FINAL TERM EXAMINATION

Year II Semester IV
Adult Health Nursing-II

Encircle the best option.

Q1: Regular oral hygiene is an essential intervention for the client who has had a stroke. Which of
the following nursing measures is inappropriate when providing oral hygiene?

a) Placing the client on the back with a small pillow under the head.
b) Keeping portable suctioning equipment at the bedside.
c) Opening the client mouth with a padded tongue blade.
d) Cleaning the client’s mouth and teeth’s with a tooth brush.

Q2: A client arrives in the emergency department with an ischemic stroke and receives tissue
plasminogen activator (t-PA) administration. Which is the priority nursing assessment?

a) Current medication
b) Complete physical and medical history
c) Time of Onset of Current stroke
d) Upcoming surgical procedure

Q3: During the first 24 hours after thrombolytic therapy for ischemic stroke, the primary goal is to
control the client’s:

a) Respiration
b) Pulse
c) Blood Pressure
d) Temperature

Q4: What is a priority nursing assessment in the first 24 hours after admission of the client with a
thrombotic stroke?

a) Cholesterol Level
b) Pupil’s size and pupillary response
c) Bowels sounds
d) Echocardiogram

Q5: What is the expected outcome of thrombolytic drug therapy?

 a) Vasoconstriction
b) Dissolved emboli
c) Prevention of hemorrhage
d) Increased vascular permeability

Q6: The client diagnosed with atrial fibrillation has experienced a transient ischemic attack (TIA).
Which medication would the nurse anticipate being ordered for the client on discharge?

a) A beta-blocker medication.
b) An anti-hyperuricemic medication
c) A thrombolytic medication
d) An oral anti-coagulation medication

Q7: Which assessment data would indicate to the nurse that the client would be at risk for a
hemorrhagic stroke?

a) A blood glucose level of 480 mg/dl

b) A right-sided carotid bruit
c) The presence of bronchogenic carcinoma
d) A blood pressure of 220/120 mmHg

Q8: A client with head trauma develops a urine output of 300 ml/hr, dry skin, and dry mucous
membranes. Which of the following nursing interventions is the most appropriate to perform
initially?

a) Evaluate urine specific gravity

b) Anticipate treatment for renal failure
c) Provide emollients to the skin to prevent breakdown
d) Slow down the IV fluids and notify the physician

Q9: When evaluating an ABG from a client with a subdural hematoma, the nurse notes the PaCO2 is
30 mm Hg. Which of the following responses best describes this result?

a) Appropriate; lowering carbon dioxide (CO2) reduces intracranial pressure (ICP).

b) Emergent; the client is poorly oxygenated
c) Normal
d) Significant; the client has alveolar hypoventilation.

Q10: A client who had a transsphenoidal hypophysectomy should be watched carefully for
hemorrhage, which may be shown by which of the following signs?

a) Bloody drainage from the ears

b) Frequent swallowing
c) Guaiac-positive stools
d) Hematuria
Q11: A patient attends hospital with complain to cold and extreme fatigue. The physician suspect
hypothyroidism, which of the following tests should be ordered?

a. Serum TSH and T4

b. Tyroid Antibodies
c. Thyroid scan
d. All of the above

Q12: All of the following are the purposes of applying traction except:

a. To keep injured bones and joints aligned

b. To prevent and treat deformity
c. To provide comfort
d. To decrease muscle spasm

Q13: During Assessment of a 65 years old lady the nurse observes a severely increased thoracic
curve or hump back. She documents her observation as:

a. Lordosis
b. Scoliosis
c. Kyphosis
d. Ankylosis

Q14: Which of the following mechanisms most commonly causes osteomyelitis?

a. Blunt Trauma
b. IV Drug abuse
c. Immunosuppression
d. Pelvic surgery

Q15: Which of the following levels of amputation is called a Syme,s amputation?

a. Hip disarticulation
b. Knee disarticulation
c. Ankle disarticulation
d. Wrist disarticulation

Q16: When the fracture line occurs at 90 degrees angle of long bone, the fracture is also known as?

a. Linear
b. Longitudinal
c. Oblique
d. Transverse

Q17: Which of the following statement about osteoarthritis is true?

a. Osteoarthritis is a rare form of arthritis commonly affecting younger women.

 b. Osteoarthritis is a slowly progressive non-inflammatory disorder of the synovial joints.
c. Osteoarthritis damages multiple small joint of the body.
d. Osteoarthritis is characterized by recurrent inflammation of joint leading to destruction of
joint structure.

