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NMC Past Questions on Surgery and Surgical Nursing

1. Mrs. Emelia Adeyoba reported to the OPD with complaints of abdominal pain that feels worse after eating, fever, nausea and vomiting. Cullen’s sign was elicited on examination. Which of the following conditions will you suspect?
A. Acute Cholecystitis
B. Acute pancreatitis
C. Acute appendicitis

2. Following sub-total gastrectomy for cancer of the stomach, the patient develops dumping syndrome. The nurse explains this to the junior nurse as:
A. Rapid passage of osmotic fluid into the jejunum
B. Build-up of faeces and gas within the large intestine
C. Passage of food from the stomach to the intestines

3. Ama Norya, a 42-year-old mother of three has been transferred to your ward from recovery ward after myomectomy. As the recipient nurse, your first nursing action will be:
A. Check for vital signs
B. Check rate of IV infusion
C. Assess for pain

4. Before a patient signs a consent form for an Abdominopelvic resection, the nurse should explain to him that the surgery will probably result in a:
A. Permanent ileostomy in the jejunum
B. Temporary colostomy in the descending colon
C. Permanent colostomy and impotence

5. A 48-year old patient undergoes open repair of a femur fracture sustained in a motor vehicle collision. Three days post-op, she develops a low grade fever, tachypnea, pleuritic chest pain and a cough. CT scan reveals a pulmonary embolism. Which of the following findings is most likely to be associated with this condition?
A. Decreased pulmonary arterial pressure
B. Decreased A-a gradient
C. Positive D-dimer test

6. Following extensive and prolonged surgery, it is important that the nurse observes the patient for depletion of which electrolyte?
A. Chloride
B. Potassium
C. Calcium

7. The rationale for wearing face masks by the surgical team is to:
A. Minimize the possibility of wound infection
B. Reduce the risk of transmitting a cold to the patient
C. Promote the sterile state of the theatre room

8. Which suture will be used to close the subcutaneous tissue after a laparotomy?
A. Chronic catgut
B. Plain catgut
C. Linen thread

9. To monitor adequate fluid in Mr. Otoo Ayivor who has undergone a thoracic surgery, the nurse would:
A. Monitor and record hourly intake
B. Administer intravenous fluids
C. Monitor effects of diuretics

10. An optimal teaching plan for an out-patient with stomach cancer receiving radiation therapy should include information about:
A. Skin care, nutrition, community resources
B. Avitaminosis, stoma care, community resources
C. Cancer support groups, alopecia, stomatitis

11. A patient is evaluated by nurse Joloto after a fall. Nurse Joloto is likely to use varus stress of the knee in the evaluation. This action of the nurse is referred to as:
A. Force that moves the joint away from the midline
B. Movement of joint toward the midline of the body
C. Stress on the Vagus nerve

12. Which of the following refers to a metabolic bone disorder characterized by inadequate mineralization of the bone matrix?
A. Rheumatoid arthritis
B. Ankylosing spondylitis
C. Osteoporosis

13. Which of the following instruments should the nurse add when setting a trolley for the Doctor to conduct vaginal examination?
A. Cusco’s speculum
B. Hager’s dilator
C. Artery forceps

14. A 5-year-old boy was brought to the hospital with tympanic membrane perforation. He has been booked for surgery. Which of the following surgical procedure will the Doctor perform for the patient?
A. Ossiculoplasty
B. Myringotomy
C. Blepharotomy

15. Mr. Appiah Kangaba, a 20-year-old university student was involved in inter-university football competition. Accidentally, he fell on his outstretched arm and hand. Physical examination revealed pain, pronounced swelling and silver-fork deformity at the wrist. As a staff nurse with the Sports Medical Team, which of the following types of fracture is Mr. Appiah likely to suffer from?
I. Colle’s fracture
II. Pot’s fracture
III. Greenstick
IV. Comminuted
Correct Answer: I

16. A 63-year-old man with history of tobacco use, diabetes, and hypertension presents with severe symptoms of claudication. His left lower extremity is cool to touch and his left big toe shows shiny skin, absent hair and no palpable dorsal pedis or posterior tibialis pulses. The arterial brachial index confirms peripheral arterial disease. What is the next step in the management of this patient?
A. Supervised exercise program
B. Smoking cessation
C. Surgical consultation

17. Master Ayi Tetteh, a 5-year-old sustained burns and was admitted to your ward. The objective of managing Ayi would include:
I. Prevention of deformity
II. Prevention of infection
III. Provision of adequate diet
IV. Replacement of lost fluids and adequate diet
*C. I, II, IV

18. Predisposing causes of cancer of the larynx include:
I. Air pollution
II. Chronic respiratory infection
III. Heavy alcohol ingestion
IV. Poor dental hygiene
*C. I, II, III

