The document contains 49 multiple choice questions about various topics in nursing and medicine. Questions 32-34 focus on arterial blood gases (ABGs) and their ability to measure acid-base balance, oxygenation status, acidity of blood, and bicarbonate levels. Question 34 presents arterial blood gas results and asks the nurse to determine which acid-base imbalance is indicated.

1. Page 5 of 26
20. The nurse is admitting a patient with hypoglycemia. Select the Sign that he/she would
NOT expect to
a. Diaphoresis
b. Diplopia .
c. Palpitation
d. Dysphagia
21. The auscultation area in the left midclavicular line at the level Of the fifth Intercostals
Space (ICS) is the best location to hear sounds from which heart valve?
a. Aortic
b. Mitral
c. Tricuspid
d. Pulmonic
22. During the physical examination of the abdomen, the nurse should follow the following
steps respectively:
a. Inspection, palpation, percussion, auscultation
b. Inspection, Palpation. percussion, auscultation
c. Inspection, auscultation, percussion, palpation
d. Auscultation, inspection, palpation, percussion
23. Which of the following solutions is considered as the safest enema solution to use for the
patient with fecal impaction?
a. Isotonic solution
b. Hypotonic solution
c. Hypertonic solution
d. Oil solution
24. Which of the following is the purpose of administering the oxygen by nasal cannula ?
a. To allow uninterrupted delivery ofoxygen while the client ingests food or
fluids.
b. To provide a high immunity
c. To provide a high concentration of oxygen
d. To provide a high flow of oxygen when attached to a venture system
25. The nurse must insert a peripheral IV catheter for the patient Who requires parenteral
nutrition. In order to decrease the risk of deep vein thrombosis or phlebitis, which vein
does the nurse choose for the infusion site?

2. Page 6 of 26
a. Wrist
b. Foot
c. Forearm
d. Antecubital
26. The nurse is assessing a patient with intravenous fluid therapy (normal saline) and
identities signs symptoms of infiltration. What is the that the nurse implements for this
patient?
b. Applies a sterile dressing ifweeping from the tissue has occurred
c. Removes the IV access
d. Stops the infusion
27. When a patient is requiring oxygen therapy. what would the nurse take into consideration?
a. Patient requires I to 10 L/min by nasal cannula in order for oxygen to be
effective
b. Oxygen induced hypoventilation is the priority when PaCO, levels are
unknown
c. Indication of oxygenotherapy. expected outcomes. and susceptible
complications
d. The goal is the highest fraction of inspired oxygen (Fi02) possible for the
particular devi being used
28. One of the most potentially hazardous procedures that the nurse faces is using and
disposing of needle and sharp. To prevent the needle, stick injuries the nurse should:
a. Use appropriate puncture-proof disposal containers to dispose of
uncapped needles and sharps
b. Throw the uncapped needles and sharps in the wastebaskets
c. Put the uncapped needles and sharps over the first shelf of the trolley
d. Give the uncapped needles and sharps to the patient to throw them in dustbin
29. The nurse assesses the diabetic patient's technique of self-monitoring of blood glucose 3
months after initial instruction. Among the following self-glucose monitoring activities,
Which ERROR noted by the nurse that would require intervention?
a. Doing the self-monitoring of blood glucose before and after exercising.
b. Puncturing the finger on the side of the finger pad
c. Cleaning the puncture site with alcohol before the puncture
d. Holding the hand down for a few minutes before the puncture
30. While receiving a unit of packed RBCs,' the patient develops chills and a temperature of
(390
C). What is the PRIORITY action for the nurse to take?

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34.A patient has the followingarterial
that
condition.the nurse recognizes t:
a. Stop the transfusion and instill normal saline
b. Notify the health care provider and the blood bank
c. Add a leukocyte reduction filter to the blood administration set
d. Recognize this as a mild allergic transfusion reaction and slow the transfusion
31. What is the BEST method of evaluating whether oxygen therapy is effective for a
patient?
a. Arterial blood gases (ABGs)
b. Pulse oximetry
c. Pulse oximetry and blood pressure
d. Pulse oximetry and respiration rate
32. Which IV therapy results in the GREATEST increase in oxygen-carrying
capacity for a patient with hypovolemic shock related to hemorrhage?
a. Lactate Ringer's solution
b. Hetastarch (Hespan)
c. Fresh frozen plasma (FFP)
d. Packed red blood cells
33. A student nurse asks the Registered Nurse (RN), what can be measured by arterial blood
gases (ABGs) among the followings:
acid-base balance.
Oxygenation status.
acidity of the blood.
glucose bound to hemoglobin.
bicarbonate (HC03—) in arterial blood
The RN responds to the student that the ABGs can measure the following:
a. i.ii&iii
c. i,ii,iii&v
mEq/L. The nurse determines
a. Metabolic acidosis.
b. Metabolic alkalosis
c. Respiratory acidosis
d. Respiratory alkalosis
35. In teaching a patient with hypertension about controlling the
a. All patients with elevated blood pressure require medication

