PERIOPERATIVE NURSING PI MAY 2023

1. When the nurse is suffering from laryngitis, which of these non-verbal

cues could be most effective in communicating with the patient?
A. Write a note and tell the patient you are sick
B. Posture and hand movements
C. A soft voice and physical appearance
D. Gesture and eye contact

2. When communicating to a patient from another culture and with another

language, the most effective way to communicate is
A. Using pictures
B. Using an interpreter
C. Using a translator
D. Using gestures

3. Which of the following is an alternative method the nurse would use to

communicate with a ventilator dependent patient?
A. Communication board with pen and paper
B. Interpreter
C. Translator
D. Gestures only

4. Impaired verbal communication refers to

A. Mental retardation
B. Hearing disability
C. Decreased, delayed or inability to process and use system symbols
D. Expressive or receptive aphasia

5. Which of these enhances feeling of wellbeing, reduces anxiety and

encourages a sense of hope?
A. Feeling better
B. Getting well
C. Going home
D. Use of humor

6. Mr. John is booked for surgery and has difficulty hearing but has a
hearing aid on. What would be the most effective way to communicate?
A. Be sure your face is visible to the patient
B. Increase the volume of your voice

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 C. Direct your voice to the ear
D. Just say what you want to say

7. The client states that “diabetes runs in our family. My glucose level has
been high.” The nurse determines that this is an example of the client’s
A. Active strategy
B. Risk factor
C. Health belief
D. Negative health behavior

8. The client receives a kidney transplant and is now unable to do

housework. She is worried about her husband’s stress level because of
her illness and the need for him to take over her daily activities in the
home. The client is in a process of adapting to a change in
A. Body image
B. Self-concept
C. Family dynamics
D. Illness behavior

9. The nurse must consider the following in assessing the external variables
that influence a client’s health beliefs and practices EXCEPT
A. Income status
B. Educational background
C. Religious practices
D. Reaction to the heart disease

10. A nurse is using holistic approach of care on a client. To incorporate

the factors that may influence the client, the nurses response to the
client should be
A. “Adapting your diet and activity will lower your blood glucose levels”
B. “Your doctor has left orders for you to follow”
C. “I would like you to perform this exercise once a day”
D. “The laboratory tests reveal the need to reduce your daily percentage
of fat”

11. A client is paraplegic and is in the hospital for an electrolyte imbalance.

Based on the levels of prevention, the client is receiving care at the
A. Health promotion
B. Tertiary prevention
C. Secondary prevention

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 D. Primary prevention

12. Which virus is known to cause cervical cancer?

A. Papilloma virus
B. Parvovirus
C. Poxvirus
D. Paramyxoviruses

13. Which of these is not a blood borne virus?

A. Human Immunodeficiency Virus
B. Hepatitis A
C. Hepatitis C
D. Hepatitis D

14. Which vector carries rabies?

A. Mosquito
B. Mice, rats
C. Rodents, monkeys
D. Dogs, foxes, bats

15. Which of the following about bacteria endospores is incorrect?

A. All bacteria can sporulate
B. Endospores can resist bad environment
C. Endospores germinate in favorable environment
D. Clostridium species can form endospores

16. Which of the following is Edward Jenner credited with?

A. Applying germ theory to medical practices
B. Developing the process of vaccination
C. Discovering the antibiotic properties
D. Discovering the process of fermentation

17. Which of the following concerning the theory of spontaneous generation

is correct?
A. States that all cells come from the pre-existing cells
B. States that life arises from non-living matter
C. The theory is believed to be true
D. The theory is believed to be untrue

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18. Which of the following is Louis Pasteur is credited with?
A. Applying germ theory to medical practices
B. Discovering antibiotic properties
C. Discovering the process of microbial fermentation
D. Creating steps to link a specific bacterium to a specific disease

19. A group of student nurses are being taught about archaea in a

microbiology class. Which of the following responses on the subject
matter by a student indicates a need for further teaching?
A. They are prokaryotes
B. They have peptidoglycan in their cell walls
C. They live in extreme environment
D. They are eukaryotes

20. Which of the following is not a characteristic feature of bacteria?

A. They are prokaryotes
B. They have peptidoglycan in their cell wall
C. They have nucleus
D. Some use photosynthesis

21. Organisms which are multicellular and eukaryotic in nature and obtain
food by absorbing nutrients from the environment are known as
A. Protists
B. Plants
C. Fungi
D. Viruses

22. Which of the following is not an airborne virus?

A. Measles virus
B. Polio virus
C. Respiratory syncytial virus
D. Parainfluenza virus

23. Mycobacterium tuberculosis causes tuberculosis being a common

cause of death worldwide. This organism is a
A. Gram positive cocci
B. Acid-fast bacilli
C. Protozoa
D. Gram-positive bacilli

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24. Which of the following describes a mutually beneficial relationship?
A. Saprophytic
B. Commensal
C. Symbiotic
D. Pathogenic

25. Which of the following is caused by protozoa plasmodia?

A. Ringworm
B. Malaria
C. Dysentery
D. Meningitis

26. Which of the following organisms is known to cause acquired

immunodeficiency syndrome (AIDS)?
A. Rhabdoviruses
B. Retroviruses
C. Reoviruses
D. Orthomyxovirus

