Health Variation Final

Health variations 1
1. Neuropathic pain
a. Is the most common type of pain
b. Lasts less than three months
c. Is a result of disease or injury of the CNS
2. Analgesia
a. Prescient ongoing pain
b. The inability to feel pain
c. The duration between doses
3. A painful response to a non painful stimulus is
a. Somatic pain
b. Hyperalgesia
c. Allodynia
4. Pain in the skin, muscle or tissue
a. Somatic
b. Idiopathic
c. Central pain
5. Agonist
a. A drug that binds to a receptor and blocks access to the endogenous ligand
b. The stimulus that is the reason for the pain
c. A drug that binds to and stimulates a receptor producing the same response as the
endogenous ligand.
d. A neuropathic hormone which stimulates the movement of signals from one neuron
to another
6. What is a neuromodulator
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a. Substances that stop pain pathways
b. Substances that alter pain pathways
c. Substances that push pain pathways
7. Endorphins
a. Initiate nerve impulse transmission.
b. Alter nerve transmission
c. Attached to neurons in the spinal cord, brain and GIT
8. What are some behavioral (voluntary responses)
a. Crying, moving away and withdrawal
b. Restlessness, crying and moving away from stimulus.
c. Fear, anger and crying
9. What are some psychological responses
a. Anxiety, anger and Anorexia
b. Hopelessness, Restlessness and Depression
c. Exaggerated weeping, moaning and Anorexia
10. Adenylate Cyclase
a. Agonises opioid receptors
b. Decreases Ca2+ entry channels
c. Breaks down ATP to form cAMP
11. Depolarization
a. Loss of difference in charge between inside and outside of plasma membrane
b. Decrease in Ca2+ entry channels
c. Changes in a cells membrane potential that makes it more negative.
12. Which are traits of Oxycodone
a. Slow release
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b. Short duration of action
c. Stronger than Buprenorphine
13. Antipyretic
a. Reduces inflammation
b. Reduces pain
c. Reduces fever
14. Prostaglandins
a. Increases inflammatory mediators to increase the action of histamine
b. Inhibits the COX enzymes
c. Reduces perception of pain
15. COX 1 and COX 2 both
a. Meditate inflammation
b. Produce prostaglandins
c. Are constantly expressed in the body
d. All of the above
16. Types of NSAIDS are
a. Oxicams and Paracetamol
b. Copper Salicylates and Idoleactic Acids
c. Morphine and Paracetamol
17. Extracellular fluid is
a. Within all areas of the human body including cells
b. Within cells only
c. Interstitial fluid and Intravascular fluid
18. Hydrostatic pressure
a. Pumping of the heart and gravity pulls water into cells
b. Pumping of the heart and gravity pushes water into cells
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c. Water shifting from an area of low to high
19. Osmotic pressure
a. Pumping of the heart and gravity pushing water across cell membranes
b. Concentration of body fluids
c. The power of a solution to draw water across a membrane.
20. Isotonic is
a. An equal concentration of solutes in both environments
b. Those that have a lower solute concentration on the outside than inside
c. Those that have a higher solute concentration on the outside than inside.
21. Hypertonic solution
a. The concentration of solutes in higher on the inside
b. The concentration is equal on both sides of the membrane
c. The concentration of solutes in higher on the outside
22. Hypotonic Solution
a. The concentration of solutes is lower on the outside
b. The concentration is equal on both sides of the membrane
c. The concentration of solutes in higher on the outside
23. Hypovolemia
a. High extracellular fluid volume
b. Low extracellular fluid volume
c. Low intracellular volume
24. Crohn’s disease characteristics are
a. Relapsing inflammatory disorder
b. Decreased flexibility of bowel wall
c. Malabsorption and Malnutrition
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d. All of the above.
25. Crohn’s disease can occur in
a. Anywhere from mouth to anus
b. Small intestine
c. Large intestine
d. Stomach
26. Some complications of Crohn’s disease are
a. Hemorrhoids and constipation
b. Anal fissures, perirectal abscess and colon obstruction
c. Shortening of the bowel and increased absorption
27. The drug Prednisolone’s main action is
a. Assist the remission of Crohn’s disease
b. Reduces the body’s immune system
c. Steroid that inhibits the release of inflammatory chemicals.
28. Crohn’s disease pain can usually be felt in the
a. Upper Right abdominal quadrant
b. Lower right abdominal quadrant
c. Lower left abdominal quadrant
29. To treat Crohn’s disease it is recommended the patient should avoid eating
a. Dairy products and spicy food
b. Fruit and vegetables
c. Ensure
30. A bowel resection is procedure where they
a. Relieve an obstruction
b. Remove the large intestine and bringing the opening of the small intestine out of an
opening on the abdominal wall
c. Remove the affected portion of the bowel
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31. Ulcerative colitis is a
a. Autoimmune disease of the large intestine
b. Systemic disease
c. Metabolic disease of the small intestine.
32. Clinical manifestations of Ulcerative colitis include
a. Less than 2-9 stools per day
b. More than 10-20 stools per day
c. Constipation
33. Ulcerative colitis usually causes pain in the
a. Lower right abdominal quadrant
b. Upper left abdominal quadrant
c. Lower left abdominal quadrant
34. Ulcerative colitis can best be described as
a. Ulcers along the inner surface of the lumen of the large intestine
b. Ulcers along the mucosa of the large intestine
c. Cobble stone appearance of the colon wall.
35. Hyperplasia is the
a. Increase in the production of cells
b. A benign tumor
c. A tumor moving to neighboring cells
36. Metastasis is the
a. New growth, abnormal proliferation
b. Mass of cells
c. Spread to distant tissue
37. When we refer to promotion we mean:
a. The cell is exposed to additional factors
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b. The process by which normal cells are transformed
c. Cellular changes become irreversible
38. A malignant neoplasm has the following characteristics
a. Capsulated, non-invasive, capsulated
b. Fast growing, non capsulated, poorly differentiated
c. Small, non well circumscribed, necrotic
39. What often causes immortal cancer cells
a. Mutation of the Apoptosis
b. Mutation of the P53 gene
c. Mutation of the telomeres
40. TSG are genes
a. That mutate into malignant immortal cells
b. That slow the cell cycle
c. That speed the cell cycle
41. Grade 2 tumors
a. Well differentiated – cells resemble tissue of origin
b. Moderately well differentiated
c. Anaplastic – undifferentiated
42. Lymph node NO grade refers to
a. Main tumor cannot be found
b. Cancer in nearby lymph node cannot be assessed
c. There is no cancer in nearby lymph nodes
43. A large benign growth is an
a. Adenoma
b. Carcinoma malignant growth
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c. Angiogenesis
44. Anemia
a. Due to the chronic blood loss from the tumor
b. Necrosis of the cells in the tumor
c. Due to lesions growing in the rectum
45. Modifiable characteristics include:
a. Cigarette smoking, medical history
b. Hx of Excessive IBD, lower BMI
c. Exposure to carcinogens, diet and lifestyle
46. What the major clause of breast cancer
a. BRCA2 mutation
b. HER2 mutation
c. P53 Genetic mutation
47. DCIS is represented by:
a. Lump in nipple and areola
b. Non-invasive confided to the ducts of breast
c. Mestastic invasive spread from breast to other areas
48. Stage 2 cancer is
a. Between 2-5 cm or tumor near breast bone
b. Invasive tumor below 2cm
c. Spread beyond breast to nearby lymph nodes
49. Chemotherapy is
a. Characterized by drugs that destroy all cells
b. Characterised by the sole use of radiation
c. Characterised by side effects including nausea, weight change, fatigue
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50. A modified radial mastectomy is
a. A surgical treatment to remove the cancerous tumor
b. Removal of the entire breast and lymph nodes
c. Removal of the nymph nodes
51. What is the medical term for Prostate cancer
a. Adenocarcinoma
b. Carcinoma
c. Ductal carcinoma
52. What is the most common site of Prostate cancer
a. The transverse zone
b. The Peripheral zone
c. The endoplasmic zone
53. What is the most common site for a prostate cancer to metastasis too
a. Bones, Lymph nodes, the rectum and bladder
b. Bones, Breasts, the rectum and stomach
c. The spine, The lymph nodes and the brain
54. What are some of the clinical manifestations of prostate cancer
a. High volume urination, incontinence and bloody stools
b. Hematuria, Low volume urination and weak stream
c. Erectile dysfunction, Hypervolemia and Pain
55. What is a Prostate specific Antigen test
a. A hormone that increases the risk of growing a tumor
b. A probe inserted in the rectum to retrieve small samples of tissue
c. A blood test that looks for the presence of a protein that’s produced by prostate
cells.
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56. What are some of the main reasons that Brachytherapy is favored for less severe cases.
a. Less risk of impotence, urinary incontinence and is minimally invasive
b. They can return back to daily like within a few days and doesn't hurt
c. Not performed under anesthetic due to lack of need for interference.
57. Types of Prostate cancer treatments are
a. Radiotherapy and Biopsy
b. Hormone therapy and High intensity ultrasound
c. Chemotherapy and radial therapy
58. How many grades of cancer are there
a. 3
b. 4
c. 5
59. How many stages of prostate cancer are there
a. 6
b. 4
c. 5
60. Grade 3 can best be described as
a. The cancer cells closely resemble normal cells
b. The cells are undifferentiated and have invaded surrounding tissue
c. The cells are poorly differentiated and more variable in shape
61. What is a complete fracture
a. Bone is broken all the way through and broken the skin
b. Bone is broken all the way through
c. Bone is damaged but still in one piece
62. A pathological fracture occurs when the bone
a. Breaks from athletic wear and tear
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b. Endures physical trauma
c. Has been weakened by disease
63. A comminuted fracture is
a. When the bone breaks through the skin
b. It breaks into two or more fragments
c. The break circles the bone
64. An extra capsular fraction occurs when
a. The break is closed to the joint but remains outside
b. The break is within the joint
c. The bone connected to the ligament or tendon breaks off from the main bone
65. What is the Diaphysis of a bone
a. The end part of a long bone
b. The porous and red bone marrow
c. The shaft or central part of a bone
66. Angiogenesis occurs in the first stage of bone healing. Angiogenesis is
a. Decrease blood flow to the entire bone
b. Increase blood flow to the entire bone
c. The blood vessels are disrupted
67. The first stage of bone healing is initiated by
a. The migration of fibroblasts to the fracture site to lay down a fibrocartilaginous soft
callus
b. Acute inflammatory response and the infiltration of the fracture site by inflammatory
cells
c. Disruption of blood vessels in the cortex, bone marrow and soft tissues at the
fracture site leading to bleeding and haematoma formation
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68. A closed reduction is when
a. The bone is moved or manipulated into alignment
b. The bone is established back into normal alignment through rods plates and screws
c. The bone is held into place by the traction of weights.
69. Immobilisation helps to prevent
a. Pain caused by movement
b. Nerve and blood vessel compression
c. Risk of further damage
d. All of the above
70. Three types of traction include
a. Manual traction, Skin traction and Skeletal traction
b. Skin traction, friction traction, metal traction
c. Skin traction, Manual traction, Bone tractions
71. What is the primary cause of acute compartment syndrome?
a. When a plaster cast is tool loose and allows the muscle compartments to swell
b. A decreased muscle compartment due to excess bleeding
c. An increased muscle compartment volume due to oedema, vascular injury, bleeding

and venous obstruction
72. Clinical manifestations of Acute compartment syndrome are
a. Pain, Parathesis, Poikilothermic and lack of pulse
b. Pain, swelling, fever and bright red skin
c. A strong pulse, full motion of limb and numbness of limb
73. A treatment for acute compartment syndrome is Fasciotomy. How is this preformed?
a. The removal of a tight fitted dressing
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b. Opening of the fascial layer to allow the compartment to drain
c. Tightening of the dressing in order to push fluids to other areas of the body
74. Complex regional pain syndrome can best be described as
a. A painful condition of the limbs after an injury such as a fracture resulting in burning
pain, shiny skin, swelling an spasms
b. A painful condition of the limbs after an injury such as a fracture resulting in mild
pain, low skin tagger and high temperature
c. A painful condition of the limbs after an injury such as a fracture resulting in changes
in skin condition from other areas of the body, increase in strength of limb and
oedema
75. Fat embolism syndrome is best described as
a. Fat droplets being released into the bloodstream via the red bone marrow or fat
tissue at the fracture site.
b. Fat droplets being released into the bloodstream via the fat tissue accumulated in
the body over time due to lack of mobility during the healing period.
c. Fat droplets being released into the bloodstream via the yellow bone marrow or fat
tissue at the fracture site.
76. What is the order of the stage of bone healing
a. Bone remodeling, bony callus formation, hematoma formation and Formation of soft
callus
b. Hematoma formation, formation of soft callus, bone remodeling and Bony callus
formation
c. Hematoma formation, Formation of soft callus, Bony callus formation and bone
remodeling.
77. Which best describes bony callus formation
a. Osteoblasts migrate to area to clean debris and Bony callus gradually calcifies and is
replaced by mature bone.
b. Osteoblasts migrate inwards and mineralise the whole callus, Bony callus formation
gradually calcifies and is replaced by mature bone.
c. Phagocytes begin cleaning up the debris and Osteoblast migrate inwards to

mineralise the hole callus
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78. Osteoporosis is a
a. Metabolic bone disorder characterized by a loss of bone mass, increased bone

fragility and an increased risk of fractures
b. A metabolic bone disorder which increases bone mass and the risk of fractures
c. A metabolic bone disorder that leads to joint pain, stiffness and instability resulting
in an increased risk of fractures.
79. What are osteophytes
a. Bony lumps found on bones of spine or around joints due to bone spurs.
b. A hormone that produces the cartilage of joints
c. A general term for osteoblast and osteoclasts
80. What is the one of the main ways to prevent/ manage osteoporosis
a. Increased calcium and fatty food intake
b. Increased calcium and vitamin D intake
c. Reduced level of weight bearing exercises
81. What is the mode of action of Bisphosphonates
a. Increases life of osteoblasts and decreases life of osteoclasts
b. Increases life of osteoclast and decreases life of osteoclasts
c. Maintains balance of osteoblast and osteoclast activity
82. What is a risk when taking Calcitonin
a. Increased osteoclast activity
b. Increased risk of hypocalcemia
c. Increased risk of hypocalcemia
83. What is the synovial membrane
a. Smooth white tissue that covers the ends of the bones
b. A layer of connective tissue that lines the surface of bones and creates synovial fluid
c. A layer of connective tissue that lines the capsule of synovial joints.
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84. Osteoarthritis is best described as
a. A degenerative systemic joint disease
b. A chronic systemic autoimmune disease
c. A degenerative joint disease
85. Rheumatoid arthritis is best described as
a. A chronic systemic autoimmune disease
b. A acute systemic autoimmune disease
c. A chronic progressive autoimmune disease
86. When diagnosing osteoarthritis with an X-ray doctors are looking for
a. Lack of synovial fluid, Swollen bone, cysts
b. Loss of joint space, Osteophytes, synovial cysts and sclerosis
c. Loss of joint space, Osteophytes, Subchondral sclerosis and Subchondral cysts.
87. All statements on Arthritis are true except
a. Worsens over a period of years
b. Stiffness decreases with activity
c. Your heart, skin and lungs are affected
88. All statements on Osteoarthritis are true except
a. Pain subsides with rest and worsens with activity
b. Joints appear red hot and swollen
c. Does not affect overall health
89. Pharmaceutical treatments for Osteoarthritis include all except
a. Paracetamol
b. Topical NSAIDS
c. DMARDs
d. Glucocorticoid injection
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90. Pharmaceutical treatments for Rheumatoid arthritis include all except
a. DMARDs
b. NSAIDS
c. Corticosteroids
d. Physical and occupational therapy
91. What do disease modifying Anti-Rheumatic drugs (DMARDs) do
a. Suppress the immune system helping slow down the destruction of disease.
b. Speed up the immune system to clear out inflammation of joints
c. Increase white blood cells
92. A Joint arthroplasty is performed in cases of Osteoarthritis and severe cases of

