RAILWAY RECRUTMENT BOARD STAFF NURSE QUESTIONS

1. In performing a bacterial wound swab, why is it necessary to cover the wound with appropriate dressing?
a. It reduces the transmission of microorganisms.
b. Promotes patient’s comfort.
c. Facilitates wound healing, absorbs exudate, and reduces risk of bacterial colonization.
d. It decreases trauma to the tissue.

2. Which of the following types of burn injury is more frequent?
a. Thermal burns
b. Chemical burns
c. Electrical burns
d. Radiation related burns

3. What kind of technique used for assessing the extent of burn that gives reproducible accuracy especially age-related cases?
a. Wallace’s “rule of nines” tool
b. Lund and Browder chart
c. Fitzpatrick’s Scale
d. Both A and B

4. Which of the following classification of burn injury that involves the muscle, bone, tendon and interstitial tissue?
a. Full thickness burn
b. Superficial partial thickness burn
c. Superficial burn
d. Subdermal burn

5. Which of the following clearly describes a stage 3 pressure injury?
a. It includes a full thickness tissue loss with exposed bone, tendon, and muscle.
b. It includes a partial thickness loss of dermis and shallow open ulcers.
c. It includes a full thickness skin loss; subcutaneous fat may be visible.
d. It is present on areas of persistent, non-blanchable redness when compared with the surrounding skin.

6. Which of the following is considered as a major factor in determining pressure injuries to patients?
a. Redness
b. Abscess
c. Edema
d. Pain

7. Which of the following strategy is not essential in preventing pressure injuries?
a. Promote rubbing and massaging the bony prominences.
b. Monitor patient’s nutrition and hydration.
c. Maintain good skin hygiene.
d. Prevent shear and friction.

8. Which of the following types of leg ulcer which is often painless?
a. Venous Ulcer
b. Arterial leg ulcer
c. Diabetic leg ulcer
d. Both A and B

9. All of the following describes the importance of using critical thinking except:
a. Nurses do not involve themselves in making important decisions.
b. Nurses use knowledge in a various field of study and subjects.
c. Nurses deal with change in a very demanding and stressful environment.
d. Nurses should use it to solve client problems and make a reasonable solution.

10. Nurses use the nursing process systematically in order to plan and provide the appropriate nursing care. Which of the following step in the nursing process where a nurse will continue, modify, or terminate the client’s plan based on the outcomes gathered?
a. Diagnosing
b. Evaluating
c. Assessing
d. Implementing

11. There are various types of assessment use by a nurse which depends on the situation. Which of the following is performed during any physiologic or psychological crisis of the patient?
a. Time-Lapsed Reassessment
b. Initial Assessment
c. Problem-Focused Assessment
d. Emergency Assessment

12. Obtaining data is a very crucial part in planning patient’s care. Which of the following types of data is also referred as the overt data?
a. Subjective data
b. Constant data
c. Objective data
d. Inherent data

13. There are different types of nursing diagnosis that a nurse can choose from. Which of the following types is considered as a client problem which is present at the time of assessing the patient?
a. Actual diagnosis
b. Wellness diagnosis
c. Risk nursing diagnosis
d. Syndrome diagnosis

14. Maslow’s hierarchy of needs clearly depicts the human needs as it is ranked based on how essential it is for our survival. Which of the following is not a characteristic of Maslow’s hierarchy of needs?
a. It is realistic, sees life clearly, and is subjective about his or her observations.
b. Has superior perception, is more decisive.
c. It is self-centered rather than problem centered.
d. It is highly effective, flexible, spontaneous, courageous, willing to make mistakes.

15. Aside from Maslow, Kalish also presented a hierarchy of needs. Which of the following needs he incorporated or added to the five levels of needs by Maslow?
a. Affection needs
b. Stimulation needs
c. Independence needs
d. Recognition needs

16. Which of the following describes a secondary level of prevention?
a. Family planning services
b. Referring a client to a support group
c. Hepatitis B Immunization
d. Denver Developmental Screening Test

17. Health behavior change is a cyclical process where a patient progress in a series number of steps. Which of the following correctly describes the contemplation stage?
a. It is the stage where the patient acknowledges that he has a problem and considers changing that behavior for the future.
b. It is the stage where the patient plans to make actions in the immediate future (e.g. within next two weeks)
c. It is the stage where the person actively participates in the course of program designed for him.
d. It is the stage where the person strives to prevent relapse by integrating actions into his life.

18. The definition of health is very complex and may consider a lot of factors. Which of the following models of health and wellness describes that a person is considered healthy as long as they can perform their roles in the society?
a. Adaptive Model
b. Role Consistency Model
c. Role Status Model
d. Role Performance model

19. Agent-host-environment model by Leavell and Clark is one of the theories which is widely use in determining illness rather than promoting wellness. It is based on the interaction of three factors: agent, host and environment. Which of the following deals with the agent factor?
a. Climate
b. Economic level
c. Lack of body nutrients
d. Family history

20. Sociologists use the term illness behavior to describe how an individual deals with his signs, symptoms, and medical regimen at the time of his illness or disease. Which of the following is not included in the four aspects of the sick role provided by Parsons?
a. Clients are held responsible for their condition
b. Clients are obliged to try to get well as quickly as possible
c. Clients are excused from certain social roles and tasks
d. Clients or their families are obliged to seek competent help

21. Growth is the physical change and increase in size. Development on the other hand is an increase in the function and skill progression. Which of the following correctly describe the principle about growth and development?
a. The pace of growth and development is even.
b. Certain stages of growth and development are more critical than the others.
c. Development becomes increasingly undifferentiated.
d. Development proceeds from simple to complex or from integrated acts to single acts.

