66 - Nursing Competitive Exams QAs - NORCET, ESIC, GUJARAT NURSING EXAM

 

Question 5081) 

Which of the following assessment findings should alert the nurse that the elderly client should be evaluated for pernicious anemia? 

A. Clubbing of the nails 

B. Bloody stools 

C. Beefy-red tongue 

D. Enlarged lymph nodes 

Answer: C 

Explanation: Early in the course of pernicious anemia, the tongue becomes beefy red and painful. Later, the tongue atrophies and becomes smooth. Nail clubbing is associated with respiratory and cardiac disorders. Numbness and tingling of the hands and feet are more common with pernicious anemia. Mild diarrhea is associated with pernicious anemia, whereas bloody stools usually are not. Colorectal bleeding is likely to lead to iron deficiency anemia. Enlarged lymph nodes are associated with leukemia, not anemia. 

Question 5082) 

An elderly client who is being treated for pernicious anemia needs to be monitored periodically for which of the following conditions? 

A. Lactose intolerance 

B. Stomach cancer 

C. Dementia 

D. Hearing loss 

Answer: B 

Explanation: The incidence of stomach cancer is increased in clients with deficiency of gastric acid. Intrinsic factor is in gastric acid. Treatment of pernicious anemia corrects the deficiency of vitamin B12 but does not alter the gastric acid production, so the client remains at risk for stomach cancer. Both lactose intolerance and hearing loss occur more commonly with aging, as does pernicious anemia. The presence of pernicious anemia does not alter the risk for either lactose intolerance or hearing loss, however. Dementia does occur in the late stages of untreated pernicious anemia, but for a client who is receiving treatment, there is no increased risk of dementia. 

Question 5083) 

Which of the following would be the best lunch for a client with folic acid deficiency anemia? 

A. Bologna sandwich and vegetable soup 

B. Grilled cheese sandwich and tomato soup 

C. Coleslaw and cream of mushroom soup 

D. Spinach salad and bean soup 

Answer: D 

Explanation: Leafy green vegetables and dried beans are good sources of folic acid. Nuts and citrus fruits are other good sources. The other options do not contain foods high in folic acid. 

Question 5084) 

The nurse administers iron using the Z track technique. What is the primary reason for administering iron via Z track? 

A. To prevent adverse reactions 

B. To prevent staining of the skin 

C. To improve the absorption rate 

D. To increase the speed of onset of action 

Answer: B 

Explanation: Iron is black and stains the skin. The Z track method of pulling the skin to one side before injecting the medications prevents staining of the skin. It also reduces pain from the medication. It does not prevent adverse reactions, improve the absorption rate, or increase the speed of onset of action 

Question 5085) 

The nurse is caring for a client who is thought to have pernicious anemia. What signs and symptoms would the nurse expect in this person? 

A. Easy bruising 

B. Beefy-red tongue 

C. Fine red rash on the extremities 

D. Pruritus 

Answer: B 

Explanation: A beefy-red tongue is characteristic of pernicious anemia. Easy bruising would be seen in a clotting disorder such as hemophilia, in leukemia, or in bone marrow depression. Pruritus is characteristic of Hodgkin’s disease. Pernicious anemia does not present a fine, red rash on the extremities. 

Question 5086) 

A 1-year-old is admitted to the hospital with sickle cell anemia in crisis. Upon admission, which therapy will assume priority? 

A. Fluid administration 

B. Exchange transfusion 

C. Anticoagulant 

D. IM administration of iron and folic acid 

Answer: A 

Explanation: Dehydration causes sickling. Sickling causes clumping and pain. The first priority of care upon admission should be the administration of fluids. Exchange transfusion, if done, is not the first priority. Anticoagulants are not the first priority. Iron and folic acid may be given but are not the first priority. They will not help stop the sickling. Folic acid and iron are necessary to make red blood cells. 

Question 5087) 

A toddler is diagnosed with sickle cell anemia. Her mother is four months pregnant with her second child. The mother asks if there is any chance the new baby will have sickle cell anemia. She says that neither she nor her husband has sickle cell anemia. What is the best response for the nurse to make? 

A. “No. Sickle cell anemia is not inherited.” 

B. “Yes. The new baby will also have sickle cell anemia.” 

C. “There is a 25% chance that each child you have will have the disease.” 

D. “Because neither of you has the disease, another child will not have it. You should ask your physician.” 

Answer: C 

Explanation: Sickle cell anemia is a recessive gene that is transmitted, giving a 25% chance that each child will have the disease. To have a child with the disease, both parents must be carriers for the disease even though neither one has the disease. 

Question 5088) 

The child with haemophilia is admitted to the hospital with a swollen knee joint. He is complaining of severe pain. What is the priority of nursing care for this child upon admission? 

A. Maintain joint function 

B. Use a bed cradle 

C. Administer aspirin as needed for pain 

D. Encourage fluids 

Answer: B 

Explanation: Hemarthrosis (bleeding into a joint) is very painful. A bed cradle will keep the bed covers off of his sore joint. Moving a bleeding joint will increase bleeding and should not be done. Aspirin is an anticoagulant and contraindicated for a hemophiliac. Fluid administration is not the priority nursing action. 

Question 5089) 

The nurse is caring for a child who has hemophilia. He is admitted with a bleeding episode. Which of the following should the nurse expect will be given to stop the bleeding? 

A. Heparin 

B. Cryoprecipitate 

C. Packed cells 

D. Whole blood 

Answer: B 

Explanation: Cryoprecipitate is frozen clotting factor and replaces the factors that the child is missing. Heparin is an anticoagulant and contraindicated for this child. Packed cells might be given after a severe hemorrhage but do not contain any clotting factors.Whole blood does not contains clotting factors. 

Question 5090) 

A 19-year-old college student reports to the health service with a sore throat, malaise, and fever of four days in duration. Examination shows cervical lymphadenopathy and splenomegaly. Temperature is 103°F. Blood is positive for heterophil antibody agglutination test. Which condition does the nurse expect this student to have? 

A. Streptococcal sore throat 

B. Infectious mononucleosis 

C. Rubella 

D. Influenza 

Answer: B 

Explanation: The findings are characteristic of infectious mononucleosis. The heterophil antibody agglutination test is diagnostic for mononucleosis. A throat culture would identify a streptococcal sore throat. Rubella (German measles) typically has a rash. The fever and sore throat are not typical of rubella. Influenza might have similar symptoms but would not have a positive heterophil agglutination test.

65 - Nursing Competitive Exams QAs - NORCET, ESIC, GUJARAT NURSING EXAM

 

Question 5071) 

A 5-year-old boy is admitted because he bled profusely when he lost his first baby tooth. After a workup, he is diagnosed as having classic hemophilia. His mother asks the nurse if his two younger sisters will also develop hemophilia. What is the best answer for the nurse to give? 

A. “They will not develop the disease.” 

B. “Statistically, one of them is likely to develop the disease.” 

C. “They are not likely to get the disease, but they may be carriers.” 

D. “If it doesn’t show up by the time they start school, they are unlikely to develop the condition.” 

Answer: 

C Explanation: Hemophilia is carried on the X chromosome and causes disease when it appears in combination with the Y chromosome in the male. Answer 1 is a true statement, but it is not complete and, therefore, not the best answer. 

Question 5072) 

The nurse has been teaching the parents of a child with hemophilia about the care he will need. Which statement by the parents indicates a need for more instruction? 