19. Director in a law firm reported to the hospital with complaints of bleeding haemorrhoids. He is shy and withdrawn. What will be the primary role of the nurse before assessment?
A. Assure client of good care
B. Call in the surgeon
C. Let a male nurse take history

20. To promote healing and prevent formation of necrotic tissue formation of venous ulcers, which of the following procedures may be performed with this condition?
A. Regular wound dressing with povidone
B. Wound debridement
C. Incision and drainage

21. Mrs. Amina Oteng, a 55-year-old woman diagnosed as having Mitral Stenosis is on admission on your ward, she is to have mitral valve replacement performed for her. A possible cause of Mrs. Oteng’s condition would be:
A. High blood pressure
B. Calcium deposits
C. Reflux of blood

22. A 19-year-old female who bites her nails presents with pain that she relates to a hangnail. On examination, there is painful, fluctuant area with erythema at the proximal nail bed. She has full painless range of motion of the joints of her finger. Sensation is intact. What is the patient’s diagnosis?
A. Herpetic whitlow
B. Onychomycosis
C. Paronychia

23. A 60-year-old woman has reported to the hospital with complaint of urinary incontinence. Which of the following is true?
A. Topical vaginal estrogen therapy can contribute to urinary incontinence
B. Obesity is a risk factor for urinary incontinence
C. Pessaries not recommended for stress urinary incontinence in post-menopausal women

24. What would be your immediate intervention when a patient’s tracheostomy tube dislodges?
A. Insert the tube and give oxygen
B. Go and get a new tube
C. Inform the doctor to give you directions

25. Which of the following methods of prostatectomy is NOT an open surgical removal of the prostate?
A. Trans-urethral
B. Supra-pubic
C. Perineal

26. A 52-year-old man spilled hot coffee on a small portion of his thigh. The burn blisters is painful. The burn blanches on examination. Which of the following is the best treatment for the burn?
A. Topical triamcinolone
B. Prophylactic antibiotics
C. Polysporin with Mepitel dressing

27. Features of hyperparathyroidism include:
A. Elevated serum calcium
B. Renal colic if patient has had calculi
C. Carpopedal spasm

28. Which of the following is the most common cause of acute scrotal pain in adults in the outpatient setting?
A. Epididymitis
B. Inguinal hernia
C. Trauma

29. Nurse is evaluating plan of care for a client with acute abdominal pain at the male surgical ward. Which of the following would the Nurse consider as expected outcomes?
I. Resolution of cause
II. Relief of abdominal pain
III. Freedom from complications
IV. Normal fluid and electrolytes
*A. I, II, III, IV

30. Which of the following is a feature of pre-eclampsia?
A. Increased potassium
B. Increased potassium transaminases
C. Hyponatremia

31. Which of the following is TRUE about antibiotic management in a patient with sepsis?
A. Most patients should receive at least a two week course of antibiotics
B. Use of more than one antibiotic is preferable
C. Every hour of delay in initiation of antibiotics is associated with increase in progression to septic shock

32. A final year student Nurse asked to explain lordosis to him. Your response will be “an excessive inward curvature of the……………….. spine”:
A. Cervical
B. Thoracic
C. Lumbar

33. Which of the following clinical signs is associated with grating from friction of bones and cartilage or entrance of air into an open fracture?
A. Crepitus
B. Ecchymosis
C. Crackles

34. A 75-year-old man with a history of type 1 von Willebrand disease (vWD) and an Hgb of 14.3g/dl is scheduled for total hip replacement surgery. Which of the following is the most appropriate treatment to decrease risk of severe bleeding during his procedure?
A. Low dose activated factor VII
B. Pre-operative erythropoietin
C. Prophylactic DDAVP

35. Which of the following intravenous fluids would the Nurse get ready in a surgical shock?
A. Ringers Lactate
B. Dextrose 50%
C. Normal saline

36. The greatest percentage of an adult’s total body water is contained in which fluid compartment?
A. Intracellular
B. Interstitial
C. Extracellular

37. You have been assigned by the charge nurse to examine a patient who has sustained burns from gas explosion. He has burns on his right arm, chest and abdomen. He has superficial burns on the right side of his neck and face. Using the rule of 9, calculate the estimated body surface of burnt area:
A. 45%
B. 49.5%
C. 27%

38. Daniel Akpaso, a 5-year-old boy on admission at the pediatric ward with a history of sore throat, difficulty in swallowing when eating, fever and chills. He was diagnosed with tonsillitis and has been booked for tonsillectomy. To rule out any systemic or related condition, in Daniel, which of the following actions will the nurse take?
A. Conduct a thorough physical examination
B. Involve mother in the care
C. Consult the doctor in charge

