Deck 1: Progressive Care Nursing (PCCN)

Question 1

A client with a left-sided heart failure is prescribed with digoxin (Lanoxin) and furosemide (Lasix). Which of the following signs and symptoms alerts the nurse for a possible occurrence of digoxin toxicity?

A)A positive Trousseau's sign
B)Leg cramps
C)Diarrhea
D)Muscle twitching

Answer 1

Leg cramps

Question 2

A 40-year-old pregnant woman presented to surgical OPD with short history of pain in the right hypochondrium radiating to the back. She also complains of nausea and vomiting associated with this episode of pain. What is the likely diagnosis?

A)Acute cholecystitis
B)Acute pancreatitis
C)Peritonitis
D)Gastritis

Answer 2

Acute cholecystitis

Question 3

What is the definitive treatment of Cholecystitis due to Cholelithiasis?

A)Laproscopic or open cholecystectomy
B)Use of antibiotics
C)Use of anti-spasmodic
D)Use of analgesics

Answer 3

Laproscopic or open cholecystectomy

Question 4

A patient, with a known case of ischemic heart disease, presented to the cardiac OPD with complaints of being breathless and irritable, even at rest, and not being able to carry out daily life activities. What class of heart failure is patient suffering from?

A)Class 1
B)Class 2
C)Class 3
D)Class 4

Question 5

A patient presented with hypertensive urgency. What is the best method of decreasing the blood pressure of the patient in this condition?

A)Immediate decreasing of blood
B)Waiting for ECG changes to come
C)Decreasing the blood pressure within a few hours
D)Decreasing the blood pressure within a few days

Question 6

All of the following are causes of Atrial Fibrillation except:

A)Thyrotoxicosis
B)Ischemic heart disease
C)Pheochromocytoma
D)Nephrotic syndrome

Question 7

What is the immediate management of Tension Pneumothorax?

A)Insertion of large bore IV cannula in 2nd intercostals space
B)Wait for chest tube to be arranged and then inserted
C)Cardiopulmonary resuscitation
D)Bronchoscopy

Question 8

All of the following measures are helpful in the treatment of foreign body aspiration except:

A)Heimlich maneuver
B)Laryngoscopy and bronchoscopy
C)Antibiotic therapy for secondary infections
D)Manual removal of foreign substance

Question 9

A physician orders increased dose of clonidine (Catapres). It is most essential for the nurse to assess for which parameter before drug administration?

A)Heart rate
B)Blood pressure
C)Blood glucose
D)Urine output

Question 10

A child presented with sharp piercing chest pain, fever, malaise, irritability, poor appetite and Dysrhythmia. He had undergone a recent surgery for valvular abnormality of the heart. What is the most likely disease to occur?

A)Pericarditis
B)Infective endocarditis
C)Pleural effusion
D)Cardiac contusion

Question 11

A young man presents with chest discomfort, dyspnea, fatigue, pressure in epigastrium and palpitations. He had a history of viral flu a few days back. Moreover, the ECG showed non-specific changes and the lab culture had a growth of influenza virus. What is the diagnosis?

A)Myocarditis
B)Pericarditis
C)Pulmonary edema
D)Endocarditis

Question 12

A middle-aged woman came to the emergency department with worsening dyspnea, pressure in head and increased respiratory rate. She was known to have pulmonary edema secondary to heart failure. On examination, there was tachycardia, tachypnea, and hypertension. ABGs were carried out which showed pH < 7.35, paCO₂>42 mm of HG, and H₂CO₃ was also high. What is the likely diagnosis?

A)Respiratory alkalosis
B)Metabolic acidosis
C)Respiratory acidosis
D)Metabolic alkalosis

Question 13

The stages of COPD can be assessed by all of the following except:

A)Functional dyspnea
B)Body mass index
C)Spirometry
D)Chest x-ray

Question 14

A patient being managed in the pulmonology ward for COPD should get all the medications except:

A)Bronchodilators
B)Corticosteroids
C)Supplemental oxygen therapy
D)Analgesics

Question 15

A known hypertensive presented with the features of stroke. His systolic blood pressure was 190 mm of Hg and diastolic pressure was 120 mm of Hg. What is the next thing that should be done?

