‘SCENARIO TTEMSI-6 Mrs Joseph brought her 2 year old son Michael othe Child Health Clinic fr his regular assessinen Daring the interview, Mrs. Joseph told the Nurse that Michael Fequenty has Temper Tantrums trem 1 Which ofthe following are predisposing factors of temper tantrums? 1. Delayed gratification |i, _Disrupive schedule ii, Realistic expectation iv. Sibling confit A. hivandii HB biianaiv © ivandiv D. Thiiiand iv rem Which ofthe following factors canbe utilized when planting strategies for handling Michaels temper 1. _Abasic understanding of eid development li, Previous experience with older siblings iii, The degree of attachment a faily embers i Thellevel of maturity ofthe parents. AL beitangii DB hiiandiv © hivandiv D.ikiivand iv1TEMS hich two approaches shoul the Nurse ws, when counselling Michae's arent about is emer tantrums? 1. Allow them to express their feetings about his behaviour Explore how they respond to these situations {Advi them on type of restrictions to impose hss on a change in tei discipline practices. g and ii andi © iiandiv D. _iivandiv. rem 4 tacouseling Mica’ parents which ofthe following pproasies may te rcommerle et Appropriate disciplinary ation? 1. Ignoring episodes ji, Rewarding behaviour iii Severe punishment iv) Takea break A Landit @® iaiiv - cand D,— tilandiv ieMS egies for managing temper tanirmns in toes nce 1. consistent measures i. prior warning ii, reinforcement of standards iy! Spanking for non-compliance ® wen Niiandiv © Kiivandiv D. ThiliandivireM6 rte persons tobe involved ingroup counseling session to dec emp tanrams te baby site, counsellor, parents B. counsellor, child, grandparents trandparenis, parents, counsellor. ® parents, child. counsellor SCENARIO2 1EMS7=10 Norse Wells a community nurse visits a rural clinie weekly cn her vst she breve an outbreak of abies among some primary schoo chien, Mowers of oo ere hildren expressed concer forthe safety of thet chile. rE ‘ro which family of organisms does the Sarcoptes Seabel belong? Ae ‘atria @ ve De ems sive areas affected by scabies in infants which are usally spre in older persons ave g Inead, neck, palms and soles head, buttock, soles and pass thighs, extemal genitalia, head and sles 1D. soles, pals fingers and buttock.irem9 The BEST way to prevent the spread of scabies i to 1 immunize all infants during their fist year of life ‘quacantine school children who become infested inform health persons about transmission, diagnosis and teatnent iv. educate communities about transmission, diagnosis and amagement AL Land i Vand i Wandiv Tivand iv ‘SCENARIO CONTINUED Benzyl Benzoate i the drug applied o skint reat scabies EM 10 ‘Which ofthe following is the MOST effective method to apply Bencyt Benzonte? A. Daily fllone by bath in evening Twice daly ollwed by x ah a ais © daily flowed by bth new tay D _ Leave fortwo day followed bya bath, Mr. and Mrs, Joseph Pu, parents of John Puff aged soven year, became antious because they observed for about three days sat there was puffiness of his face and he seemed lethargic. He was oben e we Health Centre where he was diagnosed as having Acute Glomerulo-Nepiis Tie was hecetoneeleced tothe Pediatric Unit for admission, rem 11 ‘Which specific organism is considered asthe cause of Acute Glomerulo-Nephrits i John Pull? or A. Escherichia coi Haemolytie streptococcus Staphylococcus aureus Beta staphylococcustrem iz Which ofthe following investigations is NOT likely tobe eatied out for ac with Ac Nepheitis? Aires TER (AST) 8 Bloc nvogen BUND Crate et @ _imemwenoes asaya vey rem 13 Which ofthe following specifically measures the impainment of renal function? A. Glomerular Filtration Rate BD Creatinine tes. C. Urine eulture 1D. Specific gravity of urine, rem is Which ofthe following are MAJOR considerations inthe nursing care of a child Acute Glomerul 1. Complete bed rest fi, Restricting protein intake iii, Controling sodium and Mud intake |v. Maintaining a 24 hour urine colletion, @ Cian Litedin ia ITEM 1S tn implementing Joba's nursing care plan, which nursing ations would BEST ensure his cooperation? 