A. “If my child needs something for pain or a fever, I will give him acetaminophen instead of aspirin.” 

B. “I will take my child to the dentist for regular checkups.” 

C. “I will keep my child in the house most of the time.” 

D. “My son’s Medic Alert Bracelet arrived.” 

Answer: C 

Explanation: Parents of children with hemophilia tend to overprotect them. A goal is to have the child lead as normal a life as possible. Answer 1 is correct. He should not receive aspirin because it is an anticoagulant. Answer 2 indicates good knowledge. Prophylactic dental care is important so he will not need dental work or extractions. Answer 4 indicates good knowledge. He should always wear a Medic Alert Bracelet in case he is injured. 

Question 5073) 

A college student who is diagnosed as having infectious mononucleosis asks how the disease is spread. The nurse’s response is based on the knowledge that the usual mode of transmission is through 

A. skin. 

B. genital contact. 

C. contaminated water 

D. intimate oral contact 

Answer: D 

Explanation: The virus is spread through intimate oral contact. It is called the “kissing disease.” It can also be spread by sharing eating and drinking utensils and by coughing and sneezing. 

Question 5074) 

A young man who has infectious mononucleosis asks what the treatment is for his condition. What is the best response for the nurse to make? 

A. “You will receive large doses of antibiotics for the next 10 days.” 

B. “Rest and good nutrition are the best things you can do.” 

C. “You will be given an antiviral agent that will help to control the symptoms.” 

D. “You will probably be given steroid medications for several months.” 

Answer: B 

Explanation: Rest and good nutrition are the hallmarks of treatment for mononucleosis. Recovery may take several months. Because it is caused by a virus, antibiotics are not indicated. He would receive antibiotics only if he develops a secondary infection. There are no effective antiviral agents for this condition. Steroids are not indicated. 

Question 5075) 

An 8-year-old boy is admitted to the unit with a diagnosis of acute lymphocytic leukemia. During a routine physical exam, numerous ecchymotic areas were noted on his body. The parent reported that the child has been more tired than usual lately. The parent says that the child has had a cold for the last several weeks and asks if this is related to the leukemia. The nurse’s response is based on the knowledge that: 

A. leukemia causes a decrease in the number of normal white blood cells in the body. 

B. a chronic infection such as the child has had makes a child more likely to develop leukemia. 

C. the virus responsible for colds is thought to cause leukemia. 

D. having an infection prior to the onset of leukemia is merely a coincidence. 

Answer: A 

Explanation: Leukemia causes a decrease in normal white blood cells. White blood cells are the infection fighting cells. Infections occur because of the decrease in white blood cells due to leukemia. Infections do not cause leukemia. 

Question 5076) 

A child with leukemia bruises easily. This is most likely due to which of the following? 

A. Decreased fibrinogen levels 

B. Excessive clotting elsewhere in the body 

C. Decreased platelets 

D. Decreased erythrocytes 

Answer: C 

Explanation: n leukemia, there is bone marrow failure. In addition to producing abnormal, immature white blood cells, the bone marrow fails and does not produce stem cells from which red blood cells and platelets develop. 

Question 5077) 

A child who is being treated for leukemia develops stomatitis. Which of the following nursing care measures is essential? 

A. Using dental floss to clean the teeth 

B. Frequent cleaning of the mouth with an astringent mouthwash 

C. Use of an overbed cradle 

D. Swabbing the mouth with moistened cotton swabs 

Answer: D 

Explanation: Stomatitis (mouth inflammation) is a frequent complication of chemotherapy for leukemia. He has a tendency to bleed because of his decreased platelets. Dental floss might cause bleeding. An astringent mouthwash is too strong for his tender mouth. An overbed cradle does not relate to stomatitis. Moistened cotton swabs are a gentle means of cleaning the mouth. 

Question 5078) 

When planning care for a client who is HIV positive, the nurse should do what? 

A. Teach persons coming in contact with the client to wear a gown and mask at all times 

B. Teach persons to wear gloves when handling any of the client’s body fluids 

C. Restrict visitors to immediate family 

D. Encourage the client to stay away from other persons as much as possible 

Answer: B 

Explanation: Standard precautions are indicated. Answer 1 is not correct. It is not necessary to wear a gown and mask unless there is a risk of exposure to body fluids. Answer 3 is not correct. There is no reason to limit visitors. Answer 4 is not correct. The client is HIV positive. There is no indication that the client is immunocompromised and at an increased risk of infection from others. The client will not transmit the disease unless there is contact with body fluids. 

Question 5079) 

Which action should the nurse expect to perform after a client has a bone marrow biopsy taken from the iliac crest? 

A. Apply pressure to the site for one minute 

B. Administer a narcotic analgesic 

C. Apply an adhesive bandage to the site 

D. Place the client in a recumbent position 

Answer: D 

Explanation: The client should lie in bed in a recumbent position on top of a pressure dressing that has been applied to the site. Hemorrhage poses a slight risk after this procedure. Pressure should be applied to the site for several minutes. A pressure dressing should then be applied for one hour to reduce the chances of bleeding or hemorrhage. An analgesic may be ordered and administered prior to the procedure. Use of deep breathing and relaxation techniques may also be helpful. There is seldom any pain after the biopsy, although the site may ache for a few days. 

Question 5080) 

Which of the following would be the most appropriate snack for a client who has iron deficiency anemia? 

A. Half of a grapefruit 

B. A carrot raisin salad 

C. A cup of yogurt 

D. Apple slices and cheese 

Answer: B 

Explanation: Carrots and raisins are both high in iron. Red meats and spinach are other good iron sources. Citrus fruits such as grapefruit are high in folic acid, vitamin C, and potassium, but not iron. Dairy products such as yogurt and cottage cheese provide calcium but no iron. Apples are not good sources of iron.

64 - Nursing Competitive Exams QAs - NORCET, ESIC, GUJARAT NURSING EXAM

 

Question 5061) 

An older adult is admitted to the hospital with symptoms of severe dyspnea, orthopnea, diaphoresis, bubbling respirations, and cyanosis. He states that he is afraid “something bad is about to happen.” How should the nurse position this client? 

A. Sitting upright 

B. Head lower than feet 

C. Supine 

D. Prone 

Answer: A 

Explanation: The client’s symptoms suggest pulmonary edema. Any client with severe dyspnea, orthopnea, and bubbling respirations needs to be in an upright position. An upright position decreases venous return to the heart by allowing blood to pool in the extremities. Decreasing venous return lowers the output of the right ventricle and decreases lung congestion. Sitting upright also allows the abdominal organs to fall away from the diaphragm, easing breathing. Positioned with head lower than feet would not promote venous pooling in the extremities and would increase venous return and pulmonary congestion. The supine position also would contribute to increased pulmonary congestion. The prone position, lying on the abdomen, does not decrease venous return, which is what this client desperately needs. 

Question 5062) 

An adult male has a high level of high-density lipoproteins (HDL) in proportion to low-density lipoproteins (LDL). How does this relate to his risk of developing coronary artery disease (CAD)? 

A. His risk for CAD is low. 

B. There is no direct correlation 

C. His risk may increase with exercise. 

D. His risk will increase with age. 

Answer: A 

Explanation: Although elevated LDL levels in proportion to HDL levels are positively correlated with CAD, elevated HDL levels in proportion to LDL levels may decrease the risk of developing CAD. HDL levels may increase with exercise, thereby decreasing a client’s risk of CAD. Age is not a predictor of HDL and LDL levels. 

Question 5063) 

A 72-year-old man had a total hip arthroplasty eight days ago. He suddenly develops tenderness in his left calf, a slight temperature elevation, and a positive Homan’s sign. Which of the following will be included in the initial care of this man? 

