Practice Nursing test with answers and

rationale
1. When assessing a client with chest
pain, the nurse obtains a thorough
history. Which statement of the
patient is most suggestive of anginal
pectoris?
a. The pain lasted for about 45
minutes
b. The pain resolved after I ate
sandwich
c. The pain worsened when I took a
deep breath
d. The pain occurred while I was
mowing the loan
2. After experiencing a transient
ischaemic attack (TIA), a client is
prescribed aspirin 80 mg p.o daily. The
nurse should teach the client that this
medication has been prescribed to
a. Control headache pain
b. Enhance immune response
c. Prevent intracranial bleeding
d. Decrease platelet coagulation
3. The physician prescribes several drugs
for a client with hemorrhagic stroke .
which drug order should the nurse
question.
a. Heparin sodiim (heplock)
b. Dexamethasone ( decadron)
c. Methyldopa (aldomet)
d. Phentoin (dilantin)
4. A client with peptic ulcer is about to
begin a therapeutic regimen that
includes a bland diet,antacids and
ranitindine hcl (zantac). Which
instructions should the nurse provide
before this client is discharged.

a. Eat a three balanced meal

everyday
b. Stop taking the drug when the
symptoms subside
c. Avoid aspirin and products that
contain aspirin
d. Increase the intake of fluids
containing caffeine
5. The nurse is assessing a client with
Cushings disease. Which observation
should be reported to the physician
immediately.
a. Pitting edema of the legs
b. Irregular apical pulse
c. Dry mucous membrane
d. Frequent urination
6. A client with myasthenia gravis is
receiving continuous mechanical
ventilation. When the high pressure
alarm on the ventilator sounds, what
should the nurse do?
a. Check the presence of the apical
pulse
b. Suction the patients artificial
airway
c. Increase the oxygen percentage
d. Ventilate using a manual
resuscitation bag
7. Which of the following takes the
highest priority for parkinsons crisis?
a. Altered nutrition: less than body
requirements
b. Ineffective airway clearance
c. Altered urinary elimination
d. Risk for injury

8. Which nursing diagnosis is most

appropriate for a client with Addisons
disease?

a. Fluid intake of less than 2500 ml in

24 hours

a. Risk for infection

b. Urine output of more than 200

ml/hr

b. Fluid volume excess

c. Blood p ressure of 90/50

c. Urinary retrention

d. Pulse rate of 126 beats/min

d. Hypothermia
9. Which of these signs suggest that a
client with Symptom if Inappropriate
Antidiuretic Hormone(SIADH) has
developed complications?
a. Titanic contractions
b. Neck vein distention
c. Weight loss
d. Polyuria
[Link] of these findings best
correlates with a diagnosis of
osteoarthritis?
a. Joint stiffness that decreases with
activity
b. Eythema and edema over the affected
joints
c. Anorexia and weight loss

[Link] action should the nurse include

in the plan of care for a client with a
fiberglass cast on the right hand?
a. Keep the casted arm with a light
blanket
b. Avoid handling the cast for 24 hrs
or until dry
c. Assess pedal and tibial pulses
every 24 hrs
d. Assess movement and sensation in
the fingers of the right hand.
14.A client is admitted with a serum
glucose level of 618 mg/dl. The client
is awake and oriented, with hot, dry
skin, a temperature of 100.6 F(38.1
C)PR of 116 bpm, and BP of 108/70
mmhg. Based on these findings, which
nursing diagnosis receive the highest
priority?

d. Fever and malaise

a. Fluid volume deficit r/t osmotic

diuresis

[Link] communicating with a client

with (sensory) receptive aphasia, the
nurse should?

b. Decreased cardiac output r/t

increased HR

a. Allow time for the client to respond

b. Speak loudly and articulate clearly
c. Give the client a writing pad
d. Use short, simple sentences
[Link] outcome indicates that
treatment for diabetes insipidus is
effective?

c. Altered nutrition : less than body

requirements r/t to insulin
deficiency
d. Ineffective thermoregulation r/t to
dehydration.
[Link] nursing action should take the
highest priority when caring for a
client with hemiparesis caused by
cerebrovascular accident?

a. Perform passive range of motion

exercise

mEq/L. which disorder these ABG

values suggests?

b. Place the client on the affected

side

a. Respiratory alkalosis

c. Use handrolls or pillows to support

d. Apply antiembolic stockings
[Link] nurse should include which
instruction when teaching a client
about insulin administration?
a. Administer insulin after the first
meal of the day
b. Administer insulin at a 45 degree
angle into the deltoid muscle
c. Shake the vial of the insulin
vigorously before withdrawing the
medication
d. Draw up clear insulin when mixing
two types of insulin in one syringe.
[Link] nurse should expect a client with
hypothyroidism to report which of
these health concerns?

b. Respiratory acidosis
c. Metabolic alkalosis
d. Metabolic acidosis
20.A client is admitted to the ER with
suspected overdose of unknown drug.
The client ABG values indicates
respiratory acidosis, what should the
nurse do first?
a. Prepare to assist with ventilation
b. Monitor the clients heart rhythm
c. Prepare to begin gastric lavage
d. Obtain urine for drug screening
21.A client is being returned to the room
after subtotal thyroidectomy. Which
piece of equipment is important to the
nurse to bring to the clients bedside?
a. Indwelling folley catherer kit

a. Increased appetite and weight loss

b. Tracheostomy set

b. Puffiness of the face and hands

c. Cardiac monitor

c. Nervousness and tremors

d. Humidifier

d. Increasing exophthalmos
18.A client with hypothyroidism is
receiving levothyroxine
sodium(synthroid), 50 mcg. P.O daily.
Which of these findings should the
nurse recognize as an adverse effect?
a. Dysuria
b. Leg cramps
c. Tachycardia
d. Blurred vision
19.A client ABG values are pH=7.12,
PaCO2= 40 mmHg, and HCO3= 15

[Link] of these findings is an early

sign of bladder cancer?
a. Painless hematuria
b. Occasional polyria
c. Nocturia
d. Dysuria
[Link] statement from a client who
takes Nitroglycerin ( Nitrostat) as
needed for angina pain indicates that
further teaching is necessary?
a. I store the tablets in a dark bottle

b. I take the tablet in a full glass of

water

which laboratory test when caring for

this patient?

