Ministry of Higher Education and Scientific Research

Supervision and Evaluation Apparatus

Evaluation Exam for Nursing Colleges t
Subject: Adult Nursing II Second Stage
Second-Semester Acad em ic Year : 2023 -2024
TimeAllowed:3 hours Date:261312024 Time:9:00AM

Q/Choose the best answer for each of the following questions as required. (100 mark)
1. What is the characteristic cerebrospinal fluid (CSF) finding in bacterial meningitis?
A. Elevated protein, decreased glucose, increased leukocytes
B. Decreased protein, decreased glucose, decreased leukocytes
C. Elevated protein, normal glucose, decreased leukocytes
D. Normal protein, normal glucose, increased leukocytes
E. Decreased protein, elevated glucose, normal leukocytes
2. What is an aura in the context of epilepsy?
A. A visual disturbance before a seizure D. A sound heard before a seizure
B. An odor perceived before a seizure E. A taste sensed before a seizure
C. A sensation experienced before a seizure
3. Which of the following is a common first-aid measure for someone having a seizure?
A. Putting a spoon in their mouth D. Moving them to a safer area
B. Restraining their movements E. Shouting at them to stop
C. Offering them food or water
4. What is the appropriate nursing action immediately after a patient experiences a tonic-clonic seizure?
A. Administer IV lorazepam
B. Document the duration and characteristics of the seizure
C. Encourage the patient to return to normal activities
D. Check the patient's vital signs
E. Apply cold compresses to the patient's forehead
5. The nurse is providing education to a group of nursing students about ICP. The nurse explains that
when cerebral perfusion pressure falls too low the brain is not properly perfused and brain tissue dies.
What is a normal cerebral perfusion pressure level?
A. 5-15 mmHg C. 30-45 mmHg E. 50-60 mmHg
B. 60-100 mmHg D. >160 mmHg
6. Which of the following procedure is used recently to evaluate the cerebral circulation?
A. Computed tomography scanning D. Lumber puncture
B. Cerebral angiography E. Ultrasound
C. Magnetic resonance imaging
7. A 40 -year-old female is taken to emergency room after road traffic accident (RB), she has a leg
fibula fracture and shows signs of increasing intracranial pressure. The highest priority is given to:
A. Taking and record her vital signs D. Controlling bleeding
B. Determining whether she has a broken neck E. Focus problem assessment perform
C. Observing the airway
8. The nurse had a call for help from the emergency department waiting room. There is an elderly
patient lying on the floor has head injury. What is the immediate action that the nurse must perform?
A. Perform the chin lift or jaw thrust maneuver. D. Instruct a nursing assistant to get the crash cart
B. Establish unresponsiveness. E. Starl with initial assessment
C. Initiate emergency assessment.

