SAFE JOURNEY SUPER MOCK 2024- 0257417027

CANDIDATE’S ID NUMBER ………………………………………………………

1. In nutritional management of all types of diabetes, it is important for the patient to:
A. eat regular meals at regular times
B. eliminate sucrose and other simple sugars from the diet
C. limit saturated fat intake to 30% of dietary calorie intake

2. An antidiuretic substance important for maintaining fluid balance is released by:

A. adrenal cortex
B. anterior pituitary gland
C. posterior pituitary gland

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

A. glucose from rapid CHO metabolism causing drowsiness
B. ketones from rapid fat breakdown, causing acidosis
C. nitrogen from protein catabolism causing ammonia intoxication

4. A patient with diabetes mellitus says “I cannot eat big meals. I prefer eating snacks throughout
the day”. The nurse should explain that:
A. large meals can bring about weight problems
B. regulated food intake is basic to diabetic control
C. small frequent meals are better for easy digestion

5. The treatment for diabetic ketoacidosis (DKA) and hyperglycaemic hyperosmolar non-
ketotic syndrome (HHNS) differs, primarily in that:
A. administration of glucose is withheld in HHNS until the blood glucose reaches a
normal level
B. DKA requires administration of bicarbonate to correct acidosis
C. HHNS requires greater fluid replacement to correct the dehydration

6. During assessment of the client with acromegaly, the nurse would expect the patient to
report:
A. an increase in height of 2 to 3 inches a year
B. dry, irritated skin
C. undesirable changes in appearance

7. Vasopressin (Pitressin) is administered to the client with diabetes insipidus because it:
A. decreases glucose production within the liver
B. increase tubular reabsorption of water
C. increase release of insulin from the pancreas

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8. The nurse should assess a client with Addison’s disease for which of the following?
A. Lethargy
B. Muscle spasms
C. Weight gain

9. Cushing’s disease is manifested by the excessive secretion of corticosteroids. The hormones

involved are:
A. adrenocorticotrophic hormone (ACTH)
B. glucocorticoids and aldosterone
C. glucocorticoids, aldosterone and androgens

10. The type II diabetes mellitus commonly affects:

A. newly born children
B. persons over 30 years
C. person with hypertension and kidney failure

11. To prepare a patient for a lumbar puncture, the nurse:

A. ask the patient sit on the side of the bed, leaning on a padded heart table
B. positions the patient in a lateral recumbent position with the hips, knees and neck
flexed
C. sedates the patient with medication before the test

12. The neurologic functions that are affected by a stroke are primarily related to the:
A. brain area perfused by the affected artery
B. presence or absence of collateral circulation
C. rapidity of the onset of symptoms

13. The incidence of ischemic stroke in patients with TIAs and other risk factors is reduced with
the administration of:
A. daily low-dose aspirin
B. lovastatin (Mecavor)
C. nomodipine (Nimotop)

14. Which of the following is an early complication of meningitis?

A. Cerebral oedema
B. Paralysis of the extremities
C. Temporary deafness

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15. In the management of the client with tetanus, the rationale for the administration of
antibiotics is to:

A. neutralize circulating toxins

B. prevent wound infection
C. stop the production of toxins

16. Which of the following would you consider important in the management of the patient
diagnosed with CVA and has generalized weakness on discharge?

A. A long-handled bath sponge for showering

B. Fix elevators for easy transportation
C. Fix a raised toilet seat in patient’s bathroom

17. Four days following a stroke, a patient is to start oral fluids and feedings. Before feeding the
patient, the nurse should first:
A. evaluate the patient’s ability to swallow small sips of ice water
B. order a soft diet for the patient
C. raise the head of the bed to a sitting position

18. The nurse is caring for a client diagnosed with meningitis, which intervention need to be
included in the plan of care:

A. assess for altered speech

B. administer prescribed antibiotics
C. monitor pulse oximetry

19. The kidneys are very essential in the control of acid-base balance in the body. In case of
acidosis they correct the imbalance by excreting:
A. aluminium ions
B. hydrogen ions
C. potassium ions

20. The nurse in assessing the client with bacterial meningitis, which clinical manifestation if
present would support diagnosis:

A. Chvostek’s sign
B. Kerning’s sign
C. Trousseau’s sign

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21. Which of the following symptoms would most likely indicate that a client has pyelonephritis?