1. Consideration of John’s various tikes and distikes fi, Consistency in carrying our nursing activities for John iii Fitmess i dealing with Jn’s tite and behaviour J Thoroughness in explaining to John the details of his therapeutic resime. A. Livan B. Liiiandiv ® Viitand‘ne nursing care pr 1 avoidance of additional Hi, activity and rest iii, food and fluid intake ine preventing the npred of B iitanai B.Lilandiv Ghandi, D. tt and iv ITEM 17 Which of the following is the BEST set o Limit protein intake. Monitor visiting, Organize moderate indoor activities, Maintain personal hygiene. B Give normal diet Encourage free visiting, Allow freedom of activity. Allow daily baths. Give high protein diet Restrict visitors. Avoid daily baths. Allow free outdoor activities D Encourage high protein intake. Allow free visiting Organize moderate activities, Maintain personal hygieneOe ‘SCENARIOS TEMS 18-22, Me. Renee Stewart, 17 yeas old was involved in road traffic accident. He sustained fracture 1 his [ef femur and multiple abrasions over his arms and chest. He wat taken to the Accident and Emergency Department ITEM 18 “The Accident and Emergeney doctor orders etn toxoid for Me. Stewart, tn order to evaluate the patients immunization status, the nurse should ‘A. commence the course of tetanus toxoid vaccinations B, explain the eaton for administration ofthe tetanos oxo vaccinations tsk ie had been vacinated against tetanus within the lst 3~ 5 years ‘B. _enstethathe patent has some immunity tothe discase rem The nurse can evaluate the effectiveness ofa teching session about uecessfl immunity to fetanus if the patient |. Gsisued an instrvetion card with dates to return for fallow up infections ji, told ofthe importance of showing the instruction cant on any further injury Wii presents the instruction card every time he returns Fr the follow-up inestions iy. Fetus for his follow-up injections on the days stipulated oa his instrvtibn ean. A Landi BL Landi c. Wiandiv @ tinandiv ‘SCENARIO CONTINUED Mr. Stewart had a eduction of facture and application of ®.0.P to his et ex trem 20 To observe for signs of circulatory impairment, Mr. Stewart would be asked to cough and deep breathe perform biceps exercises. Wiggle his toes trp hiselt in bedfos nena same a oh ee a Teaching/learinginstiction fe Me. Swan che which the Flos |. Check Feting in the eased tin frequently for mame, oF ining sensation.” i. “Estend and move yon ings ad es fly : Iii, "Keep your eat clean ana dry |. "Cheek erculaton in theese ins mai sowie diy ss A yaad a D Citimaiv © iitamiy tres 22 Which o the flowing stat teaching sessions? ts sould be re-crnphasied wy M.Steat bythe muse the diehanse |. "Do mot wall ow the le east without the permission ofthe dost." |i, "Ifyou have a fllow-ip appeiniment be sre to keep Tig, “Elevate the injure eto rece swelling al an : Iv, AFany mea of pessuts oF ineressed pain develop, my the dock A tani . Blandi Want iv B tibandiv SCENARIOS Qae 329) WreM2=30 “Mari, a ehteen (18) year old “A” Level salen who is preparing for examination was tought to the ‘Acie wl Eimergeney Depart yr parents who fepote ta sc ha nl sep fare fo sgh {tnd have been sobbing hysterically for he past eight hours. Marie is hyperventlatng al sites tg og "annottake i anymors” A.iognosis of Ansiety wis made, °° arenas Whit of the following beliviour would BES descr anvieiy? Sines, despa, dscinagement B. Demanding, aggressive, dehsion Animes, pessinise ojetion Apineharsion, ciness ital‘Behaviours that the nurse wou sR the following EXCEPT 1¢ A. selfesteem disturbance. ae 3 ered hueht ress. + Cpt for violence to set GH _nety lated aos tren 2s “Which of ese statment made by Ma's pans wuld mast itty combo er ans)? |A. "Nurse wish could tl you why she was baying his way” sweatin her to maintain Taily ad soa is” G sno domestic problems ately. canner epic shout Marie's conlition but | don't want he to know.” ITEM 26-30 Indicate whether the following statements are TRUE OR FAL! » Rue. inthe space provided Lowered self esteem inan adolescent may esl rom srst parental sudan.» 