REGIONAL EXAMINATION FOR NURSE REGISTRATION

CARICOM COUNTRIES

CLINICAL NURSING-OBJECTIVE TYPE QUESTIONS

February 25, 2018

RENR REVIEW
DURATION 2 ½ hrs

NO OF ITEMS: 100
1. A patient is participating in study Congestive Cardiac Failure in which his doctor is directly
involved. Which statement by the patient indicates a lack of understanding about his right as
a participant?
a) “ I will have to find a new doctor if I do not complete this study”
b) “My confidentiality will not be compromised in this study”
c) “I understand the risk associated in this study”
d) “I can withdraw from this study anytime”

2. The public health nurse asked a student at the health at what level is the cold chain when the
vaccines are stored in large walk in refrigerators. Which of the following is an accurate
answer by the student?

a. National
b. Central
c. Local
d. District

3. After receiving an MMR vaccine at the health care facility a female client began to
complain of itching and short of breathe. Which of the following allergies in the patient’s
history would alert the nurse to the patient’s reaction to the vaccine?

a. Margarine
b. Eggs
c. Milk
d. Soy products

4. The hospice nurse caring for a client diagnosed with Diabetes Mellitus type 2 observes
the client eating a bowl of ice cream. Which intervention should be PRIORITY for the
nurse?

a. Allow the client to enjoy the ice cream.

b. Check the client’s blood glucose.
c. Remind the client not to eat ice cream.
d. Suggest the client eat low-fat sweets.

5. The charge nurse of a surgical unit has been notified of an external disaster with
multiple casualties. Which client should the charge nurse request to be discharged?

a. The client scheduled for a repair of an abdominal aortic aneurysm in the

morning and whose preoperative teaching has not been started.
b. The client who had an abdominal hysterectomy 2 days ago and whose catheter has
 been removed.
c. The client who has a bleeding peptic ulcer and now has a hemoglobin of
7 mg/dL and a hematocrit of 22.1%.
d. The client who was in a motor vehicle accident and has a 6 on the Glasgow coma
scale and decorticate posturing.

6. A group of students attending an institution are deliberating whether or not to use the mailed
questionnaire as their data collection instrument. One MAJOR disadvantage of this method
is that ______.
a) it does not eliminate literacy barriers
b) it requires maximum explanation by others
c) the participant’s action may be interpreted in a way to suit the researcher
d) validity is undermined because of possible difference in the interpretation by
respondents

7. Which nursing intervention is PRIORITY for the intensive care nurse to implement when
caring for a client diagnosed with Diabetic Ketoacidosis?

a. Assess for a fruity breath odour.

b. Check blood glucose levels ac and hs.
c. Monitor the client’s pulse oximeter readings.
d. Calculate accurate IV flow rate

8. The new graduate on a surgical unit does not take breaks or go to lunch and still cannot
complete the work in a timely manner. Which statement is the preceptor’s BEST
recommendation to the new graduate?

a. Suggest the new graduate look for a different position.

b. Start administering medications 2 hours early.
c. Clock out at the end of the shift and then finish the charting.
d. Do not skip the allowed breaks except during an emergency.

9. The hospital has declared a major disaster. Which action should the nursing manager of the
medical unit implement FIRST?

a. Make rounds with the discharging doctor.

b. Instruct the staff in the disaster plan.
c. Send one nurse to the disaster command post.
d. Maintain the functioning of the unit.
10. The nurse is caring for a client newly diagnosed with HIV. Which referral is appropriate at
this time? To a:

a. Social worker to apply for disability.

b. Dietitian for a nutritional consult.
c. Psychological counsellor for therapy.
d. Chaplain to discuss spiritual issues.

11. Which data indicates therapy has been effective for the client diagnosed with Bipolar
Disorder? The client:

a. only has four episodes of mania in 6 months.

b. goes to work every day for 9 months.
c. wears a nightgown to the day room for therapy.
d. has had three motor vehicle accidents.

12. The client in the operating room states, “I don’t think I will have this surgery after all.”
Which intervention should the nurse implement FIRST?

a. Have the surgeon speak with the client.

b. Ask the client to discuss the concerns.
c. Continue to prep the client for surgery.
d. Immediately stop the surgical procedure

13. The nurse on the medical unit observes one client slapping another client in the face. Which
intervention should be PRIORITY for the nurse?

a. Discuss the aggressive behaviour with the client.

b. Document the occurrence in the client’s chart.
c. Approach the client with another staff member.
d. Instruct the client to go to the unit’s quiet room.

