Question 1

Which of the following is the most common cause of myocardial ischemia?*

A. Coronary artery disease (CAD)

B. Pericarditis

C. High potassium levels

D. Viral infection

Question 2

The client also has the nursing diagnosis Decreased Cardiac Output related to decrease plasma volume. Which finding on assessment supports this nursing diagnosis?*

A. Flattened neck veins when client is in supine position

B. Pitting edema located in feet, ankles, and calves

C. Full and bounding pedal and post-tibial pulses

D. Shallow respirations with crackles on auscultation

Question 3

A client’s arterial blood gas report indicates the pH is 7.52, PCO2 is 32 mm Hg, and HCO3 is 24mEq/L. What does the nurse identify as a possible cause of these results?*

A. Inadequate nutrition

B. Airway obstruction

C. Excessive mechanical ventilation

D. Prolonged gastric suction

Question 4

What is the main pathophysiological effect of mitral stenosis on the heart?*

A. Decreased blood flow to the kidneys

B. Decreased pulmonary pressure and right ventricular hypertrophy

C. Decreased left ventricular filling and increased left atrial pressure

D. Increased cardiac output due to aortic valve regurgitation

Question 5

What is the main physiological consequence of constrictive pericarditis?*

A. Increased myocardial contractility

B. Decreased ventricular filling and reduced cardiac output

C. Sudden rupture of the pericardium

D. Increased stroke volume

Question 6

A client is prescribed prolonged bed rest after surgery. Which complication does the nurse expect to prevent by teaching this client to avoid pressure on the popliteal space?*

A. Cerebral embolism

B. Pulmonary embolism

C. Coronary vessel occlusion

D. Dry gangrene of a limb

Question 7

In a patient undergoing surgery, it was vital to aspirate the contents of the upper gastrointestinal tract. After the operation, the following values were acquired from an arterial blood sample: pH 7.55, PCO2 52 mm Hg and HCO3- 40 mmol/l. What is the underlying disorder?*

A. Respiratory Acidosis

B. Metabolic Acidosis

C. Metabolic Alkalosis

D. Respiratory Alkalosis

Question 8

The most common source of arterial thromboembolism to the systemic circulation is :*

A. Room air that enters the circulation through intravenous lines

B. Blood stasis due to atrial fibrillation and flutter.

C. Decrease of venous return caused by clot formation in the large veins

D. Venous stasis due to immobility, obesity or prolonged leg dependency

Question 9

Which of the following is a common symptom of anemia?*

A. Excessive sweating

B. Increased appetite

C. Shortness of breath

D. High blood pressure

Question 10

A client has a nasogastric tube connected to intermittent wall suction. The student nurse asks why the client’s respiratory rate has increased. What is your best response?*

A. “It’s common for clients with uncomfortable procedures such as nasogastric tubes to have a higher rate to breathing.”

B. “The client is hyperventilating because of anxiety and we will have to stay alert for development of a respiratory acidosis.

C. “The client may have a metabolic alkalosis due to the NG suctioning and the increased respiratory rate is a compensatory mechanism.”

D. “Whenever a client develops a respiratory acid-base problem, increasing the respiratory rate helps correct the problem.”

Question 11

Three-year-old Teta is admitted to the hospital with a diagnosis of asthma and respiratory distress syndrome. The mother of the child reports to the nurse on duty that she has witnessed slight tremors and behavioral changes in her child over the past four days. The attending physician orders routine ABGs following an assessment of the ABCs. The ABG results are pH 7.35, PaCO2 72 mmHg and HCO3 38 mEq/L. What acid-base disorder is shown?*

A. Respiratory Acidosis, Fully Compensated

B. Respiratory Alkalosis, Fully Compensated

C. Respiratory Acidosis, Uncompensated

D. Metabolic Alkalosis, Partially Compensated

Question 12

Which of the following clinical signs is commonly associated with DVT?*

A. Kerning’s sign (resistance to leg extension in meningitis)

B. Homan's sign (pain in the calf on dorsiflexion of the foot)

C. Murphy’s sign (pain in the right upper quadrant)

D. Trousseau’s sign (spasm of the hand with inflation of a blood pressure cuff)

Question 13

In heart failure, what happens to the ejection fraction?*

A. It increases above normal

B. It decreases

C. It remains unchanged

D. It becomes variable

Question 14

Which of the following terms refers to rapid accumulation of fluid in the pericardial cavity, causing cardiac compression and constitute cardiac emergency?*

