State Exams Questions 20 40

STATE EXAMS (PART II)
TABLE OF CONTENTS QUESTIONS PAGES
STATE EXAMS 21 111 2 to 17
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STATE EXAMS 21
1. Which of the following represents a positive change of pregnancy
a) Morning sickness
b) Quickening
c) Positive pregnancy test
d) Foetal heart beat auscultated with Doppler
2. Maria aged 24 years, is a 3 month primagravida, visiting ante natal clinic for the first
time. Maria is concerned that she has not put on any weight. The most appropriate
advice would be
a) Due to the babies requirements you need to eat more
b) You need to exercise less or you stress the baby
c) There is no need to put on weight in the first trimester
d) Rest more and eat more carbohydrates
3. In order to prevent infection of hepatitis B virus, the pregnant woman should

a) Receive gamma globulin during the first trimester
b) Carefully wash hands before eating or preparing food
c) Receive the hepatitis B vaccine
d) Take AZT during the second and third trimester
4. Which of the following represents a recommended weight gain during pregnancy

a) 6 to 11 kgs
b) 11 to 16 kgs
c) 13 to 18 kgs
d) 18 to 20 kgs
5. A pregnant woman at 30 weeks gestation exhibits a rise in her baseline systolic blood
pressure of 32 mm Hg, a weight gain of 4 kgs since last week and difficulty removing
rings she normally wears. This is suggestive of
a) Gestational hypertenision
b) Pre eclampsia
c) Eclampsia
d) Elevated liver enzymes
6. The primary pathophysiologic basis for the clinical manifestations of pregnancy

induced hypertension (PIH) is
a) Fluid retention related to excessive salt intake
b) Ineffective excretion of fluid by the kidneys
c) Cardiac decompenstion
d) Ineffective dilatation of the vascular network to accommodate the expanding
blood volume of pregnancy
7. Which measure would be least effective in relieving the signs and symptoms of mild
pre eclampsia
a) Low salt diet
b) Period of bed rest
c) Balanced diet with protein
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d) Relaxation techniques
8. A woman with severe pre eclampsia is being monitored for assessment findings
indicative of cerebral oedema and venospasm. Which of the following would you not
expect to find
a) Hypotonic deep tendon reflexes
b) Headache
c) Vision changes including blurring and spots before the eyes
d) Insomnia
9. Newly expectant parents, ask the nurse how they can prepare their 3yr old preschool
daughter for the new baby. All of the following would be useful expect
a) tell the child about the pregnancy as soon as mother begins to look pregnant
b) Arrange for a few sleep overs with the person who will care for the child at the
time of the birth
c) Transfer their child to her new room and bed just before the expected birth of the
baby
d) Introduce their child to preschool as soon as possible
10. Inability to chew might result from damage to which cranial nerve
a) Facial
b) Trigeminal
c) Abducens
d) Vagus
11. In most people, the left cerebral hemisphere is more important for which of the
following
a) Spoken and written language
b) Space and pattern perception
c) Musical and artistic awareness
d) Imagination
12. Which of the following is true concerning the limbic system

a) It is comprised of parts of the cerebrum and diencephalon
b) It assumes a primary function in emotions
c) Both a and b
d) Neither a nor b
13. Cooridination of muscular activity is a function of the

a) Cerebral peduncles
b) Cerebellum
c) Thalamus
d) Medulla oblongata
14. Which of the following statements is correct

a) Appetite control is a function of the thalamus
b) The midbrain is a conduction pathway and reflex center
c) The cerebellum has sensory centers for thirst and speech
d) Respiratory centers are located in the basal ganglia
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15. The structure that connects the cerebral hemispheres and facilitates the sharing of
cerebral information is the
a) Corpus callosum
b) Cingulated sulcus
c) Fourth ventricle
d) Aqueduct of sylvius
16. The portion of bone laid down first in bone formation is the
a) Matrix
b) Calcium salts
c) Trabeculae
d) Marrow
17. What is the most common cause of heart failure (HF)

a) Smoking
b) Diabetes
c) Coronary artery disease
d) Family history
18. The action of ACE inhibitors (angiotensin converting enzyme) is

a) Increased urinary output, therefore decreased blood pressure
b) Relax blood vessels, therefore decreased vascular resistance
c) Strengthens cardiac contraction, therefore increase cardiac output
d) Relax cardiac muscle, therefore decrease heart rate
19. Hyperkalemia is
a) Increased serum potassium levels
b) Increased serum calcium levels
c) Increased red blood cell count
d) Increased serum chloride levels
20. Manifestations of heart failure are

a) Hepatomeglia, pitted dependent edema
b) Increased serum glucose levels
c) Increased appetite and weight gain
d) Decreased respiration and dyspnea
21. Nursing interventions associated with your clients taking loop diuretics such as
frusimide are
a) Blood sugar levels, dietary fibre
b) Monitoring of weight and K+ levels
c) Blood pressure and urinary output
d) Make sure your client eats ½ hour following administration
22. Loop diuretics act by

a) Increasing the blood flow to the glomerular network
b) Decreasing the blood flow to the kidneys therefore decreased urinary output
c) Increased H20 reabsorption in the distal convoluted tubules of the nephron
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d) Inhibition complex active pump mechanism therefore increase excretion of
electrolytes
23. The primary ossification center of long bone is located in which of the following
structures
a) Ephipysis
b) Epiphyseal plate
c) Diaphysis
d) Endosterum
24. The body tissues affected by rheumatoid arthritis is

a) Adipose
b) Muscular
c) Connective
d) Epithelial
25. The pattern of rheumatoid arthritis is best described by its

a) Chronicity
b) Remissions and exacerbations
c) Little relief from aches and pains
d) A progressive increase in disability
26. Rheumatoid arthritis is characterized by

a) Bone pain
b) Sharp tingling sensations
c) Inflammation of the joints
d) Pain and swelling of joints
27. Synovial joints are characterized by

a) Articular cartilage
b) Fibrous capsule
c) Joint cavity
d) All of these
28. The major support that the muscular system gets from the cardiovascular system
a) A direct response by controlling the heart rate and the respiratory rate
b) Constriction of blood vessels and decrease in heart rate for thermoregulatory
control
c) Nutrient and oxygen delivery and carbon dioxide removal
d) Decreased volume of blood and rate of flow for maximal muscle contraction
29. Manifestations of right sided heart failure are

a) Fatigue, cyamosis, blood tinged sputum
b) Anorexia, complaints of gastrointestinal distress, fatigue and pitted edema
c) Dyspnea, orthopnea and cyanosis
d) Fatigue dependant edema and cough
30. Nursing intervention necessary prior to the administration of digoxin is

a) Palpation of arterial pulse less than 60 beats/minute
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b) Palpation of venous pulse less than 60 beats/minute
c) Palpation of arterial pulse greater than 60 beats/minute
d) Palpation of pedal pulse less than 60 beats/minute
31. Left sided heart failure affects directly the

a) Liver and extremities
b) Lungs
c) Level of consciousness
d) Lungs and extremities
32. Basic nursing objectives in the treatment of HF are

a) Start heparinization immediately
b) Nursing the client in trendlenberg position
c) Promote rest therefore decrease workload on heart and decrease H20
accumulation
d) Assess levels of consciousness and give 02 61/min via Hudson mask
33. Define a cerebral vascular accident (CVA)

a) Sudden loss of consciousness due to a decreased contractility of the cardia
b) Loss of brain function due to disruption of blood supply to the brain
c) Intermittent spasms of blood vessels interrupting blood flow to the brain
d) Neurologic dysfunction due to diminished blood flow to the cranium
34. Cerebral thrombosis is

a) Most common cause of a stroke
b) Originates from a large vessel and lodges in the brain
c) May be caused by an arterial spasm in the brain
d) Usually occurs during strenuous exercise
35. Risk factors of CVA that cannot be altered are

a) Sex, race and raised blood cholesterol levels
b) High BP, previous TIA
c) Race, prior stroke and overweight
d) High BP, previous TIA and increased blood cholesterol levels
36. A person who has experienced a right CVA may present with
a) Receptive or expressive aphasia
b) Right hemiplegia
c) Left hemiplegia
d) Deficit of new language information
37. Where and what is the circle of willis

a) A capillary meshwork found in bowmans capsule of the nephron
b) A vascular network at the base of the brain
c) A roundabout at the top[ of bank st
d) The capsule membrane of a malignant growth
38. List the 3 main causes of stroke

a) Cerebral haemorrhage, thrombosis, embolism
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b) Cerebral thrombosis, infarction, aneurysm
c) Cerebral embolism, metastatic lesions, coagulopathy
d) Cerebral ischemia, vascular spasms, hypoxia
39. Angina symptoms include

a) Radiating pain, decreased BP and increased pulse
b) Shortness of breath, loss of consciousness and these effects may last indefinitely
c) Ringing in the ears, anxiety and cramping in the extremities
d) Shortness of breath, sweating, nausea and tiredness
40. Emphysema is
a) An alveolar disease
b) Due to hypertrophy and hyperplasia of bronchial glands
c) Persistent episodes of productive cough
d) An airway disease
41. The term blue bloater refers to

a) Decreased erythropoietin production therefore decreased 02 carrying capability of
the RBC
b) Polycythemia and cyanosis from right ventricular failure
c) Cyanosis due to decreased RBC production
d) Increased BP due to high blood volume or fluid overload
42. Bronchitis is
a) Results from a breakdown in the normal lung defence mechanisms
b) Destruction of alveolar
c) Due to enlarged terminal non respiratory bronchioles and alveolar walls
d) History of daily productive cough that last at lease 3 months, for 2 years
43. Emphysema is characterised by

a) Fat people due to decreased activity tolerance
b) Unproductive cough and pursed lip breathing
c) Pursed lip breathing and productive cough
d) Blue bloater, normal skin colour and rapid respirations
44. Nursing interventions for the CORD patient include everyone of these except
a) Improve ventilation
b) Remove secretions
c) Prevent complications
d) Promote cooperation and understanding
e) Encourage exercise to test tolerance levels
45. Bronchodilators
a) Aid the movement of secretions
b) Liquefy the sputum therefore increase expectoration
c) Include aminophylline for the acute exacerbation
d) Are only used in emergency cases
46. Corticosteroids are used

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a) Prophylactically in most cases
b) To aid in vitamin D synthesis
c) To aid the liquefaction and expectoration of sputum
d) Used during the acute exacerbation of CORD
47. The foetal presenting part is described as vertex when the

a) Face enters the pelvis first
b) Buttocks emerge with legs extended over the abdomen
c) Flexed head enters pelvis first
d) Foetal lie is longitudinal
48. When examining the umbilical cord immediately after birth the nurse should expect to
observe
a) One artery
b) Two veins
c) Whitish grey colouration
d) Slight odour
49. Vitamin K is given to the newborn to

a) Reduce bilirubin levels
b) Increase the production of red blood cells
c) Stimulate the formation of surfactant
d) Enhance the ability of the blood to clot
50. The nurse is performing a 5 minute apgar on a newborn. Which of the following
observations is included in the apgar score
a) blood pressure
b) Temperature
c) Muscle tone
d) Weight
51. At birth the major cause of heat loss is by

a) Evaporation
b) Radiation
c) Conduction
d) Convection
52. Following the birth of graces baby, a healthy male, you are assisting grace to feed her
baby for the first time. The action of prolactin at this time
a) Immediately stimulates full milk production
b) Stimulates involution
c) Is inhibited until progesterone and oestrogen levels have decreased
d) Is not influenced by other hormones
53. A newborns birth weight is 3400 grms. The maximum expected weight loss for this
newborn would be
a) 170 gms
b) 340 gms
c) 510 gms
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d) 680 gms
54. The birth weight of a breast feed newborn was 3600 grms. On the third day the
newborns weight was 3350 grms. The nurse should
a) Encourage the mother to continue breast feeding as her babys nutrient and fluid
needs are brin met
b) Suggest that the mother switch to bottle feeding as breast feeding is ineffective in
meeting her babys needs
c) Notify the doctor as the baby has lost too much weight
d) Refer the mother to a lactation consultant to improve her breastfeeding technique
55. Which of the following would be an unexpected sign of dehydration in the newborn
a) Weight loss
b) Reduced turgor
c) Concentrated urine
d) Decreased frequency and amount of urine
56. A breast fed baby will have bowel motions

a) That are yellow and runny at least twice a day
b) May go 2-3 days without a bowel motion
c) Will pas meconium for a shorter period
d) Establishes a very regular pattern of bowel motions
57. Supplementary fluids for babies

a) Are advisable to prevent jaundice
b) Are needed for the baby under phototherapy
c) May be required if the mother has had a caesarean section
d) Are unlikely to be needed if the mother is breast feeding
58. Lucy is charted 5 mls of augmentin ‘125’ T.D.S. you notice the doctor hasn’t signed
the order form. A senior colleague tells you to give it. You respond by
a) Giving the medication as ordered
b) Contacting the doctor to sign the order
c) Asking lucy if the doctor told her she would have this
d) Signing the form for the doctor
59. The augmentin is given to lucy. she is found to be allergic when she exhibits
a) Tinnitus and vertigo
b) Wheezing and urticaria
c) Abdominal cramps and diarrhoea
d) Blurred vision and ataxia
60. Jack is 15 years old. He is admitted to the hospital after briefly loosing consciousness
when tackled during a rugby game. Which of the following is an indication of
increasing intracranial pressure
a) Change in his level of consciousness
b) Anorexia and thirst
c) Increased pulse and respiration rates
d) Blurred vision and halos around lights
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61. Jack has had two seizures while hospitalised. These have been controlled by
anticonvulsant medications. Jack and his family must understand
a) The medication must be taken for at least one year
b) The doctor should be seen when the prescription has finished
c) The medication will be discontinued on discharge
d) The medication will be necessary for the rest of his life
62. Jack is prescribed rivotril 8 mgs daily. He weighs 68 kgs. The initial doses for 2-3
days should no exceed 0.01 mgs/kg/day. Your nursing responsibility is to
a) Observe for any side effects after giving the drug
b) Contact the doctor to reassess the dose prescribed
c) Consider his weight loss and administer the dose prescribed
d) Check with the charge nurse prior to administration
63. Oral suspension of rivotril, 2.5 mgs per ml is available to administer 1.8 mgs you will
give
a) 0.53
b) 0.72
c) 5.3 mls
d) 7.2 mls
64. Jack is concerned about returning to school. He should be encouraged to

a) Take leave of absence for a semester
b) Initially, attend school only part time
c) Plan an alternative lifestyle
d) Resume all previous activities
65. James aged six weeks, is admitted with a history of frequent vomiting after feeding.
The most important nursing assessment specific to this would be to observe for
a) Pain in his abdomen
b) The amount and frequency of his vomits
c) The type of milk mixture he is having
d) The level of his hydration
66. His vomiting is described as projectile, this means

a) It has an unusual colour
b) It is a forceful vomit
c) It is curd like in appearance
d) He has frequent spills
67. James is diagnosed to have pyloric stenosis. This requires surgery to

a) Increase the opening to the pyloric sphincter
b) Stretch james stomach to cope with fluids
c) Decrease the opening in the cardiac sphincter
d) Put in a gastroscopy tube to bypass the stomach
68. James is prepared for surgery by

a) Having a sedative four hours pre operatively
b) Being hydrated with IV fluids
c) Amusing him to keep him alert
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d) Feeding him on demand to keep him contented
69. James weighs 3.4 kgs. His fluid requirement is 150 ml/kg/day. To maintain his
hydration james requires
a) 20 mls per hour
b) 27 mls per hour
c) 23 mls per hour
d) 22 mls per hour
70. James mother is living in. She is breast feeding james. Nursing consideration for her
should include
a) Plenty of rest and distraction
b) Education about breast feeding
c) Providing privacy and means to express milk
d) Checking her breasts for cracked nipples
71. James returns from theatre with an apnoea monitor. This is used to monitor
a) The rate of james breathing
b) The length of his sleeping
c) The length of time between breaths
d) Delays between breaths exceeding 20 seconds
72. You are a staff nurse working in a rehabilitation unit. Carl is 12 years old. He was
involved in a road traffic accident and sustained a head injury. He has been
unconscious for four weeks. You are his primary nurse. While providing his nursing
care you will
a) Encourage his mother to always help you
b) Talk to him clearly in a normal voice
c) Provide him with intensive stimulation
d) Offer him drinks to check his swallow reflex
73. It is important to assess his level of consciousness. The first definite sign of
consciousness is when
a) His eyes begin to open
b) His facial expression changes
c) He has involuntary body movement
d) He has plantar flexion of his feet
74. Carl has a dense r) hemiplegia and some spasticity to his L) limbs. To improve his
ability to ambulate in the future it is important he
a) Always has his limbs extended when resting
b) Is turned to alternate sides two hourly
c) Has his joints flexed and rotated regularly
d) Maintains a healthy well balanced diet
75. Carl is beginning to make progress and is relearning skills. When encouraging carls
relearning of feeding you
a) Let him have a spoon and do his best
b) Occasionally try to tell him the right way to feed himself
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c) Teach him in small steps and progress at his rate
d) Take over when he makes a mess
76. Carl is learning to communicate with signals. He is using his eyes to indicate yes and
no. To encourage him to use these signals you
a) Give carl a range of choices to facilitate a decision
b) Discontinue his care until he has communicated
c) Reprimand carl and explain to him he must communicate
d) Give two choices to facilitate decision making
77. Carl is becoming irritable and communicating with loud noises which are disruptive.
He reacts to visitors and the phone ringing. To help lessen this reaction you should
a) Get some sedation charted for him
b) Use a mild punishment when he is disruptive
c) Try and find out what is really bothering him
d) Provide him with something interesting to quieten him
78. Carl is to go home for two weeks with his family. They have bee3n visiting him 2-3
times a week and feel they can cope with him at home. In planning his discharge you
would
a) Provide community contacts the family can assess
b) Encourage the parents to cope without help
c) Provide a daily schedule which is to be adhered to
d) Encourage the parents to phone if necessary
79. Hypertension, oedema and proteinuria (GPH) syndrome commonly occurs in women
who
a) Have essential hypertension
b) Have diabetes mellitus
c) Are primigravidas
d) All of the above
80. Martin is a 6 months old, admitted in acute respiratory distress. His mother has
accompanied him to hospital and is very anxious. Which isgn of repiratory distress is
evident in children and not adults
a) Rasping respirations
b) Slow respiratory rate
c) Blue peripheries
d) Intercostals indrawing
81. Martin has a hoarse cough and is wheezing. Further assessment is important. Select
the most appropriate question to initially ask his mother.
a) When did martin first start coughing and wheezing
b) How long since martin last had a drink
c) Was martin playing with toys with small pieces
d) Has martin had any medication recently
82. His diagnosis is bronchiolitis. He requires oxygen therapy for at least 24 hours. Which
is the most appropriate method of administration of oxygen for your client
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a) Oxygen tent
b) Mask
c) Nasal prongs
d) Head box or cone
83. Which is the most important nursing observation to consider for a child having
oxygen therapy
a) Monitoring his oxygen saturations regularly
b) Visual observation of childs respiratory status
c) Doing pulse and respiration recordings
d) Analysis of level of oxygen in the tent
84. Martins mother states, im not getting enough rest here and im tired and cant cope
anymore. Which is the best response to this statement
a) You need to go home and rest to have a break
b) Why hasnt your family helped you with martins care
c) Shall i get a hospital grandparent for you
d) If youd like to have a break, i’ll look after martin for you
85. Which of the following factors does research show most assists caregivers to cope
with their childs hospitalization
a) Control of decision making
b) Individualised care
c) Knowledge of what to expect
d) Time away from the child
86. Jenny aged 4 was brought to the emergency clinic while having an acute asthma
attack. Jennys breathing would be characterized by
a) Grunting inspirations
b) Wheezing on expiration
c) Frequent periods of apnoea
d) Laboured abdominal breathing
87. Nursing measures for a child suffering from an acute asthma attack would be
1. Management of IV fluids and oral fluids
2. Administering medications as ordered
3. Keep the child on flat bedrest until the acute attack is over
4. Assisting with positive pressure breathing as ordered
a) All of these
b) 1 and 2
c) 1, 2 and 4
d) 1, 3 and 4
88. Jenny is 3 years old, she has been admitted with acute asthma. Jenny requires IV
aminophylline. It is charted at 56 mg. Each vial contains 250 mg in 10 mls. You
calculate the correct dose, which is
a) 3.16 mls
b) 0.4 mls
c) 1.25 mls
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d) 2.24 mls
89. Jenny appears to have a secondary infection and is prescribed 375,000 units of
penicillin. The vial contains 600,000 units in 2 mls. Calculate the amount jenny
requires for one dose
a) 1.25 mls
b) 0.625 mls
c) 0.125 mls
d) 0.32 mls
90. The nurse encourages jennys mother to stay with her as much as possible. The
rationale for this is which of the following
a) Mothers of hospitalized children often experience guilt
b) The mothers presence will reduce anxiety and ease the childs respiratory efforts
c) Separation from mother is a major developmental threat at this age
d) The mother can provide constant observations of the childs respiratory efforts
91. Jenny is to have ventolin nebulisers every two hours until respirations improve. She
becomes distressed as soon as you try to put the mask on her face. You would best
manage this situation initially by
a) Getting her mother to assist with administration
b) Not giving it to her as being distressed may make her worse
c) Realising the importance of the ventolin so forcing it on her
d) Letting her have a mask to play with
92. As jennys condition improves she is to commence oral medication. Which approach is
most likely to gain compliance
a) Its time for your medication now, would you like to drink it with a straw or from a
glass
b) Wouldn’t you like to take your medicine now
c) You must take your medication, because the doctor says it will make you better
d) See how nicely Johnny took his medicine, now take yours
93. An asthmatic child is charted IV aminophylline. Your responsibility prior to the

giving of this drug would include checking
1. The drug with a registered nurse
2. The childs dose in relation to her weight
3. The childs identity by calling by name
4. The correct route of the drug
a) All of these
b) 1, 2 and 4
c) 1 and 4
d) 2 and 3
94. A preschooler is febrile and requires 4 hourly temperature recordings. The most
appropriate method would be
a) Orally
b) Rectally
c) Orally or axillary
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d) Axillary
95. Christina age 10 is admitted to your unit with a diagnosis of rheumatic fever. You are
her primary nurse. The causative organism for rheumatic fever is
a) Haemophilus influenza
b) Staphylococcus bacteria
c) Syncytial virus
d) Group a streptococcal bacteria
96. The most serious complication of rheumatic fever is

a) Endocarditis
b) Pneumonia
c) Arthritis
d) Meningitis
97. Christina is admitted to your unit. You are her primary nurse. Your responsibilities
will be to
a) Do an assessment and history appraisal
b) Orientate her to the area
c) Establish a trusting relationship
d) Do all of the above
98. Which of the following would support a diagnosis of chickenpox

a) Chills, headache, malaise
b) Nausea, vomiting, diarrhoea
c) Kopliks spots, photo phobia, fever
d) Sore throat, chills, fever
99. You are a practice nurse and kevins mother asks for advice on how to care for Kevin
at home. Aims of care for Kevin are
a) Ensure rest and relieve itching
b) Maintain hydration and isolate Kevin
c) Maintain hydration and relieve itching
d) Ensure rest and isolate Kevin
100. Kevins mother asks you when she can send him back to kindergarten. You
advise
a) When all spots have gone
b) In one weeks time if temperature is normal
c) He is not contagious now spots have appeared
d) When all spots are dry and crusted
101. Kevins mother asks you why the chicken pox immunisation is not offered as
part of the immunisation programme
a) There is no vaccine for chickenpox
b) There are no major sequelae of chicken pox
c) The public would not accept another immunisation
d) The vaccine for chicken pox is too expensive
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102. You are a practice nurse. Dannys mother phones you. Danny is 18 months old.
She is concerned over his difficulty with respirations and ‘barking’ cough. You
suspect he may have laryngotracheobronchitis (croup). The characteristic crowing
sound of respirations in croup is
a) Stridor
b) Rhonchi
c) Wheeze
d) Rales
103. Which of the following comments by dannys mother most strongly supports a
diagnosis of croup
a) Hes been very lethargic and drowsy these last few days
b) His older sister has bad asthma since she was 7 years old
c) He seems to cough much more when hes lying down
d) He had the flu a week ago
104. Dannys mother should be instructed to watch for signs of worsening

respiratory status, including which of the following
a) Low grade fever
b) Productive cough
c) Increased restlessness
d) Hoarse voice
105. Danny shows signs of acute respiratory distress, and his mother brings him to
the accident and emergency clinic. Which of the following changes in vital signs
would the nurse expect to note
a) Bradycardia, tachypnea
b) Bradycardia, bradypnea
c) Tachycardia, tachypnea
d) Tachycardia, bradypnea
106. Ongoing assessment of danny includesregular oximetry readings. The reading

changes to 75%. Your immediate reaction is to
a) Increase the level of oxygen being administered
b) Check the accuracy of the oximeter
c) Visually check the childs respiratory status
d) Go and get someone to check your recordings
107. Dannys health improves, he is able to go home. His mother says i have used
all my money to get the taxi here. I cannot get home. Your response is
a) Thats okay, i’ll pay for thetaxi for you
b) You cant stay here, this is an emergency clinic
c) Can i ring someone else at home for you
d) You can use a credit card with the taxi
108. Dannys mother bursts into tears. I don’t want to go home because my
husbands drunk and he’ll beat me. Your response is
a) Would you like to talk about this in a quieter place
b) Shall we ring him to see if hes sober yet
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c) I’ll contact a social worker for you
d) How often does he get drunk and beat you
109. At the time of leonards admission to hospital, it would be impossible to

accurately predict the neurological deficit that would ultimately be left because
a) With correct alignment of the severed sections of cord, some healing of fibres will
occur
b) Some of his symptoms may be the result of spinal shock rather than severance of
the cord
c) If the cord has been severed cleanly, it may be possible to suture the tracts
together
d) It is impossible for the spinal tracts to heal until the disrupted blood vessels
supplying the cord regenerate
110. Reflex control over the bowel and bladder functions following spinal injury is
expected to be regained. This control over evacuation may develop because
a) Initial bowel and bladder problems result more from psychological than from
physical injury
b) Some of the severed motor fibres will reconnect, permitting impulse transmission
c) With mobilisation and improved circulation, muscle control will improve
d) Return of parasympathetic activity will permit automatic emptying of bladder and
bowel
111. Which of the following actions should you take if a patient you know to have
cancer asks if the lump that was removed is malignant
a) Say yes and sit down and discuss this with her
b) Gloss over the question and talk about something else
c) Tell her it was benign, in case she is not supposed to know yet
d) Acknowledge your lack of seniority and ask the charge nurse to talk to her
STATE EXAMS 22
1. The three meningeal layers of the spinal cord include
a) Spinal meninges, cranial meninges, conus medullaris
b) Cauda equine, conus medullaris, filum terminale
c) White matter, gray matter, central canal
d) Dura mater, pia mater, arachnoid
2. The caudia equine is a complex of the spinal cord that includes

a) The enlargements of the cervical and thoracic regions of the cord
b) The posterior and anterior median sulci
c) The coccygeal and dentricualte ligaments
d) The filum terminale and the ventral and dorsal roots caudal to the conus
medullaris
3. The epidural space is an area that contains

a) Blood vessels and sensory and motor fibers
b) Loose connective tissue, blood vessels, adipose tissue
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c) A delicate network of collagen and elastic fibers
d) The spinal fluid
4. In the spinal cord the cerebrospinal fluid is found within the

a) Central canal and subarachnoid space
b) Subarachnoid and epidural spaces
c) Central canal and epidural space
d) Subdural and epidural spaces
5. Pain receptors are literally the

a) Dendrites of sensory neurons
b) Axons of motor neurons
c) Specialized cells that respond to a limited range of stimuli
d) Activators of motor neurons
6. Cranial nerves, III, IV, VI and XI which provide motor control are
a) Trigeminal, facial, glossopharyngeal, vagus
b) Oculomotor, trochlear, abducens, spinal accessory
c) Olfactory, optic, vestibulocochlear, hypoglossal
d) Oculomotor, hypoglossal, optic, olfactory
7. The cranial nerves that carry sensory information and involuntary motor commands
are
a) I, II, III, IV
b) II, IV, VI, VIII
c) V, VI, VIII, XII
d) V, VII, IX, X
8. The corneal reflex produces

a) Closure of the eye due to neural stimulation
b) Rapid blinking of the affected eye following contact to the cornea
c) Eye movement in the opposite direction of the stimulus
d) Constriction of the pupil of the eye
9. Which of the following effects would be the result of sympathetic activity

a) Dilation of pupils of the eye
b) Constriction of blood vessels of the viscera
c) Increased heart rate
d) All of these
10. The sympathetic division is primarily concerned with which activity

a) Conserving the bodys energy
b) Restoring the bodys energy levels
c) Expending energy and preparing to combat stress
d) Lessening the bodys level of arousal
11. A sudden sound behind and to the right, which causes a rotation of the eyes, head, and
neck to that side, is a response to the
a) Vestibule ocular reflex
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b) Consensual light reflex
c) Auditory reflex
d) Tympanic reflex
12. Jack is 19 years old. He is admitted to the hospital after briefly losing consciousness
when he was tackled during an anzac day football game. During the neurologic
assessment the nurse is careful to note and report the following response by jack
a) He did not know the name of the hospital
b) He could not remember the name of the nurse
c) He said the month was june
d) He could not remember the incident of the football field
13. __________________ is generally relieved by sitting up in a forward leaning position

a) Hyperpnoea
b) Orthopneoea
c) Apnoea
d) Dyspnoea on exertion
14. In a client with emphysema, hypoventilation could initially cause

a) Respiratory alkalosis
b) Respiratory acidosis
c) Metabolic acidosis
d) Metabolic alkalosis
15. A client is anxious and is hyperventilating. In order to prevent respiratory alkalosis

the nurse will
a) Administer oxygen
b) Instruct the client to pant
c) Have the client breathe deeply and slowly
d) Have the client breathe into a paper bag
16. A district nurse is sent to assess a new client with cor pulmonale. This term refers to
a) Enlargement of the pulmonary artery
b) Enlargement of the right ventricle
c) Atrophy of the right ventricle
d) Giant bullae growth on the lung
17. Tony buffer, 54 years old, has a long history of smoking. He decides to have lung and
blood studies done because he is very tired, is short of breath, and just does not feel
good. His blood gases reveal the following findings: pH 7.3; HCO3, 27; CO2 58.
Tonys condition may be
b) Metabolic acidosis
c) Respiratory acidosis
18. When giving advice to a vegetarian, you would suggest a good source of protein
would be contained in
a) Cereal and grains
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b) Vegetables and fruits
c) Eggs and cheese
d) Beans and lentils
19. Iron is important for healthy red blood cells. what other nutrients are also important
a) Vitamin E and vitamin c
b) Vitamin B12 and vitamin E
c) Folic acid and vitamin B12
d) Ascorbic acid and folic acid
20. The bodys need for ascorbic acid and iron are inter related because
a) Iron assists in the use of ascorbic acid
b) Iron assists in the transport of ascorbic acid
c) Ascorbic acid assists the transport of iron
d) Ascorbic acid assists the absorption of iron
21. The term phenylketonuria refers to a disorder involving

a) Increased sugar in the urine
b) Inability to metabolise some fats
c) Excessive breakdown of red blood cells
d) Inability
22. A 79 year old client has pale, cold feet bilaterally, no hair tufts on toes, and a
circumscribed 3 cm lesion on the plantar surface at the first metatarsal joint. Which of
the following is the most likely source of the clients problem
a) Insufficient venous circulation
b) Venous thrombosis
c) Expected age related physiological changes
d) Insufficient arterial circulation
23. On assessing an older client the nurse notes that the left leg is swollen and warm, with
papable pedal pulses; an open, wet ulcer above the medial malleolus, and thick,
course, brown pigmented skin surrounding the ulcer. The probable cause of the ulcer
would be
a) Acute deep vein thrombosis
b) Chronic venous insufficiency
c) Chronic arterial insufficiency
d) Chronic lymphoedema
24. A client is admitted to ED following a car accident. He complains of abdominal

discomfort. The nurse encourages the client to lie down. The reason for this action is
a) To decrease abdominal pain
b) To decrease the risk of dislodging an intra abdominal clot
c) To facilitate peristalsis
d) To decrease the risk of peritoneal infection
25. A client sustained moderate concussion. He has a Glasgow coma scale score of 7.
Which of the following interventions would you include in your care plan
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a) Decrease stimuli, monitor vital signs and neurological status nurse him flat on his
back
b) Gradually increase stimuli, monitor vital signs and neurological status, elevate the
head of the bed 60 degrees
c) Encourage family involvement, reduce monitoring at night to allow client to rest,
elevate the head of the bed 60 degrees
d) Decrease stimuli, monitor vital signs and neurological status elevate the head of
the bed 30 degrees, positioning the client on his side
26. James has sustained a fracture of his left lower leg in a car accident. Classical signs of
a fracture may include
a) Intermittent pain, flushing of surrounding tissues and vascular spasm
b) Local bone tenderness, soft tissue swelling and inability to use extremity
c) Neural compromise, sharp stabbing pain and obvious ischaemia of the extremity
d) Blanching, hyperextension and parasthesia
27. Monitoring for compartment syndrome is done by checking for

a) Active movement of the limb
b) Colour, warmth, sensation and movement of the extremity
c) Pulse and blood pressure changes
d) The tightness of the plaster cast
28. On assessment, the nurse suspects that james is developing compartment syndrome
because he complains of
a) Severe pain, motor compromise and a ‘pins and needles’ sensation
b) A radiating pain and loss of two point discrimination
c) Swelling, muscle atrophy and intermittent parasthesia
d) Dull aching, spasms and lack of fine co ordination
29. A comminuted fracture is characterised by

a) A partial break in bone continuity
b) Injury in which two bones are crushed together
c) An injury in which the bone is broke into two or more pieces
d) An injury in which the bone fragments have broken through the skin
30. A client with multiple fractures is at risk for a fat embolism. What early sign should
you monitor for
a) Haematuria
b) Mental confusion or restlessness
c) Sudden temperature elevation
d) Pallor and discolouration at the fracture site
31. Following an application of a full arm cast a client complains of deep throbbing elbow
pain. You note diminished capillary refill in the fingers. You should
a) Notify the doctor immediately and prepare to bivalve the cast
b) Cut a window in the cast over the elbow area and check for infection
c) Elevate the arm, aply ice packs and assess hourly
d) Administer prescribed analgesics and notify the doctor
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32. When assessing a patient at risk for increased intracranial pressure, the first thing you
would check is
a) Reaction to pain stimuli
b) Papillary function
d) Motor function
33. Pupillary dilation occurs when herniating brain tissue

a) Compress the occulomotor nerve
b) Chokes the optic disks
c) Stretches the optic nerve
d) Paralyses th occulare muscles
34. Changes in vital signs with increasing intracranial pressure would include
a) Hypotension and tachycardia
b) Narrowing pulse pressure and tachypnea
c) Hypotension and a pulse deficit
d) Widening pulse pressure and bradycardia
35. Bleeding within the skull results in increased intracranial pressure because
a) Arteries bleed rapidly and profusely
b) Bleeding from veins goes undetected
c) Spinal fluid is produced more rapidly
d) The cranium is a closed ,rigid vault
36. Which patient is at highest risk for pulmonary embolus

a) A 25 year old man with a history of alcohol abuse recuperating from a gastric
ulcer
b) A 36 year old woman on a liquid diet beginning an exercise programme
c) A 40 year old, obese, pregnant woman placed on bed rest
d) A 90 year old man with no identified health problems
d) Blanching, hyperextension and parasthesia

d) The rightness of the plaster case
a) Severe pain, motor compromise and a ‘pins and needles’ sensation
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40. Uraemia is a clinical syndrome associated with

a) Retention of urea and other nitrogenous wastes
b) The presence of urine in the blood
c) The presence of blood in the urine
d) High ammonia excretion
41. Spinal anaesthesia is inserted in to the

a) Intravenous space
b) Sacral canal
c) Dural membrane
d) Subarachnoid space
42. To monitor abdominal distension you should

a) Assess bowel sounds every shift
b) Measure abdominal girth at the umbilicus every 24 hours
c) Measure abdominal girth every shift, using two fixed points
d) Weigh the patient every shift
43. The fluid outside the vascular system, which surrounds tissue cells, and which
includes lymph is called
a) Interstitial fluid
b) Extracellular fluid
c) Intravascular fluid
d) Intracellular fluid
44. When there is a decrease in blood volume (as in dehydration or blood loss), the body
reacts by retaining sodium and thus water. This occurs mainly as a result of adrenal
gland secretion of
a) Aldosterone
b) Antidiuretic hormone (ADH)
c) Cortisol
d) Parathyroid hormone
45. Which of the following is a defining characteristic for a nursing diagnosis of ‘fluid
volume deficit’
a) Distended neck veins
b) Weak, rapid pulse
c) Moist rales in lungs
d) Bounding, full pulse
46. The nurse should assess carefully for hypervolaemia, (fluid volume excess) when
working with the client with
a) Nausea and vomiting
b) Kidney failure
c) Decreased fluid intake
d) Blood loss
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47. Which is probably the most accurate indication of a clients fluid balance status
a) Intake and output record
b) Skin turgor
c) Daily weight
d) Complete blood count
48. When receiving your patients serum potassium results over the phone, you discover
the results was 2.3mEq/L. Your first action is to
a) Give potassium supplements
b) Take the patients pulse
c) Call the doctor
d) Advise the patient of the result
49. Two signs of respiratory depression are

a) Decrease in muscle reflexes and mobility
b) Lowered respiratory rate and shallow breathing
c) Decreased level of consciousness and hypotension
d) Bradycardia and petechiae
50. You must not give a pre operative patient food and fluids 2 hours before the surgery
due to
a) The digestion of food and fluid interferes with the action of some anaesthetic
drugs
b) The potential for fluid volume overload
c) The risk for hypernatraemia due to the salt content in the food
d) Stomach contents increase the risk of aspiration
51. An adverse side effect of spinal anaesthesia is

a) Restlessness
b) Hypotension
c) Loss of sensation
d) Drowsiness
52. Three days post op, a patient develops a bowel obstruction. The nurse should prepare
the patient for
a) Administration of medications to stimulate peristalsis
b) Insertion of a nasogastric or intestinal tube
c) Transfer to the intensive care unit
d) Emergency surgery
would check is
b) Pupilalry function
d) Motor function
54. Which symptoms should make the nurse suspect pulmonary embolus (PE)
a) Changes in pulse rate and a slowly rising blood pressure
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b) Frothy sputum and slow, deep respirations
c) Shortness of breath, chest pain and anxiety
d) Crackles in the lung bases and pursed lip breathing
55. When you check the time tape on your clients IV bag, you note that the proper
amount has not been infused. The prescribed rate is 200 ml/hour but in the past hour
only 100 mls have infused. Your first action should be to
a) Call the physician for a new order
b) Adjust the roller clamp and increase the rate to 300 ml/hour to catch up
c) Restart the IV at a different site
d) Count the drops per minute to be sure it is running at a rate of 200 ml/hour
56. In evaluating for complications of IV therapy, which of the following are evidence
that the IV has infiltrated
a) In the past hour, only 50ml of fluid have infused
b) The insertion site is red, hot and swollen
c) The clients temperature has gone up to 38oC
d) The site is pale, cool, swollen and painful
57. Swelling and paleness of the skin at the venipuncture site could be indicative of
a) Infiltration
b) Phlebitis
c) Infection
d) Air embolism
58. Mr smith is to have one litre of normal saline Iv over 6 hours. The giving set has a
drop factor of 10. The correct flow rate would be
a) 14 dpm
b) 28 dpm
c) 140 dpm
d) 280 dpm
59. John has been prescribed dextrose/saline 125 mls per hour IV. The giving set has a
a) 125 dpm
b) 120 dpm
c) 60 dpm
d) 65 dpm
60. Hone has been prescribed plasmolyte 500 mls over 2 hours IV. The giving set has a
a) 24 dpm
b) 42 dpm
c) 84 dpm
d) 48 dpm
61. The optimal position for the comatose patient is

a) Prone
b) Supine
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c) Semi fowlers
d) Side lying
e) High semi fowlers
62. Which of the following would a nurse be testing if she asked a 65 year old patient
questions like, ‘what day is it’, ‘what time is it’ ‘what month is it’
a) Intelligence
b) Perception
c) Orientation
d) Personality
63. When a person experiences loss or decreased sensation of pain, temperature and
touch, the major nursing concern will be meeting their need for
a) Communication
b) Nutrition
c) Safety
d) Belonging
64. When caring for a patient with aphasia, you should

a) Talk loudly so she can hear you
b) Refrain from giving explanations about procedures
c) Provide as much environmental stimuli as possible to prevent feelings of isolation
d) Consider the type that the person has and adapt communications methods
accordingly
65. Narcotics are given as preanaesthetic medication to

a) Decrease oral secretions
b) Reduce the risk of intra operation DUT
c) Decrease postoperative pain
d) Reduce postoperative nausea and vomiting
66. Clinical manifestations of hypovolaemic shock include all except

a) A fall in blood pressure
b) A decreased urinary output
c) A weak, rapid, thread pulse
d) Warm moist skin
67. Your clients physician writes an order for antibiotics stat that you feel is too high a
dosage for that client. What should your reaction to this order be
a) Administer the drug as prescribed since the physician is legally responsible for
any mistakes in the order
b) Check with the prescribing physician before administering the drug
c) Administer the drug first since it is a stat drug, and then check with the physician
d) Check with the client about dosages administered to him in the past and compare
this response to the ordered dosage
68. The area of the greatest degree of flexibility along with the vertebral column is found
from
a) C3 – C7
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b) T1 – T6
c) T7 – T12
d) L1 – L5
69. The only ankle bone that articulates with the tibia and the fibula is the
a) Calcaneus
b) Talus
c) Navicular
d) Cuboid
70. Severe fractures of the femoral neck have the highest complication rate of any
fracture because
a) Primary limits are imposed by the surrounding muscles
b) Of the restrictions imposed by ligaments and capsular fibers
c) Of the thickness and length of the bone
d) The blood supply to the region is relatively delicate
71. The purpose of myoglobin in skeletal muscle cells is

a) Assist anaerobic reactions
b) Store oxygen for use during vigorous exercise
c) Catabolise pyruvic acid
d) All of these
72. With a milk product free diet, which of the following supplements would you need
a) Vitamin C and iron
b) Iron and phosphorous
c) Calcium and manganese
d) Vitamin C and riboflavin
73. Protein should be eaten as it

a) Reduces the risk of anaemia
b) Ensures an adequate supply of energy
c) Assists the body to produce new tissues
d) Maintains the bodys protein stores
74. Miss blake has suddenly had a cardiac arrest. What is the critical time period that the
nurse must keep in mind before irreversible brain damage occurs
a) 1-3 minutes
b) 8-10 minutes
c) 2-4 minutes
d) 4-6 minutes
75. David white is in the hospital with a medical diagnosis of viral pneumonia. He is
getting oxygen via a simple face mask. Why must it fit snugly over the clients face
a) Prevents mask movement and consequent skin breakdown
b) Helps the client feel secure
c) Maintains carbon dioxide retention
d) Aids in maintaining expected oxygen delivery
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76. The Heimlich manoeuvre is described in which of the following statements
a) Arms encircling persons waist from behind with firm abdominal thrusts
b) Quick, forceful blow with fist on clients sternum
c) Sweeping out foreign objects form clients mouth with fingers
d) Sharp blow on centre of clients back
77. In teaching a patient about foods that affect his fluid balance, the nurse will keep in
mind that the electrolyte which primarily controls water distribution throughout the
body is
a) Sodium
b) Potassium
c) Calcium
d) Magnesium
78. Mrs zikes is receiving frequent medication. Which of the following would be the
correct identification procedure
a) Check the identification bracelet and call mrs zikes by name
b) Check the name on the foot of the bed, and check the identification bracelet
c) Call mrs zikes by name, this is all that is needed
d) Ask mrs zikes her name, and check her identification bracelet
79. When you answer the clients call light, you note that he has suffered a wound
evisceration. Your response will be to
a) Call the physician immediately for offers. Do not touch the wound
b) Cover the wound with sterile dressing, call the lab to do a culture and then call the
physician
c) Cover the wound with sterile, saline soaked towels and immediately notify the
physician
d) Take the clients vital signs, cover the wound with a sterile towel and call the
physician
80. Which surgical consent would not be considered legal

a) Consent signed by a 36 yer old lady one hour after receiving her preoperative
medication of morphine
b) Conscent signed by 21 year old man who has a fractured leg due to an auto
accident
c) Telephone consent from the father to perform an emergency surgery on a 17 year
old girl
d) Consent signed by a 60 year old man the evening prior to surgery and prior to his
evening sedative
81. Which statement by the nurse would be most therapeutic when the client says, ‘my
friend has a terrible scar from her surgery’
a) Don’t worry, your surgeon is very good
b) You need the surgery, and a little scarring is okay
c) Are you concerned about how your surgical scar will look
d) I wouldn’t worry about that right now, all people are different
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82. Several screening tests are performed on clients preoperatively. Which test
demonstrates the presence of bleeding or anaemia
a) An elevated white blood cell count
b) Decreased haemoglobin and hematocrit
c) Elevated blood urea nitrogen
d) Hypokalemia
83. Leg exercises are taught to clients in order to increase venous return and prevent
thrombophylebitis. Which step of this procedure is incorrect
a) Alternately dorsiflex and plantar flex toes
b) Flex and extend the knee
c) Raise and lower each leg
d) Repeat exercise every one to two hours
84. Two days post surgery ms D continues to complain of pain. There are a number of
interventions available for pain relief. Which comfort measure has the potential of
increasing ms daniels risk of cardiovascular complications
a) Turn ms D every two hours
b) Place pillows under ms Ds knees
c) Splint ms Ds abdomen when she coughs
d) Encourage ambulation as tolerated
85. Your client develops a fever and complains of calf pain over an area that is red and
swollen. Nursing interventions for thrombophlebitis will include all except
a) Elevate the affected leg to heart level
b) Maintain bedrest as ordered
c) Measure bilateral calf circumference every shift
d) Massage the affected calf
86. Which of the following is an autonomic nervous system response to acute pain
a) Decreased heart rate
b) Decreased depth of respiration
c) Pupil constriction
d) Increased blood pressure
87. Which of the following is a natural opiate of the brain involved in the analgesic
system
a) Endorphins
b) Histamine
c) Collagenase
d) Neurotensi
88. Judgement and caution must be used when nonpharmacologic interventions are
applied in the treatment of acute pain because
a) No proof exists that they work
b) They are very expensive to implement
c) They are outside the scope of nursing practice
d) They do not guarantee pain relief
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89. If morphine is given intravenously, regularly as post operative analgesic for 10 days
to a multiple trauma patient, what is the possibility that this patient would become
addicted to the narcotic
a) Almost never
b) Sometimes
c) Often
d) Almost always
90. A malignant neoplasm

a) Grows very slowly
b) Is usually surrounded by a well defined capsule
c) Consists of cells that only form tissues in a very disorganised manner
d) Is composed of goblet cells
91. Which of the following characteristics generally differentiate malignant tumours from
benign tumours
1. Lack of a capsule
2. More rapid growth
3. Infiltrates normal tissues
4. Respects other cells boundaries
a) 1, 2 and 3
b) 1, 2 and 4
c) 1, 3 and 4
d) 2, 3 and 4
92. Malignant tumours and leukaemias may be treated with chemotherapy. The primary
aims of this therapy is to
1. Attack newly developing cancer cells
2. Reduce the size of a tumour
3. Build up a persons defence system
4. Reduce the oxygen bearing capacity of the blood
5. Destroy cancer cells and leave normal cells
a) 1,2 and 3
b) 1, 2 and 5
c) 2, 3 and 4
d) 2, 3 and 5
93. During chemotherapy, soreness of the mouth and anus may develop because
a) The effects of the chemotherapeutic agents concentrate in these body areas
b) These tissues normally divide rapidly and are damaged by chemotherapeutic
agents
c) The entire GI tract is involved because of the direct irritating effects of
chemotherapy
d) The tissues have become damaged fro mprolonged vomiting and diarrhoea
94. Which of the following should be considered in order to avoid skin reactions
following radiotherapy
1. Not to apply ointments of lotions
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2. Not to vigorously dry the skin
3. To apply powder p.r.n
4. To deep the skin area dry and open to air
5. To avoid exposure to sunlight
a) 1, 2 and 3
b) 2, 3 and 5
c) 3, 4 and 5
d) 1,2, 4 and 5
e) 2, 3, 4 and 5
95. A common problem after open cholecystectomy is shallow breathing. This is mainly
due to
a) The site of the incision making breathing painful
b) Damage to the phrenic nerves during surgery
c) The obese state of most patients pre operatively
d) Inadequate pre operative instruction
96. Your patient is charted 1 L normal saline 12 hourly via an IV line (drop factor 10).
Calculate the correct drops per minute (d.p.m)
a) 8
b) 12
c) 14
d) 20
e) 24
97. If the drop factor is 15, how fast should an infusion of 1000 ml normal saline run over
10 hours
a) 15 dpm
b) 20 dpm
c) 25 dpm
d) 40 dpm
98. Mrs graham is an active, retired 62 year old. She has been admitted for investigation
of possible renal calculi. Which of the following investigations would be most useful
in confirming mrs Gs provisional diagnosis of renal calculi
a) Cystoscopy
b) Intravenous pyelogram
c) Renal biopsy
d) Urinary electrolytes
99. Mrs s, aged 56 has undergone elective abdominal surgery. In the evening of the day of
surgery she feels that she wants to pass urine but is unable to do so. The nurse could
best assist her to micturate by
1. Applying manual pressure to the suprapubic region
2. Assisting her to sit at the edge of the bed and use a pan
3. Encouraging her to increase her fluid intake
4. Changing her position, ensuring comfort and giving pain relief
5. Emptying her bladder to give relief by use of a urinary catheter
a) 1 and 3
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b) 1 and 4
c) 2 and 3
d) 2 and 4
100. Side effects of radiotherapy include

a) Burns, lethargy
b) Alopecia
c) Increased rate of cell division
d) Increased WBC production
101. Cytotoxic therapy

a) Is used only as a last resort – a palliative care
b) May be used in conjunction with radiotherapy
c) Not to be given if radiotherapy is anticipated
d) Is used if surgery is impossible
102. Chemotherapy acts by

a) Attacking existing malignant cells and kill tumours
b) Decreases the blood supply to the tumour
c) Interferes with the cell division
d) Increases the clients feelings of wellness therefore giving a boost to cancer
patients
103. Cancer clients pain is assessed by

a) The doctor
b) The health care team
c) The client
d) The family
104. If paracetamol is no longer effective in the treatment of malignant pain

a) Strong opiods are prescribed
b) The end is near
c) Weak opioids and / or NSAIDS may be prescribed
d) The client needs hospitalisation for pain control
105. Important components of pain assessment include

a) Site of pain
b) Onset and patterns
c) Current therapy and effects
d) All of the above
106. Chest problems may best be prevented after cholecystectomy by

1. Giving the patient oxygen
2. Regular deep breathing and coughing
3. Keeping the patients pain minimised
4. Prophylactic antibiotic therapy
5. Keeping the patient rested and warm
a) 1 and 3
b) 1 and 4
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c) 2 and 3
d) 2 and 4
107. Your client suffers from nausea and vomiting in the early post operative
period. Vomiting at this time is most likely due to
a) Volvulus
b) Phrenic irritation
c) Effect of anaesthetic
d) Paralytic ileus
108. Mrs S is scheduled for a choelscystectomy and asks you how she will manage
without a gallbladder. Your best reply is
a) Dilute bile will still pass into your digestive tract but will be less efficient at
digesting fat
b) Your liver will not longer produce bile now so your must stay strictly off fatty
foods
c) Your gallbladder was not a very important organ and you will not miss it
d) You can take a bile supplement in your diet to compensate
109. An intravenous infusion of 500 ml dextrose/saline through a metriset infusion

set (60 drops per ml) is ordered to run over 6 hours. Calculate the drops per minute
a) 137
b) 36
c) 60
d) 83
110. An injection of morphine 7.5 mg is required – on hand are ampoules

containing 10 mg per ml. Calculate the volume to be drawn up
a) 0.5 ml
b) 0.6 ml
c) 0.65 ml
d) 0.7 ml
e) 0.75 ml
111. As the nurse assesses jack for increased intracranial pressure, she would be
concerned if she observed
a) Change in level of consciousness
b) Anorexia and thirst
c) Increased pulse and respiration rates
d) Blurred vision and halos around lights
112. A person has just been involved in an accident that affected the medulla
oblongata. The body process most directly affected by this would be
a) Sight
b) Hearing
c) Muscular coordination
d) Respiration
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113. If your are dealing with a person whose phrenic nerve has been damaged, what
would you expect to observe
a) Reduced diaphragm function
b) Less mucus secretion by the goblet cells
c) Decreased elasticity of the lung tissue
d) Increased coughing
114. The spinal cord extends through the vertebral canal fro mthe foramen magnum
to the
a) 7th cervical vertebra
b) 12th thoracic vertebra
c) 2nd lumbar vertebra
d) 1st sacral vertebra
115. Synaptic conduction of a nerve impulse can be affected by

a) Certain diseases
b) Drugs
c) Changes in Ph
d) All of these
116. Lack of muscle coordination is called

a) Monoplegia
b) Ataxia
c) Tia
d) None of these
117. Pursed lip and diaphragmatic breathing

a) Calms the anxious client
b) Speed up slow respirations and used to promote effective coughing
c) Prevents bronehiolar collapse and air trapping
d) Encourages longer inhalation and faster exhalation
118. Percussion, vibration, and postural drainage

a) Is effective management of nursing frustrations
b) Promotes loosening secretions and movement out of airway
c) Increases blood supply to area therefore increased expectoration
d) Should be done prior to all meals
119. A normal blood sugar level (BSL) is

a) 7.35 – 7.45
b) 120 – 160 mm dL
c) 4 – 7 mmol/l
d) +/- 2 mmEq
120. Blood sugar levels (BSL) are

a) Best done ½ hour prior to meals
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b) Best done ½ hour after meals
c) Need only be done for the IDDM client
d) Need an arterial blood sample
121. Diabetes is
a) An exocrine disorder
b) Decreased production of insulin by the liver
c) An endocrine disorder
d) Decreased secretion of insulin by the alpha cells in the pancreas
122. Type I diabetes are characterised by

a) Non insulin dependence
b) Majority of the diabetic population
c) Require hypoglycaemic agents to maintain glucose levels
d) Need insulin to maintain normal BSL
123. Type 2 diabetics

a) Need insulin to maintain homeostasis
b) May develop ketoacidosis easily
c) May go undetected for years
d) Are usually very slim and malnourished
124. Hyperglycemia
a) Is alright only once in a while
b) Due to an over medication of insulin
c) If left uncontrolled, this can lead to DKA in type 1 or HNK in type 2
d) Also called insulin shock reaction
125. Macrovascular complication of diabetes
a) Occur shortly after the onset of the disease
b) Affects coronary, peripheral and cerebral circulation
c) Affects the eyes and the kidneys
d) Affects sensorimotor and autonomic nerves
126. For the relief of angina, the client may

a) Call 111
b) Take a dose of glyceryl trinitrate up to 3 times, 5 minutes apart until the pain
subsides
c) Slowly exercise to the individuals tolerance level
d) Take only one dose of glyceryl trinitrate, if this has no effect, call 111
127. Ways to minimise precipitating effects of angina are

a) Avoid over exertion
b) Reduce stress
c) Avoid overeating
d) All above
128. Angina
a) May be referred to as angina majoralis
b) Not relieved by rest
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c) Include chest pain which may radiate down the arms, neck, jaw and back
d) Needs immediate medical attention
129. Angina is
a) Caused by a sudden blockage of one of the coronary arteries
b) Caused by anaerobic metabolism exciting pain receptors
c) Causes cardiac tissue necrosis and scaring
d) Interferes with cardiac contractility
130. Myocardial infarction (MI)

a) Causes irreversible tissue damage
b) The final extent of the damage depends on the ability of the surrounding tissue to
recruit collateral circulation
c) 15% of all MIs are silent
d) All of the above
131. MIs may be caused by

a) A formation of a thrombus in a coronary artery
b) Sudden progression of atherosclerotic changes
c) Prolong constriction of the arteries
d) All of the above
132. Manifestations of an MI are

a) Bradycardia
b) Necrosis of a potion of the myocardium
c) Treated only by bypass surgery
d) Not seen on an ECG for 24 hours
133. Medications which are of the utmost importance for a patient following an MI
are
a) 02
b) Stool softeners
c) Morphine
d) All of the above
134. ACE inhibitors include

a) Catopril, enalapril
b) Propranolol, atenolol
c) Niphedipine, dittiazen
d) Fruisemide
135. Antidiuretic hormone is

a) Secreted by the posterior pituitary
b) Increases glomerular filtration rate
c) Increases urinary output
d) Secreted by the hypothalamus
136. Aldosterone is
a) Secreted from the adrenal medulla
b) Increases the distal tubules reabosrption, therefore increases H20 absorption
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c) Decreases the blood pressure
d) Decreases the blood supply to the bowmans capsule
137. The renal system maintains homeostasis by

a) Maintaining electrolyte balances
b) Maintenance of blood volume
c) Conversion of vitamin d for calcium reabsorption
d) All of the above
138. Prerenal failure may be cuased by

a) Burns
b) nephrotoxic drugs
c) Multiple transfusions
d) Renal calculi
139. Acute renal failure (ARF) is

a) Incurable
b) Only curable by kidney transplantation
c) Occurs suddenly and may be reversible
d) Characterised by polyuria
140. Chronic renal failure (CRF)

a) Occurs suddenly and is reversible
b) Occurs over a long period of time an is reversible
c) Occurs over a long period of time and is irreversible
d) Is a nuisance but not fatal
141. Chronic renal failure may be characterised by

a) Lethargy, mental confusion
b) Headaches, GI symptoms
c) General weakness and bleeding tendencies
d) All of the above
142. Problems associated with CRF are

a) Polycythemia
b) Metabolic alkalosis
c) Accentuated sex drive
d) Reduced healing, susceptibility to infections
143. Nursing interventions with a client with renal failure includes

a) Increase dietary protein
b) Increase fluid intake
c) Increase potassium intake
d) Maintain adequate nutritional status and decrease the metabolic demands
144. Malignant tumours have

a) Irregular shapes with poorly defined borders
b) Cells similar to their parent cells
c) Expansive growth
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d) Fibrous capsule
145. Which of the following are not malignant

a) Sarcoma
b) Metastasis
c) Neoplasm
d) Benign
146. The world health organisations (WHO) analgesia ladder is

a) A systematic tool used for the identification of medications to prescribe for
patients with cancer pain
b) Initial treatment includes simple analgesics, to progression of mild opioids to
strong opioids
c) Opioids may be used in conjunction with anticonvulsant and antidepressant drugs
to promote effectiveness
d) All of the above
147. If your client is experiencing break through pain

a) They are not administering their medications correctly
b) Morphine should only be taken when pain is experienced
c) They may require a quick release morphine titrated to alleviate their pain
d) Start an IV and double the dose of morphine
148. Potential side effects of morphine administration for the alleviation of

malignant pain are
a) Addiction
b) Constipation, nausea and vomiting
c) Antisocial behaviour
d) Once the maximum dose of morphine is reached, the pain may no longer be
controlled
149. When an arterial blood gas (ABG) sample is taken ,the initial nursing
intervention should be
a) Assessing the movement of the extremity
b) Apply pressure to prevent an arterial bleed
c) Calming and educating the client to alleviate anxiety
d) All of the above
150. Normal oxygen saturation (SaO) values are

a) 80-100% saturation
b) 70-90%saturation
c) 90-100% saturation
d) 100% saturation
151. Approximately 1000ml (1L0 of oxygen is transported to cells each minute.

