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REVISION

SEO

(SHORT MEQ)

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1. Miss Lina, a 16-year-old client is admitted for

seizure monitoring.

a. State FOUR (4) types of generalized seizures.

b. Explain SIX (6) nursing interventions for clientafter a seizure episode.

c. State FOUR (4) complications of seizures

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2. Madam Timah, a 56- year-old clerk is diagnosed with

diabetes mellitus type 2 and admitted to the ward forblood sugar monitoring.

a. State SIX (6) clinical manifestations that are

expected to be reported by Madam Timah.

b. Explain FIVE (5) aspects of health education youwould give to Madam Timah prior discharge to preventcomplications of diabetes mellitus.

c. State FOUR (4) common complications of diabetesmellitus.

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3. Mr. Imran is a 35 years old man admitted to the Accident andEmergency department with the diagnosis of spinal cord injurydue to motor vehicle accident. The doctor confirmed him to

have total loss of motor and sensory function below level ofinjury.

a. State the type of classification of the spinal cord injury of

the above mentioned client.

b. State TWO ( 2 ) diagnostic tests for a client with spinal cordinjury

c. Write FIVE ( 5 ) Nursing Interventions for each nursingdiagnosis given below

i. Impaired physical mobility related to paralysisii. Alteration in bowel elimination related to immobility

iii. Risk for skin integrity related to lack of mobility

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4. Mrs. Ram is 40 years old came to the clinic with thecomplains of dyspnea, loss appetite, weight gain, dry skin and

constipation. The doctor records the final diagnosis asHypothyroidism.

a. State THREE ( 3 ) disorders in hypothyroidism

b. State TWO ( 2 ) risk factors for hypothyroidism

c. Write FOUR ( 4 ) Nursing Interventions for each nursingdiagnosis given below

i. Activity intolerance related to fatigueii. Imbalanced nutrition, more than requirements

related to decreased metabolic rate

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5. Mr Kevin was admitted to medical ward suspected to havemeningitis. The doctor schedule him for lumber puncture.

a. State TWO (2) purposes of Lumber puncture

b. Name TWO (2) puncture site of lumber puncture

c. Explain your nursing responsibilities before and after lumber

puncture.

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6. Mariam was admitted to the ward and scheduled forthyroidectomy.

a. Define thyroidectomy

b. List TWO (2) preoperative nursing care for Mariamc. List TWO (2) post operative care for mariam

Post-thyroidectomy , mariam complains of pain at op site.

d. Give SIX (6) nursing interventions for

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7. Calvin, 10 years old boy is admitted to the ward

and diagnosed recurrent tonsislitis. He is

scheduled for tonsilectomy after theinflammation is reduced.

a) State 2 clinical manifestation that may be

exhibited by Calvin.b) Calvin has just came back from OT for

tonsilectomy. Explain 3 post op care for Calvin

c) State 1 nursing diagnosis for post optonsilectomy

d) Exlpain 4 nursing intervention for the above

nursing diagnosis

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MCQ

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1. Which of the followings is the MOST

common cause of the dementia indegenerative conditions of the brain?

A. Encephalitis

B. Multiple sclerosis

C. Parkinsons diseases

D.Alzheimers diseases

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2. Mr Ma has recently been diagnosed withParkinsons disease. Which important topic

should the nurse include in the teaching planfor him?

A. Enhancing the immune system

B. Engaging in diversional activity

C. Maintaining a safe environment

D. Maintaining a balance nutritional diet

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3. What should the nurse do FIRST when aclient with head injury begins to have clear

drainage from his nose?

A. Insert nasal pack

B. Tilt the head back

C. Apply pressure on the nasal bridge

D. Collect the fluid in the specimen bottle

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4. Mr Tan accidently hit his head with the bar

metal and developed bruises on hisforehead. This mechanism of injury is knownas

A. penetrating.

B. acceleration.

C. deformation.

D. deceleration.

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Discussion

Acceleration - Head stuck by moving object

Deformation - Force deforms and disrupts

body integrity

Deceleration - Head hits stationary object

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5. The nurse is assessing the motor functionof an unconscious client. Which test should

be performed to assess the clientsperipheral response to pain?

A. Apply pressure on the nail bed

B. Rub the upper part of the sternum

C. Apply pressure on the orbital ridge

D. Pinch the sternocleidomastoid muscle

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6. Bells palsy is the most common type ofperipheral facial paralysis and it affects the_________ cranial nerve.

A. Fourth

B. Fifth

C. Sixth

D. Seventh

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Bell's palsy is a form of facial paralysis resulting from adysfunction of the cranialnerve VII (the facial nerve)that results in the inability to control facial muscles on theaffected side.