14. The client 2 days after a laparoscopic cholecystectomy tells the nurse, “My right shoulder
hurts so bad I can’t stand it.” Which statement is the nurse’s BEST response?

a. “This is a result of the carbon dioxide gas used in surgery.”

b. “Call a taxi and go to the emergency department immediately.”
c. “Increase the pain medication the surgeon ordered.”
d. “You need to ambulate in the hall to walk off the gas pains.”

15. The client is admitted to the emergency department with an apical pulse 134, respirations
 28, and BP 92/56, and the skin is pale and clammy. Which intervention should be the
nurse’s PRIORITY?

a. Type and cross-match the client for PRBCs.

b. Start IVs with large-bore catheters.
c. Obtain the client’s history and physical.
d. Check the client’s allergies to medications.

16. The client’s arterial blood gas (ABG) results are pH 7.34, PaCO2 50, HCO3 24, PaO2 87.
Which intervention should the nurse implement FIRST?

a. Have the client turn, cough, and deep breathe.

b. Place the client on oxygen via nasal cannula.
c. Check the client’s pulse oximeter reading.
d. Notify the doctor of the ABGs.

17. The nurse is caring for a client diagnosed with Acquired Immunodeficiency Syndrome
(AIDS). Which client problem is PRIORITY?

a. Body image disturbance.

b. Impaired coping.
c. Risk for infection.
d. Self-care deficit.

18. The nurse is preparing to administer medications for clients on a medical unit. The client
diagnosed with hypothyroidism is complaining of being hot all the time, feeling palpitations,
and being jittery. Which intervention should the nurse implement FIRST?

a. Check the client’s serum thyroid levels.

b. Assess the client for diarrhoea.
c. Document the finding in the chart.
d. Hold the client’s thyroid medication.

19. The clinic nurse is caring for a 10-year-old client diagnosed with Diabetes Mellitus type 2.
Which client problem is PRIORITY?

a. Altered nutrition, excessive intake.

b. Risk for low self-esteem.
c. Hypoglycemia.
d. Risk for loss of body part.
20. The client involved in a motor vehicle accident is being prepped for surgery when the client
asks the nurse on the unit, “What happened to my child?” The nurse knows the child is
dead. Which statement is an example of the ethical principle non-malfeasance?

a. “I will find out for you and let you know after surgery.”
b. “I am sorry but your child died at the scene of the accident.”
c. “You should concentrate on your surgery right now.”
d. “You are concerned about your child. Would you like to talk?”

21. The husband of a client on the surgical unit comes to the desk and asks the nurse,
“What is my wife’s biopsy report?” Which intervention is the nurse’s BEST action?

a. Check the chart to see whether the client has allowed the spouse to have information.
b. Obtain the pathology report and tell the husband the results of the biopsy.
c. Call the doctor and arrange a time for the husband to meet with the doctor.
d. Inform the client and husband of the biopsy results at the same time.

22. The female client was admitted to the orthopaedic unit for injuries received during a
domestic argument. The client tells the nurse, “I am afraid my husband will kill me if
I leave him. It was my fault anyway.” Which statement is the nurse’s BEST response?

a. “What did you do to set him off like that?”

b. “Do you have a plan for safety if you go back?”
c. “Why do you think it was your fault?”
d. “You should leave him before it is too late.”

23. The 36-year-old client in the women’s health clinic is being prescribed birth control pills.
Which information is important for the nurse to teach the client?

i. Do not smoke while taking birth control pills.

ii. Take one pill at the same time every day.
iii. If a birth control pill is missed, do not double up.
iv. Stop taking the pill if spotting occurs.

a. I, ii,
b. Ii, iii,
c. Iii, iv
d. I, iv

24. The Patient Care Assistant accidentally pulled the client’s chest tube out while assisting the
client to on a bed pan. Which intervention should the nurse implement FIRST?\
 a. Securely tape petroleum gauze over the insertion site.
b. Instruct the patient care assistant how to move a client with a chest tube.
c. Assess the client’s respirations and lung sounds.
d. Obtain a chest tube and a chest tube insertion tray.

25. The nurse is planning care for the client diagnosed with Parkinson’s disease (PD).
Which client problem is PRIORITY?

a. Altered nutrition.
b. Altered mobility.
c. Altered elimination.
d. Altered body image.