Most of the oxygen is transported
a) Dissolve in his plasma
b) Loosely bound to his haemoglobin
c) In the form of CO2
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d) As a free floating molecule
152. Mary a 46 year old woman, is admitted to your ward with a chest infection due
to an exacerbation of chronic obstructive pulmonary disease (COPD). A person with
emphysema is susceptible to respiratory infections primarily because
a) Failure of his bone marrow to produce phagocytic white blood cells
b) Retention of tracheobronchial secretions
c) Decreased detoxification of body fluids by compressed liver cells
d) Persistent mouth breathing associated with dyspnoea
153. Emphysema differs from chronic bronchitis in that

a) Emphysema obstruction results from mucous production and inflammation
b) Emphysema obstruction results from changes in lung tissues
c) Chronic bronchitis obstruction results from changes in lung tissue
d) There are no visual difference between the two conditions
154. The tissue change most characteristic of emphysema is

a) Accumulation of pus in the pleural space
b) Constriction of capillaries by fibrous tissue
c) Filling of air passages by inflammatory coagulum
d) Over distension, inelasticity, and rupture of alveoli
155. Which of the following results of emphysema is primarily responsible for

cardiomegaly
a) Hypertrophy of muscles encircling the bronchi
b) Increased pressure in the pulmonary circulation
c) Decreased number of circulating red blood cells
d) Secretion of excessive amounts of pericardial fluids
156. Circulatory shock can best be described as a condition in which there is

a) A state of hypotension
b) Loss of blood
c) Loss of consciousness due to blood loss
d) Inadequate blood flow to meet the metabolic needs of the body tissues
157. Causes of hypovolemic shock include

a) Vomiting and loss of body fluids
b) Allergic reactions to drugs
c) Cardiac failure
d) Hypoglycaemia
158. Early signs of hypovolemic shock include

a) Restlessness, thirst and increased heart rate
b) Decreased blood pressure and apathy
c) Increase in heart rate and increased pulse pressure
d) Decreased blood pressure and unconsciousness
159. In shock, one of the best indicators of blood flow to vital organs is
a) Rate of blood and fluid administration
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b) Blood pressure
c) The colour and temperature
d) Urine output
160. Oliguria an early sign of shock, occurs for what reason

a) Cessation of glomerular filtration
b) Acute tubular necrosis
d) Sympathetic stimulation
161. A person admitted to the emergency room with trauma and an estimated blood
loss of 1200 to 1400 mls has a blood pressure of 110/170mmHg and a heart rate of
120 beats per minute. The best explanation for these observations would be that
a) The persons actual blood loss was less than the originally estimated loss
b) The person was normally hypertensive and hence did not have as great a drop in
blood pressure as a normotensive person
c) The cause of the bleeding is now under control and the increased heart rate is due
to anxiety
d) An increase in heart rate is compensating for the loss of blood volume
162. The pale, cool, and clammy skin that is often observed in an individual with
shock, can be explained in terms of
a) Loss of red blood cells
b) Bodys attempt to shunt blood to vital organs by constricting skin vessels
c) Decreased metabolic needs that accompany shock
d) Bodys attempt to conserve heat loss
163. A 48 year old complains of chest pain. Signs and symptoms that would
support a diagnosis of myocardial infarction would include
a) Jugular vein distension and hepatomegaly
b) Fever and petechiae over the chest area
c) Nausea and vomiting and cool, clammy, pale skin
d) Pericardial friction rub and absent apical pulse
164. Teaching for the client taking GT or glycerol with nitrate for angina would
include
a) Instructing the client to take the nitroglycerin regularly
b) Explain to the client that a subsequent headache indicates ineffective medication
c) Instructing the client to put the tablet on the tongue and swallow after the tablet
dissolves
d) Teaching the client to take a tablet every 5 minutes (x3) when chest pain occurs
165. A female client is diagnosed with unstable angina. The nurse finds her crying
because she fears she will become a burden to her husband. Which of the following
nursing diagnosis would be most appropriate
a) Impaired verbal communication
b) Ineffective family coping
c) Relationship difficulties
d) Fear due to knowledge deficit
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166. Which of the following steps should a client with periodic angina pain take
first when pain occurs at home
a) Take sublingual nitroglycerin and lie down
b) Do mild breathing exercises
c) Take an extra long lasting nitrate tablet
d) Sit down and relax
167. The nurse detects premature ventricular contractions and (PVCs) on the ECG
of a client who had a mitral valve replacement 2 days ago. PVCs may be dangerous
because they
a) Significantly increase cardiac workload
b) May lead to ventricular tachycardia or fibrillation
c) Are the most common cause of myocardial infarction
d) Decreased heart rate and blood pressure
168. Blood pressure control is carried out by regulation of smooth muscle via
a) Parasympathetic stimulation
b) Parasympathetic and sympathetic stimulation
c) Sympathetic stimulation
d) None of these
169. The areas of the body that sense blood pressure are know as
a) Barareceptors
b) Chemoreceptors
c) Viscoreceptors
d) None of these
170. When taking a blood pressure, the first sound picked up by the stethoscope as
blood pulses through the artery is the
a) Mean arterial pressure
b) Pulse pressure
c) Diastolic pressure
d) Peak systolic pressure
171. At any given moment, the systemic circulation contains about

_____________ of the total blood volume
a) 10%
b) 51%
c) 71%
d) 91%
172. The nurse gets the arterial blood gases report and it shows that a person has
hypercapnia. This means that
a) There is an increased blood carbon dioxide
b) The blood oxygen level is reduced
c) Carbon dioxide has been lost
d) There is respiratory alkalosis
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173. Gregory aged 70 was admitted with congestive heart failure. Which of these
changes in physiology is present in congestive heart failure
a) Heart muscle degeneration due to old age
b) A decrease of blood flow through the heart
c) An abnormality in the structure of the heart
d) A blood clot forms in one of the heart chambers
174. The doctor asks the whanau for the corneas of iris for transplantation. The
whanau cannot make a decision right now. What is the most appropriate action nyou
should take in support of the whanau
a) Tell the doctor that this is not culturally appropriate
b) Listen to them and support them in their decision
c) Explain nto the whanau why corneas are transplanted
d) Suggest the whanau talk to the hospital chaplain
175. Tipene a 44 year old male, who identifies as maori, is admitted to your ward.
He is an insulin dependent diabetic. His whanau (family) are with him. What is your
first nursing action
a) Introduce yourself to tipene and his whanau
b) Take his baseline observations
c) Ask the whanau if there is anything they wish to know
d) Orientate tipene and his whanau to the ward
176. Oral hypoglycaemic agents are effective and short acting. Their specific action
is
a) As an oral form of insulin
b) To increase the output of insulin
c) To control the islets of langerhans
d) To decrease the output of insulin
177. Individuals whose diabetes is not well controlled are vulnerable to several
complications, which of the following are they least likely to develop
a) Artherosclerosis
b) Cateracts
c) Lympyhadenopathy
d) Nephropathy
178. The most important feature of foot care for a diabetic would be to
a) Cut nails straight across
b) Maintain adequate blood flow to the lower limbs
c) Wear sandals at all times
d) Avoid wearing garters
179. You are a community nurse in charge of an adolescent wellness centre at a

local high school. You are planning a programme to promote self esteem in
adolescence. Your final plan is governed by
a) Your perception of their needs
b) The focus of the health curriculum
c) Consultation with the adolescents
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d) Ideas from the teaching staff
180. Autoimmune disease occurs when

a) Antibodies fail to recognise own tissue as an antigen
b) Antigens fail to stimulate antibody response
c) Antibodies identify own tissue as an antigen
d) Antibody production ceases
181. You present a seminar to your colleagues on immunisation. After the

presentation you are asked to clarify the following. Immunity that results from the
natural exposure to an antigen in the environment is called
a) Active immunity
b) Natural passive immunity
c) Autoimmunity
d) Passive immunization
182. Immunity that results from antibodies that pass the placenta from mother to
foetus is called
a) Active immunity
c) Autoimmunity
d) Natural active immunity
183. In active immunisation

a) The immune system attacks normal body cells
b) The body receives antibodies produced by another person
c) Genes for antibodies are introduced into the body
d) The body is deliberately exposed to an antigen
184. Suppressor t cells act to

a) Suppress antigens
b) Limit the degree of memory in memory cells
c) Limit antigen proliferation
d) Depress the responses of other t and b cells
185. You are preparing vaccines for an immunization programme. In the

preparation of vaccines, the cold chain refers to a system of
a) Maintaining vaccines at temperatures under 10 degrees C
b) Preventing heat damage to vaccine
c) Storing vaccines at stable temperatures in a separate refrigerator
d) Transport storage and administration of vaccine in a potent state
186. Which of the following is a contraindication to immunization

a) Contact with an infectious disease
b) Prematurity
c) Temperature over 38 C
d) Asthma
187. When carrying out immunizations a nurse must have with her/him
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a) Oxygen
b) A medical officer
c) Intravenous fluids
d) Adrenaline
188. Increased incidence of meningitis led to the introduction of a new vaccine into
the new Zealand immunization schedule in 1994. The causative organism of this
disease is
a) Beta a streptococcus
b) Respiratory syncytial virus
c) Haemophilus influenza
d) Neisseria meningitis
189. The immunization usually given at 3 months of age provides protection

against
a) Diphtheria, tetanus, whopping chough, polio haemophilus influenza
b) Diphtheria, tetanus, whooping cough, polio, hepatitis B, haemophilus influenza
c) Diphtheria, tetanus, whooping cough, haemophilus influenza
d) Diphtheria, tetanus, polio, hepatitis B, haemophilus influenza
190. As a community nurse at the school you are asked to see suzie who has
unexplained bruising on her arms and legs. Your initial assessment indicates she has
been abused. Your first professional responsibility is to
a) Contact the child protection coordinator
b) Contact the childs parents
c) Contact the police
d) Carry out a full physical examination
191. It has been decided that physical abuse has occurred. Which intervention will
be implemented under the children, young persons and their families act
a) The chid will be removed from the home to a place of safety
b) The child protection coordinator calls a family case conference
c) The abuser will be removed from the home
d) The community nurse calls a family conference
192. You return to your office and receive a call from a man stating he is suzies
father. He says i believe you think i have been hitting my daughter. Your response is
a) Suzie told me you had been hitting her
b) I wont discuss this with you at the moment
c) It would be better if you rang the school
d) I cant discuss this on the phone
STATE EXAMS 23
1. A man comes to the clinic complaining of headache irritability. He lost his job a week
ago and has to relocate. He is experiencing
a) Anxiety reaction
b) Situational crises
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c) Maturational crises
d) Adventitious crises
2. Which of the following phrases best describes the major goal of crises intervention
a) Decrease anxiety
b) Facilitate personality change
c) Identify the precipitating event
d) Re-establish psychological equilibrium
3. Anne is admitted to the psychiatric unit with distorted perceptions and disordered
thoughts and cannot complete her morning care even when given directions. At this
time your nursing assessment indicated that she is experiencing which level of anxiety
a) Mild
b) Panic
c) Severe
d) Moderate
4. All the following nursing actions are appropriate for a patient experiencing anxiety,
but which one should be your initial priority when a patient is at panic level
a) Provide for the patients safety
b) Decrease environmental stimuli
c) Respect the patients use of personal space
d) Encourage the patient to discuss his feelings
5. Anne tends to use the defence mechanism of displacement. Her husband, to whom she
is very devoted, bawls her out for being disorganised and flightly. She is most likely
to react by
a) Burning his dinner
b) Scolding the delivery boy for being late
c) Telling her husband she is furious with him
d) Being an especially gracious hostess the next time they entertain
6. Mr w is a 45 year old man who is admitted to an alcohol detoxification unit. He has
had nothing to drink in 3 days. On admission his behaviours include tremor, anxiety,
visual hallucinations, insomnia, paranoia, and disorientation accompanied by
vomiting, temperature elevation, tachycardia, and diaphoresis. These are behaviours
characteristic of the syndrome known as
a) Alcoholic hallucinosis
b) Alcohol induced psychosis
c) Alcoholic seizure disorder
d) Alcohol withdrawal delirium
7. The highest priority nursing action relative to alcohol withdrawal delirium would be
a) Orientation to reality
b) Application of r
c) restraints
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d) Identification and social supports
e) Replacement of fluids and electrolytes
8. A patient with schizophrenia says to the nurse, ‘I’m like a fallen star. But I won’t go
into a bar … it would be a mar on my family, on the tar.’ This is an example of
a) A delusion
b) Word salad
c) Clang association
d) A loose association
9. A person who has schizophrenia refuses to remove her clothing. The planned nursing
intervention which indicates the best understanding of her communication is
a) Providing her with a selection of outfits in order to offer alternatives
b) Forcible removal of her clothing in order to meet her basic hygiene needs
c) Stating that she would look more attractive in clean clothes in order to increase
her self esteem
d) Telling her that she may wait and change when she is ready to in order to help her
maintain her identity
10. John smith aged 50 receives 30% burns to his face, neck, arms and upper thorax when
he pours petrol onto his barbeque. The most appropriate immediate first aid treatment
for mr smith is to
a) Roll him in a damp rug to extinguish the flames
b) Remove his burning clothes as fast as possible
c) Quickly throw him into the swimming pool
d) Quickly roll him in a wet sheet and apply ice to his burns
11. Smoke inhalation can complicate burn injuries. While waiting for the ambulance the
most appropriate position for conscious victims of smoke inhalation is
a) Sitting in the semi fowlers position
b) Laying down with neck hyperextended
c) Lying supine with the legs elevated
d) Lying in the recovery position
12. Which of the following is correct with regard to burn injuries

a) Partial thickness burns are not painful as the nerve endings are destroyed
b) Full thickness burns are often very painful as the nerve endings are irritated
c) Full thickness burns are often not painful as the nerve endings are destroyed
d) Blistering are redness often occur very quickly following a full thickness burn
13. Factors determining the severity of the burn injury include

a) Depth of burn and percentage of body surface area burnt
b) Location of the burn and age of victim
c) Size of the burn and previous medical history of the victim
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d) All of the above
14. Recent research indicates that arthritis may be an autoimmune disease. Which of the
following statements most accurately describes the process of autoimmunity
a) A rare complication of vaccination when the body reacts to the vaccine by
producing symptoms of the disease
b) An inherent factor in the blood which render the person susceptible to certain
disease
c) Lack of antitoxins in the blood which render the person susceptible to the certain
disease
d) Formation of antibodies in the blood which destroy certain healthy cells in the
individual
15. Patients with rheumatoid arthritis commonly have a raised ESR (erythrocyte
sedimentation rate) this is because
a) arthritic patients usually have a degree of anemia
b) rheumatoid factor decreases the viscosity of the cells
c) protein changes result in the erthrocytes becoming heavier
d) there is an increase in leucocyte numbers
16. chuck jones, 12 years old, has been hospitalized on the pediatric unit with an acute
asthmatic attack. He is receiving 2,000mls of 5% dextrose in water with 20
millieqivalents of KCL per day. The drop factor is 60 drops per millilitre. How many
drops per minute should he receive
a) 60
b) 68
c) 76
d) 83
17. Chick drinks small amounts of fluids, which total 400 mls per day. His daily total,
including the intravenous fluid intake is 2,400 mils. His total output is 1,500 mls per
day. The specific gravity of his urine is 1.015. based upon the evaluation of this data,
the nurse should
a) Call the physician and request a change in the amount of intravenous fluid
b) Continue to encourage chuck to drink fluids, and offer choices
c) Suggest to chuck that he eat more solid foods
d) Tell chuck that he need not force himself to drink fluids
18. A 24 hr urine collection is ordered to determine mrs cousins oestriol levels. The nurse
should advise mrs cousins to
a) Save all urine samples from the first one in the morning until the first one next
morning
b) Discard the first morning urine sample and save all urine samples including the
first one the next day
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c) Begin the collecting at any time during the day and save all urine samples for the
next 24 hours
d) Include the next urine sample after the completion of the 24 hour period, if a urine
sample has been discarded accidently
19. Mrs cousins has gestational diabetes. Assessment of mrs cousins diabetic status
during the first 24 hours after delivery should include monitoring her blood glucose
levels for a possible complication of
a) Hypoglycaemic
b) Hyperkalemia
c) Keoacidosis
d) Galactosemia
20. Mr and mrs cousins are concerned that their children will develop diabetes. The nurse
should respond that
a) Because diabetes is inherited their children should be assessed periodically
b) A genetic counsellor can determine the probability of their children developing
diabetes
c) There is little chance that their children will develop diabetes because mr cousins
is not diabetic
d) Statistical predictions of whether children of diabetics will develop diabetes are
not too reliable
21. Shirley, aged 4, has been brought to the health clinic because according to her mother,
she does not talk. She is diagnosed as having autistic behaviour. In planning long term
care for Shirley, the health team especially needs to consider
a) The role of the father in the family
b) Separating Shirley from her family
c) A nurse who will be a surrogate mother
d) Supporting the mothers role
22. Shirley has to be hospitalised. Which nurinsg approach will best help shirleys
maladaptive behaviour
a) Isolation whenever Shirley is acting out
b) Allowing Shirley to have her own way
c) Rewards given when Shirley co operates
d) A one to one relationship with Shirley
23. The nurse plans to have Shirley involved in daily sessions of therapeutic play. The
main reason for this activity is that
a) The nurse can motivate Shirley through play
b) Shirley can best express herself through play
c) Shirley will be happier when she is playing
d) The nurse will be more objective watching Shirley play
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24. Mr wolfe, a 46 year old executive, is admitted to the C.C.U. with chest pain and
shortness of breath. A diagnosis of myocardial infarction is made. One of the more
common complications of myocardial infarction is
a) Cardiac arrhythmias
b) Anaphylactic shock
c) Cardiac enlargement
d) Hypokalemia
25. The nurse observes mr wolfes monitor and identifies asystole. This arrhythmia
requires urgent attention because the heart is …
a) Beating very rapidly
b) Beating very slowly
c) Not beating
d) Beating very irregularly
26. A cardiac arrest code is called for mr wolfe. The nursing priority is to
a) Ensure the airway is clear
b) Give 4 full lung inflations
c) Compress the lower sternum 15 times
d) Check for a radial pulse
27. The commonist cause of mitral valve stenosis is

a) Atherosclerosis
b) Sub acute bacterial endocarditis
c) Rheumatic fever
d) Left ventricular failure
28. People with cardiac valve disease are especially prone to develop bacterial
endocarditis when undergoing the following type of surgery
a) Dental
b) Thoracic
c) Abdominal
d) Orthopaedic
29. Which of the following molecules cannot pass through capillary endothelium
a) Oxygen and carbon dioxide
b) Plasma proteins
c) Glucose, oxygen and carbon dioxide
d) Amino acids and water
30. Ammonia is excreted by the kidney to help maintain

a) Low bacterial levels in the urine
b) Osmotic pressure of the blood
c) Hydrostatic pressure in the glomerulus
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d) Acid base balance of the body
31. Chronic renal failure results in anaemia primarily because

a) Low levels of urea destroy red blood cells
b) The bone marrow is depressed
c) The kidney produces erythropoietin
d) High levels of vitamin k in the blood
32. Carbon dioxide acts as a

a) Respiratory stimulant
b) Vaso dilator
c) Respiratory depressant
d) Bronchodilator
33. The antidote to heparin is

a) Vitamin d
b) Vitamin k
c) Prothrombin
d) protaine sulphate
34. mr thomas has tb. Tb is spread by

a) inhalation of droplets
b) ingestion of contaminated food
c) injection with unsterile equipment
d) entry through skin lesion on the hand
35. which of the following complications may occur if mr thomas fails to take his
medications regularly
a) allergic reactions to his medications
b) loss of tissue sensitivity to tuberculin
c) bacterial resistance to the drugs
d) calcification of the lymph nodes
36. a possible toxic effect of streptomycin is

a) anaemia
b) anuria
c) deafness
d) hypotension
37. susan, aged 16 years was admitted for investigation of grand mal epilepsy following a
seizure and complaining of blurred vision. The most important test to diagnose
epilepsy would be
a) an electroencephalogram
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b) an electrocardiogram
c) lumbar puncture
d) coombe test
38. the site of vision in the brain is located in the

a) temporal lobe
b) occipital lobe
c) parietal lobe
d) thalamus
39. which of the following medication may be given to prevent a grand mal seizure
a) Dilantin
b) Bromide
c) Neocytamen
d) Levo dopa
40. Following a grand mal seizure susan is likely to be

a) Hostile
b) Hyperactive
c) Enphoric
d) Confused
41. Susans mother asks you ‘will this trouble make susan slow in school. Which response
would be most appropriate
a) Absolutely not. Susans disease has nothing to do with her intelligence
b) So long as she small seizure they will have no effect on her brain
c) There is no reason to expect the disease to decrease susans ability to learn
d) As epilepsy causes mental deteriorations, susans learning ability may be affected
42. Millie crowe, a nursing student, develops muscular weakness in her right arm and
intermittent urinary incontinence. The diagnosis of multiple sclerosis is made. The
pathology underlying the manifestations of multiple sclerosis has been identified as
the
a) Deficiency of neurotransmitters
b) Destruction of the nerve myelin sheath
c) Interference with neuronal transmission
d) Premature destruction of transmitter substance
43. When discussing the future with millie it is important to explain that multiple
sclerosis
a) Is a disorder that becomes progressively worse
b) Is caused by an underlying viral infection
c) Can be cured with appropriate treatment
d) Has remission of months or years
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44. The main goal in treating millie is to minimize the risk of
a) Prolonged discomfort
b) Symptom exacerbation
c) Delayed recovery
d) Dehydration
45. The persons who are most likely to have the greatest effect in assisting millie to
maintain a positive self concept are
a) The occupational therapists during job retraining
b) Other people with multiple sclerosis who manage independent lives
c) Physiotherapists who help her to achieve maximum mobility
d) People unaffected by multiple sclerosis such as the Ms society field worker
46. A public health nurse has been invited to talk about child health with a group of
mothers. Which is the single most important factor in the early social development of
children
a) Living in an extended family setting
b) The way their needs are met and stability
c) Their physiological status and stability
d) Their inherited biological characteristics
47. An important factor which makes two year old children feel physically secure is
a) Acknowledging they are individuals
b) Allow them to have what they want
c) Ensure they know what they can and cannot do
d) Be very strict when disciplining them at home
48. Which of eriksons psychosocial cirises is present at age four years

a) Trust versus mistrust
b) Initiative versus guilt
c) Industry versus inferiority
d) Autonomy versus shame and doubt
49. Parents are likely to have less conflict with their adolescent children if they
a) Use rules and punishment to control adolescents
b) Make a conscious effort to remember their own adolescence
c) Keep communication open and allow reasonable independence
d) Plan a set of rules which will be followed at all times
50. Which of the following statements would best help a mother who says that she does
not believe in immunisation because it is unnatural
a) Your children are in danger of infection if they were not given breast milk to gain
natural immunity
b) Immunisation assists the body to produce its own immunity and give protection
against dangerous infections
c) If your children are not immunised they will have to be kept away from other
children because they could make other children ill
d) If you do not have your children immunised they can be admitted to hospital with
infectious diseases and cost the country a lot of money
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51. The nurse should explain to a youth who has not been immunised against tetanus that
he will be given a
a) Single dose of tetanus serum
b) Single dose of tetanus toxoid
c) Small dose of tetanus anti toxin
d) Course of tetanus toxoid injections
52. Vaccinations are often given at specified intervals with weeks or months in between
each injection because
a) This is convenient to the doctors and nurses
b) A stronger secondary response is induced
c) This is a long standing medical procedure
d) The body could not cope with a large dose at one time
53. Vaccines induce immunity that is

a) Active artificially acquired
b) Passive artificially acquired
c) Active naturally acquired
d) Passive naturally acquired
54. Which of the following signs/symptoms would induce mumps

a) Swelling of the lymph nodes
b) Tenderness of the parotid gland
c) Enlargement of the prostate gland
d) Ulceration of vesicular stomatitis
55. Which option is important for the nurse to know with regard to prevention of the
spread of mumps
a) Safe disposal of all bodily excretions
b) No specific isolation measures are needed
c) Control of all food stuffs prepared for sale
d) Isolation for ten days after the last notified case
56. Which of the following is the best description of a vaccine
a) Dead modified bacilli
b) Live attenuated virus
c) Dead virus given orally
d) Antibodies suspended in serum
57. Mr adams suffers from dementia and requires a dressing to a shin wound. The nurse
suspects the wound is the result of a non accidental injury. What is the main cause of
non accidental injury in an elderly person suffering from dementia
a) A dependent person being more prone to injury
b) A long standing pattern of domestic violence
c) The home not being a suitable place for dependent person
d) The increased stress in caring for a dependent person at home
58. When dressing the shin wound the nurses most appropriate remark is
a) How did you scrape your shin mrs adams
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b) How did you scrape your wifes shin mr adams
c) This shin must hurt. Was it really an accident
d) A shin is easy to hurt. How did this injury happen
59. The most appropriate way to help mr and mrs adams at the first visit is to
a) Express professional concern at the cause of the injury
b) Conceal feelings about the possible cause of the injury
c) Reassure mrs adams that this injury will not occur again
d) Acknowledge the stress on mr adams in caring for his wife
60. Which is the major pathophysiological abnormality occurring in asthma

b) Bronchiole dysplasia
c) Spasm of the smooth muscles of the bronchi
d) Inflammation of the alveoli
61. Aminophylline 350 mg is prescribed. Each ampoule contains 250mg in 10ml. how
much should be added to the intravenous solution
a) 12 ml
b) 14ml
c) 16ml
d) 35ml
62. Jillians intravenous infusion of 300ml normal saline is due to run over 4 hours. The
drop factor is 60. How many drops per minute must be given for the IV to be
completed on time
a) 55
b) 65
c) 75
d) 85
63. Salbutamol (ventolin) is administered through a nebuliser four hourly. The primary
action of this drug is as a
a) Bronchodilator
b) Cardiac stimulant
c) Respiratory stimulant
d) Respiratory depressant
64. A client is charted nitrazepam (mogadon) tablets to sleep. She refuse to take them at
9pm. She tells you that the other nurses always leave the tablets on the locker and she
takes them when she is ready. What should you do
a) Put them back in the container
b) Give her the tablets and let her take them later
c) Tell the patient to ring when she is ready for them
d) Tell her if she doesn’t take them now she may not get them later
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65. Jo is a third year comprehensive student nurse who has just completed her elective
clinical experience. Whilst on clinical jo was able to observe the management role. Jo
noticed that the charge nurse managed to control all the activities in the ward really
well. Controlling refers to actions taken to
a) Increase job satisfaction and motivation among employees
b) Increase productivity, innovation and quality outcomes
c) Ensure that actual outcomes are consistent with those planned and anticipated
d) Determine success or failure with tasks
66. Quality control refers to activities which

a) Set standards and determine criteria
b) Determine whether standards have been met
c) Educate staff about corrective actions required
d) Evaluate, monitor or regulate services rendered to customers
67. One of the reasons the charge nurse controls well is that she has set standards for
performance. A standard is
a) An agreed upon base line condition or level of excellence
b) An evaluation instrumental tool used by all
c) A set of behaviours that are common and understood by all
d) A set of behaviours that are defined by others for a profession
68. While jo was on the ward a nursing audit was done. The nursing audit is a tool
designed to evaluate
a) The nurses clinical practice
b) The nursing care clients receive
c) The charge nurses managerial skill
d) The cost of nursing care of clients
69. Mrs gs menstrual cycle began on 27 october 1995 and finished on 31 october 1995.
She is confirmed pregnant. What is her estimated due date
a) 30 june 1996
b) 27 july 1996
c) 31 july 1996
d) 3 august 1996
70. A positive result when using a pregnancy test kit is due to

a) Chorionic gonadatropin in the urine
b) Oestrogen in the urine
c) Increased amounts of estrogen in the urine
d) More oestrogen and progesterone in the urine
71. Mrs g asks you about the reliability of pregnancy test kits. Which is the best response
a) Used according to directions, they are 95% reliable
b) You need to be trained to use and read those kits
c) The test can give inaccurate results
d) Discuss this with your chemist
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72. If mrs g were to have a threatened abortion, she is most likely to present with
a) Diminished resistance of the cervix to increasing pressure exerted by the
conception
b) Expulsion of the embryo with slight bleeding
c) Slight haemorrhage with no cervical dilation
d) Some products of conception being retained in the uterus
73. The muscular wall of the uterus is known as the

a) Endometrium
b) Endothelium
c) Mymetrium
d) Deciduas
74. Mrs g tells you she seems adjusted to the pregnancy one day and unsure of her
feelings the next. What do you tell her
a) Role change is a complex task
b) Ambivalence is quite normal in early pregnancy
c) Acceptance of the pregnancy occurs in the fifth month
d) Make an appointment with your doctor
75. Mrs gs pregnancy progresses and she is admitted in labour. Which of the following is
true of normal labour
a) The foetus is born at term
b) The foetus presents by vertex
c) The onset is spontaneous
d) All of the above
76. A normal bowel motion for baby g on its 4th day, would be
a) Small and dark green
b) Pale yellow and smell slightly offensive
c) Soft, bright yellow with a tinge of green
d) Black, tarry and soft
77. Cultural safety to practice in nursing is best describe by all of the following except
a) Actions which recognise, respect and nurture the unique cultural identify of
tangata whenua
b) Actions which safety meet expectations, rights and needs of the tangata whenua
c) Actions which empower tangata whenua by working with, rather than on behalf
d) Actions which diminish, demean, or disempower the cultural identity and well
being of and individual
78. Professor mason durie describes maori health as the

a) Spiritual, intellectual, social and family kinship components
b) Spiritual, mental physical, and family kinship components
c) Mental, physical and family kinship components
d) Physical, psychological, social and spiritual components
79. One way in which nurses can deliver more personalized, culturally safe/appropriate
care for maori clients is
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a) To be sensitive and non judgemental and expect the client to conform to
prescribed care
b) In a sensitive manner actively discourage any treatment or care strategy not
congruent with the clients own beliefs
c) Give sensitive and non judgemental explanations when refusing client requests for
own cultural/care remedies
d) Adapt nursing care plans to accommodate any treatment or care strategy
congruent with clients own beliefs
80. Communication patterns are also a cultural factor that may influence health care
practices. The best way to overcome miscommunication when nursing a maori client
would be to
a) Use jargon free language
b) Check client understanding
c) Check for any non verbal cues
d) All of the above are correct
81. When assessing families or an individual within a cultural context the nurse in either a
community or hospital setting needs to be aware of
a) Beliefs about the relationship between culture and medical intervention
b) Beliefs concerning body organs and or systems and how they function
c) Beliefs concerning social and economic responsibilities of their clients
d) Beliefs concerning medical practice and nursing care
82. Nurses have a responsibility to improve accessibility to health care for their clients,
and to provide culturally relevant and safe health care. This can be achieved by
a) Recognizing that the human experience of illness is identical to the biomedical
interpretation of disease
b) Recognizing that many maori clients have their own concepts and interpretations
about illness and health
c) Being aware that all maori clients have the same belief system regarding health,
illness and its treatment
d) Acknowledging the impact for humans experiencing the current political and
social forces on their health
83. Maori people since ancient times have always been closely attuned to nature and used
plants and herbs for remedies to cure many ailments and illnesses. The following is
correct
a) This is no longer true, in fact such customary practices are declining
b) This is continuing, with widespread use of a variety of plants for medicinal
purposes by maori people
c) This is only permitted with permission from a tohunga
d) This is no longer true, due to persistent negativity of makutu
84. The development of primary health care in maori communities requires all primary
health care providers to
a) Be involved in their own health care
b) Take greater responsibility for maori health care
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c) Identify maori health concerns and devise solutions to meet these
d) See a more equitable allocation of health resources into preventative and health
promotion programmes
85. As a staff nurse you overhear an elderly maori patient (due for surgery later in the
day) asking another nurse if his kuia could come in and say a prayer for him, to which
the nurse replies, ‘what good are prayers’, ignoring his request to carry on with other
work. What actions would you take in this situation
a) Arrange to call kuia yourself without informing the nurse or patient
b) Inform the charge nurse, explaining what you overheard and leave it for her to
deal with
c) Explain (in private) to the nurse concerned the importance of her patients needs.
Inform charge nurse if nurse concerned remains unco operative
d) Ignore the incident completely and continue on with your own work,
acknowledging that non interference is the best strategy as he is not your patient
anyway
86. You have chosen to work in an obstetric unit for your elective experience. A level 1
student nurse tells you ‘mrs t wants to take her babys’ placenta and umbilical cord.
What a strange request. Your response would be to
a) Agree with the student and say, ‘forget about it’
b) See this opportunity to promote cultural safety in a clinical setting
c) Tell the student to go and talk to the nurse manager about it
d) Ask a minister to come and talk to mrs t
87. As a community nurse you are planning a health check programme at a kohanga reo
that is on a marae. Your plan of action would include
a) Contacting the kohanga reo and establishing correct protocol for your visit
b) Research and review knowledge of cultural variables
c) A culturally appropriate health programme
d) All of the above
88. Which statement about spirometry is correct

a) FEV1 measures airflow in the small airways
b) FEV1 is the forced vital capacity in 1 minute
c) In an acute asthma episode, FEV is less than 90%
d) Normal values are based on age, weight, and sex
89. Maintenance asthma medications include

a) Salmeterol
b) Terbutaline
c) Ipratropium
d) Albuterol/pratropium
90. Adverse effects of beta2 agonists include

a) Bradycardia
b) Hypotension
c) Sedation
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d) Headache
91. Which statement about corticosteroids is correct

a) They decrease inflammation by increasing migration of T lymphocytes and
eosinophils
b) They decrease inflammation by preventing migration of T lymphocytes and
eosinophils
c) The incidence of oral yeast infections increases if the patient uses a spacer and
rinses her mouth after taking an inhaled corticosteroid
d) They re indicated for exercise induced asthma
92. The normal peak flow is

a) 50% to 60% of the predicted value
b) 60% to 70% of the predicted value
c) 70% to 80% of the predicted value
d) 80% to 100% of the predicted value
93. The national heart, lung, and blood institutes national asthma education and
prevention program recommends
a) Using an objective measurement of lung function
b) Avoiding pharmacologic therapy for asthma
c) Limiting patient and family education
d) Using a subjective measurement of lung function
94. Symptoms of an acute asthma exacerbation include

a) Shortness of breath, bradycardia, and chest tightness
b) Shortness of breath, tachycardia, and chest tightness
c) Coughing, hypotension, and bradycardia
d) Diaphoresis, hypotension and wheezing
95. Which statement about asthma is correct

a) It’s the second leading cause of hospital admissions
b) Morbidity and mortality has decreased dramatically in the past several years
c) Adults rarely are diagnosed with asthma later in life
d) Asthma is characterized by reversible airflow obstruction and airway
hyperresponsiveness to normal stimuli
STATE EXAMS 24
1. Larry and mary smith had planned their first pregnancy for sometime, but when it is
confirmed, mary feels conflicting emotions. She comes to the clinic for her first
prenatal (antenatal) visit at ten weeks gestation. Mary shares her mixed feelings about
the pregnancy with the midwife. The midwifes best response would be to
a) Encourage her to consider abortion counselling
b) Encourage her to seek support from larry
c) Reassure her that when she feels the baby move, her mixed feelings will disappear
completely
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d) Reassure her that most women experience some mixed feelings in early
pregnancy, even when their pregnancies are planned
2. Marys last menstrual period was 11 april. Her EDD (expected date of delivery) would
be
a) 4 january
b) 18 january
c) 25 january
d) 4 february
3. During a subseq1uent visit, mary states she has begun to feel foetal movement. Foetal
movement is usually felt by the pregnant woman when the fetus is approximately
a) 12 weeks gestation
b) 16 weeks gestation
c) 22 weeks gestation
d) 26 weeks gestation
4. Tui K is 22 years old and has missed two of her regular menstrual periods. Her doctor
confirms she is pregnant. This is her first pregnancy. Tui can expect to experience all
the following signs in the early stages of her pregnancy, except
a) Chadwicks sign
b) Goodells sign
c) Homans sign
d) Frequency of micturition
5. During tuis sixth weeks of pregnancy she experienced a small episode of vagina
bleeding. You would suspect
a) Placenta previa
b) Urinary tract infection
c) Threatened abortion
d) Abruption placenta
6. Tui asks for advice on diet. Which of the following is the best approach
a) Give her a list of the five basic food groups and tell her to include them in her
daily intake
b) Tell her to increase her caloric intake so she gains about 12 kg during the
pregnancy
c) Take a diet history that includes socio economic states, previous nutritional status
and food preferences
d) Take a diet history, analyse it and say what foods she must now omit
7. Tui and her partner hawea, attend antenatal classes together. One of the topics
discussed are danger signs of pregnancy. Which of the following is normal and not a
danger sign
a) Regular contraction occurring before the due date
b) Vaginal changes, including leucorrhoea
c) A sudden change in fetal activity patterns
d) Any bleeding from the vagina
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8. At 34 weeks, gestation, mary is hospitalised with severe HOP (hypertension, oedema,
proteinuria) syndrome. Which of the following represents an unusual finding for this
condition
a) Blood pressure 150/100
b) Large amount of protein in the urine
c) Convulsions
d) Generalised oedema
9. Candice meeker is expecting her first baby. Candice is interested in having an

independent midwife deliver her baby. The certified midwife is licensed to
a) Manage the care of women throughout the childbearing cycle
b) Manage the care of women only during the intrapartal period
c) Manage the care of women throughout the childbearing cycle under direct
supervison of a gp
d) Contract with a gp to do their prenatal care
10. John is timing the frequency of candices contractions. This means he is timing
a) From the end of one contraction to the beginning of the next
b) From the beginning of one contraction to the beginning of the next
c) From the beginning of one contraction until it begins to go away
d) From the beginning of one contraction until it is completely over
11. Neil grant, six months old, is admitted to the childrens ward with severe dehydration
due to vomiting and diarrhoea. Iv fluids are commenced. One of the dangers of iv
therapy is overhydration. This could lead to
a) Infiltration
b) Kidney failure
c) Rupture of the bladder
d) Pulmonary oedema
12. Neils blood pressure is very low. You realise that a low blood pressure is expected
because
a) Neil has been vomiting
b) Her has beeen receiving IV therapy
c) He has an elevated temperature
d) His circulating blood volume is low
13. Patty ray, 6 years old, is admitted to the childrens ward with a diagnosis of cystic
fibrosis. Postural drainage is ordered for patty. Postural drainage consists of
a) Chest percussion, and vibration
b) Retaining techniques, allowing patty to be more active
c) Chest percussion and positioning to drain and remove secretions from pattys lungs
d) Providing patty with exercises that will assist her to control breathing and prevent
dyspnoea
14. The most important nursing intervention in giving daily care to patty is
a) Forcing her to eat because she is malnourished
b) Seeing she receives the appropriate dietary regime
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c) Frequent skin care to remove excessive salt deposits from increased perspiration
d) Having her repress her feelings of anger
15. Patty spends a lot of time in the play room. What does make believe play in hospital
provide for a child
a) Ability to accept a parent substitute
b) opportunity to learn to know other children more quickly
c) opportunity to reject the reality of the hospital
d) opportunity to express fears
16. you are teaching pattys parents how to care for her at home. Which of the following
do you include
a) regular medication dosage according to urine testing
b) use cough suppressant only at bedtime
c) do postural drainage three times a day
d) restrict her activities
17. while working in the childrens ward, the staff nurse asks you the following questions
relating to legal issues. How would you reply
a) if they require treatment
b) if they need a blood transfusion
c) in the emergency care situation
d) in the absence of a parent or guardian
18. under what circumstances must permission from the court be sought to treat a minor
a) when the parent or guardian refuses treatment
b) In the case of parental absence, abandonment or incompetence
c) When the minor is seriously injured
d) In the case of parental separation
19. You are working with the public health nurse in a rural area. A mother attends the
childrens clinic asking for information regarding an outbreak of chicken pox in the
area. You advise
a) That the effects of chicken pox on the child are minimal and the childs schooling
will not be affected
b) That an immunisation is available for chicken pox for all children at 18 months of
age
c) That chicken pox is a notificable disease and the child must be seen by the general
practitioner if you suspect this condition
d) That chicken pox is a contagious viral disease which can be transmitted by direct
contact with skin lesions
20. Later that morning, joan smith phones to tell you that her 18 month old son, jared, has
been diagnosed with whooping cough. Joan asks you what she can do for jared. You
suggest
a) Regular fluids and increased food intake
b) Continue as normal and encourage activity
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c) Humidified air, regular fluids and rest
d) Isolate from other adults and rest
21. Matthew, is nursed at rest with the head of the bed elevated to 30 degrees as directed.
The purpose of this is to
a) Prevent Mathew developing skin abrasions from shifting and turning in the bed
b) Prevent Mathew from developing complication such as a DVT and chest
infection
c) Assisting Mathew to see and have conversations with the other patients in his
cubicle
d) Assisting in reducing any cerebral oedema Mathew may have and improving
venous drainage from his head
22. Your assessment of Mathew shows a widening pulse pressure. The term pulse
pressure refers to
a) The difference between a bounding and or thready pulse
b) The difference between a bounding and thready pulse rate
c) The difference between diastolic and systolic blood pressure
d) The difference between diastolic blood pressure and pulse rate
23. Jacksons fracture is immobilised by open reduction and internal fixation. A nurse,
new to the orthopaedic area ask you to explain what is meant by open reduction and
internal flixation. Your reply
a) Bringing both bone ends into alignment by surgical intervention and holding them
in position with a metal plate and screws
b) Brings bone ends into alignment by external manipulation and holding them in
position with a stienman pin and traction
c) Bringing bone ends into alignment by external manipulation and holding them in
position by an external fixation device
d) Bringing bone ends into alignment by surgical intervention and holding them in
position by a tight back slab and firm bandage
24. You are on duty in the surgical ward of a small rural hospital when james dickey aged
30 is admitted with a crush injury to his right arm. On arrival james arm is wrapped in
a blood soaked towel, but he hasnit received any other first aid. As you do your initial
assessment you note james has extensive soft tissue damage which includes a 15cm
laceration, a large haemotoma and severe bruising. James becomes very agitated at
the sight of the haemotoma and asks you to explain it. You reply
a) It was caused by splintering of underlying bone at the time of injury
b) It was caused by muscle spasm occurring at the time of injury
c) It was caused by blood vessels bleeding into the soft tissue at the time of injury
d) It was caused by the tearing of subcutaneous tissue at the time of injury
25. While treating james wound the doctor becomes aware that it will require extensive
debridment before good healing will occur. The term debridment means to
a) Irrigate the wound to remove blood clots
b) Cauterize all bleeding points and wash out blood clots
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c) Tie off blood vessels and nerves deep in the wound
d) Cut away all damaged and necrotic tissue and remove and foreign material
26. Due to the nature of james wound prophylactic IV antibiotics and intravenous therapy
is to be commenced. The doctor prescribes a litre of dextrose/saline over 8 hours. The
giving set you use has a drop factor of 60 drops/ml. which of the following flow rates
will ensure james receives the IV fluid within the correct time frame
a) 115
b) 125
c) 135
d) 145
27. As transfered james waits to be to theatre you note his bleeding is increasing and you
monitor him more closely. What changes to his vital signs would you expect to see if
his blood loss becomes excessive
a) Slowing of pulse rate, increasing blood pressure, elevated temperature
b) Increasing pulse rate, stable blood pressure, elevated temperature
c) Stable pulse rate, dropping blood pressure, normal temperature
d) Increasing pulse rate, dropping blood pressure, normal temperature
28. James is becoming shocked in this instance. What type of shock will this be
a) Neurogenic shock
b) Hypovolemic shock
c) Septic shock
d) Cardiogenic shock
29. Physiological compensation by the body in this type of shock will include all of the
following except
a) Vasoconstriction of the capillary beds
b) Increased pumping efficiency of the heart
c) Fluid shift extra cellular to intravascular
d) Increased sodium excretion of sodium by the kidneys
30. Henare is a 25 year old man admitted for emergency surgery, he has a left inquinal
hernia which is nonreducible. This means that he has
a) A weakness in the abdominal wall opening through which the spermatic cord
emerges
b) A hernia sac which does not return to the abdominal cavity as a result of swelling
c) Abdominal content, usually omentum or intestine descending into the groin or
scrotum creating a mass
d) A direct inguinal hernia resulting from bowel and bladder content passing through
the posterior inguinal wall
31. Pat is a 20 year old woman with a diagnosis of PID (pelvic inflammatory disease).
Her nursing assessment includes temperature 38.4c, moderate lower abdominal pain,
and an offensive vaginal discharge. Nursing interventions for pats care would include
a) Bed and chair rest with legs elevated
b) Monitor temperature and pulse twice daily
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c) Nurse at rest in a semi fowlers position
d) Monitor blood pressure three times a day
32. Pat asks you ‘is it true that some STDs can cause cervical cancer’ your answer would
be
a) Recent research strongly, suggest that both genital warts and genital herpes may
cause cervical cancer
b) Yes all the STDs are capable of causing cervical cancer
c) Any woman who has multiple partners has a high risk of developing cervical
cancer
d) Yes, but only those who have the genital herpes virus
33. Nina is 33 years old, she has had rheumatoid arthritis for the last five years, and is
currently suffering from an exacerbation of her disease. You are visiting nina with the
district nurse. Although nina is troubled with pain, she is most worried about caring
for her 8 month old son and her home. Nina and the nurse establish a plan to manage
ninas pain which is related to joint inflammation. Which of the following strategies
will provide relief for her
a) Applying warm, moist compresses 30 minutes before doing house hold activites
requiring hand and finger movements
b) Taking salicylates after activity to decrease the inflammation caused by activity
c) Loosing 5kg to limit stress placed on joints
d) Applying cold compresses after activities to numb the pain if it does occur
34. Which is the correct statement about rheumatoid arthritis. This disease
a) Affects both men and women equally
b) Mainly affects the larger weight bearing joints
c) Is a systemic disease with multiple joint involvement
d) Never occurs in children
35. Mrs mary brown aged 34 years has had abdominal surgery. 24 hours later she
complains of pain in her left calf. Your first action should be to
a) Palpate the calf to note tenderness of pain
b) Check mrs browns pedal pulses
c) Ask mrs brown to extend her leg and dorsi flex her foot and note if this causes
pain
d) Measure the circumference of the right and left calves and note the difference
36. Compartment syndrome is a possible complication of fractures. Which assessment

