using a Z
track method
27‫ د‬The first Swelling Pain Redness Hotness

manifestation of
inflammation is?
28‫ د‬Febrile convulsions Generalized Limited to upper Limited to lower Non of these

usually? limps limps
29‫ د‬The most effective Having separate Frequent hand Using disposable Isolating
way to decrease the personal care items washing equipment people known
spread of for each person whenever possible to be having
microorganisms is? infection
30‫ د‬All of the following Static and limited Based on Within the legal The steps of
are characteristics of clinical practice. knowledge. scope of nursing. the nursing
the nursing process process are
except? organized and
systemic.
31‫ د‬All the following are Carditis. Polyarthritis. Chorea. Arthralgia.

major signs of
rheumatic fever
EXCEPT?
rheumatic fever is is an abnormal means joint
an inflammatory disease that involuntary movem pain
can involve ent disorder, group
the heart, joints, skin, of neurological
and brain disorders called
dyskinesias
32‫ د‬Dr prescribed 500 cc 42 dpm. 15 ml/m. 21dpm. 80 dpm.
G5 % I‫د‬V every 8
hours to mother post
C/S, how many
drops per minute
you will regulate the
solution if the
dropping factor is 20
drops per m?
33‫ د‬Which of the Get patient’s Observe the Wash hands Request the
following nursing consent dressing and type client to
interventions is done and odor of expose the
when examining the drainage if any incision
incision wound and discharge wound
changing the
dressing?
34‫ د‬The nurse enters the Leave the Instruct the patient After few minutes, Wait for the
room to give a medication at the to take the return to that patient to
prescribed bedside and leave medication and patient’s room and return to bed
medication but the the room leave it at the do not leave until and just leave
patient is inside the bedside the patient takes the
bathroom‫ د‬What the medication medication at
should the nurse do? the bedside
35‫د‬ Ineffective Health Imbalanced Adult Failure to Pain related to

The nurse is assigned Maintenance Nutrition: Less Thrive abdominal

to a client with Than Body muscle
jaundice and collects Requirements spasms
the following data:
poor appetite,
complaints of nausea
and two episodes of
emesis in the past 2
hours‫ د‬Which of the
following diagnoses
best acknowledges
the client's
problems?
36‫ د‬Which term refers to Hemorrhage Hematopoiesis Hemoptysis Hematemesis

the expectoration of
blood from the
respiratory tract?
37‫ د‬The nurse is Vital signs Laboratory test Electrocardiograph Patient’s

assessing a result ic (ECG) description of
postoperative adult waveforms pain
patient‫ د‬Which of the
following should the
nurse document as
subjective data?
38‫ د‬The best way to Instruct the patient Instruct the patient Drop the Drop the
instill eye drops is to: to look ahead, and to lock upward, medication into the medication
drop the and drop the inner canthus into the center
medication into the medication into the regardless of eye of the canthus
center of the lower center of the lower position regardless of
lid lid eye position
39‫د‬ A male client is Assess the client’s Provide pain relief Encourage deep Splint the
admitted to the hospital airway breathing and chest wall
with blunt chest coughing with a pillow
trauma after a motor
vehicle accident‫ د‬The
first nursing priority
for this client would be
40‫د‬ A female client is A neck tumor An electrolyte Dehydration Fluid

admitted to the imbalance overload
emergency department
with complaints of chest
pain shortness of breath‫د‬
The nurse’s assessment
reveals jugular vein
distention‫ د‬The nurse
knows that when a client
has jugular vein
distension, it’s typically
due to:
A scrub nurse in the Positioning the Assisting with Applying surgical Handling
operating room has which patient gowning and drapes surgical
responsibility? gloving instruments to
the surgeon
41‫د‬ Independent Active or passive Deep-breathing Diaphragmatic and Prescribing

nursing intervention ROM exercises, and coughing abdominal total
commonly used for body repositioning, exercises with breathing exercises parenteral
immobilized patients and activities of change of position and increased nutrition, and
include all of the daily living every 2 hours hydration vitamin
following EXCEPT: (ADLs) as therapy
tolerated
42‫د‬ Independent Changing the Applying a drying Debriding the Placing the
nursing interventions patient’s position agent such as an ulcer to remove patient in a
commonly used for regularly to antacid to decrease necrotic tissue, whirlpool
patients with pressure minimize pressure moisture at the which can impede bath
ulcers include: ulcer site healing containing
povidone-
iodine
solution as
tolerated
43‫د‬ To prevent the Teach the patient Have the patient Place pillows under Lie in lateral
formation of thrombi to do foot and leg lie still the knee position
in the postoperative exercises
patient, the nurse
should
44‫د‬ When Place the client on Attach the feeding Elevate the head of Cold the
providing a continuous the left side of the bag to the current the bed. formula
enteral feeding, which bed. tubing. before
of the following action administering
is essential for the it.
nurse to do?
45‫د‬ What nursing Use sterile gloves Aspirate urine Open the drainage Disconnect
action is appropriate when obtaining from the tubing bag and pour out the catheter
when obtaining a urine port using a sterile the urine from the
sterile urine specimen syringe tubing and get
from an indwelling urine
catheter to prevent

infection?
46‫د‬ When infusing Essential amino Hyperglycemia Infection Essential fatty

total parenteral acid deficiency acid
nutrition (TPN), the deficiency
nurse should assess the
client for which of the
following
complications?
47‫د‬ The nurse is Stabilize the veins Occlude arterial Distend the veins Immobilize
preparing to start an circulation the arm
intravenous infusion‫د‬
Before inserting the
needle into a vein, the
nurse would apply a
tourniquet to the
client's arm to
accomplish which of
the following?
48‫د‬ When cleaning Clean the incision Clean the incision Clean from the Clean from
the skin around an and drain site and drain site incision to the the drain site
incision and drain site, separately. simultaneously. drain site. to the
which of the following incision.
procedures should the
nurse follow?
49‫د‬ A nurse is Compress the Deliver 12 Perform only two- Use the heel
providing sternum with both breaths/minute person CPR of one hand
cardiopulmonary hands at a depth of for sternal
resuscitation (CPR) to 1½ to 2” (4 to 5 compressions
a child, age 4 years, cm)
the nurse should:
50‫د‬ Early clinical A non tender lump Asymmetry of the Nipple retraction Pain in the
manifestations of breasts breast tissue
breast carcinoma )mass)
include all of the
following EXCEPT?
51‫ د‬A nurse is caring for client Position the client Elevate the head Use tongue Loosen
who begins to experience on the side with depressor between restrictive
seizure while in be Which head flexed teeth clothing
action should the nurse forward
implement to prevent
aspiration?

Pharmacology Questions
52‫د‬ In anticipate of further emergency treatment for a client with salicylate overdose,
which of the following medications should the nurse have available?
a) Vitamin K b) Atropine sulfate
c) Dextrose 50%. d) Sodium thioslfate
20‫د‬ Thrombolytic drugs do which of the following?

a) Dissolve clots
b) Prevent recurrence of cholesterol deposit
c) Work with nitroglycerin to relieve pain
d) Decrease anxiety for MI patients
20‫د‬ A major risk for anticoagulants and thrombolytic drugs is:

a) Hypercalcemia b) Hypokalemia
c) Hypotension d) Hemorrhage
e)
20‫د‬ The only insulin preparation that may be administered I‫د‬V is:
a) Regular insulin b) NPH
c) Insulin zinc suspension d) Ultralent
20‫د‬ When aminophyllin administered rapidly, The following effects may result:
a) Hypotension, bradycardia b) Hypertension, bradycardia
c) Hypotension, tachycardia d) Hypertension, tachycardia
20‫د‬ The drug of choice for typhoid fever is:

a) Vancomycin b) Chloramphenicol
c) Dalacin d) Erythromycin
20. All of the following are side effect of vancomycin EXCEPT:

a) Ototoxicity b) Nephrotoxicity
c) Neurotoxicity d) hypotension
20‫د‬ The which used for ulcerative colitis is:

a) Salazopyrin b) Nystatin
c) Penicillin d) Sulfa
20. All of the following are effect of adrenergic drug EXCEPT:

a) Increase heart rate b) Vasoconstriction
c) Bronchospasm d) Respiratory stimulation

