State Exams With Answers

STATES
REVISION
QUESTIONS &
ANSWERS
PART I OF II
Compiled by
Tahira Nisha
(University of Auckland)
2011
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Acknowledgment
I would like to express my heartfelt gratitude to the 3 rd year Bachelor of Nursing
students at the University of Auckland (class of 2011) who contributed to the
compilation of the state exam questions and answers. The following students
participated in answering the questions: Aarti Shenoy, Alic Alexander, Alice
Waters, Amanda-Jane Watson, Amara Dulay, Amy Stidolph, Hermina Sami,
Ara Cho, Ashlee Forgesoon, Asheigh Freeth, Asmita Dalal, Betelhem Asfaw,
Blanche Edwards, Sylvia Baker, Briar MkKinley-Sandgrove, Cara Walker,
Caroline Wilson, Chanthie Thach, Charissa Tsoi, Charlotte Hancock, Charlotte
Winn, Chris Chu, Claire Carrington, David Nicholls, Diana Kruckenhauser,
Elizabeth Chiketa, Estelle Licence, Grace Allen, Hannah Choo, Jenniver
Stevens, Jina Park, Jovita Antony, Joy Chiang, Junghee Kim, Justina Yeow,
Katherinne Barraud, Kate Comery, Kathryn Skinner, Keri Carter, Kimberly
Greenwell, Kristy Protheroe, Lisa Trebilcock, Lorraine Lee, Lydia Shaw, Maria
Garcia, Maria Kim, May Soliva, Megan Bowes, Megan Lee, Mikaela Yanke,
Miriam McDonald, Muzi Yang, Natasha Trilokekar, Nekita Naidu, Nina
Campos, Olivia Marti, Penelope Copestake, Rachael Hogan, Rachael Tolholf,
Rachael Wake, Rebecca Couch, Rebecca Ou Yang, Richstar Hizon, Ruby
Howden, Sarita McKenzie, Shirley Tang, Siniva McCormack, Sophie Atkinson,
Sophie Davies, Tasneem Mussa, Thamon Pattanajareet, Vicky Shen, Wendy
Chan, Ye-Ji Lee, Yini Ye and Melinda Batang.
Very special thanks to the following students who answered multiple sets of
questions: Hermina Sami, Sylvia Baker, Blanche Edwards, Ashlee Forgesson,
Jina Park, David Nicholls, Lisa Trebilcock, Katherinne Barraud, Penelope
Copestake, Keri Carter, Richstar Hizon, Amara Dulay and Chris Chu.
The answers provided in this booklet are merely by peer review and therefore
correct answers are not guaranteed.
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STATE EXAMS (PART I)
TABLE OF CONTENTS QUESTIONS PAGES
STATE EXAMS 1 46 3 to 12
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STATE EXAMS 1
You are caring for bill, a 50 year old man who has been hospitalised with a possible
diagnosis of pancreatitis
1. Which of the following symptoms would you anticipate observing in bill

a) Elevated white blood cell count, ankle oedema and right groin
pain b) Left upper quadrant abdominal pain, nausea, and vomiting
c) Hypoglycaemia, hypertension, and hypochondrial pain
d) Epigastric pain, pyrexia, and elevated white blood cell count
2. The initial diagnosis of pancreatitis would be confirmed if bills blood test showed a
significant elevation in serum
a) Amylase
b) Glucose
c) Potassium
d) Trypsin
3. Pain control is an important nursing goal. Which of the following medications would
be the drug of choice
a) Pethidine
b) Cimetidine
c) Morphine
d) Codeine
4. You monitor bills vital signs frequently, observing for the signs of shock. Shock is
extremely difficult to manage in pancreatitis primarily because of the
a) Frequency and severity of gastrointestinal haemorrhage
b) Vasodilating effects of kinin peptides
c) Tendency towards congestive heart failure
d) Frequent incidence of acute tubular necrosis
5. While helping bill change position in bed, you note bill has muscle twitching in his
bands and forearms. These symptoms are significant because clients who suffer from
pancreatitis are at risk of
a) Hypermagnisemia
b) Hypoglycaemia
c) Hypocalcaemia
d) Hyponatremia
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6. Bill does not drink alcohol because of his religious beliefs. When the physician
persists in asking him about his alcohol intake, bill becomes annoyed. You explain the
reasoning behind the questioning by telling bill that
a) There is a strong link between alcohol use and pancreatitis
b) Alcohol intake can interfere with some of the tests used to diagnose pancreatitis
c) Alcoholism is a major health problem and all hospitalised clients are asked about
their alcohol intake
d) The physician must obtain the pertinent facts, and religious beliefs cannot be
considered
A home care nurse begins caring for a 25 year old female called Lydia who has just
been diagnosed with human immunodeficiency virus (HIV)
7. Lydia asks the nurse, ‘how could this have happened?” the nurse responds to the
question based on the most frequent mode of HIV transmission, which is
a) Hugging an HIV positive sexual partner without using barrier precautions
b) Inhaling cocaine or other recreational drugs
c) Sharing a drink bottle with an HIV positive person
d) Sexual intercourse with an HIV positive person without using a condom
8. The physician prescribes zidovudine (AZT) a drug that acts to help

a) Destroy the virus
b) Enhance the body’s antibody production
c) Slow replication of the virus
d) Neutralise toxin; produced by the causative organism
9. Lydia acquires herpes genitalis and is counselled by the nurse concerning follow up
care. Women who have this disease are at risk of developing
a) Sterility
b) Cervical cancer
c) Uterine fibroid
rumours d) Irregular
menses
10. Which of the following nursing diagnosis categories would most likely be a priority
for a client with herpes genitalis
a) Alteration in sleep; sleep pattern disturbance
b) Nutritional deficit
c) Alteration in comfort pain
d) Alteration in breathing patterns
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11. The primary reason that a herpes simplex infection is a serious concern to a client
with HIV infection is that herpes simplex
a) Is an acquired immunodeficiency virus (AIDS) defining illness
b) Is curable only after 1 year of antiviral therapy
c) Can lead to cervical cancer
d) Causes severe electrolyte imbalances
12. In providing education to Lydia, the nurse should take into account the fact that the
most effective method known to control the spread to HIV infection is
a) Premarital serologic screening
b) Prophylactic treatment of exposed people
c) Laboratory screening of pregnant women
d) Ongoing sex education about preventive behaviours
13. Lydia becomes depressed about her diagnosis and tells the nurse “I have nothing
worth living for now.” Which of the following statements would be the best
response by the nurse
a) There is much to live for; you may not develop AIDS for years
b) You should not be too depressed; we are searching to find a cure for AIDS
c) You are right; it is very depressing to have HIV
d) Tell me more about how you are feeling at being HIV positive
James, a 34 year old man attending a sexual health clinic, is diagnosed with syphilis.
14. The organism responsible for causing syphilis is classified as a

a) Virus
b) Fungus
c) Rickettsia
d) Spirochete
15. The typical chancre of syphilis appears as

a) A grouping of small, tender pimples
b) An elevated wart
c) A painless moist ulcer
d) An itching, crusted area
16. When interviewing James, the nurse should anticipate that the most difficult problem
is likely to be
a) Motivating the client to undergo treatment
b) Obtaining a list of the clients sexual contacts
c) Increasing the clients knowledge of the disease
d) Assuring the client that records are confidential
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17. Probenecid is prescribed in conjunction with penicillin as treatment for syphilis
because probenecid helps
a) Delay detoxification of penicillin
b) Inhibit excretion of penicillin
c) Maintain sensitivity of organisms to penicillin
d) Decrease the likelihood of an allergic reaction to penicillin
18. A priority nursing diagnosis for a James would likely be

a) High risk for infection transmission related to lack of knowledge about mode of
spread
b) Pain related to cutaneous skin lesions on palms and soles
c) Altered skin tissue perfusion related to a bleeding chancre
d) Image disturbance related to alopecia
An 18 year old female college student is seen at the university health centre. She
undergoes a pelvic examination and is diagnosed with gonorrhoea
19. Which of the following responses by the nurse would be best when the client says
that she is nervous about the upcoming pelvic examination
a) can you tell me more about how you’re feeling
b) you’re not alone. Most women feel uncomfortable about this examination
c) do not worry about Dr smith. He’s a specialist in female problems
d) we’ll do everything we can to avoid embarrassing you
20. in education this client, the nurse should emphasise that in women gonorrhoea
a) is often marked by symptoms of dysuria or vaginal bleeding
b) does not lead to serious complications
c) can be treated but not cured
d) may not cause symptoms until complications occur
21. the client informs the nurse that she has had sexual intercourse with her boyfriend and
asks the nurse ‘would he have any symptoms?’ the nurse responds that in males,
symptoms of gonorrhoea include
a) impotence
b) scrotal swelling
c) urine retention
d) dysuria
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A 24 year old female client, who is on her honeymoon, comes to an ambulatory care
clinic in moderate distress with a probable diagnosis of acute cystitis
22. Which of the following symptoms would the nurse expect the client to report during
the assessment
a) fever and chills
b) frequency and burning on urination
c) suprapubic pain and nausea
d) dark, concentrated urine
23. The client asks the nurse, ‘how did I get this infection?’ the nurse should explain that
in most instances, cystitis is caused by
a) congenital strictures in the urethra
b) an infection elsewhere in the body
c) urine stasis in the urinary bladder
d) an ascending infection from the urethra
24. The physician tells the client that the infection has likely been precipitated by sexual
intercourse and that an antibiotic will be prescribed. The client becomes upset, and
tearfully asks the nurse if this means she should abstain from intercourse for the rest
of her honeymoon. What advice should the nurse offer her
a) avoid intercourse until you’ve completed the antibiotic therapy and then limit
intercourse to once a week
b) limit intercourse to once a day in the early morning after your bladder has rested
c) as long as you’re comfortable you can have intercourse as often as you wish; but
be sure to urinate within 15 minutes after intercourse
d) you and your husband can enjoy intercourse as often as you wish. Just make sure
he wears a condom and uses a spermicide
25. The client is given a prescription for co trimoxazole (bactrim) for her infection.
Which of the following statements would indicate that she understands the principles
of antibiotic therapy
a) I’ll take the pills until I feel better and keep the rest for
recurrences b) I’ll take all the pills as directed on the label
c) I’ll take the pills until the symptoms pass, then reduce the dose by half
d) I’ll take all the pills and then have the prescription renewed once
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Winston, a 22 year old man, is brought to the emergency room with an apparent head
injury after being involved in a motor vehicle accident. He is unconscious on arrival and
exhibits signs of increasing intracranial pressure. His fiancée and his older sister
accompany him
26. On Winston’s arrival in the emergency room, which of the following

considerations should receive the highest priority
a) establishing an airway
b) replacing blood losses
c) stopping bleeding from open wounds
d) determining whether he has a neck fracture
27. Which of the following methods would be best, from a legal standpoint, for obtaining
permission to treat Winston
a) having his sister sign the consent form
b) having two independent doctors agree on the need for treatment
c) obtaining a verbal consent by telephone from his mother
d) obtaining written consent from his fiancée
28. As Winston’s condition worsens, his rising intracranial pressure would be

indicated by
a) rising blood pressure and falling pulse rate
b) rising pulse rate and falling blood pressure
c) rising blood pressure and rising pulse rate
d) falling pulse rate and falling blood pressure
29. the nurse assesses the client frequently for signs of intracranial pressure, including
a) unequal pupil size
b) decreasing systolic blood pressure
c) tachycardia
d) decreasing body temperature
30. which of the following respiratory signs would indicate increasing

intracranial pressure in the brain stem
a) slow, irregular
respirations b) rapid, shallow
respirations
c) asymmetric chest expansion
d) nasal flaring
During the past few months, Elizabeth, a 56 year old woman has felt brief twinges of
chest pain while working, in her garden and has had frequent episodes of indigestion.
She comes to the hospital after experiencing severe anterior chest pain while raking
leaves. Her evaluation confirms a diagnosis of stable angina pectoris
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31. Elizabeth states, ‘I really thought I was having a heart attack. How can you tell the
difference?’ which response by the nurse would provide the client with the most
accurate information about the difference between the pain of angina and that of
myocardial infarction
a) The pain associated with a heart attack is much more severe
b) The pain associated with a heart attack radiates into the jaw and down the left arm
c) It is impossible to differentiate angina pain from that of a heart attack without an
ECG
d) The pain of angina is usually relieved by resting or lying down
32. As an initial step in treating elizabeths angina, the physician prescribes nitro-glycerine
tablets, 0.3 mg given sublingual. This drugs principal effects are produced by
a) Antispasmodic effects on the pericardium
b) Stimulation of a- and 13- receptor sites
c) Vasodilation of peripheral vasculature
d) Improved conductivity in the myocardium
33. The nurse teaches Elizabeth that which of the following meals would be best for
her low cholesterol diet
a) Hamburger, salad, and milkshake
b) Baked liver, green beans, and coffee
c) Spaghetti with tomato sauce, salad, and coffee
d) Fried chicken, green beans, and skim milk
34. Which of the following symptoms should the nurse teach Elizabeth to report
immediately to her physician
a) A change in the pattern of her pain
b) Pain during sexual activity
c) Pain during an argument with her husband
d) During or after an activity such as lawn moving
35. After stabilisation and treatment, Elizabeth is discharged from the hospital. At her
follow up appointment, she is discouraged because she is experiencing pain with
increasing frequency. She states that she visits an invalid friend twice a week and now
cannot walk up the second flight of steps to the friends apartment without pain. Which
action can the nurse could suggest that would most likely help the client deal with this
problem
a) Visit her friend early in the day
b) Rest for at least an hour before climbing the stairs
c) Take a nitro-glycerine tablet before climbing the stairs
d) Lie down once she reaches the friends apartment
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36. The nurse teaches Elizabeth that common expected side effects of nitro-glycerine
include
a) Headache, hypotension, and dizziness
b) Hypertension, flushing and forgetfulness
c) Hypotension, diplopia and shortness of breath
d) Stomach cramps, constipation and urinary frequency
37. Sublingual nitro-glycerine tablets begin to work within 1 to 2 minutes. How should
the nurse instruct the client to use the drug when chest pain occurs
a) Take one tablet every 2 to 5 minutes until the pain stops
b) Take one tablet; and rest for 10 minutes. Call the physician if pain persists after
10 minutes
c) Take one tablet, then an additional tablet every 5 minutes for a total of three
tablets. Call the physician if pain persists after 3 tablets
d) Take one tablet; if pain persists after 5 minutes, take two tablets. If pain still
persists 5 minutes later, call the physician
38. Which of the following points should the nurse include when instructing the client
with angina about sublingual nitro-glycerine
a) The drug will cause your urine to turn bright
orange b) Store the tablets in a tight, light resistant
container
c) Use the tablets only when the pain is severe
d) The shelf life of nitro-glycerine is up to 2 years
Josie, a 38 year old woman is admitted to the emergency room after being found
unconscious at the wheel of her car in the hospital car park. Josie is comatosed
and does not respond to stimuli. A drug overdose is suspected
39. Which of the following assessment findings would lead the nurse to suspect that the
coma is a result of a toxic drug overdose
a) Hypertension
b) Hyperpyrexia
c) Dilated pupils
d) Facial asymmetry
40. Blood and urine analysis confirm a diagnosis of salicylate overdose. Josie is treated
with activated charcoal, which would be administered by
a) Intravenous
infusion b) Nasogastric
tube
c) Rectal infusior
d) Oral tablets
41. What specific potential adverse effect of charcoal administration to josie must the
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nurse be aware and guard against
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a) Anaphylaxis
b) Renal
failure c)
Aspiration
d) Cardiac arrest
42. The nurse observes that josie’s right eye does not close totally. Based on this finding,
which of the following nursing interventions would be most appropriate
a) Making sure josie wears dark glasses to avoid photosensitivity
b) Irrigate her right eye with saline each duty to avoid dryness
c) Instilling neomycin eye drops to prevent conjunctivitis
d) Tape the eyelid down to keep it closed between cares
43. The nursing goal for performing passive range of motion exercises for an unconscious
client such as josie would be to
a) Preserve muscle mass
b) Prevent bone demineralisation
c) Increase muscle tone
d) Maintain joint mobility
44. When the nurse performs oral hygiene for josie, whilst she is still unconscious, which
of the following actions would be most appropriate
a) Use manual instead of mechanical ventilation
b) Keep suction apparatus available
c) Place josie in a prone position
d) Wear sterile gloves
45. When assessing josies respiratory status, which of the following symptoms may be
an early indicator of hypoxia
a) Cyanosis
b) Decreased
respirations c)
Restlessness
d) Hypotension
A 34 year old Japanese tourist, takayuki hamadi, is admitted to the hospital after
experiencing multiple trauma as a result of an automobile accident. He has three
fractured ribs, a hairline fracture of the pelvis, a compound fracture of his right tibia
and fibula, and soft tissue injuries. He is in severe pain when he arrives on the unit after
emergency surgery
46. Takayuki reports severe pain and requests frequent medication. A nursing assistant
expresses her surprise, saying, ‘I thought asian people were very stoic about pain.
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‘ your initial course of action should be
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a) Reprimand her immediately and apologise to takayuk’s family
b) Discuss her behaviour with her after you leave the room
c) Do nothing as takayuk’s understanding of English is poor
d) Report her to the charge nurse
STATE EXAMS 2
1. According to eriksons theory of emotional development, infants will develop a sense

of trust when
a) They can identify their mother and father
b) They feel a sense of belonging, accepted as part of the family
c) They can predict what is coming and needs are consistently met
d) Nutritional and hygiene needs are provided on a daily basis
2. Baby john was admitted with streptococcal pharyngitis. Upon discharge his mother
was told to return to the doctors in 2 weeks with a urine specimen. The urine would
mostly be examined
a) For fat and lipids to see if the kidneys are working
b) For protein to determine if acute glomerulonephritis is developing
c) To determine if the child is developing otitis media
d) To determine if the child should be kept on a liquid diet or progressed to a soft
3. Reduction of complications of rheumatic fever can be accomplished through which

of the following interventions
a) Administration of penicillin to children with strep throat or impetigo
b) Beginning speech therapy to reserve damage after antibiotics are completed
c) Pushing children with chorea to perform activities requiring fine motor movement
to strengthen muscles
d) Withholding salicylates to prevent joint haemorrhage
4. Newborns with heart disease are frequently brought to health professionals initially
because the infant is having
a) Difficulty sleeping
b) Irritability and
restlessness c) Difficulty
feeding
d) Cyanotic spells
5. In heart defects in which a connection exists between the right and left heart, the
blood through the connective structure flows most commonly
a) Right to left
b) Left to right
c) Bi directionally
d) Through the mitral and tricuspid valves
6. Amy is 3 months old, with a 2 day history of vomiting. Which of the following
is NOT indicative of a decreased hydration status
a) Sunken fontanelle
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b) Decreased number of wet nappies
c) Skin that is hot to the touch
d) Increased heart rate
7. Erikson’s theory of human development describes

a) Eight psychosocial crises all people are thought to face
b) Four psychosocial stages and a period of latency
c) The same number of stages as Freud but with different names
d) A stage theory that is not psychoanalytic
8. According to Piaget, the stage of cognitive development that generally characterises

pre school children is the
a) Preoperational stage
b) Sensorimotor stage
c) Oral stage
d) Psychosocial stage
9. The cephalo-caudal and proximo-distal patterns of development apply to

a) The upper extremities only
b) Physical growth, but not to motor skills
c) Variations in the timing of motor skills acquisition
d) Motor abilities as well as physical growth
10. An infant who weighs 4kg is prescribed 0.2mg/kg (IV) of morphine sulphate.
You have an ampoule of 10mg in 1ml. the volume to be administered is
a) 8 mls
b) 0.8 mls
c) 0.08 mls
d) 0.8 mgs
11. Pediculosis is common childhood infestation. It is commonly known as

a) Pin worms
b) Foot eczema
c) Head lice
d) Scabies
12. A child who weighs 20 kgs is prescribed 300 mg of paracetamol. The stock supply is
120 mg in 5 mls. The volume to be administered is
a) 1.25mls
b) 125mls
c) 125mgs
d) 12.5mls
13. Match the following sequence of milligrams to

micrograms 10.0mg, 0.012mg, 0.40mg, 0.08mg
a) 1000.0 micrograms, 120.0 micrograms, 400.0 micrograms, 8.0 micrograms
b) 10000 micrograms, 12.0 micrograms, 40.0 micrograms, 80.0
micrograms c) 10000 micrograms, 12.0 micrograms, 400 micrograms, 80.0
micrograms
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d) 1000 micrograms, 1.2 micrograms, 4.0 micrograms, 0.08 micrograms
14. All infants should have their head circumference measured at health visits. This
measurement is made from
a) Just above the eyebrows through the prominent part of the occiput
b) The center of the forehead to the base of the occiput
c) The hairline in front to the hairline in back
d) The middle of the forehead through the parietal prominence
15. While caring for a child recovering from viral pneumonia, you examine his lungs
for evidence of exudate and fluid. Which finding would suggest cause for concern
a) A respiratory rate of 20 heard on auscultation
b) Dullness of his lower lobes heard on percussion
c) A longer inspiratory than expiratory rate noticed on inspection
d) Fine rhonchi heart in the upper lobe on auscultation
16. To straighten an infant’s ear canal to examine it, you would pull the pinna
a) Down and back
b) Down and forward
c) Up and back
d) Up and forward
17. A child who has an arterial blood gas that depicts respiratory acidosis will show
a) pH is acidic, PaO2 is raised and PaCO2 is raised
b) pH is acidic, PaO2 is raised and PaCO is lowered
c) pH is acidic, PaO2 is lowered and PaCO2 is raised
d) pH is alkalotic, PaO2 is lowered and Pa CO2 is raised
18. You take an infant’s apical pulse before administering digoxin. What is the usually
accepted level of pulse rate considered safe for administering digoxin to an 8
month old baby
a) 60 bpm
b) 80 bpm
c) 100 bpm
d) 150 bpm
19. Which of the following nursing diagnosis would best apply to a child with rheumatic
fever
a) Ineffective breathing pattern related to cardiomegaly
b) Activity intolerance related to inability of heart to sustain extra workload
c) Sleep pattern disturbance related to hyperexcitability
d) High risk of violence related to development of cerebral anoxia
20. Bronchiolitis is a common infection, which peaks in incidence in

children aged _. Symptoms usually peak around day _
a) Viral, less than two years of age, three to five
b) Viral, less than six months, ten
c) Bacterial, less than two years, three to five
d) Bacterial, less than six months, three to five
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21. Generally, the child most likely to ingest a poison is
a) 10 months to 18 months
b) 1 to 4 years
c) 4 to 5 years
d) 13 to 15 years
22. The responsibility of the nurse caring for a victim of child abuse in the emergency
room would include which of the following
a) Prohibiting her parents from visiting with the child until more facts are obtained
b) Asking the parents if they have been abusing their child
c) Suggesting to the medical staff that the child be admitted for observation
d) Asking the child what they were doing that led to abuse
23. Which of the following statements is NOT true

a) Health professionals recommend exclusive breast feeding until the age of 4
months
b) Uterine involution is slowed by breast feeding
c) Almost all drugs are excreted to some extent in breast mild
d) Oxytocin is released by breastfeeding
24. Which of the following statements is NOT true of Reyes syndrome

a) Most commonly occurs In young school age children
b) Most commonly occurs after a viral infection
c) Symptoms include severe vomiting, irritability, lethargy and
confusion d) Aspirin is the treatment of choice
25. Which of the following statements is NOT true of bacterial

meningitis
a) Bacterial meningitis often presents with flu like symptoms initially
b) A rash may or may not be present
c) There is usually no associated temperature rise
d) A rash, if present, does not blanch under direct pressure
26. Fill in the gaps in the following statement

Type I (insulin dependent) diabetes is characterised by almost no
secretion. This contributes to a build up of in the blood stream. If
exogenous insulin is not administered _ and will develop
a) Insulin, glucose, hyperglycaemia and ketoacidosis
b) Glucose, insulin, hyperglycaemia and ketoacidosis
c) Glucose, insulin, hypoglycaemia, and unconsciousness
d) Insulin, hormones, ketoacidosis and unconsciousness
27. The grandmother has brought an infant to the clinic for a check up and has signed the
consent for immunization administration. Which of the following would the nurse do
first
a) ask who the infants legal guardian is
b) notify the physician immediately
c) administer the immunizations ordered
d) call the infant’s mother for verbal consent
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28. Which of the following would the nurse explain to the mother of a child
receiving digoxin (lanoxin) as the primary reason for giving this drug
a) To relax the walls of the hearts arteries
b) To improve the strength of the heartbeat
c) To prevent irregularities in ventricular contractions
d) To decrease inflammation of the heart wall
29. Paralysis in an individual with a meningomyelocele usually occurs

a) In the motor sphere below the level of the deformity
b) In the motor and sensory spheres below the level of the deformity
c) In the motor sphere above the deformity
d) In the motor and sensory spheres above the deformity
30. During the acute state of meningitis, a 3 year old child is restless and irritable. Which
of the following would be most appropriate to institute
a) Hemorrhagic
skin rash
b) Edema
c) Cyanosis
d) Dyspnea on exertion
31. Which of the following would first alert the nurse to suspect that a child with severe
gastroenteritis who has been receiving intravenous therapy for the past several
hours may be developing circulatory overload
a) A drop in blood pressure
b) Change to slow, deep respirations
c) Auscultation of moist crackles
d) Marked increase in urine output
32. The causative organism for rheumatic fever is

a) Haemophilus influenzae
b) Staphylococcus bacteria
c) Syncytial virus
d) Group A streptococcal bacteria
33. The most serious complication of rheumatic fever is

a) Endocarditis
b) Pneumonia
c) Arthritis
d) Meningitis
34. When preparing the teaching plan for the mother of a child with asthma, which of
the following would the nurse include as signs to alert the mother that her child is
having an asthma attack
a) Secretion of this, copious mucous
b) Tight, productive
cough c) Wheezing on
expiration
d) Temperature of 37.4oC
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35. A 10 year old child with a history of asthma uses an inhaled bronchodilator only
when needed. He takes no other medications routinely. His best peak expiratory flow
rate is 270 L/min. The child's current peak flow reading is 180 L/min. the nurse
interprets this reading as indicating which of the following
a) The child’s asthma is under good control, so the routine treatment plan should
continue
b) The child needs to start a short acting inhaled B2 agonist medication
c) This is medical emergency requiring a trip to the emergency department for
treatment
d) The child needs to begin treatment with inhaled cromolyn sodium (intal)
for asthma control
36. An 8 year old child with asthma states, I want to play some sports like my friends.
What can I do. The nurse responds to the child based on the understanding of which
of the following
a) Physical activities are inappropriate for children with asthma
b) Children with asthma must be excluded from team sports
c) Vigorous physical exercise frequently precipitates an asthmatic episode
d) Most children with asthma can participate in sports if the asthma is controlled
37. After instructing a mother about normal reflexes of term neonates, the nurse
determines that the mother understands the instructions when she describes the tonic
neck reflex as occurring when the neonate does which of the following
a) Steps briskly when held upright near a firm, hard surface
b) Pulls both arms and does not move the chin beyond the point of the elbows
c) Turns head to the left, extends left extremities, and flexes right extremities
d) Extends and abducts the arms and legs with the toes fanning open
38. After talking with the parents of a child with down’s syndrome, which of the
following would the nurse identify as an appropriate goal for care of the
child
a) Encouraging self care skills in the child
b) Teaching the child something new every day
c) Encouraging more lenient behaviour limits for the child
d) Achieving age appropriate social skills
39. After teaching a group of school teachers about seizures, the teachers’ role play a
scenario involving a child experiencing a generalised tonic clonic seizure. Which of
the following actions, when performed first, indicates that the nurses teaching has
been successful
a) Asking the other children what happened before the seizure
b) Moving the child to the nurses office for privacy
c) Removing any nearby objects that could harm the child
d) Placing a padded tongue blade between the child’s teeth
40. Which of the following statements obtained from the nursing history of a
toddler would alert the nurse to suspect the child has had a febrile seizure
a) The child has had a low grade fever for several weeks
b) The family history is negative for convulsions
c) The seizure resulted in respiratory arrest
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d) The seizure occurred when the child had a respiratory infection
41. Which of the following, if described by the parents of a child with cystic fibrosis,
indicates that the parents understand the underlying problem of the disease
a) An abnormality in the body’s mucus secreting glands
b) Formation of fibrous cysts in various body organs
c) Failure of the pancreatic ducts to develop properly
d) Reaction to the formation of antibodies against streptococcus
42. The nurse judges that the mother understands the term cerebral palsy when she
describes it as a term applied to impaired movement resulting from which of the
following
a) Injury to the cerebrum caused by viral infection
b) Malformed blood vessels in the ventricles caused by
inheritance c) Non progressive brain damage caused by injury
d) Inflammatory brain disease caused by metabolic imbalances
43. The mother asks the nurse whether her child with hemiparesis due to spastic cerebral
palsy will be able to walk normally because he can pull himself to a standing
position.
Which of the following responses by the nurse would be most appropriate
a) Ask the doctor what he thinks at your next appointment
b) Maybe, maybe not. How old were you when you first walked
c) It’s difficult to predict but his ability to bear weight is a positive factor
d) If he really wants to walk, and works hard, he probably will eventually
44. A father brings his 3 month old infant to the clinic, reporting that the infant has a cold,
is having trouble breathing and just doesn’t seem to be acting right. Which of the
following actions would the nurse do first
a) Check the infants heart rate
b) Weight the infant
c) Assess the infants oxygen saturation
d) Obtain more information from the father
45. In preparation for discharge, the nurse teaches the mother of an infant diagnosed with
bronchiolitis about the condition and its treatment. Which of the following statements
by the mother indicates successful teaching
a) I need to be sure to take my child’s temperature everyday
b) I hope I don’t get a cold from my child
c) Next time my child gets a cold I need to listen to the
chest d) I need to wash my hands more often
46. When developing the plan for care for a child with early duchennes muscular
dystrophy, which of the following would the nurse identify as the primary
nursing goal for the child
a) Encouraging early wheelchair use
b) Fostering social interactions
c) Maintaining function of unaffected muscles
d) Prevent circulatory impairment
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47. Which of the following would be an important assessment finding for an 8 month old
infant admitted with severe diarrhoea
a) Absent bowel sounds
b) Pale yellow urine
c) Normal skin elasticity
d) Depressed anterior fontanel
48. When obtaining the initial health history from a 10 year old child with abdominal pain
and suspected appendicitis, which of the following questions would be most helpful in
eliciting data to help support the diagnosis
a) Where did the pain start
b) What did you do for the pain
c) How often do you have a bowel movement
d) Is the pain continuous or does it let up
49. Which of the following would first alert the nurse to suspect that a child with severe
gastroenteritis who has been receiving intravenous therapy for the past several
hours may be developing circulatory overload
a) A drop in blood pressure
b) Change to slow, deep respirations
c) Auscultation of moist crackles
d) Marked increase in urine output
50. The stool culture of a child with profuse diarrhoea reveals salmonella bacilli. After
teaching the mother about the course of salmonella enteritis, which of the following
statements by the mother indicates effective teaching
a) Some people become carriers and stay infectious for a long time
b) After the acute state passes, the organism is usually not present in the stool
c) Although the organism may be alive indefinitely, in time it will be of no danger
to anyone
d) If my child continues to have the organism in the stool, an antitoxin can
help destroy the organism
51. A mother of a 1 month old infant state that she is curious as to whether her infant is
developing normally. Which of the following developmental milestones would the
nurse expect the infant to perform
a) Smiling and laughing out loud
b) Rolling from side to side
c) Holding a rattle briefly
d) Turning the head from side to side
52. A child is to receive Trilafon 24 mg po BD. The medication is available as 16 mg/5ml.

how may ml will you administer
a) 3.3
b) .75
c) 7.5
d) 0.3
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53. Which of the following age groups are most susceptible to meningococcal meningitis
a) Children below 5 years of age
b) Children between 3.6 years (preschool)
c) School age children
d) Adolescents
54. A parent asks, can I get head lice too. The nurse indicates that adults can also be
infested with head lice but that Pediculosis is more common among school children,
primarily for which of the following reasons
a) An immunity to Pediculosis usually is established by adulthood
b) School aged children tend to be more neglectful of frequent hand
washing c) Pediculosis usually is spread by close contact with infected
children
d) The skin of adults is more capable of resisting the invasion of lice
55. When developing the postoperative plan of care for an adolescent who has
undergone an appendicectomy for a ruptured appendix, in which of the following
positions would the nurse expect to place the client during the early postoperative
period
a) The semi fowlers position
b) Supine
c) Lithotomy position
d) Prone
STATE EXAMS 3
1. Mental status assessment using the ‘batomi’ formation is a useful nursing assessment
tool because it tells you
a) Whether or not a client has a mental illness
b) Details about an individual’s feeling state and cognitive functioning
c) Whether a mental illness is organic or functional in origin
d) The history of a clients symptoms and his response to stress
2. Persons with an acute psychotic illness have most difficulty in

a) Meeting dependency needs
b) Maintaining grooming and personal hygiene
c) Distinguishing between reality and unreality
d) Displaying personal feelings
3. People who have a personality disorder

a) Frequently progress to a psychotic illness
b) Become psychotic under severe stress
c) Are known as borderline personalities
d) Have ongoing difficulties in relating to others
4. Neurotic disorders are associated with

a) Inadequacy and poor stress management
b) Maladaptive behaviour related to anxiety
c) Inability to cope with demands and perceived stress
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d) Family patterns of inappropriate behaviour
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5. Which of the following statements about tardive dyskinesia is true
a) Symptoms are often permanent and do not improve with
antiparkinsonian medication
b) Symptoms will diminish as the client adjusts to long term treatment
c) Clients are seldom concerned about features of tardive dyskinesia
d) Antiparkinsonian medication will suppress the main features of tardive dyskinesia
6. Memory loss associated with old age

a) Has a sudden onset and affects both long term and short term memory
b) Has a gradual onset and affects mainly long term memory
c) Has a gradual onset and affects mainly short term memory
d) Has a sudden onset and affects mainly short term memory
7. persons who have a neurotic disorder

a) have a minor disorder that will diminish with time and maturity
b) respond well to electro convulsive therapy
c) do not develop psychotic features
d) frequently have insight into their behaviour
8. a social factor contributing to the incidence of eating disorders is

a) economic disadvantage
b) educational
disadvantage c) gender
stereotyping
d) unemployment
9. the most common features of chronic organic psychosis are

a) fluctuating confusion and disorientation
b) persistent elated mood and hyperactivity
c) thought blocking and concrete thinking
d) social withdrawal and paranoid ideation
10. phobia is best described as

a) a fear related to an identifiable traumatic event in one’s life
b) an irrational fear of a specific situation or object
c) a series of repetitive behaviours designed to relieve anxiety
d) a general sense of impending doom
11. the most appropriate treatment for phobias is

a) anxiolytic drugs
b) cognitive restructuring
c) relaxation exercises
d) systematic desensitisation
12. the best definition of a crisis is

a) any event which causes anxiety
b) a life event which is perceived as a threat to self esteem
c) a traumatic event for which coping behaviours are inadequate
d) a situation which is traumatic and involves a significant loss
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13. forensic psychiatry is the area of mental health care which is concerned
with individuals who
a) have been committed to hospital because they would not voluntarily accept
treatment
b) are not considered to be capable of caring for themselves in a non
custodial environment
c) have been charged with an offence to undergo a psychiatric examination or
treatment
d) are mentally ill and considered to be a danger to themselves or to the public
14. anxiety is best described as

a) mild form of psychosis
b) disorder of mood
c) response to stress
d) distorted sense of perception
15. Which of the following is common feature of anxiety

a) Paranoid delusions
b) Social withdrawal
c) Impaired concentration
d) Auditory hallucinations
16. A comparison of Maori and non Maori suicide rates shows that
a) Maori are less likely to commit suicide
b) Maori are much more likely to commit suicide
c) There is no difference between Maori and non Maori suicide rates
d) There are differences but they are not statistically significant
17. A person who is currently acutely depressed expresses an intention to self harm. Your
initial response would be to
a) Distract the client by talking about less depressing thoughts or ideas
b) Encourage the client to discuss their ideas of suicide to establish potential for self
harm
c) Suggest the client involves themselves with other clients to establish supportive
relationships
d) Ask the client to explain their reasons for contemplating self harm
18. A depressed client is prescribed amitriptyline. This would have the effect of
a) Clarifying his thought
processes b) Helping to raise his
mood
c) Eliminating negative ideas
d) Promoting greater self awareness
19. While watching television in the lounge a client says quickly and abruptly to the nurse,
the sun is shining in Virginia. My son is in Virginia. Who’s afraid of Virginia wolf.
Which of the following is this statement an example of
a) Concrete thinking
b) Flight of ideas
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c) Word salad
d) Depersonalisation
20. In planning the care of for the elated client a primary aim is to
a) Encourage interpersonal contact
b) Provide a non stimulating environment
c) Demand that the client follow rules
d) Accept and understand the behaviour
21. For a client suffering from mania who is unable to sleep the best approach is to
a) Fully involve the client in physical activities and exercise programmes during
daytime
b) Encourage the client to talk about underlying feelings or stressors
c) Nurse in low stimulus environment and administer prescribed antipsychotic
medication
d) Place in seclusion using medication only as a last resort
22. For a client suffering from mania who is expressing delusional ideas the
best approach is to
a) Explain to the client the distinction between rational and irrational
thinking b) Acknowledge his ideas but distract him by focusing on reality
based ideas
c) Ignore him because to do otherwise will only reinforce his ideas
d) Encourage him to stop thinking like that, as it is a symptom of his illness
23. A client who is subject to a community treatment order section 29 of the mental
health act (1992) must
a) Accept prescribed medication and attend any specified treatment center
b) Report on a weekly basis to a community mental health centre
c) Return to hospital after a period of three months for a psychiatric assessment
d) Name a primary caregiver who will accept responsibility for the clients care
and supervision
24. In preparation for living in the community a client may spend a period of time
living in a half way house. The main objective of living in a half way house is to
a) Save sufficient money in order to set up a house or flat
b) Spend time looking for a suitable job on leaving hospital
c) Assess whether the client still has any symptoms of mental illness
d) Provide the client with the opportunity to adjust to a more independent lifestyle
25. Following an automobile accident involving a fatality and a subsequent arrest for
speeding, a client has amnesia for the events surrounding the accident. This is an
example of the defence mechanism known as
a) Projection
b) Repression
c) Dissociation
d) Suppression
26. The group most at risk for developing an eating disorder is young women
a) Who are high achievers
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b) With a history of disturbed behaviour
c) Who have conflict with their
parents d) With a history of mental
illness
27. Support for a client with an eating disorder involves

a) Avoidance of family conflicts
b) Discussion of health ways of losing weight
c) Encouragement to explore issues of concern
d) Daily checks for changes in weight
28. The personality disorder associated with an inability to make decisions and the need
for constant reassurance is commonly classified as
a) Obsessive
compulsive b)
Dependent
c) Cyclothymic
d) Antisocial
29. People who have a personality disorder

a) Frequently progress to a psychotic illness
b) Become psychotic under severe stress
c) Are known as borderline personalities
d) Have ongoing difficulties in relating to others
30. A side effect resulting from long term use of antipsychotic medication is
tardive dyskinesia. Features of tardive dyskinesia include
a) Involuntary lip smacking and tongue movements
b) Dry mouth and blurred vision
c) Muscular rigidity and shuffling gait
d) Nausea and vomiting
31. A nurse working in a long term ward becomes aware that they are becoming
institutionalised. Which of the following behaviours would they be most likely
to have noticed
a) An excessive and unrealistic concern for the welfare of clients
b) A tendency to become involved in new activities
c) A lack of satisfaction with existing methods of
work d) Resistance to new ideas and change
32. One reason for ordering an individual charged with an offence to have psychiatric
examination is to determine whether that person
a) Is likely to have committed the offence he is charged with
b) Has a previous personal or family history of psychiatric illness
c) Was suffering from a mental illness at the time of the alleged offence
d) Has a mental illness which would respond to a programmed of treatment
33. Cultural considerations in the use of seclusion include
a) Use of seclusion only after consent has been obtained from the appropriate
cultural representatives
b) Listening to advice from staff of the clients culture or form the clients family
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c) Having an appropriate cultural representative available each time the seclusion
room is entered
d) Ensuring that only staff from the clients culture participate in caring for any
client in seclusion
34. Cross cultural studies on mental illness show that

a) The symptoms of mental illness are the same in all cultures
b) The incidence of mental illness the same in all cultures
c) Mental illness has culturally specific characteristics
d) Mental illness is more common amongst cultural minorities
35. The drug most commonly used in the long term treatment of bi polar disorder is
a) Diazepam
b) Lithium carbonate
c) Clozapine
d) Sodium Amytal
36. Anticholinergic side effects are common with all the following except
a) Diazepam
b) Benztropine
c) Amitriptyline
d) Thioridazine
37. Chlorpromazine is an antipsychotic medication used in the treatment of

a) Anxiety states
b) Schizophrenia
c) Depressive disorders
d) Dementia
38. Which of the following is the main reason for giving depot injections of antipsychotic
medication
a) They are more effective than oral medication
b) They overcome the problem of non adherence
c) Side effects are not as common
d) They are easier to administer than oral medication
39. A client who is committed under the mental health act (1992) is discharged from
hospital on leave. When visited by the community mental health nurse he refused his
injection of antipsychotic medication which is due that day. The best initial
approach to this would be to
a) Explain that this will mean his immediate return to hospital
b) Visit again the next day and attempt to persuade the client to accept
his medication
c) Inform the medical staff so that the clients legal status can be changed
d) Explore with the client alternative forms of treatment to medication
40. Long term use of benzodiazepine drugs (minor tranquillisers) such as diazepam
(valium) can lead to
a) Tardive
dyskinesia b)
Dependence
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c) Renal impairment
d) Akathisia
41. A client expresses the belief that he is the illegitimate son of a famous family. This is
an example of
a) Paranoid thinking
b) Pressure of speech
c) A delusion of grandeur
d) Ideas of reference
42. The best response to this statement (in previous question) is to

a) Involve the client in a group activity
b) Inform the client that he is wrong in his belief
c) Talk to the client without confirming or denying his belief
d) Spend some time with the client in an attempt to meet his need to feel important
43. At an art group a client shows the group the painting he has done. It consists of knives
and blood, with the words ‘death’ and ‘peace’ written on it. The client tells the group
that this represents his own death and release from suffering. The best response to this
is
a) Thank him for his participation and then focus the discussion on another client
b) Acknowledge his contribution and ensure that you discuss this further with him
after the group has finished
c) Request that the client use the opportunity to explore more positive aspects of his
life
d) Insist the client explain this feelings to the group and then point out positive
aspects of his life
44. A client who has been admitted for treatment of a depressive illness says he doesn’t
want to attend group activities. The reason such a client would be encouraged to
attend is that
a) He is less likely to dwell on depressive ideas while he is involved in a group
activity
b) It is an expectation that all clients attend group activities while in hospital
c) Involvement in group activities is the only way to overcome feelings of depression
d) Attendance at group activities is essential to monitor the effectiveness of
medication
45. A client with post traumatic stress disorder says ‘I should have been killed with the
rest of them. Why am I alive’ this statement is best described as an example of
a) Suicidal thinking
b) Survivor guilt
c) Depressive preoccupation
d) Neurotic conflict
46. The best way to report the clients statement (in previous question) in the nursing notes
would be
a) Client has no insight into their situation
b) Client is questioning why they are still alive
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c) Client is expressing suicidal ideas
d) Client feels responsible for death of others
47. Long acting intramuscular antipsychotic medication is used in the treatment of

schizophrenia because it
a) Has fewer side effects than oral medication
b) Has a greater antipsychotic action
c) Is more rapidly absorbed than oral medication
d) Ensures that clients receive their medication
48. Which of the following statements related to the treatment, with lithium carbonate,
of person with bipolar disorder is true
a) Most will need to take lithium carbonate for an extended period of time, perhaps
for life
b) Once the persons mood becomes euthymic, treatment can be discontinued in most
cases
c) Because of the need to maintain constant blood levels, long term injections is the
preferred form of treatment
d) Treatment is most effective in the acute stage of the illness although some
people will need long term treatment
49. An acutely ill client with the diagnosis of schizophrenia has just been admitted to the
mental health unit. When working with this client initially the nurses most
therapeutic action would be to
a) Use diversional activity and involve the client in occupational therapy
b) Build trust and demonstrate acceptance by spending some time with the client
c) Delay one to one interactions until medications reduce the psychotic symptoms
d) Involve the client in multiple small group discussions to distract attention from the
fantasy world
50. You are caring for a client who talks in a regretful way about the past. The
best response is to
a) Help them find something positive in their past
b) Help them move their thoughts to the future
c) Tell them that focusing on the past is not helpful
d) Acknowledge the clients feelings then focus on the present
51. Intervention with an angry client who is threatening violence involves