26. The nurse is assessing a client with a Spontaneous Pneumothorax who has a left-sided chest
tube. Which data indicate the treatment is effective?

a. The chest x-ray indicates consolidation.

b. The client has bilateral breath sounds.
c. The suction chamber has vigorous bubbling.
d. The client has crepitus around the insertion site.

27. The nurse working at a type C hospital is admitting a client who is Rh-negative to the labour
and delivery unit. The client is gravida 2, para 0. Which assessment data is the MOST
important for the nurse to assess?

a. Why the client did not have a viable baby with the first pregnancy.
b. If the mother received a RhoGAM injection after the last pregnancy.
c. The period of time between the client’s pregnancies.
d. When the mother terminated the previous pregnancy.

28. The administrative supervisor is staffing the hospital’s medical surgical units during
A hurricane and has received many calls from staff members who are unable to get to the
hospital. What should the supervisor do?

a. Inform the chief nursing officer.

b. Notify the on-duty staff to stay.
c. Call staff members who live close to the facility.
d. Implement the emergency disaster protocol.
29. The Emergency Room nurse is caring for a client diagnosed with COPD. Which client
problem is PRIORITY?

a. Activity intolerance.
b. Altered coping.
c. Impaired gas exchange
d. Self-care deficit.

30. The nurse is preparing to administer the second unit of packed red blood cells (PRBCs) to a
client with a bleeding gastric ulcer. Which interventions should the nurse implement?

i. Hang a bag of D5NS to keep open (TKO).

ii. Change the blood administration set.
iii. Check the client’s current vital signs.
iv. Assess for allergies to blood products.
a. I,ii,iv
b. I,iii,v
c. Ii,iii,iv
d. I,ii,iii

31. The nurse is administering medications to clients on a medical unit. Which medication
should the nurse question administering?

a. The steroid, prednisone, to the client diagnosed with COPD.

b. The anticoagulant, Heparin (Lovenox), to a client who had knee surgery.
c. The antiplatelet, Clopidogrel (Plavix), to a client being prepared for surgery.
d. The ACE inhibitor, captopril (Capoten), to a client who has a blood pressure (BP)
of 100/68.

32. The charge nurse notices Nurse Brown recapping a needle a needle at a client’s bedside.
Which action by the charge nurse is MOST APPROPRIATE?

a. Tell the nurse not to recap the needle.

b. Quietly asks the nurse to step into the hall.
c. Reprimand the nurse for not following procedure.
d. Notify the supervisor of the nurse’s behaviour

Scenario I ITEMS 31-39

During natural disasters, nursing skills are of paramount importance in preventing loss of
life, injuries and paralysis through application of the nursing process. During hurricane
Andrew, several roads became impassable and the night shift staff where ask to continue
Prior to the hurricane the doctor on duty sought to discharge some of the less critically ill
patients.

Which of the following patients would the nurse NOT advocate for to remain on the ward? A:

a. 40 year old woman with type II diabetes with a GMR of 9 mmol/l

b. 50 year old man with 2 days post op repair of the aorta
c. 35 year old man with SOB and cough
d. 24 year old who with low grade fever with a new onset of cough

33. Several patients arrive at the Accident and Emergency department. Which of the following
patients would the nurse assess as PRIORITY?

a. A 2 year old with pupils fixed and agonal gasps

b. 43 year old male with shallows cuts and minor bruises to chest and face
c. 50 year old man with head injury but no loss of consciousness
d. 20 year old male with deep laceration

34. The nurse establishes the need for immediate follow-up measures to save and sustain the
lives of survivors during the management of the disaster during which phase of the nursing
process?

a. Evaluation
b. Diagnosing
c. Assessment
d. Planning

35. After the hurricane the nurses immediate PRIORITY is to:

i. Determine life threatening cases

ii. Establish the need for follow up
iii. Assess cardiopulmonary function
iv. Keep channels of communication

a. I ii iii iv
b. I iii iv
c. Ii iii iv
d. I ii iv

36. After the hurricane the members of staff received raving reviews from the manager on how
well they did. What function of management is the manger utilizing?
 a. Planning
b. Organizing
c. Controlling
d. Evaluating