A. Warm packs to the left leg 

B. Vigorous massage of the left leg 

C. Placing the left leg in a dependent position 

D. Performing range of motion exercises to the left leg 

Answer: A 

Explanation: Warm, moist heat applied to the extremity reduces the discomfort associated with thrombophlebitis. Vigorous massage of the leg is contraindicated in any client because it may cause a thrombus to become dislodged and possibly cause a pulmonary embolus. The leg should be elevated to prevent venous stasis. Leg exercises are used to prevent thrombophlebitis; once a client has thrombophlebitis, the leg is not exercised to prevent the thrombus from becoming an embolus. 

Question 5064) 

The nurse is discussing dietary sources of iron with a client who has iron deficiency anemia. Which menu, if selected by the client, indicates the best understanding of the diet? 

A. Milkshake, hot dog, and beets 

B. Beef steak, spinach, and grape juice 

C. Chicken salad, green peas, and coffee 

D. Macaroni and cheese, coleslaw, and lemonade 

Answer: B 

Explanation: Beef, spinach, and grape juice contain iron. Milk contains no iron. 

Question 5065) Ferrous sulfate is prescribed for a client. She returns to the clinic in two weeks. Which assessment by the nurse indicates that she has NOT been taking iron as ordered? 

A. The client’s cheeks are flushed 

B. The client reports having more energy. 

C. The client complains of nausea 

D. The client’s stools are light brown. 

Answer: D 

Explanation: Iron turns stool black. The other answers all indicate compliance with the medication regimen. 

Question 5066) 

A Schilling test has been ordered for a client suspected of having pernicious anemia. What is the nurse’s primary responsibility in relation to this test? 

A. Collect the blood samples 

B. Collect a 24-hour urine sample 

C. Assist the client to x-ray 

D. Administer an enema 

Answer: B 

Explanation: The client is given radioactive vitamin B12 orally, and a 24-hour urine sample is collected to see if vitamin B12 is absorbed from the GI tract into the bloodstream and excreted in the urine. 

Question 5067) 

A client who receives a diagnosis of pernicious anemia asks why she must receive vitamin shots. What is the best answer for the nurse to give? 

A. “Shots work faster than pills.” 

B. “Your body cannot absorb vitamin B12 from foods.” 

C. “Vitamins are necessary to make the blood cells.” 

D. “You can get more vitamins in a shot than a pill.”

Answer: B 

Explanation: Injections of vitamin B12 will be necessary because without intrinsic factor, her body cannot absorb vitamin B12 from foods. 

Question 5068) 

A client who has been diagnosed as having pernicious anemia asks how long she will have to take shots. What is the best answer for the nurse to give? 

A. “Until your blood count returns to normal.” 

B. “Until your blood count returns to normal.” 

C. “For the rest of your life.” 

D. “That varies with each person. Ask your doctor.” 

Answer: C 

Explanation: Because she is deficient in intrinsic factor and cannot absorb vitamin B12 from foods, she will have to take vitamin B12 shots for life. 

Question 5069) 

A toddler has been treated for sickle cell crisis. The crisis subsides, and the child improves. Which statement is essential for the nurse to include in the discharge teaching? 

A. Your child will bruise easily. Do not let your child bump into things. 

B. Notify the physician immediately if your child develops a fever. 

C. Your child will need special help with feeding. 

D. Observe your child frequently for difficulty breathing. 

Answer: B 

Explanation: Fevers cause dehydration and sickling, which may result in a crisis. 

Question 5070) 

Which statement made by the parent of a child newly diagnosed with sickle cell anemia indicates a need for more teaching? 

A. “We are going to the mountains for our vacation this year.” 

B. “It’s a good thing she likes to drink juices.” 

C. “If she needs something for pain, I will give her baby acetaminophen.” 

D. “I will make sure that she doesn’t get chilled when it is cold outside.” 

Answer: A 

Explanation: The mountains are high in altitude and have less oxygen saturation, which may precipitate an attack. Drinking juices is good because it will help to prevent dehydration. Acetaminophen is better for the child than aspirin, which may cause acidosis. The child should be protected from extremes in temperature

63 - Nursing Competitive Exams QAs - NORCET, ESIC, GUJARAT NURSING EXAM

 

Question 5051) 

Which assessment finding would most likely indicate that a client has thrombophlebitis in the leg? 

A. Diminished pedal pulses 

B. Color changes in the extremities when elevated 

C. Red, shiny skin 

D. Coolness and pallor in the leg 

Answer: C 

Explanation: Red, shiny skin suggests inflammation. Diminished pedal pulses and color changes in the extremities when elevated are indicative of arterial insufficiency, not a clot in the vein. Coolness and pallor do not suggest inflammation; redness and warmth suggest inflammation. 

Question 5052) 

What should be included in the teaching plan for an adult who has hypertension? 

A. Reduce dietary calcium 

B. Avoid aerobic exercise 

C. Reduce alcohol intake 

D. Limit fluid intake. 

Answer: C 

Explanation: High alcohol intake contributes to increases in blood pressure. Hypertensive clients are usually advised to limit alcohol intake to the equivalent of two glasses of wine or less per day. Dietary sodium should be limited in people with hypertension; however, dietary calcium is not a contributing factor in hypertension. Aerobic exercise is helpful in controlling high blood pressure. It may also contribute to weight reduction, which can help decrease blood pressure. Restriction of fluid intake is a medical order and is not appropriate advice for a nurse to give. Fluid restriction is avoided unless other measures are not successful. 

Question 5053) 

The nurse is caring for an elderly client who has congestive heart failure and is taking digoxin. The client should be monitored for which of the following signs of toxicity? 

A. Disorientation 

B. Weight gain 

C. Constipation 

D. Dyspnea 

Answer: A 

Explanation: Disorientation and confusion are often the first signs of digitalis toxicity in the elderly. Weight gain and dyspnea are not signs of digoxin toxicity. They might indicate exacerbation of congestive heart failure. Diarrhea, not constipation, is a sign of digoxin toxicity. Constipation could occur if the client has restricted activity. 

Question 5054) 

The licensed practical nurse (LPN) is assisting the registered nurse (RN) in developing the nursing care plan for an older adult who has congestive heart failure. Which nursing diagnosis is most likely to be included? 

A. Deficient fluid volume 

B. Impaired verbal communication 

C. Chronic pain 

D. Activity intolerance 

Answer: D 

Explanation: Dyspnea and impaired oxygenation of tissues reduce the client’s ability to tolerate exercise. Excess fluid volume, manifested by edema, is much more likely to occur with congestive heart failure (CHF) than deficient fluid volume. Impaired verbal communication would describe dysphasia, which occurs with cerebrovascular accident (CVA), not CHF. Acute pain may occur with CHF when exacerbations occur. Chronic pain does not usually occur with CHF. 

Question 5055) 

The nurse is caring for a client who is being evaluated for arteriosclerosis obliterans. Which complaint is the client most likely to have? 

A. Burning pain in the legs that wakens him or her at night 

B. Numbness of the feet and ankles with exercise 

C. Leg pain while walking that becomes severe enough to force him or her to stop 

D. Increasing warmth and redness of the legs when they are elevated 

Answer: C 

Explanation: Severe leg pain while walking describes intermittent claudication, which is the most common symptom of arteriosclerosis obliterans. Pain at rest develops in the late stages of the disease. Pain is much more likely than numbness with exercise. Paresthesias (including numbness) do occur, but they are likely at rest. The legs and feet of the client with arteriosclerosis obliterans become cool and pale when elevated because there is not enough blood flow to the extremities. 