20‫د‬ The action of ventolin is:
a) Bronchospasm b) Vasoconstriction
c) Vasodilatation d) Bronchodilation
20‫د‬ The most important side effect of ventolin is:

a) Nausea b) Vomiting
c) Tachycardia d) drowsiness
20‫د‬ Symptoms of Acamol toxicity include:

a) Nephrotoxicity b) Hepatotoxicity
c) Ototoxicity d) Neurotoxicity
20. All of the following are contraindication of antihistamines EXCEPT:

a) Hypersensitivity b) Sneezing
c) Pregnancy d) Comatose patient
20‫د‬ Aspirin is classified as;

a) Antipyretic b) Analgesic
c) Anti-inflammatory d) All of the mentioned above
20. Flagyle is used to treat the following condition EXCEPT:

a) Amebiasis and trichomonasis b) Amebic liver disease
c) Pericarditis d) Amebic dysentery
20‫د‬ A drug useful in treatment of Gout is:

a) Zyloric acide b) Diclofen
c) Colchicin d) Rufenal
20‫ د‬To dissolve the embolus, which

of the following medication will Coumadin Heparin Streptokinase Aspirin
be given?
21‫ د‬Which if the following is
Bone marrow Allergic
suspected complication of Sepsis Hemoptysis
depression reaction
cehpalosporine antibiotic?
Cyanocobol
protamine
22‫ د‬Antidote for heparin overdose? vitamin K vitamin E amine
sulfate
23‫ د‬The nurse is caring for a client Dyspnea Ascites and Petechiae Gynecomast
with liver cirrhosis‫ د‬Which and fatigue orthopnea ia and
assessment findings indicate testicular
that the client has deficient atrophy
vitamin K absorption caused by

this hepatic disease?
Hypotensio
n resulting
Hypotension Hypotension
from
24‫ د‬Dopamine is useful in treating? Hypertension secondary to secondary to
decreased
anemia anesthesia
cardiac
output
25‫ د‬For a child taking cortisone Detecting Maintaining
Preventing Stimulating
therapy, the primary goal will evidence of good body
infection. appetite.
be? edema. image.
To relax
To promote To stimulate To relieve
26‫ د‬What is the primary purpose of smooth
efficient the medullary spasms of
administering aminophylline to muscles in
pulmonary respiratory the
a client with emphysema? the
circulation center diaphragm
bronchioles
27‫ د‬The nurse in charge must
monitor a patient receiving
Bone
chloramphenicol for adverse Lethal Malignant Status
marrow
drug reaction‫ د‬What is the most arrhythmias hypertension epilepticus
suppression
toxic reaction to
chloramphenicol?
28‫ د‬The nurse monitors the serum

electrolyte levels of a client who
is taking digoxin (Lanoxin)‫د‬ Hypomagne Hypocalcemi Hypokalemi
Hyponatremia
Which of the following semia a a
electrolyte imbalances is a
common cause of digitalis
toxicity?
Pediatric
1‫د‬ When caring for the child with cystic fibrosis the nurse should:
a) perform postural drainage b) encourage active exercise
c) prevent coughing d) provide small frequent feedings

Cystic fibrosis: is a genetic disorder that affects mostly the lungs but also the pancreas, liver,
kidneys and intestine. Long-term issues include difficulty breathing and coughing up sputum as a
result of frequent lung infections.
The sweat test measures the concentration of chloride that is excreted in sweat. It is used to
screen for cystic fibrosis
1. All of the following may be side effect of phototherapy EXCEPT:

a) skin rash b) dehydration
c) decreased temperature d) lethargy
1. The nursing care of brochiolitis will include the use of:

a) suctioning , increased fluid intake and administration of medication
b) careful administration of fluids and medications
c) suctioning and increase fluid intake
d) careful observation , charting and suctioning
1‫د‬ Comfortable position in the bed for patient having bronchial asthma is:
a) Lying flat on his back b) sitting upright in bed
c) lying on his abdomen d) reclining on her left side
1‫د‬ The physician orders to give 500 ml‫ د‬of I‫د‬V fluids every 10 hours, the drop factor is
60 drops/ml‫ د‬How many drops of fluids should be infused each minute:
a) 50 drops b) 25 drops
c) 42 drops d) 63 drops
6‫د‬ Which of the following nursing measures is most likely to help infant with
cleft lip and palate on feeding:
a) bubble him at frequent interval b) feed him small amount at a time
c) place the nipple on the back of his d) hold him in a lying position while
tongue feeding him
A cleft lip contains an opening in the upper lip that may extend into the nose. The opening may
be on one side, both sides, or in the middle.
A cleft palate is when the roof of the mouth contains an opening into the nose.
An infant with a cleft lip and palate typically swallows large amounts of air while being fed and
therefore should be bubbled frequently. The soft palate defect allows air to drawn into pharynx
with each swallow of formula. The stomach becomes distended with air, regurgitation, possibly
with aspiration is likely if the infant is not bubbled frequently. Feeding frequently even in small
amounts would not prevent swallowing of large amount of air. Other answers lead to
regurgitation and aspiration
1. A newborn that needs recurrent suctioning of mucus from his mouth several hours
after birth is suspected as suffering from:
a) Tracheoesophageal fistula b) Hyaline membrane disease
c) Bronchopneumonia d) Pharyngitis
Tracheoesophageal fistula: is an abnormal connection (fistula) between the esophagusand

the trachea. It is suggested in a newborn by copious salivation associated
with choking, coughing, vomiting, and cyanosis coincident with the onset of feeding.
Respiratory distress syndrome of newborn, or increasingly surfactant deficiency
disorder (SDD),called hyaline membrane disease (HMD), is
a syndrome in premature infants caused by developmental insufficiency of surfactant production
and structural immaturity in the lungs
Bronchopneumonia acute inflammation of the walls of the bronchioles
Pharyngitis is the inflammation of the pharynx. cough or fever
1. The main cause of respiratory distress syndrome is:

a) Unknown b) In adequate amount of surfactant
c) Diabetes d) Fetal stress
1‫د‬ Treatment of intussusceptions usually starts in the first 24 hours by

a) Hydrostatic barium enema b) Resection and anastomosis
c) Surgery d) All of these
when a part of the ileum or jejunum prolapses into itself.
1‫د‬ The primary sign of Esophageal atresia disease is:

a) Excessive salivation b) Vomiting
c) Constipation d) Abdominal distension
Esophageal atresia: is a congenital medical condition (birth defect) which affects the alimentary
tract. It causes the esophagus to end in a blind-ended pouch rather than connecting normally to
the stomach.
The presence of EA is suspected in an infant with excessive salivation (drooling) and in a
newborn with drooling that is frequently accompanied by choking, coughing and sneezing. When
fed, these infants swallow normally but begin to cough and struggle as the fluid returns through
the nose and mouth.
1‫د‬ Patient complaining of Vomiting is at risk for:

a) Respiratory acidosis b) Metabolic acidosis
c) Respiratory alkalosis d) Metabolic alkalosis
1‫د‬ A newborn complaining of jelly like stool, this is a primary sign

a) Hirshsprung disease b) Intussuception
c) Tracheoesophageal fistula d) Pyloric stenosis
Pain is intermittent—not because the intussusception temporarily resolves, but because the
intussuscepted bowel segment transiently stops contracting. Later signs include rectal bleeding,
often with "red currant jelly" stool (stool mixed with blood and mucus
1‫د‬ Diet of celiac disease should be low in:

a) Fat b) Fat soluble vitamins
c) Sugar d) All of these
Celiac disease: is an autoimmune disorder of the small intestine, it is a disorder involving

intolerance to the protein gluten which is found in wheat. The stool malodorous, large and soft,
diarrhea.
Coeliac disease is a condition that causes inflammation in the lining of the small intestine. The
lining of small intestine contains millions of tiny tube-shaped structures called villi. These help
food and nutrients to be digested more effectively into the body. But in people with coeliac
disease, the villi become flattened as a result of the inflammation. This means that food and
nutrients are not so readily digested by the body.
The symptoms can be kept away by having a diet free from gluten, People with coeliac disease
have an increased risk of developing complications such as osteoporosis
Managing coeliac disease simply involves removing all sources of gluten from your diet.
1‫ د‬After the nurse provides

dietary restrictions to the “Well follow “Our child must “Our child must “We’ll follow
parents of a child with these instructions maintain these maintain these these instructions
celiac disease, which until our child’s dietary dietary until our child has
statement by the parents symptoms restrictions until restrictions completely grown
indicates effective disappear.” adulthood.” lifelong.” and developed.”
teaching?
2‫د‬ Diagnosis of celiac disease does all of the following EXCEPT:

a) Stool analysis b) D-xylose test
c) Sweat test d) Intestinal biopsy
D-xylose test to diagnose conditions that present with malabsorption due to defects in the
integrity of the gastrointestinal mucosa
1‫د‬ To diagnose the condition of Hirschsprung disease you should do:

a) Rectal biopsy b) Stool analysis
c) Intestinal biopsy d) Sweat test
Hirschsprung's disease: part of the colon lacks these nerve bodies that regulate the activity of the
colon. The affected segment of the colon cannot relax and pass stool through the colon, creating
an obstruction. In most affected people, the disorder affects the part of the colon that is nearest
the anus. Rectal biopsy show a lack of ganglionic nerve cells
1. All of the following congenital cause of intestinal obstruction EXCEPT

a) Pyloric stenosis b) Hirschprng's disease
c) Intussusceptions d) Imperforated anus
Causes of Intussusceptions: appendicitis, divirticulum, polyps
1‫د‬ The most common Bacterial organism which cause pneumonia is:
a) Para influenza b) Deno organism
c) Pneumococcus d) RSV (Respiratory syncytial virus)
1. In bacterial meningitis all the following may be observed during CSF analysis
results EXCEPT:
a) high cells count b) high sugar
c) high protein d) turbidity
CSF: examined for presence and types of white blood cells, red blood cells, protein content
and glucose level The concentration of glucose in CSF is normally above 40% of that in blood.
In bacterial meningitis it is typically lower.
Neck rigidity, fever
1‫د‬ The main cause of physiologic jaundice in neonates is:

a) viral hepatitis b) drug-induced hepatitis
c) immaturity of liver d) ABO incompatibility
1‫د‬ The ultimate goal for the nurse to child who has acute gastroenteritis is:
a) Maintain hydration, electrolyte balance
b) Take complete assessment form family
c) Take V/S
d) Give antibiotics
1‫د‬ A newborn has a meningomyelocele; the nurse should place him in which position:
a) semi-Fowler's b) supine
c) prone d) non of the above is correct
Myelomeningocele also known as open spina bifida: is a birth defect where there is incomplete
closing of the backbone and membranes around the spinal cord
1. All the following nursing measures may be done for a premature baby under
phototherapy related to hyperbilirubinemia EXCEPT:
a) changing position frequently every two hours
b) unshielded gonads and eyes
c) monitoring body temperature
d) follow up for serum bilirubin levels
1‫د‬ All of the following may present with Acute glomerulonephritis EXCEPT
a) Bacteruria b) Hematuria
c) Proteinuria d) Oliguria
Acute glomerulonephritis is a disorder of the glomeruli (glomerulonephritis), or small blood

vessels in the kidneys. It is a common complication of bacterial infections, typically skin
infection by Streptococcus bacteria
1. Treatment of sickle cell crises should include

a) Correction of acidosis b) Fluids, oxygen
c) Heparin, pain management d) Factor 8, adequate oxygen
1. For a child taking cortisone therapy, the primary goal will be
a) Preventing infection b) Detecting evidence of edema
c) Stimulating appetite d) Maintaining good body image
e)
1‫د‬ A common finding in most children with congenital heart disease
a) Mental retardation b) Delayed physical growth
c) Clubbing of fingers d) Cyanosis

1‫د‬ Diagnosis of congenital heart disease usually through
a) Cardiac catheterization b) Chest x-ray and ECG
c) Echocardiogram d) All of the above
1‫د‬ Management of bacterial meningitis may include all the following EXCEPT
a) Isolation b) Oral antibiotics
c) Quiet environment d) Monitoring convulsions
Untreated, bacterial meningitis is almost always fatal
A newborn’s failure to pass meconium within the first 24 hours after birth may indicate
which of the following?
a.Hirschsprung disease
b. Celiac disease
c. Intussusceptions
d. Abdominal wall defect
Answer A
Failure to pass meconium within the first 24 hours after birth may be an indication
of Hirschsprung disease, a congenital anomaly resulting in mechanical obstruction due to
inadequate motility in an intestinal segment. Failure to pass meconium is not associated with
celiac disease, intussusception, or abdominal wall defect
1‫د‬ The most dangerous complication of untreated hypothyroidism is

a) Mental retardation b) Hypertension
c) Low weight gain d) Sensitivity to heat
The most dangerous

complication of
Lethargy poor feeding Kernicterus Jaundice in the eyes
hyperbilirubinemia in
newborn is?
Kernicterus is a bilirubin-induced brain dysfunction. Bilirubin is a highly neurotoxic substance that may become
elevated in the serum, a condition known as hyperbilirubinemia.
Normal Apgar Score at
Below 3 Below 6 Above 7 Above 10
first minute is?
No‫د‬ Sign 0 1 2
1 Heart rate Absent Below 100/min 100/min or higher
2 Respiratory effort Absent Slow, irregular Good & strong crying
3 Muscle tone Flaccid Minimal flexion Active motion
4 Reflex irritability No response Minimal response to stimuli Respond promptly
5 Colour Blue, pale Body pink, extremities blue Completely pink

a) Infant’s scoring 7-10 are free of immediate stress
b) Infant’s scoring 4-6 are moderately depressed
c) Infant’s scoring 0-3 are severely depressed
During oral Iron therapy No need for Caution the mother

preparation for Administer making mouth that iron medication
On full stomach
administration to anemic between meals care after causes the child’s stool
child, it is best to? administration white in color
Ferrous sulfate may cause constipation and upset stomach, stools dark
discolor your teeth. You can brush them
This medication should be taken on an empty stomach, at least 1 hour before or 2 hours after eating. Ferrous sulfate
usually is taken three times a day between meals
For a child with acute

glomerulonephritis and
Encourage fluid Monitor blood
impaired renal functions, Bed rest Restrict protein diet
intake pressure
you may do all the
following EXCEPT?
All the following are from
Fallot's Hypoplastic left
cyanotic congenital heart V.S.D. T.G.A.
tetraology ventricle
diseases except?
Cyanotic heart disease refers to a group of many different heart defects that are present at birth (congenital)
that result in a low blood oxygen level.
that occurs due to deoxygenated blood bypassing the lungs and entering the systemic circulation or a mixture of
oxygenated and unoxygenated blood entering the systemic circulation.
Tetralogy of Fallot
The classic form includes four defects of the heart and its major blood vessels:
Ventricular septal defect (hole between the right and left ventricles)
Narrowing of the pulmonary outflow tract (the valve and artery that connect the heart with the lungs)
Overriding aorta (the artery that carries oxygen-rich blood to the body) that is shifted over the right ventricle and
ventricular septal defect, instead of coming out only from the left ventricle
Thickened wall of the right ventricle (right ventricular hypertrophy)
Hypoplastic left heart syndrome (HLHS) is a rare congenital heart defect in which the left ventricle of the heart is
severely underdeveloped.
T‫د‬G‫د‬A‫ د‬Transposition of the great vessels is a heart defect that occurs from birth (congenital). The two major
vessels that carry blood away from the heart -- the aorta and the pulmonary artery -- are switched (transposed).
Acyanotic heart defect occurs when shunting (flowing) of blood occurs from the left side of the heart to the right
side of the heart due to a structural defect (hole) in the interventricular septum
Ventricular septal defect (VSD) (30% of all congenital heart defects)
Atrioventricular septal defect (AVSD)
Atrial septal defect (ASD)
Patent ductus arteriosus (PDA) is a congenital disorder in the heart wherein a neonate's ductus arteriosus fails to
close after birth
For a child taking cortisone Maintaining good
Preventing Detecting evidence Stimulating
therapy, the primary goal body image.
infection. of edema. appetite.
will be? 1
Which of the following
CSF results does not High protein
Turbid CSF High cell count High sugar
present with bacterial 3
meningitis?
Febrile convulsions Limited to upper Limited to Non of these
Generalized
usually? limps lower limps 1
All of the following are
White blood cells
classified as natural Vaccinations Skin Cilia
1
immunity EXCEPT?
All the following nursing
changing
measures may be done for monitoring follow up for serum
position unshielded gonads
a premature baby under body bilirubin levels
frequently every & eyes
phototherapy related to temperature 2
two hours
hyperbilirubinemia except:
1. During postoperative assessment of the neonate, the nurse would look for which initial signs of
hydrocephalus
a) Distended scalp veins and vomiting
b) Plugging fontanel and sunset eyes
c) Increased head circumference and bulging fontanel
d) Irritability and cry
1. What clinical manifestations suggest hydrocephalus in an infant?

a. Closed fontanel, high-pitched cry
b. Bulging fontanel, dilated scalp veins
c. Constant low-pitched cry, restlessness
d. Depressed fontanel, decreased blood pressure
ANS: B
Bulging fontanels, dilated scalp veins, and separated sutures are clinical
manifestations of hydrocephalus in neonates. Closed fontanel, high-pitched cry,
constant low-pitched cry, restlessness, depressed fontanel, and decreased blood
pressure are not clinical manifestations of hydrocephalus, but all should be referred
for evaluation.
The main cause of
Inadequate amount Fetal stress
respiratory distress Unknown Diabetes
of surfactant 2
syndrome for newborns is:
To diagnose the condition
Intestinal Sweat test
of Hirschsprung disease Rectal biopsy Stool analysis
biopsy 1
you should do:
All of the following may be
decreased lethargy
side effects of phototherapy skin rash dehydration
temperature 3
Except:
A child with epilepsy Notify the Put the child on his Administer Administer
suddenly starts to convulse, anticonvulsant
physician side oxygen
your first action will be 2
All the following nursing
Restraining Recording the events
measures are suitable for Keeping patent Place child on his
child’s of convulsion
child with convulsions air way side
extremities 3
except?
In a child suffering from
recurrent pneumonia and
Repeated throat Repeated blood count
retarded development, one Sweat test Chest x-ray
swabs 1
should advise the following
test:
An inborn error of
metabolism that causes Celiac Disease
G6PD Hemocystinuria Phenylketonuria
premature destruction of 1
RBC?
G6PD is a genetic condition that predisposes to hemolysis (spontaneous destruction of red blood cells) and
resultant jaundice in
(PKU) is an inborn error of metabolism involving impaired metabolism of phenylalanine, one of the amino acids.
Homocystinuria represents a group of hereditary metabolic disorders characterized by an accumulation of the amino
acid homocysteine in the serumand an increased excretion of homocysteine in the urine.
A nurse is caring for an

infant with spina bifida‫د‬ Measuring head
Obtaining skull X- Performing a Magnetic resonance
Which technique is most circumference
ray lumbar puncture imaging (MRI)
important in recognizing
possible hydrocephalus?
2‫د‬ Which of the following is true concerning rheumatic fever?