Rheumatoid arthritis. How is the procedure best described
a. Surgical fusion of a joint
b. Transection of bone to realign a joint
c. Reconstruction or replacement of joint with prosthetic parts.
93. What is the procedure Arthrodesis
a. Surgical fusion of a joint
b. Excision of synovial membranes
c. Reconstruction or replacement of joint prosthetic parts.
94. What is fentanyl
a. A topical cream to relive inflammation
b. A narcotic Analgesic which acts on the CNS to suppress the perception of pain
c. A narcotic Analgesic, which stops the growth of hormone receptive cancers.
95. Why would a person diagnosed with osteoporosis be prescribed Osterlind
a. Vitamin D is essential for regulating all aspects of calcium and phosphate use.
b. The drug inhibits osteoclast bone reabsorption
c. Calcium is essential to support physiological processes and bone strength
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96. When a person is prescribed a narcotic analgesic in the perioperative period the nurse
should
a. Asses vital signs frequently due to risk of hyperventilation
b. Assess fluid balance as drug may cause diarrhea
c. Ensure the safety of the patient due to the drugs causing sedation and euphoria
97. What is the mode of action of Meloxicam
a. Relieves fevers
b. Lowers perception of pain by blocking opioid receptors
c. Relieves inflammation and pain through the inhibition of the synthesis of

prostaglandin
98. Sulfasalazine is a
a. Topical drug that inhibits the production of prostaglandin
b. Topical drug that inhibits the production of hormones
c. Oral drug that restore estrogen
99. Prior to administrating Pethidine to a patient it is most important that the nurse
a. Measures this persons vital signs as it can increase the RR
b. Measures the persons baseline OBS as this drug can cause depression of the CNS
c. Measure this person’s pupil dilation as it can cause vasodilation.
d. Appropriate drug dose to avoid risk of undergoing and overdoses
100. Prior to administering morphine to a patient, it is most important that the nurse
a. Asks when they last defecated or urinated
b. Ensure they take the medication with food as it can cause GIT irritation
c. Asks them if they have had any previous adverse effects when taking narcotic
analgesic’s
What are the five rights of drug administration?

a) The right patient, time, documentation, procedure and disposal of hazardous
materials
b) The right drug, patient, time, documentation and route
c) The right drug, dose, route, time and patient
d) The right drug, patient, dose, reason and time
What are the four domains of nursing competency as defined by the ANMC?
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a) Critical thinking, Professional practice, Provision of care and Collaborative and
therapeutic practice.
b) Critical thinking, Professional practice, Provision and co-ordination of care
and Collaborative and therapeutic practice.
c) Critical reflection, Professional practice, Co-ordination of care and Collaborative and
therapeutic practice.
d) Critical thinking, Professional practice, Provision of care and co-ordination of care and
Evidence based care
What precautions should be taken when administering Alendronate?

a) Alendronate should be administered orally 30 minutes before eating and
patient should remain upright
b) Alendronate should be administered via IV 2 hours before eating and lay down to
counter any dizziness
c) Alendronate should be administered 30 minutes after eating
d) Alendronate should be administered via IV 30 minutes before eating
Alendronate is a?
a) Non-steroidal auto-immune drug
b) Narcotic analgesic
c) Bisphosphonate
d) A vitamin d supplement used to encourage osteoblast activity
Bisphosphonates;
a) Stimulate osteoblast activity
b) Inhibit bone resorption and when taken up by osteoclasts, and enhance
osteoclast apoptosis
c) Stimulate osteoclast and osteoblast cell death
d) Inhibit bone resorption
Kyphosis is a curving of the spine and can cause;

a) Compression of the abdominal organs
b) Compromise of respiratory function
c) Severe pain and discomfort
d) B + C
Calcitonin;
a) Inhibits bone absorption and the release of calcium ions into the blood
b) Increases the rate of calcium absorption
c) Aids in metabolising calcium
d) A + B
The modifiable risk factors of osteoporosis include?

a) History of fractures, alcohol and smoking, low impact exercise
b) Gender, lack of vitamin D and calcium, smoking
c) Alcohol consumption, smoking, poor nutrition, lack of proper exercise
d) Hypogonadism, previous fractures, smoking, lack of exercise
The reduction is oestrogen levels can increase the risk of osteoporosis because?
a) Oestrogen facilitates osteoclast apoptosis
b) Oestrogen maintains the balance of resorption and formation through programmed
call death of osteoblasts
c) Preventing the development of osteoclasts
d) Facilitates calcium absorption
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Vitamin D facilitates bone remodelling by effecting?
a) Osteoclast receptors
b) Osteoblast Receptors
c) Binding to osteocytes
d) Inhibiting osteoclast formation
What are the adverse effects related to the administration of Alendronate?

a) Headache, constipation and nausea
b) GI tract disturbances such as nausea and inflammation, musculoskeletal
pain and headache
c) Oesophageal distress, poor nutrition, and diarrhoea
d) Weight loss, pain and nausea
Why should a patient remain upright after taking Alendronate?

a) To prevent dizziness
b) To facilitate absorption
c) To avoid oesophagitis, erosions, ulcers
d) To prevent nausea and vomiting
An open fracture is;

a) A fracture where the bone becomes misaligned
b) A fracture where the bone splinters
c) A fracture which results in bone fragmentation
d) A fracture that breaks through the skin
An incomplete fracture is;

a) A fracture where the bone does not break all the way through the bone
b) A fracture where the bone splinters
c) A fracture which results in bone fragmentation
d) A fracture that breaks through the skin
A Transverse fracture is;

a) A fracture that occurs at an angle to the bone
b) A fracture that occurs straight across the bone
c) A fracture resulting from a twisting motion
d) A fracture where the bone becomes misaligned
A Torus fracture is;

a) A fracture where the bone fragments are pushed together
b) A fracture at an angle to the bone
c) A fracture where the bone cortex buckles but does not break
d) Only occurs near the joints
An Avulsion fracture is;

a) Where a fragment of bone connected to a ligament or tends breaks off from
the main bone
b) A fracture where the bone fragments are pushed together
c) Is a stress fracture
d) A fracture where the bone cortex buckles but does not break
A Comminated fracture is;

a) A fracture across several bones
b) A fracture resulting from a fall
c) A fracture that results in two or more fragments of bone
d) A fracture where the bone fragments are pushed together
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Hematoma Formation, Fibrocartilaginous callus formation, bony callus formation and bone
remodelling at stages of what?
a) Bone resorption and formation
b) Fractures Complications
c) Osteoarthritis
d) Bone Healing
Acute compartment syndrome may be caused by what?

a) A decrease in compartment size due to constriction or an increase in
compartment volume caused by Swelling (oedema), vascular injury and
bleeding, and venous obstruction
b) A increase in compartment size due to constriction or an increase in compartment
volume caused by Swelling (oedema), vascular injury and bleeding, and venous
obstruction
c) A decrease in compartment size due to constriction or an decrease in compartment
volume caused by Swelling (oedema), vascular injury and bleeding, and venous
obstruction
d) A decrease in compartment volume caused by Swelling (oedema), vascular injury and
bleeding, and venous obstruction
What are the non-modifiable factors of osteoarthritis?

a) Age, Genetics, obesity, lack of exercise and co-morbidities
b) Gender, Age and or congenital joint abnormalities
c) Genetics, Gender, previous joint injury
d) Repetitive joint loading tasks, genetics and previous injury
Rheumatoid arthritis is;

a) A condition that causes damage to the cartilage and inflammation of the joints
b) An autoimmune disease that damages the bone around the joints
c) A chronic systemic autoimmune disease that causes inflammation of
connective tissue
d) The same as osteoarthritis except having a genetic cause
What are the clinical manifestations of rheumatoid arthritis?

a) Joint stiffness, decreased range of motion, joint swelling and pain
b) Peripheral vasculitis and Interstitial lung disease
c) Joint stiffness, paralysis, joint swelling and pain
d) A + B
Pannus is;
a) The development of fibrous tissue
b) The development if bony prominences
c) The damage caused by RA to the bone
d) The destruction of articular cartilage
The pathophysiology of RA includes;

a) Fusion of the joints, destruction of cartilage and inflammation resulting in an
increased risk of fracture
b) Inflammatory response of the capsule surrounding the joint, pannus,
destruction of cartilage and fusion of the joints
c) Fusion of the joints
d) A decrease in joint cavity volume resulting in the bones rubbing together
What types of drugs are commonly used in the treatment of RA?

a) Non-Steroidal Anti-inflammatory Drugs, Corticosteroids and Disease
modifying anti rheumatic drugs
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b) Steroidal Anti-inflammatory Drugs and Corticosteroids and Disease modifying anti
rheumatic drugs
c) Narcotic Analgesics, Non-Steroidal Anti-inflammatory Drugs and Corticosteroids
d) All of the above
Ulcerative Colitis;
a) Has no known treatment
b) Does not cause an inflammatory response
c) Inflammation of discontinuous segments of bowel
d) Chronic inflammatory disease of the colon that causes ulceration of the
mucosa
What is the difference between Ulcerative colitis and Crohn’s Disease?

a) UC does not involve the mucosa
b) UC affects anywhere from mouth to anus and Crohn’s Disease can only affect the
colon
c) UC affects only the colon and Crohn’s Disease can affect anywhere from
mouth to anus
d) A + C
Rick factors for developing Ulcerative colitis include;

a) Asian or Caucasian Descent
b) Family History and poor diet
c) Caucasian decent, Ashkenazi Jews and Family history
d) Caucasian Descent and low fibre diet
The colon has three main parts what are they in order?
a) Ascending, Transverse, Descending
b) Appendix, Ascending, Descending and Rectum
c) Descending, Ascending and Rectum
d) Ascending, Transverse and Rectum
The bowel has three parts what are they in order?

a) Colon, Small bowel, Rectum
b) Small bowel, Colon, Rectum
c) Small bowel, Appendix, Rectum
d) Small bowel, Colon, Anus
The development of colorectal cancer is preceded by what?

a) Malignant neoplasms
b) Adenomatous polyp (adenoma)
c) Benign neoplasms (polyps)
d) All of the above
What is the standard bowel screening called?

a) Standard Blood Test
b) Faecal Occult Blood Test
c) Occult Blood Test
d) Stool Sample Testing
A Faecal Occult Blood Test tests for what?

a) Cancer Markers
b) Irritable Bowel Syndrome
c) Stage of Cancer
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d) Blood in Stool
What are the clinical manifestations of a colorectal cancer that has developed in the
descending colon?
a) Solid Faeces, Change in bowel habits, Bowel Obstruction, Pain and Bright
red blood
b) Liquid Faeces, Anaemia, Change in bowel habits, dark blood and pain
c) Solid Faeces, Rectal discomfort, Change in bowel habits, Pain and Bright red blood
d) Semisolid faeces, Pain, Obstruction, Anaemia and Change in bowel habits
ascending colon?
a) Solid Faeces, Change in bowel habits, Bowel Obstruction, Pain and Bright red blood
transverse colon?
What are the clinical manifestations of a colorectal cancer that has developed in the rectum?
c) Solid Faeces, Rectal discomfort, Change in bowel habits, Pain and Bright
red blood
What are risk factors for the development of prostate cancer?

a) Age, Genetics and Family History
b) Age, Genetics, History of vasectomy and a diet high in animal fats and
vitamin A
c) Age, Genetics, Alcohol consumption and poor diet
d) Family History, Poor Diet and Smoking
A radical prostatectomy
a) Removal of the prostate gland
b) Removal of part of the prostate gland
c) Involves the removal of the prostate gland and seminal vesicles, and
possible bilateral pelvic lymph node dissection.
d) Involves the removal of the prostate gland and seminal vesicles only
Mary is 82. She tripped and fell on her right arm. She is experiencing pain in her right forearm – pain
scale assessment 8 out of 10.
Mary was diagnosed with Osteoporosis 15 years ago. She has a shuffling gait, an obvious kyphosis and a
history of fragility (insufficiency) fractures. She smoked between 16 – 55 years of age. Since quitting
smoking she has a couple of gin and tonics each night. Her mother had the disease. Like her mother,
Mary has never liked or consumed dairy products.
Mary's osteoporosis has been treated with

alendronate (Fosamax) 70mgs weekly
calcium carbonate (Calcitrate) 1000mgs daily
ergocalciterol (Ostelin) 1000IU daily.
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X-ray revealed a comminuted epiphyseal fracture of the distal right radius. Mary is informed she will need
a closed reduction, done under general anaesthesia. Fentanyl 0.05mg IM is ordered as preoperative
medication.
The first stage of bone healing is initiated by

A) An acute inflammatory response and the infiltration of the fracture site by inflammatory cells
B) Angiogenesis and an increased blood flow to the site of injury
C) The migration of fibroblasts to the fracture site to lay down a fibrocartilaginous soft callus
D) Disruption of blood vessels in the cortex, bone marrow and soft tissues at the fracture site
leading to bleeding and haematoma formation
Mary's fracture would be described as a break in

A) two or more pieces, in the enlarged end of the long bone forming part of the elbow joint, on the medial
side of the forearm
B) two or more pieces, in the enlarged end of the long bone forming part of the wrist joint, on the
lateral side of the forearm
C) the shaft of the long bone on the medial side of the forearm, that pierces the skin near the elbow
D) the shaft of the long bone on the lateral side of the forearm, that pierces the skin neat the wrist
Acute compartment syndrome is a complication of fractures. What is the primary cause of acute
compartment syndrome?
A) An increase in muscle compartment volume due to oedema, vascular injury, bleeding, venous
obstruction
B) A decrease in muscle compartment volume due to bleeding from vascular injury
C) Loss of sensation and function of a limb from a tight fitting plaster
D) When a plaster cast is too loose and allows the muscle compartment to swell
Mary's kyphosis was caused by