22. One of the significant characteristics during the toddlerhood stage is the increase in psychosocial skills and motor development. Which of the following nursing implications is very important during this stage?
a. The nurse should assist in developing coping behaviors
b. The nurse should assist the parents to identify and meet the unmet needs
c. The nurse should provide opportunities for play and social activity
d. The nurse should balance between safety and risk-taking strategies to permit growth

23. Freud identified five stages of development. Which of the following correctly happens during the anal stage?
a. 6 years to puberty
b. 1 ½ to 3 years old
c. 1 to 3 years old
d. 4 to 6 years old

24. Erikson identified eight stages of development. He pointed out that during the early childhood, the central task should be autonomy versus shame and doubt. Which of the following is an indicator of negative resolution to this stage?
a. Compulsive self-restraint
b. Mistrust
c. Estrangement
d. Lack of self-confidence

25. Cognitive development deals on ways in which a person learn to think, reason out, and use language. The cognitive theory by Piaget pointed out three primary abilities which are present in each phase. Which of the following deals with the process where an individual encounters and reacts towards new situation and using the mechanisms that they already have?
a. Accommodation
b. Adaptation
c. Assimilation
d. Coping behavior

26. Which of the following maternal factors does not contribute to the higher risk of low birth weight babies?
a. Low stress levels, including physical or emotional abuse
b. Use of addictive drugs or alcohol during pregnancy
c. Complications during pregnancy, poor health status, exposure to infections
d. Poor nutrition during pregnancy

27. Reflexes are normal to newborn; they are unconscious and involuntary responses. Which of the following infant reflexes is also known as the fencing reflex?
a. Babinski reflex
b. Stepping reflex
c. Tonic neck reflex
d. Palmar reflex

28. Which of the following psychosocial development stages is considered as the crucial crisis according to Erikson?
a. Autonomy versus shame and doubt
b. Initiative versus guilt
c. Identity versus role confusion
d. Trust versus mistrust

29. Nurses use different types of therapeutic communication techniques in order to build an effective relationship towards their patients. Which of the following techniques illustrates acknowledging the patient?
a. “You trimmed your nails today and washed your hands.”
b. “Your book is here in the drawer. It is not stolen.”
c. “I’ll stay with you until your mother arrives.”
d. “Tell me about…”

30. Learning is represented by a change of behavior. Which of the following learning theories where a nurse is seen applying a humanistic theory?
a. The nurse will provide an enough time for his patient to solve problems through trial and error.
b. The nurse will acknowledge the patient for correct behavior.
c. The nurse will encourage active learning by being the facilitator and/or mentor
d. The nurse will assess a person’s developmental and individual readiness

31. Andragogy is defined as the art and science use in teaching adults. Which of the following concepts can be used as a guide for client teaching?
a. An adult’s previous experiences can be used as a resource for learning.
b. As people mature, they move from independence to dependence.
c. An adult’s readiness to learn is often not related to a developmental task or social role.
d. An adult is more oriented in learning when material is use sometime in the future.

32. Nurses as part of the health care team can contribute largely on the health literacy of patients. Which of the following client behaviors will a nurse suspects that a patient has a problem in terms of health literacy?
a. No presence of pattern of excuses for not reading the instruction materials.
b. The patient will read the instructions instead of family members.
c. Pattern of compliance
d. Patient will insist that they already understand the information given to them.

33. A leader is someone who can influence others to accomplish a specific goal. Which of the following leadership styles that has a minimal leader activity level?
a. Authoritarian Leadership Style
b. Democratic Leadership Style
c. Laissez-Faire Leadership Style
d. A and B

34. Delegation is the transfer of responsibility and authority to a competent person. It is a tool that a nurse can use in order to improve productivity. Which of the following tasks that should not be delegated to unlicensed assistive personnel?
a. Taking vital signs
b. Evaluation of care effectiveness
c. Postmortem care
d. Suctioning of chronic tracheostomies

35. Which of the following interventions that a nurse should not perform in patients suffering from hypothermia?
a. Cover the client’s scalp with a cap or turban.
b. Apply warm blankets.
c. Provide a warm environment.
d. Keep limbs far from the body.

1. Rationale: C is the correct answer because it provides a moist environment for the wound thus promotes healing as it reduces bacterial colonization. The other choices though correct but they cannot explain clearly the importance of wound dressing. A is wrong because it talks about avoiding to touch the wound. B is wrong because it is more on assisting patient’s comfortable position. D is wrong because it is more on the removal of the dressing and checking the condition of wound.

2. Rationale: A is the correct answer because the cause of thermal burns happens usually in the house (e.g. kitchen) which makes a person more prone to hot liquids or flames. B, C, and D are not considered as more frequent types though they may happen at workplace.

3. Rationale: B is the correct answer because it uses age-dependent graphs which are most preferred for children and neonates. A is incorrect because it is more applicable to adults. Children have different body proportions compared to children. C is incorrect because this scale is use to determine the color of the skin to determine the response to the UV light.

4. Rationale: D is the correct answer because it correctly defines the type of burn classification. Subdermal burn appears as white, brown, or deep red with no blisters. Grafting is required and scarring will occur. A is wrong because it only involves epidermis, dermis, and subcutaneous tissue; it appears as with or without blisters. B is wrong because it only involves epidermis and extends into the papillary or superficial layer of the dermis; there are small blisters. C is wrong because it involves only the epidermis and no blisters.

5. Rationale: C is the correct answer because it correctly defines a stage 3 pressure injury. A is wrong because it is a stage 4 pressure injury. B is wrong because it is a stage 2 pressure injury. D is wrong because it is a stage 1 pressure injury. This stage may be difficult to assess especially to individuals who have dark skin tones.

6. Rationale: D is the correct answer because it signifies that pain over the site is a precursor to tissue breakdown. A, B, C, are wrong because they are secondarily check during assessment of the skin and their presence may mean other skin condition.

7. Rationale: A is correct answer because massaging or rubbing any bony prominences will only increase the chance of developing a pressure injury leading to tissue damage. Pillows can be used to avoid pressure injury especially if the patient is positioned properly. B is essential because it allows the body to repair itself. C is essential because good skin hygiene preserves skin integrity. D explains the importance of proper positioning in order to prevent shear and friction.

8. Rationale: C is correct answer because it is associated with a loss of protective sensation (neuropathy) and/or the presence of ischemia with patients having diabetes. A is wrong because it ranges from no pain to severe, constant pain. It is often worse after standing for long periods. B is wrong because it is often accompanied by severe cramping pain in the foot or calf muscle at rest when the legs are elevated.

9. Rationale: A is the correct answer because it is not true that nurses don’t make important decisions, rather they are. These decisions often include the total well-being of their patients. B, C, and D are all options which clearly describe the importance of using critical thinking by the nurses in the work field.

10. Rationale: B is the correct answer because it is in the evaluating stage where a nurse collects the data in order to determine the outcomes. From the outcomes gathered, a nurse compares and relates it to the goals set or the patient. If changes need to be done, it is here where the nurse will continue, modify or terminate the client’s plan. A is wrong because it is the step where the nurse will analyze the data and formulate diagnostic statements. C is wrong because it is a step where a nurse collects, organize and validate the data. D is wrong because it is a step where a nurse implements the interventions planned for the patient.

