1. Mrs Smith was taken to the Accident and Emergency Unit due to anaphylactic shock. The treatment for Mrs Smith will depend on the following except:
Location
Number of Responders
Equipment and Drugs available
Triage system in the A&E
2. A patient has collapsed with an anaphylactic reaction. What symptoms would you expect to see?
The patient will have a low blood pressure (hypotensive) & will have a fast heart rate (tachycardia) usually associated with skin & mucosal changes
The patient will have a high blood pressure (hypertensive) & will have a fast heart rate (tachycardia)
The patient will quickly find breathing very difficult because of compromise to their airway or circulation. This is accompanied by skin & mucosal changes
The patient will experience a sense of impending doom, hyperventilate & be itchy all over
3. The following are ways to remove factors that trigger anaphylactic reaction except for one.
It is not recommended to make the patient should not be forced to vomit after food-induced anaphylaxis.
Definitive treatment should not be delayed if removing a trigger is not feasible.
Any drug suspected of causing an anaphylactic reaction should be stopped.
After a bee sting, do not touch the stinger for about a maximum of 3 hours.
4. Olive, a nursing assistant working with you in an Elderly Care Ward is showing signs of norovirus infection. Which of the following will you ask her to do next?
Go home and avoid direct contact with other people and preparing food for others until at least 48 hours after her symptoms have disappeared
Disinfect any surfaces or objects that could be contaminated with the virus
Flush away any infected faeces or vomit in the toilet and clean the surrounding toilet area
Avoid eating raw oysters
5. Mrs. Bond is receiving blood transfusion after a total hip replacement operation. After 15 minutes, you went back to check her vital signs and she complained of high temperature and loin pain. This may indicate:
Renal Colic
Urine Infection
Common adverse reaction
Serious adverse reaction
6. Which of the following are not signs of a speed shock?
Flushed face
Headache and dizziness
Tachycardia and fall in blood pressure
Peripheral oedema
7. John is going to receive a blood transfusion. How frequently should we do his observations?
Temperature and pulse before the blood transfusion begins, then every hour, and at the end of bag/unit.
Temperature, pulse, blood pressure and respiration before the blood transfusion begins, then after 15 minutes, then as indicated in local guidelines, and finally at the end of the bag/unit.
Temperature, pulse, blood pressure and respiration and urinalysis before the blood transfusion, then at end of bag.
Pulse, blood pressure and respiration every hour, and at the end of the bag.
8. Normal heart rate for 1 to 2 years old?
80 - 140 beats per minute
80 - 110 beats per minute
75 - 115 beats per minute
9. An Eight year old girl with learning disabilities is admitted for a minor surgery, she is very restless and agitated and wants her mother to stay with her, what will you do?
Advice the mother to stay till she settles.
Act according to company policy
Tell her you will take care of the child
Inform the Doctor
10. A nurse documents vital signs without actually performing the task. Which action should the charge nurse take after discussing the situation with the nurse?
Charge the nurse with malpractice
Document the incident
Notify the board of nursing
Terminate employment
11. What are the steps of the nursing Process?
Assessing, diagnosing, planning, implementing, and evaluating
12. For which type of waste should orange bags be used?
Waste that requires disposal by incineration
Offensive/hygiene waste
Waste which may be ‘treated
Offensive waste
13. A nurse finds it very difficult to understand the needs of a child with learning disability. She goes to other nurses and professionals to seek help. How u interpret this action
The nurse is short of self confidence
A nurse, who is well aware of her limitations seeked help from others. She worked within her competency.
She doesn’t have the kind of courage a nurse should have
14. John, 48 years old, has been exhibiting signs and symptoms of anaphylactic reaction. You want to make sure that he is in a comfortable position. Which of the following should you consider?
John should be sat up if he is experiencing airway and breathing problems.
John should be lying on his back if he is assessed to be breathing and unconscious.
John should be sat up if his blood pressure is too low.
John should be encouraged to stand up if he feels faint.
15. Mrs Smith has been assessed to have a cardiac arrest after anaphylactic reaction to a medication. Cardiopulmonary Resuscitation (CPR) was started immediately. According to the Resuscitation Council UK, which of the following statements is true?
Intramuscular route administration of adrenaline is always recommended during cardiac arrest after anaphylactic reaction.
Intramuscular route for adrenaline is not recommended during cardiac arrest after anaphylactic reaction.
Adrenaline can be administered intradermally during cardiac arrest after anaphylactic reaction.