39. Madam Atswei Mansa, a 42-year-old is recovering from anaesthesia after myomectomy. On admission, her initial BP was 120/80mmHg, 30 minutes later, her BP recorded was 112/60mmHg with pulse rate of 70bpm. Her skin was dry and warm to touch. What would be the MOST appropriate nursing action to take as the Nurse in Charge?
A. Administer oxygen
B. Notify the surgeon
C. Check vital signs every 15 minutes

40. Mr. Wilfred Sam has undergone tracheostomy. Which of the following would be the Nurse’s main goal for placing sterile moist gauze under the tracheostomy tube?
A. Promote adequate ventilation
B. Ensure humidification of inspired air
C. Maintain a patent airway

41. You have been tasked by the Charge Nurse to perform catheter hygiene for a bedridden patient. The correct method in carrying out this procedure is to:
A. Use cotton wool balls for each swabbing to and from the urethra
B. Wipe away from the urethral outlet using soap and water
C. Use gauze swab in methylated spirit to wipe around the urethra

42. You have been informed by the Emergency Unit to prepare and receive a patient with the diagnosis of intrinsic renal failure. What is the most common cause of intrinsic renal failure?
A. Ischemic injury
B. Nephrotoxin
C. Obstruction of the urethra

43. Osteomyelitis is the inflammation of the bones, especially in the arms and foot. This condition in most cases is caused by:
A. Pseudomonas
B. Salmonella
C. Staphylococcus aureus

44. Which of the under listed will indicate a third degree burns?
A. Dark colouration of the skin
B. Blister formation
C. Absence of pain at the site

45. Nurse Kodjo is carrying out routine wound dressing on the surgical ward. He must know that:
A. Sealed wound may be dressed without gloves
B. All wounds must be dressed with gloved hands
C. Dressing on a wound must be changed only when it is wet

46. Mr. Ankomah Boateng has been diagnosed of having benign prostatic hypertrophy which:
A. Predisposes to hydronephrosis
B. Causes an elevated acid phosphatase
C. Is a congenital abnormality

47. A nursing diagnosis of self-esteem disturbance related to perception of scars is identified for a patient with Buruli ulcer. Which of the following goals will take the utmost PRIORITY?
A. Promoting wound haemostasis
B. Preventing further injury
C. Promoting positive body image and coping

48. The nursing and medical team have to ensure that the ward is kept clean and safe for all patients. The BEST way a nurse can prevent cross-infection is by:
A. Preceding patient contact with hand washing
B. Performing aseptic technique correctly
C. Enforcing strict isolation procedures

49. Maame Afua Konadu has been admitted to your ward with appendicitis. The predisposing causes of her condition include:
I. Inadequate food intake
II. Kinking of the appendix
III. Presence of faecalith
IV. Persistent throat infection
Correct Answer: II, III, IV

50. Patient with traumatic head injury requires assistance in turning and positioning because of immobility and unconsciousness. Hyponatremia is common after head injury due to:
A. Sodium shifts in both intracellular and extracellular activities, electrolytes and volume
B. Sodium shifts in extracellular fluid, electrolytes and volume
C. Sodium shifts in intracellular fluid, electrolytes and volume

 

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NMC Past Questions on Paediatrics, Obstetric, Anatomy and Physiology

1. When examining a 2-year old child with an otoscope the nurse should
A) hold just the head and arms
B) hold the head straight
C) pull the pinna down and back
D) Pull the pinna up and back

2. Nursing care for a 7-year-old girl admitted with tetanus should be primarily direction towards
A) careful monitoring of urinary output
B) decreasing external stimuli
C) encouraging high intake of fluid
D) Giving adequate diet

3. Esther, 4years is rushed to the emergency ward convulsing, with the skin very hot to touch. What immediate step would you take to reduce the temperature?
A) Give her 5mls paracetamol syrup
B) Take the axillary temperature
C) Reassure the mother
D) Tepid sponge the child

4. When teaching an adolescent with Type I diabetes about dietary management the nurses should instruct him to
A) Always carry a concentrated form of glucose
B) Eat all meals at home
C) Let parent prepare food separately for him
D) Weigh all food on a gram scale

5. Adolescent girl suffering from cancer is on antineoplastic drugs. The side effect of these drugs that requires early preparation of the patient is
A) alopecia
B) constipation
C) generalized short-term paralysis
D) Retarded growth in height

6. An essential nursing action when caring for a small child with severe diarrhoea and vomiting is to
A) check weight daily
B) encourage oral fluids intake
C) keep body temperature below 38oC
D) Replace lose calories

7. During the teenage years, the nutrition focus emphasizes
A) fat intake
B) prevention of drug abuse
C) prevention of obesity
D) Self and body image

8. A 7-year-old boy has a fractured femur. He is put in P.O.P cast and is being discharged. What is the most important advice that the nurse must teach about the boy’s care?
A) Cast should be kept clean
B) Cast should not be touched for at least 12 hours
C) Circulation must be watched closely
D) Pain should be assessed every 4 hours