Question 5056) 

An adult is admitted with venous thromboembolism. What treatment should the nurse expect during the acute stage? 

A. Application of an elastic stocking 

B. Ambulation three times a day

C. Passive range of motion exercises to the legs 

D. Use of ice packs to control pain 

Answer: A 

Explanation: Compression bandages or stockings help prevent edema and promote adequate venous blood flow and are a major element in the treatment of venous thromboembolism. Bed rest is appropriate in the acute stage of venous thromboembolism. Any form of exercise of the legs would increase the risk of pulmonary emboli. Heat is appropriate in the treatment of venous thromboembolism. Ice causes vasoconstriction, which decreases blood flow to the extremities. 

Question 5057) 

The nurse is observing a client who is learning to perform Buerger-Allen exercises. The nurse knows that the client is performing these exercises correctly when the client is observed doing what? 

A. Alternately dorsiflexing and plantar flexing the feet while the legs are elevated 

B. Massaging the legs beginning at the feet and moving toward the heart 

C. Alternately walking short distances and resting with the legs elevated 

D. Elevating the legs, then dangling them, and then lying flat for three minutes in each position 

Answer: D 

Explanation: In Buerger-Allen exercises, the feet are elevated until they blanch, then dangled until they redden, and then stretched out while the client is lying flat. This promotes arterial circulation to the feet. Dorsiflexing and plantar flexing the feet help to maintain range of motion but are not BuergerAllen exercises. The client with peripheral vascular disease should never massage the legs because of the high risk of dislodging a thrombus if one is present. Walking promotes venous circulation but is not a Buerger-Allen exercise. 

Question 5058) 

What should be included in foot care for the client who has a peripheral vascular disorder? 

A. Soaking the feet for 20 minutes before washing them 

B. Walking barefoot only on carpeted floors 

C. Applying lotion between the toes to avoid cracking of the skin 

D. Avoiding exposure of the legs and feet to the sun 

Answer: D 

Explanation: Sunburn would damage the already fragile skin, increasing the risk of ulceration and infection. Feet should not be soaked. Soaking leads to maceration, predisposing to skin breakdown or infection. The client with a peripheral vascular disorder should never walk barefoot. Small sharp objects such as pins may not be visible in carpet and could be stepped on. Lotion may be applied to dry areas of the legs and feet but must be avoided between the toes, where the excess moisture the causes maceration. Ingredients in lotion provide a nutrient source for bacteria and fungi, increasing the infection risk if cracks in the skin occur. 

Question 5059) 

An adult male is being evaluated for possible dysrhythmia and is to be placed on a Holter monitor. What instructions should the nurse give him to ensure that this test provides a comprehensive picture of his cardiac status? 

A. Remove the electrodes intermittently for hygiene measures. 

B. Exercise frequently while the monitor is in place. 

C. Keep a diary of all your activities while being monitored. 

D. Refrain from activities that precipitate symptoms. 

Answer: C 

Explanation: The client should function according to his normal daily schedule unless directed to do otherwise by the physician. Keeping a diary or log of these daily activities is necessary so that it can be correlated with the continuous ECG monitor strip to determine whether the dysrhythmia occurs during a certain activity or at a particular time of day. The Holter monitor is usually worn for only 24 hours, so it is not necessary to change the leads. Activities that precipitate symptoms may be correlated with a dysrhythmia that can be treated, preventing further symptoms from occurring. Therefore, it would be helpful if the client were symptomatic while attached to the Holter monitor. 

Question 5060) 

An older adult is scheduled for coronary arteriography during a cardiac catheterization. Which nursing intervention will be essential as she recovers from the diagnostic procedure on the hospital unit? 

A. Encouraging frequent ambulation to prevent deep vein thrombosis 

B. Limiting fluid intake to prevent fluid overload 

C. Limiting dietary fiber to prevent diarrhea 

D. Assessing the arterial puncture site when taking vital signs 

Answer: D 

Explanation: Following a cardiac catheterization in which an arterial site is used for access, the puncture or cutdown site should be assessed at least as often as vital signs are monitored. The client is at risk for development of bleeding, hemorrhage, hematoma formation, and arterial insufficiency of the affected extremity. When the arterial access site is used, the client is on strict bed rest for at least several hours. Fluids are encouraged after catheterization to increase urinary output and flush out the dye used during the procedure. There is no need to restrict dietary fiber. In fact, constipation can be dangerous for cardiac clients if they strain at stool (Valsalva maneuver.)

62 - Nursing Competitive Exams QAs - NORCET, ESIC, GUJARAT NURSING EXAM

 

Question 5041) 

A low-sodium, low-cholesterol, weight-reducing diet is prescribed for an adult with heart disease. The nurse knows that he understands his diet when he chooses which of the following meals? 

A. Baked skinless chicken and mashed potatoes 

B. Stir-fried Chinese vegetables and rice 

C. Tuna fish salad with celery sticks 

D. Grilled lean steak with carrots 

Answer: A 

Explanation: Chicken is lower in sodium than beef or seafood. Baking adds no sodium to the chicken. Barbecuing adds sodium and fat, and frying adds fat and usually sodium. Mashed potatoes contain little sodium. Chinese food is usually high in sodium. Tuna fish and celery are high in sodium. Steak and carrots are high in sodium. 

Question 5042) 

An adult client is admitted with a diagnosis of left-sided congestive heart failure. Which assessment finding would most likely be present? 

A. Distended neck veins 

B. Dyspnea 

C. Hepatomegaly 

D. Pitting edema 

Answer: B 

Explanation: Dyspnea occurs with left-sided heart failure. Distended neck veins, hepatomegaly, and pitting edema are signs of right-sided heart failure. 

Question 5043) 

Digoxin (Lanoxin) and furosemide (Lasix) are ordered for a client who has congestive heart failure. Which of the following would the nurse also expect to be ordered for this client? 

A. Potassium 

B. Calcium 

C. Aspirin 

D. Coumadin 

Answer: A 

Explanation: Lasix is a potassium-depleting diuretic. Digoxin toxicity occurs more quickly in the presence of a low serum potassium. Potassium supplements are usually ordered when the client is on a potassiumdepleting diuretic. There is no indication for supplemental calcium. Aspirin and Coumadin are anticoagulants and are not indicated because the client is taking Lasix and digoxin. 

Question 5044) 

When the nurse is about to administer digoxin to a client, the client says, “I think I need to see the eye doctor. Things seem to look kind of green today.” The nurse takes his vital signs, which are blood pressure = 150/94, pulse = 60 bpm, and respirations = 28. What is the most appropriate initial action for the nurse to take? 

A. Administer the medication and record the findings on his chart 

B. Withhold the digoxin and report to the charge nurse 

C. Request an appointment with the ophthalmologist 

D. Reassure the client that he is having a normal reaction to his medication 

Answer: B 

Explanation: Disturbance in green and yellow vision is a sign of digoxin toxicity. A pulse of 60 is borderline for digoxin toxicity. When there is any possibility of digoxin toxicity, withhold the medication and report to the charge nurse. Once a person takes digoxin, it stays in the system for nearly a week. The LPN will of course record the findings, but withholding the medication is essential. The client needs to have serum digoxin levels done and does not need to be seen by an ophthalmologist. Visual disturbances are a sign of digoxin toxicity, but these are not normal. 