a) Asking the client to express their feelings verbally
b) Maintaining silence to avoid any escalation of anger
c) Asking the client what has happened to make them so angry
d) Giving brief, clear messages about what you want the client to do
52. Mr w is committed under section 11 o the mental health act 1992. He sneaks out at
night and returns to his former home. He calls the staff and tells them he is not
coming back. The staffs responsibility is to
a) Make sure he has discharged
b) Tell him to take his medication
c) Ask to have someone else talk to him
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d) Notify the police and crisis team
53. The highest priority nursing action relative to alcohol withdrawal delirium would be
a) Orientation to reality
b) Application of restraints
c) Identification and social supports
d) Replacement of fluids and electrolytes
54. The use of silence during an interview is therapeutic if

a) The person is overcome with emotion
b) The person appears uncomfortable with the current discussion
c) The nurse wishes to terminate the communication session
d) The patient wishes to terminate the communication session
55. To facilitate communication the nurse should convey

a) Accurate empathy
b) Authenticity
c) Unconditional positive regard
d) All of the above
56. The parents of a young man experiencing a schizophrenic illness ask if he is likely
to become violent. The best answer the nurse can make is that the vast majority of
mentally ill individuals
a) Are more dangerous than normal people
b) Are not more dangerous than other individuals in the population
c) Are unpredictable and therefore more dangerous than normal individuals
d) Are about as violent and unpredictable as more individuals in the population
57. While interviewing Mr. d, the nurse notes he uses neologisms and has losses
associations. This would most likely indicate the presence of
a) Mania
b) Depression
c) Defensive coping
d) Schizophrenia or psychosis
58. When monoamine oxide inhibitors (MAOIs) are prescribed, the client should be
cautioned against
a) Prolonged exposure to the sun
b) Ingesting wines and aged cheeses
c) Engaging in active physical exercise
d) The use of medications with an elixir base
59. A characteristic feature of the elated client is

a) Retarded speech
b) Increased motor and thought activity
c) Delusions of sin and guilt
d) Depressed mood
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60. To give effective nursing care to a client who is using ritualistic behaviour, the
nurse must first recognize that the client
a) Should be prevented from performing the rituals
b) Needs to realise that the rituals serve no purpose
c) Must immediately be diverted when performing the ritual
d) Does not want to repeat the ritual, but feels compelled to do so
STATE EXAMS 4
1. Culturally safe nursing care can best be achieved when the nurse has
a) An in depth knowledge of the treaty of Waitangi
b) An awareness of Maori perspectives of health
c) An awareness and acceptance of your own limits in meeting someone’s else’s
health and cultural needs
d) A knowledge of Maori protocol
2. Imagine a new virus infecting a human population for the first time. Which of
the following is most likely to lead to a rapid increase in cases worldwide
a) Severe disease with high mortality
b) Lack of hand hygiene
c) Air travel
d) High transmissibility
3. The school nurse is caring for a child with haemophilia who is actively bleeding
from the leg. Which of the following would the nurse apply
a) Direct pressure, checking every few minutes to see if the bleeding has stopped
b) Ice to the injured leg area several times a day
c) Direct pressure to the injured area continuously for 10 minutes
d) Ice bag with elevation of the leg twice a day
4. Home health nurses visit a blind diabetic patient who lives alone to monitor the
patients glucose level and administer the patients daily insulin. Evaluation of outcome
management for this patient would include
a) An absence of complications of diabetes
b) A reduction in hospitalizations for glycemic control
c) The ability of the patient to learn to use adaptive syringes
d) The patients evaluation of the services provided by the nurses
5. The nurse consults with the physician to arrange a referral for hospice care for
a patient with end stage liver disease based on the knowledge that hospice care
is indicated when
a) Family members can no longer care for dying patients at home
b) Patients and families are having difficulty coping with grief reactions
c) Preparation for death with palliative care and comfort are the goals of care
d) Patients have unmanageable pain and suffering as a result of their condition
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6. When teaching a patient who smokes about the relationship of smoking to the
development of cancer, the nurse explains that tobacco smoke is a complete
carcinogen because
a) Exposure to the smoke always causes cellular changes
b) Tobacco smoke is capable of both initiating and promoting cancer growth
c) Cancer will always develop when people who smoke are exposed to
other carcinogens
d) Tobacco smoke serves as a vehicle for the spread of cancer cells during the
progression stage of cancer
7. In teaching about cancer prevention, the nurse stresses promotion of exercise, normal
body weight, and low fat diet because
a) General aerobic health is an important defence against cellular mutation
b) Obesity is a factor that promotes cancer growth; if it is reversed, the risk of
cancer can be decreased
c) People who are overweight usually consume large amounts of fat, which is a
chemical carcinogen
d) The development of fatty tumours, such as lipomas, is increased when there is an
abundance of fatty tissue
8. A 40 year old divorced mother of four school children is hospitalized with metastatic
cancer of the ovary. The nurse finds the patient crying, and she tells the nurse that she
does not know what will happen to her children when she dies. The most appropriate
response by the nurse is
a) Why don’t we talk about the options you have for the care of your children
b) You are going to live for a long time yet, and your children will be just fine
c) I wouldn’t worry about that right now. You need to concentrate on getting well
d) Wont your ex husband take the children when you can’t care for them anymore
9. During the primary assessment of a trauma victim, the nurse determines that the
patient has a patent airway. The next assessment the nurse makes includes
a) The level of consciousness
b) Observation for external bleeding
c) The status of the patients respiration
d) The rate and character of carotid or femoral pulses
10. Which of the following viruses is usually transmitted by airborne

droplets a) Varicella zoster virus
b) Cytomegalovirus
c) Herpes simplex virus
d) Hepatitis a virus
11. Which of the following has made the biggest impact on mortality from infectious
diseases in the 20th century
a) Vaccination
b) Better housing and provision of clean water, sewerage systems
c) Antimicrobials
d) Infection control
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12. in addition to providing informational support, which of the following nursing
activities is an integral part of the role of the nurse advocate
a) maintaining the patient in a dependent role
b) assuming responsibility for directing the patients care
c) assisting the patient to make sound health care decisions
d) persuading the patient to choose exactly what the health care team recommends
13. Steve, 15 years old, is admitted with suspected meningitis. Nuchal rigidity will not
be seen in which of the following
a) intracranial haematoma
b) meningitis
c) cerebral concussion
d) intracranial tumour
14. a positive Mantoux test indicates

a) the client has active tuberculosis
b) the client has been exposed to mycobacterium
c) the client will never have tuberculosis
d) the client has been infected with mycobacterium tuberculosis
15. Which of the following would the nurse do when suspecting that a child has been
abused by the mother
a) Continue to collect information until there is no doubt in the nurses mind that
abuse has occurred
b) Ensure that any and all findings are reported to the proper state and
legal authorities
c) Keep the finding confidential, because they represent legal
privileged communication between the nurse and the mother
d) Report the findings to the physician because that falls within the responsibilities of
medical practise
16. Several high school seniors are referred to the school nurse because of suspected
alcohol misuse. When the nurse assesses the situation, which of the following
would be most important to determine
a) What they know about the legal implications of drinking
b) The type of alcohol they usually drink
c) The reasons they choose to use alcohol
d) When and with whom they use alcohol
17. When a trauma victim expresses fear that AIDS may develop as a result of a
blood transfusion, the nurse should explain that
a) Blood is treated with radiation to kill the virus
b) Screening for HIV antibodies has minimised the risk
c) The ability to directly identify HIV has eliminated this concern
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d) Consideration should be given to donating own blood for transfusion
18. A client asks the nurse, should I tell my husband I have AIDS. The nurses most
appropriate response would be
a) This is a decision alone you can make
b) Don not tell him anything unless he asks
c) You are having difficulty deciding what to say
d) Tell him you feel you contracted AIDS from him
19. When a disaster occurs, the nurse may have to treat mass hysteria first. The person or
persons to be cared for immediately would be those in
a) Panic
b) Coma
c) Euphoria
d) Depression
20. A child was bitten on the hand by a dog who had recently received a rabies shot. The
nursing priority for this child would be directed toward ensuring that the
a) Suture line remains red and dry
b) Child does not develop a fear of dogs
c) Rabies antibodies develop within 48 hours
d) Mobility of the injured hand returns to a preinjury state in 1 week
21. The school nurse is invited to attend a meeting with several parents who express
frustration with the amount of time their adolescents spend in front of the mirror and
the length of time it takes them to get dressed. The nurse explains that this
behaviour is indicative of which of the following
a) An abnormal narcissism
b) A method of procrastination
c) A way of testing the parents limit setting
d) A result of developing self concept
22. A parent asks the nurse about head lice (Pediculosis capitis) infestation during a visit
to the clinic. Which of the following symptoms would the nurse tell the parent is most
common in a child infected with head lice
a) Itching of the scalp
b) Scaling of the scalp
c) Serous weeping of the scalp surface
d) Pinpoint hemorrhagic spots on the scalp surface
23. After teaching the parents about the cause of ringworm of the scalp (tinea capitis),
which of the following, if stated by the father, indicates successful teaching
a) Over exposure to the sun
b) Infestation with a mite
c) Fungal infection of the scalp
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d) An allergic reaction
24. A mother tells the nurse that one of her children has chicken pox and asks what she
should do to care for that child. When teaching the mother, which of the following
would be most important to prevent
a) Acid base imbalance
b) Malnutrition
c) Skin infection
d) Respiratory infection
25. One litre of intravenous fluid is to be given over 4 hours. The giving set delivers
60 drops per ml. how many drops per minute should be given
a) 150
b) 250
c) 300
d) 160
26. The nurse discusses the eating habits of school aged children with their parents,
explaining that these habits are most influenced by which of the following
a) Food preference of their peers
b) Smell and appearance of foods offered
c) Examples provided by parents at mealtimes
d) Parental encouragement to eat nutritious foods
27. Which of the following is an offence under the Hydatids act 1959
a) Failure to report stray, unregistered dogs
b) Feeding raw offal to any dogs in your care
c) Tenuicollis worms in lambs at the time of killing
d) Tenuicollis cysts in any purged material from dogs
28. What is the responsibility of the nurse who, for two days, has observed the nurse
manager putting several syringes into her pocket
a) Report the matter to another nurse manager
b) Discuss the matter with your nursing colleagues
c) Watch the nurse manager to see if it happens again
d) Ignore the incident as a nurse manager is a responsible person
29. Neil, a 17 year old, is hit on the head by a cricket ball while playing with a friend
at home. He fell against the glasshouse, severely lacerating his right wrist. He as
unconscious for about 5 minutes. The initial first aid treatment for Neil would be to
a) Wrap a handkerchief tightly on the wrist
b) Check for breathing
c) Elevate the wrist
d) Wash the wrist to examine it
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30. You are taking nails recordings when he appears to have a seizure. What nursing
intervention would best assist Neil
a) Describing and recording the seizure activity observed
b) Restraining Neil in order to prevent self harm
c) Placing a tongue blade between his teeth
d) Suctioning Neil to prevent aspiration
31. Following a petit mal seizure a person is likely to be

a) Confused
b) Hostile
c) Hyperactive
d) Euphoric
32. On a follow up outpatient. Neil enquires about his anticonvulsant medication. He

needs to know that following a head injury
a) The medication must be taken for at least 1 year
b) The physician must be seen when the prescription is finished
c) The medication will be discontinued as soon as his seizures are under control
d) The medication will be necessary for the rest of his life
33. If you are with someone who has a grand mal seizure, you should
a) Loosen the clothing about their neck and wrist
b) Turn their head to the side to facilitate drainage of secretions
c) Remove nearby objects to protect their extremities from
injury d) All of the above
35. When performing a cultural assessment with a patient of a different culture, it is

important for the nurse to first ask about the patients
a) Racial heritage
b) Use of cultural healers
c) Language spoken at home
d) Affiliation with a cultural group
36. After being bitten by an unknown insect, a patient allergic to wasp stings is brought
to a clinic by a co worker. Upon arrival the patient is anxious and is having difficulty
breathing. The first action by the nurse is to
a) Administer oxygen
b) Maintain the patients airway
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c) Remove the stinger from the site
d) Place the patient in recumbent position with his legs elevated
37. During immediate care of a victim of a bite or sting to the hands or fingers, it is most
important for the nurse to
a) Elevate the affected extremity
b) Scrub the wound with an antibacterial solution
c) Apply ice to the site with ice water or ice packs
d) Remove rings and watches from the affected extremity
38. A young man seeks medical care after a friend with whom he shared needles during
illicit drug use develops hepatitis B. to provide immediate protection from
infection, the nurse expects to administer
a) Corticosteroids
b) Gamma globulin
c) Hepatitis b vaccine
d) Fresh frozen plasma
39. A 63 year old man has terminal cancer of the liver and is cared for by his wife at
home. His abdominal pain has become increasingly severe, and he now says it is
intense most of the time. The nurse recognizes that teaching regarding pain
management has been effective when the patient
a) Limits the use of opiate analgesics to prevent addiction
b) Resigns himself to the fact that pain is an inevitable consequence of cancer
c) Uses pain medication only when the pain becomes more than he can tolerate
d) Takes analgesics around the clock on a regular schedule, using additional doses
for the breakthrough pain
40. A patient is treated at a clinic with an injection of long acting penicillin for a
streptococcal throat infection. Her history reveals that she has received penicillin
before with no allergic responses. When the penicillin injection is administered, the
nurse should inform the patient that
a) She must wait in the clinic area for 20 minutes before she is discharged
b) Since she has taken penicillin before without problems, she can safely take it now
c) She would have immediate symptoms if she had developed an allergy to penicillin
d) She should monitor for fever and skin rash typical of serum sickness after
taking penicillin
41. A parent asks why it is recommended that the second dose of the measles, mumps,
rubella (MMR) vaccine be given by 12 years of age. The nurse responds based on
which of the following as the most important reason
a) The risks to a foetus are high if a girl receiving the vaccine becomes pregnant
b) The chance of contracting the disease is much lower after puberty than before it
c) The dangers associated with a strong reaction to the vaccine are increased
after puberty
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d) The changes that occur in the immunologic system may affect the rhythm of the
menstrual cycle
42. Mrs Simmon states she is not feeling well, that she cannot breathe and asks you
to please do something. Your initial response to the client is
a) You will be alright, just calm down
b) Don’t worry, the doctors have everything under control
c) I will ring the doctor to come and see you
d) I will take your recordings and ring the doctor to see you
43. For the nursing council to find a registered nurse guilty of negligence, it would
have to prove that the nurse
a) Failed to do what another careful registered nurse would have done in a similar
situation
b) Did not give competent care as defined by colleagues with the same level of
experience
c) Did not give an appropriate level of care as defined by the NZNO standards for
nursing practice
d) Did not give an appropriate level of care as defined by the NZNO code of
practice for nurses
44. Ageism is an important concept for the nurse to understand because it

a) May damage the self esteem of the elderly
b) Increases social awareness of the needs of the elderly
c) Provides statistical information regarding the elderly population
d) Promotes consideration of the diversity of the elderly population
45. A middle aged woman enjoys orienting new young women and men at work. She
enjoys being a teacher and mentor and feels she should pass down her legacy of
knowledge and skills to the younger generation. The nurse recognizes that the
woman is involved in the behaviour described by Erikson as
a) Generativity
b) Ego integrity
c) Identification
d) Valuing wisdom
46. For the nursing council to find a registered nurse guilt of malpractice following
an assault on a client, it would have to prove that the nurse
a) Intended to cause bodily harm to the client
b) Actually assaulted the client
c) Did not establish a therapeutic relationship with the client
d) Committed a felony against the client
47. Emergency interventions for a victim with upper torso injuries or face, head, or
neck trauma include
a) Suctioning to clear the airway
b) Immobilization of the cervical spine
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c) Administration of supplemental oxygen
d) Ensuring venous access with at least two large bore IV lines
48. An employee spilled industrial acids on his arms and legs at work. The appropriate
action by the occupational nurse at the facility is to
a) Apply cool compresses to the area of exposure
b) Apply an alkaline solution to the affected area
c) Cover the affected area with dry, sterile dressings
d) Flush the substance with large amounts of tap water
49. According to the privacy act 1993, when collecting health information from a client
the nurse must
a) Ensure the client is aware that health information is being collected
b) Tell the client why health information is being collected
c) Inform the client about their rights of access and
correction d) All of the above
50. An example of the use of primary prevention for family violence is

a) Working to eliminate the glamorisation of violence on television
b) Counselling a woman living in an abusive relationship about available shelter
programs
c) Calling child protective services regarding a school age child who has
reported sexual attacks by her stepfather
d) Carefully examining the skin of an elder who has just returned to an extended
care facility following a weekend with his children
51. With a patient who is homosexual, the nurses most appropriate initial action during
the preinteraction phase of the relationship should be to
a) Assist the patient in changing sexual values
b) Examine own feelings and anxieties with regard to the patient
c) Review the literature pertaining to the human sexual response
d) Attempt to identify the underlying reasons for the patients values
52. The nurse judges that the mother understands the term cerebral palsy when she
describes it as a term applied to impaired movement resulting from which of the
following
a) Injury to the cerebrum caused by viral infection
b) Malformed blood vessels in the ventricles caused by
inheritance c) Non progressive brain damage caused by injury
d) Inflammatory brain disease caused by metabolic imbalances
53. The first symptom of gonorrhoea is usually

a) Lower abdominal pain
b) A sore or ulcer on the genitals
c) Purulent vaginal discharge in the female
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d) Urethral discharge in the male
54. The first symptom of syphilis is

a) A generalised rash all over the body
b) A sore or ulcer on the genitals
c) Abdominal pain in the male
d) Purulent vaginal discharge
55. When obtaining a nursing history from parents who are suspected of abusing
their child, which of the following characteristics about the parents would the
nurse typically find
a) Attentiveness to the child’s needs
b) Self blame for the injury to the child
c) Ability to relate child’s developmental achievements
d) Evidence of little concern over the extent of the injury
56. A colleague comments: what is the relevance of the treaty of Waitangi to Maori health
a) Maori people view the treaty of Waitangi as a health document
b) Nursing practice in new Zealand is congruent with the treaty of Waitangi
c) The right to health is guaranteed to Maori under article two of the treaty of
Waitangi
d) The right to Maori involvement in health is guaranteed
57. The long term consequences of Chlamydia is most likely to be

a) Menorrhagia
b) Chronic vaginitis
c) Chronic cervicitis
d) Sterility
58. When describing the effects of insulin on the body to a patient newly diagnosed with
diabetes mellitus, the best explanation by the nurse is
a) Insulin promotes the breakdown of fatty tissue into triglycerides, which can
be used for energy
b) When proteins are taken into the body, insulin promotes their breakdown and
conversion to fats
c) Insulin stimulates the conversion of stored sugars into blood glucose and the
conversion of proteins into glucose
d) When carbohydrates, fats, and proteins are eaten, insulin promotes
cellular transport and storage of all these nutrients
59. A serious complication of acute malaria is

a) Congested lungs
b) Impaired peristalsis
c) Anaemia and cachexia
d) Fluid and electrolyte imbalance
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60. A registered nurse stops to assist at the scene of an accident but the injured man dies
before the ambulance arrives. The nurse should understand that she
a) Should leave the scene before the ambulance arrives
b) Will be covered by her actions by the good Samaritan laws
c) Has a legal duty of care to perform at a competent level as a registered nurse
d) Should pronounce the person dead at the scene
STATE EXAMS 5
1. John is admitted with neutropenia, what does the nurse assess in determining his risk
for infection
a) Length of time neutropenia has existed
b) Health status before neutropenia
c) Body build and weight
d) Resistance to infection in childhood
2. What nursing action would be important in preventing cross contamination

a) Change gloves immediately after use
b) Stand two feet from the patient
c) Speak minimally when in the room
d) Wear long sleeved shirts
3. What would you teach john and his family to avoid

a) Using suppositories or enemas
b) Using a high efficiency particulate air filter mask
c) Performing perineal care after every bowel movement
d) Performing oral care after every meal
4. 24 hours after john has a bone marrow aspiration, the nurse evaluates which of the
following as an appropriate client outcome
a) The client maintains bed rest
b) There is redness and swelling at the aspiration site
c) The client requests morphine sulphate 2mg IM every 2
hours d) There is no bleeding at aspiration site
5. During the induction stage for treatment of leukaemia, the nurse should remove which
items that the family has brought into the room
a) A bible
b) A picture
c) A sachet of lavender
d) A hairbrush
6. The goal of nursing care for a client with acute myeloid leukaemia is to prevent
a) Cardiac arrhythmias
b) Liver failure
c) Renal failure
d) Haemorrhage
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7. The nurse is evaluating the clients learning about combination chemotherapy.
Which of the following statements about reasons for using combination
chemotherapy indicates the need for further explanation
a) Combination chemotherapy is used to interrupt cell growth cycle at different
points
b) Combination chemo is used to destroy cancer cells and treat side
effects simultaneously
c) Combination chemo is used to decrease resistance
d) Combination chemo is used to minimise the toxicity from using high doses
of single agent
8. In providing care to the client with leukaemia who has developed thrombocytopenia,
the nurse assessed the most common sites for bleeding. Which of the following is not
a common site
a) Biliary system
b) Gastrointestinal tract
c) Brain and meninges
d) Pulmonary system
9. The nurses best explanation for why the severely neutropenic client is place in
reverse isolation is that reverse isolation helps prevent the spread of organisms
a) To the client from sources outside the clients environment
b) From the client to health care personnel, visitors and other clients
c) By using special techniques to dispose of contaminated material
d) By using special techniques to hand the clients linens and personal items
10. A client has received 25ml of packed red blood cells when she began to experience
low back pain and mild itching. After stopping the transfusion the nurse should
a) Administer prescribed aspirin and antihistamines
b) Collect blood and urine samples to be sent to the laboratory
c) Administer prescribed diuretics, oxygen and morphine
d) Administer prescribed vasopressors
11.11.
The nurse in the preoperative period is preparing a female client for surgery and
notices that the client looks sad. The client says, ‘I’m scared of having cancer. It’s so
horrible and I brought it on myself. I should have quit smoking years ago’. What
would be the nurses best response to the client
a) It’s okay to be scared. What is it about cancer that you’re afraid of
b) It’s normal to be scared. I would be too. Well help you through it
c) Don’t be hard on yourself. You don’t know if your smoking caused the cancer
d) Do you feel guilty because you smoked
12. Following mastectomy the client is now due to have radiation therapy. She should be
taught to care for the skin at the therapy site by
a) Washing the area with water
b) Exposing the area to dry heat
c) Applying an ointment to the area
d) Using talcum powder on the area
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13. A 42 year old woman is interested in making dietary changes to reduce her risk
of colon cancer. What dietary selections would the nurse suggest
a) Croissant, peanut butter, sandwiches, whole milk
b) Bran muffin, skim milk, sir fried broccoli
c) Bagel with cream cheese, cauliflower salad
d) Oatmeal, baked potato, turkey sandwich
14. The nurse is teaching a 19 year old client and the client’s family about what to expect
with high dose chemotherapy and the effects of neutropenia. What should the nurse
teach as the most reliable early indicator of infection in a neutropenic client
a) Fever
b) Chills
c) Tachycardia
d) Dyspnoea
15. The client is being discharged with oral chemotherapy, in teaching the client and
family how to manage nausea and vomiting at home, which of the following
should be discussed
a) Eating frequent, small meals throughout the day
b) Eating three normal meals a day
c) Eating only cold food but no salads
d) Limiting the amount of fluid intake
16. In setting up a syringe driver to administer analgesia which of the following

factors would be most important for the nurse to consider when determining the
angle at which to insert the needle
a) Size of the syringe
b) Tissue turgor
c) Length of the needle
d) Amount of subcutaneous tissue
17. A client is diagnosed with metastatic bone cancer. Which of the following
abnormal laboratory values would the nurse expect to see
a) Hypocalcaemia
b) Elevated serum alkaline phosphatase
c) Hypokalemia
d) Hypoglycaemia
18. Mrs Johnson has had a recurrence of breast cancer and has been managed at home
with support from the palliative care nurse specialist. This morning when visiting
her, the nurse noted she was experiencing severe low back pain especially when lying
down. Which of the following assessments would be the priority
a) Bowel and bladder
b) Respiratory
c) Neurological
d) Skin and pressure sore risk
19. The nurse would teach the client that a normal local tissue response to radiation is
a) Atrophy of the skin
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b) Scattered pustule formation
c) Redness of the surface tissue
d) Sloughing of two layers of skin
20. The husband of a client with cervical cancer says to the nurse, ‘the doctor told my
wife that her cancer is curable. Is he just trying to make us feel better.’ Which would
be the nurses most accurate response
a) When cervical cancer is detected early and treated aggressively, the cure rate
is almost 100%
b) The 5 year survival rate is about 75%, which makes the odds pretty good
c) Saying a cancer is curable means that 50% of all women with cancer survive
at least 5 years
d) Cancers of the female reproductive tract tend to be slow growing and respond
well to treatment
21. A priority nursing diagnosis for a client with cervical cancer who has an
internal radium implant would be
a) Pain related to cervical tumour
b) Anxiety related to self care deficit from imposed immobility during radiation
c) Impaired health maintenance related to surgery
d) Disturbed sleep pattern related to interruptions by health care personnel
22. The nurse should carefully observe a client with internal radium implants for typical
side effects associated with radiation therapy to the cervix. These effects include
a) Severe vaginal itching
b) Confusion
c) High fever in the afternoon or evening
d) Nausea and a foul vaginal discharge
23. A terminally ill client’s husband tells the nurse, ‘I wish we had taken that trip to
Europe last year. We just kept putting it off, and now I’m furious that we didn’t go.’
The nurse interprets that husbands statement as indicating which of the following
stages of adapt ion to dying
a) Anger
b) Denial
c) Bargaining
d) Depression
24. A client is newly diagnosed with cancer and is beginning a treatment plan. Which of
the following nursing interventions will be most effective in helping the client cope
a) Assume decision making for the client
b) Encourage strict compliance with all treatment regimens
c) Inform the client of all possible adverse treatment
effects d) Identify available resources
25. Mr Green has been admitted terminally ill and in need of pain management. He
has now been commenced on oral morphine. What would you also ensure the
doctor prescribe at this time
a) Antiemetics
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b) Subcutaneous fluids
c) Aperients
d) Sedatives
STATE EXAMS 6
1. A client sustained an open fracture of the femur from an automobile accident.
For which of the following types of shock should the client be assessed
a) Cardiogenic
b) Neurogenic
c) Hypovolaemic
d) Anaphylactic
2. What is the primary goal for the care of a client who is in shock
a) Preserve renal function
b) Prevent hypostatic pneumonia
c) Maintain adequate vascular tone
d) Achieve adequate tissue perfusion
3. Which of the following findings would the nurse most likely note in the client who
is in the compensatory stage of shock
a) Decreased urinary output
b) Significant hypotension
c) Mental
confusion d)
Tachycardia
4. Two days after the fracture of his femur, a client suddenly complains of chest
pain and dyspnoea. The nurse also notes some confusion and an elevated
temperature. Based on these assessment findings, the nurse suspects which of the
following complications
a) Osteomyelitis
b) Fat embolism syndrome
c) Venous thrombosis
d) Compartment syndrome
5. When the nurse asked her client and partner what type of birth control they were
planning to use, they stated that since she is breast feeding, they don’t need to have to
worry about birth control. The nurse should tell them that
a) They can decide on a method when Cindy stops breast feeding
b) No birth control is necessary until after the first menstrual
period c) Ovulation can occur when a woman is breast feeding
d) Since Cindy has become pregnant once, it will be much easier for her to become
pregnant now
6. During the post partum period many women experience mood swings which
are referred to as
a) Psychosis
b) Post partum blues
c) Detachment from infant
d) Attachment to the infant
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7. According to Erikson, an infant is in the psychosocial stage that is characterised by
the conflict of
a) Trust vs mistrust
b) Initiative vs guilt
c) Intimacy vs isolation
d) Autonomy vs shame and doubt
8. Mrs Cindy Jackson, para 1, gravid 1, had a vaginal delivery of a full term baby
yesterday. Because of the soreness of her perineum, Cindy states that she is afraid to
have a bowel movement. The nurse should encourage Cindy to
a) Ambulate frequently, eat fresh fruits and vegetables, and drink 6 – 8 glasses water
per day
b) Ask her doctor to prescribe a laxative to stimulate defecation
c) Drink 2 glasses of warm water after every meal, then try to defecate
d) Do kegel exercises twice a day, eat a low roughage diet, and drink ten glasses of
water per day
9. Mrs Frederick is scheduled for exploratory and palliative surgery the next
day. Results of blood tests show that she has a microcytic anaemia
Likely causes of microcytic anaemia is
1. A diet low in iron
2. A diet low in vitamin C
3. Chronic blood loss
4. Acute blood loss
5. Haemolytic streptococcal infection
a) 1, 3 and 5
b) 1, 2 and 5
c) 1, 2 and 4
d) 1, 2 and 5
10. Mrs Frederick is to have a blood transfusion of two units of packed cells, prior to
surgery. She is charted 350 mls over three hours through a blood giving set with a
drip factor of 15
How many drops per minute will you run the blood at
a) 20
b) 25
c) 30
d) 35
11. If Mrs. Frederick were to receive blood with which she is incompatible, the signs and
symptoms we would see, would include
1. Restlessness and anxiety
2. Generalised tingling sensations
3. Nausea and vomiting
4. Elevated temperature
5. Decreased blood pressure
a) 1, 2 and 3
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b) 1, 4 and 5
c) 2, 3 and 5
d) All of the above
12. If a client who suffers from cancer of the colon, the most common site of
metastases is the
a) Bladder
b) Liver
c) Spleen
d) Pancreas
13. Which of the following post operative complications may be avoided by pre
operative teaching
a) Wound infection
b) Wound dehiscence
c) Hypostatic pneumonia
d) Hypovolaemic shock
14. Haemorrhage during the first 12 hours post operatively is termed

a) Primary
b) Secondary
c) Intermediary
d) Reactionary
15. Mary aged 45 years is admitted to the ward for planned surgery. Mary smokes 20
cigarettes a day and drinks three glasses of wine every evening
The significance of this information for you is so that you
a) May teach deep breathing and coughing and relaxation techniques in preparation
for surgery
b) Be aware of a potentially addictive personality when planning her pain relief
post operatively
c) Can assist her to break her smoking and drinking habits when in hospital
d) May plan to include cigarettes and alcohol in her post operative regime
16. Two days later, Mary has a cholecystectomy performed, successfully. On her return
to the ward, Mary has an upper abdominal wound with a redivac, a T tube, A naso
gastric tube and an intravenous infusion in situ
When carrying out Marys post operative exercise regime, which aspect should receive
the highest priority
a) Ensuring Mary has privacy and freedom from interruption
b) That Mary knows how to breathe and cough and why it is important
c) That she knows how to support her wound and that her pain is under control
d) That there be no interruption by Marys family and friends when they visit
17. Mr Evere, a 69 year old retired musician was admitted to the intensive care unit with a
diagnosis of Adams stokes syndrome
The nurse notes mr everes pulse pressure is decreasing. Pulse pressure is the
a) Difference between the apical and radial rates
b) Force exerted against an arterial wall
c) Degree of ventricular contraction in relation to output
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d) Difference between systolic and diastolic readings
18. The physician suspects cardiogenic shock. Shock is

a) A failure of peripheral circulation
b) An irreversible phenomenon
c) Always caused by decreased blood volume
d) A fleeting reaction to tissue injury
19. The physical law explaining the greatly increased venous return accompanying mild
vasoconstriction underlies the use of
a) Adrenaline in treating shock
b) Rotating tourniquets in pulmonary oedema
c) Sympathetomy in treating hypertension
d) Digoxin to increase cardiac output
20. Culturally safe nursing care can best be achieved when the nurse has
a) An in depth knowledge of the treaty of Waitangi
b) An awareness of Maori perspectives of health
c) An awareness and acceptance of your own limits in meeting someone else’s health
and cultural needs
d) A knowledge of Maori protocol
21. Imagine a new virus infecting a human population for the first time. Which of the
following is most likely to lead to a rapid increase in cases worldwide
a) Severe disease with high mortality
b) Lack of hand hygiene
c) Air travel
d) High transmissibility
23. Home health nurses visit a blind diabetic patient who lives along to monitor the
patient’s glucose level and administer the patient’s daily insulin. Evaluation of
outcome management for this patient would include
a) An absence of complications of diabetes
b) A reduction in hospitalizations for glycemic control
c) The ability of the patient to learn to use adaptive syringes
d) The patients evaluation of the services provided by the nurses
24. The nurse consults with the physician to arrange a referral for hospice care for
a patient with end stage liver disease based on the knowledge that hospice care
is indicated when
a) Family members can no longer care for dying patients at home
b) Patients and families are having difficulty coping with grief reactions
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c) Preparation for death with palliative care and comfort are the goals of care
d) Patients have unmanageable pain and suffering as a result of their condition
25. To better understand fluid balance the nurse needs to recognise that
a) Glomerular filtration occurs in the glomerular which are small arteries in the
kidneys
b) The volume of urine secreted is regulated mainly by mechanisms that control the
glomerular filtration rate
c) An increase in the hydrostatic pressure in bowman’s capsule tends to increase the
glomerular filtration rate
d) A decrease in blood protein concentration tends to increase the glomerular
filtration rate
26. The client with unresolved oedema is most likely to develop

a) Thrombus formation
b) Tissue ischaemia
c) Proteinaemia
d) Contractures
27. Women are more susceptible to urinary tract infection because of

a) Poor hygienic
practices b) Length of
urethra
c) Continuity of the mucous membrane
d) Inadequate fluid intakes
28. The most important electrolyte of intracellular fluid is

a) Calcium
b) Sodium
c) Potassium
d) Chloride
29. In encouraging hospitalised clients to void the most basic methods for the nurse to
employ is
a) Having the client listen to running water
b) Warming a bedpan
c) Placing the clients hand in warm
water d) Providing privacy
30. Since Mr. Saul has right hemiplegia the nurse contributes to his rehabilitation by
a) Making a referral to the physio therapist
b) Not moving the affected arm and leg unless necessary
c) Beginning active exercise
d) Positioning Mr. Saul to prevent deformity and decubiti
31. Mr Saul's emotions responses to his illness would probably be determined by

a) His premobid personality
b) The location of his lesion
c) The care he is receiving
d) His ability to understand his illness
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32. Mrs Olin, a retired school teacher with rheumatoid arthritis, is admitted to hospital
with severe pain and swelling of the joints in both hands
Mrs Olin’s condition would indicate that a primary consideration of her care is
a) Motivation
b) Education
c) Control of pain
d) Surgery
33. While taking a nursing history from Mrs. Olin, the nurse promotes communication by
a) Asking questions that can be answered by a simple ‘yes’ or ‘no’
b) Telling Mrs. Olin there’s no cause for alarm
c) Asking ‘why’ and ‘how’ questions’
d) Using broad, open ended statements
34. Mr and Mrs. B were emotionally upset when their baby girl, sue, was born with a
cleft palate and double cleft lip
The nurse, in order to give the most support to the parents, should
a) Discourage them from talking about the baby
b) Encourage them to express their worries and fears
c) Tell them not to worry because the defect can be repaired
d) Show them post operative photographs of babies who had similar defects
35. The most critical factor in the immediate care of sue, after repair of the lip is
a) Maintenance of airway
b) Administration of drugs to reduce secretions
c) Administration of fluids
d) Preventing of vomiting
36. Additional nursing care for sue after the original lip repair would include
a) Placing the baby in a semi sitting position
b) Keeping the infant from crying
c) Spoon feeding for the first two days after surgery
d) Keeping the baby nil per mouth
37. Seven year old Johnny has been admitted for a tonsillectomy. The nurse
suspects haemorrhage post operatively when Johnny
a) Snores noisily
b) Becomes pale
c) Complains of thirst
d) Swallows frequently
38. Pitting oedema in the lower extremities occurs with this problem because of the
a) Increase in tissue colloid osmotic pressure
b) Increase in the tissue hydrostatic pressure at the arterial end of the capillary bed
c) Decrease in the plasma colloid osmotic pressure
d) Increase in the plasma hydrostatic pressure at the venous end of the capillary beds
39. The nurse can best assess the degree of oedema in an extremity by
a) Checking for pitting
b) Weighing the client
c) Measuring the affected area
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d) Observing intake and output
40. Mrs Smith is hospitalised with coronary heart disease. She is receiving IV fluids, her
vital signs are checked 4 hourly. She is on bed rest. She was also prescribed digoxin.
She does not seem to be acutely sick but her prognosis is guarded. Mrs Smith asks
what the coronary arteries have to do with her angina. In determining the answer, the
nurse should take into consideration that coronary arteries
a) Carry reduced oxygen content blood to the
lungs b) Carry blood from aorta to the myocardium
c) Supply blood to the endocardium
d) Carry high oxygen blood from the lungs towards the heart
41. After activity Mrs. Smith states she has angina pain. The nurse should realise that
angina pectoris is a sign of
a) Myocardial ischemia
b) Myocardial infarction
c) Coronary thrombosis
d) Mitral insufficiency
STATE EXAMS 7
1. During therapy with salbutamol (venolin) Mr. Peters complains of palpitation, chest
pain, and a throbbing headache. In view of these symptoms which of the following
statements represent the most appropriate nursing action
a) Reassure Mr. peters that these effects are temporary and will subside as he
becomes accustomed to the drug
b) Withhold the drug until additional orders are obtained from the physician
c) Tell him not to worry, he is experiencing expected side effects of medicine
d) Ask him to relax, then instruct him to breath slowly for several minutes
2. Mr Peters pulmonary function studies are abnormal. The nurse should realise that one
of the most common complication of chronic asthma is
A) Athelectasis
B) Emphysema
C) Pneumothorax
D) Pulmonary fibrosis
3. Emphysema causes a failure in oxygen supply because of

a) Infectious obstructions
b) Respiratory muscle paralysis
c) Pleural effusion
d) Loss of aerating surface
4. When the alveoli loose normal elasticity, the nurse teaches Mr. peters exercises that
lead to effective use of the diaphragm because
a) Mr peters has an increase in the vital capacity of the lungs
b) The residual capacity of the lungs has been increased
c) Inspiration has been markedly prolonged and difficult
d) Abdominal breathing is an effective compensatory mechanism that is
spontaneously initiated
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5. Mr hurt has developed acute renal failure and uraemia. Metabolic acidosis develops
in renal failure as a result of
a) depression of respiratory rate by metabolic wastes causing carbon dioxide
retention
b) inability of renal tubules to secrete hydrogen ions and conserve bicarbonate
c) inability of renal tubules to reabsorb water to achieve dilution of acid contents of
the blood
d) impaired glomerular filtration causing retention of sodium and metabolic waste
products
6. of the following, which is most important in maintaining the fluid and

electrolyte balance of the body
a) urinary system
b) respiratory system
c) antidiuretic hormone (ADH)
d) aldosterone
7. to prevent laryngeal spasms and respiratory arrest in a patient who is at risk

for hypocalcaemia, an early sign of hypocalcaemia the nurse should assess for
is
a) tetany
b) confusion
c) constipation
d) numbness and tingling around the lips or in the fingers
8. A 36 year old woman has been admitted to the hospital for knee surgery. Information
obtained by the nurse during the preoperative assessment that should be reported to
the surgeon before surgery is performed includes the patients
a) lack of knowledge about postoperative pain control
b) knowledge of the possibility of an early, unplanned pregnancy
c) history of a postoperative infection following a prior cholecystectomy
d) concern that she will be physically limited in caring for her children for a
period postoperatively
9. in is especially important for the nurse to determine the patients current use of
medications during the preoperative assessment because
a) these medications may alter the patients perceptions about surgery
b) anaesthetics alter renal and hepatic function, causing toxicity by other drugs
c) other medications may cause interactions with anaesthetics, altering the potency
and effect of the drugs
d) routine medications are usually withheld the day of surgery, requiring dosage
and schedule adjustments
10. A client with type 1 diabetes mellitus is scheduled to have surgery. The client has
been nil per mouth since midnight in preparation for the surgery. In the morning
before sending the client to the operating room, the nurse notices that the client’s
daily insulin has not been ordered. Which of the following interventions would be
most appropriate for the nurse at this time
a) obtain the clients blood glucose values and evaluate the clients need for insulin
b) contact the physician for further orders regarding insulin administration
c) give the clients usual morning dose of insulin
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d) notify the recovery room staff to obtain an order for insulin after the surgery
11. the nurse monitors a patient receiving high doses of broad spectrum antibiotics for
treatment of endocarditis for the development of
a) erysipelas
b) candidiasis
c) tinea corporis
d) verruca vulgaris
12. The nurse is evaluating the effectiveness of fluid resuscitation during the
emergent period of burn management. Which of the following indicates that
adequate fluid replacement has been achieved in the client
a) an increase in body weight
b) fluid intake is less than urinary
output c) urinary output greater than 35
ml/hr
d) blood pressure of 90/60 mm Hg
13. Cimetidine (tagamet) is prescribed for a patient with major burns. In teaching the
patient about the drug, the nurse explains that it is used to prevent the development of
a) diarrhoea
b) constipation
c) adynamic
ileus d) curling’s
ulcer
14. A client who has had a transurethral resection of the prostate (TURP) 1 day earlier
has a three way foley catheter inserted for continuous bladder irrigation. Which of the
following statements best explains why continuous irrigation is used after a TURP
a) to control bleeding in the bladder
b) to instil antibiotics into the bladder
c) to keep the catheter free from clot obstruction
d) to prevent bladder distention
15. A patient in severe respiratory distress is admitted to the medical unit at the hospital.
During the admission assessment of the patient, the nurse should
a) perform a comprehensive health history with the patient to determine the extent
of prior respiratory problems
b) complete a full physical examination to determine the effect of the respiratory
distress on other body functions
c) delay any physical assessment of the patient and ask family members about the
patients history of respiratory problems
d) perform a physical assessment of the respiratory system and ask specific questions
related to this episode of respiratory distress
16. spinal anaesthesia effects all of the following systems except

a) the sympathetic nervous system
b) the sensory system
c) the parasympathetic nervous system
d) the motor system
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17. Following assessment of a patient with pneumonia, the nurse identifies a nursing
diagnosis of ineffective airway clearance. The nurse bases this nursing diagnosis on
the finding of
a) SpO2 of 85%
b) Respiratory rate of 28
c) Presence of greenish sputum
d) Crackles in the right and left lower lobes
18. To protect susceptible patients in the hospital from aspiration pneumonia, the nurse
a) Turns and repositions immobile patients every 2 hours
b) Positions patients with altered consciousness in lateral positions
c) Monitors for respiratory symptoms in those patients who are immunosuppressed
d) Plans room assignments to prevent patients with infections from being placed with
surgical or chronically ill patients
19. A patient experiences a flail chest as a result of an automobile accident. Which

finding during a respiratory assessment would the nurse expect
a) Bloody sputum
b) Laryngeal stridor
c) Deep, irregular respirations
d) Paradoxic chest movement
20. A client is admitted to the emergency room with crushing chest injuries sustained in a
car accident. Which of the following signs would indicate a possible pneumothorax
a) Cheyne stokes breathing
b) Increased noisy breath sounds
c) Diminished or absent breath sounds on the affected side
d) A decreased sensation on the affected side
21. Joan Murray, aged 40 years, discovers a lump in the upper and outer quadrant of her
left breast when she is showering one morning. One week later, after being seen by a
surgeon, she is admitted to the ward for a biopsy of the lump and possible left
radical mastectomy. In establishing a relationship with Joan, what is the most
important factor for the nurse to consider. That
a) The diagnosis has not yet been established and the breast lump is not necessarily
malignant
b) Joan will have many questions about the possible effects of a mastectomy on her
sexual identity
c) At this time of uncertainty, Joan will need a lot of time to be alone to consider
her choices
d) Joan will be full of fear about the mass and its possible effects on her being
22. Part of Joan's pre operative preparation is practising arm and shoulder exercises. The
reason for these exercises are
a) She can be assured of maximum function of her arm and shoulder if
these exercises are carried out properly
b) That they help reduce the pain and the swelling in the area, after surgery
c) To assist peripheral venous return and thus reduce the potential for pulmonary
embolus
d) By being involved in activities related to her care, Joan is less likely to worry
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23. The reason we position Joan’s affected arm with her elbow at the level of the
right atrium and her hand higher than her elbow is to
a) Minimise the development of
oedema b) Assist venous return
c) Reduce her pain and discomfort
d) Ensure that the area is supported
24. The primary ossification center of long bone is located in which of the following
structures
a) Epiphysis
b) Epiphyseal
plate c) Diaphysis
d) Endosteum
25. The body tissue affected by rheumatoid arthritis is

a) Adipose
b) Muscular
c) Connective
d) Epithelial
26. The pattern of rheumatoid arthritis is best describe by its

a) Chronicity
b) Remissions and exacerbations
c) Little relief from aches and pains
d) A progressive increase in disability
27. Rheumatoid arthritis is characterized by

a) Bone pain
b) Sharp tingling sensations
c) Inflammation of the joints
d) Pain and swelling of joints
28. Synovial joints are characterized by