A. Ascites
B. Nausea and vomiting
C. Polyuria

22. In caring for a patient suffering from acute renal failure, the nurse is to:
A. serve fluids liberally
B. avoid serving energy foods
C. observe for signs of infection

23. The client with chronic renal failure has to maintain adequate nutritional intake. Which of the
following diets would be most appropriate?
A. High-calcium, high potassium, high protein
B. High-carbohydrate, high-protein
C. Low-protein, low-sodium, low potassium

24. Complications of renal failure include the following except:

A. severe hypertension
B. congestive heart failure
C. defective production of enzymes

25. In nephrotic syndrome, patient’s urine is reduced in volume and characteristically contains
large amounts of:
A. proteins
B. urea
C. nitrogen

26. The classical manifestation of nephrotic syndrome does not include:

A. hyperalbuminaemia
B. hyperlipidaemia
C. oedema

27. To prevent recurrence of cystitis, which of the following should the nurse encourage the
female client to include in her daily routine?
A. Douching regularly with 0.25% acetic acid
B. Increasing citrus juice intake
C. Wearing cotton underpants

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28. Ammonia is excreted by the kidney to help maintain:

A. acid-base balance of the body
B. low bacterial levels in the urine
C. normal red blood cell production

29. The test that is most specific for renal function is the:
A. BUN
B. Creatinine clearance
C. Renal scan

30. The nurse enters the room as the client is beginning to have a tonic-clonic seizure. What
action should the implement first?
A. Assess the size of the client’s pupils
B. Ensure a safe environment for patient care
C. Provide client privacy during the seizure

31. Acute gout presents as painful inflammation of the big toe which is referred to as podagra.
Which of these drugs is used in the treatment for an acute gout?
A. Allopurinol
B. Probenecid
C. Colchicine

32. Which joint disease is associated with morning stiffness that improves with activity?
A. Osteoarthritis
B. Gout
C. Rheumatoid arthritis (RA)

33. You are providing education to a patient, who was recently diagnosed with rheumatoid
arthritis, about physical exercise. Which statement made by the patient is correct?
A. “It is best I try to incorporate a moderate level of high impact exercises weekly into
my routine, such as running and aerobics”.
B. “I will be sure to rest joints that are experiencing a flare-up, but I will try to maintain a
weekly regime of range of motion exercises along with walking and riding a stationary
bike”.
C. “It is important I perform range of motion exercises during joint flare-ups and
incorporate low-impact exercises into my daily routine”.

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34. A client with rheumatoid arthritis states, “I can't do my household chores without becoming
tired. My knees hurt whenever I walk”. Which nursing diagnosis would be most appropriate?
A. Activity intolerance related to fatigue and pain.
B. Self-care deficit related to increasing joint pain.
C. Ineffective coping related to chronic pain.

35. Which of these patients listed below is not at risk for osteoporosis?
A. A 50year old female whose last menstrual period was 7 years ago.
B. A 45year old male patient who has been taking glucocorticoids for the last 6 months.
C. A 30year old male who drinks alcohol occasionally and has a BMI of 28.

36. Whenever the rate of sodium intake or output changes, there is a corresponding gain or loss
of water that tends to:
A. keep the sodium concentration constant
B. decrease the sodium concentration
C. alter the sodium concentration

37. All of the homeostatic mechanisms that monitor and adjust the composition of body fluids
respond to changes in the:
A. extracellular fluid
B. fluid balance
C. intracellular fluid

38. As a result of the aging process, the ability to regulate pH through renal compensation
changes as a result of:
A. a reduction in the number of functional nephrons
B. a reduction in the rate of insensible perspiration
C. increased ability to concentrate urine

39. A mismatch between carbon dioxide generation in peripheral tissues and carbon dioxide
excretion at the lungs is a:
A. condition known as ketoacidosis
B. metabolic acid–base disorder
C. respiratory acid–base disorder

40. Respiratory alkalosis develops when respiratory activity:

A. decreases plasma PO₂ to below-normal levels
B. lowers plasma PCO₂ to below-normal levels
C. raises plasma PCO₂ to above-normal levels

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41. How can diuretics disrupt a person's fluid and electrolyte balance?
A. They increase the amount of electrolytes in the body, and the kidneys are unable to
filter them out and excrete them.
B. They send a message to the brain to tell the kidneys to stop excreting urine.
C. They make a person urinate more frequently, so the kidneys excrete higher than
normal amounts of electrolytes.

42. In patient teaching about hypokalaemia, what is the most important education to be done?
A. Bowel management care.
B. Decreased consumption of bananas.
C. Use of rapid weight loss programs.

43. An abnormally high level of which electrolyte could be caused by hyperparathyroidism and
would result in kidney stones, confusion, muscle pain, and cardiac arrhythmias?
A. Calcium
B. Chloride
C. Potassium

44. In renal compensation of acidosis H+ secretion:

A. decreases; bicarbonate excretion increases
B. increases; bicarbonate excretion increases
C. increases; bicarbonate reabsorption increases

45. A falling blood pH and a rising concentration of carbon dioxide due to emphysema, indicate:
A. metabolic acidosis
B. metabolic alkalosis
C. respiratory acidosis

46. A nurse understands the danger of hypertonic solutions and hypernatremia when the nurse
states hypertonic solutions:
A. could increase the level of Na even more.
B. could rob the cells of Na.
C. will increase fluid in the cells

47. A nurse understands hypotonic solutions when the nurse states that:
A. cells that need to be "dried" out are best served by this solution.
B. a patient that has had diuretic therapy (DKA) will benefit from replacing cellular fluid
C. this type of fluid helps with renal problems of over drying cells.