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b. Obese persons must achieve a normal weight to lower blood pressure
c. It is not necessary to limit salt in the diet if taking a diuretic
d. Lifestyle modifications are indicated for all persons with elevated blood
pressure
36. Local anesthetics produce:
a. Analgesia, amnesia, loss of consciousness
b. Blockage of pain sensation without loss of consciousness .
c. Alleviation of anxiety and pain with an altered level of consciousness
d. A stupor or somnolent state
37. Morphine 4 mg IV was prescribed every 2 hours for severe pain. If the morphine is
supplied 10 mg per 2 mL, calculate how much morphine (in mL) you would administer at
each injection?
a. 0.08ml
b. 0.8ml C. 0.4ml
d. 0.04ml

5. Page of 26
32. Which IV therapy results in the increase in oxygen-carrying capacity for a patient
with hypovolemic shock related to hemorrhage?
a. Lactate Ringer's solution
b. Hetastarch (Hespan)
c. Fresh frozen plasma (FEP)
d. Packed red blood cells
33. A student nurse asks the Registered Nurse (RN), what can be measured by arterial
blood gases (ABGs) among the followings:
acid-base balance.
oxygenation status.
acidity of the blood.
glucose bound to hemoglobin.
bicarbonate (HC03—) in arterial blood
The RN responds to the student that the ABGs can measure the following:
a. i,ii&iii
b. i&v
c. i,ii,iii&v d. i,iii&iv
34. A patient has the following arterial blood gas
results: pH: 7, 52; PaC02:30 mmHg; HC03-:
24 mEq/L. The
nurse determines
that these results indicate:
a. Metabolic acidosis. /Jc-rmcz.( Far
c. Respiratory acidosis
d. Respiratory alkalosis
35. In teaching a patient with hypertension about controlling the condition,
a. All patients with elevated blood pressure require medication
b. Obese persons must achieve a normal weight to lower blood pressure
c. It is not necessary to limit salt in the diet if taking a diuretic
d. Lifestyle modifications are indicated for all persons with elevated blood pressure
36. Local anesthetics produce:
a. Analgesia. amnesia, loss of consciousness
b. Blockage of pain sensation without loss Of consciousness .
c. Alleviation of anxiety and pain With an altered level of consciousness
d. A stupor or somnolent state
the nurse recognizes

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37. Morphine 4 mg IV was prescribed every 2 hours for severe pain. If the morphine is supplied
10 mg per 2 mL, calculate how much morphine (in ml,) you would administer at each
injection?
a. 0.08ml
b. 0.8ml
c. 0.4ml
d. 0.04ml
7
38. The treatment of choice for simple malaria in Rwanda is Coartem. This drug is an
association oft}, following components:
a. Artemether and lumefantrine
b. Artemether and quinine
c. Artemether and coartem
d. Zentel and artemether
39. The drugs below are common used for patient with crisis of asthma, Except:
a. Aminophylline
b. Salbutamol
c. Cloxacillin
d. Prednisolone
40. An order is written for 1,000 of normal saline to be administered IV over 10 hours. The
drop factor on the IV tubing states 15 drops/mL. What is the IV flow rate?
a. 50 mL/h at 50 drops/min
b. 100 m L/h at 25 drops/min
c. 100 m L/h at 100 drops/min
d. 100 mL/h at 1 5 drops/min
41. Which Of the following statements reflects the pathogenesis of influenza virus?
a. The virus enters the host in airborne droplets
b. The virus frequently establishes persistent infections in the lung
c. Pneumonia is not associated with secondary bacterial infections
d. Viral infection does not kill cells in the respiratory tract
42. Niki, a 19-years-old girl presents with abdominal pain, nausea, bloody diarrhea, and
fever, after one week vacationing in Musanze town. Stool specimens are collected and
sent to the laboratory for bacteriologic and parasitologic examination. Bacterial cultures
are negative for intestinal pathogens. The laboratory report reveals organisms with red
blood cells inside them. The MOST likely causal agent is:

7. Page
a. Giardia lamblia
b. Shigella dysenteriae Toxoplasma gondii
d. Entamoeba histolytica
43. Kiki a 32-years-old man complains Of a urethral discharge. You perform a Gram stain
On a specimen Of the discharge and see neutrophils but no bacteria. Of the organisms
listed, which one is the MOST likely to cause the discharge?
a. Chlamydia trachomatis
b. Coxiella burnetii C. Candida albicans
d. Treponema pallidum
44. Which one of the following statement(s) regarding Plasmodium falciparum [it only
cause of cerebral malaria] is true?
is the only malarial parasite causing greater than 20% parasitaemia
c. is associated with recurrent relapses after initial treatment because of liver
hypnozoites
d. causes benign tertian malaria
45. Which is the most severe and life threatening type of meningitis?
a. Bacterial
b. Viral
c. Protozoal
d. Fungal
46. Chancroid, being a venereal disease, is caused by:
Haemophilus ducreyi
b. Neisseria gonorrhoeae
Treponemapallidum
Herpes simplex type I
47. Which ofthe following diseases is caused by eating raw or poorly cooked meat
containing larvae?
a. Trichomoniasis
b. Ascariasis
c. Filariasis
d. Tapeworm infection
48. Elephantiasis is caused by which of the following filarial infections?
a. Wuchereriasis
b. Loasis
Onchocerciasis