a) articular cartilage
b) fibrous capsule
c) joint cavity
d) all of these
29. the major support that the muscular system gets from the cardiovascular system
a) a direct response by controlling the heart rate and the respiratory rate
b) constriction of blood vessels and decrease in heart rate for thermoregulatory
control
c) nutrient and oxygen delivery and carbon dioxide removal
d) decreased volume of blood and rate of flow for maximal muscle contraction
30. as the nurse assesses jack for increased intracranial pressure, she would be
concerned if she observed
a) change in level of consciousness
b) anorexia and thirst
c) increased pulse and respiration rates
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d) blurred vision and halos around lights
31. A person has just been involved in an accident that affected the medulla oblongata.
The body process most directly affected by this would be
a) slight
b) hearing
c) muscular
coordination d)
respiration
32. if you are dealing with a person whose phrenic nerve has been damaged, what would
you expect to observe
a) reduced diaphragm function
b) less mucous secreted by the goblet cells
c) decreased elasticity of the lung tissue
d) increased coughing
33. the spinal cord extends through the vertebral canal from the foramen magnum to the
a) 7th cervical vertebra
b) 12th thoracic vertebra
c) 2nd lumbar vertebra
d) 1st sacral vertebra
34. Synaptic conduction of a nerve impulse can be affected by

a) Certain diseases
b) Drugs
c) Changes in
Ph d) All of these
35. Lack of muscle coordination is called
a) Monoplegia
b) Ataxia
c) TIA
d) None of these
36. Inability of chew might result from damage to which cranial nerve
a) Facial
b) Trigeminal
c) Abducens
d) Vagus
37. In most people, the left cerebral hemisphere is more important for which of the
following
a) Spoken and written language
b) Space and pattern perception
c) Musical and artistic awareness
d) Imagination
38. Which of the following is true concerning the limbic system

a) It is comprised of parts of the cerebrum and diencephalon
b) It assumes a primary function in emotions
c) Both a and b
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d) Neither a nor b
39. Coordination of muscular activity is a function of the

a) Cerebral peduncles
b) Cerebellum
c) Thalamus
d) Medulla oblongata
40. Which of the following statements is correct

a) Appetite control is a function of the thalamus
b) The midbrain is a conduction pathway and reflex center
c) The cerebellum has sensory centres for thirst and speech
d) Respiratory centres are located in the basal ganglia
41. The structure that connects the cerebral hemispheres and facilitates the sharing of
cerebral information is the
a) Corpus callosum
b) Cingulated sulcus
c) Fourth ventricle
d) Aqueduct of sylvius
42. The portion of bone laid down first in bone formation is the
a) Matrix
b) Calcium salts
c) Trabeculae
d) Marrow
43. The area of the greatest degree of flexibility along with the vertebral column is found
from
a) C3 – C7
b) T1 – T6
c) T7 – T12
d) L1 – L5
44. The only ankle bone that articulates with the tibia and the fibula is the
a) Calcaneus
b) Talus
c) Navicular
d) Cuboid
45. Severe fractures of the femoral neck have the highest complication rate of any
fracture because
a) Primary limits are imposed by the surrounding muscles
b) Of the restrictions imposed by ligaments and capsular fibers
c) Of the thickness and length of the bone
d) The blood supply to the region is relatively delicate
46. The purpose of myoglobin in skeletal muscle cells is

a) Assist anaerobic reactions
b) Store oxygen for use during vigorous exercise
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c) Catabolise pyruvic acid
d) All of these
47. With a milk product free diet, which of the following supplements would you need
a) Vitamin C and iron
b) Iron and phosphorous
c) Calcium and manganese
d) Vitamin c and riboflavin
48. Protein should be eaten as it

a) Reduces the risk of anaemia
b) Ensures an adequate supply of energy
c) Assists the body to produce new tissues
d) Maintains the body’s protein stores
49. Risk factors of CVA that cannot be altered are

a) Sex, race, and raised blood cholesterol levels
b) High BP, previous TIA
c) Race, prior stroke and overweight
d) High BP, previous TIA and increased blood cholesterol levels
50. A person who has experienced a right CVA may present with
a) Receptive or expressive aphasia
b) Right hemiplegia
c) Left hemiplegia
d) Deficit of new language information
51. Where and what is the circle of Willis

a) A capillary meshwork found in bowman’s capsule of the
nephron b) A vascular network at the base of the brain
c) A roundabout at the top of bank st
d) The capsule membrane of a malignant growth
52. List the 3 main causes of stroke

a) Cerebral haemorrhage, thrombosis, embolism
b) Cerebral thrombosis, infarction, aneurysm
c) Cerebral embolism, metastatic lesions, coagulopathy
d) Cerebral ischemia, vascular spasms, hypoxia
53. Angina symptoms include

a) Radiating pain, decreased BP and increased pulse
b) Shortness of breath, loss of consciousness and these effects may last indefinitely
c) Ringing in the ears, anxiety and cramping in the extremities
d) Shortness of breath, sweating, nausea and tiredness
54. Emphysema is
a) An alveolar disease
b) Due to hypertrophy and hyperplasia of bronchial glands
c) Persistent episodes of productive cough
d) An airway disease
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STATE EXAMS 8
1. Circulatory shock can best be described as a condition in which there is
a) A state of hypotension
b) Loss of blood
c) Loss of consciousness due to blood loss
d) Inadequate blood flow to meet the metabolic needs of the body tissues
2. Causes of hypovolemic shock include

a) Vomiting and los of body fluids
b) Allergic reactions to drugs
c) Cardiac failure
d) Hypoglycaemia
3. Early signs of hypovolemic shock include

a) Restlessness, thirst, and increased heart rate
b) Decreased blood pressure and apathy
c) Increase in heart rate and increased pulse pressure
d) Decreased blood pressure and unconsciousness
4. In shock, one of the best indicators of blood flow to vital organs is

a) Rate of blood and fluid administration
b) Blood pressure
c) The colour and temperature
d) Urine output
5. Oliguria, an early sign of shock, occurs for what reason

a) Cessation of glomerular filtration
b) Acute tubular necrosis
c) Metabolic acidosis
d) Sympathetic stimulation
6. A person admitted to the emergency room with trauma and an estimated blood loss of
1200 to 1400 mls has a blood pressure of 110/70 mmHg and a heart rate of 120 beats
per minute. The best explanation for these observations would be that
a) The persons actual blood loss was less than the originally estimated loss
b) The person was normally hypertensive and hence did not have as great a drop in
blood pressure as a normotensive person
c) The cause of the bleeding is now under control and the increased heart rate is due
to anxiety
d) An increase in heart rate is compensating for the loss of blood volume
7. The pale, cool, clammy skin that is often observed in an individual with shock, can
be explained in terms of
a) Loss of red blood cells
b) Body’s attempt to shunt blood to vital organs by constricting skin vessels
c) Decreased metabolic needs that accompany shock
d) Body’s attempt to conserve heat loss
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8. is generally relieved by sitting up in a forward leaning
position
a) Hyperpnoea
b) Orthopnoea
c) Apnoea
d) Dyspnoea on exertion
9. In a client with emphysema, hypoventilation could initially cause

a) Respiratory
alkalosis b) Respiratory
acidosis
c) Metabolic acidosis
d) Metabolic alkalosis
10. A client is anxious and is hyperventilating. In order to prevent respiratory alkalosis

the nurse will
b) Instruct the client to pant
c) Have the client breathe deeply and slowly
d) Have the client breathe into a paper bag
11. A district nurse is sent to assess a new client with cor pulmonale. This term refers to
a) Enlargement of the pulmonary artery
b) Enlargement of the right ventricle
c) Atrophy of the right ventricle
d) Giant bullae growth on the lung
12. Tony buffer, 54 years old, has a long history of smoking. He decides to have lung
and blood studies done because he is very tired, is short of breath, and just does not
feel good. His blood gases reveal the following findings: pH 7.3; HCO3 27; CO2 58.
Tony's condition may be
a) Respiratory alkalosis
b) Metabolic acidosis
c) Respiratory acidosis
d) Metabolic alkalosis
13. Approximately 1000ml (1L) of oxygen is transported to cells each minute. Most of
the oxygen is transported
a) Dissolved in his plasma
b) Loosely bound to his haemoglobin
c) In the form of CO2
d) As a free floating molecule
14. Mary a 46 year old woman, is admitted to your ward with a chest infection due to an
exacerbation of chronic obstructive pulmonary disease. A person with emphysema
is susceptible to respiratory infections primarily because
a) Failure of his bone marrow to produce phagocytic white blood
cells b) Retention of tracheobronchial secretions
c) Decreased detoxification of body fluids by compressed liver cells
d) Persistent mouth breathing associated with dyspnoea
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15. Emphysema differs from chronic bronchitis in that
a) Emphysema obstruction results from mucous production and
inflammation b) Emphysema obstruction results from changes in lung tissues
c) Chronic bronchitis obstruction results from changes in lung tissue
d) There are no visual difference between the two conditions
16. The tissue change most characteristic of emphysema is

a) Accumulation of pus in the pleural space
b) Constriction of capillaries by fibrous tissue
c) Filling of air passages by inflammatory coagulum
d) Over distension, in elasticity, and rupture of alveoli
17. Which of the following results of emphysema is primarily responsible

for cardiomegaly
a) Hypertrophy of muscles encircling the bronchi
b) Increased pressure in the pulmonary circulation
c) Decreased number of circulating red blood cells
d) Secretion of excessive amounts of pericardial fluids
18. A 48 year old complains of chest pain. Signs and symptoms that would support
a diagnosis of myocardial infarction would include
a) Jugular vein distension and hypatomegaly
b) Fever and petechiae over the chest area
c) Nausea and vomiting and cool, clammy pale skin
d) Pericardial friction rub and absent apical pulse
19. Teaching for the client taking GT or glycerol with nitrate for angina would include
a) Instructing the client to take the nitro-glycerine regularly
b) Explain to the client that a subsequent headache indicates ineffective medication
c) Instructing the client to put the tablet on the tongue and swallow after the
tablet dissolves
d) Teaching the client to take a tablet every 5 minutes (3x) when chest pain occurs
20. A female client is diagnosed with unstable angina. The nurse finds her crying
because she fears she will become a burden to her husband. Which of the following
nursing diagnosis would be most appropriate
a) Impaired verbal communication
b) Ineffective family coping
c) Relationship difficulties
d) Fear due to knowledge deficit
21. Which of the following steps should a client with periodic angina pain take first
when pain occurs at home
a) Take sublingual nitro-glycerine and lie down
b) Do mild breathing exercises
c) Take an extra long lasting nitrate tablet
d) Sit down and relax
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22. The nurse detects premature ventricular contractions and (PVC’s) on the ECG of a
client who had a mitral valve replacement 2 days ago. PVC’s may be dangerous
because they
a) Significantly increase cardiac workload
b) May lead to ventricular tachycardia or fibrillation
c) Are the most common cause of myocardial infarction
d) Decreased heart rate and blood pressure
23. A client is admitted to ED following a car accident. He complains of abdominal

discomfort. The nurse encourages the client to lie down. The reason for this action
is a) To decrease abdominal pain
b) To decrease the risk of dislodging an intra abdominal clot
c) To facilitate peristalsis
d) To decrease the risk of peritoneal infection
24. A client sustained moderate concussion. He has a Glasgow coma scale score of 7.
Which of the following interventions would you include in your care plan
a) Decrease stimuli, monitor vital signs and neurological status nurse him flat on his
back
b) Gradually increase stimuli, monitor vital signs and neurological status, elevate the
head of the bed 60 degrees
c) Encourage family involvement, reduce monitoring at night to allow client to
rest, elevate the head of the bed 60 degrees
d) Decrease stimuli, monitor vital signs and neurological status elevate the head of
the bed 30 degrees, positioning the client on his side
25. James has sustained a fracture of his left lower leg in a car accident. Classical signs
of a fracture may include
a) Intermittent pain, flushing of surrounding tissues and vascular spasm
b) Local bone tenderness, soft tissue swelling and inability to use extremity
c) Neural compromise, sharp stabbing pain and obvious ischaemia of the extremity
d) Blanching, hyperextension and parasthesia
26. Monitoring for compartment syndrome is done by checking for

a) Active movement of the limb
b) Colour, warmth, sensation and movement of the extremity
c) Pulse and blood pressure changes
d) The tightness of the plaster cast
27. On assessment the nurse suspects that James is developing compartment syndrome
because he complains of
a) Severe pain, motor compromise and a ‘pins and needles’ sensation
b) A radiating pain and loss of two point discrimination
c) Swelling, muscle atrophy and intermittent parasthesia
d) Dull aching, spasms and lack of fine co ordination
28. A comminuted fracture is characterised by

a) A partial break in bone continuity
b) Injury in which two bones are crushed together
c) An injury in which the bone is broken into two or more pieces
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d) An injury in which the bone fragments have broken through the skin
29. Type 2 diabetics

a) Need insulin to maintain homeostasis
b) May develop ketoacidosis easily
c) May go undetected for years
d) Are usually very slim and malnourished
30. Hyperglycemia
a) Is alright only once in a while
b) Due to an over medication of insulin
c) If left uncontrolled, this can lead to DKA in type 1 or HNK in type 2
d) Also called insulin shock reaction
31. Macrovascular complications of diabetes

a) Occur shortly after the onset of the disease
b) Affects coronary, peripheral and cerebral circulation
c) Affects the eyes and the kidneys
d) Affects sensorimotor and autonomic nerves
32. For relief of angina, the client may

a) Call 111
b) Take a dose of glyceryl trinitrate up to 3 times, 5 minutes apart until the
pain subsides
c) Slowly exercise to the individuals tolerance level
d) Take only one dose of glyceryl trinitrate, if this has no effect, call 111
33. Ways to minimise precipitating effects of angina are

a) Avoid over exertion
b) Reduce stress
c) Avoid overeating
d) All above
34. Angina
a) May be referred to as angina majoralis
b) Not relieved by rest
c) Include chest pain which may radiate down the arms, neck, jaw and
back d) Needs immediate medical attention
35. A client with multiple fractures is at risk for a fat embolism. What early sign should
you monitor for
a) Haematuria
b) Mental confusion or restlessness
c) Sudden temperature elevation
d) Pallor and discoloration at the fracture site
36. Following an application of a full arm cast a client complains of deep throbbing
elbow pain. You note diminished capillary refill in the fingers. You should
a) Notify the doctor immediately and prepare to bivalve the cast
b) Cut a window in the cast over the elbow area and check for infection
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c) Elevate the arm, apply ice packs and assess hourly
d) Administer prescribed analgesics and notify the doctor
37. When assessing a patient at risk for increased intracranial pressure, the first thing
you would check is
a) Reaction to pain stimuli
b) Papillary function
c) Level of consciousness
d) Motor function
38. Pupillary dilation occurs when herniating brain tissue

a) Compresses the occulomotor nerve
b) Chokes the optic disks
c) Stretches the optic nerve
d) Paralyses the ocular muscles
39. Changes in vital signs with increasing intracranial pressure would include
a) Hypotension and tachycardia
b) Narrowing pulse pressure and tachypnea
c) Hypotension and a pulse deficit
d) Widening pulse pressure and bradycardia
40. Bleeding within the skull results in increased intracranial pressure because
a) Arteries bleed rapidly and profusely
b) Bleeding from veins goes undetected
c) Spinal fluid is produced more rapidly
d) The cranium is a closed, rigid vault
41. What is the most common cause of heart failure (HF)

a) Smoking
b) Diabetes
c) Coronary artery disease
d) Family history
42. The action of ACE inhibitors (angiotensin converting enzyme)

is a) Increased urinary output, therefore decreased blood
pressure
b) Relax blood vessels, therefore decreased vascular resistance
c) Strengthens cardiac contraction, therefore increase cardiac output
d) Relax cardiac muscle therefore decrease heart rate
43. Hyperkalemia is
a) Increased serum potassium levels
b) Increased serum calcium levels
c) Increased red blood cell count
d) Increased serum chloride levels
44. Manifestations of heart failure are

a) Hepatomeglia, pitted dependant edema
b) Increased serum glucose levels
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c) Increased appetite and weight gain
d) Decreased respiration and dyspnoea
45. Nursing interventions associated with your clients taking loop diuretics such as
frusemide are
a) Blood sugar levels, dietary fibre
b) Monitoring of weight and K+
levels c) Blood pressure and urinary
output
d) Make sure your client eats ½ hour following administration
46. Loop diuretics act by

a) Increasing the blood flow to the glomerular network
b) Decreasing the blood flow to the kidneys therefore decreased urinary output
c) Increased H2O reabsorption in the distal convoluted tubules of the
nephron d) Inhibition complex active pump mechanism therefore increase
excretion of
electrolytes
47. Blood pressure control is carried out by regulation of smooth muscles via
a) Parasympathetic stimulation
b) Parasympathetic and sympathetic stimulation
c) Sympathetic stimulation
d) None of these
48. The areas of the body that sense blood pressure are known
as a) Baroreceptors
b) Chemoreceptors
c) Viscoreceptors
d) None of these
49. When taking a blood pressure, the first sound picked up by the stethoscope as blood
pulses through the artery is the
a) Mean arterial pressure
b) Pulse pressure
c) Diastolic pressure
d) Peak systolic pressure
50. At any given moment, the systemic circulation contains about of

the total blood volume
a) 10%
b) 51%
c) 71%
d) 91%
51. The nurse gets the arterial blood gases report and it shows that a person
has hypercapnia. This means that
a) There is an increased blood carbon dioxide
b) The blood oxygen level is reduced
c) Carbon dioxide has been lost
d) There is respiratory alkalosis
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52. Gregory, aged 70, was admitted with congestive heart failure. Which of these
changes in physiology is present in congestive heart failure
a) Heart muscle degeneration due to old age
b) A decrease of blood flow through the heart
c) An abnormality in the structure of the heart
d) A blood clot forms in one of the heart chambers
53. Manifestations of right sided heart failure are

a) Fatigue, cyanosis, blood tinged sputum
b) Anorexia, complaints of gastrointestinal distress, fatigue and pitted edema
c) Dyspnea, Orthopnoea and cyanosis
d) Fatigue dependant edema and cough
54. Nursing intervention necessary prior to the administration of digoxin is

a) Palpation of arterial pulse less than 60 bpm
b) Palpation of venous pulse less than 60 bpm
c) Palpation of arterial pulse greater than 60 bpm
d) Palpation of pedal pulse less than 60 bpm
55. Left sided heart failure affects directly the

a) Liver and
extremities b) Lungs
c) Levels of consciousness
d) Lungs and extremities
56. Basic nursing objectives in the treatment of HF are

a) Start heparinization immediately
b) Nursing the client in trendlenberg position
c) Promote rest therefore decrease workload on heart and decrease
H20 accumulation
d) Assess levels of consciousness and give 02 61/min via Hudson mask
57. Define a cerebral vascular accident (CVA)

a) Sudden loss of consciousness due to a decreased contractility of the
cardia b) Loss of brain function due to disruption of blood supply to the brain
c) Intermittent spasms of blood vessels interrupting blood flow to the brain
d) Neurologic dysfunction due to diminished blood flow to the cranium
58. Cerebral thrombosis is

a) Most common cause of a stroke
b) Originates from a large vessel and lodges in the brain
c) May be caused by an arterial spasm in the brain
d) Usually occurs during strenuous exercise
59. The term blue bloater refers to

a) Decreased erythropoietin production therefore decreased 02 carrying capability
of the RBC
b) Polycythemia and cyanosis from right ventricular failure
c) Cyanosis due to decreased RBC production
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d) Increased BP due to high blood volume or fluid overload
60. Bronchitis is
a) Results from a breakdown in the normal lung defence mechanisms
b) Destruction of alveolar
c) Due to enlarged terminal non respiratory bronchioles and alveolar walls
d) History of daily productive cough that last at least 3 months, for 2 years
61. Emphysema is characterised by

a) Fat people due to decreased activity
tolerance b) Unproductive cough and pursed lip
breathing
c) Pursed lip breathing and productive cough
d) Blue bloater, normal skin colour and rapid respirations
62. Nursing interventions for the CORD patient include everyone of these except
a) Improve ventilation
b) Remove secretions
c) Prevent complications
d) Promote cooperation and understanding
e) Encourage exercise to test tolerance levels
63. Bronchodilators
a) Aid the movement of secretions
b) Liquefy the sputum therefore increase expectoration
c) Include aminophylline for the acute exacerbation
d) Are only used in emergency cases
64. Corticosteroids are used

a) Prophylactically in most cases
b) To aid in vitamin D synthesis
c) To aid the liquefaction and expectoration of
sputum d) Used during the acute exacerbation of
CORD
65. Pursed lip and diaphragmatic breathing

a) Calms the anxious client
b) Speed up slow respirations and used to promote effective coughing
c) Prevents bronchiolar collapse and air trapping
d) Encourages longer inhalation and faster exhalation
66. Percussion, vibration and postural drainage

a) Is effective management of nursing frustrations
b) Promotes loosening secretions and movement out of airway
c) Increases blood supply to area therefore increased expectoration
d) Should be done prior to all meals
67. A normal blood sugar level (BSL)

is a) 7.35 – 7.45
b) 120 – 160 mm dL
c) 4 - 7 mmol/l
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d) +/- 2 mmEq
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68. Diabetes is
a) An exocrine disorder
b) Decreased production of insulin by the
liver c) An endocrine disorder
d) Decreased secretion of insulin by the alpha cells in the pancreas
69. Type I diabetics are characterised by

a) Non insulin dependence
b) Majority of the diabetic population
c) Require hypoglycaemic agents to maintain glucose
levels d) Need insulin to maintain normal BSL
STATE EXAMS 9
1. Angina is
a) Caused by a sudden blockage of one of the coronary arteries
b) Caused by anaerobic metabolism exciting pain receptors
c) Causes cardiac tissue necrosis and scaring
d) Interferes with cardiac contractility
2. Myocardial infarction (MI)

a) Causes irreversible tissue damage
b) The final extent of the damage depends on the ability of the surrounding tissue to
recruit collateral circulation
c) 15% of all MIs are
silent d) All the above
3. MIs may be caused by

a) A formation of a thrombus in a coronary artery
b) Sudden progression of atherosclerotic changes
c) Prolong constriction of the
arteries d) All of the above
4. Manifestations of an MI are
a) Bradycardia
b) Necrosis of a portion of the myocardium
c) Treated only by bypass surgery
d) Not seen on an ECG for 24 hours
5. Medications which are of the utmost importance for a patient following an MI are
a) 02
b) Stool softeners
c) Morphine
d) All of the above
6. ACE inhibitors include

a) Catopril, enalapril
b) Propranolol, atenolol
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c) Niphedipine, diltiazem
d) Frusemide
7. Antidiuretic hormone is
a) Secreted by the posterior pituitary
b) Increases glomerular filtration rate
c) Increases urinary output
d) Secreted by the hypothalamus
8. The renal system maintains homeostasis by

a) Maintaining electrolyte balances
b) Maintenance of blood volume
c) Conversion of vitamin D for calcium
reabsorption d) All of the above
9. Prerenal failure may be caused by

a) Burns
b) Nephrotoxic drugs
c) Multiple transfusions
d) Renal calculi
10. Acute renal failure (ARF) is

a) Incurable
b) Only curable by kidney transplantation
c) Occurs suddenly and may be reversible
d) Characterised by polyuria
11. Chronic renal failure (CRF)

a) Occurs suddenly and is reversible
b) Occurs over a long period of time and is reversible
c) Occurs over a long period of time and is irreversible
d) Is a nuisance by not fatal
12. Chronic renal failure may be characterised by

a) Lethargy, mental confusion
b) Headaches, GI symptoms
c) General weakness and bleeding tendencies
d) All of the above
13. Problems associated with CRF are

a) Polycythemia
b) Metabolic alkalosis
c) Accentuated sex drive
d) Reduced healing, susceptibility to infections
14. Nursing interventions with a client with renal failure includes

a) Increase dietary protein
b) Increase fluid intake
c) Increase potassium intake
d) Maintain adequate nutritional status and decrease the metabolic demands
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15. Malignant tumours have
a) Irregular shapes with poorly defined borders
b) Cells similar to their parent cells
c) Expansive growth
d) Fibrous capsule
16. Which of the following are not malignant

a) Sarcoma
b) Metastases
c) Neoplasm
d) Benign
17. Side effects of radiotherapy

include a) Burns, lethargy
b) Alopecia
c) Increased rate of cell division
d) Increased WBC production
18. Cytotoxic therapy

a) Is used only as a last resort – a palliative care
b) May be used in conjunction with radiotherapy
c) Not to be given if radiotherapy is anticipated
d) Is used if surgery is impossible
19. Chemotherapy acts by

a) Attacking existing malignant cells and kills tumours
b) Decreases the blood supply to the
tumour c) Interferes with the cell division
d) Increases the clients feelings of wellness therefore giving a boost to cancer
patients
20. Cancer clients pain is assessed by

a) The doctor
b) The health care team
c) The client
d) The family
21. If paracetamol is no longer effective in the treatment of malignant pain

a) Strong opioids are prescribed
b) The end is near
c) Weak opioids and/or NSAIDS may be prescribed
d) The client needs hospitalisation for pain control
22. Important components of pain assessment include
a) Site of pain
b) Onset and patterns
c) Current therapy and
effect d) All of the above
23. The world health organisations (WHO) analgesia ladder is
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a) A systematic tool used for the identification of medications to prescribe for
patients with cancer pain
b) Initial treatment includes simple analgesics, to progression of mild opioids to
strong opioids
c) Opioids may be used in conjunction with anticonvulsant and antidepressant
drugs to promote effectiveness
d) All of the above
24. If your client is experiencing break through pain

a) They are not administering their medications correctly
b) Morphine should only be taken when pain is experienced
c) They may require a quick release morphine titrated to alleviate their pain
d) Start an IV and double the dose of morphine
25. Potential side effects of morphine administration for the alleviation of malignant pain
are
a) Addiction
b) Constipation, nausea and vomiting
c) Antisocial behaviour
d) Once the maximum dose of morphine is reached, the pain may no longer be
controlled
26. When an arterial blood gas (ABG) sample is taken, the initial nursing intervention
should be
a) Assessing the movement of the extremity
b) Applying pressure to prevent an arterial bleed
c) Calming and educating the client to alleviate anxiety
d) All the above
27. Normal oxygen saturation values are

a) 80-100% saturation
b) 70-90% saturation
c) 90-100% saturation
d) 100% saturation
28. Which patient is at highest risk for pulmonary embolus

a) A 25 year old man with a history of alcohol abuse recuperating from a
gastric ulcer
b) A 36 year old woman on a liquid diet beginning an exercise programme
c) A 40 year old, obese, pregnant woman place on bed rest
d) A 90 year old man with no identified health problems
29. James has sustained a fracture of his left lower leg in a car accident. Classical signs
of a fracture may include
a) Intermittent pain, flushing of surrounding tissues and vascular spasm
b) Local bone tenderness, soft tissue swelling and inability to use extremity
c) Neural compromise, sharp stabbing pain and obvious ischaemia of the extremity
d) Blanching, hyperextension and parasthesia
30. Monitoring for compartment syndrome is done by checking for
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a) Active movement of the limb
b) Colour, warmth, sensation and movement of the extremity
c) Pulse and blood pressure changes
d) The rightness of the plaster cast
31. On assessment, the nurse suspects that James is developing compartment syndrome
because he complains of
a) Severe pain, motor compromise and a ‘pins and needles’ sensation
b) A radiating pain and loss of two point discrimination
c) Swelling, muscle atrophy and intermittent parasthesia
d) Dull aching, spasms and lack of fine co ordination
32. Uraemia is a clinical syndrome associated with

a) Retention of urea and other nitrogenous wastes
b) The presence of urine in the blood
c) The presence of blood in the urine
d) High ammonia excretion
33. Spinal anaesthesia is inserted into the

a) Intravenous space
b) Sacral canal
c) Dural membrane
d) Subarachnoid space
34. To monitor abdominal distension, you would

a) Assess bowel sounds every shift
b) Measure abdominal girth at the umbilicus every 24 hours
c) Measure abdominal girth every shift, using two fixed points
d) Weigh the patient every shift
35. The fluid outside the vascular system, which surrounds tissue cells, and which
includes lymph is called
a) Interstitial fluid
b) Extracellular fluid
c) Intravascular fluid
d) Intracellular fluid
36. When there is a decrease in blood volume (as in dehydration or blood loss), the body
reacts by retaining sodium and thus water. This occurs mainly as a result of adrenal
gland secretion of
a) Aldosterone
b) Antidiuretic hormone (ADH)
c) Cortisol
d) Parathyroid hormone
37. Which of the following is a defining characteristic for a nursing diagnosis of

‘fluid volume deficit’
a) Distended neck
veins b) Weak, rapid
pulse
c) Moist rales in lungs
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d) Bounding, full pulse
38. The nurse should assess carefully for hypervolaemia, (fluid volume excess)
when working with the client with
a) Nausea and vomiting
b) Kidney failure
c) Decreased fluid intake
d) Blood loss
39. Which is probably the most accurate indication of a clients fluid balance status
a) Intake and output record
b) Skin turgor
c) Daily weight
d) Complete blood count
40. When you check the time tape on your clients IV bag, you note that the proper
amount has not been infused. The prescribed rate is 200 ml/hour, but in the past
hour only 100 mls have infused. Your first action should be to
a) Call the physician for a new order
b) Adjust the roller clamp and increase the rate to 300 ml/hour to ‘catch up’
c) Restart the IV at a different site
d) Count the drops per minute to be sure it is running at a rate of 200 ml/hour
41. In evaluating for complications of IV therapy, which of the following are evidence
that the IV has infiltrated
a) In the past hour, only 50 ml of fluid have infused
b) The insertion site is red, hot and swollen
c) The clients temperature has gone up to
38.oC d) The site is pale, cool, swollen and
painful
42. Swelling and paleness of the skin at the venipuncture site could be indicative of
a) Infiltration
b) Phlebitis
c) Infection
d) Air embolism
43. Mr Smith is to have one litre of normal saline IV over 6 hours. The giving set has a
drop factor of 10. The correct flow rate would be
a) 14 dpm
b) 28 dpm
c) 140 dpm
d) 280 dpm
44. John has been prescribed dextrose/saline 125 mls per hour IV. The giving set has a
drop factor of 60. The correct flow rate would be
a) 125 dpm
b) 120 dpm
c) 60 dpm
d) 65 dpm
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45. Hone has been prescribed plasmolyte 500 mls over 2 hours IV. The giving set has
a drop factor of 10. The correct flow rate would be
a) 24 dpm
b) 42 dpm
c) 84 dpm
d) 48 dpm
46. The optimal position for the comatose patient is

a) Prone
b) Supine
c) Semi
fowlers d) Side
lying
e) High semi fowlers
47. Which of the following would a nurse be testing if she asked a 65 year old patient
questions like, ‘what day is it’, ‘what time is it’, ‘what month is it’
a) Intelligence
b) Perception
c) Orientation
d) Personality
48. When a person experiences loss or decreased sensation of pain, temperature and touch,
the major nursing concern will be meeting their need for
a) Communication
b) Nutrition
c) Safety
d) Belonging
49. When caring for a patient with aphasia, you should

a) Talk loudly so she can hear you
b) Refrain from giving explanations about procedures
c) Provide as much environmental stimuli as possible to prevent feelings of isolation
d) Consider the type that the person has and adapt communications methods
accordingly
50. Narcotics are given as pre-anaesthetic medications to

a) Decrease oral secretions
b) Reduce the risk of intra operation
DUT c) Decrease postoperative pain
d) Reduce postoperative nausea and vomiting
51. Clinical manifestations of hypovolemic shock include all except

a) A fall in blood pressure
b) A decreased urinary output
c) A weak, rapid, thread pulse
d) Warm, moist skin
52. Your clients physician writes an order for antibiotics stat that you feel are too high a
dosage for that client. What should your reaction to this order be
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a) Administer the drug as prescribed since the physician is legally responsible for
any mistakes in the order
b) Check with the prescribing physician before administering the drug
c) Administer the drug first since it is a stat drug, and then check with the physician
d) Check with the client about dosages administered to him in the past and
compare this response to the ordered dosage
53. Miss Blake has suddenly had a cardiac arrest. What is the critical time period that the
nurse must keep in mind before irreversible brain damage occurs
a) 1-3 minutes
b) 8-10 minutes
c) 2-4 minutes
d) 4-6 minutes
54. David white is in the hospital with a medical diagnosis of viral pneumonia. He is
getting oxygen via a simple face mask. Why must it fit snugly over the clients
face
a) Prevents mask movement and consequent skin breakdown
b) Helps the client feel secure
c) Maintains carbon dioxide retention
d) Aids in maintaining expected oxygen delivery
55. The Heimlich manoeuvre is described in which of the following statements

a) Arms encircling persons waist from behind with firm abdominal thrusts
b) Quick, forceful blow with fist on clients sternum
c) Sweeping out foreign objects from clients mouth with fingers
d) Sharp blow on centre of clients back
56. In teaching a patient about foods that affect his fluid balance, the nurse will keep in
mind that the electrolyte which primarily controls water distribution throughout the
body is
a) Sodium
b) Potassium
c) Calcium
d) Magnesium
57. Mrs Zikes is receiving frequent medication. Which of the following would be
the correct identification procedure
a) Check the identification bracelet and call Mrs. Zikes by name
b) Check the name on the foot of the bed, and check the identification bracelet
c) Call Mrs. Zikes by name, this is all that is needed
d) Ask Mrs. Zikes her name, and check her identification bracelet
58. When you answer the clients call light, you note that he has suffered a wound
evisceration. Your response will be to
a) Call the physician immediately for offers. Do not touch the wound
b) Cover the wound with sterile dressing, call the lab to do a culture and then call
the physician
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c) Cover the wound with sterile, saline soaked towels and immediately notify the
physician
d) Take the clients vital signs, cover the wound with a sterile towel and call the
physician
59. Which surgical consent would NOT be considered legal

a) Consent signed by a 36 year old lady one hour after receiving her
preoperative medication of morphine
b) Consent signed by 21 year old man who has fractured leg due to an auto accident
c) Telephone consent from the father to perform an emergency surgery on a 17
year old girl
d) Consent signed by a 60 year old man the evening prior to surgery and prior to his
evening sedative
60. Which statement by the nurse would be most therapeutic when the client says ‘ my
friend has a terrible scar from her surgery’
a) Don’t worry, your surgeon is very good
b) You need the surgery, and a little scarring is okay
c) Are you concerned about how your surgical scar will look
d) I wouldn’t worry about that right now, all people are different
61. Several screening tests are performed on clients preoperatively. Which

test demonstrates the presence of bleeding or anaemia
a) An elevated white blood cell count
b) Decreased haemoglobin and hematocrit
c) Elevated blood urea nitrogen
d) Hypokalemia
62. Leg exercises are taught to clients in order to increase venous return and prevent
thrombophylebitis. Which step of this procedure is incorrect
a) Alternately dorsiflex and plantar flex toes
b) Flex and extend the knee
c) Raise and lower each leg
d) Repeat exercise every one to two hours
63. Two days post surgery ms D continues to complain of pain. There are a number
of interventions available for pain relief. Which comfort measure has the potential
of increasing ms Daniels risk for cardiovascular complications
a) Turn ms D every two hours
b) Place pillows under ms Ds knees
c) Splint ms Ds abdomen when she
coughs d) Encourage ambulation as
tolerated
64. Your client develops a fever and complaints of calf pain over an area that is red and
swollen. Nursing interventions for thrombophlebitis will include all except
a) Elevate the affected leg to heart level
b) Maintain bed rest as ordered
c) Measure bilateral calf circumference every
shift d) Massage the affected calf
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65. Which of the following is an autonomic nervous system response to acute pain
a) Decreased heart rate
b) Decreased depth of respiration
c) Pupil constriction
d) Increased blood pressure
66. Which of the following is a natural opiate of the brain involved in the analgesic
system
a) Endorphins
b) Histamine
c) Collagenase
d) Neurotensin
67. Judgement and caution must be used when nonpharmacologic interventions

are applied in the treatment of acute pain because
a) No proof exists that they work
b) They are very expensive to implement
c) They are outside the scope of nursing
practice d) They do not guarantee pain relief
68. If morphine is given intravenously, regularly as post operative analgesia for 10

days to a multiple trauma patient, what is the possibility that this patient would
become addicted to the narcotic
a) Almost never
b) Sometimes
c) Often
d) Almost always
69. A malignant neoplasm

a) Grows very slowly
b) Is usually surrounded by a well defined capsule
c) Consists of cells that only form tissues in a very disorganised manner
d) Is composed of goblet cells
70. Which of the following characteristics generally differentiate malignant tumours

from benign tumours
1 lack of a capsule
2 more rapid growth
3 infiltrates normal tissues
4 respects other cells
boundaries a) 1, 2 and 3
b) 1, 2 and 4
c) 1, 3 and 4
d) 2, 3 and 4
71. Malignant tumours and leukaemias may be treated with chemotherapy. The primary
aims of this therapy is to
1 attack newly developing cancer cells
2 reduce the size of a tumour
3 build up a person’s defence system
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4 reduce the oxygen bearing capacity of the
blood 5 destroy cancer cells and leave normal
cells
a) 1, 2 and 3
b) 1, 2 and 5
c) 2, 3 and 4
d) 2, 3 and 5
72. During chemotherapy, soreness of the mouth and anus may develop because
a) The effects of the chemotherapeutic agents concentrate in these body areas
b) These tissues normally divide rapidly and are damaged by chemotherapeutic
agents
c) The entire GI tract is involved because of the direct irritating effects
of chemotherapy
d) The tissues have become damaged from prolonged vomiting and diarrhoea
73. Which of the following should be considered in order to avoid skin reactions
following radiotherapy
1 not to apply ointments or lotions
2 not to vigorously dry the skin
3 to apply powder p.r.n
4 to keep the skin area dry and open to
air 5 to avoid exposure to sunlight
a) 1, 2 and 3
b) 2, 3 and 5
c) 3, 4 and 5
d) 1, 2, 4 and 5
e) 2, 3, 4 and 5
74. A common problem after open cholecystectomy is shallow breathing. This is mainly
due to
a) The site of the incision making breathing painful
b) Damage to the phrenic nerves during surgery
c) The obese state of most patients pre operatively
d) Inadequate pre operative instruction
75. Chest problems may best be prevented after cholecystectomy

by 1 giving the patient oxygen
2 regular deep breathing and coughing
3 keeping the patients pain minimised
4 prophylactic antibiotic therapy
5 keeping the patient rested and warm
a) 1 and 3
b) 1 and 4
c) 2 and 3
d) 2 and 4
76. Your client suffers from nausea and vomiting in the early post operative period.
Vomiting at this time is most likely due to
a) Volvulus
b) Phrenic irritation
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c) Effect of anaesthetic
d) Paralytic ileus
77. Mrs S is scheduled for a cholecystectomy and asks you how she will manage
without a gallbladder. Your best reply is
a) Dilute bile will still pass into your digestive tract but will be less efficient
at digesting fat
b) Your liver will no longer produce bile now so you must stay strictly off fatty
foods
c) Your gallbladder was not a very important organ and you will not miss it
d) You can take a bile supplement in your diet to compensate
78. An intravenous infusion of 500 ml dextrose/saline through a metriset infusion set (60
drops per ml) is ordered to run over 6 hours. Calculate the drops per minute
a) 137
b) 36
c) 60
d) 83
79. An injection of morphine 7.5 mg is required – on hand are ampoules containing 10

mg per ml. Calculate the volume to be drawn up
a) 0.5 ml
b) 0.6 ml
c) 0.65 ml
d) 0.7 ml
e) 0.75 ml
80. Your patient is charted 1 L normal saline 12 hourly via an IV line (drop factor 10).
Calculate the correct drops per minute (d.p.m)
a) 8
b) 12
c) 14
d) 20
e) 24
81. If the drop factor is 15, how fast should an infusion of 1000 ml normal saline run
over 10 hours
a) 15 dpm
b) 20 dpm
c) 25 dpm
d) 40 dpm
82. Mrs Graham is an active, retired 62 year old. She has been admitted for investigation
of possible renal calculi. Which of the following investigations would be most useful
in confirming Mrs G’s provisional diagnosis of renal calculi
a) Cystoscopy
b) Intravenous pyelogram
c) Renal biopsy
d) Urinary electrolytes
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83. Mrs S, aged 56, has undergone elective abdominal surgery. In the evening of the day
of surgery she feels that she wants to pass urine but is unable to do so. The nurse
could best assist her to micturate by
1 applying manual pressure to the suprapubic region
2 assisting her to sit at the edge of the bed and use a
pan 3 encouraging her to increase her fluid intake
4 changing her position, ensuring comfort and giving pain relief
5 emptying her bladder to give relief by use of a urinary catheter
a) 1 and 3
b) 1 and 4
c) 2 and 3
d) 2 and 4
STATE EXAMS 10
1. Critical thinking skills that assist the nurse in appropriately setting priorities are
which type of nursing skill
a) Intellectual
b) Interpersonal
c) Technical
d) Mechanical
2. Which of the following peripheral pulses is the most common site for obtaining
a pulse in an emergency
a) Carotid artery
b) Radial artery
c) Brachial artery
d) Temporal artery
3. Culturally safe nursing practice involves

a) Relating to all clients in a neutral manner regardless of their cultural heritage
b) Asking clients about knowledge of their own cultural heritage
c) Ensuring clients are nursed by nurses from their own
culture d) Using appropriate resources to meet clients identified
needs
4. The nurse notifies the physician when it is determined that an adult male clients pulse
is 52 beats per minute because the client is experiencing
a) Cardiovascular
collapse b) Bradycardia
c) Tachycardia
d) Dysrhythmia
5. Potential sources of client data useful to the nurse for a comprehensive assessment
include
a) client
b) family
c) medical
records d) all of
the above
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6. vital signs are measured in order to
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a) regulate the clients condition within a narrow range
b) provide clues to the physiologic functioning of the body
c) comply with the doctors order for vital signs to be taken at prescribed intervals
d) assess the psychological status of the client
7. In effective communication, the course sends a message to the receiver. Which of

the following describes the process by which reception and comprehension of the
message are verified
a) noise
b) feedback
c) channel
d) decoder
8. the frequency of assessing vital signs depends upon the

a) doctors orders
b) nurses discretion
c) availability of
personnel d) patients
condition
9. where should the stethoscope be placed upon the auscultation of apical beat
a) fifth intercostals space at left midclavicular line
b) the epigastric area at the tip of the sternum
c) third intercostals space over the right ventricle
d) between the aortic and tricuspid areas
10. which of the following best indicates good blood circulation to the extremities
a) blood pressure in normal range
b) dorsalis pedis pulses strong and equal bilaterally
c) mucous membranes pink and moist
d) venous patterns readily identifiable
11. measuring the clients response to nursing interventions and the clients progress
toward achieving goals is done during which phase of the nursing process
a) planning
b) nursing
diagnosis c)
evaluation
d) assessment
12. the primary source of data for evaluation is the

a) physician
b) client
c) nurse
d) medical record
13. the criteria for determining the effectiveness of nursing actions are based on the
a) nursing diagnosis
b) expected outcome
c) clients satisfaction
d) nursing interventions
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14. the planning step of the nursing process includes which of the following activities
a) assessing and diagnosing
b) evaluating goal achievement
c) performing nursing actions and documenting them
d) setting goals and selecting interventions
15. the nursing care plan is

a) a written guideline for implementation and evaluation
b) a documentation of client care
c) a projection of potential alterations in client behaviours
d) a tool to set goals and project outcomes
16. the nurses act is administered by the

a) new Zealand nurses organisation
b) nursing council of new Zealand
c) division of nursing (department of health)
d) all of the above
17. the registrar of nurses is employed in the

a) department of health
b) nursing council
c) nurses organisation
d) hospital boards association
18. the nursing council is

a) bureau in the department of health
b) a subcommittee of the nurses organisation
c) an incorporated society
d) a statutory body
19. the nursing council does all of the following except

a) administer the nurses act
b) administer the hospitals act
c) approve schools of nursing
d) issue practising certificates
20. the act which provides for the nursing council to have disciplinary jurisdiction over
the conduct of registered and enrolled nurses is
a) the nurses act of 1977
b) the nurses regulation act of 1977
c) the hospital act of 1951
d) the area health board act of 1989
21. Nurses employed in any setting can be formal complaint is made against them. By
law to whom should these complaints be addressed
a) the medical superintendent
b) the registrar of the nursing council
c) the medical officer of health
d) the executive director of the nurses organisation
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22. the maintenance of standards, discipline, examinations are administered by the
nursing council under which act of parliament
a) crimes act
1961 b) nurses act
1977
c) accident rehabilitation and compensation insurance act
d) official information act 1982
23. As you prepare a client for surgery she states that although she has signed her
consent form she doesn’t really understand what the doctor told her. She asks what
sort of operation is she to have. You respond with
a) I’ll just give you your pre medication and soon you’ll be alright
b) you seem worried about your operation, would you like to stay
c) I can see you are upset. I’ll get the doctor to explain the operation again to clarify
if for you
d) You don’t have to worry, the doctors do this operation all time
24. If a client is admitted and dies within 24 hours following surgery must be notified by
law
a) Significant others
b) Doctor
c) Medical superintendent
d) Coroner
25. All of the following are a coroners case except

