1. Which of the following is not a scope and practice of emergency nursing?

D. Emergencies are caused by acts of nature or emerging diseases.

B. Nursing interventions are done interpedently.

C. Nursing and medical interventions are based on assessment data.

A. Patients in the emergency room have a variety of actual and potential problems, and their conditions
may change constantly.

2. As a nurse, you know that when assessing Glasgow Coma Scale, the lowest possible score is _____? *

D. 0

B. 16

C. 3

A. 1

3. As a nurse, you know that when assessing Glasgow Coma Scale, the highest possible score is _____?

B. 4

A. 5

D. 15

C. 16

4. Which of the following is NOT a risk factor of colorectal cancer?

D. A history of inflammatory bowel disease

C. Diet high in fat, protein, and low in fiber

A. Diet high in fat, protein, and high in fiber

B. Family history of colon cancer

5. The following are the clinical manifestations of colorectal cancer EXCEPT?

C. Passage of blood in the stool

A. Fatigue

D. Unexplained anemia

B. Weight gain

6. Symptoms associated with rectal lesions are the following EXCEPT?

B. The feeling of incomplete evacuation after a bowel movement

A. Bloody stool

D. Alternating constipation and diarrhea

C. Proctosigmoidoscopy

7. The most important diagnostic procedures for cancer of the colon are the following EXCEPT?

B. Proctosigmoidoscopy

C. Carcinoembryonic antigen (CEA)

D. Colonoscopy

A. Urinalysis

8. Adjuvant therapy is an additional cancer treatment given after the primary treatment to lower the risk
that the cancer will come back. Which of the following is not an adjuvant therapy?

A. Chemotherapy

C. Radiation therapy

B. Immunotherapy

D. None of the above

9. Emergency department triage is an important nursing function. A nurse working the evening shift is
presented with four patients at the same time. Which of the following patients should be assigned the
highest priority?

C. A patient with abdominal and chest pain, following a large, spicy meal.

A. A patient with low-grade fever, headache, and myalgias for the past 72 hours.

B. A patient who is unable to bear weight of the left foot, with swelling and bruising following a running
accident.

D. A child with a one-inch bleeding laceration on the chin but otherwise well after falling while jumping
on his bed.

10. A patient arrives in the emergency department and reports splashing concentrated household cleaner
in his eye. Which of the following nursing actions is a priority?

D. Test visual acuity

A. Irrigate the eye repeatedly with normal saline solution.

C. Patch the eye.

B. Place fluoresscein drops in the eye.

11. The nurse, caring for a patient recovering from an acute myocardial infarction, is planning
interventions to reduce the risk of which type of shock?

A. Cardiogenic

D. Neurogenic

C. Anaphylactic

B. Hypovolemic

12. In conducting a primary survey on a trauma patient, which of the following is considered one of the
priority elements of the primary survey?

A. Complete sets of vital signs

D. Initiation of pulse oximetry

B. Palpation and auscultation of the abdomen

C. Brief neurologic assessment

13. All but one, are the Elements of Emergency Action Principles:

D. Determine the number of patients and additional resources

C. Mechanism of injury or nature of illness

A. Scene Safety

B. Scene Size Up

14. When assessing the eyes of a patient who was involved in a car accident, the nurse notices an unequal
pupil. The nurse is aware that this is called:

D. Anisocoria

A. Ataxia

B. Doll’s Eye

C. Anorexia

15. It is the duty of a community nurse to educate and train the community for unexpected events such as
disaster. Disaster is defined as:

C. Interesting fact or event, that is unusual or difficult to understand or explain fully.

A. Sudden catastrophic event leading to disruption of life patterns in a certain locality that will lead
to the loss of life and property in addition to multiple injuries.

B. Phenomenon or human activity that poses threat to people, structure, and economic assets.

D. A perilous situation that arises suddenly and threatens the life or welfare of a person or a group of
people.
16. The following are the stages of Critical Incident Stress Debriefing EXCEPT:

D. Debriefing

A. Follow- up

C. Defusing

B. Follow-down

17. When taking a health history, the nurse screens for manifestations suggestive of diabetes type 1.
Which of the following manifestations are considered the primary manifestations of diabetes type 1 and
would be most suggestive of diabetes type 1 and require follow up investigation?

