BSc Nursing Licensure Exam preparation SET 2

Q1

What is the best nursing intervention to prevent skin breakdown in a patient with a vesicovaginal fistula?

A

Elevate the affected limb to reduce swelling.

B

Encourage the patient to engage in strenuous physical activity.

C

Apply a topical antibiotic ointment to the fistula opening.

D

Maintain meticulous perineal hygiene and protect the area with absorbent pads.

Q2

A patient with communication difficulties following a traumatic brain injury is struggling to express their needs. Which nursing intervention is MOST effective in supporting their communication?

A

Focusing solely on written communication to avoid confusion.

B

Utilizing non-verbal communication strategies and assistive devices to facilitate interaction.

C

Speaking slowly and loudly to ensure the patient hears you clearly.

D

Assuming the patient fully understands your instructions based on their prior communication skills.

Q3

A patient is diagnosed with a bacterial infection. Which of the following is the MOST important reason for obtaining a drug resistance profile?

A

To determine the most effective antibiotic to use.

B

To identify the patient's preferred medication.

C

To calculate the appropriate dosage of the antibiotic.

D

To provide a detailed history of the patient's previous illnesses.

Q4

A patient is on the third level of the WHO pain ladder. Their pain remains uncontrolled. The next appropriate step would be:

A

Consulting with the physician.

B

Recommending a non-pharmacological intervention.

C

Switching to acetaminophen.

D

Increasing the morphine dose.

Q5

Which of the following is a priority intervention for a patient experiencing pyelonephritis?

A

Initiate intravenous antibiotics.

B

Encourage dietary changes to reduce inflammation.

C

Administer oral medications for pain relief.

D

Monitor blood glucose levels.

Q6

When managing a patient with Enteric fever, the nurse recognizes that the key nursing intervention is to:

A

Administer intravenous fluids to correct dehydration.

B

Maintain strict hygiene to prevent the spread of the bacteria.

C

Encourage the patient to consume a diet rich in probiotics.

D

Administer antipyretics to reduce fever.

Q7

What is the defining characteristic of Preeclampsia?

A

Decreased blood pressure.

B

Hypertension and proteinuria

C

Increased appetite and nausea.

D

Fever and edema.

Q8

In a situation requiring immediate action, such as a patient experiencing a sudden change in vital signs, which leadership style is most effective?

A

Transformational leadership

B

Autocratic leadership

C

Laissez-faire leadership

D

Participative leadership

Q9

What is the primary difference between sterilization and disinfection?

A

Disinfection only targets viruses.

B

Disinfection is more effective than sterilization.

C

Sterilization completely kills microorganisms; disinfection reduces their number.

D

Both terms refer to the same process.

Q10

During which phase of the therapeutic relationship is the nurse primarily focused on establishing trust and rapport with the patient?

A

The termination phase.

B

The initial assessment phase.

C

The intervention phase.

D

The evaluation phase.

Q11

A patient reports a sudden onset of severe pain in their chest, radiating to their left arm. The nurse should IMMEDIATELY:

A

Encourage the patient to rest and take deep breaths.

B

Activate the hospital's rapid response team.

C

Administer nitroglycerin based on the patient's reported symptoms.

D

Obtain a detailed history of the patient's symptoms.

Q12

A patient recovering from chemotherapy reports muscle weakness and fatigue. The nurse should prioritize:

A

Assessing the patient's nutritional status and providing supportive care.

B

Immediately restarting the chemotherapy regimen.

C

Administering high-dose vitamin supplements.

D

Encouraging the patient to engage in strenuous exercise.

Q13

A patient with Amyotrophic Lateral Sclerosis (ALS) is experiencing increased difficulty swallowing. What is the initial nursing intervention?

A

Encourage frequent sips of water.

B

Restrict fluid intake to prevent aspiration.

C

Position the patient in a high-Fowler's position.

D

Administer a thick liquid diet.

Q14

A patient with a peptic ulcer is exhibiting signs of anemia. Which intervention is MOST appropriate?

A

Encourage frequent bowel movements.

B

Increase dietary protein intake.

C

Administer iron supplements without assessment.

D

Monitor hemoglobin and hematocrit levels regularly.

Q15

The nurse understands that gas gangrene is primarily caused by which type of bacteria?

A

Clostridium perfringens

B

Staphylococcus aureus

C

Streptococcus pyogenes

D

Pseudomonas aeruginosa

Q16

What is the primary goal of continuous maternal and fetal monitoring during the second stage of labor?

A

To facilitate fetal rotation.

B

To encourage fetal movement.

C

To provide comfort to the laboring woman.

D

To detect any changes in maternal or fetal condition.

Q17

What is the primary purpose of a nursing intervention to promote skin integrity in bedridden patients?

A

Applying a topical antiseptic

B

Frequent repositioning

C

Providing a high-protein diet

D

Administering pain medication

Q18

A patient with a nasogastric tube is receiving continuous gastric evacuation. What is the most important factor to monitor?

A

The rate of tube flushing.

B

The patient's blood pressure.

C

The patient's fluid and electrolyte balance.

D

The color of the expelled gastric contents.

Q19

Which of the following is the MOST critical initial intervention for a patient with a clinical diagnosis of oral leukoplakia?

A

Prescribing a proton pump inhibitor

B

Encouraging frequent oral hygiene with a soft toothbrush

C

Referral for biopsy and histopathologic examination

D

Initiating topical corticosteroids

Q20

What is the purpose of using a non-adherent pad within a bandage?