a) An unexpected death of client 24 hours after admission
b) Death of a client with an infectious disease
c) An unexpected death 24 hours after surgery
d) No established cause of death
26. Richard a 25 year old mildly retarded person was admitted to accident and emergency
due to multiple fractures after a motor bike accident. Richard is to have an emergency
laparotomy due to internal bleeding. The crimes act states that consent in the above
case is
a) Implied from the circumstances surrounding the case and the need to
take immediate action for the welfare of the individual
b) Written and must be freely given and fully understood if major surgery was to be
performed
c) Mentally ill and demented clients must have a consent of a parent or a guardian or
significant others representing them
d) Valid only if the client is 16 years and over or if married
27. Whilst in theatre, a friend who knew Richard very well, rings to inquire about the
client’s condition. You are the staff nurse on duty. The official secrets act of 1951
allows you to
a) Give the full information as he is a very close friend of the client
b) Give him the information as he is a member of the health profession
c) Give him information in general terms concerning the condition of the client
d) None of the above
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28. After surgery Richard is taken to the intensive care unit but dies shortly thereafter.
A legal responsibility in cases of unexplained death up to 24 hours after surgery is
to
a) Lay the body out so that the family and friends can see the
client b) Send a coroners referral for investigation
c) Make sure the clients name and address and the circumstances surrounding the
death are written in the 24 hours census book
d) Ensure that personal belonging are inspected and signed for by the family
29. Debbie a 16 year old student, is admitted in a semi conscious state with a history of a
58 pound weight loss in 3 months. Preliminary diagnosis is acute anorexia nervosa.
Which of the following admissions lab values should the nurse caring for Debbie
consider to most critical
a) Glucose 8.0
b) Potassium 3.0
c) Sodium 144
d) Haemoglobin 10
30. Which vital sign would provide the most essential information in light of Debbie's
current lab values
a) Temperature
b) Pulse
c) Respirations
d) Blood pressure
31. Claire aged 30 and single, is brought to the mental health unit by her brother, who
tells the nurse that she has become increasingly overactive and out of control over the
past 2 months. She begins tasks but doesn’t complete them, takes little time to eat and
sleep and spends large amounts of money and is now in debt. Which approach would
be most therapeutic in working with Claire?
a) Teaching the patient about banking procedures, then extending this approach
to everyday issues
b) Confronting the patient about all her inappropriate behaviour
c) Kindly but firmly guiding the patient into such activities such as bathing and
eating
d) Showing the patient that she is in a controlled environment so that no difficulties
arise later
32. Claire lost 15lb last week and now weights 100lb. the nurse formulates a nursing
diagnosis based on the diagnostic category altered nutrition: less than body
requirements. Which goal is most appropriate initially
a) The patient will consume an adequate diet
b) The patient will maintain her current weight of 100lb
c) The patient will gain 1lb per week
d) The patient will remain adequately hydrated
33. Claire's hydration and nutrition needs would be to

a) Leave finger foods and liquids in her room and let her eat and drink as she moves
about
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b) Bring her to the dining room and encourage her to sit and eat with calm,
quiet companions
c) Explain meal time routines and allow her to make own decisions about eating
d) Provide essential nutrition through high calorie gavage (naso gastric) feedings
34. The physician decides to start Claire on lithium therapy. Which of the following
best describes her dietary requirements while she is receiving this medication
a) A high calorie diet with reduced sodium and adequate fluid
intake b) A regular diet with normal sodium and adequate intake
c) A low calorie diet with reduced sodium and increased fluid intake
d) A regular diet with reduced sodium and adequate fluid intake
35. Michelle aged 25 is found sitting on the floor of the bathroom in treatment clinic with
moderate lacerations to both wrists. Accompanied with broken glass she sits staring
blankly at her bleeding wrists while staff members call for an ambulance. How should
the nurse approach Michelle initially
a) Enter the room quietly and move beside Michelle to assess her injuries
b) Call for staff backup before entering the room and restraining Michelle
c) Move as much glass away from Michelle as possible and quietly sit next to her
d) Approach Michelle slowly while speaking in a calm voice, calling her name and
telling her that the nurse is here to help her
36. Michelle is taken to the hospital and admitted on an emergency basis for 5 days
compulsory assessment and treatment. Michelle says to the admitting nurse. I’m not
staying here. I was a little upset and did a stupid thing. I want to leave. Which
response is most appropriate
a) Unfortunately, you have no right to leave at this time. You must be evaluated
further
b) Cutting your wrists certainly was a stupid thing to do. What were you trying
to accomplish anyway
c) You have been admitted on an emergency basis and can be held you have the
right to consult a lawyer about your admission
d) I can see you’re upset. Why don’t you try to relax. You can explain to the doctor
what upset you. If what you say is true, you’ll be released sooner.
37. Determining michelles suicide potential during the mental status examination,
involves assessing several factors, the most significant of which is her
a) History of previous suicide
attempts b) Suicide plan
c) Emotional state
d) Self esteem
38. Michelle is placed on suicide precautions, which include constant observation. When
the nurse accompanies her to the bathroom. Michelle complains, I can’t believe this. I
can’t even go to the bathroom without being watched. How would you like to have
me watching you go to the toilet. Which response by the nurse is best
a) I’m sure I wouldn’t like it very much, but then I didn’t try to hurt myself
b) I’m sorry but these are the rules. Someone must be with you at all times
c) If it’s more comfortable for you, I can stand right outside as long as the door
is open. Would you agree to that
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d) I would probably feel uncomfortable too, but ensuring your safety is my first
priority. I must stay in the room with you
39. 5 days of hospitalization. Michelle is to be discharged and an outpatient basis at the

day of treatment clinic. During discharge planning, the nurse should set as a priority
short term goals Michelle will
a) Identify support systems to help manage stress
b) Verbalise feelings of shame regarding her suicide attempt
c) Demonstrate an uplifted mood and optimism about the future
d) Admit that her wrist slashing was an attention seeking behaviour and not a
true suicide attempt
40. Upon transfer to the psychiatric unit Megan is informed by the admitting nurse that it
will be necessary to check her belongings for any unsafe or banned items. She
begins to scream angrily. What’s the matter with you. I’m upset. Get away from me.
The nurse should first
a) Administer emergency tranquillizers as ordered
b) Place Megan in seclusion and restraints
c) Eliminate the belongings search so as to avoid upsetting her
d) Set verbal limits on her behaviour
41. Megan requests a weekend pass two days after transfer to the psychiatric unit. Her
primary nurse informs her following the treatment team meeting that the pass has not
been approved. Megan responds angrily. They all hate me, they’re so mean. I know
you’d have let me go. You’re the only decent nurse here. The nurses best response is
a) I would have approved it, but you’re right I’m only one voice
b) I don’t think the others realise how hard you’ve been trying
c) Megan you’ll never get a pass behaving this way
d) This was the teams’ decision. Let’s talk about why we feel it’s not appropriate
now
42. Megan’s behaviour in this situation illustrates the use of which defence mechanism
a) Splitting
b) Reaction formation
c) Conversion
d) Repression
43. Megan’s doctor resumes her regular dosage of amitriptyline. Which effect of this
medication might the staff and patient expect to see first
a) Elevated mood
b) Improved reality testing
c) Improved sleep pattern
d) Fewer hallucinations and delusions
44. Wilfred a 42 year old executive, is admitted for treatment of his alcoholism. The
most important factor in Wilfred’s rehabilitation is
a) His emotional or motivational readiness
b) The qualitative level of his physical state
c) His familys' accepting attitude
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d) The availability of community resources
45. Which one of the following remarks of Wilfred, made prior to discharge from hospital
would show the most realistic assessment of his situation in relation to avoiding future
drinking problems
a) I promise I’ll never get drunk again
b) I will cut down my drinking so I drink only socially
c) I can stop drinking providing my wife keeps off my back
d) I’m going to try hard to stay away from that first drink
46. John is a 32 year old man with a 5 year history of psychiatric admissions. He is
escorted to the mental health unit by the police. He is dishevelled, confused and his
records state that he has been diagnosed as chronic undifferentiated schizophrenic.
The nurse observes john sitting in the hall looking frightened. He is curled up in a
corner of the bench with his arms over his head and covering his face. How should the
nurse approach the patient
a) Walk over to the bench, sit beside him quietly, and place an arm around
his shoulders, then say I’m the nurse and wait for a response
b) Allow him to remain alone on the bench, where he can observe the unit for a half
hour or so until he is more comfortable
c) Greet him warmly saying hi I’m the nurse. This is a very nice unit. I think you’ll
like it here. Let me show you around
d) Sit about 3 or 4 feet from him on the bench and say hello john I’m a nurse on this
unit. You appear frightened then wait for a response
47. John responds to the nurse by curling up on the bench even tighter. His arms still
cover his head and his hands are clasped tightly over his ears. The nurse should
a) Show acceptance of johns behaviour by remaining with him and reassuring him,
gently stroking his arms and shoulders
b) Tell john that she will leave him for a while and will return later when he feels
more relaxed
c) Say gently john ill just sit here quietly with you for a while then remain seated
nearby
d) Say john, most people feel uncomfortable in hospitals. You shouldn’t be afraid.
I’m here to help you
48. Later that evening, the nurse finds john crouched in the corner of his room, with a
curtain covering him. His roommate is sitting on the bed laughing and saying this guy
is really a nut. He should be in a padded cell. How should the nurse respond to the
roommate
a) Say I’m sure John's behaviour is frightening to you. I understand that you are
trying to cover up how you really feel by laughing
b) Say id appreciate it if you’d step outside for awhile. I’d like to talk with you after I
help john
c) Say nothing and attend to john
d) Say in a neutral tone. I think your laughing is making john feel worse. How would
you feel if you were john
49. What is the least threatening approach to john while he sits huddled under the curtain
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a) Sit next to him on the floor without speaking, and wait for him to acknowledge
the nurse
b) Gently remove the curtain and say, john this is the nurse. What happened
c) Approach john slowly and say. John this is the nurse. You appear to be very
frightened. Can you tell me what you are experiencing
d) Call for assistance and do not approach john until at least two other staff
members are present
50. Because john has previously responded well to treatment with haloperidol (serenace),
the doctor orders haloperidol 10mg orally twice a day. Which adverse effect is most
common with this medication
a) Extrapyramidal symptoms
b) Hypotension
c) Drowsiness
d) Tardive dyskinesia
51. During the next several days, john is observed laughing, yelling and talking to himself.
His behaviour is characteristic of
a) Delusion
b) Looseness of association
c) Illusion
d) Hallucination
52. John tells the nurse, the earth is doomed, you know. The ozone is being destroyed by
hair spray. You should get away before you die. John appears frightened as he say this.
The most helpful response is to
a) Say john I think you are overreacting. I know that some concern about the earth’s
ozone layer, but there is no immediate danger to anyone
b) Say I’ve heard about the destruction of the ozone and its effect on the earth. Why
don’t you tell me more about it
c) Ignore johns statement and redirect his attention to activity on the unit
d) Say john are you saying you feel as though sometimes will happen to you. I don’t
believe we are in danger right now
53. After a half hour, john continues to ramble about the ozone layer being doomed to die.
He paces in an increasingly agitated mood he begins to speak more loudly. At this
time, the nurse should
a) Check to see whether the doctor ordered haloperidol
b) Allow john to continue pacing but observe him closely
c) Try to involve john in a current events discussion group that is about to start
d) Tell john to go to his room for a while
54. Henry is brought to the mental health unit by his wife who states for the past week her
husband has refused all meals and accused her of poisoning him, he has become
withdrawn, forgetful and inattentive and has frequent mood swings. Henry appears
suspicious. His speech which is only partly comprehensible reveals that his thoughts
are controlled by delusions of possession by the devil. He claims the devil told him
that people around him are trying to destroy him. The doctor diagnoses paranoid
schizophrenia. Schizophrenia is best described as a disorder characterised by
a) Disturbed relationships related to an inability to communicate and think clearly
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b) Severe mood swings and periods of low to high activity
c) Multiple personalities, one of which is more destructive than the
others d) Auditory and visual hallucinations
55. The nursing assessment of Henry should include careful observation of his
a) Thinking, perceiving and decisions making skills
b) Verbal and nonverbal communication processes
c) Affect and behaviour
d) Psychomotor activity
56. When communicating with Henry the nurse should initially

a) Remain silent and wait for Henry to speak first
b) Talk with Henry as one would talk with a healthy person
c) Allow Henry to do all the talking
d) Speak to Henry using simple, concrete language
57. The patients thought content can be evaluated on the basis of which assessment area
a) Presence or absence of delusions
b) Unbiased information from the patients psychiatric history
c) Degree of orientation to person, place and time
d) Ability to think abstractly
58. Henry mentions that voices are telling him that he is in danger and that he will be safe
only if he stays in his room and avoids ‘zoids’. How should the nurse respond
a) I understand that these voices are real to you, but I want you to know that I do not
here them
b) Don’t worry. I won’t let anything happen to you here
c) What else can you tell me about the voices
d) Many patients hear voices when they come here. The voices will go away when
you get better
59. The innermost layer of the eye is

a) Sclera
b) Retina
c) Choroid
d) Conjunctive
60. The nurse observes Henry pacing in his room. He is alone but in an angry tone. When
asked what he was experiencing he replies the devil is yelling in my ear. He say
people here want to live. The nurses best response is
a) Can you tell me more about what the devil is saying
b) How do you feel when the devil says such things to you
c) I don’t hear any voice. Henry are you feeling afraid now
d) Henry the devil cannot talk to you
61. Mary is admitted under section 11 of the mental health (compulsory assessment and
treatment act 1992). The definition of mental disorder under the act includes all of the
following except
a) A seriously diminished ability to care for
yourself b) Mental handicap and substance abuse
c) An abnormal state of mind
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d) A serious danger to self or others
62. Marys rights under the act include, the right

a) To information about her status, to respect of her culture identity, to seek
legal representation
b) To respect as a human being, to respect of her cultural values, to receive visitors
and make phone calls
c) To information about her status, to receive treatment to health care, to change her
treatment at her request
d) To receive visitors and make telephone calls, to refuse seclusion on
cultural grounds, to seek a judicial inquiry
63. Mary asks for review of her legal status. Your action would be
a) Explain that her status will be reviewed by the responsible clinician before the end
of five days
b) Reassure her that you understand how frustrating it must to be in hospital
against her will
c) Offer to phone the client advocate on Marys behalf
d) Explain section 16 to Mary and allow her to phone the district inspector
64. Under section 30 of the mental health act (1992), the inpatient treatment order lasts
for
a) 2 months
b) 4 months
c) 6 months
d) 12 months
65. Under section 111 of the mental health act (1992) a person admitted to hospital, not
already subject to any assessment and treatment can be detained, for how long, if
considered mentally disordered
a) 24 hours
b) 12 hours
c) 6 hours
d) 3 hours
66. Lisa tell the nurse that she has gained 2kg in a month and plans to diet by skipping
lunches. Which of the following responses would be the most appropriate
a) Have you noticed that your hands and feet have become swollen
b) You should cut down on high calorie foods like cake and candy, but you shouldn’t
skip lunch
c) Your weight gain is just right for you for this period of your pregnancy. You are
doing fine
d) You’re supposed to gain a lot of weight its good for the baby. You’ll lose it after
the baby is born
67. 50mg is equal to

a) 0.5 gram
b) 5 grams
c) 5000 micrograms
d) 50,000 micrograms
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68. The drugs used to treat Parkinson’s disease act by
a) Increasing cholinergic activity and increasing dopamine
b) Reducing cholinergic activity and increasing dopamine
c) Increasing cholinergic activity and reducing dopamine
d) Reducing cholinergic activity and reducing dopamine
69. Recent research indicates that arthritis may be an autoimmune disease. Which of the
following statements most accurately describes the process of autoimmunity
a) A rare complication of vaccination when the body reacts to the vaccine by
producing symptoms of the disease
b) An inherent factor in the blood which renders the person susceptible to certain
diseases
c) Lack of antitoxins in the blood which render the person susceptible to the certain
diseases
d) Formation of antibodies in the blood which destroy certain healthy cells in the
individual
70. Patients with rheumatoid arthritis commonly have a raised ESR (erythrocyte
sedimentation rate). This is because
a) Arthritic patients usually have a degree of anaemia
b) Rheumatoid factor decreases the viscosity of the cells
c) Protein changes result in the erythrocytes becoming heavier
d) There is an increase in leukocyte numbers
71. Before administering a dose of digoxin the patients pulse (apex beat) should be taken.
Which is the correct action for the nurse to take if the pulse is found to be under 60
beats per minute
a) Give the drug and take the pulse again an hour later
b) Give the drug and notify the staff nurse that the pulse is slow
c) Do not give the drug and report the slow pulse to the doctor
d) Omit the drug and make a note on the nursing care plan
72. Which of the following can be causes of anaemia in the elderly

1. Apathy and depression
2. Ill fitting dentures
3. A physiological inability to utilize food properly
a) 3 only
b) 1 and 2
c) 1 and 3
d) 1, 2 and 3
73. Old people are inevitably a burden on the community (assertion) because old people
cannot work because they are slow and cannot be relied on (reason). With reference to
the above statement which of the following is true
a) Both assertion and reason are true statements but the reason is not a correct
explanation of assertion
b) The assertion is true but the reason is a false statement
c) The assertion is false but the reason is a true statement
d) Both the assertion and reason are false statements
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74. A common problem with the elderly is their reluctance to drink adequate amounts of
fluid. The most probable reason for this is that they are
a) Frightened of being incontinent
b) More likely to sweat than younger people
c) Unable to afford adequate fluids
d) Afraid of developing diarrhoea
75. Haemorrhage into the anterior chamber of the eye following a cataract extraction is
called
a) Hyaemia
b) Hyphaema
c) Hayfever
d) Hyena
76. Mrs Adams suffers from dementia and requires a dressing to a shin wound. The nurse
suspects the wound is the result of a non accidental injury. What is the main cause of
non accidental injury in an elderly person suffering from dementia
a) A dependent person being more prone to injury
b) A long standing pattern of domestic violence
c) The home not being a suitable place for a dependent person
d) The increased stress in caring for a dependent person at home
77. When dressing the shin wound the nurses most appropriate remark is
a) How did you scrape your shin Mrs. Adams
b) How did you scrape your wife’s shin Mr. Adams
c) This shin must hurt. Was it really an accident
d) A shin is easy to hurt. How did this injury happen
78. The most appropriate way to help Mr. and Mrs. Adams at the first visit is to
a) Express professional concern at the cause of the injury
b) Conceal feelings about the possible cause of the injury
c) Reassure Mrs. Adams that this injury will not occur again
d) Acknowledge the stress of Mr. Adams in caring for his wife
79. An increased incidence of vaginal infections occurs when contraceptive pills are taken
because there is
a) A shift in the vaginal pH
b) Drying of the vagina mucosa
c) An increase in vaginal fluids
d) A reduction in white cell numbers
80. What action should the nurse take when on three home visits the mother of a nine
months old baby prevents him from being seen as ‘he is sleeping’
a) Notify the social welfare of the situation
b) Notify the family doctor in writing of this occurrence
c) Insist on seeing the child and refuse to leave the home
d) Respect the patients right to accept or refuse treatment
81. Which is the major pathophysiological abnormality occurring in asthma
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a) Cardiac arrhythmias
b) Bronchiole dysplasia
c) Spasm of the smooth muscles of the bronchi
d) Inflammation of the alveoli
82. Which of the following sings/symptoms would indicate mumps

a) Swelling of the lymph nodes
b) Tenderness of the parotid gland
c) Enlargement of the prostate gland
d) Ulceration of vesicular stomatitis
83. Which option is important for the nurse to know with regard to prevention of the
spread of mumps
a) Safe disposal of all bodily excretions
b) No specific isolation measures are needed
c) Control of all food stuffs prepared for sale
d) Isolation for ten days after the last notified case
84. Which of the following is the best description of a vaccine

a) Dead modified
bacilli b) Live attenuated
virus
c) Dead virus given orally
d) Antibodies suspended in serum
85. Mrs Shaw brings her 8 year old daughter Jane to the clinic. Jane has eczema. Jane’s
eczema is most likely the result of
a) Inadequate skin care and hygiene
b) Excretion of acids through sweat pores
c) An inherited predisposition to skin infections
d) Sensitivity to a substance in her external environment
86. Eczema is the term used to describe a (n)

a) Acute, contagious inflammation of the skin
b) Non contagious inflammatory response of the skin
c) Fungal infection more commonly seen in childhood
d) Condition marked by the appearance of erythematous wheals
87. Which statement best describes ‘vesicle’

a) Reddened, pinprick like rash
b) Small round area of discolouration
c) Small area of swelling on the skin
d) Small blister filled with serous fluid
88. You are employed as a practice nurse. A friend telephones and asks if her boyfriend
has been to see the doctor this week. Your most appropriate response is
a) I don’t know
b) I’ll have to ask the doctor
c) I am not able to tell you that
d) Just a moment, ill check the files
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89. Aminophylline 350mg is prescribed. Each ampoule contains 250mg in 10ml. how
much should be added to the intravenous solution
a) 12ml
b) 14ml
c) 16ml
d) 35ml
90. Jillian’s intravenous infusion of 300ml normal saline is due to run over 4 hours. The
drop factor is 60. How many drops per minute must be given for the IV to be
completed on time
a) 60 dpm
b) 75 dpm
c) 100 dpm
d) 47 dpm
91. A client is charted nitrazepam (mogadon) tablets to sleep. She refuses to take them at
9pm. She tells you that the other nurses always leave the tablets on the locker and she
takes them when she is ready. What should you do
a) Put them back in the container
b) Give her the tablets and let her take them later
c) Tell the patient to ring when she is ready for them
d) Tell her if she doesn’t take them now she may not get them later
92. Hyperventilation may initially cause

a) Metabolic acidosis
b) Metabolic alkalosis
c) Respiratory acidosis
d) Respiratory alkalosis
93. Your neurologic assessment indicates increased ICP (intracranial pressure), so you
raise the head of the bed 15 to 30 degrees in order to
a) Improve arterial flow to the brain
b) Promote venous drainage from the
brain c) Improve respirations
d) Increase cardiac output
94. Pulse pressure is defined as the

a) Pressure felt at the radial artery over the wrist
b) Pressure of the heart beating against arterial walls
c) Difference between the apical and radial pulses
d) Difference between the systolic and diastolic blood pressures
STATE EXAMS 11
1. Mr March sixty year old farmer, was admitted to a private hospital for rehabilitation
following a cerebro vascular accident which resulted in right sided hemiplegia. When
cerebro vascular accident causes occlusion of blood supply to one area of the brain,
loss of voluntary muscle control is usually evident on
a) The same side of the body as the brain damage
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b) The opposite side of the body to the brain damage
c) The opposite side of the face
d) Both sides of the body
2. Which of the following is most important for Mr. march to succeed in a rehabilitation
programme
a) Knowledge of the services available to him
b) Families
encouragement c) Personal
goals
d) His relationships with the health team
3. A rehabilitation programme for Mr. march should begin with

a) Strengthening his weak side
b) Teaching him to walk
c) Utilising the movement he still has
d) Establishing speech
4. There is evidence that Mr. March suffers a mild degree of expressive aphasia. This
would be evidenced by which of the following behaviours
a) Mr march has difficulty in understanding what is spoken to him although he can
verbally express his needs appropriately
b) Mr march has difficulty in both understanding what is spoken to him and in
verbally communicating with others
c) Mr march understands what is spoken to him but has difficulty in forming
and expressing words
d) Mr march has difficulty interpreting sensory stimuli causing him to
respond inappropriately
5. Mr March is enthusiastic about his exercise programme. He exercises should be

a) Frequent and of short duration
b) Twice daily and extensive
c) Carried out in the physiotherapy department
d) Confined to the affected side
6. A rehabilitation programme should promote

a) Client autonomy and independence
b) The best possible level of mobility and ambulation
c) Psychological and social adjustment
d) All of the above
7. While Mr. March is hospitalised, the nurse is concerned with preventing the
complications of prolonged bed rest. Mr March already has a reddened area over
the sacrum and coccyx. The nurse knows that the most important action to prevent a
decubitus ulcer is to
a) Keep the skin area clean, dry and free from urine, faeces and perspiration
b) Place an alternating air pressure or water mattress on the bed
c) Massage the reddened area with lotion or oil to stimulate circulation
d) Turn and reposition the client at least q2h; avoid positioning him on the affected
side if possible
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8. Which of the following is the most correct statement about positioning the stroke
client
a) Flexor muscles are generally stronger than extensors
b) Extensor muscles are generally stronger than flexor
c) The fingers should be flexed tightly
d) The footboard should be flush with the mattress
9. Mrs Sweetman, aged sixty two years has non insulin dependent diabetes mellitus. She
recently returned home from hospital where she received treatment for any infection
of her left big toe. Mrs Sweetman's toe infection resulted from an injury of which she
was unaware. The most likely reason for this would be that
a) Her vision is impaired
b) She did not regularly wash her feet
c) She finds it difficult to flex her knees and
hips d) She has diminished sensation in her feet
10. Mrs Sweetman’s foot problems result from neuropathic, vascular and
infectious changes. The most important feature of foot care should be
a) Inspect the feet daily and wash with mild soap and water
b) Maintain adequate blood flow to the lower limbs
c) Rub the feet with alcohol once a week
d) Avoid wearing garters of constricting shoes
11. The first priority in caring for a person whose tissues have insufficient blood supply
is to
a) Prevent and relieve symptoms
b) Promote the development of collateral circulation
c) Protect the tissues from any injury
d) Relieve the pain associated with vasodilation
12. Peter aged 10 diagnosed as moderately mentally retarded. He lives in a IHC residence
and attends a special school. You are employed as a carer at the residence. A major
strategy in teaching peter is based on behaviour modification principles. An important
element in peters management then is the use of reinforcement. Which statement best
defines what a reinforce is for peter.
a) A reinforce is anything you think peter will enjoy
b) A reinforce is anything peter gains enjoyment from even if it appears to an
observer to be producing pain
c) A reinforce is anything which precedes a response which is likely to increase
the probability of that response occurring again
d) A reinforce is anything that follows a response that decreases the probability of
that response occurring again
13. You wish to teach peter to put on his pants. If the first step in his training programme
was doing up his belt correctly. This method would best be described as
a) Graduated guidance
b) Forward chaining
c) Backward chaining
d) Prompting
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14. When teaching peter to pull his pants up a physical prompt by guiding peters hand
is used. As Peters' learning increases the physical prompt becomes no more than a
gentle touch. This is an example of
a) Stimulus control
b) Fading
c) Reinforcing
d) Positive practice
15. Peter has a temper tantrum during which he lies on the floor at the entrance to the
hallway. This is making it difficult for other residents. He has been asked to get up
but continues his tantrum. Using the principles of extinction how would you deal with
peter
a) Continuing to ask him in a firm voice to get up
b) Ignore him and instruct the other residents to step over him
c) Explain to him that he is blocking the entrance and it is unsafe for him to remain
where he is
d) Let him know that if he doesn’t get up immediately he will be punished
16. What would be the most likely effect initially on peters behaviour when
commencing to apply the principles of extinctions
a) Behaviour shows minimal change
b) Inappropriate behaviour would increase
c) Inappropriate behaviour would rapidly
decrease d) Inappropriate behaviour would slowly
decrease
17. Peter has a habit of hugging new staff members and visitors to the residence. In
order for extinction of this inappropriate social behaviour it would be necessary for
him
a) Not to be punished for inappropriate behaviour
b) To be rewarded for inappropriate behaviour
c) To be punished for inappropriate behaviour
d) Not to receive reinforcement for this in appropriate behaviour
18. If the staff were to apply the principles of response cost in dealing with peters
inappropriate social behaviour they could do so by
a) Taking away something that peter found reinforcing such as restricting his TV
viewing
b) Taking away from peter something that he found unpleasant such as having to eat
his vegetables
c) Applying an aversive stimuli such as making him stay in his room
d) Ignoring the inappropriate behaviour but reinforcing an appropriate behaviour
such as his willingness to help with the dishes
19. Peter also suffers from epilepsy. During a seizure he falls to the ground is
unconscious and begins to convulse. The best immediate response would be
to
a) Cradle peters head in your lap
b) Place something in peters mouth to prevent him biting his tongue
c) Hold his arms down
d) Move him to a place of safety
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20. Which of the following tests furnishes the best diagnostic information about seizures
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a) Electroencephalogram
b) Cerebral angiogram
c) Cerebral tomography
d) Electrocardiogram
21. Peter does not regain consciousness after his seizure, but after a brief pause in the
convulsions the seizure continues. The term for this is called
a) Frequent seizures
b) Febrile seizures
c) Status epilipticus
d) Petit mal seizures
22. Major epilepsy normally follows which of the following sequences

a) Aura, tonic phase, clonic phase, recovery
b) Aura, clonic phase, tonic phase, recovery
c) Aura, tonic phase, recovery
d) Aura, clonic phase, recovery
23. Mr Jones aged 72 years has chronic obstructive respiratory disease (CORD). He is
a smoker. In the early stages of CORD the most effective way of delaying the
disease process is to encourage Mr. Jones to
a) Use purse lip breathing and pace physical activity
b) Stop smoking
c) Avoid environmental air pollutants
d) Avoid people with infections
24. The safest and most effective way to clear secretions from the respiratory tract is
a) Postural drainage
b) An effective cough
c) Pharyngeal suctioning
d) Endotracheal suctioning
25. Carl comes to the mental health clinic where you work because of nervousness. He
tells you I have butterflies in my stomach most of the time. I haven’t missed work but
it is getting harder to concentrate on things for a long time. What level of anxiety is
Carl most likely experiencing
a) Mild
b) Moderate
c) Severe
d) Panic
26. Which of the following questions would be the best way to begin taking carls history
a) Could you tell me about your family
b) What are you feeling now
c) Have you ever felt this way before
d) Does anyone else in your family experience these feelings
27. Which of the following explains the major differences between normal anxiety
and the syndrome associated with anxiety reactions
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a) Normal anxiety is constant; an anxiety reaction is intermittent and rather
short lived
b) Normal anxiety is free floating; in an anxiety reaction there is an impending
sense of doom
c) An anxiety reaction is seldom controllable and usually must run its course
d) Normal anxiety is a fact of life and rarely becomes an anxiety reaction
28. Signs and symptoms associated with anxiety are

a) Complaints of apprehension, narrowed perception, stomach pains and
restlessness b) Inability to get to sleep, early morning awakening, excessive weight
loss and lack
of energy
c) Ideas of reference, grandiose delusion, hallucinations and delusions
d) Spending or giving away large amounts of money
29. Carl complains of severe inner left arm and neck pain during the last few days.
This pain probably the result of
a) Vasoconstriction because of arterial spasms
b) Myocardial ischemia
c) Fear of death
d) Irritation of nerve endings in the cardiac plexus
30. Carl collapses in a shopping mall as he experiences a cardiac arrest. What would be
the first action in this situation
a) Call a doctor
b) Establish an airway
c) Start closed chest massage
d) Give a bolus of sodium bicarbonate
31. Upon admission to the coronary care unit, oxygen was ordered for Carl. The primary
purpose of oxygen administration in this situation is to
a) Relieve dyspnoea
b) Relieve cyanosis
c) Increase oxygen concentration in the myocardium
d) Supersaturate the red blood cells
32. The most dangerous period for Carl, following his myocardial infarction is
a) The first 24 to 48 hours
b) The first 73 to 96 hours
c) 4 to 10 days after the myocardial infarction
d) From the onset of symptoms until treatment begins
33. Carl is now considerably improved, wants to talk about his sexual activity after he
has been discharged. What would be the nurses initial approach
a) Give Carl some written material and then answer questions
b) Plan a teaching session with Carl and his wife
c) Answer his questions accurately and directly
d) Provide enough time and privacy so that he can express his concerns fully
34. Michael has been brought by the police into the psychiatric unit. He was found curled
up under a bridge. When asked his name all he would say was nice boy. His father
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informs you that he has not had a psychotic episode for 2 years, and that medication
has controlled his condition. This episode occurred when Michael refused his
medication. Which of the following areas should the nurse gather data first
a) Michaels perception of reality
b) Michaels physical condition
c) The observations of Michael, made by the police
d) Michaels speech patterns
35. Michael becomes regressed and withdrawn. He appears to be listening to something,

the nurse hears nothing. What is the most appropriate response
a) Give him an additional dose of his antipsychotic medication
b) Ignore his behaviour
c) Contact his doctor and request a seclusion
order d) Talk to him about what he has
experiencing
36. Michael’s doctor prescribes haloperidol, 6mgs IM for three doses. After the third
dose of the medication, Michael is still severely regressed and also agitated. He also
appears to be hallucinating. What would the nurse do
a) Call the doctor for further orders
b) Administer another dose of the medication
c) Record the results of the medication
d) Observe the client for an hour
37. Michael yells for the nurse. As the nurse enters his room he says do you see there
the Virgin Mary is appearing. Which of the following is the best nursing response
a) No I don’t see her but I understand she is real to you
b) She is not there. You must be imagining things Michael
c) Show me where in the room she is appearing
d) The virgin Mary is appearing
38. Michael is very withdrawn, he moves slowly and is uncommunicative. The best initial
goal is which of the following
a) Michael will increase his social skills
b) Michael will be orientated to reality
c) Michael will increase his level of communication
d) Michael will form a trusting relationship with the nurse
39. Jeff Oakes has cancer of the rectum and has consented to surgery for removal of the
rectum and the formation of a permanent colostomy. A gastric suction tube is inserted
before Mr. Oakes goes to surgery in order to
a) Facilitate administration of high caloric, nutritious liquids immediately after
completion of the procedure
b) Prevent accumulation of gas and fluid in the stomach both during and following
surgical action
c) Provide a reliable means of detecting gastrointestinal haemorrhage during the
operative procedure
d) Serve as a stimulus to restore normal peristaltic movement following recovery
from anaesthesia
40. Sections of colon both above and below the tumour were removed in order to prevent
a) Direct extension and metastatic spread of the tumour
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b) Post op paralysis and distension of the bowel
c) Accidental loosening of bowel sutures post operatively
d) Pressure injury to perineal suture line
41. Mr Oakes will receive tube feedings post operatively. Tube feedings provide adequate
nutrition for all of the following clients except
a) Those who have difficulty in swallowing
b) Those who are comatose
c) Those who do not have a functioning gastrointestinal tract
d) Those who are anorexic
42. Mr Oakes recovers from surgery. He is scheduled to return to the hospital in a month
for a course of chemotherapy. Before leaving he says to you I’m not sure I want to
come back. Maybe I’ll just take my chances. What would be the best response
a) It is your decision and you should do as you feel best
b) What concerns you most about coming back
c) Have you discussed this with your wife and doctor
d) The survival rate with adjuvant chemotherapy is quite high
43. Four year old Sean white was admitted to hospital with burns received while playing
with matches. His legs and lower abdomen are burned. On assessment of Sean's
hydration status, which of the following indicates less than adequate fluid
replacement
a) Decreasing hematocrit and increasing urine volume
b) Falling hematocrit and decreasing urine
volume c) Rising hematocrit and decreasing urine
volume
d) Stable hematocrit and increasing urine volume
44. Which signs/symptoms indicate overhydration

a) Dieresis
b) Drowsiness and lethargy
c) Dyspnea, moist rales
d) Warmth and redness around intravenous site
45. Sean’s output via his foley catheter is 10mL/hour. What should be the first nursing
action
a) Check the catheter to see if it is plugged (blocked)
b) Call the doctor immediately
c) Record the information on the chart
d) Increase the intravenous fluids
46. The doctor has prescribed 500ml of IV fluid to be given over 10 hours. Using
a soluset which delivers 60 drops per ml, calculate the rate in drops per min
a) 48
b) 50
c) 52
d) 54
47. Sean starts oral feeding it is particularly important that his client has a high amount of
a) Fats and
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carbohydrates b) Minerals
and vitamins
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c) Fluids and vitamins
d) Proteins and carbohydrates
48. What would be the best diversional activity for Sean while he is in reverse isolation
a) Lace leather
wallets b) Watch
television
c) Play with puppets
d) Use computer word games
49. Christine Harvey, aged 21 is to have a bronchoscopy in two hours time under
general anaesthetic. Why are food or fluids not permitted before this procedure
a) The anaesthetic will not be absorbed
b) Vomiting may occur during the procedure
c) Indigestion may be a problem for Christine
d) Christine may suffer from diarrhoea
50. Christine refuses to remove her wedding ring before she is transferred to theatre.
Which action should you take in this situation
a) Remind her that you are not responsible for the loss
b) Warn her the ring may slip off during surgery
c) Tell he she should give the ring to her
husband d) Secure the ring to her finger with tape
51. Christine is asked to remove her make up before going to theatre. Why is this
important
a) The makeup may contaminate the anaesthetic mask
b) The anaesthetist may have difficulty assessing her condition
c) The theatre is a sterile environment and make up carries micro organisms
d) The facemask is more likely to slip if she is wearing makeup
52. Soon after returning to the ward Christine asks for a drink. She should be given water
first, rather than a milky drink
a) Water is more easily absorbed than milk
b) Water quenches a person’s thirst more rapidly
c) Milk can cause lung infection if the gag reflex has not returned
d) Milk has a more irritating effect on a person’s throat
53. Allan martin, is admitted to hospital with acute chest pain. Provisional diagnosis is
myocardial infarction. When asking about the quality of a clients chest pain you
are primarily looking for
a) An indication of its severity
b) The patient’s own description
c) A response found on a list of possible descriptions
d) Its cause
54. When a client is anxious and upset about chest pain, it is best to
a) Explain in detail the pathologic changes that may be occurring
b) Provide short, clear explanations of your assessment and treatment interventions
c) Don’t say anything until you are sure of his diagnosis
d) Explain that his doctor can answer his questions better
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55. The nurse asks you to check some pain relief for Mr. Martin’s severe chest pain. This
prescription is for morphine 6mgs every 2 hours. The stock available is morphine
10mg in 1 ml. calculate the correct amount
a) 0.5ml
b) 0.6ml
c) 1 ml
d) 1.3ml
56. The doctor prescribes Frusemide (lasix) intravenously for Mr. Martin. What is the
action of Frusemide
a) Diuretic
b) Antiemetic
c) Analgesic
d) Bronchodilator
57. What side effects of Frusemide (lasix) should the nurse be aware of
a) Hypervolaemia
b) Hypovolaemia
c) Hypotension
d) Hypoventilation
58. The doctor prescribes heparin 7,500 i.u subcutaneous BID. The vial contains heparin
25,000 units/ml. what volume should be given s.c
a) 0.2ml
b) 0.3ml
c) 0.4ml
d) 0.7ml
59. What is the essential nursing action to take when caring for a patient who is having
heparin
a) Observe for signs of drowsiness
b) Watch for side effects of the drug
c) Record blood pressure and pulse 4 hourly
d) Monitor patient for signs of internal or external haemorrhage
60. Mrs Phillips is admitted to your ward in acute respiratory distress following an
asthmatic attack. In which position should the nurse place Mrs. Phillips to assist her
breathing
a) High fowlers
b) Semi fowlers
c) Orthopneic
d) Supine with pillows
61. Which signs would indicate your client may have

hypoxaemia a) Anxiety, restless and confusion
b) Cough, strong pulse rate, apprehension
c) Hypotension, alert, tachycardia
d) Hyperventilation, warm peripheries, alert
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62. Mrs Phillips is prescribed 1 litre of normal saline .9% over 6 hours. This is to be
delivered via a soluset which has a drop factor of 60. Calculate the correct drops per
minute
a) 100
b) 125
c) 167
d) 180
63. Mrs Maring was brought to an acute psychiatric unit by the police. She was found
wandering around the streets, incoherent, and her behaviour appeared to be
inappropriate. She was tentatively diagnosed as having schizophrenia. The nurse
knows that a diagnosis of schizophrenia implies that a patient would manifest which
of the following behaviours
a) Inability to concentrate
b) Loss of contact with reality
c) Guilt feelings
d) Feelings of worthlessness
64. Mrs Maring says that the voices are telling her to do things and she can’t stop
listening. The best response from the nurse would be
a) Never mind the voices; let’s just concentrate on the game
b) The voices will go away soon
c) I don’t hear any voices. I think the voices are part of your illness. Try to listen to
what I’m saying
d) Everyone hears voices at times
65. Mrs Maring after a two week stay, appears much better. She is in contact with reality
and is able to interact with others in an appropriate way. The doctor is sending her
home with medication. The most common medications given for schizophrenia are
a) ECT
b) Phenothiazines
c) MAO inhibitors
d) Antidepressants
66. A young Maori man dies, as a result of a motor bike accident. The doctor requests his
kidneys for a transplant. His whanau refuse. What is the most appropriate action of
the nurse in this situation
a) You accept the wishes of the whanau
b) You pressure the whanau to re consider
c) You seek permission from other whanau members
d) You support the doctor to over ride what the whanau wish to do
67. Mr H a 72 year old kaumatua (elder) is admitted to the medical ward with cellulitis
of his left leg. He is placed on strict bed rest. Because he is whakama (embarrassed)
he refuses to use a bedpan and demands to walk to the toilet. How should you deal
with this situation
a) Give him a bed pan anyway
b) Talk over the situation with him
c) Tell him to doctor has ordered bed rest
d) Ask the other patients to leave the room
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68. While assessing Mr. h you find his daughter answers all your questions for him. The
most culturally appropriate action is to
a) Question him privately when the daughter leaves
b) Send her out so Mr. h will answer on his own
c) Accept this as appropriate and continue the assessment
d) Ignore her as you need to have the information form Mr. H
69. The tohunga (healer) prescribes a specially prepared solution to be placed on Mr. H
legs. What is the most appropriate response in this situation
a) Get the doctor to talk to the tohunga
b) Refuse as it may be unhygienic and cause infection
c) Explain to Mr. h that medication from the doctor is more
acceptable d) Ensure both types of treatment may be combined to
assist Mr. h
70. Mr T aged 80 has had a right below knee amputation. As a Maori he wishes that his
amputated foot be returned to him. What is the cultural significance of this request
a) It is the appropriate action to do in Maori society today
b) Maori people prefer to keep all their body parts after surgery
c) Because of the spiritual links between Maori people and the land
d) Because he is worried about what the hospital will do with his foot
71. Following a cerebral vascular accident (stroke) Mr. M aged 80 is unconscious. Some
members of the whanau (extended family) wish to take him home. What is the most
appropriate action to take in this situation
a) Help and support the whanau appropriately
b) Tell them that Mr. h needs hospital care
c) Check to ensure they have enough whanau support
d) Ask if the whanau are capable of nursing him safely
72. A Maori manager 26 dies within 24 hours of admission in the A and E clinic in
which you work. His family wish to take him home immediately to prepare for his
tangi. He has not been certified dead by a doctor and because of his death within 24
hours, it becomes a coroner’s case. Your response to the whanau is
a) Forbid them to leave
b) Allow them to leave
c) Ask them under what circumstances he died
d) Ask them if they understood the process of certification and coroners proceedings
73. True labour can be differentiated from prodromal or false labour in that in true labour
there is a
a) Strengthening of uterine contractions with walking
b) Failure of presenting part to descend
c) Lack of cervical effacement or dilation
d) Cessation of uterine contractions with walking
74. First foetal movements felt by the mother are known as

a) Ballottement
b) Engagement
c) Lightening
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d) Quickening
75. Growth is most rapid during the phase of prenatal development known as
a) Implantation
b) First trimester
c) Second trimester
d) Third trimester
76. The chief function of progesterone is the

a) Establishing of secondary male sex characteristics
b) Rupturing of follicles for ovulation to occur
c) Development of female reproductive organs
d) Preparation of the uterus to receive a fertilised ovum
77. Mrs Green a 22 year old primigravida is attending prenatal clinic. Mrs Green is
concerned because she has read that nutrition during pregnancy is important for
proper growth and development of the baby. She wants to know something about the
foods she should eat. The nurse should
a) Give her a list of foods so she can better plan her
meals b) Assess what she eats by taking a diet history
c) Emphasise the importance of limiting salt and highly seasoned foods
d) Instruct her to continue eating a normal diet
78. Mrs Green states, I’m worried about gaining too much weight because I’ve heard it’s
bad for me. The nurse should respond
a) Yes, weight gain causes complications during pregnancy
b) Don’t worry about gaining weight. We are more concerned if you don’t gain
enough weight to ensure proper growth of your baby
c) The pattern of your weight gain will be of more importance than the total amount
d) If you gain over 7 kgs you’ll have to follow a low calorie diet
79. Immediate critical observation for apgar scoring includes

a) Respiratory rate
b) Heart rate
c) Presence of meconium
d) Evaluation of moro reflex
80. Which part of the hands is most affected in cases of primary irritant dermatitis
a) Between the fingers
b) Flexor aspects of the fingers
c) Medial aspects of the hands
d) Back of the hands
81. Why is this particular area of the hands most affected