9. A 7-year-old boy is admitted to the kids ward with suspected right sided pneumonia. The appropriate position for the child would be
A) head of bed elevated 10o
B) in a prone position
C) in supine position
D) Turned on the right side

10. A one –year-old girl is admitted to the ward diagnosed with dysentery. On discharge, what is the most important information the nurse must impart to the mother?
A) As soon as the child has diarrhoea place her on NPO for 8 hours
B) Do not wait for so long the next time before you bring the child to the hospital
C) Observe good hygiene to reduce faeco-oral spread
D) Start with anti-diarrhoea medication before bringing the child to hospital

11. The purpose of traction for children with fracture is to
A) Make the bone grow faster
B) Prepare the area for surgery
C) Prevent future fractures
D) Realign bone fragments

12. To promote absorption of an iron supplement it should be administered
A) During meal
B) Immediately before meals
C) Two hours after meals with orange juice
D) Two hours after meals with milk

13. The side effects of oral iron therapy include
I. Blackened stools
II. Darkened teeth
III. Darkening of the skin
IV. Gastric irritation
A) I, II and III
B) I, II and IV
C) II, III and IV
D) I, II, III and IV

14. A child with lymphatic leukaemia has a very low platelets count. An appropriate nursing intervention would be to
A) discourage active play to avoid getting hurt
B) Encourage a high fibre diet
C) Keep the child isolated to avoid infection
D) Provided frequent rest periods

15. What signs and symptom would you expect in a 3-year old girl diagnosed to diabetes mellitus?
A) Bed-wetting, increased thirst, hunger, weight gain
B) Bed-wetting, lethargy, poor appetite, weight loss
C) Increased hunger, thirst, weight gain
D) Weight loss, bed-wetting, lower leg cramping

16. Nursing care that helps to prevent sickle cell crisis is
A) careful observation of all vital signs
B) high iron, low fat, high-protein diet
C) limitation of activity
D) Protection from infection

17. A 6-year-old girl is admitted sickle cell crisis. Priority nursing concerns would be
A) Hydration and pain management
B) Nutrition and antibiotics
C) Nutrition and hydration
D) Pain management and antibiotics

18. The nurse would explain to a mother whose child has been given tetanus toxoid the injection will confer
A) Life-long active natural immunity
B) Life-long passive immunity
C) Long-lasting active immunity
D) Temporary passive natural immunity

19. A common finding on most children with cardiac abnormalities
A) A family history of cardiac abnormalities
B) Cyanosis and clubbing of finger tips
C) Delayed physical growth
D) Mental retardation

20. When administering IV fluids to a dehydrated infant the most critical factor confronting the nurse is the
A) Assurance of sterility
B) Calculation of fluid volume to be infused
C) Maintenance of the fluid at body temperature
D) Maintenance of the prescribed rate of flow

21. Before administering a tube feeding to an infant the nurse should
A) Irrigate the tube with water
B) Place the baby in the recumbent position
C) Provide the baby with a pacifier
D) Slowly instil 10ml of formula

22. An 18months girl on admission with severe asthmatic attack is put on prednisolone 15mg b.i.d. the nurse should
A) Check the child’s oesinophils count daily
B) Ensure the child rests as much as possible
C) Keep the child NPO except for medication
D) Prevent exposing the child to infection

23. The primary task to be accomplished by an infant between 12 and 15 months of age is to learn to
A) Climb stairs
B) Say simple words
C) Use a spoon
D) Walk erect

24. Which of the following will make you suspect that a child with measles is developing bronchopneumonia?
A) Increased pulse rate
B) Increased respiration
C) Redness of eyes
D) Wheezing

25. Growth and development of the infant is influenced by
I. Environment
II. Heredity
III. Nutrition
IV. Religion
A) I and II
B) II and IV
C) I, III and IV
D) I, II and III

26. Which of the under listed drugs will you get ready for use when a child is brought to the emergency room with convulsion?
A) Ampicillin
B) Chloroquine
C) Hydrocortisone
D) Phenobarbital

27. How would you reduce anxiety in a child on admission?
A) Changing nurses daily
B) Confining child to bed
C) Involving parents in the care
D) Seeing familiar faces daily
A) I and II
B) I and III
C) III and IV
D) I, II and III

28. Who should sign the consent form of an 11-year old boy for operation
A) Parents after explanation
B) Relative of the child
C) Sister in charge
D) The child after careful explanation

29. The most influential factor negatively affect the health status of children is
A) Chronic illness
B) Family predisposition to illness
C) Poverty
D) Prematurity

30. The mouth of an infant who has thrush will be managed by
I. Administration of nystatin suspension
II. Brushing the teeth
III. Gently removing the white patches
IV. Saline swabbing of mouth
A) I and IV
B) II and III
C) I, II and III
D) II, III and IV