A

To absorb excess fluid from the wound.

B

To increase the bandage's compression.

C

To provide a more comfortable sensation for the patient.

D

To protect the wound from direct contact with the adhesive.

Q21

A patient is experiencing nausea and vomiting. Which intervention is MOST appropriate to implement FIRST?

A

Administer antiemetic medication

B

Assess the patient's level of consciousness

C

Offer the patient a bland diet

D

Elevate the head of the bed

Q22

A 5-year-old child has a fever of 102°F (38.9°C). What is the MOST appropriate initial nursing intervention?

A

Give the child large amounts of fluids.

B

Administer antipyretic medication as prescribed.

C

Apply a cool compress to the forehead.

D

Avoid administering any medication.

Q23

Esophageal diverticula most commonly occur at which anatomical site?

A

Pharyngoesophageal junction (Killian's triangle)

B

Mid-esophagus

C

Distal esophagus (epiphrenic region)

D

Gastroesophageal junction

Q24

What is the PRIMARY purpose of using 'side rails' on a patient's bed?

A

To provide a comfortable resting place

B

To assist the patient with repositioning

C

To provide a surface for the patient to hold onto

D

To prevent falls

Q25

What is the MOST crucial aspect of managing a patient receiving a jejunal feeding?

A

Strictly adhering to the prescribed feeding schedule.

B

Monitoring blood glucose levels continuously.

C

Providing frequent physical examinations.

D

Meeting the patient's psychological needs.

Q26

When assessing a patient receiving a jejunostomy tube, which vital sign is MOST critical to monitor?

A

Temperature.

B

Intake and output of the feeding tube.

C

Blood pressure.

D

Respiratory rate.

Q27

A patient with severe burn injuries is experiencing significant pain. The nurse determines that applying a cool compress to the affected area is the most appropriate initial intervention based on established principles. What is the primary rationale for this choice?

A

To promote vasoconstriction, reducing pain and inflammation.

B

To directly numb the nerve endings and eliminate pain.

C

To create a localized cooling effect and decrease tissue damage.

D

To increase blood flow and accelerate tissue healing.

Q28

The purpose of a clinic visit within the context of family health nursing is primarily to:

A

Offer initial assessment, education, and referral services to the family.

B

Provide long-term care for chronic illnesses.

C

Conduct in-depth psychological evaluations of family members.

D

Offer comprehensive medical treatment for acute illnesses.

Q29

What is the main role of the Islets of Langerhans?

A

Secretion of hormones to regulate blood glucose

B

Waste filtration

C

Calcium regulation

D

Lymphocyte production

Q30

Which of the following is a primary goal of monitoring a patient receiving a Glucose Tolerance Test (GTT)?

A

Assessing the patient's response to exercise.

B

Measuring the patient's bone density.

C

Detecting early-stage diabetes mellitus.

D

Determining the patient's overall cholesterol levels.

Q31

A patient presents with sudden onset of blurry vision, eye pain, and redness. Examination reveals a corneal ulcer. The MOST appropriate initial nursing intervention is:

A

To administer systemic antibiotics without consulting the ophthalmologist.

B

To apply a sterile ophthalmic lubricant to the affected eye and report findings to the ophthalmologist.

C

To apply a warm compress to the eye to relieve pain.

D

To advise the patient to continue their normal activities to avoid further irritation.

Q32

Which of the following best describes the primary function of a bicarbonate buffer system in maintaining acid-base balance?

A

Stimulating cellular respiration

B

Increasing the concentration of oxygen in the blood

C

Neutralizing excess hydrogen ions (H+)

D

Promoting the excretion of carbon dioxide

Q33

What is the typical schedule for administering the DPT vaccine to infants?

A

2, 4, and 6 months

B

8, 12, and 16 weeks

C

1, 3, and 5 months

D

6, 10, and 14 weeks

Q34

Which action is essential when a patient demonstrates signs of hypoxic hypoxia?

A

Starting intravenous fluids.

B

Initiating cardiac monitoring only.

C

Administering a sedative.

D

Immediate administration of supplemental oxygen.

Q35

What is the primary nursing responsibility when managing a patient with a vesicovaginal fistula?

A

To advocate for the patient's holistic needs, including physical, psychological, and social support.

B

To avoid discussing sexual health concerns with the patient.

C

To solely focus on managing urinary output.

D

To administer all prescribed medications without consultation.

Q36

What is the MOST appropriate initial action when a patient reports difficulty with function?

A

Administer pain medication regardless of the cause.

B

Notify the patient's family members without patient consent.

C

Assess the patient's specific functional limitations and needs.

D

Immediately prescribe assistive devices.

Q37

Lithium toxicity can manifest with which of the following signs and symptoms?

A

Improved mood and energy.

B

Neurological symptoms such as tremors and confusion.

C

Increased appetite and weight gain.

D

Elevated blood glucose levels.

Q38

A patient expresses a preference for a traditional healer for a chronic condition. Your role is best described as:

A

Ignoring the patient's preference and focusing solely on prescribed medications.

B

Immediately referring the patient to a Western medical specialist.

C

Exploring the potential for collaboration between the patient's chosen healer and the formal healthcare team.

D

Discrediting the traditional healer's practices.

Q39

Which hormonal imbalance would MOST directly contribute to the biochemical processes involved in muscle contraction?

A

Reduced secretion of thyroid hormone.