27. Which of the following is not a gram-negative bacterium?

A. Escherichia coli
B. Salmonella
C. Hemophilus influenza
D. Streptococcus pneumonia

28. Which of the following bacteria commonly cause urinary tract infection?
A. Escherichia coli
B. Salmonella
C. Neisseria meningitidis
D. Neisseria gonorrhoeae

29. While providing teaching to a group of young nurses on salmonella, the

perioperative nurse advises the students to be mindful of the bacteria
due to its ability to cause
A. Hepatobiliary tract infection
B. Central nervous system infection
C. Enteric fever and gastroenteritis in the elderly
D. Respiratory and central nervous system infection especially in infants

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30. The bacteria hemophilus influenza is known to cause
A. Respiratory and central nervous system infection especially in infants
B. Enteric fever
C. Cellulitis
D. Endocarditis

31. Which of the following antibiotics works by inhibiting the folic acid
converting enzyme?
A. Trimethoprim
B. Amoxicillin
C. Metronidazole
D. Rifampicin

32. The physician has ordered some laboratory tests for Mr. Ayo. Following
the results of the investigation, it was confirmed that Mr. Ayo has
poliovirus infection. Which of the following clinical manifestations would
the nurse expect from Mr. Ayo?
A. Gastroenteritis
B. Myocarditis
C. Spinal paralysis
D. Conjunctivitis

33. Which of the following best describes research?

A. Search again and again
B. Finding solution to any problem
C. Working in scientific way to search for truth of any problem
D. Scientific observation

34. The word research is derived from a French word known as

A. Reserch
B. Recherche
C. Resourch
D. Research

35. The following are the purposes of doing research EXCEPT

A. To provide evidence-based practice
B. To find the solution to problem
C. To measure the strength and weakness of the profession
D. For continuity of care

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36. Research is related to all the following EXCEPT
A. Discovery of new idea
B. Providing solution to problem
C. Investigation of a problem
D. Reviewing scholarly work

37. Applied research is a type of research which can be categorized as

A. Historical research
B. Pragmatic research
C. Contractual research
D. Qualitative research

38. Most researchers interpret Action Research as

A. Case findings
B. Ex post facto
C. Research initiated to solve immediate problem
D. Research with socioeconomic objective

39. The first stage in research process is

A. Review of literature
B. Identification of problem
C. Research justification
D. Data analysis

40. In existing literature, most philosophers feel that basic research is

concerned with
A. Fundamental research
B. Exploratory research
C. Applied research
D. Case control research

41. The nurse is trying to explain Analytical research to a group of student

nurses. Which of the following statements by the nurse on the subject
matter is correct?
A. It is a type of research that discovers ways of finding solution to an
immediate problem
B. It gathers knowledge and skills
C. It is used in formulating hypothesis
D. It analyses the facts/information that already exist

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42. Research pertaining to pure mathematics/natural laws is
A. Qualitative research
B. Empirical research
C. Analytical research
D. Fundamental research

43. Which of the following is not a step in the research process?

A. Topic identification
B. Problem identification
C. Research justification
D. Data analysis

44. Research conducted based on abstract ideas/concepts is

A. Empirical research
B. Conceptual research
C. Field research
D. Experimental research

45. When explaining descriptive research to a year two student, which of

the following statements would you consider appropriate?
A. It discovers ways of finding solution to immediate problem
B. It gathers knowledge and skills
C. It describes the state of affairs as it exists and it is fact finding
D. It is used in formulating hypothesis

46. Most researchers correlate descriptive research with

A. Analytic
B. Behavioral
C. Statistical
D. Quasi-experimental

47. The following can be categorized as Descriptive research EXCEPT

A. Fact finding enquiry
B. Hypothesis testing
C. Ex post facto research
D. Experimental research

48. Which of the following is not a feature of fundamental research?

A. Basic research
B. Pure research

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 C. Gathers knowledge and skills
D. Solves problems

49. Which of the following is not a feature of descriptive research?

A. It is a fact-finding enquiry
B. Researcher has no control over variable
C. Descriptive research is used in hypothesis testing
D. It is based on measurement of quality

50. The following are attributes of an experimental research EXCEPT

A. Controlling
B. Observation
C. Reference collection
D. Manipulation

51. Research conducted to study the effect of certain policy or programme

is best described as
A. Applied research
B. Descriptive research
C. Evaluation research
D. Causal research

52. Research conducted to establish cause and effect relationship between

variables is known as
A. Causal research
B. Pragmatic research
C. Survey research
D. Longitudinal research

53. Newton gave the three laws of motion. The research which led to this
discovery is categorized as
A. Descriptive
B. Sample survey
C. Fundamental
D. Applied

54. Which of the following is not an example of a peripheral device?

A. Keyboard
B. Register
C. Mouse

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 D. Speaker

55. A programme can best be described as a

A. Hardware device
B. Set of instructions
C. Memory device
D. Register

56. Which of the following is not found in the CPU?

A. ALU
B. Memory
C. Control unit
D. Printer

57. The speed at which a CPU processes data in order to convert it is

measured in
A. Megabytes
B. Gigahertz
C. Gigabytes
D. Decibels

58. Complex scientific research is usually done using

A. Micro computers
B. Mini computers
C. Super computers
D. Mainframe computers

59. The main component that formed the basis for the second-generation
computers was
A. Vacuum tubes
B. Integrated circuits
C. Transistors
D. Resistors