2. Divorce is positive contributing factor to anxiety in adolescence 1 ‘Adolescents ae always unable to get along with parc 2 Economie sats shoul be considered wen assessing parent-child ont i fies. 30. ibn rivalry maybe a causative Factor of ast inthe adolescent Trem 31 _Tue mre asks Mare to breathe lato paper bg none lo crete problem of hypervntinon “Tis i doe because st fsitates an increase inthe oxygen satiation level ofthe blood i faces abichwrmlates the brain and ease depression of he respiratory system, C. _COncvatent inthe bid will be reduced 5. This lends to a reduction of oxygen, causing the diaphragm to el.“The init nursing intervention for the patent wun severe anny srg ep eating unis an ion eines Change immediate environment C_skelient to deserbe intensity of estings. 1D. se value lariieation to resolve confit, rem 33 In order to relieve the signs and symptoms of tetany whi Marie as developed asa hyperventilation, which ofthese drugs willbe given? A. Chioropromamige BL Diazepam > Calcio gluconate D. Chloropromazine ‘SCENARIOS THEMS 2442 Miss Mary Dumont, aged twenty (23) years is admitted to the Medical War fr the secon time ia si {6) month with a diagnosis of Urinary Tract Infection. On admission her temperature was T 10 (69:4) and she was experiencing chills trem a4 Factors that may contribute to Mary's Urinary Tract Infcton ince 1 cohabitation with multiple partners. i, posteroe to anterior perineal cleaning methods Ti proximity of ureta i elation to perineum. — Jy. tse oF different contraceptive devices. Bivona Be tana iv © Liivandiv D.—lividvandivAbnormal constituents found in Mary s wrne sy 1 ii i ITEM 36 categories f medication which ar eetve in th etmen patent wth Urinary Trost Infection include Hi, anagesies and steroids fii, anigepties and antibiotics.“ Is, anibioties and steroids A Landi {andi ciandiv D. tiandiv : rem s7 Stabe topes toe ncaa in teahinglouseling ssi fr females wit Urinary Tat Inesion inchde 1 uid intake tion intake hygiene evualatvty A bilan B Nilandiv © biiandiv 3 titvandives eet ay Fees HF Ee pai WT <1 bleed wea itagen, i, creatine clearance ik, culture and sensi iy ialyse a ren 9 Which ofthe following woul be the MOST appa usin ner efi fr Miss Boon chin the ate phase wer lass? A. Allowing Miss Dusit o vent he eines Giving her opies amt of is Collecting mi-sra winespecinen 1D. Testing her urine to ly 1 rong Miss Dunn Increasing Hid intake “Taking the femperature we howe tena "he goals oF eare which would he MOST stale wh ing cane Ine Nis Dum agen 1. increase her intake: Ti reduce her by temperature fil inimize the risk of re-nteton 16. cout he ole syle practicesreat ven planing hg an cosines i Miz Du = OS to ince a Tatlowing aspects ESCEPT the ‘SCENARIO? rrents.43 = 2 sack aged twenty-seven (27 yur ah was ake 9 te Enea pepanment wth ag shot woud daa sche, On arvaiwar entess can 3 aged, Tea paraowical We de to a “sucking” woud ingens cg ws md, itis ee TS oc). 0 120, 49, BP BONO wn, wen as snc tt ating vO es pled ETM? 1. Stat intravenous infos i Give oxen via fee mask Hl ce patent in Fowler's rst ie at witha resin A Candi whieh ofthe following oe clinics manifestations Peete? rreM 44 1 Shap, Knifetke eet pa fi, Decreased breath sounds Wi. Sucking aise om inspiration wie ovement chest wal ting iio AC band B. Biandiv CMa iv © Vainwtih the owing cmptietons of Preotorms wil aSSSS IMMEDIA eos ITEM 46 der esa dedangta doe techie he ala ik 3 8 ren a7 Tension prcumotior Haemethorss Empiiysem Shock XCERT to reinove fd and ac for the pleural a=" rete the sizeof he plewal space ree ah normal negative peste within he Wolk so expan