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48. Which of the following occurs when large amounts of pure water are consumed?
A. A fluid shift occurs, and the volume of the ICF decreases.
B. Osmolarities of the two compartments are slightly lower.
C. The ECF becomes hypertonic to the ICF.

49. The symptoms of low potassium (hypokalaemia) include:

A. both muscle weakness and paralysis
B. muscle weakness alone
C. paralysis alone

50. The lungs respond to metabolic alkalosis by:

A. decreasing the respiratory rate
B. increasing the respiratory rate
C. keeping the respiratory rate constant

51. Acute respiratory acidosis can occur in each of the following instances except when:
A. chemoreceptors fail to respond to pH changes
B. normal respiratory function is compromised but compensatory mechanisms have not
failed
C. pulmonary ventilation cannot be increased

52. A patient with feeding tube is having severe watery stool, lethargic, with poor skin turgor, a
pulse rate of 120, and hyperactive reflexes. Nursing interventions would include:
A. Administering salt tablets and monitoring hypertonic parenteral solutions
B. Administering sedatives
C. Measuring and recording intake and output and daily weights

53. You are taking a health history on a patient and notice their eyes seem a bit yellow and the
skin seems jaundiced. What word/phrase best describes this type of objective observation?
A. A complication of treatment.
B. A sign.
C. A symptom.

54. Mr Agyei is diagnosed with FVD; which of the following nursing diagnoses might apply to
his condition?
A. Altered urinary elimination
B. decreased cardiac output
C. increased cardiac output

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55. Alexander has hypotonic FVE; which of the following findings would the nurse expect to
assess in the patient?
A. hypotension and pitting oedema
B. poor skin turgor and increased thirst
C. weight gain and thirst

56. Which of the following condition would a nurse expect atropine to be administered?
A. Angina pectoris
B. Hypertensive crisis
C. Third –degree heart block

57. The vitamin essential for nucleo-protein, synthesis and maintenance of normal erythropoiesis
is vitamin
A. 6
B. 9
C. 17

58. Early in therapy patients receiving anti-hypertensives are observed for

A. Diaphoresis
B. difficulty in breathing
C. orthostatic hypotension

59. The nurse explains to the patient on diuretic therapy that the drug reduces blood pressure by:
A. decreasing potassium excretion
B. dilating blood vessels
C. increasing sodium excretion

60. Patients on antihypertensive are warned to avoid:

A. alcoholic beverages
B. excessive exercises
C. high carbohydrates foods

61. Patients who have diuretics as part of their antihypertensive therapy are observed for:
A. Dehydration
B. fluid overload
C. hyperkalaemia

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62. Which of the following condition increases a patient’s likelihood of developing digitalis
toxicity?
A. Hypercalaemia
B. Hypocalaemia
C. Hyperkalaemia

63. The vitamins which is therapeutically effective for the treatment of pernicious anaemia is
known as:
A. cyanocobalamin
B. folic Acid
C. hydrochloride

64. The iron preparation that corrects erythropoetic abnormalities induced by iron deficiency but
does not stimulate erythropoiesis is/are:
A. ferrous gluconate
B. ferrous fumerate
C. ferrous sulphate

65. Drugs that inhibit the actions of acetylcholine a neuro-transmitter and used in the treatment
of glaucoma is/are:
A. adrenergic blockers
B. cholinergic blockers
C. epinephrine blockers

66. When asked how adrenegics reduce blood pressure, the nurse responds that these drugs:
A. decrease potassium excretion
B. dilate blood pressure
C. increase the excretion of sodium from the body

67. In explaining the action of calcium channel blockers, the nurse states that they:
A. eliminate calcium from around cell membranes
B. inhibit the movement of calcium ions across cell membranes
C. keep calcium within cell membranes

68. Patients receiving peripheral vasodilating agents may experience dizziness and light
headedness and are instructed to:
A. ask for assistance when ambulating
B. drink extra fluids to eliminate this adverse effect
C. remain flat in the bed for 1 hour after the administration of the drug

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69. Which of these agents acts by dilating pupils and relaxing focus muscles?
A. Miotics
B. Miosis
C. Mydriatics

70. The first action the nurse takes before the administration of insulin is:
A. carefully select a site
B. check glucose level
C. check the prescription order

71. Nitrates are recommended for treating cardiovascular disorders and act by:
A. decreasing the lumen of smooth vessels
B. dilating coronary arteries
C. relaxing smooth vessels

72. Daniel is diagnosed with FVD; which of the following nursing diagnoses might apply to his
condition?
A. Altered urinary elimination
B. Decreased cardiac output
C. Increased cardiac output

73. Joshua is receiving furosemide and Digoxin; which laboratory data would be the most
important to assess in planning the care for the client?
A. Calcium level
B. Potassium level
C. Sodium level

74. A patient with renal failure is likely to suffer from which electrolyte imbalance?
A. Hyperkalaemia
B. Hypocalcaemia
C. Hypokalaemia

75. A client is diagnosed with metabolic acidosis, which would the nurse expect the health care
provider to order?
A. Bronchodilator
B. Potassium
C. Sodium bicarbonate