11. Rationale: D is the correct answer because it is the type of assessment use in order to identify any life threatening problems and/or new or overlooked problems. A is wrong because it is done during several months after initial assessment. B is wrong because it is performed within specified time after admission to a health care facility. C is wrong because it is performed during the ongoing process of nursing care.

12. Rationale: C is the correct answer because an objective data are the ones which can be detected by someone else (observer) and can be measured using accepted standard procedures; this is the reason why it is also termed as signs or overt data. A is wrong because a subjective data is also referred as symptoms or covert data; these type of data is the one that the patient feels.  B is wrong because a constant data are information which doesn’t change over a period of time (e.g. blood type). D is completely wrong because it is not included in the types of data that a nurse acquires.

13. Rationale: A is the correct answer because an actual diagnosis is made based on the signs and symptoms present. B is wrong because it “describes human responses to levels of wellness in an individual, family, or community that have a readiness for enhancement: (NANDA International, 2005, p.277). C is wrong because it is made based on the presence of risk factors that suggest that a problem will likely occur if it is left untreated and/or left unseen by the healthcare team. D is wrong because it is a type of diagnosis which is related to a number of other diagnoses.

14. Rationale: C is the correct answer because Maslow’s hierarchy of needs is not self-centered rather it is problem centered. A, B, and D are all characteristics of Maslow’s hierarchy of needs.

15. Rationale: B is the correct answer because it is one of the needs that Kalish added between the physiologic and safety and security needs of Maslow. A is wrong because affection needs is under the love and belongingness needs of Maslow. C and D are wrong because independence needs and recognition are under the self-esteem needs of Maslow.

16. Rationale: D is correct because a Denver Developmental Screening Test is an example of screening survey and/or procedures. A and C are wrong because they are both primary level of prevention. B is wrong because it is an example of a tertiary level of prevention.

17. Rationale: A is correct because it correctly defines the contemplation stage. B is wrong because it is the preparation stage. C is wrong because it is the action stage. D is wrong because it is the maintenance stage.

18. Rationale: D is correct because this model considers that sickness is the inability to fulfill one’s role. A is wrong because this model deals about how an individual adapts with his environment towards to good health. Both B and C are wrong because they are not included in the accepted models of health and illness.

19. Rationale: C is the correct answer because lack of body nutrients predisposes a certain individual in acquiring a disease; other example include environmental factor or stress factor. A and B are both wrong because climate and economic level are all example of environment factor. D is wrong because family history is an example of host factor; other example includes age and lifestyle habits.

20. Rationale: A is correct because it is not included in the four aspects; it is not true that clients are held responsible for their condition. B, C, and D are all included in the four aspects of sick role.

21. Rationale: B correctly describe the about growth and development. A is wrong because the pace of growth and development is uneven; as such, growth is greater during infancy compared to childhood. C is wrong because development becomes increasingly differentiated, i.e. it starts in a generalized response to a skilled specific response. D is wrong because development proceeds from single acts to integrated acts.

22. Rationale: D is correct because this nursing intervention is very important in toddlerhood stage. A is wrong because it is important during adolescence stage. B is wrong because it is important during neonatal stage. C is wrong because it is important in the preschool stage.

23. Rationale: B is correct because during this age that anal stage happens. A is wrong because it happens during latency stage. C is wrong because it is just a diversion to the choices. D is wrong because it happens during the phallic stage.

24. Rationale: A is correct because it is the right negative resolution during early childhood; others include compulsive compliance and defiance.  B and C are both wrong because they happen during infancy stage. D is wrong because it happens during late childhood stage.

25. Rationale: C is the correct term for the definition given above. A is wrong because accommodation is defined as the process of change where cognitive processes mature sufficiently to allow an individual to solve problems that were unsolvable before. Both B and D are wrong because they mean the same thing; it is the ability to deal with the demands in the environment.

26. Rationale: A is correct because a low stress level will result to a less risk of low birth weight baby. B, C, and D are all maternal factors that contribute to the higher risk of low birth weight babies.

27. Rationale: C is correct because tonic neck reflex is the other term for fencing reflex; it is defined as the postural reflex which disappears after 4-6 months. A is wrong because Babinski reflex is characterized as rising of the big toe and fanning out of other toes when the sole of the foot is being stroked. B is wrong because it is also known as the walking or dancing reflex which disappears at about 2 months. D is wrong because a palmar reflex happens when a small object is placed against the palm of the hand causing the fingers to curl on it.

28. Rationale: D is correct because according to Erikson the resolution of this stage will determine how a person will handle to resolve the next stages to come. A, B, and C are all diversion to the question.

29. Rationale: A is correct because the statement acknowledges the patient in a nonjudgmental way. B is wrong because it uses a presenting reality technique. C is wrong because it uses an offering self technique. D is wrong because it uses an open-ended questions technique.

30. Rationale: C is correct because it describes how a nurse clearly applies the humanistic theory towards his patient. D is wrong because the nurse applies the cognitive theory. A and B are both wrong because they describe a nurse who uses the behavioristic theory.

31. Rationale: A is correct because an adult will response to either new or same situations based on the previous experiences that they encountered. B is wrong because people will mature from dependence to independence. C is wrong because an adult’s readiness is related to developmental task or social role. D is wrong because adult is more oriented in learning when the materials are presented immediately and not in the future.

32. Rationale: D is correct because it indicates that a patient may have a problem with his health literacy level. A, B, and C are not client behaviors that will indicate a health literacy problem to a patient.

33. Rationale: C is correct because a minimal leader activity level depicts a laissez-faire style which is why it is considered as inefficient. A and B are both wrong because they are both high in terms of leader activity level.

34. Rationale: B is correct because evaluation of care effectiveness should be done by nurses; unlicensed assistive personnel are not required to create a nursing care plan. A, C, and D are tasks which can be delegated to unlicensed assistive personnel.

35. Rationale: D is the answer because the limbs should not be far from the body but rather close to it. A, B, and C are all nursing interventions that can be done to patients with hypothermia.

INTERVIEW QUESTIONS FOR NURSES

Other than common interview questions like Tell me about yourself, about your family and your skills, the interviewer may ask some questions about your professional experience or from nursing subjects.  The most commonly asked questions in general hospital interviews are,

1) What are the emergency drugs kept ready in your casualty or in ICU?

2) Did you assist Lumbar puncture? what is the position used for lumbar puncture?

3) Do you know how to do cardio pulmonary resuscitation? Explain.

4) What is the drip rate in micro dripset?

5) What injection given before blood transfusion?