A) her loss of height
B) the aging process
C) compression fractures of her vertebrae
D) lack of medication compliance
Osteoporosis is a
A) metabolic bones disorder characterised by inadequate or delayed mineralisation of bone matrix in
mature compact and spongy bone resulting in softening of bone (osteocalcin).
B) metabolic bone disorder characterised by a loss of bone mass and increased bone fragility and
an increased risk of fractures
C) degenerative disease of joints that leads to joint pain, stiffness and instability leading to increased risk
of falls and bone fractures
D) progressive metabolic skeletal disorder resulting from excessive metabolic activity, with excessive
bone remodelling resulting in larger and softer bone, pain, skeletal deformities arthritis and fractures
Fentanyl is a
A) non-narcotic analgesic that inhibits neuropathic pain
B) non-steroidal ant-inflammatory drug (NSAID) that inhibits peripheral pain
C) narcotic analgesic that acts on the Central Nervous System (CNS) to suppress the perception
of pain
D) nitric oxide biosynthetic pathway inhibitor that moderates the transmission of peripheral pain
Mary was prescribed ergocalciferol (Osterlind) because

A) vitamin D is essential for regulating all aspects of calcium and phosphate use by the body
B) calcium is essential to support physiological processes and bone strength
C) this drug inhibits osteoclast mediated bone resorption (bisphosphonates)
D) it inhibits bone resorption and the release of calcium ions back into the blood (calcitonin)
Which of the following statements describes fracture reduction?
Page 23
A) The bone fragments are held in place to facilitate bone healing
B) The bone fragments are realigned close to their original anatomical position
C) The injured limb is raised above the level of the heart
D) The injured limb is immobilised in a plaster back slab
One factor that would have contributed Mary's development of osteoporosis is

A) Increased androgen levels
B) decreased androgen levels
C) decreased oestrogen levels
D) increased oestrogen levels
Non-modifiable risk factors that may have contributed to the development of Mary's osteoporosis include
A) drinking more than one standard alcohol drink per day, cigarette smoking, lack of calcium intake
B) age, more than one standard drink of alcohol per day, family history of osteoporosis
C) cigarette smoking, Caucasian family origins, family history of osteoporosis
D) history of fragility fractures, family history of osteoporosis, age
A simple total mastectomy involves the removal of the

A) tumour and surrounding margins of breast tissue (lumpectomy)
B) entire breast, underlying chest muscles and lymph nodes under the arms (radical mastectomy)
C) breast tissue and lymph nodes under the arms (modified radical mastectomy)
D) complete affected breast only
Anthony Logon is a 63 year old male. For the past three months he has noticed small amounts of blood
and occasionally mucus in his stools. He has a sensation of pressure in the rectum and noticed his stools
are thinner, like a pencil. His doctor palpated a mass in his rectum and ordered a colostomy.
A large sessile lesion was found and a biopsy revealed adenocarcinoma.
Mr Logon is scheduled for an Abdo perineal resection and sigmoid colostomy.
Mr Logon's surgery involves the removal of the

A) entire colon, and the creation of a pouch from the terminal ileum that is anastomosed to a permanent
stoma formed from the sigmoid colon
B) affected area of the colon and a double-barrel colostomy formed from the sigmoid colon
C) sigmoid colon, rectum and anus through abdominal and perineal incisions, and the creation of
a permanent stoma formed from the proximal sigmoid colon
D) entire colon, and the anastomosis of the terminal ileum to the anus
Colorectal cancer always begins as

A) a sessile lesion
B) an adenomatous polyp
C) a granulomatous lesion
D) a single cell with modified DNA
The most common site for the development of colorectal cancer is the
A) rectum and sigmoid colon
B) sigmoid colon and descending colon
C) ascending colon
D) sigmoid colon
Primary prevention of colorectal cancer includes

A) increase the dietary intake of carbohydrates and reduce the ingestion of proteins
B) consume a high protein diet and reduce fruit and vegetable intake,
C) reduce the ingestion of fat, refined sugar, red meat and increase intake of dietary fibre
D) decrease intake of dietary fibre, fatty foods and red meat
Page 24
The primary complications of colorectal cancer are
A) diarrhoea, perforation of the bowel, weight loss
B) bowel obstruction, perforation of the bowel, direct extension of the tumour to adjacent organs
C) pencil-shaped stools, bowel obstruction, anaemia and fatigue
D) blood in the stools, constipation, weight loss, anaemia and fatigue
Amour, 64 years old, has been admitted to hospital with a diagnosis of stage liA, T1 N0 M0 cancer in her
left breast. Cherie has elected to have a simple total mastectomy. Her mother had died from breast
cancer at 59. Cherie is married and has two children. She had regular periods until the age of 56. Cherie
normally has regular mammograms, but as she and her husband had been doing a bit of travelling, she
had realised that she had not had a mammogram for four years.
Cherie has smoked since she was 22, approximately 20 cigarettes per day. She states that she drinks a
couple of glasses of wine most evenings and that she eats a well balanced diet but gets little exercise.
Her BMI is 28.5.
Cherie's oncologist has recommended that Cherie has a course of Chemotherapy, radiotherapy and
commence taking tamoxifen after her surgery.
Cherie should be advised that complications that may occur from ingesting tamoxifen are
A) fat embolism, weight loss, hot flushes
B) deep vein thrombosis (DVT) and pulmonary embolism, increased risk of developing
endometrial cancer
C) popular skin rash, vaginal dryness, anorexia and fatigue
D) anaemia, deep vein thrombosis, fat embolism
Non-modifiable risk factors that may have contributed to Cherie's development of breast cancer are
A) physical inactivity, drinking more than one alcoholic drink per day, obesity
B) postmenopausal age, family history of breast cancer, late menopause
C) having children after 30 years old, family history of breast cancer, gender
D) age, premenopausal, family history of breast cancer
Cherie should be advised to participate in self breast examination of her right breast
A) in the week after menstruation (premenopausal women)
B) in the week before menstruation occurs
C) on the same day or date of each month
D) once every three months
The staging of Cherie's breast cancer can be explained as a

A) tumour no larger than 2cms, no regional lymph node involvement, no distant metastasis
B) tumour no larger than 5cms,metastasis to axillary nodes, no distant metastasis
C) tumour larger than 5cms, involvement of moveable axillary lymph nodes, presence of distant
metastasis
D) tumour of any size, axillary fixed node involvement, presence of distant metastasis
Jeremy Myers, 36 years old, has been a competitive swimmer since he was 10 years old. During his
teenage year and until his late 20s, Jeremy trained rigorously every day. Over recent years he has tried to
continue to swim regularly but now finds the pain and stiffness in his shoulders is debilitating and limits his
activities.
Jeremy is now experiencing considerable shoulder immobility and pain at rest. Jeremy has had a
previous arthroscopy of his shoulders to alleviate some of the discomfort he experienced. His orthopaedic
specialist has now recommended he has total joint arthroplasty of both shoulders.
Jeremy has been prescribed meloxicam (Mobic. to manage his osteoarthritis. He finds he also needs to
take aspirin a couple of times a day to reduce his pain and discomfort.
Page 25
Jeremy should be reminded to take aspirin
A) on an empty stomach to prevent nausea
B) with a glass of mild to mask its bitter taste
C) just before going to bed to avoid the effects of dizziness
D) with meals to reduce gastric irritation
Aspirin is effective in the management of osteoarthritis as it

A) provides analgesia through the blockade of opioid receptors
B) reduces inflammation through cytokine modulation (bDMARd.
C) suppresses inflammation by inhibiting the proliferation of immune cells (e.g. methotrexate)
D) relieves inflammation and pain through the inhibition of the synthesis of prostaglandin
The pain associated with the early osteoarthritis is described as

A) aching, relieved by rest and aggravated by use of the joint
B) shooting, constant, not relieved by rest
C) aching pain at night accompanied by tingling and numbness (late disease)
D) cramping pain associated with exposure to cold environments
The structural changes that would have occurred in Jeremy's joints affected by osteoarthritis include
A) formation of bone cysts, formation of pannus, joint stiffness
B) tinning and loss of cartilage, sclerosis of subchondral bone, formation of osteophytes
C) flaking of cartilage, joint stiffness, synovitis
D) fissures extending into subchondral bone, bone cysts, formation of pannus
Total joint arthroplasty is a procedure performed to

A) replace both surfaces of the affected joint with prosthetic parts
B) visualise, debride and flush out the joint to remove debris (arthroscopy)
C) relieve pain and provide support in the affected joint through surgical fixation (arthrodesis)
D) realign the affected joints
What is osteoclast activity?

a) The creation of new bone
b) Resorption, the removal of bone
c) The remodelling on bone
d) The removal of calcium from bone
What is formation in relation to bone?

a) The creation of new bone through osteoblast activity
b) The creation of new bone through osteoclast activity
c) The depositing of calcium in new bone
d) When oestrogen binds to osteoblasts to activate bone formation
Intravenous fluid that nay be used with safety in the management of a person experiencing
a fluid volume deficit in the perioperative period includes
0. 9% sodium chloride (NaCl)
3% sodium chloride
10% dextrose in water (D10W)
Hypervolemia refers to
Decreased extracellular fluid (low blood volume)
High intravascular volume (increased blood volume)
Excessive interstitial fluid (oedema)
Decreased interstitial fluid
The management of a fluid volume excess in the perioperative period includes
Page 26
A restriction of fluid intake
Aggressive fluid replacement therapy
Increased foods containing sodium in the diet
The administration of drugs that retain sodium
Hypertonic solutions
Attract solutes into cells
Do not shrink or expand cells
Draw water out of cells - shrink cells
Facilitate the movement of water into cells and cause cells to swell
Intravenous fluid that nay be used with safety in the management of a person experiencing
a fluid volume deficit in the perioperative period includes
3% sodium chloride
Complications that may develop from fluid volume excess include

Cerebral and pulmonary oedema
Hypovolemic shock
Postural hypotension
Acute renal failure
Extracellular fluid includes fluid

Within cells only
In blood vessels only
Only in the space between the cells and blood vessels
All body fluid outside the cells
The management of a fluid volume deficit in the perioperative period includes

The rapid administration of intravenous fluids
Gradual rehydration with oral or intravenous fluids
The restriction of fluid intake
Avoid food or fluids that contain sodium
Intracellular fluid includes the fluid

Within cells
In blood vessels only
Only in the space between the cells and blood vessels
Hydrostatic pressure is defined as

The power of a solution to push water across a membrane
Oedema is the result of

Excess interstitial fluid
Clinical manifestations of fluid volume deficit include

Thirst, weight loss, increased temperature
Decreased urine output, oedema, poor skin turgor
Dry skin and mucous membranes, weight gain, increased BP
Tachycardia, hypertension, decreased capillary refill
Clinical manifestations of hypervolemia include

Oedema, polyuria, increased thirst
Page 27
Weight gain, decreased urine output, increased pulse rate
Moist crackles in the lungs, weight loss, oedema
Distended neck veins, increased blood pressure, polyuria
A complication that may develop from severe fluid volume deficit is

Hypovolemic shock
Hypertonic solutions
Draw water out of cells - shrink cells
As a person ages, the percentage of body water to body weight

Decreases compared to a younger adult
A neuron is
A cell body that contains a nucleus
An axon that extends the length of the spinal cord
The basic unit of the nervous system that sends and receives information
The progression of the nerve impulse across the synaptic cleft
An individual's response to pain is not influenced by family, community and culture.

True
False
Narcotic analgesics increase both the pain threshold and pain tolerance.
True
False
Behavioral responses to pain include

Fear, withdrawal, moaning, crying
Protecting the painful area, stoicism, anger
Reluctance to move, grimacing, crying, restlessness
Anxiety, depression, anger, withdrawal
Endorphins are found attached to neurons in

Peripheral nerves only
The spinal cord only
The brain only
The brain, spinal cord and the GIT
Common-adverse effect of non- steroidal anti-inflammatory drugs are

Dyspepsia, gastric irritation, peptic ulcers
Narcotic analgesics alter the perception of pain and the emotional response to pain.
True
False
Common adverse effects of narcotic analgesics are

Decreased respiratory rate, cough suppression, hypotension, sweating
Nausea, vomiting, diarrhea, decreased respiratory rate
Sense of euphoria, sedation, hypertension, urinary incontinence
Miosis, peripheral vasoconstriction, vomiting and diarrhea
A neuromodulator is a substance that

Can alter pain pathways by altering nerve impulse transmission
Can stimulate nociceptors
Has no effect on nerve impulses
Page 28
Are released only in the spinal cord
A painful condition that results from peripheral nerve damage caused by infections or
diseases are called
A Neuralgia
Somatic pain
Visceral pain
Referred pain
Nociceptors are stimulated by chemical mediators that are released as a result of

Tissue trauma, ischemia and inflammation
Common features of complex regional pain syndrome (CRPS. include

Vasoconstriction, vasodilation and muscle wasting
Colicky, intermittent pain and cramping
Pain that may radiate or be referred
Nausea, vomiting and hypotension
Affective (psychological. responses to pain include

Anxiety, depression, anger, withdrawal
Central pain is pain related to a lesion, trauma or inflammation in the

Brain or spinal cord
Chemical mediators released from inflamed and/or damaged tissue that are capable of
stimulating nociceptors include
Histamine, prostaglandins, bradykinin
Ulcerative colitis is a chronic inflammatory bowel disorder affecting the mucosa and
submucosa of the colon and rectum.
True
False
The area of the gastrointestinal tract (GIT. typically affected by ulcerative colitis is
Any part of the GIT from the mouth to the anus
The terminal ileum and ascending colon
The colon in a continuous pattern progressing proximally from the rectum
The retro sigmoidal region of the anal canal only
Complications of ulcerative colitis include

Toxic megacolon, bowel obstruction, fistula formation
Bowel obstruction, fistula formation, bowel perforation
Toxic megacolon, hemorrhage, bowel strictures
Fistula formation, bowel obstruction, hemorrhoids
Fulminant colitis (pancolitis. involves the

Retro-sigmoidal area of the rectum only
Terminal ileum
Rectum and descending colon
Entire colon
In the course of the inflammatory process of ulcerative colitis, the mucosa becomes red,
edematous, and very friable. Increased friability of the mucosa leads to
Tongue like projections of bowel mucosa forming
The mucosa being easily broken and bleeding is common
Increased local inflammation and warmth in the mucosa
A granular appearance of the mucosa
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The clinical manifestations of Crohn's disease include
Persistent bloody diarrhea, palpable mass in the lower left abdominal quadrant, fatigue,
weight loss, anemia
Persistent diarrhea with pus, anorectal lesions such as fissures, ulcers, fistulas, weight gain,
hypervolemia, fatigue
Fatigue, weight loss, malaise, anorectal lesions such as fissures, ulcers, fistulas,
pain in lower right abdominal quadrant
Persistent diarrhea with blood and pus, lower left quadrant pain, anemia, malaise, fatigue
Corticosteroids are
Not used to treat Crohn's disease because of their significant adverse effects
Used to maintain a remission of Crohn's disease
Used to treat acute episodes of Crohn's disease
Maintained as continuous management of Crohn's disease
Enteral diets, such as Ensure may be advised for a person experiencing an acute
exacerbation of Crohn's disease because
They are largely absorbed in the jejunum and allow the inflamed bowel to rest
The person with acute Crohn's disease is too fatigued to chew
They have a high lactose content
They are a very palatable protein shake
In the course of the inflammatory process of ulcerative colitis, abscesses form in the mucosa
and penetrate the submucosal layers of the colon. An abscess is a
Cavity containing pus surrounded by inflamed tissue
The dietary management of a person who has ulcerative colitis should include
A high intake of protein, calories and vitamins
Chronic inflammation of the colon in ulcerative colitis leads to