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d. The Guinea worm infection
49. One of the following is a zoonotic viral disease caused by a bite of infected animal
through introduction of infectious saliva is:
Rabies
b. Poliomyelitis
Herpes simplex infection
d. Herpes zoster
50. The essential component Of Freud's personality theory that serves to alert the ego to
internal or external danger is:
a. Libido
b. Anxiety
c. Defense
d. id
s or
51. Behaviour modification is an example Of which of the löllowing treatment methods:
a. Enable the individual to unlearn maladaptive behaviours and emotions
b. Enable the individual to explore their childhood behaviours
c. Enable the individual to analyse the behaviour of others
d. Enable the individual to modify the behaviour of others
52. The nurse should include which of the following plan of continuing care for a
moderately depressed client?
a. Allowing the client time to be alone to decide in which activities to engage
b. Offering the client an opportunity to make some decisions
c. Making all decisions to relieve the client of this responsibility
d. Encouraging the client to decide how to spend leisure time
53. You are caring for a male client who has suicidal tendency. When accompanying the
client to the restroom. should:
a. Observe her
b. Allow her to urinate
c. Open the window and allow her to get some fresh air

9. Page
d. Give her privacy
54. Which of the following is the correct route of blood through the heart from the systemic
circúlation to the pulmonary circulation and back to the systemic circulation?
a. Right atrium, tricuspid valve, right ventricle, pulmonary semilunar valve, left
atrium, mitral valve, left ventricle, aortic semilunar valve
b. Left atrium, tricuspid valve, left ventricle, pulmonary semilunar valve, right
atrium, mitral valve. right ventricle, aortic semilunar valve
c. Left atrium, pulmonary semilunar valve, right atrium, tricuspid valve, left
ventricle, aortic semilunar valve. right ventricle, mitral valve
d. Right atrium, mitral valve, right ventricle, pulmonary semilunar valve, left atrium,
tricuspid valve, left ventricle, aortic semilunar valve
55. The work of breathing is the energy required by the respiratory muscles to overcome
hindering forces that may interfere thoracic expansion. Which of the following
statements on work of breathing is TRUE?
a. Increased airway diameter increases airway resistance
b. Surfactant increases alveolar surface tension
C. Lung disease can increase work of breathing
d.In health. work of breathing accounts for 50% of total body energy expenditure
56. When you exhale. air flows through respiratory structures in which sequence?
a. Alveolus, bronchiole, , larynx, trachea, pharynx, nasal cavity
Alveolus, trachea , bronchus, bronchiole, , larynx, , pharynx, nasal cavity
c. Alveolus, bronchus, bronchiole, trachea , larynx, pharynx, nasal cavity
d. Alveolus, bronchiole, bronchus. trachea, larynx, pharynx, nasal cavity

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57. When you inhale, the diaphragm:
Relaxes and moves inferiorly
b. Relaxes and moves superiorly
Contracts and moves superiorly
d. Contract and move inferiorly
58. During an interview, the nurse needs to obtain specific information about the signs
and symptoms Of a health problem. To obtain these data most efficiently. the nurse
should use:
a. Active listening
b. Open-ended questions
c. Closed-ended questions
d. Seeking clarification
59. A nursing diagnosis of ineffective peripheral tissue perfusion would be validated by
which of the following?
a. Bounding radial pulse
b. Irregular apical pulse
c. Carotid pulse stronger on the left side than the right
d. Absent posterior tibial and pedal pulses
60. Which of the following element is BEST categorized as secondary subjective data?
a. The nurse measures a weight loss of 5 kilos since the last clinic visit.
b. Spouse states the client has lost all appetite.
c. The nurse palpates edema in lower extremities.
d. Client sates severe pain when walking up stairs.
61. Which of the following pieces of information is considered as objective data?
a. The patient respiratory rate is 28 breaths per minute.
b. The patient states. "l feel short of breath."
c. The patient is short of breath.
d. The patient is feeling panicky.
62. Following a motorcycle accident, the parent refuses to permit withdrawal of life support
from the child with no apparent brain function. Although the nurse believes that the
child should be allowed to die and organ donation considered, the nurse support their
decision. Which moral principle provides the basis for the nurse action?
Respect for autonomy
b. Non-maleficence
Beneficence
d. Justice