37. The casualty manager had a fourth year student, 2 newly graduate and 2 senior staff nurse.
When assigning duties, the nurse manager’s PRIORITY is:

a. Job description of staff

b. Seniority of staff
c. The person’s ability
d. Priority level of casualties

38. An elderly client says to the nurse, “our house got washed away during the storm and the
two goats we had in our name died”. Which of the following response by the nurse is
therapeutic?

a. “That is awful, but right now we are trying to save lives”

b. “That must be hard for you, how are you going to survive?”
c. “ you are not the only one, we are doing the best we can”
d. “that is a terrible loss, our social support will be working with you”

39. A Rastafarian sustained a deep laceration to his hair-line. The doctor ordered his hair shaved
for it to be sutured. The patient refused to shave his hair. The nurse told the patient that he
must have his hair shaved. The nurse breaches the clients right to:

a. Informed consent
b. Self-determination
c. Practice religion
d. Be told of alternatives

40. The nurse manager assigned a client who sustained head and spinal cord injury with
bilateral femoral fracture to a final year nursing student. During the care the client
developed increase intracranial pressure and pulmonary embolism (PE). The managers
action of delegation conflicts with which element of the ICN code of ethics

a. Nurses and practice

b. Nurses and people
c. Nurses and co-worker
d. Nurses and profession
41. A number of sewer systems got disrupted in spilled into the potable water supply during the
hurricane. When instructing the clients on safe water consumption, the SAFEST way to
purify water is to:

a. Add two drops of bleach to 5 parts of water

b. Strain with a clean cloth
c. Boil for 1-2 minutes
d. Filter with sand
End of scenario

42. The use of social media outside of nursing school or the work place can cause tremendous
consequences if used in ways that interfere with the privacy of patients, even if the nurse’s
or student’s intentions are not malicious. Which of the following is TRUE about social
media postings

a. Posts are private and accessible only to the intended recipient.

b. Once content has been deleted, it is no longer accessible.
c. No harm is done if patient information is disclosed only to the intended recipient.
d. Professional boundaries are still firmly in place, even off duty, although social media
may cause you to believe that they are not.

43. Nurses, as health care providers, have certain rights, responsibilities, and recognition
through various laws, or statutes. The Practice Act in each jurisdiction accomplishes at least
four objectives, which includes?

I. Definition of the practice of professional nursing

II. Setting the minimum educational qualifications and other requirements for licensure
III. Determination of the legal titles and abbreviations nurses may use
IV. Providing disciplinary action of licensees for certain causes

a) i ii
b) i ii iii
c) ii iii iv
d) i ii iii iv

44. Continuing education is a term that has become progressively more prominent in recent
years within nursing. Continuing education may help the nurse to achieve all of the
following EXCEPT ____________________.

a) A need to keep abreast of new developments in terms of knowledge, skills and

technology to ensure continuing competence in their current job
b) A need to enhance their knowledge and skills to be able to initiate and respond to
change in the working environment as additional roles may be demanded of them
 c) May help them to develop personal and professional effectiveness and increasing
job satisfaction.
d) Working sessional while earning re-licensure hours at the same time

45. Stereotyping is a hindrance to communication, and affects optimum care given to patient of
a different language. Which of the following statement would be considered stereotyping by
the nurse?

a. “I will only care for patients when they can speak English”
b. “All patients coming to the hospital must bring a translator”
c. “the patient should not come to the hospital if they don’t speak English”
d. “I should be trained to speak another language as a nurse”

46. A patient presents to the emergency department with a history of chronic gastric ulcer that
has perforated. Which of the following findings would the nurse anticipate?

a. Heart burn
b. Rebound abdominal tenderness
c. Increase urinary output
d. Decrease urinary output

47. Which of the following describes the variables in research?

a. characteristics of persons, things or situations that change or vary and are

manipulated
b. empirical evidence that drives the research process
c. the instruments used to gather data during research
d. the various literature used to gather data

48. The population needs to be identified as a step in the research process. Which of the
following statements describes the population?

a. Subset or frame of all the research subjects

b. Animate or inanimate subjects required to be studied
c. Data on subjects for which a problem is identified
d. A step in which the study to be undertaken is identified

49. A patient with burn injury to the chest and face would have which of the following is the
INITIAL PRIORITY on admission
 a. Fluid
b. Oxygen
c. Nutrition
d. Infection

50. The nurse assesses the lab results of a patient on Furosemide (Lasix) and notes a potassium
level of 2.0. For which of the following would the nurse anticipate the client will complain
of?