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 9' A23'year-old client has been hit on the head with a baseball bat. The nurse
notes clear fluid draining
from his ears and nose. Which of the following nursing interventions should
be done first?
A' Suction the nose to maintain airway patency D. Check the fluid for dextrose with a dipstick
B. Insert nasal and ear packing with sterile gauze E. Assess breathing
C. Position the client flat in bed
10' A client comes into the ER after hitting his head in a road traffic
accident. He is alert and oriented.
which of the following nursing interventions should be done first?
A. Call for an immediate chest x-ray
B. Assess full ROM to determine extent of injuries
C. Open the airway with the head-tilt chin_lift maneuver
D. Immobilize the client,s head and neck
E. General blood test
11. Which of the following medical terms is referred to CSF escaping
from the ears?
A. Rhinonhea C. pyonhea E purulent
B. Trichonhea D. Otorrhea
12' The nurse providing care for a patient with an altered level of consciousness.
Which of the following
nursing intervention takes the highest priority?
A. Maintaining accurate records of intake and C. performing range of motion exercise.
output. D. Maintaining a patent airway.
B. Inserting a nasogastric tube. E. Insertion of chest tube
13' Surgical opening in the skull to excise a tumor, evacuate blood clot,
relieve Intra cranial pressure, or
repair an aneurysm:
A' Lobectomy C. Laminectomy E. Craniectomy
B. Cranialactomy D. Craniotomy.
14. The nurse should know that the amount of urine for patients with anuria is less than:
A' 50 mLl24hr* c. 400 mLr24lrs. E. 1000 ml/24hrs.
B. 100 mLl24hrs. D. 600 mLl24tus.
15. Pyuria is the presence of .......... in urine.
A. Red blood cells. c. Epithelial celrs. E. Microorganisms.
B. White blood cells. D. Dead cells.
16. The normal glomerular filtration rate is about:
A' 100 mllminute.
-120 C. 140- l60mLlminute. E. 1g0-200ml/minute.
B. 120 - 140 mLlminute. D. 160 _ l g0 mll minute.
17' Which one is NOT the main cardinal signs and symptoms for patients with
renal disorders include all
the following?
A. change in voiding. D. Gastrointestinal signs and
B. Pain. symptoms.
C. Change in mentality. E. Nausea and vomiting.
18' A nurse is taking care of patients with kidney stone. The nurse expects that
the location of pain during
physical examination should be at:
A. Perinium area. C. Urethra meatus area. E. Costovertebral angel area.
B. Suprapubic area. D. Lower back area.
19' Patients with urology disorders could have gastrointestinal system disorders (such
as nausea and
vomiting) due to:
A. Cross infection between two systems. D. Complications of electrolyte imbalance.
B. Shared anatomic and sensory innervation. E. Azotemia
C. Side effects of elevated blood urea level.
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 20' The specific diagnostic procedure that provides direct visualization of
urinary bladder is:
A. Entero-scope. C. Cystoscope. E. MRI.
B. Ultrasonography. D. CT scan.
21' The nurse should monitor patients after cystoscope specifically for
the signs and symptoms of:
obstruction.
A. Urinary tract C. Hydronephrosis. E. Urinary retention.
B. urinary incontinency. D. urinary tract infection
22.Untreated chronic kidney diseases can lead to:
failure.
A. Acute kidney C. End stage kidney diseases. E. pyelonephritis.
B. Kidney stone. D. Glomerulonephritis.
23. The glomerular filtration rate (GF'R) for patients with End Stage Kidney
Diseases is:
A' Less than 15 ml/IVIinute. C. Less than 45 ml/Jvlinute. E. Less than 60 ml/JvIinute.
B. Less than 30 ml/I\ulinute. D. Less than 50 mll Minute.
24'Patients with end stage kidney diseases could have cardiovascular problems (such
as pericarditis) due
to:

fC. SffiliflirTlur,yp.nension
Uremia.
B Hli!ffi,#i
25' Nursing diagnosis for patients with end stage kidney diseases includes fluid
volume excess due to:
A. Sodium and water retention. D. Heart failure.
B. Decrease nutritional intake. E. Increase consumption of water
C. Increase urine output.
26. Which one is NOT an upper urinary tract infection?
A. Cystitis. C. Urethritis. E. pyelonephritis.
B. Complicated cystitis. D. prostatitis.
27' Anurse is taking care of patients with Urinary Tract infection. The nurse should advise
the patients
that the best way to treat the infection should include all the following except:
A. Avoid high fluid intake. D. avoid alcohol and cola beverage.
B. Perform urine for culture and sensitivity test. E. Consume liberate amount of water
C. Avoid spicy food.
28' One specific tip that the nurse should education patients with urinary tract
infection to lower urine
bacterial count is:
A. Increasing fluid intake. D. Avoiding alcohol beverage.
B. Using Antimicrobial agent. E. prohibiting sexual activities for a while
C. Voiding every 2 to 3 hrs.
29.The main sign and symptom for patients with kidney stone is:
A. Colic Pain. C. Gastrointestinal problems. E. Chill.
B. Change in voiding. D. Fever.
30. The nurse should educate patients with kidney stones to drink plenfy amount
of water after
performing Extracorporeal Shock Wave Lithotripsy (ESWL) or Double J stent (DJ
stent) because
patients could have:
A. Blockage of urinary B. Hematuria. D. Infection.
system. C. Pyuria. E. Urinary retention.
31. Which one is NOT the major goals of nursing care for patients with kidney stone?
A. Relief of pain. D. Absence of complications.
B. Prevention of renal cancer. E. Maintain normal kidney function.
C. Prevention of recurrence of kidney stone.