Q18: Identify the bacteria not associated with the cause of bacterial meningitis:

a) Cryptococcus neoformans.
b) Haemophilus influenza
c) Neisseria meningitides
d) Streptococcus pneumonia

Q19: The most severe form of meningitis is considered to be:

a) Bacterial
b) Viral
c) Aseptic
d) Fungal

Q20: One of the recommended antibiotics for patients with bacterial meningitis that could cross the
blood brain barrier is:

a) Penicillin
b) Vancomycin
c) Ciprofloxacin
d) All of the above

Q21: Which of the following values is considered normal for ICP?

a) 0 to 15 mm Hg
b) 25 mm Hg
c) 35 to 45 mm Hg
d) 120/80 mm Hg

Q22: Problems with memory and learning would relate to which of the following lobes?

a) Temporal
b) Occipital
c) Frontal
d) Parietal

Q23: If a male client experienced a cerebrovascular accident (CVA) that damaged the hypothalamus,
the nurse would anticipate that the client has problems with:

a) Body temperature control

b) Balance and equilibrium
 c) Visual acuity
d) Thinking and reasoning

Q24: Which nursing diagnosis takes highest priority for a client with Parkinson’s crisis?

a) Imbalanced nutrition: Less than body requirements

b) Ineffective airway clearance
c) Impaired urinary elimination
d) Risk for injury

Q25: Nurse Marty is monitoring a client for adverse reactions to dantrolene (Dantrium). Which
adverse reaction is most common?

a) Excessive tearing
b) Urine retention
c) Muscle weakness
d) Slurred speech

Q26: Which client is most likely to receive opioids for extended periods of time?

a) A client with fibromyalgia

b) A client with phantom limb pain
c) A client with progressive pancreatic cancer
d) A client with trigeminal neuralgia

Q27: In caring for a young child with pain, which assessment tool is the most useful?

a) Simple description pain intensity scale

b) 0-10 numeric pain scale
c) Faces pain-rating scale
d) McGill-Melzack pain questionnaire

Q28: Which route of administration is preferred if immediate analgesia and rapid titration are
necessary?

a) Intraspinal
b) Patient-controlled analgesia (PCA
c) Intravenous (IV)
d) Sublingual

Q29: Which route of administration is preferable for administration of daily analgesics (if all body
systems are functional)?

a) Oral
b) I/V
c) I/M
 d) S/L

Q30: A first day postoperative client on a PCA pump reports that the pain control is inadequate.
What is the first action you should take?

a) Deliver the bolus dose per standing order

b) Contact the physician to increase the dose
c) Try non-pharmacological comfort measures
d) Assess the pain for location, quality, and intensity

Q31: Prime contributor of atherosclerosis is

a) Accumulation of monocytes
b) Accumulation of mesophyll
c) Accumulation of albumin
d) Accumulation of cholesterol

Q32: Atherosclerosis and arteriosclerosis are classified as

a) Diseases of arteries
b) Diseases of bones
c) Diseases of liver
d) Diseases of kidneys

Q33: Disease in which cholesterol and fatty materials accumulates in wall of arteries is:

a) Diabetic syndrome
b) Tuberculosis
c) Arteriosclerosis
d) Atherosclerosis

Q34: The commonest cause of abdominal aortic aneurysm is?

a) Trauma
b) Syphilis
c) Atherosclerosis
d) Vacullitis

Q35: Which of the following signs and symptoms would most likely be found in a client with mitral
regurgitation?

a) Exertional dyspnea
 b) Confusion
c) Elevated creatine phosphokinase concentration
d) Chest pain

Q36: Cholesterol, frequently discussed in relation to atherosclerosis, is a substance that:

a) May be controlled by eliminating food sources

b) Is found in many foods, both plant and animal sources
c) All persons would be better off without because it causes the disease process
d) Circulates in the blood, the level of which usually decreases when unsaturated fats are
substituted for saturated fats