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7. The 5

th

cranial nerve function is tested using

A. a stetchoscope.

B. coffee and vanilla.C. a cotton ball and a pin.

D. a measuring tape and a pencil.

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OOOTTAFVGHVA

OOOToTouchAndFeelVaginalGirlHaeVAn

http://iahealth.net/wp-content/uploads/2008/12/cranial-nerves.pnghttp://www.nature.com/nrn/journal/v2/n9/images/nrn0901_611a_t2.gif

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http://www.nature.com/nrn/journal/v2/n9/images/nrn0901_611a_t2.gif

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8. The client with a stroke has residual dysphagia.

When a diet order is initiated, the nurse should AVOID

doing which of the following?

A. Giving the client thin liquids.

B. Placing food on the unaffected side of the mouth.

C. Allowing plenty of time for chewing and swallowing.

D. Giving thickened liquids to the consistency of

oatmeal.

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9. Ms Mariam is diagnosed with bacterial

meningitis. The assessment of flexing theclients neck causes flexion of the hipsand knees is called

A. decebrate

B. decorticate

C. Kernigs signD. Brudzinskis sign

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DISCUSSION

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10. A client, aged 22, is admitted with bacterial

meningitis. Which hospital room would be the bestchoice for this client?

A. An isolation in front of the nurses station.

B. A private room downs the hall from the nursesstation.C. A two-bed room with a client who previously hadbacterial meningitis.

D. A semiprivate room with a 32-year-old client whohas viral meningitis.

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11. An adult client has a medical diagnosis ofincreased intracranial pressure and is being

cared for in the neurology unit. The care planincludes elevating the head of the bed andpositioning the clients head in proper

alignment. The nurse recognizes that these

actions are effective because they act by

A. reducing pain.

B. promoting venous drainage.

C. preventing a valsalva maneuver.

D. making it easier for the client to breathe.

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12. Which of the following describe acongenital condition where a baby is bornwithout the brain and cranial vault?

A. Anencephaly

B. Microcephaly

C. HydrocephalyD. Cerebral Palsy

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13. A child is diagnosed with hydrocephalus. Sheis scheduled for insertion of ventriculoperitonealshunt. This surgery will be performed to drainexcess cerebrospinal fluid from the ventricle of

the brain into the

A. peritoneal cavity of the abdomen

B. right atrium of the heartC. lungs

D. kidney

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DISCUSSION

VENTRICULOPERITONEAL SHUNT

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14. Which of the following will the nurseobserve in the client with the initial phase of

generalized tonic-clonic seizures?

A. Vacant staring and abruptly ceasing allactivity

B. Facial grimaces, patting motions and lipsmacking

C. Jerking in one exremity that spread gradually

to adjacent areaD. Loss of consiousness, body stiffening andviolent muscle contraction

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Question 14

Discussion

Types of seizures

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Types of seizures

Seizures

Partial Generalized

Neurologicabnormality limitedto a specific part orfocus of the brain

Neurologic abnormalityinvolves the both

cerebral hemisphere ofthe brain

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Types of seizures- Cont

Seizures

Partial Generalized

1. Simple

partial

2. Complex

partial1. Absence

3. Tonic4. Clonic

2.

Mycolonic

5. Tonic-Clonic

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Signs & Symptoms

3. Tonic seizurecont

Abrupt increase in muscular tone and

muscular contraction.

Body become rigid, respirations are interrupted

for temporary

Patient may cyanotic, jaw fixed and hands are

clenched, eye opened wide, pupils are fixed

and dilated

Last from 30 seconds to several minutes

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Signs & Symptoms

4. Clonic seizure

Rhythmatic muscular contraction and

relaxation.

Excessive saliva, incontinent, may bite the lips

and tongue

Lasting several minutes

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15. Mr. Joy is a 18 years old student admitted in

the medical ward. He is diagnosed as having

actual seizure. What is the first nursing action?

A. Provide privacy to the patient

B. Pad the bed side rails

C. Maintain the patients airway

D. Assess the level of consciousness.

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16. A male client is having a tonic-clonic seizure.

What should the nurse do first?

A. Elevate the head of the bed.B. Take precautions to prevent injury.

C. Restrain the clients arms and legs.

D. Place a tongue blade in the clients mouth.

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17. The following are the purposes of lumber

puncture EXCEPT to

A. Rule out brain injury

B. Diagnose brain neoplasm

C. Rule out infection of the brain

D. Diagnose autoimmune disease of theCNS

DISCUSSION

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INDICATIONS FOR LUMBAR PUNCTURE

Diagnostic indications:

1. Measuring of CSF pressure

2. Obtaining CSF for laboratory analysis

3. Injecting oxygen or a radiopaque substance for radiographicvisualization of the structures of the nervous system of the spinalcanal and meninges and brain.

Therapeutic indications:

1. Removing blood or pus from the subarachnoid space,

2. Injecting drugs

3. withdrawing CSF to reduce intracranial pressure,

4. Introducing a local anesthetic to induce spinal anesthesia,

5. Placing a small amount of the patient's blood in the subarachnoidspace to form a clot to patch a hole in the dura to prevent leak ofCSF into the epidural space.