a) Moisture tends to collect there
b) New cells are generated at a slower
rate c) Skin thickness is relatively thinner
d) Flora are more concentrated
82. The lesions of primary irritant dermatitis appear as tiny fluid filled elevations called
a) Vesicles
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b) Macules
c) Papulses
d) Nodules
83. The major form of treatment in the initial stage of contact dermatitis is the application
of
a) Wet compresses
b) Dry dressings
c) Topical antibiotics
d) Oil based medications
STATE EXAMS 12
1. Lucy is charted 5mls of augmentin 125 TDS. You notice the doctor hasn’t signed the
order form. A senior colleague tells you to give it. You respond by
a) Giving the medication as ordered
b) Contacting the doctor to sign the order
c) Asking Lucy if the doctor told her she would have this
d) Signing the form for the doctor
2. The augmentin is given to Lucy. She is found to be allergic when she exhibits
a) Tinnitus and vertigo
b) Wheezing and urticaria
c) Abdominal cramps and diarrhoea
d) Blurred vision and ataxia
3. Jack is 15 years old. He is admitted to the hospital after briefly losing consciousness
when tackled during a rugby game. Which of the following is an indication increasing
intracranial pressure
a) Change in his level of consciousness
b) Anorexia and thirst
c) Increased pulse and respiration rates
d) Blurred vision and halos around lights
4. Jack has had two seizures while hospitalised. These have been controlled by
anticonvulsant medications. Jack and his family must understand
a) The medication must be taken for at least one year
b) The doctor should be seen when the prescription has finished
c) The medication will be discontinued on discharge
5. Jack is prescribed rivotril 8 mgs daily. He weighs 68 kgs. The initial doses for 2-3
days should not exceed 0.01 mgs/kg/day. Your nursing responsibility is to
a) Observe for any side effects after giving the drug
b) Contact the doctor to reassess the dose prescribed
c) Consider his weight loss and administer the dose prescribed
d) Check with the charge nurse prior to administration
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6. Lucy Rogers, 5 years old, has had a recent upper respiratory tract infection. Now
she is febrile and complains of a painful left ear. Acute otitis media is diagnosed.
The typical appearance of the tympanic membrane in acute otitis media is
a) Red and bulging
b) Grey and concave
c) Yellow and retracted
d) Red and concave
7. Lucy’s symptoms may be relieved most effectively by

a) Warm
compresses b)
Paracetamol elixir
c) Ice packs
d) Warm olive oil drops
8. Children are more likely to develop acute otitis media from an upper respiratory
infection than adults because of their
a) Inadequate resistance to
infection b) Eustachian tubes size
and shape
c) Lack of acquired immunity to the causative organism
d) Increased susceptibility to colds
9. The organism most commonly responsible for acute otitis media is

a) Streptococcus pyogenes
b) Staphylococcus albus
c) Haemophilus influenza
d) Escherichia coli
10. Kevin aged 19 is admitted with an acute attack of asthma. During an asthmatic
attack, the reaction to excessive histamine release would be
1. Bronchospasm
2. Bronchodilation
3. Excessive mucous production
4. Production of I.G.E antibodies
a) 1,3 and 4
b) 1,3 and 5
c) 1,4 and 5
d) 2,3 and 4
11. The hypersensitive reaction in asthma is due to the

a) Antigen – antibody response
b) Antigen – histamine release
c) Inhalation of pollens
d) Release of histamine
12. Which of the following signs would a person admitted to hospital with an acute
attack of asthma present with
a) Dyspnea, tachycardia, anxiety
b) Dyspnea, bradycardia, frothy sputum
c) Tachycardia, chest pain, pallor
d) Increased anxiety, sweating, chest pain
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13. A primiparous woman, one day postpartum, calls the nurse into her room the
woman explains that while breastfeeding, she experienced uterine cramps and a
heavy gush that soaked through her pad to the bed. The nurse should
a) Palpate the woman’s fundus
b) Tell the woman that this often happens when breastfeeding
c) Administer PRN ergometrine medication
d) Assist the woman with perineal care and changing her pad
14. The lochia of the postpartum woman second day after birth should exhibit each of the
following except
a) Deep red and thick blood
b) A few large clots
c) Fleshy odour
d) Moderate amount – 15cm on pad after 1 hour
15. The risk for constipation in the postpartum period is related to all except
a) Tenderness of the episiotomy
b) Decreasing levels of oestrogen
c) Decreased abdominal muscle tone
d) Fear of pain and of ripping sutures during a bowel movement
16. Primary sites for postpartum infections would include all of the following except
a) Respiratory tract
b) Endometrium
c) Urinary tract
d) Breasts
17. When caring for a postpartum woman with a uterine infection the nurse should
a) Administer an antipyretic when the temperature rises above
37.5oC b) Provide at least 2000mls of fluid a day
c) Obtain specimens for cultures before initiating antibiotic treatment
d) Reassure the woman that future reproduction will not be affected
18. A definition of cor pulmonale is

a) L) sided heart failure secondary to disease of the lungs
b) L) sided heart failure secondary to R) sided heart
failure c) R) sided heart failure secondary to severe lung
disease
d) Disease of the lungs secondary to R) sided heart failure
19. The main function of alveoli is

a) Bacterial filtration
b) Exchange of gases
c) Conduction of gases
d) Pleural attachment
20. The patency of the trachea is maintained by

a) Incomplete rings of cartilage
b) Circular smooth muscle fibres
c) Thickly layered pseudo stratified epithelium
d) Elastic connective tissue
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21. Human milk is preferably to cow’s milk because
a) Human milk is a non laxative effect
b) Human milk has more calories per ml
c) Human milk is great mineral content
d) Human milk offers greater immunologic benefits
22. Which of the following neonates will most likely need additional respiratory
support at birth
a) The infant born by normal vaginal delivery
b) The infant born by caesarean birth
c) The infant born vaginally after 12 hours of labour
d) The infant born with high levels of surfactant
23. During the transition from foetal to neonatal circulation, the newborn cardiovascular
system accomplishes which of the following anatomic and physiologic alterations
1. Closure of the ductus venosus
2. Closure of the foramen ovale
3. Closure of the ductus arteriosis
4. Increased systemic pressure and decreased pulmonary artery
pressure
a) 1,2,3 and 4
b) 1,2 and 3
c) 2,3 and 4
d) 1,3 and 4
24. A woman diagnosed with marginal placenta praevia gave birth vaginally 15 minutes
ago. She is at greatest risk for
a) Haemorrhage
b) Infection
c) Urinary retention
d) Thrombophlebitis
25. The primary nursing focus of the fourth stage of labour would be to
a) Prevent infection
b) Facilitate newborn – parent interaction
c) Enhance maternal comfort and
rest d) Prevent haemorrhage and
shock
26. Which of the following results of emphysema is primarily responsible

for cardiomegaly
a) Hypertrophy of muscles encircling the bronchi
b) Increased pressure in the pulmonary circulation
c) Decreased number of circulating red blood cells
d) Secretion of excessive amounts of pericardial fluids
27. The tissue change most characteristic of emphysema is

a) Accumulation of pus in the pleural space
b) Constriction of capillaries by fibrous tissue
c) Filling of air passages by inflammatory coagulum
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d) Over-distention, inelasticity and rupture of alveoli
28. Which of the following positions is most comfortable for a person with emphysema
a) Lying flat in bed
b) Reclining on his/her left side
c) Sitting of the edge of the bed
d) Lying flat on their back (supine)
29. A person of the following factors commonly predisposes to emphysematous lung

changes
a) Chemical irritation of bronchiolar and alveolar linings
b) Sudden increase in intrapulmonary pressure coincident with hypertension
c) Obstruction of air passages by spasms of bronchiolar muscles
d) Senile degenerative changes in the vertebral bodies and intervertebral discs
30. Oxygen therapy is administered at low concentrations (below 35%), for people
with chronically elevated pCO2 levels, as for some people with chronic obstructive
respiratory disease, in order to prevent
a) Depression of the respiratory centre
b) Decrease in red blood cell formation
c) Rupture of emphysematous bullae
d) Excessive drying of respiratory mucosa
31. A newborns birth weight is 3400krms. The maximum expected weight loss for this
newborn would be
a) 170
grms b) 340
grms
c) 510 grms
d) 680 grms
32. The birth weight of a breast feed newborn was 3600 grms. On the third day
the newborns weight was 3350 grms. The nurse should
a) Encourage the mother to continue breast feeding as her baby’s nutrient and fluid
needs are being met
b) Suggest that the mother switch to bottle feeding as breastfeeding is ineffective
in meeting her baby’s needs
c) Notify the doctor as the baby has lost too much weight
d) Refer the mother to a lactation consultant to improve her breastfeeding technique
33. Which of the following would be an unexpected sign of dehydration in the

newborn a) Weight loss
b) Reduced turgor
c) Concentrated urine
d) Decreased frequency and amount of urine
34. The nurse would recognise that a new mother understood breastfeeding instructions
when she explains
a) I feed my baby every two hours around the clock
b) I always start feeding on my right breast, as my baby feeds best on that breast
c) I use both the football and the traditional positions for feeding
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d) I let my baby continue to suck for a while on the second breast once its empty
35. Which of the following actions of a breastfeeding mother indicate the need for
further instruction
a) Holds breast with four fingers along the bottom and thumb at the top
b) Leans forward to bring breast towards the baby
c) Stimulates the rooting reflex than inserts nipple and areola into newborns open
mouth
d) Puts her finger into newborns mouth before removing breast
36. Characteristically, respirations of the client in diabetic acidosis are

a) Shallow and irregular
b) Uneven in rate and depth
c) Deep, rapid, with acetone breath, (kussmaul)
d) Rapid and shallow
37. The most important feature of foot care for a diabetic would be to
a) Cut nails straight across
c) Wear sandals at all times
d) Avoid wearing garters
38. Excessive thirst for people with diabetes mellitus is a result of

a) Need for increased amounts of water to hydrolyse food during
digestion b) Loss of excessive body water due to increased daily urine
volume
c) Reflex adaption to a sustained elevation of body temperature
d) Compensatory adjustment to decreased production of posterior pituitary hormone
39. For people with diabetes mellitus polyuria is the result of

a) Increased glomerular permeability due to generalized vascular damage
b) Increased glomerular filtration due to decreased serum albumin concentration
c) Increased volume of glomerular filtrate due to elevated blood
pressure d) Decreased water resorption due to high tubular osmotic
pressure
40. A normal CBG (capillary blood glucose) reading is within the range of
a) 1-5 mmol/L
b) 4-7 mmol/L
c) 6-12 mmol/L
d) 3-10 mmol/L
41. The foetal presenting part is described as vertex when the

a) Face enters the pelvis first
b) Buttocks emerge with legs extended over the abdomen
c) Flexed head enters pelvis first
d) Foetal lie is longitudinal
42. When examining the umbilical cord immediately after birth the nurse should expect to
observe
a) One artery
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b) Two veins
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c) Whitish grey colouration
d) Slight odour
43. Vitamin K is given to the newborn to

a) Reduce bilirubin levels
b) Increase the production of red blood cells
c) Stimulate the formation of surfactant
d) Enhance the ability of the blood to clot
44. The nurse is performing a 5 minute apgar on a newborn. Which of the

following observations is included in the apgar score
a) Blood pressure
b) Temperature
c) Muscle tone
d) Weight
45. At birth the major cause of heat loss is by

a) Evaporation
b) Radiation
c) Conduction
d) Convection
46. The newborn would respond most effectively to feeding in which state
a) Drowsy
b) Quiet alert
c) Active
alert d) Crying
47. A pregnant woman at 30 weeks gestation exhibits a rise in her baseline systolic blood
pressure of 32mmHg, a weight gain of 4 kgs since last week and difficulty removing
rings she normally wears. This is suggestive of
a) Gestational
hypertension b) Pre
eclampsia
c) Eclampsia
d) Elevated liver enzymes
48. The primary pathophysiologic basis for the clinical manifestations of pregnancy
induced hypertension (PIH) is
a) Fluid retention related to excessive salt intake
b) Ineffective excretion of fluid by the kidneys
c) Cardiac decompensation
d) Ineffective dilatation of the vascular network to accommodate the expanding
blood volume of pregnancy
49. Which measure would be least effective in relieving the signs and symptoms of mild
pre eclampsia
a) Low salt diet
b) Period of bed rest
c) Balanced diet with protein
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d) Relaxation techniques
50. A woman with severe pre eclampsia is being monitored for assessment findings
indicative of cerebral oedema and venospasm. Which of the following would you
not expect to find
a) Hypotonic deep tendon reflexes
b) Headache
c) Vision changes including blurring and spots before the eyes
d) Insomnia
51. Newly expectant parents, ask the nurse how they can prepare their 3yr old preschool
daughter for the new baby. All of the following would be useful except
a) Tell the child about the pregnancy as soon as mother begins to look pregnant
b) Arrange for a few sleep overs with the person who will care for the child at the
time of the birth
c) Transfer their child to her new room and bed just before the expected birth of the
baby
d) Introduce their child to preschool as soon as possible
52. A patient with a diagnosis of schizophrenia says to the nurse ‘I’m like a fallen star.
But I won’t go to the bar… it would be mar on my family, on the tar’. This is an
example of
a) A loose association
b) A delusion
c) Word salad
d) Clang association
53. A person diagnosed with schizophrenia tells the nurse that ‘the voices have told me
I’m in danger’. He stays in his room, wears the same clothes, and avoids cracks on the
floor. The nurses best initial response to this information is
a) I know that these voices are real to you, but I don’t hear them
b) Don’t worry, you’re safe here. I won’t let anything happen to you
c) You need to get out of your room and get your mind occupied
d) Would you like some p.r.n medication
54. Mr P a new client on the ward, allows himself to be escorted to the day room.
However he does not speak in response to you. The most therapeutic nursing
intervention is to
a) Ignore his silence and talk about superficial topics such as the weather
b) Involve him in group psychotherapy so other patients can encourage him to talk
c) Point out that he is making others uncomfortable with his silences
d) Plan time to spend with him, in silence, if that is his choice
55. In communicating with a client experiencing delusions, what is it best to do
a) Logically explain the delusions
b) Tell the client that they aren’t real
c) Acknowledge his belief, but state your own understanding
d) Ignore this topic when it is brought up
56. Mr P is prescribed Clozapine tablets, initially at 50mg mane and 100 mg nocte. What
is the most likely side effect that will be first noted
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a) Neutropenia
b) Akathesia
c) Sedation
d) Agranulycytocis
57. On discharge what is the most important piece of information you must give to Mr. p
a) Report any flu like symptoms immediately
b) Ensure no doses of clozapine are missed
c) Don’t take clozapine with alcohol
d) Visit your GP regularly
58. Which of the following represents a positive change of pregnancy

a) Morning sickness
b) Quickening
c) Positive pregnancy test
d) Foetal heart beat auscultated with Doppler
59. Which of the following statements can be used as a guideline for planning diets
during pregnancy
a) A increase of 300 calories per day beginning in the first trimester
b) A ten percent increase in protein above daily requirements
c) Iron supplementation is recommended for women whose diets are lacking in iron
d) The requirement for folic acid is increased by 50 percent
60. In order to percent infection of hepatitis B virus, the pregnant woman should
a) Receive gamma globulin during the first trimester
b) Carefully wash hands before eating or preparing
food c) Receive the hepatitis B vaccine
d) Take AZT during the second and third trimester
61. Which of the following represents a recommended weight gain during pregnancy
a) 6-11 kgs
b) 11-16 kgs
c) 13-18 kgs
d) 18-20 kgs
62. John’s behaviour are increasingly annoying to other patients. The best nursing
approach is to
a) Explain that he must try to conserve his energy
b) Set limits on his behaviours and be consistent in approach
c) Tell him he is annoying to others and ask him to stay in his room
d) Ask him to walk to town to burn off energy
63. John also has been described as having flight of ideas. These would be likely
present when john
a) Asks for a cup of tea, but tells you later he doesn’t want it
b) Takes a long time to make his point in conversation
c) Rapidly changes topic in conversation, sometimes without apparent connection
d) Speaks in a staccato voice and says words you don’t understand
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64. John has been prescribed chlorpromazine (largactil) tablets 150mg nocte since being
on the ward. The most likely reason for this is to
a) Cause a deep dreamless sleep
b) To reduce agitation, anxiety and tension
c) To reduce external stimuli
d) To prevent long term mood swings
65. John tells you he feels faint when he first gets out of bed, since taking the largactil.
Which response would best assist john
a) Tell him not to get until the nurse is present
b) Suggest he does not get up until he has taken the medication
c) Tell him to discuss this with the doctor
d) Explain he should sit on the bed for a time before standing
66. John has also taking lithium carbonate capsules. Creatinine clearance tests
ordered during lithium carbonate therapy determines the functioning of the
a) Liver
b) Pancreas
c) Renal system
d) Thyroid gland
67. Mihi means traditional greetings and is normally extended to

1. The land
2. The meeting house
3. The dead
4. The people present
5. The reason for the hui
a) 1,2 and 5
b) 1,3 and 4
c) 2,3 and 4
d) All of the above
68. The internal migration of Maori people from rural to urban life since the mid 1940s
has adversely affected Maori health. What is the most likely reason for this
a) Overcrowding within urban communities
b) Increased exposure to infectious diseases
c) Dietary changes from naturally produced to processed
food d) Loss of cultural, social, and spiritual ties
69. Maori communities are encouraging Maori to be involved in health research with their
own people. What is the most likely reason for this
a) That ownership of the information will remain with Maori
b) Previously there has been little feedback which has been useful to Maori
c) Non Maori promote themselves on Maori research
d) Non Maori researchers are unaware of Maori values
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70. Which of the following interventions would be most helpful for David in dealing with
his impending death
a) Distract him by initiating conversation that does not deal with his disease
b) Encourage him to reach out and spend more time with his wife and children
c) Listen and encourage David to reminisce about his life
d) Help him to spend much of his time sleeping
71. David tells the nurse, that he does not want his wife and children to know that his is
dying. What would be the most helpful response
a) They would not want you to upset yourself by worrying about
them b) You are concerned that they will be distressed
c) I think we should talk about something less stressful for you
d) Sit quietly and say nothing
72. Which of the following interventions is the most effective in helping David’s wife and
children deal with David’s impending death
a) Try to keep all the family at the same stage in the grieving process
b) Encourage the family to verbalise their grief to the nurse
c) Encourage the family to spend as much time as possible with David
d) Encourage the family to cry but not in the presence of David
73. Your client has cancer, nobody can tell him until his surgeon arrives from 5
days away. However in the meantime his anxiety is increasing. What should you
do
a) Contact a social worker/chaplain to spend time with him
b) Give him relaxation tapes to listen to
c) Tell him his results are not back yet
d) Speak with the doctor who is acting in the surgeons place
74. Your patient, who is a voluntary admission to a mental health unit, leaves the
following day without telling anyone. Legally, what is required to staff
a) Provide care for him at home
b) Re admit him under a compulsory order
c) Get police to bring him in to sign a statement
d) Do nothing, the patient has rights to leave health care at any time
75. Pepe a 26 year old, developmentally delayed Maori man, who at aged two years
contracted meningitis. He has been cared for in an institution, and is now to be moved
to the community. Pepe is able to live in the community. What action should be taken
now
a) Ring his whanau to advise them of his discharge
b) Ask the social worker to tell the family Pepe is to be discharged
c) Arrange for Pepe to visit with his whanau
d) Organise a conference with the whanau
76. What statement would best describe your next action

a) Organise regular meetings between nursing staff and whanau prior to discharge
b) Support Pepe's whanau in being able to visit and to be involved in his discharge
planning
c) Invite the whanau in to explain what will be required of them in caring for Pepe
d) Make sure the whanau understand Pepe limitations in self care
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77. Pepe has been discharged to a marae based community house. How would you
ensure his continued well being
a) Set up regular appointments to monitor Pepe’s well being
b) Explain to the community workers Pepe’s requirements
c) Arrange for Pepe to attend the local sheltered workshop
d) Ensure Pepe and his whanau have ongoing support and access to resources
78. Blake a 65 year old kaumatua (elder) is admitted with urinary retention. He is quiet
and appears withdrawn. Blake’s whanau arrived. A female doctor tells them he needs
a urinary catheter inserted. Blake’s son refuses to have a young woman doctor
catheterise his father. What is your most appropriate response
a) Let us talk about this together
b) I will contact the Maori support person for you
c) I will inform the doctor of your decision
d) Tell him that this is the only doctor available
79. Blake falls in the shower sustaining a laceration to his right elbow. His family
are angry and upset. What is the most appropriate action to take in this situation
a) Enquire of the whanau if Blake has had previous falls
b) Offer for them to take to the doctor
c) Acknowledge their anger and discuss ways to prevent further falls
d) Acknowledge their anger and ensure the whanau it will not happen again
80. Charlie a 62 year old who identifies as Maori is admitted to your ward with shortness
of breath. He is very anxious and has no family with him. What is the most
appropriate initial action to take
a) Introduce Charlie to others in the room
b) Telephone his whanau to come and visit
c) Carry out a physical assessment on Charlie
d) Acknowledge Charlie’s anxiety and ask how you can help
81. Iris condition deteriorates and she dies. What is the most appropriate nursing action to
help the whanau
a) Ensure privacy for the family to have karakia (prayers)
b) Allow a spokesperson to contact the rest of the family
c) Move iris body to a side room
d) Offer the whanau to go to a quiet room for a cup of tea
82. The doctor asks the whanau for the corneas of iris for transplantation. The
whanau cannot make a decision right now. What is the most appropriate action
you should take in support of the whanau
a) Tell the doctor that this is not culturally appropriate
b) Listen to them and support them in their decision
c) Explain to the whanau why corneas are transplanted
d) Suggest the whanau talk to the hospital chaplain
83. Stanley progresses well. His chest tube is removed. He still does not have much of
an appetite and is concerned about his diet. Which of these responses would be of
help
a) Eat three large meals a day that are high in carbohydrates
b) Eat three large meals a day that are high in protein
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c) Eat six small meals a day that are high in carbohydrates
d) Eat six small meals a day that are high in protein
84. Select the most appropriate nursing intervention to assist. Stanley to mobilise without
becoming breathless
1. Gradually increase mobility
2. Assess respiratory function related to mobility
3. Administer oxygen prior to mobilising
4. Increase time up by 10 minutes per day
5. Continually assess respiratory function
a) 1 and 5
b) 4 and 5
c) 1 and 2
d) 3 and 5
85. Tom a 38 year old businessman, voluntarily admits himself to a detoxification unit.
He admits to drinking one large bottle of vodka each day. Which of the following
ego defence mechanisms is a top and continuing priory in dealing with alcoholic
clients
a) Dependency
b) Denial
c) Paranoia
d) Projection
86. Of the following approaches to the treatment of alcoholism, which has been found
to be the most effective to date
a) Membership in alcoholics anonymous
b) Family systems approach
c) Treatment alcoholism as a chronic disease
d) Individual psychotherapy
STATE EXAMS 13
1. Mr quang duc pho 65 years old is admitted to hospital after arriving with a group of
boat people from Vietnam. On the basis of the results of a Mantou’s test, chest x ray
examination, and sputum cultures a diagnosis of active pulmonary tuberculosis is
made. The most appropriate area in which to nurse Mr. quang on admission is
a) A single room, isolated from all other patients
b) The general male ward
c) Among other patients with infectious disease
d) With other male Vietnamese refugees
2. The nurse evaluates Mr. quangs Mantoux test as positive by the presence of
a) A small red swelling less than 7mm in
diameter b) An erythematous area greater than
7mm
c) Swelling and erythema together measuring between 7mm and 9mm
d) A lump greater than 7mm in diameter
3. On Mr. quangs chest x ray film a lesion is observed in an upper lobe. Why is this
area of the lung most commonly affected in tuberculosis
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a) There is an slightly higher oxygen concentration in the upper lobes
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b) Sputum collects more readily in upper lobes than in lower lobes
c) Upper lobes are less easily ventilated than are lower lobes
d) Tubercule bacilli are less dense than air and therefore remain in the upper lobes
4. Which of the following precautions must the nurse take when attending routinely
to Mr. quang
a) Put on a gown, mask and gloves
b) Wash hands thoroughly after handling contaminated articles
c) Wear a mask when in close proximity to him
d) Insist that he wear a mask when care is given
5. Mr quang tuberculosis is considered to be under control when

a) He becomes Mantoux negative
b) His chest x ray film is free of any lesion
c) He has three consecutive negative sputum cultures
d) His symptoms of tuberculosis have subsided
6. Quangs chemotherapy regime includes the drugs ethambutol, riampicin. What is the
rationale for prescribing triple therapy for Mr. quang
a) The combination of three drugs is necessary to destroy the tubercule bacillus
b) If there is resistance to one drug, effective double therapy is assured
c) High serum levels of the drugs are achieved early in the treatment
d) The Asian strain of tuberculosis is particularly resistant the chemotherapy
7. Mr quangs daily ethambutol dosage is based on 25mg per kg of body weight. Given
that he weighs 48kg and ethambutol is dispensed in 400mg tables, how many
tablets should the nurse administer
a) Two
b) Three
c) Four
d) Five
8. Which of the following symptoms are associated with ethambutol toxicity

a) Nausea and vomiting
b) Vertigo and ataxia
c) Blurred vision and colour blindness
d) Tinnitus and hearing loss
9. Mr quangs is concerned because his urine has changed to an orange red colour. The
most appropriate response is
a) This is a usual side effect of one of your tablets
b) Ill test your urine to see if there is blood present
c) This is a desired effect of your treatment
d) The drug which is causing this will be discontinued
10. The most likely reason streptomycin is not prescribed for Mr. quang is because
a) Streptomycin is no longer considered an effective antituberculosis drug
b) His age puts him at risk for developing eighth cranial nerve damage
c) The drug is extremely potent and should be reserved for resistant strains
of tuberculosis
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d) His low bodyweight could predispose him to loss of visual acuity
11. For how long will Mr. quang need treatment

a) Until he leaves the hospital
b) For 18 months
c) Until all tests are negative
d) For two years
12. One of Mr. quangs cousins in Mantoux negative. Evaluate this finding
a) No evidence of tuberculosis
b) A subclinical case of tuberculosis
c) Inactive tuberculosis
d) Possible military tuberculosis
13. Given his negative Mantoux reaction what is the appropriate action for Mr. quangs
cousin
a) Discharge from hospital
b) No treatment is necessary
c) Commence triple therapy
d) Chest examination by x ray
14. On commencing night duty it is noted that the other staff member on duty smells
strongly of alcohol and does not appear to be in a fit state to be on duty. What action
should be taken
a) Report the incident to nursing council
b) Make some strong coffee for him/her to counteract the alcohol
c) Ignore the situation as the alcohol was not drunk when on duty
d) Report the incident, as soon as possible, to a senior nurse on duty
15. You are working on a ward where several staff members complain about carrying
another nurses workload. As a colleague, you have professional responsibility to
a) Tell them to do their own work and not be concerned with others
b) Suggest they speak to the nurse concerned in order to negotiate the workload
c) Talk to the nurse and encourage her to try some other form of work
d) Tell them to sort it out between themselves without involving other people
16. The NZNA standards for nursing practice were developed to

a) Provide outcome criteria for the evaluation of nursing practice
b) Provide a framework for standardised nursing care
c) Promote the development of a theory for nursing
d) Define the scope of nursing practice
17. Mrs Fitzpatrick, a client in a ward opposite Chris, asks the nurse ‘what is wrong with
that person opposite me’? what should the nurse say
a) I do not know
b) Oh nothing, she just wanted to talk about some problems she is having
c) I’ll get the doctor to talk to you
d) I’m sorry I cannot disclose that information
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18. Chris says he wants to discharge herself and go home. Which of the following is
the best nursing response
a) I will ask the doctor to talk with you
b) It would be very unsafe for you to leave hospital without proper medical
treatment c) Can we walk about what is worrying you
d) If that’s what you have decided I will get a self discharge form
19. Larry and Mary smith had planned their first pregnancy for some time, but when it is
confirmed, Mary feels conflicting emotions. She comes to the clinic for her first
prenatal (antenatal) visit at ten weeks gestation. Mary shares her mixed feelings
about the pregnancy with the midwife. The midwifes best response would be to
a) Encourage her to consider abortion counselling
b) Encourage her to seek support from Larry
c) Reassure her that when she feels the baby move, her mixed feelings will
disappear completely
d) Reassure her that most women experience some mixed feelings in early pregnancy,
even when their pregnancies are planned
20. Marys last menstrual period was 11 April. Her EDD (expected date of delivery)
would be
a) 4 January
b) 18 January
c) 25 January
d) 4 February
21. During a subsequent visit, Mary states she has begun to feel foetal movement. Foetal
movement is usually felt by the pregnant woman when the foetus is approximately
a) 12 weeks
gestation b) 16 weeks
gestation
c) 22 weeks gestation
d) 26 weeks gestation
22. Tui k is 22 years old and has missed two of her regular menstrual periods. Her
doctor confirms she is pregnant. This is her first pregnancy. Tui can expect to
experience all the following signs in the early stages of her pregnancy except
a) Chadwick’s sign
b) Goodells sign
c) Humans sign
d) Frequency of micturition
23. During tuis sixth week of pregnancy she experienced a small episode of vaginal
bleeding. You should suspect
a) Placenta previa
b) Urinary tract infection
c) Threatened abortion
d) Abruption placenta
24. Tui asks for advice on diet. Which of the following is the best approach
a) Give her a list of the five basic food groups and tell her to include them in her
daily intake
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b) Tell her to increase her caloric intake so she gains about 12 kg during
the pregnancy
c) Take a diet history that includes socio economic status, previous nutritional status
and food preferences
d) Take a diet history, analyse it and say what foods she must now omit
25. Tui and her partner hawea, attend antenatal classes together. One of the topics
discussed are danger signs of pregnancy. Which of the following is normal and not a
danger sign
a) Regular contractions occurring before the due date
b) Vaginal changes, including leucorrhoea
c) A sudden change in foetal activity patterns
d) Any bleeding from the vagina
26. At 34 weeks gestation, Mary is hospitalised with severe HOP (hypertension, oedema,
and proteinuria) syndrome. Which of the following represents an unusual finding for
this condition
a) Blood pressure 150/100
b) Large amount of protein in the urine
c) Convulsions
d) Generalised oedema
27. Candice meeker is expecting her first baby. Candice is interested in having an
independent midwife deliver her baby. The certified midwife is licensed to
a) Manage the care of women throughout the childbearing cycle
b) Manage the care of women only during the intrapartal period
c) Manage the care of women throughout the childbearing cycle under
direct supervision of a GP
d) Contract with a GP to do their prenatal care
28. John is timing the frequency of candices contractions. This means he is timing
a) From the end of one contraction to the beginning of the next
b) From the beginning of one contraction to the beginning of the next
c) From the beginning of one contraction until it begins to go away
d) From the beginning of one contraction until it is completely over
29. Neil grant, six months old, is admitted to the children’s ward with severe dehydration
due to vomiting and diarrhoea, IV fluids are commenced. One of the dangers of IV
therapy is overhydration. This could lead to
a) Infiltration
b) Kidney failure
c) Rupture of the bladder
d) Pulmonary oedema
30. Neil’s blood pressure is very low. You realise that a low blood pressure is expected
because
a) Neil has been vomiting
b) He has been receiving IV therapy
c) He has an elevated temperature
d) His circulating blood volume is low
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31. Patty ray 6 years old, is admitted to the children’s ward with a diagnosis of
cystic fibrosis. Postural drainage is ordered for patty. Postural drainage consists
of
a) Chest percussion, and vibration
b) Retraining techniques, allowing patty to be more active
c) Chest percussion and positioning to drain and remove secretions from patty’s
lungs
d) Providing patty with exercises that will assist her to control breathing and
prevent dyspnoea
32. The most important nursing intervention in giving daily care to patty is
a) Forcing her to eat because she is malnourished
b) Seeing she receives the appropriate dietary regime
c) Frequent skin care to remove excessive salt deposits from increased perspiration
d) Having her repress her feelings of anger
33. Patty spends a lot of time in the play room. What does make believe play in hospital
provide for a child
a) Ability to accept a parent substitute
b) opportunity to learn to know other children more quickly
c) opportunity to reject the reality of the
hospital d) opportunity to express fears
34. you are teaching patty’s parents how to care for her at home. Which of the following
do you include
a) regular medication dosage according to urine testing
b) use cough suppressant only at
bedtime c) do postural drainage three
times a day
d) restrict her activities
35. while working in the children’s ward, the staff nurse asks you the following questions
relating to legal issues. How would you reply. When may a child be treated without
parental consent
a) if they require treatment
b) if they need a blood transfusion
c) in the emergency care situation
d) in the absence of a parent or guardian
36. under what circumstances must permission from the court be sought to treat a minor
a) when the parent or guardian refuses treatment
b) in the case of parental absence, abandonment or incompetence
c) when the minor is seriously injured
d) in the case of parental separation
37. you are working with the public health nurse in a rural area. A mother attends the
children’s clinic asking for information regarding an outbreak of chicken pox in the
area. You advise
a) that the effects of chicken pox on the child are minimal and the child’s schooling
will not be affected
b) that an immunisation is available for chicken pox for all children at 18 months
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of age
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c) that chicken pox is a notifiable disease and the child must be seen by a
general practitioner if you suspect this condition
d) that chicken pox is a contagious viral disease which can be transmitted by
direct contact with skin lesions
38. later that morning, Joan smith phones to tell you that her 18 month old son, Jared, has
been diagnosed with whooping cough. Joan asks you what she can do for Jared. You
suggest
a) regular fluids and increased food intake
b) continue as normal and encourage activity
c) humidified air, regular fluids and rest
d) isolate from other adults and rest
39. Matthew, is nursed at rest with the head of the bed elevated to 30 degrees as directed.
The purpose of this is to
a) prevent Mathew developing skin abrasions from shifting and turning in the
bed b) prevent Mathew from developing complications such as a DVT and chest
infection
c) assisting Mathew to see and have conversations with the other patients in his
cubicle
d) assisting in reducing any cerebral oedema Mathew may have and improving
venous drainage from his head
40. your assessment of Matthew shows a widening pulse pressure. The term pulse
pressure refers to
a) the difference between a bounding and or thread pulse
b) the difference between a bounding and thread pulse rate
c) the difference between diastolic and systolic blood pressure
d) the difference between diastolic blood pressure and pulse rate
41. Jacksons fracture is immobilised by open reduction and internal fixation. A nurse,
new to the orthopaedic area asks you to explain what is meant by open reduction
and internal fixation. You reply
a) bringing both bone ends into alignment by surgical intervention and holding them
in position with a metal plate and screws
b) bringing bone ends into alignment by external manipulation and holding them in
position with a Steinman pin and traction
c) bringing bone ends into alignment by external manipulation and holding them in
position by an external fixating device
d) bringing bone ends into alignment by surgical intervention and holding them in
position by a tight back slab and firm bandage
42. you are on duty in the surgical ward of a small rural hospital when James dickey aged
30 is admitted with a crush injury to his right arm. On arrival James arm is wrapped in
a blood soaked towel, but he hasn’t received any other first aid. As you do your initial
assessment you note James has extensive soft tissue damage which includes a 15cm
laceration, a large haematoma and severe bruising. James becomes very agitated at the
sight of the haematoma and asks you to explain it. You reply
a) it was caused by splintering of underlying bone at the time of injury
b) it was caused by muscle spasm occurring at the time of injury
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c) it was caused by blood vessels bleeding into the soft tissue at the time of injury
d) it was caused by the tearing of subcutaneous tissue at the time of injury
43. while treating James wound the doctor becomes aware that it will require extensive
debridement before good healing will occur. The term debridement means to
a) irrigate the wound to remove blood clots
b) cauterize all bleeding points and wash out blood clots
c) tie off blood vessels and nerves deep in the wound
d) cut away all damage and necrotic tissue and remove and foreign material
44. due to the nature of James wound prophylactic IV antibiotics and intravenous therapy
is to be commenced. The doctor prescribes a litre of dextrose/saline over 8 hours. The
giving set you use has a drop factor of 60 drops/ml. Which of the following flow rates
will ensure James receives the IV fluid within the correct time frame
a) 115
b) 125
c) 135
d) 145
45. As James waits to be transferred to theatre you note his bleeding is increasing and
you monitor him more closely. What changes to his vital signs would you expect to
see if his blood loss becomes excessive
a) Slowing of pulse rate, increasing blood pressure, elevated temperature
b) Increasing pulse rate, stable blood pressure, elevated temperature
c) Stable pulse rate, dropping blood pressure, normal temperature
d) Increasing pulse rate, dropping blood pressure, normal temperature
46. James is becoming shocked in this instance. What type of shock will this be
a) Neurogenic shock
b) Hypovolemic shock
c) Septic shock
d) Cardiogenic shock
47. Physiological compensation by the body in this type of shock will include all of the
following except
a) Vasoconstriction of the capillary beds
b) Increased pumping efficiency of the heart
c) Fluid shift extra cellular to intravascular
d) Increased sodium excretion of sodium by the kidneys
48. Henare is a 25 year old man admitted for emergency surgery, he has a left inguinal
hernia which is nonreducible. This means that he has
a) A weakness in the abdominal wall opening through which the spermatic cord
emerges
b) A hernia sac which does not return to the abdominal cavity as a result of swelling
c) Abdominal content, usually omentum or intestine descending into the groin or
scrotum creating a mass
d) A direct inguinal hernia resulting from bowel and bladder content passing through
the posterior inguinal wall
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49. Pat is a 20 year old woman with a diagnosis of PID (pelvic inflammatory disease).
Her nursing assessment includes temperature 38.4c, moderate lower abdominal pain,
and an offensive vaginal discharge. Nursing interventions for pats care would include
a) Bed and chair rest with legs elevated
b) Monitor temperature and pulse twice daily
c) Nurse at rest in a semi fowlers position
d) Monitor blood pressure three times a day
50. Pat asks you is it true that some STDs can cause cervical cancer. Your answer would
be
a) Recent research strongly, suggests that both genital warts and genital herpes may
cause cervical cancer
b) Yes all the STDs are capable of causing cervical cancer
c) Any woman who has multiple partners has a high risk of developing
cervical cancer
d) Yes but only those who have the genital herpes virus
51. Nina is 33 years old, she has had rheumatoid arthritis for the last five years, and is
currently suffering from an exacerbation of her disease. You are visiting Nina with the
district nurse. Although Nina is troubled with pain, she is most worried about caring
for her 8 month old son and her home. Nina and the nurse establish a plan to manage
Nina's pain which is related to joint inflammation. Which of the following strategies
will provide relief for her
a) Applying warm, moist compresses 30 minutes before doing house hold activities
requiring hand and finger movements
b) Taking salicylates after activity to decrease the inflammation caused by activity
c) Loosing 5 kg to limit stress placed on joints
d) Applying cold compresses after activities to numb the pain if it does occur
52. Which is the correct statement about rheumatoid arthritis? This disease
a) Affects both men and women equally
b) Mainly affects the larger weight bearing joints
c) Is a systemic disease with multiple joint involvement
d) Never occurs in children
53. Mrs Mary brown, aged 34 years, has had abdominal surgery. 24 hours later she
complains of pain in her left calf. Your first action should be to
a) Palpate the calf to note tenderness or pain
b) Check Mrs. browns pedal pulses
c) Ask Mrs. brown to extend her leg and dorsi flex her foot and note if this causes
pain
d) Measure the circumference of the right and left calves and note the difference
54. Compartment syndrome is a possible complication of fractures. Which assessment

data should the nurse report immediately
a) Increasing pain out of proportion to the sustained injury
b) Capillary refill which takes two seconds
c) Parathesia which decreases with movement of the affected part
d) Mild oedema of the affected limb
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55. Mrs skinner has a blood transfusion in progress following hip replacement .her
blood group is a. This means that in an emergency she could receive blood from
a) Any other group
b) Any group except b
c) Group A only
d) Group A and O only
56. Twelve hours after the operation Mrs. skinner started shivering and complaining of
pain in her back. Her pulse was very rapid. In these circumstances which one of
the following should the nurse do first
a) Take her temperature
b) Give her an extra blanket
c) Send for medical aid
d) Stop the blood transfusion
57. The most probable explanation for Mrs. skinners symptoms is

a) Infection of the urinary tract
b) Reaction to the anaesthetic
c) An allergic reaction to the blood transfusion
d) An allergic reaction to the metal prosthesis
58. John an 18 year old student, has been assigned to your care. He is jaundiced and his
clinical appearance suggests that he has hepatitis a. Hepatitis a is an inflammatory
condition of the liver caused by
a) Auto immune processes following a viral
infection b) a virus which infects the person via the
GI system
c) a virus which is only transmitted via contaminated blood products
d) a virus which is mainly transmitted by sharing needles
59. following a bout of hepatitis A most people can expect
a) to become a carrier
b) frequent relapses
c) lifelong immunity to hepatitis A
d) increased risk of liver cancer
60. the jaundice in hepatitis a is best described a

a) haemolytic
b) bilio static
c) obstructive
d) hepato cellular
61. the incubation period is

a) less than 10 days
b) 5-15 days
c) 15-50 days
d) 40-60 days
62. Smoking is bad for people with chronic respiratory disorders because cigarette
smoke a) Destroys the cilia which cleanse debris from the airways
b) Inhibit s the inspiratory centres in the central nervous system
c) Inhibit nerves involved in the reflex pathways involved in coughing
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d) Prevents the vocal cords closing tightly together when swallowing
63. One reason why smokers with chronic respiratory problems should not be
given medications that inhibit the cough reflex, as
a) These medications dry up mucous and make secretions difficult to expel
b) The hypoxic drive is inhibited causing a slow in breathing rate
c) Coughing is their only means of preventing mucous accumulating in the lungs
d) In people with chronic problems these medications have no effect anyway
64. Asthma is a disorder primarily characterised by

a) Hyperinflation and over expansion of lung tissue
b) Spastic constriction of the respiratory airways
c) A breakdown in the walls of alveolar tissue
d) Chronic dilation and expansion of the airways
65. During acute asthmatic attacks theophylline medications are given because they
a) Stimulate the inspiratory centre
b) Raise the blood PO2 levels
c) Hyperinflate the lung
d) Dilate the bronchioles
66. Aminophylline comes in ampoules of 250mgs in 10mls. How much in mls, would
you draw up to obtain 300mgs
a) 8.3
b) 12.0
c) 83.0
d) 120.0
67. In the early stages of obstruction to urine flow, symptoms which a client with an
enlarged prostate gland might experience include
a) Difficulty in emptying his bladder and Haematuria
b) Foul smelling urine with a high bacteria count
c) Complete retention of urine and dribbling
d) Frequency, urgency, a poor stream and nocturia
68. A client is prescribed 1 litre of dextrose/saline to be given over 3 hours. If the IV

giving set has a drop factor of 15 drops per ml, which of the following, in drops
per minute, gives the correct rate
a) 17
b) 33
c) 67
d) 83
69. Your client states that she is most unhappy with the care she is receiving from her
doctor and wishes to change doctors. You respond
a) Would you like to talk to me about why you are unhappy with your care – I may
be able to help
b) Okay should be no problem, it’s your choice after all
c) I don’t think that’s a good idea – it can glad to the doctor becoming annoyed
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d) Hospital policy does not allow for you to make a choice of doctor but would
you like to talk to me about your concerns
70. Jenny is 22 years old and has been admitted under section 8 of the mental health
act (1992). This period of assessment of jenny is for
a) 14 days
b) 6 months
c) 7 days
d) 5 days
71. Jenny feels frightened and is obviously psychotic. She feels persecuted and
has paranoid delusions that we will harm her. Delusions, like this are
a) False ideas that are entrenched and permanent
b) Fixed, false beliefs that do not respond to reasoning
c) Transitory fantasies which diminish with medication
d) Illogical ideas which can be reasoned and explained to her
72. Jenny’s family tell you that they feel frightened when she talks about people who
are going to harm her. They ask you what they should say. A therapeutic response to
the family would be
a) Talk about something else and distract Jenny's attention
b) Identify that you know she is really going to be harmed
c) Identify with how she is feeling and state what you see as reality
d) Tell them to ignore the comments and respond positively to jenny
73. Jenny has been commenced on chlorpromazine medication and has been sitting
outdoors. She complains of sunburn and you note how reddened her skin seems. As
a nurse you are aware that his is due to
a) Ultraviolet light and the fairness of Jenny’s skin
b) A skin reaction to the medication jenny commenced
c) Increased photosensitivity to ultraviolet light from the chlorpromazine
d) Allergic reaction to the medication and subsequent redness of skin
74. Jenny approaches you, clasping your hands and telling you she needs help. You note
that her eyes appear to have rolled backwards and that her neck is rigid. Your nursing
diagnosis is
a) Attention seeking behaviour with manipulative overtones
b) Parkinson’s disease and high level of anxiety
c) Oculogyric crisis due to extra pyramidal side effects
d) Akathisia due to side effects from the medication
75. In an acute presentation, such as jenny, the need to administer medication so as

to address the situation is important. The most likely choice of drug would be
a) Trifluoperazine
b) Thioridazine
c) Haloperidol deaconate
d) Benzotropine mesylate
76. When administering this medication what is the dosage and upper limit or ceiling in a
twenty four hour period
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a) 2mgs, up to 6mgs/24hrs
b) 6mgs, up to 12mgs/24hrs
c) 20mgs, up to 60mgs/24hrs
d) 4mgs, up to 12mgs/24hrs
77. Following this episode, jenny is commenced on a regular