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32. The nurse should consider each of the following treatment in plan of care for patients with end stage
renal failure to avoid and manage muscle pain:
A. Sodium chloride. C. Potassium chloride. E. Calcium gluconate.
B. bicarbonate D. Magnesium sulfate.
33. Patients with end stage kidney diseases could suffer from mental deterioration. The nurse should
consider which of the following statement as a cause of mental deterioration:
A. Anemia. C. Azotemia. E. Water retention.
B. Blood acidosis. D. Cardiovascular problems.
34. The most important complication that could threatens the life of patients with end stage kidney
diseases receiving hemodialysis includes:
A. Fluid and electrolyte imbalance. D. Anemia.
B. Blood-born Infection. E. Muscle twitching.
C. Hypotension.
35. The main goal of nursing care for patients with end stage kidney diseases receiving hemodialysis
includes:
A. Maintain ideal body weight without excess fluid.
B. Maintain adequate nutritional intake.
C. Increase patients'knowledge about the disease process.
D. Improve patients' self-esteem.
E. Maintain normal quality of life.
36. Which of the following is NOT the most common infection term used for UTI?
A. Endometriosis c. Pyelonephritis E. Nephritis
B. Cystitis D. Urethritis
37. What is the most commonly used drug for the treatment of acute bacterial UTIs in both females and
males?
A. Rifampin C. Amoxicillin E. Antipyrol
B. Miconazole D. Nitazoxanide
38. Acute UTI can be treated at home and the symptoms can go away usually within 48 hours. What are
the different measures that can subside the pain during urination and can help to get rid of the
symptoms?
A. Drinking plenty of water can reduce the infection
B. Any antibiotics can help to reduce any type of UTIs
C. Cranberry juices have been found effective to ease the pain
D. Cleaning only of the genital area and taking a shower
E. Using antiseptic soap for showering
39. What is the most common symptom of UTI?
A. Fever C. Dysuria E. Anuria
B. Chills D. Nausea
40. Which of the following is a risk factor for recurrent UTIs?
A. Male gender c. Postmenopausal state E. ethnic group
B. Young age D. Diabetes mellitus
41. A 68-year-old female patient has been admitted to the hospital with symptoms of a urinary tract
infection (UTI). The patient reports frequent urination, pain while urinating, and lower abdominal pain.
What is the primary goal of nursing care for a patient with a UTI?
A. To prevent the spread of infection to other patients
B. To reduce pain and discomfort
C. To improve kidney function
D. To prevent the development of sepsis
E. To prevent possible complications
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42.What is the recommended daity fluid intake for a patient with a history of renal stones?
A. 500 mL C. 2,000 mL E. 4,000 ml
B. 1,000 mL D. 3,000 ml
43. The primary nursing intervention for a patient with a renal stone is?
A. Encouraging fluid intake D. Encouraging ambulation
B. Administering pain medication E. Apply cold compresses
C. Monitoring
urine output
44. What is the most common type of renal stone?
A. Calcium oxalate C. Uric acid E. Calcium sulphate
B. Struvite D. Cystine
45. What is lithotripsy?
A. A surgical procedure to remove a renal stone
B. A non-invasive procedure that uses shock waves to break up a renal stone
C. A medication used to dissolve a renal stone
D. An imaging test to diagnose a renal stone
E. An invasive procedure to detect
renal stone
46. Which of the following interventions is NOT appropriate for a patient with renal stones?
A. Encouraging fluid intake D. Encouraging bed rest
B. Administering pain medication E. Avoid exposure to sun
C. Administering diuretics
47. what is the most common complication of peritoneal dialysis?
A. Infection C. Blood clots E. Bleeding
B. Hypotension D. Kidney damage
48. What is the primary cause of ESRD?
A. Chronic kidney disease C. Hypertension E. Liver disease
B. Diabetes D. Heart disease
49. What is the most common cause of death in ESRD patients?
A. cardiovascular disease c. Respiratory failure E. Infection
B. Cancer D. Kidney failure
50. What is the primary cause of anemia in ESRD patients?
A. Iron deficiency C. Folate deficiency E. Vitamin 86 deficiency
B. Vitamin B12 deficiency D. Erythropoietin deficiency
51. what is the recommended dietary restriction for a patient with ESRD?
A.
Low protein, low potassium, and low phosphorus diet
B.
High protein, low potassium, and low phosphorus diet
C. Low protein, high potassium, and high phosphorus diet
D. High protein, high potassium, and high phosphorus diet
E. High protein, high sodium, and high phosphorus diet
52. What is the primary pathophysiological mechanism underlying benign prostatic hyperplasia
@pH)?
A. Excessive androgen production D. proliferation of prostatic tissue
B. Chronic inflammation of the prostate E. Neurological dysfunction
C. Hormonal imbalance
53. Which diagnostic test is typically used to assess the severity of benign prostatic hyperplasia (BpH)?
A. Electrocardiogram (ECG) D. Digital rectal examination (DRE)
B. Magnetic resonance imaging (M2) E. Spirometry
C. Prostate-specific antigen (PSA) test