6) Give me a example for diuretics?

7) Tell me some trade names of antibiotics used in your last job?

8) Tell me the name of ventilator you operated in your previous job?

9) What all are the injection used for local anesthesia?

PSC QUESTIONS 2

1.  A Slightly movable joint is a :

          A. Synartrosis     B. Amphiarthrosis

          C. Diarthrosis     D. Gomphosis

2. The muscle that closes the mouth is:

          A. Masseter         B. Platysma

          C. Levator labiv superiors    D. Buccinator

3. The nerves that do not enter into the formation of a plexus are :

          A. C1 - C5           B. T2  - T12

          C. C4 - T5           D. C1 - T4

4. Hypothyroidism in children causes :

          A. Myxedema       B. Dwarfism

          C. Cretinism        D. Acromegaly

5. A line of tender along the middle of the abdomen is called :

          A. Linea Alba        B. Linea nigra

          C. Linea aspera    D. Patent ductus Arteriosus

6. The normal capacity of gall bladder is :

          A. 60 ml               B. 50 ml

          C. 70 ml               D. 40 ml

7. The bone named as shin bone is :

          A. Fibula               B. Ulna

          C. Tibia                 D. Radius

8. The ligamentous structure which attach to the posterior part of the tongue is:

          A. Frenulum linguae     B. Papilla

          C. Uvula                       D. Filiform papillae

9. The suprapleural membrance, otherwise known as sibson’s facia on which the artery lies is :

          A. Pleural artery 
         
          B. Subclavian Artery

          C. Phrenic artery        D. Coronary artery

10. The smallest cranial nerve :

          A. Olfactory               B. Optic

          C. Oculomotor           D. Trochlear

11. Hearing apparatus situated in which portion of the temporal bone:

          A. Petrous portion
         
          B. squamous portion                         

          C. Zygoma                 D. Pterygoid

12. Small glands in labia majora:

          A. Bulbourethral gland

          B. Bartholin’s gland

          C. Sebacious gland     D. Coper’s gland

13. Normal bladder capacity is :

          A. 230 ml                   B. 260 ml

          C. 250 ml                   D. 270 ml

14. Which cell forms the epidermal layer of skin:

          A. Columnar epithelium                    

          B. Transitional epithelium

    C. Stratified epithelium

    D. Ciliated epithelium
15. Muscles of cheek is :

    A. Buccinator            B. Masseter

    C. Platysma              D. Orbicularis oculi

16. Seventh cervical vertebra :

    A. Atlas                     B. Vertebral prominens

    C. Pedicle                  D. Coccyx

17. Mucoid tissue found in human eye:

          A. Aqueous humour    

          B. Vitreous humour 

          C. Tears                     D. Warton’s jelly

18. Smallest carpal bone :

    A. Pisiform                 B. Trapezium

    C. Lunate                   D. Hametate

19. Vitamin D deficiency in adults result :

          A. Roclets                   B. Osteoporosis

          C. Osteomalacia          D. Scurvy

20. Teeth in their socket are example of :

          A. Gomphosis              B. Syndesmosis

          C. Synarthroses           D. Amphiarthroses

21. A ring shaped fold of dura matter that covers the cella turcica :

    A. Hypophysis cerebri                       

    B. Diaphragma sellae

    C. Tentorium cerebelli    D. Falx cerebelli

22. At birth the breast often secrete milk in male as well as female known as:

    A. Colostrum               B. Witches milk

    C. Galactocele              D. All the above

23. Normal pressure of CSF is :

    A. 60 – 140 mm of water

    B. 50-80 mm of water 

    C. 20-30 mm of water 

    D. 80-120 mm of water

24. Total number of ventricle in brain :

    A.  4                            B. 3

    C. 6                             D. 2

25. Embedded mass of white matter in each cerebral hemisphere are certain small areas of gray matter :

    A. Corpus callosum       B. medulla

    C. Basal ganglia            D. Pons Varolli

26. Covering membrance of myofibril :

    A. Sarcolemma            B. Muscle bundle

    C. Neurilemma            D. Myosine

27. The communication between 3rd and 4th ventricles of brain :

    A. Foramen of Luska

    B. Sylvius aqueduct

    C. Foramen of Monro     D. Arachnoid vill

28. Bulbo urethral gland is :

          A. Bartholin’s gland       B. Cowper’s gland

          C. Brunner’s gland       

          D. Glands of Montgomery

29. Largest papillae present on tongue :

          A. Circumvallate papilla

          B. Fungiform papilla

          C. Filiform papilla         D. Frenulum linguae

30. Colle’s fracture commonly seen in :

    A. Distal end of radius

    B. Proximal end of radius

    C. Any part of Radius     D. None

31. Epinephrin is secreted by :

    A. Adrenal medulla         B. Thyroid gland

    C. Parathyroid gland       D. Adrenal cortex

32. Length of inguinal canal is :

          A. 4 cm                           B. 5 cm

          C. 4.5 cm                        D. 3 cm

33. A patient is being prepared for paracentesis to reduce ascites, before the procedure the nurse should instruct the patient to :