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63. When a nurse is suturing a wound, she/he is advised to not pull sutures too tight in order
to prevent which of the following surgical complications?
Surgical site infection
b.Post-operative bleeding
Ischemia
d. Poor wound healing
64.A break in sterility occurs during surgery when the scrub nurse touches:
a. The mask with sterile gloved hands.
b. The sterile gloved hands to the gown at chest level
c. The drape at the incision site with sterile gloved hands
d. The lower arm to the instruments on the instrument tray
65.What will the nurse do to prevent airway obstruction in the postoperative patient Who is
unconscious or semiconscious?
a. Encourage deep breathing
b. Administer oxygen per mask
c. Elevate the head ofthe bed
d. Position the patient in a side-lying position
66.Which patient is ready for discharge from Phase I Post Anesthesia care Unit (PACU)-to the
clinical unit?
a. Arouses easily, pulse is 1 12 bpm, respiratory rate is 24, dressing is saturated, sa02
is 88%
b. Difficult to arouse, pulse is 52, respiratory rate is 22, dressing is dry and intact,
Sa02 is
c. Awake. vital signs stable, dressing is dry and intact, no respiratory depression,
Sa02 is 920/0
d. Arouses, blood pressure (BP) higher than preoperative and respiratory rate is 10,
no excess bleeding. sa02 is 90%
67.What is the advantage of a tracheostomy over an endotracheal (ET) tube for long-term
management of an upper airway obstruction?
a. A tracheostomy is safer to perform in an emergency.
b. An ET tube has a higher risk of tracheal pressure necrosis.

12. page 14 of 26
c. A tracheostömy tube allows for more comfort and mobility.
d. An ET tube is more likely to lead to lower respiratory tract infection
68.The patient with a new ileostomy needs discharge teaching. What should the nurse plan to
include in this teaching?
a. The pouch can be worn for up to 2 weeks before changing it.
b. Decrease the amount of fluid intake to decrease the amount of drainage.
c. The pouch can be removed when bowel movements have been regulated.
d. If leakage occurs, promptly remove the pouch, clean the skin, and apply a new
pouch.
69.On examining a patient 8 hours after colostomy, what should the nurse expect to find?
a. Hyperactive, high-pitched bowel sounds
b. A brick-red, puffy stoma that oozes blood
c. A purplish stoma, shiny and moist with mucus
d. A small amount of liquid fecal drainage from the stoma
70. What is the best answer by the nurse working in surgical ward when asked by a
student nurse, about the conditions in which the Plasma Transfusions is MOST
indicated?
l. Severe burns
ll. Liver failure
Ill. Severe infection
IV. Haemophilia
The answer is:
b. l, Il, Ill
c. IV only
d. I & IV
71.A patient is admitted to the emergency department with acute abdominal pain. What
nursing intervention should the nurse implement first?
a. Measurement of vital signs
b. Administration of prescribed analgesics
Assessment of the onset, location. inte sity, duration, and character of the pain
d. Physical assessment of the abdomen r distention, bowel sounds, and
pigmentation changes

13. page 15 of 26
72.To preserve function and the ability to perform activitie Of daily living (ADLs), what
should the nurse teach the patient with Osteoarthritis (QA)?
a. Avoid exercise that involves the affected joints
b. Plan and organize task performance to be less stressful to joints
c. Maintain normal activities during an acute episode to prevent loss Of
function
d. Use mild analgesics to control symptoms when performing tasks that cause
pain
73.A patient has fallen in the bathroom of the hospital room and reports pain in the upper right
arm and elbow. Before splinting the injury, the nurse knows that the priority management
of a possible fracture Should include which action?
Ele<ation of the arm
b. Application Of ice to the site
Notification of the health care provider
d.Neurovascular checks below the site of the injury
74.A nursing intervention to assist a preoperative client in coping with fear of pain would be
to:
a. Describe the degree of pain expected
b. Explain the availability of pain medication
c. Divert the client when talking about pain
d. Infom the client of the frequency of pain medication
75.What is the BEST management of the first-degree burn?
a. Apply a good quality burn cream or ointment
b. Clean the area thoroughly with hot soapy water
c. Apply a constricting hand between the burn and the heart
d. Apply cool running water until there is little or no remaining pain
76.A patient has a TBSA deep partial-thickness and full-thickness burn to the right anterior
chest and entire right arm. What is important for a nurse to assess in this patient?
a. Presence of pain
b. Swelling of the arm
c. Presence of pulse in the arms
d. Formation of eschar
77.The cremasteric reflex is absent in which problem of the scrotum and testes?
a. Hydrocele

14. page 16 of 26
b. Varicocele
c. Spermatocele
d. Testicular torsion
78.The patient had a fracture. At 3 weeks to 6 months there is clinical union, and this is the
first stage of healing that is sufficient to prevent movement of the fracture site when the
bones are gently stressed. How is this stage of fracture healing documented?
a. Ossification
b. Remodeling
c. Consolidation
d. Callus formation
79.A patient with a fractured tibia accompanied by extensive soft tissue damage initially has a
splint applied and held in place with an elastic bandage. What early Sign should alert the
nurse that the patient is developing compartment syndrome?
a. Paralysis of the toes
b. Absence Of peripheral pulses
c. Distal pain unrelievéd by dpioid analgesics
d. Skin over the injury site is blanched when the bandage is removed
80.Prevention of calcium oxalate stones would include dietary restriction of which foods or
drinks?
a. Milk and milk products
b. Dried beans and dried fruits
c. Liver, kidney, and sweetbreads
d. Spinach, cabbage, and tomatoes
A patient with chronic osteomyelitis has been hospitalized for a surgical debridement
procedure. What does the nurse explain to the patient as the rationale for the surgical
treatment?
a. Removal Of the infection prevents the need for bone and skin grafting.
b. Formation Of Scar tissue has led to a protected area of bacterial growth.
c. The process of depositing new bone blocks the vascular supply to the bone.
d. Antibiotics are not effective against microorganisms that cause chronic
osteomyelitis
82. What is the most common cause of shock in a surgical patient?
a. Hypovolemia
b. Anaphylaxis
c. Sepsis
d. Cardiac failure