data should the nurse report immediately
a) Increasing pain out of proportion to the sustained injury
b) Capillary refill which takes two seconds
c) Parathesia which decreases with movement of the affected part
d) Mild oedema of the affected limb
37. Mrs skinner has a blood transfusion in progress following hip replacement. Her blood
group is A. this means that in an emergency she could receive blood from
a) Any other group
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b) Any group except B
c) Group a only
d) Group A and O only
38. Twelve hours after the operation mrs skinner started shivering and complaining of
pain in her back. Her pulse was very rapid. In these circumstances which one of the
following should the nurse do first
a) Take her temperature
b) Give her an extra blanket
c) Send for medical aid
d) Stop the blood transfusion
39. The most probable explanation for mrs skinners symptoms is

a) Infection of the urinary tract
b) Reaction to the anaesthetic
c) An allergic reaction to the blood transfusion
d) An allergic reaction to the metal prosthesis
40. John an 18 yr old student, has been assigned to your care. He is jaundiced and his
clinical appearance suggests that he has hepatitis A. hepatitis A is an inflammatory
condition of the liver caused by
a) Auto immune processes following a viral infection
b) A virus which infects the person via the GI system
c) A virus which is only transmitted via contaminated blood products
d) A virus which is mainly transmitted by sharing needles
41. Following a bout of hepatitis A most people can expect

a) To become a carrier
b) Frequent relapses
c) Lifelong immunity to hepatitis A
d) Increased risk of liver cancer
42. The jaundice in hepatitis a is best described as

a) Haemolytic
b) Bilio static
c) Obstructive
d) Hepato cellular
43. The incubation period is

a) Less than 10 days
b) 5-15 days
c) 15-50 days
d) 40-60 days
44. A reason why smokers with chronic respiratory problems should not be given
medications that inhibit the cough reflex as
a) These medications dry up mucous and make secretions difficult to expel
b) The hypoxic drive is inhibited causing a slowing in breathing rate
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c) Coughing is their only means of preventing mucous accumulating in the lungs
d) In people with chronic problems these medications have no effect anyway
45. Asthma is a disorder primarily characterised by

a) Hyperinflation and over expansion of lung tissue
b) Spastic constriction of the respiratory airway
c) A breadown in the walls of alveolar tissue
d) Chronic dilation and expansion of he airways
46. During acute asthmatic attacks theophylline medications are given because they
a) Stimulate the inspiratory centre
b) Raise the blood PO2 levels
c) Hyperinflate the lung
d) Dilate the bronchioles
47. Aminophylline comes in ampoules of 250mgs in 10 mls. How much in mils, would
you draw up to obtain 300mgs
a) 8.3
b) 12.0
c) 83.0
d) 120.0
48. In the early stages of obstruction to urine flow, symtoms which a client with an
enlarged prostate gland might experience include
a) Difficulty in emptying his bladder and hematuria
b) Foul smelling urine with a high bacteria count
c) Complete retention of urine and dribbling
d) Frequency, urgency a poor stream and nocturia
49. A client is prescribed 1 litre of dextrose/saline to be given over 3 hours. If the IV

giving set has a drop factor of 15 drops per ml, which of the following, in drops per
minute, gives the correct rate
a) 17
b) 33
c) 67
d) 83
50. Your client states that she is most unhappy with the care she is receiving from her
doctor and wishes to change doctors. You respond
a) Would you like to talk to me about why you are unhappy with your care I may be
able to help
b) Okay should be no problem, its your choice after all
c) I don’t think that’s a good idea it can lead to the doctor becoming annoyed
d) Hospital policy does not allow for you to make a choice of doctor but would you
like to talk to me about your concerns
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51. In an acute presentation, such as jenny, the need to administer medication so as to
address the situation is important. (frightened and psychotic). The most likely choice
of drug would be
a) Trifluoperazine
b) Thioridiasine
c) Haloperidol decanoate
d) Benzotropine mesylate
52. When administering this medication what is the dosage and upper limit or ceiling in a
twenty four hour period
a) 2mgs, up to 6mgs//24 hrs
b) 6mgs, up to 12mgs/24 hrs
c) 20 mgs, up to 60mgs/24hrs
d) 4mgs, up to 12mgs/24hrs
53. Following this episode, jenny is commended on a regular anticholinergic

antiparkinsonia drug. The most likely drug of choice would be
a) Procyclidine
b) Lorazepam
c) Pipothiazine
d) Diazepam
54. Jenny is charted this medication. Which of the following drug orders reflects the
amount/dosage to be received accurately
a) 5mgs TDS
b) 20mgs nocte
c) 10mgs QQH
d) 15mgs mane and 15mgs nocte
55. Jenny responds well to her care and is discharged 14 days later. She is charted an
antipsychotic injectable medication which the mental health nurse gives her at home.
The medication is flupenthixol decanoate. The dosage and frequency is likely to be
a) 400mgs every 3 weeks
b) 150mgs every week
c) 60mgs every 3 weeks
d) 200mgs every 2 weeks
56. Tom has a diagnosis of bipolar affective disorder and his family ask you to talk with
them about it. They ask you what an affective disorder is. A therapeutic response is
a) An abornality in the mood or feeling state of a person
b) A dysfunctional emotive illness exacerbated intermittently
c) A chronic and progressive deterioration in the emotion of a person
d) A strange feeling which is abnormal in origin
57. Tom is admitted to the unit where you work. You are concerned in your assessment to
ensure he is physically well. You care plan would include therefore, a focus on
a) Rest and sleep, fluid and nutritional needs, elimination and personal safety
b) Relationship needs, diet and exercise, and group therapy
c) Counselling needs, altered thought processes and orientation
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d) Food and fluids, lowered mood and poor communication
58. Foms family asks you why he must take the big white tablets. They say they tast like
chalk and that he only needs them when he is sick. A therapeutic response would be
a) I can understand how it seems that way but the tablets work best when they are
taken all the time
b) That’s why he is sick because he should have been taking them
c) You ought to be encouraging him to take them all the time
d) Yes, perhaps encourage him to take them just when he needs to
59. Tom is due for a test today and the lab technicians arrive to do the blood test. Tom
asks you what the level needed in his blood is. The correct response is
a) 1.5-2meg
b) 0.1-0.3meg
c) 0.5-1.3meg
d) 1.0-1.9meg
60. Toms level comes back from the lab who ring you to tell you that his level is very
high. The immediate nursing actions would involve
a) A check to see if a.m. dose was given, discontinue meds and notify doctor
b) Commencement on fluid balance chart and vital recordings
c) Encourage fluid intake and continue meds and document observations
d) Inform tom he is toxic, place on bedrest and notify next of kin
61. Tom is assessed and has lithium toxicity. The symptoms we would expect to see as
nurses are
a) Palpitations, skin rash and headache
b) Photophobia, bradycardia and dyspnoea
c) Coarse tremor, diarrhoea, vomiting and sluggishness
d) Thirst, nausea, skin rash and pain on dorsal flexion
62. You are a domicillary nurse and have been visiting liz in the community. Liz is
receiving an antipsychotic in injectable form. Which medication is not an injectable
antipsychotic
a) Pipothiazine
b) Thioridiazine
c) Haldol decanoate
d) Flupenthixol
63. Before liz was commenced on her medication you asked that she be charted a test
dose. This lower dose is
a) Given then reviewed after 5 days before regular charting begins
b) Given fortnightly for a period of six months
c) Administered and then followed immediately by a regular dose if no reaction is
noted
d) Administered once and then repeated weekly for four weeks
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64. Liz continues to request that her injection site be in her buttock and refuses to have it
in the thigh. You have permission to do this. You assure the accurate site by
a) Locating the upper, outer quadrant of the buttock
b) Locating the lower, outer quadrant of the buttock
c) Locating the iliac crest and administering the injection
d) Locating the midline and injecting 3cms to the side of it
65. In regularly dispensing injectable medication you are aware as a nurse that the
medication is locally irritating. You therefore
a) Administer it in one area only
b) Rub the area gently following administration
c) Rotate sites and do not rub/massage the area
d) Apply heat and massage the area
66. Jan is a first line manager responsible for the care of a group of patients. She is
concerned because for the last three weeks the physiotherapist has been late to see the
patients and sometimes has not come at all. She has called the physiotherapist but the
situation has not improved. Jans next action should be to
a) Write a memo to the physiotherapy department
b) Contact a nursing clinical advisor
c) Notify the physician of the situation
d) Consult her nurse manager
67. In organisations the primary management function is to

a) Assess and establish goals
b) Establish a framework in which to function
c) Plan for results
d) Control all operations
68. Cohesiveness is important to all teams. This means

a) The process a group goes through in deciding what do do
b) A mutual attraction which holds a group together
c) A decision made by a knowledgeable leader for the group
d) A strong organisational support system of the group
69. Part of jans postion requires her to manage the budget. This is
a) A statement of future expenditures
b) A list of current expenditure
c) A plan for meeting expenses
d) A recording of past expenditure
70. Jan is aware that nursing tasks and quality of nursing practice are compared with
which pivotal question
a) Does the performance match standards and objectives
b) Does the performance reflect interest and enthusiasm for the job
c) Does performance indicate knowledge and expertise
d) Does performance leave the patients comfortable
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71. Elanor brown aged 20 is a passenger who is thrown clear when the car she is
travelling in this a lamp post. Elanor exhibits internal bleeding later diagnosed a
ruptured spleen. First aid care for elanor includes elevating her limbs. This is done to
a) Decrease her venous return
b) Lower her blood pressure
c) Increase her venous return
d) Assist her to breathe
72. Elanor is admitted to the accident and emergency department in advanced stage 2
shock. When taking her base line observations you would expect to find
a) Elevated BP, elevated pulse rate and elevated respiratory rate
b) Decreased bP, decreased pulse rate and decreased respiratory rate
c) Decreased BP, increased pulse rate and increased respiratory rate
d) Decreased BP, decreased pulse rate and increased respiratory rate
73. Elanor is catherterised and her urine output is monitored hourly. This is done to
a) Provide an indication of her renal perfusion
b) Ensure she does not go into fluid overload
c) Ensure she is receiving adequate hydration
d) Monitor the concentration of serum electrolytes
74. Elanor also requires additional nursing observations. Which of the following is the
most appropriate
a) Mental status exam and urinary electrolytes
b) Level of consciousness and abdominal girth
c) Papillary reaction to light and limb movement
d) Swallowing reflex and orientation to time and place
75. A sample of elanors blood is sent to the laboratory for cross matching. When elanor
blood group has been identified the best treatment for her is to transfuse her with
a) Packed cells
b) Whole blood
c) Lactated ringers
d) Plasma
76. John smith, aged 50 receives 30% burns to his face, neck arms and upper thorax when
he pours petrol onto his barbecue. The most appropriate immediate first aid treatment
for mr smith is to
a) Roll him in a damp rug to extinguish the flames
b) Remove his burning clothes as fast as possible
c) Quickly throw him into the swimming pool
d) Quickly roll him in a wet sheet and apply ice to his burns
77. Smoke inhalation can complicate burn injuries. While waiting the ambulance the most
appropriate position for conscious victims of smoke inhalation is
a) Sitting in the semi fowlers position
b) Laying down with neck hyperextended
c) Lying supine with the legs elevated
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d) Lying in the recovery position
78. Which of the following is correct with regard to burn injuries

a) Partial thickness burns are often very painful as the nerve are destroyed
b) Full thickness burns are often very painful as the nerve endings are irritated
c) Full thickness burns are often not painful as the nerve endings are destroyed
d) Blistering and redness often occur very quickly following a full thickness burn
79. Factors determining the severity of the burn injury include

a) Depth of burn and percentage of body surface area burnt
b) Location of the burn on the body and age of the victim
c) Size of the burn and previous medical history of the victim
d) All of the above
STATE EXAMS 25
1. Ampicillin 100mg IM has been charted for an infant. Ampicillin 250mg in 2ml is
available. Which dose should be given
a) 0.4 ml
b) 0.5 ml
c) 0.8 ml
d) 1.0 ml
e) 1.5 ml
2. What is the earliest age of the infant when the mother can sign an interin order for
adoption
a) At birth
b) 5 days
c) 7 days
d) 10 days
e) 14 days
3. What is the most likely cause of breast engorgement at three days post partum
a) Stasis of milk in ducts
b) Poor suckling by the infant
c) Strong suckling for long periods
d) Poor venous and lymphatic drainage
e) Frequent feeding at irregular intervals
4. What is the essential point to teach a woman in regard to self perineal toilet
a) Avoid using toilet paper
b) Empty her bladder completely
c) Wash her bands before and after
d) Empty her bowel immediately prior
e) Observe the blood loss on the pad
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5. Mrs brodie was transferred to the post natal ward with her newly delivered baby. Mrs
brodie is human immunodeficiency virus antibody positive. Which of these
precaustions should the nurse take
1. Gloves worn for cord care
2. Disposable napkins for the baby
3. Single room with adjoining toilet facility
4. Plastic gloves and apron for the nurse disposing of body fluids
5. Discourage mrs brodies visitors
a) 1 and 2
b) 1, 3 and 5
c) 2, 4 and 5
d) 2, 3 and 4
e) 1, 2, 3 and 4
6. Mrs todd is in the post natal exercise room. Baby todd, a healthy two day old is
suctioned because he is mucosy. What is the responsibility of the nurse to mrs todd
a) Go to the exercise room and bring her back to the ward
b) Inform her when she returns from the exercise class
c) Inform her only if she asks if all was well while she was away
d) Say nothing about the suctioning if she asks what happened during her absence
7. Mrs todds nurse has a paronychia (infected finger). What action should the nurse take
a) Take sick leave
b) Go to work as usual
c) Work with the paronychia covered
d) Go to work and only care for mrs todd
e) Inform the nurse in charge and ask for ‘dry duties’
8. Mrs todd is found to have a haemoglobin of 68g% and is ordered a blood transfusion.
She says to the nurse who is checking the blood, ‘I don’t really want this, but the
doctor says I have to’. What should the nurse do
a) Discuss the matter with the doctor and give the blood if she confirms the need
b) Not give the blood until the doctor has discussed it with the patient
c) Start the blood as charted and inform the doctor of the patients concern
d) Encourage the patient to have the blood and give it when she consents
e) Not give the blood if the patient remains unsure and notify the doctor of this
decision
9. Mrs todd is placed in a room with three other people, she asks ‘what is the matter with
that person opposite me’ what should the nurse say
a) She do not know
b) Everything they know about the patient
c) That it is the other persons business
d) They will ask someone else to talk to her
e) They are in no position to give that information
10. What is the most likely cause of abdominal pain and offensive lochia in the
puerperium
a) A pelvic abscess
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b) Venereal disease
c) Retained products
d) A cervical infection
11. A rehabilitation programme should promote

a) Client autonomy and independence
b) The best possible level of mobility and ambulation
c) Psychological and social adjustment
d) All of the above
12. While mr march is hospitalised, the nurse is concerned with preventing the
complications of prolonged bed rest. Mr march already has a reddened area over the
sacrum and coccyx. The nurse knows that the most important action to prevent a
decubitus ulcer is to
a) Keep the skin area clean, dry and free from urine, faeces and perspiration
b) Place an alternating air pressure or water mattress on the bed
c) Massage the reddened area with lotion or oil to stimulate circulation
d) Turn and reposition the client at least q2hrly; avoid positioning him on the
affected side if possible
13. Which of the following is the most correct statement about positioning the stroke
client
a) Flexor muscles are generally stronger than extensors
b) Extensor muscles are generally stronger than flexor
c) The fingers should be flexed tightly
d) The footboard should be flush with the mattress
14. Mrs sweetman, aged sixty two years, has non insulin dependent diabetes mellitus. She
recently returned home from hospital where she received treatment for an infection of
her left big toe. Mrs sweetmans toe infection resulted from an injury of which she was
unaware. The most likely reason for this would be that
a) Her vision is impaired
b) She did not regularly wash her feet
c) She finds it difficult to flex her knees and hips
d) She has diminished sensation in her feet
15. Mrs sweetmans foot problems result from neuropathic, vascular and infectious
changes. The most important feature of foot care should be to
a) Inspect the feet daily and wash with mild soap and water
b) Maintain adequate blood flow to the lower limbs
c) Rub the feet with alcohol once a week
d) Avoid wearing garters of constricting shoes
16. Peter has a temper tantrum during which he lies on the floor at the entrance to the
hallway. This is making it difficult for other residents. He has been asked to get up but
continues his tantrum. Using the principles of extinction how would you deal with
peter
a) Continuing to ask him in a firm voice to get up
b) Ignore him and instruct the other residents to step over him
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c) Explain to him that he is blocking the entrance and it is unsafe for him to remain
where he is
d) Let him know that if he doesn’t get up immediately, he will be punished
17. What would be the most likely effect initially on pters behaviour when commensing
to apply the principles of extinctions
a) Behaviour shows minimal change
b) Inappropriate behaviour would increase
c) Inappropriate behaviour would rapidly decrease
d) Inappropriate behaviour would slowly decrease
18. Peter has a habit of hugging new staff members and visitors to the residence. In order
for extinction of this inappropriate social behaviour it would be necessary for him
a) Not to be punished for inappropriate behaviour
b) To be rewarded for inappropriate behaviour
c) To be punished for inappriate behaviour
d) Not to receive reinforcement for this inappropriate behaviour
19. If the staff were to apply the principles of response cost in dealing with peters
inappropriate social behaviour they could do so by
a) Taking away something that peter found reinforcing such as restricting his TV
viewing
b) Taking away from peter something that he found unpleasant such as having to eat
his vegetables
c) Applying an aversive stimuli such as making him stay in his room
d) Ignoring the inappropriate behaviour but reinforcing an appropriate behaviour
such as his willingness to help with the dishes
20. The safest and most effective way to clear secretions from the respiratory tract is
a) Postural drainage
b) An effective cough
c) Pharyngeal suctioning
d) Endotracheal suctioning
21. Carl comes to the mental health clinic where you work because of nerviousness. He
tells you ‘I have butterflies in my stomach most of the time. I havnt missed work but
it is getting harder to concentrate on things for a long time. What level of anxiety is
carl most likely experiencing
a) Mild
b) Moderate
c) Severe
d) Panic
22. Which of the following questions would be the best way to begin taking carls history
a) Could you tell me about your family
b) What are you feeling now
c) Have you ever felt this way before
d) Does anyone else in your family experience these feelings
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23. Which of the following explains the major differences between normal anxiety and
the syndrome associated with anxiety reactions
a) Normal anxiety is constant; an anxiety reaction is intermittent and rather short
lived
b) Normal anxiety is free floating; in an anxiety reaction there is an impending sense
of doom
c) An anxiety reaction is seldom controllable and usually must run its course
d) Normal anxiety is a fact of life and rarely becomes an anxiety reaction
24. Signs and symptoms associated with anxiety are

a) Complaints of apprehension, narrowed perception, stomach pains and restlessness
b) Inability to get to sleep, early morning awakening, excessive weight loss and lack
of energy
c) Ideas of reference, grandiose delusion, hallucinations and delusions
d) Spending or giving away large amounts of money
25. Michael has been brought by the police into the psychiatric unit. He was found curled
up under a bridge. When asked his name all he would say was ‘nice boy’. His father
informs you that he has not had a psychotic episode for 2 years, and that medication
has controlled his condition. This episode occurred when Michael refused his
medication. Which of the following area should the nurse gather data first
a) Michaels perception of reality
b) Michaels physical condition
c) The observations of Michaels, made by the police
d) Michaels speech patterns
26. Michael becomes regressed and withdrawn. He appears to be listening to something,

the nurse hears nothing. What is the most appropriate response
a) Give him an additional dose of his antipsychotic medication
b) Ignore his behaviour
c) Contact his doctor and request a seclusion order
d) Talk to him about what hes experiencing
27. Michaels doctor prescribes haloperidol, 6 mgs IM for three doses. After the third dose
of the medication, Michael is still severly regressed and also agitated. He also appears
to be hallucinating. What would the nurse do
a) Call the doctor for further orders
b) Administer another dose of the medication
c) Record the results of the medication
d) Observe the client for an hour
28. Michael yells for the nurse. As the nurse enters his room he says ‘do you see there the
virgin mary is appearing. Which of the following is the best nursing response
a) No I don’t see her but I understand she is real to you
b) She is not there. You must be imagining things Michael
c) Show me where in the room she is appearing
d) The virgin mary is appearing
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29. Michael is very withdrawl, he moves slowly and is uncommunicative. The best initial
goal is which of the following
a) Michael will increase his social skills
b) Michael will be orientated to reality
c) Michael will increase his level of communication
d) Michael will form a trusting relationship with the nurse
30. Four year old sean white was admitted to hospital with burns received while playing
with matches. His legs and lower abdomen are burned. On assessment of seans
hydrated status, which of the following indicates
a) Decreasing hematocrit and increasing urine volume
b) Falling hematocrit and decreasing urine volume
c) Rising hematocrit and decreasing urine volume
d) Stable hematocrit and increasing urine volume
31. Which signs/symptoms indicate overhydration

a) Dieresis
b) Drowsiness and lethargy
c) Dyspnea, moist rales
d) Warmth and redness around intravenous site
32. Seans output via his foley catheter is 10ml hour. What should be the first nursing
action
a) Check the catheter to see if it is plugged (blocked)
b) Call the doctor immediately
c) Record the information on the chart
d) Increase the intravenous fluids
33. The doctor has prescribed 500ml of IV fluid to be given over 10 hours. Using a
soluset which delivers 60 drops per ml, calculate the rate in drops per min
a) 48
b) 50
c) 52
d) 54
34. When sean starts oral feeding it is particularly important that his client has a high
amount of
a) Fats and carbohydrates
b) Minerals and vitamins
c) Fluids and vitamins
d) Proteins and carbohydrates
35. Allan martin, is admitted to hospital with acute chest pain. Provisional diagnosis is
myocardial infarction. When asking about the quality of a clients chest pain you are
primarily looking for
a) An indication of its severity
b) The patients own description
c) A response found on a list of possible descriptions
d) Its cause
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36. When a client is anxious and upset about chest pain, it is best to
a) Explain in detail the pathologic changes that may be occurring
b) Provide short, clear explanations of your assessment, and treatment interventions
c) Don’t say anything until you are sure of his diagnosis
d) Explain that his doctor can answer his questions better
37. The nurse asks you to check some pain relief for mr martins severe chest pain. This
prescription is for morphine 6 mgs every 2 hours. The stock available is morphine 10
mg in 1 ml. calculate the correct amount
a) 0.5 ml
b) 0.6 ml
c) 1 ml
d) 1.3ml
38. The doctor prescribes frusemide (lasix) intravenously for mr martin. What is the
action of frusemide
a) Diuretic
b) Antiemetic
c) Analgesic
d) Bronchodilator
39. What side effects of frusemide (lasix) should the nurse be aware of
a) Hypervolaemia
b) Hypovolaemia
c) Hypotension
d) Hypoventilation
40. Mrs maring was brought to an acute psychiatric unit by the police. She was found
wandering around the streets, incoherent, and her behaviour appeared to be
inappropriate. She was tentatively diagnosed as having schizophrenia. The nurse
knows that a diagnosis of schizophrenia implies that a patient would manifest which
of the following behaviours
a) Inability to concentrate
b) Loss of contact with reality
c) Guilt feelings
d) Feelings of worthlessness
41. Mrs maring says that the voices are telling her to do things and she cont stop listening.
The best response from the nurse would be
a) Never mind the voices; lets just concentrate on the game
b) The voices will go away soon
c) I don’t hear any voices. I think the voices are part of your illness. Try to listen to
what im saying
d) Everyone hears voices at times
42. Mrs maring, after a two week stay, appears much better. She is in contact with reality
and is able to interact with others in an appropriate way. The doctor is sending her
home with medication. The most common medications given for schizophrenia are
a) ECT
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b) Phenothiazines
c) MAO inhibitors
d) Antidepressants
43. A young maori man dies, as a result of a motor bike accident. The doctor requests his
kidneys for a transplant. His whanau refuse. What is the most appropriate action of
the nurse in this situation
a) You accept the wishes of the whanau
b) You pressure the whanau to re consider
c) You seek permission form other whanau members
d) You support the doctor to over ride what the whanau wish to do
44. Mr H, a 72 year old kaumatua (elder) is admitted to the medical ward with cellulitis of
his left leg. He is palced on strict bed rest. Because he is whakama (embarrassed) he
refuses to use a bedpan and demands to walk to the toilet. How should you deal with
this situation
a) Give him a bedpan anyway
b) Talk over the situation with him
c) Tell him the doctor has ordered bed rest
d) Ask the other patients to leave the room
45. True labour can be differentiated from prodromal or false labour in that in true labour
there is a
a) Strengthening of uterine contractions with walking
b) Failure of presenting part to descend
c) Lack of cervical effacement or dilation
d) Cessation of uterine contractions with walking
46. First fetal movements felt by the mother are known as

a) Ballottement
b) Engagement
c) Lightening
d) Quickening
47. Growth is most rapid during the phase of prenatal development known as
a) Implantation
b) First trimester
c) Second trimester
d) Third trimester
48. The chief function of progresterone is the

a) Establishment of secondary male sex characteristics
b) Rupturing of follicles for ovulation to occur
c) Development of female reproductive organs
d) Preparation of the uterus to receive a fertilised ovum
49. Mrs greene, a 22 year old primigravida is attending prenatal clinic

a) Give her a list of foods so she can better plan her meals
b) Assess what she eats by taking a diet history
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c) Emphasise the importance of limiting salt and highly seasoned foods
d) Instruct her to continue eating a normal diet
50. Mr quang duc pho 65 years old, is admitted to hospital after arriving with a group of
‘boat people’ from Vietnam. On the basis of the results of a mantoux test, chest x ray
examination, and sputum cultures a diagnosis of active pulmonary tuberculosis is
made. The most appropriate area in which to nurse mr quang on admission is
a) A single room, isolated from all other patients
b) The general male ward
c) Among other patients with infectious disease
d) With other male Vietnamese refugees
51. The nurse evaluates mr quangs mantoux test as positive by the presence of
a) A small red swelling less than 7mm in diameter
b) An erythematious area greater than 7mm
c) Swelling and erythema together measuring between 7mm and 9mm
d) A lump greater than 7mm in diameter
52. On mr quangs chest x ray film a lesion is observed in an upper lobe. Why is this area
of the lung most commonly affected in tuberculosis
a) There is a slightly higher oxygen concentration in the upper lobes
b) Sputum collects more readily in upper lobes than in lower lobes
c) Upper lobes are less easily ventilated than are lower lobes
d) Tubercule bacilli are less dense than air and therefore remain in the upper lobes
53. Which of the following precautions must the nurse take when attending routinely to
mr quang
a) Put on a gown, mask and gloves
b) Wash hands thoroughly after handling contaminated articles
c) Wear a mask when in close proximity to him
d) Insist that he wear a mask when care is given
54. Mr quangs tuberculosis is considered to be under control when

a) He becomes mantoux negative
b) His chest x ray film is free of any lesion
c) He has three consecutive negative sputum cultures
d) His symptoms of tuberculosis have subsided
55. For how long will mr quang need treatment

a) Until he leaves the hospital
b) For 18 months
c) Until all tests are negative
d) For two years
56. One of mr quangs cousins in mantoux negative. Evaluate this finding

a) No evidence of tuberculosis
b) A subclinical case of tuberculosis
c) Inactive tuberculosis
d) Possible military tuberculosis
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57. Given his negative mantoux reaction, what is the appropriate action for mr quangs
cousin
a) Discharge from hospital
b) No treatment is necessary
c) Commence triple therapy
d) Chest examination by x ray
58. Mrs fitzpatick, a client in a ward opposite chris, asks the nurse ‘what is wrong with
that person opposite me. What should the nurse say
a) I do not know
b) Oh nothing. She just wanted to talk about some problems she is having
c) Ill get the doctor to talk to you
d) Im sorry I cannot disclose that information
59. Chris says she wants to discharge herself and go home. Which of the following is the
best nursing response
a) I will ask the doctor to talk with you
b) It would be very unsafe for you to leave hospital without proper medical treatment
c) Can we talk about what is worrying you
d) If that’s what you have decided I will get a self discharge form
STATE EXAMS 26
1. Cholesterol is frequently discussed in relation to atherosclerosis. Cholesterol is a

substance that
a) All persons would be better off without because it causes the disease process
b) Circulates in the blood, the level of which responds usually to dietary substitutions
of unsaturated fats for saturated fats
c) Is found in many foods, both plant and animal sources
d) Maybe controlled entirely by eliminating food sources
2. Angina pectoris is caused by

a) Sudden and complete occlusion of one or more coronary arteries
b) Mild ischaemia due to temporary or partial occlusion of the coronary artery
c) Obstruction of blood flow between the right and the left atria
d) Mild ischaemia due to partial blockage of the aorta
3. The symptoms of angina pectoris are the result of

a) A reduction in the amount of blood circulating through the heart
b) More oxygen being required by the heart muscle than is available
c) The lack of oxygen carrying capacity in the blood supply
d) An interruption to the blood supply which results in decreased tissue perfusion
4. Evaluation of the effectiveness of cardiac nitrates is based on

a) Relief of anginal pain
b) A decrease in blood pressure
c) Improved cardiac output
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d) Dilation of superficial blood vessels
5. Death following a myocardial infarction is most likely caused by

a) Dysrhythmia
b) cardiogenic shock
c) congestive heart failure
d) ventricular rupture
6. which of the following factors increases insulin resistance

a) obesity
b) hypoglycemia
c) decrease in amyloid deposits
d) increase in muscle mass
7. in metabolism of carbohydrate, the most important function of insulin is

a) precipitating the breakdown of glycogen in the liver
b) to facilitate the passage of glucose into the cell
c) acting as a antagonist to glucagon in the muscle sheath
d) increasing the circulating blood sugar level
8. which of the following is the most preventable risk factor for preventing chronic
obstructive pulmonary disease (COPD)
a) adequate nutrition
b) regular exercise
c) exposure to dust and pollen
d) cigarette smoking
9. when teaching the diabetic who is taking insulin, the nurse emphasizes the importance
of exercise, which
a) prevents mental deterioration
b) often decreases insulin requirements
c) prevents muscle dystrophy
d) often improves visual acuity
10. blood is ejected into the circulation as the chambers of the heart becomes smaller.
This action of the heart is referred to as
a) systole
b) diastole
c) hypertension
d) ejection fraction
11. the patient is experiencing orthopnea. What is the best position for this patient for
relief of symptoms
a) sitting upright leaning forward slightly
b) low fowlers
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c) prone
d) Trendelenburg
12. Which of the following would be most appropriate for a patient who is receiving
diuretic therapy for cardiac failure
a) Check laboratory results for creatinine levels
b) Monitor for hypotension
c) Encourage the patient to spend time outdoors to aid in vitamin D absorption
d) Discourage use of potassium
13. Which of the following complications of diabetes is termed macrovascular

a) Retinopathy
b) Stroke (cerebro vascular accident
c) Nephropathy
d) Renal failure
14. Large quantities of frothy blood tinged sputum would indicate which of the following
a) Suctioning required
b) Severe pulmonary oedema
c) Respiratory infection
d) Pneumothorax
15. An adult patient has damage to the electrical conduction of the ventricles of the heart.
The nurse would expect to see changes in the
a) Decreases myocardial oxygen consumption
b) Causes venous constriction
c) Decreases collateral circulation in the heart
d) Causes arterial constriction
16. Which of the following may develop in the patient when ketone bodies accumulate in
excessive amounts
a) Hypovolemia
b) Polyuria
c) Diabetic ketoacidosis
d) Blurred vision
17. A patient has been admitted to the hospital with the diagnosis of type 1 diabetes
mellitus. From this information you recognise that this patient
a) Has an autosomal dominant disease
b) Is a maori or Polynesian origin and over the age of 50
c) Is insulin deficient and exogenous insulin dependent
d) Is insulin resistant and relies on oral hypoglycaemic agents for glucose control
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18. Which of the following patients with diabetes may require exogenous insulin but not
likely to experience ketoacidosis
a) The person with type 2 diabetes mellitus
b) The person with type 1 diabetes mellitus
c) The person with type 1 gestational diabetes
d) The person with reactive hypoglycaemia
19. Which of the following statements is true regarding type 1 diabetes mellitus
a) There is no genetic or hereditary pattern
b) There is no strong familial link
c) There is a strong autoimmune basis
d) There is no environmental link
20. If your patients insulin is labelled U-100, this means

a) 100 units per dose
b) 100 units in the bottle
c) 100 mg per unit
d) 100 units per millilitre
21. Which of the following are oral hypoglycaemic agents

a) Oral insulin
b) Insulin substitutes
c) Artificial insulin
d) Sulfonylureas
22. Your patient is experiencing hypoglycaemia related to excessive insulin. Your first
line treatment for this type of hypoglycaemia in the conscious patient with diabetes is
a) An injection of glucagon
b) An intravenous injection of 50% glucose
c) Simple carbohydrates, such as juice
d) Complex carbohydrates, such as rice or potatoes
23. In metabolism of carbohydrates, the most important function of insulin is

a) Precipitating the breakdown of glycogen in the liver
b) To facilitate the passage of glucose in the cell
c) Acting as an antagonist to glucagon in the muscle sheath
d) Increasing the circulating blood sugar level
24. Which of the following factors increases insulin resistance

a) Obesity
b) Hypoglycaemia
c) Decrease in amyloid deposits
d) Increase in muscle mass
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25. Which of the following findings would indicate that a person with diabetes might be
suffering from neuropathy
a) Blurred vision
b) Loss of memory
c) Numbness of arms
d) Sensory loss in legs
26. When water is lost from the body but there is no electrolyte loss, the condition which
occurs is
a) Osmotic diuresis
b) Shock
c) Dehydration
d) Water intoxication
27. The nurse teaches a client with COAD how to perform pursed lip breathing,
explaining that this technique will assist respiration in what manner
a) Slows the expiratory rate and gives the client control of respiratory patterns
b) Promotes maximal inhalation for better oxygenation of the lungs
c) Prevents collapse of bronchioles and air trapping in the lungs during expiration
d) Loosens secretions so that they may be coughed up more easily
28. Mr langley aged 50 has severe emphysema, during assessment the nurse notes that he
has jugular vein distention and oedematous feet. The nurse recognises that these finds
are indicative of which complication of COAD
a) Acute respiratory failure
b) Fluid volume excess secondary to cor pulmonale
c) Pulmonary oedema caused by left sided heart failure
d) Secondary respiratory infection
29. The most dangerous complication of oxygen therapy for persons with chronic
obstructive lung disease is
a) Pulmonary embolism
b) Damage to alveolar and lung parenchyma
c) Dry lung secretions and promote atelectasis
d) Depression of the respiratory drive
30. A compensatory mechanisms for respiratory acidosis is

a) Retention of hydrogen ions by the kidneys
b) Decreased rate and depth of respiration
c) Increased bicarbonate production by the kidneys
d) Decrease bicarbonate production by the kidneys
31. Mrs green has an acute episode of right sided heart failure and is receiving frusemide
(lasix). The symptoms mrs green most likely displayed on admission are
a) Dyspnoea, oedema and fatigue
b) Weakness, palpitations, nausea
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c) Fatigue, vertigo and headache
d) A feeling of distress when breathing

33. Heart failure may be defined as

a) The inability of the heart of pump sufficient blood to the tissues
b) The inability of the heart to pump sufficient blood to the myocardium
c) The inability of the atrio ventricular valves to control blood flow within the heart
d) Inflammation of the endocardium
a) Dyspnoea, oedema, fatigue
35. The nurse notes that mrs greens abdomen is distended. The nurse should realise that
the client with congestive heart failure develops ascites because of
a) Increased pressure within the circulatory system
b) Rapid diffusion of solutes and solvents into plasma
c) Rapid osmosis from tissue spaces to cells
d) Loss of cellular consituents in blood
36. In the systemic circulation, blood returning to the heart from the legs would have to
pass through the
a) Right coronary artery
b) Inferior vena cava
c) Abdominal aorta
d) Thoracic aorta

a) Obesity
b) Hypoglycemia
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a) Blurred vision
b) Loss of memory
c) Numbness of arms
39. In metabolism of carbohydrate, the most important function of insulin is
b) To facilitate the passage of glucose in to the cell
40. Lasix 15 mg is ordered for a client. Available stocks contain 10mg in a 2ml ampoule.
The correct dose would be
a) 5ml
b) 3ml
c) 1.5 ml
d) 2.5ml
41. If you suspect the dose of a prescribed medication is too high, your best action would
be to
a) Delay giving it until an adequate explanation is given to you about the dosage
b) Give it once, but don’t repeat the medication until the dosage is confirmed
c) Give it if the medication is given orally, but delay it if it is given by injection
d) Give the dose you know is appropriate

a) Dysrhythmia
b) Cardiogenic shock
c) Congestive heart failure
d) Ventricular rupture
43. When collecting a client from post anaesthetic recovery room, the nurse places the
highest priority on assessing
a) The patients level of consciousness
b) The condition of the surgical site
c) The status of fluid and electrolyte balance
d) The adequacy of respiratory function
44. DKA occurs when there is

a) A profound lack of insulin in the body
b) A severe decrease in blood glucose
c) Insufficient insulin production
d) Excessively rigid glycemic control
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45. Which symptom of DKA causes patients to seek care
a) Dehydration
b) Abdominal discomfort
c) Acetone breath
d) Blurred vision
46. Which of the following is a late sign of DKA

a) Diarrhoea
b) Hypertension
c) Lethargy
d) Deep rapid breathing
47. What makes HONK so dangerous

a) It has an insidious onset
b) It presents with a myriad of symptoms
c) It has a rapid downhill course
d) It mimics other diabetic problems
48. Plasma glucose levels in HONK are usually

a) <11 mmol/L
b) 11-27 mmol/L
c) 13.8-44 mmol/L
d) >33mmol/L
49. The goals for emergency treatment of DKA and HONK include all the following
except
a) Correcting the underlying cause
b) Normalising glucose
c) Restoring fluid and electrolytes
d) Stabilising respiratory status
50. The nurse should instruct the diabetic patient to follow all of the following sick day
guidelines except
a) Drink plenty of caffeine free fluids
b) Always take your normal dose of insulin even if you cant eat
c) Monitor blood glucose every six to eight hours
d) Always take your oral diabetic medications even if you cant eat
d) Pneumothorax
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The nurse would expect to see changes in
a) P wave
b) T wave
c) Qrs complex
d) U wave
53. To relieve angina pectoris symptoms, the nurse administers nitroglycerin sublingual
to the patient. Which of the following is an action of nitroglycerin
a) Decreases myocardial oxygen comsumption
excessive amounts
a) Hypovolemia
b) Polyuria
d) Blurred vision
55. To gain a postoperative patients co operation in ambulating, coughing, deep

breathing, and turning, which intervention is most important for the nurse to perform
a) Administer analgesics freely to achieve the patients relative freedom from pain
b) Ensure that the patient understands the rationale for these activities
c) Warn the patient about complications that can occur if the activities are not
performed
d) Praise the patient when the activities are completed
56. The nurse is teaching a group cardiac patients to evaluate the nutritional content of
food. The nurse explains that if a serving of 100 gram peanut butter has 36 grams of
fat and 190 calories the percentage of fat per serving is
a) 52%
b) 66%
c) 36%
d) 18%
57. Mr doncald graham, aged 81, has a large obstruction that occurred as a result of a
faecal impaction. During assessment of mr graham, the nurse recognises which
finding as consistent with a large bowel obstruction
a) Rapid onset of copious vomiting
c) Referred pain to the back
d) Constant, generalised abdominal pain
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58. The physician orders 2 units of blood to be infused for a client who is bleeding.
Before blood administration the nurses highest priority should be
a) Obtaining the clients vital signs
b) Allowing the blood to reach room temperature
c) Monitoring the haemoglobin and hematrocrit levels
d) Determining proper typing and cross matching of blood
59. A feature of type 1 diabetes is

a) Autoimmune destruction of pancreatic beta cells in pancreas
b) Late onset usually older than 40 years
c) Resistance to insulin in target tissues
d) Obesity
60. The percentage of the people with diabetes type 2 out of all diabetic clients is
a) Over 40%
b) Over 50%
c) Over 60%
d) Over 80%
61. Type 2 diabetes usually requires

a) Oral hypoglycaemic medications, diet and exercise
b) Sub cutaneous insulin
c) Regular daily monitoring of blood sugar levels
d) Four times daily monitoring of blood sugar levels
STATE EXAMS 27
1. Critical thinking skills that assist the nurse in appropriately setting priorities are which
type of nursing skill
a) Intellectual
b) Interpersonal
c) Technical
d) Mechanical
2. Factors that influence goal achievement include the
a) Clients age and developmental goals
b) Nurses ability to focus on the client
c) Strong commitment by the instituation to client care
d) Nurses commitment to the utilisation of the nursing process
3. The nurse notes that a hospitalised adult client has orthopnea. The nurse plans to
assess the clients respiration while the client
a) Lies in a side lying position in bed
b) Sits upright in a chair
c) Has the head of the bed elevated 20o
d) Lies supine in bed
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4. Which position best facilitates assessment of a clients lung expansion
a) Sitting
b) Supine
c) Dorsal recumbent
d) Prone
5. A client with chronic constipation tells the nurse that he would like to improve his
diet. Besides encouraging high fibre foods, the nurse should instruct the client to
a) Drink 2000 to 3000 ml of fluid daily
b) Refrain from eating spicy foods
c) Eat more processed cheese daily
d) Avoid milk products
6. When a dressing is removed from a wound the nurse notices that the drainage is
bright red blood. This exudates would be described as
a) Serosanguineous
b) Purulent
c) Serous
d) Sanguineous
7. Important data to include in a spirituality assessment would be

a) General spirituality beliefs
b) Judgement about a clients belief
c) Appropriate client interventions
d) Rationale for specific belief
8. An adult client is to have a complete bed bath. Before beginning the bath, the nurse
should
a) Offer the client the bedpan
b) Lower the clients bed to the lowest position
c) Assist the client to brush her teeth
d) Remove the clients hospital gown
9. The nurse knows that to promote sleep in the hospital for a client, the client must
a) Feel comfortable and safe
b) Have physiotherapy completed early
c) Take medications by 10.00pm
d) Have adequate exercise
10. The department of health advises that all infants six weeks of age should be
immunised against the diseases of
a) Diphtheria, tetanus, measles, hepatitis B
b) Diphtheria, tetanus, whooping cough, measles
c) Diphtheria, whooping cough, tetanus, hepatitis B
d) Diphtheria, whooping cough, rubella, hepatitis B
11. The department of health advised that all children should first be immunised against
rubella in action at age
a) 3 months
b) 5 months
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c) 15 months
d) 5 years
12. Which statement would best help a mother who says that she does not believe in
immunisation because it is unnatural
a) Your children are in danger of infection if they were not given breast milk to
gain natural immunity
b) Immunisation assists the body to produce its own immunity and give
protection against dangerous infections
d) If you do not have your children immunised they can be admitted to hospital
with infectious diseases and cost the country a lot of money
13. What is the most appropriate response by the nurse to the question ‘is morbilli a
serious disease’
a) It is a normal childhood complaint
b) It can cause deformities in the foetus
c) Septic skin lesions usually follow this condition
d) Complications such as otitis media or pneumonia can occur
14. A mother thinks her daughter has measles and is worried because her next door
neighbour is three months pregnant. The nurse should advise the mother
a) The foetus would not be affected at this stage
b) She should bring her daughter promptly to the doctor
c) The daughter should be kept away from the neighbour
d) She should be immediately vaccinated against rubella
15. Which of the following responses should the nurse give to the question, ‘why is
immunisation against rubella recommended when rubella is usually a mild illness
a) Rubella is serious in childhood but not in adults
b) Rubella is the cause of severe complications in the newborn baby
c) Rubella can cause deformity in the developing foetus if the mother contracts it
d) Rubella has been identified as the cause of blindness and heart defects
developing in pre schoolers
16. A five year old has been discharged from hospital after having swallowed his mothers
contraceptive pills. Which is the most important advice for the nurse to give when
making follow up home visit
a) Keep all medicines in a locked cupboard
b) Take out of the bottle only the dose required each time
c) Use child resistant containers for all medicines
d) Dispose of unwanted medicines or chemicals safety
17. Which information source provides most knowledge about the health problems of a
community
a) The local health groups
b) The prevalence of unemployment
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c) The standard of available housing
d) Mortality and morbidity statistics
18. What action should the nurse take when on three home visits the mother of nine
months old baby prevents him from being seen as ‘he is sleeping’
a) Notify the social welfare of the situation
b) Notify the family doctor in writing of this occurrence
c) Insist on seeing the child and refuse to leave the home
d) Respect the patients right to accept or refuse treatment
19. Violence and rejection of children in a society have been considered as associated
health problems. Which is the most appropriate first step in planning to reduce
violence
a) Introduce legislation aimed at curbing violence
b) Reduce violence on television at peak viewing times
c) Examine the social, cultural and economic conditions and assumptions of
society
d) Teach all health workers to recognise the factors which predispose to violence
20. When planning nursing care for a client with a different cultural background, the
nurse should
a) Identify how cultural variables impact on the health problem
b) Try to explain how the client must fit into hospital routines
c) Speak slowly and clearly to ensure effective communication
d) Allow family to provide care during the hospital stay
21. What action has been proposed to improve maori health in the short term
a) Provide jobs and better access to health care
b) Raise the social, economic and cultural status of maori
c) Provide funding for nga tohunga and nga kamatura
d) Start education programmes on the marae
22. When making a home visit to a maroi family which of the following actions should
the nurse be aware of
1. Taking her shoes off at the door
2. Avoiding placing her nursing bag on the kitchen table
3. Obtaining good eye contact with each person she speaks with
4. Greeting male members of the family first
a) 1 and 2
b) 1 and 4
c) 2 and 3
d) 3 and 4
23. Mr Sherwood aged 78 years is admitted following a suspected cerebral vascular

accident. He has a left hemiplegia, and is comatosed. All of the following can be used
to assess a patients level of consciousness except
a) Degree of orientation to surroundings
b) Quality of verbal responses
c) Reaction to painful stimulation
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d) Muscular power and tone
24. Even though mr Sherwood is unconscious the nurse should continue to talk to him
while providing care
a) In order to show that mr Sherwood is not bein neglected
b) Because his family might see this as a positive prognosis
c) Because talking encourages a response when consciousness improves
d) Because he may be able to hear, yet not respond
25. When mr Sherwood regains consciousness he is unable to move his right arm or leg.
Which type of paralysis is mr Sherwood most likely to have at this stage
a) Bilateral
b) Flaccid
c) Periodic
d) Incomplete
26. Mr sherwoods mouth is drawn over to the left. This suggests non conduction by the
a) Left facial nerve
b) Right facial nerve
c) Left abducent nerve
d) Right trigeminal nerve
27. Mr Sherwood seems to understand what is said to him but speaks in garbled words or
inappropriate phrases. This is referred to as
a) Dysphagia
b) Global aphasia
c) Expressive amnesia
d) Expressive aphasia
28. Mr Sherwood describes a throbbing bi frontal and suboccipital headache after a
lumbar puncture. This is likely to be
a) Relieved by lying supine
b) Anxiety related
c) A sign of spinal cord compression
d) Related to increased intracranial pressure
29. Mrs Sherwood asks if her husband will ever regain the use of his arm and leg. The
nurse should know that mr Sherwood can be expected to regain some degree of
function because
a) Neurons will be regenerated to replace dead ones
b) Some of the paralysis will subside as does cerebral oedema
c) Strokes are characterized by functional rather than organic changes
d) Periods of remission and exacerbation of the paralysis always occur
30. Mr Sherwood inability to speak is most likely due to

a) Paralysis of muscles of the larynx
b) Pressure on the brain stem
c) Damage to the nerves of the face and tongue
d) Injury to the cortical speech centre
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31. Jillian, aged 11 years, was admitted to hospital with an acute attack of asthma. How
does asthma affect respiration
a) Lessens the expulsive action of cilia
b) Destroys the structure of alveolar walls
c) Prevents full use of respiratory muscles
d) Obstructs the flow of air through the airways

33. Breathing in asthma is commonly described as

a) Gasping
b) Grunting
c) Wheezing
d) Stertorous
34. R difficulties can most effectively be relieved by agents which cause

a) Bronchodilation
b) Increased oxygen tension
c) Decreased production of mucus
d) An action against causative allergens
35. In jillians immediate care the nurse should stay with her and
a) Assist her in controlled expiration
b) Use oxygen as a ventilator stimulus
c) Explain that the doctor has increased her drugs
d) Provide reassurance that treatment is being effective
36. Aminophylline 350mg is prescribed. Each ampoule contains 250mg in 10ml. how
a) 12ml
b) 14 ml
c) 16 ml
d) 35 ml
37. While jillian is having intravenous aminophylline, the most important nursing action
is to
a) Assess the intravenous site once each duty
b) Sit her well up in bed to aid ventilation
c) Monitor her respiratory and heart rates regularly
d) Record all medications as charted when they have been given
completed on time
a) 55
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b) 65
c) 75
d) 85
39. Even after intravenous medication jillian is still anxious, dyspnoic and restless;
respiratory rate is 36; she is still wheezing and using her accessory muscles. What
action must the nurse take
a) Jillian needs physiotherapy to help her breathing
b) Lack of response to treatment requires medical review
c) She needs to use her inhaler as well as her medication
d) A higher concentration of oxygen will help her breathe more easily
40. As part of the treatment regime the doctor prescribes ampicillin (ampicyn) 400mg. the
ampoule contains 500mg in 10ml. what volume should be given
a) 4ml
b) 6ml
c) 8ml
d) 12ml
41. After her severe attack of asthma jillian says ‘im never going to get better, im going to
die’ what is the most appropriate response by the nurse
a) Joke with her and get her to laugh
b) Reassure her that she will be alright
c) Arrange to spend some time sitting with her
d) Listen to her talk all about her problems
a) Broncho’dilator
43. Which is the most important reason for administering ventolin through a nebuliser
a) A low dose can be given for local effect
b) The method is more acceptable to children
c) The drug is completely absorbed and acts quickly
d) It is the most convenient method when an oxygen mask is in use
44. All of the following must be done when jillian is using her inhaler except
a) Shake the inhaler before using it
b) Expire fully before inhaling the spray
c) Hold the inhaler within ones open mouth
d) Use the inhaler repeatedly until some relief is felt
45. Which is the first step in helping jillian to live a normal life in spite of her asthma
a) Monitor her long term drug therapy
b) Help her understand the nature of the condition
c) Teach her parents postural drainage with percussion and vibration
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d) Listen to her difficulties and help her find ways of coping with them
46. What should the nurse do when jillian refuses to get involved in an activity because of
fear of an asthma attack
a) Take away other privileges until she participates
b) Allow her to remain in bed when she is short of breath
c) Listen to her and encourage participation in the activity
d) Let her decide what type of activities she would like to do
47. The most important factor about jillians prognosis that her parents should know is that
she
a) Has an unpredictable prognosis
b) Will never be completely cured
c) May experience other disabling symptoms
d) Can recover but attacks can recur if she is under stress
48. Mrs hill a 30 year old housewife, with a husband and three children, has just been told
by her doctor that she has multiple sclerosis. Multiple sclerosis is characterised by
a) Increasing deterioration which ultimately ends in death
b) Gradual deterioration with progressive loss of movement
c) Recurrences and remissions extending over a period of many years
d) Loss of movement and sensory functions, mainly in the lower body
49. The diagnosis of multiple sclerosis is usually made after

a) Confirmation of positive blood tests
b) Recurring bouts of acute depression
c) Identification of the micro organism causing the disease
d) Signs of damage to the nervous system that occur from time to time
50. Mrs hills family should be included in discussions on

a) Her dietary requirements
b) The fact that the illness wont improve
c) The need for daily physiotherapy for her limbs
d) How to encourage mrs hill to remain self reliant
51. What is the best amount of exercise for mrs hill

a) Resting quietly as much as possible
b) Exercising daily but not getting too tired
c) Just exercising smaller muscles, not her large muscles
d) Doing as much as she can to prevent contractures occurring
52. Why should a person who has multiple sclerosis always be very careful to avoid
infections such as the common cold
a) It takes longer to get over an infection
b) Poor immunity is associated with the disease
c) Infection may trigger off an acute episode of the disease
d) An infection masks other symptoms and prevents early intervention
53. Mrs hill expresses hopelessness about her loss of independence. Which of the
following statements by the nurse would be most helpful
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a) What is it that worries you most
b) Could your family help you a bit more
c) You may be setting goals which are too high
d) Your depression is just part of your disease
d) People unaffected by multiple sclerosis such as the MS society field worker
55. Mr green, 56 years old has been in hospital for two weeks with a diagnosis of cerebral
thrombosis. His symptoms include expressive aphasia, right sided paralysis and loss
of the gag reflex. As part of the long term planning the nurse should
a) Help the family accept the fact that mr green cannot be verbally
communicated with
b) Wait for mr green to verbalize his needs regardless of how long it takes
c) Begin associating words with physical objects
d) Help mr green accept this disability as permanent
56. Mrs green seems unable to accept the idea that her husband must be encouraged to do
things for himself. The nurse may be able to work around these feelings by
a) Telling mrs green to let her husband do things for himself
b) Letting mrs green know that the nursing staff has full responsibility for the
patients activities
c) Letting mrs green assume the responsibility as she sees fit
d) Asking mrs green for her assistance in planning the activities most helpful to
the patient
children
b) The way their needs are met by others
a) Acknowledge they are individuals
59. Which of eriksons psychosocial crises is present at age four years

