HAAD EXAM  C.

After non-pharmacological

methods fail

A patient requires tracheal suctioning  D. As the patient requests them

through the nose. Which of the following A patient is admitted to a hospital with

nursing acute renal failure. The patient wakes up

action would be incorrect? complaining of abdominal pain. On

 A. Lubricating the catheter with assessment, the nurse observes edema to

sterile water the patient's

 B. Applying suction while ankles and distended neck veins. The

withdrawing the catheter from the patient is dyspneic with a blood pressure

nose of 200/96

 C. Applying suction for a minimum mmHg. The proper nursing diagnosis for

of 30 seconds this patient is:

 D. Rotating the catheter while  A. Deficient fluid volume related to

withdrawing it disease process

Pain management for terminally ill patients  B. Excess fluid volume related to

is most effective when analgesics are decreased glomerular filtration rate

given:  C. Knowledge deficit related to

 A. Around the clock proper medication regimen

 B. Only when clearly needed

  D. Acute pain related to renal  B. Received less than 3 doses of

edema tetanus toxoid

The nurse knows that the greatest risk for  C. Not had a dose of tetanus toxoid

a patient with a ruptured ectopic in the past 4 years

pregnancy is:  D. Not had a dose of tetanus

 A. Hemorrhage leading to toxoid in the past 10 years

hypovolemic shock A 3-month-old infant is admitted with a

 B. Strictures and scarring of the diagnosis of ventricular septal defect. The

fallopian tube physical

 C. Adhesions and scarring from assessment for this infant would reveal:

blood in the abdomen  A. High pitched cry

 D. Infertility resulting from  B. Harsh heart murmur

treatment with a salpingectomy  C. Bradycardia

A trauma patient with open wounds  D. Hypertension

arrives in the emergency department. The The administration of which of the

nurse would following types of parenteral fluids would

know that a tetanus injection is needed if result in a

the patient has: lowering of the osmotic pressure and

 A. Only received 3 doses of tetanus cause the fluid to move into the cells?

toxoid  A. Hypotonic
  B. Isotonic The correct way to trim the toe nails of a

 C. Hypertonic patient with diabetes is to:

 D. Colloid  A. Cut the nails in a curve and then

Nursing management of the patient with file

external otitis includes:  B. Cut the nails straight across and

 A. Irrigating the ear canal with then file

warm saline several hours after  C. File the nails straight across and

instilling lubricating ear drops square only

 B. Inserting an ear wick into the  D. File the nails in a curved arch

external canal before instilling the with low sides only

ear drops to disperse the Salem has Alzheimers disease. He is

medication agitated and repeatedly asks to go home.

 C. Teaching the patient how to The most

instill antibiotic drops into the ear appropriate nursing intervention for him is

canal before swimming to:

 D. Instilling ear drops without the  A. Isolate him in a single room

dropper touching the auricle and  B. Find activities to keep him

positioning the ear upward for 2 occupied

minutes afterwards  C. Ask the physician to discharge

him
  D. Administer a minor tranquillizer  B. Stabilize the heart rate when it is

During the initial pain assessment process, above 100 beats per minute

the nurse should:  C. Stabilize the heart when the

 A. Perform pain relief measures patient has had a heart attack

 B. Teach the patient about pain  D. Regulate the heart when the

therapies patient is going for open heart

 C. Conduct a comprehensive pain surgery

assessment When taking care of a patient who has

 D. Provide appropriate treatment undergone open reduction and internal

and evaluate its effect fixation of a

The immediate treatment for ventricular fractured left tibia, the nurse should keep

fibrillation is: the leg:

 A. Precordial blow  A. Straight to reduce flexion

 B. Defibrillation deformities

 C. Bolus of lidocaine  B. Immobilized to enhance bone

 D. Ventricular pacing healing

The purpose of a cardiac pacemaker is to:  C. Adducted to attain alignment

 A. Initiate and maintain the heart  D. Elevated to minimize venous

rate when SA node is unable to do stasis

so
A nurse prepares to set up a secondary  C. Fill out a medication error

intravenous (IV) cannula. The primary IV reporting form

infusing  D. Assess the patient's condition

is normal saline. In order for the secondary While preparing for a kidney biopsy the

cannula to infuse correctly, the nurse nurse should position the patient:

should set  A. Prone with a sandbag under the

up the primary IV to: abdomen

 A. Hang higher than the secondary  B. Lateral opposite to biopsy site

IV  C. Supine in bed with knee flexion

 B. Hang at the same level as the  D. Lateral flexed knee-chest

secondary IV A patient with a central venous line

 C. Hang lower than the secondary develops sudden clinical manifestations

IV that include a

 D. Discontinue before the decrease in blood pressure, an elevated

secondary IV starts heart rate, cyanosis, tachypnea, and

When discovering a medication error, the changes in

nurse's FIRST action is to? mental status. Which of the following is

 A. Call the nurse supervisor the most likely cause of these symptoms?

 B. Call the physician  A. An air embolism

 B. Circulatory overload
  C. Venous thrombosis physician orders heat packs every 2 hours

 D. Developing bacteremia and you feel this order may worsen the

Order: 1000 ml of D5W to run for 12 hours. tissue

Using a micro drip set calculate the drops congestion. An appropriate nursing action