c. I check for my tongue to tingle

when I take a tablet

a. RBC count

d. Ill go to the hospital if 3 tablets, 5

minutes apart dont relieve the
pain
[Link] nurse is assessing the puncture
site of a client who has received a
purified protein derivative test. Which
finding indicates a need for further
evaluation?
a. 15 mm induration
b. Reddened area
c. 10 mm bruise
d. Blister
25.A client must take streptomycin
sulfate for TB. Before the therapy
begins, the nurse should inform the
client to inform the physician if which
of the following symptoms occur?
a. Decreased color discrimination

b. Serum uric acid

c. Serum potassium
28.A client has been diagnosed with type
1 insulin dependent DM. which clients
comment correlates best with this
disorder?
a. I was thirsty all the time. I just
couldnt get enough to drink
b. It seemed like I had no appetite. I
had to get myself eat
c. I had cough and cold that jjust
didnt seem to go away
d. I noticed a pain when I went to the
bathromm
29.A client is receing chemotherapy for
breast cancer. Which assessment
finding indicates chemotherapy
induced fluid and electrolyte
imbalance?

b. Increased urinary frequency

a. Urine output of 400 ml in 8 hrs

c. Decreased hearing acuity

b. Serum potassium level of 3.6

mEq/L

d. Increased appetite.
[Link] a late stage of AIDS, a client
demonstrates signs of AIDS related
dementia. The nurse should give
highest nursing prioroity to which of
the following nursing diagnosis?
a. Bathing or hygiene self care deficit
b. Impaired cerebral perfusion
c. Dysfunctional grieving
d. Risk for injury
27.A client with gout is receiving
Probenecid. The nurse should monitor

c. BP of 120/64 to 130/72 mmHg

d. Dry oral mucous membrane and
cracked lips
[Link] chemotherapy, a client develops
N/V . for this client, the nurse should
give the highest priority to which
action in the plan of care?
a. Serve small portions of bland food
b. Encourage rhythmic breathing
exercise
c. Administer metoclopromide and
dexamethasone as prescribed

d. Withould fluid for the the first 4-6

hrs
31.A client is receiving Zidovdine
(Retrovir) to treat AIDS, for this client,
the nurse should monitor the value of
which laboratory test?
a. RBC count
b. Fasting blood glucose
c. Serum calcium
d. Platelet count
32.A client seeks care for low back pain of
2 weeks duration. Which assessment
finding suggests a herniated
intervertebral disk?
a. Pain that radiates down the posterior
thigh
b. Back pain when the knees are flexed
c. Atrophy of the lower legs
d. Positive Homans sign
[Link] a client with hepatitis b, the nurse
should monitor closely for the onset
development of which clinical
manifestation?

c. Consuming a high protein , high

fiber diet
d. Taking only enteric medications
[Link] prevent esophageal reflux in a
client with hiatus hernia, the nurse
should provide which discharge
instructions?
a. Lie down after meals to promote
digestion
b. Avoid coffee and alcoholic
beverages
c. Consuming low protein, high fiber
diet
d. Limit fluids with meals
36.A client with increasing difficulty
swallowing , weight loss and fatigue
just received a diagnosis of
esophageal cancer. Because this client
has difficulty swallowing, the nurse
should give the highest priority to
which action.
a. Helping the client cope with body
image disturbance
b. Ensuring adequate nutrition

a. Jaundice

c. Maintaining a patent airway

b. Arm and leg pruritus

d. Preventing injury

c. Fatigue during ambulation

d. Irritability and drowsiness
34.A client is recovering from ileostomy
that was performed to treat
inflammatory bowel disease. During
the teaching discharge, the nurse
should stress:
a. Increasing fluid intake to prevent
dehydration
b. Wearing appliance pouch only at
bedtime

[Link] nurse is caring for a client with

cirrhosis. Which manifestations
indicate deficient Vit. K absorption
caused by this liver disease?
a. Dyspnea and fatigue
b. Ascites and orthopnea
c. Purpura nd petechaie
d. Gynecosmastia and testicular
hypertrophy
[Link] days ago, the client underwent an
autograft for secof and third degree

burns on the arms. Now the nurse

finds the client doing arm ecxercise.
Te nurse knows that exercise should
be avoided because it may.
a. Dislodge the autograft

a. Encourage oral feedings as soon as

possible
b. Develop an alternative
communication method

b. Increase the edema in the arms

c. Keep the tracheostomy cuff fully

inflated

c. Increase the amount of scarring

d. Keep the client flat in bed

d. Decrease circulation of the fingers

39.A client with UTI receives a
prescription for cotrimoxazole (Septra)
2 tablets P.O daily for 10 days. Which
observation best demonstrates that
the client followed the prescribed
regimen?
a. Increase urine output to 2L in 24
hrs
b. Decreased flank and abdominal
discomfort
c. Absence of bacteria on urine
culture
d. Normal RBC count
40.A client has undergone laryngectomy
and tracheostomy formation. Which
instruction should the nurse give to
the client and family about the
operation?
a. The tracheostomy tube should be
cleaned with alcohol and water.
b. Family members should conitinue
to converse with the client

[Link] a left pneumonectomy, a client

has a chest tube for drainage. For this
client, the nurse must
a. Monitor fluctuations in the water
seal chamber
b. Clamp the chest tube once every
shift
c. Encourage coughing and deep
breathing
d. Milk the chest tube every 2 hrs
43.A client reports sharp chest pain in the
right side of the chest and difficulty of
breathing and has respiratory rate of
40 bpm. Which goal should the nurse
consider as the top priority?
a. Maintainance of adequate
circulatory volume
b. Maintainance of effective
respiration
c. Anxiety reduction
d. Pain reduction

c. Oral intake should be limited to 1

week only

44.A client develops brigh red urine while

receiveing heparin for pulmonary
embolus. What should the nurse do
first?

d. The amount of protein in the diet

should be limited

a. Decrease the heparin infusion rate

[Link] caring for a client who has just

had a total laryngectomy,the nurse
should plan to

b. Prepare to administer protamine

sulfate
c. Monitor the paritial thromboplastin
time(PTT)

d. Stop the infusion for 2 hrs and start

it at a lower dose as prescribed
[Link] a client is chronic bronchitis, which
sign should lead the nurse to suspect
right heart failure (cor pulmonale)
a. Circumoral cyanosis
b. Bilateral crackels
c. Productive cough
d. Leg edema
[Link] caring for a client with
endotracheal tube, the nurse should
consider which action to be the most
important?