A. Pericardial hypertrophy

B. Pericardial Effusion

C. Pleural effusion

D. Cardiac Tamponade

Question 15

Which of the following conditions refers to decrease in both systolic and diastolic BP on standing and always accompanied by dizziness, blurred /or loss of vision associated syncope?*

A. Idiopathic Hypotension

B. Isolated hypertension

C. Orthostatic Postural Hypotension

D. Chronic Hypotension

Question 16

A nurse is caring for a client on bed rest. How can the nurse help prevent a pulmonary embolus?*

A. Teach the client how to exercise the legs.

B. Maintain the knee gatch position at an angle.

C. Limit the client’s fluid intake.

D. Encourage use of the incentive spirometer

Question 17

Which of the following is NOT a modifiable risk factor for hypertension?*

A. Smoking

B. Sedentary lifestyle

C. High salt intake

D. Age

Question 18

Autophagy is typically activated in response to:*

A. Cellular stress and starvation

B. DNA damage

C. High oxygen levels

D. Excess nutrients

Question 19

A nurse is caring for a client with an infection caused by group A beta-hemolytic streptococci. The nurse should assess this client for responses associated with which illness?*

A. Rheumatoid arthritis

B. Rheumatic fever

C. Spinal meningitis

D. Hepatitis A

Question 20

Leukemia is a cancer affecting which type of blood cells?*

A. Plasma cells

B. White blood cells

C. Red blood cells

D. Platelets

Question 21

How does autophagy differ from apoptosis?*

A. Autophagy occurs only in neurons, whereas apoptosis occurs in all cells

B. Apoptosis occurs only in cancer cells, while autophagy occurs in all cells

C. Autophagy causes inflammation, whereas apoptosis does not

D. Autophagy is an energy-dependent survival process, while apoptosis leads to cell death

Question 22

A client with angina complains that the angina pain is prolonged and severe and occurs at the same time each day, most often in the morning, on further assessment a nurse notes that the pain occurs in the absence of precipitating factors and at rest. This type of anginal pain is best described as:*

A. Stable angina

B. Unstable angina

C. Variant angina

D. Non-anginal pain

Question 23

Kabeba’s grandmother has been suffering from persistent vomiting for two days now. She appears to be lethargic and weak and has myalgia. She is noted to have dry mucus membranes and her capillary refill takes >4 seconds. She is diagnosed as having gastroenteritis and dehydration. Measurement of arterial blood gas shows pH 7.5, PaO2 85 mm Hg, PaCO2 40 mm Hg, and HCO3 34 mmol/L. What acid-base disorder is shown?*

A. Metabolic Alkalosis, Partially Compensated

B. Respiratory Alkalosis, Uncompensated

C. Respiratory Acidosis, Partially Compensated

D. Metabolic Alkalosis, Uncompensated

Question 24

Kanuma is a 54-year-old with a history of chronic obstructive pulmonary disease (COPD) and was rushed to Kibogora hospital emergency department with increasing shortness of breath, pyrexia, and a productive cough with yellow-green sputum. He has difficulty communicating because of his inability to complete a sentence. One of his sons, Jacob, says he has been unwell for three days. Upon examination, crackles and wheezes can be heard in the lower lobes; he has tachycardia and a bounding pulse. Measurement of arterial blood gas shows pH 7.3, PaCO2 68 mm Hg, HCO3 28 mmol/L, and PaO2 60 mm Hg. How would you interpret this?*

A. Metabolic Acidosis, Partially Compensated

B. Respiratory Acidosis, Uncompensated

C. Metabolic Alkalosis, Uncompensated

D. Respiratory Acidosis, Partially Compensated

Question 25

After seeking medical care, different investigations were performed and a dilation and failure of the right ventricle was confirmed. while the doctor explained to the patients, he noticed that the etiology is “Tricuspid regurgitation” Define Tricuspid regurgitation:*

A. Tricuspid regurgitation is an inability of the tricuspid valve leaflets to open properly

B. Tricuspid regurgitation happens when the valve leaflets fail to close completely, permitting blood flow to continue even when the valve is supposed to be closed

C. Tricuspid regurgitation is an outflow obstruction that increases pressure within the right ventricle as it tries to eject blood through the narrowed opening

D. Tricuspid regurgitation is a scarring that causes the leaflets to become fibrous and fused and the chordae tendineae becomes shortened

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