a) it is usually associated with glomerulonephritis
b) symptoms disappear shortly after the fever decrease and the temperature returns to
normal
c) the child should resume normal activities as soon as she feels well
d) it usually follows a streptococcal infection
Which of the following Group A Beta-
organisms is responsible Streptococcal Haemophilus Staphylococcus hemolytic
for the development of pneumonia influenza aureus streptococcus
rheumatic fever?
A 4-month-old with
meningococcal meningitis Instituting Obtaining
Administering Orienting the parents
has just been admitted to respiratory history
acetaminophen to the pediatric unit
the pediatric unit‫ د‬Which isolation information
(Paracetamol)
nursing intervention has precautions from the parents
the highest priority?
When caring for an 11- A reduced white A decreased Shallow Tachypnea
month-old infant with blood cell count platelet count respirations
dehydration and metabolic
acidosis, the nurse expects
to see which of the
following
Maternity
sharp pains painless

spotting in the
1‫د‬ Symptoms of placenta in the bleeding in the watery discharge
early months
previa would include? absence of last months of prior to birth
of pregnancy
bleeding pregnancy
Bleeding in the first trimester of pregnancy is quite common and may be due to the following:
 Miscarriage (pregnancy loss)
 Ectopic pregnancy (pregnancy outside the uterus, usually in the fallopian tube)
 Infection
Placenta previa is a condition in which the placenta is attached close to or covering the cervix
(opening of the uterus).
The greatest risk of p3lacenta previa is bleeding (or hemorrhage). Bleeding often occurs as the
lower part of the uterus thins during the third trimester of pregnancy in preparation for labor
The most common symptom of placenta previa is vaginal bleeding that is bright red and not
associated with abdominal tenderness or pain, especially in the third trimester of pregnancy
Placental abruption is the premature separation of a placenta from its implantation site in the
uterus. Within the placenta are many blood vessels that allow the transfer of nutrients to the fetus
from the mother
Placental abruption is dangerous because of the risk of uncontrolled bleeding (hemorrhage), with
less oxygen and nutrients going to the baby. Although severe placental abruption is rare, other
complications may include the following:
 Hemorrhage and shock
 Disseminated vascular coagulation (DIC)--a serious blood clotting complication.
 Poor blood flow and damage to kidneys or brain
 Stillbirth
 Hemorrhage during labor

The most common symptom of placental abruption is dark red vaginal bleeding with pain during
the third trimester of pregnancy.
 Vaginal bleeding
 Abdominal pain
 Uterine contractions that do not relax
 Blood in amniotic fluid
 Nausea
 Thirst
 Faint feeling
delivery of removal of bulging of the complete cervical

2‫د‬The 2nd stage of labor ends with?
the baby the placenta perineum dilation
Stages of Labour
1‫ د‬Stage of Cervical Dilation
 Begins with the first true labour contractions and ends with complete dilation of
cervix (10 cm dilation).
 It’s the longest stage of labour
a) Latent phase: occur from 0 to 3 cm dilation
b) Active phase: occur from 4-7 cm dilation
c) Transitional phase: occur from 8-10 cm dilation
1‫ د‬Second Stage of Labour = Stage of Expulsion

 Begins with complete dilation of cervix and ends with birth of fetus.
1‫ د‬Third Stage of Labour = Placental Stage

 Begins with delivery of the fetus and ends with delivery of the placenta.
1‫ د‬Fourth Stage of Labour

 Begins with delivery of placenta and continue until the postpartum condition
when the woman becomes stabilized usually 2 hour after delivery.
3‫د‬ The main goal for management of ectopic pregnancy:

a) To remove ectopic pregnancy and preserve productive function of the tube
b) To restore fetus life
c) To restore mother life
d) To decrease mother pain
Ectopic pregnancy: refers to embeds of a fertilized ovum in any place other than the
endometrium of the uterus
3‫د‬ An Ultra sound is done to confirm that the client has an ectopic Pregnancy‫ د‬The
nurse explains that in an ectopic implantation of the fertilized ovum most commonly occurs
in the‫د‬
a) Intro uterine lining b) Ovary
c) Fallopian tube d) Peritoneal cavity

3‫د‬ Which of the following is true about the function of the amniotic fluid:
a) It allows for growth and free movement of the fetus.
b) It equalizes pressure and protects the fetus.
c) It maintains a constant temperature for the fetus.
d) All of the above
3‫د‬ The following are true about the umbilical cord EXCEPT:
a) It extends from the fetus to the placenta and transmits the umbilical vessels.
b) It has two arteries and one vein.
c) It has two veins and one artery.
d) It has two veins and two artery.
3‫د‬ All the following are true about pre-eclampsia EXCEPT:

a) It occurs at multigravida and over 35 years old.
b) It is associated with hydatiform mole, multiple pregnancy and maternal diabetics.
c) The pathology is well known.
d) It is a disease of theories.
Preeclampsia
 Syndrome of pregnancy-induced hypertension manifested by hypertension, proteinuria,
edema and frequently other organ system disturbances.
 Etiology: Unknown but there are some theories illustrate the condition:
o Uterine ischemia.
o Autoimmune disease.
 Risk factors:
 Primigravida, multiple gestation and family history of preeclampsia or eclampsia.
 Diabetes mellitus, chronic hypertensive vascular, autoimmune or renal disease.
 Extremes of maternal age (younger than 20 or older than 35 years)
Hydatidiform mole is a malignant tumor of the trophoblast with a tendency toward rapid and
widespread metastasis. S & S: Painless bleeding
3‫د‬ Fertilization usually occurs in the:

a) Uterus b) Vagina
c) fallopian tube d) Cervix
3‫د‬ Which of the following symptoms are considered positive signs of pregnancy:
a) Amenorrhea
b) Frequency of urination
c) Heaviness and tingling in breasts
d) Ultra sound
3‫د‬ A pregnant client's last menstrual period began on October 12‫ د‬The nurse calculates
the estimated date of delivery (EDD) as:
a) June 5 b) June 19
c) July 5 d) July 19
+1 year =
−3 months =
+7 days =
Situation:
Mona is pregnant for the first time. She visited the clinic when she was thirty weeks pregnant.
She complained of swollen feet, legs, and hands. She also had headache, blurred vision,
excessive weight gain, blood pressure of 144/96 and +2 proteinuria.
3‫د‬ What is Mona’s diagnosis?
a) Essential hypertension b) Pre-eclampsia
c) Eclampsia d) Glomeruonephritis
Eclampsia is the onset of seizures (convulsions) in a woman with pre-eclampsia. Pre-eclampsia

is a disorder of pregnancy in which there is high blood pressure and either large amounts
of protein in the urine or other organ dysfunction
hypertension and proteinuria before the onset of a convulsion, the hallmark of eclampsia
 High blood pressure above 160 / 110 mm Hg, Increase in the quantity of protein in urine,
Abdominal pain, Oliguria, and Loss of consciousness
3‫د‬ Increasing of Mona’s weight result from:

a) Retention of sodium and water b) Increased blood pressure
c) Increase progesterone level d) Kidney lesion
Progesterone is Natural diuretic

3‫د‬ A client with pregnancy-induced hypertension (PIH) probably exhibits which of the
following symptoms?
a) Proteinuria, headaches, and vaginal bleeding
b) Headaches, double vision, and vaginal bleeding
c) Proteinuria, headaches, and double vision
d) Proteinuria, double vision, and uterine contractions
3‫د‬ The nurse is caring for a 16-year-old pregnant client‫ د‬The client is taking an iron
supplement‫ د‬What should this client drink to increase the absorption of iron?
a) A glass of milk b) A cup of hot tea
c) A liquid antacid d) A glass of orange juice
3‫د‬ A client is in the 8th month of pregnancy‫ د‬To enhance cardiac output and renal
function, the nurse should advise her to use which body position?
a) Right lateral b) Left lateral
c) Supine d) Semi-Fowler's
Supine position: pressure of gravid uterus on the inferior vena cava and lead to reduction in
venous return
3‫د‬ A client who's 2 months pregnant complains of urinary frequency and says she gets
up several times at night to go to the bathroom‫ د‬She denies other urinary symptoms‫ د‬How
should the nurse intervene?
a) Advise the client to decrease her daily fluid intake
b) Refer the client to a urologist for further investigation
c) Explain that urinary frequency isn't a sign of urinary tract infection (UTI)
d) Explain that urinary frequency is expected during the first trimester
3‫د‬ The nurse is assessing a pregnant woman‫ د‬Which signs or symptoms indicate a
hydatidiform mole?
a) Rapid fetal heart tones b) Abnormally high (HCG) levels
c) Slow uterine growth d) Lack of symptoms of pregnancy
 HCG are elevated up to 1 to 2 million IU in 24 hours (Normal hCG at 10 week ≈
400,000 IU).
 Their presence in the urine is accepted as a sign of pregnancy (shown 8-10 days after
conception in the maternal serum), and an excessive amount is present in the case of
hydatidiform moles
3‫د‬ During a routine prenatal visit, a pregnant client reports heartburn‫ د‬To minimize
her discomfort, the nurse should include which suggestion in the plan of care?
a) Eat small, frequent meals b) Limit fluid intake sharply
c) Drink more citrus juice d) Take sodium bicarbonate
3‫د‬ Which of the following is a characteristic of true labor contraction:

a) Cervical dilatation does not occur
b) Discomfort is usually located in the abdomen
c) Contraction occur at regular interval and close together
d) Contraction may relieve by walking
3‫د‬ Labor is divided into how many stages?