B

Elevated levels of cortisol.

C

Increased levels of parathyroid hormone.

D

Decreased levels of insulin.

Q40

A patient on a loop diuretic reports nausea and vomiting. The nurse's first action should be to:

A

Change the patient's position to the left side.

B

Increase the patient's oral fluid intake.

C

Administer an antiemetic medication.

D

Assess the patient's electrolyte levels, particularly potassium.

Q41

Which laboratory finding is MOST indicative of active inflammation in a patient with ulcerative colitis?

A

Low Creatinine Levels

B

Normal White Blood Cell Count

C

Elevated Erythrocyte Sedimentation Rate (ESR)

D

Increased Albumin Levels

Q42

A patient is experiencing diarrhea and is becoming dehydrated. The nurse recognizes that the primary goal of IV fluid replacement should be:

A

To correct electrolyte imbalances and maintain hydration.

B

To reduce gastrointestinal motility.

C

To provide a concentrated source of carbohydrates.

D

To increase urine output to eliminate toxins.

Q43

A patient reports sudden onset of sharp pain in one ear accompanied by dizziness. Which of the following is the MOST immediate nursing action?

A

Instruct the patient to lie down and remain still.

B

Immediately insert a cotton swab into the ear canal.

C

Assess the patient's vital signs, including blood pressure and heart rate.

D

Administer an over-the-counter analgesic.

Q44

A registered nurse is observing a patient. Which of the following is a core function of their role?

A

To conduct research on new medical technologies.

B

To manage the financial budgets of the healthcare facility.

C

To solely focus on administrative tasks within the healthcare system.

D

To provide direct patient care and implement prescribed treatment plans.

Q45

A woman in obstructed labor demonstrates signs of fetal distress. What is the MOST important immediate assessment?

A

Fetal heart rate monitoring

B

Examination of the vaginal membranes

C

Administration of oxygen to the patient

D

Assessment of maternal blood pressure

Q46

A woman in labor reports experiencing significant anxiety about the potential for fetal distress. What is the MOST appropriate initial nursing assessment?

A

Continuous fetal heart rate monitoring

B

Administering a sedative medication

C

Encouraging the mother to focus on breathing

D

Providing a warm drink

Q47

The BCG vaccine is administered at birth. What disease does it primarily protect against?

A

Tuberculosis

B

Polio

C

Diphtheria

D

Measles

Q48

Which of the following best describes the primary purpose of delegation in nursing?

A

To eliminate the nurse's responsibility for patient care.

B

To assign tasks to qualified personnel to enhance patient care.

C

To reduce the nurse's workload regardless of skill level.

D

To ensure all tasks are performed by the registered nurse.

Q49

Which of the following best describes the role of a good first aider?

A

To provide immediate assistance while awaiting professional medical care.

B

To provide long-term medical treatment.

C

To diagnose the patient's condition.

D

To perform complex surgical procedures.

Q50

What is the primary goal of applying a sterile dressing to a wound?

A

To promote rapid healing.

B

To improve cosmetic appearance.

C

To maintain a sterile environment and prevent infection.

D

To provide pain relief.

Q51

Setting priorities in nursing care is a key aspect of the planning stage. Which of the following is the *most* appropriate method for prioritizing patient needs?

A

Prioritizing based solely on the patient's age.

B

Prioritizing based on the nurse's personal preferences.

C

Using a nursing priority scale (e.g., Maslow's Hierarchy of Needs).

D

Ignoring patient's concerns and focusing only on medical tests.

Q52

A patient with gout presents with severe pain and swelling in the metatarsophalangeal joints. The nurse should anticipate that the primary treatment will involve:

A

Applying ice packs to reduce inflammation.

B

Administration of medications to lower uric acid levels.

C

Administering analgesics for pain relief.

D

Restricting fluid intake.

Q53

A patient with a potassium level of 3.2 mEq/L is prescribed a potassium supplement. Which of the following is the *most* appropriate initial action for the nurse?

A

Immediately administer the full prescribed dose of the potassium supplement.

B

Administer half the prescribed dose and reassess in 1 hour.

C

Notify the physician immediately to adjust the potassium order.

D

Monitor the patient's potassium level closely.

Q54

Which of the following is a key developmental task associated with the middle-aged adult stage?

A

Developing motor skills.

B

Learning to walk.

C

Establishing independence.

D

Maintaining health and wellness.

Q55

A nurse is preparing to comfort a child on surgery day. What is the best initial response?

A

Immediately asking the child about their fears.

B

Acknowledge their fear and engage positively, such as commenting on a favorite toy.

C

Offering the child a large meal.

D

Requesting the child to remain quiet.

Q56

Which of the following best describes the primary mechanism of action for neuro-muscular blocking agents in managing musculoskeletal pain?

A

Directly stimulating pain receptors to reduce sensation.

B

Reducing the production of inflammatory cytokines.

C

Interfering with nerve impulse transmission and muscle contraction.

D

Increasing blood flow to the affected area to promote healing.

Q57

A patient is experiencing difficulty breathing. Which intervention would be most appropriate to initially address this?

A

Instruct the patient to take a deep breath

B

Administer oxygen via face mask

C

Elevate the head of the bed

D

Administer morphine

Q58

A patient reports experiencing irregular bleeding and spotting following the insertion of a hormonal contraceptive. Which action is the MOST critical initial step for the nurse to take?