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76. Mr. Mensah has the following arterial blood gas (ABG) values: pH of 7.34, partial pressure
of arterial oxygen of 80 mm Hg, partial pressure of arterial carbon dioxide of 49 mm Hg, and
a bicarbonate level of 24 mEq/L. Based on these results, which intervention should the nurse
implement?
A. Administering low-flow oxygen
B. Encouraging the client to cough and deep breath
C. Instructing the client to breathe slowly into a paper bag

77. A client with very dry mouth, skin and mucous membranes is diagnosed of having
dehydration. Which intervention should the nurse perform when caring for a client diagnosed
with fluid volume deficit?
A. Assessing urinary intake and output
B. Monitoring arterial blood gas (ABG) results
C. Obtaining the client’s weight weekly at different times of the day

78. Nana Kodua’s lab test revealed that his serum calcium is 2.5 mEq/L. Which assessment data
does the nurse document when a client diagnosed with hypocalcaemia develops a carpopedal
spasm after the blood-pressure cuff is inflated?
A. Positive Chvostek’s sign
B. Positive Trousseau’s sign
C. Tetany

79. Mr Adamu’s lab test just revealed that her chloride level is 96 mEq/L. As a nurse, you would
interpret this serum chloride level as:
A. high
B. low
C. within normal range

80. A patient is being admitted with dehydration due to nausea and vomiting. Which fluid would
you expect the patient to be started on?
A. 0.225% saline
B. 5% Dextrose in 0.9% Saline
C. 0.9% Normal Saline

81. A 57year old with diabetes insipidus is on admission in your ward. Which of the following
findings should the nurse report to the physician?
A. Potassium of 4.0 mEq
B. Urine output of 350mL in 8hrs
C. Weight gain of 2kg in a week

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82. A client with type 1 diabetes mellitus has diabetic ketoacidosis. Which of the following
findings has the greatest effect on fluid loss?
A. Decreased serum potassium level
B. Hypotension
C. Rapid, deep respirations

83. A client has recently been diagnosed with type 2 diabetes mellitus and is to take tolbutamide.
By which of the following actions does the drug reduce blood glucose level?
A. Combining with glucose to render it inert
B. Lowering the renal threshold of glucose
C. Stimulating insulin release from functioning beta cells in the pancreas

84. A client begins to expectorate blood and the nurse describes this episode as:
A. Haematemesis
B. Haematoma
C. Haemoptysis

85. Tenesmus, a painful straining to empty the bowel is common in:

A. Amoebic dysentery
B. Cholera infection
C. Paratyphoid fever

86. Neomycin (Mycifradin) and a Neomycin enema have been prescribed for a client with
cirrhosis. The expected outcome of this therapy is to:
A. Block ammonia formation
B. Prevent straining during defecation
C. Reduce abdominal pressure

87. The nurse should teach the client with jaundice to improve his self-image by:
A. Covering both eyes with moistened gauze pads
B. Instilling an ophthalmic anaesthetic as prescribed
C. Wearing dark glasses

88. The nurse has noticed that a client with acute pancreatitis occasionally experiences muscle
twitching and jerking. How should the nurse interpret these symptoms?
A. The client has a nutritional imbalance
B. The client is experiencing a reaction to the drug meperidine (Demerol)
C. The client may be developing hypocalcaemia

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89. A client with an obstruction to the renal artery causing renal ischemia exhibits hypertension.
One factor that may contribute to the hypertension is;
A. decreased aldosterone secretion
B. increased renin release.
C. increased antidiuretic hormone (ADH) secretion

90. The nurse must be alert for signs of respiratory acidosis in the client with emphysema,
because this individual has a long-term problem with oxygen maintenance and:
A. carbon dioxide gas is not excreted
B. Hyperventilation occurs, even if the cause is not physiologic
C. Localized tissue necrosis occurs as a result of poor oxygen supply to the area

91. A hospitalized client is dyspnoeic and has been diagnosed with left pneumothorax by chest x-
ray. Which of the following signs or symptoms observed by the nurse most clearly indicates
that the pneumothorax is rapidly worsening?
A. Hypertension
B. Pain with respiration
C. Tracheal deviation to the right

92. An obsessed diabetic patient requires weight control, because obesity:

A. causes pancreatic islet cell exhaustion
B. reduces insulin binding at receptor sites.
C. reduces pancreatic insulin production.