60. A smart watch is an example of

A. A wearable computer
B. A first-generation computer
C. An embedded computer
D. A video game console

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61. Which of the following illnesses may be caused by an internet
addiction?
A. Depression
B. Common cold
C. Hypertension
D. A rash

62. What type of network is usually found in schools and businesses

located in a small geographical area?
A. Wide area network
B. Main area network
C. Local area network
D. Peripheral area network

63. The computer monitor is also known as

A. CCTV
B. UVD
C. VDU
D. DVU

64. What is the first page of a website called?

A. First page
B. Web page
C. New page
D. Home page

65. Which part of the computer is the RAM located?

A. Expansion board
B. External device
C. Mother board
D. CPU

66. Which of the following is specific to users’ needs?

A. System software
B. Compilers
C. Application software
D. Software

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67. Which of the following is not an input device?
A. Keyboard
B. Mouse
C. Visual display unit
D. Light pen

68. Which of the following is the processing unit of the computer?

A. Mother board
B. Graphic card
C. Memory
D. CPU

69. In the field of information and communication technology (ICT), the

term Bit stands for?
A. Binary digit
B. Binary tree
C. Binary information term
D. Bivariate term

70. Which of the following is also known as a Read/Write memory?

A. ROM
B. RAM
C. DVD
D. Hard disk

71. Microsoft word is an example of

A. An operating system
B. A processing device
C. Application software
D. An input device

72. The word processing feature that catches most of the random
typographical errors and misspellings is known as
A. Grammar checker
B. Word checker
C. Spell checker
D. MS word

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73. Which type of programme acts as an intermediary between a user of a
computer and a computer hardware?
A. Operating system
B. User thread
C. Super user thread
D. Application system

74. Which of the following software will be most appropriate for performing
numerical and statistical calculations?
A. Database
B. Document processor
C. Graphics package
D. Spread sheet

75. Which of the under listed cells of the human body does not have a
nucleus?
A. Red blood cells
B. White blood cells
C. Skeletal muscle cells
D. Mucosal lining of the small intestine

76. The smallest and functional unit of life is

A. System
B. Organ
C. Cell
D. Tissue

77. The thoracic cage is formed posteriorly by

A. Vertebral column, sternum and intercostal space
B. Vertebral column, ribs and intercostal space
C. Diaphragm, intercostal space and vertebral column
D. The root of the neck and vertebral column

78. The lymphoid tissue is one of the tissues of the body and can also be
called
A. Dense connective tissue
B. Articular tissue
C. Brown tissue
D. Reticular tissue

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79. The main cavities of the body consist of
A. Cranial, perineal, thoracic and pelvic
B. Thoracic, pelvic, cranial and abdominal
C. Pelvic, cranial, haversian and intestinal
D. Peritoneum, thoracic, abdominal and neural

80. The two primary bronchi are formed when the trachea divides at the
level of
A. 3rd thoracic vertebra
B. 5th thoracic vertebra
C. 6 thoracic vertebrae
D. 7th thoracic vertebra

81. Respiration is a fundamental aspect of human life. The most important

muscles of respiration in a normal quiet breathing are
A. Alveoli, diaphragm and intercostal muscles
B. Smooth muscle, alveoli and diaphragm
C. External intercostal muscles and the diaphragm
D. Internal and external intercostal muscles and the alveoli

82. Which of the following is not a component of pancreatic juice?

A. Cholecystokinin
B. Amylase
C. Lipase
D. Trypsinogen

83. The amount of air passing into and out of the lungs during each cycle
of breathing is called
A. Inspiration reserved volume
B. Tidal violence
C. Functional capacity
D. Tidal volume

84. The wall of the alimentary tract is formed by

A. 3 layers
B. 4 layers
C. 5 layers
D. 6 layers

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85. There is always a small quantity of gastric juice present in the stomach
even when it contains no food, this is called
A. Fasting juice
B. Dormant juice
C. Residual juice
D. Terminal juice

86. The phases involved in the secretion of gastric juice include

A. Cephalic phase, gastric phase and alimentary phase
B. Gastrointestinal phase, pancreatic phase and cephalic phase
C. Cephalic phase, gastric phase and intestinal phase
D. Stomach phase, cephalic phase and gastrin phase

87. The walls of the intestinal villi consist of

A. Squamous epithelia tissue
B. Columnar epithelia tissue
C. Cuboidal epithelia tissue
D. Simple epithelia tissue

88. The maximum number of Adenosine Triphosphate molecules are

produced by
A. Citric acid cycle
B. Glycolysis
C. Anaerobic respiration
D. Oxidative phosphorylation

89. At what phase of gastric secretion is secretin produced?

A. Intestinal phase
B. Cephalic phase
C. Gastric phase
D. Latent phase

90. Which part of the gastrointestinal tract is the peye’s patches found?
A. Duodenum
B. Jejunum
C. Large intestine
D. Ileum

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91. Which part of the gastrointestinal tract is Vitamin B12 absorbed?
A. Large intestine
B. Terminal ileum
C. Duodenum
D. Stomach

92. The most common site for blood borne spread of stomach malignancy is
A. Pancreas
B. Oesophagus
C. Liver
D. Duodenum

93. The glands of the small intestine are responsible for the production of
intestinal juice. What is the quantity of intestinal juice secreted by these
glands on a daily basis?
A. 1000ml
B. 1200ml
C. 1400ml
D. 1500ml

94. The principal constituents of the intestinal secretion are

A. Urea, water and bile salt
B. Secretin, water and bile salt
C. Water, gastric juice and secretin
D. Water, mucus and mineral salts