A

Schedule an immediate appointment with a gynecologist.

B

Assess the patient's vital signs and perform a pelvic examination.

C

Advise the patient to continue taking the medication as prescribed.

D

Recommend a change to a different hormonal contraceptive.

Q59

Which of the following is a key component of assessing a patient's pain?

A

Assuming the patient's pain is due to a physical injury.

B

Ignoring the patient's pain if they are anxious.

C

Relying solely on the patient's subjective verbal report.

D

Utilizing a validated pain scale to quantify the patient's experience.

Q60

A nurse observes a fetal heart rate exhibiting a transition period (140-160 bpm) immediately after birth. This is most likely a sign of:

A

The presence of fetal anemia.

B

A normal physiological response to the change in environment.

C

Transition to postnatal circulation.

D

Severe fetal distress requiring immediate intervention.

Q61

A patient in a stupor is unresponsive to verbal stimuli. The next step in assessment should be:

A

Performing a cranial nerve examination.

B

Checking for airway patency.

C

Administering a sedative.

D

Providing a warm blanket.

Q62

What is the most important reason for including a 'research proposal'?

A

To demonstrate the nurse's understanding of medical terminology.

B

To ensure compliance with hospital regulations.

C

To provide a convenient reference for nurses during patient care.

D

To systematically investigate a clinical problem and contribute to nursing knowledge.

Q63

Why must the tetanus toxoid (TT) vaccine be stored in a refrigerator at 2 - 8°C?

A

Because it contains a live virus

B

To maintain its potency and effectiveness

C

Because it is administered intravenously

D

Because it is a more complex vaccine than others

Q64

A mother shares a traditional healing practice involving herbal remedies for her newborn's cough. Which action best reflects the nurse's role in this situation?

A

Immediately discontinuing the use of the herbal remedy.

B

Offering the herbal remedy to the infant as a complementary treatment.

C

Collaborating with the mother to determine if the remedy is safe and appropriate, considering potential interactions with standard medical care.

D

Referring the mother to a specialist for evaluation of the infant's condition.

Q65

A patient with cardiogenic shock is hypotensive and exhibits signs of poor peripheral perfusion. Which intervention is MOST critical to maintain adequate tissue perfusion?

A

Restrict oral intake to minimize fluid loss.

B

Monitor the patient's urine output closely.

C

Administer vasopressors to increase systemic vascular resistance.

D

Initiate rapid fluid resuscitation with crystalloid solutions.

Q66

A patient with a jejunostomy feeding reports nausea and vomiting. The priority nursing action is to:

A

Assess the patient's hydration status and electrolyte balance.

B

Administer antiemetic medication without assessment.

C

Immediately discontinue the jejunal feeding.

D

Increase the rate of the jejunal feeding.

Q67

A patient experiencing diarrhea is exhibiting signs of dehydration (decreased skin turgor, dry mucous membranes). Which intervention is MOST critical in the initial management?

A

Monitor urine output closely

B

Initiate oral rehydration therapy with a balanced electrolyte solution

C

Restrict oral intake to minimize fluid loss

D

Administer intravenous fluids containing only sodium chloride

Q68

Which of the following laboratory findings would MOST strongly suggest an acute inflammatory response in a patient with suspected ulcerative colitis?

A

Elevated Erythrocyte Sedimentation Rate (ESR)

B

Decreased White Blood Cell Count

C

Low Serum Albumin

D

Normal Liver Function Tests

Q69

A patient is receiving a sponge bath. The nurse notices redness and irritation on the patient's skin. What should the nurse do FIRST?

A

Notify the physician

B

Increase the water temperature

C

Continue the bath to fully cleanse the skin

D

Apply a heavy cream to the irritated area

Q70

A patient post-hip replacement surgery is exhibiting signs of discomfort. Which intervention would be most effective in addressing this?

A

Wound dressing

B

Airway maintenance

C

Monitoring BP and return of consciousness

D

Reducing pain and discomfort

Q71

Which of the following best describes the primary goal of hospice care?

A

To provide comfort and support to patients and their families during the final stages of life.

B

To cure the patient's underlying illness.

C

To focus solely on aggressive medical interventions.

D

To prolong the patient's life at all costs.

Q72

A patient experiencing acute excitement and violence during a manic episode is most appropriately managed by:

A

Providing the patient with a warm bath.

B

Administering a benzodiazepine to reduce agitation.

C

Encouraging the patient to verbalize their feelings.

D

Initiating an antipsychotic medication immediately.

Q73

Which of the following is a *priority* nursing intervention for a patient experiencing significant discomfort related to a vaginal uterine prolapse?

A

Assess the patient's pain level and implement appropriate pain management strategies.

B

Recommend a strict fluid restriction to reduce bladder pressure.

C

Immediately apply a cold compress to the affected area.

D

Instruct the patient to avoid any activities that could exacerbate the prolapse.

Q74

Which of the following is the primary goal of administering a saline bolus to a patient with hypotension?

A

Decrease Cardiac Output

B

Increase Blood Volume

C

Reduce Heart Rate

D

Increase Peripheral Vasodilation

Q75

When assessing a patient experiencing insomnia, which finding would warrant immediate investigation?

A

The patient reports difficulty falling asleep due to a change in sleep schedule.

B

The patient reports a consistent pattern of difficulty falling asleep and staying asleep.

C

The patient reports difficulty falling asleep due to a new medication.

D

The patient reports occasional difficulty falling asleep due to stress.