93. Which assessment would indicate to the nurse that the client is at risk for haemorrhagic
stroke?
A. Blood glucose of 480mg/dl
B. Blood pressure of 220/120mmhg
C. Right –sided carotid bruit

94. Which of the following best describes the vaginal discharge as seen in gonorrhoea?
A. Thick and black
B. Thin and yellow
C. Thick and green

95. The appearance of the vaginal discharge in cases of candidiasis is:

A. Cheese-like
B. Pellet
C. Purulent

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96. A patient is seen at the outpatient clinic for a sudden onset of inflammation and severe pain
in the big toe. A diagnosis of gout is made on the basis of:
A. a family history of gout
B. elevated serum uric acid levels
C. sodium urate crystals in synovial fluid

97. In addition to a decreased apical rate, the nurse knows that she must withhold the
administration of digoxin if the client experiences:
A. sinusitis
B. chest pain
C. blurred vision

98. The nurse understands that in assessing an adult patient who is conscious with the problem of
dehydration the nurse is likely to find the following features except:
A. increased pulse
B. inelastic skin
C. increased blood pressure

99. When a client is diagnosed with aplastic anaemia, the nurse monitors for changes in which of
the following physiological functions?
A. Bleeding tendencies
B. Intake and output
C. Peripheral sensation

100. When administering a thrombolytic drug to the client experiencing an MI, the nurse
explains to him that the purpose of this drug is to:
A. help keep him well hydrated
B. dissolve clots he may have
C. prevent kidney failure

101. Which of the following clinical manifestations would the nurse expect to find when
assessing a client with varicose veins?
A. Dilated, twisted, visible leg veins and nocturnal cramps
B. Intermittent claudication and non-palpable pedal pulses
C. Marked limb enlargement and non-pitting oedema

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102. A female patient is concerned about the signs and symptoms of idiopathic
thrombocytopenic purpura. The nurse explains that it could include the following except:
A. dysmenorrhoea
B. epistatxis
C. oral bleeding

103. When a client with thrombocytopenia has a severe headache, the nurse knows that this
may indicate:
A. cerebral bleeding.
B. migraine headache.
C. stress of the disease

104. A teenager who has acne tells the nurse that he has squeezed out several blackheads. The
nurse should explain that:
A. squeezing causes keratinization of the sebaceous canal
B. squeezing causes oxidation of sebum
C. squeezing often causes rupture of the sebaceous follicle, inflammation and scaring

105. The nurse who is planning care for the client who is legally blind should do which of the
following as most important to ensure the client’s safety.
A. Describe the weather conditions to the client
B. Leave doors partially opened
C. Orient the client verbally and physically to the room

106. The nurse in performing the Rinne test on a client with suspected hearing impairment.
The nurse places the tuning fork on the:
A. forehead in the midline
B. mastoid bone
C. vertex of the skull

107. Which of the following nursing diagnosis would the nurse consider as the highest priority
in the management of the client with Meniere’s disease?
A. Altered sensory perception
B. Risk for disturbed sleep pattern
C. Risk for physical injury

108. A client is diagnosed with glaucoma. Which symptom would the nurse expect the client
to report?
A. Floating spots in the vision
B. Halos around lights
C. Yellow haze around everything

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109. The client reports of ringing in the ears. Which would be the most appropriate term for
the nurse to document?
A. Otorrhoea
B. Presbycusis
C. Tinnitus

110. Which of the following is not a predisposing factor to the occurrence of Acne Vulgaris?
A. Adolescence
B. Greasy skin
C. Intake of high carbohydrate diet

111. When a client who is being managed for severe pericarditis experiences distended neck
veins with tightness in the chest, the nurse understands that the client has developed:
A. cardiac tamponade
B. myocardial dystrophy
C. systemic dysrhythmia

112. During which stage of the menstrual cycle does the endometrium layer of the uterus
thicken?
A. Luteal Phase
B. Proliferative Phase
C. Secretory Phase

113. The nurse is assessing the pH level of the vaginal environment of a 26-year-old client.
Which of the following would be an expected finding for this client? pH level of:
A. 4.0
B. 5.7
C. 6.9

114. The structure that takes blood flow to the glomerulus for filtration is known as the:
A. afferent arteriole
B. efferent arteriole
C. peritubular capillaries

115. What is their most common formation site for the formation of renal calculi?
A. Bladder
B. Ureter
C. Urethra

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116. Nurse Danso is reviewing a client’s fluid intake and output record. It is expected that
fluid intake should be:
A. approximately equal to the urine output.
B. double the urine output.
C. inversely proportional to the urine output

117. The nurse reads in an admission note that the physical examination of a client revealed an
impairment of cranial nerve II. The nurse instructs caregivers to do which of the following
when caring for the client?
A. Clear the clients’ path of obstacles
B. Serve food at room temperature
C. Whisper to client

118. Which nursing diagnosis takes highest priority for a female client with hyperthyroidism?
A. Body image disturbance related to weight gain and oedema
B. Imbalanced nutrition: Less than body requirements related to thyroid hormone excess
C. Risk for imbalanced nutrition: More than body requirements related to thyroid
hormone excess

119. Which of the following cranial nerves is not involved in the sensation of taste?
A. Assessory
B. Glossopharyngeal
C. Vagus

120. Which of the following hormones would be expected to increase if you were studying all
day for a test and skipped breakfast and lunch?
A. Calcitonin
B. Glucagon
C. Insulin

121. A patient experiences loss of pain sensation to the right side of his face. Which of the
following cranial nerve is likely to be affected?
A. Cranial nerve II
B. Cranial nerve VI
C. Cranial nerve VII