A. Excessive intake of calories, rapid weight gain, and difficulty losing weight.

D. An increase in three areas: thirst, intake of fluids, and hunger

B. Poor circulation, wound healing, and leg ulcers.

C. Lack of energy, weight gain, and depression

18. Which of the following informations or facts about colorectal cancer and colon polyps is not true?

C. When chromosomal damage increases further within the polyp, cell growth becomes uncontrolled, and
the cells begin to spread, that is, they become cancer.

B. Precancerous colorectal polyps are most commonly called adenomatous polyps.

A. Removing benign colorectal polyps can prevent colorectal cancer.

D. Decreasing age is the main risk factor for colorectal cancer. Around 90% of colorectal cancers
are diagnosed after age 20.

19. Which of the following informations or facts about colorectal cancer and ulcerative colitis is not true?

A. Chronic ulcerative colitis causes inflammation of the inner lining of the colon.

C. The risk for cancer begins to increase after birth, eight to 10 weeks.
B. Colon cancer is a recognized complication of chronic ulcerative colitis.

D. The risk of developing colon cancer in a patient with ulcerative colitis also is related to the location
and the extent of his or her disease.

20. The following are the nursing interventions for colorectal cancer patients EXCEPT:

B. Help make referrals to other services, such as to a psychologist if there is a concern about distress.

A. Provide information and education to the patient/family

D. Be the point of contact for them – give them false reassurances.

C. Act in the best interest of the patient and their family to help coordinate the diagnosis, treatment and
after-care of a person

21. A client newly diagnosed with diabetes mellitus has been stabilized with insulin injections daily. A
nurse prepares a discharge teaching plan regarding the insulin. The teaching plan should reinforce which
of the following concepts?

D. Systematically rotate insulin injection sites

C. Always keep insulin vials refrigerated

A. Increase the amount of insulin before unusual exercise

B. Ketones in the urine signify a need for less insulin

22. A client with diagnosis of diabetic ketoacidosis(DKA) is being treated in the emergency room. Which
finding would a nurse expect to note as confirming this diagnosis?

D. Comatose state

A. Elevated blood glucose level and a low plasma bicarbonate

B. Decreased urine output

C. Increased respiration and an increase in pH

23. A nurse teaches a client with diabetes mellitus about differentiating between hypoglycaemia and
ketoacidosis. The client demonstrate an understanding of the teaching by stating that glucose will be
taken if which of the following symptoms develop?
A. Fruity breath odor

C. Blurred vision

B. Shakiness

D. Polyuria

24. A client with diabetes mellitus demonstrates acute anxiety when first admitted for the treatment of
hyperglycemia. The most appropriate intervention to decrease the client’s anxiety would be to

A. Administer a sedative

D. Convey empathy, trust, and respect toward the client

C. Ignore the signs and symptoms of anxiety so that they will soon disappear

B. Make sure the clients knows all the correct medical terms to understand what is happening

25. Diabetic coma results from an excess accumulation in the blood of

D. Glucose from rapid carbohydrate metabolism, causing drowsiness

C. Ketones from rapid fat breakdown, causing acidosis

A. Sodium bicarbonate, causing alkalosis

B. Nitrogen from protein catabolism

101. The statement is true about the sources of vitamin K is:

A. Vitamin K is found in a wide variety of foods, so there is no danger of deficiency

B. Almost all vitamin K sufficient for metabolic needs is produced by intestinal bacteria

C. Vitamin K is rarely found in dietary food sources, so a natural deficiency can easily occur

D. Usually vitamin K can easily be absorbed without assistance, so all that is consumed is absorbed.
102. The main function of adipose tissue in fat metabolism is synthesizing and:

C. Regulating cholesterol production

D. Using lipoproteins for fat transport

B. Storing triglycerides for energy reserves

A. Releasing glucose for energy

103. When fat compounds accumulate to abnormal levels in the blood, the diet maybe modified as an
effort to control them. The foods most affected by such diet therapy would be:

D. Grains

B. Animal fats

A. Fuits

C. Vegetable oils

104. Amino acids are involved in total body metabolism building and rebuilding various tissues. Of these,
a number are essential amino acids. This means that:

A. These amino acids can be made by the body because they are essential to life

B. The body cannot synthesize these amino acids and thus they must be obtained from the diet

D. After synthesizing these amino acids, the body uses them in key processes essential for growth

C. These amino acids are are essential in body processes and the remaining amino acids are not

105. The food group lowest in natural sodium is:

D. Meat

A. Milk

B. Vegetables

C. Fruits
106. Most of the work of changing raw fuel forms of carbohydrates to the refined usable fuel glucose is
accomplished by enzymes located in the:

A. Mouth

C. Small intestines

D. Stomach mucosa

B. Large intestines

107. Specific nursing responsibility in preparing a client for a sigmoidoscopy and barium enema includes:

B. Ensuring the client's understanding of the procedure

C. Witholding food and fluid for 8 hours

D. Administering soapsuds enemas until clear

A. Giving castor oil the afternoon before

110. A client with a peptic ulcer in the duodenum would probably describe the associated pain as:

D. A generalized abdominal pain intensified by moving

B. A gnawing sensation relieved by food

A. An ache radiating to the left side

C. An intermediate colicky flank pain

111. A client is scheduled for pyloroplasty and vagotomy because of strictures caused by ulcers
unresponsive to medical therapy. The nurse reinforces the client's understanding by stating that the
vagotomy serves to:

A. Increase the heart rate

D. Eliminate pain sensations

C. Decrease secretion in the stomach

B. Hasten gastric emptying

112. To understand diabetes insipidus, the nurse must be aware that an antidiuretic substance important
for maintaining fluid balance is released by the:

C. Posterior pituitary

D. Anterior pituitary

B. Adrenal medulla

A. Adrenal cortex

113. In an emergency the rapid adjustments made by the body are associated with increased activity of
the:

A. Thyroid gland

D. Pancreatic gland

C. Adrenal gland

B. Pituitary gland

114. Following a head injury a client develops a deficiency of antidiuretic hormone. Normally secretion
of ADH causes:

D. Urine concentration to decrease

C. Glomerular filtration to decrease

A. Serum osmolarity to increase

B. Tubular reabsorption of water to increase

115.When a client is first admitted hyperglycemic hyperosmolar nonketotic syndrome (HHNKs), the
nurse's priority is to provide:

C. Fluid replacement

D. Dietary instruction

A. Oxygen

B. Carbohydrates
116. Ketone bodies appear in the blood and urine when fats are being oxodized in great amounts. This
condition is associated with:

A. Alcoholosm

B. Bone healing

D. Positive nitrogen balance

C. Starvation

117. Oral hypoglycemic agents maybe used for clients with:

C. Ketosis

D. Obesity

B. Type I diabetes

A. Some insulin production

118. Diabetic coma results from an excess accumulation in the blood of:

C. Ketones from rapid fat breakdown, causing acidosis

D. Glucose from rapid carbohydrate metabolism, causing drowsiness

B. Nitrogen from protein catabolism

A. Sodium bicarbonate, causing alkalosis

119. Which of the following is the highest priority when planning care for a diabetic client?

B. Reducing activities

C. Adjustment of diet

A. Prevention of infection

D. Reducing stress
120. A patient with diabetes mellitus ask the nurse if he should exercise. The nurse's response should be
based on the theory that exercise will:

A. Increase blood glucose

D. Increase total cholesterol

B. Decrease levels of high density lipoproteins

C. Decrease the body's need for insulin

121. Mrs. Ayoto is admitted to the hospital for thyroidectomy. She first asks for help because of a goiter
of thyroid. Mrs. Ayoto's pre operative nursing care includes monitoring for signs and symptoms of
thyroid storm such as:

D. Weight gain and lethargy

B. Fever and tachycardia

C. Hypoglycemia and decreased metabolic rate

A. Hypothermia and bradycardia

122. After thyroidectomy,a priority nursing implementation to Mrs. Ayoto's care is:

C. Check lab results for increased calcium levels.

A. Monitor bleeding on the front of the dressing on her neck.

B. Monitor every hour for signs of respiratory distress.

D. Take vital signs every six hour

123. When evaluating the treatment of the client with pheochromocytoma,the nurse would expect to see
the improvement in the control of the following symptoms:

D. Hypertention,tachycardia,nervousness

C. Hypotention

B. Hypoglycemia

A. Weight gain,buffalo hump

124. Mr. Fernandez takes oral medication for Addison's disease. He is going for abdominal surgery this
morning. A priority nursing implementation is to:

C. Explain the rational of NPO order, before the abdominal surgery.

B. Ascertain if he has received his corticosteroids IV this morning.

A. Discuss the effect of low steroid levels in wound healing.

D. Demonstrates deep breathing exercises.

Mrs. Ayo is a 60 year old, newly diagnosed diabetic. She is 31 kg overweight.125. As a new diabetic, the
first topic to Ayo should be taught about is:

D. How to test blood for glucose

B. Diabetic exchange list

C. Nature of disease process of DM

A. How to give subcutaneous injections of insulin

126. Oral hypoglycaemic medication was prescribed for Mrs. Ayo because she :

C. Has a mid form of diabetes that can be controlled by oral insulin

B. Has pancreas that secretes sufficient insulin when stimulated by injections.

D. Has diabetes that is difficult to control.

A. Does not want to give her injections

127. Mrs. Ayo understands your health teachings by accurately selecting the following signs and
symptoms of hypoglycemia:

B. Hot and dry skin

D. Kussmaul's respirations

A. Sweating,nervousness,dizziness

C. Thirst,glycosuria
Mrs. Javier, a 54-year-old housewife, is diagnosed as having acromegaly. She is scheduled for
hypophysectomy.128. You observed Mrs. Javier and note that she is evidencing which of the following
signs and symptoms of acromegaly?

D. Blindness and weight loss

C. Enlarge hands and feet

A. Polyuria and polydipsia

B. Hypotension and bradycardia

129. After hypophysectomy, Mrs. Javier returning to the unit. Priority nursing care to prevent increasing
intracranial pressure is by:

A. Maintaining the head of the bed in flat position.

C. Giving decadron as prescribed

D. Encouraging ambulation

B. Keep client over hydrated

130. Mark Effron,26 year old is attending an endocrine clinic for the treatment of her hypothyroidism. As
a nurse you will teach him about her health regimen, which includes:

D. Long-term iodine therapy

B. A cool, quit environment

A. A diet with reduce calories

C. A warm stimulating envirnment

131. Marky,30 years old has undergone tests which indicates that he has a deficiency of a parathormone
secretion. Potential complications that Marky should be informed about include:

C.Laryngeal spasms

D.Kidney stones

A.Osteoporosis
B.Lethargy

132. Mrs. Santiago is depressed about the changes in her personal appearance that are related to Cushing's
disease. Some of these changes maybe reversed by surgery. Mrs. Santiago is particularly like to exhibit
which of the following changes?