31. What action would a nurse take when a child refuses to take his medication?
A) Coax or plead with him to take it
B) Let him see other children taking their medication
C) Tell him that you will give him an injection
D) Urge him to take it to make him well

32. Which of the following is an early complication of meningitis?
A) Cerebral oedema
B) Deafness
C) Hydrocephalus
D) Paralysis

33. The clinical manifestations of a child with marasmus include
I. Good appetite
II. Miserable looking
III. Oedema
IV. Wasting
A) I and II
B) I, II and IV
C) I, III and IV
D) II and IV

34. An 8-year old boy on admission with sickle cell crisis is for discharge. The education you would give to the child and parents should include
I. Ensuring that prescribed drugs are taken daily
II. Sleeping at least 14 hours a day
III. Taking balanced diet
IV. Taking plenty of nourishing fluids
A) I and II
B) I, II and III
C) II, III and IV
D) I, III and IV

35. Factors contributing to normal growth before and after birth include
I. Nutrition
II. Sex hormones
III. Trophic hormones
IV. Weight of mother
A) I and II
B) I, II and III
C) I and III
D) I, II and IV

36. Which of the following sets of symptoms will suggest that a child is suffering from meningitis?
A) Fever, headache, vomiting, opisthotonus
B) Fever, headache, trismus, opisthotonus
C) Fever, headache, trismus, spasms
D) Photophobia, trimus, headache, opisthotonus

37. What is the immediate priority in the nursing care of a 6-year-old child admitted with pneumonia?
A) Elimination
B) Exercise
C) Nutrition
D) Rest

38. A mother of 6 months old child wants to know what foods are introduced first. The answer would be
A) Cereal an soft boiled egg for breakfast
B) Milled rice, cereal and mashed fruits
C) Meat, fish then add fruits and vegetables
D) Sweets such as fruits and vegetable

39. What care would you give to a baby undergoing phototherapy?
I. Ensure adequate fluid intake
II. Ensure maximum skin exposure
III. Maintain the baby’s temperature
IV. Protect the eyes from light
A) I, II and III
B) I, II and IV
C) I, III and IV
D) I, II, III and IV

40. In nursing an unconscious child your objective is to
I. Ensure the child is safe and comfortable
II. Maintain hydration, nutrition and excretion
III. Prevent complications
IV. Stimulate the child
A) I, II and III
B) I, II and IV
C) I, III and IV
D) I, II, III and IV

 

NMC Past Questions on Paediatrics, Obstetric, Anatomy and Physiology Set 2

41. After circumcision of a new born male, the most essential immediate post-operative thing to observe is:
A) Decreased urinary output
B) Haemorrhage
C) Infection
D) Shrill or piercing cry

42. The physician should be informed the following observation in a 7 year old child with fractured femur with full leg cast.
A) Cast still damp and worm after 24 hours
B) Increase urinary output
C) Inability to move the toe
D) Pedal pulse of 90 b/m

43. The following criterion is most likely to be used by the physician to select drug for a 6 year old with pneumonia
A) Child tolerance of the drug
B) Physician’s preference for the drug
C) Selectivity of the causative organism
D) Sensitivity of the causative organism

44. The most earliest sign of sexual maturity in young girls between 9 to 12 years
A) Attention to grooming
B) Increase in size of the breast
C) Interest in opposite sex
D) The appearance of axillary and pubic hair

45. In leukaemia the following occur EXCEPT
A) Decreased platelets
B) Increase white blood cell production
C) Liver remains normal
D) Normal bone marrow is replaced with blast cells

46. The phallic stage in Freud’s psychosexual development is between age;
A) 1 to 3 years
B) 3 to 5 years
C) 3 to 6 years
D) 6 to 8 years

47. The nurse understands that in patent ductus arteriosus, blood shunt
A) Aorta into the pulmonary artery
B) Inferior vena cava to left atrium
C) Left atrium to right atrium
D) Pulmonary artery to the aorta

48. A three year old child who has ingested a bleach will exhibit the following EXCEPT
A) Anxiety
B) Drooling
C) Severely burning pain in the mouth
D) Cyanosis

49. A viral infection in a child characterized by red blotchy rash and Koplik’s spot is known as;
A) Chicken pox
B) Diphtheria
C) Measles
D) Pertussis

50. In caring for a child with superficial burns, the following actions are taken EXCEPT
A) Break the blisters before dressing
B) Clean the area
C) Cover area with sterile dressing
D) Serve analgesics

51. When responding to a call of a visually impaired child on admission, it is important for the nurse to
A) Address the child when she enters the room
B) Respond to the call promptly
C) Send an orderly to attend to the child
D) Touch the child before speaking to him or her

