First semester\second exam Al-Najah National University Student name

Adult Health Nursing1 \Final exam Faculty Of Nursing Student number

Miss Fatima Hirzallah

1-Of the following persons, who is most likely to be at risk for tuberculosis(T.B):
a-Tobacco farmer
b- -Housewife
c-Homeless man
d-Day care workers

2-When teaching about tuberculosis (TB), it is known that which tests are needed to
confirm the disease?

Sputum and chest x-ray

Four positive test
Chest x-ray only
Skin test only

3-The nurse should be alert for a complication of bronchioectasis is:

a-atelectasis
b-emphysema
c-pleurisy
d-pneumonia

4-A client has COPD. One way to improve lung function is to eliminate one of the
risk factors. The most important, well-known risk factor is?
a-Exposure to asbestos
b-Cigarette smoking
c-Exposure to allergens
d-Exposure to woo smoke

5-A patient with asthma given aminophylline to:

a-deacrese body inflammation reaction

b-relax pulmonary vessels
c-reduce sleep and rest
d-cause dilation of bronchi

6-After a laryngectomy a client is concerned about improvement the ability to

communicate. The nurse should arrange for the client to learn more about:
a-Sign language
b-Body language
c-Esophageal speech
d-Computer generated speech

1
First semester\second exam Al-Najah National University Student name
Adult Health Nursing1 \Final exam Faculty Of Nursing Student number
Miss Fatima Hirzallah

7-Atrial flutter may best be describe as:

a. An irregular, chaotic ventricular rhythm
b. An irregular rhythm with little wave formation between QRS complex
c. An atrial rhythm characterized by a sawtooth pattern between QRS
complex
d. A barely discernible rhythm, not associated with any heart muscle activity

8 - Catecholamine’s (epinephrine and nor epinephrine) act to:

a. Decrease blood pressure
b. Promote coagulation
c. Trigger vasodilation
d. Increase heart rate

9-A client has edema in the lower extremities. The nurse should suspect:
a-Lung disease
b-Pulmonary edema
c-Myocardial infarction
d-Right ventricular heart failure

10-The nurse suspects a client is in cardiogenic shock. The nurse understands that this
type of shock is:
a-an irreversible phenomenon
b-a failure of the circulatory pump
c-usually a fleeting reaction to tissue injury
d-generally caused by decreased blood volume

11-In the caring for a client with vasovagal syncope, the nurse should know that the
associated temporary loss of consciousness is most commonly related to :
a- vestibular dysfunction
b- sudden vascular fluid shifting
c- postural hypotension
d- bradyrhythmia.

12-the nurse in the coronary care unit (CCU) should observe for one of the
More common complication of myocardium infarction ,which is :
a. hypokalemia
b. Cardiac Dysrhythmias
c. Cardiac enlargement
d. anaphylactic shock

13- A new onset MI can be recognized by which of the following ECG

changes?
a- Q-waves
b- Smaller R-waves
c- Widened QRS
d-ST segment elevation

2
First semester\second exam Al-Najah National University Student name
Adult Health Nursing1 \Final exam Faculty Of Nursing Student number
Miss Fatima Hirzallah

14-A 60-year-old male with a history of angina pectoris complains of chest pain
radiating to the neck and left arm. The nurse's best initial response is which of the
following?

Administer oxygen per nasal cannula

Notify the physician
Administer aspirin
Administer sublingual nitroglycerin

Questions 15-17 refer to the following situation.

Ms. X. is admitted to the intensive care unit after she developed disseminated
intravascular coagulation (DIC) following a vaginal delivery.

15- What is the result of DIC?

a- Hypersensitive response to an antigen, resulting in anaphylaxis

b- Depletion of clotting factors and excessive fibrinolysis, resulting in simultaneous
microvascular clotting and hemorrhage
c-.Vasodilatation, resulting in hypotension
d- Septic shock, resulting in vasodilation and decreased perfusion

16-Laboratory values for DIC will show abnormalities in:

a- liver function tests.
b- tests for renal function.
c- clotting studies.
d- blood glucose levels.

17-when caring for a client with disseminated intravascular coagulation (DIC), it is

important for the nurse to:
a-Asses for hommans sign
b-Avoid intramuscular injections
c-Take temperatures via the rectal route
d-Apply sequential compression stockings

18-A client is admitted with suspected atelactasis when assessing this individual, the
nurse should expect:
a-slow deep respiration
b-diminished breath sound
c-a dry, unproductive cough
d-a normal oral temperature

19-the most frequent symptom of lung cancer:

a-sputum production
b- dyspnea
c-couphing
d-sever pain

3
First semester\second exam Al-Najah National University Student name
Adult Health Nursing1 \Final exam Faculty Of Nursing Student number
Miss Fatima Hirzallah

20-as assessment information, a nurse knows that the majority of Pulmonary emboli
originate in:
a-deep leg veins
b-pelvic area
c-lung tissue
d-right atrium of the heart

21-the nurse assesses a pt for a possible pulmonary embolism. The nurse looks for
frequent sign ,which is :
a-cough
b-syncope
c- hemoptyis
d-tachypnea

22-Anticoagulation with heparin is administered in an attempt to maintain partial

prothromboplastin time (PTT) at how many times the normal values :

a - 0.5 to1
b- 1.5 to 2
c- 2.5 to 3
d- 3.0

23-A patient presents moderately short of breath and dyspneic. A chest x-ray
examination reveals a large right pleural effusion with significant atelectasis. The
physician is most likely to order which of the following procedures?
a- Thoracentesis
b- Bronchoscopy
c- V/Q scan
d- Repeat chest x-ray