a) Five b) Three
c) Two d) Four
3‫د‬ A multiparous client is admitted to the labor and delivery area with painless vaginal
bleeding‫ د‬Ultrasonography shows that an edge of her placenta meets but doesn't occlude
the rim of the cervical os‫ د‬This finding suggests:
a) placenta previa. b) A low-lying placenta.
c) Abruptio placentae. d) None of them
Para: delivery , mulitparous
Gravid: pregnant
True Labor False Labor

Contractions occur at regular intervals, last 30 to 60 Contractions usually not regular.
seconds. Contractions do not get closer together; may
Contractions get gradually closer together and stronger. stop after an hour or so.
Contractions may be felt in your back and lower Contractions not usually felt in your back
abdomen. Contractions stop with walking.
Contractions continue or increase with walking. Discomfort does not increase.
There is increasing discomfort. Your cervix does not change.
Your cervix softens, shortens, and dilates.
3‫د‬ Which of the following should be the nurse's initial action immediately following the
birth of the baby?
a) Aspirating mucus from the infant's nose and mouth
b) Drying the infant to stabilize the infant's temperature
c) Promoting parental bonding
d) Identifying the newborn
3‫د‬ Which of the following describes the rationale for administering vitamin K to every
newborn ?
a) Infants don't receive the clotting factor in uterus.
b) The infant lacks intestinal flora to make the vitamin.
c) It increase the minimal level of vitamin K found in the infant.
d) The drug prevents the development of phenylketonuria (PKU).
Vitamin K is made naturally in the intestine but as newborn babies have very little bacteria in
their intestine they do not make enough. As your baby grows they will start to make enough
vitamin K
3‫د‬ Which of the following would the nurse expect to assess as presumptive signs of
pregnancy ?
a) Amenorrhea and nausea & vomiting
b) Uterine enlargement and Chadwick's sign
c) A positive pregnancy test and a fetal outline
d) Braxton Hicks contractions and Hegar's sign
Chadwick's sign is a bluish discoloration of the cervix, vagina, and labia resulting from
increased blood flow, It can be observed as early as 6 to 8 weeks after conception, its presence is
an early sign of pregnancy.
Hegar's sign a softening in the consistency of the uterus, and the uterus and cervix seem to be
two separate regions, 4–6 weeks
Braxton Hicks contractions : uterine contractions that sometimes start around six weeks into a
pregnancy , tightening of the uterine muscles for one to two minutes
What is the
midwifery
Take the
immediate action Change the
Test fluid with pH paper. Count the fetal heart rate. mother blood 3
after artificial wet bedding.
pressure
rupture of
membranes?
Artificial rupture of membranes (AROM), also known as an amniotom. Reasons:
To induce labor or augment uterine activity.
To enable the doctor or midwife to monitor the baby's heartbeat internally
To check the color of the fluid.
To avoid having the baby aspirate the contents of the amniotic sac at the moment of birth
To help relieving
Eat fruits,
constipation
increase fluid
during Use glycerin suppositories Use a mild
intake and Eat hard food. 2
pregnancy, you as needed. laxative
exercise
should instruct
regularly.
the mother to?
The main
Dealing with
objectives of
minor
antenatal care
Education and information Screening Treatment of complication pregnancy 3
contain all the
associated
following
problems
Except?
Pregnant women
should receive Diet and
educational Personal hygiene, rest, and nutrition Danger signs during All of the
4
messages about exercise during pregnancy during pregnancy above
which of the pregnancy
following?
Procedure that
should be
performed for
every woman Symphysis –fundal Test for
Ultrasound of baby Pelvimetry 1
during routine measurement syphilis
antenatal care at
second
trimester?
Fundal height, is a measure of the size of the uterus used to assess fetal growth and development during pregnancy
12 wks: pubic symphyis
20 wks: umbilicus
36 Xiphoid process
In case of
antepartum Prepare for
Take
hemorrhage, the blood
Vaginal examination assessment Vital signs very frequent 1
nurse can do the transfusion if
and history.
following needed
EXCEPT?
No vaginal examination should be attempted, It may initiate running bleeding from a placenta praevia
Which of the
followings is the
most
Increase Prolonged labor and None of the
predisposing Obesity 3
parity immobility above
factors of
thrombophlebiti
s in puerperium?
All of the Detecting of
following are fetal heart Fetal parts
Visualization of the fetus
positive signs of sounds by Quickening palpated by 3
by ultrasound or X-ray
pregnancy, fetal the examiner
except? stethoscope
Quickening woman starts to feel or perceive fetal movements in the uterus.
3‫د‬ During the first 3 months, which of the following hormones is responsible for maintaining pregnancy?
a) Human chorionic gonadotropin (HCG) b) Progesterone
c) Estrogen d) Relaxin
 HCG: Serve functions as prolonging the life of corpus luteum during pregnancy and inhibit
menstruation.
 Oestrogens are primarily responsible for the conversion of girls into sexually-mature women.
development of breasts, further development of the uterus and vagina
Anew client has

had pregnancy
test to determine
if she is
(HCG) human chorionic follicle stimulating
pregnant, the estrogen progesterone 1
gonadotropin hormone
hormone
responsible for
appositive test
result is?
The hormone
responsible for
the development Luteneizing
Follicle Stimulating
of the ovum Estrogen Progesterone hormone 3
hormone (FSH)
during the (LH)
menstrual cycle
is?
A mother her 12-Aug-09 12-Jan-10 12-Jul-09 12-Sep-10 2
first day of last
menstrual period
was on 5/4/2009
what is her
expected date of
delivery?
The Anti-D is
given within 72
labor abortion Both neither 3
hours to Rh-ve
women after?
Prevention of Rh alloimmunization
Which of the
history of
following is an
previous
indication for hypotonic
cesarean cervical dilation less than 3
the use of prolapse of the cord uterine 4
section more cms
oxytocin for contractions
than five
your client in
years ago
labor?
Fertilization
usually occurs in
uterus Vagina fallopian tube Cervix 3
the:
Several minutes
after a vaginal
delivery, nursing
assessment
reveals blood
gushing from the
Uterine
client’s vagina, Cervical or vaginal Placental Postpartum
involution 2
umbilical cord laceration separation hemorrhage
(shrinkage)
lengthening, and
a globular-
shaped uterus‫د‬
The nurse
should suspect
which condition?
Which of the
following would
the nurse most
likely expect to
find when
Rigid, Premature
assessing a Titanic uterine
Excessive vaginal bleeding boardlike rupture of 2
pregnant client contractions
abdomen membranes
with abruption
placenta?
In placenta External Lower segment of the Lower

Internal cervical os partly
previa cervical os uterus with the edges near portion of the 3
covering the opening
marginalis, the slightly the internal cervical os uterus
completely
placenta is found covering the
covering the
at the opening
cervix
The nurse notes
a swelling on the
neonate’s scalp Ca
Perinatal
that crosses the Cephallic hematoma put Hemorrhage edema 2
caput
suture line‫ د‬The succedaneum.
nurse documents
this condition as:
Caput succedaneum presents as a scalp swelling that extends across the midline and over suture lines and is
associated with head molding. Caput succedaneum does not usually cause complications and usually resolves over
the first few days. caused by the pressure of the presenting part of the scalp against the dilating cervix
The first thing

that a nurse No part of the
The cord
must ensure cord is The cord is still
The cord is intact is still 2
when the baby’s encircling the attached to the placenta
pulsating
head comes out baby’s neck
is
During the
fourth stage of
labor, the most Breast Bowel
Uterine atony Degree of pain 1
important engorgement movement
assessment
should be for:
A nurse is caring
for a client in
labor‫ د‬The
external fetal
Prepare for
monitor shows a Check for
emergency
pattern of Change the client’s position Administer oxygen placenta 1
cesarean
variable previa
section
decelerations in
fetal heart rate‫د‬
What should the
nurse do first?
Variable decelerations in fetal heart rate are bad sign, indicating compression of the umbilical cord. Changing the
client’s position from supine to side-lying may immediately correct the problem. An emergency cesarean section is
necessary only if other measures, such as changing position. Administering oxygen may be helpful, but the priority
is to change the woman’s position and relieve cord compression.
The normal
110 to 160 140 to 180
range of FHR is 90 to 140 bpm 100 to 140 bpm 2
bpm bpm
approximately:
Which of the Cervical dilatation does not Discomfort is Contractions are more Contraction 3
following is a occur usually frequent and have some may be
characteristic of located in the type of regular pattern relieved by
true labor abdomen walking

contraction:
During a routine
prenatal visit, a
pregnant client
reports
heartburn‫ د‬To Take
Limit fluid
minimize her Eat small, frequent meals Drink more citrus juice sodium 1
intake
discomfort, the bicarbonate
nurse should
include which
suggestion in the
plan of care?
After teaching a pregnant woman who is in labor about the purpose of the episiotomy, which of the following
purposes stated by the client would indicate to the nurse that the teaching was effective?
a. Ensures quick placenta delivery
b. Shortens the second stage of labor,
c. Prevents perineal edema.
d. Enlarges the pelvic inlet
An episiotomy serves several purposes. It shortens the second stage of labor, substitutes a clean surgical incision
for a tear. An episiotomy helps prevent tearing of the rectum
The nurse in charge is caring for a postpartum client who had a vaginal delivery with a midline episiotomy‫د‬
Which nursing diagnosis takes priority for this client?
a. Risk for infection related to the type of delivery
b. Pain related to the type of incision
c. Risk for deficient fluid volume related to hemorrhage
d. Urinary retention related to periurethral edema
Hemorrhage jeopardizes the client’s oxygen supply — the first priority among human physiologic needs.
Therefore, the nursing diagnosis of Risk for deficient fluid volume related to hemorrhage takes priority over
diagnoses of Risk for infection, Pain, and Urinary retention.
A client with
pregnancy-
induced Headaches, Proteinuria,
hypertension Proteinuria, headaches, and double vision, Proteinuria, headaches, double vision,
3
(PIH) probably vaginal bleeding and vaginal and double vision and uterine
exhibits which of bleeding contractions
the following
symptoms?
A pregnant
client's last
menstrual period
began on
October 12‫ د‬The Jun-05 Jun-19 July 5 July 19 4
nurse calculates
the estimated
date of delivery
(EDD) as:

The ultrasound
was done for
Salwa as a
routine
procedure‫ د‬The
result showed
that Salwa has
an ectopic
Peritoneal
Pregnancy‫ د‬The Intro uterine lining Ovary Fallopian tube 3
cavity
nurse explains
that in ectopic
pregnancy,
implantation of
the fertilized
ovum most
commonly
occurs in:
Fever, foul
lochial discharge
and puerperal hypertensive
puerperal psychosis postpartum hemorrhage 2
subinvolution of sepsis disorder
the uterus are
signs of:
Lochial discharge of blood, mucus, and tissue
puerperal sepsis is any bacterial infection of the female reproductive tract following childbirth or miscarriage. Signs
and symptoms usually include a fever greater than 38.0 °C, chills, lower abdominal pain, and possibly bad-
smelling vaginal discharge. It usually occurs after the first 24 hours and within the first ten days following delivery.
Sudden gush of
blood or
lengthening of
the cord after placental abruption
placenta previa placental retention 2
the delivery of separation placenta
infant should
warn the nurse
of:
Because of the
position of the
fetus, an
episiotomy has
to be performed
to enlarge the it is more heals more
it is more difficult to repair it involve a more blood
birth canal‫د‬ painful than faster than 4
than laceration loss than laceration
Which of the laceration laceration
following is an
advantage of
episiotomy over
lacerations
(tear)?

Which is a
pushing of abdominal
primary power uterine contractions intrathoracic pressure 1
the mother contraction
of labor?
The time
between uterine intensity interval duration frequency 2
contractions is:
During which of
the following
phase of the
menstrual cycle Menstrual Secretory
Ischemic phase Proliferative phase 4
is it ideal for phase phase
implantation of a
fertilized egg to
occur?
Menstrual phase :Menstruation is triggered by reduced levels of the hormones estrogen and progesterone at the end
of the previous menstrual cycle. The onset of a new menstrual period indicates that the woman is not pregnant. .
The proliferative phase: is the second phase of the uterine cycle when estrogen causes the lining of the uterus to
grow, or proliferate, during this time
Ischemic phase: period lasting 1 or 2 days; the ischemia results in shrinkage and degeneration of the endometrium.
Secretory phase: The progesterone and the estrogen are at a high level during the secretory phase, and they help
prepare the endometrium to secrete nutrients that would nourish a conceptus if a fertilized egg were to implant in it.
If conception and implantation do not occur, the pituitary gland will reduce LH and FSH production.
Which of the
history of
following is an
previous
indication for hypotonic
cesarean cervical dilation less than
the use of prolapse of the cord uterine 4
section more 3 cms
oxytocin for contractions
than five
your client in
years ago
labor?
The Anti-D is
given within 72
baby Rh both either positive or Father Rh
hours to Rh baby Rh negative 3
positive negative negative
negative women
if:
A mother her
first day of last
menstrual period
8 December
was on 15/3/2012 22-Nov-12 22 December 2012 8-Nov-12 3
2012
what is her
expected date of
delivery:
Which of the
followings is the
most
Increase
predisposing Obesity Early ambulation immobility 4
parity
factors of
thrombophlebiti
s in puerperium?
The nurse
teaches a client
scheduled for an
intravenous
pyelogram (IVP)
what to expect
when the dye is
injected‫ د‬The
nurse would
know that the A metallic taste
Flushing of
client has Chest pain Cold chills 4
the face
correctly ‫معدني‬
understood what
was taught when
he states that he
may experience
which of the
following
sensations when
the dye is
injected?
Magnesium sulfate is used to prevent or stop seizures (eclampsia) during pregnancy.

Prevent seizures in a woman with moderate to severe preeclampsia. When magnesium sulfate is
used during labor and delivery,
symptoms of magnesium toxicity (nausea, muscle weakness, loss of reflexes) occur during
magnesium sulfate treatment.
1‫د‬ A Diabetic patient was amputated following an unexpected necrosis on the right
leg, he sustained and undergone BKA (below knee amputation)‫ د‬He then underwent
therapy on how to use his new prosthetic leg‫ د‬this is a type of what level of prevention?
a) primary b) secondary
c) tertiary d) none of above
2. All of the following are live attenuated vaccine EXCEPT

a) Mumps b) Sabine
c) Pertussis d) BCG
Attenuation takes an infectious agent and alters it so that it becomes harmless or less virulent.
An attenuated vaccine is a vaccine created by reducing the virulence of a pathogen, but still
keeping it viable (or "live").
Viral: measles vaccine, mumps vaccine, rubella vaccine, chicken pox vaccine, oral polio
vaccine (Sabin).
Bacterial: BCG vaccine, typhoid vaccine
Inactivated vaccine: killing the microbe with chemicals, heat or radiation. Such vaccine are more
stable and safer than live vaccine. The dead microbes cant mutate back to their disease causing
state. Inactivated vaccine usually don’t require refrigeration. Such as: Pertussis and IPV
inactivated polio vaccine
2‫د‬ Which of the following vaccines never be frozen
a) DTP b) BCG
c) Measles d) MMR
2‫د‬ The best temperature to keep vaccine in refrigerator is

a) 2-8 º C b) 2-4 º C
c) 0-10 º C d) 0-6 º C
2‫د‬ The best site for BCG vaccine administration is

a) Intramuscular b) subcutaneous
c) intradermal d) oral
Intra-dermal: BCG
Oral: OPV
SC: Measles
IM: hep., TT, DPT
2‫د‬ Which of the following are primary causes of death among infant stage
a) congenital anomalies b) sudden infant death syndrome
c) respiratory distress syndrome d) all of the above
2‫د‬ Which the following vaccine are given to protect from Diphtheria and tetanus
disease ‫ د‬it should suitable for children old than six year and pregnant woman
a) TT b) Measles
c) Td d) DTP
Five doses: between 2 months and 15 years
2‫د‬ An incidence rate of a disease refer to:

a) the measurement of the existing number of cases identified in a given population
b) the measurement of the number of new cases identified in a given period of time
c) how the community health nurse determines the risk factors of the disease
d) the measurement of the entire population at risk in designed area.
Incidence is the rate of new (or newly diagnosed) cases of the disease. It is generally reported as
the number of new cases occurring within a period of time (e.g., per month, per year).
Prevalence is the actual number of cases alive, with the disease either during a period of time
(period prevalence) or at a particular date in time (point prevalence).
2‫د‬ Palestinian health care system consider :
a) social welfare system b) free enterprise system
c) Transition system d) comprehensive system
A social welfare system is a program that provides assistance to needy individuals and families.
An economic system where few restrictions are placed on business activities. This system aims
for limited restrictions on trade and minimal government intervention.
Transitional care refers to the coordination and continuity of health care during a movement from
one healthcare setting to either another or to home, called care transition
Comprehensive health care system: coordination, physical, psychosocial, spiritual, referral,
research, evidence base, holistic…..
2‫د‬ One a advantage of the home visit for the community health nurse includes:
a) being able to control environmental distraction.
b) understanding client life style is easier in family residence.
c) client transportation concern are a non relevant personal situation.
d) non of the above.
2‫د‬ Immunization is example of:

a) active natural immunity b) active artificial immunity
c) passive natural immunity d) passive artificial immunity
Naturally acquired active immunity occurs when the person is exposed to a live pathogen,
develops the disease, and becomes immune as a result of the primary immune response.
Naturally acquired passive immunity occurs during pregnancy, in which certain antibodies are
passed from the maternal into the fetal bloodstream.
Artificially acquired active immunity can be induced by a vaccine, a substance that contains the
antigen. A vaccine stimulates a primary response against the antigen without causing symptoms
of the disease.
Artificially acquired passive immunity is a short-term immunization by the injection of

antibodies, such as gamma globulin, that are not produced by the recipient's cells.
2‫ د‬Which of the following is natural active immunity

a) acquired through host infection b) anti titanic serum
c) antibodies from mother to baby by milk d) immunization
2‫د‬ The preventive services in which a special test or standardized examination

procedure is used to identify patients requiring special intervention called
a) Screening b) promotion
c) prevention d) evaluation
Screening, in medicine, is a strategy used in a population to identify an unrecognized disease in
individuals without signs or symptoms