95. The portal fissure of the liver is found at

A. The region on the anterior surface of the liver
B. The region on the posterior surface of the liver
C. The region on the superior surface of the liver
D. The region on the lateral surface of the liver

96. A synergistic action of one drug against another drug that causes an
increased response by the body is
A. Sensitivity
B. Allergy
C. Potentiation
D. Anaphylaxis

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97. When creams are to be used during surgical procedures, the
perioperative nurse would expect that
A. The cream should be double-wrapped and the inner sterile packaging
placed directly on the sterile field
B. The cream should be single-wrapped and the sterile pack removed
while the scrubbed nurse picks it up
C. The cream should be dispensed directly into gallipot
D. The cream should be dispensed directly on the scrubbed nurse’s palm

98. According to the Joint Commission on Accreditation of Healthcare

Organisation (JCAHO), the contents of a sterile field drug label should
include the following EXCEPT
A. Drug name
B. Strength of the drug
C. Amount if not apparent by markings on the container
D. Date of manufacture

99. Drugs in vials must be removed from the vials before injection. To do
this, the circulating nurse is expected to
A. Use a syringe and hypodermic needle
B. Pour it directly into the gallipot
C. Pop off the cap and pour over the lip
D. Pour the injection directly into the surgical field

100.Which of these actions by a circulating nurse should the perioperative

scrubbed nurse address?
A. The circulating nurse pours the entire solution for irrigation into a
sterile basin
B. The circulating nurse withdraws a drug from the vial and dispenses
via the needle into a gallipot on the operation field
C. The circulating nurse uses a filter when withdrawing drugs from a
glass ampoule
D. The circulating nurse labels an unused drug

101.Which of these adverse effects should a nurse expect to observe in a

patient on heparin?
A. Venous thrombosis
B. Arterial thrombosis
C. Haematuria
D. Deep vein thrombosis

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102.What terminology is generally used to indicate that a drug has reached
the circulation and available to all the tissues?
A. Metabolism
B. Pharmacodynamics
C. Distribution
D. Bioavailability

103.Parenteral injections can be administered via the following routes

EXCEPT
A. Transdermal
B. Intravenous
C. Intramuscular
D. Intradermal

104.A patient is placed on aspirin. Which of these therapeutic responses

should the nurse watch out for?
A. Anti-inflammatory effects
B. Low grade fever
C. Platelet aggregation
D. Increased appetite

105.The advantages of oral administration include the following EXCEPT

A. Large surface area for absorption
B. It is convenient
C. It will undergo first pass metabolism
D. It can be easily reversed

106.Which of these factors may not modify the efficacy and dose of a drug?
A. Intercurrent illness
B. Nutritional factors
C. Patient’s age
D. Patient’s sex

107.Documentation is an essential aspect of perioperative nursing practice

and includes all the following EXCEPT
A. Billing and reimbursement
B. Performance improvement
C. Assessment of patient’s environment
D. Legal permanent record

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108.In the operating theatre, the design of the suit allows for flexibility.
Which of these is not an example of the physical layout in the operating
theatre?
A. Central corridor and core style
B. Central corridor or hotel style
C. Peripheral corridor or race track
D. Grouping and cluster plan

109.A designated unit in the operating room within unrestricted zone which
is made available for patients to change from street clothes into a gown
and wait with the family is called
A. Post anesthetic care unit
B. Pre anesthetic care unit
C. Holding unit
D. Recovery room area

110.Laminar airflow in the operating room is installed to combat

A. High humidity
B. Airborne particles
C. High temperature
D. Respiratory tract infection

111.As a perioperative nurse in-charge of a new facility, what type of

flooring will you advise to be used?
A. Seam polyvinyl chloride
B. Seamless polyvinyl chloride
C. Seamless polyvinyl calcium
D. Seam polyvinyl calcium

112.In the event of inadequate illumination in the operating theatre, what

type of light would you advice the management of your facility to use?
A. White fluorescent which may be incandescent
B. White fluorescent which may not be incandescent
C. Green and white fluorescent which may not be incandescent
D. Non-fluorescent light without incandescent

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113.The major concern in ensuring adequate operating room ventilation
include the following EXCEPT
A. How air is filtered
B. How air is distributed
C. How air is exhausted
D. How air is diluted

114.A surgical procedure which is based on purpose will include all the
following EXCEPT
A. Major surgeries
B. Diagnostic surgeries
C. Reconstructive surgeries
D. Ablative surgeries

115.When a scrub nurse gets accidentally pricked with a needle during

surgical procedure that leads to infection. Such a nurse is experiencing
what type of hazard?
A. Chemical
B. Biological
C. Mechanical
D. Physical

116.Fire incidence in the operating room is usually associated with which of

these factors?
A. Oxygen, nitrous oxide and fuel
B. Fuel, nitrous oxide and ignition
C. Oxygen, fuel and compressed air
D. Fuel, ignition and oxygen

117.According to the Spaulding classification of patient care items, those

items that can get in contact with the skin or mucous membrane are
called
A. Critical items
B. Semi critical items
C. Non critical items
D. Clean items

118.The circulating nurse is preparing for a surgical procedure for a known

Hepatitis B patient. Aside the routine aseptic technique, the circulating
nurse is also expected to

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 A. Perform barrier nursing
B. Observe respiratory precaution
C. Provide standard precaution
D. Isolate the patient