52. The nurse would assess the following in an infant with hydrocephalus
A) Abdominal girth
B) Fontanels
C) Urinary output
D) Vital signs

53. The most critical factor in the immediate care of an infant after repair of cleft lip is
A) Administration of drugs to reduce oral secretions
B) Administration of intravenous infusion
C) Maintenance of patent airway
D) Prevention of vomiting

54. How long after birth physiological jaundice usually occurs
A) 24 hours
B) 48 hours
C) 72 hours
D) 1 week

55. Rhesus incompatibility usually occurs when the mother
A) And foetus are both rhesus
B) And foetus are both rhesus positive
C) Is rhesus negative and foetus is rhesus positive
D) Is blood group O and foetus is group AB

56. The first step in the management of toxic substances is
A) Administer appropriate antidote
B) Administer supportive and symptomatic care
C) Prevent further absorption
D) Remove obvious remnants

57. The following is the best way to detect fluid retention in a child with nephrotic syndrome
A) A measurement of abdominal girth daily at the same time
B) Monitoring of the amount of 24 hours urine collected daily at same time
C) Monitoring of child’s weight daily at the same time
D) None of the above

58. Which of the following disease condition in vitamin B1 deficiency
A) Beriberi
B) Mumps
C) Pellagra
D) Scurvy

59. In assessing a 2-month old infant the nurse expects the child to
A) Bang hold object together
B) Raise hand chest and can hold in position
C) Roll from supine to prone position
D) Sits alone, uses hands for support

60. At which age in the developmental stages is an infant expected to have first tooth eruption?
A) 3-4 months
B) 5-9 months
C) 10-12 months
D) 13-18 months

61. An infant with birth weight 2,500mg without regards to gestational age is termed as
A) Intra uterine growth retardation
B) Low birth weight
C) Preterm
D) Small for date

62. Which of the following is a causative organism for pemphigus neonatorium
A) Candida albican
B) Staphylococcus aureus
C) Streptococcus
D) Varicella zoster

63. In caring for a child with sickle cell crisis the most important nursing intervention would be
A) Give iron supplement
B) Maintenance of adequate nutrition
C) Prevention of infection
D) Relief of pain

64. When teaching a mother how to administer eye drop to a 5-year old child the nurse should ask her to place the drop
A) Anywhere that makes contact with the eye surface
B) Inside the lower eyelid
C) On the sclera as the child looks to the side
D) Under the upper eyelid

65. A 5-month old child develops severe diarrhoea and has been put on IV fluids. The nurse must observe the rate of flow to
A) Avoid fluid getting into the tissue
B) Prevent cardiac overload
C) Prevent increased urinary output
D) Replace all fluids lost

66. A child in sickle cell crisis will need the following
I. Analgesic
II. Exercise
III. Plenty of fluid
IV. Warmth
A) II and II
B) II and IV
C) IV and I
D) I, III and IV

67. The nurse suspect bleeding when a child who has had tonsillectomy
A) Becomes pale
B) Complains of thirst
C) Cough persistently
D) Swallows frequently

68. Which of the following will make you suspect that a child with measles is developing bronchopneumonia
A) Increase pulse rate
B) Increased respiration
C) Redness of eye
D) Wheezing respiration

69. The nurses’ immediate action when a child is rushed in with severe diarrhoea and vomiting will be
A) Keep child warm in bed
B) Prepare trolley for intravenous infusion
C) Reassure mother of safety of the child in the hospital
D) Start oral rehydrated therapy
A) I and II
B) II and IV
C) II,III and IV
D) I, II, III and IV

70. How would you reduce anxiety in a child on admission
I. Changing nurses daily
II. Confining child to bed
III. Involving parent in the care
IV. Seeing familiar faces daily
A) I and II
B) I and III
C) III and IV
D) I, II and III

71. The presence of parents during painful procedure on their toddler should be
A) Based on individual assessment of the parent
B) Based on the type of procedure to be performed
C) Discourage for the benefit of the parent and the child
D) Encourage and permitted if the child desires their presence

72. The most important nursing intervention for a 3-year old child with nephrotic syndrome is
A) Encourage fluids
B) Maintaining bed rest
C) Prevention of infection
D) Regulating the diet

73. Which of the following children should a nurse in the out-patient department see first
A) An 18 months old with jaundice
B) A 4-year old with nephrotic syndrome
C) 12 months old with febrile convulsion
D) 2 years old with sickle cell crisis

74. A 6 year old child is admitted to the hospital with pneumonia. An immediate priority in the child’s nursing care would be
A) Nutrition
B) Medication
C) Reassurance
D) Rest

75. When caring for a neonate with an imperforate anus, the nurse should observe the urine for
A) Acetone
B) Bile
C) Blood
D) Meconium