Question 5045) 

An adult client is admitted to the hospital with peripheral vascular disease of the lower extremities. He has several ischemic ulcers on each ankle and lower leg area. Other parts of his skin are shiny and taut with loss of hair. A primary nursing goal for this client should be to do which of the following? 

A. Increase activity tolerance 

B. Increase activity tolerance 

C. Protect from injury 

D. Help build a positive body image 

Answer: C 

Explanation: Because the client has such poor blood supply to his legs, the nurse must be very careful to protect him from injury. Increasing activity tolerance might be desirable but is certainly not the primary nursing goal. Note that the question does not indicate that he has poor exercise tolerance. There are no data in the question to indicate that the client is anxious. He may need help in building a positive body image because his legs are disfigured, but this is certainly not a high priority 

Question 5046) 

An adult client who has peripheral vascular disease of the lower extremities was observed smoking in the waiting area. What is the most appropriate response for the nurse to make regarding the client’s smoking? 

A. “Smoking is not allowed for patients with blood diseases.” 

B. “Smoking causes the blood vessels in your legs to constrict and reduces the blood supply.” 

C. “Smoking increases your blood pressure and strains your heart.” 

D. “Smoking causes your body to be under greater stress.” 

Answer: B 

Explanation: This is an accurate answer that relates his behavior to his illness. All of the other statements are true about smoking but do not relate to his current health problem. 

Question 5047) 

An Adult client with peripheral Vascular Disease tells the nurse he is afraid his left leg is not improving and may need to be amputated. How should the nurse respond? 

A. “You and your wife should discuss your feelings before surgery.” 

B. “You sound concerned about your leg and possible surgery.” 

C. “It is better to have an amputation when the ulcers are not improving.” 

D. “You don’t need to be afraid of surgery.” 

Answer: B 

Explanation: This response opens communication and allows him to talk about his feelings. The other answers do not allow him to discuss his feelings with the nurse now. 

Question 5048) 

An adult is diagnosed with hypertension. He is prescribed chlorothiazide (Diuril) 500 mg PO. What nursing instruction is essential for him? 

A. Drink at least two quarts of liquid daily 

B. Avoid hard cheeses. 

C. Drink orange juice or eat a banana daily. 

D. Do not take aspirin 

Answer: C 

Explanation: Chlorothiazide (Diuril) is a potassium-depleting diuretic. Orange juice and bananas are good sources of potassium. It is not necessary to increase fluids to two quarts when the client is taking a diuretic. Hard cheeses should be avoided when the client is taking monoamine oxidase inhibitors (MAOIs). MAOIs are antidepressants. People who take Coumadin should not take aspirin. 

Question 5049) 

A low-sodium diet has been ordered for an adult client. The nurse knows that the client understands his low-sodium diet when the client selects which menu? 

A. Tossed salad, carrot sticks, and steak 

B. Baked chicken, mashed potatoes, and green beans 

C. Hot dog, roll, and coleslaw 

D. Chicken noodle soup, applesauce, and cottage cheese 

Answer: B 

Explanation: Chicken is low in sodium, as are mashed potatoes and green beans. Carrot sticks, steak, hot dogs, soup, and cottage cheese are all high in sodium 

Question 5050) 

A female client is admitted to the hospital with obesity and deep vein thrombophlebitis (DVT) of the right leg. She weighs 275 pounds. Which of the following factors is least related to her diagnosis? 

A. She has been taking oral estrogens for the last three years. 

B. She smokes two packs of cigarettes daily. 

C. Her right femur was fractured recently. 

D. She is 30 years old. Answer: D Explanation: Age is least related to DVT. Oral estrogens, smoking, and a broken leg are all risk factors for DVT.

61 - Nursing Competitive Exams QAs - NORCET, ESIC, GUJARAT NURSING EXAM

 

Question 5031) 

An adult who is admitted for a cardiac catheterization asks the nurse if she will be asleep during the cardiac catheterization. What is the best initial response for the nurse to make? 

A. “You will be given a general anesthesia.” 

B. “You will be sedated but not asleep.” 

C. “The doctor will give you an anesthetic if you are having too much pain.” 

D. “Why do you want to be asleep?” 

Answer: B 

Explanation: Persons who are undergoing cardiac catheterization will receive a sedative but are not put to sleep. Their cooperation is needed during the procedure. Asking “why” makes the client defensive and is not appropriate for this client at this time. Give the client the information asked for. 

Question 5032) 

During the admission interview, a client who is admitted for a cardiac catheterization says, “Every time I eat shrimp I get a rash.” What action is essential for the nurse to take at this time? 

A. Notify the physician. 

B. Ask the client if she gets a rash from any other foods. 

C. Instruct the dietary department not to give the client shrimp. 

D. Teach the client the dangers of eating shrimp and other shellfish. Allergy to shellfish is indicative of an allergy to iodine. The dye used in a cardiac catheterization 

Answer: A 

Explanation: Allergy to shellfish is indicative of an allergy to iodine. The dye used in a cardiac catheterization occur. Because the exam is scheduled for the morning, the nurse should notify the physician immediately. The other actions might have relevance but are not essential (safety related) at this time. 

Question 5033) 

The nurse is preparing a client for a cardiac catheterization. Which action would the nurse expect to take? 

A. Administer a radioisotope as ordered. 

B. Give the client a cleansing enema. 

C. Locate and mark peripheral pulses. 

D. Encourage high fluid intake before the test. 

Answer: C 

Explanation: It is essential to monitor peripheral pulses after the procedure. They should be assessed before the procedure to determine location and baseline levels. An iodine dye is used during a cardiac catheterization, not a radioisotope. There is no need to give the client an enema. Fluids may be encouraged after the test. The client will be NPO for eight hours before the test. 

Question 5034) 

A young adult with a history of rheumatic fever as a child is to have a cardiac catheterization. She asks the nurse why she must have a cardiac catheterization. The nurse’s response is based on the understanding that cardiac catheterization can accomplish all of the following EXCEPT: 

A. assessing heart structures. 

B. determining oxygen levels in the heart chambers. 

C. evaluating cardiac output. 

D. obtaining a biopsy specimen. 

Answer: D 

Explanation: A biopsy specimen cannot be obtained during a cardiac catheterization. Heart structures can be assessed, oxygen levels in the heart chambers can be determined, and cardiac output can be measured during a cardiac catheterization 

Question 5035) 

When a client returns from undergoing a cardiac catheterization, it is most essential for the nurse to: 

A. check peripheral pulses. 

B. maintain NPO. 

C. apply heat to the insertion site. 

D. start range of motion exercises immediately. 

Answer: A 

Explanation: Checking peripheral pulses is of highest priority. The complications most likely to occur are hemorrhage and obstruction of the vessel. The client is NPO before the procedure, not after. Cold may be applied to the insertion site to vasoconstrict. Heat vasodilates and is contraindicated because it might cause bleeding. Range of motion exercises might cause bleeding. The extremity used for the insertion site is kept quiet immediately following a cardiac catheterization. 

Question 5036) 

A male client with angina pectoris has been having an increased number of episodes of pain recently. He is admitted for observation. During the admission interview, he tells the nurse that he has been having chest pain during the last week. Which statement by the client would be of greatest concern to the nurse? 

A. “I had chest pain while I was walking in the snow on Thursday.” 

B. “We went out for a big dinner to celebrate my wife’s birthday, but I couldn’t enjoy it because I got the pain before we got home from the restaurant.” 

C. “I had chest pain yesterday while I was sitting in the living room watching television.” 

D. “I felt pain all the way down my left arm after I was playing with my grandson on Monday.” 

Answer: C 

Explanation: This answer indicates pain at rest, which suggests a progression of the angina. The other answers all indicate pain with known causes of angina, such as exercise, cold environment, or eating. 