A)Monitor the blood pressure and wait until it drops to normal
B)Immediately give t-PA
C)Immediately give SK
D)Immediately drop the blood pressure

Question 16

After having a fight, a young man presented to the trauma center with a lacerated wound in the right chest. Patient was in severe respiratory distress. Examination showed there was tachycardia and tachypnea. Moreover, breath sounds were absent in right chest. Chest x-ray showed mediastinal shift to left. What is the most likely diagnosis?

A)Tension pneumothorax
B)Spontaneous pneumothorax
C)Pneumonia
D)Emphysema

Question 17

A patient presented to medical OPD with all the signs and symptoms of heart failure. His echocardiography showed increased right ventricle workload, right ventricle hypertrophy, displaced interventricular septum and tricuspid regurgitation. What is the most important test to confirm the diagnosis in this regard?

A)ECG
B)Chest x-ray
C)Echocardiography (already done)
D)Right-sided cardiac catheterization

Question 18

All of the following may be the cause of primary pulmonary hypertension except:

A)COPD
B)Pulmonary emboli
C)Sickle cell disease
D)Raynaud's disease

Question 19

What is seen in the Chest x-ray of a patient suffering from Pneumonia?

A)Consolidation
B)Cavity
C)Diffuse patches
D)Solitary nodule

Question 20

All the statements are true about SARS (severe acute respiratory syndrome) except:

A)Temp> 38 degree centigrade, headaches, general malaise
B)Dry cough and dyspnea
C)Decreased white cell and platelet count in blood tests
D)Frequent nausea and vomiting

Question 21

All the following will help in relieving the pain and discomfort caused by Pericarditis except:

A)Use of analgesics
B)Use of anti-inflammatory drugs like ibuprofen, etc.
C)Use of corticosteroids
D)Use of nitroglycerines

Question 22

A lady presented to medical emergency with cough, Tachypnea and Dyspnea. On examination, she had wheeze in her chest; she was not able to complete one sentence in a single breath and was having tachycardia. She had a history of allergic dermatitis and hay fever. What is the likely diagnosis?

A)Status asthmaticus
B)Acute exacerbation of COPD
C)Pulmonary embolism
D)Pulmonary infarction

Question 23

A patient was put on ventilator after doing a tracheostomy. What points are considered during the care of a tracheostomy patient?

A)Continuous monitoring of vital signs
B)Respiratory status to ensure patency
C)Regular suctioning of secretions
D)All of the above

Question 24

Which of the following insulins has the longest duration of action?

A)Humalog (lispro H)
B)NPH
C)Regular
D)Ultralente

Question 25

All of the following factors can increase the level of glucose in the blood except:

A)Stress
B)Renal failure
C)Hyperthyroidism
D)Insulinoma

Question 26

If a patient is anemic, then what do you expect in the cardiovascular examination of the patient?

A)Third heart sound
B)Gallop rhythm
C)Murmurs
D)All of above

Question 27

A patient was suspected to be having disseminated intravascular coagulation (DIC). His D-dimers were carried out. What finding do you expect from a patient if he is really having DIC?

A)Increased
B)Decreased
C)No change
D)All of the above

Question 28

The branch of ethics that involves making sure that the medical treatment given is the most morally correct choice, given the different options that might be available and the differences inherent in the varied levels of treatment is called:

A)Empowering patients
B)Bioethics
C)Confidentiality
D)None of the above

Question 29

Edward from another hospital comes to seek the medical record of patient William. The duty nurse should ensure that:

A)The senior nurse signs a release before providing medical records to another party
B)The doctor signs a release before providing medical records to another party
C)The patient signs a release before providing medical records to another party
D)She directly hands over the medical records since the person seeking this information is a doctor.

Question 30

White, who was suffering from sarcoidosis, said to the nurse, "I shouldn't cry about this."? The nurse replied, "That's right! You are an adult."? This communication of the nurse is?