per would be:

minute (gtts/min):  A. Contact the physician and

 A. 20 gtts/min discuss your concerns about the

 B. 45 gtts/min order

 C. 60 gtts/min  B. To include the order in the

 D. 83 gtts/min nursing care plan and monitor

A patient voided a urine specimen at 9:00 outcome

AM. The specimen should be sent to the  C. Complete an incident report

laboratory before: form and document concerns in

 A. 9:30 AM the nursing notes

 B. 10:00 AM  D. Involve the patient by asking

 C. 10:30 AM what his treatment preference is

 D. 11:00 AM The minimal amount of urine that a post-

An 84-year-old man has arthritis and is operative patient weighing 60 kgs should

admitted for a severely edematous knee. pass is?

The  A. 120 ml/hr

  B. 90 ml/hr  A. Be alert to hypersensitivity

 C. 60 ml/hr response to the prescribed

 D. 30 ml/hr medications

When caring for a patient with impaired  B. Encourages the patient to carry

mobility that occurred as a result of a an epinephrine kit in case of an

stroke (right allergic reaction

sided arm and leg weakness). The nurse  C. Advise the patient to use aspirin

would suggest that the patient use which in case of febrile illnesses

of the  D. Admit the patient to a single

following assistive devices that would room with limited exposure to

provide the best stability for ambulating? health care personnel

 A. Crutches A patient who has just had a miscarriage

 B. Single straight-legged cane at 8 weeks of gestation is admitted to

 C. Quad cane hospital. In

 D. Walker caring for this patient, the nurse should be

While assessing a patient, the nurse learns alert for signs of:

that he has a history of allergic rhinitis,  A. Dehydration

asthma,  B. Subinvolution

and multiple food allergies. The nurse  C. Hemorrhage

must:  D. Hypertension
The nurse should observe for which of the  C. Use the remaining dose within 2

following symptoms in a patient who has hours for another patient

just  D. Pour the remaining dose down

undergone a total thyroidectomy: the nearest sink

 A. Weight gain A patient is to receive 50mL of fluid in 1/2

 B. Depressed reflexes hour (30 min). The infusion pump should

 C. Muscle spasm and twitching be set

 D. Irritable behavior to deliver how many milliters per hour?

A patient is ordered 75mg of pethidine  A. 25 ml/hr

which comes in an ampoule of 100mg/2ml.  B. 50 ml/hr

What  C. 75 ml/hr

would the nurse do with the remaining  D. 100 ml/hr

pethidine after drawing up the required A male patient with a right pleural effusion

dose? noted on a chest X-ray is being prepared

 A. Lock up the remaining dose in for

the medication cupboard to use thoracentesis. The patient experiences

later severe dizziness when sitting upright. To

 B. Ask a fellow staff nurse to provide a

witness the disposal of the safe environment, the nurse assists the

remaining drug
patient to which position for the The best dietary advice a nurse can give to

procedure? a woman diagnosed with mild pregnancy-

 A. Prone with head turned toward induced hypertension is to:

the side supported by a pillow  A. Follow a strict low salt diet

 B. Sims’ position with the head of  B. Restrict fluid intake

the bed flat  C. Increase protein intake

 C. Right side-lying with the head of  D. Maintain a well-balanced diet

the bed elevated 45 degrees A nurse has been working in a general

 D. Left side-lying with the head of hospital on the same medical unit for 6

the bed elevated 45 degrees years. The

After application of a cast in the upper Behavioral Unit is desperately short staffed

extremity, the patient complains of severe and the nurse is asked to work her shift in

pain in the this

affected site. Which of the following would other unit. What would be the expected

the nurse initiate? response of the nurse to this request?

 A. Administer analgesics as ordered  A. "I will go to the unit and

 B. Assess neurovascular status hopefully the behavioral health

 C. Notify his physician staff members will assist me with

 D. Pad the edges of the cast my assignment."

  B. "I cannot go. I have no previous many milligrams are

behavioral health experience. I do available per ml?

not want to reduce the quality of

 A. 0.25 mg/ml
patient care."
 B. 0.5 mg/ml
 C. "I have no previous behavioral
 C. 1 mg/ml
health experience. I am willing to
 D. 2 mg/ml
go and help with any duties that
A patient with pneumonia is coughing up
are similar to those I perform on
purulent thick sputum. Which one of the
my unit."
following
 D. "I should not be expected to
nursing measures is most likely helpful to
float to another unit without a
loosen the secretions?
proper orientation. I will fill out an
 A. Postural drainage
incident report if I am sent there."
 B. Breathing humidified air