None of the Above
16. The nurse has made an error in documenting client care. Which appropriate action should the nurse take?
Draw a line through error, initial, date and document correct information
Document a late addendum to the nursing note in the client’s chart
Tear the documented note out of the chart
Delete the error by using whiteout
17. Which of the following are signs of anaphylaxis?
swelling of tongue and rashes
dyspnoea, hypotension and tachycardia
hypertension and hyperthermia
cold and clammy skin
18. When do you wear clean gloves?
Assisting with bathing
Feeding a client
When there is broken skin on hand
Any activity which includes physical touch of a client
19. Signs of hypovolemic shock would include all except:
restlessness, anxiety or confusion
shallow respiratory rate, becoming weak
rising pulse rate
low urine output of <0.5 mL/kg/h E. pallor (pale, cyanotic skin) and later sweating
20. What is meant by ‘Gillick competent’?
Children under the age of 12 who are believed to have enough intelligence, competence and understanding to fully appreciate what's involved in their treatment.
Children under the age of 16 who are believed to have enough intelligence, competence and understanding to fully appreciate what's involved in their treatment
Children under the age of 18 who are believed not to have enough intelligence, competence and understanding to fully appreciate what's involved in their treatment.
Children under the lawful age of consent who are believed not to have enough intelligence, competence and understanding to
21. A mentally capable client in a critical condition is supposed to receive blood transfusion. But client strongly refuses the blood product to be transfused. What would be the best response of the nurse?
Accept the client's decision and give information on the consequences of his actions
Let the family decide
Administer the blood product against the patients decision
The doctor will decide
22. The following are signs & symptoms of hypovolemic shock, except:
Confusion
Rapid heart rate
Strong pulse
Decrease Blood Pressure
23. You are about to administer Morphine Sulfate to a paediatric patient. The information written on the controlled drug book was not clearly written - 15 mg or 0.15 mg. What will you do first?
Not administer the drug, and wait for the General Practitioner to do his rounds
Administer 0.15 mg, because 15 mg is quite a big dose for a paediatric patient
Double check the medication label and the information on the controlled drug book; ring the chemist to verify the dosage
Ask a senior staff to read the medication label with you
24. While giving an IV infusion your patient develops speed shock. What is not a sign and symptom of this?
Circulatory collapse
Peripheral oedema
Facial flushing
Headache
25. During blood transfusion, a patient develops pyrexia, and loin pain. Rn interprets the situation as
Common reaction to transfusion
Adverse reaction to blood transfusion
Patient has septicaemia
26. As you visit your patient during rounds, you notice a thin child who is shy and not mingling with the group who seemed to be visitors of the patient. You offered him food but his mother told you not to mind him as he is not eating much while all of them are eating during that time. As a nurse, what will you do?
inform social service desk on suspected case of child neglect
ignore incident since the child is under the responsibility of the mother
raise the situation to your head nurse and discuss with her what intervention might be done to help the child
27. There is a child you are taking care of at home who has a history of anaphylactic shock from certain foods, the nurse is feeding him lunch, he looks suddenly confused, breathless and acting different, the nurse has access to emergency drugs access and the mobile phone, what will she do?
She will keep the child awake by talking to him and call 911 for help
She will raise the child’s legs and administer Adrenaline and call the emergency services
The nurse will keep the child in standing position and try to reassure the child
28. Patient developed elevated temperature and pain in the loin during blood transfusion. This is indicative of:
Severe blood transfusion reaction
Common blood transfusion reaction
29. What does intermediate care not consist of?
Maximise dependent living
Prevent unnecessary acute hospital admission
Prevent premature admission to long-term residential care
Support timely discharge form hospital
30. Which of the following is an average heart rate of a 1-2 year old child?
110-120 bpm
60-100 bpm
140-160 bpm
80-120 bpm
31. The nurse needs to validate which of the following statements pertaining to an assigned client?
The client has a hard, raised, red lesion on his right hand.
A weight of 185 lbs. is recorded in the chart
The client reported an infected toe
The client's blood pressure is 124/70. It was 118/68 yesterday.
32. Debra is going to receive blood transfusion. How frequently should we do her observation?
Temperature and Pulse before the blood transfusion begins, then every hour, and at the end of bag/unit
Temperature, pulse, blood pressure and respiration before the blood transfusion begins, then after 15 min, then as indicated in local guidelines, and finally at the end of bag/unit.
Temperature, pulse, blood pressure and respiration and urinalysis before the blood transfusion, then at end of bag.