119.The operating room is an environment that houses several surgical

team members and as such human error cannot be completely
eliminated. Which of these is a common route of transmission?
A. Indirect person to person contact
B. Direct item to person contact
C. Direct person to person contact
D. Indirect item to person contact

120.As a circulating nurse in the operating room, which of these measures

would you adopt to correct a breech in aseptic technique during draping
procedure?
A. Organizing a tutorial on how draping is properly done
B. Collecting the draping from whoever is doing it at that point in time
C. Ensuring that the personnel that breech the aseptic technique is
sanctioned
D. Encouraging the surgical team members to correct the error and if
possible, providing them with another drape

121.The following are components of an appropriate operating room attire

EXCEPT
A. Wearing of head cover, street coat and gloves in semi restricted area
B. Wearing of scrub suit and head cover by all personnel in semi
restricted area
C. Wearing of mask in the restricted area
D. Wearing of protective gloves and shoe covers

122.The most important factor to be considered in the prevention of post-

operative infection is
A. Practice of aseptic technique
B. Administration of premedication
C. Proper position intra-operatively
D. Consumption of adequate fluid

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123.The following are characteristics of anti-microbial skin cleansing agents
EXCEPT
A. Independent of cumulative action
B. Non irritating and non-sensitizing
C. Broad spectrum and corrosive
D. Fast action and effective

124.As a scrub nurse preparing to scrub before taking a surgical procedure,

which of the following actions must be done first?
A. Application of antimicrobial agent
B. Drying of hands and arm
C. Wetting of arm and hand
D. Wearing of gown

125.The circulating nurse in the operating room discovers that one of the
surgeons is sensitive to latex gloves. Which of these actions by the
circulating nurse is not an ideal method of creating a latex free
environment?
A. Use of low allergen latex glove
B. Putting latex precaution posters all over
C. Give priority to latex sensitive patients by performing their surgeries
first
D. Always use a powder glove

126.Which of these is not included in the levels of prevention?

A. High level
B. Interim low level
C. Low level
D. Intermediate level

127.Bioburden is a term used to describe

A. The bacteria spores present on the surface after sterilization
B. The aseptic process for the maintenance of sterility
C. The number of microorganisms present on the surface
D. The resistance of microorganisms to aseptic technique

128.The term surgical team connotes

A. A unit providing the continuum of care beginning with preoperative
care and entirely through the perioperative procedures and post-
operative recovery

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 B. A unit with several surgeons, physicians from different specialties
through the perioperative phase
C. A group with all members of the operating theatre that are present at
a particular time of surgery
D. A unit with physicians and nurse anesthetists

129.The following are all sterile team members EXCEPT

A. Surgeon
B. Assistant surgeon
C. Anesthetist
D. Scrub nurse

130.Who remains at the side of the patient during the administration of

anesthesia?
A. Circulating nurse
B. Scrub nurse
C. Nurse anesthetist
D. Health assistant

131.Which of the following is not a consideration for the use of a surgical

needle?
A. The body of the needle could be either round, flat or straight
B. The depth of the bite through tissue determines the appropriate
needle length
C. The body is usually produced according to surgeon’s preferences
D. Tough or fibrous tissues require a heavier gauge needle

132.A needle with a continuous unit and the suture strand is known as
A. Fresh eye needle
B. Swaged on needle
C. Unswaged needle
D. Double armed attachment needle

133.Some needles have an attachment secured so that the suture strand

does not separate from the needle inadvertently but gets released slowly
when pulled off intentionally. This type of needle is called
A. Hand free needle
B. Double armed attachment
C. Single armed attachment
D. Controlled release needle attachment

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134.Which of the following is not an example of a stapling instrument?
A. Internal stapler
B. Linear stapler
C. Intraluminal circular stapler
D. Extracorporeal linear stapler

135.Surgical incisions or wounds are covered with sterile dressing for at

least
A. 12 to 24 hours
B. 15 to 24 hours
C. 24 to 48 hours
D. 48 to 72 hours

136.Which of the following is not a fabricating material for the production of

instruments?
A. Ironstone
B. Alloy
C. Vitallium
D. Titanium

137.What type of instrument does the tonsil snare belong to?

A. Grasping instrument
B. Clamping and occluding instrument
C. Debulking instrument
D. Probing instrument

138.Which of the following is not a factor affecting quality assurance?

A. Lack of resources
B. Personnel problem
C. Proper maintenance of infrastructure
D. Unreasonable patients and attendants

139.Standard operating procedure is synonymous to

A. Nursing audit
B. Quality assurance
C. Internal reference manual for a particular procedure
D. External reference manual for a particular procedure

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140.Which of the following sign is the nurse expected to observe during
assessment of a patient with the diagnosis of appendicitis?
A. Generalized abdominal pain
B. Rebound tenderness in the right iliac region
C. Pain in the right lumbar region
D. Pain in the right hypochondriac region

141.In assessment, the nurse is most likely to collect timely, specific

information by asking which of the following questions?
A. Would you describe how you feel?
B. How are you today?
C. What would you like to talk about?
D. Where does it hurt?