B.Large hands and feet

D.Nervousness

A. Weight gain, moon faces, increase facial tremors

C.Bulging eyeballs

133. When teaching Mrs. Santiago about her diet, you will describe a diet, which is:

B. Low CHO, low CHON, low K, low Na

A. High CHO, high CHON, high Na ,high K

D. Low CHO, high CHON, high K, and low Na

C. High CHO, low CHON, low K, and high Na

134. Of the following diet, which is recommended in the case of DM?

A. High caloric diet

B.Low fat diet

C.Low CHO

D .Diet rich in mineral diet

135. Glucocorticoids and mineralocorticoids are hormones secreted by:

A. Pancreas

D.Pituitary gland

C.Adrenal glands
B.Hypohysis

136. Of the following, which is the common symptom of DM?

D.Blurring vision

C.Edema

B.Severe headache

A. Bleeding of gums

137. When caring an elderly people with DM, it is most important to the nurse to:

A. Know that all diabetics must have insulin

D. Know the major adjustments in their diet

B.Understand their personalities and habits

C.Teach them how to do urinalysis and give them their own insulin

138. DM is usually recognized by:

A. Albumin in urine

B. Glucose in the urine

D.K in the urine

C. Urea in the urine

139. The ketosis occurring in uncontrolled diabetes is caused by the excessive oxidation of:

C.CHO

A.CHON

B. Fats

D. Minerals
140. The assessment of a client that would be most indicative of diabetes insipidus is:

B. Low urine specific gravity

D. Decreased serum osmolality

C. Elevation of blood pressure

A. Increased blood glucose

141. Acromegaly is produced of over secretion of:

C.Thyroid hormone

A. Testosterone

D. Adrenocorticotropic hormone

B.Growth hormone

142. In Cushing's syndrome, excessive amounts of glucocorticoids and mineralocorticoids will increase
the client's:

A. Urine output

B. Glucose level

C.Serum potassium

D. Immune response

143. Hypotension associated with Addison's disease involves a disturbance in the production of:

B. Androgens

A. Estrogens

C. Glucocorticoids

D. Mineralocorticoids
144. The most common cause of DKA is:

C. Increase insulin use

D. Inadequate food intake

A. Emotional stress

B. Presence of infection

145. Following hypophysectomy, the nurse specifically should observe the client for early signs of:

C. Bleeding at the suture line

D. Increased ICP

B. Respiratory distress

A. Urinary retention

146. Which of the following is the highest priority when placing care for a diabetic patient?

C. Reducing activities

A. Adjustment of diet

B. Prevention of infection

D. Reducing activities

147. An acute episode resulting from any form of stress that makes the adrenal cortical function beyond
its capabilities is:

D. Cushing's disease

B. Cushing's syndrome

A. Addison's disease

C. Adrenal crisis

148. Local manifestation of acromegaly are the following except:

D. Tetany
C. Blindness

B. Diplopia

A. Headache

149. All but one is major cause of pituitary disease:

D. Muscle cramps

C. Non-functioning tumors

B. Pituitary infarction

A. Functioning tumors

150. Which of the following best explains why “endocrine diseases develop secondary to pituitary
disorders and as a consequence of non-endocrine disease”:

A. Secondary failure of an endocrine gland

B. Functional disorders of an endocrine gland

D. Failure of an end organ to respond to a hormone

C. Production of a hormone by a non-endocrine gland

108. A client with gastric ulcer disease asks the nuse the reason for antibiotic therapy that includes
metronidazole( Flagyl). The nurse should explain that antibiotics are prescribed to:

D. Reduce hydrochloric acid secretion

B. Treat Helicobacter pylori infection

C. Potentiate the effect of antacids

A. Augment the immune response

109.Most peptic ulcers occurring in the stomach are in the:

C. Body of the stomach

A. Cardiac portion

D. Esophageal junction

B. Pyloric portion

1. Which of the following statements, if made by a client who is being administered Adriamycin
(doxorubicin hydrochloride), would indicate to a nurse that the client needs further instruction about the
use of the drug?

D. "I may develop an irregular heartbeat."

C. "I can expect to have diarrhea."

A. "My hair is going to fall out and my urine will turn red."

B. "I will need to limit my fluid intake to two glasses per day."

2. A child with Hodgkin's disease is receiving Cytoxan (cyclophosphamide) for treatment. The nurse
should include which of the following strategies in the care plan?

B. Assess the child's apical heart rate and respiratory rate

C. Ensure proper positioning

A. Monitor the child's intake and output

D. Evaluate the child's hemoglobin and hematocrit level

3. The nurse assesses a client for common symptoms of carcinoma of the bladder, which include?

C. Burning sensation on urination

D. Narrowing of urine stream

B. Nocturia

A. Painless hematuria
4. The most common site of breast cancer is believed to be in the:

C. Lower outer quadrant

A. Lower inner quadrant

D. Upper inner quadrant

B. Upper outer quadrant

5. A nurse is educating a client prior to an intracavitary cesium insertion as therapy for cervical cancer.
which of the following statements, if made by the client, would indicate the need for further instruction?

A. "My husband will visit for 30 minutes only."

C. "I will have a catheter in my bladder in my bladder."

B. " I will need to ambulate for at least an hour daily."

D. "I will need to eat low- fiber foods."

6. Which of these findings should a nurse expect to identify when assessing a client who is receiving
radiation therapy for cancer of the esophagus?