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b) Make a conscious effect to remember their own adolescence
61. A man has a bleeding socket after getting his tooth removed. The correct action to
take is to
a) Give him an ice cube to suck
b) Give him a warm saline mouthwash
c) Pack the socket with ribbon gauze
d) Tell him to bite on a gauze pad for twenty minutes
62. Mr smith suffered severe burns to both legs from flames at a barbecue on the beach.
His friends carried him to the waters edge and let the sea flow over his legs. Which
statement is correct about the suitability of this first aid treatment
a) Advisable to reduce the heat of the flames
b) Strongly recommended as sea water is healing
c) Risky because of the contaminants in sea water
d) Not acceptable because of the risk of chilling and shock
63. A 42 year old farmer is pinned under his tractor. His breathing is laboured, he is
slightly cyanosed, shocked and has severe chest pain. While waiting for the doctor the
nurse should especially note any
a) Alteration in pain
b) Decrease in temperature
c) Change in his respirations
d) Increase in the amount of restlessness
64. The farmer is removed from behind the wheel. He is in severe respiratory distress and
is becoming more cyanosed. The farmer is found to have an open pneumothorax. The
most appropriate first aid is to
a) Seal the wound in the chest wall
b) Start mouth to mouth resuscitation
c) Place the farmer to in recovery position
d) Lie the farmer flat, extending his neck
65. The ambulance driver gives the farmer oxygen therapy. This improves his respirations
and decreases his degree or acidosis by decreasing the
a) Carbon dixide and carbonic acid in the blood and the ratio of carbonic acid to
bicarbonate
b) Hydrogen ion concentration in the blood and increasing the ratio of carbonic
acid to bicarbonate
c) Carbonic acid, so chloride moves into the red cells leaving more sodium
available to form bicarbonate
d) Build up of potassium in the blood stream and increasing oxygenation of the
haemoglobin in the blood cells
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a) Your children are in danger of infection if they were not given breast milk to
gain natural immunity
b) Immunisation assists the body to produce its own immunity and give
protection against dangerous infections
d) If you do not have your children immunised they can be admitted to hospital
with infectious diseases and cost the country a lot of money
he will be given a
69. Vaccines induced immunity that is

70. Which of the following signs symptoms would indicate mumps

d) Ulceration of vesicular stomatitis
spread of mumps

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73. Mrs shaw brings her 8 year old daughter jane to the clinic. Jane has eczema. Janes
eczema is most likely the result of
a. Inadequate skin care and hygiene
b. Excretion of acids through sweat pores
c. An inherited predisposition to skin infections
d. Sensitivity to a substance in her external environment
74. Excema is the term used to describe a (n)

a) Acute, contagious inflammation of the skin
b) Non contagious inflammatory response of the skin
c) Fungal infection more commonly seen in childhood
d) Condition marked by the appearance of erthematous wheals
75. Which statement best describes ‘vesicles’

a) Reddened, pinprick like rash
b) Small round area of discolouration
c) Small area of swelling on the skin
d) Small blister filled with serous fluid
76. You are employed as a practice nurse. A friend telephones and asks if her boyfriend
has been to see the doctor this week. Your most appropriate response is
a) I don’t know
b) Ill have to ask the doctor
c) I am not able to tell you that
d) Just a moment, ill check the files
S TATE EXAMS 28
1. Mrs adams suffers from dementia and requires a dressing to a shin wound. The nurse
b) A long standing pattern of domestic violence
c) The home not being a suitable place for a dependent person
2. When dressing the shin wound the nurse most appropriate remark is
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4. An increased incidence of vaginal infections occurs when contraceptive pills are taken
because there is
a) A shift in the vaginal pH
b) Drying of the vaginal mucosa
c) An increase in vaginal fluids
d) A reduction in white cell numbers
5. What action should the nurse take when on three home visits the mother of the nine
months old baby prevents him from being seen as he is sleeping

7. The first and probably the most important awareness that a person with an intellectual
disability should be assisted to develop is a feeling of
a) Trust
b) Belonging
c) Acceptance
d) Physical satisfaction
8. Which is not a characteristic of a therapeutic environment

a) Free communication
b) Everyone doing as they like
c) Provision of learning experiences
d) Modifying authoritarian structures
9. A person in a training session using reinforcement will learn most effectively when he
a) Is reinforced intermittently
b) Is reinforced contingently
c) Is reinforced non contingently
d) Initiates others who are contingently reinforced
10. Norman aged 10 has a severe intellectual disability, but is a physically active child.
He has been admitted to hospital for assessment. The best indication that a child
reacts poorly to frustration is when he
a) acts silly to gain attention
b) is jealous of attention given to others
c) sulks because he thinks playmates are begin unfair
d) throws temper tantrums when he does not get his own way
11. the most helpful assessment for planning the nursing care of a person with a severe
intellectual disability is
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a) details of his abilities
b) a description of his characteristic syndrome
c) a study of photographic records of his progress
d) data relevant to past and present environmental factors
12. aminophylline 350mg is prescribed. Each ampoule contains 250mg in 10ml. how
a) 12ml
b) 14ml
c) 16ml
d) 35ml
completed on time
a) 55
b) 65
c) 75
d) 85
a) Broncho dilator
15. A client is charted nitrazepam (mogadon) tablets to sleep. She refuses to take them at
9pm. She tells you that the other nurses always leave the tables on the locker and she
16. Hyperventilation may initially cause

a) Metabolic acidosis
d) Respiratory alkalosis
17. The nurse should explain to Normans mother that an electro encephalogram is
a) Like a mild electric shock, but is not painful
b) Helpful in finding the cause of his epilepsy
c) A test to record the electrical activity of the brain
d) A test to find the cause of the childs behaviour disturbance
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18. Normans father asks if he can expect his sons condition to improve. Which is the most
appropriate reply for the nurse to give
a) Yes but it will take a long time
b) No but he can be helped with therapy
c) No but further degeneration will not take place
d) No but his condition can be controlled with drugs
19. The concept of normalisation as a direction of care for the mentally disabled would
ensure that norman is treated as an individual
a) With human rights and needs
b) According to actual mental age
c) With adaptive deficits
d) According to actual chronological age
20. Which of the following is the most important information to give to the parents when
they take norman home for the weekend
a) Advice about his general abilities
b) A report on his progress at school
c) The details of his training programme
d) The changes noticed in his general condition
21. Peter aged 19 is disabled due to intellectual impairment and epilepsy. He is ambulant
and lives at home. The nurse is asked to visit as peter has developed mumps. Which
of the following micro organisms cause mumps
a) Viruses
b) Bacteria
c) Gram negative organism
d) Gram positive organism
22. Which of the following signs symptoms would indicate mumps

d) Inflammation of naso pharyngeal lymph tissue
spread of mumps
24. The best way to help peter develop his creative potential is by
a) Motivation to become independent by earning some money
b) Accepting as valuable something he has made
c) Concentrating on the lessening of his liabilities
d) Group activities that encourage him to interact with others
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25. Which of the following is essential in assisting the family to help peter to develop
independence
a) Observe what he can and cannot do
b) Recognise his need to be treated as a normal adolescent
c) Stress that going away from home is a creative adventure
d) Gain an insight into the limitations imposed by his family circumstances
26. Simon aged 14 years is paraplegic and has an athetoid type of cerebral palsy. He has
been admitted to a psychopaedic assessment unit. Which of the following best
describes athetoisis
a) Hypertonicity of head, neck and shoulder muscles
b) Voluntary writing or throwing movements of the whole body
c) Hypotonia and impairment of postural fixation of the trunk
d) Involuntary movements affecting almost all muscles of the body
27. What characterises the muscle movement of athetosis

a) Abnormal reflex activity
b) Exacerbated by attempts at intentional movement
c) Exaggerated spasticity in movement
d) Slow, writhing, continous involuntary movements
28. All of the following may be the cause of chronic constipation except
a) Very refined food
b) Too much fibre in the diet
c) Too little fluid in the diet
d) Poor muscle tone in the bowel
29. Which of the following is the best combination of foods to help relieve constipation
a) Raw fruit and vegetables
b) Cooked meat and raw vegetables
c) Cooked fruit and refined cereals
d) Refined cereals and well cooked vegetables
30. How are passive exercises undertaken
a) Without the persons active assistance
b) Without any help from the physiotherapist
c) Only with assistance from the physiotherapist
d) By the use of weights to strengthen the muscles
31. Why is joint movement promoted in simons physiotherapy programme

a) Prevents contractures of his muscles
b) Stimulates voluntary muscular movements
c) Maintains circumduction of the hip joint
d) Maintains the strength of his leg muscles
32. Which action is most likely to prevent the formation of a bed sore
a) Changing the position every two hours
b) Placing a sheepskin under the buttocks
c) Placing a rubber ring under the buttocks
d) Vigorously massage the area with silicone cream
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33. The most helpful measure to assist a 14 year old boy with paraplegia and cerebral
palsy to cope with urinary incontinence is to
a) Offer a urinal at regular intervals
b) Keep a disposable urinal in place at all times
c) Teach him to use a penile appliance and self emptying bag
d) Insert a retention catheter to prevent overdistension of the bladder
34. Which urinary tract problem is most likely to occur as a complication of immobility
a) Haematuria and infection
b) Stress, incontinence and infection
c) Renal calculi and infection
d) Bladder distension and haematuria
35. Bruce, aged 15 years has had a moderate intellectual disability from infancy. He has
recently moved into a hostel and attends a special school where his behaviour is
reported to be both antisocial and disruptive. What is the most likely reason or bruces
recently reported behaviour problem
a) He has no single set of ideals on which he can depend
b) He is concerned about what may happen next to him
c) His thoughts about being independent have caused an identity crises
d) He needs to regain a feeling of security and confidence he felt when he lived at
home
36. The most effective behaviour therapy in bruces situation would be to

a) Punish him so that disruptive tendencies are eliminated
b) Develop a reliable behaviour pattern for effective social functioning
c) Arrange contingencies between his behaviour and its long term consequences
d) Manipulate the environmental factors to make acceptable behaviour highly
probable
37. What is the most important reason for keeping records during bruces behaviour
therapy programme
a) Provide a primary source of baseline information
b) Provide evidence of programmes that achieve their desired effect
c) Limit personal biases when his behavioural programme is discussed
d) Provide some objective method for evaluating the outcome of the techniques used
38. Which of the following should be undertaken first when planning a behaviour therapy
programme for bruce
a) Consulting his relatives
b) Assessing his present level of functioning
c) Deciding on the overall goals for his programme
d) Arranging with the psychologist for psychological testing
39. When introducing bruce to a reward schedule it is best to

a) Make sure bruce feels he never gets enough of the reward
b) Use a strong reward for target behaviour every time it happens
c) Use the chosen schedule until his behaviour is completely controlled
d) Use an intermittent schedule until bruce understands what is expected of him
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40. Which of the following applies when changing bruce from a continuous to an
intermittent behaviour schedule
a) Explain to him what is happening
b) Reduce the number of rewards slowly
c) Use only natural rewards for target behaviour
d) Continue to reward target behaviour each time it occurs
41. The primary principle in preparing a new teaching programme for bruce is to
a) Prevent him repeating mistakes
b) Use and extend his current learning achievements
c) Assist him to achieve a satisfactory quality of life
d) Offer encouragement for socially appropriate behaviour
42. Prescribed is heparin 125000 units. The vial you have contains heparin 1 mega unit in
2mls. What is the correct dose
a) 0.025 mls
b) 0.25 mls
c) 0.5 mls
d) 1.0 ml
43. The doctor orders 1000 mls of barts to be infused over 8 hours. The drip factor is 15.
What is the number of drops per minute
a) 3
b) 30
c) 31
d) 310
44. Penicillin 250 mgs is prescribed. The drug available in powdered form is reconstituted
to contain 600 mg in 2 ml. what amount should be given
a) 0.75 ml
b) 0.8 ml
c) 0.83 ml
d) 0.9 ml
45. Under the misuse of drugs act 1975, a registered nurse may be convicted in a criminal
court of law for
a) Giving prescribed sedation to a patient in hospital
b) Possessing a controlled drug, not prescribed for the nurse by a medical
practitioner
c) Signing the controlled drug register, having given a prescribed medication
d) Refusing to give a prescribed controlled drug to a patient suffering from chronic
pain
46. The preliminary precaution that must be observed first before the nurse gives the
ampule of medication handed to her by the charge nurse is to
a) Wash her hands
b) Sight the doctors prescription
c) Check the charge nurse gives the orders in writing
d) Check the prescription is writing in duplicate on the patients chart
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47. Mrs jan carr is a 45 year old, non maori woman who is married and has two adult
children living away from home. Recently mrs carr has experienced a weight loss of
10 kg, has disturbed sleep patterns and has very little energy. She is admitted to
hospital with a diagnosis of depression. What other feature is she likely to
demonstrate on admission
a) Flight of ideas
b) Halluscinations
c) Feelings of persecution
d) Feelings of worthlessness
48. The most important priority in your assessment would be to gain information
concerning which of the following
a) Unresolved conflicts
b) Ideas of self harm
c) Current stresses
d) Previous history
49. Mrs carr tells you she would like to go to sleep and never wake up. Which response is
the most appropriate
a) Lets go for a walk to cheer you up
b) Youll feel better in a day or so
c) Are you saying you want to die
d) Your medication will make you feel differently
50. Mrs carr is assessed as being actively suicidal and has refused all food and fluids
since admission this morning. Choose the most appropriate group of nursing
interventions
a) Nutrition, psychotherapy and medication
b) Constant observation, supportive care and nutrition
c) Supervised activity, nutrition and family visits
d) Constant observation nutrition and medication
51. Mrs carr is given tricyclic anti depressant medication. After four days she tells you
that the pills are not working. Choose the most appropriate action
a) Report her statement to the house surgeon
b) Tell mrs carr that the medication will take at least 10 days to start working
c) Discuss mrs carrs anxieties about medication with her
d) Record her statement in the nursing records
52. Mrs carr asks you how long she will have to take medication. Your most appropriate
response would be
a) The medication takes a maximum of four weeks to be fully effective
b) Usually people continue on this type of medicine all their lives
c) Once your condition improves your medication may be gradually reduced
d) The maximum time on this type of medication is six to twelve months
53. Mrs carr complains of a dry mouth. The most likely reason for this is
a) Insufficient fluids
b) Anxiety
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c) Side effects of medication
d) Nervous system response
54. Four weeks later mrs carr is granted weekend leave. She tells you she has a bottle of
anti depressants at home, which she will take if things do not go well. Your response
would be to
a) Tell her that the responsibility is hers
b) Listen and report to the team so that her leave can be reconsidered
c) Make a contract with her that she will not harm herself
d) Reassure her that she is much improved and will cope with leave
55. The physician orders a different type of medication when mrs carr does not respond
positively to a tricyclic anti depressant. While the patient is taking the newly
prescribed drug, tranylcyclopromine sulphate (parnate), which one of the following
reactions is likely to occur if the patients diet includes foods containing tyramine
a) Heart block
b) Grand mal seizure
c) Hypertensive crises
d) Renal failure
56. Mrs carr again obtains permission for leave. Which one of the following preparations
by her husband indicates the best understanding of the her needs
a) Planning to involve her in their usual at home pursuits
b) Bringing her bed downstairs so she can rest during the day
c) Scheduling a day of interesting activites outside of the home
d) Arranging for a friend of the family to watch her at all times
57. Mrs carr has learnt that practicing relaxation gives her a feeling of control over her
depressing thoughts. The particular part of the nervous system activated through
relaxation training is the
a) Sympathetic nervous system
b) Parasympathetic nervous system
c) Central nervous system
d) Peripheral vasoconstriction
58. Eric smythe, a 45 year old non maori man is admitted as an informal patient the
psychiatric unit after a week in intensive care following an over dose of imipramine.
He had been on this medication for depression for the preceding twelve months.
During the interview, you as the admitting nurse, observe that no longer appears
depressed, is somewhat detached and is joking about his foolishness (referring to his
suicide attempt). Eric requests discharge, stating that he is afraid to lose any more
time off work and that his family will not cope if he doesn’t go home now. From the
interview data you assume that
a) Eric has gained insight into his self destructive behaviour
b) Eric desire to return to work and his family indicates good judgement
c) Erics affect indicates that his bout of depression is now over
d) Erics comments may indicate he is suicidal and is trying to bide it
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59. Establishing a therapeutic relationship with eric will contribute to which of the
following
a) The feeling that he is worthless
b) The feeling that others pressure him
c) The feeling that he is overprotected
d) The feeling that others want him to live
60. One day when erics wife visits she finds him quietly weeping and saying he cant go
on. She asks you to calm him down. Your best response would be
a) All right, ill talk to him and see if I can find out whats wrong
b) If you just sit quietly with him, im sure hell calm down
c) Its hard to see him so upset, but he needs to let the feelings out
d) We can both stay with him until he has regained control if you like
61. One of the things that the nurse must be aware of when caring for eric as he recovers
from depression is
a) He is considered less of a suicide risk than when severly depressed
b) He is no longer considered a suicide risk as he recovers
c) He is considered more of a suicide risk when he is recovering
d) He is considered more of a suicide risk when in the depths of depression
62. While on leave eric again takes an overdose of his antidepressants. He rings the ward
to let you know he will not be back and tells you why. What approach will you take in
this situation
a) Keep him on the phone and send the police to bring him to hospital
b) Persuade him to put his wife on the phone and ask her to bring him to hospital
c) Convince him to drive himself back to the hospital to get treatment
d) Look up his address go out and bring him to hospital yourself
63. The team decide that erics condition is serious. They decide he should undergo a
course of E.C.T. before his first treatment at 8am, you should be sure eric has
a) Has recently urinated
b) Has not drunk for 12 hours
c) Signed a consent form
d) Has not eaten for 12 hours
e) All of the above
64. Mrs smythe asks you what to expect when she visits eric after his treatment, which of
the following is the most accurate information
a) It is possible that he may not recognise you for a few days
b) There will probably be a temporary and expected loss of memory
c) He will be so confused that it will be best not to visit today
d) He will be very sleepy and unable to tolerate a long visit
65. Eric makes good progress with E.C.T and antidepressant therapy and is ready for
discharge. He asks you what signs to look out for in the future that might indicate a
recurrence of depression. Your best response is
a) Grandiosity, insomnia, self devaluation, psychomotor retardation
b) Persecution, insomnia, self devaluation, psychomotor retardation
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c) Paranoia, insomnia, self devaluation, psychomotor retardation
d) Withdrawal, insomnia, self devaluation, psychomotor retardation
66. You are working the evening shift in the intensive care unit. You observe that there
are times when patients appear not to respond to injections of diazepam (valium). On
further investigation you discover that the lack of response occurs ofter the
medication has been administered by mrs H, a day shift nurse. One evening mrs H is
assigned to work with you on the evening shift because one of the regular staff is
absent. After dinner you observe that one of the patients received diazepam but is still
anxious. You also observe that mrs H appears slightly euphoric, uncoordinated, and
her speech is slurred. The first action for you to take is
a) Arrange to observe mrs h when she prepared medications
b) Ask other nurses if they have observed anything unusual
c) Call the nursing supervisor and ask her to confront mrs h with you
d) Tell mrs h that you know she has been stealing drugs
67. What distinguishes substance dependence from substance abuse

a) Tolerance for the substance and psychological dependency
b) Tolerance for the substance and polydrug abuse
c) Tolerance for the substance and withdrawal reactions
d) Psychological dependency and withdrawal reactions
68. It is determined that mrs h has a drug abuse problem. A positive initial intervention
would be
a) Dismissal from her job
b) Referral to a self help group
c) Counselling by the head nurse
d) Referral to a drug treatment programme
69. When withdrawing the client from benzodiazepines the most important thing to
remember is
a) To get the client off the substance as quickly as possible
b) To perform an accurate assessment and establish a baseline before proceeding
c) To get the client off the substance slowly
d) To educate them re other problem solving techniques
70. Which of the following groups of responses is characteristic of addiction to

antianxiety agents
a) Psychological addiction, tolerance no physical addiction
b) Physical addiction, tolerance, no psychological addiction
c) Psychological addiction, no physical addiction, no tolerance
d) Physical addiction, psychological addiction, tolerance
71. Mr D B brown a 45 year old non maori man is admitted to the ward in which you are
working following a domestic dispute, during which time he smashed the family
home up and punched his fist through a window, causing severe lacerations of his
hand, for which he has received treatment. It is suspected that a drinking problem has
played a major part in his presentation. This may be confirmed by his developing
early signs of withdrawal which would include
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a) Anxious, restless, and perspiring profusely
b) Presenting as undernourished and unsteady on his feet
c) Confused and disorientated
d) Denying vehemently that he has a drinking problem
72. Generally, the long term course of alcoholism

a) Follows a common progression in different people
b) Differs between men and women but is the same within the sexes
c) Shows that blockouts after modest drinking are a valid early indicator of
alcoholism
d) Is highly variable for each individual
73. How can it be that alcohol consumption is initiated to reduce distress, if most of its
effects are negative
a) Denial of the negative effects keeps drinkers as seeing them as a punishment
b) The negative effects are transient and weak, while the positive effects are
powerful and long lasting
c) People who start to drink have a diminished capacity to learn from experience
d) Negative effects of alcohol consumption are relatively remote, while positive
effects are immediate
74. One night when mr browns wife does visit, after two weeks, she asks to speak you
privately and tells you that her husband has asked her to come home again. She
wonders whether this is just another ploy, or should she give the marriage another go.
Would you
a) Advise her that alcoholics lie and deceive, and can never change
b) Tell her that marriage is for better or worse and that the most appropriate thing to
do is for them to get back together again
c) Advise her to get professional help for herself, in order to work out her immediate
priorities, preferably from an alcohol related agency
d) Tell her that shes best out of it; suggest terminating as its only like to happen
again
75. Co dependent people would be best served from a therapeutic point of view in
a) Helping their partner get help
b) Getting out of the situation before they get physically hurt
c) Looking at the damage the dependency has caused them
d) Finding out why they always end up with a loser
76. Kate elliot, a 38 year old non maori woman, is admitted to hospital. She shares a flat
with her long time friend edith. Edith tells you that kate has recently become over
active and upset and claims that her butcher and local supermarket are both trying to
poison her. The newspaper is printing lies about her past and she has started a few
fires in their garden recently in an attempt to burn the newspaper. She is unable to
sleep at night and is always finding things to do. Last night she was vacuum cleaning
the flat at 3 am. Kate is unable to add any information as she switches topics so
rapidly she does not make sense. Which of the following is the best description of the
reason for kates admission
a) She is creating a disturbance
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b) She is frightened of being poisoned
c) She is a danger to herself and others
d) She has no one to look after her
77. Which of the following is a priority for kates care on admission

a) Distract her from unrealistic thoughts
b) Orient her to reality
c) Alleviate her anxiety
d) Introduce her to others
78. To assist kate to regain self control she is given an intramuscular injection of
ahlorpromazine 100mg. following the injection her blood pressure is likely to be
a) Much higher than before
b) Moderately higher than before
c) About he same as before
d) Marginally lower than before
79. Kates mood settles and she says she feels her old self except for dizziness when she
stands up. Which of the following responses would you choose
a) It is nothing to worry about, just try to straighten up more slowly in future
b) Its quite normal at your age, especially if you bend with straight knees
c) You medicine has many side effects and dizziness is one of them
d) Sit down in your chair and ill check your blood pressure
80. Kate continues to complain of dizziness and says she feels nauseous most of the time.
Which of the following signs would lead you to suspect lithium toxicity
a) Weight gain, staggering, thirst
b) Weight gain, hypertension thirst
c) Vomiting, thirst, hypertension
d) Vomiting, coarse tremor, staggering
81. In the client with an elevated mood there is often difficulty with diet because they
a) Feel unworthy of food
b) Are preoccupited with trivialities
c) Do not slow down long enough to eat
d) Think the food is poisoned
82. John, aged 18 years, has been a patient in a psychiatric unit for three days. He was
brought in for 5 day compulsory assessment in response to his self destructive
behaviour and his threats to harm others. On admission he is mistrustful and is
experiencing hallucinations. He has had one previous admission when he was
diagnosed as having schizophrenia. While communicating with john, the nurse should
a) Remain silent with him and not encourage him to verbalise
b) Talk with john as she would a normal person
c) Allow john to do all the talking
d) Use simple concrete language when talking to john
83. Schizophrenia is often characterised by a lack of insight. This refers to

a) Poor social skills
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b) Superficiality
c) Failure to recognize that they are suffering from anemotional disorder
d) Difficulty in reading other peoples motives
84. John is taking chlorpromazine 100mg q.i.d. after 4 days he is unable to sit for any
length of time, fidgets a lot, and tends to wander around the unit. Which side effect is
he exhibiting
a) Dystonia
b) Akathisia
c) Parasthemia
d) Dyskinesia
85. John refuses his antipsychotic tablets because he thinks he is getting too drowsy.
Which of the following is the most appropriate initial nursing action
a) Offer it in an alternative form
b) Discuss with him the consequences of refusing
c) Accept his refusal and record this
d) Crush the tablets and add them to his food
86. The four ‘A”s of schizophrenia are

a) Association, ambivalence, alienation and autism
b) Ambivalence, autism, affect and association
c) Affect, ambivalence, assimilation, and autism
d) Affect, accommodation, autism and ambivalence
STATE EXAMS 29
1. Which of the following is not a typical sign of early epatitis
a) Ascites
b) Slightly yellowing of the sclera
c) Clay stools
d) Anorexia
2. During the infectious stage, a person with hepatitis A is excreting the virus mainly in
a) Faeces
b) Urine
c) Saliva
d) All body fluids
3. When a person is in the infectious stage of hepatitis A, special precautions are taken
when you
a) Take a food tray to the person
b) Administer medications
c) Gave an antiemetic injection
d) Remove a used bedpan
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4. Client has been back from surgery for several hours and has not asked for pain
medication. The client and nurse are from different cultural groups. Being aware of
cultural influences on health behaviours, the nurse will
a) Realise the client probably does not feel as much pain as some people
b) Wait for the client to ask before bringing pain medication
c) Look for non verbal signs of pain, such as holding the incision or lying still
d) Tell the client to be sure to call her if he/she is in pain
5. Although the home health nurse has taught the client the importance of taking his
antibiotic exactly every six hours, he still cannot seem to take it on schedule. In
evaluating the facts of her teaching, the holistic nurse should consider that the client
(who is from a different culture) possibly
a) Is relating to time differently than she
b) Has not understood what she taught
c) Does not believe the medicine will help
d) All of above
6. Smoking is bad for people with chronic respiratory disorders because cigarette smoke
a) Destroys the cilia which cleanse debris from the airways
b) Inhibits the inspiratory centres in the central nervous system
c) Inhibit nerves involved in the reflex pathways involved in coughing
d) Prevents the vocal cords closing tightly together when swallowing
7. One reason why smokers with chronic respiratory problems should not be given
medications that inhibit the cough reflex is
a) These medications dry up mucus and make secretions difficult to expel
b) The hypoxic drive is inhibited causing a slowing in breathing rate
c) Coughing is their only means of preventing mucous accumulating in the lungs
d) In people with chronic problems these medications have no effect anyway
8. Asthma is a disorder primarily characterised by
a) Hyperinflation and over expansion of lung tissue
b) Spastic constriction of the respiratory airways
c) A breakdown in the walls of alveolar tissue
d) Chronic dilation and expansion of the airways
9. During acute asthmatic attacks theophylline medications are given because they
a) Stimulate the inspiratory centre
b) Raise the blood PO2 levels
c) Hyperinflate the lung
d) Dilate the bronchioles
10. Aminophylline comes in ampoules of 250 mgs in 10 mls. How much in mls, would
you draw up to obtain 300 mgs
a) 8.3
b) 12.0
c) 83.0
d) 120.0
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11. In the early stages of obstruction to urine flow, symtoms which a client with an
enlarged prostate gland might experience include
a) Difficulty in emptying his bladder and hematuria
b) Foul smelling urine with a high bacteria count
c) Complete retention of urine and dribbling
d) Frequency, urgency, a poor stream and nocturia
12. A client is prescribed 1 litre of dextrose/saline to be given over 3 hours. If the I>V
giving set has a drop factor of 15 drops per ml, which of the following, in drops per
a) 17
b) 33
c) 67
d) 83
13. Your client states that she is most unhappy with the care she is receiving from her
doctor and wishes to change doctors. You respond
a) Would you like to talk to me about why you are unhappy with your care – I may
be able to help
b) Okay – should be no problem, its your choice after all
c) I don’t think that’s a good idea – it can lead to the doctor becoming annoyed
d) Hospital policy does not allow for you to make a choice of doctor but would you
like to talk to me about your concerns
14. Johnny is 22 years old and has been admitted under section 8 of the mental health act
(1992). Period of assessment of Johnny is for
a) 14 days
b) 6 months
c) 7 days
d) 5 days
15. In an acute presentation, such as Johnny, the need to administer medication so as to

address the situation is important. The most likely choice of drug would be
a) Trifluoperazine
b) Thioridiazine
c) Haloperidol decanoate
d) Benzotropine mesylate
16. When administering this medication what is the dosage and upper limit or ceiling in a
twenty four hour period
a) 2mgs, up to 6mgs/24hrs
b) 6mgs, up to 12mgs/24hrs
c) 20mgs, up to 60mgs/24hrs
d) 4mgs, up to 12mgs/24hrs
17. Following this episode, Johnny is commenced on a regular anticholinergic

antiparkinsonian drug. The most likely drug of choice would be
a) Procyclidine
b) Lorazepam
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c) Pipothiazine
d) Diazepam
18. Johnny is charted this medication. Which of the following drug orders reflects the
amount/dosage to be received accurately
a) 5mgs TDS
b) 20mgs nocte
c) 10mgs QQII
d) 15mgs mane and 15mgs nocte
19. Johnny responds well to her care and is discharged 14 days later. He is charted an
antipsychotic injectable medication which the mental health nurse gives her at home.
The medication is flupenthixol deconoate. The dosage and frequency is likely to be
a) 400mgs every 3 weeks
b) 150mgs every week
c) 60mgs every 3 weeks
d) 200 mgs every 2 weeks
20. Tom has a diagnosis of bipolar affective disorder and his family ask you to talk with
them about it. They ask you what an affective disorder is. The therapeutic response
would be
a) An abnormality in the mood or feeling state of a person
b) A dysfunctional emotive illness exacerbated intermittently
c) A chronic and progressive deterioration in the emotion of a person
d) A strange feeling which is abnormal in origin
21. Tom is admitted to the unit where you work. You are concerned in your assessment to
ensure he is physically well. Your care plan would include therefore, a focus on
a) Rest and sleep, fluid and nutritional needs, elimination and personal safety
b) Relationship needs, diet and exercise, and group therapy
c) Counselling needs, altered thought processes and orientation
d) Food and fluids, lowered mood and poor communication
22. Toms family asks you why he must take the big white tablets. They say they taste like
chalk and that he only needs them when he is sick. A therapeutic response would be
a) I can understand how it seems that way but he tablets work best when they are
taken all the time
b) That’s why he is sick because he should have been taking them
c) You ought to be encouraging him to take them all the time
d) Yes, perhaps encourage him to take them just when he needs to
23. Tom is due for a test today and the lab technicians arrive to do the blood test. Tom
asks you what the level needed in his blood is. A correct response is
a) 1.5 – 2meg
b) 0.1 – 0.3 meg
c) 0.5 – 1.3 meg
d) 1.0 – 1.9 meg
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24. Toms level comes back from the lab who ring you to tell you that his level is very
high. The immediate nursing actions would involve
a) A check to see if a.m dose was given, discontinue meds and notify doctor
b) Commencement on fluid balance chart and vital recordings
c) Encourage fluid intake and continue meds and document observations
d) Inform tom he is toxic, place on bedrest and notify next of kin
25. Tom is assessed and has lithium toxicity. The symptoms we would expect to see as
nurses are
a) Palpitations, skin rash and headache
b) Potophobia, bradycardia and dyspnoea
c) Coarse tremor, diarrhoea, vomiting and sluggishness
d) Thirst, nausea, skin rash and pain on dorsal flexion
26. You are a domicillary nurse and have been visiting liz in the community. Liz is
receiving an antipsychotic in infectable form. Which medication is not an injectable
antipsychotic
a) Pipothiazine
b) Thioridiazine
c) Haldol decanoate
d) Flupenthixol
27. Before liz was commenced on her medication you asked that she be charted a test
dose. This lower dose is
a) Given then received after 5 days before regular charting begins
b) Given fortnightly for a period of six months
c) Administered and then followed immediately by a regular dose if no reaction is
noted
d) Administered once and then repeated weekly for four weeks
28. Liz continues to request that her injection site be in her buttock and refuses to have it
in the thigh. You have permission to do this. You assure the accurate site by
a) Locating the upper, outer quadrant of the buttock
b) Locating the lower, outer quadrant of the buttock
c) Locating the iliac crest and administering the injection
d) Locating the midline and injecting 3cms to the side of it
29. In regularly dispensing injectable medication you are aware as a nurse that the
medication is locally irritating. You therefore
a) Administer it in one area only
b) Rub the area gently following administration
c) Rotate sites and do not rub/massage the area
d) Apply heat and massage the area
30. Jan is a first line manager responsible for the care of a group of patients. She is
concerned because for the last three weeks the physiotherapist has been late to see the
patients and sometimes has not come at all. She has called the physiotherapist but the
situation has not improved. Jans next action should be to
a) Write a memo to the physiotherapy department
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b) Contact a nursing clinical advisor
c) Notify the physician of the situation
d) Consult her nurse manager
31. In organisations the primary management function is to

a) Assess and establish goals
b) Establish a framework in which to function
c) Plan for results
d) Control all operations
32. Cohesiveness is important to all teams. This means

a) The process a group goes through in deciding what to do
b) A mutual attraction which holds a group together
c) A decision made by a knowledgeable leader for the group
d) A strong organisational support system of the group
33. Part of jans position requires her to manage the budget. This is
a) A statement of future expenditures
b) A list of current expenditure
c) A plan for meeting expenses
d) A recording of past expenditure
34. Jan is aware that nursing tasks and quality of nursing practice are compared with
which pivotal question
a) Does the performance match standards and objectives
b) Does the performance reflect interest and enthusiasm for the job
c) Does performance indicate knowledge and expertise
d) Does performance leave the patients comfortable
35. Elanor brown aged 20 is a passenger who is thrown clear when the car she is
travelling in hits a lamp post. Eleanor exhibits internal bleeding later diagnosed a
ruptured spleen. First aid care for Eleanor includes elevating her limbs. This is done to
a) Decrease her venous return
b) Lower her blood pressure
c) Increase her venous return
d) Assist her to breathe
36. Eleanor is admitted to the accident and emergency department in advanced stage 2
shock. When taking her base line observations you would expect to find
a) Elevated BP, elevated pulse rate and elevated respiratory rate
b) Decreased BP, decreased pulse rate and decreased respiratory rate
c) Decreased BP, increased pulse rate and increased respiratory rate
d) Decreased BP, decreased pulse rate and increased respiratory rate
37. You are a community nurse working with families who have lost a child to sudden
infant death syndrome. A parent says ‘sally was so healthy I just cant understand what
would have caused this. Where did we go wrong’. What is the most appropriate
response
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a) I don’t know why you feel responsible for what happened to sally
b) Try not to blame yourself for sallys death
c) You didn’t no one knows the cause of S.I.D.S
d) Did sally seem sick before bedtime
38. The primary etiology of S.I.D.S is

b) Unknown
c) Depression of respirations
d) Exhaustion
39. Sudden infant death syndrome often occurs

a) Between 2-6 months following birth
b) Within 3 weeks of birth
c) More than 6 months after birth
d) Between 9-12 months of age
40. Babies who die from sudden infant death syndrome/S.I.D.S are more frequently
a) Low birthweight babies
b) Born to a mother over 40
c) From middle class families
d) From families with a history of s.I.D.S
41. Research has indicated that the best way to try to reduce the incidence of sudden
infant death syndrome is
a) Feeding baby four hourly
b) Having baby sleeping on their back
c) Wrapping baby up firmly
d) Sleeping prone
42. A family have already had one child die from SIDS. They are offered an apnoea
monitor for their new baby. To assist this family you should begin by
a) Teaching cardiopulmonary resuscitation
b) Teaching use of monitoring equipment including safety precautions
c) Creating an opportunity for parents to discuss their feeling and concerns
d) Referring to an appropriate support group in the community
43. Items relate to congenital defects in children. A positive diagnostic test for cystic
fibrosis is
a) Sweat analysis
b) Sputum analysis
c) Liver function test
d) Bone marrow biopsy
44. The earliest recongnizable clinical manifestations of cystic fibrosis is

a) Foul smelling, frothy, greasy stools
b) Recurrent pneumonia and lung infections
c) Meconium ileus
d) History of poor intestinal absorption
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45. In providing nourishment for a child with cystic fibrosis, which of the following
factors should the nurse keep in mind
a) Most fruits and vegetables are not well tolerated
b) Diet should be high in carbohydrates and protein
c) Diet should be high in easily digested carbohydrates and fats
d) Fats and proteins must be greatly curtailed
46. Which statement expresses accurately the genetic implications of cystic fibrosis
a) If it is present in a child both parents are carriers of this defective gene
b) It is inherited as an autosomal dominant trait
c) It is a genetic defect found primarily in non white population groups
d) There is a 50% chance that siblings of an affected child will also be affected
47. Which of the following statements best describes hirschsprung disease

a) It is a disease characterized by the absence of parasympathetic ganglion cells in a
segment of the colon
b) It is a disease that results in excessive peristaltic movements within the
gastrointestinal tract
c) It is a disease that results in frequent evaculation of solids, liquids, and gas
d) It is often diagnosed in newborns when they fail to pass the transitional stool
within 24 hours after birth
48. Congential defects of the genitourinary tract such as hypospadias are usually repaired
as early as possible to
a) Prevent mental illness
b) Prevent separation anxiety
c) Promote acceptance of hospitalization
d) Promote development of normal body image
49. Hypospadias refers to which of the following

a) Urethral opening along dorsal surface of penis
b) Urethral opening along ventral surface of penis
c) Absence of an urethral opening
d) Penis shorter than usual for age
50. Foetal alcohol syndrome results when the

a) Mother is an alcoholic
b) Mother drinks excessively during the first trimester
c) Alcohol consumed by the mother is in excess of the brains ability to detoxify
d) Alcohol consumed by the mother is in excess of the livers ability to detoxify
51. The doctor observed a child with phloric stenosis closely during feeding periods.
Which of the following observations made of the exposed abdomen is most indicative
of pyloric stenosis
a) Abdominal rigidity
b) Substernal retraction
c) Visible peristalsis
d) Marked distention
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52. Physical characteristics associated with downs syndrome include
1. Slanting eyes with prominent epicanthic folds
2. Single palmar creases on the hands
3. Small mouth with protruding tongue
4. The presence of the Mongolian blue spot
a) 1 and 2
b) 1 and 3
c) 1, 2 and 4
d) 1, 2 and 3
53. You are asked about the incidence of downs syndrome. The incidence/1000 live births
is greatest when the maternal age is
a) Under 16 years
b) 16-20 years
c) 21-40 years
d) Over 40 years
54. The genetic defect which causes downs syndrome is mostly due to
a) Trisomy
b) Meiosis
c) Mutation
d) Mitosis
55. Sophie one day old was born with a hernia protrusion of a sac li?? Cyst of meninges,
spinal fluid and a portion of the spinal cord with its nerves through a defect in the
vertebral column. This defect in the vertebral column is called
a) Hydrocephalus
b) Encephalocele
c) Meningocele
d) Meningomyelocele
56. Sophies paralysis is most likely to occur

a) In the motor sphere below the level of the deformity
b) In the motor and sensory spheres below the level of the deformity
c) In the motor sphere above the deformity
d) In the motor and sensory spheres above the deformity
57. You are sophies primary nurse in the special care baby unit. When her father visits for
the first time, he is most likely to exhibit which reaction
a) Anger
b) Depression
c) Disbelief
d) Bargaining
58. Sophies father is standing hesitantly beside the incubator. What is your best initial
action
a) Show him how to touch and talk to his daughter
b) Give him a detailed explanation of his daughters defect
c) Ask him if he wants to hold his daughter
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d) Ask him how his wife is doing
59. The most important nursing intervention when caring for sophie would be
a) Placing sophie on her side to decrease pressure on the spinal cord
b) Applying a heat lamp to facilitate drying and toughening of the sac
c) Measure head circumference daily to identify developing hydrocephalus
d) Assist the parents to bond with sophie
60. This type of congenital deformity is commonly known as spina bifida. Spina bifida is
1. A deformity of the spine due to injury at birth
2. A congenital malformation of the spine
3. A developmental defect of the spine where one or more vertebrae fail to
fuse
4. A gap in the spine where only the spinal cord proteudes
5. A gap in the spinal column where meninges, cerebral spinal fluid and/or
spinal cord are contained in a sac
a) 1 and 5
b) 2 and 4
c) 1,2 and 5
d) 2, 3 and 5
61. A spinal cord defect such as sophies positioned at lumbar 1, would result in
a) Total paralysis of arms and legs
b) Lack of sensation of arms and legs
c) Total paralysis of legs with bladder involvement
d) Total paralysis and lack of sensation of legs with bowel and bladder involvement
62. Some children with spina bifida show spinal deformities at birth or develop them
during growth after birth eg kyphosis which is
a) The spine bends sideways and also rotates on a vertical axis – often a rib hump is
present
b) The lumbar spine bows inwards
c) A lateral curve of the spine
d) The spine bows backwards and resembles the letter c when viewed from the side
in a sitting position
63. Sophie’s head measurements are of concern. The doctor diagnoses hydrocephalus.
This is most accurately defined as
a) Greatly increased head diameter due to spreading of the sutures by massive
cerebral oedema
b) Progressive enlargement of the head due to excessive accumulation of
cerebrospinal fluid
c) Elevation of the dome of the skull by a haematoma secondary to skull fracture
d) Distention of the frontal, maxillary and ethnoid sinuses with inflammatory
exudates
64. Cane suddently complains of severe chest pains, is dyspnoeic and shocked. Which of
the following steps would you take
1. Lie the client prone in bed
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2. Assess cardio vascular function
3. Check respiratory rate
4. Administer I.M omnopon 10mg as charted
5. Administer oxygen via a mask at 6 litres per minute
a) 2, 3 and 4
b) 2, 3 and 5
c) 1, 2, 3, and 4
d) 2, 3, 4, and 5
65. The causative factors of shock following a myocardial infarction are

1. Undetected and untreated arrhythmias
2. Rupture of chordate tendinae
3. Administration of IV morphine 5 mg
4. Diminished cardiac output
5. Six glycerol trinitrate tablets prior to admission
a) 3, 4 and 5
b) 2, 3 and 4
c) 1, 4 and 5
d) 1, 2 and 4
66. The main therapeutic action of IV morphine given to a client following a myocardial
infarction is to
a) Relax the client and allow him/her to sleep
b) Relieve pain and to help prevent severe shock
c) Relieve acute level of anxiety
d) Relieve pain and stimulate respiratory function
67. The occupation health nurse observes a sucking chest wound in the right wall of
Harvey, a man who has been involved in an industrial accident. The initial action by
the nurse should be to
a) Immediately cover the wound with anything available
b) Assess the chest for asymmetry
c) Obtain a sterile petroleum gauze dressing
d) Place Harvey in an upright position
68. To facilitate lung expansion, the nurse should encourage Harvey to breath in which
manner
a) Shallowly, through the nose
b) Inhale deeply, then exhale with the mouth and nose closed
c) Inhale normally, breathe out through pursed lips
d) Breathe as normally as possible
69. Which of the following type of crises is Harvey experiencing

a) Developmental crises
b) Adventitious crises
c) Situational crises
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d) Maturational crises
70. Later, the occupational health nurse is asked to give a session on chest injuries. The
most important pre crises emphasis would be
a) Accident prevention
b) Chest assessment
c) Pathophysiology of chest injuries
d) Rapid treatment techniques
71. In spite of treatment in the hospital emergency department, Harvey dies. His death
becomes a coroners case because
a) The doctor refused to sign a death certificate
b) He dies in suspicious circumstances
c) He hadn’t seen his general practitioner for a long time
d) His family refused permission for an autopsy
72. Percy a 55 year old is suffering from parkinsons disease. You are administering anti
parkinsons drugs. Which of the following would increase their absorption
a) Marmite sandwich
b) Glass of milk
c) Glass of water
d) Plain biscuit
73. Which of the following are symptoms of parkinsons disease

a) Speech disturbance, confusion
b) Muscle rigidity, tremors
c) Weak arms, difficulty in swallowing
d) Depression, hemianopia
74. Percy often has difficulty maintaining balance while ambulating. The most helpful
intervention to prevent him falling would be
a) Instruct him to wear elastic stockings
b) Instruct him to use wide based stance
c) Teach him how to perform range of motion exercises
d) Instruct him to change position slowly
75. The nursing care plan for percy should include

a) Restricted ambulation
b) Scheduled rest periods
c) A diet high in protein
d) Cold packs for finger joints
76. Parkinsonian crisis occurs when

a) The client overdoses on their anti Parkinson drugs
b) The clients basal ganglia starts to make its own dopamine again
c) The client forgets to take their anti Parkinson drugs for a day or more
d) The client is allergic to the anti Parkinson drugs
77. Parkinsonian crisis may lead to