b. Notify the physician immediately

c. Assess the irrigation catheter for
patency and drainage
d. Asminsiter meperidine 50 mg IM as
prescribe
49.A client with arterial insuffieciency has
just undergone below knee
amputation of the right leg. Which
action should the nurse include in the
post op[ care plan?
a. Elevate the stump fot the first 24
hrs
b. Maintain the client on complete
bed rest

a. Auscultate the lungs for bilateral

breath sounds

c. Appy heat to the stump as the

client desires

b. Turning the client from side to side

every 2 hrs

d. Remove the pressure dressing

after the first 8 hrs

c. Monitor serial blood gas every 4 hrs

[Link] of these laboratory test is the

most accurate indicator of renal
function

d. Provide frequent oral hygiene

[Link] nurse administer albuterol
(Proventil) as prescribed to a client
with emphysema. Which findings
indicate that the drug is producing a
therapeutic effect?
a. RR of 22 bpm
b. Dialted and reactive pupils
c. Urine output of 40 ml/hr
d. PR of 100 bpm
[Link] transurethral resection of the
prostate for benign prostatic
hypertrophy, a client returns to the
room with continous bladder irrigation.
On the first day after surgery, the
client reports bladder pain, what
should the nurse do first?
a. Increase the IV flow rate

a. BUN
b. Creatinine clearance
c. Serum creatinine
d. Urinalysis
[Link] nursing intervention is the most
important when caring for a client with
acute pyelonphritis?
a. Administer sitz bath twice a day
b. Increase fluid intake to 3 L a day
c. Use an indwelling (folley) catheter
to measure urine output accurately
d. Encourage the client to drink
cranberry juice to acidify the urine

[Link] nursing intervention is the most

important during the acute oliguric
phase of acuter renal failure?

c. Maintain bed rest for 72 hrs postop

d. Turn the patient from side to side
using the log rolling technique

a. Encouraging coughing and deep

breathing exercise
b. Promoting carbohydrate intake
c. Limiting fluid intake
d. Controlling pain
53.A client with renal failure is
undergoing continous ambulatory
peritoneal dialysis (CAPD). Which
nursing diagnosis is most apporopriate
for this client?
a. Altered urinary elimination
b. Toileting self care deficit
c. Sensory or perceptual alterations
d. Dressing or grooming self care
deficit
54.A client is admitted with a cervical
spine injury caused by a diving
accident. When planning this clients
care,the nurse should give which
nursing diagnosis the highest priority?
a. Impaired physical mobility
b. Ineffective breathing pattern
c. Sensory or perceptual alteration
d. Activity intolerance
[Link] nurse is developing a plan of care
for a patient who has undergone a
laminectomy to repair a herniated
intervertebral disk. Which action
should the nurse include?
a. Keep the pillow under the knees at
all time
b. Place the client in a semi fowlers
position

[Link] nurse must total parenteral

nutrition(TPN) through a triple lumen
catheter line. What can the nurse do
to prevent complications?
a. Cover the catheter insertion site
with an occlusive dressing
b. Use clean technique when
changing the dressing
c. Insert an indwelling urinary
catheter
d. Keep the client on complete bed
rest.
[Link] nurse assesses a client shortly
after kidney transplant surgery. Which
postoperative finding should the nurse
report to the physician immediately?
a. Serum potassium of 4.9 mEq/L
b. Serum sodium of 135 mEq/L
c. Temperature of 99.2 F (37.3)
d. Urine output of 400 ml in 24 hrs
58.A cient is admitted with a gunshot
wound to the abdomen. After an
exploratory laparatomy, the client ,
the client is transferred to the ICU.
Which assessment finding suggests
that the client now is developing acute
renal failure?
a. BUN level of 22 mg/dl
b. Serum creatinine level of 1.2 mg/dl
c. Temperature of 1.2 F
d. Urine output of 400 ml in 24 hrs

59.A client seeks care for severe pain in

the right upper quadrant of the
abdomen, which is accompanied by
nausea and vomiting. The physician
makes a diagnosis of acute
cholecystitis and cholelithiasis. For this
client, which nursing diagnosis should
receive the highest priority?
a. Pain r/t biliary spasm
b. Knowledge deficit r/t prevention of
recurrence
c. Anxiety r/t unknown outcome of
hospitalization
d. Altered nutrition: less than body
requirements r/t to biliary
inflammatioin
[Link] a client with advanced liver
cirrhosis, which assessment finding
best indicates deterioration of liver
function?
a. Fatigue and muscke weakness
b. difficulty in arousal
c. Nausea and anorexia
d. Weight gain
61.A client is admitted with increased
ascites associated with cirrhosis.
Which nursing diagnosis should
receive the highest priority?
a. Fatigue
b. Fluid volume excess
c. Ineffective breathing pattern
d. Altered nutrition: less than body
requirements
62.A client with advanced cirrhosis has a
prothrombin time of 15 seconds
compared to a control time of 11 sec.
which drug should the nurse expect to
administer?

a. Spironolactone (alsdactone)
b. Phytonadione( mephyton)
c. Furosimide (Lasix)
d. Warfarin (Coumadin)
[Link] physician prescribes
spironolactone(Aldactone) 50 mg P.O
four times daily for a client with fluid
retention due to liver cirrhosis, which
finding indicates that the drug is
producing a therapeutic effect?
a. Serum K level of 3.5 mEq/L
b. Weight loss of 2 lb in 24 hrs
c. Serum Na level of 135 mEq/L
d. Blood pH of 7.25
[Link] preparing a client with for
cholecystectomy, the nurse explains
that incentive spirometry will be used
after surgery. The nurse also should
tell the client the primary purplose of
incentive spirometry is:
a. Increases respiratory effectiveness
b. Preclude the need for nasogastric
intubation
c. Improve nutritional status during
the recovery period
d. Decrease the amount of respiratory
anesthesia
65.A client is transferred to ICU after
evacuation of a subdural hematoma.
To reduce the risk of increasing
intracranial pressure , the nurse
should:
a. Encourage oral fluid intake
b. Suction the client once per shift
c. Elevate the head of the bed to high
fowlers

d. Administer a stool softener as

prescribed

a. Remove the weight once every

shift

[Link] days after repairing a clients

ruptured cerebral aneurysm, the
physician orders mannitol (osmitro)
1.5 g/kg, to be infused over 60
minutes. If the client weighs 175 lbs,
how many grams of mannitol should
be administered?