Q76

When assessing a patient's mental health, what is the primary focus of the nurse?

A

To determine the patient's socioeconomic status.

B

To identify changes in mood, thought processes, and behavior.

C

To diagnose the patient with a specific mental disorder.

D

To administer medication to alleviate symptoms.

Q77

Which of the following is a key component of managing pain in a patient with a lumbar spinal stenosis?

A

Maintain Spinal Immobilization

B

Restrict Patient Movement

C

Encourage Prolonged Bed Rest

D

Promote Spinal Mobility

Q78

Which of the following interventions is MOST effective in reducing physiological responses associated with acute stress?

A

Implementing relaxation techniques such as deep breathing or guided imagery.

B

Providing the patient with a list of stressful news articles to read.

C

Administering a high dose of an anti-anxiety medication immediately.

D

Encouraging the patient to engage in rapid, shallow breathing.

Q79

Which of the following is a key component of insulin therapy administration?

A

Delaying insulin administration until after meals.

B

Using a standard thermometer to measure patient temperature.

C

Accurate measurement of insulin dosage.

D

Administering insulin via oral route.

Q80

A patient is being taught range of motion exercises. The nurse observes the patient attempting to move their elbow beyond a comfortable range. What is the nurse's BEST course of action?

A

Encourage the patient to continue, as pushing through pain builds strength.

B

Administer a muscle relaxant to facilitate movement.

C

Stop the exercise and assess the patient for pain and potential injury.

D

Adjust the exercise to a smaller range of motion.

Q81

What is the primary purpose of a fecal test for occult blood?

A

To assess the patient's hydration status.

B

To determine the patient's bowel movement frequency.

C

To measure stool fat content.

D

To detect hidden blood in the stool.

Q82

Which physiological change is MOST commonly associated with the fight-or-flight response?

A

Reduced gastric motility.

B

Increased oxygen consumption.

C

Decreased heart rate.

D

Increased blood pressure.

Q83

A patient is receiving treatment for anemia. You note a decrease in their hemoglobin level. What is the next most appropriate step in your assessment?

A

Administer an immuno-modulating drug

B

Increase the dosage of the current medication

C

Administer thrombolytic agents

D

Evaluate the patient's underlying cause of anemia

Q84

A patient is placed in the lateral position. What is a primary benefit of this positioning technique?

A

Enhances venous return

B

Promotes deep breathing

C

Facilitates drainage of facial edema

D

Reduces blood pressure

Q85

A patient with a diagnosed mental health condition expresses suicidal ideation. The nurse's first step should be:

A

To assess the patient's immediate risk of harm, document the assessment, and implement safety measures as indicated.

B

To simply document the statement without further assessment.

C

To provide reassurance and encourage the patient to 'snap out of it'.

D

To immediately notify the police and initiate involuntary commitment proceedings.

Q86

A patient reports a pain level of 8/10. According to current best practices, the initial nursing intervention should be:

A

Notify the physician immediately without further assessment.

B

Immediately administer an opioid analgesic.

C

Instruct the patient to relax and focus on their breathing.

D

Assess the patient's pain characteristics (location, quality, radiation, and aggravating/alleviating factors).

Q87

A patient reports feeling isolated and lacking social support. What is the nurse's initial priority?

A

Explore the patient's social network and needs.

B

Focus solely on the patient's physical health.

C

Immediately recommend a referral to a social worker.

D

Tell the patient to simply be more outgoing.

Q88

When assisting a patient out of bed, the nurse utilizes a friction-reducing technique. This technique primarily focuses on:

A

Applying a low-friction slide sheet to the patient's skin before movement.

B

Rapidly moving the patient to minimize muscle strain.

C

Maintaining a perpendicular angle between the bed and the patient's body.

D

Using a mechanical lift to reduce the nurse's effort.

Q89

A patient reports feeling overwhelmed and hopeless. Which therapeutic communication technique is MOST appropriate in this situation?

A

Providing solutions to the patient's problems

B

Offering reassurance immediately

C

Asking the patient to describe the problem in detail

D

Paraphrasing

Q90

Which of the following is the *most* important factor to consider when calculating a patient's fluid needs after a surgical procedure?

A

The type of surgical procedure performed.

B

The hospital's standard fluid replacement protocol.

C

The patient's age and weight alone.

D

The patient's pre-operative fluid status and estimated fluid losses due to surgery.

Q91

A patient requests pain medication. The nurse should first:

A

Immediately administer the prescribed pain medication.

B

Assess the patient's pain using a standardized pain scale.

C

Administer the medication based on the patient's preference.

D

Ask the patient how much pain they are in.

Q92

A patient with a diagnosis of Generalized Anxiety Disorder reports feeling overwhelmed by worry and difficulty concentrating. Which intervention is MOST aligned with current best practices for managing anxiety symptoms?

A

Recommend that the patient simply 'try to relax' without further investigation or support.

B

Prescribe a high dose of a benzodiazepine to immediately reduce anxiety symptoms.

C

Collaborate with the patient to develop a personalized coping strategy incorporating relaxation techniques and cognitive restructuring.

D

Instruct the patient to avoid all stressful situations to minimize anxiety triggers.

Q93

Which of the following infections is MOST commonly associated with a mucopurulent vaginal discharge?

A

Trichomoniasis

B

Vulvovaginal Candidiasis

C

Bacterial Vaginosis

D

Chlamydia

Q94

A patient with a pressure injury on their sacrum requires meticulous skin care. Which of the following interventions is MOST appropriate?