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a) Hypoglycaemia
b) Death
c) Rash and severe tremors
d) Anaphylactic reaction
78. Percy deteriorates rapidly. Which of the following would be the most appropriate long
term nursing goal
a) Improving percys symptoms with medication
b) Increasing percys independence
c) Improving percys self esteem
d) Helping percy accept increasing parkinsonian symptoms
79. Which of the following observations indicate toxicity to levodopa

a) Decreased muscle rigidity
b) Anorexia, vomiting
c) Psychotic episodes
d) Excessive salivation
80. Patricia wakes up one morning with a severe headache. While attempting to get up to
take some aspirin she collapses. Her husband sends for the doctor, who, suspecting a
cerebrovascular accident arranges hospitalisation. On admission patricia is comatosed.
All the following can be used when assessing a patients level of consciousness except
a) Degree of orientation to surroundings
b) Reaction of the pupils to light
c) Reaction to painful stimuli
d) Ability to obey commands
81. In assessing consciousness, you begin by using

a) Verbal stimulation
b) Tactile stimulation
c) Light pain
d) Deep pain
82. Your neurologic assessment includes monitoring urinary output. That’s becaused
a) Injury to the hypothalamus causes oliguria
b) Polyuria with specific gravity of <1.005 is desired
c) Volume depletion will increase ICP (intracranial pressure)
d) Hyponatremia can lead to cerebral edema
83. The unconscious patient

a) Cannot perceive stimuli through the five senses
b) Is unable to perceive auditory stimuli
c) Is able to perceive auditory stimuli
d) Can only respond to painful stimuli
84. Safety precautions in caring for the unconscious patient should include all the
following except
a) Maintain in recovery position
b) Support head and limbs when moving
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c) Provide only clear liquids orally
d) Speak calmly and frequently to the patient
85. Your client is unresponsive and shows unilateral reflexes. You would
a) Observe his vital signs and wait
b) Suspect a spinal injury
c) Suspect a drug overdose
d) Call a doctor and anticipate surgery
86. bleeding within the skull results in increased intracranial pressure because
d) The cranium is a closed, rigid vault
87. When assessment a client at risk for increased intracranial pressure. The first thing
you would check is
d) Motor function
88. Papillary dilation occurs when herniating brain tissue

a) Compresses the occulomotor nerve
d) Paralyses the ocular muscles
89. Contralateral muscle weakness develops because of

a) Cerebellar dysfunction
b) Compression of the pariental lobe
c) Pressure on the vasomotor centre
d) Pressure on the sensory motor pathway
90. If intracranial pressure is increasing, the patient is apt to complain of a headache

a) On coughing or straining
b) When the head of the bed is elevated
c) Late in the day
d) When you shine a light in his eyes
91. The most crucial consequence of a cerebral vascular accident is

a) Inability to communicate
b) Acute hypotension
c) Cerebral anoxia
d) Hemiplegia
92. After a stroke the strong adductor muscles favour the formation contractures. There is
a tendency for the
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a) Foot to drop (plantar flexion)
b) Arm to be drawn to the chest
c) Elbow to hyperextend
d) Wrist to drop
93. An action most likely to contribute to recovery of speech would

a) Anticipate their wishes so as to eliminate the need to talk
b) Communicate by means of questions which can be answered shaking the head
c) Speak slowly so that they are able to lip read
d) Listen patiently as they attempt to talk
94. Discharge planning for patricia should begin

a) When her condition has stabilized and she understands instructions
b) When she begins to ask questions about home care
c) At the time she is admitted to the ward
d) When her family begin to ask for information
95. Phyllis a 65 year old retired secondary school teacher with a history of hypertension,
currently on medication, falls to the ground unconscious while attending an opera.
State the level of priority in which you would take the following measures for an
unconscious client
1. Check for other injuries
2. Notify his relatives
3. Take and record of his temperature, pulse and respirations
4. Observe and record his pupil responses to light
5. Assess his level of consciousness
a) 1,3,4,5,2
b) 1,4,5,3,2
c) 3,4,5,1,2
d) 5,4,3,1,2
96. Ann a student nurse, is playing tennis after duty when she is stung by a bee. Her
friends recognise signs of systemic anaphylaxis and immediately take her to the
emergency department. The signs and symptoms of systemic anaphylaxis include
dyspnoea and which of the following
a) Facial oedema, hypotension
b) Facial oedema, hypertension
c) Polyuria, hypotension
d) Polyuria, hypertension
97. Your priority in the immediate care of a person in anaphylactic shock is to

a) Raise the legs to increase blood volume to vital organs
b) Maintain an airway to ensure ventilation
c) Ensure fluids to maintain urinary output
d) Pack ice around patient to reduce inflammation
98. The most effective drug in the immediate treatment of anaphylactic shock is
a) Penicillin
b) Solu-medrol
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c) Benadryl
d) Adrenalin
99. Mrs green 29 years old, is admitted with acute abdominal pain, vomiting and
suspected peritonitis. After admission mrs green is on nil per mouth in anticipation of
early
a) Diagnosis
b) X-ray
c) Ultrasound scan
d) Surgery
100. Mrs green is going to theatre for a laparotomy. She should sign the operation
consent form
a) After the house surgeon has spoken to mrs greens partner
b) Before administration of anaesthesia
c) Before pre medication is administered
d) After explanation by the nurse
101. Mrs green returns from theatre following an appendectomy. Your immediate
nursing response would be to assess
a) Wound site
b) Intravenous line
c) Heart rate
d) Airway
102. Mrs green is ordered intravenous normal saline 1000ml over 8 hours. You
have a metriset in situ (drop factor =60). How many drops per minute will you be
monitoring this at
a) 21
b) 42
c) 84
d) 125
103. Mrs green develops a paralytic ileus. Which of the following is almost always
an indication of paralytic ileus
a) Alteration in vital signs
b) Increasing abdominal distension
c) Persistent vomiting
d) Absence of bowel motions
104. Mrs green has a naso gastric tube inserted to

a) Reduce gastric motility
b) Decompress the bowel
c) Evacuate blood clots
d) Assess volume of gastric content
105. Mrs greens temperature is 39.4o Celsius. Which of the following would most
effectively reduce her temperature
a) Fanning and panadol, tepid sponge
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b) Fanning and stemetil, tepid sponge
c) Fanning and stemetil, remove bed clothes
d) Fanning and panadol, ice packs
106. Mrs green is ordered amoxicillin 1.2gm. on hand are 500 mgm vials, each to
be dissolved in 2ml of sterile water. How much will you give
a) 2.4ml
b) 3.6ml
c) 4.8ml
d) 5.2ml
107. On the third day of hospitalisation a patient informs the nurse that she would
rather bathe at night. To best promote continuity of care the nurse should
a) Explain the am care is given in the morning
b) Verbally inform the other health team members
c) Indicate this preference on the nursing care plan
d) Encourage her to modify her routine while hospitalised
108. The charge nurse directs the nurse to do something that is outside the legal
role of the nurse. The nurse should
a) Complete the task and grieve later
b) Notify the supervisor immediately
c) Decline to do the assigned task
d) Inform the union representative
109. After a month in the hospital a jewish patient says she misses lightening her
candles on Friday night (shabbas licht). The most therapeutic response would be
a) It must be difficult to change old habits
b) Religious traditions have a peaceful effect
c) I am sorry but that’s against the fire code
d) I will try to arrange it so you can light your candles
110. Mrs hill is charted nitrazepam (mogadon) tablets to sleep. She refuses to take
them at 9pm. She tells you that the other nurses always leave the tablets on the locker
and she takes them when she is ready. What should you do
111. The nurse is working in a surgical ward. Ivan, aged 18 years is admitted to
hospital with a fractured leg following a car accident. He is in a shocked condition
due to loss of blood and is hyperventilating. Which of the following recordings
indicate shock
a) Blood pressure 110/70, respiration 34, pulse 120
b) Blood pressure 128/90, respiration 32, perspiring
c) Blood pressure 120/80, pulse 70, skin cold and clammy
d) Blood pressure 78/56, pulse 152, weak, thread; perspiring
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113. Without describing to them what is involved, the surgeon asks for consent for
surgery from ivans parents. What is your responsibility in this situation
a) Ensure the parents have been given appropriate information
b) Question the validity of this consent
c) Ensure the consent form is completed
d) Check whether the parents have any questions about the surgery
114. Ivan is prescribed pethidine 75mg intramuscularly as a premedication. The

drug is available in ampoules containing 100mg in 2ml. what dosage should be
administered
a) 0.75ml
b) 1.25ml
c) 1.5ml
d) 1.75ml
115. The nurse believes the drug dose prescribed for ivan is incorrect. The best
action to take is
a) Refuse to give the medication
b) Give the medication as prescribed by the doctor
c) Withhold the medication and check the dosage with the doctor
d) Give the medication and consult a current drug handbook
116. Why does a person who has a fracture of a bone feel pain
a) Bones contain many nerve endings
b) The nerve endings are irritated by the jagged bone ends
c) There is always severe haemorrhage with any type of fracture
d) There is damage to surrounding tissue and the muscles go into spasm
117. Which group of observations would the nurse make when checking the limb
for vascular occlusion after the application of a plaster cast to limb
a) Heat, burning, loss of feeling, immobility
b) Loss of function, redness, swelling, pain
c) Coldness, stiffness, odour, loss of feeling
d) Coldness, impairment of function, swelling, discolouration
118. Which option explains the numbness or a tingling sensation felt by the patient
under the plaster cast
a) This is due to nerve damage or pressure on the nerve
b) This will subside as soon as he gets used to the cast
c) As soon as the cast dries, these symptoms may disappear
d) The wet cast is cold and this impulse is passed onto the nerves
119. Which is the most important nursing measure for a person in a plaster cast
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a) Inspect the cast once a day
b) Always investigate any complaint
c) Observe the skin at edges of the cast
d) Observe the cast for limpness or cracks
120. Which is the first action the nurse should take when a patient in leg traction
complains of pain
a) Remove the weights
b) Increase the weights
c) Tell the doctor when he does his rounds
d) Check the patients position, weights and cords
121. A reporter from a local paper phones the ward and asks for information on
ivans condition. What is the appropriate response in this circumstance
a) Ivan has a broken leg but is comfortable
b) Ill go and get the senior nurse on duty who will assist you with your queries
c) I cannot give you any information
d) Please contact the senior medical adviser for such information
122. The nurse is working in a psychiatric hospital. Susan aged 22 years is a lab
technician who has a long history of compulsive food avoidance and a desire to be
thin. Susan looks wasted and has pitted ankle edema. Height 162cm, weight 32kg. she
is prescribed rest and a diet high in protein and calories. What is the most likely
psychiatric diagnosis for susan
a) Anorexia nervosa
b) Myasthenia gravis
c) Neurotic depression
d) Acute psychotic disorder
123. Denial is an important part of susans behaviour. Which of the following

intervensions is most therapeutic at the start of her care
a) Confronting her with her problem of weight loss
b) Discussing the issue of her work related problems
c) Discussing the concept of slimness in relation to obesity
d) Attempting to establish rapport by discussing her interests
124. Susan is dehydrated. The doctor orders 500ml normal saline Iv over 2 hours.
The administration set delivers 15 drops per ml. what is the correct number of drops
to be administered per minute
a) 44
b) 62
c) 70
d) 100
125. Which of the following signs/symptoms are most likely to be present in maries
condition
1. Nausea
2. Dysmenorrhoea
3. Distorted body image
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4. Weight loss
5. Down like hair growth
a) 1,2
b) 1,4
c) 2,5
d) 3,4,5
126. Susan dislikes foods high in caloric value. Which action is most likely to
change maries eating pattern
a) Allow her to choose her own diet
b) Encourage her to eat what she can
c) Allow her to eat only what she wants
d) Encourage her to eat small, frequent meals
127. What is susan likely to do in order to prevent gaining weight

1. Dispose of her food
2. Leave some food on her plate
3. Undertake very little exercise
4. Ask for aperients for constipation
5. Induce vomiting immediately after meals
a) 1,2
b) 3,4
c) 1,3,5
d) 1,2,4,5
128. Which treatment will best help susan establish personal relationships
a) Sociodrama
b) Psychodrama
c) Group therapy
d) Occupational therapy
129. On taking charge of the ward one afternoon duty, the nurse discovers that a
patient is missing. Which is the correct action to take
a) Call the police, search the ward, check the patients status
b) Check the patients status, call the senior nurse ,check the ward
c) Check the patients status, check the ward, call the senior nurse
d) Check the patients status, call the senior medical advisor, call the senior nurse
130. The nurse checks the drugs with a colleague who says, im not sleeping well,
how about checking out a couple of mogadon for me to take home. Which is the
appropriate response by the nurse
a) Refuse, but offer panadeine
b) Discuss the reason why she cannot oblige
c) Encourage her to talk about her sleeplessness
d) Report the matter to the manager for advice
131. A voluntary psychiatric patient left the hospital the day following her
admission without telling anyone. What action is the hospital required by law to take
with regard to this patient
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a) Provide domicillary nursing care for the patient in the home
b) Legal action to have the patient re admitted to the hospital
c) Ask the police to make the patient return to the hospital to sign a statement
d) No legal action, as the patient has the right to leave a health care facility
132. What should be the action of the nurse who is in charge of the ward when the
police arrive to interview a committed (compulsory) patient who is responding to
treatment
a) Refuse them entry to the ward
b) Allow them their legal right to enter
c) Discuss the situation with patient
d) Refer them to the senior medical advisor
133. A nurse who is concerned that a patient is being treated harshly by one of the
visiting psychiatrists should first
a) Tell the charge nurse
b) Inform the senior medical officer
c) Inform the patients relatives of the problem
d) Discuss the problem with the psychiatrist concerned
134. A psychiatric patient asks the nurse to post a letter he has written. The nurse
should
a) Post it as requested
b) Say she cannot post it
c) Open it to check the contents
d) Hand it unopened to the nurse manager
135. The most distinctive feature of community mental health centers is an

emphasis on
a) Psychotherapy as opposed to somatic therapy
b) Prevention of psychological problems
c) Improved training for psychiatric workers
d) Revolving door policies
136. When caring for a client in a drugged state, the nurse is often faced with verbal
abuse. The nurse should handle this abuse by
a) Insulting the client since it is deserved
b) Making a neutral response to the client
c) Refusing to provide care for the client
d) Ignoring the client and leaving the room
137. With regard to informed consent and the law, which of the following persons
require decisions to be made for them
1. Prisoners
2. Mentally handicapped
3. Residents of nursing homes
4. Adolescents under 16
5. Comatose clients
a) 1,2,3
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b) 2,3,4
c) 2,4,5
d) 3,4,5
138. When administering medications, a nurse responsibilities include all of the

following except
a) Deciding the correct dose
b) Knowing the side effects
c) Knowing the average dose
d) Securing the patients co-operation
139. The treaty of Waitangi was in essence a partnership between the

a) Maori chiefs and governor gray
b) Maori chiefs and European settlers
c) Maori inhabitants of new Zealand and the british government
d) Maori chiefs and the English
140. Social policy makers have argued that maori health has suffered greatly
because of inappropriate health service delivery. This can be attributed to
a) Provision of a totally monocultural western type health care system
b) Lack of government health functioning
c) Low number of maori health providers
d) Maori urban migration
141. Which is the most appropriate response by the nurse making her first home
visit to a newborn baby and mother when she learns from a neighbour that the mother
and baby are at tangi on the local marae
a) Leave a note to say she called
b) Leave a message with the neighbour
c) Visit the marae in search of mother and baby
d) Wait for the mother and baby to return from the tangi
e) Leave a note with your phone number and date of next visit
142. The nurse visits the local marae based health clinic. Grace jones, aged 6
months has a chronic respiratory condition. Mrs jones states my grandmother says
that grace is sick because the whenua (placenta) was not disposed of properly. What is
the nurses most appropriate response
a) Grace is sick because of bacterial infection
b) What do you think about your grandmothers statement
c) The placenta should have been buried under a tree
d) What does your grandmother suggest to help grace and can I help
143. In hauora the 1988 report which considered maori health standards, the
leading cause of maori infant deaths was identified as
a) Gastroenteritis
b) Middle and inner ear infections
c) Meningitis
d) Sudden infant death syndrome
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144. The report also found the maori have relatively high rates of physical and
mental ill health. According to the report, the main reason for this is that they
a) Prefer to consult a tohunga regarding any health problem
b) Generally have poorer nutrition and stress management skills
c) Put family interests before the needs of the individual
d) Are more likely to be unemployed or have low earning capacity
e) Are disadvantaged socially, economically and culturally
STATE EXAMS 30
1. Mrs latu, a tongan, is being admitted in the late first state of labour. She tells the nurse
her husband is, ‘in the waiting room’. Which is the most appropriate response
a) Would you like me to bring your husband in now
b) Would you like to have your husband present at delivery
c) It would be good for your husband to be with you when baby is born
d) Do you know it helps a father bond with his baby if he sees the birth
e) If he is not comfortable with you now, he is probably better not coming in for
delivery
2. Effective timing of contractions is undertaken by placing the fingers lightly on the

fundus of the uterus. This is because the fundus is the
a) Most accessible area to feel
b) Area that never fully relaxes
c) Most contractile part of the uterus
d) Portion where there is least discomfort
e) Area where the upper and lower segments meet
3. Which physiological factors are responsible for the pain experienced during labour
1. Contraction of uterine muscle when it is in an ischaemic state
2. Pressure on nerve ganglia in the cervix and lower uterine segment
3. Stretching of ligaments adjacent to the uterus and in the pelvic joints
4. Stretching and displacement of the tissues of the vulva and perineum
a) 1 and 2
b) 1 and 4
c) 1, 2 and 3
d) 2, 3 and 4
e) 1, 2, 3 and 4
4. The doctor has just assessed the cervical dilatation as six centimetres. The woman
begins to cry out saying ‘the baby is coming, the baby is coming’ which action should
the nurse take
a) Tell her to relax
b) Give her analgesic
c) Examine the perineum
d) Ask her partner to calm her
e) Wheel her into the delivery suite
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5. Mrs finau, a samoan, is admitted to hospital in labour. Her husband and mother in law
are in the waiting room. The best way to provide support for mrs finau is to
a) Ask her husband to be with her
b) Check often but allow her to labour alone
c) Ask her mother in law to be with her
d) Spend time with her throughout her labour, providing companionship
6. Which action should the nurse take when mrs finaus membranes rupture while she is
being examined
1. Observe the liquor
2. Inform the midwife
3. Apply a sterile pad
4. Record the blood pressure
5. Record the fetal heart rate
a) 1 and 5
b) 2 and 5
c) 3, 4 and 5
d) 1, 2, 3 and 5
e) 1, 2, 3, 4 and 5
7. Which of the following should not be done under any circumstances during the third
stage of labour
a) Express clots after the placenta is out
b) Let the mother ‘push’ the placenta out unaided
c) Use cord traction and simultaneously push the fundus down
d) Pull gently on the cord after the cord has lengthened
e) Wait longer than 5 minutes before delivering the placenta
8. This relates to mother and infant. What preliminary safety precaution must the nurse
observe before giving an ampoule of anti D serum to a woman who recently gave
birth
a) Wash her hands
b) Sight the doctors prescription
c) Collect the equipment for giving the anti D
d) Check it with the nurse in charge
e) Ensure the prescription is written in triplicate on the patients chart
9. What must happen to the newborn baby before it is taken from the delivery room
a) Identified by name
b) Put to the mothers breast
c) Shown to the patient
d) Checked for skin lesions
e) Wrapped up firmly on his side
10. To whom is the ‘notification of birth’ form forwarded after completion

a) Senior medical adviser
b) Medical officer of health
c) Hospital social worker
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d) Medical officer of obstetrics
e) Registrar of births, deaths and marriages
11. A newborn baby is cyanosed and appears not to be breathing. Which of the following
is the appropriate first action to take
a) Go to find assistance
b) Clear the airway by suctioning
c) Commence mouth to mouth resuscitation
d) Administer oxygen via a nasal catheter
e) Check to see whether he has an atresia
12. Which statement best describes the basis for maternal bonding in the neonatal period
a) Parental acceptance of the baby
b) Maternal recognition of the baby
c) Stimulation of the maternal reflex
d) Establishment of successful breast feeding
e) Maintenance of contact between mother and child
13. Which nursing action is essential before giving the baby an intragastric tube feed
a) Check the feed has been warmed
b) Place him in a semi prone position
c) Check the tubing is in the stomach
d) Run sterile water through the tubing
e) Place air into the stomach via the tubing
14. Signs of sepsis in the infant would include all the following except
a) Irritability
b) Constipation
c) Abnormal temperature
d) Poor sucking reflex and feeding
e) Irregular respirations or periods of apnoea
15. Relate of nursing in the community. Which is the most appropriate response by the
nurse making her first home visit to a newborn baby and mother when she learns from
a neighbour that the mother and baby are at a tangi on the local marae
a) Leave a note to say she called
b) Leave a message with the neighbour
c) Visit the marae in search of mother and baby
d) Wait for the mother and baby to return from the tangi
e) Leave a note with your phone number and date of next visit
16. A four year old has been discharged from hospital after having swallowed his fathers
blood pressure tablets. Which is the most important advice for the nurse to give when
making a follow up home visit
a) Keep all medicines in a locked cupboard
b) Take out of the bottle only the dose required each time
c) Use child resistant containers for all medicines
d) Dispose of unwanted medicines or chemicals safely
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e) Return substances to the medicine cabinet immediately after use
17. When making a home visit to a maori family which of the following actions should
the nurse be aware of
1. Taking her shoes off at the door
2. Avoiding placing her nursing bag on the kitchen table
3. Obtaining good eye contact with each person she speaks with
4. Greeting male members of the family first
a) 1 and 2
b) 1 and 4
c) 2 and 3
d) 3 and 4
18. Which information source provides most knowledge about the health problems of a
community
a) Data on environmental pollution
b) The prevalence of unemployment
c) The standard of available housing
d) The local health groups
e) Mortality and morbidity statistics
19. If a child tips boiling water over herself what is the most appropriate first aid action to
take
a) Remove her clothing
b) Apply a soothing lotion
c) Pour cold water over the burn
d) Cover the burnt area with clean sheets
20. What action should the nurse take when a three home visits the mother of nine months
old baby prevents him from being seen as ‘he is sleeping’
a) Question neighbours closely
b) Notify the social welfare of the situation
c) Notify the family doctor in writing of this occurrence
d) Insist on seeing the child and refuse to leave the home
e) Respect the patients right to accept or refuse treatment
21. The nurse is working in a children ward. Brian, aged 5 years, is admitted to hospital
with burns to his legs, arms and lower abdomen. What is the purpose of an
intravenous infusion commenced while brian is in the accident and emergency
department
a) To correct hypovolaemia
b) To administer packed cells
c) To quickly obtain blood samples
d) To quickly administer pain relief
e) To administer large doses of hydrocortisone
22. 200ml of barts solution is prescribed to infuse over 3 hours. The drip factor is 60
drops per ml. How many drips per minute should be given
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a) 33
b) 47
c) 53
d) 67
e) 73
23. The rate of the intravenous infusion is less than that prescribed and also
approximately 2 hours behind the ordered schedule. The best action by the nurse is to
a) Consult the physician concerning a new schedule for the intravenous infusion
b) Calculate a new drip rate so that within a 24 hour period. The total amount of
ordered solution will be infused
c) Increase the drip rate so that the total amount of ordered solution will be infused
within an 4 hour period
d) Restart the drip rate to the prescribed rate so the total ordered amount for the 4
hour period will be infused
e) Allow the transfusion to proceed at a slower rate to prevent over hydration
24. Which body reaction will occur if the blood pressure of a very shocked person with
severe burns is allowed to remain low
a) Renal failure
b) Dehydration
c) Spastic colon
d) Deep vein thrombosis
e) Protein loss from the burned areas
25. Which blood test is used to help estimate the amount of fluid replacement required
a) Hematocrit level
b) Complete blood count
c) Blood creatinine level
d) Blood oxygen tension (pO2)
e) Leukocyte differential count
26. The main aim in the treatment of a partial thickness burns will be to prevent
a) Infection
b) Haemorrhage
c) Inflammation
d) Blistering
e) Discolouration
27. Which electrolyte is lost from the body in the largest amount during the first 48 hours
following a severe burn
a) Sodium
b) Calcium
c) Potassium
d) Magnesium
e) Phosphorus
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28. Which part of the skin contains the injured nerve endings and receptor cells which
cause the pain following a burn
a) Dermis
b) Underlying muscle
c) Subcutaneous layer
d) Horny layer of the epidermis
e) Basal cell layer of the epidermis
29. Necrotic tissue in a burnt area supports clostridium tetani. A characteristic of the
clostridium tetani organisms is their ability to
a) Acidify body fluids
b) Agglutinate red blood cells
c) Cause destruction of muscle tissues
d) Live without the presence of oxygen
e) Take up sodium ions from body tissues
30. Penicillin 125mgms is prescribed prophylactically. The drug available in powdered

form is reconstituted to contain 600mg in 2ml. What amount should be given
a) 0.23ml
b) 0.4ml
c) 0.7ml
d) 0.73ml
e) 0.8ml
31. Brian is found to have a chest infection. The micro organism is sensitive to
gentamycin sulphate. Brian is charted 8mg BD. The ampoule in the ward is labelled
80mg in 2 ml. What volume should be given
a) 0.2ml
b) 0.4ml
c) 0.8ml
d) 1.0ml
32. Which is the main reason for a person recovering from burns needing a high protein
diet
a) Prevents infection
b) Rebuilds damaged tissue
c) Assists with utilisation of vitamins and minerals
d) Prevents contractures developing
e) Improves the use of available iron to overcome anaemia
33. Respiratory difficulties can most effectively be relieved by agents which produce
a) Bronchodilation
b) Increased oxygen tension
c) Decreased production of mucous
d) Increased production of mucous
e) An action against causative allergens
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34. Thirty minutes after the intravenous medication is commenced mr jones is anxious,
restless and dyspnoeic; respiratory rate is 36. He is still wheezing and using his
accessory respiratory muscles. What is the most appropriate decision for the nurse to
make
a) He needs to use his inhaler as a supplementary aid
b) He needs a higher concentration of oxygen
c) Lack of treatment response requires medical review
d) He needs physiotherapy to aid effective breathing
35. When using a ventolin inhaler, it is important to do all of the following except
a) Shake the inhaler before using it
b) Expire fully before inhaling the spray
c) Hold the aerosol within ones open mouth
d) Use the inhaler repeatedly until some relief is felt
36. Which behaviour may the nurse observe in mr jones shortly before he has an asthma
attack
a) Greater restfulness
b) Increased irritability
c) A sense of contentment
d) Decreased independence
e) A sense of superiority
37. The most important factor about his prognosis that mr jones should know is that he
a) Has an unpredictable prognosis
b) Will never be ‘completely’ cured
c) May experience other disabling symptoms
d) Will require ongoing stress therapy
e) Can recover but under stress attacks may recur
38. Aminophylline is used in the treatment of asthma mainly because it

a) Improves the action of the heart
b) Dries up the bronchial secretions
c) Relaxes the smooth muscles of the airways
d) Stimulates the respiratory centre of the brain
e) Relieves the persons anxiety and restlessness
39. The role of parent surrogate is most therapeutic when the nurse
a) Respects the need for dependence and fosters this need
b) Avoids restricting the behaviour and makes decisions for him
c) Allows a completely permissive environment, to encourage the person to take
responsibility for himself
d) Allows the patient to be dependent as long as necessary, but encourages
independence as soon as possible
e) Conveys complete acceptance of the behaviour and willingness t o do for him
what he cannot do himself
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40. What is the first action of the nurse who is about to give jeff an 8 year old, his pre
medication when she notices crumbs around his mouth
a) Check for any food in his locker
b) Ask him when he last had something to eat
c) Give the pre medication and then report your observation
d) Report your observation before giving the pre medication
41. The nurse is working in a medical area. Mr jones, aged 53 years, was admitted with
an acute attack of asthma. How does asthma affect respiration
a) Lessens the expulsion action of cilia
b) Destroys the structure of alveolar walls
c) Prevents full use of respiratory muscles
d) Obstructs the flow of air through the airways

c) Inflammation of the alveoli
d) Constriction of the pleural lining
e) Spasm of the smooth muscles of the bronchi
43. Breathing in asthma is commonly described as

a) Wheezing
b) Stertorous
c) Grunting
d) Gasping
e) Gurgling
44. All of the following are side effects of aminophylline except

a) Nausea
b) Headache
c) Insomnia
d) Hypertension
e) Increased heart rate
45. Mr jones requires digoxin for a heart condition. What effect does the drug digoxin
have
a) Lower the blood pressure
b) Raises the blood pressure
c) Slows and strengthens the heart beat
d) Increases and strengthens the heart beat
e) Increases and regulates the heart beat
46. Mr jones asks why his pulse rate is noted before each dose of digoxin. Which is the
most appropriate explanation for him
a) There is really nothing to worry about
b) We want to see if you are having sufficient of the drug
c) If you have tachycardia it would be dangerous to give you the dose
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d) If your pulse is rather slow, it may indicate that the drug is accumulating in your
body
e) If your pulse is too slow the doctor may have charted the incorrect dosage of the
drug
47. The doctor orders 1000 mls of barts to be infused over 8 hours. The drip factor is 15.
What is the number of drops per minute
a) 3
b) 30
c) 31
d) 300
e) 310
48. Mr jones says he feels very depressed. What aspects of his thinking/behaviour should
be explored with mr jones
a) His interactions and feelings toward other members of the household
b) His thoughts and feelings about his illness
c) The reasons for allowing depressing thoughts and feelings to overcome him
d) Religious beliefs about life and death
e) Recent interactions with members of his own family
49. The nurse is asked to administer 15,000 international units of heparin to mr jones. The
ampoule contains 25,000 international units in one millilitre. Which amount should be
given
a) 0.2ml
b) 0.6ml
c) 0.8ml
d) 1.2ml
e) 1.6ml
50. Mr jones has a cardiac arrest. In performing external cardiac compression in adults,
downward vertical pressure is exerted on the heart by
a) Pushing the fleshy part of the clenched fist on the lower sternum and the heel of
the other hand on top of it
b) Placing the heels of each hand side by side. Extending the fingers over the chest
c) Putting the heel of one hand on the lower sternum and the heel of the other hand
on top of it
d) Placing the heel of one hand on the xiphisternum and the heel of the other hand on
top of it
e) Spreading the fingers of one hand on the lower sternum and the fingers of the
other hand on top of them
51. Mr jones dies. The best answer to a telephone caller asking the condition of mr jones
is to
a) Say the patient is deteriorating rapidly
b) Say that the patient has just died and express condolences
c) Ask them to hold the line while a senior nurse is called
d) Say you cannot provide any further information about the patient
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e) Ask if the caller is a relation, then tell them the patient is dead
52. What action should be taken in circumstances where a person is wearing a registered
nurses medal to which she is not entitled
a) Tell the principal nurse at your hospital
b) Ignore the situation as you do not want to get involved
c) Ask the person what she is doing wearing a registered nurses medal
d) Go to her employer, and tell him that you know she is not a registered nurse
e) Write to the nursing council giving her name and the name of her place of
employment
53. The nurse is working in a surgical ward. jeremy, aged 14 years is admitted to hospital
with a fractured leg following a car accident. Jeremy is in a shocked condition due to
blood loss. He is hyperventilating. Which of the following recordings indicate shock
a) Blood pressure 110/70, respiration 34, pulse 120
b) Blood pressure 128/90, respiration 32, perspiring
c) Blood pressure 120/80, pulse 70, skin cold and clammy
d) Blood pressure 78/56, pulse 152, weak, thread perspiring
e) Pulse 84, irregular, skin hot and dry, voided 50 mls clear urine

c) Respiratory failure
d) Respiratory acidosis
e) Respiratory alkalosis
55. Without describing to them what is involved, the surgeon asks for consent for surgery
from jeremys parents. What is your responsibility in this situation
a) Ensure the parents has been given appropriate information
b) Question the validity of this consent
c) Ensure the consent form is completed
d) Check whether the parents have any questions about the surgery
56. Jeremy is prescribed pethidine 75mgs intramuscularly as a premedication. The drug is

available in ampoules containing 100mgs in 2ml. What dosage should be
administered
a) 0.125ml
b) 0.75ml
c) 1.25ml
d) 1.5ml
e) 1.75ml
57. The nurse believes the drug dose prescribed for Jeremy is incorrect. The best action to
take is
a) Refuse to give the medication
b) Give the medication as prescribed by the doctor
c) Withhold the medication and check the dosage with the doctor
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d) Check the drug dosage against another patients chart
e) Give the medication and consult a current drug handbook
58. After the operation a traffic officer comes to the ward and asks to interview Jeremy in
regard to the car accident. What is the appropriate action
a) Direct him to jeremys room
b) Be present during the interview
c) Ensure jeremys parents are present during the interview
d) Assess whether Jeremy is well enough to be interviewed
59. A reporter from a local paper phones the ward and asks for information on jeremys
condition. What is the appropriate response in this circumstance
a) Jeremy has a broken leg but is comfortable
b) Ill go and get the senior nurse on duty who will assist you with your queries
c) I cannot give you any information
d) Please contact the senior medical adviser for such information
60. Mrs lever, aged 72 years was admitted for removal of a cataract from her right eye.
Which statement best defines the term cataract
a) Severely increased pressure within the eye
b) clouding or opacity of the crystalline lens
c) Incoordinated action of muscles of the eyeball
d) Ulceration of the cornea secondary to infection
e) Low grade bacterial infection of the iris and ciliary body
61. Which physiological change is mrs lever likely to have noted
a) Gradual blurring of vision
b) Severe unilateral headaches
c) Floating spots before the eyes
d) Halo effects around bright lights
e) Itching and increased watering of her eyes
62. Which post operative behaviour will mrs lever be protected from if shown the room
and ward layout on admission
a) Boredom
b) Hostility
c) Depression
d) regression
e) Disorientation
63. A cataract in an older person is probably due to

a) Low grade infection
b) Endocrine imbalance
c) Mechanical trauma of the lens
d) Degenerative changes of the lens
e) Increased intra ocular pressure
64. Atropine eye drops 1% are instilled into the eye pre operatively to produce the
condition of
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a) Decreased tearing
b) Papillary dilation
c) Palpebral relaxation
d) Capillary constriction
e) Decreased intra ocular pressure
65. Which of the following is your responsibility when preparing mrs lever for surgery
a) Obtaining consent for the surgery
b) Giving an explanation of the surgery
c) Advising on alternative treatments
d) Ensuring the patient understands the surgery
66. Despite your explanation to mrs lever about her pre medication, she insists she does
not want it. Your response is to
a) Tell mrs lever she cannot have surgery without pre medication
b) Take mrs lever to the operating theatre and tell the nurse she has not had pre
medication
c) Advise her doctor that she does not wish to have pre medication
d) Ask her husband to persuade her to have the pre medication
67. Pethidine has been ordered for severe headache. When should the nurse give the
pethidine
a) Only when the headache becomes very severe
b) Every four hours whether mrs lever needs it or not
c) Not more often than six hourly to prevent her becoming addicted
d) When mrs lever says the headache is unbearable and asks for an analgesic
e) As often as necessary to keep mrs lever comfortable and control restlessness
68. The misuse of drugs regulations 1977 states that controlled drugs should be stored in a
a) Locked metal cupboard fixed to the building
b) Locked safe, within a locked cupboard designated for dugs
c) Specified locked cupboard in an area designated for drug administration
d) Locked metal cabinet on drug trolley
69. When counting the pethidine ampoules you discover that there is one short. Your
responsibility in this situation is to
a) Check with the pharmacist who did the restock
b) Record the correct stock in the drug register
c) Withhold giving the pethidine until the loss is accounted for
d) Tell the nurse in charge and document the loss
70. In what circumstance may a nurse be convicted in a court of law under the misuse of
drugs act 1975
a) Giving prescribed sedation to a patient in hospital
b) Possessing a controlled drug, not prescribed for the nurse by a medical
practitioner
c) Signing the controlled drug register, having given a prescribed medication
d) Administering a controlled drug under medical guidance in an emergency
e) Refusing to give a controlled drug to a patient suffering from chronic pain
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71. You return to the office to find a stranger reading mrs levers notes. What should you
do first
a) Remove the notes from the person
b) Ask the person to identify themselves
c) Request that the person leave the office
d) Check whether other notes have been disturbed
STATE EXAMS 31
1. Robert Obrien, 49 years old, has early cirrhosis of the liver due to 10 years of alcohol
abuse. After recent blank out spells he admits himself to the alcohol unit for
treatment. The nurse observes withdrawal symptoms that require immediate
intervention. Which would be the best approach when giving the prescribed
medication
a) Gain his cooperation by explaining the procedure
b) Give him the injection when he is not aware
c) Restrain his arms and legs with restraints
d) Explain and have other staff members restrain him
2. Mr Obrien reacts angrily to being told he will need further treatment and must remain
in the hospital another week. He blames the staff for this setback. Which plan would
be most therapeutic
a) Telling him to calm down when he has these outbursts
b) Encouraging expression of his true feelings
c) Leaving him alone until he calms down
d) Explaining to him why these treatments are necessary
3. Mrs Obrien asks the nurse what to do if she smells alcohol on her husbands breath
after he is discharged. Which response would best help mr Obrien and his wife work
through his periods of relapse
a) Confront Robert whenever he has been drinking
b) Talk about neutral topics and show an interest in him
c) Tell him to go to his room and sleep
d) Call his boss and make excuses for his absences
4. Mr Obrien is admitted 1 year later with jaundice, ascites and peripheral oedema.
While taking his social history he states he is impotent the nurse should recognize that
a) Impotency is of psychogenic origin
b) Impotency is a symptom of cirrhosis of the liver
c) Antidepressants can cause impotency
d) Male impotency shows a sharp decline after the age of 40
5. The laboratory studies indicate an increase in mr obriens circulating oestrogens. A

symptom associated with this is
a) Gynecomastia
b) Hirsutism
c) Increased libido
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d) Thrombophlebitis
6. The physician orders serum albumin 25% intravenously. The expected outcome from
this administration would be decreased
a) Urinary output
b) Jaundice
c) Abdominal girth
d) Serum ammonia
7. Joey one week old was born with a cleft lip and cleft palate. He has returned to the
unit for surgery to repair his cleft lip. The nurse should position him on his
a) Back
b) Left side
c) Stomach
d) Right side
8. Joeys mother asks the nurse if she will spoil him by holding him whenever he starts to
cry. The nurse should reply that it is most important to prevent crying at this time
a) Therefore, spoiling him should not be the major concern
b) However, once his lip has healed he should be allowed extra crying time
c) Furthermore he needs extra holding and cuddling because he cannot suckle
d) But she should try first to comfort him in the crib to avoid spoiling him
9. Robert 3 weeks old after a history of projectile vomiting, has a surgical repair of his
pyloric stenosis. He is returned to the unit, alert, his intake and output are balanced
and his vital signs are stable. He is ready for his first oral feeding, which sould consist
of a small amount of
a) Glucose water
b) Sterile water
c) Skimmed milk and water
d) Dilute formula
10. Roberts parents ask if he will always have a sensitive stomach. The nurse should
respond that the prognosis is excellent
a) But he will need close medical supervision until solid foods are his main source of
nutrition
b) Provided he learns to eat slowly and remains sitting for 1 hour after meals
c) Although a revision will probably be required during the rapid growth period of
adolescence
d) With complete relief of symptoms and no future problems anticipated
11. A client confides in you that her 16 year old daughter lisa is 5 months pregnant but
refuses to return to the clinic for her scheduled visit. The nurse explains that lisa
should be told that each visit is important
a) Even though problems rarely occur during the second trimester
b) Because toxaemia usually occurs at this time and can be controlled if recognised
early
c) Even though she had no problems at her last visit
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d) Because at her age complications are more likely to occur that could affect he or
the baby
12. Lisa tells the nurse that she has gained 2 kg in a month and plans to diet by skipping
lunches. Which of the following responses would be the most appropriate
a) Have you noticed that your hands and feet have become swollen
b) You should cut down on high calorie foods like cake and candy, but you shouldn’t
skip lung
c) Your weight gain is just right for you for this period of your pregnancy, you are
doing fine
d) Your supposed to gain 2 kgs of weight its good for the baby youll lose it after the
baby is born
13. 50mg is equal to

a) 0.5 gram
b) 5 grams
c) 5000 micrograms
d) 50,000 micrograms
14. The drugs used to treat parkinsons disease act by

a) Increasing cholinergic activity and increasing dopamine
b) Reducing cholinergic activity and increasing dopamine
c) Increasing cholinergic activity and reducing dopamine
d) Reducing cholinergic activity and reducing dopamine
15. Recent research indicates that arthritis may be an autoimmunedisease. Which of the
following statements most accurately describes the process of autoimmunity
a) A rare complication of vaccination when the body reacts to the vaccine by
producing symptoms of the disease
b) An inherent factor in the blood which renders the person susceptible to certain
diseases
c) Lack of antitoxins in the blood which render the person susceptible to the certain
disease
d) Formation of antibodies in the blood which destroy certain healthy cells in the
individual
16. Patients with rheumatoid arthritis commonly have a raised ESR (erythrocyte
sedimentation rate). This is because
a) Arthritic patients usually have a degree of anaemia
b) Rheumatoid factor decreases the viscosity of the cells
c) Protein changes result in the erythrocytes becoming heavier
d) There is an increase in leucocyte numbers
17. Before administering a dose of digoxin the patients pulse (apex beat) should be taken.
Which is the correct action for the nurse to take if the pulse is found to be under 60
beats per minute
a) Give the drug and take the pulse again an hour later
b) Give the drug and notify the staff nurse that the pulse is slow
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c) Do not give the drug and report the slow pulse to the doctor
d) Omit the drug and make a note on the nursing care plan
18. Which of the following can be causes of anaemia in the elderly

1. Apathy and depression
2. Ill fitting dentures
3. A physiological inability to utilize food properly
a) 3 only
b) 1 and 2
c) 1 and 3
d) 1, 2 and 3
19. Old people are inevitably a burden on the community (assertion) because old people
cannot work because they are slow and cannot be relied on (reason). With reference to
the above statement which of the following is true
a) Both assertion and reason are true statements but the reason is not a correct
explanation of assertion
b) The assertion is true but the reason is a false statement
c) The assertion is false but the reason is a true statement
d) Both the assertion and reason are false statements
20. A common problem with the elderly is their reluctance to drink adequate amounts of
fluid. The most probable reason for this is that they are
a) Frightened of being incontinent
b) More likely to sweat then younger people
c) Unable to afford adequate fluids
d) Afraid of developing diarrhoea
21. Haemorrhage into the anterior chamber of the eye following a cataract extraction is
called
a) Hyaemia
b) Hyphaema
c) Hyfever
d) Hyena
22. Mr d has an enlarged prostate gland. The development of increased frequency is likely
to be a result of
a) Inability to empty the bladder completely
b) Delay in initiating micturition
c) Slowness of the urinary stream
d) Burning on micturition
23. Chuck jones 12 years old has been hospitalized on the pediatric unit with an acute
asthmatic attack. He is receiving 2,000 mls of 5% dextrose in water with 20
millieqivalents of KCL per day. The drop factor is 60 drops per millilitre. How many
drops per minute should he receive
a) 60
b) 68
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c) 76
d) 83
24. Chuck drinks small amounts of fluids, which total 400 mls per day. His daily total
including the intravenous fluid intake is 2,4000 mls. His total output is 1 ,500 mls per
day. The specific gravity of his urine is 1.015. based upon the evaluation of this data
the nurse should
a) Call the physician and request a change in the amount of intravenous fluid
b) Continue to encourage chuck to drink fluids, and offer choices
c) Suggest to chuck that he eat more solid foods
d) Tell chuck that he need not force himself to drink fluids
25. A 24 hour urine collection is ordered to determine mrs cousins oestriol levels. The
nurse should advise mrs cousins to
a) Save all urine samples from the first one in the morning until the first one next
morning
b) Discard the first morning urine sample and then save all urine samples including
the first one the next day
c) Begin the collection at any time during the day and save all urine samples for the
next 24 hours
d) Include the next urine sample after the completion of the 24 hour period, if a urine
sample has been discarded accidentally
26. Mrs cousins has gestational diabetes. Assessment of mrs cousins diabetic status
during the first 24 hours after delivery should include monitoring her blood glucose
levels for a possible complication of
a) Hypoglycaemia
b) Hyperkalemia
c) Ketoacidosis
d) Galactosemia
27. Mr and mrs cousins are concerned that their children will develop diabetes. The nurse
should respond that
a) Because diabetes is inherited their children should be assessed periodically
b) A genetic counsellor can determine the probability of their children developing
diabetes
c) There is little chance that their children will develop diabetes because mr cousins
is not diabetic
d) Statistical predictions of whether children of diabetics will develop diabetes are
not too reliable
28. A client is given a prescription for chlorothiazide, (chlotride) 500mg once a day.
Patient teaching concerning the drug should include the necessity for
a) Restricting fluid intake to 1.000 ml/day
b) Taking the drug before retiring
c) Avoiding the use of alcohol
d) Checking his blood pressure daily
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29. Mr smith has a transient cerebral ischemic attack with the following symptoms:
aphasia, dizziness and numbness in the left arm. His nursing care plan should include
provision for
a) Physical safety measures
b) Suctioning
c) Seizure precautions
d) Positioning every 2 hours
30. A CT scan is ordered for mr smith. Preparation for the procedure should include
a) Not allowing him anything by mouth after midnight
b) Administering sedation as ordered
c) Instructing him concerning the importance of lying still
d) Explaining that a lumbar puncture will be necessary
31. Shirley aged 4 has been brought to the health clinic because according to her mother
she does not talk. She is diagnosed as having autistic behaviour. In planning long term
care for Shirley, the health team especially needs to consider
a) The role of the father in the family
b) Separating Shirley from her family
c) A nurse who will be a surrogate mother
d) Supporting the mothers role
32. Shirley has to be hospitalized. Which nursing approach will best help shirleys
maladaptive behaviour
a ) isolation whenever Shirley is acting out
b) Allowing Shirley to have her own way
c) Rewards given when Shirley cooperates
d) A one to one relationship with Shirley
33. The nurse plans to have Shirley involved in daily sessions of therapeutic play. The
main reason for this activity is that
a) The nurse can motivate Shirley through play
b) Shirley can best express herself through play
c) Shirley will be happier when she is playing
d) The nurse will be more objective watching Shirley play
34. Mr wolfe a 46 year old executive is admitted to the CCU with chest pain and
shortness of breath. A diagnosis of myocardial infarction is made. One of the more
common complications of myocardial infarction is
b) Anaphylactic shock
c) Cardiac enlargement
d) Hypokalemia
35. The nurse observes mr wolfes monitor and identifies asystole. This arrhythmia
requires urgent attention because the heart is
a) Beating very rapidly
b) Beating very slowly
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c) Not beating
d) Beating very irregularly
36. A cardiac arrest code is called for mr wolfe. The nursing priority is to
a) Ensure the airway is clear
b) Give 4 full lung inflations
c) Compress the lower sternum 15 times
d) Check for a radial pulse
37. The commonest cause of mitral valve stenosis is

a) Atherosclerosis
b) Sub acute bacterial endocarditis
c) Rheumatic fever
d) Left ventricular failure
38. People with cardiac valve disease are especially prone to develop bacterial
endocarditis when undergoing the following type of surgery
a) Dental
b) Thoracic
c) Abdominal
d) Orthopaedic
39. Mr kent is a 78 year old with pneumonia which of the following signs and symptoms
would indicate a fluid deficit
1. Skin that remains wrinkled and peaked when pinched
2. Weakness and lethargy
3. Elevated pulse and respiratory rates
4. Dyspnoea and cyanosis
a) 1, 2 and 3
b) 1, 3 and 4
c) 1, 2 and 4
d) 1, 2, 3 and 4
40. Which of the following molecules cannot pass through capillary endothelium
a) Oxygen and carbon dioxide
b) Plasma proteins
c) Glucose, oxygen and carbon dioxide
d) Amino acids and water
41. Ammonia is excreted by the kidney to help maintain

a) Low bacterial levels in the urine
b) Osmotic pressure of the blood
c) Hydrostatic pressure in the glomerulus
d) Acid base balance of the body
42. Chronic renal failure results in amaemia primarily because

a) Low levels of urea destroy red blood cells
b) The bone marrow is depressed
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c) The kidney produces erythropoietin
d) High levels of vitamin K in the blood
43. Carbon dioxide acts as a

a) Respiratory stimulant
b) Vaso dilator
c) Respiratory depressant
d) Bronchodilator
44. The antidote to heparin is

a) Vitamin D
b) Vitamin K
c) Prothrombin
d) Protamine sulphate
45. Mr Thomas was admitted with pulmonary TB. When taking mr Thomas medical
history the nurse should be alert for any mention of the following symptoms of
tuberculosis
1. Loss of weight
2. Easily fatigued
3. Afternoon fever
4. Night sweats
5. Blood tinged sputum
a) 1, 2 and 3
b) 1 and 2
c) All of the symptoms
d) 1, 3 and 5
46. TB is spread by
a) Inhalation of droplets
b) Ingestion of contaminated food
c) Injection with unsterile equipment
d) Entry through skin lesion on his hand
47. Which of the following complications may occur if mr Thomas fails to take his
medications regularly
a) Allergic reactions to his medications
b) Loss of tissue sensitivity to tuberculin
c) Bacterial resistance to the drugs
d) Calcification of the lymph nodes
48. A possible toxic effect of streptomycin is

a) Anaemia
b) Anuria
c) Deafness
d) Hypotension
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49. Susan aged 16 years was admitted for investigation of grand mal epilepsy following a
seizure and complaining of blurred vision. The most important test to diagnose
epilepsy would be
a) An electroencephalogram
b) An electrocardiogram
c) Lumbar puncture
d) Coombes test
50. The site of vision in the brain is located in the

a) Temporal lobe
b) Occipital lobe
c) Parietal lobe
d) Thalamus
51. Which of the following medication may be given to prevent a grand mal seizure
a) Dilantin
b) Bromide
c) Neocytamen
d) Levo dopa
52. Following a grand mal seizure susan is likely to be

a) Hostile
b) Hyperactive
c) Euphoric
d) Confused
53. Susans mother asks you will this trouble make susan slow in school which response
would be most appropriate
a) Absolutely not. Susans disease has nothing to do with her intelligence
b) So long as she has small seizures they will have no effect on her brain
c) There is no reason to expect the disease to decrease susans ability to learn
d) As epilepsy causes mental deteriorations, susans learning ability may be affected
54. Millie crowe a nursing student develops muscular weakness in her right arm and
intermittent urinary incontinence. The diagnosis of multiple sclerosis is made. The
pathology underlying the manifestations of multiple sclerosis has been identified as
the
a) Deficiency of neurotransmitters
b) Destruction of the nerve myelin sheath
c) Interference with neuronal transmission
d) Premature destruction of transmitter substance
55. When discussing the future with millie it is important to explain that multiple
sclerosis
a) Is a disorder that becomes progressively worse
b) Is caused by an underlying viral infection
c) Can be cured with appropriate treatment
d) Has remissions of months or years
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56. The main goal in treating millie is to minimize the risk of
a) Prolonged discomfort
b) Symptom exacerbation
c) Delayed recovery
d) Dehydration
d) People unaffected by multiple sclerosis such as the MS society field worker
58. Mr green 56 years old has been in hospital for two weeks with a diagnosis of cerebral
thrombosis. His symptoms include expressive aphasia, right sided paralysis and loss
of the gag reflex. As part of the long term planning the nurse should
a) Help the family accept the fact that mr green cannot be verbally communicated
with
b) Wait for mr green to verbalize his needs regardless of how long it takes
c) Begin associating words with physical objects
d) Help mr green accept this disability as permanent
59. Mrs green seems unable to accept the idea that her husband must be encouraged to do
things for himself. The nurse may be able to work around these feelings by
a) Telling mrs green to let her husband do things for himself
b) Letting mrs green know that the nursing staff has full responsibility for the
patients activities
c) Letting mrs green assume the responsibility as she sees fit
d) Asking mrs green for her assistance in planning the activities most helpful to the
patient
children
b) The way their needs are met by others
a) Acknowledge they are individuals
62. Which of eriksons psychosocial crises is present at age four years

Page 157 of 257
b) Make a conscious effort to remember their own adolescence
64. A man has a bleeding socket after getting his tooth removed. the correct action to
take is to
a) Give him an ice cube to suck
b) Give him a warm saline mouthwash
c) Pack the socket with ribbon gauze
d) Tell him to bite on a gauze pad for twenty minutes
65. Mr smith suffered severe burns to both legs from flames at a barbecue on the beach.
His friends carried him to the waters edge and let the sea flow over his legs. Which
statement is correct about the suitability of this first aid treatment
a) Advisable to reduce the heat of the flames
b) Strongly recommended as sea water is healing
c) Risky because of the contaminants in sea water
d) Not acceptable because of the risk of chilling and shock
66. A 42 year old farmer is pinned under his tractor. His breathing is laboured, he is
slightly cyanosed, shocked and has severe chest pain. While waiting for the doctor the
nurse should especially note any
a) Alteration in pain
b) Decrease in temperature
c) Change in his respirations
d) Increase in the amount of restlessness
67. The farmer is removed from behind the wheel. He is in severe respiratory distress and
is becoming more cyanosed. The farmer is found to have an open pneumothorax. The
most appropriate first aid is to
a) Seal the wound in the chest wall
b) Start mouth to mouth resuscitation
c) Place the farmer in recovery position
d) Lie the farmer flat, extending his neck
68. The ambulance driver gives the farmer oxygen therapy. This improves his respirations
and decreases his degree of acidosis by decreasing the
a) Carbon dioxide and carbonic acid in the blood and the ratio of carbonic acid to
bicarbonate
b) Hydrogen ion concentration in the blood and increasing the ratio of carbonic acid
to bicarbonate
c) Carbonic acid, so chloride moves into the red cells leaving more sodium available
to form bicarbonate
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d) Build up of potassium in the blood stream and increasing oxygenation of the
haemoglobin in the blood cells
a) Your children are in danger of infection if they were not given breast milk to gain
natural immunity
b) Immunisation assists the body to produce its own immunity and give protection
against dangerous infections
d) If you do not have your children immunised they can be admitted to hospital with
infectious diseases and cost the country a lot of money
he will be given a
72. Vaccines induce immunity that is

73. Which of the following signs/symptoms would indicate mumps

d) Ulceration of vesicular stomatitiis
spread of mumps

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76. Mrs shaw brings her 8 year old daughter jane to the clinic. Jane has eczema. Janes
eczema is most likely the result of
a) Inadequate skin care and hygiene
b) Excretion of acids through sweat pores
c) An inherited predisposition to skin infections
d) Sensitivity to a substance in her external environment
77. Eczema is the term used to describe a (n)

b) Excretion of acids through sweat pores
c) An inherited predisposition to skin infections
d) Sensitivity to a substance in her external environment
78. Eczema is the term used to describe a (n)

b) Non contagious inflammatory response of the skin
c) Fungal infection more commonly seen in childhood
d) Condition marked by the appearance of erythematous wheals
79. Which statement best describes ‘vesicle’

a) Reddened, pinprick like rash
b) Small round area of discolouration
c) Small area of swelling on the skin
d) Small blister filled with serous fluid
80. You are employed as a practice nurse. A friend telephones and asks if her boyfriend
has been to see the doctor this week. Your most appropriate response is
a) I don’t know
b) Ill have to ask the doctor
c) I am not able to tell you that
d) Just a moment ill check the files
81. Mrs adams suffers from dementia and requires a dressing to a shin wound. The nurse
b) A long standing pattern of comestic violence
c) The home not being a suitable place for a dependent person
82. When dressing the shin wound the nurse most appropriate remark is
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84. An increased incidence of vaginal infections occurs when contraceptive pills are taken
because there is
a) A shift in the vaginal pH
b) Drying of the vaginal mucosa
c) An increase in vaginal fluids
d) A reduction in white cell numbers
85. What action should the nurse take when on three home visits the mother of a nine
months old baby prevents him from being seen as ‘he is sleeping’

87. Aminophlline is prescribed. Each ampoule contains 250 mg in 10ml. How should be
added to the intravenous solution
a) 12ml
b) 14ml
c) 16ml
d) 35ml
completed on time
a) 55
b) 65
c) 75
d) 85
a) Broncho dilator
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90. A client is charted nitrazepam (mogadon) tablets to sleep. She refuses to take them at
9pm. She tells you that the other nurses always leave the tablets on the locker and she