te ang and cbesion oe reenter een covningan ep iting xe He pint wk an under ater sa ranage system inl clearing the bone of secretions ‘promoting ur eSPansion einai patency ofthe dante rae pulnon and ina-peoal Presse ii anit ds © bias @ Tuivandiy bo lihitandivad SCENARIO 8 ITEMS 48-51 Mrs. Mary Alfred, a twenty-eight (28) year old mother of three (3) children ages four (4), six (6), and eight (8) works as @ machinist ata garment factory. Mrs. Alfred complained of severe pain ia her lower tack after lifting a heavy box, and she stated that she felt as “if something gave way.” Her supervisor took her to the hospital where she was diagnosed as Prolapsed Intervertebral Disc. ITEM 48, X-Ray of the spine and myelogram are tests used to confirm the diagn: Disc. of Prolapsed Intervertebral Which of the following are rationales for using these tests? 1 Demonstrating area of pressure. ii, Identifying other lesions, ii, Localizing specific spinal nerve. Iv. Recording echoes from the spinal cord. @ tandii B. [and iit C tiandiv DB. Tivandiv, ITEM 49 Which of the following are appropriate nursing diagnoses for Mrs, Alfred? 1. Alteration in comfor related to spinal injury ji, __Discolouration of the lower limbs associated with poor circulation. Tir” Disturbance setfconep seated impaired mb te ingaied onal paamsiaerieis datz ® tani inte eta D. tiandsITEM 50 Which ofthe following types of deugs may be administered toa patient suffering from Prolapsed Inwervertebral Dis? 1. Antibiotics ii, Anticinflammatory. i, Emeties| iy, Steroids A Landii and ii Wand iv D.Wivandiv ITEM st The appropriate diet fr a patient with Prolapsed Intervertebral Dise should consist of A. extra roughage, resirited calories and low fat. high carbohydrate high poten, and increased fui. a G___ith poe, ow fat and igh crbohyate ©) incensed Mids, eta rousage and restrited alors SCENARIO 9 TEEMS-2-54 ‘Susan, aged 33, was rushed to the Aceident and Emergeney Department with history of sever, lower Abdominal pain of sx hours duration. On examination by the Physician, she was diagnesed as having an scopic pregnancy rrEM 82 “The patient with an ectopic pregnancy will present signs and symptoms including Lise in temperature Ti, severe, lower abdominal pin, ii, vaginal Bleeding iv. signs of shock. 1, fi and ii iv and iv 2 © hitenaiv DB Livitend\onturmation ot an e:tope pregnancy is made onthe basis of he clinical manifestation an the {oliowing diagnostic tests EXCEPT stoner & oetamogibin ev © Spraton of lody Tid rom Puck of Doulas D.__falptonof mans Post af Deg rreMs4 Complications ofan ectopic pregnancy include ll ofthe fllowing EXCEPT eoik intetiiy tata occiion pelvic inflammatory dee -_———$_ me. o SCENARIO? THEMIS S560 2° Atahea fired recent, Mrs. Renny 45 yes mothe of wo 2) teenage daughters had her blood rp 4S. pressure and weight checked Hor BP was 210/120 mmHg. Weight 82 kg (180 Ibs). When interviewed she stated the fllowing ‘She was an insurance agent ‘Se was diagnocsd wit hypertension 5 years ago Ste is on Atenolol (Tenormin) 100 mg dally She ha! not aken her medication for 4 weeks. Sie nas referred the Accident and Emergency Departneat and was admits for stabilization, ITEM ss The shor term goals which shouldbe set for Mrs, Benay on admision ar to 1. allay her anxiety i, increas diuresis lik, reduce her blood pressure level Iv. se ago ody weight wacky andi @ tain © Uandiv D.tivand ivITEM $6 “Which ofthe following dietary regimes would be BEST suited for Mrs. Benny? 1 Restricted protein Restricted salt Limited fui intake iv, Reduced carbohydrates and fat. AC Vandi Land i land iv Wand iv ~ ireM s7 “The doctor di not indicate how often Ye wanted Mrs. Benny's blood pressure taken. “The nurse however should monitor and record her blood pressure A. hourly daily four hourly 3. twice daily , ITEM s8 Mrs. Benny is worried about the welfre of her two teenage daughters. In order to duce her aniety ‘which ofthe fllowing is MOST suitable for the nurse to do? A. Arrange forher daughters to visit her every morning 1B. Geter next oF kin to see after her daughters C.