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54. Which of the following is a common symptom of bladder cancer?
A. Chest pain C. Hemoptysis E. Abdominal bloating
B. Headache D. Hematuria
55. What is the most significant risk factor for the development of bladder cancer?
A. Smoking C. High alcohol intake E. Family history of lung
B. Obesity D. Sedentary lifestyle cancer
56. Which type of bladder cancer accounts for the majority of cases?
A. Transitional cell carcinoma C. Adenocarcinoma E. Melanoma
B. Squamous cell carcinoma D. Small cell carcinoma
57. What is the gold standard diagnostic test for bladder cancer?
A. Complete blood count (CBC) D. Prostate-specific antigen (PSA) test
B. Chest X-ray E. Colonoscopy
C. Urine cytology
58. Which treatment modality is often used for Iocalized bladder cancer?
A. Chemotherapy D. Transurethral resection of bladder tumor
B. Radiation therapy (TURBT)
C. Immunotherapy E. Hormone therapy
59. What surgical procedure is commonly performed for the treatment of severe benign prostatic
hyperplasia (BPH) that does not respond to medical therapy?
A. Appendectomy c. Prostatectomy E. Gastrectomy
B. Cholecystectomy D. Thyroidectomy
60. What is the priority nursing intervention for an unconscious patient?
A. Administering pain medication D. Providing oral care
B. checking vital signs E. Assisting with ambulation
C. Assessing neurologic status
61. Which positioning is recommended for an unconscious patient to prevent aspiration?
A. Prone position C. Side-lying position E. Sitting position
B. Supine position D. Trendelenburg position
62. What is the preferred method for providing oral care to an unconscious patient?
A. Brushing teeth vigorously D. Using mouthwash with alcohol
B. Providing ice chips E. Moistening lips and oral mucosa with a sponge
C. Performing oral suctioning
63. Which of the following is a common symptom of benign prostatic hyperplasia (BPH)?
A. Hematuria c. Urinary frequency E. palpitations
B. Dyspnea D. Visual disturbances
64. A 4l-year-old man asks the nurse what he can do to decrease the risk of BPH. The nurse explains that
A. riding a bicycle raises prostate-specific antigen levels and may increase BPH risk.
B. prevention is not possible because prostatic enlargement occurs with normal aging.
C. decreasing butter and margarine and increasing fruits in the diet may help.
D. taking a daily vitamin E supplement has reduced prostate size in some men.
E. Limiting exercises
65. The nurse orders a blood test for prostate-specific antigen (PSA) when an enlarged prostate is palpated
during a routine examination of a 56-year-old man. When the patient asks the nurse the purpose of the
test, the nurse's response is based on the knowledge that
A. elevated levels of PSA are indicative of metastatic cancer of the prostate.
B. PSA testing is the "gold standard" for making a diagnosis of prostate cancer.
C. baseline PSA levels are necessary to determine whether treatment is effective.
D. PSA levels are usually elevated in patients with cancer of the prostate.
E. Not related to Prostatic disorder
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 66. A client has passed a renal calculus. The nurse sends the specimen to the laboratory
so it can be
analyzed for which of the following factors?
A. Antibodies
B. Type of infection
C. Composition of calculus
D. Size and number of calculi
E. Pain medication
67. what is the most common primary marignant brain tumor in adults?