Question 5037) 

The nurse responds to the call light of a client who has a history of angina pectoris. He tells the nurse that he has just taken a nitroglycerin tablet sublingually for anginal pain. What action should the nurse take next? 

A. If the pain does not subside within five minutes, place a second tablet under his tongue 

B. Position him with head lower than feet 

C. Administer a narcotic as needed (PRN) for pain if he still has pain in 10 minutes 

D. Call his physician and alert the code team for possible intervention 

Answer: A 

Explanation: Nitroglycerin can be given at five-minute intervals for up to three doses if the pain is not relieved. Positioning with head lower than feet increases cardiac workload and would make the client worse. PRN narcotics are not usually ordered for clients who have anginal pain. Nitroglycerin, a vasodilator, is usually the medication of choice. At some point, the physician will need to be called, but there is no need to alert the code team for possible intervention. 

Question 5038) 

The nurse is teaching an adult who has angina about taking nitroglycerin. The nurse tells him he will know the nitroglycerin is effective when: 

A. he experiences tingling under the tongue. 

B. his pulse rate increases. 

C. his pain subsides 

D. his activity tolerance increases 

Answer: C 

Explanation: Pain relief is the expected outcome when taking nitroglycerin. Vasodilation of coronary vessels will increase the blood supply to the heart muscle, decreasing pain caused by ischemia. Tingling under the tongue and a headache indicate that the medication is potent. His pulse rate should decrease when the pain is relieved. Increase in activity tolerance is nice, but nitroglycerin is given to relieve anginal pain. 

Question 5039) 

A client with angina will have to make lifestyle modifications. Which of the following statements by the client would indicate that he understands the necessary modifications in lifestyle to prevent angina attacks? 

A. “I know that I will need to eat less, so I will only eat one meal a day.” 

B. “I will need to stay in bed all the time so I won’t have the pain.” 

C. “I’ll stop what I’m doing whenever I have pain and take a pill.” 

D. “I will need to walk more slowly and rest frequently to avoid the angina.” 

Answer: D 

Explanation: Walking more slowly and resting decreases energy expenditure and prevents an attack. Answer 3 treats an attack. By the time he has pain, he is experiencing angina. To prevent angina, he needs to walk slowly and rest frequently. He should eat small, frequent meals—not one large meal. He should exercise within his tolerance level. Staying in bed predisposes the client to the complications of immobility, such as clots and pneumonia. 

Question 5040) 

A client who has been treated for angina is discharged in stable condition. At a clinic visit, he tells the nurse he has anginal pain when he has sexual intercourse with his wife. What is the best response for the nurse to make? 

A. “Do you have ambivalent feelings toward your wife?” 

B. “Many persons with angina have less pain when their partner assumes the top position.” 

C. “Be sure that you attempt intercourse only when you are well rested and relaxed.” 

D. “You might try having a cocktail before sexual activity to help you relax.” 

Answer: B 

Explanation: Reducing his physical activity reduces the cardiac workload. This response suggests a way that he can engage in sexual activity with minimum strain on the heart. Ambivalent feelings toward his wife are unlikely to cause anginal pain. There is some truth to being well rested and relaxed, but telling him that this is the only time he should have intercourse is not realistic. The nurse should not advise the client to have an alcoholic beverage before sexual activity. 

60 - Nursing Competitive Exams QAs - NORCET, ESIC, GUJARAT NURSING EXAM

 

Question 5021) 

Which of the following information is appropriate for a pregnant woman has a positive history of herpes but has no lesions during the present pregnancy? 

A. You will be isolated from your newborn infant following delivery 

B. She will be evaluated at the time of delivery for herpetic genital tract lesions and if lesions are present a cesarean section will be needed. 

C. There is little risk to your newborn infant during this pregnancy birth and following delivery 

D. Virginal deliveries can reduce neonatal infection risks even if you have an active lesion at birth. 

Answer: B 

Explanation: The women is evaluated for active genital herpes lesion at the time of delivery, and if lesions are present a cesarean delivery will be needed it is one of indications of the cesarean section. 

Question 5022) 

The gold standard for the treatment of hot flushes is ......... 

A. Oxytocin administration 

B. Progesterone administration 

C. Estrogen administration 

D. Serotonin administration 

Answer: C 

Explanation: Decrease in level of estrogen in cause of hot flushes. Hot flushes mean sudden falling of warmth usually most intense over face, neck chest and profuse sweating. It commonly occurs due to menopause the gold standard for the treatment of hot flushes is estrogen administration. 

Question 5023) 

Which of the following is not true about pre-menstrual syndrome? 

A. It occurs during the last half of menstrual cycle 

B. It resolves with the onset of menstrual cycle 

C. It occurs during the luteal phase 

D. It resolves with the onset of ovulation 

Answer: D 

Explanation: Pre-menstrual syndrome (PMS) refers to physical and emotional symptoms that occur in the 1 to 2 weeks before menses physical symptoms include breast tenderness bloating and psychological symptoms include mood saving anger, it occurs in the last half of menstrual cycle (luteal phase) and typically ends with the of menstrual flow. 

Question 5024) The nurse counts an adult’s apical heart beat at 110 beats per minute. The nurse describes this as: 

A. asystole. 

B. bigeminy. 

C. tachycardia. D. bradycardia. 

Answer: C 

Explanation: Tachycardia in an adult is defined as a heart rate above 100 beats per minute. Asystole is cardiac arrest. There is no heartbeat. Bigeminy means that the heartbeats are coming in pairs. Bradycardia in an adult is defined as a heart rate of 60 beats or less per minute. 

Question 5025) 

A client has an elevated AST 24 hours following chest pain and shortness of breath. This is suggestive of which of the following? 

A. Gallbladder disease 

B. Liver disease 

C. Myocardial infarction 

D. Skeletal muscle injury 

Answer: C 

Explanation: AST is an enzyme released in response to tissue damage. The symptoms are suggestive of myocardial damage. AST rises 24 hours after a myocardial infarction. It will also rise when there is liver damage and skeletal muscle injury. This client has symptoms typical of myocardial infarction. Gallbladder disease may present with pain in the right scapula (shoulder blade) region but would not have an elevated AST. 

Question 5026) An adult has a coagulation time of 20 minutes. The nurse should observe the client for which of the following? 

A. Blood clots 

B. Ecchymotic areas 

C. Jaundice 

D. Infection 

Answer: B 

Explanation: The normal clotting time is 9 to 12 minutes. A prolonged clotting time would suggest a bleeding tendency; the client should be observed for signs of bleeding, such as ecchymotic areas. Blood clots would occur with a clotting time of less than normal. Jaundice occurs with liver damage or rapid breakdown of red blood cells, such as is seen in sickle cell anemia. Infection occurs when there are too few white blood cells. 

Question 5027) 

A prothrombin time test should be performed regularly on persons who are taking which medication? 

A. Heparin 

B. Warfarin 

C. Phenobarbital 

D. Digoxin 

Answer: B 

Explanation: A prothrombin time test is done to determine the effectiveness of warfarin. A partial thromboplastin time test is done for persons taking heparin. Phenobarbital and digoxin do not require regular clotting tests. Serum levels of these drugs may be done if the client is on long-term therapy. 

Question 5028) Which prothrombin time value would be considered normal for a client who is receiving warfarin (Coumadin)? 

