Practice Test 1
A nurse cares for a 45-year-old man with primary tumor. Which one of these conditions should the nurse consider as incorrect regarding primary brain tumors?
- Presence of chronic daily headache
- Presence of focal limb weakness without edema
- Association with generalized seizures
- Association with personality change
- Presence of transient ischemic attack
Correct Answer: A. Presence of chronic daily headache
Presence of chronic daily headache is rarely seen in brain tumors. Focal weakness and generalized seizures are more commonly seen in primary brain tumors. Headache from raised ICP is typically seen when waking and it is resolved when standing up.
A nurse is caring for a 55-year-old male patient in the emergency department, who is presented with peripheral cyanosis. The nurse must know that one of the following conditions is not a risk factor for developing peripheral cyanosis. Which one is it?
- Venous thromboembolism
- Peripheral vascular disease
- Raynaud’s disease
Correct Answer: D. Methemoglobinemia
Methemoglobinemia causes spurious cyanosis. The patient can appear to be cyanosed even in the presence of normal arterial oxygen. All other above- mentioned conditions typically feature in peripheral cyanosis.
A 65-year-old male patient who was resting, suddenly develops severe left-sided chest pain with a crescendo pattern which lasts for more than 10 minutes. What type of angina is the patient suffering from?
- Microvascular angina
- Angina syndrome X
- Stable angina
- Unstable angina
- Effort angina
Correct Answer: D. Unstable angina
Sudden chest pain at rest which lasts for more than ten minutes along with crescendo pattern and severe onset is a typical symptom of unstable angina. Any one of these three symptoms presented in a patient is unstable angina. Microvascular angina is also known as Angina syndrome X, which shows angina-like chest pain but the causes may be different. Stable angina is also known as effort angina and it shows symptoms of chest discomfort and other symptoms that are precipitated by running and walking. It also occurs with minimum symptoms or non-existent symptoms during rest.
Which of the following medications is a fast-acting drug in treating asthma symptoms?
- Leukotriene antagonist
- Mast cell stabilizer
Correct Answer: E. Anti-cholinergic
Anti-cholinergic is used as a fast-acting medication in the treatment of asthma. All other above-listed medications come under long-term control of asthma.
A nurse cares for a 45-year-old man, who is a chain smoker. He is diagnosed with acute cluster headache. One of the following is not a typical feature of cluster headache, which one is it?
- Headache for 18 hours
- Relief of symptom with high flow oxygen
Correct Answer: A. Headache for 18 hours
Cluster headache occurred in the above-mentioned patient as he was a chain smoker. Middle-aged men and smokers are prone to develop cluster headache. It is a part of a spectrum of benign headaches called trigeminal autonomic cephalalgias. Such attacks last for less than 180 minutes. All other above-listed features are typical of cluster headache.
In colostomy with irrigation, which one of the following conditions allows the person to wear a gauze cap over the stoma, instead of a pouch?
- Ostomy of sigmoid colon
- Ostomy of ascending colon
- Ostomy of transverse colon
- Ostomy of iliac colon
- Ostomy of any part of colon
Correct Answer: A. Ostomy of sigmoid colon
A person with colostomy, who has ostomy of sigmoid colon will have the choice to irrigate. The person need not wear a pouch; instead he or she can wear a gauze cap over the stoma and can schedule irrigations at convenient timings. In all other above-mentioned cases, this is not possible.
Which type of emphysema is associated with alpha-1-antitrypsin deficiency?
- Centrilobular emphysema
- Panlobular emphysema
- Paraseptal emphysema
- Irregular emphysema
- Distal acinar emphysema
Correct Answer: B. Panlobular emphysema
Panlobular emphysema is associated with alpha-1-antitrypsin deficiency, where there is enlargement of all air spaces from bronchioles to alveoli. All other above- mentioned types of emphysema are not associated with alpha-1-antitrypsin deficiency.