76. A child with acute leukaemia is put on prednisolone and other drugs. One side effect of prednisolone is
A) Alopecia
B) Anorexia
C) Mood changes
D) Weight loss

77. One of the complication of pinworm infections is
A) Appendicitis
B) Hepatitis
C) Pneumonia
D) Stomatis

78. A child sitting on a chair in the playroom begins a tonic seizure with a clenched jaw. What should the nurse do?
A) Attempt to open the jaw
B) Lower the child to the floor
C) Place a large pillow under the head
D) Shout for assistance

79. A primary task to be accomplished between 12 and 15 months of age is to start
A) Climbing stairs
B) Say simple words
C) Use a cup
D) Walk erect

80. The following are common childhood communicable disease EXCEPT
A) Measles
B) Pneumonia
C) Tuberculosis
D) Whooping cough

81. An infant should be able to hold its head erect at
A) 1 month
B) 2 month
C) 3 month
D) 4 month

82. Permanent dentition begins at/around what age(in years)
A) 2 years
B) 4 years
C) 6 years
D) 8 years

83. If a child develops a reaction during blood transfusion the nurse should
A) Call the paediatrician
B) Relief symptoms with drugs
C) Slow the flow rate
D) Stop the transfusion

84. A 9 year old boy with acute lymphocyte leukaemia having prednisolone and vincristine complain of constipation. What is the cause of the constipation
A) Enlarged spleen obstructing the bowel
B) Leukaemia mass obstructing the bowel
C) Side effect of vincristine
D) Toxic effect of prednisolone

 

NMC Past Questions on Paediatrics, Obstetric, Anatomy and Physiology Set 6

201. A patient with enteritis would be placed on this diet
A) High carbohydrate
B) High residue
C) Low fat
D) Low residue

202. Increased blood pressure with bounding pulse and a complaint of headache during infusion is indicative of
A) Air embolism
B) Fluid overload
C) Hypoglycaemia
D) Sepsis

203. Which of the following is responsible for Haemophilia ‘A’?
A) VIII
B) IX
C) X
D) XIII

204. Which of these would be LEAST helpful in communicating with an aphasic Cerebrovascular Accident (CVA)?
A) Allowing plenty of time for patient to respond
B) Completing the sentence that patient cannot finish
C) Looking directly at patient during attempt at speech
D) Speaking to the patient at a lower rate

205. The MOST sensitive indicator of all cardiac enzymes in myocardial cell damage is
A) Alkaline phosphate
B) Creatine kinase
C) Lactic dehydrogenase
D) Serum glutamic-oxaloacetic transaminase

206. An intravenous analgesic is frequently administered to relieve chest pain associated with myocardial infarction. The drug of choice is usually
A) Codeine sulphate
B) Hydromorphine hydrochloride
C) Meperidine hydrochloride
D) Morphine sulphate

207. The basic cause of angina pectoris is believed to be
A) Dysrhythmias triggered by stress
B) Insufficient coronary blood flow
C) Emboli found in the coronary vessels
D) Spasms of the vessel walls owing to excessive secretion of adrenaline

208. Which of the following instructions would you give to a patient with pulmonary emboli on discharge?
A) Dorsiflex your feet several times, hourly whilst sitting
B) Do postural drainage exercise on waking up and at bed time
C) Increase your fluid intake daily to one litre
D) Sleep with the head of your bed elevated thirty to forty degrees

209. Which of these interventions would prevent respiratory complication in caring for an elderly patient on bed rest?
A) Changing the position every 2 hours
B) Decreasing oral fluid intake
C) Holding the breath every hour
D) Monitoring vital signs every shift

210. Which of the following assignments would you give to a nursing assistant?
A) Administering medication
B) Giving evacuate enema
C) Patient teaching after discharge
D) Giving blood transfusion

211. Subcutaneous injection is given for the following reasons. When
I. Small volume of the drug is required
II. Slow absorption is a priority
III. The drug is not likely to damage the superficial tissue
IV. The drug is not likely to damage the muscles
A) I, II and III
B) I, II and IV
C) I, II and IV
D) I, II, III and IV

212. Precautions to be taken during oxygen administration include the following EXCEPT
A) Avoid naked flames or fire
B) Apply alcohol on patient’s skin
C) Do not use oil on the oxygen cylinder
D) Keep cylinder in a cool place

213. Nursing diagnosis represents the
A) Assessment of client data
B) Actual nursing intervention
C) Client’s health problems
D) Proposed plan of care

214. The most common symptom of pruritus is
A) A rash
B) Itching
C) Flaking
D) Pain

215. Which of the following is a symptom of increased intracranial pressure?
A) Facial flushing
B) Photophobia
C) Tachycardia
D) Vomiting

216. In inspecting the turbinate’s of a patient, which instrument should the nurse use?
A) Ear speculum
B) Laryngoscope
C) Nasal speculum
D) Otoscope