    A. Empty his bladder        B. East low fat diet

    C. Remain nill orally for 24 hrs

    D. Assume supine position

34. Early post operative complication of cataract are as follows except:

          A. Infection        B. Retinal detachment

          C. Iris prolapse  D. Hyphema

35. The percentage of water in the average adult human body is :

          A. 80%                          B. 60%

          C. 40%                          D. 20%

36. A client is to receive Isuprel prn The effect of this is:

    A. Produce sedation
 
    B. Relax bronchial spasm

    C. Decrease blood pressure

    D. Increase bronchial secretion

37. While instructing nitroglycerine therapy the most important fact is :

   A. Limit the number of tablet to 4 per day.
   
   B. Discontinue the medication if head ache
       develops.

   C. Store the medication in a dark container
       
    D. Increase the number of tablets in dizziness
        occurs.

38. Early symptoms of morphine overdose include :

          A. Slow pulse rate, respiration and sedation

          B. Slow respiration, dilated pupil, restlessness

    C. Profuse sweating, pinpoint pupils, and deep
        sleep

    D. Slow respiration constricted pupil and deep
         sleep

39. Anginal pain increases with activity indicate :

    A. Myocardial insufficiency                
   
    B. Myocardial ischemia

    C. Myocardial infarction 
   
    D. Coronary thrombosis

40. A cardiogenic shock is :
          
          A. An irreversible process
       
    B. A Failure of peripheral circulation

    C. Fleeting reaction to tissue injury                   
    D. Caused by decreased blood volume

41. Adams strokes syndrome is a result of :

          A. Complete atrioventricular block

          B. Bundle branch block

    C. Myocardial infarction
   
    D. Cardiac arrhythmia

42. The important feature of Adams strokes syndrome is :
    A. Nausea and vertigo
   
    B. Flushing and slurred speech

    C. Cephalgia and blurred vision

    D. Syncope and low ventricular rate

43. The highest incidence of Hodgkin’s disease is in :

          A. Children                 B. Young adults

          C. Elderly persons       D. Middle aged.

44. Vitamin K is essential for normal blood clotting because it promotes :

          A. Platelet aggregation

          B. Ionization of blood calcium

    C. Fibrinogen formation by the liver 

    D. Prothrombin formation by liver

45. A bilirubin level above 2 mg/100ml blood volume may indicate:

    A. Hemolytic Anemia      B. Pernicious anemia

    C. Decreased rate of red cell destruction.
  
    D. Low oxygen carrying capacity of RBC

46. Degree of edema can best assessed by ;

          A. Weighing the client    B. Checking for pitting

          C. Measuring affected area

          D. Observing intake and out put

47. A patient with atelectasis can be presented with :

          A. Slow, deep respiration

          B. A dry unproductive cough

          C. A normal oral temperature

          D. Diminished breath sounds

48. To help a client to obtain maximum benefits after postural drainage:

          A. Administer oxygen as necessary

          B. Place the patient in sitting position

          C. Encourage the client to cough deeply

          D. Encourage the client to rest for 30 minutes

49. The probable cause of spontaneous pneumothorax is a :

          A. Pleural friction rib

          B. Tracheoesophageal fistula

          C. Rupture of sub pleural bleb

          D. Puncture wound on the chest wall

50. If the client become extremely drowsy and the pulse and respiration increased followed by a spontaneous pneumothorax may indicate :

    A. Hypercapnia          B. Hypokalemia

    C. Elevated PO2         D. Respiratory alkalosis

51. The most common complication of chronic asthma is :
          A. Atlectasis               B. Emphysema

          C. Pheumothorax       D. Pulmonary fibrosis

52. A client has chest tube drainage system. When caring for this client the nurse should :

          A. Palpate surrounding area for crepitus

          B. Clamp the chest tube when suctioning

          C. Change the dressing aseptically

          D. Empty the drainage chamber

53. The position of a patient who is recovering from general anesthesia is:

    A. Supine position    B. Side lying position

    C. High fowlers position

    D. Semifowler’s position

54. When the gavage tube is inserted the client should place in:

    A. Supine position     B. Mid-fowlers position

    C. High fowler’s position   D. Side lying position

55. Most peptic ulcer occurring in the stomach are :

          A. Pyloric portion         B. Cardiac portion

          C. Esophageal portion  D. Body of the stomach

56. The maximum safe height of enema can during administration of enema:

    A. 30 cm                      B. 37 cm

    C. 45 cm                      D. 66 cm

57. A client with cholelithiasis experience discomfort after ingesting fatty goods because :

          A. Fatty foods are hard to digest

          B. Bile flow into the intestine is obstructed

          C. The liver is manufacturing inadequate bile

          D. Inadequate closure of ampulla of vater

58. After cholecystectomy the client’s diet will be :

          A. High in fat and carbohydrate
         
          B. High in protein and calorie

          C. Low in fat

          D. Low in protein and carbohyd rate.

59. The major cause of post transfusion hepatitis is :

          A. Hepatitis A              B. Hepatitis B

          C. Hepatitis C              D. Hepatitis D

60. Emergency medical treatment for bleeding esophageal varices but does not control bleeding is :

          A. Gastric lavage           B. Gastric suctioning

          C. Balloon tamponade   D. Amicar

61. The nurse should protect the client’s skin surrounding a colostomy opening by using :

           A. Alcohol                 B. Mineral oil

           C. Skin barriers        D. Tincture of benzoin

62. When performing a colostomy irrigation insert the catheter into the stoma :

           A. 5 cm                     B. 10 cm

           C. 15 cm                   D. 20 cm

63. The solution of choice used to maintain patency of intestinal tube is ;

           A. Sterile water           B. Isotonic solution

           C. Hypotonic solution  D. Hypertonic solution

64. Cushing’s syndrome may be associated with diabetes mellitus because :

           A. Cortical hormones stimulate rapid
               weight less

           B. Excessive ACTH damages pancreatic cells

           C. Tissue catabolism results in negative
               nitrogen balance

           D. Glucocorticoids accelerate process of
                gluconeogenesis

65. Desmopresin Acetate is a drug of choice for diabetes insipidus. The effectiveness should be evaluated by the clients :