STATE EXAMS 32
1. Angela Roberts aged 9 years fell off a ladder whilst trying to put a fairy on the
Christmas tree. Although angela hit her head when she fell she was fully conscious
when her mother found her. Her left arm was very painful, she could not move it, but
otherwise, apart from being very pale and frightened, she seemed unhurt. Mrs Roberts
took angela to the accident and emergency department of the local hospital. There it
was found that she had sustained a greenstick fracture of the midshaft of the left
radius and ulna. Bearing in mind what we know of angela which one of the following
observations would it be most important for the nurse to maintain accurately after
angela has been admitted to the childrens ward
a) Temperature
b) Blood pressure
c) Power and movement of her lower limbs
d) Size and reaction of her pupils
2. A greenstick fracture is defined as one in which the

a) Bone is bent but there is not break in the continuity of the compact tissue of
periosteum
b) Bone is broken at one side and bent at the other
c) Periosteum is completely severed while the underlying compact tissue is unbroken
d) Periosteum and compact tissue are not broken but the underlying bone marrow is
damaged
3. Which one of the following is associated with the greatest risk of damage to the
brachial artery
a) Dislocated of shoulder
b) Dislocation of elbow
c) Mid shaft fracture of radius
d) Supracondylar fracture of humerus
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4. A comminuted fracture is defined as one which always
a) Communicates with an open wound
b) Has the bone broken into more than two pieces
c) Causes injury to the surrounding organs
d) Has the fractured ends of the bone driven into each other
5. After he had seen the xrays thehouse surgeon explained to mr and mrs Roberts that he
would need their permission to get angelas arm in a good position, and apply plaster
of paris. He also explained that in view of the fact that angela had fallen from a height
he would prefer to keep her in hospital overnight for observation, but providing there
were no complications she could go home the following day. Prior to having the
plaster applied, angelas arm was manipulated. In this situation, manipulation is a term
which implies
a) An open surgical operation to ensure the bone fragments are in a good position
and not trapping any nerves or blood vessels
b) Movement of the fragments of the bone, at the fracture site until they are in a good
position for healing
c) The insertion of guide wires to ensure that the bone is in perfect alignment
d) Violent forceful movements of the injured arm to free the bone fragments from
surrounding ligaments and so prevent adhesions
6. Which of the following is the most important feature in the drying of angelas cast
a) Avoid covering the plaster with plastic sheeting
b) Ease the plaster with bending shears at the first sign of swelling of the fingers
c) When touching the plaster, use only the palm of the hands
d) Avoid using any forms of hot convection air currents
7. If angela complains of tingling and itching inside her plaster at a point level with the
head of the ulna, which of the following explanations should the nurse suspect first.
The symptoms are probably caused by
a) A perfectly natural return of sensation following the original injury
b) The early stages of a pressure sore forming
c) Damage to the peripheral sensory nerve supply
d) The radial artery being trapped by the bone fragments
8. With reference to the healing of a fracture, which of the following statements is true
a) Callus formation is the first stage of repair
b) The first stage of repair is haematoma formation, which is gradually replace by
granulation tissue
c) A broken bone will eventually unite and be restored to full function, but the torn
periosteum will never repair
d) Callus is not formed until after full ossification has taken place
9. Mrs skinner 43 years, is diagnosed as having rheumatoid arthritis. Which of the

following statements is true regarding rheumatoid arthritis
a) Equally common in both sexes
b) More common in women than men
c) Rare in young adults
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d) Never occurs in children
10. Rheumatoid arthritis and osteo arthritis (osteo arthrosis) differ in that rheumatoid
arthritis
a) Is usually associated with systemic disturbance
b) Usually results from injury to a joint
c) Affects mainly larger weight bearing joints
d) Is a progressive non inflammatory condition
11. With reference to rheumatoid arthritis, which of the following statements is true
a) There is no known cure for this condition
b) A common complication of this condition is damage to the valves of the heart
c) Primary symptoms occur within 10 days of the patient having a haemolytic
streptococcal infection
d) Involvement of the joints or the cervical vertebrae is rate
12. The stiffness associated with rheumatoid arthritis is typically described as

a) Better after resting
b) Bad in the morning and gets worse as the day progresses
c) At its worst in the morning and improves as the day progresses
d) Present all the time and keeps me awake at night
13. Which of the following analgesics is most commonly prescribed for patients with
rheumatoid arthritis
a) Aspirin
b) Pethidine
c) Meralen (flufenamic acid)
d) Ponstan (mefanamic acid)
14. Mrs skinner was later in hospital for six weeks. During this time her general condition
improved considerably. She was discharged, arrangements were made for her to
attend physiotherapy. Which of the following is of prime importance in the care of the
patient during an acute (active) phase of rheumatoid arthritis
a) Rest the body and the affected limbs
b) Rest the body but give vigorous active exercises to the affected limbs
c) Apply splints to the affected limbs
d) Encourage the patient to walk about the ward and increase the range of activity
each day
15. During the (acute) phase of rheumatoid arthritis the patient should be nursed in which
of the following positions
a) Upright
b) Recumbent
c) Lateral
d) A variety of different positions
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16. When mrs skinner attended the physiotherapy department as an outpatient, she was
given local applications of heat. The main purpose of this form of treatment is to
a) Produce sufficient temporary pain relief to enable the patient to perform her
exercises
b) Increase the range of movement to the affected joints without the need of active
exercises
c) Increase the supply of white cells to the affected joints and so reduce
inflammation
d) Reduce swelling of the joint
17. Six years have passed and twice in recent years mrs skinner has been admitted to
hospital. The first time for an arthrodesis of the left knee and the second time for an
arthroplasty of the right knee. The purpose of an arthrodesis is to provide a joint
which
a) Have a full range of movement
b) Has a limited range of movement
c) Is stable but not moveable
d) Is moveable but not stable
18. Which of the following activities is mrs skinner most likely to need help as a result of
having had an arthrodesis of the knee
a) Putting on her shoes
b) Using the toilet
c) Washing her legs
d) Cutting her toe nails
19. Following arthrodesis of the knee, the most difficult action for a patient to perform is
a) Standing
b) Walking
c) Rising from a chair to the standing position
d) Turning over in bed
20. Which of the following is the most important duty of the nurse caring for mrs skinner
in the immediate post operative period
a) Maintain a clear airway
b) Record her pulse and blood pressure ½ hourly
c) Prevent her from moving her legs
d) Ensure that any instruction from the surgeon concerning application of traction are
carried out at once
21. Mrs skinner has a blood transfusion in progress following hip replacement. Her blood
group is A. This means that in an emergency she could receive blood from
a) Any other group
b) Any group except B
c) Group A only
d) Group A and O only
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22. Twelve hours after the operation mrs skinner started shivering and complaining of
pain in her back. Her pulse was very rapid. In these circumstances which one of the
following should the nurse do first
a) Take her temperature
b) Give her an extra blanket
c) Send for medical aid
d) Stop the blood transfusion
23. John an 18 year old student, has been assigned to your care. He is jaundiced and his
clinical appearance suggests that he has hepatitis A. Hepatitis A is an inflammatory
condition of the liver caused by
a) Auto immune processes following a viral infection
b) A virus which infects the person via the GI system
c) A virus which is only transmitted via contaminated blood products
d) A virus which is mainly transmitted by sharing needles
24. Following a bout of hepatitis A most people can expect

a) To become a carrier
b) Frequent relapses
c) Lifelong immunity to hepatitis A
d) Increased risk of liver cancer
25. The jaundice in hepatitis A is best described as

a) Haemolytic
b) Bilio-static
c) Obstructive
d) Hepato-cellular
26. The incubation period is

a) Less than 10 days
b) 5-15 days
c) 15-50 days
d) 40-60 days
27. During the infectious stage, a person with hepatitis A is excreting the virus mainly in
a) Faeces
b) Urine
c) Saliva
d) All body fluids
28. When a person is in the infectious stage of hepatitis A, special precautions are taken
when you
a) Take a food tray to the person
b) Administer medications
c) Gave an antiemetic injection
d) Remove a used bedpan
29. The most common cause of chronic liver failure in new Zealand is
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a) Post hepatitis fibrosis
b) Alcoholic cirrhosis
c) Hepatic damage following overdose of paracetamol
d) Drug induced hepatic fibrosis
30. Mrs G asks you about sexually transmitted diseases. Among other facts you tell her
a) STDs are not cured without treatment
b) You cannot get STDs more than once
c) You can only get one STD at a time
d) STDs are only transferred from heterosexual contact
31. Staff working in STD clinics use a non judgemental approach. A judgemental
approach is likely to have which of these effects
a) Generate hostility in the client
b) Relieve clients reeling of guilt
c) Cause an inability of understanding in client
d) Give rise to a sense of abandonment in client
32. Which of the following attitudes displayed by STD clinic staff are the most
therapeutic
a) Accepting, sympathetic, friendly
b) Supportive, motherly, friendly
c) Sincere, understanding, consistent
d) Strict, clinical, punishing
33. Joe is 15 years old and attends a local high school. He lives with his mother, brother
and sister in a rented flat. Three months ago joes school performance began falling
and his teacher contacted joes mother. Where joe once had been a moderately bright
student with a small circle of friends, his teacher reported that joe had become less
communicative. He also noticed joe was less inclined to mix or join in group activities
such as games, and in class, often seemed distracted and preoccupied. Which of the
following is psychologically significant and requires further assessment
a) Joes concern about acne
b) Joes concern about the world
c) Joes concern about what is real
d) Joes concern about pocket money
34. Joes mother shares that his behaviour has changed at home too. Which is not typical
behaviour of normal adolescence
a) Spending long periods of time alone in his room
b) Awake all night some nights during the weeks
c) Less inclined to talk, more sulky and moody
d) less co operative, more inclined to get angry
35. a favourable outcome to the life crisis of adolescence would include

a) an ability to feel intimate
b) concern for family, society, and future generations
c) an integrated image of oneself as a unique person
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d) confidence in productive skills, learning how to work
36. joe looks worried and tells you that he can cause terrible things to happen just by
thinking about them. To prove this, he relates when he is thinking about aeroplanes
and one crashed on the same day. Your most therapeutic response would be
a) no. Its just a coincidence that the plane crashed
b) what sort of plane was it and where did it happen
c) it must be a scary feeling to believe you have that responsibility
d) that must make you a very powerful person, eh
37. you consider joe to be quite disturbed and communicate this to joes doctor. Eventually
joe is hospitalised for assessment and treatment. Joe continues to have delusions.
Reality for joe will be reinforced by
1. listening to him carefully
2. calling him by name
3. calling him at mealtimes
4. reminding him to change his clothes
a) 1, 2 and 3
b) 2 only
c) 1, 2 and 4
d) All of the above
38. Therapeutically, doing what you say you will is important in establishing
a) Patterns of reliability
b) Trust in a relationship
c) Self respect
d) Patterns of predictability
39. At the next team meeting it is decided to commence joe on medication in an attempt
to impose a control on his disordered thoughts. Of the following which will contribute
most to the teams choice of the mode of administration of the drug
a) Joes attitude to medication generally
b) The amount of the insight about his situation
c) Joes trust in the medical staff
d) Joes trust in his primary nurse
40. In any situation where restraint is necessary, which of the following is not true
a) Questions asked by the patient are answered by one staff member
b) One staff member per limb is the minimum safe requirement
c) Medication will always be given to effect control
d) The patient is most safely restrained lying down
41. Mr white is a depressed patient who has said ‘im fed up don’t intend to go on like
this’. The nurse should
a) Ask him directly if he is considering suicide
b) Ignore the statement and continue the conversation
c) Change the subject but report incident to charge nurse
d) Comment that others are worse off than he is
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42. The most common event to trigger addictive behaviour in the elderly is
a) A change in work status
b) Death of a spouse
c) Divorce
d) A move
43. Disulfiram (antabuse) is given to people suffering from alcoholism

a) To ease their anxiety
b) To discourage them from drinking
c) To help them with depression
d) during detoxification
44. individuals experiencing violent mood swings suffer from

a) unipolar mood disorders
b) bipolar mood disorders
c) endogenous depression
d) manic mood disorders
45. smoking is bad for people with chronic respiratory disorders because cigarette smoke
a) destroys the cilia which cleanse debris from the airways
b) inhibits the inspiratory centres in the central nervous system
c) inhibit nerves involved in the reflex pathways involved in coughing
d) prevents the vocal cords closing tightly together when swallowing
46. one reason why smokers with chronic respiratory problems should not be given
medications that inhibit the cough reflex is
a) these medications dry up mucus and make secretions difficult to expel
b) the hypoxic drive is inhibited causing a slowing in breathing rate
c) coughing is their only means of preventing mucus accumulating in the lungs
d) in people with chronic problems these medications have no effect anyway
47. asthma is a disorder primarily characterised by

a) hyperinflation and over expansion of lung tissue
b) spastic constriction of the respiratory airways
c) a breakdown in the walls of alveolar tissue
d) chronic dilation and expansion of the airways
48. during acute asthmatic attacks theophylline medications are given because they
a) stimulate the inspiratory centre
b) raise the blood PO2 levels
c) hyperinflate the lung
d) dilate the bronchioles
49. aminophylline comes in ampoules of 250mgs in 10mls. How much in mls, would you
draw up to obtain 300mgs
a) 8.3
b) 12.0
c) 83.0
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d) 120.0
50. A client is prescribed 1 litre of dextrose/saline to be given over 3 hours. If the IV

giving set has a drop factor of 15 drops per ml, which of the following in drops per
a) 17
b) 33
c) 67
d) 83
STATE EXAMS 33
1. Cholesterol is frequently discussed in relation to atherosclerosis. Cholesterol is a

substance that
a) All persons would be better off without because it causes the disease process
b) Circulates in the blood, the level of which responds usually to dietary substitutions
of unsaturated fats for saturated fats
c) Is found in many foods, both plant and animal sources
d) Maybe controlled entirely by eliminating food sources

c) Obstruction of blood flow between the right and the left atria

d) An interruption to the blood supply which results in decreased tissue perfusion


a) Dysrhythmia
b) cardiogenic shock
c) congestive heart failure
d) ventricular rupture
6. which of the following factors increases insulin resistance

a) obesity
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b) hypoglycemia
c) decrease in amyloid deposits
d) increase in muscle mass
7. in metabolism of carbohydrate, the most important function of insulin is

a) precipitating the breakdown of glycogen in the liver
b) to facilitate the passage of glucose into the cell
c) acting as a antagonist to glucagon in the muscle sheath
d) increasing the circulating blood sugar level
8. which of the following is the most preventable risk factor for preventing chronic
obstructive pulmonary disease (COPD)
a) adequate nutrition
b) regular exercise
c) exposure to dust and pollen
d) cigarette smoking
9. when teaching the diabetic who is taking insulin, the nurse emphasizes the importance
of exercise, which
a) prevents mental deterioration
b) often decreases insulin requirements
c) prevents muscle dystrophy
d) often improves visual acuity
10. blood is ejected into the circulation as the chambers of the heart becomes smaller.
This action of the heart is referred to as
a) systole
b) diastole
c) hypertension
d) ejection fraction
11. The patient is experiencing orthopnea. What is the best position for this patient for
relief of symptoms
a) sitting upright leaning forward slightly
b) low fowlers
c) prone
d) Trendelenburg
12. Which of the following would be most appropriate for a patient who is receiving
diuretic therapy for cardiac failure
a) Check laboratory results for creatinine levels
b) Monitor for hypotension
c) Encourage the patient to spend time outdoors to aid in vitamin D absorption
d) Discourage use of potassium
13. Which of the following complications of diabetes is termed macrovascular

a) Retinopathy
b) Stroke (cerebro vascular accident
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c) Nephropathy
d) Renal failure
d) Pneumothorax
The nurse would expect to see changes in the
a) Decreases myocardial oxygen consumption
excessive amounts
a) Hypovolemia
b) Polyuria
d) Blurred vision
17. A patient has been admitted to the hospital with the diagnosis of type 1 diabetes
mellitus. From this information you recognise that this patient
a) Has an autosomal dominant disease
b) Is a maori or Polynesian origin and over the age of 50
c) Is insulin deficient and exogenous insulin dependent
d) Is insulin resistant and relies on oral hypoglycaemic agents for glucose control
18. Which of the following patients with diabetes may require exogenous insulin but not
likely to experience ketoacidosis
a) The person with type 2 diabetes mellitus
b) The person with type 1 diabetes mellitus
c) The person with type 1 gestational diabetes
d) The person with reactive hypoglycaemia
19. Which of the following statements is true regarding type 1 diabetes mellitus
a) There is no genetic or hereditary pattern
b) There is no strong familial link
c) There is a strong autoimmune basis
d) There is no environmental link
20. If your patients insulin is labelled U-100, this means

a) 100 units per dose
b) 100 units in the bottle
c) 100 mg per unit
d) 100 units per millilitre
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21. Which of the following are oral hypoglycaemic agents
a) Oral insulin
b) Insulin substitutes
c) Artificial insulin
d) Sulfonylureas
22. Your patient is experiencing hypoglycaemia related to excessive insulin. Your first
line treatment for this type of hypoglycaemia in the conscious patient with diabetes is
a) An injection of glucagon
b) An intravenous injection of 50% glucose
c) Simple carbohydrates, such as juice
d) Complex carbohydrates, such as rice or potatoes
23. In metabolism of carbohydrates, the most important function of insulin is

b) To facilitate the passage of glucose in the cell

a) Obesity
b) Hypoglycaemia
a) Blurred vision
b) Loss of memory
c) Numbness of arms
26. When water is lost from the body but there is no electrolyte loss, the condition which
occurs is
a) Osmotic diuresis
b) Shock
c) Dehydration
d) Water intoxication
27. The nurse teaches a client with COAD how to perform pursed lip breathing,
explaining that this technique will assist respiration in what manner
a) Slows the expiratory rate and gives the client control of respiratory patterns
b) Promotes maximal inhalation for better oxygenation of the lungs
c) Prevents collapse of bronchioles and air trapping in the lungs during expiration
d) Loosens secretions so that they may be coughed up more easily
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28. Mr langley aged 50 has severe emphysema, during assessment the nurse notes that he
has jugular vein distention and oedematous feet. The nurse recognises that these finds
are indicative of which complication of COAD
a) Acute respiratory failure
b) Fluid volume excess secondary to cor pulmonale
c) Pulmonary oedema caused by left sided heart failure
d) Secondary respiratory infection
29. The most dangerous complication of oxygen therapy for persons with chronic
obstructive lung disease is
a) Pulmonary embolism
b) Damage to alveolar and lung parenchyma
c) Dry lung secretions and promote atelectasis
d) Depression of the respiratory drive
30. A compensatory mechanisms for respiratory acidosis is

a) Retention of hydrogen ions by the kidneys
b) Decreased rate and depth of respiration
c) Increased bicarbonate production by the kidneys
d) Decrease bicarbonate production by the kidneys
a) Dyspnoea, oedema and fatigue

33. Heart failure may be defined as

a) The inability of the heart of pump sufficient blood to the tissues
b) The inability of the heart to pump sufficient blood to the myocardium
c) The inability of the atrio ventricular valves to control blood flow within the heart
d) Inflammation of the endocardium
a) Dyspnoea, oedema, fatigue
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35. The nurse notes that mrs greens abdomen is distended. The nurse should realise that
the client with congestive heart failure develops ascites because of
a) Increased pressure within the circulatory system
b) Rapid diffusion of solutes and solvents into plasma
c) Rapid osmosis from tissue spaces to cells
d) Loss of cellular consituents in blood
36. In the systemic circulation, blood returning to the heart from the legs would have to
pass through the
a) Right coronary artery
b) Inferior vena cava
c) Abdominal aorta
d) Thoracic aorta

a) Obesity
b) Hypoglycemia
a) Blurred vision
b) Loss of memory
c) Numbness of arms
39. In metabolism of carbohydrate, the most important function of insulin is

b) To facilitate the passage of glucose in to the cell
40. Lasix 15 mg is ordered for a client. Available stocks contain 10mg in a 2ml ampoule.
The correct dose would be
a) 5ml
b) 3ml
c) 1.5 ml
d) 2.5ml
41. If you suspect the dose of a prescribed medication is too high, your best action would
be to
a) Delay giving it until an adequate explanation is given to you about the dosage
b) Give it once, but don’t repeat the medication until the dosage is confirmed
c) Give it if the medication is given orally, but delay it if it is given by injection
d) Give the dose you know is appropriate

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a) Dysrhythmia
b) Cardiogenic shock
c) Congestive heart failure
d) Ventricular rupture
43. When collecting a client from post anaesthetic recovery room, the nurse places the
highest priority on assessing
a) The patients level of consciousness
b) The condition of the surgical site
c) The status of fluid and electrolyte balance
d) The adequacy of respiratory function
44. DKA occurs when there is

a) A profound lack of insulin in the body
b) A severe decrease in blood glucose
c) Insufficient insulin production
d) Excessively rigid glycemic control
45. Which symptom of DKA causes patients to seek care

a) Dehydration
b) Abdominal discomfort
c) Acetone breath
d) Blurred vision
46. Which of the following is a late sign of DKA

a) Diarrhoea
b) Hypertension
c) Lethargy
d) Deep rapid breathing
47. What makes HONK so dangerous

a) It has an insidious onset
b) It presents with a myriad of symptoms
c) It has a rapid downhill course
d) It mimics other diabetic problems
48. Plasma glucose levels in HONK are usually

a) <11 mmol/L
b) 11-27 mmol/L
c) 13.8-44 mmol/L
d) >33mmol/L
49. The goals for emergency treatment of DKA and HONK include all the following
except
a) Correcting the underlying cause
b) Normalising glucose
c) Restoring fluid and electrolytes
d) Stabilising respiratory status
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50. The nurse should instruct the diabetic patient to follow all of the following sick day
guidelines except
a) Drink plenty of caffeine free fluids
b) Always take your normal dose of insulin even if you cant eat
c) Monitor blood glucose every six to eight hours
d) Always take your oral diabetic medications even if you cant eat
d) Pneumothorax
The nurse would expect to see changes in
a) P wave
b) T wave
c) Qrs complex
d) U wave
53. To relieve angina pectoris symptoms, the nurse administers nitroglycerin sublingual
to the patient. Which of the following is an action of nitroglycerin
a) Decreases myocardial oxygen comsumption
excessive amounts
a) Hypovolemia
b) Polyuria
d) Blurred vision
55. To gain a postoperative patients co operation in ambulating, coughing, deep

breathing, and turning, which intervention is most important for the nurse to perform
a) Administer analgesics freely to achieve the patients relative freedom from pain
b) Ensure that the patient understands the rationale for these activities
c) Warn the patient about complications that can occur if the activities are not
performed
d) Praise the patient when the activities are completed
56. The nurse is teaching a group cardiac patients to evaluate the nutritional content of
food. The nurse explains that if a serving of 100 gram peanut butter has 36 grams of
fat and 190 calories the percentage of fat per serving is
a) 52%
b) 66%
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c) 36%
d) 18%
57. Mr doncald graham, aged 81, has a large obstruction that occurred as a result of a
faecal impaction. During assessment of mr graham, the nurse recognises which
finding as consistent with a large bowel obstruction
a) Rapid onset of copious vomiting
c) Referred pain to the back
d) Constant, generalised abdominal pain
58. The physician orders 2 units of blood to be infused for a client who is bleeding.
Before blood administration the nurses highest priority should be
a) Obtaining the clients vital signs
b) Allowing the blood to reach room temperature
c) Monitoring the haemoglobin and hematrocrit levels
d) Determining proper typing and cross matching of blood
59. A feature of type 1 diabetes is

a) Autoimmune destruction of pancreatic beta cells in pancreas
b) Late onset usually older than 40 years
c) Resistance to insulin in target tissues
d) Obesity
60. The percentage of the people with diabetes type 2 out of all diabetic clients is
a) Over 40%
b) Over 50%
c) Over 60%
d) Over 80%
61. Type 2 diabetes usually requires

a) Oral hypoglycaemic medications, diet and exercise
b) Sub cutaneous insulin
c) Regular daily monitoring of blood sugar levels
d) Four times daily monitoring of blood sugar levels
STATE EXAMS 34
1. Following surgery, mr J is ready to be transferred from the recovery unit to the

surgical ward when
a) The vital signs are established and the temperature is normal
b) The gag reflex and voluntary movements have returned
c) His blood transfusion is completed and reflexes are normal
d) He pushes the airway out and respiration are normal
e) He regains consciousness and vital signs are stabilised
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2. On the way back from the operating theatre mr j stops breathing and becomes very
cyanosed. Your best action would be to
a) Commence cardiac massage
b) Ensure that his airways are clear
c) Give oxygen
d) Send the orderly for medical aid
e) Return mr j to theatre
3. Mr j is charted pethidine 100 mg for post operative pain. As a registered nurse you
have to make the decision about giving the first post operative dose of analgesic. It is
generally regarded that this should be given
a) Only if the patient asks for it
b) Before the pain becomes too severe
c) When pain is severe
d) When the doctor tells you to give it
e) When the supervisor permits it to be given
4. Wound bleeding which occurs seven to ten days post operatively is most likely due to
a) Infection
b) Defective suturing
c) Not enough exercise
d) Premature removal of wound drain
e) Premature removal of sutures
5. Which of the following may be the cause for inability to void following lower
abdominal surgery
a) Oedma of urethra
b) Spasm of bladder sphincter
c) Atony of bladder muscle
d) Fear
e) Pressure of the bladder against the pubes
6. The nurse notices that the clients surgical wound is swollen and red. The client
complains of pain and says it feels warm. This condition is known as
a) Maladaption
b) Inflammatory response
c) Hormonal activity
d) Exhaustion stage
7. A patient develops the following signs 48 hours following surgery 1 progressive

(faecal) vomiting 2 marked abdominal distension 3 absence of bowel sounds. What is
likely to be wrong with this patient
a) Impaction of faeces
b) Paralytic ileus
c) Irritable bowel
d) Early peritonitis
8. The purpose of reversible surgery for ulcerative colitis is to

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a) Reduce anaemia
b) Rest the bowel
c) Improve the appetite
d) Alleviate abdominal pain
9. An 82 year old woman is admitted with a fractured hip. She is thin, and her skin has
poor turgor; she is alert and cooperative. This client is at risk for developing pressure
sores. Which factor increases her risk the most
a) A haemoglobin level of 14 g/100ml
b) An adequate muscle mass
c) The absence of the shearing force
d) Moisture on the skin
10. Which intervention would the nurse use to prevent post operative deep vein
thrombosis
a) Encourage the client to stay in bed
b) Maintain skin integrity
c) Order a sheepskin for the bed
d) Teach the client to do leg exercises
11. The nurse suspects that a client has a deep vein thrombosis. The nurses initial action is
to
a) Document findings in the clients chart
b) Massage the area
c) Measure the circumference of the calf
d) Notify the physician
12. Which of the following best states the rationale for assessing preoperative vital signs
a) Complies with standard policy for all clients admitted to the hospital
b) Helps to determine which anesthetic should be given to the client
c) Provides a baseline to assist in determining problems
d) Reassures the client that he is being cared for appropriately
13. Which of the following signs would indicate that mrs Collins is haemorrhaging post
operatively
a) Decreased BP, pulse and respirations
b) Decreased BP, increased pulse and respirations
c) Increased BP, pulse and respirations
d) Increased BP, and respirations, decreased pulse
14. Mr Dixon, aged 42 years is admitted with alcohol dependency and cirrhosis of the
liver. The main aid in the treatment of an alcoholic is to help him to
a) Become independent of his dependency on alcohol
b) Become dependent on an alternative support
c) Give up alcohol and associating with drinkers
d) Feel completely independent and self sufficient
e) Realise the hurt his actions have caused his family
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15. Mr Dixon brings with him his morphine tablets prescribed by his general practitioner.
What action should the nurse take
a) Put the bottle on the drug trolley
b) Take the patient to send them home
c) Hand them in immediately to be locked up
d) Tell the patient to keep them in his locker
e) Put them in her pocket to later give to the charge nurse
16. The alcoholics anonymous organisations step wise programme includes

1. Acceptance of ones powerlessness to manage the use of alcohol
2. Receiving the forgiveness and guidance of a higher power
3. Making restriction to those one has harmed as a result of drinking
4. Taking regular inventory of ones motives and actions through meditation
5. Providing support for others needing release from alcoholism
a) 1 and 2
b) 3 and 4
c) 1, 4 and 5
d) 2, 3 and 4
e) 1, 2, 3 4 and 5
17. The next day mr Dixon refused to eat in the dining room with other patients, despite
suggestions from the nurse. This behaviour is best recorded as
a) He is depressed and not eating
b) He was uncooperative and refused to eat with others
c) He preferred to eat in his room, against nurses advice
d) The patient seemed withdrawn and did not follow suggestion
e) He did not eat in the dining room
18. What is the cause of ascites in cirrhosis of the liver

a) Renal failure due to back pressure
b) Biliary obstruction by fibrous tissue
c) Reduced hepatic synthesis of albumin
d) Malnutrition due to the lack of protein
e) Renal failure due to portal hypertension
19. A week later you meet mr Dixons neighbour. She tells you that mr Dixon has gone
into hospital and asks you what wrong with him .your best response is to
a) Tell her that you cannot discuss any details about patients
b) Acknowledge her concern and suggest that she talks to mrs Dixon
c) Suggest that she rings the ward and enquiries about mr Dixon
d) Explain to her the symptoms of alcohol dependency
20. The first phase of the nurse patient relationship with mr Dixon mainly involves
a) Making contact with him
b) Determining his wants and needs
c) Assessing his needs for nursing care
d) Establishing a therapeutic goal for him
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e) Establishing comfortable rapport with him
21. Which behaviour of the nurse will provide the best therapeutic care of mr Dixon
a) Liking every patient she cares for
b) Accept the patient as a human being
c) Sympathizing with mr Dixons problems
d) Keeping a distant professional attitude
e) Accept mr Dixons maladaptive behaviour
22. Mr Dixon finds verbal communication difficult. It would be most helpful and
therapeutic to
a) Involve mr Dixon in a group activity so he has a choice of persons to talk to
b) Focus on mr doxon and his problems and mention similar problems of your own
c) Ask mr Dixon direct questions which require straight forward concrete answers
d) Ask several non productive questions that will not make mr dixon feel threatened
e) Engage in a concurrent activity with mr Dixon in which he can feel more
comfortable
23. After a day of abstinence, mr Dixon has coarse tremors of the hands. He asks how
long it will be before his ‘shakes go away’. The nurse should base her reply on the
fact that the tremors
a) Come and go regardless of treatment
b) Usually are relieved after two days of abstinence
c) Can only be relieved by anti parkinsonism medication
d) Are a permanent condition due to irreversible central nervous system damage
e) May persist for several days or longer after alcoholic intake has stopped
24. Delirium tremens (withdrawal delirium) is regarded as a serious complication. What

are the signs and symptoms of delirium tremens
1. Tremulousness
2. Talkativeness
3. Anxiety, uncontrollable fear
4. Visual, tactile and auditory hallucinations
a) 1 and 2
b) 1, 2 and 3
c) 1, 3 and 4
d) 2, 3 and 4
e) 1, 2, 3 and 4
25. Mr Dixon was committed to an institution under the alcoholism and drug addiction
act 1966 and is thought well enough to leave hospital prior to the expiry of the
commitment to achieve this aim he should
a) Apply to the court for early release
b) Be discharged by the admitting officer
c) Be placed on trial leave by the doctor
d) Plan to attend the hospital as an outpatient
e) Plan to attend the national society of alcoholism and drug addiction
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26. Mr Dixon is diagnosed as having hepatitis B. With which of the following should
special precautions be taken
1. Toothbrush, sputum bottle and handkerchiefs
2. Handling the patients personal property
3. Electric shaver, crockery and cutlery
4. Blood products, syringes and needles
5. Urine soaked clothing and bedlinen
a) 1 and 2
b) 2 and 5
c) 1, 4 and 5
d) 3, 4 and 5
e) 2, 3, 4 and 5
27. How does alcohol cause indigestion

a) Increased pancreatic enzyme action
b) Decreased bile production
c) Irritates the stomach lining
d) Stimulates the stomach juices
e) Causes pain from a damaged liver
28. Alcoholics anonymous is an organisation which caters for

a) Anyone seeking assistance to overcome an alcohol problem
b) Anyone who is interested in helping people with alcoholism in the community
c) Relatives and friends of people with alcoholism who understand how to help them
d) Religious people who are willing to hive free assistance and counsel to people
suffering from alcoholism
e) Professional people with special skills and understanding about alcoholism and
how to overcome it
29. What change does mr Dixon need to make before he can be helped with his drinking
problem
a) Decide he wants to stop drinking
b) Recognise he can control his drinking habits
c) Be willing to change his way of life and make new friends
d) Admit that alcohol is causing problems in his life and that he needs help
e) Accept responsibility for his drinking and face up to his problem
30. Mr Dixon is prescribed antabuse. What is the action of antabuse

a) Inhibits albumin production in the liver
b) Inhibits the metabolism of alcohol by the liver
c) Induces vomiting by acting on the stomach lining
d) Interferes with the action of alcohol in the brain
e) Interferes with the excretion of alcohol form the kidneys
31. Antabuse may be prescribed to help a person with a drinking problem to

a) Remove the need for alcoholic beverages
b) Ease misery so benefits other treatment
c) Provide a disincentive to take alcohol
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d) Repair body tissues directly affected
e) Reduce the side effects of alcoholism
32. Mr Dixon says that some colleagues have asked him to go out for a drink at the hotel
with them. The best response by the nurse is
a) Would you like to spend some time with your colleagues
b) you definitely must not go, as you have no will power
c) Go but you are not allowed to drink as you are on antabuse
d) Would you like to discuss ways of dealing with this request
e) A few drinks will not hurt. Later we can discuss how you coped
33. Mr Dixon feels faint while in the bath. The first action of the nurse should be to
a) Call for help
b) Take his pulse
c) Hold his head out of the water
d) Pull the plug and let the water out
e) Get him out of the bath with assistance
34. For several years you have headed a ward where a registered nurse who works hard is
well intentioned and safe, but fails to practise at an acceptable level of competence.
Several of the staff complain about ‘carrying’ this nurse
a) Tell them to do their own work and not be concerned with others
b) Tell them to sort it out themselves
c) Tell them you will have a talk with her about her poor performance
d) Talk to the nurse and encourage her to try some other form of work
e) Tell the nurse to speak to the others who are complaining
35. One of the complaining staff says she is going to report this staff member to the
principal nurse, before you have had a chance to handle the situation. Do you
a) Encourage her to do this
b) Forbid her from doing this
c) Arrange for you and her to talk to the staff member together
d) Arrange for all the staff to have a meeting about it with the staff member
e) Ask the supervisor her advice
36. A patient tells you he has heard negative ‘whispers’ about the staff member from
other staff. He says her care of him has been exemplary. Do you
a) Chastise the gossiping staff
b) Thank the patient and say it will go no further
c) Use the information when trying to persuade the supervisor to intervene
d) Do nothing
e) Use the information positively when approaching the staff member about her
standards of care
37. The staff member who has been complained about comes to you and says she wants a
transfer to another ward as the staff have become unbearable to work with. Do you
a) Call all the staff together and challenge them with this
b) Call in the supervisor and ask her to intervene
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c) Use this opportunity to discuss with the staff member how she feels about her
standards of care
d) Say you will arrange a transfer
e) Arrange for her to have a holiday
38. A charge nurse friend of yours tells you this staff member has asked to go to her ward
and asks you your opinion of her work ability. Do you
a) Praise her work to get rid of her
b) Tell the charge nurse all the negative aspects
c) Suggest a trial period in another ward
d) Say she will have to ask nursing administration
e) Say you will let her have all the work appraisal records with the staff members
permission
39. Mr Williams is a 48 year old taxi driver who drinks heavily. Recently the pain in his
right leg which has become progressively worse, so he sought advise of his general
practitioner. The doctor told him he has atherosclerosis and arranged for him to be
seen by a specialist. He is then admitted for rest and investigations. Atherosclerosis is
best described as
a) An allergic response
b) A narrowing of the veins
c) A narrowing of the arteries
d) An inflammation of the arteries
e) A blocking of an artery
40. The reason to advise mr Williams to stop smoking is because smoking

a) Produces muscle spasm
b) Lowers cardiac output
c) Constricts the arterioles
d) Increases blood carbon dioxide levels
e) Causes venous stasis
41. The priority care for mr Williams ischaemic leg is to

a) Maintain complete bed rest
b) Stop mr Williams from smoking
c) Improve his peripheral circulation
d) Protect his leg from injury
e) Perform regular physiotherapy to the affected leg
42. The best advice to give mr Williams on discharge is for him to

a) Exercise regularly
b) Avoid exposure to cold and excessive heat
c) Take analgesics every four hours
d) Wear a supportive bandage
e) Remain on bed rest at home
43. Mr shaw a newspaper reporter aged 38, is married with three young children. They
have their own home and a large garden. Whilst cutting the lawn mr shaw suddenly
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had severe chest pain and felt unwell. His wife called the doctor who diagnosed a
myocardial infarction and sent for the ambulance. Mr shaw was admitted to the
coronary care unit. Myocardial infarction is best described as
a) Death of heart muscle
b) A clot in the coronary artery
c) Lack of blood to the heart muscle
d) Thickening of the arteries of the heart
e) Spasm of the coronary arteries
44. The nurses first action when the oscilloscope connected to a patient suddenly shows a
straight line is to
a) Initiate CPR
b) Call an emergency
c) Connect him to another monitor
d) Give a predcordial thump
e) Check his pulse rate
45. The most important observations for the nurse to make when mr shaw returns to the
ward to convalesce concern
a) His urinary output
b) The amount of exercise he does
c) The amount of activity that induces heart pain
d) The amount of food he eats
e) His pulse rate and blood pressure
46. The action potential of each heart beat begins in the

a) Sinoatrial node
b) Purkinje fibres
c) Atrioventricular node
d) Intercalated discs
e) Fossa ovalus
47. Muscle contraction occurs when

a) Myosin is converted into actin
b) Glucose is converted into muscle glycogen
c) Actin and myosin slide between each other
d) Smooth muscle is transformed into skeletal muscle
e) Hormones are released into the cross bridges
48. Mrs E is 60 she has pernicious anaemia. She is admitted to hospital for investigation
and treatment. As she is transferred from the wheelchair to her bed the nurse notes her
shortness of breath. Her dyspnoea was probably the result of
a) Hypoxia
b) Anxiety
c) Heart failure
d) Pneumonia
e) Splenomegaly
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49. The smooth beefy red appearance of mrs Es tongue is probably due to
a) Low grade infection
b) Chemical irritations
c) Mechanical trauma
d) Vitamin deficiency
e) Poor oral hygiene
50. A 21 year old male patient called david has been admitted to your ward having been
involved in a major house fire. He has suffered severe burns, involving the whole of
his trunk, and has sustained a compound fracture of his left femoral shaft. What % of
his body area has been burnt
a) 9%
b) 18%
c) 36%
d) 54%
e) 72%
51. At the time of injury david would have most benefited by the following treatment to
his burnt area
a) Removing his clothing
b) Application of cold water
c) Covering with a clean water
d) Covering with a clean sheet
e) Covering burnt area with antiseptic cream
f) Soak area in sodium bicarbonate
52. David is a normal healthy adult. What would his haemotocrit (packed cell volume)
have been before his accident
a) 25%
b) 45%
c) 65%
d) 85%
e) 95%
53. shock, due to a haemorrhage from a compound fracture of the femur is called
a) neurogenic
b) oligaemic
c) vasomotor
d) toxaemic
e) anaphylactic
54. 48 hours after his injury david is still receiving intra venous fluids and develops a
‘bubbly cough’ rising pulse rate and dyspneoa. Which of the following courses of
action will you and the doctor take
1. Obtain a sputum specimen for culture and sensitivity
2. Place david in trendelenbergs position
3. Prepare david for a chest aspiration
4. Administer oxygen to david
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5. Slow down or stop IV fluids
a) 1, 2 and 3
b) 2, 3 and 4
c) 3, 4 and 5
d) 1, 3 and 4
e) 1, 4 and 5
55. When davids condition has been stabilized he is to undergo surgery under a general
anaesthetic. His most important immediate pre operative care is to ensure that
a) His consent form has been signed
b) He has not drunk or eaten anything for 4-6 hours
c) His relatives have been notified
d) His pre medication has been given
e) He has emptied his bowels
56. Immediately following surgery the most important role of the recovery nurse is to
a) Record davids pulse and blood pressure
b) Maintain a clear airway
c) Observe his dressing for haemorrhage
d) Assess davids level of consciousness
e) Give david pain relieving medication
57. David returns to the ward with closed suction drainage to his leg wound. The purpose
of closed suction drainage in a surgical wound is to
a) Prevent haematoma formation
b) Allow the nurse to measure blood loss accurately
c) Prevent david from moving the body part operated on
d) Draw the edges of the wound together
e) Prevent tissue hypoxia
58. The purpose of a dry dressing to a wound is to

1. Protect the wound from contamination
2. Pull the edges of the wound together
3. Provide a means for the application of medication
4. Protect the wound from friction
5. Allow wound debridement
a) 1, 2 and 3
b) 2, 3 and 4
c) 1, 3 and 4
d) 2, 3 and 5
e) 2, 4 and 5
59. You have a close friend mrs Alexander age 85. While visiting with her she asks you if
she can change her dietary habits. You reply that elderly women need a diet that is
a) Low in protein, high in fibre
b) High in phosphorus, low in fibre
c) High in protein, high in calcium
d) High in thiamine, high in copper
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e) Low in phosphorus, how in calcium
60. The majority of elderly clients live in

a) Nursing homes
b) Boarding homes for the elderly
c) Their own homes
d) Retirement villages
e) Flats for the elderly
61. Mrs Alexander complains of constipation and she asks you for suggestions of
measures to be used on an occasional basis. You recommend
a) Milk of magnesia
b) Soap suds enema
c) Dulcolax suppositories
d) Tap water enema
e) Senekot tablets
62. Over the last several months you have noticed that you must talk louder when
speaking to mrs Alexander. You are aware that mrs alexanders hearing difficulty is
most likely due to
a) Serious otitis media
b) Conductive deficit
c) Presbycusis
d) Otosclerosis
e) Otitis externa
63. You notice that mrs Alexander also appears lonely. To help alleviate her loneliness
you suggest that she
a) Make a life review scrapbook which focuses on important occasions in her life
b) Join an exercise class for elderly clients at the YMCA
c) Phone her son who lives in a distant town at least twice a week
d) Pursue her needlework interest by joining a needlework club
e) Contact her son and organise a holiday visit with him
64. Mrs Alexander states that she is having difficulty sleeping at night. You suggest that
she
a) Ask her general practitioner to prescribe a hypnotic
b) Drink a warm cup of tea prior to bedtime
c) Engage in an active exercise programme once hour before bedtime
d) Drink a glass of warm milk at night and take naps as needed
e) Keep herself awake during the day with plenty of activity
65. The skin change which mrs Alexander is most likely to exhibit is
a) Increased elasticity
b) Decreased number of sweat glands
c) Increased subcutaneous fat
d) Decreased number of epidermal cells
e) Increased melanin production
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66. Mrs Alexander mentions that her skin is dry, particularly in winter. You suggest to her
that she
a) Use bath oils each time she bathes
b) Applies a moisturising cream after her bath
c) Uses a cooler water temperature when she bathes
d) Applies an astringent agent after her bath
e) Take a multivitamin tablet daily
67. Mr Matthews (65) is admitted to your ward with the complaint of gradual loss of
vision. What occupies most of the anterior chamber of the eye
a) Vitreous body
b) Aqueous fluid
c) Perilymph
d) Endolymph
e) Optic disc
68. The pathophysiology of chronic open angle glaucoma is

a) Pressure of the anteriorly displaced iris against the filtration network
b) Clogging of the aqueous outflow tract with inflammatory debris
c) Thickening of the meshwork covering the canal of schlemm
d) Overproduction of aqueous humor by hypertrophied ciliary body
e) Degeneration of sclera veins preventing absorption of aqueous humor
69. Mr Matthews should be advised to protect his eyes for an hour or two following
intraocular pressure readings because
a) The weight of the pressure measuring device may rupture sclera vessels
b) Mechanical irritation of the eye produces severe temporary photophobia
c) Corneal anaesthesia renders the eye insensitive to the presence of a foreign body
d) Mineral oil used as a lubricant retards normal lacrimal secretions
e) His eyes will need time to restore their normal surface tensions following
tonometry
70. Pilocrpine is effective in treating glaucoma because it

a) Draws the iris away from the cornea allowing aqueous to drain from the anterior
chamber
b) Depresses cells of the ciliary body responsible for aqueous humor production
c) Relaxes extraocular muscles permitting increase in the diameter of the globe
d) Closes the opening between the iris and the lens preventing forward movement of
the vitreous
e) Fosters aqueous outflow by dilating the canal of schlemm
71. Mr Matthews 40 year old son asks you if he will get glaucoma when he is older.
Which of the following responses by the nurse would be most helpful
a) Tell me how you feel about the possibility of your getting glaucoma
b) You have made a useful observation. It would be a good idea to have your eyes
examined now
c) Scientists haven’t yet worked out all the genetic patterns involved, but glaucoma
is inheritable
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d) In this day and age there are so many diseases which have been found to be
inherited
e) You are obviously worried about your eyesight, so i suggest you have your eyes
examined
72. Cathy is 4 years old and is admitted suffering from glomerulonephritis. She has
passed red urine at home, has a puffy face and is lethargic and anorexic. Which of the
following will be most reduced by bedrest
a) Oedema
b) Malaise
c) Haematuria
d) Hypertension
e) Proteinuria
73. It would be most important to know the following about cathy; she has
a) Lost weight since yesterday
b) Not eaten her lunch
c) Started vomiting
d) worsening haematuria
e) experienced generalised itching
74. one of the following disorders is considered contributory to cathys condition – recent
a) measles
b) cold sores
c) red eye
d) mumps
e) tonsillitis
75. one of the following foods should be omitted when tempting cathy to eat
a) jelly beans
b) bananas
c) lollies
d) crisps
e) chocolate
76. marsha 9 years old is admitted suffering from rheumatic fever. She lives with her
parents 3 brothers and 2 sisters in a flat. On admission her temperature is elevated and
she has painful joints. The most important intervention is providing care during the
acute phase of her illness is
a) maintaining contact with her parents
b) physical and psychological rest
c) a nutritious diet
d) maintaining her interest in school
e) preventing infection
77. the doctor orders salicylates for marsha. The nurse should be aware that some of the
toxic symptoms of this drug are
a) tinnitus and nausea
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b) dermatitis and blurred vision
c) drowsiness and charge in breath odour
d) chills and pyrexia
e) leg cramps and oliguria
78. the cardiac valves most often affected as a result of rheumatic fever
a) aortic and tricuspid
b) tricuspid and mitral
c) tricuspid and pulmonary
d) mitral and pulmonary
e) mitral and aortic
79. what is the most likely cause of abdominal pain and offensive lochia in the
pneuperium
a) a pelvic abscess
b) venereal disease
c) retained products
d) a cervical infection
80. what is the physiological reason for the administration of vitamin K to the newborn
a) prevents clotting
b) prevents jaundice
c) promotes clotting
d) increases the prothrombin time
81. treatment of renal failure is aimed at

a) increasing the flow of urine from the kidney
b) preventing the loss of electrolytes through the kidneys
c) decreasing the workload of the kidneys
d) preventing protein depletion by increasing the protein intake
e) increasing the removal of electrolytes through the excretion of urine
82. typical symptoms of hypothyroidism include

a) increased appetite and weight loss
b) muscle twitching and dysphagia
c) consistant weight gain and increasing fatigue
d) increased thirst and weight loss
83. a client who is paralyzed down one side is said to be

a) guadriplegic
b) hemiplegic
c) paraplegic
d) monoplegic
e) tetraplegic
84. a client who experiences aphasia has lost his

a) ability to speak
b) hair from his head
c) sense of taste
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d) appetite for food
e) ability to swallow
85. angina pectoris occurs as a direct result of

a) reduction in the volume of blood passing through the chambers of the heart
b) an increase in the volume of blood passing through the chamber of the heart
c) a reduction in the blood supply to the muscles of the heart
d) a complete absences of the blood supply to a portion of the myocardium
e) an increase in the blood to the muscles of the heart
86. which is the most important health information kiwifruit farmers need to know
a) how to complete accident compensation claims
b) legislation relating to the health of farm workers
c) wear protective clothing when using toxic sprays
d) prevention of disease transmitted from animal to men
87. the problem of hydatids can be easily corrected because

a) eggs survive only in sheep and the cycle can be interrupted
b) the hydatid life cycle is dependent on the dog as the carrier
c) humans seldom become contaminated because of strict handwashing
d) the parasite can only survive inside the bodies of dogs and sheep
88. which of the following is an offence under the hydatids act 1959
a) feeding raw offal to any dogs in your care
b) failure to report stray, unregistered dogs
c) tenuicollis worms in lambs at the time of killing
d) tenuicollis cysts in any purged material from dogs
89. mr wood aged 42 has a mole on his back which he asks you to look at. Which of the
following changes are characteristic of a melanoma
a) a change in colour and decrease in size
b) bleeding from and decrease in size
c) increase in size and change in colour
d) bleeding from and increase in size
90. mr brown complains that he has blurred vision. What is the most appropriate nursing
action to take
a) check his blood glucose level
b) advise him to get stronger glasses
c) explain that he should wear dark glasses
d) suggest he visits his doctor for a checkup
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STATE EXAMS 35
1. in planning care of a client admitted to ICU with pneumothorax the nurse should
recognise that an opening in the chest wall, causes the lung on that side to
a) expand due to intake of atmospheric air
b) collapse due to disturbed negative pressure in the pleural space
c) expand due to altered lung pressures
d) collapse due to disturbed positive pressure in the pleural space
2. oedema may be caused by

a) increasing capillary permeability
b) increasing hydrostatic pressure
c) reducing plasma proteins
d) increasing interstitial proteins
e) any of the above
3. Kevin aged 19 is admitted with an acute attack of asthma. During an asthma attack
the reaction to excessive histamine release would be
1. Bronchospasm
2. Bronchodilation
3. Excessive production of mucous
4. Production of IGE antibodies
5. Tachycardia
a) 1, 3 and 4
b) 1, 3 and 5
c) 1, 4 and 5
d) 2, 3 and 4
4. Which of the following signs would a person be admitted to hospital with an acute
attack of asthma present with
a) Dyspnoea, tachycardia, anxiety
b) Dyspnoea, bradycardia, frothy sputum
c) Tachycardia, chest pain, pallor
d) Increased anxiety, sweating, chest pain
5. It has been suggested that _______________ asthma may be caused by

environmental antigens
a) Extrinsic
b) Intrinsic
c) Nonatopic
d) B and c
6. A client diagnosed with acute exacerbation of asthma, is dyspneic orthopneic and

irritable. Her admission history was partially done by on the previous shift. Your best
course of action would now be
a) Wait or try to obtain the necessary information from the clients family
b) Obtain the information from the client
c) Obtain the information from the medical notes
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d) Obtain part of the history now and the rest later
7. When a client diagnosed with liver failure secondary to cirrhosis of the liver the nurse
would assess which of the following signs indicating portal hypertension
a) Fluid wave on abdominal percussion
b) Dark frothy urine
c) Clay coloured stools
d) Tremors of the hands
8. Portal hypertension results from which of the following pathophysiologic processes

a) Obstructed blood flow from the GI tract to the liver
b) Diversion of ascetic fluid from the peritoneal cavity back to the venous system
c) Rupture of oesophageal varices
d) Obstruction of bile flow through the common bile duct
9. When caring for client following a large 2/3 litre paracentesis the nurse should focus
on monitoring for which of the following complications to ensure safe care
a) Respiratory distress
b) Encephalopathy
c) Bleed from the site
d) Vascular collapse
10. A client is diagnosed with renal calculi. Nursing interventions to help prevent stone
recurrence would include
a) Encouraging fluid intake to 1000ml daily
b) Explaining the need for decreased physical activity
c) Encouraging dietary modification based on the stones composition
d) Teaching the client to care for ileal conduit
11. ________________ is generally relieved by sitting up in a forward leaning position

a) Hyperpnoea
b) Orthopnoea
c) Apnoea
d) Dyspnoea on exertion
12. In a client with emphysema, hypoventilation could initially cause

b) Respiratory acidosis
13. A client is anxious and is hyperventilating. In order to prevent respiratory alkalosis

the nurse will
a) Administer oxygen
b) Instruct the client to pant
c) Have the client breathe deeply and slowly
d) Have the client breathe into a paper bag
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14. A district nurse is sent to assess a new client with cor pulmonale. This term refers to
a) Enlargement of the pulmonary artery
b) Enlargement of the right ventricle
c) atrophy of the right ventricle
d) Giant bullae growth on the lung
15. Tony buffer 54 years old has a long history of smoking. He decides to have lung and
blood studies done because he is very tired is short of breath and just does not feel
good. His blood gases reveal the following findings pH 7.3 HCO3 27 CO 58 tonys
condition may be
16. A 79 year old client has pale cold feet bilaterally, no hair tufts on toes, and a
circumscribed 3cm lesion on the plantar surface of the first metatarsal joint. Which of
the following is the most likely source of the clients problem
a) Insufficient venous circulation
b) Venous thrombosis
c) Expected age related physiological changes
d) Insufficient arterial circulation
17. On assessing and older client the nurse notes that the left leg is swollen and warm,
with palpable pedal pulses; an open, wet ulcer above the medial malleolus; and thick,
course, brown pigmented skin surrounding the ulcer. The probable cause of the ulcer
would be
a) Acute deep vein thrombosis
b) Chronic venous insufficiency
c) Chronic arterial insufficiency
d) Chronic lymphoedema
18. Interventions to relieve discomfort associated with chronic arterial occlusive vascular
disease are directed at
a) Improving venous return from the involved extremity
b) Avoiding narcotic analgesic drugs
c) Preventing oedema in the extremities
d) Increasing circulation to the extremities
19. Normal physiological changes in the aging pulmonary system include