b. Maintain the bed in knee gatch

position

a. 263 g
b. 119 g
c. 75g
d. 60 g
67.A client is receiving a n I.V infusion of
mannitol after undergoing intracranial
pressure surgery for removal of a
brain tumor. To determine if this drug
is producing its therapeutic effect, the
nurse should consider which as the
most significant
a. Decrease level of consciousness
b. Elevated BP
c. Increased urine output
d. Decreased heart rate
68.A client is hospitalized for open
reducrion of a fractured femur. During
postoperative assessments, the nurse
monitors for signs of fat embolism,
which include:
a. Pallor and coolness of the affected
leg
b. Nausea and vomiting after eating
c. Hypothermia and bradycardia
d. Restlessness and petechiae
69.A client is in Bucks skin traction for
right hip fracture. The nurse should
include which action in this clients
plan of care.

c. Keep the client is a semi fowlers

position
d. Maintain traction in correct body
allignment
70.A client who has just received a
diagnosis of early glaucoma is being
prepared for discharge. Which
information should the nurse provide
during this clients discharge teaching
session?
a. Instructions for eye patching
b. Discharge assessment of visual
acuity
c. Demonstration of eye drop
instillation
d. Instructions on intraocular lens
cleaning
71.A client was admitted to a coronary
care unit with acute myocardial
infarction (MI). Now the client report
midsternal pain radiating down the left
arm, appears restless and is slightly
diaphoretic. The nurse obtains the
following assessment findings: T= 00.
6 F (37.5 C); PR = 102 bpm,
regular;slightly labored respiration of
26 bpm, and BP of 150/90 mmHg.
When planning the clients care, the
nurse should give the highest priority
to which nursing diagnosis?
a. Risk for altered body temperature
b. Decreased cardiac output
c. Anxiety
d. Pain

72.A client with cirrhosis of the liver is

increaslingly confused and combative.
Which of the following diets would the
nurse expect to be ordered for this
client?
a. Low fat, low sodium
b. High carbohydrate, low protein
c. Low potassium ,low phosphorus
d. Gluten and wheat free.
[Link] of the following should the
nurse teach a client using recombinant
epoetin alpha (Epogen) for chronic
renal failure?
a. This drug will help with the
bleeding problems associated with
kidney damage
b. Epoetin alpha should reduce
fatigue and improve energy level
c. Taking this medication may reduce
the need for dialysis
d. Once a good blood level is
established, the injectable form will
be changed to an oral form
[Link] appropriate plan of care for a client
admitted with renal colic would
include which of the following?
a. Inserting an indwelling urinary
catheter
b. Straining all urine
c. Maintaining T tube patency
d. Limiting fluid intake
[Link] statement would not be
included in discharge teaching for a
client with a history of rheumatoid
arthritis who was treated with severe
anemia secondary to GI hemorrhage?
a. Take your iron supplement with
orange juice

b. Use aspirin for joint pain

c. Plan to take iron for 6 months
d. Avoid taking iron with tea or
calcium supplements
76.A client with exacerbation of COPD
and pneumonia has the following ABG
results: pH 7.30, PaC02 60 mmHg,
PaO2 75 mmHg and HCO3 is 24 Meq/L.
The nurse anticipates wich
intervention?
a. Increase oxygen via face mask
b. Encourage coughing and deep
breathing
c. Admister sodium bicarbonate
d. No intervention is neede. ABG
values are normal
77.A client with cerebrovascular accident
has a nursing diagnosis of ineffective
airway clearance. The goal for this
client is to mobilize pulmonary
secretions. Which action should the
nurse plan to take to meet this goal?
a. Reposition the client every 2 hrs
b. Restrict fluids to 1000 ml in 24 hrs
c. Asminister O2 by nasal canula as
ordered
d. Keep the head of the bed at a 30
degrees angle
78.A client is admitted to the hospital
with a productive cough, night sweats
and fever. Which of these actions is
most important in the clients initial
plan of care?
a. assess the clients temperature
every 8 hrs
b. place the client in respiratory
isolation

c. monitor the clientf fluidintake and

output
d. wear gloves during all client
contact
79.a client with heart failure has been
receiving an IV infusion at 125 ml/hr.
Now the client is short of breath and
the nurse notes of bilateral crackles,
neck vein distention and tachycardia.
What should the nurse do first?
a. Notify the physician
b. Discontinue the IV access device
c. Administer the prescribed diuretic
d. Slow the infusion and notify the
physician
[Link] bronchoscopy, the client must
receive NPO until the gag reflex
returns. What is the best way to
assess the gag reflex?
a. Instruct the client to cough
b. Ask the client to extend the tongue
c. Tickle the uvula with a tongue
blade
d. Observe while the client swallows
sips of water.
81.A client with shock due to hemorrhage
has these V/S: T= 97.6 F(36.4C), PR=
140 bpm, BP of 60/30 mmHG. For this
client, the nurse should question
which physicians order?
a. Monitor urine output every hr
b. Infuse IV fluids at 83 ml/hr
c. Admister oxygen by nasal canula at
3 L/min
d. Draw specimens for hemoglobin
and hematocrit every 6 hrs

82.A client with history of atrial fibrillation

presents to the outpatient clinic with
nausea, vomiting, HR of 55 bpm, and
visual disturbances. The nurse would
further assess the client for which of
the following conditions?
a. Digitalis glycoside toxicity
b. Angina
c. Heart failure
d. Depression
83.A clients ABG values are pH of 7.29,
PaO2 48 mmHg, PaCO2 76 mmHg,
HCO3 of 36 mEq/l. the plan of care for
this client with these values would
include close monitoring for which of
the following s/sx?
a. Cyanosis and restlessness
b. Flushed skin and lethargy
c. Weakness and irritability
d. Anxiety and fever
[Link] postural drainage, movement
of secretions from the lower
respiratory tract to the upper
respiratory tract occurs due to:
a. Friction between the cilia
b. Force of gravity
c. Increased insulin use
d. Increased red blood cell production
[Link] with COPD may be bedridden
at home and get little exercise. Which
of the following is a normal physiologic
reaction to prolonged period of bed
rest and inactivity?
a. Increased sodium retention
b. Increased calcium excretion
c. Increased insulin use

d. Increased red blood cell production

[Link] a client with COPD who has trouble
raising respiratory secretions, which of
the following nursing measures would
help reduce the tenacity of secretions?
a. Ensuring that the clients diet is low
in Na
b. Ensuring that the clients oxygen
therapy is continous
c. Helping the client maintain a high
fluid intake
d. Keeping the client in sitting
position as much as possible
[Link] nurse teaches the client with
COPD to assess for signs and
symptoms of right sided heart failure
which include:
a. Clubbing of nail beds
b. Hypertension
c. Ankle edema
d. Increased appetite
[Link] caring for a client who has
sustained an MI, the nurse notes eight
premature ventricular contractions in
1 minute on the cardiac monitor. The
client is receiving an IV infusion of 5%
dextrose in water and 2 L/minte of
oxygen. The nurses first course of
action would be to:

b. Elevated creatinine phosphokinase

(CPK) value
c. Agrees to participating in cardiac
rehabilitation program
d. Can perform personal self care
activities without pain.
[Link] of the following is expected for
a client on the day of hospitalization
after an MI? the client:
a. Has minimal chest pain
b. Can identify risk factors for MI
c. Agrees to participating in cardiac
rehabilitation program
d. Can perform personal self care
activities without pain
[Link] measures for the client who
has had an MI include helping the
client to avoid activity that results in
valsalva maneuver. Which of the
following actions would help prevent
valsalva maneuver? Have the client:
a. Take fewer deep breaths
b. Clench teeth while moving in bed
c. Drinks fluids through a straw
d. Avoid holding breath during activity
92.A basic principle of any rehabilitation
program , including cardiac
rehabilitation begins:

a. Increase the IV infusion rate

a. On discharge from hospital

b. Notify the physician promptly

c. Increase the oxygen concentration

b. On discharge from cardiac care

unit

d. Administer a prescribed analgesic

c. On admission to the hospital

[Link] the following findings is an

indicative of MI?
a. Elevated serum cholesterol level

d. Four weeks after the onset of

disease
[Link] client has a history of heart failure
and the nurse is preparing the client to

go home. The nurse should instruct

the client to:
a. Monitor urine output daily
b. Maintain bed rest for at least one
week
c. Monitor daily potassium intake
d. Weigh daily
[Link] is administred IV to clients
with CHF primarily because the drugs
acts to :
a. Dilate coronary artery
b. Increase myocardial contractility
c. Decrease cardiac dysrhytmias
d. Decrease electrical conductivity in
the heart
[Link] client ask the nurse about the
reason for taking enalapril maleate.
The nurse based her response on the
fact that enalapril is prescribed for
people with heart failure to:
a. Lower blood pressure by increasing
peripheral resistance
b. Lower the heart rate by slowing the
conduction sytem
c. Block the conversion of angiotensin
1 to angiotesin 11
d. Increase cardiac contractility
thereby improving cardiac output
[Link] tartrate a Beta adrenergic
antagonsist may be administered to a
client with heart failure because it acts
to:
a. Reduce peripheral vascular
resistance
b. Increase peripheral vascular
reistance

c. Reduce fluid volume

d. Improve myocardial contractility
[Link] most effective measure the nurse
can use to prevent the wound
infection when changing a clients
dressing after coronary artery bypass
surgery is to:
a. Observe careful handwashing
procedures
b. Cleanse the incisional area with
antiseptic
c. Use prepacked sterile dressing to
cover the wound
d. Place soiled dressings in a
waterproof bag before disposing
them
[Link] information obtained by the
nurse when assessing a patient
admitted with mitral valve stenosis
should be communicated to the health
care provider immediately?
a. The pt has a loud diastolic murmur
all across the precordium
b. The pt has crackles audible to the
lung apices
[Link] caring for a pt with infective
endocarditis of the tricuspid valve, the
nurse will plan to monitor the pt for:
a. Flank pain
b. Hemiparesis
c. Dyspnea
d. splenomegaly
100. the nurse is taking a history from a 24
y/o pt with hypertrophic cardiomyopathy.
Which information obtained by the nurse is
the most important?
a. the pt reports using cocaine once
at 16 y/o

b. the patient has a history of upper

respiratory infection
c. the pts 29 year old brother has had
a sudden cardiac arrest
d. the pt has a family history of CAD
Answers to part 1
1. D. precipitating factors of angina
include exertion during physical
activities,colds, after heavy meals ,
emotional stress wherein theres an
increase oxygen demand but less
supply d/t of obstruction of blood flow.
It may also occur during rest as a
result of coronary spasm. Pain usually
last for 3-5 minutes or 15-20 min
especially after a heavy meal or
anger.
2. D. TIA is caused by temporary
decreased in blood flow , could be
caused by atherosclerosis,emboli or
thrombi. Anticoagulants such as
aspirin is given to dissolve the clot or
prevent platelet aggregation that
could lead to emboli or thrombi.
3. A. hemorrhagic stroke can lead to
seizures. Thus antiseizures such as
phentoin is prescribed. One often
cause is hypertension causing small
vessels in the brain to rupture and
bleed thus antihypertensive such as
methyldopa is included. The bleeding
also cause edema or inflammation to
the surrounding tissues so antiinflammatory such as dexamethason
is given to reduce the edema. Heparin
is an anticoagulant that may cause
further bleeding and should be
questioned.
4. C. teaching should include small
frequent feeding to avoid too much
HCl acid secretion, completing the
prescribed medications even the
patient seems to feel better, avoiding
gastric irritants such as caffeine,

highly flavored foods, aspirin may

cause ulcer and bleeding and should
be avoided.
5. C. cushings disease is an excessive
production of
mineralocorticoids( aldosterone- for
sodium and water reabsorption),
glucocorticoids( cortisol- breakdown of
fats and protein and gluconeogenesis)
and androgens (masculine hormone.
Although a pitting edema is a
characteristic symptom of cushing
disease because of excessive water
and sodium reabsorption, it is not an
emergency condition. Irregular apical
pulse is the primary concern and
should be reported immediately.
6. B. the ventilator will alarm to let the
caregiver know there is a problem.
Some of the most common alarms are
high pressure, low pressure and
battery. If the high pressure alarm
sounds, it means that air is having a
hard time getting into the lungs, it
usually means suctioning is needed to
get extra secretions out of the airway.
Low pressure means that there might
be an airleak or a disconnected tube.
7. B. Parkinsons crisis is also referred as
acute akinesia present in advanced
state of the disease. The rigidity of the
intercoastal muscle makes the patient
unable to cough out accumulated
sputum/secretions .thus, patients with
parkinsons disease are prone to
repiratory infections.
8. A. Addisons disease is also known as
Adrenal insufficiency. Theres
insufficient adrenocorticotropic
hormone (ACTH) production which
includes epinephrine and
norepinephrine that are helpful in the
flight and fight response. If the body is
unable to fight off stressors, this will
lead to body exhaustion and increase
susceptibility to illnesses and

infections. Another adrenal hormone is

aldosterone which is responsible for
water and sodium reabsorption.
Insufficient amount of this leads to
increased loss of sodium and water,
not urine retention and fluid excess.
Excessive loss of sodium and water
can lead to dehydration and increase
temperature.