a. Tetany and irritability

b. Muscle pain and weakness
c. Diarrhea and bradycardia
d. Low blood pressure and decrease urine output

51. A patient came to the accident and emergency department with a red rash on the arm and
told the nurse it appears whenever I where my cotton jacket. The nurse concludes that the
client is likely having:

a. Allergic Dermatitis
b. Contact Dermatitis
c. Atopic Dermatitis
d. Psoriasis

52. A patient on the dermatology unit presents with a patches on the arm which appears white
and flaky with a crusty base. The nurse explains to the client that the process of
development is:

a. Premature melanocytes
b. Premature development of epidermal cells
c. Contact dermatitis due to skin allergies
d. Infection of the skin due to bacterial activity

53. A newly Graduate 24yrs old has an idea that he wanted to implement a project to improve
the nursing profession. What should he do before carrying out his task?

a. Get the necessary training

b. Consult the Procedural manual
c. Inform the department supervisor
d. Conduct a pilot study before moving forward
54. A nurse returns to work after years of staying at home, subsequent to upgrading to a post
basic course. On returning to work, proper procedure was forgotten on how to carry out
dressing and wound care skills. What action should the ward manager take?

a. Have the nurse demonstrate a dressing procedure

b. Have the nurse review the procedure manual
c. Arrange in-service refresher course for the nurse
d. Have the nurse mentored by another nurse

55. The nurse is caring for an 85yr-old with chronic dementia. What would be the nurse’s
PRIORITY?

a. Give patient chores to prevent boredom

b. Leave room the same .(furniture)
c. Place colorful items in the room
d. Place pictures and clocks in the room

56. A patient has mood swing and complaint of always feeling tired. Which of the following
systems would be MOST affected?

a. Neuro and Reproductive

b. CV and Nervous system
c. Endocrine system and Reproductive
d. CV ,urinary system

57. A patient diagnosed with Tuberculosis (TB), was instructed to wear a mask around the
house. The nurse anticipates that this is to prevent communication spread by:

a. Contact
b. Droplet
c. Isolation
d. Reverse barrier

Scenario 2 Items 56-59

The nurse plays an important role in the preservation of evidence in cases such as rape,
gunshot wounds, stabbing and other violent incidence.

58. 13yrs old Paulette came to A&E department after been raped and had abusive trauma to
both legs. Upon examination Nurse X was told to cover the wound stat by Dr. Smith. what
should the nurse do?
 a. The nurse should wait until the police arrives
b. cover wound stat as ordered by the Doc
c. Refuse as it is ethical thing to do so
d. Secure the victims cloth so the police can retrieve it

59. Five hours later the police officers arrived and demand the dressing remove so that they can
take pictures of the wound. Nurse Nicolette appropriate action would be?

a. Allow the police officers to speak to the physician in charge

b. Allow a child psychologist to be there while proceeding taken place.
c. Inform the nursing supervisor of the presence of the police
d. Remove the dressing and allow the police to take the pictures

60. The officers later want to gain access to the patients file. What should Nurse Nicolette do?

a. Tell officers that she is using the silent code

b. Allow officers to look in it
c. Tell them you are not allow to do so
d. Refer to physician in charge

61. Ten year old Paul the brother of Paulette and her parents arrive asking nurse Nicolette what
is the child diagnoses? In this case what should the nurse do?

a. Tell them after all he is just a child

b. Direct parents to physician
c. Tell Paul but not the parents
d. Tell them to ask Nicolette

62. The nurse is taking the obstetric history of a woman with 12 live births, 2 abortions, 6
living, and currently pregnant. What is her gravidity and parity?

a. G14 p6
b. G14 p6 +2
c. G15 p6 +2
d. G15 p6 +6

63. The nurse is teaching a client about soluble insulin. Which of the following statement by the
client express understanding?

a. I should eat 30 minutes before taking the insulin

 b. I should take insulin 30 minutes before meal
c. I should check my blood sugar 30 minutes after meal
d. If I feel dehydrated I should not take my insulin

64. The nurse about to administer 20units soluble insulin checks the client’s blood glucose and
got a reading of 4.5 mmol/l. what should the nurse do?

a. Withhold the insulin and recheck blood glucose in 30 minutes

b. Administer the insulin as prescribed
c. Inform the physician of the blood glucose
d. Document the reading and withhold the insulin