 C. Percussion over the affected

A patient is to receive 25mg/hr of an lung

aminophylline infusion. The solution  D. Coughing and deep breathing

prepared by the exercises

pharmacy contains 500mg of A 21 year old woman is being treated for

aminophylline in 1000ml of D5W. How injuries sustained in a car accident. The

patient
has a central venous pressure (CVP) line  B. Administer an antipyretic such as

insitu. The nurse recognizes that CVP aspirin or acetaminophen

measurements:  C. Place ice packs to the neck,

 A. Estimate Cardiac output axillae, scalp and groin

 B. Assess myocardial workload  D. Encourage foods and oral fluids

 C. Determine need for fluid that contain carbohydrates and

replacement electrolytes

 D. Determine ventilation -

perfusion mismatch Thirty minutes after starting a blood

A construction worker was brought to the transfusion a patient develops tachycardia

emergency department and admitted with and

the tachypnea and complains of chills and low

diagnosis of heat stroke due to strenuous back pain. The nurse recognizes these

physical activity during hot weather symptoms as characteristic of:

conditions.  A. Circulatory overload

Which action should the nurse take?  B. Mild allergy

 A. Immediately immerse the patient  C. Febrile response

in cold water to reduce the  D. Hemolytic reaction

patient's temperature As a part of the treatment given to a child

with leukemia the child is placed on

reverse which of the following stages of patient

barrier isolation to: care?

 A. Protect the child from injury  A. Post-operative

 B. Protect the child from infectious  B. Pre-operative

agents  C. Intraoperative

 C. Provide the child with a quiet  D. Post anesthesia

environment To maintain the airway and promote

 D. Keep the child away from other respiratory function, the best position for

children the nurse to

The rationale for having the patient void place the unconscious patient in the Post

before an abdominal paracentesis Anesthesia Care Unit (PACU) is:

procedure is to:  A. Supine

 A. Minimize discomfort  B. Lateral

 B. Avoid abdominal distention  C. Trendelenberg

 C. Prevent bladder puncture  D. Fowler's

 D. Reduce infection rate When the post-operative patient returns

The best time for the nurse to teach an to the surgical unit, the priority is to:

anxious patient about the patient  A. Assess the patient's pain

controlled  B. Measure the patient’s vital signs

analgesic (PCA) pump would be during

  C. Monitor the rate of the IV should be alert

infusion for which of the following side effects?

 D. Check the physician’s post-  A. Constipation

operative orders  B. Flatulence

When taking routine post-operative  C. Nausea

observations on a patient who underwent  D. Vomiting

an A patient with severe, protracted vomiting

exploratory laparotomy, the nurse plans to will often have what electrolyte

monitor which important finding over the abnormality?