13.D. It is unnecessary to keep the cast

warm, it should be exposed to cool air.
Fiberglass is dried up within 10-15
minutes, theres no need to assess the
pedal and tibial pulses since its not
the one casted. The casted part is the
right arm so it is important to check
distal circulation and sensation. Assess
brachial and ulnar pulse.

9. B. antidiuretic hormone(ADH) prevents

diuresis or urination. Excessive ADH
leads to excess Na and H2O retention
thereby gaining weight. Increased
amount of fluid in the blood vessels
causes increased venous return and
fluid overload. Chronic condition may
lead to congestive heart failure in
which distended neck vein is one of
the sign

14.A. hyperglycemia could lead to

osmotic dieresis leading to fluid
volume deficit as manifested by dry
skin. Decreased cardiac output cant
be related to increasese HR, it is d/t
dehydration and increased heart rate
is a compensatory mechanism .
theres no data for insulin deficiency ,
there might be enough insulin but the
cells are resistant to use it.

10.A. osteoarthritis is not an

inflammatory disease thereby doesnt
produce inflammatory and systemic
sign and symptoms. It s a wear and
tear degenerative disease. Pain can
occur after repetitive use of the joint .
pain and stiffness can also occur after
a long period of inactivity such as
when you go to bed at night and suffer
a pain and stiffness when you wake up
in the morning.

[Link] ko pa

[Link] aphasia is characterized by

fluent but meaningless speech with
severe impairment of the ability
understanding spoken and written
words. Short and simple sentences
should be used.
12.A. DI is characterized by inadequate
antidiuretic hormone leading to
excessive loss of Na and H20 followed
by hypotension and tachycardia.
Tachycardia is a compensatory
mechanism in an effort to pump more
blood d/t the decreasing circulating
fluid. It is important to increase the
fluid intake to prevent hypovolemic
shock.

16.D. Insulin is usually administered

before meal to anticipate the increase
of blood sugar after eating. Never
administer a subcutaneous insulin
deltoid because you might give it IM.
Deltoid is muscular so it is only used
for IM insulin route. Dont shake the
bottle to mix, just roll gently between
hands or by turning the bottle up and
down slowly.
17.B. thyroid hormones are responsible
for many metabolic processes. Options
A,C,D are result of hyperthyroidism d/t
increased metabolism and
neuromuscular hyperactivity. One
function of thyroid hormone is protein
synthesis which maintain osmotic
pressure in the blood vessels . if
protein concentration in the vessels is
decreased,theres a fluid shift into the
extracellular space leading to edema.
18.C. synthroid adverse effects typically
resulted from overdose and include
the signs and symptoms of

hyperthyroidism which includes

tachycardia.
19.D. pH is below normal which suggest
an acidosis. PaCO2 is for respiratory
index while HCO3 is for metabolic. The
pH follows HCO3, thereby it is
metabolic acidosis
20.A. always follow the principle of ABC
prioritization, Airway, breathing,
circulation. Respiratory acidosis is
typically the result of accumulation of
CO2 in the body tissues due to
hypoventilation. First priority is to
assist with the prescribed therapy
which includes means to improve
ventilation.
21.B. Bleeding / hematoma is a life
threatening complication that
obstructs airway postthyroidectomy.
Tracheostomy set should be at the
bedside to establish airway
immediately if respiratory distress
occurs.
22.A. In an early stage of cancer, it
usually starts as a tumor , as tumor
invades vascularized tumor, it may
cause bleeding.
23.B. Nitroglycerin is an unstable
substance and easily denatured when
exposed to heat and light. The dark
bottle protect the drug from the light.
If the drug doesnt tingle under the
tongue, it could be that its not
working anymore, it could be expired
or denatured. You should not take
more than 3 tablets , if the pain is not
relieve in 15 minutes, you should
consult the doctor because this is not
an angina pain anymore, it could be a
myocardial infarction.
24.A. mantoux test or tuberculin test is a
screening test for pulmonary
tuberculosis. It is done by introducing
a protein derivative of the causative
bacteria in the dermis of the skin.

After 48-72 hours, an induration of 10

mm or more is a positive test and
indicates that you might be positive
for PTB, a further evaluation and
testing is needed to confirm the
presence of PTB.
25.C. Streptomycin is an antibiotic
belonging to the aminoglycosides
family. Aminoglycosides work by
inhibiting the bacterial protein
synthesis. Streptomycin frequently
affects the vestibular branch of the
auditory nerve causing nausea,
vomiting, vertigo. Symptoms subside
and recovery occur following
discontinuation of the drug. In long
term therapy however, ototoxic effect
causes hearing loss when extensive is
usually permanent.
26.A. the main problem mention is
dementia. People with dementia may
not be able to think well enough to do
normal activities of daily living such as
getting dressed and eating.
27.A. Probenecid works by decreasing
uric acid in the blood by promoting its
kidney exctetion.
In overdosage and intoxication, it
causes various hematologic side
effects.
28.A. DM type 1 is a decreased in insulin
production leading to increasing
amount of glucose in the blood.
Hyperglycemia causes osmotic
diuresis that leads to frequent
urination and leads to dehydration.
29.D. A,B,C are normal findings. S/E iof
chemotherapy includes nausea and
vomiting, prolonged N/V caused
dehydration.
30.C. it is more logical and appropriate to
administer prescribed antiemtic first
before feeding the patient. This is to
avoid vomiting after a meal.

31.A. the most serious S/E of zidovudine

is anemia, myopathy and neutripenia
[Link] protruded or herniated disk
irritates or compressed the
surrounding nerve endings which
causes severe back pain radiating to
the thighs.
33.D. all options are clinical manifestation
of hepatitis B. I think the most correct
answer is D, because it needs closer
monitoring and care.
34.A. ileostomy is bringing out the ileum
which is the end of the small intestine
into an opening on the abdomen. One
important function of the colon is
water absroption, since water is not
anymore pass through the colon ,
most fluid is lost into the pouch rather
than being absorb making the client
more prone to dehydration. Pouch
should be worn all the time. Low fiber
diet should be advised postoperatively
because surgery causes the bowel to
swell making digestion of fiber
difficult. Once the swelling has
subsided(usually after 8 wks) the
patient can resume a normal diet.
35.B. instruction to the patient should
include avoiding acid stimulant such
as coffee, alcohol, fatty foods,aspirin,
tobacco, chocolate, peppermint,etc.
you should also instruct patient to
remain in upright position for atleat 30
min after eating and sleeping with the
bed slightly elevated, small frequent
feeding is better tolerated than 3 big
meals.
36.B. Esophageal CA presents many signs
and symptoms. However the question
is asking specifically on the problem
r/t to difficulty swallowing. You should
look for a problem that is most related
to difficulty swallowing, that is
insufficient food intake and nutrition.
The nurse should then ensure