24. The nurse is assessing a client with pleural effusion. The nurse expect to find:
a. Deviation of the trachea towards the involved side
b. Reduced or absent of breath sounds at the base of the lung
c. Moist crackles at the posterior of the lungs
d. Increased resonance with percussion of the involved area

25-In the emergency department chest tubes are inserted to a client in the second
intercostal spaces and one at the base of the lung. The nurse understands that the tube
in the second intercostals space will:

a-Remove the air that is present in the intrapleural space

b-Drain serosanguieous fluid from the intrapleural compartment
c-Provide access for the instillation of medication into the pleural space
d-Permit the development of positive pressure between the layers of the pleura

4
First semester\second exam Al-Najah National University Student name
Adult Health Nursing1 \Final exam Faculty Of Nursing Student number
Miss Fatima Hirzallah

26-With Hodgkin’s disease, the lymph nodes usually affected first are the:

a-Axillary
b-Inguinal
c-Cervical
d-Mediastinal

27- A client admitted with newly diagnosed with Hodgkin’s disease. Which of the
following would the nurse expect the client to report?
a. Lymph node pain
b. Weight gain
c. Night sweats
d. Headache

28-A characteristic of iron-deficiency anemia is nail alterations. This condition can be

described as
a- clubbed nails.
b-ridged nails.
c-Spoon-shaped nails
d- convex nails.

29-A client is diagnosed with iron deficiency anemia. During diet teaching, the nurse
would emphasis the use of food high in which substance:
a-Vitamin A
b-Vitamin C
c-Vitamin B
d-Vitamin K

30-What is the diagnostic study used to evaluate hemolytic anemia

a- Hemoglobin electrophoresis
b- Total iron binding capacity
c-Complete blood count
d- Serum ferritin

31-Diminished-to-absent breath sounds on the right side, tracheal deviation to the left
side, and asymmetrical chest movement are indicative of which of the following
disorders?
a- Tension pneumothorax
b- Pneumonia
c- Pulmonary fibrosis
d-Atelectasis

5
First semester\second exam Al-Najah National University Student name
Adult Health Nursing1 \Final exam Faculty Of Nursing Student number
Miss Fatima Hirzallah

32-A serum bilirubin is performed on a client who is weak, dyspneic, and

jaundiced. A bilirubin level above 2mg/100 ml blood volume could indicate:
a. Hemolytic anemia
b. Pernicious anemia
c. Decreased rate of red blood cell destruction
d. Low oxygen carrying capacity of erythrocytes

33-The increased tendency toward coronary and cerebral seen in individuals

with polycythemia vera is attributable to the:

a--Increased viscocity
b-Fragility of the cells
c-Elevated blood pressure
d-Immaturity of red blood cells

34-A definitive diagnosis of cystic fibrosis is based on the following diagnostic test :
a-bronchoscopy
b-CT scan
c-sweat chloride test
d-pulmonary function test

35-The major cause of death in patients with leukemia is believed to be:

a-anemia
b-dehydration
c-emboli
d-infection

36-Acute lymphatic leukemia (ALL) most common in:

a- elderly
b- young children less than15 years
c- young children more than 15 years
d- adult

Q1-What is the nursing management for pt post tonsillectomy ? (3mark)

---------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------
--------------------------------------------------------------------------------------------------

6
First semester\second exam Al-Najah National University Student name
Adult Health Nursing1 \Final exam Faculty Of Nursing Student number
Miss Fatima Hirzallah

Q2-Mr. j.k is a42 years old, 75 Kg ,who was received on nursing unit from the
recovery room after having a labratomy for cholecystectomy pt with abdominal
drain , on inintial assessment Mrj.k was alert ,his skin was cool , pale ,moist, and
his abdominal drain was drainage blood 750 ml\hr , urine out put(U\O) was 50 ml
over 2 hrs ,V\S were BP 80\60mmhg HR:120b\m ,RR:35b\m, The nurse assessed
that the pt was experiencing shock .

1-What is the type of shock according to previous assessment? and defined it ?

(2mark)
--------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------

2-What is the appropriate therapeutic management & nursing management of shock ?

(6mark)
-------------------------------------------------------------------------------------------------------
-------------------------------------------------------------------------------------------------------
-------------------------------------------------------------------------------------------------------
-------------------------------------------------------------------------------------------------------
-------------------------------------------------------------------------------------------------------
-------------------------------------------------------------------------------------------------------
-------------------------------------------------------------------------------------------------------
-------------------------------------------------------------------------------------------------------
-------------------------------------------------------------------------------------------------------
-------------------------------------------------------------------------------------------------------

Q3-Mr O.J ,he is a 70 years old admitted to emergency as a case of pulmonary edema
secondary o congestive heart failure C\O : dyspnea , chest pain, he is anxious and
irritable V\S were BP 110\60mmhg , HR:110 b\m ,RR 25b\m

1-What is the underlying causes of pulmonary edema? (2mark)

-------------------------------------------------------------------------------------------------------
-------------------------------------------------------------------------------------------------------
-------------------------------------------------------------------------------------------------------

7
First semester\second exam Al-Najah National University Student name
Adult Health Nursing1 \Final exam Faculty Of Nursing Student number
Miss Fatima Hirzallah

2-What is the appropriate nursing intervention for Mr O.J? (6mark)

-------------------------------------------------------------------------------------------------------
-------------------------------------------------------------------------------------------------------
-------------------------------------------------------------------------------------------------------
-------------------------------------------------------------------------------------------------------
-------------------------------------------------------------------------------------------------------
-------------------------------------------------------------------------------------------------------
-------------------------------------------------------------------------------------------------------
-------------------------------------------------------------------------------------------------------
-------------------------------------------------------------------------------------------------------
--