next  A. Decreased potassium and

hour? decreased chloride

 A. Serosanguinous drainage on the  B. Increased sodium and decreased

surgical dressing chloride

 B. Blood pressure of 105/65 mmHg  C. Increased potassium and increased

sodium
 C. Urinary output of 20 mls in the

 D. Decreased sodium and increased

last hour
chloride
 D. Temperature of 37.6 °C

A patient has been taking Aluminum

Hydroxide daily for 3 weeks. The nurse


RECENT MOH UAE, DHA AND HAAD LICENSING EXAM QUESTIONS
1. If the patient had duodenum
metastatic cancer to duodenum and
pancreas and not affected to other
body aprts. Which level you will be
assessed —-increased blood sugar
level.RECENT DHA QUESTIONS –
NOVEMEBR -2108:
2. Over infusion of IV fluid to pneumonia
patient what you will assess—skin
colour, nail bed,edema,——
respiratory distress(crackles).
3. Potassium level 2.5 .Plan for surgery .
what option you will choose—Inform
doctor(hypokalemia).
4. Patient is planning for abdominal
surgery . which regular medicine you
will ask patient to stop –warfarin
5. Prothrombin level10.5-before surgery
–what option you will take –
precaution from bleeding, inform
doctor ,continue assessment ———
normal level(continue assessment)
6. Pneumonia patient –cough, green
sputum –which assessment sounds –
broncial , tympanic, bloating,
abdominal bloating.—- tympanic
7. Burn in upper neck, face, and arms –
which arterial pulse you can check—
femoral pulse.
8. Patient with jugular vein distension,
breathing difficulty—hypoxia, edema,
myocardial infection,……..Right
ventricular failure
9. Patient with hair on face , arms
,acne—which hormone level will
increase—cortisole
10. Yearly vaccine —flu vaccine-
Infuenza.
11. If the patient is above 75 years
old . what is the normal process at
his age?—decreased sexual process,
bed rest 10 hours , urinary
incontinence 81 years old. ——
urinary incontinence 81 years old.
12. Baby screening . What assessment
further you will assess or teaching—
capillary, babinski, papillary—
Babinski response
13. Patient comes to you for medication
for diabetic and hypertension. After 2
weeks patient come to you .BP
reading was high. What you will
do?—Recheck BP.
14. Shortenss of breathing after having
medication—–is it—side effect,
 adverse reactions,…,… .—-Side
effects
15. Narcan (naloxone) is the antidote
for—-opiod analagesics
16. Post amputation above knee. You
give pre op analgesic medication for
what?—decrease phantom limb pain.
17. Pictures for moro reflex, rooting
reflexand sucking reflux-asked which
reflex.
18. Ceiliac disease what food should not
give.—-BROW food
19. Constipation patient — –which we
eat –which is bulking food –milk, fruit
juices, wheat.—
20. Antiplatelets discontinue before
surgery–aspirin
21. Angina patient given nitroglycerine—
what action –myocardial contractility,
heart output,cardiac
arrhythmia,……..myocardial
contractility
22. Height and weight table –BMI-height
6feet and 3 inch and weight is 140
lb—ceheck patient is over wight,
underweight, obesteity or normal—–
normal.(140 lb=63.5kg) , 6feet 3
inch=1.9metere. So BMI=
weight/height in metere square=
63.5/3.61=17.59. (so 18 -25 kg/m2 is
normal)
23. Diabetic normal wound –what
dressing you will give for the small
wound—antibiotic ointment,
debridement ointment, gauze
dressing—–dry gauze dressing.
24. Wound is 7.5 inch in arm.You
prepare patient for suturing . which
type of anesthesia you will suggest—
local anesthesia
25. Post mastectomy patient-checked
patient after 2 weeks –your
treatment is effective—-Patient is
closing the cubpord with same
extremity.
26. Pain scale is 6-10 . Which anglagesics
can order—morphine
27. Epidemic survey—
28. You are on duty..Other nurse
comeout and find you , that you are
sleeping —,…….—–
29. You are on duty. You didn’t give
medicine to patient and went outside
with another nurse– Patient right,
criminal law?— negligence
30. Medication rights before giving
medicine—choose correct option –
Right patient-Right drug-Right dose-
Right time-Right route-Right
education-right to refuse-right
assessment-right evaluation-right
documentation.
31. Married men coming to your clinic.
And asked for help—what is your
initial assessment of his problem—
sexual problem.
RECENT DHA QUESTIONS-OCTOBER -2018:
 1. MI patient ECG changes—“T” wave
inversion , ST elevation
2. Hyokalemia signs and symptoms-
3. Gastro esophageal reflux disease-
position- in adults reverse
trendelenburg position
4. Glasgow coma scale—
5. Patient complaints of chest pain –
nitroglycerine given -previous history
of depression. Nurse should ask what
question redarding patient history?—
has taken benzodiazepines in the
morning.
6. MRSA patient isolation method—
strict contact isolation.
7. X-ray diaphragm –patient having
complaints of continous cough,
hemoptysis, crackles—–In xray which
findings?—pneumonia.