adequate nutrition in relation to this

problem.
37.C. Vit K is important in the clotting
mechanism of the body. Lack of this
can lead to bleeding. Purpura and
petechiae are forms of bleeding
38.A. avoid exercise for 3-4 wks because
this may stretch and injure the graft.
39.C. Antibacterial should work for what
its designed for and that is to
eliminate the causing bacteria of a
disease. Even though the symptoms
subside, still a number of the
causative bacteria is present in the
urinary tract, if the medication is
stopped without completing the
prescribed duration of antimicrobial
therapy, they will again multiply and
cause the exacerbation of the disease.
Therefore, it is important to complete
the whole duration of the drug therapy
to ensure elimination of all the
bacteria.
40.B. inner cannula is cleaned with
Hydrogen Peroxide and rainsed with
water. The stoma is also cleaned using
a soapy wash cloth then rinsing it.
Inner surrounding of the stoma with
driep up sputum crust can be cleaned
with a cotton tipped swab soaked in
hydrogen peroxide. Alcohol promotes
dryness. Theres no indication why you
have to limit fluid intake. Protein
intake should be increased to promote
healing. Patient can still communicate
with proper speech therapy and
learning other means of
communication.
41.B. keep the bed elevated to promote
ventilation of the lungs and reduces
edema and swelling of the neck. The
patient is on NGT feeding
temporarily , no food is allowed by
mouth until the pharyngeal suture line
is healed. The tracheostomy cuff

should not be fully inflated to avoid

pressure trauma to the windpipe.
Usually 10 ml of air is used and the
cuff should be deflated once in a while
to relieve the pressure. In total
laryngectomy, speech rehabilitation
training is necessary( esophageal
voice, electrolarynx) or using sign
language.
42.A. clamp is only necessary when there
is a leak along the tubing and is used
to locate the leak. Clamp should only
be used in a limited time to prevent
tension pneumothorax and
mediastinal shift. Milking is only per
MD order. To ensure that the drainage
system is intact, the nurse should
monitor for gently fluctuations in the
water seal chamber with each
inspiration and [Link] is
called tidaling. Though coughing and
deep breathing is also an important
teaching, making sure the drainage
system is intact is more important to
serves its purpose.
43.B. Follow the ABC
prioritization( [Link], [Link],
[Link])
44.C. Assess first before you intervene.
PTT is used to test how long it takes
your blood to clot and check for
bleeding problems especially when the
patient is on blood thinning therapy
such as heparin .
45.D. the question is asking specifically
about sign of righ heart failure. Cor
pulmonale is a right ventricular
hypertrophy due to chronic lung
disease. Right side heart failure is
usually associated with signs of the
venous system. Due to the
hyperthropy of the right ventricle,
there is insufficient filling, thus blood
backs up to the venous system
causing peripheral edema.

46.A. the most priority is to ensure a

patent airway, auscultating the
presence of breathsound is an
indication that the air way is patent.
47.A. albuterol is a bronchodilator that
relaxes muscle of the airway and
increases airflow into the lungs
48.C. always assess first before you
intervene. Clots along the drainage
can cause urine stasis and aggravate
pain.
49.A. this is to prevent edema.
50.B. Creatinine clearance. Creatine is a
byproduct of metabolism and excreted
by the kidney.
51.B. increase fluid intake is very
important to flushes out bacteria
52.C. in oliguric phase , it doesnt mean
that there is an insufficient fluid
intake, its because theres a decrease
glomerular filtration leading to fluid
accumulation in the body and fluid
overload. Emphasize Na and fluid
restriction at this point.
53.C. peritonitis is the most major risk in
peritoneal dialysis d/t to introduction
of microorganism through the
catheter.
54.B. airway and breathing is always the
priority.
55.D. Pillows under knees can be used
but should not be kept at all time to
promote venous return and prevent
blood clot formation. Ambulation is
encouraged within hours after surgery
to promote lung aeration. Pt can be
positioned supine with a pillow under
neck or at the sides. The patient
should also change position at least
every 2 hrs , when turning the body
should be moved as a unit.

56.A. patients with central line catheter

are ambulatory and urinary catheter is
not needed unless theres some
kidney pathology that requires the use
of it. Sterile technique is used when
changing the dressing , occlusive
dressing is used to prevent air from
entering the line.
57.D. Normal serum potassium level is
3.5-5 mEq/L, normal serum sodium is
135-145 mEq/L. normal urine output is
at least 30 ml/hr .
58.D. The first phase of acute renal
failure is oliguric phase with urine
output of 400ml or less in 24 hrs.
Normal urine ourput in 24 hrs is 1500
ml. normal serum creatinine is .7-1.4
mg/dl. BUN is not significantly
increased normal bun is 10-20 mg/dl.
59.A. one principle of prioritization is to
look on the clients needs on the
clients perspective . pain is considered
as the 5th vital sign. The pain is severe
that needs to be addressed first
among the other options.
60.B. All options except D are signs and
symptoms of liver cirrhosis but option
B poses the most serious
complication. Advanced liver cirrhosis
can lead to hepatic encephalopathy
which is the accumulation of toxins in
thebrain leading to decreased mental
function and coma.
61.C. airway and breathing is always the
priority. The patient has difficulty of
breathing because of the pressure
exerted by the enlarged abdomen to
the diaphragm.
62.B. The patient has prolonged clotting
time which predisposes the patient to
bleeding . Coaugulant such as
phytonadion (Vit. K)should be given to
counteract effect .warfarin is an
ancticoagulant which place the patient
in increased risk of bleeding.