A 'cobblestone' appearance of the lumen of the colon
The formation of deep fissures
Atrophy, narrowing and shortening of the colon and loss of haustra
The formation of fistulas between the colon and the perineum
Immunosuppressant drugs are not used to treat acute exacerbations of Crohn's disease and
ulcerative colitis as they have an onset of action three to six months.
True
False
Fistulas are
A cleft or groove extending deeply into the bowel wall
Tube-like passages that form connections between an internal organ and the skin
or between two organs
A proliferation of fibrous connective tissue
Tongue-like projections of bowel mucosa
5-aminosalicylic acid (-ASA. drugs inhibit the inflammatory processes of Crohn's disease and
ulcerative colitis by inhibiting the synthesis of prostaglandins.
True
False
The inflammatory lesions of Crohn's disease progress

In a continuous pattern proximally from the rectum
To the adjacent submucosa of the bowel wall
As 'skip lesions' with intervening areas of normal bowel
Page 30
To involve the entire colon
The initial lesions that develop in Crohn's disease are aphthoid lesions. An aphthoid lesion is
a
Shallow lesion with a wide base and raised margins
Premenopausal women are advised to perform self-breast examination every

Two months after the age of forty
Month on the same day or date
Month in the week before menstruation
Month in the week after menstruation
The incidence of breast cancer in women

Decreases with age
Increases with age
Is not age related
Peaks in the pre-menopause period
Postmenopausal women are advised to do self-breast examination

Two months after the age of forty
Month on the same day or date
Month in the week before menstruation
Month in the week after menstruation
Modifications to the DNA of breast tissue cells are caused by

Genetic alterations
Environmental agents
Maternal and paternal germlines
Genetic alterations, environmental agents or their interactions
The area of the breast most commonly affected by breast cancer is the
Upper outer quadrant
Lower outer quadrant
Area surrounding the areolar
The nipple and areolar
A mutation on the BRCA1 gene

Causes mutations on chromosome 17
Changes an initial normal cell into a cancer cell
May lead to the uncontrolled proliferation of cells
Causes suppression of normal cell growth
To reduce the risk of breast cancer, a woman should

Maintain a healthy body weight, participate in regular activity, and have a low fat
diet
Not take oral contraceptives, avoid vigorous exercise, have regular mammograms
Eat many fresh fruits and vegetables, not breastfeed, take oral contraceptives
Eat a diet high in animal fat, have regular exercise, maintain a healthy body weight.
Most breast cancers (around 70%. arise from the

Epithelial cells of the lobules
Epithelial lining of the glands of Montgomery in the areola
Epithelial linings of the lactiferous ducts
Subepithelial cells of the acini
Following mastectomy and lymph node dissection, it is critical that the nurse
Does not elevate the arm on the surgical side
Page 31
Measures blood pressure and sites IVIs on the nonsurgical side
Instructs the woman not to exercise the arm on the surgical side
Elevates the arm on the nonsurgical side
A simple mastectomy is a surgical procedure during which the

Entire affected breast, the underlying chest muscles, the lymph nodes under the arm are
removed
Affected breast and axillary lymph nodes are removed
Tumor and surrounding margin of breast tissue is removed
Complete affected breast is removed
A 76 year old female is diagnosed with osteoporosis by dual x-ray absorptiometry.

This lady is at a high risk for the development of
Bone infections
Joint injuries
Bone fractures
Osteopenia
A 70 year old woman presents with a hip fracture. She is diagnoses with osteoporosis.
One factor that most likely contributed to her condition is
Increased androgen levels
Decreased estrogen levels
Excessive strenuous exercise
Excessive dietary calcium
Osteoporosis is diagnosed when a person is assessed as having a bone density T-score of ?-

2.5 where normal bone density is considered to be ?-1. What technological imaging device is
used to measure T-scores (bone mineral density)?
Bone mineral density T-score is assessed by
Ultrasound
CT scan
X-ray
Dual imagery x-ray absorptiometry (DXA)
What is the role of regular weight bearing exercise in the primary prevention of
osteoporosis?
Regular weight bearing exercise
Places mechanical stress on bones which decreases bone formation and increases bone
resorption
Places mechanical stress on bones which increases bone formation and decreases
bone resorption
Maintains joint mobility to help prevent falls
Improves balance and gait deficits to help prevent fall
Bisphosphonates (e.g. alendronate) is a common family of drugs used to treat osteoporosis.

Which of the following statements is important patient education for the person taking these
drugs?
It is important that the person taking Bisphosphonates is told to
Take the medication with food to enhance its absorption
Take the medication just before going to bed to minimise the effects of nausea
Remain upright for a minimum of 30 minutes after taking the medication to avoid
the risk of gastritis occurring
Take the medication with a glass of milk to avoid the metallic taste
Exposure of unprotected skin to UV radiation is important in the prevention of osteoporosis

because
Page 32
UV light is responsible for vitamin D to be absorbed from the diet to facilitate its binding to
calcium so that calcium is able to form the extracellular bone matrix
UV light is responsible for the conversion of the precursors of vitamin D to
vitamin D?, which is then processed by the liver and kidneys to become activated
vitamin D (calcitriol)
UV light is responsible for the absorption of calcium into the blood stream to facilitate the
homeostasis of Vitamin D in the body
UV light is responsible for the breakdown of dietary vitamin D to its simplest form to enable
it to enter the blood stream to maintain to maintain calcium homeostasis
Non-modifiable risk factors for the development of osteoporosis include

Inadequate dietary calcium, inadequate UV exposure, inadequate weight bearing exercise
Increasing age, Glucocorticoid therapy of? 3 months, family history of
osteoporosis
Cigarette smoking, Caucasian family origins, family history of osteoporosis
History of fragility fracture, BMI < 20kg/m², increasing age
What is the rationale for the administration of calcium supplements in the management of
osteoporosis? Calcium supplements are administered to
Ensure the prevention of primary osteoporosis
Increase calcium stores to prevent iatrogenic osteoporosis
To build calcium stores in the prevention and management of osteoporosis
To build calcium stores to maintain peak bone mass density in premenopausal women
At what stage in a person's lifetime should they engage in dietary and lifestyle strategies to
prevent osteoporosis? A person should engage in dietary and lifestyle habits to prevent
osteoporosis
During childhood
During young adulthood
After turning 30
At the onset of menopause
Which of the following statements provides one explanation why men generally display
clinical manifestations of osteoporosis at an older age than women?
The peak bone mass density (BMD) of a male is not affected by a decline in estrogen
The peak BMD of a male is not affected by a decline in male sex hormones
The peak BMD of a male is generally 8% to 10% higher than the peak BMD of a
female
The peak BMD of a male is generally 8% to 10% lower than the BMD of a female
In the event that a person experiences hypocalcemia, Parathyroid hormone (PTH) mobilises
calcium from bone by binding to osteoblasts which indirectly signals an increase in
osteoclast number and activity. What is the rationale for this physiological process? PTH
mobilises calcium from bone when hypocalcemia occurs in order to
Mobilise calcium back into blood so that excess calcium can be excreted out of the body via
the kidneys
Prevent deposits of calcium salts forming in the soft tissues and kidneys
Move calcium back into blood to support the calcium dependent physiological
processes of the body
Facilitate the absorption of more calcium back into bones
Modifiable risk factors for the development of osteoporosis include

Inadequate dietary calcium, inadequate UV exposure, inadequate weight bearing
exercise;
Inadequate dietary calcium, inadequate weight bearing exercise, family history of
osteoporosis
Inadequate weight bearing exercise, Caucasian family origins, inadequate UV exposure
Page 33
Inadequate dietary vitamin D, BMI < 20 kg/m², increasing age.
What is the role of calcium in the maintenance of bone mass density? Calcium is responsible
for
Forming much of the extracellular matrix of trabecular bone
Forming most of the organic matrix of cortical bone
Facilitating the uptake of vitamin D into bone
Controlling levels of parathyroid hormone in bone
Primary prevention of osteoporosis includes

Identifying individuals at risk of fractures
Commencing hormone replacement therapy in postmenopausal women
Ensuring an adequate intake of dietary calcium
Commence vitamin D replacement therapy in the fourth decade
Low dietary intake of calcium is a modifiable risk factor for developing osteoporosis. Which
of the following groups contain good dietary sources of calcium?
Good dietary sources of calcium are
Milk, yoghurt, rhubarb, kale
Milk, cheese, yoghurt, herrings
Milk, yoghurt, sardines, soft drinks
Milk, cheese, sardines, dried figs
Which of the following pathological changes are characteristic of osteoporosis? The

pathological changes that are characteristic of osteoporosis are
Cortical bone becomes denser and trabecular bone thickens
Cortical bone thickens and trabecular bone thins
Cortical bone becomes porous and thin and the structural integrity of trabecular
bone is impaired
Cortical bone becomes porous and loses its trabecular meshwork and compact bone
becomes weak
Which of the following processes leads to osteoporosis in the years after an individual
achieves their peak bone mass density (BMD)?
Bone formation by osteoclasts exceeds bone resorption by osteoblasts
Bone formation by osteoblasts exceeds bone resorption by osteoblasts
Bone resorption by osteoblasts exceeds bone formation by osteoclasts
Bone resorption by osteoclasts exceeds bone formation by osteoblasts
Which of the following strategies may be employed to help a person diagnosed with
osteoporosis prevent falls? A strategy that may help prevent falls in a person who is
diagnosed with osteoporosis is
Increase dietary intake of calcium
Assess past history of falls
Have regular bone mass density assessments
An exercise program tailored to meet the individual’s specific needs and abilities
Strategies used to diagnose prostate cancer are patient history,

Prostate specific antigen (PSA. levels, biopsy, MRI and CT scan
PSA assessment, digital rectal examination (DRE. MRI
PSA assessment, DRE, trans-rectal ultrasound (TRUS. and biopsy
PSA assessment, TRUS, biopsy, CT scan
Which of the following statements most accurately describes the significance of prostate
specific antigen (PSA. assessment as a tool for diagnosing prostate cancer?
PSA is organ-specific so an increased level is diagnostic of prostate cancer
There is a normal range for PSA so an increased level is diagnostic of prostate cancer
Page 34
PSA is cancer-specific so any increase in levels is diagnostic of prostate cancer
An increase in PSA levels over time is more significant than one reading in the
diagnosis of prostate cancer
Clinical manifestations of prostate cancer include

Erectile dysfunction, bone, hip and pelvic pain, urgency, blood in the faeces
Bone or joint pain, frequency, hematuria, incomplete bladder emptying
Low sperm count, nocturia, nerve pain, difficulty commencing voiding
Poor flow of urine, weight gain, haematospermia, migratory bone pain
Which of the following specific dietary strategies may reduce a man's risk of developing
prostate cancer
Reduce protein intake and increase high fibre fruit and vegetables
Reduce fruit intake, increase vegetable intake, and reduce intake of animal fats
Increase intake of tomatoes, pink grapefruit and watermelon, reduce red meat
and fat intake
Increase vitamin E intake and avoid tomatoes, red meat and high fat foods
Complications that may occur after a simple prostatectomy (TURP. include

Urinary incontinence, hemorrhage, infection
Impotence, retrograde ejaculation, polyuria
Urinary retention, uremia, clot retention
Dribbling of urine, muscle weakness, infection
Risk factors for the development of prostate cancer include

Age, family history of prostate cancer, having a vasectomy
Family history of prostate cancer, infertility, diet high in animal fat
Having a vasectomy, celibacy, excessive supplemental vitamin A
Genetic and hereditary factors, age, insufficient vitamin K
Obstruction to the flow of urine may be caused by the

Enlarging tumour compressing the urethra
Enlarging tumour compressing the ureter
Tumour occupying space in the bladder
Metastatic spread to the kidneys
The most common site for metastasis from a primary prostate cancer is
The bowel
Bone, particularly the hips and vertebrae
The liver and spleen
The brain
Almost all primary prostate cancers are adenocarcinomas that develop in the
Capsule of the prostate gland
Medial lobe of the prostate gland
Central zone of the prostate gland
Peripheral zone of the prostate gland
The action of anti-androgen agents in the treatment of prostate cancer is to

Enhance the movement of androgens into the cancer cells to prevent tumour growth
Cause the tumour to shrink by blocking androgens entering the cells
Prevent the production of nucleic acid and DNA production
Interrupt the cell life cycle in the G1 phase
Which of the following statements describes the procedure transurethral resection of the
prostate (TURP)?
Page 35
A laser bean is delivered by a cystoscope transurethral to cut, coagulate and vaporise
excessive prostatic tissue with several short bursts of energy
A surgical procedure to remove the prostate, prostate capsule, seminal vessels and a portion
of the neck of the bladder through open or laparoscopic surgery
A surgical procedure to remove the prostate, prostate capsule, seminal vessels and a portion
of the neck of the bladder through a perineal incision
Prostate tissue that is obstructing the urethra is removed using a resectoscope
and electro cautery via the urethra, flushed into the bladder, and flushed from the
bladder after the procedure
Complications of radiation therapy include

Cystitis, constipation, urethral stricture
Diarrhoea, rectal ulcer, urinary incontinence
Proctitis, peritonitis, erectile dysfunction
Bowel obstruction, rectal stricture, azotemia
The outer covering of each bone, made from fibrous connective tissue, is called the
________________.
A) epiphysis
B) diaphysis
C) articular cartilage
D) periosteum
Inside the epiphyses of each long bone, mostly ________________ can be found.
A) compact bone
B) spongy bone
C) cartilage
D) yellow marrow
Compact bone is made up of _______________ cemented together.

A) osteocytes
B) perforating canals
C) osteons
D) trabeculae
Which of these statements is not true about intramembranous bones?

A) They begin with a cartilage model.
B) They form between flat sheets of connective tissue.
C) Skull bones are formed in this way.
D) Osteoblasts deposit new bone along blood vessels within the layers.
The cells that tear down and remodel bone are the ________________.
A) osteoblasts
B) osteocytes
C) osteoclasts
D) macrophages
Which of these factors is not necessary for normal bone growth and development?
A) growth hormone
B) high fat diet
C) male and female sex hormones
D) Vitamins A, C, and D
Which type of bone fracture occurs as an incomplete break in the bone?

A) greenstick
B) oblique
C) compound
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D) simple
Which type of fracture breaks the bone into several fragments?

A) complete
B) impacted
C) comminuted
D) spiral
What is the last stage in the repair of a fracture?

A) bony callus
B) hematoma
C) inflammation
D) fibrocartilage callus
A fracture is:
Any break in the continuity of a bone.
A break in the continuity of a bone and tendon.
A break in the continuity of a bone and ligament.
A partial break in the continuity of a bone.
Fracture healing progresses over how any phases?

4
2
1
3
From the age of 35 years onwards, more bone cells are lost than replaced in the body.
True
False
Gout only affects the higher socioeconomic classes.