          A. Pulse rate               B. Serum glucose

          C. Arterial blood pH    D. Intake and out put

66. An important nursing intervention specific for client with addison’s disease is:

          A. Encouraging exercise

          B. Restrict fluid intake

          C. Protecting from exertion

          D. Monitor for hypokalemia

67. The ABG analysis reflect diabetic acidosis may be :

          A. Increased PH             B. Decreased PO2

          C. Increased PCO2         D. Decreased HCO3

68. Underproduction of thyroxine produces :

          A. Myxedema                 B. Acromegaly

          C. Graves disease           D. Cushing’s disease

69. The most appropriate diet for a client with Grave’s disease would be :

          A. Soft                           B. High caloric

          C. Low Sodium               D. High roughage

70. The hormone that tends to decrease calcium concentration in blood :

          A. Calcitonin                B. Aldosterone

          C. Triiodothyronine      D. Parathyroid hormone

71. The most commonest cause for diabetics ketoacidosis :

          A. Emotional stress    B. Presence of infection

          C. Increases insulin dose

          D. Inadequate food intake

72. Primary treatment of diabetic acidosis is :

          A. IV fluid                     B. Potassium

          C. NPH insulin              D. Oral glucose

73. A seizure that is characterized by an abrupt loss of consciousness that occur without any warn :

          A. Randmal seizure         B. Petitmal seizure

          C. Psychomotor seizure   D. Jacksonian March

74. Name one adjunctive therapy for client with refrartory mysthania gravis :

          A. Plasmapheresis           B. Pyridostigmine

          C. Neostigmine                D. Lanoxin

75. Most common intracranial tumor :

          A. Gliomas                 B. Oligodendrogliomas

          C. Ependymomas       D. Pituitary tumor

76. Manitol is contraindicted for a patient with ;

          A. Cardiac disorder          B. Hepatic disorder

          C. Respiratory disorder    D. Renal disorder

77. Caustive organism of urinary tract infection :

          A. E.coli                      B. Staphylococci

          C. Pneumococci           D. Niesseria

78. Widely used antibiotic for the treatment of UTI :

          A. Erythromyin            B. Pencillin

          C. Sulfonamide            D. Neomycine

79. Inability to detect a specific sensation is :

          A. Agnosia                   B. Stereognosis

          C. Paresthesia             D. Anosmia

80. A progressive degenerative disease that affect the myelin sheeth of neuron :

          A. Parkinson’s disease     B. Multiple sclerosis

          C. Guillain Barre syndrome     D. Gliomas

81. Disease associated with upper motor lesion ;

          A. Mysthenia gravis        B. Polyneuritis

          C. Poliomyelitis              D. Cerebral palsy

82. Stasis of urine is known to predispose to the formation of :

          A. Calcium stone            B. Gluconite stone

          C. Phosphatic stone        D. Oxaloacetic stone

83. A procedure done to relieve interactable pain in the upper thorax :

          A. Rhizotomy                  B. Rhinotomy

          C. Cordotomy                 D. Chondrectomy

84. Pressure on the jugular vein increase the pressure in CSF. This is known as:

          A. Homan’s sign            B. Romberg’s sign

          C. Chvostek’ sign          D. Queckenstedt’s sign

85. Intramedullary nailing is used in treatment of :

          A. Slipped epiphysis of the femur

          B. Fracture of the shaft of the femur

          C. Fracture of neck of femur

          D. Intertrochanteric fracture

86. After total hip replacement surgery avoid placing the client in a:

          A. Supine position     B. Lateral position

          C. Orthopneic           D. Semi-fowler’s position

87. The joints most likely to be involved in a client with osteoarthritis are the:

          A. Hip and knees      B. Angle and metatarsals

          C. Fingers and metacarpals

          D. Cervical spine and shoulder

88. The primary consideration when caring for a client with Rheumatoid arthritis

          A. Surgery                B. Comfort

          C. Education             D. Motivation

89. For the diagnosis of Multiple myeloma the test done is :

          A. Alkaline phosphate  B. Pancreatic lipase

          C. Uric acid                 D. Bence Jones protein

90. A client with osteoporosis is vulnerable to :

          A. Fatigue fracture       B. Pathologic fracture

          C. Greenstick fracture  D. Compound fracture

91. Dexamethasone may be administered to a client after a stroke to :

          A. Improve renal blood flow

          B. Maintain circulatory volume

          C. Reduce intracranial pressure

          D. Prevent development of thrombi

92. Speech center is situated in :

          A. Parietal lobe                B. Frontal lobe

          C. Occipital lobe              D. Temporal lobe

93. A temporary ileostomy is changed :

          A. Every 5 – 8 days          B. Every 2 – 3 days

          C. Every 3 – 4 days          D. Every 4 – 7 days

94. The foot drop can be prevented by the use of :

          A. Splint                          B. Blocks

          C. Cradles                       D. Sand bag

95. Permanent ileostomy should be changed :

          A. 6 months of one year    B. 4 – 6 years

          C. 1 – 2 years                   D. 3 – 4 years

96. Why bleeding occurs after ileostomy :

          A. Injury to the ileum

          B. Lack of vitamin K synthesis

          C. Ulceration around skin        D. Infection

97. Name the colostomy performed on a temporary basis :

          A. Transverse colostomy

          B. Mucous colostomy

          C. Longitudinal colostomy

          D. Ascending colostomy

98. A procedure for injecting a radiopaque substance into the duct of salivary gland

          A. Apicocectomy             B. Glossectomy

          C. Sialogram                  D. Pyelogram

99. Absence of peristalsis in the esophagus:

          A. Esophageal stricture   B. Diverticulum

          C. Hiatus Hernia            D. Achalasia

100. Bulging of esophageal mucosa through weakened portion is called ;

          A. Achalasia           B. Achlorhydria

          C. Hiatus Hernia    D. Esophageal diverticulum
Answers:-
1. B.     2. C.     3. A.     4. C.     5. A.     6. A.     7. C. 

8. A.     9. B.    10. A.   11. A.   12. B.   13. A.   14. C.

15. B.  16. B.   17. B.   18. A.   19. C.    20. A.   21. B. 
22. B.  23. A.   24. A.   25. C.   26. A.    27. B.   28. B. 
29. A.  30. B.   31. A.   32. A.   33. A.    34. D.   35. B. 
36. B.  37. C.   38. D.   39. B.    40. B.    41. A.   42. D.

43. B.  44. D.   45. A.   46. C.   47. D.    48. C.   49. C. 
50. A.  51. B.   52. A.   53. B.    54. C.    55. A.   56. C. 
57. B.  58. B.   59. C.   60. B.    61. C.    62. B.   63. B. 
64. D.  65. D.   66. C.   67. D.   68. A.    69. B.   70. A. 
71. B.  72. A.    73. B.   74. A.   75. A.    76. A.   77. A. 
78. C.  79. A.    80. B.   81. D.   82. C.    83. A.  84. D. 
85. B.  86. C.    87. A.   88. B.   89. D.    90. B.   91. C. 
92. A.  93. C.    94. A.   95. D.   96. B.    97. A.   98. C. 
99. D. 100. D.

ESI MODEL QUESTIONS & ANSWERS - STAFF NURSE RECRUITMENT

1) Which is the most important nurse's responsibility on the day of surgery?

a) Remove all clothing's
b) Send blood for investigations
c) Teach deep breathing exercises
d) Administer Pre-anesthetic medications


2) The purpose of post-operative deep deep breathing and coughing exercises are to:

a) Reduce pain
b)Prevent wound infection
c) Prevent Apnea
d) prevent atelectasis

3) Soft systolic ejection murmur heard in elder person is commonly due to:

a) Sclerotic changes of aortic leaflets
b) left ventricle become smaller
c) Decreased elasticity & widening of aorta
d) Increased Blood pressure

4) Gerontology is the study of

a) Old age
b) care of old
c) Diseases related to aging
d) Aging process

5) Which of the following manifestations would a nurse expect to observe in a patient immediately following a tonic-clonic generalized seizure?

a) Apnea
b) Tachypnoea
c) Lethargy
d) Hypersalivation

6) The precipitating factor for myasthenic crisis is;

a) Increase intake of fatty acids
b) Omitted doses of medication
c) Weight lifting
d) Excess medication