142.Which of these statements pertaining to an assigned client does the

perioperative nurse need to validate?
A. The client has a hard, raised, red lesion on his left leg
B. A weight of 90kg is recorded in the chart
C. The client reported an infected toe
D. The client’s blood pressure is 124/70 mmHg and 118/68 mmHg the
previous day

143.The client reports nausea and constipation. Which of the following

would be the priority nursing action?
A. Complete an abdominal assessment
B. Collect a stool sample
C. Administer anti-nausea medication
D. Notify the physician

144. The perioperative nurse observes that the patient who had surgery for
staging of cancer of the cervix is often sighing and saying in a low tone “I
am never going to get over this.” When encouraged to participate in care,
the client says “I don’t have energy.” The nurse believes that these cues
are suggestive of which of the following nursing diagnosis?
A. Hopelessness and powerlessness
B. Interrupted sleep pattern
C. Disturbed self esteem
D. Self-care deficit

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145.Which of these desired outcomes written by the perioperative nurse is
correctly written and measurable?
A. The client will lose 2kg within the next two weeks
B. The client will have a normal bowel pattern
C. The nurse will provide skin care at least thrice daily
D. The client will breathe better after resting for 10 minutes

146.While assisting a client from bed to chair, the nurse observes that the
client looks pale and is beginning to perspire heavily. Which of the
following activities of reassessment would the nurse then perform?
A. Help client into the chair but more quickly
B. Document client’s vital signs taken just prior to moving the client
C. Help client back to bed immediately
D. Observe client’s skin color and take another set of vital signs

147.The nurse informs the physical therapy department that a client is too
weak to use a walker and needs to be transported by wheelchair. Which
step of the nursing process is the nurse engaging in at this time?
A. Assessment
B. Planning
C. Implementation
D. Evaluation

148.Which nursing theorist defined nursing as a unique function?

A. Roy
B. King
C. Orem
D. Henderson

149.A nurse is to conduct head to toe assessment of a newly admitted client

into the surgical ward. What would be the most appropriate action for
the nurse to do when assessing the patient’s abdomen?
A. Palpate the abdomen before auscultation
B. Percuss the abdomen before auscultation
C. Auscultate the abdomen before palpation
D. Perform deep palpation before light palpation

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150.A patient had a stomach resection for stomach cancer. The nurse
should teach the patient about the loss of the hormone that stimulates
gastric secretion, gastric motility and maintains lower esophageal
sphincter tone which is
A. Gastrin
B. Secretin
C. Cholecystokinin
D. Gastric inhibitory peptide

151.The nurse palpates the patient’s abdomen for rebound tenderness and
discovered severe pain. This symptom is an indication of
A. Hepatic cirrhosis
B. Peritoneal inflammation
C. Gall bladder distension
D. Splenomegaly

152.Mrs. Thomas, a 60-year-old woman is booked for a percutaneous

transhepatic cholangiography to restore biliary drainage. Which of the
following statements by the client should the nurse be worried about?
A. I am allergic to bee sting
B. I am allergic to iodine
C. I have had epigastric pain for 2 months
D. I have a pacemaker because my heart rate was slow

153.Mrs. Adamu had a small-bore nasogastric (NG) tube post laryngectomy.

Which of these interventions is important before commencing enteral
feeding?
A. Aspiration
B. Auscultation of air
C. Set head of bed at 40 degrees
D. Verify NG tube placement on X-ray

154.A patient has been scheduled for gastroduodenostomy (Billroth 1

operation) for stomach cancer. If the patient starts complaining of
generalized weakness, sweating, palpitations and dizziness 15 to
30minutes after eating, this is indicative of
A. Malnutrition
B. Bile reflux gastritis
C. Dumping syndrome
D. Post prandial hypoglycemia

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155.In the preoperative phase, a nurse is preparing to pass a nasogastric
tube for a 68-year-old patient who is vomiting due to abdominal mass
and suspected small intestinal obstruction. The nurse should educate
the patient that the procedure is necessary because
A. The tube will help drain the stomach contents and prevent further
vomiting
B. The tube will push past the area that is blocked and this helps to stop
vomiting
C. The tube is just a standard procedure before many types of surgeries
to the abdomen
D. The tube will enable us measure your stomach contents so that we
can plan what type of IV fluid replacement would be best

156.A 65-year-old man has been scheduled for prostatectomy and he is yet
to sign the informed consent form. The patient states that the doctor has
not really explained what the surgical procedure entails. What is the
most appropriate intervention to be taken by the nurses?
A. Ask family members whether they have discussed the surgical
procedure with the doctor
B. Have the patient sign the form and state that the doctor will visit to
explain the procedure before surgery
C. Explain the planned surgical procedure as well as possible outcome
and have the patient sign the consent form
D. Delay the patient’s signature on the consent and notify the physician
about the conversation with the patient

157.When assessing the patient’s understanding about the care of

ileostomy, what statement by the patient indicates that the patient needs
more teaching?
A. I will be able to regulate when I have stool
B. I will be able to wear the pouch until it leaks
C. Dried fruits and popcorn must be chewed very well
D. The drainage from my stoma can damage my skin

158.After an abdominal surgery, a 45-year-old woman complains of severe

gastric pains with abdominal distension. Which of the following
prescribed medications will be most appropriate for the nurse to
administer?
A. Morphine sulphate

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 B. Ondansetron
C. Acetaminophen
D. Metoclopramide

159.Mr. Danladi had a laparoscopic cholecystectomy done. What discharge

teaching is appropriate?
A. A low-fat diet may be better tolerated for several weeks
B. Do not return to work or normal activities for 3 weeks
C. Bile colored drainage will probably drain from the incision
D. Keep the bandages on and the puncture site dry until it heals