True
False
The joints most affected by osteoarthritis are those in the hand, wrist, neck, lower back, hip,
knee, ankle, and feet.
True
False
Pain associated with peptic ulcer disease is often unpredictable and unpreventable.
True
False
The breasts are located:

Between the sixth and seventh ribs on the anterior chest wall supported by the pectoral muscles.
Between the third and seventh ribs on the anterior chest wall supported by the pectoral muscles.
Between the third and seventh ribs on the posterior chest wall supported by the pectoral muscles.
Between the third and seventh ribs on the anterior chest wall supported by the gluteal muscles.
A fistula is an normal opening or passage between two organs or spaces that are not normally separated or an
normal passage to the outside of the body.
True
False
Leiomyomas are malignant tumours.

True
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False
A significant risk factor for endometrial cancer is prolonged oestrogen stimulation as well as obesity.
True
False
Dysuria is another word for:

Impotence.
Blood in the urine.
Difficulty breathing.
Difficulty passing urine.
The term cancer means

A) cell division.
B) out of control.
C) crab.
D) lobster.
Cancer is often the result of activation of ____ to ____ and the inactivation of ____ genes.
A) oncogenes, tumor-suppressor genes, proto-oncogenes
B) proto-oncogenes, oncogenes, tumor-suppressor genes
C) oncogenes, proto-oncogenes, tumor-suppressor genes
D) proto-suppressor genes, suppressors, oncogenes
About 50% of all human cancers may involve an abnormal or missing

A) oncogene.
B) proto-oncogene.
C) p53 gene.
D) BRCA-1 gene.
Inherited retinoblastoma requires ____ mutation(s) or deletion(s).

A) one
B) two
C) three
D) four
In which of the human cells listed below is telomerase active?

A) blood
B) bone
C) muscle
D) sperm
Which of the following is not a characteristic of cancer cells?

A) loss of cell cycle control
B) transplantability
C) loss of contact inhibition
D) all are characteristic
BRCA-1 is associated with which cancer?

A) breast
B) thyroid
C) nerve
D) leukemia
If 85% of lung cancer cases occur in heavy smokers, can lung cancer still have a genetic
origin?
A) yes
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B) no
An increasing number of women in the rural south die from ____ cancer.
A) breast
B) colon
C) lung
D) mouth
Which of the following statements about telomerase is incorrect?
A) It is an enzyme that adds DNA to telomeres.
B) It serves as the template for telomeres lengthening.
C) It is not activated in cancer cells.
D) Its activity continually resets the cellular clock.
Familial cancer is caused by

A) a mutation in somatic cells only.
B) a mutation in germline cells only.
C) a germline mutation plus a somatic mutation in affected tissue.
D) two germline mutations.
A cancerous tumor eventually grows faster than surrounding tissues because a greater
proportion of its cells are dividing. True or false?
A) true
B) false
Which type of cancer in humans is directly caused by a viral infection?

A) acute T cell leukemia
B) Wilms' tumor
C) Burkitt's lymphoma
D) Rous sarcoma
An oncogene transcribed and translated with another gene produces a

A) transcribed protein.
B) fusion protein.
C) fusion cell.
D) cancer protein.
The P53 protein normally promotes

A) DNA repair.
B) tumor formation.
C) cell division.
D) apoptosis.
The P53 gene is especially prone to

A) point mutation.
B) chromosomal rearrangement.
C) loss.
D) none of the above.
FAP colon cancer results from ____ mutation(s).

A) one
B) two
C) three
D) four or more
Which type of study compares the incidence of a type of cancer among very different groups
of people?
A) population
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B) case-control
C) prospective
D) empiric
Which type of study would compare cancer rates seen in a group of individuals who take
herbal supplements versus those in a control group who do not use the supplement?
A) population
B) case-control
C) prospective
D) empiric
Which of the following cancers develops from loss of tumor suppression?

A) cute T cell leukemia
B) Wilms' tumor
C) Burkitt's lymphoma
D) Rous sarcoma
Why is genetic counseling for familial breast cancer difficult?

A) BRCA1 and BRCA2 are incompletely penetrant.
B) Breast cancer can occur in other ways.
C) Not all mutations are associated with disease.
D) all of the above
Which of the following is not a traditional cancer treatment?

A) blocking telomerase
B) inhibiting angiogenesis
C) stimulating specialization
D) none of the above
A mutation in which gene makes nearby DNA more susceptible to replication errors?
A) APC
B) BRCA1
C) P53
D) RB
Which of the following may contribute to causing cancer?

A) a mutation in a gene that slows the cell cycle
B) faulty DNA repair
C) loss of control over telomere length
D) all of the above
The colon is also called the:

A. Stomach
B. Ileum
C. Large bowel
D. Duodenum
The terminal portion of the small intestine is known as the:

A. Duodenum
B. Jejunum
C. Ileum
D. Caecum
The major function of the large intestine is to:

A. Remove waste materials
B. Secrete digestive enzymes
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C. Produce prothrombin
D. Regulate the release of bile
Hormones that inhibit gastric secretion include:

A. Secretin
B. Gastrin
C. Insulin
D. Histamine
Peptic ulcer mainly occurs in the:

A. Large intestine
B. Mouth
C. Stomach
D. Spleen
Parotitis is the inflammation of the:

A. Stomach
B. Uterus
C. Bladder
D. Rectum
If a patient experiences severe nausea and vomiting, it may result in:

A. Inflammation of the oral cavity
B. Inflammation of the colon
C. Fluid and electrolyte imbalance
D. Depletion of fat in the body
Colitis is the inflammation of the:

A. Colon
B. Stomach
C. Gall bladder
D. Spleen
The creamy substance that enters the duodenum is called:

A. Chyme
B. Saliva
C. Bile
D. Pancreatic juice
The small intestine is sometimes called:

A. Mega colon
B. Large bowel
C. Small bowel
D. Stomach
Nearly all colorectal cancers are:

A. Adenocarcinomas
B. Sarcomas
C. Lymphomas
D. Non-invasive
The layer of the digestive tract that contains blood vessels, lymphatic nodes and elastic fibers is the:
A. Serosa
B. Submucosa
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C. Mucosa
D. Tunica externa
If an incision is made in the small intestine, the first layer of tissue to be cut is:
A. Serosa
B. Submucosa
C. Mucosa
D. Tunica externa
Most prostate cancers are:

A. Adenocarcinomas
B. Leiomyoma
C. Astrocytoma
D. Sarcoma
Early stage prostate cancers can be:

A. Symptomatic
B. Infectious
C. Asymptomatic
D. Associated with a sexually transmitted infection
In prostate cancer paraplegia may be:

A. Secondary to bladder neck obstruction
B. Secondary to spinal cord compression
C. Only present in men under 40 years
D. Secondary to ethnicity
Cryotherapy refers to:

A. The insertion of radioactive material into the bladder
B. The insertion of chemotherapeutic drugs into the bladder
C. The insertion of radioactive and chemotherapeutic materials into the bladder
D. The use of extreme cold in surgery or other medical treatment
An infiltrating carcinoma of the nipple epithelium is called:

A. Paget's disease
B. Perth’s disease
C. Peronei’s disease
D. Pemphigoid disease
Mastalgia refers to:

A. Carcinoma in situ
B. Pain or discomfort in the breast
C. Invasive carcinoma
D. Numbness
Where there are palpable lesions in breast cancer:

A. No treatment is needed
B. Fine-needle aspiration is required
C. There is a need to make a referral to palliative care services
D. Antibiotics are required
Adjuvant treatment for breast cancer involves:

A. Surgery only
B. Radiation and surgery only
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C. Radiation therapy, chemotherapeutic and biological agents
D. Biological agents only
Osteomyelitis refers to:

A. An infection of the bone covering
B. An infection of the joint
C. An infection of bone marrow
D. An infection of the epiphysis
An involucrum is:
A. A layer of old bone
B. The formation of bone
C. An encasing sheath of live bone
D. An encasing sheath of dead bone
In osteomyelitis the major cause of bone infections is:

A. Staphylococcus aureus
B. E. coli
C. Streptococci
D. Gonococci
Osteomyelitis commonly affects:

A. Irregular bone
B. Long bone
C. Short bone
D. Flat bone
Rheumatoid arthritis is:

A. An inflammatory condition
B. An infectious disease
C. A condition that only affects women
D. A condition that only affects men
An auto-immune condition:
A. Always leads to cancer
B. Occurs when the immune system mistakenly attacks the body's own tissues
C. Causes infertility
D. Responds to chemotherapy
The joint(s) most commonly affected in rheumatoid arthritis are:

A. The atlas
B. The hands, feet and wrists
C. The spine
D. The patella
The most common complication of rheumatoid arthritis is:

A. Loss of hair
B. Amenorrhea
C. Carpal tunnel syndrome
D. HIV
Which of the following risk factors for osteoporosis is modifiable?

Older age
Gender
History of amenorrhea
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Low body weight
Which of the following nutritional factors influences osteoporosis risk?

Vitamin E
Vitamin C
Biotin
Vitamin D
Which of the following exercises is not protective against bone loss and osteoporosis?
Swimming
Running
Strength training
Tennis
Which fat soluble vitamin is essential to preventing osteoporosis?

E
K
D
A
Crohn’s disease:
a. Is caused by mumps virus
b. Is more common in Asians than in Jews
c. Tends to occur in families
d. Is less frequent in temperate climates than in tropical ones
e. Is improved by smoking
Recurrence after operation for Crohn’s disease:

a. Occurs after operations for ileal Crohn’s but not colonic Crohn’s
b. Is usually found just proximal to an enteric anastomosis
c. Rarely requires reoperation
d. Occurs in 1% of patients at risk per year during the first 10 years after the operation
e. Is prevented by maintenance therapy with corticosteroids
What are the typical patterns of distribution of Crohn’s disease?

a. disease limited to the colon
b. disease limited to the terminal ileum
c. disease affecting any part of the gut from the mouth to the anus
d. inflammation limited to the small bowel
e. perianal disease, including fistulae, fissures and abscesses
Ulcerative Colitis with malignancy

a) Has a better prognosis than Carcinoma Colon alone
b) Is related to disease activity
c) Is related to duration of ulcerative colitis
d) Malignancy is more in anon rectal ulcerative colitis
In ulcerative colitis with toxic megacolon lowest recurrence is seen in

a) complete proctocolectomy and brook's ileostomy
b) Ilea rectal anastomosis
c) Koch’s pouch
d) Ilea anal pull through procedure
All are premalignant except

a) Turcot syndrome
b) Cowden syndrome
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c) Juvenile polyposis coli
d) none
Colonic polyps are seen to regress with

a) Azathioprine
b) streptococci
c) Sulindac
Q60) All are precancerous for carcinoma colon except

a. Crohn's disease
b. Bile acids
c. Fats
d. carotene
Toxic Megacolon is associated with all except

a) Ulcerative colitis
b) Crohn's Disease
c) Pseudomembranous Colitis
d) Shigella
Common prostate cancer symptoms include

Slow urinary stream
Frequent urination
Problems during sexual intercourse
All of the above
1. Crohn’s disease is primarily a gastrointestinal (GTI) system condition,