—_Toyto impress her that worying will inecease her blood pressure Discuss the nature ofthe problem with he. rrews9 tn planning for Mis. Ben 's discharge from hospital she shouldbe encouraged t0 1. reorganize daily schedules. |i, have annual opthalmie examinations Til, sleep at east 6 8 hours day. Fe. keep appointments for follow up care. A tila Cian ® tives Bitten"Peay, se aavice wate souls e given on unege Ww Wer Ben an Ne eaves permit COMO! ot ‘her hypertension would be 1a |. participate in a daily exercise program Ti, heck weight dily before breakfast. Ti, Check blod pressre every moring nd evening iv. Reduce exposure to stressful situations AL band & tetiv Wand it D. liandiv ‘SCENARIO LL MTEMS41=72 admited to « Medical Ward with a history of, nausea, vomiting and severe abdorinal pains raining to the back. On examination his vital signs wee: ‘T 102 F (9.0), Blod pressare 110/60 mmFig. Blood ghisose 2SGme/dl. He had some epigastric tenderness and abdominal distention. He is thn and undernourished. He is a known alcoholic for five ests A Gagnon of Pancreatitis war made ITEM 61 From she Nurses’ knowledge ofthe laboratory data for a patient suffering from Pancreatitis which ofthe following clinical Findings are corrst? 1. WBC greater than 16,000 cfnm. Ii, Serum ealeium less than 8 mgd Hii, Blood glucose greater than 200 mg/dl fs. Blevated BUN after 48 hous. Lit and it if and iv Hi, iiland iv ® tikitarde B a ITEM 62 ‘Which ofthe following neurologiesl signs is Mr. George likely to portray? Diplopia Ireablity Amnesia DB Ataxiatne expectea neurological manitestations or mr. George on assessment Would Iie a Ine rOLOWINg EXCEPT ‘A. clouded sensorium JB delirium tremens repression i aeenias rem 64 ‘The uboetry et wih Is MOR widely ue contin a cagnsts of panceatnis AL Aid Phosphaase 3 Biiubin Tox C_Pasme Protein Levels © SenmAnyiae restos “The result ofan initial Blood Lipase Test fora client diagnosed with Pancreatitis is expected to be © ctevated normal C.—sub-normat D. initially eratic ITEM 66 \Whict of the following patient care goals would be of LEAST priority for Mr. George during the first 24 hours after his admission? . A. Reduce body temperature to within normal limit B. Relieve abdominal distention and gastrie motility ( Restore normal nutritional status Maintain normal blood volume. ITEM 67 ‘The client goal that would be personally of GREATEST priority to Mr. George with an acute attack of Pancreatitis would be to A. relieve nausea and vomiting. ) restore adequate comfort levels through pain relict C. increase knowledge of the causes of his condition, D. improve his cardiac outputve wana vs eeuive LIEW POR” 10 he patient with Pancreatitis would be MOST specially related to : 1. clectolye imbalance i, Awlecusis « Hit Pain iv. Hyperglyeaemia andi and i Hand iv Hiandiv on@> id and electrolyte loss resulting from emesis and nasogastric suctioning ‘he appropriate nursing diagnosis likely to be made are 1. compromised cardio-pulmonary function ii, aeration in tissue perfusion, Tit, potential for diminished ucinary output Jy here respiratory sas A Tand BL landiv Handi eand iv rem 70 Calcium depletion due to vomiting would cause the nurse to anticipate which ofthese problems? Vergo ‘Tetny C.—_Steataerhoea D. Generalized cedema irem71 Which ofthese isthe MOST likely potential problem to anticipate because of Mr. George's malnourished state? AL Purpura BL Kemictenss CParalytic ileus ©) decubitus ulcers‘tne primary reason tor maintaining be rest oe Mr. ieorge 810 decrease dy mea trey ein va simlatin ITEM 83 In order to plan a satisfactory dietary regime for Mrs. Adams, consideration should be given to 1. her emotional health ii, facilities for food preparation. ii, social and economic resources iv her general physical health. 