A)Therapeutic communication
B)Non-therapeutic communication
C)Diagnostic communication
D)Curative communication

Question 31

Patient characteristics that must be considered if a nurse's competencies are to match the patient's include:

A)Resiliency and vulnerability
B)Stability and complexity
C)Both A and B
D)None of the above

Question 32

The delivery of care is impacted by all of the forces except:

A)Social forces
B)Political forces
C)Economic forces
D)Regional forces

Question 33

The Ethical principle that the patient has the right to make decisions about his or her own care is called as:

A)Informed consent
B)Autonomy
C)Bioethics
D)None of the above

Question 34

An Ethical Principle that relates to the distribution of limited resources of healthcare benefits to members of society is called:

A)Bioethics
B)Justice
C)Empowering patients
D)None of the above

Question 35

An Ethical Principle that involves performing actions that are for the purpose of benefiting another person is called:

A)Informed consent
B)Bioethics
C)Confidentiality
D)Beneficence

Question 36

The nurse is caring for an elderly client who is prescribed with oral pain medications. The nurse would particularly monitor the signs of adverse reactions of the drugs for the following reasons except:

A)Decreased number of nerve cells
B)Decreased drug clearance by the kidneys
C)Increased number of nephrons
D)Decreased blood flow to the brain

Question 37

A woman presented in medical OPD with epigastric pain, heart burn and dysphagia. On further inquiry, she also has earache and chronic cough, especially at night. What is she suffering from?

A)Gastroesophageal reflux disease
B)Pancreatitis
C)Respiratory tract infection
D)None of the above

Question 38

A 10-year-old girl comes to the emergency department crying after being hit in the face by a baseball. The nurse will assess the pain on a scale of:

A)1-5 scale
B)1-10 scale
C)1-15 scale
D)1-20 scale

Question 39

A 25-year-old patient presented to surgical OPD. Acute appendicitis was the likely diagnosis. Which other disease can mimic acute appendicitis among the following?

A)Ulcerative colitis
B)Acute flare up of Crohn's disease
C)Acute pancreatitis
D)Acute cholecystitis

Question 40

All of the following are the causes of dysphagia in a patient except:

A)Stroke
B)Neuromuscular disorders like myasthenia gravis
C)Dementia
D)Pneumonia

Question 41

In the basic research concepts, a sample that is too small may lack:

A)internal validity
B)internal and external validity
C)external validity alone
D)neither internal nor external validity

Question 42

Indicators of quality outcome according to ACCN synergy include:

A)Adherence to discharge plans
B)Satisfaction of patient and family
C)Rate of complications
D)All of above

Question 43

Supporting families of dying patients before death includes:

A)encouraging family members to stay with the patient as long as they wish
B)sending card or condolence note
C)staying with the family quietly allowing them to talk and cry
D)using the patient's name when talking to the family

Question 44

How many stages of grief are there in Kubler-Ross's proposal?

A)8
B)7
C)4
D)5

Question 45

The skills needed for collaboration are:

A)willingness to compromise
B)clear communication
C)ability to work with teams
D)all the above

Question 46

In patient's characteristics, what does stability means:

A)Ability to recover from a devastating illness
B)Factors that put a person at increased risk
C)A trait that allows a patient to maintain a state of equilibrium despite illness and challenges
D)A behavior that occurs when more than one system is involved

Question 47

In the pain scale, what does 3-5 indicates:

A)Mild pain
B)Moderate pain
C)Very severe pain
D)Severe pain

Question 48

Which is the correct order of steps of systems thinking?

A)Define issue, describe behavior pattern, define patterns of performance, find solutions
B)Describe behavior pattern, define issue, find solutions, define patterns of performance
C)Define patterns of performance, define issue, find solutions, describe behavior pattern
D)Define issue, describe behavior pattern, find solutions, define patterns of performance

Question 49

What is the first step of problem solving?