8. RSV (pediatric questions)
9. Variant /prince metal angina—it
occurs due to coronary spasm . pain
occurs same time each day . it can
occur at rest.
10. Digoxin:
Digoxin: As a cardiac glycoside action
increase the ventricular contraction and
decrease heart rate. Therapeutic range 0.5
to 2ngm/ml. If the therapeutic range more
than 2ngm/ml –digoxin toxicity.Ionotropic .
Signs of digoxin toxicity: decreased heart
rate, nausea, vomiting, halo ring
vision(greenish yellow circular around the
light)
Antidote-Digibind-digoxin immune fab.
Before giving digoxin should check the
apical pulse if it is <60b/mt in adult or 90-
110b/mt in children—withhold the
digoxin.monitor the posttassium during
digoxin toxicity . administer pottssium rich
food.
CROUP SYNDROME :
Inflammation of respiratory tract (larynx,
trachea, and bronchi)
Causative organism-RSV, para influenza
virus
C/F: Barking cough, hoarsness of voice ,
inspiratory stridor, mild fever.
Mgt: humidified oxygen, hand hygiene ,
tripod position.
Should not give cough syrup or tablets
because it causes thickening of sputum.
Complication : Airway obstruction
Child with tonsillitis and croup syndrome ,
the child may exibit tripod position that the
sign of airway obstruction should notify the
physician
Home care instruction:
Have the client breath night cool air or air
from an open freezer.
11. Post pleural effusion patient during
physical examination which position
–semi fowlers position
12. Pulse volume scale
13. Right side CVA patient exercise—-
14. Parietal lobe function —temperature,
touch, pain perception.
15. Medulla oblongata functions—
respiration, heart rate, bp
16. Occulomotor—3rd cranial nerve—
cause constriction of pupil.
17. Muscle ache due to vigorous exercise
—-cause by lactic acid
18. Crutch—wearing weight on axillae
can cause crutch palsy by pressure
on the brachial plexus , weight
should be supported by the hands
on the cross bars of the crutches.
19. Hemiplegia—paralysis of one side of
the body.
20. Paraplegia—–paralysis of both lower
extremities and lower tgrunk.
21. Paresis od upper and lower
extremity—
22. 23 year old man sickle cell crisis pain
score 10/10. Nursing diagnosis?—
23. Right breast biopsy before doing
procedure , patient ask nurse what is
the post op complication?
24. Descending osteomy site diagram
25. Patient is know case of DM,
complaints of lethargy, poor skin
turgor, nausea, vomiting , -nursing
diagnosis?—
26. After 65 years , which vaccine one to
give?—
27. New born apgar score—-
28. Vaginal surgery position—
29. A client experiences traumatic brain
injury. Which finding identified by the
nurse indicate damage toupper
motor neurons.—a. absent reflexes,
b.flaccid paralysis, c. trousers sign, d.
babinski response —Answer-
babinski response.
30. Multiple sclerosis patients –increased
rsik for—
31. Parkinson patient most tremor when
occurs—
32. Mechanical ventilation
33. Rombergs test-
34. Water intoxication syndrome
35. Define pulse pressure—difference
between systolic and diastolic BP.
36. Growth and development-12 to 20
year old boy –psychological crisis
37. Toddler ——-co-operative play
38. Iron deficiency anemia , leukemia
symptoms—
39. TOF (hypercyanotic/blue spell)which
position—knee chest or quating
position to prevent right to left
shunt.
40. Aortic aneurysm treatment?—
surgical repair
41. Intake and output?—calculation
42. Patient complaints of break down of
nose treatment?—
43. Deep vein thrombosis surgery?—
44. Patient complaints of severe
abdominal pain . abdominal
assessment perform order-
45. Patient having right arm fracture cast
applied.Left lower arm transfusion
going . Patient complaints of pain .
 which site the IV line to be PIAGETS COGNITIVE DEVELOPMENT
changed?—same hand upper area. THEORY:
46. Endoscopy which position— Left  0-2 years-sensori motor
LateralPosition and Prone Position  2-7 years-pre operational-ego
for Endoscopic Retrograde centric-compare with past, present
Cholangiopancreatography.. andfuture
47. A nurse is caring for an anxious ,  7-12years-concrete operational-
fearful client. Which client response mathematical-classification,addition,
indicate sympathetic nervous system substraction.
control—skin pallor.  12 years-adult-formal operational-
48. Sigmoidoscopy complications— abstract , thinking,creative and
Perforation,bleeding and infection. concrete thinking.
49. 20 year old boy Erickson stage –
identity versus role confusion
Developmental mile stones:
2-3month
4-5monthg
AGE 6-7month
CENTRAL TASK
Birth-18 mos 8-9 month
Trust vs Mistrust
1½ to 3 y/o 10-11 month
Autonomy vs Shame & doubt
3 to 6 y/o 12-13 month
Initiative vs guilt
6 to 12 y/o 14-15month
Industry vs Inferiority
12–20 y/o 18th month
Identity vs role confusion
18-25 y/o 24th month
Intimacy vs isolation
25-65 y/o 21/2 yearGenerativity vs stagnation
65 y/o to death 3 year Integrity vs despair