C. Alopecia and petechiae

A. Tingling sensation

D. Hypersalivation

B. Gingival hyperplasia and dry mouth

7. Which of the following is the earliest sign of laryngeal cancer?

D. Anorexia

A. Dysphagia

C. Hoarseness

B. Sore throat
8. Which of the following would most likely predispose the client to ovarian cancer?

D. Fatty foods

A. Trauma

B. Multiple pregnancy

C. Having the first baby at age 25

9. Which of the following is usually increased in advanced prostatic cancer?

C. Serum alkaline phosphatase

B. Serum acid phosphatase

D. Serum amylase

A. Levels of testosterone

10. The normal testes can be described by all of the following except:

D. Lump-free

B. Egg-shaped

A. Smooth

C. Spongy

11. Which of the following types of medication should be used in the treatment of breakthrough pain in
clients with chronic cancer?

C. Short-acting opioid

B. Long-acting analgesic

A. Non- opioid

D. Non-steroidal anti- inflammatory agent

12. Which of the following statements is not correct regarding testicular cancer?
C. A cancerous testes is spongy

D. Pain is an early symptom of testicular cancer.

B. History of cryptorchidism increases the risk for testicular cancer.

A. Testicular cancer usually affects men between 15 and 35 years of age

88. Which of the following types of insulin should a nurse have available to administer intravenously to
client receiving total parenteral nutrition and with an elevated blood glucose level?

A. Insulin zinc suspension (Lente)

D. Isophane insulin (NPH)

C. Semi-lente insulin (Semitard)

B. Regular insulin (Humulin R)

89. A client with hyperthyroidism is started with propylthiouracil (PTU). After 2-4 weeks improvement,
which of the following areas indicate a positive effect of the drug?

C. Sleep pattern

D. Exercise

A. Memory

B. Speech

90. Which initial etiological factor establishes a nursing diagnosis of fluid volume deficit in a client with
Addison's disease?

C. Melanocyte-stimulating hormone excess

A. Glucocorticoid excess

B. Mineralocorticoid deficiency

D. Melanocyte-stimulating hormone deficit

91. When assessing a client with Cushing's syndrome, the nurse should expect the client to demonstrate:

C. decreased growth of facial hair

B. ectomorphism, moon face and hypoglycemia

D. increased resistance to bruising and bleeding

A. lability of mood, hyperglycemia, and excessive facial hair

92. In planning the care of a client with diabetes insipidus, priority must be the prevention of:

A. Foot ulcer

D. Excessive food intake

C. High blood glucose

B. Excessive fluid loss

93. To which of the following nursing diagnoses would a nurse give priority when caring for a client who
has syndrome of inappropriate secretion of anti diuretic hormone(SIADH)?

B. Altered nutrition

D. Fluid volume excess

C. Urinary incontinence

A. Decreased cardiac output

94. A client with hypoparathyroidism should be given which of the following foods:

C. Seaweeds

B. Grapes

A. Spinach

D. Orange juice
95. A 33-year old client with hypothyroidism has not been complying with the medical regimen for the
past several years. The nurse would expect the client to manifest which of the following?

C. Pheochromocytoma

D. Myxedema

A. Addisonian crisis

B. Thyroid storm

96. Which of the following manifestations is a priority for the nurse to assess in a client with
pheochromocytoma?

A. Dry skin

C. Hypoglycemia

D. Hypertension

B. Bradycardia

97. A 40-year old client who has a pituitary adenoma had transphenoidal hypophysectomy. A nurse is
providing the client discharge instructions. Which statement by the nurse is accurate?

B. "You will have to be in complete bed rest for two weeks."

C. "You will lose your ability to suck liquids through a straw."

D. "You will need to adjust your oral hygiene routine."

A. "You will need to limit your fluid intake."

98. The hallmark sign for the diagnosis of diabetes mellitus is the presence of:

A. Ketonuria

D. Hyperglycemia

C. Kussmaul's breathing

B. Acetone odor of breath

99. What is the highest priority, in terms of goal of care, by the nurse after a client's prostatectomy?
D. To prevent respiratory distress

A. To prevent infection

C. To prevent impotence

B. To prevent bleeding

100. When providing care to a dying client, the nurse should focus on all of the following, Except:

B. Reflecting on her/his concept of death and its significance

C. Preserving the rights of the client- his/her need for dignity, security and self worth and his/her family

D. Reducing personal contact with the client to maintain objectivity.

A. Promoting the client's comfort