A. 12 seconds 

B. 20 seconds 

C. 60 seconds 

D. 98 seconds 

Answer: B 

Explanation: When a client is receiving Coumadin, the prothrombin time should be 1.5 to 2 times the normal value, which is 11 to 12.5 seconds. Twenty seconds falls within that range. Twelve seconds is normal for someone who is not receiving Coumadin. Sixty seconds is normal for a partial thromboplastin time (PTT) test. Ninety-eight seconds on a PTT would be acceptable for a client who is receiving heparin. It should be 1.5 to 2 times the normal range of 60 to 70 seconds. 

Question 5029) 

The nurse is caring for a client who is receiving heparin. What drug should be readily available? 

A. Vitamin K 

B. Caffeine 

C. Calcium gluconate 

D. Protamine sulfate 

Answer: D 

Explanation: The antidote for heparin is protamine sulfate. Vitamin K is the antidote for Coumadin. Calcium gluconate is the antidote for magnesium sulfate. Caffeine is a central nervous system stimulant and will increase alertness and heart rate. 

Question 5030) 

An adult who is receiving heparin asks the nurse why it cannot be given by mouth. The nurse responds that heparin is given parenterally because: 

A. it is destroyed by gastric secretions. 

B. it irritates the gastric mucosa 

C. it irritates the intestinal lining. 

D. therapeutic levels can be achieved more quickly. 

Answer: A 

Explanation: Heparin is a protein and is destroyed by gastric secretions. It is given either intravenously or subcutaneously for that reason. 

59 - Nursing Competitive Exams QAs - NORCET, ESIC, GUJARAT NURSING EXAM

 

Question 5011) 

When performing a postpartum assessment on a patient a nurse notes the presence of clots in the lochia. The nurse examines the clots and notes that they are larger than 1 cm which of the following nursing actions is most appropriate: 

A. documents the finding 

B. notify physician 

C. reassess the client in 2 hours 

D. encourage increased oral intake of fluids 

Answer: B 

Explanation: The presence of blood clots larger than 1 cm is indicative of hemorrhage, which needs to be notified to the physician/gynecologist immediately. 

Question 5012) The main cause of venous thrombosis in puerperal women is............. 

A. increase viscosity of blood due to dehydration 

B. decreased viscosity of blood during labor 

C. stasis of blood in veins due to late ambulation 

D. increase intake of fat in diet 

Answer: C 

Explanation: Venous stasis in the lower limbs is caused by increased vein distensibility and the gravid uterus acting as a mechanical impediment to venous stasis and vascular damage are a triad of initiating factors for venous thrombosis. In addition, there are increased levels of most of the circulating clotting factors in preparation for placental separation. 

Question 5013) 

A woman is 37 weeks pregnant and she is bleeding profusely with no pain is suggestive of: 

A. Antepartum hemorrhage 

B. Unavoidable hemorrhage 

C. Accidental hemorrhage 

D. Concealed hemorrhage 

Answer: A Explanation: Women is 37 weeks pregnant and she is bleeding profusely without pain it is suggestive of antepartum hemorrhage (APH) bleeding from or into the genital tract after 24 weeks of pregnancy but the child birth is known as antepartum hemorrhage. 

Question 5014) A client is scheduled for a pap smear. The nurse provides instructions to the client regarding preparation for the test: 

A. the test can be performed during menstruation 

B. fluids are restricted on the day of the test 

C. the test is painless 

D. vaginal douching is required 2 hours before the test 

Answer: D 

Explanation: Vaginal douching is required 2 hours before the test as it will cleanse the cervix and prevent exfoliated or dead tissues in sample. 

Question 5015) A nurse needs to check the most important parameter if patient is on magnesium sulphate level is: 

A. urine output>30mlfhr 

B. presence of knee jerk reflex 

C. respiration is > 12 per minute 

D. blood pressure < 140/90 mm Hg 

Answer: B 

Explanation: Diminished/absence of deep tendon reflex is one of the earliest signs of magnesium toxicity when a patient receives MgSO4 therapy the nurse must assess deep tendon reflexes (knee jerk reflex) frequently information from DTRs will help nurses develop judgment about titrating the administration and prevent magnesium toxicity. 

Question 5016) Which one of the following anti-tuberculosis drugs cannot be given during pregnancy: 

A. Rifampicin 

B. Ethambutol 

C. Streptomycin 

D. INH 

Answer: C Explanation: Rifampicin INH and ethambutol are safe during pregnancy streptomycin can cause harmful effects in the fetus as it readily crosses the placental barrier. 

Question 5017) Two days after having a cesarean birth a client complains of pain in the right lag what should be the nurse's initial response? 

A. Apply warm soaks 

B. Massage the affected area 

C. Encourage ambulation and exercise 

D. Maintain bed rest and notify the practitioner 

Answer: D 

Explanation: Temporary nerve irritation or injury can occur with anesthesia which might cause leg pain after C - section it is usually resolved within a few days after rest. Applying warm soaks and massaging affected area is not recommended ambulation and post-natal exercise are encouraged as soon as possible but no an appropriate initial response to the complains of pain. 

Question 5018) First day of last menstrual period is October 19,2017. What is the expected date of delivery? 

A. July 12, 2018 

B. July 26, 2018 

C. August 12, 2018 

D. August 26, 2018 

Answer: B 

Explanation: Naegele's formula - add 9 calendar month and 7 days to LMP, LMP = 19/10/2017 + 9 month = 19/07/2018 + 7 days , so EDD = July 26, 2018. 

Question 5019) The nurse preparing to administer the Rubella vaccine to two days postpartum women. The nurse should caution the client to avoid : 

A. Sunlight for 3 days 

B. Scratching the injection site 

C. Scratching for 2 to 3 months after the vaccination 

D. Sexual intercourse for 2 to 3 months after vaccination 

Answer: C 

Explanation: Pregnancy needs to be avoided for 1 to 3 months as rubella is live vaccine which can give adverse effect on fetus. This is usually administered to the patient who are IgG NEGATIVE. 

Question 5020) Before a client with syphilis can be treated the nurse must determine the........... 

A. Portal of entry 

B. size of the chancre 

C. existence of allergies 

D. name of sexual contact 

Answer: C 

Explanation: Penicillin injection is the treatment of syphilis allergic reaction to the penicillin can be life threatening whenever the patient comes for the penicillin injection each time antibiotic sensitivity test is to be repeated and if skin reaction is positive for allergic reaction then the patient can be given alternative therapy as ceftriaxone or erythromycin. 

58 - Nursing Competitive Exams QAs - NORCET, ESIC, GUJARAT NURSING EXAM

 

Question 5001) 

A common finding in most children with cardiac anomalies is: 

A. Metal Retardation 

B. Delayed Physical Growth 

C. Cyanosis and Clubbing of Fingertips 

D. A Family History of Cardiac Anomalies 

Answer: B 

Explanation: Oxygen is necessary for growth of cells. Decreased oxygen in the developing child causes a slow growth rate. 

Question 5002) 

A 6-year-old child with sickle cell disease is admitted with a pain crisis. Priority nursing concerns would be: 

A. Nutrition and Hydration 

B. Nutrition and Antibiotics 

C. Hydration and Pain Management 

D. Pain Management and Antibiotics 

Answer: A 

Explanation: Hydration is necessary to promote and maintain hemodilutation, pain in the area of involvement is a major problem in pain crisis and demands priority care. 

Question 5003) 

To control bleeding in a child with hemophilia A, the nurse would give: 

A. Blood 

B. Fresh Frozen Plasma 

C. Factor VIII Concentrate 

D. Factor II, VII, IX, X Complex 

Answer: C 

Explanation: Factor VIII is the missing plasma component necessary to control bleeding in hemophilia A. 