which other body system is mainly involved? – Immune system
2. The cause of Crohn’s disease is – idiopathic
3. The clinical manifestations of Crohn’s disease include – pain in lower
right abdominal quadrant
4. The initial lesions that develop in Crohn’s disease are aphthoid lesions.
An aphthoid lesion is a – shallow lesion with a wide base and
raised margins
5. Complications of Crohn’s disease include – bowel obstruction,
increased risk of colon cancer
6. The lesions of Crohn’s disease may affect – all layers of the bowel
wall
7. Gastro-oesophageal reflux disease (GORD) commonly manifests as
reflux. Reflux is an alternative term for – Regurgitation
8. The following are all clinical manifestations of Gastro-oesophageal
reflux disease (GORD) which may be used in the diagnostic process
except – Dyspnoea
9. Gastro-oesophageal reflux disease (GORD) or gastroesophageal reflux
disease (GERD) – also commonly known as acid reflux disease is- a
disease of the distal oesophagus and stomach
10. Gastro-oesophageal reflux disease (GORD) is a chronic
Gastrointestinal disorder affecting many people. Which one of the
following options is not a lifestyle change for the management of
GORD in adults - Avoid eating meals during the day
11. The following are complications of gastro-oesophageal reflux
disease (GORD) except – Bowel cancer
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12. Which of the following two (2) are often used as diagnostic
syndromes of Gastro-oesophageal reflux disease (GORD) –
indigestion and haemoptysis
13. Bisphosphonates (For example: Alendronate/Fosamax) are a
common group of drugs used to treat osteoporosis. Which of the
following statement is important patient education for the person
taking these drugs? It is important that the person taking Alendronate
– remain upright for a minimum of 30 mins after taking the
medication to avoid the risk of gastritis occurring
14. At what stage in a person’s lifetime should they engage in
dietary and lifestyle strategies to prevent osteoporosis? A person
should engage in dietary and lifestyle habits to prevent osteoporosis –
From childhood
15. Osteoporosis can be diagnosed by assessing bone density. Image
used to measure bone mineral density (using T-scores) is called – dual
imagery x-ray absorptiometry (DXA)
16. Which of the following statements provides one explanation why
men generally display clinical manifestations of osteoporosis at an
older age than woman? – men do not often experience the
sudden drop in hormone (oestrogen) levels that women do at
menopause
17. A 70 years old woman presents with a hip fracture. She is
diagnoses with osteoporosis. One factor that most likely contributed to
her condition is – decreased oestrogen levels
18. Which of the following processes leads to osteoporosis in the
years after an individual achieves their peak bone mass density
(BMD)? – Bone resorption by osteoclasts exceeds bone
formation by osteoblasts
19. Osteoarthritis most commonly occurs in the – knees, hips,
hands and spine of men and women over 40 years
20. Osteoarthritis is characterised by - localised loss and damage
to articular Cartlidge, osteophytosis (newborn formation of
joint margins), changes to subchondral bone, synovitis and
thickening of the joint capsule
21. Osteoarthritis is traditionally thought of as a ‘wear and tear’
disease which occurs as we age. Which of the following statements is
correct about the pathogenesis of osteoarthritis? - Osteoarthritis
result from the failure of chondrocytes to maintain
homeostasis between synthesis and degradation of these
extracellular matrix components.
22. Which of the following is not a risk factor for the development of
osteoarthritis? - loss of weight
23. Non-modifiable risk factors for the development of osteoporosis
include – increasing age, family history of osteoporosis
24. Modifiable risk factors for the development of osteoporosis
include- inadequate dietary calcium, inadequate UV exposure,
inadequate weight bearing exercise;
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25. What is the role of calcium in the maintenance of bone mass
density? Calcium is responsible for – forming much of the
extracellular matrix of trabecular bone
26. What is the role of regular weight-bearing exercise in the primary
prevention of osteoporosis? Regular weight bearing exercise – places
mechanical stress on bones which increases bone formation
and decreases born resumption
27. Which of the following strategies may be employed to help a
person diagnosed with osteoporosis prevent falls? A strategy that may
help prevent falls in a person who is diagnosed with osteoporosis is -
An exercise program tailored to meet the individual’s specific
needs and abilities
28. Which of the following is not identified as a risk factor for
osteoporosis - weight loss
29. The following medications are commonly prescribed for adults in
the management of Gastro-oesophageal reflux disease (GORD) except
– Clexane
30. Esomeprazole is a common drug prescribed for patients with
Gastro-oesophageal reflux disease (GORD). The mechanism of action
(of esomeprazole) is – Esomeprazole is a proton pump inhibitor
31. A common drug prescribed in the management of Crohn’s
disease is Sulfasalazine (Salicylazosulfapyridine). The main mechanism
of action of this drug is: The inhabitation of prostaglandins,
resulting in local anti-inflammatory effects in the colon
32. Fissures are - a knife-like cleft or groove extending deeply
into the bowel wall
33. Fistulas are - an abnormal connection or passageway that
connects two organs or vessels that do not usually connect
34. Typically, the initial lesson that develops in Crohn’s disease is - a
small inflammatory aphthoid lesion in the mucosa and
submucosa of the bowel
35. The Conservative management of a person who has
osteoarthritis includes - muscle strengthening exercises, a
balance between activity and rest, analgesics
36. Exposure of unprotected skin to UV radiation is important in the
prevention of osteoporosis because - UV light is responsible for the
conversion of the precursors of vitamin D, which is then
activated by the liver and kidneys to vitamin D (calcitriol)
37. Corticosteroids are - used to treat acute episodes of Crohn’s
disease
38. The area of Gastrointestinal track (GIT) that maybe affected by
Crohn’s disease is - any part of the GIT from the mouth to the
anus
39. Crohn’s disease can affect any part of the Gastrointestinal track
(GIT). The parts most commonly affected by Crohn’s disease are –
terminal ileum and ascending (right colon) colon
40. Primary prevention of osteoporosis includes - Ensuring an
adequate intake of dietary calcium
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41. Clinical manifestations of osteoarthritis include - aching pain
aggravated by weight bearing, joint stiffness and deformity,
muscle wasting
1.The rationale for performing a sentinel lymph node biopsy is to: assess
the closest lymph node for metastasis.
2.Postmenopausal women are advised to do self breast examination:
month on the same day or date.
Most breast cancer (around 70% arise from the):epithelial linings of the
lactiferous ducts.
3.To reduce the risk of breast cancer, a women should: maintain a
healthy body weight, participate in regular activities.
4.A mutation on the BRCA1 gone: may lead to the uncontrolled
proliferation of the cell.
5.A major long-term complication following a mastectomy and lymph
node dissection is: lymphedema of the arm on the surgical side.
6.Clinical magnification of the breast cancer include: nipple discharge,
persistent rash over nipple area burning stinging or pricking
sensation.
7.The majority of breast cancer in women is: oestrogen dependent.
Page 48
8.The incidence of breast cancer in women: Increase with age.
9.Which of the following statements most accurately describes the
significant of prostate specify antigen(PSA assessment as a tool for
diagnosing prostate cancer: An increase is PSA levels time is more
significant then one reading in the diagnosis of the prostate cancer.
10.Strategies used to diagnose prostate cancer are patients history:PSA
assessment DRE transrectal ultrasound.
11.Risk factors for the development of prostate cancer include: age
family history of prostate cancer, having a vasectomy.
12.The most common site metastasis from a primary prostate cancer
is:bone,particulary the hips and vertebrae.
13.Obstruction to the flow of urine may be caused by the:enlatging
tumour compressing the urethra.
14.The action of anti androgen agents in the treatment of prostate cancer
is to: cause the tumor to shrink by blocking androgens entering the
cells.
15.Which of the following statements describe the procedure
transurethral resection of the prostate(TURP):Prostate tissue that is
Page 49
obstructing the urethra is removed a resect scope and electro
cautery via the urethra flushed into the bladder and flushed from
the bladder after the procedure.
16.Almost all primary prostate cancer are adenocarcinomas that develop
in the: peripheral zone of the prostate gland.
17.Clinical manifestation of the prostate cancer include: bone or joint
pain, frequency, haematuria, incomplete bladder.
18.Complications that may occur after a simple prostatectomy(TURP
include):urinary incontinence, hemorrhage, infection.
19. Complication of radiation therapy include: Diarrhoea,rectal ulcer
urinary incontinence.
20.Which of the following specific dietary strategies may reduce a man
risk of developing of prostate cancer: increase intake of tomatoes, pink
grapefruit and watermelon, reduce red meat and fat.
21.A 54 year old male was recently diagnosed with osteoarthritis. Which
of the following symptoms is most likely experiencing?:joint swelling.
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22.When helping a patient with rheumatoid arthritis plan a daily routine,
the nurse informs the patient that is most helpful to start the day with:A
warm bath followed by short rest.
23.patient having an exacerbation of her rheumatoid arthritis with joint
pain and swelling in both hands. The nurse teaches the patient that:cold
application to the joint prior to exercise will decrease the pain.
24.A 70 year old obese patient man has bilateral osteoarthritis of the
hips. The most beneficial measure to protect his hips is to: start a
weight reduction die to obtain healthy body weight.
25.A patient with an acute exacerbation of rheumatoid arthritis has
localised pain and inflammation of the fingers, wrists and feet with
swelling, redness and limited movements of the joints. In the
management of the disease, a patient outcome which is appropriate for
the patient at this time is to:achieve satisfactory control of pain and
fatigue.
26.A 60 year old woman has osteoarthritis of the left knee. On
examination the nurse would expect to find: pain upon joint
movement.
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27.teaching a patient to protect small joints affected by rheumatoid
arthritis, the nurse instructs the patient to: avoid activities that require
continuous use of the same muscles.
28.A patient is beginning therapy with oral methotrexate for rheumatoid
arthritis. The nurse will teach the patient about the importance of:
having routine renal and hepatic function tests.
29.A 58 year old woman has been diagnosed with osteoarthritis of her
hands and feet. She is very upset about the diagnosis and tells the nurse
she is too young to have arthritis and at this rate she will be hopelessly
crippled by the time she is 70. The best response to the patient is that:
osteoarthritis is more common with aging but is usually localised
and does not cause deformity.
30.The doctor has prescribed a NSAID twice daily for a patient with
osteoarthritis. The patient complains that after three weeks of use the
medication does not seem to be controlling her pain. The nurse
understands that: another type of NSAID may be indicated because of
variations in individual response to the drugs.
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31.A 35 year-old woman has recently been diagnosed with rheumatoid
arthritis. Initially her husband and children were supportive but are now
showing an increased lack of patience when she is unable to be involved
in some family activities. The most appropriate response by the nurse in
this situation is: inform the patient about local arthritis support
groups that offer education and support for patients and families.
32.month and has generalized symptoms is taking high dose NSAID's
and an oral glucocorticoid. The medical officer has ordered
Methotrexate. The patient asks the nurse why Methotrexate is necessary
since the pain and swelling have been well controlled. The nurse tells the
patient that: starting methotrexate early can help delay joint
degeneration.
33.A five year old female was diagnosed with juvenile rheumatoid
arthritis. The treatment option for this disease is: supportive.
34.Rheumatoid arthritis is: is an autoimmune disease.
35.The primary cause of duodenal ulcers is: bacterial infection.
36.Coeliac disease is caused by alterations of the intestinal: villi.
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37.A 52-year-old presents with bleeding from the rectum. This condition
is referred to as: hematochezia.
38.The vomiting reflex can be stimulated by: severe pain.
39.A 40-year-old male who consumes a diet high in fat and low in fibre
is at risk for: cancer of the colon and rectum.
40.Which modifiable risk factor is associated with oesophageal, stomach
and colorectal cancer: cigarette and alcohol use.
41.A 60-year-old male is diagnosed with cancer of the oesophagus.
34.Which of the following factors most likely contributed to his disease:
reflux oesophagitis.
42.Which of the gastrointestinal cancers has the highest rate of incidence
and is responsible for the highest number of deaths: colorectal.
43.A three-month-old female develops colicky pain, abdominal
distention and diarrhoea after drinking cow's milk. The best explanation
for her symptoms is: an excess of undigested lactose in her digestive
tract, resulting in increased fluid movement into the digestive lumen
and increased bowel motility.
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44.A 16-year-old female presents with abdominal pain in the right lower
quadrant. Physical examination reveals rebound tenderness and a low-
grade fever. A possible diagnosis would be: appendicitis.
45.The management of fluid volume deficit in the perioperative period
includes: gradual rehydration with oral or intravenous fluid.
46.A fluid that contains the same concentration of solutes as plasma is:
an isotonic solution.
47.Odema is the result of: excess interstitial fluid.
49.Fluid volume excess includes: high intravascular fluid, excess
interstitial fluid.
50.Hydrostatic pressure is defined as: The power p\of solution to push
water across a membrane.
51.intravenous fluid that may be used with safety in the management of
a person experience a fluid volume deficit in the perioperative periods
include: 9%sodium chloride
52.A Fluid volume deficit includes: A decreased in intravascular,
interstitial and intracellular fluid.
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53.A common cause of hypervolemia in the perioperative period is :An
excessive administration of intravenous fluid
54.Clinical manifestation of fluid volume deficit includes: thirst, weight
loss, increased temperature.
55.Hypotonic solutions: Facilitate the movement of water into cells
and cause of cell swell.
56.A bone fracture in which one, both or all bone fragments are out of
normal alignment is classified as: open reduction of a bone fracture/ A
displaced fracture.
57. A bone fracture where bone is broken into two or more fragments is
classified as: A comminuted fracture.
58. A bone fracture where bone is damaged but still in one piece is
classified as: An incomplete fracture.
59. A fracture where bone breaks through the skin is classified as: An
open fracture.
60: A bone fracture that encircles the bone is classified as: A spiral
fracture.
61. A bone fracture where pieces of bone are pushed into each other is
classified as: An impacted fracture.
62. A compression fracture occurs when: The fracture is wedged or
squeezed together on one side of the bone.
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63. A fracture of the neck of the femur is classified as: An intracapsular
fracture.
64. An extracapsular fracture is occurs when the fracture is: Close to,
but remains outside the joint capsule.
65. A greenstick fracture is described as a fracture where: One cortex is
perforated and the spongy bone is splintered.
66.A fracture that occurs at the site of a pre-existing abnormality is
classified as: A pathological fracture.
67. A fracture that involves the break up and separation of a portion of
the articular cartilage as a result of trauma is classified as: A
transcondylar fracture.
68. Which of the following groups are clinical manifestations of a
fractured bone: Deformity, loss of sensation, swelling.
69. Fracture blisters occur in which of the following situations: When
pressure in a muscle compartment in an injured limb is too high.
70. Where on the body are fracture blisters most likely to occur: Areas
where there is little soft tissue between bone and skin, for example
knees, ankle, elbow, foot.
71. Acute compartment syndrome is a major complication of bone
fractures. What is the primary cause of acute compartment syndrome:
An increase in muscle compartment volume due to oedema, vascular
injury, bleeding, venous obstruction.
72. What is a muscle compartment? A muscle compartment is: Muscle,
nerves and blood vessels of an extremity encased in an inelastic
fascia.
73. Clinical manifestations of the development of acute compartment
syndrome in an injured limb include: Diminished reflexes, severe pain,
changes in sensation.
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74. The management of compartment syndrome includes: Removal of
restrictive dressings, casts, splinting.
75. Which of the following are clinical manifestations of Complex
Regional Pain Syndrome: Limb flushed and warm, thin shiny skin,
muscle wasting.
76. The pathogenesis of a fat embolism
is: Fat droplets are released from bone marrow and fat tissue at the
fracture site and enter the venous system.
77. The first stage of bone healing is initiated by: Disruption of blood
vessels in the cortex, bone marrow and soft tissues at the fracture
site leading to bleeding and hematoma formation.
78. Angiogenesis occurs in the first stage of bone healing. Angiogenesis:
Increases blood flow to the entire bone.
79.Which of the following statements describes the fibrocartilaginous
callus formation that occurs in bone healing: The fibrocartilaginous
callus is not strong enough for weight bearing.
80. Which of the following cells is responsible for the formation of the
bony callus in fracture healing: Osteoblasts.
81. In the final stage of bone healing, bone remodeling occurs. During
this stage: Compact bone replaces spongy bone around the periphery
of the fracture site and trabeculae are formed along lines of stress.
82.Which of the following statements describes fracture reduction: The
bone fragments are realigned close to their original anatomical
position.
83. Immobilisation of a suspected fracture helps to reduce:Risk of
further bleeding, soft tissue damage, nerve and blood vessel
compression.
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84. Plaster or synthetic casts are often applied to an extremity where a
bone fracture has occurred. The rationale for applying a cast is
to:Provide immobilization.
85. Prolonged capillary refill in the extremities of a limb that has been
placed in a plaster cast may be an indication tha: The cast is too tight or
swelling has occurred.
86. The fragments of a bone fracture are moved or manipulated into
correct alignment without opening the skin. This technique is referred to
as: Closed reduction.
86. Which of the following statements is a description of an open
reduction of a bone fra: A surgical procedure in which bone
fragments are realigned using pins and stability.
87. Which of the following procedures is an example of internal fixation:
Hip arthroplasty.
88. Which of the following are advantages of open reduction of a bone
fracture: More precise restoration of bone alignment, earlier
mobilisation.
89. The goals of traction include: To correct and maintain skeletal
alignment of bones and joints
To immobilise the fracture site to promote healing
To reduce muscle spasm.
90. is a complication of inadequate fracture reduction or immobilisation.
Malunion is: When the bone ends have healed in an incorrect
anatomical position.
91. Which of the following strategies helps to preserve function,
maintain muscle strength and reduce joint stiffness during the course of
fracture healing. Isometric exercises of the affected extremities.
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92. Which of the following are advantages of open reduction of a bone
fracture: More precise restoration of bone alignment, earlier
mobilisation.
93. The pathogenesis of a fat embolism syndrome is: Fat droplets are
released from bone marrow and fat tissue at the fracture site and
enter the venous system.
94. Neuromodulator are substance that are: found in the pathways that
control information about pain in the nervous system.
95. Narcotic analgesics increase both the pain threshold and pain
tolerance: true.
96.Chemical mediators released from inflamed and/or damaged tissue
that are capable of stimulating nociceptors include:histamine,
prostaglandins, bradykinin.
97. Common adverse effects of narcotic analgesics are: decreased
respiratory rate, cough suppression, hypotension.
98. Common-adverse effect of non- steroidal anti-inflammatory drugs
are: dyspepsia, gastric irritation, peptic ulcers.
99. An individual's response to pain is not influenced by family,
community and culture:false.
100.Nalaxone is a: narcotic antagonist.
101. Pain caused by injury or disease of the peripheral or central nervous
system is known as: neuropathic pain.
102. A painful condition that results from peripheral nerve damage
caused by infections or diseases are called: a neuralgia.
103. When a person is being administered a narcotic analgesic in the
perioperative period the nurse should: assess pupillary responses as
narcotic analgesics may cause constriction of pupil.
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104. characteristics of acute pain include: sudden onset, lasts less than
three (3) months, usually has an identified cause.
105.Central pain is pain related to a lesion, trauma or inflammation in
the: brain or spinal cord.
106. A neuromodulator is a substance that is released from: neurons and
transmit signals to other neu.
107. Narcotic drugs include: pethidine, codeine, oxycodone.
108. Pain caused by injury or disease of the peripheral or central nervous
system is known as: neuropathic pain.
109.Crohn’s disease is primarily a gastrointestinal (GTI) system
condition, which other body system is mainly involved? – Immune
system
110.The cause of Crohn’s disease is – idiopathic
111.he clinical manifestations of Crohn’s disease include – pain in
lower right abdominal quadrant
112.The initial lesions that develop in Crohn’s disease are aphthoid
lesions. An aphthoid lesion is a – shallow lesion with a wide base and
raised margins
113.Complications of Crohn’s disease include – bowel obstruction,
114.The lesions of Crohn’s disease may affect – all layers of the bowel
wall
115.Gastro-oesophageal reflux disease (GORD) commonly manifests as
116.The following are all clinical manifestations of Gastro-esophageal
except – Dyspnea
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117.Gastro-oesophageal reflux disease (GORD) or gastroesophageal
reflux disease (GERD) – also commonly known as acid reflux disease
is- a disease of the distal oesophagus and stomach
118.Gastro-oesophageal reflux disease (GORD) is a chronic Gastro
intestinal disorder affecting many people. Which one of the following
options is not a lifestyle change for the management of GORD in adults
- Avoid eating meals during the day
119.The following are complications of gastro-oesophageal reflux
120.Which of the following two (2) are often used as diagnostic
syndromes of Gastro-oesophageal reflux disease (GORD) – indigestion
and hemoptysis
121.Bisphosphonates (For example: Alendronate/Fosamax) are a
following statement is important patient education for the person taking
these drugs? It is important that the person taking Alendronate – remain
upright for a minimum of 30 mins after taking the medication to avoid
the risk of gastritis occurring
122.At what stage in a person’s lifetime should they engage in dietary
and lifestyle strategies to prevent osteoporosis? A person should engage
in dietary and lifestyle habits to prevent osteoporosis – From childhood
Osteoporosis can be diagnosed by assessing bone density. Image used to
measure bone mineral density (using T-scores) is called – dual imagery
x-ray absorptiometry (DXA)
123.Which of the following statements provides one explanation why
men generally display clinical manifestations of osteoporosis at an older
age than woman? – men do not often experience the sudden drop in
hormone (oestrogen) levels that women do at menopause
Page 62
124.A 70 years old woman presents with a hip fracture. She is diagnoses
with osteoporosis. One factor that most likely contributed to her
condition is – decreased oestrogen levels
125. Which of the following processes leads to osteoporosis in the years
after an individual achieves their peak bone mass density (BMD)? –
Bone resorption by osteoclasts exceeds bone formation by osteoblasts
126.Osteoarthritis most commonly occurs in the – knees, hips, hands
and spine of men and women over 40 years
127.Osteoarthritis is characterised by - localised loss and damage to
articular Cartlidge, osteophytosis (newborn formation of joint
margins), changes to subchondral bone, synovitis and thickening of
the joint capsule
128.Osteoarthritis is traditionally thought of as a ‘wear and tear’ disease
which occurs as we age. Which of the following statements is correct
about the pathogenesis of osteoarthritis? - Osteoarthritis result from
the failure of chondrocytes to maintain homeostasis between synthesis
and degradation of these extracellular matrix components.
129.Which of the following is not a risk factor for the development of
130Non-modifiable risk factors for the development of osteoporosis
131.Modifiable risk factors for the development of osteoporosis include-
inadequate dietary calcium, inadequate UV exposure, inadequate
weight bearing exercise;
132.What is the role of calcium in the maintenance of bone mass
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133.What is the role of regular weight-bearing exercise in the primary
mechanical stress on bones which increases bone formation and
decreases born resumption
134.Which of the following strategies may be employed to help a person
diagnosed with osteoporosis prevent falls? A strategy that may help
prevent falls in a person who is diagnosed with osteoporosis is - An
exercise program tailored to meet the individual’s specific needs and
abilities
135.Which of the following is not identified as a risk factor for
136.The following medications are commonly prescribed for adults in
the management of Gastro-oesophageal reflux disease (GORD) except –
Clexane
138. A common drug prescribed in the management of Crohn’s disease
is Sulfasalazine (Salicylazosulfapyridine). The main mechanism of
action of this drug is: The inhabitation of prostaglandins, resulting in
local anti-inflammatory effects in the colon
139.Fissures are - a knife-like cleft or groove extending deeply into the
bowel wall
small inflammatory aphthoid lesion in the mucosa and submucosa of
the bowel
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142. The Conservative management of a person who has osteoarthritis
includes - muscle strengthening exercises, a balance between activity
and rest, analgesics
143.Exposure of unprotected skin to UV radiation is important in the
conversion of the precursors of vitamin D, which is then activated by
the liver and kidneys to vitamin D (calcitriol)
144.Corticosteroids are - used to treat acute episodes of Crohn’s
disease
Crohn’s disease is - any part of the GIT from the mouth to the anus
147.Primary prevention of osteoporosis includes - Ensuring an
aggravated by weight bearing, joint stiffness and deformity, muscle.
149. The third order neurons of the neuronal pain pathway carries
information about a painful stimulus from the:
150. pain threshold refers to: when a person has a conscious sensation
of pain in response to a stimulus.
151.The first order neurons of the neuronal pain pathway carries
information about a painful stimulus from the :peripheries to the spinal
cord.
152.Nociceptors are stimulated by chemical mediations that are