A)define the issue
B)collect data
C)identify concepts
D)consider reason for action

Question 50

The responsibility of the patient and his/her family is to:

A)provide honest information about health issues and medical history
B)ask for clarification if they don't understand information provided
C)follow the plan of care that is outlined
D)all the above

Question 51

A 38-year-old woman presented to accident and emergency department with short history of abdominal pain and distention, severe constipation, vomiting, dehydration and respiratory distress. On examination, she was having abdominal rigidity and no bowel sounds were audible. What is the most likely diagnosis based on this clinical scenario?

A)Bowel or intestinal obstruction
B)Appendicitis
C)Peritonitis
D)Pancreatitis

Question 52

Which is the key quality concept below?

A)Accessibility
B)Coordination
C)Respect
D)All the above

Question 53

The synergy model of nursing practice places which of the following as the central focus?

A)Needs of the doctors
B)Needs of the nurses
C)Needs of the patients
D)Needs of the patient's relatives

Question 54

A 50 years old male was admitted in the hospital for the treatment of hip osteoarthritis. During his stay in the general ward he developed off and on fever, sore throat and cough. His Total leukocyte count was raised, which was otherwise normal at admission. What has he developed?

A)Nosocomial infection
B)Water borne infection
C)Surgery related infection
D)None of the above

Question 55

A young boy has ingested 20 tylenol (acetaminophen). What do you expect he is likely to have due to this?

A)Fulminant hepatic failure
B)Renal failure
C)Cardiac failure
D)Stroke

Question 56

Which among the following is included in the Learning Styles?

A)Visual learners
B)Kinesthetic learners
C)Only B
D)Both A and B

Question 57

During the round of the ward, consultant was discussing about a 50 years old patient suffering from end stage renal disease. He said that certain metabolic problems start occurring in this condition and creatinine clearance decreased to < 10 ml/min. moreover fluid and electrolyte balance, acid base balance, hormone production and waste removal are also affected. What is he pointing towards?

A)Uremic syndrome
B)Cushing syndrome
C)Nephritic syndrome
D)None of the above

Question 58

A 50 year old female a known case of HIV/AIDS, presented to medical OPD with general weight loss, night sweats, general debility, fever, productive cough and hemoptysis. What is she suffering from?

A)Pneumonia
B)Tuberculosis
C)Emphysema
D)Bronchiectasis

Question 59

A 20 years old girl presented with high fever, diarrhea, myalgia and widespread erythematous rash that has the appearance of bad sunburn, with subsequent desquamation. On examination he had hypotension. She gives history of recent tampon use. What is the likely diagnosis?

A)Toxic shock syndrome
B)Necrotizing fasciitis
C)Herpes zoster
D)Shingles

Question 60

Stroke or cerebrovascular accidents are classified as:

A)Ischemic and hemorrhagic
B)Only ischemic
C)Only hemorrhagic
D)None of the above

Question 61

If the patient has temp >38 degree centigrade or subnormal rectal temperature < 36 degress centigrade, tachypnea or PaCO₂ < 32 mm of Hg, what is the diagnosis?

A)Systemic inflammatory response syndrome
B)Septic shock
C)Neurogenic shock
D)None of the above

Question 62

A patient presents in the cardiac emergency department with left-sided chest pain. His ECG shows ST segment elevations. Patient complains that this pain occurs cyclically, i.e., at the same time each day and during rest period. What is the most likely treatment?

A)Calcium channel blockers
B)Beta blockers
C)Alpha blockers
D)ACE inhibitors

Question 63

The most common cause or type of cerebral aneurysms is:

A)Congenital
B)Direct trauma
C)Infection
D)Connective tissue disorder

Question 64

A known hypertensive man presented with severe headache, altered state of consciousness and a claim that this is the worst headache he has ever experienced. What is the cause?

A)Intracranial bleed
B)Subarachnoid headache
C)Stroke
D)All of the above

Question 65

A young man had a motorcycle accident and sustained major injury to the head. He was brought in this condition to the accident and emergency department. The monitor showed that he was having alternating bradycardia and tachycardia, his BP was 180/110 mm of Hg and he was in an altered state of consciousness. What would be the first step in saving the life of this patient?