65. The nurse manager when evaluating subordinates uses the component of management:

a. Controlling
b. Directing
c. Staffing
d. Organizing

66. A primigravida is instructed to offer her breast to the baby for the first time within 30
minutes after delivery. What is the purpose of offering the breast this early?

a. To initiate the occurrence of milk let down reflex

b. To stimulate milk production by the mammary acini
c. To make sure that the baby is able to get the colustrum
d. To allow the woman to practice breastfeeding in the presence of the health worker

67. How does the nurse display professional accountability in omission while doing a procedure
to a child?

a. Inform the child of the commission

b. Documentation of commission
c. Noting comission and avoid doing same next time
d. Inform physician

68. Which of the following are correct guidelines to follow for a DNR order

a. Patient has no input in care given

b. Family knows patient may die within 48hrs
c. Continue to give treatment for comfort and treatment for symptoms
d. There is a written order in patient’s chart signed by the client
69. The document that provides professional standards and a framework for professional
decision making that ensures decisions are made with the HIGHEST integrity is
the_______.

a. Nurse and Midwives Act.

b. Code of Ethics.
c. Hospital’s Policy Statements
d. Bylaws of Nursing Associations

70. Which of the following could eventually change the historical status of nursing as a female-
dominated profession?

a) Salary compensation increasing to attract more men

b) The proportion of men in nursing beginning to increase
c) More men graduating from baccalaureate and higher degree programs
d) More male graduates of nursing programmes being employed at hospitals

71. Which of the following societal changes have done little in promoting the nurse’s
continuing education?

a) Previously unknown diseases are being identified.

b) Patients have increasingly more complex and varied health needs.
c) There is a relative increase in the number of children in the population.
d) New technologies are being developed that require continual knowledge updates.

72. An Enrolled Assistant Nurse who is returning to school to pursue a baccalaureate degree in
nursing states, “I don’t know why I am putting myself through this. I have practiced just fine
for 10 years as an Enrolled Nurse.” Which strategy, recommended by a friend, would be
helpful in overcoming this feeling?

a. “Why don’t you take a one semester break from school?”

b. “Remember that a lot of people are depending on you.”
c. “Just think how much better a nurse you will be when you finish.”
d. “Think about all the extra money you will get when you graduate.”

73. What would be the priority of care for a client with stage 2 Alzheimer’s disease who
becomes agitated and refuse to answer questions during an interview?

a. Ask the client if the questions are upsetting in any way

b. Discontinue the interview
c. Explain that the questions are necessary to complete plan of care
d. Give client a break and reconvene later

74. Which of the following screening guidelines indicates the nurse understands the current
 guidelines for health promotion and disease prevention?

a. Colorectal screening should begin at age 50 and plan should include a colonoscopy
every 5 years
b. Prostate screening should begin at age 35 and evaluated on a yearly basis
c. Blood cholesterol screening should begin at age 30 and be evaluated yearly
d. Blood pressure screening should begin at age 25 and evaluated yearly

75. A hypertensive client returns to the out-patient medical clinic for reevaluation of his
medication. His blood pressure is 170/95. The nurse questions the client regarding how he is
taking his medication. What response by the client indicates that he understands and has
been taking the medication as prescribed?

a. “I take my medication every morning. If my blood pressure is high I take another

dose in the evening”
b. “I take my medication every day at the same time regardless of how I feel. I have not
missed any doses”
c. I take my medication every day and make sure I drink lots of water when I take it”
d. If I feel sick in the morning I skip the dose and take 2 in the afternoon”

76. A female client reports to the nurse that for the past 3 months the lump in her left breast has
been growing larger. Which action should the nurse recommend the client take?

a. Notify the doctor to schedule a mammogram

b. Continue to do her monthly breast self-exam
c. Stop taking contraceptives
d. Reduce the sodium and fat in her diet

77. To assist a mother in providing appropriate foods for her 2-year-old child, the nurse would
identify which PRIORITY as being the HIGHEST?

a. Provide the child with finger foods

b. Allow the child to eat favorite foods
c. Encourage a diet higher in protein than other nutrients
d. Limit the number of snacks during the day

78. A client with active Tuberculosis who is refusing to eat or make eye contact should receive
which PRIORITY from the nurse?

a. Limit contact with the client to reduce the risk of transmission of infection.
b. Place a “no visitors” sign on the door to give the client privacy
c. Ask doctor for a referral to counselling
d. Spend extra time with the client to assess the client’s emotional status