15. page 17 of 26
83. What is the most common hernia?
a. Inguinal hernia
b. Femoral hernia
c. Abdominal hernia
d. Incisional hernia
84. What is the characteristic of chronic inflammation?
a. It may last 2 to 3 weeks
b. Infective endocarditis is an example of chronic inflammation The injurious
agent persists or repeatedly injures tissue
d. Neutrophils are the predominant cell type at the site of inflammation
85. Which nutrients aid in capillary synthesis and collagen production by the fibroblasts in
wounc healing?
a. Fats
b. Proteins
c. Vitamin A
d. Vitamin C
86. The process of removing excess fluid from the peritoneal cavity is known as:
a. Purification
b. Paracentesis
c. Rehydration
d. Dialysis
87. The following pathologies can lead to the acute abdomen, EXCEPT
a. Peritonitis,
b. The intestine occlusion
c. Urinary lithiasis
d. Biliary lithiasis
88. A patient is to the emergency department with an injured lower 10110wing a)'all
rock climbing, Ille identifies the presence of" fracture based on what cardinal sign
ol' fracture?
swelling
Muscle
b.

16. page 18 of 26
c. Obvious
defi'l'mity d, Pain
and tenderness
SO. Which description is most characteristic Of osteoarthritis (OA) When compared to rheumatoid
arthritis
a. In ()S. rheumatoid fhctors (RIG) are positive
b. O/A is not systemic or symmetric
c. Most commonly occurs in women d, In ()A, morning joint stifffiess lasts
one to several hours
90. The patient asks. • •What does the doctor mean when he says that I have an avulsion fracture
in my leg? I thought I had a sprain!" What is response by the nurse?
a. "It is a fracture with more than two fragments"
b. "The line of the fracture is twisted along the shaft of the bone
"It means that a ligament pulled a bone fragment loose"
d. "The line of the fracture is at right angles to the longitudinal axis of the bone"
91. The client returned from major surgery 3 hours ago and requires medication for pain. Which
of the following is THE BEST consideration, the nurse should know?
a. Prescription drugs rarely cause addiction when used according to accepted medical
protocol
b. All drugs should be withheld until the client's past substance abuse history is
evaluated
c. It is best to wait until the client can no longer tolerate the pain to avoid addiction
problems
d. Clients often request analgesia when it is not really needed
92. Which of the following parameters is the MOST critical when a nurse is assessing a client with
an overdose of sedatives after surgery?
a. Cardiac stimulation
b. Respiratory suppression
c. Hepatic dysfunction
d. Depression of consciousness
93. An ambulatory client who received a prescription for a right antibiotic 2 weeks ago after minor
surgery now presents with the same symptoms of bacterial infection. Which of the following
conditions should the nurse suspect?
a. Faulty and low-quality medication
b. Toxic adverse effects of the drug c, Excessive dosage of the
prescription

17. page 19 of 26
d. Nonadherence to the prescribed therapy
The surgical client is to receive a vaginal suppository. Which education should
the nurse include in the instructions to the client concerning the drug•s
administration?
a. Remove the suppository 5 minutes after insertion.
b. Cleanse the perineal area with soap and water before insertion.
c. Insert the suppository only in the morning.
d. Urinate before insertion of the suppository.
95. A client who uses over-the-counter phenylephrine nasal spray asks the nurse how
the medication works. The nurse's response would be:
a. Phenylephrine helps to shrink the swelling in your nose by tightening the blood
vessels
there
b. phenylephrine works to locally destroy invading organisms that cause colds and flu.
c. Phenylephrine coats the nasal passages to reduce swelling
d. Phenylephrine is absorbed after you swallow it to act as a decongestant
Which ofthe following factors DQES NOT influence the choice of the type of anesthesia?
a. Age of the patient
b. Sex of the patient
c. Length of surgery
d. Surgical procedure
97. A 43-year-old man underwent an emergency minor arm re-pair procedure after a car
accident. A standard dose of lidocaine was administered near the brachial plexus for
peripheral nerve block. Fifteen minutes later. the anesthesia was still incomplete, and
another dose of lidocaine was administered. Which of the following adverse effects
would MOST likely occur after the administration of the anaesthetic?
a. Ventricular tachycardia
b. Drowsiness
c. Convulsions
d. Hypertensive crisis
98. A 53-year old man was brought to the emergency department after suffering a hand
injury that required immediate surgery. Local anesthesia was performed by brachial
plexus block. The surgeon
estimated that the procedure should last about 3 hours. Which of the following local
anaesthetics would be appropriate for this patient?
96.