A. Meningioma C. Pituitary adenoma E. Medulloblastoma

B. Glioblastoma multiforme D. Acoustic neuroma
68. Which type of brain tumor arises from the cells that form the protective covering of the
brain and spinal
cord?
A. Glioma C. pituitary adenoma E. Acoustic neuroma
B. Meningioma D. Medulloblastoma
69. which of the following is not a common symptom of brain tumors?
A. Headaches D. Muscle weakness
B. Seizures E. persistent hiccups
C. Visual disturbances
70. which imaging modality is typically used to diagnose brain tumors?
A. Ultrasound D. X-ray
B. Magnetic resonance imaging (MRD E. positron emission tomography (pET)
scan
C. Computed tomography (CT) scan
71. what is the primary cause of increased intracranial pressure?
A. Hypotension C. Hypoxemia E. Meningitis
B. Cerebral edema D. Hypertension
72. Which of the following is a common sign of increased intracranial pressure?
A. Bradycardia C. Tachycardia E. Bradypnea
B. Hypertension D. Hypotension
73. what is the normal range for intracranial pressure (ICp) in adults?
A. 5-10 mmHg C. 15-20 mmHg E. 25_3}mmHg
B. 10-15 mmHg D. 20-25 mmHg

74. Which intervention is appropriate for managing increased intracranial pressure?

A. Administering sedatives D. Administering anticoagulants
B. Administering hypertonic saline E. Encouraging deep breathing exercises
C. Elevating the head of the bed to 90 degrees