79. What would be the PRIORITY intervention to promote safety in the environment for a
client with marked depression of CD4+ cells?
 a. Discard any standing water left in containers or equipment
b. Teach the importance of viral load check
c. Use sterile linins on the bed
d. Ensure adequate nutrition

80. 4-year-old Mary was admitted for ingestion of bleach. After a teaching session, which
statement by Mary’s mother indicates a correct understanding of poison prevention at
home?

a. “we store gasoline for the lawn mower in the garage”

b. “all our medication are kept in original containers”
c. We keep all our cleaning products in the bathroom”
d. “I keep most of our medication in my purse”

81. A client with a colostomy wants to know if other people will be able to smell him. What
would be the BEST response by the nurse?

a. “keep your bag clean to reduce this possibility”

b. “You can eat onions, beans and cucumbers”
c. “you could eat oranges, yogurt and drink milk”
d. “you can take a nonprescription medicine that controls smell”

82. What would be the priority nursing action to teach the client and close associates to prevent
the spread of Hepatitis A?

a. Wash their hands every time they go to the bathroom

b. Refuse to use any blood products
c. Teach drug addicts to avoid sharing needles
d. Always use condoms during sexual intercourse

83. A client is been screened for Hepatitis B. which finding from serum analysis would confirm
the diagnosis?

a. Presence of core antigen

b. Presence of surface antigen
c. Elevated serum bilirubin
d. Presence of jaundice

84. A client presents with the following ABG report: Ph-7.47; pCO2-34mmHg; HCO3-
24mEq/L. what would be the PRIORITY of care for this client?

a. Assist client to slow down breathing and assist with rebreathing device
b. Call the doctor to report the respiratory acidosis
c. Place the client in semi-fowler position and encourage deep breathing and coughing
d. Place in side lying position to prepare for respiratory therapy
85. What would be the HIGHEST PRIORITY for a client 72 hours after having second-
degree burns to 20% of his body in the lower abdominal area, back, and both legs

a. Airway
b. Body image
c. Fluid and electrolyte
d. Pain

86. A client with closed head injury suddenly begins to vomit. Which information is the most
important to report when calling the physician?

a. Increasing lethargy
b. Heart rate of 60bpm
c. Sodium level of 145 mEq/L
d. Presence of facial symmetry

87. A client has been newly diagnosed with hyperthyroidism. Which of the following should the
nurse have as the priority plan of care?
a. Provide extra blankets for warmth
b. Increase sensory stimuli
c. Frequent low calorie snacks
d. Ophthalmic drops on a regular basis

88. A client with cancer of the prostate is admitted to the hospital with neutropenia. Which signs
and symptoms are most important for the nurse to report to the next shift?
a. Arthralgia and stiffness
b. Vertigo and headache
c. General malaise and anxiety
d. Temperature elevation and lethargy

89. A client is beginning peritoneal dialysis. During the first infusion of dialysate, the
experiences mild abdominal discomfort. What should the nurse do?
a. Stop the infusion
b. Decrease the total infusion volume
c. Inform the client that the discomfort is only temporary
d. Notify the doctor

90. What should the nurse teach the client who is been discharged about sublingual
Nitroglicerin (Nitrostat)?
a. Take the medication 5 minutes after the pain has started and three 5 minutes apart
b. Stop taking the medication if a burning sensation is present
c. Take the medication on an empty stomach
d. Avoid abrupt changes in posture when taking the drug

91. The nurse tells the patient that she has an enema to receive before going to surgery. When
 the patient’s daughter arrives the patient tells the daughter that she has edema and has to do
surgery. Which part of the communication process was compromised?
a. Sender
b. Receiver
c. Message
d. Feedback

92. A patient with hypothyroidism is on Levothyroxine (synthroid). The nurse is correct if she
administers the medication at which time of the day?

a. Before breakfast
b. At lunch time
c. At bedtime
d. Two hours before the main meal

93. The nurse when carrying out health promotion on the prevention of Leptospirosis stresses
which of the following as MOST IMPORTANT?

a. Proper disposal of garbage

b. Wearing proper boots outdoor
c. Reporting any jaundice and yellow urine
d. Keeping rain water catchment properly covered