a) Decreased flow resistance
b) No change in gas exchange
c) Stiffening of the chest wall
d) Improved elastic recoil
20. A nurse educator explains to a group of new graduates that normally ventilation is
regulated by the central chemoreceptor response to levels of
a) O2
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b) pH
c) CO2
d) pCO2
21. approximately 1000ml (1L) of oxygen is transported to mr jones cells each minute.
Most of the oxygen is transported
a) dissolved in his plasma
b) loosely bound to his haemoglobin
c) in the form of CO2
d) as a free floating molecule
22. mary a 46 year old woman is admitted to your ward with a chest infection due to
acute exacerbation of chronic obstructive pulmonary disease (COPD). A person with
emphysema is susceptible to respiratory infections primarily because
a) failure of her bone marrow to produce phagocytic white blood cell
b) retention of tracheobronchial secretions
c) decreased detoxification of body fluids by compressed liver cells
d) persistent mouth breathing associated with dyspnoea
23. emphysema differs from chronic bronchitis is that

a) emphysema obstruction results from mucous production and inflammation
b) emphysema obstruction results from changes in lung tissues
c) chronic bronchitis obstruction results from changes in lung tissue
d) there are no visual difference between the two conditions
24. the tissue change most characteristic of emphysema is

a) accumulation of pus in the pleural space
b) constriction of capillaries by fibrous tissue
c) filling of air passages by inflammatory coagulum
d) over distension inelasticity and rupture of alveoli
25. which of the following results of emphysema is primarily responsible for

cardiomegaly
a) hypertrophy of muscles encircling the bronchi
b) increased pressure in the pulmonary circulation
c) decreased number of circulating red blood cells
d) secretion of excessive amounts of pericardial fluids
26. which of the following statements indicates that a 70 year old stroke client with right
lower paralysis understands ways to prevent pressure sores
a) ill shift my weight while sitting, and examine my right foot daily
b) ill spend my day in a reclining chair and massage my right leg every day
c) ill wear my support stockings and get my daughter to give me a good back rub
every night
d) ill sit on an inflatable ring in my chair and wear comfortable non skid shoes
27. a client diagnosed with congestive heart failure is placed digoxin 0.125mg daily. A
nursing intervention for this medication is
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a) do no administer if radial pulse is less than 60
b) hold medication if digoxin level is low
c) administer if apical pulse is 84
d) administer if potassium level is 3.1mEq/L
28. the nurse would assess which of the following signs and symptoms in the client
whose serum potassium level is 3.1mEq/L
a) anorexia, fatigue, and muscle cramping
b) tetany, elevated temperature and seizures
c) hot, flushed skin, dieresis and hypotension
d) headache, drowsiness and tachypnoea
29. which of the following data would lead the nurse to establish falling precautions for
an elderly ambulatory hospital client being treated for congestive heart failure and
depression
a) use of cathartics
b) chronic depression
c) excessive dieresis
d) slow ambulation
30. a client is admitted with complaints of lethargy, confusion during the last few days
and lose of appetite with nausea and vomiting over the last two weeks. The clients
ECG shows a shortened QT interval. Based on this data the nurse would suspect that
the client is experiencing
a) hyponatremia
b) hypermagnesemia
c) hypercalcemia
d) hyperkalemia
31. a 48 year old complains of chest pain. Signs and symptoms that would support a
diagnosis of myocardial infarction would include
a) jugular vein distension and hepatomegaly
b) fever and petechiae over the chest area
c) nausea and vomiting and cool, clammy, pale skin
d) pericardial friction rub and absent apical pulse
32. teaching for the client taking GT or glycerol with nitrate for angina would include
a) instructing the client to take the nitroglycerin regularly
b) explain to the client that a subsequent headache indicates ineffective medication
c) instructing the client to put the tablet on the tongue and swallow after the tablet
dissolves
d) teaching the client to take a tablet every 5 minutes (x3) when chest pain occurs
33. a female client is diagnosed with unstable angina. The nurse finds her crying because
she fears she will become a burden to her husband. Which of the following nursing
diagnoses would be appropriate
a) impaired verbal communication
b) ineffective family coping
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c) relationship difficulties
d) fear due to knowledge deficit
34. which of the following steps should a client with periodic angina pain take first when
pain occurs at home
a) take sublingual nitroglycerin and lie down
b) do mild breathing exercises
c) take an extra long lasting nitrate tablet
d) sit down and relax
35. the nurse detects premature ventricular contractions and (PVCs) on the ECG of a
client who had a mitral valve replacement 2 days ago. PVCs may be dangerous
because they
a) significantly increase cardiac workload
b) may lead to ventricular tachycardia or fibrillation
c) are the most common cause of myocardial infarction
d) decrease heart rate and blood pressure
36. which of the following signs and symptoms would the nurse assess for the client
diagnosed with chronic open angle glaucoma
a) gradual loss of peripheral vision
b) cloudy appearing lens
c) no pain or eye redness
d) complaints of floating spots
37. which of the following post operative assessment findings would indicate intraocular
haemorrhage
a) temperature elevation
b) diplopia
c) visual floaters
d) eye pain
38. when teaching a client how to do a testicular self examination the nurse should advise
him that
a) tenderness is an early sign of testicular cancer
b) the testes should feel smooth and oval with no masses
c) masses are difficult to find and prognosis for cancer cure is poor
d) a firm pea size lump may be normal
39. the nurse and client would identify which the following outcomes for a client
diagnosed with a sexually transmitted disease
a) the client demonstrates increased lymphadenopathy
b) the client reports decreased sexual activity
c) the client reports decreased pain and discharge
d) the client chooses sexual partners who do not need treatment
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Bleeding within the skull results in increased intracranial pressure because
would check is
d) Motor function
42. Papillary dilation occurs when herniating brain tissue

a) Compresses the occulomotor nerve
d) Paralyses the occular muscles
44. A client has hypertension and is started on medication. You ask about the clients
usual stressors and ways of dealing with them because
a) The major cause of primary hypertension is excessive stress
b) Measures to reduce stress are important when treating hypertension
c) To foster a better nurse client relationship
d) Stress must be reduced before learning can occur
45. A client is admitted for a transient ischemic attack. The clients family asks what is a
TIA. The best response would be
a) I think you should ask the doctor would you like me to call her for you
b) The blood supply to the brain has decreased and permanent damage has occurred
c) A TIA is a temporary interruption of blood flow to the brain but the symptoms are
temporary
d) TIA means transient ischemic attack
46. An expected outcome during the acute phase for the client with a stroke includes
a) Airway patent
b) Contractures treated
c) Minimal cerebral perfusion
d) Lowered fluid and electrolyte levels
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48. A client is admitted to ED following a car accident. He complains of abdominal

discomfort. The nurse encourages the client to lie down. The reason for this action is
a) To decrease abdominal pain
b) To decrease the risk of dislodging an intra abdominal clot
c) To facilitate peristalsis
d) To decrease the risk of peritoneal infection
49. A client sustained moderate concussion. He has a Glasgow coma scale score of 7.
Which of the following interventions would you include in your care plan
a) Decrease stimuli, monitor vital signs and neurological status nurse him flat on his
back
b) Gradually increase stimuli, monitor vital signs and neurological status, elevate the
head of the bed 60 degrees
c) Encourage family involvement, reduce monitoring at night to allow client to rest,
elevate the head of the bed 60 degrees
d) Decrease stimuli, monitor vital signs and neurological status elevate the head of
the bed 30 degrees, positioning the client on his side
d) Blanching, hypertension and parathesia

a) Severe pain, motor compromise and a pins and needles sensation
53. A comminuted fracture is characterised by

a) A partial break in bone continuity
b) Injury in which two bones are crushed together
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c) An injury in which the bone is broken into two or more pieces
d) An injury in which the bone fragments through the skin
54. A client with multiple fractures is at risk for a fat embolism. What early sign should
you monitor for
a) Haematuria
55. Following an application of a full arm cast a client complains of deep throbbing
elbow pain. You note diminished capillary refill in the fingers. You should
a) Notify the doctor immediately and prepare to divalve the cast
b) Cut a window in the cast over the elbow area and check for infection
c) Elevate the arm, apply ice packs and asses hourly
d) Administer prescribed analgesics and notify the doctor
56. The priority nursing diagnosis for a client with an ear drum perforation would be
a) Knowledge deficit regarding general ear care
b) Sensory/perceptual alteration relating to hearing loss
c) Risk for injury related to infection
d) Pain related to vertigo, nausea and vomiting
57. Hearing loss resulting from a large amount of dry, hard wax in the ear canal would be
classified as
a) Conductive
b) Perceptive
c) Sensorineural
d) Impacted
58. Neil a 17 year old is hit on the head by a cricket ball while playing with a friend at
home. He fell against the glasshouse, severely lacerating his right wrist. He was
unconscious for about 5 minutes. On arrival at the emergency department he was
drowsy. Neil should be
a) Sent home with an adult to observe him
b) Admitted to a neurosurgical ward
c) Observed in hospital
d) Sent home with head injury instructions
59. Circulatory shock can best be described as a condition in which there is

a) A state of hypotension
b) Loss of blood
c) Loss of consciousness due to blood loss
d) Inadequate blood flow to meet the metabolic needs of the body tissues
60. Causes of hypovolemic shock include

a) Vomiting and loss of body fluids
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b) Allergic reactions to drugs
c) Cardiac failure
d) Hypoglycemica

62. In shock one of the bet indicators of blood flow to vital organs is
a) Rate of blood and fluid administration
b) Blood pressure
c) The colour and temperature
d) Urine output
63. Oliguria an early sign of shock occurs for what reason

a) Cessation of glomerular filtration
b) Acute tubular necrosis
d) Sympathetic stimulation
64. A person admitted to the emergency room with trauma and an estimated blood loss of
1200 to 1400 mls has a blood pressure of 110/70 mmHg and a heart rate of 120 beats
per minute. The best explanation for these observations would be that
a) The persons actual blood loss was less than the original estimated loss
c) The cause of the bleeding is now under control and the increased hear rate is due
to anxiety
65. The pale cool and clammy skin that is often observed in an individual with shock, can
be explained in terms of
a) Loss of red blood cells
b) Bodys attempt to shunt blood to vital organs by constricting skin vessels
c) Decreased metabolic needs that accompany shock
d) Bodys attempt to conserve heat loss
66. Which of the following represents the most appropriate criterion for evaluating a
clients management of elevated phosphate levels in chronic renal failure
a) The client eliminates dairy products from the diet
b) The client increases dietary calcium intake
c) The client takes iron supplements with meals
d) The client takes phosphate binding medications with meals
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67. The spouse of a client with chronic renal failure confides to the nurse that the client
has been confused, irritable, and paranoid and that as a result is causing marital
problems. Which of the following diagnoses would you make
a) Noncompliance with prescribed medication regimen
b) Self esteem disturbance related to lose of kidney function
c) Anxiety related to the dialysis procedure
d) Altered family processes related to the effects of chronic renal failure
68. When teaching a client about home peritoneal dialysis the nurse should explain that
the primary concept in prevention of peritonitis is to
a) Consume a high sodium diet
b) Increase the amount of dextrose in the dialysis solution
c) Maintain aseptic technique throughout the procedure
d) Add heparin to the dialysis solution
69. Which of the following statements regarding allergic dermatitis is correct

a) Reaction to the allergen is immediate
b) Contact dermatitis always results from a chemical irritant
c) The effects of allergic dermatitis rarely progress beyond skin rash
d) The range and intensity of reaction varies depending on the allergen
70. When preparing a client for magnetic resonance imaging the nurse should
a) Obtain informed consent and administer prescribed medication
b) Cleanse the injection site using aseptic technique
c) Remove any jewellery and inquire about metal implants
d) Assess for allergies to seafood and iodine
71. A benign neoplasia

1. Grows very slowly
2. Is usually surrounded by well defined capsule
3. Consists of cells that only form tissues in a very disorganised manner
4. Is composed of goblet cells
a) 1,2 and 3
b) 1, 2 and 4
c) 1, 3 and 4
d) 2, 3 and 4
72. Which of the following characteristics generally indicate a malignant tumor

1. Lack of capsule
2. More rapid growth
3. Infiltrates normal tissues
4. Respects other cells boundaries
a) 1, 2 and 3
b) 1, 2 and 4
c) 1, 3 and 4
d) 2, 3 and 4
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73. Malignant tumors often spread to parts of the body away from the primary site of the
cancer. This invasive process is called
a) Anaplasia
b) Metastasis
c) Neoplasm
d) Transformation
74. A client who has been receiving radiation therapy for breast cancer complains of
dysphagia and skin texture changes at the radiation site. To help reduce the risk of
complications and to enhance healing the nurse would advise the client
a) Apply heat to the radiation site to increase metabolic activity
b) Eat a diet high in protein and calories to optimise tissue repair
c) Apply cool packs to the radiation site to reduce swelling
d) Drink warm fluid frequently throughout the day to relieve discomfort on
swallowing
STATE EXAMS 36
1. Typically the pain of angina pectoris occurs on exertion and improves after resting.
This is because
a) Increased effort causes constriction of the coronary arteries
b) The heartbeat is weak
c) The sinoatrial node is not receiving sufficient stimulation
d) The blood supply to the myocardium is inadequate for increased activity
2. A 48 year old complains of chest pain. Signs and symptoms that would support a
diagnosis of myocardial infarction would include
a) Jugular vein distension and hepatomegaly
b) Fever and petechiae over the chest area
c) Nausea, vomiting and cool clammy pale skin
d) Pericardial friction rub and absent apical pulse
3. What symptoms are commonly associated with an acute MI

a) Crushing substernal pain, diaphoresis nausea and dyspnoea
b) Syncope increased urine output and decreased respiratory rate
c) Chest pain relieved by rest syncope tachycardia and dyspnoea
d) Nausea tinnitus diaphoresis and chest pain relieved by nitroglycerin
4. The chief pharmacological action of glyceryl trinitrate is to

a) Constrict cardiac chambers
b) Stimulate myocardial fibres
c) Accelerate cardiac contraction
d) Dilate coronary arteries
5. Angina is caused by
a) Friction between the visceral and parietal pericardium
b) A decrease in the alveolar surface for gas exchange
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c) Increased blood pressure in the pulmonary circulation
d) An inadequate supply of oxygen to the myocardium
6. Before administration of digoxin you record a clients radial pulse. You would
withhold this medication if the pulse was
a) 90 beats per minute or above
b) 80 beats per minute or below
c) 70 beats per minute or below
d) 60 beats per minute or below
7. Congestive heart failure can best be described as

a) Excessive hypertrophy of the heart
b) Inability of the heart to pump sufficient blood to meet the needs of the body
c) A condition that develops because of coronary heart disease
d) The impaired pumping ability due to cardiac dysrhythmias
8. Signs and symptoms of left sided heart failure include

a) Cyanosis cough with frothy sputum dyspnoea
b) Oedema of the dependent extremities and orthopnea
c) Enlargement of the liver and anorexia
d) Cyanosis and peripheral edema
9. It is thought that ankle oedema develops in congestive heart failure as a consequence

of
a) Elevated hydrostatic pressure in capillaries distal to distended veins
b) The congested liver which produces an excess quantity of albumin
c) Retention of sodium and water in the inadequately perfused kidney
d) Decreased osmotic pressure of the blood secondary to anaemia
10. The usual cause of myocardial infarction is

a) Critical reduction in blood supply in the coronary arteries
b) Marked increase in muscle metabolism
c) Sudden irregularity of cardiac contraction
d) Gradual reversal of impulse conduction
11. All of the following are causes of acute renal failure except
a) Glomeruloneophritis
b) Acute urinary tract obstruction
c) Nephrotoxic
d) Diabetic nephropathy
12. When a client with chronic renal failure is evaluated one of the hallmarks of renal
disease is
d) Respiratory isolation
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13. If a client is experiencing alkalosis the clients kidneys will compensate by
a) Retaining hydrogen ions
b) Retaining bicarbonate ions
c) Excreting sodium ions
d) Excreting potassium ions
14. The nurse plans to weigh a client to determine the clients fluid balance status. The
nurse plans to weigh the client
a) Before breakfast
b) After breakfast
c) After supper
d) Before bedtime
15. The type of pressure whereby force is exerted by a fluid against the container wall is
termed
a) Filtration
b) Oncotic
c) Metabolic
d) Hydrostatic
16. The nurse is caring for a client with congestive failure when the client asks the nurse
‘why are my hands so swollen’ the nurse should explain to the client that the oedema
is due to the retention of
a) Sodium
b) Potassium
c) Magnesium
d) Phosphorus
17. Water movement between the intracellular fluid compartment and the extracellular
compartment is primarily a function of
a) Osmotic forces
b) Plasma oncotic pressure
c) Antidiuretic hormone
d) Filtration
18. Oedema may be caused by

a) Increasing capillary permeability
b) Increasing hydrostatic pressure
c) Reducing plasma proteins
d) Any of the above
19. The tissue change most characteristic of emphysema is

a) Accumulation of pus in the pleural space
b) Constriction of capillaries by fibrous tissue
c) Filling air passages by inflammatory coagulum
d) Over distention, inelasticity and rupture of alveoli
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20. When planning care for a client with chronic lung disease who is receiving oxygen by
was of nasal cannula the nurse expects that
a) The oxygen should always be humidified
b) The rate will be 2 litres per minute or less
c) Arterial blood gases will be drawn every 4 hours
d) The rate will be 6 litres per minute or more
21. The pathophysiology of asthma includes

1. Spasm of bronchial muscles
2. Dilation of terminal bronchioles
3. Oedema of bronchial mucosa
4. Excessive mucous production
5. Filling of alveoli with exudates
a) 1
b) 4
c) 1, 3 and 4
d) 2, 3 and 5
22. Mr parks has chronic obstructive pulmonary disease. The nurse has taught him pursed
lip breathing that helps him by
a) Increasing carbon dioxide, which stimulates breathing
b) Teaching him to prolong inspiration and shorten expiration
c) Helping liquefy his secretions
d) Decreasing the amount of air trapping and resistance
23. Which of the following signs would a person admitted to hospital with an acute attack
of asthma present with
a) Dyspnoea, tachycardia anxiety
b) Dyspnoea bradycardia frothy sputum
c) Tachycardia chest pain pallor
d) Increased anxiety sweating chest pain
24. A nurse educator explains to a group of student nurses that normally ventilation is
regulated by the central chemoreceptor response to levels of
a) O2
b) pH
c) Co2
d) pCO2
25. salbutamol (ventolin) is given to the patient in order to produce which of the
following effects
a) relaxation of bronchial spasm
b) acceleration of pulmonary circulation
c) reduction of the amount of respiratory secretion
d) liquefaction of the respiration secretions
26. a home health nurse is sent to assess a new client with cor pulmonale. This term refers
to
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a) enlargement of the pulmonary artery
b) enlargement of the right ventricle
c) atrophy of the right ventricle
d) giant bullae growth on the lung
27. which of the following positions is most comfortable for a person with emphysema
a) lying flat in bed
b) reclining on his/her left side
c) sitting on the edge of the bed
d) lying flat on their back (supine)
28. a client is anxious and is hyperventilating. In order to prevent respiratory alkalosis the
nurse will
a) administer oxygen
b) instruct the client to pant
c) have the client breathe deeply and slowly
d) have the client breathe into a paper bag
29. a district nurse instructing client with chronic obstructive pulmonary disease about the
disease explains that gas exchange from the pulmonary system to the blood occurs
through
a) osmosis
b) diffusion
c) active transport
d) oncotic pressure
30. which of the following blood gas values are considered within the normal range
a) pH 7.25; pCO2 25 to 35mmHg pO2 50 to 100mmHg
b) pH 7.35 to 7.45 pCO2 45 to 50 mmHg pO2 90 to 100mmHg
c) pH 7.35 to 7.45 pCO2 35 to 45 mmHg pO2 80 to 100mmHg
d) pH 7.30 to 7.40 pCO2 30 to 45 mmHg pO2 70 to 100mmHg
31. excessive thirst for people with diabetes mellitus is a result of

a) need for increased amounts of water to hydrolyse food during digestion
b) loss of excessive body water due to increased daily urine volume
c) reflex adaptation to a sustained elevation of body temperature
d) compensatory adjustment to decreased production of posterior pituitary hormone
32. characteristically respirations of the client in diabetic acidosis are

a) shallow and irregular
b) uneven in rate and depth
c) deep rapid with acetone breath (kussmaul)
d) rapid and shallow
33. what is the result of fasting in a diabetic person receiving insulin

a) hypoglycaemia
b) hyperglycaemia
c) underproduction of insulin
d) none of the above
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34. insulin is necessary for normal body function because it
a) stimulates the liver to release glucose
b) causes the breakdown of fats for energy
c) cause excess glucose to be excreted by the kidneys
d) stimulates body cells to take in glucose
35. why do some diabetic patients often experience delayed wound healing in lower limbs
a) glucose aids in healing
b) most diabetics are obese
c) impaired circulation
d) impaired metabolism of vitamin C
36. insulin dependent diabetes mellitus (IDDM) is common in persons under age 30yrs
who produce
a) no insulin
b) ketoacids
c) minimal insulin
d) increased insulin
37. suitable emergency treatment at onset of a hypoglycaemic attack would be to

a) record blood pressure and pulse and report to the doctor
b) obtain a blood glucose level and record vital signs
c) give the patient a glucose drink
d) smell the patients breath for acetone
38. a normal C.B.G (capillary blood glucose) reading is within the range of
a) 1-5 mmol/L
b) 4-7 mmol/L
c) 4-12 mmol/L
d) 3-10 mmol/L
39. Helen has been admitted to the ward in which you are working for stabilisation of
diabetes mellitus. She is charted a short acting and long acting insulin. Insulin cannot
be given orally because it is
a) Irregularly absorbed from the intestine
b) Absorbed too slowly to be effective
c) Rendered inactive by gastro intestinal enzymes
d) Excreted before a sufficient amount has been absorbed
40. Helens initial presenting signs and symptoms prior to diagnosis would probably have
included
a) Polydipsia weight loss polyuria
b) Weight loss itchy skin cough
c) Polyuria visual disturbances cough
d) Itchy skin polyuria weight gain
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41. A flight attendant has acquired hepatitis A after a trip abroad. The best way to prevent
the spread of this disease is
a) Testing blood supplies
b) Good personal hygiene
c) Antibiotic therapy
d) Respiratory isolation
42. A client who has cirrhosis of the liver, will present with jaundice and
a) Paresthesias
b) Redness of the palms
c) White facial blotches
d) Swollen moist skin
43. Common signs and symptoms associated with liver dysfunction include
a) Diarrhoea and increased blood clotting
b) Coma, disseminated intravascular coagulation and oedema
c) Jaundice, ascites and excess bleeding
d) Gastrointestinal bleeding and fever
44. Which o fthe following does the liver store

a) Excess carbohydrates
b) Cholesterol
c) Plasma proteins
d) Aldosterone
45. Parkinsonism has several characteristic symptoms. When assessing a client with this
disease the nurse may observe
a) Normal speech
b) Facial tremor
c) Shuffling gait
d) Fast body movement
46. In understanding the pathophysiology of parkinsons disease the nurse is aware that his
degenerative process is caused by a loss of
a) Dopamine
b) Zona incerta
c) Acetycholine
d) Gamma amino butyric acid
47. Which of the following characteristics generally indicate a malignant tumor

a) Lack of capsule
b) More rapid growth
c) Infiltrates normal tissues
d) All of the above
48. Malignant tumors often spread to parts of the body away from the primary site of the
cancer. This invasive process is called
a) Anaplasia
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b) Metastasis
c) Neoplasm
d) Transformation
49. Jack aged 30 years has been admitted to your ward with a respiratory infection. He is
diagnosed as being HIV positive (human immunodeficiency virus). Which of the
following has a similar mode of transmission to the HIV virus
a) Influenza
b) Hepatitis B
c) Herpes simplex
d) Chicken pox
50. HIV is transmitted by which of the following

a) Mosquitos
b) Toilet seats
c) Exchange of infected blood/serum
d) Food handling
51. Mr Robert jones aged 74 years is admitted with a diagnosis of myocardial infarction.
The chest pain mr jones has experienced is probably
a) Heavy crushing central
b) Intense sharp pain on inspiration
c) Rhythmic waves of pain that run across the chest
d) Intense burning behind the sternum
52. Mr jones has a decreased ability to tolerate activity. This is due to

a) A fear of suffering another heart attack if he is active
b) Difficulty in being able to breathe because of pain
c) Raised cardiac enzymes interfering with muscle function
d) Overall loss of energy as a consequence of a myocardial infarction
53. Which of the following would suggest to you that mr harper had developed a paralytic
ileus
a) Decreasing pulse rate
b) Abdominal colic
c) Lack of bowel sounds
d) Increasing blood pressure
54. The emotional process mr harper is most likely to go through following the formation
of his colostomy is
a) Denial of the existence of the colostomy
b) Anger at the surgeon for altering his body image
c) Guilt regarding previous lifestyle
d) Grief for loss of normal body function
55. Coronary artery disease is a generic term used broadly to encompass

a) Pathological conditions involving the coronary arteries
b) All conditions that result in congestive heart failure
c) Coronary arteriosclerotic heart disease
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d) Changes as a consequence of atherogenesis

c) Obstruction to blood flow between the right and left atria

d) A reduction in circulating blood volume with consequential ischaemia
58. It is thought that regular mild exercise may be beneficial to the client with ischaemic
heart disease, because exercise
a) Increases the thickness of the cardiac muscle
b) Causes dilatation of the lower cardiac chambers
c) Accelerates development of myocardial collateral circulation
d) Decreases glycogen stores in the myocardium
59. Mr john powers a 55 year old businessman consulted his doctor concerning episode of
pressing chest pain. The diagnosis after tests is arteriosclerotic heart disease with
angina pain. Characteristically the onset of angina pectoris causes a person to
a) Breathe deeply
b) Bend forward
c) Become immobile
d) Lose balance
60. When a woman lies on her back during active labour she may experience
a) Hypertension
b) Supine hypotension syndrome
c) Abnormal blood loss
d) A prolapsed cord
61. The term position of the foetus refers to

a) The relationship of the long axis of the foetus to the long axis of the mother
b) The posture which the foetus assumes in the uterus
c) The degree of descent of the foetus in the pelvis
d) The relationship of the presenting part of the foetus to the four quadrants of the
pelvis
62. Lactation following birth is initiated by the

a) Rise in level of luteinising hormone
b) Release of oxygocin in response to suckling
c) Rise in the level of prolactin
d) Drop in levels of oestrogen and progesterone
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63. A major function of the colon is
a) Absorption of bile pigments
b) Secretion of electrolytes
c) Secretion of vitamin K
d) Absorption of water
64. Which of the following diets is most likely to cause bowel cancer
a) High calorie, high fibre
b) High fibre, low calorie
c) Low fibre, high fat
d) High protein, high fibre
65. Mr Thomas harper aged 51 years is admitted to the hospital with a diagnosis of cancer
of the descending colon. He is scheduled for a bowel resection and formation of
colostomy. Common symptoms of colonic and rectal cancer include
a) Nausea vomiting and anaemia
b) Abdominal pain altered bowel function and rectal bleeding
c) Rectal bleeding weight loss and diarrhoea
d) A boardlike abdomen rebound tenderness and rectal bleeding
66. The most important reason for mr harper to have an intravenous infusion following
his surgery is to
a) Meet fluid and electrolyte requirement
b) Prevent nausea and vomiting
c) Facilitate drug administration
d) Maintain blood pressure
67. Mr Lecramp is anxious about his condition and tends to hyperventilate. This will lead
to _______________ his carbon dioxide levels which will lead to
____________________
a) Increase, respiratory acidosis
b) Decrease, respiratory alkalosis
c) Decrease, metabolic acidosis
d) Increase, respiratory alkalosis
68. You notice that mr lecramp has dry skin, concentrated urine, and seems to be losing
weight. You suspect that he is suffering from
a) Kidney infarction
b) Hypoglycaemia
c) Dehydration
d) Myxedema
69. The factors that normally affect water balance are hydrostatic (fluid) pressure and
osmotic pressure due to the concentration of proteins and ions that attract water. In the
elderly a possible cause of oedema would be due to decreased ________________
pressure in the blood due to inadequate _____________ intake
a) Hydrostatic, protein
b) Osmotic, protein
c) Hydrostatic, diuretic
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d) Osmotic, diuretic
70. Louise smith suspects she is pregnant. Pregnancy may be positively confirmed by
a) Feelings of nausea throughout the day
b) Presence of vaginal discharge
c) Hearing the foetal heart
d) Tingling sensation in the breast
71. The expelling of mature ovum by the ovary is known as

a) Conception
b) Ovulation
c) Fertilisation
d) Oogenesis
72. Louise suspects the onset of labour by

a) A feeling of tightness in her abdomen
b) Increased vaginal discharge
c) A sudden burst of energy
d) Blood stained vaginal discharge
73. In the primigravida during the first stage of labour

a) Effacement precedes dilatation of the cervix
b) Dilatation precedes effacement of the cervix
c) Effacement and dilatation occur simultaneously
d) Effacement is dependent upon dilation
74. Senile dementia alzheimers type (SDAT) is

a) Primarily a disease of the brain itself
b) Primarily a disease of the blood vessels supplying the brain
c) Has focal neurological symptoms like hemiparesis and dysphagia
d) Has a rapid progression and death within weeks of onset
75. Legal and financial matters can be a problem when a person has alzheimers disease. A
nominated person may be given power of attorney. This means that the person can
a) Alter the clients will
b) Delegate a clients legal affairs to someone else
c) Act on the clients behalf
d) Be liable for the clients debts
76. If one looked at the brain of a person who had diet of alzheimers one would see
a) Swelling of the brain and shrunken ventricles
b) Diffuse cerebral atrophy with enlargement of the ventricles and sulci
c) Extra ventricles
d) Enlargement of the pituitary gland putting pressure on the optic nerve
77. A client who had a thrombus occluding the posterior cerebral artery which supplies
the occipital lobe would be most likely to have which of the following deficits
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a) Visual disturbance including loss of one half the visual field on the side of the
stroke and colour blindness
b) Ataxia vertigo and dysphagia
c) Contralateral hemiparesis and receptive aphasia
d) Urinary incontinence and problems making decisions
78. The reason a stroke on the left side of the brain is more likely to affect language
function is because
a) In approximately 90% of people, the left hemisphere is the dominant hemisphere
b) We only listen with our right ear which is supplied by the left hemisphere
c) This leads to paralysis of the vocal cords
d) An embolus in the vertebral artery has occurred
79. Mr lecramp is a 68 year old client who is on a medical care ward following surgery to
clear artheriosclerosis plaquing in his right popliteal artery. You learn that he had a
mild myocardial infarction three years ago. He is also suffering from short term
memory loss and slight left sided hemiparesis. Based on the rest of his history, you
would expect the cause of his memory loss and hemiparesis to be
a) MID (multi infarct dementia)
b) SDAT (senile dementia alzheimers type)
c) A brain tumour
d) Depression of the elderly
80. Based on his vascular symptoms which of the following would you expect mr
lecramp has done for much of his life
a) Been a smoker
b) Played golf
c) Exercised regularly
d) Consumed lots of fruit and vegetables
81. Being seropositive to HIV means that the

a) Serum is positive for virus particles
b) Individual has antibodies against the virus
c) Serum contains antigens against the virus
d) Individual cannot be reinfected with HIV
82. In a person with AIDS the number of

a) Helper T lymphocytes decrease
b) B lymphocytes decrease
c) Lymphocytes remains the same
d) Macrophages increase
83. Cells that clean up cellular debris bacteria and foreign matter are
a) Macrophages
b) Erythrocytes
c) Platelets
d) Fibroblasts
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84. Dysplasia is tissue that is
a) Abnormal
b) Cancerous
c) Invasive
d) Inflamed
85. Abnormal changes in the cells of the cervix usually occur in the
a) Columnar epithelium
b) Squamous epithelium
c) Squamocolumnar junction
d) Endocervical canal
86. Carcinoma in situ describes

a) Mild dysplasia
b) Invasive cancer that has breeched the basement membrane
c) Premalignant cells that have not invaded the basement membrane
d) An increase in the number of basal cells
87. The ovaries

a) Are attached to the uterus by the uterine tubes
b) Have a cortex and a medulla
c) Lie outside the peritoneal cavity
d) Are continuous with the fallopian tubes
88. Wernickes area is a part of the brain found at the junction of the temporal parietal and
occipital lobes, usually in the left hemisphere. If its blood supply is occluded the
client will have difficulty with
a) Speech comprehension
b) Listening
c) Fine motor control
d) Recognising faces
89. Amnesia a phenomenon that illustrates some aspects of the defense mechanism called
a) Displacement
b) Undoing
c) Reaction formation
d) Repression
90. Irvin yalom identified corrective re enactment of the primary family group as a
curative factor in group therapy. This is best described as
a) Assigning family roles to group members with role plays
b) Opportunity to confront traumatic events from past family experiences
c) Ability of members to alter learning experiences gained in their families
d) Inclusion of family members for confrontation purposes
91. While you are facilitating a group session one of the members brian slams his fist into
the chair arm and yells why cant we smoke here its stupid rule and makes us more
tense. Your most appropriate response would be
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a) I cant change the rules now brian
b) Yes i agree its very tense here
c) We don’t allow that kind of behaviour here
d) How do other people feel right now
92. Later brian says to you things are a bit rough right now. You respond with tell me
whats going on for you brian. This is an example of
a) Immediacy
b) Non possessive warmth
c) Respect
d) Concreteness
93. The next day you find brian crying and clutching a photo of his recently deceased
wife. When you admire it he hands it to you saying you have it nurse , i wont be
needing it ill be with her soon. Your most appropriate response would be
a) I don’t want to take your photo
b) You seem to be having a rough day
c) Im a little worried about you, brian
d) Are you planning to kill yourself, brian
94. Brian commences a regime of tricyclic antidepressant medication. After one day he
tells you that he wants to stop taking the pills as he is too sleepy and cant concentrate.
Your best action would be to
a) Talk to him about the benefits of medication
b) Check his dosage and times of administration
c) Encourage him to continue with the current regime
d) Refer him to the doctor as soon as possible
95. HIV is a virus that

a) Consists of DNA surrounded by a protein coat
b) Attacks the B lymphocytes in the lymph nodes
c) Causes kaposis sarcoma in men
d) Binds to the CD4 protein on macrophages
96. You notice a 50c coin sized blood stain on the outside of Nathans cast. Your most
appropriate action is to
a) Explain to Nathan that this is normal
b) Measure his vital signs every 15 minutes
c) Notify the doctor
d) Outline the area with a pen and observe
97. Alcohol hallucinosis usually occurs

a) During a bout of heavy drinking
b) Within 48 hours after heavy drinking
c) After a long period of abstinence from drinking
d) At any time during drinking or abstinence
98. An essential feature of an opiate intoxication is

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a) Disturbed sleep
b) Papillary constriction
c) Psychomotor agitation
d) Coarse tremor
99. A client taking chlorpromazine an antipsychotic drug, experiences inner restlessness

and cannot stay still. This is a side effect known as
a) Akathesia
b) Dystonia
c) Paradox
d) Opisthotonos
100. A client says everyone here hates me. Indicate the most appropriate response
a) Perhaps youre in a bad mood today
b) What do you mean by everyone
c) You can depend on me to be nice to you
d) I don’t like to hear you so upset
101. People suffer from retrograde amnesia typically cannot remember

a) Traumatic events of childhood
b) Events just prior to a head injury
c) Who and where they are
d) Significant events following brain trauma
102. A week post operatively you notice miss Johnston has a small area of broken
skin on her sacrum. Your most appropriate nursing action is to
a) Change her position from side to side 2 hourly to relieve pressure on her sacrum
b) Ensure she has a diet rich in first class protein and vitamin D
c) Complete an incident form and describe the area in the nurses report
d) Cover area with a dressing and teach client pelvic floor exercises
103. Nathan willams aged 17 is admitted to your ward unconscious with head
injuries and compound midshaft fractures of his (R) radium and ulna. Part of your
assessment includes observing Nathan for signs of increasing intracranial pressure. A
combination of signs indicating that this is taking place is
a) Slow bounding pulse, rising blood pressure, pyrexia, sluggish papillary reaction to
light
b) Rapid weak pulse, falling blood pressure, restlessness, temperature below 36oC
c) Rapid weak pulse, normal blood pressure, lethargy, intermittent pyrexia
d) Rapid bounding pulse, apyrexia, pinpoint pupils and brisk pupilliary reaction to
light, restlessness
104. Since Nathan is unconscious, you would expect him to be

a) Unable to react to painful stimuli
b) Incontinent of urine and faeces
c) Incapable of involuntary motion
d) Incapable of hearing
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105. Nathan temperature should be taken
a) Orally
b) Rectally
c) Per axilla
d) In the groin
106. Nathan regains consciousness and within 48 hours his behaviour is typical of
level 5 on rancho los aminos scale. He would be
a) Alert, able to respond to simple commands and perform overlearned tasks such as
eating and dressing, but his short term memory is poor
b) Drowsy most of the time, but pulls away from discomfort eg insertion of a
nasogastric tube
c) Capable of brief periods of alertness, and will slowly open eyes or squeeze your
hand on command
d) Able to perform daily routines automatically but unable without remembering
them, has limited insight but enjoys recreational activities
107. An appropriate intervention to promote Nathans cognitive recovery at this

stage is to
a) Take him shopping at the hospital shop
b) Arrange a leave weekend at home with his family
c) Play simple memory and card games with him
d) Nurse him in a low stimulus environment
108. Once stable, Graeme is transferred to a spinal injuries rehabilitation unit. A

base concept of rehabilitation is
a) Rehabilitation is a speciality area with unique methods for meeting client needs
b) Rehabilitation is unnecessary for clients returning to their usual activities
following hospitalization
c) Rehabilitation needs, immediate or potential, are exhibited by all clients with
health problem
d) Rehabilitation needs are best met by the clients family and community resources
109. Optimum independence within the range of his residual functional ability is a
primary rehabilitative goal for Graeme. You are most likely to help him achieve this
by
a) Demonstrating ways he can be independent
b) Establishing long term goals with Graeme
c) Reinforcing success in tasks accomplished
d) Pointing out his errors and helping him correct them
110. Miss Johnson aged 18 is admitted with a sub capital fractured (L) neck of
femur. She is awaiting surgical fixation of her fracture. To relieve pain, miss Johnston
is placed in
a) Balanced skeletal traction
b) Gravitational traction
c) Manual traction
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d) Skin traction
111. Avascular necrosis of the head of the femur is a common complication of this
injury. You are aware this is caused by
a) Infection of the surgical wound
b) Immobilisation after reduction of the fracture
c) Disruption of the blood supply to the head of the femur
d) Weight bearing before the fracture is healed
112. Miss Johnston has just returned to the ward following a matchette-brows
hemiarthroplasty of her (L) femur. She has a pillow placed between her legs to keep
them in a position of
a) Flexion
b) Extension
c) Adduction
d) Abduction
113. You check to make sure that miss johnstons ‘redivac ‘is draining properly.
You know that the main purpose of the ‘redivac’ is to
a) Prevent formation of a haematoma
b) Allow assessment of drainage characteristics
c) Accurately measure the drainage from the post operative site
d) Provide a sterile negative pressure drainage environment
114. On the third post operative day, miss Johnston complains of pain in her
unaffected leg. You notice that the area along the saphenous vein is swollen, reddened
and warm. Your most appropriate nursing action is to
a) Apply continuous hot compresses
b) Elevate the affected leg
c) Apply an elastic stocking to the affected leg
d) Notify the doctor
115. One morning while sam is in his crib, the nurse notes his jaws are clamping
and he is having a seizure. The most important nursing responsibility at this time is to
a) Insert a padded tongue depressant
b) Start oxygen at 10 litres per minute by mask
c) Protect sam from harm from the environment
d) Restrain sam to prevent injury to soft tissue
116. Febrile convulsions are common in children and

a) Usually occur after the first year old life
b) The cause is usually readily identified
c) May occur in minor illnesses
d) Occur more frequently in females than males
117. Eight year old Jennifer is admitted to the hospital with deep, rapid
respirations; flushed, dry cheeks; nausea and increased thirst. Her history reveals she
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has had type 1 diabetes mellitus for two years. In reviewing the pathophysiology of
her illness with Jennifer the nurses plan should take into consideration that
a) Jennifer will respond favourably to opportunities to participate in her care
b) Jennifer is in the abstract level of cognition
c) Peer influence will decrease in importance to her
d) Her current developmental task involves achieving a sense of dignity
118. Jennifer received a combination of short and long acting insulin at 0700 hours.
The nurse should be aware that jennifers response prior to lunch at noon will be
controlled by
a) The long acting rather than the short acting insulin
b) Equal effects of both the short and long acting insulin
c) Decreasing effects of short acting and increasing effects of long acting insulin
d) Increasing effects of short acting and long acting insulin
119. Graeme is a new client admitted to the emergency department with a

suspected spinal cord injury at C5/6. He is cyanotic and his vital signs are temp
36.5C, pulse 96/min, respirations 40/min, blood pressure 90/50. Your most
appropriate nursing actin is to
a) Hyperextend his neck to open his airway
b) Monitor his vital signs at frequent intervals
c) Use the jaw thrust method to open his airway
d) Notify the doctor and have a tracheotomy tray available
120. David aged one year weighs 12.6 kg but is pale and lethargic. His
haemoglobin level is 5g and he has an enlarged heart. When taking a nursing history
from his mother the nurse learns that he refuses food so she gives him 3 litres of milk
per day from a bottle. The nurse suggests that his mother
a) Put a large hole in the teat and put baby food in with his milk
b) Take him to the metabolic clinic for a check up
c) Immediately begin the weaning process
d) Give him finger foods such as raisings and chopped meat
121. David should have been started on solid food by at least five or six months of
age because
a) His foetal reserve of iron was depleted
b) It would have taught him how to chew
c) His bone marrow activity had decreased at this time
d) It would have helped control his weight
122. Anaemia a nutritional problem encountered in children and adults involves

several different nutrients. The nutrients include proteins iron vitamin B12 and
a) Carbohydrates
b) Thiamine
c) Calcium
d) Folic acid
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123. Freddy 12 months of age is brought to the paediatric clinic for a regular
physical assessment. In reviewing his immunisations for the past ten months the nurse
would expect him to have been immunised against
a) Measles, rubella, polio, tuberculosis and pertussis
b) Polio, pertussis, tetanus and diphtheria
c) Measles, mumps rubella and tuberculosis
d) Pertussis, tetanus, polio and measles
124. The measles immunisation is usually routinely given after 12 months of age
because of the
a) Increased hazard of side effects in infants
b) Presence of maternal antibodies during the first year
c) Contradictory effects it has on pertussis, diphtheria and tetanus immunisations
d) Rare incidence of measles infection prior to 12 months of age
125. Three year old sam has bad a fever for several days, his neck is rigid and is
now vomiting. While being examined he has a convulsion and is admitted to the ward.
While instituting nursing measures to reduce sams fever, the nurse recognises that an
important consideration is to
a) Monitor vital signs every ten minutes
b) Force oral fluids
c) Measure output every hour
d) Limit exposure to prevent shivering
STATE EXAMS 37
1. Mrs legend and her son frank are seen at the clinic. They both have severe upper
respiratory tract infections and the physician plans to prescribe tetracycline
(minomycin). The nurse reminds him that frank is six years old and that mrs legend is
in her 18th week of pregnancy. This data is important because the drug may cause
a) Persistent vomiting when given to small children and pregnant women
b) Tooth enamel defects in children under eight years of age and in the maturing
foetus
c) Lower red blood cell production at times in their development when anaemia is a
common problem
d) Changes in the bone structure of young children and pregnant women
2. Four year old sandy has a seizure disorder and has been taking phenytoin (dilantin)
for three years. An important nursing measure for sandy would be to
a) Check the urinal frequency
b) Administer scrupulous oral hygiene
c) Check for papillary reaction
d) Observe for flushing of the face
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3. A small toddler is admitted to the hospital because of sudden hoarseness and an
insistence on continuous and somewhat unintelligible speech. In talking with the
mother, the nurse will be particularly concerned about
a) Acute respiratory tract infection
b) Undetected laryngeal abnormality
c) Respiratory tract obstruction due to a foreign body
d) Retropharyngeal abscess
4. When picked up, eight month old lucy screams. On assessment you will ask lucys
mother about
a) Her food and specific vitamins given to her
b) Accidents and injuries and the importance of their prevention
c) Any other behaviours that may have been noticed
d) Limiting lucys play time and activities with other children in the family
5. Fifteen minutes ago ailson was given panadol 500mgs for her pain. She is crying and
continues to complain of pain. Your initial intervention is
a) Contacting the doctor and getting more panadol charted
b) Telling her she is disturbing the other children
c) Turning the television on, giving her something to watch
d) Involving her with an interactive activity
6. You are a community nurse at a health centre. Your role includes the assessment of
children and information sharing with parents and families. Why doesn’t the doctor
prescribe an antibiotic for me when i have a cold
a) It is better to reserve the use of antibiotics for more severe infections
b) If you were prescribed an antibiotic for every cold the causative organism would
become resistant
c) Since the common cold is caused by a virus, antibiotics are unnecessary and
ineffective
d) The side effects of antibiotics rule our their use for such a simple condition as a
cold
7. As a community nurse at the school you are asked to see suzie who has unexplained
bruising on her arms and legs. Your initial assessment indicates she has been abused.
The most useful strategy for this prevention of sexual abuse is
a) Teaching children not to talk to strangers
b) Developing childrens self esteem and personal power
c) Teaching self defence skills
d) Teaching children about sexual abuse
8. Robert and Tanya married and had three children. Robbie john and katya. With their
children Robert and Tanya form
a) A family of orientation
b) A family of procreation
c) An extended family
d) A communal family
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9. Your child health unit has adopted the concept of family centred care. Family
centered care
a) Considers the child within the context of her/his family
b) Considers the whole family as being the client
c) Encourages at least one parent to remain in hospital
d) Encourages parents to have a rest from caring for their children
10. Staff encourage family involvement in the team process by

a) Including families in team meetings as the time for discharge approaches
b) Encouraging families to indentify goals for their child
c) Informing parents about the recommendations developed for their child
d) Insisting that families attend team meetings
11. Of the following is a contraindication to immunization

a) Contact with an infectious disease
b) Prematurity
c) Temperature over 38oC
d) Asthma
12. Carrying out immunizations a nurse must have with her/him

a) Oxygen
b) A medical officer
c) Intravenous fluids
d) Adrenaline
13. Based incidence of meningitis led to the introduction of a new programme into the
new Zealand immunization schedule in 1994. Causative organism of this disease is
a) Beta A streptococcus
b) Respiratory syncytial virus
c) Haemophilus influenza
d) Neisseria meningitis
14. Immunization usually given at 3 months of age provides protection

a) Diphtheria, tetanus, whooping cough, polio, haemophilus influenza
b) Diphtheria, tetanus, whooping cough, polio, hepatitis B, haemophilus influenza
c) Diphtheria, tetanus, whooping cough, haemophilus influenza
d) Diphtheria, tetanus, polio, hepatitis B, haemophilus inflenzae
15. James weighs 3.4kgs. his fluid requirement is 150 ml/kg/day to maintain his hydration
james requires
a) 20 mls per hour
b) 27 mls per hour
c) 23 mls per hour
d) 22 mls per hour
16. James mother is living in. She is breast feeding james. Nursing consideration for her
should include
a) Plenty of rest and distraction
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b) Education about breast feeding
c) Providing privacy and means to express milk
d) Checking her breasts for cracked nipples
17. James returns from theatre with an apnoea monitor. This is used to monitor
a) The rate of james breathing
b) The length of his sleeping
c) The length of time between breaths
d) Delays between breaths exceeding 20 seconds
18. Five year old bill has been involved in a road traffic crash and has fractured right
femur. He is accompanied by his parents. The most effective pain management for
bill would include
a) Using a pain scale, PRN medication and diversion therapy
b) Using a pain scale, regular medication and diversion therapy
c) Questioning about pain, PRN medication and diversion therapy
d) Observing non verbal behaviour, regular medication and repositioning
19. Jenny is to have ventolin nebulisers every two hours until respirations improve. She
becomes distressed as soon as you try to put the mask on her face. You would best
manage this situation initially by
a) Telling her mother to give the nebuliser
b) Not giving it to her as being distressed may make her worse
c) Realising the importance of the ventolin so forcing it on her
d) Letting her have a mask to play with, thus withholding the first dose
20. Jennys breathing would be characterised by

a) Grunting inspirations
b) Wheezing on expiration
c) Frequent periods of apnoea
d) Laboured abdominal breathing
21. Kevin aged 19 is admitted with an acute attack of asthma. The major use of
aminophylline is an acute attack of asthma is to
a) Decrease autonomic nervous system response
b) Prevent production of histamine
c) Reduce bronchial oedema
d) Relieve bronchospasm
22. The action of hydrocortisone is an asthma attack is to

a) Improve gaseous exchange
b) Relieve bronchospasm
c) Reduce histamine release
d) Reduce inflammation
23. Justice proceedings for young people under the age of 17 years are administered by
a) The children, young persons and their families act
b) The guardianship act
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c) The young persons protection act
d) The family, whanau and young persons act
24. After an offence has been committed, this act supports the offenders by
a) The police, the social workers and the maori wardens meet with the offender
b) The offender having the same rights as an adult to access a lawyer
c) Members of the family the offender and a multi disciplinary group meeting
d) The extended family meeting and deciding on a plan for the offender
25. You present a seminar to your colleagues on immunisation. After the presentation you
are asked to clarify the following. The main reason why some maori do not take their
children for immunisation is because
a) The services do not meet the needs of maori
b) The mothers lose their infant record books
c) They are unaware of the importance of immunisation
d) It is too expensive to visit the doctor
26. Immunity that results from the natural exposure to an antigen in the environment is
called
a) Active immunity
c) Autoimmunity
d) Passive immunization
27. When preparing a client for magnetic resonance imaging (MRI) the nurse should
a) Obtain informed consent and administer prescription medication
b) Cleanse the injection site using asceptic technique
c) Remove any jewellery and inquire about metal inplants
d) Assess for allergies to seafood or iodine
28. A client who has been receiving radiation therapy for breast cancer complains of
dysphagia and skin texture changes at the radiation site. To help reduce the risk of
complications and to enhance healing. The nurse would advise the client
a) Apply heat to the radiation site to increase metabolic activity
b) Eat a diet high in protein and calories to optimise tissue repair
c) Apply cool packs to the radiation site to reduce swelling
d) Drink warm fluid frequently throughout the day to relieve discomfort on
swallowing
29. A client who recently received high dose chemotherapy has a white cell count of
1000/mm3. How can the nurse best help protect the client during hospitalisation
a) Monitor closely for signs of infection
b) Place the client in protective isolation
c) Wash hands carefully before caring for the client
d) Restrict all visitors
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30. 16 year old diabetic client exhibits the following, school truancy, admission for
uncontrolled diabetes, missed insulin injections and isolation from friends. Which of
the following nursing diagnosis would apply
a) Knowledge deficit
b) Altered thought processes
c) Altered nutrition
d) Ineffective coping
31. Diabetic ketoacidosis most commonly is precipitated by

a) Overeating
b) Infection
c) A missed insulin dose
d) Psychologic stress
32. The nurse should advise diabetic client with an open foot would to
a) Clean the foot, and observe for infection
b) Soak the foot daily and bandage it
c) Clean the foot and apply mercurochrome
d) Elevate the foot and apply heat
33. A client has a seizure at home with family. Which of the following questions would
the nurse ask the family concerning the seizure
a) What was the client doing before the seizure
b) How do you feel after witnessing the seizure
c) Can you tell me how long the seizure lasted
d) Did anyone say something to upset the client
34. Which of the following would be the most appropriate goals of care for a hospitalised,
terminally ill, cachectoic 90 year old client
a) He will verbalise that he is pain free, not hungry, and happy to remain in bed
b) He will demonstrate effective coughing and deep breathing exercises, ability to eat
independently, and acceptance of his diagnosis
c) He will be free of skin breakdown, demonstrate adequate nutritional intake, and be
able to take part in desired activities
d) He will exhibit no signs and symptoms of deep vein thrombosis pneumonia, or
urinary tract infection
STATE EXAMS 38
1. Amanda aged 38 is admitted to hospital after a motor vehicle accident. Amanda has
one litre of fluid running intravenously every 12 hours. The drop factor of the metriset
is 60 drops per minute. How many drops per minute should be given
a) 68 drops per minute
b) 83 drops per minute
c) 96 drops per minute
d) 120 drops per minute
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2. In terms of section 50 of the area health board act 1983 information about the injuries
of a patient admitted after an accident may be given by the
a) Hospital telephonist
b) Charge nurse on duty
c) Doctor authorised by the chief medical officer
d) Patients next of kin
3. In terms of section 50 of the area health board act 1983 information about a patient
suffering from the results of an accident may be given within
a) 48 hours of the accident
b) 24 hours of the accident
c) 48 hours of admission
d) 24 hours of admission
4. In terms of section 50 of the area health boards act 1983 information about a patient
suffering from the results of an accident may be given to
a) An accredited reporter
b) Any police constable
c) Telephoning next of kin
d) All of the above
5. What immediate action would you take if you suspect any type of blood transfusion
reaction
a) Notify the patients doctor and blood bank
b) Take vital signs
c) Obtain an order for an antihistamine
d) Stop the transfusion
6. A client with multiple fractures is an risk for a fat embolism. What early sign should
you monitor for
a) Haematuria
7. Timothy aged 40 years is admitted to the emergency department. The most