217. An important component of the physical examination in relation to nursing process is
A) A holistic approach to the assessment phase
B) Completion of the nursing evaluation phase
C) Establishment of baseline for the patient
D) The generation of a definitive nursing diagnosis

218. When evaluating the extracellular fluid volume deficit state (ECFVD), the nurse should initially assess the patient for
A) Cardiac arrhythmias
B) Polyuria
C) Signs of dehydration
D) Trousseau’s sign

219. A patient suffering from coronary artery disease is MOST likely at risk of developing
A) Extracellular fluid volume excess
B) Hyperosmolar fluid volume deficit
C) Intracellular fluid volume deficit
D) Iso-osmolar fluid volume deficit

220. Osteoarthritis is associated with the following signs and symptoms EXCEPT
A) Bouchard’s nodes
B) Pannus formation
C) Tenderness of the joint
D) Joint pain

221. The nurse knows that the most critical time period for diagnosis of myocardial infarction is
A) Between the third and fifth day after the attack
B) The first hour after symptoms begin
C) Within 24 hours of the onset of symptoms
D) Within the first 48 hours after the attack

222. The following are composition of urine EXCEPT
A) Ammonia
B) Bromides
C) Chlorides
D) Oxalates

223. The basis or framework used to evaluate the patient’s response to nursing intervention can be found in the nursing
A) Care plan
B) Diagnosis
C) Goals
D) Interventions

224. A decrease in peristalsis noted in an older client by the nurse is most likely to result
A) Bowel incontinence
B) Constipation
C) Fluid volume deficit
D) Impaired swallowing

225. Which of the following laboratory tests would the nurse monitor when a client is receiving warfarin sodium (Coumadin) therapy?
A) Arterial blood gases
B) Serum potassium
C) Prothrombin time (P.T)
D) Partial thromboplastin time (P.T.)

226. What measure would the nurse employ to ensure that a patient receiving total parenteral nutrition (TPN) does not develop osmotic diuresis as a complication?
A) Administer the solution slowly
B) Keep infusion at room temperature
C) Monitor the flow rate carefully
D) Protect the solution from light

227. Which of the following is most likely to be associated with bulimia patients?
A) Denial of abnormal eating
B) Depression
C) Fear of thinness
D) Social withdrawal

228. The nurse assists the patient to assume which position for insertion of gastrointestinal tube?
A) High fowler’s
B) Recumbent
C) Lateral
D) Supine

229. Nursing assessment of a patient with liver failure would include observation of
A) Abnormal bleeding
B) Diarrhoea
C) Hypotension
D) Hypothermia

230. The hormone aldosterone is produced by the
A) Adrenal cortex
B) Adrenal medulla
C) Adrenal matrix
D) Adrenal parenchyma

231. The extent of a patient’s renal damage would be reflected by the results of this blood test
A) Alkaline phosphatase
B) Creatinine
C) Potassium
D) Uric acid

232. Why should a client’s bowel be cleansed before intravenous pyelogram? To
A) Facilitate passage of the cystoscope into the urethra
B) Minimize his discomfort during the process
C) Promote visualization of the kidney’s, ureters and bladder
D) Permit maximum filling of the bladder with the radio-opaque dye

233. Hypoglycaemia is associated with
A) Facial flushing
B) Pruritus
C) Thirst
D) Tremors

234. Insulin is not taken orally because
A) Molecules are too large to be absorbed through the gastrointestinal tract
B) It inhibits the action of pancreatic digestive enzymes
C) It causes ulceration of gastrointestinal tract
D) It is destroyed by gastrointestinal enzymes

235. Which of the following under listed statements is a symptom of meningitis?
A) A negative Babinski response
B) Areas of paraesthesia of lower extremities
C) Peri-orbital oedema
D) Resistance to neck flexion

236. Which of these exercises would you prescribed for a client after an acute phase of rheumatoid arthritis?
A) Cycling
B) Jumping
C) Running
D) Swimming

237. The achievement of haemostasis would be indicative first by a decrease in
A) Blood pressure
B) Pulse rate
C) Respiration
D) Temperature

238. Which of these positions is BEST for a client on heparin with phlebitis?
A) Low-Fowler’s with legs elevated
B) Reverse Trendelenburg’s
C) Supine with legs flexed
D) Lateral with legs flexed

239. The purpose of dexamethasone administration is to
A) Alleviate pain
B) Promote urinary diuresis
C) Prevent infection
D) Reduce intracranial swelling

240. A child has rheumatoid fever which of the following nursing measures is likely to be most effective in minimizing his joint pains?
A) Applies ice to the affected joints
B) Limits movement of the affected joints
C) Massages the affected joints
D) Puts affected joints through range of the motion exercise