COMPREHENSIVE

1. A nurse provides instructions to a client who is taking levothyroxine (Synthroid). The nurse tells the client to take the
medication:
A. With Food
B. On An empty stomach
C. At bedtime with a snack
D. At a lunch time
2. A client is scheduled for a subtotal thyroidectomy. Iodine solution (Lugol solution, potassium iodide solution) is
prescribed. A nurse prepares to administer the medication, knowing that the therapeutic effect of this medication is
to:
A. Increase thyroid hormone production
B. Suppress thyroid hormone production
C. Replace thyroid hormone
D. Prevent the oxidation of iodide
3. A client who has undergone a subtotal thyroidectomy is subject to complication in the first hour after surgery. The
nurse should obtain and keep at the bedside equipment to:
A. Begin total parenteral nutrition
B. Start a cut down infusion
C. Administer tube feedings
D. Perform a tracheostomy
4. Which of the following symptoms might indicate that a client was developing tetany after a subtotal thyroidectomy?
A. Pains in the joints of the hands and feet
B. Tingling in the fingers
C. Bleeding on the back of the dressing
D. Tension on the suture line
Mr. Bon Go, a 50 yrs. old executive, has been having a periodic chest pain after walking up a flight of stairs. He reported to
health clinic for physical examination.
Explanation for Questions 5-9 about Mr. Bon Go.
A Myocardial infarction is the most common type of cardiac emergency. It is often life threatening and occurs
when areas of the heart muscle (myocardium) dies because of reduced blood flow results in an inadequate
oxygen supply to the myocardium(Ischemia). The most critical period for a patient with an MI is the first 48 hrs
following the attack.