A)Checking airway
B)Checking breathing
C)Checking circulation
D)None of the above

Question 66

Understanding Jehovah's Witnesses is an example of:

A)cultural competence
B)cultural sensitivity
C)response to diversity
D)none of the above

Question 67

A young man presented to medical emergency in a state of unconsciousness which had so far lasted for 16 minutes. According to his relatives, he has absolutely normal half an hour back, when he suddenly started having spastic tonic and clonic movements, convulsions and frothing from the mouth. After this episode, he went unconscious. What is the most likely diagnosis?

A)Epilepsy
B)Parkinsonism
C)Alzheimer's disease
D)Psychosis

Question 68

In Q wave Myocardial Infarction, the peak CK levels occur in:

A)30 hours
B)12 hours
C)36 hours
D)27 hours

Question 69

A known diabetic and hypertensive presented in medical emergency with acute onset of right-sided hemiplegia, altered level of consciousness and inability to speak. On examination, gag reflex was absent, plantars were upgoing and the power on the right side was markedly decreased. What is the likely diagnosis?

A)Stroke
B)Epilepsy
C)Parkinsonism
D)Dementia

Question 70

A nurse is monitoring a client who was recently admitted to the unit after a cardiac catheterization. Which of the following ordered assignments is the nurse's priority?

A)Assess the client's heart rate
B)Monitor the client's urinary output
C)Assess pulses distal to insertion site
D)Assess pulses proximal to the insertion site

Question 71

The nurse is caring for a 59-year-old male client with a known case of chronic obstructive pulmonary disease. The client had an appendectomy a day before. Which of the following is a priority intervention in preventing respiratory complications?

A)Maintain the flow of oxygen at 4 to 5 L at all times
B)Help client to turn to sides every 2 hours and ambulate around the room
C)Have the client perform deep breathing exercises every morning and before sleeping
D)Ensure that hourly nebulization is done

Question 72

In the approaches to teaching, internet modules are suitable for:

A)academic or detailed information
B)small groups
C)independent learners
D)giving targeted instructions for individuals

Question 73

All of the following are contraindications to thrombolytic therapy in case of stroke except:

A)Evidence of cerebral or subarachnoid hemorrhage
B)Recent stroke head trauma or surgery
C)Uncontrolled hypertension or seizures
D)Low RBC count

Question 74

A nurse is monitoring a client's chest tube drainage system. The following findings are not a cause of concern except:

A)Intermittent bubbling in the water seal
B)Gentle bubbling in the suction control chamber
C)Continuous bubbling during inspiration and expiration in the water seal chamber
D)The water in the water seal bottle moves up as the client inhales and moves down as the client exhales

Question 75

Ideally, the thrombolytic medication should be given to the patient of stroke within:

A)1 hour
B)2 hours
C)3 hours
D)4 hours

Question 76

The most common cause of gastrointestinal bleed is:

A)Trauma
B)Endoscopy procedures
C)Peptic ulcer
D)Alcohol intake

Question 77

A client comes to the emergency department complaining of left substernal chest pain. Which of the following orders is a priority?

A)Administration of sublingual nitroglycerin
B)Assessing the client's ECG tracing
C)Administration of supplemental oxygen, as ordered
D)Providing a calm and quiet environment

Question 78

Occlusion of circumflex coronary artery results in:

A)Posterior wall infarction
B)Inferior MI
C)Anterior MI
D)Left Lateral MI

Question 79

What would be identified on the arterial blood gas results as a reflection of acute respiratory distress syndrome?

A)Low PaO₂ levels
B)High PaO₂ levels
C)Decreased PaCO₂
D)Increased HcO3

Question 80

A female client with diabetes mellitus II comes to the facility complaining of weakness and dizziness. Initial assessment reveals a heart rate of 105 beats per minute, cold extremities, and pallor. The client reported that she had her insulin shot about 2 hours ago. Which of the following actions of the nurse is the least appropriate?

A)Check the client's blood glucose
B)Offer ½ can of orange juice
C)Prepare insulin
D)Offer about 4 Lifesavers