94. A 65-yr-old client is admitted and is prescribed 2 units of blood for hemoglobin of 6.5g/dl.
Which of these actions is vital to administering the blood safely

i. Following protocol and check client identity with blood label by two nurses
ii. Place client near the nurses station in case of allergic reactions
iii. Discontinue the blood if reaction occur and keep vains open with 0.9%
Normal saline in dextrose
iv. Check client pulse and temperature every 15 minutes within the first hour
a. I ii iii
b. I ii iv
c. Ii iii iv
d. I iii iv

95. Food and water borne diseases can become major epidemics and as such health promotion
should be specific towards the prevention of such occurrences. Which of the following is a
waterborne disease that results in bloody diarrhea?

a. Salmonella Typhei
b. Amoebic dysentery
c. Vibrio Cholerae
d. Bacillary dysentery

96. An 89-yr-old client has an order for Metformin (Glucophage). What is the most important
 nursing consideration?

a. Ensure the client eats before administering the drug

b. Educate the client on the symptoms of lactic acidosis
c. Assess the blood glucose levels
d. Notify the doctor and question the order

97. Which of the following is correct information for the public health nurse to give to parents
regarding the prevention of worm infestation?

a. Avoid playing with dogs and cats

b. Avoid swimming in rivers
c. Avoid walking barefoot
d. Avoid eating left over food

98. When teaching a newly diabetic client about regulating diabetes at home, the nurse would
include which instructions?

a. Limit vigorous exercise

b. Eliminate sugar from the diet
c. Check blood sugar at regular intervals
d. Limit carbohydrates in the diet

99. A client on oxygen calls the nurse and showed her smoke coming from another client’s bed.
What should the nurse do IMMEDIATELY?

a. Call for help

b. Sound the fire alarm
c. Use the available fire extinguisher
d. Contain the fire to prevent the spread to other clients

100. A client presents with moon face, buffalo hump, pronounce truncal fat and a BP of
160/90. Which action would nurse consider to be highest priority?
a. Prevent skin breakdown
b. Prevent infections
c. Teach client signs and symptoms of hypoglycemia
d. Prevent fluid overload

101. A client who is in the terminal phases of a debilitating muscular disease tells his wife that
he believes he is not going to make it, and it’s the doctors and nurses fault. According to
Kubler Ross this client is at the stage of

a. Denial
b. depression
c. bargaining
d. anger
102. The nursing action which best reflects the concept of therapeutic communication is:
a. Agreeing with the patient’s statements
b. Making time to talk to the patient and family
c. Letting the patient take control of the main topic
d. Using interviewing skills to discuss the patient’s concerns

103. What would be the HIGHEST PRIORITY for a client 72 hours after having second-
degree burns to 20% of his body in the lower abdominal area, back, and both legs

a) Oxygen
b) Psychosocial
c) Fluids/Nutrition
d) Safety

104. A group of student nurses decided to weigh their exam scores against each other for the
academic year. During the first semester, the students studied for three months and had an
average 50% pass mark. In the next exam they studied for six months and had 65%. On the
final exam they studied for 12 months and had an average of 80%. This research would be
MOST likely a/an _________________ study.
a) Comparative
b) Longitudinal
c) Experimental
d) Cohort

105. A researcher wants to study the number of well-endowed women buying at a bakery on a
Saturday between the hours of 10-11 am. The research instrument MOST suited to conduct
this study is a/an ___________.
a) interview
b) observation
c) questionnaire
d) interview schedule

106. Which of the following studies will MOST LIKELY be conducted using a qualitative
approach?

a)  A study investigating changes in family dynamics following the sudden death of a

child.
b) A study designed to measure weight-loss trends in middle adults who increase
walking.
c) A study comparing the results of two antihypertensive medications given to patients
who have diabetes mellitus.
 d) A study tracking change in reading level for children treated with behavioral therapy
for attention-deficit activity disorder

107. Knowing that malnutrition is a frequent community health problem, the public health
nurse decided to conduct nutritional assessment. What population is particularly susceptible
to protein energy malnutrition (PEM)?

a) Pregnant women and the elderly

b) Over 5 year old children
c) 1-4 year old children
d) School age children

108. A newly licensed nurse received specific knowledge of management skills while in
nursing school. What does the nurse need now? 

a) Nothing until the nurse has acquired enough bedside experience to become a
manager
b) Time to see how these skills will be needed in the future
c) A manager who can help with skills transfer from school to work
d) A job working as a manager in a small hospital