ANSWERS:

1.d
2.d
3.a
4.d
5.c

SOUDI PROMETRIC EXAM FOR NURSES

1.The doctor ordered 1 pack of red blood cells (PRBC) to be transfused to a patient.  The nurse prepares the proper IV tubing. The IV tubing appropriate for blood transfusion comes with?

a)   Air vent
b)   Microdrip chamber
c)   In-line filter
d)   Soluset

2. The expected yet negative (harmful ) result for posthemodialysis is a decrease in?

a)   Creatinine
b)   BUN
c)   Phosphorus
d)   Red blood cell count

3. A patient was brought to the emergency room after she fell down the stairs. Which of the following is the best indicator for increased intracranial pressure in head and spinal injury?

a)  Inability to move extremities
b)  Decreased respiratory rate
c)  Increase in pulse and blood pressure
d)  Decrease level of consciousness

4. A new nurse is administering an enema to a patient. The senior nurse should intervene if the new nurse?

a)  Hangs the enema bag 18 inches above the anus
b)  Positions the client on the right side
c)  Advances the catheter 4 inches into the anal canal
d)  Lubricates 4 inches of the catheter tip

5. The medication nurse is going to give a patient his morning medications. What is the primary action a nurse should do before administering the medications?

a)  Provide privacy
b)  Raise head of the bed
c)  Give distilled water
d)  Check client’s identification bracelet

6.  A 30-year-old client is admitted with inflammatory bowel syndrome (Crohn’s disease). Which of the following instructions should the nurse include in the health teaching? Select all that apply

a)  Corticosteroid medication is part of the treatment
b)  Include milk in the diet
c)  Aspirin should be administered
d)  Antidiarrheal medication can help

7. The nurse responder finds a patient unresponsive in his house. Arrange steps for adult CPR.

a)   Assess consciousness
b)  Give 2 breaths
c)   Perform chest compression
d)  Check for serious bleeding and shock
e)   Open patient’s airway
f)    Check breathing

___, ___, ___, ___, ___, ___

8. Which of the following has mostly likely occurred when there is continuous bubbling in the water seal chamber of the closed chest drainage system?

a)   The connection has been taped too tightly
b)   The connection tubes are kinked
c)    Lung expansion
d)   Air leak in the system

9. Which if the following young adolescent and adult male clients are at most risk for testicular cancer?

a)  Basketball player who wears supportive gear during basketball games
b)  Teenager who swims on a varsity swim team
c)   20-year-old with undescended testis
d)   Patient with a family history of colon cancer

10. The nurse plans to frequently assess a post-thyroidectomy patient for?

a)   Polyuria
b)   Hypoactive deep tendon reflex
c)    Hypertension
d)   Laryngospasm

11. An 18-month-old baby appears to have a rounded belly, bowlegs and slightly large head. The nurse concludes?

a)   The child appears to be a normal toddler
b)   The child is developmentally delayed
c)   The child is malnourished
d)   The child’s large head may have neurological problems.

12. A nurse is going to administer 500mg capsule to a patient. Which is the correct route?

A.)

 

B.)

 

C.)

 

D.)

13. An appropriate instruction to be included in the discharge teaching of a patient following a spinal fusion is?

a)  Don’t use the stairs
b)  Don’t bend at the waist
c)   Don’t walk for long hours
d)   Swimming should be avoided

14. A nurse is preparing to give an IM injection of Iron Dextran that is irritating to the subcutaneous tissue. To prevent irritation to the tissue, what is the best action to be taken?

a)   Apply ice over the injection site
b)  Administer drug at a 45 degree angle
c)  Use a 24-gauge-needle
d)  Use the z-track technique

15. What should a nurse do prior to taking the patient’s history?

a)  Offer the patient a glass of water
b)  Establish rapport
c)   Ask the patient to disrobe and put on gown
d)  Ask pertinent information for insurance purposes

16. A pregnant woman is admitted for pre-eclampsia. The nurse would include in the health teaching that magnesium will be part of the medical management to accomplish the following?

a)     Control seizures
b)    promote renal perfusion
c)     To decrease sustained contractions
d)    Maintain intrauterine homeostasis

17. A nurse is going to administer ear drops to a 4-year-old child. What is the correct way of instilling the medicine after tilting the patient’s head sidewards?

a)  Pull the pinna back then downwards
b)  Pull the pinna back then upwards
c)  Pull the pinna up then backwards
d)  Pull the pinna down then backwards

18. A nursing student was intervened by the clinical instructor if which of the following is observed?

a)  Inserting a nasogastric tube
b)  Positioning the infant in a “sniffing “position
c)  Suctioning first the mouth, then the nose
d)  Squeezing the bulb syringe to suction mouth

19. Choose amongst the options illustrated below that best describes the angle for an intradermal injection?

A.)

B.)

C.)

D.)

20. During a basic life support class, the instructor said that blind finger sweeping is not advisable for infants. Which among the following could be the reason?

a)  The mouth is still too small
b)  The object may be pushed deeper into the throat
c)  Sharp fingernails might injure the victim
d)  The infant might bite

21.  A nurse enters a room and finds a patient lying on the floor. Which of the following actions should the nurse perform first?

a)   Call for help
b)   Establish responsiveness of patient
c)   Ask the patient what happened
d)   Assess vital signs

22. A patient with complaints of chest pain was rushed to the emergency department. Which priority action should the nurse do first?

a)   Administer morphine sulfate intravenously
b)  Initiate venous access by performing venipunture
c)   Administer oxygen via nasal cannula
d)  Complete physical assessment and patient history

23. A rehab nurse reviews a post-stroke patient’s immunization history. Which immunization is a priority for a 72-year-old patient?

a)   Hepatitis A vaccine
b)  Hepatitis B vaccine
c)  Rotavirus Vaccine
d)  Pneumococcal Vaccine

24. Several patients from a reported condominium fire incident were rushed to the emergency room. Which should the nurse attend to first?

a)   A 15-year-old girl, with burns on the face and chest, reports hoarseness of the voice
b)  A 28-year-old man with burns on all extremities
c)  A 4-year-old child who is crying inconsolably and reports severe headache
d)  A 40-year-old woman with complaints of severe pain on the left thigh

25. The nurse is teaching a mother whose daughter has iron deficiency anemia. The nurse determines the parent understood the dietary modifications, if she selects?

a)  Bread and coffee
b)  Fish and Pork meat
c)  Cookies and milk
d)  Oranges and green leafy vegetables