5. The nurse should make which of these interpretations of Mr. Go’s chest pain?
A. Chest pains on exertion can be expected during middle age.
B. It is normal to experience discomfort after exercise.
C. Additional information is needed to evaluate the chest pain
D. Chest pains indicate myocardial damage.
Mr. Bon Go is seen by a physician and is admitted to coronary unit of the hospital with MI. His orders include cardiac
monitoring.
6. Myocardial Infarction occurred as a result of which of these pathological alterations?
A. Oedema of the pericardium
B. Interference of blood supply to the heart muscle
C. Malfunction at the sinoatrial node
D. Hypertrophy of the left ventricle
7. When initiating the cardiac monitoring, the nurse should explain to Mr. Bon Go that the procedure is done for which
of these purpose
A. To monitor how much blood the heart is pumping
B. To monitor the rate and rhythm of the heart
C. To monitor how much fluid the body is retaining
D. To monitor the strength of myocardium
Mr. Go develops edema of the lower extremeties. His orders include digoxin 0.25mg p.o. daily and furosemide (Lasix) 40
mg. IV stat.
8. The earliest desired therapeutic effect of digoxin and lasix for Mr. Bon Go would be indicated by which of these
outcomes?
A. His vital signs are stable
B. His urine output increases
C. He stops complaining of tightness in his chest
D. He is able to expectorate bronchial secretions
9. While he is receiving Digoxin and Lasix, he should be assessed for side effects of these drugs, which include
A. Increased intraocular pressure C. Hypokalemia
B. Hypertension D. Polycythemia
Mrs Susan Bello, 21 years old, is attending the prenatal clinic because she missed two menstrual periods and she thinks
she is pregnant.
10. Mrs Bello is to have pelvic examination. She says, ‘’I’m so nervous. I’ve never had one of those exams before. I’ve
heard that it’s so terrible.” In addition to acknowledging her concern, which of these actions would probably be most
helpful to Mrs. Bello?
A. Have Mrs. Bello handle the equipment to be used during the examination
B. Tell Mrs. Bello to breathe rapidly and squeeze the nurse’s hand when she feel discomfort
C. Say to Mrs. Bello, “many woman fear this exam, then they will find about it that worrying is worse than the exam
itself.
D. Say to Mrs. Bello, I’ll be with you and will explain what is happening during the examination.
11. Mrs Bello is 8 weeks pregnant. This is her first pregnancy. She says to the nurse, “For the past week, i haven’t been
able to keep anything on my stomach except tea and water.” Based on the information, it is most important for the
nurse to make which of these assessments of Mrs. Bello?
A. Whether her urine contains chorionic gonadotrophin.
B. Whether her urine contains acetone.
C. Whether she is experiencing a decrease in her energy level
D. Whether there have been changes in her stool colour.
12. Mrs. Bello, attends the antenatal clinic. She is 11 weeks pregnant. Mrs. Bello says, “I was having heartburn and I
found that eating small amounts at a time really helps”. This is an appropriate measure for Mrs. Bello to take
because it
A. Depresses vagal control of the pyloric sphincter
B. Reduces the chance of reflux through the cardiac sphincter.
C. Decreases the production of hydrochloric within the stomach
D. Lessen the work load of the circulatory system in absorbing the end products of digestion
13. When she is 18 week pregnant she attends her prenatal check up. The nurse do the Leopold’s manoeuvre. The manoeuvres
consist of four distinct actions, each helping to determine the position of the foetus. These manoeuvre help identify the
following except;
A. Number of foetuses
B. Degree of the presenting part’s descent into the pelvis
C. Presenting part, foetal lie and foetal attitude
D. Expected location of the point of maximal impulse (PMI) of the foetal heart tones on the woman’s pelvis.
14. According to Mrs. Susan Belo, her LMP is November 15, 2008. Using Nagele’s rule, what is her expected date of
confinement?
A. July 22, 2009
B. August 22, 2009
C. August 18, 2009
D. February 22, 2009
15. The nurse assessed Mrs. Bello and she knows this is the relationship between the long axis of the fetal body and
the long axis of he woman’s body
A. fetal lie B. fetal presentation C. fetal station D. leopold’s maneuver:
16. Method of determining foetal growth in uterus by measuring fundic height during mid-pregnancy
A. Mc Donald’s Rule B. Bartholomew’s Rule C. Leopold’s Manoeuvres D. Naegels’s rule
17. It is common and systematic ways to determine the position of a foetus inside the woman's uterus through
observation and palpation to determine foetal presentations and positions.
A. Mc Donald’s Rule B. Bartholomew’s Rule C. Leopold’s Manoeuvres D. Naegels’s rule
18. This Leopold’s manoeuvre is to determine what part of the baby lies in the upper part of the uterus.
A.1st Manoeuvre B. 2nd Manoeuvre C. 3rd Manoeuvre D. 4th Manoeuvre
19. This is the grasping with the thumb and fingers of one hand to the lower portion of the maternal abdomen just above
the symphysis thus confirming the impressions of the first manoeuvre as well as providing information.
A.1st Maneuver B. 2nd Maneuver C. 3rd Maneuver D. 4th Maneuver
20. This method is most successful to determine the direction the foetal back is facing. One hand will feel a smooth,
hard, resistant surface while on the opposite side, one will feel number of angular nodulations such as the knees and
elbows of the foetus will be felt.
A.1st Maneuver B. 2nd Maneuver C. 3rd Maneuver D. 4th Maneuver
21. Mrs Bello is told that she will probably feel the baby move before her next clinic visit. She ask the nurse what’s the baby’s
movement will feel like. The nurse should give her which of the following information about the early movement of a foetus?
A. “It will probably feel like a rumbling similar to how your stomach feels when you are hungry.”
B. “It will probably feel like an intermittent thumping.”
C. “It will probably feel like a rhythmic tapping.”
D. “It will probably be a fluttering type of sensation.”
22. Mrs. Mary Chase is now admitted to the hospital with her husband. On admission, the foetal heart rate is 136b/min. An hour
later the FHT is 124b/min. Which of these actions should the nurse take?
A. Elevate the legs of Mrs. Chase so that they are higher than the fundus
B. Continue monitoring FHT
C. Discuss the findings to the physician STAT
D. Instruct Mrs. Chase to take deep breaths through her mouth
23. Mrs. Mary Chase asks the nurse what stage of labor does the crown occur?
A. First stage
B. Second stage
C. Third stage
D. Fourth stage
24. The labour progresses satisfactorily. Mrs Chase s now transferred to delivery room and is prepared for delivery. When
preparing for the environment, it is most important to identify which of these nursing diagnoses
A. Potential for maternal infection due to invasive procedures during delivery
B. Potential for maternal cold stress due to room temperature of delivery room
C. Potential for infant respiratory distress due to level of humidity in the labour room
D. Potential for maternal overstimulation due to amount of staff activity in the delivery room
25. Several factors affect labor. Which of the following factors refer to the passage way?
A. Size of the fetal head and its ability to mold to the maternal pelvis
B. The presentation of the fetus in connection to the maternal pelvis
C. Structure of the maternal pelvis
D. The fetal attitude and the relationship of the fetal parts to one another
26. Mrs. Chase has successfully delivered baby boy at 8am and has a five minute Apgar score of 9.Which of these findings is
generally consistent with this score?
A. A respiratory rate of 20.
B. A pulse rate of 70.
C. Blue hands and feet
D. Legs and arms fully extended
 27. In rendering an immediatete nursing care to the newborn the nurse should do all the following except
A. APGAR score (Appearance, Pulse, Grimace, Activity and Respiration)
B. Anthropometric Measurements (HC , AC, CC, Wt. and Ht.) and Vital Signs , Temperature (Rectal)
C. Crede’s Prophylaxis and Vitamin C
28. She asks the nurse about food rich in iron. The nurse should instruct the client to consume which of the following foods that
contain the highest source of dietary iron:
A. Milk
B. Dark, green leafy vegetables
C. Potatoes
D. Cantaloupe

Situation: Mr. Liberatore, age 76, is admitted to your unit. He has a past medical history of hypertension, DM, hyperlipidemia. Recently he has
had several episodes where he stops talking in midsentence and stares into space. Today the episode lasted for 15 minutes. The
admission diagnosis is impending CVA.
29. The episodes Mr. Liberatore has been experiencing are probably:
A. small cerebral hemorrhages
B. TIA’s or transient ischemic attacks
C. Secondary to hypoglycemia
D. Secondary to hyperglycemia
A. left-sided paralysis
B. visual loss
c. no alterations in speech
d. no impairment of bladder
upper motor neuron disease may be manifested in which of the following clinical signs?
A. spastic paralysis, hyperreflexia, presence of babinski reflex C. muscle atrophy, fasciculations
B. flaccid paralysis, hyporeflexia D. decreased or absent voluntary movement
A.
B. Frontal D. Parietal