122. When caring for a male client with diabetes insipidus, nurse Juliet expects to administer:
A. furosemide (Lasix)
B. regular insulin
C. vasopressin (Pitressin)

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123. Nurse Oliver should expect a client with hypothyroidism to report which health
concerns?
A. Increased appetite and weight loss
B. Nervousness and tremors
C. Puffiness of the face and hands

124. Madam Joy has an increased serum calcium level. Which of the following hormones are
likely to be produced in response?
A. Calcitonin
B. Cortisol
C. Parathyroid hormone

125. During which cycle day of a typical 28day menstrual cycle does the follicular phase
occur? Cycle days:
A. 1-14
B. 7-13
C. 14-28

126. In Intravenous therapy, flow rate of an infusion is influenced by the following.

I. The position of the forearm.
II. The position and patency of the tubing.
III. The height of the infusion bottle.
IV. Possible infiltration or fluid leakage.
A. I, II and III
B. II, III and IV
C. I, II, III and IV

127. Arrange the following nursing interventions in order of importance during blood
transfusion reaction.
I. Notify the physician immediately
II. Observe vital signs (TPR & BP) as often as every 5mins.
III. Start IV Line (0.9% normal saline solution)
IV. Stop the blood transfusion
A. I, II, III, and IV
B. I, IV, II and III
C. IV, III, I and II

128. Madam Sandra Narh has been requested to do KUB. As a nurse you under that KUB is an
X’ ray of the:
A. kidneys, urethra and bladder
B. kidneys, ureters and bladder
C. kidneys, uterus and bladder

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129. During oxygen therapy, the gas is humidified for the following reasons except to:
A. help increase flow of the oxygen
B. help mobilise secretions in the airway passages
C. prevent irritation of the airway passages

130. Mr. Kofi Nyame, 62years old man has been admitted to the ward with a cardiac
condition. Upon checking his vital signs, the following observations were made: respiration
32bpm, temperature 37.2ºC, pulse 100bpm, BP 140 / 90mmHg with oxygen saturation
(Sp02) level at 88%. Which of the following will be your immediate intervention?
A. Inform the doctor immediately
B. Reassure patient he will be fine.
C. Start oxygen therapy immediately

131. Diet to be given to a patient with cardiovascular disease (CVD) should help reduce the
risk of:
A. chest pain
B. fluid retention
C. weight loss

132. Foods that are allowed freely for the patient with cardiovascular disorder include all
except:
A. ice cream
B. tea
C. weak coffee

133. Education of the cardiovascular patient should include sex because they need:
A. mild sexual life
B. moderate sexual life
C. no sexual life

134. Mr Nsiah is recuperating from stroke and the nurse is teaching him how to live with the
condition without being a liability. This phase is referred to as:
A. occupational therapy
B. physiotherapy
C. rehabilitation

135. Mr Kenneth Akoto complains of pain, numbness and tingling sensation in the right leg
after cardiac catheterization. This denotes:
A. arterial insufficiency
B. arrhythmia
C. vasovagal reaction
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136. Hajia Sukula, 55years trader has been diagnosed of Acute renal failure and is to undergo
dialysis. She has understood the need to do haemodialysis compared to peritoneal dialysis
because of the high risk of:
A. haemorrhage
B. infection
C. swelling

137. Hajia Sukula complained of chest pain after the procedure (haemodialysis). What could
be the cause of this symptom she is experiencing?
A. Anaemia
B. Dysrryhthmia
C. Hypertension

138. Eye Irrigation is contrary indicated in a situation when one is/has:

A. a raptured globe
B. exposed to alkaline or acidic chemicals
C. foreign body on the eye

139. These are indications for lumbar puncture except:

A. Cerebral haemorrhage
B. Multiple sclerosis
C. Transtentorial herniation

140. Kofi reports frequent episodes of epigastric pain that awakens him during the night, a
feeling of fullness in the abdomen, and anxiety about his health. Based on this data, which
nursing diagnosis would be most appropriate?
A. Activity intolerance related to abdominal pain.
B. Ineffective individual coping related to exacerbation of duodenal ulcer.
C. Sleep pattern disturbance related to epigastric pain.

141. A client is to have a KUB x-ray done, which of the following would be ordered to
prepare the client for this x-ray?
A. An enema will be given before the examination
B. Fluid and food will be withheld the morning of the examination
C. No special preparation is required for the examination

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142. A client is scheduled for an intravenous pyelography (IVP) to determine the location of a
stone. Which of the following measures would be most important for the nurse to include in
pretest preparation?
A. Checking her history for allergy to iodine
B. Ensuring adequate fluid intake the day of the test
C. Preparing her for the possibility of bladder spasms.