Question 5004) 

Breast is composed of: 

A. glandular tissues only 

B. connective tissues only 

C. connective and fatty tissues 

D. glandular and fatty tissues 

Answer: D 

Explanation: breast is composed of glandular tissues (special tissues which produces milk) and the collection of fats cells called as adipose tissues. 

Question 5005) The cause of change in size and appearance of breasts during pregnancy is: 

A. due to the secretion of estrogen and progesterone 

B. because of the weight gain 

C. due to increased metabolic rate that causes the breasts to become larger 

D. cortisol secreted by the adrenal 

Answer: A 

Explanation: the secretion of estrogen and progesterone causes the change in size and appearance of breasts during pregnancy. Weight gain cause stretching of breast, not a change in size and appearance. 

Question 5006) 

Hormone responsible for ovulation is: 

A. FSH 

B. LH 

C. Estrogen 

D. Progesterone 

Answer: B 

Explanation: Luteinizing hormone is a hormone produced by gonadotropic cells in the anterior pituitary gland. In females, an acute rise LH triggers ovulation and development of the corpus luteum. FSH is responsible for follicle maturation. 

Question 5007) Fleeting abdominal pain due to follicular bleeding causing peritoneal irritation is called as: 

A. corpus hemorrhagicum 

B. mittelschmerz 

C. Corpus luteum 

D. corpus albicans 

Answer: B 

Explanation: Minor bleeding from the follicle into the abdominal cavity may cause peritoneal irritation and fleeting lower abdominal pain it is known as mittelschmerz. After ovulation hemorrhage into the remains of the follicle usually occurs resulting in structure called a corpus hemorrhagicum. 

Question 5008) 

The hormone responsible for the menstrual cycle are: 

A. Gonadotropins 

B. Estrogen and progesterone 

C. Gonadotropins and estrogen 

D. Gonadotropins, estrogen and progesterone 

Answer: D 

Explanation: Gonadotropins (LH and FSH) released from anterior pituitary that stimulates the follicles in the ovary causing the maturation and then final release of the ovum. Growing follicles releases the estrogen and progesterone that causes the uterine cells hyperplasia and increase the endometrial thickness of uterus. 

Question 5009) The large amount of progesterone secreted during the secretory phase of the menstrual cycle is responsible for: 

A. the onset of ovulation 

B. the regulation of menstruation 

C. the incidence of capillary fragility 

D. sustaining the thick endometrium of the uterus 

Answer: D 

Explanation: progesterone is important hormone that condition the endometrium by sustaining the thick endometrium in preparation for implantation of a fertilized ovum progesterone prepares the uterus for receiving the fertilized ovum. 

Question 5010) A prenatal client with a history of heart disease has been instructed on care at home. Which statement if made by the client would indicate that the client understands her needs. 

A. there is no restriction on people who visit me

B. I should avoid stressful 

C. my weight gain is not important 

D. I should rest on my right side 

Answer: B 

Explanation: A prenatal client who has a history of heart disease should be instructed to avoid stressful situations which can aggravate the sympathetic nervous system thereby increasing the risk for acute cardiac emergency remaining statements are related to healthy practices but do not directly give idea about patients understanding regarding heart disease

25 - Nursing Competitive Exams QAs - NORCET, ESIC, GUJARAT NURSING EXAM

 

        

Question 6271) 

The client is to undergo kidney transplantation with a living donor. Which of the following preoperative assessments is important 

A. Urine output 

B. Signs of graft rejection 

C. Signs and symptoms of rejection 

D. Client’s support system and understanding of lifestyle changes. 

Answer: D 

Explanation: Client’s support system and understanding of lifestyle changes because the client undergoing a renal transplantation will need vigilant follow-up care and must adhere to the medical regimen. The client is most likely anuric or oliguric preoperatively but postoperatively will require close monitoring of urine output to make sure the transplanted kidney is functioning optimally. While the client will always need to be monitored for signs and symptoms of infection, it’s most important post-op will require close monitoring of urine output to make sure the transplanted kidney is functioning optimally. While the client will always need to be monitored for signs and symptoms of infection, it’s most important postoperatively due to the immunosuppressant therapy. Rejection can occur postoperatively 

Question 6272) A male adult patient on mechanical ventilation is receiving pancuronium bromide (Pavulon), 0.01 mg/kg I.V. as needed. Which assessment finding indicates that the patient needs another pancuronium dose? 

A. Leg movement 

B. Finger movement 

C. Lip movement 

D. Fighting the ventilator 

Answer: D 

Explanation: the inj pancuronium bromide is a neuromuscular blocking agent and used for patients on ventilators 

Question 6273) A client who is receiving streptokinase therapy suddenly had a nose bleeding. The nurse ensures the availability in which of the following medication? 

A. Vitamin K (Mephyton). 

B. Deferoxamine (Desferal). 

C. Aminocaproic acid (Amicar). 

D. Diphenhydramine (Benadryl). 

Answer: C 

Explanation: Aminocaproic acid (Amicar) because Bleeding can be reversed with the use of aminocaproic acid as an antidote for streptokinase. Option A is the antidote for warfarin sodium toxicity. Option B is the antidote for iron toxicity. Option D is an antihistamine that can be used for any allergic reaction. 

Question 6274) 

The clinic nurse notes that the physician has documented a diagnosis of herpes zoster (shingles) in the client’s chart. Based on an understanding of the cause of this disorder, the nurse determines that this definitive diagnosis was made following which diagnostic test? 

A. Wood’s light examination. 

B. Patch test. 

C. Skin biopsy. 

D. Culture of the lesion. 

Answer: D 

Explanation: Culture of the lesion. Because With the classic presentation of shingles, the clinical examination is diagnostic. A viral culture of the lesion provides the definitive diagnosis. Herpes zoster is caused by a reactivation of the varicella-zoster virus, the virus that causes chickenpox. Option A: In a Wood’s light examination, the skin is viewed under ultraviolet light to identify superficial infections of the skin. Option B: A patch test is a skin test that involves the administration of an allergen to the surface of the skin to identify specific allergies. Option C: A biopsy would provide a cytological examination of tissue. 

Question 6275) 

What is the primary reason for administering morphine to a client with myocardial infarction? 

A. To sedate the client 

B. To decrease the client’s pain 

C. To decrease the client’s anxiety 

D. To decrease oxygen demand on the client’s heart 

Answer: D 

Explanation: To decrease oxygen demand on the client's heart because primary purpose of morphine to decrease the oxygen demand, although morphine also decrease pain and Anxiety while causing sedation but it isn't given primarily for those reasons... 

Question 6276) 

During the client’s dialysis, the nurse observes that the solution draining from the abdomen is consistently blood tinged. The client has a permanent peritoneal catheter in place. Which interpretation of this observation would be correct? 

A. Bleeding is expected with a permanent peritoneal catheter 

B. Bleeding indicates abdominal blood vessel damage 

C. Bleeding can indicate kidney damage. 

D. Bleeding is caused by too-rapid infusion of the dialysate. 

Answer: B 

Explanation: Bleeding indicates abdominal blood vessel damage Because the client has a permanent catheter in place, blood tinged drainage should not occur. Persistent blood tinged drainage could indicate damage to the abdominal vessels, and the physician should be notified. Option C: The bleeding is originating in the peritoneal cavity, not the kidneys. Option D: Too rapid infusion of the dialysate can cause pain