A

Apply a full-body sponge bath daily.

B

Use a harsh antiseptic solution for cleaning.

C

Massage the affected area vigorously.

D

Apply a barrier cream specifically designed for pressure injuries.

Q95

A patient asks the nurse about the effectiveness of emergency contraception after a missed dose. The nurse should advise the patient to:

A

Self-treat with over-the-counter remedies.

B

Continue with the next scheduled dose without further consideration.

C

Ignore the missed dose and continue with the intended treatment plan.

D

Seek immediate medical advice and discuss the situation with a healthcare professional.

Q96

What is the typical depth of injection for an intramuscular injection into the deltoid muscle?

A

3 inches (7.6 cm).

B

2 inches (5 cm).

C

Approximately 1 inch (2.5 cm).

D

0.5 inches (1.25 cm).

Q97

Which of the following is a key clinical indicator of progressing Staphylococcus-induced osteomyelitis?

A

Stable body temperature

B

Improved range of motion

C

Decreased appetite

D

Increasing pain and swelling at the infection site

Q98

Which of the following actions is MOST important for a nurse to take when removing gloves after using contact precautions?

A

Simply remove gloves and continue with the next task.

B

Place gloves in a designated biohazard container.

C

Decontaminate hands with soap and water or an alcohol-based hand sanitizer.

D

Discard gloves and immediately wash hands with antiseptic solution.

Q99

A 68-year-old patient with chronic obstructive pulmonary disease (COPD) complains of shortness of breath while lying flat. Which nursing position is most appropriate to alleviate dyspnea?

A

Supine

B

Trendelenburg

C

Semi-Fowler's (30-45°)

D

Prone

Q100

A pregnant woman presents with severe abdominal pain and vaginal bleeding. Which intervention is the initial, most appropriate action?

A

Administer antacids

B

Administer oxygen

C

Start intravenous fluids

D

Prepare for potential emergency surgery

Q101

A nurse is collecting data using a Likert scale. Which type of question is being asked?

A

A question that assesses the degree to which a respondent agrees or disagrees with a statement.

B

A question that requires the respondent to provide a written description of their experience.

C

A question that requires the respondent to select one correct answer from a list.

D

A question that asks for a numerical measurement of a specific characteristic.

Q102

A 5-year-old child presents with a history of a recent head injury and is exhibiting confusion and disorientation. Which assessment is MOST critical to perform first?

A

Monitoring the child's blood glucose levels

B

Administering intravenous fluids to maintain hydration

C

Providing a quiet and dimly lit environment

D

A detailed neurological examination, including assessment of level of consciousness and cranial nerve function

Q103

A 68-year-old patient complains of decreased hearing acuity, especially for high-frequency sounds, and difficulty understanding speech in noisy environments. Which type of hearing loss is most likely?

A

Presbycusis

B

Conductive hearing loss

C

Meniere's disease

D

Otitis media

Q104

Which of the following is the correct term for difficulty breathing when lying flat?

A

Tachypnea

B

Orthopnea

C

Dyspnea

D

Bradypnea

Q105

What is the primary purpose of administering a beta-blocker to a patient with hypertension?

A

Reduce Heart Rate and Blood Pressure

B

Decrease Cardiac Output

C

Increase Blood Volume

D

Strengthen Peripheral Vasoconstriction

Q106

Primary sedimentation in sewage treatment primarily aims to:

A

Break down organic matter

B

Reduce the biochemical oxygen demand (BOD)

C

Remove larger particulate matter and settle solids

D

Disinfect the wastewater

Q107

A patient presents with sudden onset chest pain, shortness of breath, and a rapid respiratory rate. Auscultation reveals diminished breath sounds on the left side. What is the most immediate nursing action?

A

Elevate the patient's legs without further assessment.

B

Administer oxygen and prepare for potential chest x-ray.

C

Administer morphine for pain relief.

D

Encourage the patient to cough forcefully.

Q108

A postpartum patient reports experiencing mild discomfort and vaginal discharge. Which statement best describes the expected nature of this discharge?

A

A normal occurrence that should be monitored for excessive bleeding.

B

A result of improper perineal care.

C

Lochia - characterized by gradual decrease in volume and color.

D

A sign of infection requiring immediate antibiotic treatment.

Q109

Which of the following is NOT a standard criterion for referral of a pregnant woman from a primary health-care centre to a secondary level facility?

A

Maternal hemoglobin of 9.0 g/dL.

B

Gestational age of 41 weeks with intact membranes.

C

Persistent vomiting leading to dehydration.

D

Known rhesus negative mother without anti-D prophylaxis.

Q110

A client with a diagnosis of pelvic inflammatory disease (PID) is receiving intravenous antibiotics. Which nursing assessment should be performed before each dose?

A

Measure blood pressure and heart rate

B

Check serum calcium level

C

Assess for peripheral edema

D

Evaluate visual acuity

Q111

Which of the following BEST describes the primary physiological reason for the increase in uterine contractions during the second stage of labor?

A

Increased maternal pain perception.

B

Increased maternal blood volume.

C

Increased oxytocin levels stimulated by fetal head pressure.

D

Decreased progesterone levels.

Q112

The optimal temperature range for a newborn placed under a radiant warmer during immediate care is:

A

32-34 °C

B

34-36 °C

C

36-38 °C

D

38-40 °C

Q113

What is erythropoiesis?