143. An electroencephalogram (EEG) is ordered for a client. What action should the nurse
take when the client is served a breakfast consisting of a soft boiled egg, toast with butter,
orange juice and coffee on the morning of the EEG.
A. Nothing must be served
B. Remove the coffee
C. Remove the toast and butter only

144. Diabetes mellitus is the result of a:

A. complicated pregnancy
B. disorder of the pancreas
C. disorder of the pituitary gland

145. A 60-year-old male patient is suspected of having coronary artery disease. Which non-
invasive diagnostic method would the nurse expect to be ordered to evaluate cardiac
changes?
A. Cardiac catheterization
B. Magnetic Resonance Imaging
C. Pericardiocentesis

146. Madam Asare has been admitted to the emergency ward with provisional diagnosis of
meningitis. The nurse assists with lumber puncture procedure to confirm diagnosis. She
positions the patient at the edge of the bed with the back arched. This position will help to:
A. Collect the cerebrospinal fluid between lumber 1 and 2
B. Decrease the spaces to cause a steady flow of cerebrospinal fluid
C. Increase spaces between the vertebrae for easy collection of cerebrospinal fluid

147. During catheter hygiene, the nurse cleans catheter from:

A. its insertion to the drainage bag
B. the labia majora, minora and the vestibule
C. urinary meatus in circular motion and moves down

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CANDIDATE’S ID NUMBER ………………………………………………………

148. The use of an ultrasound in most invasive procedures is to help establish all except:
A. avoid damage to structures involved
B. mark the location of the structures
C. outline the walls of the structure

149. Mr. Emmanuel Awudu is being prepared for lumbar puncture procedure. As part of the
baseline neurological data the nurse will assess:
A. abdomen, weigh patient and measure abdominal girth at largest point
B. movement, sensation and muscle strength of the lower limbs
C. movement, sensation and muscle strength of the upper limbs

150. The following are the advantages of autologous blood transfusion except:
A. avoid blood born infections
B. eliminates transfusion reaction of incompatibility
C. filters blood removing anticoagulants

151. A female client with a urinary diversion tells the nurse, “This urinary pouch is
embarrassing. Everyone will know that I’m not normal. I don’t see how I can go out in public
anymore”. The most appropriate nursing diagnosis for this patient is:
A. anxiety related to the presence of urinary diversion
B. low self-esteem related to feelings of worthlessness
C. disturbed body Image related to creation of a urinary diversion

152. The primary reason for taping an indwelling catheter laterally to the thigh of a female
client is to:
A. Allow the client to turn without kinking the urinary catheter
B. Avoid pressure on the urethra and pulling on retention balloon
C. Prevent accidental urinary catheter removal from place

153. In Haemodialysis, the dialyser is the artificial kidney and in Peritoneal dialysis the
dialyser is the:
A. abdomen
B. kidney
C. peritoneum

154. A client with Heart Failure has been receiving 10mg of Furosemide twice daily. The
nurse noticed that the client’s weight has increased by 5kg over the last two days. The nurse
understands that this is an indication of:
A. failure of treatment regimen
B. inappropriate assessment of patient
C. inexperienced work of nurses

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155. Sudden cardiac arrest means that the heart:

A. has a cycle of beating and stopping
B. skips beats
C. stops beating

156. Which of the following is not one of the three main factors influencing blood pressure?
A. Blood volume
B. Emotional state
C. Peripheral resistance

157. Select the correct statement about factors that influence blood pressure.
A. An increase in cardiac output corresponds to a decrease in blood pressure, due to the
increased delivery.
B. Excess red cell production would cause a blood pressure increase
C. Systemic vasodilation would increase blood pressure, due to diversion of blood to
essential areas.

158. A patient asks the nurse, “what is heart failure”? Which of the following is the nurse’s
best response?
A. “Heart failure is a build-up of blood in the aorta from the heart’s left ventricle”.
B. “The heart is unable to pump enough blood for the body’s oxygen needs”.
C. “With a failing heart, the heart stops beating, so blood is not pumped out”.

159. Which of the following statements is true about ischaemic heart diseases?
A. A critical haemodynamic coronary stenosis is a prerequisite for an acute coronary
syndrome.
B. Coronary vasospasm is a common cause of myocardial infarction.
C. Most myocardial infarctions originate from coronary plaques that do not cause
significant haemodynamic stenosis.

160. A patient who has been treated for heart failure is being discharged from the hospital on
furosemide (Lasix) 20mg daily. Which of the following statements by the patient would
indicate understanding of instructions for this medication?
A. “I will drink lots of fluids with the Lasix”.
B. “I will take the Lasix at bedtime”.
C. “I will take the Lasix in the morning”.