Promotion: the process of enabling people to increase control over their health
2‫د‬ Crude mortality rate may be defined as :

a) number of deaths occurring in a calendar year per the number of the total population during
the same period multiplied by 1000
b) number of death of infant under 1 year of age per 1000 live births
c) number of death of a woman while pregnant per 1000 number of live birth
d) number of deaths occurring in a calendar year per the number of the total death of
population during the same period multiplied by 100000
Crude death rate – the total number of deaths per year per 1,000 people
Infant mortality rate – the number of deaths of children less than 1 year old per 1,000 live
births.
2‫د‬ The host , environment and agent are constitute part of the
a) wheel model b) epidemiological cycle
c) epidemiological triangle d) prospective study
2‫د‬ Which the following phrases best serves as a definition of epidemiology

a) science that with the incidence , distribution, determinate and control of health and
illness in population
b) science that with the incidence and prevalence of disease among population
c) science that study specific disease develops in the population
d) non of the above
2‫د‬ A female client undergoes yearly mammography‫ د‬This is a type of what level of
prevention?
a) primary b) secondary
c) tertiary d) none of above
The child return to the clinic post DPT vaccine with convulsion so the nurse decided to
a. deprivation the child from DPT
b. give the child DT next visit
c. child need admission to treat the convulsion
d. tell him that DPT vaccine not related to convulsions
1. a and b 2. b and c 3. c and d 4. a and d
DPT-induced recurrent seizures and acute encephalopathy in a child possibly due to pertussis
fraction.
An example of an environmental assessment tools is

a) APGAR family function
b) echomap
c) genogram
d) family map
APGAR family function: To assess a family member’s perception of family functioning by

examining his/her satisfaction with family relationships.
Echomap:a family assessment tool consisting of a graphic representation of a family relationship
with its environment.
A genogram is a pictorial display of a person's family relationships and medical history
which of the following is / are element of primary health care

a. health education
b. immunization
c. endemic disease control
d. all of the above
Epidemic: An outbreak of disease that attacks many people’s at about the same time and may
spread through one or several communities
Epidemic: Diseases sometimes spread rapidly and grow in the total number of people they affect
over a given time and place
Pandemic: When an epidemic spreads throughout the world
Endemic: a disease that exists permanently in a particular region or population.
2‫ د‬Presence of an event at much higher frequency than expected or normal in
community from past in short period time
a. epidemic
b. pandemic
c. endemic
d. all of the above
2. A viral infection characterized by red blotchy rash and koplik’s spots in the mouth
is:
a) Rubeola b) Rubella
c) Chicken pox d) Mumps
Rubella and rubeola share similar names. Both are caused by a virus. Both cause a skin rash.
Rubella is also called German measles. Rubella can be a serious disease for a pregnant woman.
is an infection caused by the rubella virus.
The rash of rubella (German measles) is pink or light red, spotted, and lasts up to three days.
Other symptoms may include one to two days of a mild fever, swollen lymph nodes and joint
swelling
The rash of rubeola (regular measles) is a full-body red or reddish-brown rash. However the first
symptom is usually a hacking cough, runny nose and high fever.
Additionally, a common marker found in measles are Koplik spots, which appear in the mouth as
small red spots with blue white centers
Chickenpox, also known as varicella, is a highly contagious disease caused by the

initial infection with varicella zoster virus(VZV). The disease results in a characteristic skin rash

that forms small, itchy blisters. It usually starts on the face, chest, and back and then spreads to
the rest of the body
2‫د‬ Orchitis and sterility in male result as serious complication of

a) Rubella b) Measles
c) Mumps d) Diphtheria
The community health nurse

should determine an event at
much higher frequency than
all answer are
expected or normal in a epidemic pandemic endemic 1
correct
community from past usually
in short period of time; this
event called?
Immunization of a child to
prevent measles belongs to Primary Secondary Intermediate Tertiary 1
what level of prevention?
An .
Which of the following would
Safe water and immunization Adequate Cardiac
not include under the primary 4
clean air program for public housing. transplant
health care :
preschoolers surgery.
Is a problem-
Seeks to make
Characterized solving Is one in which
each of its
by minimum community; it members have a
systems
A Healthy Community is all citizen identifies, high degree of
resources 1
of the following except : participation in analyzes, and awareness that
available to all
decision organizes to "we are a
members of the
making. meet its own community".
community.
needs.
The acquired
knowledge that
the family A kind of
How will the
members use to nursing practice
family function None of the
Family health means : generate their in which the 2
together as a above.
behavior that family is the
unit.
influence family unit of service.
structure and
function.
Family is the unit of services in all health care delivery

To identify
To review the To identify the
The Community Health To identify strengths and
morbidity and biology and
Nurse’s primary purpose economic deficiencies in
mortality chemical of the 3
when assessing the community situation of the relation to
statistics of the community .env
is to : client. preventive
community. irnment
health practices.
Perform several
Conduct a nursing care
during the first visit it is most Begin building complete measurements Arrange for
important for the community trustful assessment of to convince the several more 1
health nurse to: relationship the family and family that he visits
the patient knows what he
is doing
The antibodies transferred Passive natural Active natural artificial

TB immunity 1
from mother to baby give him: immunity immunity immunity
Giving
instructions and
Which of the following is health education A mammogram Rehabilitation
Infant
considered as a secondary to preparatory screening test of a patient with 3
vaccination
preventive measure? school students for breast cancer limb amputation
who are not
smoking
Nurse Sbreen is teaching the Explaining Encouraging

Keeping a night
parents of a school-age child‫د‬ Prevent normalcy of the child to
light on to allay 1
Which teaching topic should accidents fears about body dress without
(decrease) fears
take priority? integrity help
Fatma gave birth to a term

baby with yellowish skin and
sclera‫ د‬The baby is placed on Low serum Normal RBC Low platelet
O2 level of 99% 1
phototherapy‫ د‬The treatment bilirubin and WBC count count
is effective when blood test
shows:
A couple with one child had

been trying, without success
for several years to have Primary Secondary Irreversible
Sterility 2
another child‫ د‬Which of the Infertility Infertility infertility
following terms would
describe the situation?
Infertility is the inability of a person to reproduce by natural means
Primary infertility refers to couples who have not become pregnant after at least 1 year having sex without using
birth control methods.
Secondary infertility refers to couples who have been able to get pregnant at least once, but now are unable.
Infertility is caused by many sources, including nutrition, diseases, and other malformations of the uterus.
Psychiatric
1‫د‬ Paranoid personality disorder is example of:
a) Cluster A personality disorder b) Cluster B personality disorder
c) Cluster C personality disorder d) Cluster D personality disorder
Personality disorders are a class of mental disorders characterized by maladaptive patterns of

behavior, cognition, and inner experience, exhibited across many contexts and deviating
markedly from those accepted by the individual's culture.
Cluster A (odd disorders) These disorders are often associated with schizophrenia
Paranoid personality disorder:
Schizoid personality disorder
Schizotypal personality disorder
Schizophrenia is a mental disorder often characterized by abnormal social behavior and failure
to recognize what is real. Common symptoms include false beliefs, unclear or confused thinking,
and auditory hallucinations
Cluster B (dramatic, emotional or changeable disorders)
Antisocial personality disorder
Borderline personality disorder
Histrionic personality disorder: ( attention-seeking)
Narcissistic personality disorder:
Cluster C (anxious or fearful disorders)
Avoidant personality disorder
Dependent personality disorder
Obsessive-compulsive personality disorder
Other personality disorders
Personality change due to another medical condition
2‫د‬ All of the following are clinical symptoms occur during anorexia nervosa ECEXPT‫د‬
a) Behavioral symptoms b) Physical symptoms
c) Psychological symptoms d) Endocrine symptoms
Anorexia nervosa is an eating disorder characterized by a low weight, fear of gaining weight, a
strong desire to be thin, and food restriction. Some will exercise excessively, force themselves
to vomit, or use laxatives to produce weight loss
Bulimia nervosa, is an eating disorder characterized by eating a large amount of food in a short
amount of time and vomiting or taking a laxative.
2‫د‬ All of the following are indication to Electro-Convulsive Therapy (ECT) EXCEPT
a) Severe depression b) Catatonic schizophrenia
c) Hyperactivity manic patients d) Epilepsy
Electroconvulsive therapy: referred to as shock treatment, is a standard psychiatric treatment in
which seizures are electrically induced in patients to provide relief from psychiatric illnesses
2‫د‬ Fatma female patient 30 years, admitted to psychiatric hospital with impulsivity
feeling emptiness , difficult being alone ,with suicidal ideation , Fatma is experiencing:
a) Borderline personality disorder b) Avoidant personality disorder
c) Histrionic personality disorder d) Paranoid personality disorder
Borderline personality disorder: pervasive pattern of instability in relationships, self-image,

identity, behavior and affects often leading to self-harm and impulsivity
Histrionic personality disorder: pervasive pattern of attention-seeking behavior and excessive
emotions.
Paranoid personality disorder: characterized by a pattern of irrational suspicion and mistrust of
others
Avoidant personality disorder: pervasive feelings of social inhibition and inadequacy, extreme
sensitivity to negative evaluation.
2‫د‬ Chlorpromazine (Largactil) is :

a) Antipsychotic b) Anti anxiety
c) Anti depressant d) Anti Parkinsonism
2‫د‬ Trihexphenidyl hydrochloride (Artane ) is:

a) Antipsychotic b) Anti anxiety
c) Anti depressant d) Anti Parkinsonism
Trihexphenidyl hydrochloride (Artane) is used for the symptomatic treatment of Parkinson's

disease
Parkinson's diseaseis a degenerative disorder of the central nervous system mainly affecting
the motor system.
Parkinson's disease can cause neuropsychiatric disturbances which can range from mild to
severe. This includes disorders of speech, cognition, mood, behaviour, and thought
2‫د‬ Which of the following phrases most accurately defines the term phobia:
a) Persistent, irrational fear of an objectively non-threatening object or situation
b) Repetitive, persistent, intrusive ideas, thoughts, images or impulses
c) A specified set of rules governing the performance of ritual like behaviors
d) A tendency to exhibit an exaggerated startle response even in non-threatening
situations
2‫د‬ An individual experience chronic anxiety that is: uncomfortable an intense, along
with tension and somatic manifestation this person eventually seeks treatment, which of the
following diagnosis most likely applied to him:
a) Panic attack b) Panic disorder
c) Generalized anxiety d) Depression
Generalized anxiety disorder is an anxiety disorder characterized by excessive, uncontrollable

and often irrational worry, that is, apprehensive expectation about events or activities
Panic attacks are periods of intense fear or apprehension of sudden onset accompanied by at
least four or more bodily or cognitive symptoms (such as heart palpitations, dizziness, shortness
of breath, or feelings of unreality) and of variable duration from minutes to hours. Panic attacks
usually begin abruptly and may reach a peak within 10 to 20 minutes but may continue for hours
in some cases. Panic attacks are not dangerous and should not cause any physical harm.
Panic disorder is an anxiety disorder characterized by recurring panic attacks, causing a series
of intense occurrence of extreme anxiety during panic attacks.
Depression is a state of low mood and aversion to activity that can affect a person's thoughts,
behavior, feelings and sense of well-being.[1][2] People with depressed mood can feel
sad, anxious, empty, hopeless, helpless, worthless, guilty, irritable..
Agoraphobia (fear of public places)

aquaphobia , hydrophobe (water)
photophobia (light)
2‫د‬ Hallucination is the following phrase EXCEPT :

a) Occur only in mentally
b) Is misinterpretation of external stimuli
c) Auditory hallucination associated with schizophrenia
d) Visual hallucination suggests organic cause
2. All of the following are mental health team EXCEPT:

a) Psychiatrist b) Psychiatric nurse
c) Psychiatric social worker d) Family
2‫د‬ All of these etiology for schizophrenia EXCEPT:

a) Increase dopamine level in the brain b) Family theory (double bind)
c) Genetic d) Stress life style
Genetics and early environment, as well as psychological and social processes, appear to be
important contributory factors.
Loss of False fixed

Thinking
Delusion is connection Subjective disorder of sensory believes not
disturbances and
known as? with reality perception. supported by
hallucination.
and logic. logic.
* Delusion: this is an irrational belief that someone holds in spite of strong evidence to the contrary
* Illusion: this is where the body's senses are trick ‫( )خدعة‬to see things that aren't there (or distorted versions of
what is there). This can come from optical effects, or from glitches ‫ خلل‬in the sensory system.
* Hallucination: when your brain create images that aren't there and perceives them as real.
Which one Hallucination occur There is no There are
Perception is impaired in psychosis
of the in psychosis insight in personality
following
change in
statement is neurosis
psychosis
false
A neurotic disorder can be any mental imbalance that causes or results in distress. In general, neurotic
conditions do not impair or interfere with normal day to day functions, but rather create the very
common symptoms of depression, anxiety, or stress. It is believed that most people suffer from some sort of
neurosis as a part of human nature
Psychosis refers to any mental state that impairs thought, perception, and judgment. Psychotic episodes might
affect a person with or without a mental disease. A person experiencing a psychotic episode might hallucinate,
become paranoid, or experience a change in personality.
The nurse is
planning to
care for a
client
diagnosed Altered
with nutrition: Impaired
Risk for violence
schizophrenia‫د‬ less than Ineffective family coping verbal
for self or others
Which body communication
nursing requirement
diagnosis
should receive
the highest
priority?
The
individual
who
Restricting Keeping the
demonstrates Calling attention to
the client client busy to
obsessive the behavior. Supporting but limiting the behavior.
movements. distract him.
compulsive
behavior can
be treated by?
Obsessive–compulsive disorder (OCD) is a mental disorder where people feel the need to check things
repeatedly, have certain thoughts repeatedly, or feel they need to perform certain routines repeatedly.
The most
nursing
diagnosis in Sensory
Altered thought High risk for
the patient perceptual Impaired skin integrity
process injury.
with alternation.
delusional
disorder is:
Hopelessness, Dementia Acute psychosis Depressive
loss of energy, Manic episode.
sleep episode
disturbances,
isolation and
suicidal

ideation"
indicated
which of the
following
coexisting
mental
disorder?
The most accurate definition of depression as used in psychiatry is?

Disturbance mood as reaction to the loss of a love object.
Major
depression
episodes Thoughts about
Can not enjoy life Hyperactive Trouble (disorder) in concentration
include all of death
the following
except:
Anger,
Denial, anger,
The stages of Numbness, anger, loneliness,
Depression, guilt, identification and bargaining,
grieving are resolution, and depression,
resolution depression and
identified as: reorganization and
acceptance
resolution

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‫مراجعة شاملة‬

‫‪Dr. Motasem Said Salah‬‬ ‫‪motasem_salah@hotmail.com‬‬

2. Atherosclerosis impedes coronary blood flow by which of the following

2‫ د‬Which of the following conditions is most commonly responsible for myocardial

3‫ د‬What supplemental medication is most frequently ordered in conjunction with

5‫ د‬What is the first intervention for a client experiencing myocardial infarction?

6‫ د‬Which of the following classes of medications protects the ischemic myocardium by

Dr. Motasem Said Salah motasem_salah@hotmail.com

7‫ د‬What is the most common complication of a myocardial infarction?

heart failure is the second most common complication.

9‫ د‬Which of the following parameters should be checked before administering digoxin?

Dr. Motasem Said Salah motasem_salah@hotmail.com

13‫ د‬What is the most common cause of abdominal aortic aneurysm?

Dr. Motasem Said Salah motasem_salah@hotmail.com

1‫د‬ Which of the following is a false statement in relation to ECG?

2‫د‬ How should the nurse interpret this pattern?

1. All of the following is considered as a clinical manifestation of hypovolemia,

1‫د‬ Nursing responsibilities before the thoracentesis should include:

1‫د‬ Which of the following defines orthopnea?

1‫د‬ Which of the following symptoms are mainly frequent in pericarditis?

1‫ د‬Which of the following assessment findings indicates hypovolemic shock?

1‫ د‬The underlying pathophysiologic alteration in all types of shock is:

1‫ د‬If non of the following positions is contraindicated, which position would be

C. Provide physical and psychological rest. D‫ د‬Prevent invasive infections.

2‫ د‬The pain associated with Angina pectoris, is due to?

1‫ د‬Which of the following finding is indicative of MI?

2‫ د‬How should the nurse interpret this pattern?

1‫ د‬Estimate the heart rate for this Figure:

2‫د‬ How should the nurse interpret this pattern?

1‫ د‬Dopamine is useful in treating:

1‫د‬ Which of the following statements is correct regarding CVP line:

1‫ د‬The symptoms of decrease CVP are:

1‫ د‬Which of the following is a false diagnosis when the CVP increased:

Dr. Motasem Said Salah motasem_salah@hotmail.com

1. Exercise will be contraindication in all following cases, Except:

4‫ دد…… د‬is a bulbous protrusion of one side of the arterial wall‫د‬

Edema, Weakness, Fatigue, A feeling

8‫ د‬The most common

9‫ د‬Client whose condition is

11‫ د‬When assessing a client with Extensive

12‫د‬ A client who has been admitted

13‫ د‬The most common

Edema, Weakness, Fatigue, A feeling

Supine with Head

16‫ د‬Client whose condition is

19‫ د‬When teaching a 48-year-

A long term Peripheral

Dr. Motasem Said Salah motasem_salah@hotmail.com

1‫د‬ Which of the following is a disadvantage for insertion a femoral line:

Hypokalemia: ECG: flattened T waves, prominent U waves, ST depression, prolonged PR

1‫د‬ Which of the following is correct regarding hypovolemia:

1‫د‬ All of the following is used to manage a cases of hypocalcemia, Except:

Dr. Motasem Said Salah motasem_salah@hotmail.com

Most common cause hypocalcemia – depressed function or surgical removal of the

D5W: isotonic solution , NaCl 0.9%, RL

D10%, 3, 5% NaCl: hypertonic

Hypotonic: 0.45 NaCl

1‫د‬ Which of the following is/are complication of fluid therapy:

1‫د‬ All of the following is considered as a causes for hypokalemia, Except:

1‫د‬ Patient complaining of Vomiting is at risk for:

1. A 57-year-old client is admitted with a diagnosis of acute myocardial infarction‫د‬

1. A 71-year-old client develops hypertension, tachycardia, and increased respirations

1‫ د‬Which disease, explain the term of blue bloater:

4‫د‬ The respiratory center is located in the and __‫د‬