anticholinergic antiparkinsonian drug. The most likely drug of choice
would be
a) Procyclidine
b) Lorazepam
c) Pipothiazine
d) Diazepam
78. Jenny is charted this medication. Which of the following drug orders reflects the
amount/dosage to be received accurately
a) 5mgs T.D.S
b) 20mgs nocte
c) 10mgs Q.Q.II
d) 15mgs mane and 15mgs nocte
79. Jenny responds well to her care and is discharged 14 days later. She is charted an
antipsychotic injectable medication which the mental health nurse gives her at
home. The medication is flupenthixol deaconate. The dosage and frequency is likely
to be
a) 400mgs every 3 weeks
b) 150 mgs every week
c) 60mgs every 3 weeks
d) 200mgs every 2 weeks
80. Tom has a diagnosis of bipolar affective disorder and his family ask you to talk with
them about it. They ask you what an affective disorder is. A therapeutic response
would be
a) An abnormality in the mood or feeling state of a person
b) A dysfunctional emotive illness exacerbated intermittently
c) A chronic and progressive deterioration in the emotion of a person
d) A strange feeling which is abnormal in origin
81. Tom is due for a test today and the lab technicians arrive to do the blood test. Tom
asks you what the level needed in his blood is. A correct response is
a) 1.5-2meg
b) 0.1-0.3meg
c) 0.5-1.3meg
d) 1.0-1.9meg
82. Toms level comes back from the lab who ring you to tell you that his level is very
high. The immediate nursing actions would involve
a) A check to see if a.m. dose was given, discontinue meds and notify doctor
b) Commencement on fluid balance chart and vital recordings
c) Encourage fluid intake and continue meds and document observations
d) Inform tom he is toxic, place on bed rest and notify next of kin
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83. Tom is assessed and has lithium toxicity. The symptoms we would expect to see
as nurses are
a) Palpitations, skin rash and headache
b) Photophobia, bradycardia and dyspnoea
c) Coarse tremor, diarrhoea, vomiting and sluggishness
d) Thirst, nausea, skin rash and pain on dorsal flexion
84. You are a domiciliary nurse and have been visiting Liz in the community. Liz is
receiving an antipsychotic in infectable form. Which medication is not an injectable
antipsychotic
a) Pipothiazine
b) Thiroidiazine
c) Haldol deconoate
d) Flupenthixol
85. Before Liz was commenced on her medication you asked that she be charted a
test dose. This lower dose is
a) Given then reviewed after 5 days before regular charting begins
b) Given fortnightly for a period of six months
c) Administered and then followed immediately by a regular dose if no reaction
is noted
d) Administered once and then repeated weekly for four weeks
86. Liz continues to request that her injection site be in her buttock and refuses to have it
in the thigh. You have permission to do this. You assure the accurate site by
a) Locating the upper, outer quadrant of the buttock
b) Locating the lower, outer quadrant of the buttock
c) Locating the iliac crest and administering the injection
d) Locating the midline and injecting 3cms to the side of it
87. In regularly dispensing injectable medication you are aware as a nurse that the
medication is locally irritating. You therefore
a) Administer it in one area only
b) Rub the area gently following
administration c) Rotate sites and do not
rub/massage the area
d) Apply heat and massage the area
88. Jan is a first line manager responsible for the care of a group of patients. She is
concerned because for the last three weeks the physiotherapist has been late to see the
patients and sometimes has not come at all. She has called the physiotherapist but the
situation has not improved. Jan’s next action should be to
a) Write a memo to the physiotherapy department
b) Contact a nursing clinical advisor
c) Notify the physician of the situation
d) Consult her nurse manager
89. In organisations the primary management function is to

a) Assess and establish goals
b) Establish a framework in which to function
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c) Plan for results
d) Control all operations
90. Cohesiveness is important to all teams. This means

a) The process a group goes through in deciding what to do
b) A mutual attraction which holds a group together
c) A decision made by a knowledgeable leader for the
group d) A strong organisational support system of the
group
91. Part of Jan's position requires her to manage the budget. This is
a) A statement of future expenditures
b) A list of current expenditure
c) A plan for meeting expenses
d) A recording of past expenditure
92. Jan is aware that nursing tasks and quality of nursing practice are compared with
which pivotal question
a) Does the performance match standards and objectives
b) Does the performance reflect interest and enthusiasm for the job
c) Does performance indicate knowledge and expertise
d) Does performance leave the patients comfortable
93. Elanore brown aged 20, is a passenger who is thrown clear when the car she is
travelling in hits a lamp post. Eleanor exhibits internal bleeding later diagnosed a
ruptured spleen. First aid care for Eleanor includes elevating her limbs. This is done
to
a) Decrease her venous return
b) Lower her blood pressure
c) Increase her venous return
d) Assist her to breathe
94. Eleanor is admitted to the accident and emergency department in advanced stage
two shock. When taking her base line observations you would expect to find
a) Elevated BP, elevated pulse rate and elevated respiratory rate
b) Decreased BP, decreased pulse rate and decreased respiratory
rate c) Decreased BP, increased pulse rate and increased respiratory
rate
d) Decreased BP, decreased pulse rate and increased respiratory rate
95. Eleanor is catheterised and her urine output is monitored hourly. This is done to
a) Provide an indication of her renal perfusion
b) Ensure she does not go into fluid overload
c) Ensure she is receiving adequate hydration
d) Monitor the concentration of serum electrolytes
96. Eleanor also requires additional nursing observations. Which of the following is the
most appropriate
a) Mental status exam and urinary electrolytes
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b) Level of consciousness and abdominal girth
c) Papillary reaction to light and limb movement
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d) Swallowing reflex and orientation to time and place
97. A sample of Eleanor’s blood is sent to the laboratory for cross matching. When
Eleanor’s blood group has been identified the best treatment for her is to transfuse her
with
a) Packed cells
b) Whole blood
c) Lactated
ringers d) Plasma
98. John smith aged 50 receives 30% burns to his face, neck, arms and upper thorax
when he pours petrol onto his barbecue. The most appropriate immediate first aid
treatment for Mr. smith is to
a) Roll him in a damp rug to extinguish the flames
b) Remove his burning clothes as fast as possible
c) Quickly throw him into the swimming pool
d) Quickly roll him in a wet sheet and apply ice to his burns
99. Smoke inhalation can complicate burn injuries. While waiting the ambulance the most
appropriate position for conscious victims of smoke inhalation is
a) Sitting in the semi fowlers position
b) Laying down with neck hyperextended
c) Lying supine with the legs elevated
d) Lying in the recovery position
100. Which of the following is correct with regard to burn injuries

a) Partial thickness burns are not painful as the nerve endings are destroyed
b) Full thickness burns are often very painful as the nerve endings are irritated
c) Full thickness burns are often not painful as the nerve endings are destroyed
d) Blistering and redness often occur very quickly following a full thickness burn
101. Factors determining the severity of the burn injury include

a) Depth of burn and percentage of body surface area burnt
b) Location of the burn on the body and age of the victim
c) Size of the burn and previous medical history of the victim
d) All of the above
STATE EXAMS 14
1. You consider Joe to be quite disturbed and communicate this to Joe’s doctor.
Eventually Joe is hospitalised for assessment and treatment. Joe continues to
have delusions. Reality for Joe will be reinforced by
1. Listening to him carefully
2. Calling him by name
3. Calling him at mealtimes
4. Reminding him to change his clothes
a) 1, 2 and 3
b) 2 only
c) 1, 2 and 4
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d) All of the above
2. In view of his age and stage of development, and given his disorder thinking, Joe will
most likely need all except
a) Reminding to wash his body
b) Reminding to change his clothes
c) Reminding to attend group
d) Reminding to eat and drink
3. Therapeutically, doing what you say you will is important in establishing

a) Patterns of reliability
b) Trust in a relationship
c) Self respect
d) Patterns of predictability
4. At the next team meeting it is decided to commence Joe on medication in an attempt

to impose a control on his disorder thoughts. Of the following, which will contribute
most to the teams choice of the mode of administration of the drug
a) Joes attitude to medication generally
b) The amount of insight about his situation
c) Joes trust in the medical staff
d) Joes trust in his primary nurse
5. Of the following which is likely to contribute to the choice selecting a depot

medication for a patient
a) The patient requesting the medication be given by injection
b) Convenience for the community psychiatric nurse
c) Likelihood of the client defaulting with oral medications
d) Convenience for the clients family
6. In any situation where restraint is necessary, which of the following is not true
a) Questions asked by the patient are answered by one staff member
b) One staff member per limb is the minimum safe
requirement c) Medication will always be given to effect
control
d) The patient is most safely restrained lying down
7. When caring for potentially suicidal patients, the nurse should

1. Respect their right to privacy foremost
2. Know their where3abouts at all times
3. Remove dangerous objects from their rooms
4. Allow weekend leave to boost morale
a) 1 and 2
b) 2 and 3
c) 3 and 4
d) 1 and 3
8. Mr white is a depressed patient who has said ‘I’m fed up. I don’t intend to go on like
this’ the nurse should
a) Ask him directly if he is considering suicide
b) Ignore the statement and continue the conversation
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c) Change the subject but report incident to charge nurses
d) Comment that others are worse off than he is
9. Disulfiram (antabuse) is given to people suffering from alcoholism

a) To ease their anxiety
b) To discourage them from drinking
c) To help them with depression
d) During detoxification
10. Which of the following is a temporary form of amnesia, usually occurring at

higher levels of intoxication
a) An alcohol psychosis
b) A hypersensitive
reaction c) A blackout
d) A hangover
11. Which of the following is not a progressive stage of addiction

a) Experimentation
b) Compulsive involvement
c) Infrequent involvement
d) Harmful involvement
12. When a person tries to make up for weaknesses in one area by playing up strengths in
another, it is termed
a) Displacement
b) Compensation
c) Projection
d) Rationalisation
13. The client you are caring for under section 8 of the mental health act (1992) declines
their medication. At what stage does verbal consent need to be given before
assessment and treatment can continue
a) one month in to the compulsory treatment order
b) At any time during the hospitalisation
c) Following the second extension of the compulsory treatment order
d) Whenever consent is sought for treatments
14. The act specifically excludes a number of diagnostic groups from compulsory
assessment and treatment. These include
a) Substance abuse, intellectual handicap and personality disorder
b) Manic depressive psychoses and schizophrenia
c) Hebephrenia, schizo affective illness and drug induced psychoses
d) Paranoid schizophrenia, bi polar affective disorder and psychoses
15. A family approach you for information about compulsory treatment orders and the
length of time that these are for. An appropriate response would be
a) A period of six months initially and then an extension of the order may be sought
b) For an indefinite period which is always variable
c) You need to ask the judge who will determine this
d) For a one year period and then reviewed annually
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16. Mr Elias who is a 19 year old, pakeha male, who has been admitted to ED following
a motorbike accident. Mr Elias had been drinking heavily in isolation prior to the
accident and his flatmates had discovered a suicide note in his room. In the admitting
room doctors have made a provisional diagnosis of head injury, right pneumothorax
and a compound fracture of his right tibia and fibula. Emergency nursing in this
situation is concerned with focussing on your patients immediate needs and setting
priority of care. Therefore your first nursing action is to
a) Suction his airway and administer oxygen by mask
b) Do a rapid assessment for baseline blood pressure and pulse
c) Assess for clear airway and presence of respirations
d) Assess levels of consciousness and papillary reaction
17. The Glasgow coma scale is used to establish the level of consciousness. All of the
following are used except
a) Papillary response to light
b) Eye opening on request
c) Verbal response on request
d) Motor response on request
18. Changes in the patient’s condition which would indicate increasing intracranial
pressure are
a) Stable level of consciousness, increasing pulse rate, widening pulse pressure
b) Stable level of consciousness, increasing pulse rate, stable pulse pressure
c) Increasing level of consciousness, decreasing pulse rate, narrow pulse pressure
d) Decreasing level of consciousness, decreasing pulse rate, widening pulse pressure
19. Mr Elias general condition deteriorates with hypovolemic shock. The cardinal signs of
which are
a) Slowing of pulse rate, increasing blood pressure, elevated temperature
b) Increasing pulse rate, stable blood pressure, elevated temperature
c) Increasing pulse rate, dropping blood pressure, normal temperature
d) Stable pulse rate, dropping blood pressure, normal temperature
20. To evaluate the effectiveness of fluid replacement for the patient in hypovolemic
shock, you would first look for return to normal range of
a) Haemoglobin
b) Pulse rate
c) Temperature
d) Blood pressure
21. Mr Elias compound fracture of the tibia and fibula is immobilised by open reduction
and internal fixation. A nurse, new to the orthopaedic area asks you to explain what is
meant by open reduction and internal fixation. You reply
a) Bring both bone ends into alignment by surgical intervention and holding them in
position with a metal plate and screws
b) Bringing bone ends into alignment by external manipulation and holding them
in position with a Steinmann pin and traction
c) Bringing bone ends into alignment by external manipulation and holding them in
position by an external fixing device
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d) Bringing both bone ends into alignment by surgical intervention and holding
them in position by a tight back slab and firm bandage
22. Mr Evans is a twenty year old patient admitted with hepatitis B to a medical ward you
are working on. Jaundice has developed because
a) The liver is unable to absorb vitamin B
b) Prothrombin time is prolonged
c) Of the damaged livers inability to metabolise bilirubin
d) Liver enzymes are released and liver function decreases
23. For which of the following reasons would a patient with jaundice develop the nursing
diagnosis of high risk for impaired skin integrity
a) Jaundice is associated with decubitus formation
b) Jaundice impairs urea formation
c) Jaundice produces pruritus due to impaired bile excretion
d) Jaundice leads to decreased tissue perfusion
24. Henare is a 25 year old man admitted for emergency surgery, he has a left inguinal
hernia which is nonreducible. This means that he has
a) A weakness in the abdominal wall opening through which the spermatic cord
emerges
b) A hernia sac which does not return to the abdominal cavity a result of swelling
c) Abdominal content, usually omentum or intestine descending into the groin, or
scrotum creating a mass
d) A direct inguinal hernia resulting from bowel and bladder content passing through
the posterior inguinal wall
25. Pat asks you ‘is it true that some STDs can cause cervical cancer’ your answer would
be
a) Recent research strongly, suggest that both genital warts and genital herpes may
cause cervical cancer
b) Yes all the STDs are capable of causing cervical cancer
c) Any woman who has multiple partners has a high risk of developing
cervical cancer
d) Yes but only those who have the genital herpes virus
26. Four purposes of chromosomal studies, amniocentesis is most commonly performed

a) Anytime in early pregnancy
b) Usually not until after the 12th week
c) Usually not until after the 20th week
d) Anytime during pregnancy
27. Tina, a midwife, tells an antenatal class that progesterone is considered the hormone
most responsible for maintaining pregnancy. Where is the primary source of
progesterone found throughout most of the pregnancy
a) The placenta
b) The corpus luteum
c) The ovary
d) The pituitary gland
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28. Larry and Mary smith had planned their first pregnancy for some time, but when it is
confirmed, Mary feels conflicting emotions. She comes to the clinic for her first
prenatal (antenatal) visit at ten weeks gestation. Mary shares her mixed feelings
about the pregnancy with the midwife. The midwifes best response would be to
a) Encourage her to consider abortion counselling
b) Encourage her to seek support from Larry
c) Reassure her that when she feels the baby move, her mixed feelings will
disappear completely
d) Reassure her that most women experience some mixed feelings in early pregnancy,
even when their pregnancies are planned
29. During a subsequent visit, Mary states she has begun to feel foetal movement. Foetal
movement is usually felt by the pregnancy woman when the foetus is approximately
a) 12 weeks gestation
b) 16 weeks gestation
c) 22 weeks gestation
d) 26 weeks gestation
30. Mary and Larry are proud parents of a baby girl weighing 3050 gms. The apgar is
nine at one minute. With an above apgar score the baby’s
a) Heart beat is absent
b) Body is pink but extremities are blue
c) Muscle tone is flaccid
d) Reflex irritability is absent
31. You assess Mary’s fundus and find the fundus to be firm and off centre. You would
suspect
a) A retained placenta
b) A full bladder
c) The fundus is not well contracted
d) There are clots in the fundus
32. On day five Mary, and her baby are ready for discharge. You tell Mary that should her
vaginal bleeding increase excessively (secondary postpartum haemorrhage), she
should notify her primary care given immediately. The most likely cause will be
a) Uterine fibroids
b) Lacerations during delivery
c) Retained placental fragments
d) Low haemoglobin levels
33. Mary is breast feeding for the first time. She may require assistance. What is the most
important factor to ensure successful breast feeding
a) Ensure comfortable position for mother
b) Ensure baby is attached to breast properly
c) Ensure baby’s suction is broken before detaching from breast
d) A support person is with her while feeding
34. Another mother tui also chooses to breastfeed. You are aware that breastfeeding is
a natural form of contraception in that it is 98 effective, providing that
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a) The baby is less than six months old and taking most of the nourishment
from breast milk
b) The mothers menses have not returned and the baby is less than six months old
c) The baby is less than nine months old and feeding six to eight times per day
d) The baby is less than nine months old and has been fully breastfeed
35. During the discussion tui and henare ask what the Guthrie test is for you reply it is
a test that
a) Assesses haemoglobin levels in the new born
b) Assesses the babies serum bilirubin levels
c) Identifies congenital disorders of metabolism
d) Identifies the hepatitis B virus
36. You are the staff nurse working in the children’s ward. You are caring for Hugh Jones
aged 4, who has been admitted with meningitis. Hugh’s parents are upset and feeling
guilty that they did not recognise highs illness earlier. Your response would be to
a) Inform them about meningitis and discuss how they could have recognised it
earlier
b) Tell them they should have taken Hugh to the doctor earlier and consequently he
would not have been as sick as he is now
c) Reassure them the effects of meningitis occur over a period of time and that they
could not have acted any sooner
d) Get the doctor to come and speak to them about the effects the disease will have
on Hugh
37. Meningitis is a life threatening illness and it poses a grave concern for hughs parents.
As Hughes nurse you help to reduce their anxiety by the following
1. Educate them about the illness so they can understand its effects on Hugh
2. Explain procedures so they can understand and help with highs care
3. Explain that Hughes irritability is part of the illness
4. Give them time to discuss their concerns
a) 1 and 3
b) 2 and 4
c) 1, 3 and 4
d) All of the above
38. Benjamin Johnson, aged 4 falls off his bike when playing. You are working in the
emergency department when he is admitted. Using the Glasgow coma scale you
assess all of the following except
a) His temperature and pulse
b) His best motor response
c) His best verbal response
d) His ability to open his eyes
39. You also observe Benjamin for signs of increased intracranial pressure which include
a) Increase in pulse rate, drop in blood pressure
b) Increase in pulse rate, rise in blood pressure
c) Decrease in pulse rate, rise in blood pressure
d) Decrease in pulse rate, drop in blood pressure
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40. You are working with the public health nurse in a large urban area. You visit a day
care centre at the request of the staff to visit Joel Hinton, aged 3 years. The staff are
concerned because Joel is becoming disruptive, has poor concentration, and has
visible bruising. He has walked with a limp for the past week. On arrival at the day
care centre, you would
a) Observe Joel at play with other children
b) Ring Joel's family to ask them what is wrong with Joel
c) talk to the staff about Joel
d) assess the situation and meet with Joel
41. you are going to report your suspicions regarding Joel to the appropriate authority.
The appropriate authority in this situation is
a) department of health
b) Joel’s teacher at school or principal
c) Joel’s general practitioner or practice nurse
d) the police, or department of social welfare
42. Sarah miles has brought her six week old daughter Sophie in to see the public health
nurse you are working with .she wants to talk about the immunisation schedule as she
is not sure if she should have Sophie immunised. She expresses concern that Sophie
may react to the vaccine. The public health nurses best response would be
a) yes, this can happen but the research is inconclusive
b) this is very rare, however you and Sophie should stay for 20 minutes after the
vaccine
c) don’t worry as the chance of Sophie having a reaction is minimal
d) don’t worry as this is only of concern if another member of your family has
reacted to a vaccination
43. Sarah asks how immunisations work. You explain the differences between active and
passive immunisation. Which of the following is not associated with passive
immunisation
a) protection is immediate
b) human globulin is given containing
antibodies c) it provides lifelong immunity
d) this type of immunity is provided through breastfeeding
44. the following day, Louisa whiti attends the clinic with her son Jayden, aged 3 years.
Louisa has noted Jayden’s behaviour is more disruptive than usual, and he does not
respond to her calling him. Your initial nursing assessment would include which of
the following
a) referral to a psychologist
b) telling Louisa about the possibility of sibling rivalry
c) reassuring Louisa this is normal behaviour for a 3 year
old d) inspection of both ears and a hearing test
45. later that afternoon, Susan Jones aged 4 years comes to the clinic with her father
anu. Susan has had recurrent bilateral otitis media with effusion for 6 months. She is
booked for a myringotomy next week. Anu asks what this means. A myringotomy is
a) a surgical incision of the mastoid
b) a surgical incision of the tympanic membrane
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c) a surgical incision of the Eustachian tube
d) the surgical removal of the adenoids
46. john is unit manager in a local hospital. John is trying to build a climate of
accountability in this unit. This means
a) nurses should involve patients and families in decisions and offer explanations for
actions
b) registered nurses should report back to the unit manager regularly through the day
c) the unit manager is ultimately responsible for all the registered nurses actions
d) all of the above are true of accountability
47. john realises however that as a nurse manager he is accountable for his decisions. He
takes this to mean that
a) he is able to make decisions in accordance with his beliefs and values
b) what is best for the patient overrides all other considerations
c) he is responsible for his actions and the consequence of his decisions
d) as nurse manager he is able to pass on to others praise or blame for outcomes of
decisions
48. accountability in the maintenance of quality nursing practice influenced most by

a) individual ideas regarding ethics, competence, commitment integrity
b) knowledge of professional standards and institutional and professional philosophy
c) knowledge of the nurses act and nursing councils role as well as malpractice
decisions
d) all of the above have an influence
49. john is unit manager at a large aged care centre unit. Because increased competition in
all areas of health care john is keen to see quality maintained on the unit. Appropriate
quality indicators he could used could be
a) repetition of work and adverse events
b) inappropriate placements and waiting times
c) cancelled services and patient withdrawals
d) all of the above would be useful indicators
50. john wants the staff to understand quality assurance and the difference from quality
control. He tells them that quality assurance means
a) staff must monitor their own practice and take responsibility
b) at the end of each week staff will reflect on ways to improve
c) that specific check points will be put in place to monitor progress
d) random audits will be done of nursing care to spot check
51. one way of improving quality is to set standards. These

a) are broad aims or goals of the organisation
b) form the basis of an organisation’s mission statement
c) must be a specific statement about every aspect of care
d) describe what constitutes good care and state criteria to measure performance
52. john found his staff were concerned to improve care and conserve resources. They
agreed that standards
a) increased morale and empowered staff
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b) facilitated staff thinking through and implementing change
c) enabled staff to put their own ideas into action
d) all of the above are true of this process
53. current literature identifies serious difficulties faced by the novice entering the
workforce. New graduates often experience reality shock. This could be described as
a) having to suddenly drop one set of values and adapt to a new subculture
b) a situation where one feels unhappy in the new job and decide to move on
c) surprise and disequilibrium experienced on moving from a familiar to a new
culture
d) the challenge of becoming competent and effective in the new culture
54. the first phase of reality shock is often known as the honeymoon phase, graduates
would be wise to
a) explain their values and beliefs at the onset so that co-workers understand them
b) be as helpful as possible to co workers and build up a support system
c) do their own work to the best of their ability and keep to themselves
d) share their new enthusiasm and try to motivate other staff to new ways
55. gradually graduates move into the ‘recovery’ phase; this is a time to
a) re evaluate values, keep worthwhile values and transfer them to work setting
b) drop all the professional values learnt in school and adapt to unit values
c) subjugate both school values and work values and decide not to cause problems
d) start to watch all advertisements and look for a better job
56. Mrs. skinner has a blood transfusion in progress following hip replacement. Her
blood group is a. This means that in an emergency she could receive blood from
a) any other group
b) any group except B
c) group A only
d) group A and O only
57. twelve hours after the operation Mrs. skinner started shivering and complaining of
pain in her back. Her pulse was very rapid. In these circumstances which one of
the following should the nurse do first
a) take her temperature
b) give her an extra blanket
c) send for medical aid
d) stop the blood transfusion
58. the most probable explanation for Mrs. skinners symptoms is

a) infection of the urinary tract
b) reaction to the anaesthetic
c) an allergic reaction to the blood transfusion
d) an allergic reaction to the metal prosthesis
59. john an 18 year old student, has been assigned to your care. He is jaundiced and his
clinical appearance suggests that he has hepatitis A. Hepatitis A is an inflammatory
condition of the liver caused by
a) auto immune processes following a viral infection
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b) a virus which infects the person via the GI system
c) a virus which is only transmitted via contaminated blood products
d) a virus which is mainly transmitted by sharing needles
60. following a bout of hepatitis a most people can expect

a) to become a carrier
b) frequent relapses
c) lifelong immunity to hepatitis a
d) increased risk of liver cancer
61. the jaundice in hepatitis A is best described as

a) haemolytic
b) bilio static
c) obstructive
d) hepato cellular
62. the incubation period is

a) less than 10 days
b) 5-15 days
c) 15-50 days
d) 40-60 days
63. Which of the following is not a typical sign of early hepatitis

a) Ascites
b) Slightly yellowing of the sclera
c) Clay stools
d) Anorexia
64. During the infectious stage, a person with hepatitis A is excreting the virus mainly
in a) Faeces
b) Urine
c) Saliva
d) All body fluids
65. When a person is in the infectious stage of hepatitis A, special precautions are taken
when you
a) Take a food tray to the person
b) Administer medications
c) Gave an antiemetic injection
d) Remove a used bedpan
66. A client has been back from surgery for several hours and has not asked for pain
medication. The client and nurse are from different cultural groups. Being aware of
cultural influences on health behaviours, the nurse will
a) Realize the client probably does not feel as much pain as some people
b) Wait for the client to ask before bringing pain medication
c) Look for non verbal signs of pain, such as holding the incision or lying still
d) Tell the client to be sure to call her if he/she is in pain
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67. Although the home health nurse has taught the client the importance of taking his
antibiotic exactly every six hours, he still cannot seem to take it on schedule. In
evaluating the effects of her teaching, the holistic nurse should consider that the client
(who is from a different culture) possibly
a) Is relating to time differently than she
b) Has not understood what she taught
c) Does not believe the medicine will
help d) All of above
68. Smoking is bad for people with chronic respiratory disorders because cigarette
smoke a) Destroys the cilia which cleanse debris from the airways
b) Inhibits the inspiratory centres in the central nervous system
c) Inhibit nerves involved in the reflex pathways involved in coughing
d) Prevents the vocal cords closing tightly together when swallowing
69. One reason why smokers with chronic respiratory problems should not be given
medications that inhibit the cough reflex is
a) These medication dry up mucous and make secretions difficult to expel
b) The hypoxic drive is inhibited causing a slowing in breathing rate
c) Coughing is their only means of preventing mucous accumulating in the lungs
d) In people with chronic problems these medications have no effect anyway
70. Asthma is a disorder primarily characterised by

a) Hyperinflation and over expansion of lung tissue
b) Spastic constriction of the respiratory airways
c) A breakdown in the walls of alveolar tissue
d) Chronic dilation and expansion of the airways
71. During acute asthmatic attacks theophylline medications are given because they
a) Stimulate the inspiratory centre
b) Raise the blood PO2 levels
c) Hyperinflate the lung
d) Dilate the bronchioles
72. Aminophylline comes in ampoules of 250mgs in 10mls. How much in mls, would
you draw up to obtain 300mgs
a) 8.3
b) 12.0
c) 83.0
d) 120.0
73. In the early stages of obstruction to urine flow, symptoms which a client with an
enlarged prostate gland might experience include
a) Difficulty in emptying his bladder and Haematuria
b) Foul smelling urine with a high bacteria count
c) Complete retention of urine and dribbling
d) Frequency, urgency, a poor stream and nocturia
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74. A client is prescribed 1 litre of dextrose/saline to be given over 3 hours. If the IV
giving set has a drop factor of 15 drops per ml, which of the following in drops per
minute, gives the correct rate
a) 17
b) 33
c) 67
d) 83
75. Your client states that she is most unhappy with the care she is receiving from her
doctor and wishes to change doctors. You respond
a) Would you like to talk to me about why you are unhappy with your care I may be
able to help
b) Okay should be no problem, it’s your choice after all
c) I don’t think that’s a good idea it can lead to the doctor becoming annoyed
d) Hospital policy does not allow for you to make a choice of doctor but would
you like to talk to me about your concerns
STATE EXAMS 15
1. Mr tawhai, a 23 year old shearer presents in ED acutely ill with peritonitis. He says
that he has had abdominal pain over the last 2 weeks but has been reluctant to seek
help as he needs to continue working to support his large extended whanau. In your
assessment your best response would be one of the following
a) Voice your disapproval of his non compliance. Tell him the consequences of his
actions
b) Explain to him that its responsibility to seek treatment early
c) Empathise with the many factors in his life that make it difficult to seek
early treatment
d) Blame his acute condition on his reluctance to seek earlier treatment
2. Mrs netane, 68 year old is admitted with septicaemia following below knee
amputation. She says to you that she has been treated by the Maori healer and she
wants them to keep treating her. Your reply would be
a) To encourage her choice to have the Maori healer participate in her care
b) To tell Mrs. netane that you will pass her request on to medical staff
c) To tell Mrs. netane that it’s not part of hospital policy but she could seek a Maori
healer on discharge
d) To tell Mrs. netane that western medicine is more advanced and the Maori healer
hasn’t fixed her condition so far
3. Mr smith a deeply religious 75 year old is about to have a blood sample taken when
the Maori minister appears to take prayers with him. The technician is in a hurry to
do her rounds. You
a) Tell the Maori minister to wait until after the blood sample has been
taken b) Tell the technician to come back at a later time
c) Offer to take prayers with Mr. smith if he has the blood test first
d) Seek medical advice
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4. Mrs Jones, a closed brethren in B block is on a restricted diet. Her family and church
members regularly bring in food for her. You
a) Take the food and put it in the kitchen for the nurses supper
b) Tell the family and the church members sternly not to bring in any more food
because she is on a restricted diet
c) Tells Mrs. Jones not to let the family and church members feed her any longer
d) Tell Mrs. Jones, her family and church members the consequences of her eating
the wrong diet
5. Mr lance is a 22 year old homosexual whose partner died last year from aids. He
presents at your GP practice without an appointment. He is coughing uncontrollably
and sweating profusely in the waiting room which is full. You
a) Tell him to leave as he doesn’t have an appointment and he’s upsetting the other
patients
b) Take him to the treatment room and ask the GP to examine him when he has a
chance
c) Quietly tell the receptionist that he probably has the aids virus and to be
careful when she serves him
d) Take him to the treatment room so he doesn’t infect those in the waiting room
6. Mr Prasad, a sikh is admitted to ICPU in an acute psychotic episode. You are told to
remove his head dress so that he doesn’t hand himself. He begs you to leave it on.
You
a) Order sedation for him and remove the head dress when he has quieted down
b) Use ‘calming and restraint’ with two other nurses and remove his head dress
c) Empathise with his pleading and leave the head dress.
d) Ring the Sikh translator on the hospital phone list and ask him to come and tell Mr.
Prasad that it’s ok to have his head dress removed
7. Mary Maher is a primigravida, who has diabetes and required insulin for the last year.
She has been told her insulin needs will increase during pregnancy. This statement is
based on the fact that
a) The placenta produces a hormone that decreases maternal glucose levels
b) The placenta produces a hormone that decreases the effectiveness of
maternal insulin
c) Her diabetic condition is becoming more
severe d) None of the above
8. Mary is scheduled to have an amniocentesis. She is concerned that the placenta will
be punctured and her baby will lose its adequate source of oxygen. The nurse
assures Mary that it is unlikely the placenta will be punctured because
a) The placenta is implanted in the fundus and insertion of the needs for
amniocentesis is in the lower region of the uterus
b) The membrane covering the placenta is almost impossible to penetrate with a
needle prior to term
c) Ultrasound is used just prior to amniocentesis to locate the placenta and
prevent such a risk
d) Amioscopy is performed just prior to amniocentesis to locate the placenta and
prevent such a risk
9. Following an amniocentesis, Mary should be advised to
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a) Be on bed rest for at least the next 24-48 hours
b) Report any uterine contractions or abdominal pain
c) Record her temperature 4 hourly for the next 24 hours
d) Observe for blood in her urine
10. Mary states at her next ante natal visit to her midwife that she has begun to feel foetal
movement. Foetal movement is usually felt by the pregnant woman when the foetus is
approximately
a) 12 weeks gestation
b) 16-20 weeks gestation
c) 22-24 weeks gestation
d) 26-28 weeks gestation
11. Mary can expect to experience all the following signs in the early stages of
her pregnancy, except
a) Chadwick’s sign
b) Goodells sign
c) Humans sign
d) Frequency of micturition
12. Marys pregnancy progresses well and she goes into spontaneous labour at 38 weeks
gestation. Her diabetes has been well controlled by insulin. Mary is now in active
labour. On vaginal examination, her midwife finds that the foetal head is at -1 station.
This means that the foetal head is
a) 1cm below the ischial spines
b) 1cm above the ischial spines
c) 1cm below the iliac spines
d) 1cm above the iliac spines
13. You assisting the midwife who tells you Mary is now in the transitional phase of the
first stage of labour. In the transitional phase the cervix is
a) 0-3cm dilated
b) 3-5cm dilated
c) 5-7cm dilated
d) 7-10cm dilated
14. Marys husband Sean is timing the frequency of her contractions. This means he is
timing from the
a) Beginning of one contraction to the beginning of the next
b) End of one contraction to the beginning of the next
c) Beginning of one contraction until it begins to go away
d) Beginning of one contraction until it is completely over
15. The midwife takes Marys blood pressure between contractions. The chief purpose
underlying this action is because
a) It is more comfortable for Mary
b) Diastolic blood pressure lowers between contractions
c) Maternal blood pressure does not change with contractions
d) Systolic blood pressure increases during uterine contractions
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16. When Mary and Sean’s baby girl Yara is born ,she does not cry immediately, but at
one minute she is crying lustily and her baby is pink with blueness of extremities.
Her heart rate is 156. The baby has an apgar score of
a) 7
b) 8
c) 9
d) 10
17. Johanna brown, 18 months old is admitted to the children ward with a diagnosis of
bronchiolitis. Erikson has referred this age as a period of
a) Industry
b) Self
actualisation c)
Trust
d) Autonomy
18. On admission, Johanna is clinging to her mother and refuses to stay in the cot. Denise,
Johanna’s mother is upset. You would state
a) Put her in the cot and leave her for half an hour
b) It is normal for Johanna to want to stay with you
c) Give her some toys and she’ll be alright
d) She’ll soon get over it
19. Bronchiolitis is most commonly caused by which of the following microorganisms

a) Respiratory syncytial virus
b) Chlamydia bacteria
c) Parainfluenza virus
d) Enterovirus
20. When doing Johanna’s physical assessment you notice her respiratory function is
diminished. This is because Johanna’s
a) Alveoli are destroyed
b) Temperature is elevated
c) Bronchioles are inflamed
d) Heart rate is increased
21. Johanna is scheduled for regular nebulizer treatment for the purpose of
a) Administering bronchodilators
b) Providing a dry mist to ease breathing
c) Reversing respiratory acidosis
d) Administering oxygen
22. On taking Johanna’s vital signs, you notice her temperature is 39.5 degrees. You
would
a) Check her temperature again in half an hour
b) Give aspirin as prescribed and tepid sponge
c) Wrap her in a blanket to prevent chills, and administer paracetamol as
prescribed d) Tepid sponge her and administer paracetamol as prescribed
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23. As well as ensuring Johanna’s respiratory status is stable, a further priority in
your nursing intervention is
a) Giving her toys to play with
b) Spending time with Johanna to establish a rapport
c) Encouraging fluids and observing hydration status
d) Continuing with normal activities to reduce separation anxiety
24. Johanna has recovered from the acute stage of her illness. In planning for
her discharge, Denise is encouraged to
a) Allow Johanna to rest and play as she feels able
b) Keep Johanna in bed as much as possible
c) Offer her small toys to occupy her
d) Discourage interaction with other children
25. Dominic black, six months old, is admitted to the children’s ward with severe
dehydration due to vomiting and diarrhoea. Iv fluids are commenced, one of the
dangers of IV therapy is overhydration. This could lead to
a) Infiltration
b) Kidney failure
c) Rupture of the bladder
d) Pulmonary oedema
26. Dominic’s blood pressure is very low. You realize a low blood pressure is expected
because
a) Dominic has been vomiting
b) His circulation blood volume is low
c) He has been receiving iv therapy
d) He has an elevated temperature
27. Jo is a third year comprehensive student nurse who has just completed her elective
clinical experience. Whilst on clinical Jo was able to observe the management role. Jo
noticed that the charge nurse managed to control all the activities in the ward really
well. Controlling refers to actions taken to
a) Increase job satisfaction and motivation among employees
b) Increase productivity, innovation and quality outcomes
c) Ensure that actual outcomes are consistent with those planned and anticipated
d) Determine success or failure with tasks
28. Quality control refers to activities which

a) Set standards and determine criteria
b) Determine whether standards have been met
c) Educate staff about corrective actions required
d) Evaluate, monitor or regulate services rendered to customers
29. One of the reasons the charge nurse controls well is that she has set standards for
performance. A standard is
a) An agreed upon base line condition or level of excellence
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b) An evaluation instrument tool used by all
c) A set of behaviours that are common and understood by all
d) A set of behaviours that are defined by others for a profession
30. While Jo was on the ward a nursing audit was done. The nursing audit is a tool
designed to evaluate
a) The nurses clinical practice
b) The nursing care clients receive
c) The charge nurses managerial skill
d) The cost of nursing care of clients
31. Jo is keen to develop her own leadership and management skills. She knows as a
newly registered nurse she will need to
a) Be able to organise herself well
b) Communicate with others effectively
c) Manage time effectively
d) All of the above
32. A conflict situation arose on the ward while Jo was there. It is important in resolving
conflict for a manager to
a) Make sure the better side wins
b) Tell each side what they need to do
c) Leave each side with their self esteem intact
d) Make sure the conflict is resolved immediately
33. Constructive conflict can

a) Keep everyone on their toes
b) Encourage growth
c) Improve relationships on the
ward d) All of the above
34. There was always plenty of equipment in Jo's ward and one of the staff told her that
the charge nurse ‘has great budgeting skills’. She probably meant that
a) The budget was used as a master plan for annual operation of the ward
b) The budget was used as a tool to evaluate the wards performance over the year
c) The budget allowed maximum utilization of resources to meet short and long
term needs
d) All of the above would be correct about budgets
35. Jo's elective experience brought home to her the fact that nurse often have to make
decisions of an ethical nature. An ethical dilemma exists for the nurse when
a) Two nurses cannot agree on a course of action
b) The doctor and nurse are in conflict
c) A conflict exists between the nurses personal values and professional ethics
d) A conflict exists between the nurse and doctors personal values
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36. Mr Smyth has been admitted to the surgical ward with a provisional diagnosis of
peritonitis. Mr Smyth is examined by the surgeon who asks for him to be prepared for
theatre. This preparation will probably include
1. Commencing IV fluids
2. Gastric aspiration
3. A bowel washout
4. Gastric lavage
a) 1 and 2
b) 2 and 3
c) 1 and 4
d) 3 and 4
37. Which of the following is not a usual cause of peritonitis

a) Diverticulitis
b) Pancreatitis
c) Gastro enteritis
d) Perforated ulcer
38. It is possible that intraperitoneal inflammation can be localised. It is surrounded and

sealed off by
a) Mesentery
b) Omentum
c) Peritoneum
d) Granulation tissue
39. Post surgery Mr. Smyth has IV therapy – 1 litre of dextrose saline 8 hourly with
potassium 30 mmols in each litre. It is necessary to augment IV therapy with
potassium in this instance because
a) It is routine following this type of surgery
b) Excessive sodium is retained when potassium is not given
c) Potassium loss is excessive following this type of surgery
d) Nil by mouth reduces potassium absorption
40. Mr Smyth has a naso gastric tube in situ on free drainage. The function of the
naso gastric tube in this instance is to
a) Prevent gastric reflux
b) Allow the gut to rest and heal
c) Allow for return of peristalsis
d) Maintain long term nil by mouth
41. For pregnancy confirmation what instructions regarding a specimen urine would
you give
a) Give a voided specimen during her first visit
b) Instruct her on how to give a sterile specimen
c) Bring in the first voided specimen in the morning
d) A catheterised specimen will be required
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42. Which of the following is a complication of gestational proteinuria hypertension
(GPH/HOP) syndrome
a) Hydrous fetalis
b) Placenta praevia
c) Ictinus
neonatorum d)
Placental abruption
43. An acute communicable disease that can cause severe deformities in the foetus if
contracted during pregnancy is
a) Syphilis
b) Morbilli
c) Gonorrhoea
d) Tuberculosis
44. Pregnancy predisposes a woman to urinary tract infection because

a) There is a decrease in leucocytes in pregnancy
b) Urinary stasis results from dilated ureters
c) Vaginal flora becomes easily
infected d) Of an altered pH (acidity) of
urine
45. For an initial prenatal visit to the doctor, which of the following tests will be done
a) Blood pressure, urinalysis, ultrasound, blood pressure
b) Weight, blood pressure, family history, blood group
c) Urinalysis, weight, blood pressure, blood group
d) Blood group, weight, blood pressure, oestriols
46. Dietary counselling for a pregnant client would include

a) Referral to the dietician
b) Discussing the importance of limiting salt to prevent gestational proteinuria
hypertension (GPH) syndrome
c) Asking her what she eats at each meal
d) Telling her that proteins are essential for foetal development
47. A 36 weeks primigravida, complains that her fingers are swelling. The nurse should
a) Tell her to take her rings off
b) Say that further bed rest will resolve this problem
c) Advise her to drink less fluid
d) Take her blood pressure
48. To prevent or ease varicose veins during pregnancy, women should be advised to
a) Elevate the legs when sitting
b) Sit in an upright chair with feet flat on the floor
c) Avoid excessive walking
d) Put on firm stockings after getting up
49. Foetal distress during labour may be indicated by