18. page 20 of 26
a. Prilocaine
b. Procaine
c. Tetracaine
d. Cocaine
99. A 2-year old girl was brought to the emergency department after cutting
with a kitcyzn few minutes earlier. The fingers were bleeding.
Examination revealed two clean wrn•rd•• middle and ring fingers of the
right hand. The doctor decided to suture the •wounds under anesthesia
using lidocaine without epinephrine. Epinephrine was avoided to prevent
which of following possible complications?
a. Wound infection
b. Ischemic gangrene
c. Excessive bleeding
d. Delayed wound repair
100. A patient is in the acute phase Of burn management. The patient experienced full-
thickness burns to the and sacral area of the body. In the patient's plan Of care,
which nursing diagnosis is priority at this time?
a. Impaired skin integrity
b. Risk fry fluid volume
c. Risk for infection
d. Ineffective coping
101. You find an adult man who is 30 years Old with nasal bleeding. What wouu you
take to control the bleeding?
a. Sit casualty down, lean forward and pinch soft of nose
b. Sit casualty down, lean backward and pinch soft ofnose
c. Lie casualty down pinch soft Ofnose
d. Lie casualty down and top of nog
102. How should you open the airway ofan unconscious casualty?
a. Head tilt and chin lift
b. Jaw thrust
c. Head tilt and jaw thrust
d. Lift the chin
103. What should you do FIRST, if you are alone first aider with an unconscious
in one district of Rwanda?
a. Start CPR with 30 chest compressions
b. Give five initial rescue breaths
c. Call 912 requesting AED (defibrillator) and ambulance
d. Give two initial rescue breaths
knife
rm

19. page 21 of 26
104. Which is Correct ratio Of chest compressions to rescue breaths for use in CPR
Of an adult casualty?
a. 2 30 rescue breaths
b. 5 compressions: I rescue breath
c. 15 compressions: 2 rescue breaths
d. 30 compressions: 2 rescue breaths
A nurse is revising a client's care plan. During which step of the nursing process does
a revision take place?
a. Assessment
b. Planning
c. Implementation
d. Evaluation
106. After assessing the client, the nurse formulates the following nursing diagnoses. Place
them in order of priority, Sith the MOST important (classified as high) listed FIRST:
l. Constipation
2. Anticipated grieving
3. Ineffective ainvay clearance
4. Ineffective tissue perfusion.
The answer is:
107. Nursing diagnosis mostly differs from medical diagnosis in that they are:
a. Dependent upon medical diagnosis for the direction of appropriate
intervention
b. Primarily concerned with caring, while medical diagnoses are primarily
concerned with curing
c. Primarily concerned with human response, while medical diagnoses are
primarily concerned with pathology
d. Primarily concerned with psychosocial parameters, while medical
diagnoses are primarily concerned with physiological parameters
A postoperative patient has a nursing diagnosis of pain related to effects Of
medication and decreased gastro-intestinal motility as evidenced by abdominal
pain and distention and inability to pass flatus. Which nursing intervention is
MOST appropriate for this patient?

20. page 22 of 26
a. Ambulate the patient more frequently
b. Assess the abdomen for bowel sounds
c. Place the patient in high Fowler's position
d. Withhold opioids because they decrease bowel motility
109. A nurse mentor asks a nurse student to localize organs in the abdominal regions.
A student will localize an organ that lies just distal to the sternum in which of
the following abdominal regions?
a. Epigastric
b. Hypochondriac
c. Hypogastric
d. Umbilical
Ito. of the patient complaining of abdominal pain. a nurse palpates all quadrants. Which
of the following organs is located beneath the diaphragm in the left upper quadrant
ef the abdominal cavity?
a. Duodenum
b. Gallbladder
c. Liver
d. Spleen
I l l . A diaphragm is an important muscle that separates two cavities. Which of the
following cavities are separated the diaphragm?
a. Thoracic and pelvic
b. Dorsal and ventral
c. Thoracic and pleural
d. Thoracic and abdominal
112. A 39-year-old woman visits the outpatient clinic and complains of inability to reach
a pantry shelf just above her head. History reveals that 2 months ago she underwent a
mastectomy procedure and she did not have this complaint prior to the surgery. Which
nerve was most likely damaged during surgery to result in the patient's complaint?
a. Spinal accessory
b. Long thoracic
c. Radial
d. Thoracodorsal
13. When taking care of a client diagnosed to have an acute myocardial infarction with
multiple vessel disease, which of the following vessels will be surgically intervened
to restore the good functioning of the myometrium?
a. Carotid artery