PSYCHO SEXUAL THEORY-SIGMUND 50. Muscle dystrophy mostly after?–

FREUD: appears between the ages of 2
1. Infancy-oral stage and 16but can appear as late as
2. Toddler-anal stage age 25.
3. Pre schooler-phalic stage 51. CVA patient-eating assistance by
4. Schooler-latency stage nurse—encourage client to
5. Adolescents-genital stage participate in feeding process.
52. Hemiparesis client reluctant to use
cane. Nurse explains that cane will
help to —-maintain balance to
improve stability.
53. CVA patient-position should be
changed —- 1 to 2 hours interval
54. CVa patient –prevention of foot drop
by—-
55. Left hemiplegia client—rehabilitation
initiation by nurse—position the
client to prevent contractures.
56. CVA patient –hemiplegia—
exxercise—passive range of motion
exercise.
57. Right hemiplegia pt—nurse checking
BP in right arm –Produces inaccurate
readings.
58. Dysarthria—nursing care—effective
communication
59. Emotional liability is associated with
brain trauma-client often becomes
uncontrollably tearful.
60. Position for CVA patient initially—-
lateral.(absence of gaga reflex is
common after CVA. To prevent
aspiration Lateral position can be
provided)
61. Coma patient –most clinical
indicator—urinary incontinence.
62. Ruptured cerebral aneurysm –most
clinical indicator—sudden severe
headache.
63. Nursing action for a client who
experience hemianopsia—place
objects within the visual field.
64. TIA (trans Ischemic Attack) –more
chance to develop CVa with in 2-5
years.
65. Hydrocephalus 2weeks after cranial
surgery for ruptured cerebral
aneurysm-due to what physiological
response—blocked absorption of
fluid from arachnoid space.
66. Head injury patient –nurseshould
assess for increased ICP-which
clinical indicator should assess—
slowing of heart rate
67. Therapeutic effect of mannitol—
decrease ICP.
68. Before starting chemotherapy what
to do?—monitor for hematological
parameter(blood counts).
69. A nurse should expect to identify loss
of which ability when assessing an
unconscious patient—controlling
elimination.
70. Epiglotitis nursing diagnosis—
71. Head trauma patient –nursing care—
monitor client for signs of brain
injury and symptoms of increased
ICP(headache,dizziness, visual
disturbances, fever ,stupor,
decreased LOC).
72. Thermoregulation centre—-
hypothalamus
 73. Expressive aphasia nursing care—
provide positive feedback when the
client uses a word correctly.
74. Patient had abdominoplasty , having
drainage tube at right thigh. Which
assessment should be doen by
nurse?
75. Patient vitals BP: 80/30, P.R-120?mt,
R.R-20?mt. Abnormal vital signs—
BP: 80/30
76. Urinary tract infection diet—
Cranberry juice
77. TB patient , the nurse is explaining
disease condition . Among the
following reply from patient—
teaching is effective?
78. Child is having inguinal hernia —
further instruction?–
79. After head trauma –client complaints
of ringing ears—which cranial nerve
is affected—vestibulococchlear
nerve(8th)
80. TB transmission-airborne
81. Injury to which part of brain during
an accident –client will not survive—-
medulla oblongata.
82. Client with history of seizure posted
for arteriogram –pt is on NPO-order
of medicine is oral anticonvulasant
1hour before procedure –what the
nurse should do?—ask health care
provider if the drug can be given IV.
83. Cerebrum work?
CENTRAL NERVOUS SYSTEM:
Parts: Brain and spinal cord
Parts of Brain:
-Cerebrum-cerebellum-pons-diencephalon.
Cerebrum:
Frontal lobe-thinking,problem solving,
decision making,cognition
Temporal lobe—hearing, speech, smell , tast
Occipital lobe—viison, and colour
perception
Parietal lobe—perception, pain, pressure ,
temperature, touch
Cerebellum—equilibrium and coordination
Romber’s test:it is used to check the
equilibrium finger to nose co-ordination test.
Medulla: –controls the vital signs
Diencephalon—hypothalamus—
thermoregulation
SPINAL CORD:
It extend from the lower portion of brain
stem C1 to C2.
Covering of brain and spinal cord is
meninges.
Blood supply to brain is cerebral artery.
Anterior cerebral artery syndrome:
 Hemiparesis-hemiplegia-sensory
deficit primarily involving the leg and
perineum-apraxia-urinary
incontinence.
Posterior cerebral artery syndrome:
-contilateral homonymous hemianoxia-
visual agnosia –aphraxia-memory deficit-
chorea-intentional tremor
Basilar artery:
-upper extremity spasm of the hand- PERRLA:-Pupil Equal Round Reacting to
contralateral hemi anesthesia—ptosis Light and Accomodation
AUTONOMIC NERVOUS SYSTEM: 4. Trochlear nerve—upward and
It consist of symapathetic and downward movement of eye and eye
parasympathetic system: muscles.
Sympathetic (anticholinergics) 5. trigeminal –sensory—sensation
Parasympathetic
of (cholinergic)
Dilate the pupil face,cornea,oral and Constrict
nasal mucosa.
the pupil
Increases HR Motor—corneal reflex—chewing
Decreases HR
and
Consist the blood vessels mastication Dilate the blood vessels
Bronchodilation 6. Abduscent –lateral movement
Bronchoconstriction
of the
Decrease GI mobility eye Increases GI mobility
Constrict the sphincter 7. Facial—sensory –anterior
Relaxes
2/3the
rd
ofsphincter
Inhibit secretions taste perception (saltStimulate
and sweet).
secretions
Stimulate production of epinephrine and nor epinephrine Motor-facial expression-smiling
No effect5 and
Dry mouth puffing out. Increased salivation
Neurotransmitter involved is nor epinephrine 8. vestibule cochlear—hearing
Acetyl choline
and
balancing
PERIPHERAL NERVOUS SYSTEM: 9. Glossopharyngeal—sensory –
posterior 1/3rd of taste perception