1. Marked change in foetal heart rate
2. Irregularity of foetal heart rate
3. Meconium stained liquor
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4. Hyperactivity of the foetus
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a) 1 and 2
b) 3 and 4
c) 2, 3 and 4
d) 1, 2, 3 and 4
50. Which of the following can be described as a sign of true labour
a) A show of blood and mucous
b) Contractions increasing in frequency
c) Progressive cervical dilation
d) Rupture of the membranes
51. In the mechanism of labour for a right occipito posterior (R.O.P) position,
external rotation of the head follows
a) Extension of the incipit and face
b) Internal rotation of the shoulders
c) Crowning of the occiput
d) Restitution of the head
52. Which mechanism of labour is responsible for the delivery of the foetal head
a) Extension
b) External rotation
c) Expulsion
d) Effacement
53. Crowning occurs when

a) The largest diameters of the baby’s head have passed through the pelvic inlet
b) The largest diameters of the baby’s head have passed through the pelvic outlet
c) The largest diameters of the baby’s head are encircled by the vaginal opening
d) None of the above
54. Presentation of the foetus refers to the

a) Level of foetal head in the pelvis
b) Part of the foetus lying in the lower pole of the uterus
c) Part of the foetus lying over the os during labour
d) Relationship of the denominator to the maternal pelvis
55. Position of the foetus refers to

a) The relationship of the foetal parts to each other
b) That part of the foetus that engages in the maternal pelvis
c) The relationship of the long axis of the foetus to the long axis of the mother
d) The relationship of the denominator to the maternal pelvis
56. In caring for pre term infants, which of the following precautions should be
taken against retrolental fibroplasias
1. Oxygen administration should be discontinued as soon as feasible
2. Oxygen concentration should be monitored
3. Daily tests should assess serum bilirubin levels
4. Eye covering should be applied to infants during phototherapy
a) 1 and 2
b) 2 and 4
c) 3 and 4
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d) 1, 3 and 4
57. Neonatal hypoxia may be due to

a) Persistent effects of intra uterine hypoxia
b) Congenital
abnormalities c) Intracranial
bleeding
d) All of these
58. The neonates body temperature during the first several days is
1. Dependent upon the environment
2. Stable between 36.6 to 37.2 C
3. Dependent upon caloric intake
4. Immune to environmental changes
5. Dependent upon baby’s physiological state
a) 2, 4 and 5
b) 1, 2 and 5
c) 1, 3 and 5
d) All of these
59. The skin of a newborn infant may be covered with a yellowish cheese like substance
called
a) Lanugo
b) Milia
c) Mongolian
spot d) Vernex
caseosa
60. A baby just born who has a spontaneous cry and breathing is established within 30
seconds. The apgar rating will probably be
a) 10
b) 9
c) 8
d) 7
61. The foetal heart rate per minute is normally between

a) 90-120
b) 100-150
c) 120-160
d) 130-170
62. The approximate daily fluid requirement for a 7 day old baby who is healthy
and weighs 3.5 kilograms, will be
a) 110ml
b) 210ml
c) 330ml
d) 525ml
63. You are working in an obstetric hospital and a mother asks you about blood being
taken from her baby’s heel. You tell her this is routinely done on neonates for a
series of tests including the
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a) Rhesus test
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b) Phenylalanine test
c) Guthrie test
d) Bilirubin test
64. For a healthy full term baby, the earliest the Guthrie test is reliable is
a) Immediately following birth
b) 24 hours following
birth c) 48 hours following
birth
d) 5 days following birth
65. You are asked about the likely outcome of treatment of (P>K>U>) phenylketonuria.
Your answer should include
a) Normal development is assured if treatment is adhered to
b) Treatment by diet is necessary until adulthood.
c) Treatment by diet is designed to reverse the process of brain damage
d) Treatment by diet is essential for the prevention of mental deficiency
66. After birth the closure of the foramen ovale occurs because
a) Clamping of the umbilical vein reduces pressure in the right atrium
b) Expansion of the lungs and increased pulmonary circulation increases pressure in
the left atrium
c) With its first cry the infant increases blood flow to the right side of its heart
d) A and b
67. Foetal blood bypasses the lung by means of the

a) Foramen ovale
b) Ductus venosus
c) Ductus
arteriosis d) Both a
and c
68. Retraction of uterine muscles during the first stage of labour causes
a) Reduction of the uterine capacity
b) Thinning of the uterine wall
c) Lengthening of the muscle fibres
d) Placental separation
69. The most important factor in preventing post partum haemorrhage from the
placental site is
a) Complete separation of the placenta and membranes
b) Spasm of the muscular walls of the uterine arteries
c) Prevention of trauma of the uterus and birth canal
d) Contraction of the middle layer of the myometrium
70. A post partum haemorrhage is any blood loss exceeding

a) 200 millilitre
b) 300 millilitre
c) 500 millilitre
d) 1000 millilitre
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71. Persistent red lochia is
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a) A normal phenomenon
b) Associated with cardiac
disease c) A prime cause of
anaemia
d) A sign of possible infection
72. If a mother has placental abruption, the major sign she will exhibit is
a) Painful bleeding
b) Painless bleeding
c) Hypertension
STATE EXAMS 16
1. When receiving your patient’s serum potassium results over the phone, you discover
the results was 2.3 mEq/L. Your first action is to
a) Give potassium supplements
b) Take the patients pulse
c) Call the doctor
d) Advise the patient of the result
2. Two signs of respiratory depression are

a) Decrease in muscle reflexes and mobility
b) Lowered respiratory rate and shallow breathing
c) Decreased level of consciousness and hypotension
d) Bradycardia and petechiae
3. You must not give a preoperative patient food and fluids 2 hours before the surgery
due to
a) The digestion of food and fluid interferes with the action of some
anaesthetic drugs
b) The potential for fluid volume overload
c) The risk for hypernatraemia due to the salt content in the food
d) Stomach contents increase the risk of aspiration
4. An adverse side effect of spinal anaesthesia is

a) Restlessness
b) Hypotension
c) Loss of sensation
d) Drowsiness
5. Three days post op, a patient develops a bowel obstruction. The nurse should prepare
the patient for
a) Administration of medications to stimulate peristalsis
b) Insertion of a nasogastric or intestinal tube
c) Transfer to the intensive care
unit d) Emergency surgery
6. When assessing a patient at risk for increased intracranial pressure, the first thing
you would check is
a) Reaction to pain stimuli
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b) Papillary function
c) Level of consciousness
d) Motor function
7. Which symptoms should make the nurse suspect pulmonary embolus (PE)
a) Changes in pulse rate and a slowly rising blood pressure
b) Frothy sputum and slow, deep respirations
c) Shortness of breath, chest pain and anxiety
d) Crackles in the lung bases and pursed lip breathing
8. Lucy is charted 5 mls of augmentin ‘125’ T.D.S. you notice the doctor hasn’t signed
the order form. A senior colleague tells you to give it. You respond by
a) Giving the medication as ordered
b) Contacting the doctor to sign the order
c) Asking Lucy if the doctor told her she would have this
d) Signing the form for the doctor
9. The augmentin is given to Lucy. She is found to be allergic when she exhibits
a) Tinnitus and vertigo
b) Wheezing and urticaria
c) Abdominal cramps and diarrhoea
d) Blurred vision and ataxia
10. Jack is 15 years old. He is admitted to the hospital after briefly losing consciousness
when tackled during a rugby game. Which of the following is an indication of
increasing intracranial pressure
a) Change in his level of consciousness
b) Anorexia and thirst
c) Increased pulse and respiration rates
d) Blurred vision and halos around lights
11. Jack has had two seizures while hospitalised. These have been controlled by
anticonvulsant medications. Jack and his family must understand
a) The medication must be taken for at least one year
b) The doctor should be seen when the prescription has finished
c) The medication will be discontinued on discharge
12. Jack is prescribed rivotril 8 mgs daily. He weighs 68 kgs. The initial doses for 2-3
days should not exceed 0.01 mgs/kg/day. Your nursing responsibility is to
a) Observe for any side effects after giving the drug
b) Contact the doctor to reassess the dose prescribed
c) Consider his weight loss and administer the dose prescribed
d) Check with the charge nurse prior to administration
13. Ana’s husband offers to bless the room. State the most appropriate action in this
situation
a) Accept the offer to bless the room
b) Seek the hospital chaplains permission first
c) Insist on contacting the Maori chaplain
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d) The blessing will not be necessary
14. Ana is told by her doctor that she has terminal cancer. He offers palliative
radiotherapy. Ana and her husband refuse this treatment and wish to go home. What is
your first nursing responsibility
a) Support them in their decision
b) Document their decision in the nursing notes
c) Contact the doctor immediately
d) Contact the hospital social worker
15. Ten days later, the district nurse visits Ana. She is distressed about the number of
visitors smoking in the house. What is the most appropriate action to take
a) Explain the Ana’s husband of his wife’s concern
b) Ask those who are smoking to leave the
room c) Politely tell the smokers to smoke
outside
d) Telephone for advice from a Maori community worker
16. Sarah, a 42 year old woman, who identifies as Maori, is to have a mastectomy. She is
accompanied by her 17 year old daughter Amy. Which of the following breast
symptoms may indicate the presence of breast cancer
1 retraction of the nipple
2 Pickering of the skin
3 discharge from the nipple
4 alteration of contour
a) 1
b) 2
c) 3
d) All of the above
17. You visit Wiremu’s home, he invites you in. What should be your first action
a) Great Wiremu with a cheerful kia ora
b) Make an initial assessment of Wiremu’s appearance
c) Introduce yourself and state why you are visiting
d) Make a brief assessment of the state of the home
18. What assessment will you need to make of Wiremu

a) Assess his physical condition
b) Identify the level of whanau support
c) Assess his interactions with his children
d) Do a psychosocial assessment
19. Ana attends the local kohanga reo. You wish to visit to assess her at school. What
protocols do you need to follow
a) Advise Wiremu that you will attend the kohanga reo
b) Contact the Maori public health nurse to assess Ana
c) Suggest Wiremu arrange for you both to visit the kohunga reo
d) Ring the kohunga reo to arrange a visit
20. Ana has school sores and is being treated by her grandmother. Ana has not
been taking her prescribed antibiotics. What should your response be
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a) Tell Wiremu that Ana should take the prescribed antibiotics
b) Acknowledge the value of Maori health remedies
c) Express your concern that Ana will infect other children
d) Discuss how both treatments are of value in curing Ana
21. A colleague comments to you that she is concerned about a elderly client, Moana,
who identifies as Maori. Moana is in early stages of Alzheimer’s disease and is
wandering away from her home. Your colleague believes Moana should be cared for
in an institution where she is less likely to harm herself. What should be your reply to
your colleague
a) Yes, I agree she would be safer in an institution
b) Has she been assessed by her GP
c) Has she got family involved in her care
d) I would call in a social worker to help

a) Asking clients about their knowledge of their cultural heritage
b) Relating to all clients in a neutral manner regardless of their culture
c) Ensure clients are nursed by nurses of their own culture
d) Use of appropriate resources to meet clients identified cultural needs
23. Maori communities are encouraged Maori to be involved in health research with their
c) Dietary changes from naturally produced to processed food
d) Loss of cultural, social, and spiritual ties
25. In clause 2 of the treaty of Waitangi (Maori version) Maori were guaranteed
possession and control of their taonga. Taonga means
a) All land that Maori choose not to sell
b) All land and fisheries
c) Land, forests and fisheries
d) All thing help precious by the Maori
26. A pregnant woman at 30 weeks gestation exhibits a rise in her baseline systolic blood
pressure of 32mm Hg, a weight gain of 4 kgs since last week and difficulty removing
rings she normally sears. This is suggestive of
a) Gestational hypertension
b) Pre eclampsia
c) Eclampsia
d) Elevated liver enzymes
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27. The primary pathophysiologic basis for the clinical manifestations of pregnancy
induced hypertension (PIH) is
a) Fluid retention related to excessive salt intake
b) Ineffective excretion of fluid by the kidneys
c) Cardiac decompensation
d) Ineffective dilatation of the vascular network to accommodate the expanding
blood volume of pregnancy
28. Which measure would be least effective in relieving the signs and symptoms of mild
pre eclampsia
a) Low salt diet
b) Period of bed rest
c) Balanced diet with protein
d) Relaxation techniques
29. A woman with severe pre eclampsia is been monitored for assessment findings
indicative of cerebral oedema and venospasm. Which of the following would you
not expect to find
a) Hypotonic deep tendon reflexes
b) Headache
c) Vision changes including blurring and spots before the eyes
d) Insomnia
30. Newly expectant parents, ask the nurse how they can prepare their 3yr old preschool
daughter for the new baby. All of the following would be useful except
a) Tell the child about the pregnancy as soon as mother begins to look pregnant
b) Arrange for a few sleep overs with the person who will care for the child at the
time of the birth
c) Transfer their child to her new room and bed just before the expected birth of the
baby
d) Introduce their child to preschool as soon as possible
31. The foetal presenting part is descry bed as vertex when the
a) Face enters the pelvis first
b) Buttocks emerge with legs extended over the abdomen
c) Flexed head enters pelvis first
d) Foetal lie is longitudinal
32. When examining the umbilical cord immediately after birth the nurse should expect to
observe
a) One artery
b) Two veins
c) Whitish grey colouration
d) Slight odour
33. Vitamin K is given to the newborn to

a) Reduce bilirubin levels
b) Increase the production of red blood cells
c) Stimulate the formation of surfactant
d) Enhance the ability of the blood to clot
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34. The nurse is performing a 5 minute apgar on a newborn. Which of the following
observations is included in the apgar score
a) Blood pressure
b) Temperature
c) Muscle tone
d) Weight
35. At birth the major cause of heat loss is by

a) Evaporation
b) Radiation
c) Conduction
d) Convection
36. Following the birth of graces baby, a healthy male, you are assisting grace to feed
her baby for the first time. The action of prolactin at this time
a) Immediately stimulates full milk production
b) Stimulates involution
c) Is inhibited until progesterone and oestrogen levels have decreased
d) Is not influenced by other hormones
37. A newborns birth weight is 3400 grms. The maximum expected weight loss for this
newborn would be
a) 170
grms b) 340
grms
c) 510 grms
d) 680 grms
38. The birth weight of a breast feed newborn was 3600 grms. On the third day
the newborns weight was 3350 grms. The nurse should
a) Encourage the mother to continue breastfeeding as her baby’s nutrient and fluid
needs are being met
b) Suggest that the mother switch to bottle feeding as breastfeeding is ineffective
in meeting her baby’s needs
c) Notify the doctor as the baby has lost too much weight
d) Refer the mother to a lactation consultant to improve her breastfeeding technique
39. Which of the following would be an unexpected sign of dehydration in the

newborn a) Weight loss
b) Reduced turgor
c) Concentrated urine
d) Decreased frequency and amount of urine
40. A breast fed baby will have bowel motions

a) That are yellow and runny at least twice a day
b) May go 2-3 days without a bowel motion
c) Will pass meconium for a shorter period
d) Establishes a very regular pattern of bowel motions
41. Supplementary fluids for babies

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a) Are advisable to prevent jaundice
b) Are needed for the baby under phototherapy
c) May be required if the mother has had a caesarean
section d) Are unlikely to be needed if the mother is breast
feeding
42. An asthmatic child is charted IV aminophylline. Your responsibility prior to the

giving of this drug would include checking
1 the drug with a registered nurse
2 the child’s dose in relation to her
weight 3 the child’s identity by calling by
name
4 the correct route of the drug
a) All of these
b) 1, 2 and 4
c) 1 and 4
d) 2 and 3
43. A preschooler is febrile and requires 4 hourly temperature recordings. The

most appropriate method would be
a) Orally
b) Rectally
c) Orally or axillary
d) Axillary
44. Christina age 10 is admitted to your unit with a diagnosis of rheumatic fever. You are
her primary nurse. The causative organism for rheumatic fever is
a) Haemophilus influenza
b) Staphylococcus bacteria
c) Syncytial virus
d) Group A streptococcal bacteria
45. The most serious complication of rheumatic fever is

a) Endocarditis
b) Pneumonia
c) Arthritis
d) Meningitis
46. Christina is admitted to your unit. You are her primary nurse. Your responsibilities
will be to
a) Do an assessment and history appraisal
b) Orientate her to the area
c) Establish a trusting relationship
d) Do all of the above
47. Jenny appears to have a secondary infection and is prescribed 375,000 units of
penicillin. The vial contains 600.000 units in 2 mls. Calculate the amount jenny
requires for one dose
a) 1.25 mls
b) 0.625 mls
c) 0.125 mls
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d) 0.32 mls
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48. The nurse encourages Jenny’s mother to stay with her as much as possible. The
rationale for this is which of the following
a) Mother of hospitalized children often experience guilt
b) The mothers presence will reduce anxiety and ease the child’s respiratory efforts
c) Separation from mother is a major developmental threat at this age
d) The mother can provide constant observations of the child’s respiratory efforts
49. Jenny is to have ventolin nebulisers every two hours until respirations improve. She
becomes distressed as soon as you try to put the mask on her face. You would best
manage this situation initially by
a) Getting her mother to assist with administration
b) Not giving it to her as being distressed may make her worse
c) Realising the importance of the ventolin so forcing it on her
d) Letting her have a mask to play with
50. As Jenny’s condition improves she is to commence oral medication. Which

approach is most likely to gain compliance
a) It’s time for your medication now, would you like to drink it with a straw or
from a glass
b) Wouldn’t you like to take your medicine now
c) You must take your medication, because the doctor says it will make you better
d) See how nicely Johnny took his medicine, now take yours
51. Martins mother states, ‘I’m not getting enough rest here and I’m tired and can’t cope
any more’. Which of the best response to this statement
a) ‘you need to go home and rest to have a break’
b) ‘why hasn’t your family helped you with martins care’
c) ‘shall I get a hospital grandparent for you’
d) ‘if you’d like to have a break, I’ll look after martin for you’
52. Which of the following factors does research show most assists caregivers to
cope with their child’s hospitalization
a) Control of decision making
b) Individualised care
c) Knowledge of what to expect
d) Time away from the child
53. Jenny aged 4 was brought to the emergency clinic while having an acute asthma
attack. Jenny’s breathing would be characterised by
a) Grunting inspirations
b) Wheezing on expiration
c) Frequent periods of apnoea
d) Laboured abdominal breathing
54. Nursing measures for a child suffering from an acute asthma attack would be
1 management of IV fluids and oral fluids
2 administering medications as ordered
3 Keep the child on flat bed rest until the acute attack is
over 4 Assisting with positive pressure breathing as ordered
a) All of these
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b) 1 and 2
c) 1, 2 and 4
d) A, 3 and 4
55. Jenny is 3 years old, she has been admitted with acute asthma. Jenny requires
IV aminophylline. It is charted at 56 mg. Each vial contains 250 mg in 10 mls.
You calculate the correct dose, which is
a) 3.16 mls
b) 0.4 mls
c) 1.25 mls
d) 2.24 mls
56. Hypertension, oedema and proteinuria syndrome commonly occurs in woman who
a) Have essential hypertension
b) Have diabetes mellitus
c) Are primigravida
d) All of the above
57. Martin is a 6 months old, admitted in acute respiratory distress. His mother has
accompanied his to hospital and is very anxious. Which sign of respiratory distress is
evident in children and not adults
a) Rasping respirations
b) Slow respiratory rate
c) Blue peripheries
d) Intercostals indrawing
58. Marin has hoarse cough and is wheezing. Further assessment is important. Select the
most appropriate question to initially ask his mother
a) When did martin first start coughing and wheezing
b) How long since martin last has a drink
c) Was martin playing with toys with small
pieces d) Has martin had any medication recently
59. His diagnosis is bronchiolitis. He requires oxygen therapy for at least 24 hours. Which
is the most appropriate method of administration of oxygen for your client
a) Oxygen tent
b) Mask
c) Nasal prongs
d) Head box or cone
60. Which is the most important nursing observation to consider for a child having
oxygen therapy
a) Monitoring his oxygen saturations regularly
b) Visual observation of child’s respiratory status
c) Doing pulse and respiration recordings
d) Analysis of level of oxygen in the tent
61. State your initial action before beginning a diabetic education programme for Tipene
and his whanau (family)
a) Assess their level of understand of diabetes
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b) Obtain pamphlets about diabetes that are bi lingual
c) Negotiate a time when whanau can be present
d) Contact the diabetic education nurse
62. How will you know if Tipene understands the information

a) He repeats the information in his own words
b) He demonstrates use of the equipment
c) He has seen the Maori nurse educator
d) He has his whanau with him
63. Tao is 24 year old man who identifies as Maori. He is an acute admission, via the
police, under a committal order. On admission he appears preoccupied, physically
untidy and is unable to speak. This is his third admission. What would your priority
of care be for Tao over the next two hours
a) Encourage Tao to talk about what has happened
b) Ensure that he is not left alone
c) Complete a mental health assessment
d) Notify his relatives of his admission
64. Following a cultural assessment profile, Tao expresses fear of being on his own. Your
best action would be
a) Encourage his whanau to come and be with him
b) Encourage him to talk about his fears
c) Ensure he has adequate prescribed medication
d) Reassure him that he is safe here
65. Taos mother reports that she has been unhappy with his previous care. How best
would you ensure the whanau are satisfied with the standard of care
a) Tell the whanau to visit daily
b) Arrange an appointment for the whanau to see the
doctor c) Involve the whanau in all decision making
d) Make sure whanau are familiar with ward procedures
66. The doctor asks the whanau for the corneas of iris for transplantation. The
whanau cannot make a decision right now. What is the most appropriate action
you should take in support of the whanau
a) Tell the doctor that this is not culturally appropriate
b) Listen to them and support them in their decision
c) Explain to the whanau why corneas are transplanted
d) Suggest the whanau talk to the hospital chaplain
67. Oral hypoglycaemic agents are effective and short acting. Their specific action is
a) As an oral form of insulin
b) To increase the output of insulin
c) To control the islets of langerhans
d) To decrease the output of insulin
68. Individuals whose diabetes is not well controlled are vulnerable to

several complications, which of the following are the least likely to
develop
a) Atherosclerosis
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b) Cataracts
c) Lymphadenopathy
d) Enphropathy
69. The most important feature of foot care for a diabetic would be to
a) Cut nails straight across
c) Wear sandals at all times
d) Avoid wearing garters
70. The whanau are very anxious about her condition. What is the most appropriate action
to take
a) Identify the spokesperson and explain what is happening
b) Take the whanau to a quiet room and discuss their concerns
c) Acknowledge their anxiety and allow a whanau member to stay
d) Assure them that the doctors will do everything they can
71. You are alone with iris when she suddenly collapses. What is your first priority
a) Commence cardiac massage
b) Ring emergency phone number
c) Maintain an airway
d) Summon help from other staff
72. Typically, the pain of myocardial infarction is different from the pain of angina in that
the pain of myocardial infarction is
a) Intermittent in nature
b) Is relieved by anginine
c) Is relieved by rest
d) May occur at rest
73. Which of the following symptoms often follow a myocardial

infarction 1 pallor
2 diaphoresis
3 anxiety
4 breathlessness
5 vomiting
a) 1 and3
b) 2 and 4
c) All but 5
d) All of the above
help the whanau
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76. Considering article 1 of the treaty of Waitangi (partnership), which statement best
describes this principle in Pepe’s care
a) The whanau are the initiators. The health care workers are the supporters
b) The whanau work with the health care workers in providing care
c) The partnership is between the health care workers and the whanau
d) The partnership is between the Maori community and the crown
77. How do you relate the treaty of Waitangi, to the importance of Pepe being discharged
to his whanau
a) The institution could no longer provide for his care
b) It ensures that Pepe’s cultural heritage is protected
c) That Pepe will be safer in a Maori community
d) That the principle of tino rangatiratanga is maintained
78. Piripi a 16 year old ‘street kid’ with a history of alcohol and solvent abuse, is
alienated from his Maori culture. He has expressed to you a desire to re-establish
himself with his blood whanau and his culture. Choose the most appropriate initial
action you would take to assist Piripi in learning about his culture
a) Identify Piripi'ss tribal affiliations
b) Locate the nearest marae
c) Ask a Maori colleague for assistance
d) Tell him not to be concerned, you can learn that later
79. Piripi has very little understanding of substance abuse. How would you begin to
educate him
a) Give him some pamphlets and handouts
b) Arrange an appointment with the doctor involved
c) Invite his whanau to be involved with his
learning d) Check that he can read and write
STATE EXAMS 17
1. Which of the following are characteristics of malignant tumours and not of
benign tumours
1 lack of a capsule
2 more rapid growth
3 less mature cells
4 spread to distant parts
a) 1
b) 2
c) None of the above
d) All of the above
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2. Hine refuses to sign the consent form until she is sure that her breast will be returned
following surgery. What action should you take to ensure Hines wishes are respected
a) Document and support Hine in her decision
b) check hospital policy about legal requirements
c) tell the doctor of Hines request
d) inform the whanau of the situation
3. it is agreed Hine will take her breast home. A consent form is signed. What action
must you now take to ensure Hines request
a) enter the information on the operation form
b) telephone the theatre staff before Hine goes to theatre
c) supply an appropriate container to receive the breast
d) document her request in the nursing notes
4. Hine returns to a single cubical. Her whanau ask to stay the night. The staff nurse
says this is not appropriate for that number to stay. What action should you take
a) negotiate other suitable accommodation for whanau
b) explain politely that the nurse in charge disagrees
c) tell them that only two people can stay at one time
d) explain there are no extra mattresses
5. iris a 55 year old woman, who identifies as Maori, is admitted to the emergency
department with severe chest pains. Her whanau are with her. What immediate
nursing action is the most appropriate to take
a) show the whanau where the waiting room is
b) interview the whanau regarding iris’s previous history
c) carry out a physical examination in a non threatening manner
d) administer oxygen and monitor her blood pressure and pulse
6. which of the following would support a diagnosis of chickenpox

a) chills, headache, malaise
b) nausea, vomiting, diarrhoea
c) kopliks spots, photo phobia, fever
d) sore throat, chills, fever
7. you are a practice nurse and Kevin’s mother asks for advice on how to care for
Kevin at home. Aims of care for Kevin are
a) ensure rest and relieve itching
b) maintain hydration and isolate Kevin
c) maintain hydration and relieve
itching d) ensure rest and isolate Kevin
8. Kevin’s mother asks you when she can send him back to kindergarten. You advise
a) when all spots have gone
b) in one weeks time if temperature is normal
c) he is not contagious now spots have
appeared d) when all spots are dry and crusted
9. Kevin’s mother asks you why the chicken pox immunisation is not offered as part
of the immunisation programme
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a) there is no vaccine for chickenpox
b) there are no major sequelae of chicken pox
c) the public would not accept another immunisation
d) the vaccine for chickenpox is too expensive
10. you are a practice nurse. Danny’s mother phones you. Danny is 18 months old. She
is concerned over his difficulty with respirations and ‘barking’ cough. You suspect
he may have laryngotracheobronchitis (croup). The characteristic ‘crowing’ sound of
respirations in croup is
a) stridor
b) rhonchi
c) wheeze
d) rales
11. Vicky has noticed an increase in weight due to the medication. What advice should
you give
a) discuss the benefits of maintaining regular exercise and having a sensible diet
b) encourage her to join weight watchers clinic
c) contact the hospital dietician to make an appointment
d) stop worrying, it is usual to put on weight with this medication
12. with increasing redundancies in Tui’s area of employment, she is keen to insure she
stays well. What advice should you give her
1 encourage her to keep in contact with her whanau for support
2 discuss ways of maintaining support system while overseas
3 discuss ways of coping with extra stress
4 provide relaxation tapes to use to ensure adequate sleep
a) 1, 3 and 4
b) 2, 3 and 4
c) 1, 2 and 3
d) All of the above
13. Tui’s employers have stated that all staff must undertake bicultural workshops. She is
asked to relate how the treaty of Waitangi relates to Maori health. How best would tui
respond
a) We are all one people with equal rights to health care
b) Because you are Maori the treaty gives you priority health care
c) The treaty guarantees the rights of Maori to decide their own health needs
d) Article 3 guarantees the right to equitable health care
14. Wiremu, who identifies as Maori is a 32 year old solo father, his wife died one year
ago. He is caring for 8 year old hone and 4 year old Ana. Hone’s teacher is concerned
about his disruptive behaviour at school and asks you to visit the home
a) Send a letter to Wiremu asking him to meet you at the school
b) Go to see Wiremu at his home
c) Organise a family conference at the school
d) Ring Wiremu to explain why you wish to see him
15. Kiri refuses to eat her food. She says ‘you are poisoning me’ your most helpful
response is
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a) That must be a scary feeling for you
b) Why do you say that
c) I’m not poisoning you, it is good for you to eat your food
d) Do try your lunch. The food is safe
16. Kiri refuses to eat in the dining room despite suggestions from you to do so. Her
behaviour would most accurately reported as
a) Negative behaviour demonstrated at mealtime
b) Patient seemingly withdrawn, does not follow suggestion
c) Did not eat dining room, even though suggested she do
so d) Preferred to eat in her room, against nurses advice
17. That night you find Kiri huddled in the corner of her room. She tells you that her dead
husband appeared to her. What immediate action should you take
a) Check that she had her night medication
b) Stay with her until she settles, then reassess the situation
c) Reassure her that her dead husband is not in the room
d) Notify the doctor and ask for extra sedation for her
18. Tui a 23 year old woman who identifies as Maori, attends a clinic for her maintenance
injection of fluphenazine deconate 12.5 ml. She has been employed as a cabin crew
attendant for the last 5 years, expresses the following concerns to you. Although her
present medication has controlled her previous psychiatric breakdown, will this be
sufficient in the future. State your best response
a) As long as you don’t stop taking this medication
b) As your situation changes you may need your medication adjusted
c) Providing you keep your appointments, we can monitor the effectiveness of
your medication
d) We can work together to manage your situation to maintain your well-being
19. Which of the following comments by Danny’s mother most strongly supports a
diagnosis of croup
a) He’s been very lethargic and drowsy these last few days
b) His older sister has had asthma since she was 7 years old
c) He seems to cough much more when he’s lying down
d) He had the flu a week ago
20. Danny’s mother should be instructed to watch for signs of worsening respiratory
status, including which of the following
a) Low grade fever
b) Productive cough
c) Increased restlessness
d) Hoarse voice
21. Danny shows signs of acute respiratory distress, and his mother brings him to the
accident and emergency clinic. Which of the following changes in vital signs
would the nurse expect to note
a) Bradycardia, tachypnea
b) Bradycardia,
bradypnea c) Tachycardia,
tachypnea
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d) Tachycardia, bradypnea
22. Ongoing assessment of Danny includes regular oximetry readings. The reading
changes to 75%. Your immediate reaction is to
a) Increase the level of oxygen being administered
b) Check the accuracy of the oximeter
c) Visually check the child’s respiratory status
d) Go and get someone to check your recordings
23. Danny’s health improves, he is able to go home. His mother says ‘I have used all my
money to get the taxi here. I cannot get home. Your response is
a) That’s okay, I’ll pay for the taxi for you
b) You can’t stay here, this is an emergency clinic
c) Can I ring someone else at home for you
d) You can use a credit card with the taxi
24. Danny’s mother bursts into tears. I don’t want to go home because my husband’s
drunk and he’ll beat me’. Your response is
a) Would you like to talk about his in a quieter place
b) Shall we ring him to see if he’s sober yet
c) I’ll contact a social worker for you
d) How often does he get drunk and beat you
25. The immunization usually given at 3 months of age provides protection against
a) Diphtheria, tetanus, whooping cough, polio, haemophilus influenza
b) Diphtheria, tetanus, whooping cough, polio, hepatitis B, haemophilus influenza
c) Diphtheria, tetanus, whooping cough, haemophilus influenza
d) Diphtheria, tetanus, polio, hepatitis B, haemophilus influenza
26. As a community nurse at the school you are asked to see Suzie who has unexplained
bruising on her arms and legs. Your initial assessment indicates she has been
abused.
Your first professional responsibility is to
a) Contact the child protection coordinator
b) Contact the child’s parents
c) Contact the police
d) Carry out a full physical examination
27. It has been decided that physical abuse has occurred. Which intervention will be
implemented under the children, young persons and their families act
a) The child will be removed from the home to a place of safety
b) The child protection coordinator calls a family case conference
c) The abuser will be removed from the home
d) The community nurse calls a family conference
28. You return to your office and receive a call from a man stating he is Suzie’s father. He
says, ‘I believe you think I have been hitting my daughter’. Your response is
a) Suzie told me you had been hitting her
b) I won’t discuss this with you at the moment
c) It would be better if you rang the
school d) I can’t discuss this on the phone
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29. Tao’s mother believes he has mate Maori (Maori illness) and states ‘he will never get
well here’. How would you best respond
a) Notify a Maori health worker
b) How can we help you to meet Tao’s needs
c) Explain to her about mental illness
d) Arrange for a tohunga (Maori healer) to see Tao
30. Tao is referred to a Maori mental health unit. Of what benefit would this referral be
to Tao
a) Maori people understand how to best care for Maori
b) The unit can provide a safe spiritual environment
c) His whanau would feel more comfortable when visiting
d) He will comply with treatment readily
31. Kiri a 36 year old woman who identifies as Maori is admitted to the psychiatric unit
with a provisional diagnosis of paranoid schizophrenia. Who’s the statement that best
describes the behaviours Kiri would exhibit
a) Illusions, flight of ideas, suspiciousness
b) Visual hallucinations, ritualistic behaviour
c) Echolalia, delusions, fearfulness
d) Suspiciousness, visual and audible hallucination
32. What particular aspect should you consider when assessing Kiri
a) Cultural/spiritual reasons for her changed behaviour
b) Any recent loss in Kiri’s family
c) Inability to cope with recent stresses
d) Physical reasons for changed behaviour
33. What priority action should you take when identifying reasons for Kiri’s behaviour
a) Obtain a detailed history from Kiri
b) Check for a history of mental illness in the family
c) Arrange for a family interview to discuss Kiri’s current situation
d) Complete a physical assessment of Kiri
34. In active immunisation

a) The immune system attacks normal body cells
b) The body receives antibodies produced by another person
c) Genes for antibodies are introduced into the body
d) The body is deliberately exposed to an antigen
35. Suppressor T cells act to

a) Suppress antigens
b) Limit the degree of memory in memory cells
c) Limit antigen proliferation
d) Depress the responses of other T and B cells
36. You are preparing vaccines for an immunization programme. In the preparation
of vaccines, the cold chain refers to a system of
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a) Maintaining vaccines at temperatures under 10 degrees centigrade
b) Preventing heart damage to vaccine
c) Storing vaccines at stable temperatures in a separate refrigerator
d) Transport storage and administration of vaccine in a potent state
37. Which of the following is a contraindication to immunization

a) Contact with an infectious disease
b) Prematurity
c) Temperature over 38oC
d) Asthma
38. When carrying out immunizations a nurse must have with her/him
a) Oxygen
b) A medical officer
c) Intravenous
fluids d) Adrenaline
39. Increased incidence of meningitis led to the introduction of a new vaccine into the
new Zealand immunization schedule in 1994. The causative organism of this
disease is
a) Beta A streptococcus
b) Respiratory syncytial virus
c) Haemophilus influenza
d) Neisseria meningitis
40. You are a community nurse in charge of an adolescent wellness centre at a local
high school. You are planning a programme to promote self esteem in adolescence.
Your final plan is governed by
a) Your perception of their needs
b) The focus of the health
curriculum c) Consultation with the
adolescents
d) Ideas from the teaching staff
41. Autoimmune disease occurs when

a) Antibodies fail to recognise own tissue as an antigen
b) Antigens fail to stimulate antibody response
c) Antibodies identify own tissue as an antigen
d) Antibody production ceases
42. You present a seminar to your colleagues on ‘immunisation’. After the presentation
you are asked to clarify the following. Immunity that results from the natural
exposure to an antigen in the environment is called
a) Active immunity
b) Natural passive immunity
c) Autoimmunity
d) Passive immunization
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43. Immunity that results from antibodies that pass the placenta from mother to foetus is
called
a) Active immunity
b) Natural passive immunity
c) Autoimmunity
d) Natural active immunity
44. It is important to assess his level of consciousness. The first definite sign of
consciousness is when
a) His eyes begin to open
b) His facial expression changes
c) He has involuntary body movement
d) He has plantar flexion of his feet
45. Carl has a dense R) hemiplegia and some spasticity to his L) limbs. To improve his
ability to ambulate in the future it is important he
a) Always has his limbs extended when resting
b) Is turned to alternate sides two hourly
c) Has his joints flexed and rotated regularly
d) Maintains a healthy well balanced diet
46. Carl is beginning to make progress and is relearning skills. When encouraging Carl’s
relearning of feeding you
a) Let him have a spoon and do his best
b) Occasionally try to tell him the right way to feed
himself c) Teach him in small steps and progress at his rate
d) Take over when he makes a mess
47. Carl is learning to communicate with signals. He is using his eyes to indicate yes
and no. To encourage him to use these signals you
a) Give Carl a range of choices to facilitate a decision
b) Discontinue his care until he has communicated
c) Reprimand Carl and explain to him he must
communicate d) Give two choices to facilitate decision
making
48. Carl is becoming irritable and communicating with loud noises which are disruptive.
He reacts to visitors and the phone ringing. To help lessen this reaction
you should
a) Get some sedation charted for him
b) Use a mild punishment when he is disruptive
c) Try and find out what is really bothering him
d) Provide him with something interesting to quieten him
49. Carl is to go home for two weeks with his family. They have been visiting him 2-3
times a week and feel they can cope with him at home. In planning his discharge
you would
a) Provide community contacts the family can access
b) Encourage the parents to cope without help
c) Provide a daily schedule which is to be adhered to
d) Encourage the parents to phone if necessary
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50. James is prepared for surgery by
a) Having a sedative four hours pre operatively
b) Being hydrated with I.V. fluids
c) Amusing him to keep him alert
d) Feeding him on demand to keep him contented
51. James weighs 3.4 kgs. His fluid requirement is 150mls/kg/day. To maintain his
hydration James requires
a) 20 mls per hour
b) 27 mls per hour
c) 23 mls per hour
d) 22 mls per hour
52. James mother is living in. She is breast feeding James. Nursing consideration for her
should include
a) Plenty of rest and distraction
b) Education about breast feeding
c) Providing privacy and means to express milk
d) Checking her breasts for cracked nipples
53. James returns from theatre with an apnoea monitor. This is used to monitor
a) The rate of James breathing
b) The length of his sleeping
c) The length of time between breaths
d) Delays between breaths exceeding 20 seconds
54. You are a staff nurse working in a rehabilitation unit. Carl is 12 years old. He was
involved in a road traffic accident and sustained a head injury. He has been
unconscious for four weeks. You are his primary nurse. While providing his nursing
care you will
a) Encourage his mother to always help you
b) Talk to him clearly in a normal voice
c) Provide him with intensive stimulation
d) Offer him drinks to check his swallow reflex
55. Oral suspension of rivotril, 2.5 mgs per ml is available to administer 1.8 mgs you
will give
a) 0.53
b) 0.72
c) 5.3 mls
d) 7.2 mls
56. Jack is concerned about returning to school. He should be encouraged to

a) Take leave of absence for a semester
b) Initially, attend school only part time
c) Plan an alternative lifestyle
d) Resume all previous activities
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57. James aged six is admitted with a history of frequent vomiting after feeding. The most
important nursing assessment specific to this would be to observe for
a) Pain in his abdomen
b) The amount and frequency of his vomits
c) The type of milk mixture he is
having d) The level of his hydration
58. His vomiting is described as projectile, this means

a) It has an unusual colour
b) It is a forceful vomit
c) It is curd like in appearance
d) He has frequents spills
59. James is diagnosed to have pyloric stenosis. This requires surgery to

a) Increase the opening to the pyloric sphincter
b) Stretch James stomach to cope with fluids
c) Decrease the opening in the cardiac sphincter
d) Put in a gastroscopy tube to bypass the stomach
60. In the meeting house during the marae visit, Raewyn offers you a peppermint. Which
of the following is the most appropriate way to response to Raewyn
a) Any food needs to be blessed before we eat here
b) We should share these peppermints with everyone
c) It is culturally inappropriate to eat in the meeting house
d) It is appropriate only to eat between speakers
61. The Maori community health committee approaches you for input into their
health care submission for the regional health authority. Your response would be
a) How can I best assist your committee
b) I do not feel qualified to do that
c) I will write up a draft copy for you
d) I will discuss this with my colleagues first
62. Margaret a kaiako (a teacher) at the kohunga reo tells you that tama has fallen
and grazed his knee. Tama has hepatitis B. What advice should the nurse give to
the teacher
a) Wash your hand before and after attending to tama
b) Keep tama’s eating utensils separate from others
c) Cover the graze with a waterproof dressing
d) Keep tama at home until the graze heals
63. Margaret asks you to give a teaching session to the mothers about hepatitis B. What
would be your first action in implementing this session
a) access a video and pamphlets about hep B
b) set a time and date immediately with the teacher
c) arrange for the mothers to come and visit your clinic
d) meet with the mothers and teacher to arrange a suitable time
64. you discover more than half the children at kohanga reo have not been
vaccinated against hep B. What should your first action be
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a) discuss with the caregivers and parents what they wish to do about this
b) give these children hep B vaccinations explaining that it is essential for their
protection
c) report your findings to the health department as soon as possible
d) inform the ministry of education to gain funding for them to be immunised
65. you are working in a bicultural relationship with the local Maori health initiative on
diabetes. Which statement would best describe your role within this initiative
a) to set up a structure that allows access to funds
b) to teach the Maori initiative about health reforms
c) to provide resource materials and information
d) to promote partnership, protection and participation in Maori health
66. you have invited Raewyn your supervisor to attend. As part of the preparation for the
visit what is essential for Raewyn to know
a) learn Maori greetings so she can communicate with the marae committee
b) learn about the treaty of Waitangi so she can be culturally safe
c) learn about marae protocol, so she can behave appropriately
d) learn about the history of the marae
67. Raewyn asks you what cultural safety means

a) to provide care that acknowledges others values and beliefs
b) to insure that all clients get adequate care
c) to meet the recommendations as laid out in the treaty of Waitangi
d) to make sure that a Maori nurse works with a Maori client
68. she then asks how cultural safety relates to the treaty of Waitangi. Your replay
would be
a) the treaty was signed by both Maori and pakeha
b) hospital charters acknowledge the treaty in caring for Maori
c) the rights of all Maori clients are being meet according to the treaty
d) acknowledges the choice for Maori in order to meet their health needs
69. Raewyn is very excited about the coming marae visit, and surprises you two days
prior to the event by saying ‘as 1993 was women’s suffrage year, I want to make a
speech during the welcome’. Your response should be
a) tell her she should talk to the elders of the community
b) ‘that’s exciting, which song do you want me to sing in support’
c) We should discuss this with the Maori elders involved with our research project
d) Contact a Maori nurse in the community to support her
70. The treaty of Waitangi was signed by

a) Missionaries and Maori chiefs
b) The new Zealand government and Maori people
c) Cpt. Hobson and Maori chiefs of north Auckland
d) A representative of the British crown and Maori chiefs
71. Traditional Maori health practices were outlawed by which of the following acts
of parliament
a) Suppression of rebellion act 1860
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b) Native lands act 1865
c) Suppression of tohunga act 1908
d) Constitution act 1852
72. Maori attend tangi (funeral) because they need to
1 share with the bereaved family in their grief
2 reaffirm family and friendship ties
3 take the opportunity to come together
4 look back on their past to make that past come alive
5 Gain prestige on the marae
a) 1, 2 and 4
b) 1, 3 and 4
c) 1, 2, 3 and 4
d) All the above
73. Maori see “primary health care” initiatives as being

a) Maori driven, Maori controlled, Maori financed and government supported
b) The first line of contact with a Maori doctor and Maori nurse
c) The place where as Maori we go to speak our language only
d) The government sharing the resources 50/50 thus ensuring equity
STATE EXAMS 18
1. A client asks the nurse why menstruation ceases once pregnancy occurs. The nurse
best response would be that this occurs because of the
a) Reduction in the secretion of hormones by the ovaries
b) Production of oestrogen and progesterone by the ovaries
c) Secretion of luteinizing hormone produced by the pituitary
d) Secretion of follicle stimulating hormone produced by the pituitary
2. First foetal movements felt by the mother are known as

a) Lightening
b) Quickening
c) Ballottement
d) Engagement
3. A primigravida client asks the nurse if she can continue to have a glass of wine
with dinner during her pregnancy. Which of the following would be the nurses best
response
a) The effects of alcohol on a foetus during pregnancy are unknown
b) You should limit your consumption to beer and wine
c) You should abstain from drinking alcoholic beverages
d) You may have 1 glass of alcohol per day
4. Before teaching clients about nutritional needs during pregnancy, the nurse should be
aware that
a) Carbohydrate needs are decreased during pregnancy
b) Calories needs increased by a maximum of 100 calories per day
c) The need for protein increases gradually throughout pregnancy
d) Calcium and phosphorous needs decreased gradually during pregnancy
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5. A pregnant client asks the clinic nurse how smoking will affect her baby. The nurses
answer reflects the following knowledge
a) The placenta is permeable to specific substances
b) Smoking relieves tension and the foetus responds accordingly
c) Vasoconstriction will affect both foetal and maternal blood vessels
d) Foetal and maternal circulation are separated by the placental barrier
6. Which of these observations should a pregnant woman report immediately