In case of gouty arthritis, the speed of onset for an attack is
- Weeks to months
Correct Answer: C. Hours
In the case of gouty arthritis, the speed of onset for the attack is hours. In the case of osteoarthritis, it takes months for an attack while in the case of rheumatoid arthritis, it takes weeks to months for an attack.
A nurse is caring for an 80-year-old woman, who is diagnosed with dementia. Which cognitive area will not be affected in the elderly woman?
Correct Answer: E. Emotion
Dementia involves a set of signs and symptoms where there is impairment in cognitive areas like memory, attention, problem-solving, and language. Emotion is not included in cognitive areas. Emotion is associated with mood and temperament.
A 32-year-old male has pyloric stenosis secondary to chronic peptic ulceration. Which one of the following electrolyte imbalances would the nurse anticipate in a patient with pyloric stenosis?
Correct Answer: C. Hypokalemia
High levels of aldosterone are seen in case of pyloric stenosis, which retains sodium and in turn, excretes large amounts of potassium into the urine that subsequently leads to hypokalemia. The other above-mentioned electrolyte imbalances are not related to pyloric stenosis.
Pericardial rub is auscultated in which part of the chest by a nurse for a patient with pericarditis?
- Upper right sternal border
- Lower left sternal border
- Upper left sternal border
- Lower right sternal border
- Middle sternal region
Correct Answer: B. Lower left sternal border
The classic sign of pericarditis is a pericardial rub friction, which is auscultated on a cardio-vascular examination. It is auscultated on the lower left sternal border. In all other above-mentioned areas, the friction is not seen.
Which one of the following is considered as the best benzodiazepine in the treatment of status epilepticus?
Correct Answer: D. Lorazepam
The best benzodiazepine for the treatment of status epilepticus is Lorazepam, as its duration of action is extended for a period of 2-8 hours. It also has high affinity for GABA receptors and has less lipid solubility. If Lorazepam is not available, or when I.V. access is impossible, then Diazepam is given for status epilepticus. The other above-mentioned drugs are not used for status epilepticus.
A nurse cares for a patient with reversible ischemic neurologic deficit or RIND. The nurse must identify that this cerebral infarct would last for about
- More than 24 hours but lesser than 72 hours
- More than 18 hours but lesser than 48 hours
- More than 12 hours but lesser than 24 hours
- More than 6 hours but lesser than 12 hours
- More than 2 hours but lesser than 6 hours
Correct Answer: A. longer than 24 hours but fewer than 72 hours
Cerebral infarct lasts for a period ofmorethan 24 hours andless than 72 hours in a patient with reversible ischemic neurologic deficit or RIND. All other above-mentioned durations is not related to RIND. But the symptom of a TIA lasts for a few minutes or less than 24 hours. Brain injury occurring in TIA lasts only a few minutes.
A nurse cares for a 38-year-old male with acute pneumonia. Which one of the following would the nurse consider as a severe symptom of pneumonia?
- Productive cough
- Fever with chills
- Stabbing chest pain during deep inspiration
- Increased respiratory rate
- Persistent vomiting
Correct Answer: E. Persistent vomiting
The most severe symptom of pneumonia is persistent vomiting.The other severe symptoms of pneumonia include decreased thirst, convulsions, high temperature and blue-tinged skin. The people with infectious pneumonia have cough, fever with chills, stabbing chest pain during deep breaths and an increased respiratory rate. These are all considered as the typical signs and symptoms of pneumonia.
A nurse cares for a 45-year-old woman with cerebral aneurysm. The nurse must understand that the cerebral aneurysm occurs most commonly in
- Posterior cerebral artery
- Anterior cerebral artery
- External carotid artery
- Internal carotid artery
- Middle cerebral artery
Correct Answer: B. Anterior cerebral artery
Cerebral aneurysm occurs commonly in anterior cerebral artery, which is attached to the circle of Willis. This leads to severe strokes and in turn leads to death. The next common site of cerebral aneurysm is the internal carotid artery. Other above-mentioned areas are not the common sites of cerebral aneurysm occurrence.