DISCUSSION

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18. Madam Anna is suspected to havemeningitis and was scheduled for lumbarpuncture. In which position should the nurseplace her during the procedure?

A. Lateral with a pillow under the hip

B. Prone with trendelenburgs postion

C. Prone with a pillow under the abdomenD. Lateral with knee chest and head bent

down unto chest

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DISCUSSION

Position of client during Lumbar puncture

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19. The nurse is preparing the client for EEG(Electro Encephalogram) tomorrow. Whatspecific instruction the nurse must give tothe client?

A. Encourage client to eat and sleep well

B. Advice the client to avoid crowded area

C. Avoid applying any oil and gel after shampoo

D. Instruct client to do deep breathing exerciseto reduce anxiety

DISCUSSION

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INDICATIONS:

1. To evaluate seizures disorder2. To localize tumors

Other used / A secondary clinical use

of EEG:-is in the diagnosis of coma,

encephalopathies, and brain death,

tumors and stroke

DISCUSSION

http://en.wikipedia.org/wiki/File:EEG_cap.jpg

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20. A client has just undergone transsphenoidal

resection of a pituitary adenoma. The nurse

includes which of the following in the plan care?

A. Remove the nasal packing in 12 hours

B. Administer acetylsalicylic acid (aspirin) for asevere headache

C. Observe the client for frequent swallowing

D. Remind the client to cough and breathe

deeply

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21. The nurse is caring for a client who

underwent surgical hypophysectomy. Which of

the following assessments is MOST essential for

the nurse to perform immediately?

A. Heart rate.

B. Respiration.

C. Blood pressure.

D. Serum calcium levels.

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22. A male client with a history of hypertension

is diagnosed with primary hyperaldosteronism.

This diagnosis indicates that the clientshypertension is caused by excessive hormone

secretion from which of the following glands?

A. Pancreas.

B. Parathyroid.

C. Adrenal cortex.D. Adrenal medulla.

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23. Nurse Riya is aware that the MOST

appropriate nursing diagnosis for a client with

Addisons disease is

A. hypothermia.

B. urinary retention.

C. risk for infection.

D. excessive fluid volume.

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23. Nurse Riya is aware that the MOST

appropriate nursing diagnosis for a client with

Addisons disease is

A. hypothermia.

B. urinary retention.

C. risk for infection.

D. excessive fluid volume.

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24. Which of these signs suggest that a male

client with the syndrome of inappropriate

antidiuretic hormone (SIADH) secretion is

experiencing complications?

A. Polyuria.

B. Weight loss.

C. Neck vein distention.

D. Tetanic contractions.

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26. Nurse Oliver should expect a client with

hypothyroidism to report which health

concerns?

A. Thyroid gland swelling.

B. Nervousness and tremors.

C. Puffiness of the face and hands.D. Increased appetite and weight loss.

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27. A nurse is assisting to prepare a plan of care

for a client with hyperthyroidism and is

instructing the client regarding dietarymeasures. Which of the following foods are

included in the plan of care?

A. Those high in bulk and fiber

B. Those high in calories

C. Those low in carbohydrates

D. Those low in calories

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28. An adult is currently being treated at the

clinic for Graves disease. It is essential for the

nurse to assess for which of the following signs

immediately?

A. Goiter.

B. Tachycardia.

C. Constipation.

D. Hypothermia.

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30. When instructing the female client

diagnosed with hyperparathyroidism about diet,

nurse Gina should stress the importance ofwhich of the following?

A. Restrict fluids.B. Increase fluids.

C. Restrict sodium.

D. Restrict potassium.

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31. A nurse is monitoring a client withhypoparathyroidism for signs of hypocalcemia.

The nurse wraps a blood pressure (BP) cuffaround the clients arm, fills the cuff, andmonitors for spasms of the wrist and the hand.The nurse documents the findings, knowing that

this technique checks for the presence of whichof the following?

A. Kernigs sign

B. Babinskis signC. Chvosteks sign

D. Trousseaus sign

DISCUSSION

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DISCUSSION

Trousseaus sign

Chvosteks sign

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32. Nurse Ruth is assessing a client after a

thyroidectomy. The assessment reveals muscletwitching and tingling, along with numbness inthe fingers, toes, and mouth area. The nurse

should suspect which complication?

A. Tetany.

B. Thyroid storm.C. Haemorrhage.

D. Laryngeal nerve damage.

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33. The nurse is preparing a room to receive

post-thyroidectomy client from operationtheatre. The nurse should ensure that which ofthe following equipment is available at the

bedside.