a) Backache
b) Weight gain
c) Vaginal bleeding
7. A pregnant client with diabetes is referred to the clinic nutritionist for nutritional
assessment and counselling. The dietary programme worked out for this client would
be
a) A diet high in protein of good biologic value and decreased calories
b) A balanced diet to meet increased dietary needs with insulin adjusted as necessary
c) Adequate balance of carbohydrate and fat to meet energy demands and prevent
ketosis
d) A low carbohydrate, low calorie diet to stay within her present insulin coverage
and avoid hyperglycaemia
8. A client experiences an episode of painless vaginal bleeding during the last trimester.
The nurse realises that this may be caused by
a) Placenta previa
b) Abruption placenta
c) Frequent intercourse
d) Excessive alcohol ingestion
9. A 17 year old client at 33 weeks gestation diagnosed with mild pre eclampsia is
prescribed bed rest at home. The nurse instructs the client to contact the health
care provider immediately if she experiences which of the following
a) Blurred vision
b) Ankle edema
c) Increased energy levels
d) Mild backache
10. The nurse evaluates that the danger of a seizure in a woman with eclampsia ends
a) After labour begins
b) After delivery occurs
c) 24 hours post partum
d) 48 hours post partum
11. During a preparation for parenting classes one of the participants asks the nurse, how
will I know if I am really in labour. Which of the following statements about true
labour contractions would be the nurses best response
a) Walking around helps to decrease true contractions
b) True labour contractions may disappear with ambulation, rest or sleep
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c) The duration and frequency of true labour contractions remain the same
d) True labour contractions are felt first in the lower back, then the abdomen
12. True labour can be differentiated from false labour because in true labour contractions
will
a) Bring about progressive cervical dilatation
b) Occur immediately after membrane rupture
c) Stop when the client is encouraged to walk
d) Be less uncomfortable if the client is in a side lying position
13. The two most important predisposing causes of puerperal or postpartum infection are
a) Haemorrhage and trauma during labour
b) Preeclampsia and retention of placenta
c) Malnutrition and anaemia during pregnancy
d) Organisms present in the birth canal and trauma during labour
14. When measuring the fundal height of a primigravida client at 20 weeks gestation, the
nurse would anticipate locating the fundal height at which of the following points
a) Halfway between the clients symphysis pubis and umbilicus
b) At about the level of the clients umbilicus
c) Between the clients umbilicus and xyphoid process
d) Near the clients xyphoid process and compressing the diaphragm
15. Which of the following recommendations would be the most appropriate preventative
measure to suggest to a primigravida client at 30 weeks gestation who is experiencing
occasional heartburn
a) Eat smaller and more frequent meals during the day
b) Take a pinch of baking soda with water before meals
c) Decrease fluid intake to four glasses daily
d) Drink several cups of regular tea throughout the day
16. A multiparous client, 28 hours after caesarean delivery, who is breast feeding
complains of severe cramps or after pains. The nurse explains that these are caused by
which of the following
a) Flatulence accumulation after a caesarean delivery
b) Healing of the abdominal incision after caesarean delivery
c) Side effects of the medications administered after delivery
d) Release of oxytocin during the breast feeding session
17. A primiparous client with a neonate who is 36 hours old, asks the nurse, why does my
baby spit up a small amount of formula after feeding the nurse explains that the
regurgitation is thought to result from which of the following
a) An immature cardiac sphincter
b) A defect in the gastrointestinal system
c) Too frequent burping of the infant
d) Moving the infant during the feeding
18. A breast feeding primiparous client who delivered 8 hours ago asks the nurse, how
will I know that my baby is getting enough to eat. Which of the following would the
nurse include in the teaching plan as evidence of adequate intake
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a) Six to eight wet nappies by the fifth day
b) Three to four transitional stools on the fourth day
c) Ability to fall asleep easily after feeding on the first day
d) Regain of lost birth weight by the third day
19. A primiparous client who is beginning to breast feed her neonate asks the nurse. Is it
important for my baby to get colostrums. When instructing the client, the nurse
would explain that colostrums provides the neonate with which of the following
a) More fat than breast milk
b) Vitamin K, which the neonate lacks
c) Delayed meconium passage
d) Passive immunity from maternal antibodies
20. While the nurse is preparing to assist the primiparous client to the bathroom to void
for 10 hours after a vaginal delivery under epidural anaesthesia, the client says that
she feels dizzy when sitting up on the side of the bed. The nurse explains that this is
most likely caused by which of the following
a) Effects of the anaesthetic during labour
b) Haemorrhage during the delivery process
c) Effects of analgesics used during labour
d) Decreased blood volume in the vascular system
21. After explaining to a primiparous client about the causes of her neonates cranial
moulding, which of the following statements by the mother indicates the need for
further instruction
a) The moulding was caused by an overlapping of the baby’s cranial bones during
my labour
b) The amount of moulding is related to the amount and length of pressure on the
head
c) The moulding will usually disappear in a couple of days
d) Brain damage may occur if the moulding doesn’t resolve quickly
22. When teaching a primiparous client about the growth and development of the
neonate, which of the following would the nurse include as the usual age at which
most babies are able to drink from a cup independently
a) 5 to 7 months
b) 8 to 10 months
c) 12 to 14 months
d) 15 to 16 months
23. After explaining to the mother of a male neonate scheduled to receive an injection of
vitamin K soon after birth about the rationale for the medication, which of the
following statements by the mother indicates successful teaching
a) The moulding was caused by an overlapping of the baby’s cranial bones during
my labour
b) The amount of moulding is related to the amount and length of pressure on the
head
c) The moulding will usually disappear in a couple of days
d) Brain damage may occur if the moulding doesn’t resolve quickly
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24. When teaching a primiparous client about the growth and development of the
neonate, which of the following would the nurse include as the usual age at which
most babies are able to drink from a cup independently
a) 5 to 7 months
b) 8 to 10 months
c) 12 to 14 months
d) 15 to 16 months
25. After explaining to the mother of a male neonate scheduled to receive an injection of
vitamin K soon after birth about the rationale for the medication. Which of the
following statements by the mother indicates successful teaching
a) My baby doesn’t have the normal bacteria in his intestines to produce this vitamin
b) My baby is at a high risk for a problem involving his bloods ability to clot
c) The red blood cells my baby formed during pregnancy are destroying the vitamin
K
d) My baby’s liver is not able to produce enough of this vitamin so soon after birth
26. After an 8 hour uneventful labour a client delivers a baby boy spontaneously under
epidural block anaesthesia. As the nurse places the baby in the mother’s arms
immediately following delivery the mother asks, is he normal. The most
appropriate response by the nurse would be
a) Most babies are normal; of course he is
b) He must be all right, he has such a good strong cry
c) Yes because your labour and pregnancy were so normal
d) Shall we unwrap him so you can look him over yourself
27. When caring for a multiparous client who is HIV positive and asking to breast
feed her neonate as soon as possible, which one the following instructions about
breast mild would the nurse include in the teaching plan
a) It may help to prevent the spread of the HIV virus
b) It contains antibodies that can help protect the neonate from HIV
c) It can be beneficial for the bonding process
d) It has been found to contain the retrovirus HIV
28. The nurse has been assigned to care for several post partum clients and their
neonates on a birthing unit. Which of the following clients would the nurse assess
first
a) A multipara at 48 hours postpartum who is being discharged
b) A primipara at 2 hours post partum who delivered a term neonate vaginally
c) A multipara at 24 hours post partum whose infant is in the special care nursery
d) A primipara at 48 hours after caesarean delivery of a term neonate
29. A 16 year old primipara has decided to place her baby for adoption. The adoptive
parents are on their way to hospital when the mother says I want to see the baby one
last time, which of the following would the nurse do
a) Tell the client it would be best if she didn’t see the baby
b) Allow the client to see the baby through the nursery window
c) Contact the physician for advice related to the clients situation
d) Allow the client to see and hold the baby for as long as she desires
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30. While making a home visit to a woman on her third day postpartum, you discover this
new mother sitting by her bed crying. She states nothing is wrong; she just ‘feels sad’.
Which of the following would be your best response to her
a) I’ll keep confidential any problem you want to discuss with me
b) You have a beautiful boy; you shouldn’t feel sad about that
c) Do you wish you’d had a girl instead of a boy
d) Feeling sad when you know you shouldn’t must be very confusing
31. During a home visit on the fourth postpartum day, a primiparous client tells the nurse
that she has been experiencing breast engorgement. To relieve engorgement, the nurse
teaches the client that before nursing her baby, the client should do which of the
following
a) Apply an ice cube to the nipples
b) Rub her nipples gently with lanolin
cream c) Express a small amount of breast
milk
d) Offer the neonate a small amount of formula
32. A primigravida client at 8 weeks gestation tells the nurse that since having had sexual
relations with a new partner 2 weeks ago, she has noticed flu like symptoms,
enlarged lymph nodes, and clusters of vesicles on her vagina. The nurse refers the
client to a physician because the nurse suspects which of the following sexually
transmitted diseases
a) Gonorrhoea
b) Chlamydia trachomatis infection
c) syphilis
d) herpes genitalis
33. which of the following statements about the first stage of childbirth is right
a) it usually lasts 1-2 hours
b) it consist of dilatation or widening of the cervix
c) contractions are continuous at this stage
d) it is the shortest of the stages of the birth
34. the first stage of the labour ends when

a) the baby’s head moves through the cervix into the vaginal canal
b) dilatation of the cervix begin
c) baby has the left mothers body
d) effacement of the cervix
35. during childbirth dilatation of the cervix occur when

a) the 1st stage
b) the 2nd stage
c) the 3rd stage
d) shortly before the contraction occur
36. the end of the second stage of childbirth is indicated by

a) the initial dilatation of the cervix
b) the emergence of the baby from the mothers body
c) the exploitation of the placenta
d) contraction that occurs every 8-10 minutes
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37. the placenta is expelled from the mothers body during
a) 1st stage
b) 2nd stage
c) 3rd stage
d) 4th stage
38. The normal method of child birth is
a) Vaginal
b) Medicated
c) Caesarean
d) Prepared
39. Which of the food items provide the best source of protein
a) Carrots, peas and enriched butter
b) Whole wheat bread, butter and spinach
green c) Egg, pork chops and macaroni and
cheese
d) Dried fruits, molasses and cornbread
40. A teaching plan to ensure a client is eating enough carbohydrates

a) Chicken, tuna and egg
b) Liver ham and tomatoes
c) Apple corn and bread
d) Boiled eggs, catfish and broccoli
41. Which of the following is correct information to include in the nutritional

counselling of the pregnant adolescent
a) Adolescents should definitely take a prescribed iron supplements
b) Pregnant adolescents frequently have diets that have too high in calcium
c) Pregnant adolescents have the same dietary requirement for foods as do adult
42. If you are a vegetarian, you are most likely to get iron from
a) Milk and milk products
b) Bread and cereals
c) Green vegetables whole grains, some beans and peas and nuts
d) Orange and apples
43. To assist the body to absorb iron, it is important to eat

a) Tomato apples and potatoes
b) Tomato potatoes and pumpkins
c) Tomato, kiwifruit and oranges
d) Tomato onions and parsnips
44. A 28 woman has just had pregnancy confirmed she is particular concerned about
the weight gain, the nurse should tell her
a) All pregnant woman should gain at least 12-14 kgs
b) The optimal amount weight gain depends on factors such as health and bone
structure
45. A client states, ‘I have heard that a pregnant woman needs more iron, is that true
a) Yes a pregnant woman needs at least twice as much iron
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46. For woman of normal weight the average whole weight gain during pregnancy
a) 13-16
kgs b) 12-14
kgs
c) 8-10 kgs
d) 1 kg per week
47. A client states, why is protein is so important during pregnancy the nurse should
explain that protein is necessary to
A) Development of foetal teeth and bone
B) Grown of foetal and maternal tissues
C) Prevention of anaemia
D) Blood coagulation
48. A nurse states I am concerned about eating the proper foods during my pregnancy. I
know the milk group is important but I do not like to drink milk
a) Cottage cheese and dry cereal and 25 ml of orange juice
b) Ice cream hot cake and eggs
c) Cheese, yoghurt, and custard pudding
d) Powdered milk
49. Prepared teaching how to breathe during pregnancy is

to a) Minimise fear and pain
50. During pregnancy the capacity of the uterus increase from about 5ml to 10ml or more.
This is primarily a result of
Hypertrophy (increase in size of the pre existing cells)
51. A woman who is pregnant for the first time is referred to as a

Primigravida
52. A client notices that the nurse has written the word miltigravida in her chart and she
asks what it means
Miltigravida is women experiencing two more births
53. When testing a client about the side effect of smoking while pregnant, the
information that the nurse must include is that smoking leads to an increase risk of
for the unknown child
A low birth weight
STATE EXAMS 19
1. Which of the following has made the biggest impact on mortality from infectious
diseases in the 20th century
a) Vaccination
b) Better housing and provision of clean water, sewerage systems
c) Antimicrobials
d) Infection control
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2. In addition to providing informational support, which of the following nursing
activities is an integral part of the role of the nurse advocate
a) Maintaining the patient in a dependent role
b) Assuming responsibility for directing the patients care
c) Assisting the patient to make sound health care decisions
d) Persuading the patient to choose exactly what the health care team recommends
3. Steve 15 years old is admitted with suspected meningitis Nuchal rigidity will not be
seen in which of the following
a) Intracranial haematoma
b) Meningitis
c) Cerebral concussion
d) Intracranial tumour
4. A positive Mantoux test indicates

a) The client has active tuberculosis
b) The client has been exposed to mycobacterium
c) The client will never have tuberculosis
d) The client has been infected with mycobacterium tuberculosis
5. Which of the following would the nurse do when suspecting that a child has been
abused by the mother
a) Continue to collect information until there is no doubt in the nurses mind that
abuse has occurred
b) Ensure that any and all findings are reported to the proper state and
legal authorities
c) Keep the findings confidential, because they represent legal
privileged communication between the nurse and the mother
d) Report the findings to the physician because that falls within the responsibilities of
medical practise
6. Several high school seniors are referred to the school nurse because of suspected
alcohol misuse. When the nurse assesses the situation, which of the following
would be most important to determine
a) What they know about the legal implications of drinking
b) The type of alcohol they usually drink
c) The reasons they choose to use alcohol
d) When and with whom they use alcohol
7. After teaching the parents about the cause of ringworm of the scalp (tinea capitis),
which of the following if stated by the father, indicates successful teaching
a) Overexposure to the sun
b) Infestation with a mite
c) Fungal infection of the scalp
d) An allergic reaction
8. A mother tells the nurse that one of her children has chicken pox and asks what she
should do to care for that child. When teaching the mother, which of the following
would be most important to prevent
a) Acid base imbalance
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b) Malnutrition
c) Skin infection
d) Respiratory infection
9. One litre of intravenous fluid is to be given over 4 hours. The giving set delivers
60 drops per ml. How many drops per minute should be given
a) 150
b) 250
c) 300
d) 160
10. The nurse discusses the eating habits of school aged children with their parents,
explaining that these habits are most influenced by which of the following
a) Food preference of their peers
b) Small and appearance of foods offered
c) Examples provided by parents at mealtimes
d) Parental encouragement to eat nutritious foods
11. Which of the following is an offence under the Hydatids act 1959
a) Failure to report stray, unregistered dogs
b) Feeding raw offal to any dogs in your care
c) Tenuicollis worms in lambs at the time of killing
d) Tenuicollis cysts in any purged material from dogs
12. What is the responsibility of the nurse who, for two days, has observed the nurse
manager putting several syringes into her pocket
a) Report the matter to another nurse manager
b) Discuss the matter with your nursing colleagues
c) Watch the nurse manager to see if it happens again
d) Ignore the incident as a nurse manager is a responsible person
13. When performing a cultural assessment with a patient of a different culture, it is

important for the nurse to first ask about the patients
a) Racial heritage
b) Use of cultural healers
c) Language spoken at home
d) Affiliation with a cultural group
14. After being bitten by an unknown insect, a patient allergic to wasp stings is brought
to a clinic by a co worker. Upon arrival the patient is anxious and is having difficulty
breathing. The first action by the nurse is to
b) Maintain the patients airway
c) Remove the stinger from the site
d) Place the patient in recumbent position with his legs elevated
15. During immediate care of a victim of a bite or sting to the hands or fingers, it is most
important for the nurse to
a) Elevate the affected extremity
b) Scrub the wound with an antibacterial solution
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c) Apply ice to the site with ice water or ice packs
d) Remove rings and watches from the affected extremity
16. A young man seeks medical care after a friend with whom he shared needles during
illicit drug use develops hepatitis B. To provide immediate protection from
infection, the nurse expects to administer
a) Corticosteroids
b) Gamma globulin
c) Hepatitis B vaccine
d) Fresh frozen plasma
17. A 63 year old man has terminal cancer of the liver and is cared for by his wife at
home. His abdominal pain has become increasingly severe, and he now says it is
intense most of the time. The nurse recognizes that teaching regarding pain
management has been effective when the patient
a) Limits the use of opiate analgesics to prevent addiction
b) Resigns himself to the fact that pain is an inevitable consequence of cancer
c) Uses pain medication only when the pain becomes more than he can tolerate
d) Takes analgesics around the clock on a regular schedule, using additional doses
for breakthrough pain
18. A middle aged woman enjoys orienting new young women and men at work. She
enjoys being a teacher and mentor and feels she should pass down her legacy of
knowledge and skills to the younger generation. The nurse recognizes that the
woman is involved in the behaviour described by Erikson as
a) Generativity
b) Ego integrity
c) Identification
d) Valuing wisdom
19. For the nursing council to find a registered nurse guilty of malpractice following
an assault on a client, it would have to prove that the nurse
a) Intended to cause bodily harm to the client
b) Actually assaulted the client
c) Did not establish a therapeutic relationship with the client
d) Committed a felony against the client
20. Emergency interventions for a victim with upper torso injuries or face, head, or
neck trauma include
a) Suctioning to clear the airway
b) Immobilization of the cervical spine
c) Administration of supplemental oxygen
d) Ensuring venous access with at least two large bore IV lines
21. An employee spilled industrial acids on his arms and legs at work. The
appropriate action by the occupational nurse at the facility is to
a) Apply cool compresses to the area of exposure
b) Apply an alkaline solution to the affected area
c) Cover the affected area with dry, sterile dressings
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d) Flush the substance with large amounts of tap water
22. According to the privacy act 1993 when collecting health information from a client
the nurse must
a) Ensure the client is aware that health information is being collected
b) Tell the client why health information is being collected
c) Inform the client about their rights of access and
correction d) All of the above
23. An example of the use of primary prevention for family violence is

a) Working to eliminate the glamorisation of violence on television
b) Counselling a woman living in an abusive relationship about available shelter
programs
c) Calling child protective services regarding a school age child who has
reported sexual attacks by her stepfather
d) Carefully examining the skin of an elder who has just returned to an extended care
facility following a weekend with his children
24. The long term consequences of Chlamydia is most likely to be

a) Menorrhagia
b) Chronic vaginitis
c) Chronic cervicitis
d) Sterility
25. When describing the effects of insulin on the body to a patient newly diagnosed with
diabetes mellitus, the best explanation by the nurse is
a) Insulin promotes the breakdown of fatty tissue into triglycerides, which can be
used for energy
b) When proteins are taken into the body, insulin promotes their breakdown and
conversion to fats
c) Insulin stimulates the conversion to sugars into blood glucose and the conversion
of proteins into glucose
d) When carbohydrates, fats, and proteins are eaten, insulin promotes
cellular transport and storage of all these nutrient
26. A serious complication of acute malaria is

a) Congested lungs
b) Impaired peristalsis
c) Anaemia and cachexia
d) Fluid and electrolyte imbalance
27. A registered nurse stops to assist at the scene of an accident but the injured man dies
before the ambulance arrives. The nurse should understand that she
a) Should leave the scene before the ambulance arrives
b) Will be covered by her actions by the good Samaritan laws
c) Has a legal duty of care to perform at a competent level as a registered nurse
d) Should pronounce the person dead at the scene
28. During the initial postoperative assessment of a patients stoma formed with a
transverse colostomy, the nurse finds it to be brick red with moderate oedema and
a
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small amount of bleeding. The most appropriate interpretation of this finding by the
nurse is that there is
a) A viable stoma with high vascularity
b) Obstruction of the stoma with venous congestion.
c) Inadequate blood supply to the stoma caused by oedema
d) An abnormal stomal condition that should be reported to the surgeon
29. A client has been diagnosed with viral hepatitis. Which of the following expected
outcomes would be most appropriate for the client
a) Achieve control of abdominal pains
b) Increase activity levels gradually
c) Be able to breathe without difficulty
d) Experience relief from edema
30. A client has signs of increased intracranial pressure (ICP). Which of the following
is an early indicator of deterioration in the clients condition
a) Widening pulse pressure
b) Decrease in the pulse rate
c) Dilated, fixed pupil
d) Decrease in level of consciousness
31. During the initial phase of care for a patient with spinal cord trauma at C5 level, the
nurse gives high priority to maintaining respiratory function because
a) There is total loss of diaphragmatic and intercostals muscle function
b) Extension of edema above the site of the injury may affect phrenic nerve function
c) Immobilization of the patients spine promotes pooling of respiratory secretions
d) Without abdominal muscle control the patient cannot adequately cough
32. A client whose condition remains stable after a myocardial infarction gradually
increases his activity. Which of the following conditions should the nurse assess to
determine whether the activity is appropriate for the client
a) Oedema
b) Cyanosis
c) Dyspnea
d) Weight loss
33. The nurse is preparing to administer 0.1 mg of digoxin (lanoxin) intravenously.

Digoxin comes in a concentration of 0.5 mg/2mls. How many millilitres (ml) should
the nurse administer
a) 0.2 ml
b) 0.4 ml
c) 2.2 ml
d) 2.5 ml
34. To promote bowel evacuation in a patient with irregular bowel elimination, the nurse
teaches the patient that the effects of the gastro colic and duodenocolic reflexes can
facilitate bowel elimination if the patient attempts defecation
a) After physical exercise
b) After the first daily meal
c) Upon arising in the morning
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d) Upon the sight and smell of food
35. A patient who has an obstruction of the common bile duct is most likely to manifest
a) Malena
b) Steatorrhea
c) Decreased serum cholesterol levels
d) Increased serum indirect bilirubin levels
36. When giving advice to a vegetarian, you would suggest a good source of protein
would be contained in
a) Cereal and grains
b) Vegetables and
fruits c) Eggs and
cheese
d) Beans and lentils
37. Iron is important for healthy red blood cells. what other nutrients are also important
a) Vitamin E and vitamin C
b) Vitamin B12 and vitamin E
c) Folic acid and vitamin B12
d) Ascorbic acid and folic acid
38. The body’s need for ascorbic acid and iron are inter related because
a) Iron assists in the use of ascorbic acid
b) Iron assists in the transport of ascorbic acid
c) Ascorbic acid assists the transport of iron
d) Ascorbic acid assists the absorption of iron
39. The term phenylketonuria refers to a disorder involving

a) Increased sugar in the urine
b) Inability to metabolise some fats
c) Excessive breakdown of red blood
cells d) Inability to break down amino acid
40. A 79 year old client has pale, cold feet bilaterally, no hair tufts on toes, and a
circumscribed 3 cm lesion on the plantar surface at the first metatarsal joint. Which of
the following is the most likely source of the clients problem
a) Insufficient venous circulation
b) Venous thrombosis
c) Expected age related physiological changes
d) Insufficient arterial circulation
41. On assessing an older client the nurse notes that the left leg is swollen and warm,
with palpatable pedal pulses; an open, wet ulcer above the medial malleous; and
thick, course, and brown pigmented skin surrounding the ulcer. The probable cause of
the ulcer would be
a) Acute deep vein thrombosis
b) Chronic venous insufficiency
c) Chronic arterial insufficiency
d) Chronic lymphoedema
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42. At the time of Leonards admission to hospital, it would be impossible to accurately
predict the neurological deficit that would ultimately be left because
a) With correct alignment of the severed sections of cord, some healing of fibres
will occur
b) Some of his symptoms may be the result of spinal shock rather than severance
of the cord
c) If the cord has been severed cleanly, it may be possible to suture the
tracts together
d) It is impossible for the spinal tracts to heal until the disrupted blood vessels
supplying the cord regenerate
43. Reflex control over the bowel and bladder functions following spinal injury is
expected to be regained. This control over evacuation may develop because
a) Initial bowel and bladder problems result more from psychological than from
physical injury
b) Some of the severed motor fibres will reconnect, permitting impulse transmission
c) With mobilisation and improved circulation, muscle control will improve
d) Return of parasympathetic activity will permit automatic emptying of bladder and
bowel
44. Which of the following actions should you take if a patient you know to have
cancer asks if the lump that was removed is malignant
a) Say yes and sit down and discuss with her
b) Gloss over the question and talk about something else
c) Tell her it was benign, in case she is not supposed to know yet
d) Acknowledge your lack of seniority and ask the charge nurse to talk to her
45. Sally tells you she is pregnant. The first day of her last normal menstrual period
was the 18 February 2003. Her EDD or EDC is
a) 18 November
2003 b) 25 November
2003
c) 25 December 2003
d) 18 December 2003
46. Sally states I have heard that a pregnant woman needs more iron. Is that true. The
nurses best response would be
a) Yes a pregnant woman, 23-40 years, needs 25% more iron
b) Yes but the increase is so small a pregnant woman can meet the needs by eating a
well balanced diet
c) Yes pregnant women needs at least twice as much iron than non pregnant women
d) Only pregnant adolescents have an increased needs for iron
47. Sally asks why it is important to eat protein during pregnancy. The nurse should
explain, protein is necessary for the
a) Development of foetal bones and teeth
b) Growth of foetal and maternal tissues
c) Prevention of anaemia
d) Coagulation of the blood
48. For women of normal weight, the average total weight gain during pregnancy is
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a) 15-16
kgs b) 12-14
kgs
c) 8-10 kgs
d) 1 kg per week
49. Sally tells you that she has heard that pregnant women need to take folic acid. It
is recommended that women take 0.8 mg folic acid orally daily
a) From when finding out about the pregnancy until 12 weeks gestation
b) Throughout the whole pregnancy
c) From 12 weeks before conception to 12 weeks after
conception d) From 4 weeks before conception to 12 weeks after
conception
50. Sally’s friend has rubella and she is worried that it might affect her foetus. Rubella
has the greatest potential for damage when it is contracted during which period of
pregnancy
a) The first 12 weeks
b) 12-16 weeks
c) After 16 weeks
d) All of the above periods
51. Sally asks the nurse how will she know when she is going into labour. One of
the signs of impending labour is
a) A blood show
b) Increasing fatigue
c) Shortness of breath
d) Sudden weight gain of 0.5-1.5 kg
52. Sally goes into labour. Her partner asks you how to measure the frequency
of contractions. The nurses best response is
a) From the beginning of the contraction to the end of the contraction
b) From the end of a contraction to the beginning of the next contraction
c) From the beginning of a contraction to the beginning of the next contraction
d) From the beginning of a contraction to the end of the next contraction
53. The nurse tells sally she in the first stage of labour. The first stage of labour ends
when
a) The baby’s head moves through the cervix into the vaginal canal
b) Dilatation of the cervix begins
c) The baby has left the mothers body
d) Full effacement of the cervix has occurred
54. Up until 1840, settlers in new Zealand were

a) Subject to Maori (tribal) law
b) Obliged to obey Busby's instructions
c) Governed from new south Wales
d) In effect not answerable to any laws
55. The Waitangi tribunal was established under the treaty of Waitangi
act a) 1840
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b) 1953
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c) 1975
d) 1986
56. The steps to cultural safety are in this order

a) Safety, awareness and sensitivity
b) Awareness, sensitivity and safety
c) Sensitivity, awareness and safety
d) Sensitivity, safety and awareness
57. Which of the following acts of parliament outlawed traditional Maori health practices
b) Tohunga suppression act 1907/1908
c) Native lands act 1865
58. Colonisation is the process whereby

a) Military dictatorship is set up
b) Democracy is the means of
government c) An independent republic is
established
d) A government extends its sovereignty and imposes political control over an alien
people or territory
59. Colonisation has historically had a negative impact on the health of indigenous people.
In the early stages of colonisation in new Zealand which diseases had the strongest
impact
a) Measles, influenza, tuberculosis
b) Cancer, coronary heart disease
c) Diabetes type 2, hypertension, arthritis
d) Chronic obstructive pulmonary diseases
60. In new Zealand health services, bicultural partnerships are characterised by

a) Maori involvement in health delivery and decision making
b) Separate waiting lists for Maori clients
c) Maori agreeing to policy developed by the ministry of health
d) Non Maori health professionals learning marae protocol
61. Durie, M (2001) states: large scale alienation of Maori land in the nineteenth century
had implications for health and disease. Which of the following does this apply to
a) Loss of identity
b) Loss of core features of culture
c) Increased mortality and morbidity
d) All of the above
STATE EXAMS 20
a) Asking clients about their knowledge of their cultural heritage
b) Relating to all clients in a neutral manner regardless of their culture
c) Ensure clients are nursed by nurses of their own culture
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d) Use of appropriate resources to meet clients identified cultural needs
2. Maori communities are encouraging Maori to be involved in health research with their
c) Dietary changes from naturally produced to processed food
d) Loss of cultural, social and spiritual ties
4. In clause 2 of the treaty of Waitangi (Maori version) Maori were guaranteed

possession and control of their taonga. Taonga means
a) All land that Maori choose not to sell
b) All land and fisheries
c) Land, forests and fisheries
d) All things held precious by the Maori
5. Treaty of Waitangi was signed by
a) Missionaries and Maori chiefs
b) The new Zealand government and Maori people
c) Captain Hobson and Maori chiefs of north Auckland
d) A representative of the British crown and Maori chiefs
6. Traditional Maori health practices were outlawed by which of the following acts
of parliament
b) Native lands act 1865
c) Suppression of tohunga act 1908
7. Maori attend tangi (funeral) because they need

to
1. Share with the bereaved, family in their grief
2. Reaffirm family and friendship ties
3. Take the opportunity to come together
4. Look back on their past to make that past come alive
5. Gain prestige on the marae
a) 1, 2 and 4
b) 1, 3 and 4
c) 1, 2, 3 and 4
d) All of the above
8. Maori see ‘primary health care’ initiatives as being

a) Maori driven, Maori controlled, Maori financed and government
supported b) The first line of contact with a Maori doctor and Maori nurse
c) A place where as Maori we go to speak our language only
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d) The government sharing the resources 50/50 thus ensuring equity
9. You are a public health nurse, who has compelled a project on diabetes involving
Maori clients. You are to visit the local marae to share the results. You are working
in a bicultural relationship with the local Maori health initiative on diabetes. Which
statement would best describe your role within this initiative
a) To set up a structure that allows access to funds
b) To teach the Maori initiative about health reforms
c) To provide resource materials and information
d) To promote partnership, protection and participation in Maori health
10. You have invited Raewyn your supervisor to attend. As part of the preparation for the
visit what is essential for Raewyn to know
a) Learn Maori greetings so she can communicate with the marae committee
b) Learn about the treaty of Waitangi so she can be culturally safe
c) Learn about marae protocol, so she can behave appropriately
d) Learn about the history of the marae
11. Raewyn asks you what cultural safety means

a) To provide care that acknowledges others values and beliefs
b) To ensure that all clients get adequate care
c) To meet the recommendations as laid out in the treaty of Waitangi
d) To make sure that a Maori nurse works with a Maori client
12. She then asks how does culturally safety relate to the treaty of Waitangi. Your reply
would be
a) The treaty was signed by both Maori and pakeha
b) Hospital charters acknowledge the treaty in caring for Maori
c) The rights of all Maori clients are being meet according to the treaty
d) Acknowledges the choice for Maori in order to meet their health needs
13. Raewyn is very excited about the coming marae visit, and surprises you two days
prior to the event by saying ‘as 1993 was women’s suffrage year, I want to make a
speech during the welcome’. Your response should be
a) Tell her she should talk to the elders of the community
b) That’s exciting, which song do you want me to sing in support
c) We should discuss this with the Maori elders involved with our research project
d) Contact a Maori nurse in the community to support her
14. In the meeting house during the marae visit, Raewyn offers you a peppermint. Which
of the following is the most appropriate way to response to Raewyn
a) Any food needs to be blessed before we eat here
b) We should share these peppermints with everyone
c) It is culturally inappropriate to eat in the meeting house
d) It is appropriate only to eat between speakers
15. The Maori community health committee approaches you for input into their
health care submission for the regional health authority. Your response would be
a) How can I best assist your committee
b) I do not feel qualified to do that
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c) I will write up a draft copy for you
d) I will discuss this with my colleagues first
16. Margaret a kaiako (a teacher) at the kohunga reo tells you that tama has fallen and
grazed his knee. Tama has hepatitis B. What advice should the nurse give to the
teacher
a) Wash your hand before and after attending to tama
b) Keep Tama's eating utensils separate from
others c) Cover the graze with a waterproof
dressing
d) Keep tama at home until the graze heals
17. Margaret asks you to give a teaching session to the mothers about hepatitis B. What
would be your first action in implementing this session
a) Access a video and pamphlets about hep B
b) Set a time and date immediately with the teacher
c) Arrange for the mothers to come and visit your clinic
d) Meet with the mothers and teacher to arrange a suitable time
18. You discover more than half the children at kohanga reo have not been
vaccinated against hep B. What should your first action be
a) Discuss with the care givers and parents what they wish to do about this
b) Give these children hep B vaccinations explaining that it is essential for their
protection
c) Report your findings to the health department as soon as possible
d) Inform the ministry of education to gain funding for them to be immunised
20. Considering article 1 of the treaty of Waitangi (partnership), which statement best
describes this principle in Pepe’s care
a) The whanau are the initiators. The health care workers are the supporters
b) The whanau work with the health care workers in providing care
c) The partnership is between the health care workers and the whanau
d) The partnership is between the Maori community and the crown
21. How do you relate the treaty of Waitangi, to the importance of Pepe being discharge
to his whanau
a) The institution could no longer provide for his care
b) It ensures that Pepe’s cultural heritage is protected
c) That Pepe will be safer in a Maori community
d) That the principle of tino rangatiratanga is maintained
22. Piripiri a 16 year old street kid, with a history of alcohol and solvent abuse, is
alienated from his Maori culture. He has expressed to you a desire to re
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establish
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himself with his blood whanau and his culture. Choose the most appropriate initial
action you would take to assist piripi in learning about his culture
a) Identify piripis tribal affiliations
b) Locate the nearest marae
c) Ask a Maori colleague for assistance
d) Tell him not to be concerned, you can learn that later
23. Piripi has very little understanding of substance abuse. How would you begin to
educate him
a) Give him some pamphlets and handouts
b) Arrange an appointment with the doctor involved
c) Invite his whanau to be involved with his learning
d) Check that he can read and write
24. How would you best assist piripi to stay free of substance abuse following discharge
a) Check that he is booked in for random urine tests
b) Make sure he understands the consequences of continued abuse
c) Stress the importance of keeping his follow up appointments
d) Provide whanau with ongoing support and resources
25. Colleague comments, why are all these street kids allowed open visiting. How
would you respond
a) It’s easier than being involved in confrontation
b) Maori patients have special
rights c) Because they are his
whanau
d) The company keeps him quiet
26. Hine, a 42 year old woman, who identifies as Maori. Is to have a mastectomy. She is
accompanied by her 17 year old daughter Sarah. Which of the following breast
symptoms may indicate the presence of breast cancer
1. Retraction of the nipple
2. Puckering of the skin
3. Discharge from the nipple
4. Alteration of contour
a) 1
b) 2
c) 3
d) All of the above
27. Which of the following are characteristics of malignant tumours are not of
benign tumours
1. Lack of a capsule
2. More rapid growth
3. Less mature cells
4. Spread to distant parts
a) 1
b) 2
c) None of the above
d) All of the above
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28. Hine refuses to sign the consent form until she is sure that her breast will be returned
following surgery. What action should you take to ensure Hines wishes are respected
a) Document and support Hine in her decision
b) Check hospital policy and legal requirements
c) Tell the doctor of Hines request
d) Inform the whanau of the situation
29. It is agreed Hine will take her breast home. A consent form is signed. What
action must you now take to ensure Hines request
a) Enter the information on the operation form
b) Telephone the theatre staff before Hine goes to theatre
c) Supply an appropriate container to receive the breast
d) Document her request in the nursing notes
30. Hine returns to a single cubicle. Her whanau ask to stay the night. The staff nurse
says this is not appropriate for that number to stay. What action should you take
a) Negotiate other suitable accommodation for whanau
b) Explain politely that the nurse in charge disagrees
c) Tell them that only two people can stay at one time
d) Explain there are no extra mattresses
31. Iris a 55 year old woman, who identifies as Maori, is admitted to the emergency
department with severe chest pain. Her whanau are with her. What immediate nursing
action is the most appropriate to take
a) Show the whanau where the waiting room is
b) Interview the whanau regarding iris’s previous history
c) Carry out a physical examination in a non threatening manner
d) Administer oxygen and monitor her blood pressure and pulse
32. The whanau are very anxious about her condition. What is the most appropriate action
to take
a) Identify the spokesperson and explain what is happening
b) Take the whanau to a quiet room and discuss their concerns
c) Acknowledge their anxiety and allow a whanau member to stay
d) Assure them that the doctors will do everything they can
33. You are alone with iris when she suddenly collapses. What is your first priority
a) Commence cardiac massage
b) Ring emergency phone number
c) Maintain an airway
d) Summon help from other staff
34. Typically, the pain of myocardial infarction is different from the pain of angina in
that the pain of myocardial infarction is
a) Intermittent in nature
b) Is relieved by anginine
c) Is relieved by
rest d) May occur at
rest
Page 215 of
35. Which of the following symptoms often follow a myocardial infarction
1. Pallor
2. Diaphoresis
3. Anxiety
4. Breathlessness
5. Vomiting
a) 1 and 3
b) 2 and 4
c) All but 5
d) All of the above
help the whanau
37. State your initial action before beginning a diabetic education programme for Tipene
and his whanau (family)
a) Assess their level of understanding of diabetes
b) Obtain pamphlets about diabetes that are bi lingual
c) Negotiate a time when whanau can be present
d) Contact the diabetic education nurse
38. How will you know if Tipene understands the information

a) He repeats the information in his own words
b) He demonstrates use of the equipment
c) He has seen the Maori nurse educator
d) He has his whanau with him
39. Tao is 24 year old man who identifies as Maori. He is an acute admission, via the
police, under a committal order. On admission he appears preoccupied, physically
untidy and is unable to speak. This is his third admission. What would your priority
of care be for Tao over the next two hours
a) encourage Tao to talk about what has happened
b) ensure that he is not left alone
c) complete a mental health assessment
d) notify his relatives of his admission
40. following a cultural assessment profile, Tao expresses fear of being on his own. Your
best action would be
a) encourage his whanau to come and be with
him b) encourage him to talk about his fears
c) ensure he has adequate prescribed medication
d) reassure him that he is safe here
41. Taos mother reports that she has been unhappy with his previous care. How best
would you ensure the whanau are satisfied with the standard of care
a) tell the whanau to visit daily
Page 216 of
b) arrange an appointment for the whanau to see the
doctor c) involve the whanau in all decision making
d) make sure whanau are familiar with ward procedures
42. Taos mother believes he has mate Maori (Maori illness) and states he will never get
well here. How would you best respond
a) notify a Maori health worker
b) how can we help you to meet Taos needs
c) explain to her about mental illness
d) arrange for a tohunga (Maori healer) to see Tao
43. tao is referred to a Maori mental health unit. Of what benefit would this referral be
to Tao
a) Maori people understand how to best care for Maori
b) the unit can provide a safe spiritual environment
c) his whanau would feel more comfortable when visiting
d) he will comply with treatment more readily
44. Kiri, a 36 year old woman who identifies as Maori is admitted to the psychiatric unit
with a provisional diagnosis of paranoid schizophrenia. Choose the statement that best
describes the behaviours Kiri would exhibit
a) illusions, flight of ideas, suspiciousness
b) visual hallucinations, ritualistic behaviour
c) echolalia, delusions, fearfulness
d) suspiciousness, visual and audible hallucinations
45. what particular aspect should you consider when assessing Kiri
a) cultural/spiritual reasons for her changed
behaviour b) any recent loss in Kiris family
c) inability to cope with recent stresses
d) physical reasons for changed behaviour
46. what priority action should you take when identifying reasons for Kiri's behaviour
a) obtain a detailed histor4y from Kiri
b) check for a history of mental illness in the family
c) arrange for a family interview to discuss Kiri’s current situation
d) complete a physical assessment of Kiri
47. Kiri refuses to eat her food. She says you are poisoning me. Your most helpful
response is
a) that must be a scary feeling for
you b) why do you say that
c) I’m not poisoning you, it is good for you to eat your food
d) do try your lunch. The food is safe
48. Kiri refuses to eat in the dining room despite suggestions from you to do so. Her
behaviour would most accurately reported as
a) negative behaviour demonstrated at mealtime
b) patient seemingly withdrawn, does not follow suggestion
c) did not eat in dining room, even though suggested she do so
Page 217 of
d) preferred to eat in her room, against nurses advice
49. that night you find Kiri huddled in the corner of her room. She tells you that her dead
husband appeared to her. What immediate action should you take
a) check that she had her night medication
b) stay with her until she settles, than reassess the situation
c) reassure her dead husband is not in the room
d) notify the doctor and ask for extra sedation for her
50. tui, a 23 year old woman who identifies as Maori, attends a clinic for her maintenance
infection of fluphenazine deconate 12.5 ml. She has been employed as a cabin crew
attendant for the last 5 years, recently she has been transferred to international flights.
She expresses the following concerns to you. Although her present medication has
controlled her previous psychiatric breakdown, will this be sufficient in the future.
State your best response.
a) As long as you don’t stop taking this medication
b) As your situation changes you may need your medication adjusted
c) Providing you keep your appointments, we can monitor the effectiveness of
your medication
d) We can work together to manage your situation to maintain your wellbeing
51. She has noticed an increase in weight due to the medication. What advice should
you give
a) Discuss the benefits of maintaining regular exercise and having a sensible diet
b) Encourage her to join a weight watchers clinic
c) Contact the hospital dietician to make an appointment
d) Stop worrying, it is usual to put on weight with this medication
52. With increasing redundancies in tuis area of employment, she is keen to insure she
stays well. What advice should you give her
1. Encourage her to keep in contact with her whanau for support
2. Discuss ways of maintaining support system while overseas
3. Discuss ways of coping with extra stress
4. Provide relaxation tapes to use to ensure adequate sleep
a) 1, 3 and 4
b) 2, 3 and 4
c) 1, 2 and 3
d) All of the above
53. Tuis employers have stated that all staff must undertake bicultural workshops. She is
asked to relate how the treaty of Waitangi relates to Maori health. How best would tui
respond
a) We are all one people with equal rights to health care
b) Because you are Maori the treaty gives you priority health care
c) The treaty guarantees the rights of Maori to decide their own health needs
d) Article 3 guarantees the right to equitable health care
54. Wiremu, who identifies as Maori is a 32 year old solo father, his wife died one year
ago. He is caring for 8 year old hone and 4 year old Ana. Hones teacher is
concerned
Page 218 of
about his disruptive behaviour at school and asks you to visit the home. How should
you best initiate contact with this family
a) Send a letter to Wiremu asking him to meet you at the school
b) Go to see Wiremu at his home
c) Organise a family conference at the school
d) Ring Wiremu to explain why you wish to see him
55. You visit Wiremu's home, he invites you in. What should be your first action
a) Greet Wiremu with a cheerful kia ora
b) Make an initial assessment of Wiremu’s appearance
c) Introduce yourself and state why you are visiting
d) Make a brief assessment of the state of the home
56. What assessment will you need to make of Wiremu

a) Assess his physical condition
b) Identify the level of whanau support
c) Assess his interactions with his children
d) Do a psychosocial assessment
57. Ana attends the local kohanga reo. You wish to visit to assess her at school. What
protocols do you need to follow
a) Advise Wiremu that you will attend the kohanga reo
b) Contact the Maori public health nurse to assess Ana
c) Suggest Wiremu arrange for you both to visit the kohanga reo
d) Ring the kohanga reo to arrange a visit
58. Ana has school sores and is being treated by her grandmother. Ana has not
been taking her prescription antibiotics. What should your response be
a) Tell Wiremu that Ana should take the prescribed antibiotics
b) Acknowledge the value of Maori health remedies
c) Express your concern that Ana will infect other children
d) Discuss how both treatments are of value in curing Ana
59. A colleague comments to you that she is concerned about a elderly client, Moana,
who identifies as Maori. Moana is in early stages of Alzheimer’s disease and is
wandering away from her home. Your colleague believes Moana should be cared for
in an institution where she is less likely to harm herself. What should be your reply
to your colleague
a) Yes , I agree she would be safer in an institution
b) Has she been assessed by her gp
c) Has she got family involved in her care
d) I would call in a social worker to help
Page 219 of

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STATES

TABLE OF CONTENTS QUESTIONS PAGES

STATE EXAMS 11 83 92 to 105

STATE EXAMS 12 86 105 to 117

STATE EXAMS 13 101 117 to 132

STATE EXAMS 14 75 132 to 144

STATE EXAMS 15 72 144 to 155

STATE EXAMS 16 79 155 to 166

STATE EXAMS 17 73 166 to 177

STATE EXAMS 18 53 177 to 184

STATE EXAMS 19 61 184 to 193

STATE EXAMS 20 59 193 to 202

1. Which of the following symptoms would you anticipate observing in bill

8. The physician prescribes zidovudine (AZT) a drug that acts to help

14. The organism responsible for causing syphilis is classified as a

15. The typical chancre of syphilis appears as

18. A priority nursing diagnosis for a James would likely be

26. On Winston’s arrival in the emergency room, which of the following

28. As Winston’s condition worsens, his rising intracranial pressure would be

30. which of the following respiratory signs would indicate increasing

1. According to eriksons theory of emotional development, infants will develop a sense

3. Reduction of complications of rheumatic fever can be accomplished through which

7. Erikson’s theory of human development describes

8. According to Piaget, the stage of cognitive development that generally characterises

9. The cephalo-caudal and proximo-distal patterns of development apply to

11. Pediculosis is common childhood infestation. It is commonly known as

13. Match the following sequence of milligrams to

20. Bronchiolitis is a common infection, which peaks in incidence in

23. Which of the following statements is NOT true

24. Which of the following statements is NOT true of Reyes syndrome

25. Which of the following statements is NOT true of bacterial

26. Fill in the gaps in the following statement

29. Paralysis in an individual with a meningomyelocele usually occurs

32. The causative organism for rheumatic fever is

33. The most serious complication of rheumatic fever is

52. A child is to receive Trilafon 24 mg po BD. The medication is available as 16 mg/5ml.

2. Persons with an acute psychotic illness have most difficulty in

3. People who have a personality disorder

4. Neurotic disorders are associated with

6. Memory loss associated with old age

7. persons who have a neurotic disorder

8. a social factor contributing to the incidence of eating disorders is

9. the most common features of chronic organic psychosis are

10. phobia is best described as

11. the most appropriate treatment for phobias is

12. the best definition of a crisis is

14. anxiety is best described as

15. Which of the following is common feature of anxiety

27. Support for a client with an eating disorder involves

29. People who have a personality disorder

34. Cross cultural studies on mental illness show that

37. Chlorpromazine is an antipsychotic medication used in the treatment of

42. The best response to this statement (in previous question) is to

47. Long acting intramuscular antipsychotic medication is used in the treatment of

51. Intervention with an angry client who is threatening violence involves

54. The use of silence during an interview is therapeutic if

55. To facilitate communication the nurse should convey