26. Which of the following is the most common clinical manifestation of G6PD following ingestion of aspirin?

a)   Kidney failure
b)  Acute hemolytic anemia
c)   Hemophilia A
d)  Thalassemia

27. The nurse assesses a client with an ileostomy for possible development of which of the following acid-base imbalances?

a)  Respiratory acidosis
b)  Metabolic acidosis
c)  Metabolic alkalosis
d)  Respiratory alkalosis

28. The nurse anticipates which of the following responses in a client who develops metabolic acidosis.

a)   Heart rate of 105 bpm
b)  Urinary output of 15 ml
c)   Respiratory rate of 30 cpm
d)    Temperature of 39 degree Celsius

 29. A client has a phosphorus level of 5.0mg/dL. The nurse closely monitors the client for?

a)     Signs of tetany
b)    Elevated blood glucose
c)     Cardiac dysrhythmias
d)    Hypoglycemia

30. A nurse is caring for a child with pyloric stenosis. The nurse would watch out for symptoms of?

a)   Vomiting large amounts
b)   Watery stool
c)    Projectile vomiting
d)   Dark-colored stool

 ANSWER AND RATIONALS

1.) Answer: C

An in-line filter is required for blood transfusions.

2.) Answer: D

Negative outcome: Hemodialysis decreases red blood cell count which worsens anemia, because RBCs are lost in dialysis from anticoagulation during the procedure, and from residual blood that is left in the dialyzer.

3.) Answer: D

Decrease in level of consciousness and headache are early signs of increase in intracranial pressure (ICP). Altered level of consciousness is the most common symptom that indicates a deficit in brain function.

4.) Answer: B

Recall the anatomy of the colon. The appropriate position is left lateral to facilitate flow of enema by gravity into the colon.

5.) Answer: D

Recall the 12 Rights of administration. Checking the patient’s name is critical for client-safety.

6.) Answer: A , D

Crohn’s disease is a chronic inflammation of the colon with symptoms of diarrhea, abdominal pain, and weight loss. Corticosteroid is a treatment for Crohn’s disease. Antidiarrheal can give relief to diarrheal episodes. Aspirin should be avoided as it can worsen inflammation. Those with Crohn’s disease are mostly lactose intolerant, so choice no. (2) is incorrect.

 7.) Answer: A, E, F, C, B, D

In accordance with the new guidelines, remember AB-CABS. A-airway B-breathing normally? − C-chest compression A-airway open B-breathing for patient S-serious bleeding, shock, spinal injury. The nurse should first assess consciousness of the patient. Next, open patient’s airway to check for breathing. When there is no breathing, immediately perform chest compression then give 2 breaths, do the cycle of care over. Finally, check for serious bleeding, shock, and spinal injury.

8.) Answer: D

Continuous bubbling seen in water-seal bottle/ chamber indicates an air leak or loose connection, and air is sucked continuously into the closed chest drainage system.

9.) Answer: C

Testicular cancer is most likely to affect males in late adolescence. Undescended testis is also one major risk for testicular cancer.

10.) Answer: D

Hypocalcemia occurs when there is accidental removal or destruction of parathyroid tissue during surgical removal of the thyroid gland.  Laryngospasm is one of the clinical manifestations of tetany, an indicator of hypocalcemia.

11.) Answer: A

It’s normal for a toddler to have bowlegs and a protruding belly. The head still appears somewhat large in proportion from the rest of the body.

12.) Answer: D

13.) Answer: B

There is 6-8 months activity restriction following a spinal fusion.  Sitting, lying, standing, normal stair climbing, walking, and gentle swimming is allowed. Bending and twisting at the waist should be avoided, along with lifting more than 10 lbs.

14.) Answer: D

Z-track technique is used to administer drugs especially irritating to the subcutaneous tissue. This method promotes absorption of the drug by preventing drug leakage into the subcutaneous layer.

15.) Answer: B

Establishing rapport is a way to gain trust that will lead for a patient to relax. You can get more insights and information from a patient when rapport is established.

16.) Answer: A

Low magnesium (hypomagnesemia) produces clinical manifestations like increased reflexes, tremors, and seizures. Magnesium Sulfate is the drug of choice to prevent seizures in pre-eclampsia and eclampsia.

17.) Answer: C

Ear canal of children ages 3years and above can be straightened by pulling the pinna up then backwards. For children below 3 years of age, the ear canal can be straightened by pulling the pinna down then backwards.

18.) Answer: A

Infants are nose breathers. A gastric tube may be inserted to facilitate lung expansion and stomach decompression, but not a nasogastric tube as it can occlude the nare, thus, making breathing difficult for the infant.

19.) Answer: B

20.) Answer: B

Blind finger sweeps are not recommended in all CPR cases especially for infants and children because the foreign object may be pushed back into the airway.

21.) Answer: B

First step in cardiopulmonary resuscitation (CPR) is assessing responsiveness of the patient.

22.) Answer: C

Priority nursing action is to administer oxygen to patients with chest pain.  Chest pain is caused by insufficient myocardial oxygenation.

23.) Answer: D

Pneumococcal Vaccine is a priority immunization for the elderly. Seniors, ages 65 years old and above, have higher risk for serious pneumococcal infection and likely have low immunity. This is administered every 5 years.

24.) Answer: A

Burns on the face and neck can cause swelling of the respiratory mucosa that can lead to airway obstruction manifested by hoarseness of voice and difficulty in breathing. Maintaining an airway patency is the main concern.

25.) Answer: D

Dark green leafy vegetables are good sources of iron. Oranges are good sources of vitamin C that enhances iron absorption in the small intestines.

26.) Answer: B

Individuals with G6PD may exhibit hemolytic anemia when exposed to infection, certain medications or chemicals. Salicylates such as Aspirin damages plasma membranes of erythrocytes, leading to hemolytic anemia.

27.) Answer: B

Lower GI fluids are alkaline in nature and can be lost via ileostomy. Thus, loss of HCO3, results to metabolic acidosis.

28.) Answer: C

Initially, respiratory system will try to compensate metabolic acidosis. Patients with metabolic acidosis have high respiratory rate.

29.) Answer: A

Normal phosphorus level is 2.5 – 4.5 mg/dL .The level reflects hyperphosphatemia which is inversely proportional to calcium. Client should be assessed for tetany which is a prominent symptom of hypocalcemia.

30.) Answer: C

Clinical manifestations of pyloric stenosis include projectile vomiting, irritability, constipation, and signs of dehydration, including a decrease in urine output.