released as a result of: tissue trauma, ischemia and inflammation.
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153.Tissue injure leads to the release of inflammatory mediations
vasodilation and increased capillary permedbility.vasodilation and
increased capillary permeability leads to the stimulation of nociceptors
through: oedema, local swelling.
153. The nurse should advise the person who is ingesting non steroidal
anti inflammatory drugs to: take the medication with food.
154.The most common adverse effects of non steroidal anti
inflammatory drugs are: dyspepsia,gastric irration ,peptic ulcer.
155.The actions of most non steroidal anti inflammatory drugs include:
anti inflammatory antipyretic analgesic.
156.Central pain is pain related to a lesion trauma or inflammation in
the: brain or spinal cord.
157.Narcotic drugs include: pethidine,codeine,oxycodone.
158.which of the following statements best describe the role of a
perioperative nurse. providing care to patients before during and
after surgery.
159.incident pain occur when: activities ,dressing or procedures
increase the pain experience.
160.comman adverse effect of narcotic analgesics are: decreased
respiratory rate, cough suppression, hypotension.
161.clinical manifestation of narcotic toxicity include: reduce level of
consciousness,pinpoint pupils, respiratory depression.
162.A painful condition that results from peripheral nerve damage
caused by infections or disease are called: a neuralgia.
163.Based on expert opinion ,the following interventions have been the
mainstays of treatment for patients with uncomplicated diverticulitis
exepct:surgical resection.
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163. An outpunching of the mucosa of the lining of the bowel without
inflammation is called: diverticulum.
164.The following are complications of diverticulitis except:
hypertension
165, second-order neurons of neuronal pain pathway carrying
information about a painful stimulus from
Spinal cord to the thalamus
166. The conscious perception of pain is transmitted by the
Three neuronal pain pathway
A common cause of fluid volume deficit in the perioperative period is

Excessive losses of GIT fluid, vomiting, diarrhea, suctioning
Fibrosis causes
Narrowing and shortening of the bowel
Narcotic analgesics are the preferred treatment for mild, moderate and
severe pain
False
What percentage of people with Crohn’s are affected in the small bowel?
30-40%
Crohn’s disease is curable

False
Which is NOT a surgical intervention in treating Crohn’s ?

Splenectomy
Page 67
1. Crohn’s disease is primarily a gastrointestinal (GTI) system condition,
which other body system is mainly involved? – Immune system
2. The cause of Crohn’s disease is – idiopathic
3. The clinical manifestations of Crohn’s disease include – pain in lower
right abdominal quadrant
4. The initial lesions that develop in Crohn’s disease are aphthoid lesions.
An aphthoid lesion is a – shallow lesion with a wide base and
raised margins
5. Complications of Crohn’s disease include – bowel obstruction,
6. The lesions of Crohn’s disease may affect – all layers of the bowel
wall
7. Gastro-oesophageal reflux disease (GORD) commonly manifests as
8. The following are all clinical manifestations of Gastro-oesophageal
except – Dyspnoea
9. Gastro-oesophageal reflux disease (GORD) or gastroesophageal reflux
disease (GERD) – also commonly known as acid reflux disease is- a
disease of the distal oesophagus and stomach
10. Gastro-oesophageal reflux disease (GORD) is a chronic Gastro
intestinal disorder affecting many people. Which one of the following
options is not a lifestyle change for the management of GORD in adults
- Avoid eating meals during the day
11. The following are complications of gastro-oesophageal reflux
12. Which of the following two (2) are often used as diagnostic
syndromes of Gastro-oesophageal reflux disease (GORD) –
indigestion and hemoptysis
13. Bisphosphonates (For example: Alendronate/Fosamax) are a
following statement is important patient education for the person
taking these drugs? It is important that the person taking Alendronate
– remain upright for a minimum of 30 mins after taking the
medication to avoid the risk of gastritis occurring
14. At what stage in a person’s lifetime should they engage in
dietary and lifestyle strategies to prevent osteoporosis? A person
should engage in dietary and lifestyle habits to prevent osteoporosis –
From childhood
15. Osteoporosis can be diagnosed by assessing bone density. Image
used to measure bone mineral density (using T-scores) is called – dual
imagery x-ray absorptiometry (DXA)
16. Which of the following statements provides one explanation why
men generally display clinical manifestations of osteoporosis at an
older age than woman? – men do not often experience the
sudden drop in hormone (oestrogen) levels that women do at
menopause
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17. A 70 years old woman presents with a hip fracture. She is
diagnoses with osteoporosis. One factor that most likely contributed to
her condition is – decreased oestrogen levels
18. Which of the following processes leads to osteoporosis in the
years after an individual achieves their peak bone mass density
(BMD)? – Bone resorption by osteoclasts exceeds bone
formation by osteoblasts
19. Osteoarthritis most commonly occurs in the – knees, hips,
hands and spine of men and women over 40 years
20. Osteoarthritis is characterised by - localised loss and damage
to articular Cartlidge, osteophytosis (newborn formation of
joint margins), changes to subchondral bone, synovitis and
thickening of the joint capsule
21. Osteoarthritis is traditionally thought of as a ‘wear and tear’
disease which occurs as we age. Which of the following statements is
correct about the pathogenesis of osteoarthritis? - Osteoarthritis
result from the failure of chondrocytes to maintain
homeostasis between synthesis and degradation of these
extracellular matrix components.
22. Which of the following is not a risk factor for the development of
23. Non-modifiable risk factors for the development of osteoporosis
24. Modifiable risk factors for the development of osteoporosis
include- inadequate dietary calcium, inadequate UV exposure,
inadequate weight bearing exercise;
25. What is the role of calcium in the maintenance of bone mass
26. What is the role of regular weight-bearing exercise in the primary
mechanical stress on bones which increases bone formation
and decreases born resumption
27. Which of the following strategies may be employed to help a
person diagnosed with osteoporosis prevent falls? A strategy that may
help prevent falls in a person who is diagnosed with osteoporosis is -
An exercise program tailored to meet the individual’s specific
needs and abilities
28. Which of the following is not identified as a risk factor for
29. The following medications are commonly prescribed for adults in
the management of Gastro-oesophageal reflux disease (GORD) except
– Clexane
31. A common drug prescribed in the management of Crohn’s
disease is Sulfasalazine (Salicylazosulfapyridine). The main mechanism
Page 69
of action of this drug is: The inhabitation of prostaglandins,
resulting in local anti-inflammatory effects in the colon
32. Fissures are - a knife-like cleft or groove extending deeply
into the bowel wall
small inflammatory aphthoid lesion in the mucosa and
submucosa of the bowel
35. The Conservative management of a person who has
osteoarthritis includes - muscle strengthening exercises, a
balance between activity and rest, analgesics
36. Exposure of unprotected skin to UV radiation is important in the
conversion of the precursors of vitamin D, which is then
activated by the liver and kidneys to vitamin D (calcitriol)
37. Corticosteroids are - used to treat acute episodes of Crohn’s
disease
Crohn’s disease is - any part of the GIT from the mouth to the
anus
40. Primary prevention of osteoporosis includes - Ensuring an
aggravated by weight bearing, joint stiffness and deformity,
muscle wasting
HV1 Module 2:
1. The mechanism of action of non-steroidal anti-inflammatory drugs (NSAIDS): inhibits the

synthesis of prostaglandins by inhibiting the activity of the cyclooxygenase (COX)
enzymes:
True.
2. Characteristics of acute pain include:

Sudden onset, lasts less than three (3) months, usually has an identified cause.
3. Central pain related to a lesion, trauma, or inflammation in the:

Brain or spinal cord.
4. A neuromodulator is a substance that:

Can alter pain pathways by altering nerve impulse transmission.
5. Narcotic analgesics increase both the pain threshold and pain tolerance:
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True
6. Clinical manifestations of narcotic toxicity include:

Reduced level of consciousness, pinpoint pupils, respiratory depression.
7. Narcotic drugs include:

Pethidine, codeine, oxycodone.
8. Narcotic analgesics are the preferred treatment for mild, moderate and severe pain:
False.
9. Naloxone is a:
Narcotic antagonist.
10. Distraction redirects a person’s attention away from the pain. If distraction strategies
encourage laughter, endorphins may be release:
True.
11. Incident pain occurs when:

Activities, dressings, or procedures increase the pain experience.
12. Common-adverse effect of non-steroidal anti-inflammatory drugs are:

Dyspepsia, gastric irritation, peptic ulcers.
13. Neuromodulators are substance that are:

Found in the pathways that control information about pain in the nervous system.
14. Narcotic analgesics alter the perception of pain and the emotional response to pain:
True.
15. Which of the following statements best describes the role of perioperative nurse:
Providing care to patients before, during and after surgery.
Module 9:
16. Which of the following cells is responsible for the formation of the bony callus in fracture
healing?
Osteoblasts
17. Clinical manifestations of the development of acute compartment syndrome in an injured

limb include
Diminished reflexes, severe pain, changes in sensation
18. A greenstick fracture is described as a fracture where

One cortex is perforated, and the spongy bone is splintered
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19. A bone fracture where pieces of bone are pushed into each other is classified as
An impacted fracture
20. A fracture that occurs at the site of a pre-existing abnormality is classified as

A pathological fracture
21. Where on the body are fracture blisters most likely to occur?
Areas where there is little soft tissue between bone and skin, for example knees, ankle,
elbow, foot
22. An extracapsular fracture is occurring when the fracture is
Close to, but remains outside the joint capsule
23. The pathogenesis of a fat embolism syndrome is

Fat droplets are released from bone marrow and fat tissue at the fracture site and enter the
venous system
24. Which of the following statements describes the fibrocartilaginous callus formation that
occurs in bone healing?
The fibrocartilaginous callus is not strong enough for weight bearing
25. Which of the following procedures is an example of internal fixation?