Q37: A client has been admitted to the hospital with a diagnosis of suspected bacterial endocarditis.
The complication the nurse will constantly observe for is:

a) Presence of heart murmur

b) Systemic emboli
c) Fever
d) Congestive heart failure

Q38: The nurse expects that a client with mitral stenosis would demonstrate symptoms associated
with congestion in the:

a) Aorta
b) Right atrium
c) Superior vena cava
d) Pulmonary circulation

Q39: Asthma is characterized by:

a) An inflammatory diseases
b) Irreversible bronchospasm resulting from inflammation of airways.
c) Obstruction of airways by mucous plugs
d) Obstructive diseases caused by destruction of alveolar walls

Q40: The most common early manifestation of chronic bronchitis is:

a) A daily productive cough

b) Dyspnea
c) Cyanosis
d) Right ventricular failure
Q41: A nurse is teaching a patient with chronic obstructive pulmonary diseases regarding exercise,
which of the following she should emphasize?

a) Have established rest periods

b) Exercise strenuously when possible
c) Use medications during exercise
d) Avoid exercise

Q42: Which of the following organism is mostly implicated in causing community acquired
pneumonia?

a) Staphylococcus aureus
b) Pseudomonas aeruginosa
c) Streptococcus pneumonia
d) Mycoplasma pneumonia

Q43: Which of the following diagnostic tests help confirm the diagnosis of pneumonia?

a) Chest X-ray
b) Sputum culture
c) Blood culture
d) ABG analysis

Q44: Which of the following is the most important risk factor for lung cancer?

a) Cigarette smoking
b) Working in asbestos industry
c) Genetic predisposition
d) Exposure to low level radiation

Q45: Which of the following is the earliest manifestation of lung cancer?

a) Hemoptysis
b) Persistent pneumonia
c) Weight loss
d) Hoarseness

Q46: The nurse understand that the patient diagnosed with pulmonary embolism will be treated by:

a) Streptokinase
 b) Tissue Plasminogen activator
c) IV Heparin sodium
d) Sodium Warfarin

Q47: A normal PH value ranges from:

a) 7.20 to 7.34
b) 7.35 to 7.45
c) 7.46 to 7.55
d) 7.56 to 7.65

Q48: A patient with the bicuspid valve disorder will have impaired blood flow between the:

a) Vena cava and right atrium

b) Right atrium and right ventricle
c) Right ventricle and pulmonary artery
d) Left atrium and left ventricle

Q49: Which of the following tests for iso-enzyme activity indicates cardiac damage?

a) CK-MM
b) CK-MB
c) CK-DB
d) CK-BB

Q50: The primary reason of peripheral arterial occlusive disease is:

a) Atherosclerosis
b) Embolism
c) Thrombosis
d) Vasospasm

Q51: Curative management of varicose veins is:

a) Sclerotherapy
b) Laser therapy
c) Ligation and stripping
d) PTBA
Q52: Which of the following conditions commonly occur in a patient with most common form of
cardiomyopathy?

a) Heart failure
b) Sudden death
c) Cardiac tamponed
d) Pericardial effusion

Q53: Among the following risk factors for coronary artery diseases which one can be corrected?

a) Advanced age
b) Male sex
c) High blood pressure
d) Heredity

Q54: The most common cause of coronary artery diseases is:

a) Hyperglycemia
b) Stress
c) Vasospasm
d) Atherosclerosis

Q55: The risk of coronary artery diseases increases when serum cholesterol level is more than:

a) 190 mg/dl
b) 200 mg/dl
c) 150 mg/dl
d) 125 mg/dl

Q56: The primary diagnostic tool for the evaluation of infective endocarditis is:

a) ECG
b) Echocardiography
c) Blood culture
d) Blood count

Q57: In teaching a newly diagnosed type-I diabetic “Survival skills” the nurse includes information
about:

a) Weight loss measures

 b) Eliminating sugar from diet
c) Need to increase rest
d) Prevention of hypoglycemia

Q58: A patient with type-1 diabetes is advised to avoid over the counter drugs. Which of the
following over the counter drugs the patient should avoid?

a) Valium
b) Ibuprofen
c) Antacids
d) Aspirin

Q59: The nurse is assessing a patient admitted with left-sided heart failure. Which of the following
the nurse should expect to find?