160.A patient newly diagnosed with appendicitis develops fever,

hypertension and tachycardia. The nurse suspects which of the following
complications?
A. Intestinal obstruction
B. Peritonitis
C. Bowel ischemia
D. Deficient fluid volume

161.Mrs. Terngu, a 50-year-old woman just had hemorrhoidectomy. Which

position will be ideal for her in the early postoperative period after the
procedure?
A. High fowler’s
B. Supine
C. Side lying
D. Trendelenburg’s

162.The perioperative nurse while educating a newly posted student to her

unit tells her that another name for the Whipple procedure is
A. Cholangiopancreatography
B. Pancreatoduodenectomy
C. Cholangiogram
D. Cholecystogram

163.Mr. Uche who is newly diagnosed with peritonitis complains of severe

pain in the lower abdomen. Which of the following findings would further
confirm his diagnosis?
A. Pain is localized at a position halfway between the umbilicus and the
right iliac crest
B. Pain occurs 2 hours after resting

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 C. Pain subsides after eating
D. Pain is in the left lower quadrant

164.Mr. Segun, a 19-year-old man admitted into the surgical unit with
complaint of severe pain in the lower abdomen with low grade fever
suddenly stops complaining of pain without any intervention. The nurse
might suspect that
A. The appendix is still distended
B. The appendix may have ruptured
C. An increased intrathoracic pressure will occur
D. Signs and symptoms of peritonitis will occur

165.A patient has just been diagnosed of gastric cancer. Which of the
following diagnostic tests may be performed to further confirm this
diagnosis?
A. Barium enema
B. Colonoscopy
C. Gastroscopy
D. Serum chemistry level

166.Mr. Jeremiah has just had gastric resection. Which of the following
problems should the nurse focus his postoperative care on?
A. Body image
B. Nutritional needs
C. Skin care
D. Spiritual needs

167.A client has a percutaneous endoscopic gastrostomy tube inserted for

tube feedings. Before starting a continuous feeding, the nurse should
place the client in?
A. Semi fowler’s position
B. Supine position
C. Reverse Trendelenburg’s position
D. High fowler’s position

168.A patient is being monitored for early signs of dumping syndrome.

Which symptom indicates this occurrence?
A. Abdominal cramping and pain
B. Bradycardia and indigestion
C. Sweating and pallor

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 D. Double vision and chest pain

169.The nurse is preparing a discharge teaching plan for Mr. Jones who
had an umbilical hernia repair. Which of the following would the nurse
include in the plan?
A. Restricting pain medication
B. Maintaining bed rest
C. Avoiding coughing
D. Irrigating the drain

170.A 40-year-old woman comes to the emergency department because she

has pain in her right arm two hours after she fell in her home. Physical
examination shows swelling and deformity of the right arm. The patient
is unable to dorsiflex the wrist. X-ray studies show a spiral mid-shaft
fracture of the humerus. Which of the following nerves is most likely
affected by this fracture?
A. Axillary
B. Median
C. Ulnar
D. Radial

171.A 32-year-old man comes to the clinic because he has had pain in his
back for the past 24 hours. The patient says he first noticed the pain
when he awoke in the morning and had difficulty getting out of bed. He
had been playing flag football the day before the pain began but did not
sustain any injury during the game. Which of the following is the most
appropriate initial step?
A. Anti-inflammatory and muscle relaxant therapy
B. CT scan of the lumbar spine
C. Epidural injection of a corticosteroid
D. MRI of the lumbar spine

172.A male neonate who was delivered vaginally at term one hour ago has a
deformity of the right foot. The position of the foot cannot be passively
corrected. Which of the following disorders is the most likely diagnosis?
A. Calcaneovalgus
B. Pes planus
C. Metatarsus adductus
D. Congenital clubfoot

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173.A 35-year-old woman who is obese comes to the orthopaedic clinic
because she has pain and swelling of her right ankle 24 hours after she
sustained a twisting injury when she slipped on an icy sidewalk. The
most appropriate nursing management is
A. Application of a long leg cast
B. Application of a short leg cast
C. Application of a working boot
D. Close reduction and external fixation

174.An expected outcome of cast application that the nurse evaluates is

A. Skin irritation of the cast edges
B. Decreased capillary refill and pallor
C. Tingling and numbness distal to the cast
D. Slight oedema, soreness and limitation of range of movement

175.Mr. Dauda who had undergone a total hip replacement complains of

pain in the operation site. Which of the following is the most appropriate
initial nursing action?
A. Administer the ordered analgesic
B. Instruct the patient to do deep breathing and coughing exercise
C. Assess the patient’s pain level and vital signs
D. Change the patient’s position

176.Which instruction is most important to provide when discharging a

client from the emergency department following penetrating foot injury?
A. Refrain from crossing the leg at the knee or ankle
B. Call the health care provider at the first sign of any red streaks
appearing on the foot or leg
C. Avoid smoking until the entire wound is no longer open to the air
D. Watch for signs and symptoms of anaphylaxis from the tetanus toxoid

177.A 17-year-old patient with a leg fracture who is scheduled for surgery is
an emancipated minor. She has a statement from the court for
verification. Which intervention by the nurse is most appropriate?
A. Witness the permit after consent is obtained by the surgeon
B. Call a parent or legal guardian to sign the permit since the patient is
under 18
C. Obtain verbal consent since written consent is not necessary for
emancipated minors
D. Ignore the case since it is a minor case