Hip arthroplasty
26. Immobilisation of a suspected fracture helps to reduce

Risk of further bleeding, soft tissue damage, nerve and blood vessel compression
27. In the final stage of bone healing, bone remodelling occurs. During this stage
Compact bone replaces spongy bone around the periphery of the fracture site and
trabeculae are formed along lines of stress
28. The management of compartment syndrome includes

Removal of restrictive dressings, casts, splinting
29. A bone fracture where bone is damaged but still in one piece is classified as
An incomplete fracture
30. A fracture that involves the breakup and separation of a portion of the articular cartilage
because of trauma is classified as
A transchondial fracture
31. Which of the following groups are clinical manifestations of a fractured bone?
Deformity, loss of sensation, swelling
Page 72
32. The fragments of a bone fracture are moved or manipulated into correct alignment without
opening the skin. This technique is referred to as
Closed reduction
33. A bone fracture in which one, both or all bone fragments are out of normal alignment is
classified as
A displaced fracture
34. Which of the following strategies helps to preserve function, maintain muscle strength,
and reduce joint stiffness during the course of fracture healing?
Isometric exercises of the affected extremities
35. The first stage of bone healing is initiated by

Disruption of blood vessels in the cortex, bone marrow and soft tissues at the fracture site
leading to bleeding and haematoma formation
36. A bone fracture where bone is broken into two or more fragments is classified as
A comminuted fracture
37. Which of the following statements describes fracture reduction?

The bone fragments are realigned close to their original anatomical position
38. Angiogenesis occurs in the first stage of bone healing. Angiogenesis

Increases blood flow to the entire bone
39. Prolonged capillary refill in the extremities of a limb that has been placed in a plaster cast
may be an indication that
The cast is too tight, or swelling has occurred
40. Which of the following are advantages of open reduction of a bone fracture?
More precise restoration of bone alignment, earlier mobilisation
41. What is a muscle compartment? A muscle compartment is

Muscle, nerves and blood vessels of an extremity encased in an inelastic fascia
42. A fracture where bone breaks through the skin is classified as

An open fracture
43. is a complication of inadequate fracture reduction or immobilisation. Malunion is

When the bone ends have healed in an incorrect anatomical position
44. Fracture blisters occur in which of the following situations?

When pressure in a muscle compartment in an injured limb is too high
45. Which of the following are clinical manifestations of Complex Regional Pain Syndrome?
Limb flushed and warm, thin shiny skin, muscle wasting
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46. Plaster or synthetic casts are often applied to an extremity where a bone fracture has
occurred. The rationale for applying a cast is to
Provide immobilization
47. A compression fracture occurs when

The fracture is wedged or squeezed together on one side of the bone
48. Acute compartment syndrome is a major complication of bone fractures. What is the
primary cause of acute compartment syndrome?
An increase in muscle compartment volume due to oedema, vascular injury, bleeding,

venous obstruction
49. The goals of traction include

To correct and maintain skeletal alignment of bones and joints
To immobilise the fracture site to promote healing
To reduce muscle spasm
50. A fracture of the neck of the femur is classified as

An intracapsular fracture
51. Which of the following statements is a description of an open reduction of a bone

fracture?
A surgical procedure in which bone fragments are realigned using pins and stabilising
bars.
52. A bone fracture that encircles the bone is classified as

A spiral fracture
Week 5 Breast Cancer
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53.
Most breast cancers (around 70%. arise from the
epithelial linings of the lactiferous ducts
54. A mutation on the BRCA1 gene

may lead to the uncontrolled proliferation of cells
55. The action of tamoxifen in relation to preventing and treating breast cancer is to inhibit
tumour growth by
blocking the oestrogen receptor sites of cancer cells
56.
A modified radical mastectomy is a surgical procedure during which
affected breast and axillary lymph nodes are removed
58. Premenopausal women are advised to perform self-breast examination every

month in the week after menstruation
59.The majority of breast cancer in women is

oestrogen dependant
60.Modifications to the DNA of breast tissue cells are caused by

genetic alterations, environmental agents or their interactions
61.A major long term complication following a mastectomy and lymph node dissection is
lymphedema of the arm on the surgical side
62.The incidence of breast cancer in women

increases with age
63. .The action of tamoxifen in relation to preventing and treating breast cancer is to inhibit tumour growth by
blocking the oestrogen receptor sites of cancer cells
64. A positive sentinel lymph node biopsy result would indicate

cancer cells have spread via lymph to the node closest to the tumour
65. BRCA1 and BRCA2 gene mutations

can be inherited from the maternal and paternal gene lines
66. A simple mastectomy is a surgical procedure during which the

complete affected breast is removed
67.The area of the breast most commonly affected by breast cancer is the
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upper outer quadrant
68.Clinical manifestations of breast cancer include

nipple discharge, persistent rash over nipple area, burning, stinging or pricking sensation
69.A woman who has a mutation on the BRCA1 gene

has a high lifetime risk of developing breast cancer and an increased risk of developing ovarian cancer
70. Postmenopausal women are advised to do self-breast examination

month on the same day or date
71. Risk factors for the development of breast cancer include

early menarche, using HRT for more than 5 years, oral contraceptive use
72. Following mastectomy and lymph node dissection, it is critical that the nurse
measures blood pressure and sites IVIs on the nonsurgical side
Week 3: Fluid Balance

1. Clinical manifestations of hypervolaemia include:
Distended neck veins, increased blood pressure, polyuria
2. Complications that may develop from fluid volume excess include
Cerebral and pulmonary oedema.
3. Extracellular fluid includes fluid
4. Intracellular fluid includes the fluid
With in cells.
5. Hypertonic solutions
Draw water out of cells-shrink cells.
6. A common cause of hypervolaemia in the preoperative period is
An excessive administration of intravenous fluids.
7. Intravenous fluid that may be used with safety in the management of a person
exerienceing a fluid volume deficit in the perioperative period includeds
8. The management of a fluid volume excess in the perioperative period includes
A restriction of fluid intake
9. As a person ages, the percentage of body water to body weight
Decrease compared to a younger adult
10. A fluid that contains a higher concentration of solutes than plasma is
A hypertonic solution .
Page 76
Week 4: GIT and Bowel Cancer
1. Which of the gastrointestinal cancers has the highest rate of incidence and is
responsible for the highest number of deaths colorectal.
2. A 40-year-old male who consumes a diet high in fat and low in fibre is at risk for
cancer of the colon and rectum.
3. Which modifiable risk factor is associated with oesophageal, stomach and colorectal
cancer cigarette and alcohol use.
4. A 60-year-old male is diagnosed with cancer of the oesophagus. Which of the

following factors most likely contributed to his disease reflux oesophagitis.
5. A 16-year-old female presents with abdominal pain in the right lower quadrant.
Physical examination reveals rebound tenderness and a low-grade fever. A possible
diagnosis would be appendicitis.
6. The primary cause of duodenal ulcers is bacterial infection
7. A three-month-old female develops colicky pain, abdominal distention and diarrhea

after drinking cow’s milk. The best explanation for her symptoms is an excess of
undigested lactose in her digestive tract, resulting in increased fluid movement into
the digestive lumen and increased bowel motility.
8. Coeliac disease is caused by alterations of the intestinal villi.
9. The vomiting reflex can be stimulated by severe pain.
10. A 52-year-old presents with bleeding from the rectum. This condition is referred to as
haematochezia.
Page 77
Week-6 (Prostate Cancer)
1. The action of anti-androgen agents in the treatments of Prostate cancer is to cause the tumour to shrink
by blocking androgens entering the cells.
2. Obstruction to the flow of urine may be caused by the enlarging tumour compressing the urethra.
3. Strategies used to diagnose prostrate cancer are patient history PSA assessment, DRE, transrectal
ultrasound (TRUS) and biopsy.
4. Which of the following statements describes the procedure transurethral resection of the prostrate
(TURP)? Prostrate tissue that is obstructing the urethra is removed using a resectoscope and electro
cautery via the urethra, flushed into the bladder after the procedure.
5. Complication of radiotherapy includes diarrhoea, rectal ulcer, urinary incontinence.
6. Complication that may occur after a simple prostatectomy (TURP) includes, urinary incontinence,
haemorrhage, infection
7. The most common site of metastasis from a primary prostate cancer is bone, particularly the hips and
vertebrae
8. Which of the following specific dietary strategies may reduce a man’s risk of developing a prostate
cancer increase intake of tomatoes, pink grapefruit, and watermelon, reduce red meat and fat intake.
9. Which of the following statements most accurately describes the most significance of prostrate specific
antigen (PSA) assessment as a tool for diagnosing prostrate cancer? An increase in PSA levels over
time is more significant than one reading in the diagnosis of prostate cancer.
10. Clinical manifestation of prostate cancer includes bone or joint pain, frequency, haematuria,
incomplete bladder emptying.
11. Risk factors for the development of prostate cancer include age, family history of prostate cancer,
having a vasectomy.
12. Almost all primary prostate cancers are adenocarcinomas that develop in the peripheral zone of the
prostate gland.
Week 1(preoperative nursing principles)
1. Nociceptors– Afferent (sensory) nerve fibre endings in all body tissues except the
brain that reacts to pain (noxious stimuli) and endogenous chemical substances.
2. Nociceptive Pain – Pain produced by nociceptive (painful) stimuli which have the
potential to cause peripheral tissue damage.
3. Referred pain – Occurs where there is a disconnection between the injury site and
pain location.
4. Psychogenic pain – Report of pain where no pathological cause can be found after
exhaustive examination.
5. Central pain – Pain caused by a lesion in the brain, spinal cord, vascular lesion,
tumour, trauma, inflammation.
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6. Breakthrough pain – Pain that occurs between dose of analgesia.
7. Neuropathic pain – Pain caused by injury or disease of the peripheral or central
nervous system.
8. Somatic pain – Pain arises from nerve receptors originating in the skin or close to the
body’s surface.
9. Complex Regional Pain Syndrome – Neuropathic pain that is cause by nerve damage
from major or minor trauma.
10. Phantom pain – Pain sensation, often severe, experienced in a missing limb after
amputation.
11. Visceral pain – Pain arising from body organs.
12. Neuralgias – Painful conditions that result from peripheral nerve damage caused by
infections or diseases.
13. Nociceptors - A subpopulation of the primary sensory neurons in skin, muscle and
viscera that are responsible for the detention all sensation.
14. Action potential – An electrical impulse transmitted across the plasma membrane of
a nerve fibre.
15. Cerebral cortex – A layer of neurons and synapses (grey matter) on the surface of the
cerebral hemispheres, folded into gyri with about two third buried in fissures.
16. Neuromodulators – Substance found in the pathways that control information about
painful stimuli that are released by neurons and transmit signals to other neurons.
17. Cell body – The part of a cell that contains the nucleus and surrounding cytoplasm.
18. Axon – An extension of a neuron, usually long and slender capable of conducting
action potentials or nervous impulses.
19. Thalamus – A large ovoid-shaped mass comprising a collection of nuclei. Regarded
as a relay structure as all of the sensory pathways and many of the circuits of the
cerebellum, basil ganglia and limbic system involve the thalamus.
20. Endorphins – Naturally occurring opioid peptides present in neurons in the spinal
cord, brain, and GIT.
21. Neuron – A cell that forms the basic unit of the nervous system and which sends and
receives information. It consists of a cell body and one or more processes (dendrites
and/or axons).
22. Efferent nerves – Nerve fibres that transmit impulses away or outwards from a nerve
Page 79
centre such as the brain, spinal cord.
23. Afferent nerves – Nerve fibres that transmit impulses from the periphery towards the
central nervous system
24. Synapse – The space or gap between two neurons, or a neuron and an organ across
which a nerve impulse is transmitted.
25. Analgesic – A drug that relieves pain
26. Pain tolerance – The amount of pain a person can endure before
outwardly responding to it
27. Behavioural response – observed physical actions and inferred and
interpretable mental behaviour in response to a stimulus.
28. Narcotic analgesic – A drug derived from opium or synthetically
produced.
29. Opiates – Compounds derived directly from opium (dried exudates
of the poppy).
30. Hyperbaric oxygen therapy – The intermittent inhalation of 100%
oxygen in a hyperbaric chamber at a pressure higher that
760mmHg – the normal atmospheric pressure at sea level.
31. Antipyretic – an agent that reduces body temperature.
32. Pain threshold – the point at which a stimulus activates pain
receptors and produces a sensation of pain.
33. Affective response – responses that include the expression of
feelings, emotions, moods.
34. Agonist – A drug that binds to and stimulates a receptor, producing
the same response as the endogenous ligand (molecules/ chemical
compound bound to that site).
35. Antagonist – A drug that binds to the receptors and blocks access
to the endogenous ligand (molecules/ chemical compound bound to
that site), thus reducing the normal response.
36. Opioids – Compounds mimicking the effects of opium that are
prepared synthetically.
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Health Variation Final

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Health variations 1

a. Is the most common type of pain

b. Lasts less than three months

c. Is a result of disease or injury of the CNS

a. Prescient ongoing pain

b. The inability to feel pain

c. The duration between doses

3. A painful response to a non painful stimulus is

4. Pain in the skin, muscle or tissue

b. The stimulus that is the reason for the pain

b. Substances that alter pain pathways

c. Substances that push pain pathways

a. Initiate nerve impulse transmission.

b. Alter nerve transmission

c. Attached to neurons in the spinal cord, brain and GIT

8. What are some behavioral (voluntary responses)

a. Crying, moving away and withdrawal

b. Restlessness, crying and moving away from stimulus.

c. Fear, anger and crying

9. What are some psychological responses

a. Anxiety, anger and Anorexia

b. Hopelessness, Restlessness and Depression

c. Exaggerated weeping, moaning and Anorexia

10. Adenylate Cyclase

a. Agonises opioid receptors

b. Decreases Ca2+ entry channels

c. Breaks down ATP to form cAMP

a. Loss of difference in charge between inside and outside of plasma membrane

b. Decrease in Ca2+ entry channels

c. Changes in a cells membrane potential that makes it more negative.

12. Which are traits of Oxycodone

c. Stronger than Buprenorphine

a. Increases inflammatory mediators to increase the action of histamine

b. Inhibits the COX enzymes

c. Reduces perception of pain

15. COX 1 and COX 2 both

c. Are constantly expressed in the body

d. All of the above

16. Types of NSAIDS are

a. Oxicams and Paracetamol

b. Copper Salicylates and Idoleactic Acids

c. Morphine and Paracetamol

17. Extracellular fluid is

a. Within all areas of the human body including cells

b. Within cells only

c. Interstitial fluid and Intravascular fluid

18. Hydrostatic pressure

a. Pumping of the heart and gravity pulls water into cells

b. Pumping of the heart and gravity pushes water into cells

19. Osmotic pressure

b. Concentration of body fluids

c. The power of a solution to draw water across a membrane.

a. An equal concentration of solutes in both environments

21. Hypertonic solution

a. The concentration of solutes in higher on the inside

b. The concentration is equal on both sides of the membrane

c. The concentration of solutes in higher on the outside

22. Hypotonic Solution

a. The concentration of solutes is lower on the outside

b. The concentration is equal on both sides of the membrane

c. The concentration of solutes in higher on the outside

a. High extracellular fluid volume

b. Low extracellular fluid volume