1, ji and ii [il and iv A 3 C. iiitand iv © Wihiiianay‘rs, Adams snould be encourage to ake daly Walk n order to prevent © caer ep en tony t eee cee ©. Seve lg gta dace BSepessn ad aby ‘SCENARIOS ITEMS 86-94 ‘Twenty-eight year old Mr. Jonathan Willams, a aboure, sexually ative fore past S years has jst been diagnose as having Primary Syphilis. He has come tothe health cente for management of his condition, ITEM 6 Which ofthe following clinical manifestations should the nurse ark about during history taking? |. Enlarged regional Ipmph nodes i, Chanere om his penis lik, A low grade fever iv. Discharge from lesion AL Iiland it @ biimdiv © beiivand iv De titvand ireMs7 Which ofthe following subjective and objective data would you use to determin that Mr. Wiliams is experiencing an alteration in body image? He 1, coves hips rig you nspcion. Hi, sksrepenely fhe wi here ele cary out noma sexu fon api, Ui, Ghimeerpatealy at isla pares cased ts poten Ive ett ee extenely woe abut hs condion @ tai r teh cand Do tantar wittams says ne ei ike ining sume Seve Us CN, is nmin MOST appropriate intervention? 1, Allow him to verbalize his fears“ ii, Tell him that there i nothing you can do if he wants to kil himself ii, Couns him and indicate tha the disease may be cured t this tage. Iv, Tell him to stop talking abou ling himself 2=° ITEM 99, fn counselling Mr. Williams what advice wil you give him regarding sexual behaviours during this stage? ‘A. Telli that he disease is ot contagious his stage, He should have sexual itereourse wih one fil pane. ©. Advise him on comet condom usage. Be He sould abstain fom sexal intercourse ireM90 ‘Which ofthe following would NOT be an appropri longterm bjs for Mr, Wiliams? A. Preventing snfction B. _ Encouraging ll pares tobe weated ‘retin pope pon Mylene ‘Making regula visits tothe ci. memo Which of he following i the eusztive agent pi AL Xebera ooomoboe 8 Tncsomonas Vaginas LO Treponeme Paladin Candida AlbicansWhich ofthe folowing subjective and objective date woud tll you that he is having wn allergic reaction? 1, Red patches appear on hs extremities, fi, Hecomplais of ump in his throst ii, He complains of generalised itching iv. He complains of pain at injection site. |i ana it B Liiandiv Chiitandiv BL tesa memo Me, Wiis’ VORL. test shows psn’ Apstne VOR. tt ee which fhe fon? ‘ ea D. Systematic antibodies rreMo4 A person with a specific VDRL test canbe cure t which stage of Syphilis? Primary Secondary Tertiary Latent and Bo Landiv Hand i DB. tilandiv‘SCENARIOINT TTEMS95 100 Jane Jeck, four years old, is admied to Paediatric une with a history of enlarged abdomen, welght loss, ‘orexia and fever. Upon physical examination a mass was fin the right lower qasdrant ofthe abdomen. She was diagnosed as vor infesation. ITEM 95 Based on Jane's assessment data which ofthe following helminth ie ikely tobe isolated upon laboratory investigation? A. Hookwor B Enterobius Trichuristchura B) Ascaris lumbricoider ITEM 96 In planning care for Jane, wo objectives wll be to 1. observe Jane for sans of septiczemia Hi, preveat eeinfetion iii treat he infection |v. murs Jane in isolation A Landi Bo Landy Wand i D. tiandv ITEM97 (One drug of choice in the weatment of Jane's sonditon is @ — Merendazole B Thiabendszole Flagyl D.Alcopar‘You ae administering caret Jane, Which of alow mT estan mts nnn intbecare? A. Giving prescribed medication Bf Colesng sol specimen fr vestigation © Teesingall meters fan's fay S_lueatng moter on personal hen of il ITEM 99 + Which ofthe following wil be beneficial to Jane when planing he ise? 1, Lite uid fi, High protein ii, rom Supplements jy Highcarbohydrate A Tand. Bandi © Uni and ITEM 100 ‘You are teaching Jane's mother ebout prevention of worm infestation. Which ofthe following wit you include in your teaching? 1. Handwashing after using the toilet ‘Wearing shoes when se is ouside ‘Washing fruits before eating Handwashing resting. @ biiand at