A

Filtering waste.

B

Forming red blood cells.

C

Regulating blood pressure.

D

Transporting oxygen.

Q114

Which statement best reflects the principle of equity in primary health care?

A

All individuals receive the same amount of health resources regardless of need.

B

Resources are distributed according to the ability to pay.

C

Health services are accessible to all, especially the underserved, based on need.

D

Only urban populations receive priority in health service allocation.

Q115

What is the primary purpose of assessing uterine tone following delivery?

A

To evaluate cervical dilation.

B

To promote fetal circulation.

C

To assess fetal movement.

D

To maintain uterine contraction and prevent postpartum hemorrhage.

Q116

In Nepal's Integrated Management of Childhood Illness (IMCI) guidelines, which environmental factor is most strongly associated with acute respiratory infections in children under five?

A

Indoor air pollution from biomass fuel

B

Contaminated drinking water

C

Lack of hand-washing facilities

D

Poor drainage

Q117

A community nurse plans to evaluate the mental health needs of the elderly in a Kathmandu ward. Which data collection method aligns with community health nursing best practice?

A

Administering a structured interview using the Geriatric Depression Scale (GDS) during home visits

B

Collecting blood samples for neurochemical analysis

C

Observing the elderly only during clinic hours

D

Relying solely on reports from family members without direct assessment

Q118

Which vital sign is most indicative of a patient experiencing influenza?

A

Cough

B

Elevated blood pressure

C

Increased heart rate

D

Decreased respiratory rate

Q119

Which of the following best describes the primary focus of clinical psychology?

A

The study of long-term societal trends impacting health.

B

The development of educational programs for nurses.

C

The investigation of personality traits in healthy individuals.

D

The assessment and treatment of mental and behavioral disorders.

Q120

A nurse is teaching a patient about the side effects of a medication that is a competitive antagonist at the GABA-A receptor. Which adverse effect is most likely?

A

Sedation and respiratory depression

B

Increased seizure frequency

C

Bradycardia

D

Hypoglycemia

Q121

A patient is experiencing chest pain. An ECG shows ST-segment depression. The nurse should immediately:

A

Encourage the patient to rest in a quiet room.

B

Notify the physician and initiate cardiac monitoring.

C

Administer an anti-anxiety medication.

D

Administer nitroglycerin.

Q122

Which of the following best describes the purpose of the WHO pain ladder?

A

To prioritize non-pharmacological interventions exclusively.

B

To quickly determine the exact dose of opioid medication for a patient.

C

To provide a systematic approach to pain management, escalating medication dosages as needed.

D

To eliminate all pain medications from a patient's chart.

Q123

During an outbreak of acute watery diarrhea in a pediatric ward, the infection control team implements cohorting. What does cohorting entail?

A

Grouping patients with the same infection together and assigning dedicated staff

B

Isolating each patient in a single room with negative pressure

C

Administering prophylactic antibiotics to all ward patients

D

Restricting all visitors and staff movement indefinitely

Q124

A patient consistently refuses to participate in group therapy sessions, citing a strong preference for solitary activities. Considering the individual-society relationship, the nurse should:

A

Respect the patient's autonomy while continuing to assess their social needs and potential barriers to engagement.

B

Assume the patient's refusal is solely due to a lack of understanding of the therapeutic benefits.

C

Force the patient to attend group sessions to ensure they receive the full benefit of the intervention.

D

Immediately terminate all social support referrals due to the patient's resistance.

Q125

Which of the following is the MOST significant long-term complication associated with chronic urinary obstruction?

A

Increased risk of urinary tract infections.

B

Urinary incontinence.

C

Renal failure.

D

Decreased glomerular filtration rate.

Q126

Which of the following is a 'Summative Evaluation' method?

A

Weekly quiz

B

Mid-term clinical appraisal

C

Final comprehensive licensing examination

D

Daily bedside feedback

Q127

A nursing student is conducting a study to determine the relationship between nursing workload and the incidence of medication errors. Which research design is most suitable?

A

Experimental design

B

Correlational design

C

Phenomenological design

D

Grounded theory

Q128

A patient presents with vaginal discharge, itching, and dysuria. Laboratory tests reveal the presence of *Neisseria gonorrhoeae*. Which of the following is the MOST appropriate initial intervention?

A

Suggest a wait-and-see approach, monitoring for symptom resolution.

B

Recommend a course of oral fluconazole.

C

Prescribe a topical azithromycin.

D

Administer a single dose of ceftriaxone.

Q129

A patient with severe dehydration is exhibiting lethargy and confusion. Which of the following interventions is the MOST appropriate initial action, considering Maslow's hierarchy?

A

Encourage the patient to engage in social activities.

B

Provide the patient with a comfortable environment.

C

Discuss the patient's long-term health goals.

D

Administer intravenous fluids to address physiological needs.

Q130

Which mineral is essential for hemoglobin formation?

A

Calcium

B

Iron

C

Zinc

D

Magnesium

Q131

A patient with chronic renal failure presents with generalized edema and bilateral crackles on auscultation. Which nursing intervention is MOST critical to address this fluid overload?

A

Administer potassium supplements to prevent hypokalemia.

B

Monitor fluid intake and output meticulously and administer diuretics as prescribed.

C

Encourage the patient to elevate the legs above heart level several times daily.

D

Provide education on a low-sodium diet for long-term fluid management.