a) Engorged neck veins

b) Dyspnea
c) Abdominal distention
d) Tremors of hand

Q60: A patient is being treated with tab.Digoxin for supraventricular tachycardia. What signs and
symptoms are indicative of digoxin toxicity?

a) Convulsions
b) Yellow vision
c) Vertigo
d) Muscle cramping

Q61: A patient is admitted to the CCU with the complain of dizziness and fatigue and is diagnosed
SVT, The nurse is aware that due to rapid heart rate the patient is at risk of developing:

a) Unstable angina
b) Myocardial infarction
c) Heart failure
d) Hypertension

Q62: The nurse is auscultating the breath sound of a patient with cardiac failure. The breath sounds
what the nurse expected to hear are:

a) Crackles
 b) Wheezes
c) Friction rub
d) Rhonchi

Q63: Which of the treatment modalities is appropriate for the management of cardiogenic shock?

a) Inotropes, e.g. Dopamine to improve contractility

b) ACE inhibitor to increase preload and decrease afterload of the heart
c) Vasopressors to increase systemic vascular resistance
d) Beta blockers to increase heart rate and increase contractility

Q64: A patient in the CCU has developed ventricular tachycardia. His heart rate is 160 beat/min, he
is hemodynamically stable. The nurse anticipates that the patient will be treated by:

a) Defibrillation
b) Administration of verapamil
c) Administration of Lidocaine
d) Administration of digoxin

Q65: When performing chest compressions on a adult, where should you place your hands on the
chest When you are performing chest compressions?
a) On the top half of the breastbone
b) Over the heart, on the left side of the chest at the nipple line
c) Over the very bottom of the breastbone, on the xiphoid
d) On the lower half of the breastbone, at the nipple line in the center of the chest

Q66: Which of the following types of angina is most likely to progress into M.I?

a) Stable angina
b) Unstable angina
c) Nocturnal angina
d) Variant angina

Q67: The sensation of pain that is described most commonly by the patient of angina is:

a) Knife like
b) Heaviness
c) Sharp
d) Tearing

Q68: The most common cause of myocardial infarction is:

 a) Aneurysm of coronary artery
b) Thrombus formation in the coronary artery
c) Occlusion of coronary artery by an embolus
d) Vasospasm of coronary artery

Q69: What is the correct way to create an open airway?

a) Chin-lift, Head-tilt
b) Jaw Thrust
c) Head-tilt, Chin-lift
d) Head-tilt, Jaw Thrust

Q70: The most common complication after acute myocardial infarction is:

a) Cardiac tamponed
b) Cardiac failure
c) Pulmonary embolism
d) Dysrhythmias

Q71: The nurse is assessing a patient admitted with left-sided heart failure. Which of the following
the nurse should expect to find?

a) Engorged neck veins

b) Dyspnea
c) Abdominal distention
d) Tremors of hand

Q72: The length of the external auditory canal in adult is approximetly:

a) 1.5 cm
b) 2.5 cm
c) 3.5 cm
d) 1 cm

Q73: The most common cause of conductive hearing loss is:

a) Foreign body in external ear

b) Otitis media with effusion
c) Noise pollution
d) Ototoxic drugs
Q74: Which part of the external auditory canal contains hair follicle?

a) Outer half of the canal

b) Inner half of the canal
c) Middle one-third of the canal
d) Throughout the ear canal

Q75: Caloric test is done to assess:

a) Auditory function
b) Vestibular function
c) Brainstem function
d) Cochlear function
Answer keys:

1. A 2. c 3. c 4. b 5. b 6. d 7. d
8. a 9. a 10. b 11. a 12. c 13. c 14. a
15. c 16. d 17. b 18. a 19. a 20. b 21. a
22. a 23. a 24. b 25. c 26. c 27. c 28. c
29. a 30. d 31. b 32. a 33. d 34. c 35. a
36. d 37. b 38. d 39. a 40. a 41. a 42. c
43. b 44. a 45. b 46. c 47. b 48. d 49. b
50. a 51. c 52. a 53. c 54. d 55. b 56. c
57. d 58. d 59. d 60. b 61. c 62. a 63. a
64. c 65. d 66. b 67. b 68. b 69. c 70. d
71. d 72. b 73. b 74. a 75. b