1.Olfactory –function –smell (tongue)-bitter , sour.Motor-chewing
2. Optic –vision and swalloeing –gag reflex.
3. Occulomotor—movement of eye, 10. vagal nerve—parasympathetic
movement of eyeball, elevation of system. –dcrease Hr—Decrease BP—
upper eyelid , papillary constriction increases secretion—sensation
ASSESSMENT OF PUPILS: behind the ear—helps in
-Unilateral pupil dilatation indicates phonation—production of HCL.—
compression of 3rd cranial nerve gag reflex.
Mid point fluid pupil indicates —mid brian 11. spinal accessory nerve—moveemnt
injury of shoulder and dry
-pin point fixed pupils indicate pons damage 12. hypoglossal –movement of tongue
, dry toxicity or poisoning during swallowing and speaking.
-Bilateral dilated fixed pupils indicate death 13. primary responsibility of a nurse
Normal pupil dilatation is 3-5mm. during generalized motor seizures—
1L 24%
2L 28%+4each
3L 32%
4L 36%
5L 40%
6L 44%
—clearing the immediate C/F: prodrome: “ 3 c’s ”: c ough, c oryza, c
environment for client safety. onjunctivitis, fever, eyelid edema .Koplik
Assessment of temperature: spots (1-2 days before and after rash): small
The elevated temperature increases the white papules on red base of buccal
metabolic rate of the brain. Elevation in mucosa, maculopapular rash spreads over
temperature indicates dysfunction of face and hairline over 3 days
hypothalamus. Complications: secondary bacterial infection
Assessment of respiration: (lung, otitis media, sinusitis)-
1. Chyne stroke respiration –Rhythmic Bronchopneumonia, croup – encephalitis –
with periods of apneoa that indicates ataxia, vomiting, seizures, coma
metabolic dysfunction or dysfunction Treatment: supportive and symptomatic (i.e.
in the cerebral hemisphere or basal Ocular care, appropriate treatment of
ganglia. secondary bacterial infection)-
2. Neurogenic hyperventilation : — immunoglobulin to prevent or modify
3. Midbrain function? disease if administered within 6 days.
4. Measles outbreak in community . 86. Oxygen delivery system:
where to inform?—primary health
centre. method
Measles(Rubeolla): NASAL CANNULA
-paramyxovirus-airborn disease-sources: Simple face mask
direct contact with infected person , NRM(deliver highest con of oxygen)
transplacental route
Venture mask(accurate oxygen)
Period of communicability—from 4 days to
5 days after the rashes appear. . RECENT DHA QUESTIONS –June-2018:
Rashes appears 3-4 days after prodormal 1. Painful vaginal bleeding—abruptio
stage. placenta
Isolation –negative pressure isolation with 2. 12-18month teeth eruption—canine
mask teeth
3. Paresis of ciliary muscles of left eye –
morbillivirus– incubation: 10-14 days – what function nurse should assess—
Infectivity: 4 days pre-rash – spread: droplet focusing the lens on near objects.
4. A client had craniotomy for
meningioma. For what response
nurse assess client in PACU unit—(a.
dehydration, b. blurred vision, c.
wound infection, 4. Narrowing pulse
pressure)—answer-blurred vision.
5. 125ml/hour—drug calculation –to
find out total fluid for 8 hours.
6. Gout increased fluid intake —to
excrete uric acid
7. Glaucoma patient—therapy must be
continued for life to prevent damage
to optic nerve from increased
intraocular pressure.
8. Cystic fibrosis exercise—blowing
bubbles
9. CT contract effects—flushing of face
and sensation of warmth.
10. The nurse assist Dr. to perform
L.P.when pressure is placed on the
jugular vein during L.P.,spinal
pressure is expected to increase.
Which sign the nurse should expect
health care provider to document—-
Queckenstedt sign.(if there is no
obstruction , pressure on the jugular
vein cause increased ICP. This , in
turn , cause Increase in spinal fluid
pressure.
11. Skin lesion on the nose—(picture)
12. After 30 minutes of blood
transfusion, patient having chills and
back ache , nursing action——stop
transfusion.
13. Pain in the right lower quadrant—
14. Apgar score(repeated)
15. When entering a room nurse
identifies that a client is having a
seizure. What should the nurse do
inaddition to protecting the client
from self inury—(a. insert oral airway,
b. monitor the seizure activity, c.turn
the client on left side, d.begin
oxygen by mask at 8L/minute.—
answer: monitor the seizure activity.
16. Glasgow coma scale(repeated)
A client is admitted post traumatic brain
injury and multiple fractures. The clients eye
remains closed , and there is no evidence of
verbalization or movement , when the nurse
changes the position. What score on the
Glasgow coma scale should the nurse
document —–answer:3.
17. Allen’s test—ABG (repeated)
18. Brain tumor in occipital lobe—
cause—visual hallucination.
19. Parotidectomy post op
complication—facial nerve
dysfunction.
20. ABG analysis PH:7.25, pcO2: 39Hco3-
20?—-metabolic acidosis
21. TB—negative pressure room
22. Phenytoin(Dilantin) –control seizure
disorder –discharge advise-“will
probably be continued for life”
23. Rapid accumulation of air in the
pleural space—tension
pneumothorax
PNEUMOTHORAX:
Pneumothorax:
Collapse of a lung resulting by accumulation
of more air in the pleural space.
C/M:
Sudden unilateral pleuritic chest pain, may
be mild discomfort or sharp, that increases
on exertion, dyspnoea, anxiety , drowsiness,
tachycardia, rapid, shallow respirations,
diaphoresis, progressive cyanosis.
Breath sound on affected side are
diminished or absent.
Types:
Closed/sponatenous – No external wound
due to rupture of pulmonary bleb(air filled
spaces) commonly seen in smokers.
Open pneumothorax-due to gun shoot
injury or direct stab wound .Priority mgt:
cover with sterile gauze vented dressing.
Management :
 Provide fowlers position-placement
of ICD-thoracentesis-chest
physiotherapy.
TENSION PNEUMOTHORAX: Rapid
excessive accumulation of air with in the
pleural space as a result of blunt chest injury
(penetrating chest injury). It is due to
increased intra thoracic pressure. Commonly
seen in mechanical ventilation with PEEP . In
this air will entger in lunds but will not leave
Clinical manifestations-unilateral air entry,
mediastinal shift, tracheal deviation towards
unaffected side , severe dyspnea, diminished
or absent breath sound on affected side,
shallow respiration, dyspnoea.
Management: needle decompression
n(2nd or 3rd intercostals space).
24. Infant pulse checking site—-brachial
25. ECG—VF,AF
26. Prostatectomy nursing intervention—
sexual dysfunction.
27. Ritalin side effect–-Insomnia
28. Asthma auscultating sound—–
wheezing
29. Pulmonary embolism diagnostic
evaluation—-pulmonary
angiography
30. MRSA precaution—sterile gown,
gloves, mask
31. Examples of epidemic disease—TB
32. Pneumonia mode of transmission—
airborne
33. Forceful extension of thigh leads to
severe pain—-appendicitis
34. Cholecystityis surgical
management—cholecystectomy
35. GERD— leads to respiratory tract
infection.
36. Hepatitis A precaution—
handwashing
37. Diarrhoea precaution—-hand
washing
38. Spermatogenesis occurs—at the time
of puberty.
39. Projectile vomiting and palpable
mass—pyloric stenosis
40. Chovestek sign, positive trousseaus
sign c/m—tetany-hypocalcemia
41. Prostate cancer patienmt-which
diagnostic test to be monitored—
prostate specific antigen(PSA)(higher
the level , greater the tumor burden)
42. Which part of the brain help for co
ordination—cerebellum
43. Multiple sclerosis-which statement
indicate further teaching is
required—“I will take a hot bath to
help relax mymuscles”.
44. Multiple sclerosis nursing
intervbention—space activities
throughout day to prevent fatigue.
45. Baby with meningocele which
position to be avoided —supine
position(provide prone position)
46. Heart failure which sound is heard—
rales
47. 18th week of gestation colour of
amniotic fluid–-clear
48. Uterine contraction –1 question
49. Glomerulonephritis –how to prevent
recurrent attack?—seek early
treatment for respiratory tract
infection.
50. How to prevcent infection from
urinary retention catheter?—
cleansing around meatus routinely.
51. Client diagnose with urethritis.before
starting antibiotic nurse should plan
for – sending urine culture
52. Renal calculi-nursing actions –select
all that apply question- monitoring
I/O ,straining the urine at each
voiding, administering prescribed
analgesics.
53. Urinary calculus–composed of uric
acid –client should avoid ——-organ
meats and meat extracts.
54. Nephrolithotomy post op findings –
which finding should be reported to
DR.(a. passage of pink-tinged urine,
b. Pink drainage on dressing , c.
intake of 1750mlk in 24 hours,d. urine
output of 20 to 30 ml/hour)……urine
output 20-30ml/hour.
55. Amyotrophic lateral sclerosis(AML) –
position after eating—semi fowlers.
56. ESRD clinical indicators-–azotemia,
hypertension.
57. Bladder cancer pt-for cystectomy
and ileal conduit –pre op plan—
administer cleansing enema and
laxatives as ordered.
58. Suprapubic prostatectomy tube-—
cystostomy.
59. CRF pt,which clinical manifestation
indicated for hemopdialysis?—–
hyperkalemia.
60. Acute kidney failure pt-become
confused and irritable-cause of this
behavior:–—an increased BUN.
61. How nurse can obtain accurate urine
output for a client with continous
 bladder irrigation-–substract volume
of irrigant drain into 2 separate bags.
62. Spinal cord injury-para plegia—
problem—bladder control
63. Myasthenia gravis patient experience
dysphagia-nursing priority—raise
head of the bed.
64. Guillen Barre syndrome(GBS) –which
assessment indicate more frequent
monitoring—ascending weakness.
65. Lasix side effects—hypokalemia
66. Cystic fibrosis, child plays—blowing
bubbles
67. Phantom limb pain –1
question(repeated questions)
68. Right side mastectomy patient—
draiange tube to be placed in which
side—right side.
69. Normal breath sound heard in lower
lobe–-vesicular
70. Musical sound —wheezing
71. Extra cellular fluid buffer—
bicarbonate
72. Causative organism for pneumonia—
overcrowded: —-mycoplasma
pneumonia-community acquired
pneumonia
73. Pulse deficit—difference between
apical and peripheral pulse
74. CPR—chest compression-1 question-
100 compression
75. Post op patient complaining of
severe stabbing chest pain—
pulmonary embolism
76. Patient with complaints of fever and
had 2 weeks streptococcal throat
infection—the murse expect
physician should order which test—
77. Sickle cell crisis—1 q—IV fluid
therapy
78. BMI-1Q
79. Cholecystectomy surgery site—
picture
80. Intervention to prevent atelectasis ina
client with fractured ribs due to chest
trauma—encourage coughing and
deep breathing
81. ABG of a client with COPD
deteriorates, and respiratory failure is
impending . which clinical indicator
should the nurse assess first—mental
confusion.
82. Decreased oxygen to the vital
centres in the brain results in——
restlessness and confusion.
83. A nurse is caring for a client with
severe dyspnoea who is receiving
oxygen via venture mask. What
should the nurse do when caring for
this client while eating?—–monitor
oxygen saturation levels when
eating.(because mask cannot be
worn when eating., the client may
become hypoxic . a nasal cannula
may be needed to deliver oxygen
while the client is eating.