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CANDIDATE’S ID NUMBER ………………………………………………………

161. Which of the following does the nurse understands is a major cause of left-sided heart
failure?
A. Hypertension
B. Pulmonary valve stenosis
C. Septal defects

162. Which of the following is not a common source of transmission for Hepatitis A virus?
I. Blood
II. Food
III. Semen
IV. Water
A. I and II
B. I and III
C. III and IV

163. A patient is admitted to the emergency room with very painful mid-epigastric pain felt in
the back, elevated glucose, fever, and vomiting. During the head-to-toe assessment, you
notice bluish discoloration around the belly button. As the nurse, you know that this is called
……………………… sign.
A. Cullen's
B. Grey-Turner's
C. McBurney's

164. A patient with a peptic ulcer is suddenly vomiting dark coffee ground emesis. On
assessment of the abdomen you find bloating and an epigastric mass in the abdomen. Which
complication may this patient be experiencing?
A. Obstruction of pylorus
B. Perforation
C. Upper gastrointestinal bleeding

165. You are educating a group of patients at an outpatient clinic about peptic ulcer formation.
Which statement is correct about how peptic ulcers form?
A. “Peptic ulcers can form when acid penetrates unprotected stomach mucosa. This
causes histamine to be released which signals to the parietal cells to release more
hydrochloric acid which erodes the stomach lining further”.
B. “Peptic ulcers form when acid penetrates unprotected stomach mucosa. This causes
pepsin to be released which signals to the parietal cells to release more pepsinogen
which erodes the stomach lining further”.
C. “The release of prostaglandins causes the stomach lining to breakdown which allows
ulcers to form”.

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CANDIDATE’S ID NUMBER ………………………………………………………

166. In the stomach lining, the parietal cells release ……………… and the chief cells release
…………… which both play a role in peptic ulcer disease.
A. hydrochloric acid, and pepsinogen
B. pepsin, hydrochloric acid
C. pepsinogen, gastric acid

167. The most reliable index to determine the respiratory status of a client is to:
A. determine the presence of a femoral pulse
B. listen and feel the air movement
C. observe the skin and mucous membrane for colour

168. Aminophylline (theophylline) is prescribed for a client with acute bronchitis. A nurse
administers the medication, knowing that the primary action of this medication is to:
A. promote expectoration
B. relax smooth muscles of the bronchial airway
C. suppress the cough

169. A 69-year-old client appears thin and cachectic. He’s short of breath at rest and his
dyspnoea increases with the slightest exertion. His breath sounds are diminished even with
deep inspiration. These signs and symptoms fit which of the following conditions?
A. Asthma
B. Chronic obstructive bronchitis
C. Emphysema

170. It is highly recommended that clients with asthma, chronic bronchitis, and emphysema
have Pneumovax and flu vaccinations for which of the following reasons?
A. All clients are recommended to have these vaccines
B. Respiratory infections can cause severe hypoxia and possibly death in these clients.
C. These vaccines produce bronchodilation and improve oxygenation

171. During chemotherapy for lymphocytic leukaemia, Mathew develops abdominal pain,
fever, and “horse barn” smelling diarrhoea. It would be most important for the nurse to
advise the physician to order:
A. enzyme-linked immunosuppressant assay (ELISA) test
B. flat plate X-ray of the abdomen
C. stool for Clostridium difficile test

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CANDIDATE’S ID NUMBER ………………………………………………………

172. A 22-year-old man is admitted to the hospital with complaints of fatigue and weight loss.
Physical examination reveals pallor and multiple bruises on his arms and legs. The results of
the patient’s tests reveal acute lymphocytic leukaemia and thrombocytopenia. Which of the
following nursing diagnoses most accurately reflects his condition?
A. Alteration in comfort
B. Potential for injury
C. Potential for self-harm

173. A 68-year-old woman is diagnosed with thrombocytopenia due to acute lymphocytic

leukaemia. She is admitted to the hospital for treatment. The nurse should assign the patient
to a:
A. private room so that she will not be infected by other patients and health care workers.
B. private room so that she will not infect other patients and health care workers.
C. semiprivate room so that she will have the opportunity to express her feelings about
her illness

174. The treatment protocol for a client with acute lymphatic leukaemia includes prednisone,
methotrexate, and cimetidine. The purpose of the cimetidine is to:
A. Decrease the secretion of pancreatic enzymes
B. Enhance the effectiveness of methotrexate
C. Prevent a common side effect of prednisone

175. A patient is undergoing the induction stage of treatment for leukaemia. The nurse teaches
family members about infection precautionary measures. Which of the following statements
made by family members indicates that the family needs more education?
A. “We will bring in family pictures and get well cards”.
B. “We will bring in fresh flowers to brighten the room”.
C. “We will bring in personal care items for comfort”.

176. The most aggressive form of Hodgkin’s Lymphoma is:

A. lymphocyte depletion
B. lymphocyte predominant
C. mixed cellularity

177. Infection commonly related to Hodgkin’s lymphoma is:

A. cytomegalovirus
B. epstein Barr Virus
C. helicobacter pylori

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178. Lymphoblastic Lymphomas are related to all the following except:

A. development to acute lymphocytic leukaemia
B. mostly are B-cell phenotype
C. potentially curable in young patients

179. To prevent excessive bleeding during surgery a patient with Haemophilia A may be
given:
A. factor IX concentrate
B. factor VIII concentrate
C. whole blood

180. During an assessment of a patient experiencing acute haemorrhage and anaemia, the
healthcare provider is most likely to find:
A. Hypotension
B. Jaundice
C. tachycardia

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