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75. what is the recommended treatment for bacteriar meningitis?
A. Antiviral medication C. Antibiotic therapy E. Intravenous fluids
B. Antifungal medication D. Antipyretic medication
76. Which of the following microorganisms is a common cause of bacterial meningitis in adults?
A. Varicella-zoster virus C. Herpes simplex virus E. Human immunodeficiency virus
B. Streptococcus pneumoniae D. Epstein-Barr virus
TT.Elevating the head of the bed by degrees are a preventative measure to minimize aspiration in
unconscious patients.
A. l0 c. 30 E. 50
B. 15 D. 20
78. ................ is a level of unconsciousness where patients only react to noxious stimuli.
A. Alert C. Restless E. Coma
B. Stuperous D. Drowsy
79. The term for a prolonged state of unconsciousness with no response to internal or external stimuli
is.
A. Delirium C. Coma E. Alert
B. Lethargy D. Sleep apnea
80. Which of the following diagnostic tests is most specific for diagnosing epilepsy?
A. X-ray C. EEG E. MRI
B. ECG D. CT scan.
81. The Nurse witnesses someone experiencing a seizure. What is the most important action to take?
A. action is to stay calm and protect the person from injury.
B. Restrain them and try to stop their movements.
C. Give anti-epileptic drug.
D. Siting position.
E. Take a video of the seizure.
82. Which one is contraindicated for a patient with a mild head injury to take as a pain killer?
A -Acetaminophen C -Aspirin E _paracetamol
B -lbuprofen D -Naproxen
83. Problemswith memory and learning would relate to which of the following lobes?
A-Frontal C-Temporal E-parietal
B -Fronto-temporal D -Occipital
84. The patient cannot feel the temperature of a hot oven while cooking. Which lobe could be
dysfunctional?
A -Frontal C -Occipital p _Temporal
B -Fronto-temporal D-parietal
85. which one is the score for eye opens spontaneousry in GCS scale?
4.2 c.8 8.3
8.4 D.l
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86. what imaging technique is commonly used to diagnose increased ICp?
A. Electroencephalogram (EEG) D. positron emission tomography (pET) scan
B. Magnetic resonance imaging (MRI) E. X-ray
C. Computed tomography (CT) scan
87. which medication is commonly used to reduce cerebrar edema?
A. Acetaminophen C. Dexamethasone E. penicillin
B. Ibuprofen D. Metoclopramide
88. what is the primary goal of managing increased intracranial pressure?
A. Preventing seizures C. Improving cerebral D. Reducing CSF production
B. Lowering blood pressure perfusion E. Inducing sleep
89. Which of the following complications is associated with untreated increased ICp?
A. Hypertension c.
cerebral herniation E. Alopecia
B. Diabetes mellitus D. Encephalitis
90. Which nursing intervention is most appropriate for a patient with increased intracranial pressure (ICp)
during the assessment phase?
A. Administering anticoagulants D. providing pain medication as needed
B. Elevating the head of the bed E. Monitoring neurological status frequently
C. Encouraging deep breathing exercises
91. During the assessment phase of the nursing process for a patient with a brain tumor, which assessment
should the nurse prioritize?
A. Skin integrity assessment C. Abdominal assessment
B. Respiratory assessment D. Neurological assessment
E. Musculoskeletal
assessment
92. Which nursing intervention is essential for managing potential complications of increased intracranial
pressure (ICP) in a patient with a brain tumor?
A. Encouraging deep breathing exercises D. Restricting fluid intake
B. Administering antihypertensive medications E. Applying warrn compresses to the head
C. Providing frequent neurologic assessments
93. Which symptom is indicative of increased intracranial pressure (ICP) in a patient with a brain tumor?
A. Decreased heart rate c. Bradypnea E. Increased appetite
B. Hypotension D. Headache
94. Which type of brain tumor originates from the cells that line the ventricles or the central canal of
the
spinal cord?
A. Glioma C. Medulloblastoma E. Acoustic neuroma
B. Meningioma D. Ependymoma
95. What is a common symptom of brain tumors located in the frontal lobe?
A. visual disturbances c. personarity changes E. Hearing loss
B. Memory loss D. Difficulty swallowing

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96. What is a common symptom of a concussion in patients with head injuries?
A. seizures visual disturbances
c. E. Hypertension
B. Memory loss D. Difficulty swallowing
97. What is a priority nursing intervention for a patient with a head injury who is experiencing increased
intracranial pressure?
A. Administering hypertonic saline solution D. Providing a low-protein diet
B. Placing the patient in a supine position E. Administering anticoagulants
C. Encouraging the Valsalva maneuver
98. Which of the following is a common symptom of a brain abscess?
A. Tinnitus C. Severe headache E. Skin pigmentation changes
B. Vision hallucination D. Blurred vision
99. What is the treatment of choice for brain abscess?
A. Antibiotics C. Radiation therapy E. Immunotherapy
B. Chemotherapy D. Surgery
100. Which of the following is not a risk factor for developing a brain abscess?
A. Chronic sinusitis C. Diabetes mellitus E. Immunocompromised state
B. Head trauma D. Genetic factors
101. Which of the following imaging techniques is commonly used to diagnose brain abscess?
A. MRI C. Ultrasound E. pET Scan
B. X-ray D. CT scan
102. Which of the following is not a typical symptom of a brain abscess?
A. Nausea and vomiting D. Loss of taste and smell
B. confusion or altered mental status E. Speech difficulties
C. Visual disturbances
103. Which part of the brain is most commonly affected by brain abscesses?
A. cerebellum Frontal lobe
c. E. Temporal lobe
B. Occipital lobe D. Brainstem
104. Which of the following is a common cause of fungal Meningitis?
A. Cryptococcus C. Neisseria meningitidis E. Escherichia coli
B. Streptococcus pneumoniae D. Haemophilus influenzae

10s. What is the gold standard diagnostic test for meningitis?

A. Lumbar puncture C. MRI scan E. Urinalysis
B. Blood culture D. CT scan

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