Q132

During a bed bath, what is the best way to ensure patient comfort?

A

Rapidly changing the water temperature.

B

Ignoring patient feedback regarding temperature.

C

Maintain a comfortable patient position.

D

Using a high-pressure water stream.

Q133

When caring for a newborn with neonatal jaundice, what is the primary goal of phototherapy?

A

To prevent dehydration

B

To increase the baby's appetite

C

To reduce the baby's skin temperature

D

To convert bilirubin into a water-soluble form for excretion

Q134

Which of the following is a key consideration when assessing the relationship between the fetal skull and the maternal pelvis during labor?

A

The length of the maternal uterine artery.

B

The mother's age.

C

The mother's blood pressure.

D

The degree of fetal engagement.

Q135

Which of the following is a core component of the 'love and belonging needs' within Maslow's hierarchy?

A

Achieving personal goals.

B

Pursuing intellectual pursuits.

C

Maintaining physical health.

D

Seeking connection and intimacy with others.

Q136

When reviewing research related to nursing, what is the primary importance of understanding 'basic terminologies'?

A

To accurately interpret research methodologies, statistical analyses, and study findings.

B

To prioritize the study based on its publication date.

C

To immediately apply the research findings to clinical practice.

D

To memorize the names of all researchers involved in the study.

Q137

Which of the following best describes the pathophysiology of aortic stenosis?

A

Narrowing of the aortic valve.

B

Increased blood flow through the mitral valve.

C

Damage to the coronary arteries.

D

Dilatation of the aorta.

Q138

Which of the following is the *primary* goal of administering oxytocin during labor?

A

To prevent fetal hypoxia

B

To promote fetal movement

C

To decrease the mother's blood pressure

D

To stimulate uterine contractions

Q139

A patient diagnosed with Cushing's syndrome is experiencing muscle weakness, high blood pressure, and skin bruising easily. Which laboratory value is MOST critical to monitor to assess the severity of the condition?

A

Serum cortisol level.

B

Serum calcium level.

C

Serum glucose level.

D

Serum potassium level.

Q140

A patient presents with fever, cough, and muscle aches. Initial assessment reveals a temperature of 38.5°C (101.3°F), rapid breathing, and a productive cough. Which of the following is the MOST appropriate initial nursing intervention?

A

Administer an immediate dose of ibuprofen for fever reduction.

B

Administer antibiotics without further assessment.

C

Isolate the patient to prevent potential spread of infection.

D

Encourage the patient to drink large amounts of fluids.

Q141

Which hazard presents the greatest immediate risk to a nurse?

A

Biological hazards

B

Sharp hazards

C

Radiological hazards

D

Chemical hazards

Q142

Which anatomical region is the mediastinum located within?

A

Mediastinum

B

Abdomen

C

Thorax

D

Pelvis

Q143

A patient with a history of pyloric stenosis is admitted with symptoms of projectile vomiting and abdominal distension. What is the MOST immediate nursing intervention?

A

Administering antiemetic medication

B

Frequent monitoring of gastric residuals

C

Performing a complete abdominal ultrasound

D

Initiating intravenous fluid replacement

Q144

A patient with a new diagnosis of hypertension reports a headache and blurred vision. Which of the following is the MOST appropriate initial action for the nurse to take?

A

Instruct the patient to increase their fluid intake.

B

Administer a non-steroidal anti-inflammatory drug (NSAID) for pain relief.

C

Immediately administer a diuretic to lower blood pressure.

D

Measure the patient's blood pressure and assess their vital signs.

Q145

Which statement best describes the nurse's responsibility when prescribing musculoskeletal muscle relaxants?

A

Monitor only for signs of respiratory depression.

B

Administer the medication at the highest possible dose for maximum pain relief.

C

Ignore the patient's reported side effects unless they are severe.

D

Carefully evaluate the patient's neurological status and potential contraindications before administration.

Q146

A nurse is reviewing the informed consent process for a research study. Which statement BEST reflects the core ethical principle guiding this process?

A

Minimizing the number of participants to reduce potential risks

B

Obtaining a signed document solely to fulfill legal requirements

C

Guaranteeing the participant will benefit directly from the research findings

D

Ensuring the participant understands the study's purpose, potential risks, and their right to withdraw at any time

Q147

A patient with Parkinson's disease experiences tremors and rigidity that interfere with self-care. Which nursing intervention is MOST appropriate for managing these symptoms?

A

Encourage the patient to engage in strenuous exercise to suppress the tremors.

B

Restrict fluid intake to decrease tremor severity.

C

Assist the patient with activities of daily living as needed while promoting independence.

D

Administer an increased dose of levodopa whenever the rigidity worsens.

Q148

A nurse is documenting a literature review. Which referencing style is most appropriate for a journal article?

A

MLA style.

B

APA style.

C

Chicago style.

D

Vancouver style.

Q149

A nurse is educating a patient about opportunistic infections. Which of the following microorganisms is MOST likely to be considered an opportunistic pathogen?

A

Streptococcus pneumoniae

B

*Pneumocystis jirovecii*

C

Staphylococcus aureus

D

Escherichia coli

Q150

Which of the following best describes the concept of 'recovery' in mental health?

A

A process of achieving a meaningful and fulfilling life despite living with a mental illness.

B

Strict adherence to a prescribed medication regimen.

C

Permanent institutionalization in a psychiatric facility.

D

Complete eradication of all symptoms of mental illness.