21. page 23 of 26
b. Coronary artery
c. Abdominal vein
d. Coronary vein
4. For a client with appendicitis, an urgent surgical intervention decision to remove the
appendix was taken. What do you know about McBurney point that has been decided
to be incised?
a. A point one third Ofthe distance from the left anterior superior iliac spine to the
umbilicus
b. A point two third of the distance from the left anterior superior iliac spine to the
umbilicus
c. A point one third of the distance from the right anterior superior iliac spine to the
umbilicus
d. A point two third of the distance from the right anterior superior iliac spine to the
umbilicus
5. The otitis media is the condition to be treated promptly to prevent its complications.
Which Of the following can be the most prevalent complication of untreated otitis
media?
a. Fluctuating or persistent hearing loss
b. Perforation of the tympanic membrane
c. Development of cholesteatomas
d. Chronic infection of the middle ear
1 16. At which area a patient is most likely to experience pain due to infection of the
ethmoidal air cells sinus?
a. At the base of the skull
b. On the forehead
c. In the cheeks
d. Between the eyes
1 17. A patient was seen in the clinic for an episode of epistaxis, which was controlled by
placement of anterior nasal packing. During discharge teaching, the nurse instructs the
patient :
a. To use aspirin for pain relief
b. To remove the packing later that day
c. TO avoid vigorous nose blowing and strenuous activity
d. To skip the next dose of antihypertensive medication
118. A 12kg child is 9% dehydrated. He should be rehydrated with ORS as per the following
dosage:
a. 900mls of ORS during the first hour then 300mls in the following three hours
k. 600mls of ORS during the first hour then 300mls in the following three hours

22. page 24 of 26
c. 300mls of ORS during the first hour then 900mls in the following three hours
d. 300mls of ORS during the first hour then 600mls in the following three hours
1 19. What is the LEI management for a 7 months old child who lost 3% of his weight due to
diarrhea?
a. Give amoxicillin 500mg and IV normal saline that runs in I hour
b. Give Ampicillin 500mg and IV normal saline that runs in 2 hours
c. Give ORS after each stool and Zinc 10mgOD/14days
d. Give ORS after each stool and Zinc 20mgOD/14days
120. The following reasons explain the cause of metabolic acidosis in gastroenteritis EXCEPT:
a. Loss of bicarbonate in stools
b. Accumulation of lactic acid from tissue hypoxia secondary to
hypovolemia
c. ORS given during treatment
d. The absorption of short chain acids produced in the colon from
bacterial fermentation 121. If the physician suspects meningitis, he or she Will order
laboratory tests to help make the diagnosis. The tests will likely include:
a. A lumbar puncture (spinal tap) to collect a sample of spinal fluid
b. stool sample
c. CRP and ASLO
d. Blood smear
122. Ifa 3-year-old female child finds you in consultation at a health center, the following
signs will bea reason for transfer to the district hospital EXCEPT:
a. Convulsions
b. Fever of 39.20
C
c. Lethargy Or lethargic child
d. Vomiting everything
123. A patient sustained a laceration of the perineum during delivery; it involved the muscles
of perineal body but not the anal sphincter. Such a laceration would be classified as:
a. First degree
b. Second degree
c. Third degree
d. Forth degree
124. An unstable lie of the fetus is associated with all the following EXCEPT:
a. Prematurity
b. Grand multiparity
c. Fundal fibroid

23. page 25 of 26
d. Cervical fibroid
125. A 33-year-old woman at 37 weeks' gestation presents with moderate to severe vaginal
bleeding. The ultrasound confirms the placenta praevia. Which of the following
interventions would be used for best management ofthis pregnant woman?
a. Induction of labor
b. Give tocolytic drugs
c. Caesarean section
d. Artificial rupture of the membrane
126. 24 -year- old patient has the following obstetric history: G2, PI, AO. She is at 34th
week of
gestation and presented to emergency service with vaginal bleeding. Which one of the
following is NOT TRUE?
a. Admit the patient
b. Do vaginal examination immediately
c. Do cross-match blood
d. Do ultrasound
127. Postpartum hemorrhage can occur due to all the followings EXCEPT:
a. Polyhydramnios
b. Placenta praevia
c. Abruptio placenta
d. Postdate pregnancy
| 28. The most serious complication of preterm premature rupture ofmembrane
(PPROM) at 28 weeks is:
a. Fetal compression anomaly.
b. Pulmonary hypoplasia.
c. Intrauterine infection
d. Abruption placenta.
129. When examining the placenta, what type of blood vessels are found in the umbilical cord?
a. An artery and a vein
cb. Two arteries and a
vein
c. An artery and two veins
d. Two veins and two arteries
130. Which Of Statement is true for physiological jaundice?
a. Occur in 6 hours after delivery