Pulse, blood pressure and respiration every hour, and at the end of the bag
33. Which of the following is not a criteria for anaphylactic reaction:
Sudden onset and rapid progression of symptoms
life threatening airway and/ or breathing and/or circulation problems
skin and/or mucosal changes (flushing, urticaria and angioedema)
skin and mucosal changes only
A and B only
all of the above
A, B and C
34. U just joined in a new hospital. U see a senior nurse beating a child with learning disability. Ur role
Neglect the situation as u r new to the scenario
Intervene at the spot, speak directly to the senior in a non-confronting manner, and report to management in writing
Inform the ward in-charge after the shift
35. All but one are signs of anaphylaxis:
itchy skin or a raised, red skin rash
swollen eyes, lips, hands and feet
hypertension and tachycardia
abdominal pain, nausea and vomiting
36. Signs and symptoms of septic shock?
Tachycardia, hypertension, normal WBC, non pyrexial
Tachycardia, hypotension, increased WBC, pyrexial
Tachycardia, , increased WBC, normotension, non pyrexial
Decreased heart rate, decreased blood pressure, normal WBC and pyrexial
37. After lumbar puncture, the patient experienced shock. What is the etiology behind it?
Increased ICP
Headache
Side effect of medications
CSF leakage
38. Management of moderate malnutrition in children?
supplimentary nutrition
immediate hospitalization
weekly assessment
document intake for three days
39. Which is not a sign or symptom of speed shock?
Headache
A tight feeling in the chest
Irregular pulse
Cyanosis
40. Recognition of the unwell child is crucial. The following are all signs and symptoms of respiratory distress in children EXCEPT:
Lying supine
Nasal flaring
Intercostal and sternal recession
adopting an upright position
41. What is clinical benchmarking?
The practice of being humble enough to admit that someone else is better at something and being wise enough to try to learn how to match and even surpass them at it.
A systematic process in which current practice and care are compared to, and amended to attain, best practice and care
A system that provides a structured approach for realistic and supportive practice development
All of the above
42. Which bag do you place infected linen?
water-soluble alginate polythene bag before being placed in the appropriate linen bag, no more than % full
orange waste bag, before being placed in the appropriate linen bag, no more than % full
white linen bag, after sorting, no more than % full
43. You are assisting a doctor who is trying to assess and collect information from a child who does not seem to understand all that the doctor is telling and is restless. What will be your best response?
Stay quiet and remain with the doctor
Interrupt the doctor and ask the child the questions
Remain with the doctor and try to gain the confidence of the child and politely assess the child's level of understanding and help the doctor with the information he is looking for
Make the child quiet & ask his mother to stay with him
44. What are the signs and symptoms of shock during early stage (stage 1-3)?
hypoxemia
tachycardia and hyperventilation
hypotension
acidosis
45. You were asked by the nursing assistant to see Claudia whom you have recently given trimetophrim 200 mgs PO because of urine infection. When you arrived at her bedside, she was short of breath, wheezy and some red patches evident over her face. Which of the following actions will you do if you are suspecting anaphylaxis?
call for help and give oxygen
give oxygen and salbutamol nebs if prescribed and call for help
give oxygen, administer adrenaline 500 mcg IM, give salbutamol nebs if prescribed and call for help
call for help, give oxygen, administer adrenaline 500 mcg IM, give salbutamol nebs if prescribed.
46. When communicating with children, what most important factor should the nurse take into consideration?
Developmental level
Physical development
Nonverbal cues
Parental involvement
47. Mrs Smith had developed Steven-Johnson syndrome whilst on Carbamazepine. She is now being transferred for the ITU to a bay in the Medical ward. Which patient can Mrs Smith share a baby with?
a patient with MRSA
a patient with diarrhoea
a patient with a fever of unknown origin
a patient with Stephen Johnson Syndrome
48. Susan, 72 years old patient is being treated with antibiotics for her UTI. After three days of taking them, she developed diarrhoea with blood stains. What is the most possible reason for this?
Antibiotics causes chronic inflammation of the intestine
An anaphylactic reaction
Antibiotic alters her Gl flora which made Clostridium-difficile to multiply
she is not taking the antibiotics with food
49. Where is revision on the nursing process done? During:
Diagnosis
Planning
Implementation
Evaluation
50. You saw a relative of a client has come with her son, who looks very thin, shy & frightened. You serve them food, but the mother of that child says "don't give him, he eats too much". You should:
Raise your concern with your nurse manager about potential for child abuse & ask for her support
Ignore the mother & ask the relative if the child is abused.
Ignore the mother's advice & serve food to the child.
Ignore the situation as she is the mother & knows better about her child.