A. Nasogastric tray.

B. Tracheostomy tray.C. Lumbar puncture tray.

D. Central venous tray set-up.

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34. The nurse is doing discharge teaching with a clientwho has had a bilateral adrenalectomy. What should

be included in the teaching plan?

A. Telling her that after 1-2 years she will likely notneed to take medication.

B. Explaining that she will need to take corticosteroidsfor the rest of her life.C. Reinforcing that steroid should be slowly tapered if

she decides to stop taking them.D. Teaching her urine and blood testing to help in theregulation of steroid dosages.

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35. Two day after a left eye cataractextraction, a client complains of nausea,

vomiting and seeing halo around thelights. What is the indication of this signs?

A. Dislocated lens

B. Detached retina

C. Corneal abrasion

D. Increase intraocular pressure

DISCUSSION

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Possible complications of cataract surgery

1. Haemorrhagehyphaema (bleeding into ant.

chamber)

2. Infection this is probably one of the most serious

complications but is quite rare and usuallyhappens within the first week or two after surgery

3. Retinal detachment

4. Glaucoma develop as a result to adhesions formingbetween the iris and the cornea, blocking the filtrationangle and secondary to a hyphaema

DISCUSSION

DISCUSSION

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Characteristic of Glaucoma

1. Pain

2. Nausea and vomiting

3. Halos or rainbows around artificial lights

4. Blurring of vision

5. Pupil dilated & fixed (via examination)

6. Cornea edematous (Via examination)

SCUSS O

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36. A nurse is assessing a client admitted

with photophobia and decreased vision.Which of the following is an abnormalintraocular pressure?

A. 6-8 mmHg

B. 10-14 mmHg

C. 12-18 mmHgD. 18-20 mmHg

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37 A i i t id i t ti t

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37. A nurse is preparing to provide instruction to

a client with glaucoma about prescribed

treatment measures for the disorder. The nurseunderstands that the goal of treatment is:

A. Producing mydriasis in the eyeB. Promoting dilatation of the pupil of the eyes

C. Maintain intraocular pressure at reduced level

D. Increasing the formation of aqueous humor

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38. A client is admitted with a detached retina of

the left eye. The nurse covered both eyes with

eye pad. What is the rationale for this

intervention?

A. To prevent infection

B. To decrease eye movement

C. To prevent photophobia

D. To prevent nystagmus

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39. When obtaining the health history from a male

client with retinal detachment, the nurse expectsthe client to report

A. frequent episodes of double vision.

B. light flashes and floaters in front of the eye.

C. headaches, nausea, and redness of the eyes.

D. a recent driving accident while changing lanes.

.

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40. In planning the pre-operative care for a client

with a retinal detachment, the nurse should include

which of the following in the plan of care?

A. Restrict ambulation.

B. Maintain flat bed rest.

C. Apply eye pad on the affected eye.

D. Have client wear dark glasses for reading.

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41. Which of the followings refractive disorders

can be corrected by using convex lenses?

A. Myopia.

B. Hyperopia.

C. Presbyopia.

D. Astigmatism.

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42. Which of the following is used to perform

visual acuity test?

A. Penlight.

B. Visual field.

C. Snellen chart.

D. Opthalmoscope.

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43. A 9-year-old girl complains of difficulty

seeing at dusk. What could be the possible cause

for her condition?

A. Vitamin A deficiency.

B. Vitamin K deficiency.

C. Vitamin C deficiency.D. Vitamin D deficiency.

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44. The nurse observes that the right eye ofan unconscious client does not closecompletely. Which nursing intervention isMOST appropriate?

A. Irrigate the eye every shift

B. Instill artificial tears 8 hourly

C. Lightly tape the eyelid to close

D. Put on dark eyeglasses at all times

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45. Which of the following is the BEST way for the

nurse to assist a blind client in ambulation?

A. Push the client in a wheelchair when necessary.

B. Allow client to walk down the hall with his or her

hand along the wall.C. Allow client to walk beside the nurse with thenurses hand on the clients back.

D. Allow client to take nurses arm with the nursewalking slightly ahead of the client.

l h h f

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46. A client aged 36 years has a history of

Chronic otitis media. The most common surgical

intervention for otitis media is

A. ossiculoplasty

B. mastoidectomy

B. tympanoplasty

D. myringotomy

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47. A nurse is suctioning the airway of a client

with a tracheostomy. To safely perform the

procedure, the nurse should to which of thefollowing?

A. Turn on wall suction to 190 mm Hg

B. Withdraw the catheter while suctioning

C. Insert the catheter until resistance is felt

D. Renter the catheter into tracheotomy after

suctioning the mouth

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48. A client who just underwent tonsillectomy

has become restless. The nurse notes anincreasing pulse rate, slight pallor, and frequentswallowing. The nurse interprets that:

A. The clients need medication

B. This is an expected post operative finding

C. The client may have post operative bleedingD. The client most likely has some mild postoperative edema