Furosemide and Spironolactone are

diuretics.
63.B. Sprironolactone is a K sparing
diuretic . It is used to excrete extra
fluid from the body , therby, lose of
body weight means tha most fluid are
being excreted out.
64.A. incentive spirometry is a breathing
device that promote maximal lung
aeration and respiratory effectiveness
65.D. Elevate only to 15-30 degrees to
promote venous return and reduce
cerebral edema. Enforce any fluid
restriction and monitor carefully input
and output. Avoid activities that
increase intrathoracic or
intraabdominal pressure such as
straining during bowel movement, this
impedes blood flow from the cranium.
Suctioning can stimulate the vagal
reflex and further increase ICP,
suctioning is only done if its extremely
necessary.
66.1 kg= 2. 2 lbs
175 lb X 1 kg = 79.55 lbs
2.2 lbs
79.55 lbs X 1.5 g= 119 g

67.C. mannitol is a diuretic that excretes

extra fluid out from the body.
Increased UO is an indication that
mannitols desired effect is achieved
68.A. bone marrow is also composed of
fat globules that may escapes out
during bone fracture and causes fat
embolism. The fat globules can
impede blood flow making the
affected leg pale and cool.
69.D. traction should be continuous , the
weight is never removed nor
interrupted. The patient is in supine

with neck supported by a pillow. The

leg with a traction should be held
straight and never flexed.
70.C. Glaucoma occurs due to the
pressure build up in the eye by
increased amount of aqueous vitrous
humor. Eye drops could either work by
promoting the flow of the aqueous
fluid or decrease the production of it.
71.D. One priority in acute MI is pain
control drugs such as morphine to
reduce catecholamine induced oxygen
demand to injured heart muscle.
72.A. cirrhosis may lead to malnutrition. It
is essential to maintain a healthy ,
nutritious diet such as increasing
carbohydrate and protein intake. Low
fat diet should be observed because
bile is needed for digestion and bile is
not sufficiently produced in cirrhotic
liver. Salt and Na intake should also be
minimal because patients with
cirrhosis tends to retain extra fluid.
When liver cirrhosis is complicated by
hepatic encephalopathy, then this is
the time that protein intake should be
limited.
73.B. kidney produced erythropoietin
necessary for blood cell formation,
kidney damage leads to anemia. Signs
and symptoms of anemia include easy
fatigability and body weakness.
Epogen is given SQ or IV to aids in
erythropoeisis and reduces symptoms
of anemia
74.B. renal colic is a very excruciating
pain caused by the passage of stone
along the ureter. Indwelling catheter
will not ease the pain. It may in fact
add more to the pain experience. T
tube is used to drain bile . Increased
fluid intake should be encourage to
help flush the stone. It is appropriate
to collect all urine and strain for stone
passage to assess effectiveness of

therapy and or to study the stone

composition.
75.B. Vit C such as orange juice enhances
absorption, tea, coffee and calcium
reduces iron absorption. Aspirin is
avoided because it is a blood thinner
and aggravates bleeding
76.B. Doctors always prescribed a low
oxygen delivery to patients with COPD
usually at 2 L/min because high
concentration of oygen can depress
the respiratory drive. Besides high
oxygen concentration is of no use if
the airway is obstructed with
secretions. It is very important to
encourage the pt to cough out
secretions to help clear the airway and
encourage deep breathing. All ABG
values are abnoramal.
77.A. Fluid may be increased to liquefy
secretions. Oxygen administration and
putting the pt in semi fowlers do not
help in mobilizing secretions. stroke
patients who are on bed rest are prone
to respiratory complications because
of retention of secretions. Therefore
assisted ambulation and frequent
positioning may help to mobilize
secretions .
78.B. the signs and symptoms presented
are indications of PTB. Its a safe
precautionary practice to place the pt
in respiratory isolation to prevent
cross infection while further
assessment and evaluation is carried
out.
79.B. the nurse should suspect a
circulatory overload because of the
assessment findings. Initial action is to
stop the IV to stop further introduction
of fluid.
80.C. contraction of the back of the throat
when the uvula is tickled means that
gag reflex has returned.

81.B. Iv rate should be a fast drip to

immediately restore the fluid volume
[Link] are given to patients with
cardiac problems to strengthen heart
contraction. Initial s/sx of Digitalis
toxicity is GI manifestation such as
N/V, loss of appetite, diarrhea. Other
symptoms include visual changes,
slow pulse , confusion etc.
83.B. With the ABG values presented, the
pt is suffering from respiratory
acidosis.
84.B. In postural drainage, the patient is
placed on a trendelenberg position so
gravity aids in the movement of
mucus to the upper respiratory tract.
85.B. Immobilization causes calcium lose
from the bones into the bloodstream
and cause hypercalcemia. The kidney
in response of hypercalcemia
increases its excretion.
86.C. increased fluid intake loosen up
secretions thus easy to expectorate
87.C. one classical sign of right side heart
failure is edema due to decreased
venous return.
88.B . Because PVC s may signal an
impending life threatening rhythm ,
notify the physician if the pt has more
than six PVCs per minute.
89.B. creatine phospholinase is an
enzyme normally found in muscle
fibers. It is released in the
bloodstream when there is muscle
damage. MI is the interruption of blood
supply causing heart muscle cells to
die.
[Link] not sure of the correct answer, but
I guess the best option is B. Pain in MI
doesnt last until the following day.
Most patients after a heart attack are
hesitant to resume activities, bed rest

is advised at least for the first couple

of days at least 1-2 days. Patients are
strongly advised to participate in
cardiac rehabilitation program to help
patients to recover quickly and
improve their overall physical, mental
and social functioning.
91.D. straining against a closed epiglottis
which includes holding breath or
forceful expiration stimulates valsalva
maneuver. Pts should be advised to
avoid holding breaths while moving .
92.C. rehabilitation begins upon
admission
93.D. weight gain can be a sign that you
the pt is retaining fluid and his heart
condition is worsening.
94.B. Digitalis is given to increase cardiac
contractility followed by decreased in
HR
95.C. Enalapril is an ACE inhibitor
(Angiotension Converting Enzyme
inhibitor) that decreases BP.
Angiotensin II is a potent
vasoconstrictor.
96.A. beta adrenergic antagonist
antagonizes the action of sympathetic
response. It works by reducing the
force of contraction of heart muscles
thereby reducing peripheral resistance
and blood pressure .
97.A. Proper handwashing has always
been the single most effective
measure to prevent cross
contamination and infection.
98.B. Mitral valve stenosis is the
narrowing and stiffening of the mitral
valve caused oftenly caused by
rheumatic fever in adults. Due to the
narrowed valve, blood is not efficiently
pumped into the left ventricle, over
time, pressure in the atrium increases
and blood is backed up to the lungs

and cause pulmonary hypertension

and pulmonary edema which is
manifested by presence of lung
crackles.
99.C. Infective endocarditis is due to
bacterial or fungal infection that
affects the endocardium of the heart
especially the heart valves. Over time,
materials called vegetations
developed along the valves. These
contain bacteria, blood clots, debri
from the infection. This vegetations
prevent the valve from working
properly and will lead to cardiac
failure.
100.
C. although the specific causes
of hypertrophic cardiomyopahty are
not yet fully known. The primary cause
seems to be genetic.