characteristic sign of a fat embolism is
a) Petechiae
b) Dyspnoea
c) Altered level of consciousness
d) Hypertension
8. After injury the signs and symptoms of fat embolism usually occur within
a) 6 to 12 hours
b) 24 to 72 hours
c) 3 to 5 days
d) 1 week
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9. Two primary signs of fat embolism are
a) Dyspnoea and hypotension
b) Haemoptysis and chest pain
c) Dyspnoea and altered level of consciousness
d) Calf pain and petechiae
10. The drugs most often used to prevent and treat fat embolism are
a) Bronchodilators
b) Rapid acting diuretics
c) Antibiotics
d) Steroids
11. You visit sally who has a medical diagnosis of parkinsons disease. While sallys
husband makes a cup of tea you discuss with sally what their expectations are of your
visit. Her answers are slow and difficult to understand. What should you do in this
situation
a) Ignore her slowness of speech and continue with the discussion
b) Continue the conversation and check your understanding with her
c) Stop and wait for her husband to return to interpret for her
d) Finish her sentences for her to reduce her frustration level
12. Sallys husband says my wife takes so long to do anything. What is the most
appropriate response to make to this statement
a) You know thats due to the illness
b) You find this frustrating don’t you
c) Do you think its time you had a break
d) Is this something new that has occurred
13. On your next visit to sallys residence you notice that sallys husband often answers for
his wife. You can see that her tremor is becoming more pronounced and she is no
longer attempting to participate in the conversation. What is the best action to take in
this situation
a) Continue to speak directly to sally
b) Ask sallys husband not to respond for his wife
c) Suggest sally take medication to reduce the tremor
d) Address all your questions to sallys husband
14. Vera aged 79 who has been diagnosed as having alzheimers disease, has become more
confused and disoriented and requires continuous nursing care. Her husband seems
dewildered and asks what is going to happen to my wife. The most appropriate
response is
a) We will do our best to look after your wife
b) We will assess vera and keep you informed
c) Don’t worry your wife will soon be well again
d) She will be alright now and soon back to her old self
15. When making an assessment and care plan the nurse should consider that vera
a) Cannot be trusted to be responsible for any of her daily care needs
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b) Is more likely to be able to remember current experiences than past ones
c) Has been confused and disoriented since before her admission to hospital
d) May have moderate to severe memory impairment and shorter periods of
concentration
16. During the assessment period the nurse is told that vera has a bath once a week.
Which factor should be considered when planning for hygiene needs
a) Hygiene practices are learned in childhood and always stay the same
b) Attention to cleanliness is more important in hospital than at home
c) To be able to look after ones own hygiene is an independent adult behaviour
d) Hygiene practices are influenced by cultural identity personal idiosyncrasies and
values
17. Vera feels faint while in the bath. The first action of the nurse should be to
a) Call for help and support vera
b) Hold her head out of the water
c) Pull the plug and let the water out
d) Get her out of the bath with assistance
18. All of the following are appropriate in versa care except

a) Hurrying her through the daily activities
b) Only helping her as often as is appropriate
c) Engaging her in reality oriented conversations
d) Being firm and gentle, assisting her where needed
19. Irene requires an intravenous infusion. You are assisting the doctor with this
procedure. The doctor has made three attempts to insert the cannula and Irene appears
distressed. What advocacy role should the nurse take in this
a) Refuse to continue to assist the doctor any further and leave the room
b) Recommend the doctor uses more local anaesthetic to ease the pain
c) Comfort Irene and reassure her it will soon be over
d) Take the doctor aside and suggest that he call another doctor to assist
20. A patient is ordered 500ml of intravenous fluid over a 3 hour period. The intravenous
set delivers 60 drops per ml. You will monitor the rate to run at
21. Allen is stabbed in the right anterior chest. Allen is admitted to the emergency
department with a haemothorax. Blood is accumulating in his
a) Chest wall
b) Bronchial tree
c) Pleural space
d) Thoracic cavity
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22. A chest drain is inserted. The nurse recognises that this treatment is effective
primarily because it
a) Re establishes a negative pressure in the pleaural space
b) Promotes haemotstasis and coagulation of retained blood
c) Collapses the unaffected lung and allows for greater expansion of functional lung
tissue
d) Permits the accumulation of free air in the chest
23. Which of the following explains the presence of a crackling sensation under allens
skin
a) Pleural effusion
b) Pulmonary contusion
c) Percutaneous hyperoxaemia
d) Subcutaneous emphysema
24. A policeman begins to remove the knife from allens chest. He is stopped by the
ambulance officer because
a) It will be painful
b) Allen should remove the knife himself
c) The hands should be gloved
d) Movement can cause more damage
25. Allens condition deteriorates and he developes a tension pneumothorax. This

complication being caused by
a) Air causing pressure on the mediastinal space
b) Decrease of air with each inspiration
c) An increase in the pulmonary artery pressure
d) Pulling or tension on the chest tubing
26. The nurse monitors allen for the signs of mediastinal shift. The nurse should watch
particularly for which of the following
a) Decreasing cyanosis
b) Dyspnoea and stridor
c) Tachycardia and hypertension
d) Tracheal deviation
27. Allen becomes hypotensive, apprehensive and has a feeling of tightness in his chest.
The nurse should anticipate which of the following treatments
a) Insertion of a large needle into the pleural space
b) Emergency thoracotomy
c) Diagnostic electrocardiograph
d) Intubation and controlled mechanical ventilation
28. Lignocaine is supplied in 20ml ampoules of a 2% solution. In pharmacological terms,

a 2% solution (W/V) means
a) 2g in 100ml
b) 2mg in 100ml
c) 200mg in 100ml
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d) 200mg in 1ml
29. You are asked to give lignocaine 40mg from a 20ml ampoule of lignocaine 2%. How
much will you give
a) 0.2ml
b) 2ml
c) 0.4ml
d) 4ml
30. Rosemary is being prepared for a craniotomy due to an extradural haemorrhage. The
doctor prescribes the following drugs for rosemary preoperatively. Which medication
should the nurse question prior to administration
a) Atropine
b) Corticosteroids
c) Mannitol
d) Morphine
31. Rosemary is placed in the lateral position during surgery. Which specific
postoperative observation would you now make
a) Observe the knees for flexion contractures
b) Check the shoulders for decubiti
c) Monitor for postural hypotension
d) Evaluate chest expansion
32. Postoperatively the nurse observes rosemary for signs of increased intracranial
pressure which are
a) Bradycardia and ear discomfort
b) Headaches and papillary changes
c) Confusion and hyperthermia
d) Anorexia and nausea
33. If increased intracranial pressure was suspected in the postoperative period, in which
position would rosemary be placed
a) Flat with feet elevated
b) Head of the bed elevated 30 degrees
c) Side lying
d) Prone
34. 3 days post intracranial surgery rosemary develops a fever, nuchal rigidity and
headache. Which of the following would you suspect
a) Cerebral emboli
b) Increased intracranial pressure
c) Meningitis
d) Extradural haematoma
35. Penicillin 450,000 units is charted for your client. In stock is penicillin 1 mega unit in
5 mls. Calculate the volume you will administer to your client
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a) 1.75 mls
b) 2.00 mls
c) 2.75 mls
d) 2.25 mls
36. Cane a 68 year old is scheduled for abdominal surgery. Cane is nil by mouth after
midnight prior to surgery. Which explanation is most appropriate in response to his
request to explain why he cant eat
a) You will not have to go to the toilet after surgery
b) The stomach should be empty to prevent vomiting during surgery
c) The anaesthesia works faster on an empty stomach
d) There is not enough time before surgery to digest the food
37. Which of the following is an essential concern of the nurse pre operatively
a) Doctor has prescribed the most appropriate surgery
b) Consent form is correctly completed
c) Patient understands and agrees to the operation
d) Clients family is informed of the surgery
38. Cane is receiving morphine 10mg IM prn for post operative pain. The most crucial
time for assessing his respiratory status is
a) Immediately after the morphine is given
b) 10 minutes after the morphine is given
c) 30 minutes after the morphine is given
d) All the time
39. If respiratory depression is noted in cane, the nurse should prepare to administer
which of the following drugs
a) Aminophylline
b) Lasix
c) Naloxone
d) Numorphan
40. You are monitoring canes vital signs every 15 min post surgery. Which of the
following changes should be reported immediately
a) A systolic blood pressure that drops 30mm Hg
b) Dry, cool, skin
c) A pulse rate that increases and decreases with respirations
d) A diastolic pressure at 70mm Hg
41. Which nursing action would best help to prevent post operative thrombophlebitis in
cane
a) Encouraging pre operative ambulation
b) Assisting cane to sit up in bed after surgery
c) Keeping cane nil by mouth
d) Reminding cane to move his feet
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42. Kate aged 40 is admitted to the hospital after several episodes of right upper quadrant
abdominal pain and intolerance to fatty and gas forming foods. A diagnosis of biliary
colic is made. The ingestion of fatty foods will precipitate the pain of biliary colic
because
a) Increased fat in the stomach increases peristalsis
b) Fat in the duodenum initiates contraction of the gallbladders
c) Fat in the duodenum increases abdominal distention
d) Increased fat intake may result in a gallbladder obstruction
43. In preparing kate for surgery, which of the following laboratory values would concern
you enough to call the doctor
a) WBC 10 x (10 c9) /L
b) Hemoglobin, 90g.L
c) Urine pH 8.5
d) Hematocrit .42
44. Following insertion of a nasogastric tube before surgery you ascertain that the tube is
properly placed by
a) Placing the end of the tube in a glass of water to make sure bubbles appear in the
water on expiration
b) Injecting 10ml of air into the tube and palpating for abdominal distention
c) Listening for the sound in the stomach with a stethoscope as 5ml of air is injected
into the tube
d) Feeling the end of the tube for the passage of air from the stomach
45. As a pre operative medication you are to give 75mg of pethidine intramuscularly.
Pethidine injection contains 50mg/ml. How much of the solution should be
administered
a) 0.5 ml
b) 0.75 ml
c) 1 ml
d) 1.5 ml
46. In administering kates IM analgesic you should insert the needle at a

a) 15 degree angle
b) 45 degree angle
c) 60 degree angle
d) 90 degree angle
47. Following her cholecystectomy kate returns from recovery room with intravenous
fluids a penrose drain, ET tube and a nasogastric tube. Once settled in her bed, she
complains of nausea and looks like she is gagging. Your initial response in this
situation is to
a) Administer ordered antiemetic
b) Check the nasogastric tube for patency
c) Check the wound for bleeding or dehiscence
d) See whether the t tube has been dislodged
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48. Kate is to receive 1000 ml of IV fluids every 8 hours. Her IV set delivers 20 drops per
ml. The drip rate should be set at
49. To prevent the most common complication following a cholecystectomy, it would be

most important for kate to
a) Have the abdominal dressing changed prn for heavy drainage
b) Increase fluid intake and decrease fat intake
c) Receive prn pain medication at intervals ordered
d) Cough and deep breathe every 2 hrs and fully expand her lungs
50. A post operative symptom that should be reported to the house surgeon immediately
is
a) A temperature of38.3c
b) An incisional pain
c) A productive cough
d) Audible bowel sounds
51. Kates abdomen feels distended and she complains of nausea. The nasogastric tube
appears to be in place. You should
a) Notify the physician
b) Administer the prescribed antiemetic
c) Irrigate the tube with 10 ml of sterile normal saline
d) Inject 50 ml of air into the tube to check for patency
52. In changing kates dressing it is particularly important to place a sterile dressing

around the penrose drain because
a) Leakage of bile from the penrose can cause skin irritation
b) The evacuated bile is normally high in bacteria and should not contact the
abdominal incision
c) Absorption of bile by 4 x 4s aid in accurate measurement
d) The suture line must be protected from moisture
53. While kate is being turned her nasogastric tube becomes dislodged and falls on the
bed. You should
a) Notify the house surgeon and fill out an incident report
b) Leave the tube out since this indicates no further need for one
c) Obtain a new tube from central supply and prepare for insertion
d) Administer kates prescribed medication for nausea
54. James has sustained a fracture of his left lower leg in a car accident. Monitoring for
compartment syndrome is done by checking for
b) Colour, warmth, sensation, movement of the extremity
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55. Which of the following criteria is the most important in assessing the affected
extremity for compartment syndrome
a) Excessive pain, unrelieved by analgesia
b) Numbness, pins and needles
c) Inability to extend fingers, toes
d) Decreased blood flow to extremity
56. With compartment syndrome, james toes would be

a) Red and inflamed
b) Swollen and pink
c) Cool and ashen
d) Unchanged in appearance
57. Vera aged 79 who has been diagnosed as having alzheimers disease, has become more
confused and disoriented and requires continuous nursing care. Her husband seems
dewildered and asks ‘what is going to happen to my wife’ the most appropriate
response is
a) We will do our best to look after your wife
b) We will assess vera you informed
c) Don’t worry, your wife will soon be well again
d) She will be alright now and soon back to her old self
58. Jack aged 30 years has been admitted to your ward with a respiratory infection. He is
diagnosed as being HIV positive. Which of the following has a similar mode of
transmission to the HIV virus
a) Influenza
b) Hepatitis B
c) Herpes simplex
d) Chicken pox
59. When caring for jack a client who has HIV which of the following infection control
precautions are necessary
a) Disposable food trays
b) Gowns, gloves and masks for all procedures
c) Gowns and masks for routine procedures
d) None of the above
60. HIV is transmitted by which of the following

a) Mosquitos
b) Toilet seats
c) Exchange of infected blood/semen
d) Food handling
61. Teaching for the client taking sublingual nitroglycerin for angina would include
a) Instructing the client to take the nitroglycerin regularly
b) Explain to the client that a subsequent headache indicates ineffective medication
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c) Instructing the client to put the tablet on the tongue and swallow after the tablet
dissolves
d) Teaching the client to take a tablet every 5 minutes (x3) when chest pain occurs
62. Connor a 55 year old is admitted to the hospital with a diagnosis of essential
hypertension and angina. The usual dose of nitroglycerin is
a) 60 mg
b) 6.0 mg
c) 0.6 mg
d) 0.06 mg
63. The chief pharmacologic action of glycerine trinitrate is to

a) Constrict cardiac chambers
b) Stimulate myocardial fibres
c) Accelerate cardiac contraction
d) Dilate coronary arteries
64. A client is prescribed digoxin 0.125 mg, in the morning. You have digoxin tablets
0.25mg. which of the following will you give
a) Two tablets (of dogoxin 0.25mg)
b) One tablet (of dignoxin 0.25mg)
c) Half a tablet (of digoxin 0.25 mg)
d) One and a half tablets (of digoxin 0.25 mg)
65. Before administration of digoxin you record a clients radial pulse. You would
withhold this medication if the pulse was
a) 90 beats per minute or above
b) 80 beats per minute or below
c) 70 beats per minute or below
d) 60 beats per minute or below
66. Which is the most appropriate action for the nurse to take when Arnold says he has
pain in the calf of his leg especially on movement
a) Discuss this information with his doctor
b) Record the comments on Arnolds nursing records
c) Gently massage the area to relieve the pain
d) Tell him to flex and move his leg to promote venous return
67. You discover the nurse on a previous duty has given your patient a wrong drug
dosage. What action would you take
a) Give the prescribed medication, then inform the doctor
b) Assess the doctors notes and give a lower dose
c) Assess the patients vital signs and inform the charge nurse
d) Assess the patient give an adjusted dose, inform the doctor
68. You are setting up for a catheterization when the emergency call bell rings three
times. What would be your immediate action in this situation
a) Cover the trolley with a sterile guard and answer the bell
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b) Continue to prepare the sterile trolley
c) Immediately answer the bell, leaving what you are doing
d) Ignore the bell as other staff are available
69. Which of the following diseases is notifiable under the health act
a) HIV human immunodeficiency virus
b) Hepatitis A
c) Rheumatic fever
d) Epiglottitis
70. A client asks to see her records in a public hospital. Which act covers this situation
a) Official information act 1982
b) Hospital act 1980
c) Privacy act 1993
d) Nurses act 1980
71. If a client is admitted and dies within 24 hours following surgery who must be
notified by law
a) Significant others
b) Doctor
c) Medical superintendent
d) Coroner
72. All of the following are a coroners case except

a) An unexpected death of client 24hrs after admission
b) Death of a client with an infectious disease
c) An unexpected death 24hrs after surgery
d) No established cause of death
73. Neil a 17 year old is hit on the head by a cricket ball while playing with a friend at
home. He fell against the glasshouse, severely lacerating his right wrist. He was
unconscious for about 5 minutes. On arrival at the emergency department he was
drowsy. You are taking neils recordings when he appears to have a seizure. What
nursing intervention would best assist neil
a) Describing and recording the seizure activity observed
b) Restraining neil in order to prevent self harm
c) Placing a tongue blade between his teeth
d) Suctioning neil to prevent aspiration
74. A client diagnosed with congestive heart failure is placed digoxin 0.125 mg daily. A
nursing intervention for this medication is
a) Do not administer if radial pulse is less than 60
b) Hold medication if digoxin level is low
c) Administer if apical pulse is 84
d) Administer if potassium level is 3.1 mEq/L
75. A patient has been charted 0.25 mg. You have on hand digoxin PG 62.5mcg. which of
the following would you give
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a) Quarter of a tablet
b) Two and a half tablets
c) Three tablets
d) Four tablets
76. Signs and symptoms of digitalis toxicity include

a) Anorexia, nausea, and vomiting
b) Urinary retention, dysuria and diaphoresis
c) Headache, constipation and polyuria
d) Rapid pulse, nausea and cyanosis
77. When caring for a client with pancretitis why would the nurse expect to administer
pethidine rather than morphine sulphate for pain analgesia
a) Pethidine provides more prolonged analgesia than morphine
b) Unlike pethidine, morphine causes spasms of the sphincter of oddi
c) Pethidine is less addicting than morphine
d) Unlike pethidine morphine may cause liver dysfunction
78. What is the first responsibility of the nurse who finds, when checking the drugs
between morning and afternoon duty, that ten ampoules of pethidine are missing
a) Notify the nurse manager immediately
b) Report the matter to the doctor immediately
c) Search patient records for non recorded administration
d) Document for the senior nurse to investigate the situation
79. Pethidine, which has been prescribed 3.4 hourly prn has just been given to a patient
with a brain tumour who has a severe headache. When should the pethidine be given
again
a) Only when the headache becomes very severe
b) Every four hours whether the patient needs it or not
c) Not more than six hourly to prevent addiction
d) As often as necessary for patient comfort
80. You are on duty in the emergency department. A client is admitted and scheduled for
an emergency laparotomy. Indicate the act which relates to consent for medical
procedures
a) Nurses act 1977
b) Official information act 1982
c) Accident compensation act 1972
d) Hospital act 1980
81. Maui a 2 year old maori boy is admitted with 10% burns. His mother who identifies
as maori is very distressed. The doctor tells her to go to the waiting room while he
examines maui. A major electrolyte imbalance occurring in the first 24 hours in a
client with 20% burns would be
a) Hypocalcaemia
b) Hyponatremia
c) Hypokalaemia
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d) Hypercalcaemia
82. The acid base imbalance that occurs in the first 24 hours following a 10% burn will be
a) Respiratory acidosis
c) Respiratory alkalosis
83. The surface and colour of third degree burns would be

a) Moist, blistered and reddened
b) Moist, whitish, mottled red
c) Dry, whitish or charred
d) Dry whitish slough
84. Cane a 68 year old is scheduled for abdominal surgery. During the metabolic response
to trauma, such as major surgery, potassium is released from the cells and excreted. A
low serum potassium would be suspected if the patient has
1. Weakness of large muscles
2. Muscle cramps
3. Abdominal distension and poor peristalsis
4. Abdominal cramps and diarrhoea
a) 1 and 3
b) 1 and 4
c) 2 and 3
d) 2 and 4
85. Bill aged three sustained a fractured left femur and second and third degree burns over
43% of his body following an accident in which his parents were killed. The
paramedic communicated to the hospital that bill was burned on both anterior and
posterior of his torso including his arms and hands. On arrival at the emergency
department bill is semi conscious his radial pulse is 160 per minute, respirations 32
per minute and blood pressure 60/30. The rule of nine used to evaluate burns is done
to estimate
a) Need for fluid replacement
b) Amount of skin surface burned
c) Loss of electrolyte
d) Depth of burn
86. Which of the following types of burn cause the most pain
1. Superficial
2. Partial thickness
3. Full thickness
4. Full thickness and underlying structures
a) 1 only
b) 1 and 2
c) 2 and 3
d) 3 and 4
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87. The cause of death of a patient some days after being severly burned is most likely to
be
a) Shock
b) Dehydration
c) Kidney failure
d) Sepsis
88. Dennis aged 70 is admitted to hospital with a myocardial infarction. Dennis is given
80mg frusemide (lasix) intravenously. What is the action of frusemide
a) Diuretic
b) Antiemetic
c) Analgesic
d) Bronchodilator
89. What side effects of frusemide (lasix) should the nurse be aware of
a) Hypervolaemia
b) Hypovolaemia
c) Hypotension
d) Hypoventilation
90. Which of the following is a postrenal cause of acute renal failure

a) Ischaemia of kidney tissue
b) Prostatism
c) Nephrotoxic drugs
d) All of the above
91. When renal function is interrupted

a) Acid base abnormalities occur
b) Fluid and electrolytes are out of balance
c) Endocrine and metabolic malfunctions take place
d) All of the above
Bleeding within the skull results in increased intracranial pressure because
94. When suctioning a patient with increased intracranial pressure, you would
a) Choose a large catheter to clear the airway quickly
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b) Suction gently for no more than 15 seconds
c) Encourage the patient to cough to bring up secretions
d) Lower the head of the bed
95. The critical pathologic event that precipitates most neurologic emergencies is
a) Airway obstruction
b) Increase intracranial pressure (ICP)
c) Cerebrovascular accident
d) Traumatic head injury
96. Patricia wakes up one morning with a severe headache. While attempting to get up to
take some aspirin she collapses. Her husband sends for the doctor, who, suspecting a
cerebro vascular accident arranges hospitalisation. On admission patricia is
comatosed. In assessing consciousness you begin by using
a) Verbal stimulation
b) Tactile stimulation
c) Light pain
d) Deep pain
97. Your neurologic assessment includes monitoring urinary output. Thats because
a) Injury to the hypothalamus causes oliguria
b) Polyuria with specific gravity of <1.005 is desired
c) Volume depletion will increase ICP (intracranial pressure)
d) Hyponatremia can lead to cerebral edema
98. Rosemary is being prepared for a craniotomy, due to an extradural haemorrhage. Your
neurologic assessment indicates increased ICP (intracranial pressure) so you raise the
head of the bed 15 to 30 degrees in order to
a) Improve arterial flow to the brain
b) Promote venous drainage from the brain
c) Improve respirations
d) Increase cardiac output
99. Fifteen minutes after commending a blood transfusion you observe your patient to be
flushed, dyspnoeic and complaining of itchiness. In order of priority your actions will
be
a) Stop infusion, call for help, take vital signs, remain with patient
b) Stop infusion, commence normal saline infusion, take vital signs, notify doctor
c) Stop infusion, ring 3 bells, elevate foot of bed, call doctor
d) Stop infusion, call for help, take vital signs, elevate foot of bed
100. A person admitted to the emergency room with trauma and an estimated blood
loss of 1200 to 1400 ml has a blood pressure of 110/70mmHg and a heart rate of 120
beats minute. The best explanation for these observations would be that
a) The persons actual blood loss was less than the originally estimated loss
c) The cause of the bleeding is now under control and the increased heart rate is due
to anxiety
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102. Which of the following represents the most appropriate criterion for evaluating
a clients management of elevated phosphate levels in chronic renal failure
a) The client eliminates diary produces from the diet
b) The client increases dietary calcium intake
c) The client takes iron supplements with meals
d) The client takes phosphate binding medications with meals
103. Pharmacological solutions may be expressed in ratio form. Which of the

following would give 1mg of drug in 1ml of solution
a) 1:1
b) 1:10
c) 1:100
d) 1:1000
104. You wish to give 375,000 units of penicillin. The vial contains 600,000 units
in 2mls. Calculate the amount required
a) 0.32 mls
b) 0.625 mls
c) 0.125 mls
d) 1.25 mls
105. What is the first action of the nurse when a patient refuses to take an ordered
medication
a) Safely dispose of the unused drug
b) Refer the matter to the medical staff
c) Record the incident on the patients chart
d) Ask the patient the reason for refusing the drug
106. A medical mishap, accident rehabilitation and compensation insurance act

1992 means
a) Failure to observe a reasonable standard of skill by health professionals
b) Harm caused following proper care is rare and severe
c) Compensation is given to people if medical care does not meet an expected
outcome
d) Rare and severe illness can be compensated for
107. Medical misadventure in the accident rehabilitation and compensation

insurance act
a) Medical error and medical mishap causing personal injury
b) Negligence by health professionals causing patient death
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c) Mistakes in medical practice causing patient death
d) Mistakes made by hospital staff causing injury or death
108. Section 160 of the crimes act 1961

a) Identifies nurses legal duty to use reasonable knowledge and skill
b) Allows for the charge of murder or manslaughter if a nurse is found negligent
c) Identifies the nurses legal duty to provide the necessaties of life
d) Outlines the possible punishment for nurses found guilty of medical manslaughter
STATE EXAM 39
1. The nurses act is administered by the

a) New Zealand nurses organisation
b) Nursing council of new Zealand
c) Division of nursing (department of health)
d) All of the above
2. The registrar of nurses is employed in the

a) Department of health
b) Nursing council
c) Nurses organisation
d) Hospital boards association
3. The nursing council is

a) A bureau in the department of health
b) A subcommittee of the nurses organisation
c) An incorporated society
d) A statutory body
4. The nursing council does all of the following except

a) Administer the nurses act
b) Administer the hospitals act
c) Approve schools of nursing
d) Issue practising certificates
5. The act which provides for the nursing council to have disciplinary jurisdiction over
the conduct of registered and enrolled nurses is
a) The nurses act of 1977
b) The nurses regulation act of 1977
c) The hospital act of 1951
d) The area health board act of 1989
6. Nurses employed in any setting can have formal complaints made against them. By
law to whom should these complaints be addressed
a) The medical superintendant
b) The registrar of the nursing council
c) The medical officer of health
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d) The executive director of the nurses organisation
7. The maintenance of standards, discipline, examinations and registration are

administered by the nursing council under which act of parliament
a) Crimes act 1961
b) Nurses act 1977
c) Accident rehabilitation and compensation insurance act 1992
d) Official information act 1982
8. As you prepare a client for surgery she states that although she has signed her consent
form she doesn’t really understand what the doctor told her. She asks what sort of
operation is she to have. You respond with
a) I’ll just give you your premedication and soon you’ll feel alright
b) You seem worried about your operation, would you like me to stay
c) I can see you are upset. I’ll get the doctor to explain the operation again to clarify
if for you
d) You don’t have to worry, the doctors do this operation all the time
9. If a client is admitted and dies within 24 hours following surgery who must be
notified by law
a) Significant others
b) Doctor
c) Medical superintendent
d) Coroner
10. All of the following are a coroners case except

a) An unexpected death of client 24 hours after admission
b) Death of a client with an infectious disease
c) An unexpected death 24 hours after surgery
d) No established cause of death
11. One of the relevant parts of the abortion act of 1977 is authorization for the
performance of an abortion. Which statement is true
a) No abortion can be done unless authorized by 2 certifying consultants
b) Abortions can be performed anywhere where there are consultants
c) A woman who decides to have an abortion can ask a general practitioner
d) Only consultants can perform an abortion
12. Which statement is true regarding consent for an abortion

a) A female of any age can consent to or refuse an abortion
b) A guardian or parent can consent to or refuse an abortion if a child is not of legal
age
c) Only females under 16 years of age can give consent to an abortion
d) Only females over 16 years of age can give consent to an abortion
13. You note that a child you are caring for was given a double dose of Panadol. Your
responsibility would be to
a) Ensure adequate airway and breathing
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b) Fill out an incident form and inform the doctor
c) Inform the nurse who gave the medication
d) Keep it to yourself as no damage was apparent
14. Richard a 25 year old mildly retarded person was admitted to accident and emergency
due to multiple fractures after a motor vehicle accident. Richard is to have an
emergency laparotomy due to internal bleeding. The crimes act states that consent in
the above case is
a) Implied from the circumstances surrounding the case and the need to take
immediate action for the welfare of the individual
b) Written and must be freely given and fully understood if major surgery was to be
performed
c) Mentally ill and demented clients must have a consent of a parent or a guardian or
significant others representing them
d) Valid only if the client is 16 years and over or if married
15. Whilst in theatre a friend who knew Richard very well, rings to inquire about the
client’s condition. You are the staff nurse on duty. The official secrets act of 1951
allows you to
a) Give the full information as he is a very close friend of the client
b) Give him the information as he is a member of the health profession
c) Give him information in general terms concerning the condition of the client
d) None of the above
16. After surgery Richard is taken to the intensive care unit but dies shortly thereafter. A
legal responsibility in cases of unexplained death up to 24 hours after surgery is to
a) Lay the body out so that the family and friends can see the client
b) Send a coroners referral for investigation
c) Make sure the clients name and address and the circumstances surrounding the
death are written in the 24 hours census book
d) Ensure that personal belonging are inspected and signed for by the family
17. Debbie a 16 year old student is admitted in a semi conscious state with a history of a
58 pound weight loss in 3 months. Preliminary diagnosis is acute anorexia nervosa.
Which of the following admission lab values should the nurse caring for Debbie
consider to most critical
a) Glucose 80
b) Potassium 3.0
c) Sodium 144
d) Haemoglobin 10
18. Which vital sign would provide the most essential information in light of Debbie’s
current lab values
a) Temperature
b) Pulse
c) Respirations
d) Blood pressure
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19. Nutritional assessments of Debbie during this acute stage should include all of the
following except
a) Urine output
b) Level of consciousness
c) Skin turgor
d) Urine dextrostix
20. The nursing diagnosis of highest priority for Debbie in her acute anorexic episode
would be
a) Alteration in nutrition: less than body requirements
b) Alteration in health maintenance
c) Fluid volume deficit
d) Disturbance in self concept
21. All of the following are common characteristics of anorexia nervosa except
a) Preoccupation with food
b) Fear of developing sexuality
c) Independence from parental and peer pressures
d) Distorted body image
22. The nurse recognises that anorexic behaviour often stems from the clients desire
a) For self abuse or self mutilation
b) To punish herself for past behaviour through starvation
c) To gain control over an aspect of her life
d) To express hatred towards her parents
23. The nurse should recognise that Debbie has recovered from her psychological
conflicts associated with anorexia when she
a) Demonstrates an increase in weight
b) Demonstrates ser4um electrolytes within normal parameters
c) Reduces her exercise regimen to only once a day
d) Makes a date with a companion for dinner
24. Claire aged 30 and single, is brought to the mental health unit by her brother, who
tells the nurse that she has become increasingly overactive and out of control over the
past 2 months. She begins tasks but doesn’t complete them, takes little time to eat and
sleep and spends large amounts of money and is now in debt. Which approach would
be most therapeutic in working with Claire?
a) Teaching the patient about banking procedures, then extending this approach to
everyday issues
b) Confronting the patient about all her inappropriate behaviour
c) kindly but firmly guiding the patient into such activities as bathing and eating
d) showing the patient that she is in a controlled environment so that no difficulties
arise later
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25. Claire lost 15 lb (6.8kg) last week and now weighs 100 lb (45.4 kg). The nurse
formulates a nursing diagnosis based on the diagnostic category altered nutrition: less
than body requirements. Which goal is most appropriate initially
a) The patient will consume an adequate diet
b) The patient will maintain her current weight of 100lb
c) The patient will gain 1 lb (0.5 kg) per week
d) The patient will remain adequately hydrated
26. The best approach to meeting claires hydration and nutrition needs would be to
a) Leave finger foods and liquids in her room and let her eat and drink as she moves
about
b) Bring her to the dining room and encourage her to sit and eat with calm, quiet
companions
c) Explain mealtime routines and allow her to make her own decisions about eating
d) Provide essential nutrition through high calorie gavage (naso gastric) feedings
27. The physician decides to start Claire on lithium therapy. Which of the following best
describes her dietary requirements while she is receiving this medication
a) A high calorie diet with reduced sodium and adequate fluid intake
b) A regular diet with normal sodium and adequate intake
c) A low calorie diet with reduced sodium and increased fluid intake
d) A regular diet with reduced sodium and adequate fluid intake
28. A few days later, Claire tells the nurse, I’m so ashamed of myself. I don’t deserve to
be here and be taken care of. Which action best demonstrates the nurses
understanding of the patients needs
a) Expressing relief that Claire has recognised the foolishness of her behaviour
b) Calling a team meeting to increase protection against possible self destructive
behaviour
c) Reporting to staff members that Claire appears to be developing insight into her
behaviour
d) Telling Claire that she has done nothing that she should regret
29. Claire would benefit most from which activity during the manic phase of her illness
a) Playing a game of badminton
b) Attending the units weekly bingo game
c) Putting together an intricate puzzle
d) Drawing or painting in her room
30. Early signs of lithium toxicity include

a) Tremors nausea vomiting and diarrhoea
b) Ataxia, confusion and seizures
c) Elevated white blood cell count and orthostatic hypotension
d) Restlessness, shuffling gait and involuntary muscle movements
31. The over activity observed in mania is believed to be a defence against underlying
feelings of depression. Which of the following defence mechanisms best identifies
this process
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a) Displacement
b) Reaction formation
c) Projection
d) Denial
32. Michelle aged 25 is found sitting on the floor of the bathroom in the treatment clinic
with moderate lacerations to both wrists. Surrounded by broken glass, she sits staring
blankly at her bleeding wrists while staff members call for an ambulance. How should
the nurse approach Michelle initially
a) Enter the room quietly and move beside Michelle to assess her injuries
b) Call for staff backup before entering the room and restraining Michelle
c) Move as much glass away from Michelle as possible and quietly sit next to her
d) Approach Michelle slowly while speaking in a calm voice, calling her name and
telling her that the nurse is here to help her
33. Michelle is taken to the hospital and admitted on an emergency basis for 5 days
compulsory assessment and treatment. Michelle says to the admitting nurse, im not
staying here. I was a little upset and did a stupid thing. I want to leave. Which
response is most appropriate
a) Unfortunately you have no right to leave at this time. You must be evaluated
further
b) Cutting your wrists certainly was a stupid thing to do. What were you trying to
accomplish anyway
c) You have been admitted on an emergency basis and can be held. You have the
right to consult a lawyer about your admission
d) I can see you’re upset. Why don’t you try to relax? You can explain to the doctor
what upset you. If what you say is true, you’ll be released sooner.
34. Dete3rmining Michelle suicide potential during the mental status examination,
involves assessing several factors, the most significant of which is her
a) History of previous suicide attempts
b) Suicide plan
c) Emotional state
d) Self esteem
35. Michelle is placed on suicide precautions, which include constant observation. When
the nurse accompanies her to the bathroom, Michelle complains, I can’t believe this. I
can’t even go to the bathroom without being watched. How would you like to have
me watching you go the toilet? Which response by the nurse is best
a) I’m sure i wouldn’t like it very much, but then i didn’t try to hurt myself
b) I’m sorry but these are the rules. Someone must be with you at all times
c) If it’s more comfortable for you, i can stand right outside as long as the door is
open. Would you agree to that
d) I would probably feel uncomfortable too, but ensuring your safety is my first
priority. I must stay in the room with you
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36. After 5 days hospitalisation, Michelle is to be discharged and treated on an outpatient
basis at the day treatment clinic. During the discharge planning, the nurse should set
as a priority short term goal that Michelle will
a) Identify support systems to help manage stress
b) Verbalise feelings of shame regarding her suicide attempt
c) Demonstrate an uplifted mood and optimism about the future
d) Admit that her wrist slashing was an attention seeking behaviour and not a true
suicide attempt
37. Megan aged 26 enters the emergency room for treatment of an acute overdose of
amitriptyline. Megan is very lethargic but rousable on admission. Gastric lavage is
performed, and vital signs are stable when she is transferred to ICU for close
observation. Of greatest concern during the next 48 hours would be
a) WBC of 6000
b) ECG changes
c) K+ value of 3.6
d) Slightly elevated TPR
38. Megan tells the ICU nurse, I’m sorry i didn’t die. Life is useless. Why did you have to
save me? The best response of the nurse would be
a) You know you don’t mean that
b) It’s our job Megan. Nothing is ever that bad
c) I know you’re feeling hopeless. Tell me what’s happening
d) Let’s concentrate on getting well. In a few days you’ll feel differently
39. Further history indicates Megan has been seeing a psychiatrist for depressive
symptoms and has been diagnosed as having borderline personality disorder. The
nurse would be most surprised to learn that this patient
a) Believes she has been chosen by god to be his special messenger on earth
b) Has a history of episodic substance abuse
c) Has made other suicide attempts
d) Has a pattern of unstable, intense relationships with others
40. Upon transfer to the psychiatric unit, Megan is informed by the admitting nurse that it
will be necessary to check her belongings for any unsafe or banned items. She begins
to scream angrily, what’s the matter with you. I’m upset. Get away from me. The
nurse would first
a) Administer emergency tranquillizers as ordered
b) Place Megan in seclusion and restraints
c) Eliminate the belongings search so as to avoid upsetting her
d) Set verbal limits on her behaviour
41. Megan requests a weekend pass two days after transfer to the psychiatric unit. Her
primary nurse, informs her following the treatment team meeting that the pass has not
been approved. Megan responds angrily, they all hate me, they’re so mean. I know
you’d have let me go. You’re the only decent nurse here. The nurses best response is
a) I would have approved it, but you’re right. I’m only one voice
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b) I don’t think the others realise how hard you’ve been trying
c) Megan, you’ll never get a pass behaving this way
d) This was the team’s decision. Let’s talk about why we feel it’s not appropriate
now
42. Megan’s behaviour in this situation illustrates the use of which defence mechanism
a) Splitting
b) Reaction formation
c) Conversion
d) Repression
43. Megan’s doctor resumes her regular dosage of amitriptyline. Which affect of this
medication might the staff and patient expect to see first
a) Elevated mood
b) Improved reality testing
c) Improved sleep pattern
d) Fewer hallucinations and delusions
44. Mary is admitted under section 11 of the mental health assessment and treatment act
(1992). The definition of mental disorder under the act includes all of the following
except
a) A seriously diminished ability to care for oneself
b) Mental handicap and substance abuse
c) An abnormal state of mind
d) A serious danger to self or others
45. Marys rights under the act include, the right

a) To information about her status, to respect of her cultural identity, to seek legal
representation
b) To respect as a human being, to respect of her cultural values, to receive visitors
and make phone calls
c) To information about her status, to receive treatment and health care, to change
her treatment at her request
d) To receive visitors and make telephone calls, to refuse seclusion on cultural
grounds, to seek a judicial inquiry
46. When it is time for Mary to take medication, she says to you, you can’t make me take
this; I’m only on an assessment section. Choose the best reply
a) This must seem confusing to you Mary, but under the act we can require you to
take treatment
b) Under the act we can make you take medication and if you don’t we will have to
give you an injection
c) I can see this must be confusing Mary, but you are right you are not required to
take treatment on section 11
d) Section 11 is an assessment section but you can be required to take medication
47. Mary asks for a review of her legal status. Your action would be
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a) Explain that her status will be reviewed by the responsible clinician before the end
of five days
b) Reassure her that you understand how frustrating it must be to be in hospital
against her will
c) Offer to phone the client advocate on Marys behalf
d) Explain section 16 to Mary and allow her to phone the district inspector
48. A nurse finds john crouched in the corner of his room with a curtain covering him.
His roommate is sitting on the bed laughing and saying ‘this guy is really a nut. He
should be in a padded cell. How should the nurse respond to the roommate
a) Say I’m sure john’s behaviour is frightening to you. I understand that you are
trying to cover up how you really feel by laughing
b) Say, ‘I’d appreciate it if you’d step outside for awhile. I’d like to talk with you
after I help john’
c) Say nothing and attend to john
d) Say, in a neutral tone, ‘i think your laughing is making john feel worse. How
would you feel if you were john’
49. What is the least threatening approach to john while he sits huddled under the curtain
a) Sit next to him on the floor without speaking, and wait for him to acknowledge the
nurse
b) Gently remove the curtain and say, ‘john, this is the nurse. What happened
c) Approach john slowly and say, ‘john this is the nurse. You appear to be very
frightened. Can you tell me what you are experiencing
d) Call for assistance and do not approach john until at least two other staff members
are present
50. Because john has previously responded well to treatment with haloperidol (serenace),
the doctor orders haloperidol 10mg orally twice a day. Which adverse effect is most
common with this medication
a) Extrapyramidal symptoms
b) Hypotension
c) Drowsiness
d) Tardive dyskinesia
51. During the next several days, john is observed laughing, yelling and talking to
himself. His behaviour is characteristic of
a) Delusions
b) Looseness of association
c) Illusion
d) Hallucination
52. John tells the nurse, ‘the earth is doomed, you know. The ozone layer is being
destroyed by hair spray. You should get away before you die.’ John appears
frightened as he say this. The most helpful response is to
a) Say, ‘john i think you are overreacting. I know there is some concern about the
earth’s ozone layer, but there is no immediate danger to anyone’
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b) Say, ‘I’ve heard about the destruction of the ozone layer and its effect on the
earth. Why don’t you tell me more about it’
c) Ignore john’s statement and redirect his attention to some activity on the unit
d) Say, ‘john is you saying you feel as though something bad will happen to you. I
don’t believe we are in danger right now’
53. After a half hour, john continues to ramble about the ozone layer and being doomed to
die. He paces in an increasingly agitated manner, and he begins to speak more loudly.
At this time, the nurse should
a) Check to see whether the doctor ordered haloperidol PRN
b) Allow john to continue pacing but observe him closely
c) Try to involve john in a current events discussion group that is about to start
d) Tell john to go to his room for a while
54. After several months, john improves, and the doctor decides to change the medication
to haloperidol decanoate (Haldol Decanoate). Why is this change made
a) Haloperidol decanoate is more effective
b) Haloperidol decanoate has fewer side effects
c) A change in medication produces a better response
d) Haloperidol decanoate can be given monthly instead of daily
55. Henry is brought to the mental health unit by his wife who states that for the past
week her husband has refused all meals and accused her of poisoning him; he has
become withdrawn, forgetful and inattentive and has frequent mood swings. Henry
appears suspicious. His speech, which is only partly comprehensible, reveals that his
thoughts are controlled by delusions of possession by the devil. He claims that the
devil told him that people around him are trying to destroy him. The doctor diagnoses
paranoid schizophrenia. Schizophrenia is best described as a disorder characterized by
a) Disturbed relationships related to an inability to communicate and think clearly
b) Severe mood swings and periods of low to high activity
c) Multiple personalities, one of which is more destructive than the others
d) Auditory and visual hallucinations
56. The nursing assessment of Henry should include careful observation

a) Thinking, perceiving and decision making skills
b) Verbal and nonverbal communication processes
c) Affect and behaviour
d) Psychomotor activity
57. When communicating with Henry the nurse should initially

a) Remain silent and wait for Henry to speak first
b) Talk with Henry as one would talk with a healthy person
c) Allow Henry to do all the talking
d) Speak to Henry using simple, concrete language
58. The patients thought content can be evaluated on the basis of which assessment area
a) Presence or absence of delusions
b) Unbiased information from the patients psychiatric history
Page 254 of 257
c) degree of orientation to person, place and time
d) Ability to think abstractly
59. Henry mentions that voices are telling him that he is in danger and that he will be safe
only if he stays in his room and avoids ‘zoids’ how should the nurse respond
a) I understand that these voices are real to you, but I want you to know that I do not
here them
b) Don’t worry. I won’t let anything happen to you here.
c) What else can you tell me about the voices
d) Many patients hear voices when they come here. The voices will go away when
you get better
60. The innermost layer of the eye is

a) Sclera
b) Retina
c) Choroid
d) Conjunctiva
61. The nurse observes henry pacing in his room. He is alone but talking in an angry tone.
When asked what he was experiencing, he replies ‘the devil is yelling in my ear. He
say people here want to hurt me’. The nurses best response is
a) Can you tell me more about what the devil is saying to you
b) How do you feel when the devil says such things to you
c) I don’t hear any voice, henry. Are you feeling afraid right now
d) Henry the devil cannot talk to you
62. Henry has been hearing voices for many years. An approach that has proven effective
is for the hallucinating patient to
a) Practice saying ‘go away’ or ‘stop’ when he hears voices
b) Take an as-needed dose of his psychotropic medication when ever hears voices
c) Sing loudly to drown out the voices and to distract himself
d) Go to his room until the voices go away
63. Henry requests that his room be changed. He states that his roommate is homosexual
and has been making advances to him. He wants to be in a private room. How should
the nurse reply
a) Remind henry that he is in a hospital and not a hotel and tell him that patients are
assigned to rooms on the basis of need
b) Tell henry that his request will be discussed that morning and if a room is
available he will be moved
c) Inform henry that his roommate is not homosexual and that he should get to know
him better
d) Ask henry if he is physically attracted to his roommate
64. Physical activity is an important part of the schizophrenic patients treatment plan.
Assuming henry is capable of the following activities which one is most appropriate
for him
a) Taking a daily brisk walk with a staff member
Page 255 of 257
b) Playing a basketball game
c) Participating in touch rugby
d) Playing tennis with another patient and a staff member
65. Plans are being made for henrys discharge. His wife expresses concern over whether
her husband will continue to take his prescribed medication. The nurse should inform
her that
a) Her concern is valid but henry is an adult and has the right to make his own
decisions
b) She can easily mix the medication in henrys food if he stops taking it
c) Henry can be given a long acting medication that is administered every 1 to 4
weeks
d) Henry knows that he must take his medications as prescribed to avoid future
hospitalizations
66. The generic name for stelazine is

a) Chlorpromazine
b) Diazepam
c) Trifluoperazine
d) prochloperazine
STATE EXAMS 40
1. Up until 1840, settlers in new Zealand were

a) Subject to maori (tribal) law
b) Obliged to obey busbys instructions
c) Governed from new south wales
d) In effect not answerable to any laws
2. The Waitangi tribunal was established under the treaty of Waitangi act in
a) 1840
b) 1953
c) 1975
d) 1986
3. The steps to cultural safety are in this order

a) Safety, awareness and sensitivity
b) Awareness, sensitivity and safety
c) Sensitivity, awareness and safety
d) Sensitivity, safety and awareness
4. Which of the following acts of parliament outlawed traditional maori health practices
a) Suppression of rebellion act 1860
b) Tohunga suppression act 1907/1908
c) Native lands act 1865
d) Constitution act 1852
5. Colonisation is the process whereby

Page 256 of 257
a) A military dictatorship is set up
b) Democracy is the means of government
c) An independent republic is established
d) A government extends its sovereignty and imposes political control over an alien
people or territory
6. Colonisation has historically had a negative impact on the health of indigenous

people. In the early stages of colonisation in new Zealand which diseases had the
strongest impact
a) Measles, influenza, tuberculosis
b) Cancer, coronary heart disease
c) Diabetes type 2, hypertension, arthritis
d) Chronic obstructive pulmonary diseases
7. In new Zealand health services, bicultural partnerships are characterised by

a) Maori involvement in health delivery and decisions making
b) Separate waiting lists for maori clients
c) Maori agreeing to policy developed by the ministry of health
d) Non maori health professionals learning marae protocol
8. Durie, M (2001) states: large scale alienation of maori land in the nineteenth century
had implications for health and disease. Which of the following does this apply to
a) Loss of identity
b) Loss of core features of culture
c) Increased mortality and morbidity
d) All of the above
9. Sally tells you she is pregnant. The first day of her last normal menstrual period was
the 18 february 2003. Her EDD or EDC is
a) 18 november 2003
b) 25 november 2003
c) 25 december 2003
d) 18 december 2003
10. Sally states, i have heard that a pregnant woman needs more iron. Is that true. The
nurses best response would be
a) Yes a pregnant woman, 23-40 years, needs 25% more iron
b) Yes but the increase is so small a pregnant woman can meet the need by eating a
well balanced diet
c) Yes pregnant women need at least twice as much iron than non pregnant women
d) Only pregnant adolescents have an increased need for iron
11. Sally asks why it is important to eat protein during pregnancy. The nurse should
explain, protein is necessary for the
a) Development of fetal bones and teeth
b) Growth of fetal and maternal tissues
c) Prevention of anemia
d) Coagulation of the blood
Page 257 of 257

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STATE EXAMS (PART II)

TABLE OF CONTENTS QUESTIONS PAGES

STATE EXAMS 21 111 2 to 17

STATE EXAMS 22 192 17 to 44

STATE EXAMS 27 76 90 to 101

STATE EXAMS 28 86 101 to 114

STATE EXAMS 29 144 114 to 136

STATE EXAMS 30 71 136 to 148

STATE EXAMS 31 91 148 to 162

STATE EXAMS 32 50 162 to 170

STATE EXAMS 33 61 170 to 178

STATE EXAMS 34 90 178 to 193

STATE EXAMS 35 74 194 to 205

STATE EXAMS 36 125 205 to 223

STATE EXAMS 37 34 223 to 228

STATE EXAMS 38 108 228 to 245

STATE EXAMS 39 66 245 to 256

STATE EXAMS 40 11 256 to 257

3. In order to prevent infection of hepatitis B virus, the pregnant woman should

4. Which of the following represents a recommended weight gain during pregnancy

6. The primary pathophysiologic basis for the clinical manifestations of pregnancy

12. Which of the following is true concerning the limbic system

13. Cooridination of muscular activity is a function of the

14. Which of the following statements is correct

17. What is the most common cause of heart failure (HF)

18. The action of ACE inhibitors (angiotensin converting enzyme) is

20. Manifestations of heart failure are

22. Loop diuretics act by

24. The body tissues affected by rheumatoid arthritis is

25. The pattern of rheumatoid arthritis is best described by its

26. Rheumatoid arthritis is characterized by

27. Synovial joints are characterized by

29. Manifestations of right sided heart failure are

30. Nursing intervention necessary prior to the administration of digoxin is

31. Left sided heart failure affects directly the

32. Basic nursing objectives in the treatment of HF are

33. Define a cerebral vascular accident (CVA)

34. Cerebral thrombosis is

35. Risk factors of CVA that cannot be altered are

37. Where and what is the circle of willis

38. List the 3 main causes of stroke

39. Angina symptoms include

41. The term blue bloater refers to

43. Emphysema is characterised by

46. Corticosteroids are used

47. The foetal presenting part is described as vertex when the

49. Vitamin K is given to the newborn to

51. At birth the major cause of heat loss is by

56. A breast fed baby will have bowel motions

57. Supplementary fluids for babies

64. Jack is concerned about returning to school. He should be encouraged to

66. His vomiting is described as projectile, this means

67. James is diagnosed to have pyloric stenosis. This requires surgery to

68. James is prepared for surgery by

93. An asthmatic child is charted IV aminophylline. Your responsibility prior to the

96. The most serious complication of rheumatic fever is

98. Which of the following would support a diagnosis of chickenpox

104. Dannys mother should be instructed to watch for signs of worsening

106. Ongoing assessment of danny includesregular oximetry readings. The reading

109. At the time of leonards admission to hospital, it would be impossible to

2. The caudia equine is a complex of the spinal cord that includes

3. The epidural space is an area that contains

4. In the spinal cord the cerebrospinal fluid is found within the

5. Pain receptors are literally the