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178.Nurse Bello is to come up with a plan of care for his patient scheduled
for cataract surgery. Which of these is most appropriate?
A. Self-care deficit
B. Anxiety
C. Imbalanced nutrition
D. Disturbed sensory perception

179.While preparing a patient for cataract surgery, which of the following

eye-drops should the nurse expect in the physician’s order?
A. Mydriatics medication
B. Miotic medication
C. Osmotic diuretic
D. Thiazide diuretic

180.Aphakia is a condition that can arise after cataract extraction. During

health teaching, the nurse would describe it as
A. A “keyhole” pupil
B. Loss of accommodation
C. Retinal detachment
D. Absence of the crystalline lens

181.Nurse Joy works in the preoperative ward. While preparing her patients
for eye surgery, she is expected to
A. Clip the client’s eyelashes
B. Obtain informed consent with the client’s signature and place the
forms on the chart
C. Verify the client has been on NPO since midnight or at least 8 hours
before surgery
D. Verify the affected eye has been patched 24 hours before surgery

182.Mr. Tanko had cataract extraction of the right eye 2 hours ago. Which
of these findings will require the nurse to re-educate Mr. Tanko?
A. He is asleep on his right side
B. He is not wearing his glasses
C. He feels asleep while watching TV
D. He is wearing the eye shield while asleep

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183.Mr. Ade has been booked for cataract extraction of the right eye in 5
days. The nurse is to discuss about
A. Avoiding any type of drug which can cause bleeding
B. Administering eye drops that will dilate the eye 72 hours before
surgery
C. Making arrangements for hospitalization for 3 days
D. Avoiding lifting or pushing objects heavier than 8kg

184.Madam Ashake had retinal detachment surgery and gas tamponade

was used to flatten the retina. Which of these interventions should the
nurse implement first?
A. Position the client as prescribed
B. Educate on signs of increased intraocular pressure
C. Explain the importance of follow up visits
D. Assess the eye for signs of complications

185. The nurse suddenly finds a young man on the ground with a stick
lodged in his eye. What should be the immediate intervention?
A. Stabilize the stick as much as possible
B. Carefully remove the stick from the eye
C. Place the young man in high fowler’s position
D. Flush the eye with water if available

186.The normal threshold of hearing in young adult is

A. 0 db
B. 10 db
C. 20 db
D. 30 db

187.Which virus causes sensorineural hearing loss (SNHL)?

A. Corona virus
B. Mumps virus
C. Adenovirus
D. Rotavirus

188.Permanent hearing loss results from prolonged exposure to noise level

greater than
A. 40 db
B. 85 db
C. 100 db

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 D. 140 db

189.Perichondritis of the auricular cartilage is most commonly caused by

A. Staphylococcus
B. Pseudomonas
C. Candida
D. Streptococcus

190.The direction of water jet while doing syringing of the ear should be
A. Anterior-inferior
B. Posterior-superior
C. Anterior-superior
D. Posterior-inferior

191.The commonest cause of acute otitis media in children is

A. Hemophilus influenzae
B. Streptococcus pneumoniae
C. Staphylococcus aureus
D. Pseudomonas

192.While providing health teaching to a client with acute otitis media, the
nurse explains that the most common complication of the condition is
A. Deafness
B. Cholesteatoma
C. Mastoiditis
D. Facial nerve palsy

193.Which part of the ear contains the receptors for hearing?

A. Cochlea
B. Middle ear
C. Utricle
D. Tympanic cavity

194.A patient is admitted to the hospital with suspected polycythemia vera.

Which of the following symptoms is consistent with the diagnosis?
A. Weight loss
B. Hypertension
C. Headache
D. Pruritus

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195.The perioperative nurse is teaching a client with polycythemia vera
about potential complications from the disease before undergoing tooth
extraction. Which manifestations would the nurse not include in the
client’s teaching plan?
A. Visual disturbance
B. Hearing loss
C. Headache
D. Orthopnea

196.The perioperative nurse is admitting a client with hypoglycemia who is

also booked for oral surgery. Which signs and symptoms should the
nurse not expect?
A. Thirst
B. Palpitation
C. Diaphoresis
D. Slurred speech

197.When planning care for a client undergoing maxillofacial surgery who is

experiencing symptoms, which client care activities can the nurse
appropriately delegate to the student nurse?
A. Pre-visit
B. Obtaining the client’s weight
C. Evaluating the client’s response to premedication
D. Informed consent

198.Nurse Ada is caring for a middle-aged client who has undergone tooth
scaling. The client has two children. Which concept about families
should the nurse consider when providing care for this client?
A. Family roles do not change because of illness
B. The effects of an illness on a family depend on the stage of the family’s
life cycle
C. Children typically are not affected by adult illness
D. Most illnesses are hereditary

199.An ingested foreign body may lodge in the following areas of the body
EXCEPT
A. The tonsil
B. The vallecula
C. The mucosa
D. The pyriform fossa

36
200.A nurse is caring for a client in the intensive care unit who is intubated
and mechanically ventilated. Upon assessment, the nurse notes the
client has cheilosis. Based on this data, which is the priority intervention
for this client?
A. Checking for ill-fitting dentures
B. Suggesting an increase in fluid intake
C. Providing oral care
D. Lubricating the lips using an antimicrobial ointment

37