24. page 26 of 26
b. Neurological sequel are commonly Observed
c. Best treated by phototherapy
d. Start on 2nd
day after delivery
131. one ofthe following assertions indicates the normal range ofbody temperature ofa neonate.
Which value is the correct answer?
a. 35.50
C t0 37.OO
C b. 36.00
C to 37.50
C ec. 36.50
C to 37.50
C d. 36.OO
C to
37.OO
C
132. A 66 years old woman has come to you with the complaints of hot flushes irritability, joint
pains with lack of sleep. Most appropriate treatment would be:
a. Hysterectomy
b. Vitamins
c. Combined oestrogen, progesterone preparations
d. Phyto-oestrogens Selective estrogen receptor modulators (SERMS) 133.
Cryptomenorrhea occurs due to:
a. Imperforate hymen
Cervical stenosis
c. Amputation of cervix
d. Uterus malformation
134. Which of the following is NOT a component of good youth policy?
a. Recognition of cultural and gender influences and promotion of youth involvement
b. Focus on youth as a homogenous population
c. A holistic integrated and cross-sectorial approach to youth and youth development
d. Ensuring young people can obtain appropriate youth-friendly information and care
135, In which Of the following ways do gender norms typically affect the sexual behavior
of young people?
a. Gender norms encourage young women to not have sex with multiple
partners in order to improve their reputation among peers
b. Gender norms encourage young men to respect their female partners' wishes
c. Gender norms discourage parents from discussing of condoms and sexual
related issues with their children or discuss it in public openly
d. Gender norms encourage young men in same-sex relationships to talk openly
about their sexual relationships with other men and ask for information on
how to protect themselves from HIV
136. Intersectoral coordination is necessary because;

25. page 27 of 26
a. Community needs may not be primarily medical in nature
b. Other agencies may respond better to the local problem
c. Health resources are generally inadequate
d. All Ofthe above
137. Which Of the following processes characterizes the level of disease
prevention known as tertiary prevention?
a. Prevention of disease before its biological onset
b. Prevention of disease progression and additional disease complications
after overt clinical disease occurs
c. Prevention Of clinical illness through the early and asymptomatic
detection and remediation of certain disease conditions
d. Prevention Of illness through appropriate individual and group behavior
modification designed to minimize infection risk
138. What is the function Of management where managers verify whether
everything occurs in conformity with the plan adopted?
a. Planning
b. Organizing
c. Controlling
d. Coordinating
139. Managing change is a responsibility of:
a. Top managers
b. Middle managers
c. First line managers
d. Every manager
140. The nurse is caring for a patient with a urinary catheter. Which of the followin
g
i
s the important nursing action for the nurse to take to prevent urinary tract
infection in this patient?
a. Force fluids to 4000Ml every 24hours.
b. Empty the urinary bag every 4 hours around a
clock.
c. Maintain a closed catheter system. 1 d. Wash
the perineum every 8 hours.
141. What of solution should be used to irrigate a nasogastric tube?
a. Normal saline 0.9% •
b. Normal Saline 9%
c. Ringer lactate
d. Glucose 5%

26. page 28 of 26
142. Which of the following clients meet the criteria for selection Of the carotid
or femoral site for assessment of the pulse rather than a radial pulse?
a. A client is in shock
b. The pulse changes with body position changes
c. A client with arrhythmia
d. It is less than 24hours since a client's surgical operation
143. The patient who is short Of breath should be positioned to conserve energy
while allowing for maximum lung expansion. Which of the following
positions is the PEST to reduce dyspnea for the patient who is in bed?
a. Supine position
b. Lateral position
Semi —Fowler's position
d. Lying flat
144. The immediate treatment of an acute episode ofconstipation is:
a. An enema
b. Increased liquid
c. Emulsifiers
d. Give vegetables and fruits
145. A patient is concerned that he may have asthma. Of the symptoms that he
relates to the nurse are:
i. Allergic rhinitis
Prolonged inhalation .
iii. History of skin
allergies iv. Cough,
especially at night
v. Gastric reflux or heartburh
Which ofthefollowing ones suggest asthma or riskfactorsfor asthma?
i, iii & iv
b. ii, iv & v only
c. i, iii, v
d. iii& iv
146. The followings are the risk factors ofhypertension:
i. Age i i.
Obesity ili.

27. page 29 of 26
Gender iv.
Race
v. Genetic link
Among the aforementioned risk factors of hypertension, what are non-modifiable risk
factors for primary hypertension?
a. i, & ii
b. ii & iii
c. i, v & iii only
d. i, iii, iv & v
147. The polydipsia and polyuria related to diabetes mellitus are PRIMARILY
caused by:
a. The release ofketones from cells during fat metabolism
b. Fluid Shifts resulting from the osmotic effect of hyperglycemia
c. Damage to the kidneys from exposure to high levels of glucose
d. Changes in RBCs resulting from attachment of excessive glucose to
hemoglobin
148. The edema that occurs in nephritic syndrome is due to:
a. Decreased aldosterone secretion from adrenal insufficiency
b. Increased hydrostatic pressure caused by sodium retention
c. Increased fluid retention caused by decreased glomerular filtration
d. Decreased colloidal Osmotic pressure caused by loss of serum albumin
149. ShockisBESTdefinedas:
a. Cardiovascular collapse
b. Loss of sympathetic tone
c. Inadequate tissue perfusion
d. Blood pressure less than 90mmHg systolic
150. Mrs. D. calls you asking which vaccines that her young infant of 9 days old is
going to receive. One of the following shall be your answer to Mrs.D:
a. PolioOandBCG
b. Only BCG is essential
c. Polio l, pentavalent l, and Rotateq I
d. Vitamin A to prevent blindness.

28. page 30 of 26