Medical Surgical Nursing PDF

MEDICAL SURGICAL NURSING INDEX MEDICAL SURGICAL NURSING S.NO. TOPIC NAME 1. CELL & TISSUE 2. BLOOD 3. CARDIO VASCULAR SYSTEM 4. NERVOUS SYSTEM 5. RENAL SYST...

MEDICAL SURGICAL NURSING INDEX MEDICAL SURGICAL NURSING S.NO. TOPIC NAME 1. CELL & TISSUE 2. BLOOD 3. CARDIO VASCULAR SYSTEM 4. NERVOUS SYSTEM 5. RENAL SYSTEM 6. ENDOCRINE SYSTEM 7. G.I. SYSTEM 8. SENSORY ORGAN & SKIN INTEGUMENTARY SYSTEM 9. RESPIRATORY SYSTEM 10. MUSCULOSKELETAL SYSTEM 11. ONCOLOGY -:: 1 ::- MEDICAL SURGICAL NURSING 14. A system is defined as a group of......... that CELL & TISSUE function together? 1. Antibodies are produced by: (a) Cells (b) Tissues (a) Plasma cells (b) Lymphocytes (c) Molecules (d) Organs (c) Erythrocytes (d) Basophils 15. Which is the biggest cell in the body? 2. The type of muscle found in the visceral organs (a) Nerve cells (b) Cardiac cells and blood vessels is called (c) Renal cells (d) Ovum (a) Voluntary (b) Cardiac 16. Anatomy is a term, which means the study of? (c) Myocardium (d) Involuntary (a) Physiology (b) Morphology 3. Smooth muscle tissue is located in: (c) Cell Function (d) Human Function (a) The stomach (b) Urinary bladder 17. Mitosis is a condition of: (c) Intestines (d) All of the Above (a) Cell division with half chromosomes 4. Which of the following body structure (b) Cell division without reduction keratinized stratified epithelium is found? (c) Cell breakdown (a) Conjunctiva of the eyes (d) Cell death (b) Stomach 18. Proteins that are to be used outside the cell (c) Airway are synthesized: (d) Hair (a) In the mitochondria 5. The hereditary determinants of humans are (b) On free ribosome received from: (c) On the smooth endoplasmic reticulum (a) Allele (b) Genes (d) On the rough endoplasmic reticulum (c) Nucleus (d) Cytoplasm 19. Which of the following is the largest organelle 6. Which of the following is the hereditary of a cell? material of cells? (a) Mitochondria (b) Lysosome (a) D.N.A in the chromosomes (c) Ribosome (d) Nucleus (b) Protein in the ribosomes 20. Transformation of one type of cell into another (c) R.N.A in the nucleus type is called: (d) Ribosomes in the cytoplasm (a) Hyperplasia (b) Metaplasia 7. Which of the following 'Power house of a cell? (c) Dysplasia (d) Anaplasia (a) Ribosome (b) Golgi apparatus 21. The cell from which human body develops is (c) Mitochondria (d) Lysosome known as 8. Which of The epithelial tissue which lines the (a) Zygote (b) Sperm urinary bladder is- (c) Ovum (d) Ovary (a) Squamous (b) Columnar 22. The structure called are intracellular areas ith (c) Stratified (d) Transitional specific function? 9. Bones are the example of which of the (a) Inclusions (b) Organs following? (c) Organelles (d) Macromolecules (a) Epithelium tissue (b) They are not tissues 23. What is the smallest functional unit of the (c) Muscle tissue (d) Connective tissue body? 10. The thickest human skin is? (a) Cell (b) Molecule (a) Palm (b) Sole (c) Atom (d) Tissue (c) Neck (d) Head 24. Meibomian glands are 11. Which of the following is an example of tissue? (a) Sebaceous glands (a) Brain (b) Blood (b) Sweat glands (c) Liver (d) Stomach (c) Mixed 12. Which of the Cell organ is related to synthesis (d) None of ATP? 25. What is the Percentage of body weight formed (a) Mitochondria (b) Golgi body by body water in an adult? (c) Lysosome (d) Ribosome (a) 40% (b) 90% 13. What is the cell organ which synthesizes (c) 80% (d) 60% protein, is 26. The breast is a modification of? (a) Mitochondria (b) Golgi body (a) Sebaceous Gland (b) Sweat Gland (c) Lysosome (d) Ribosome (c) Thyroid Gland (d) Pituitary gland -:: 2 ::- MEDICAL SURGICAL NURSING 27. Which of the following known as protein 37. Which one is produced by mesoderm? factory? (a) Heart and notochord (a) Ribosome (b) Mitochondria (b) Heart and brain (c) Lysosome (d) Ovary (c) Spinal cord and notochord 28. Which of the function of Golgi apparatus cell (d) Brain organelle is helpful in? 38. The inner most layer of epidermis is called as (a) Pinocytosis (a) Germinative (b) Exocytosis (b) Lucidum (c) Endocytosis (c) Granulosum (d) None of them (d) Corneum 29. Blood vessels are present in: 39. The colour of skin is affected by except? (a) Epidermis layer (a) Melanin (b) Adipose tissue (b) Level of Hb saturation (c) Dermis layer (c) Level of bile pigments in blood (d) None of them (d) Vitamin-D 30. Blood brain barrier is made up of 40. Which of the following pigment is responsible (a) Astrocytes for maintain the colour of skin is? (b) Oligodendrocytes (a) Red pigment (c) Oligodendroglia (b) Carotene (d) Microglia (c) Melanin 31. Wavy fibers in the absence of other myocardial (d) Liver pathology suggest what to the autopsy 41. What is the Function of skin includes except? pathologist? (a) Protection (a) Amyloidosis (b) Regulation of body temperature (b) Cobalt cardiomyopathy (c) Formation of vitamin - D (c) Hypertrophic cardiomyopathy (d) Respiration regulation (d) Sudden coronary death 42. Which of the following is Temperature 32. What is the most important function of sweat regulating centre? glands is? (a) Thalamus (a) Maintaining body temperature (b) Cerebellum (b) Maintaining water and electrolyte balance (c) Medulla oblongata (c) Maintaining cleanliness of body (d) Hypothalamus (d) Protection to the heart 43. Which of the following is the largest organ of 33. Which of the following techniques uses a sugar body? to look at the functioning of the brain? (a) Brain (a) EEG (b) CT scan (b) Kidney (c) MRI scan (d) PET scan (c) Liver 34. Sebaceous glands are not found on: (d) Skin (a) Axilla (b) Palms of the hands ANSWER KEY (c) Soles of feet 1. [b] 2. [d] 3. [c] 4. [d] 5. [b] (d) Both B and C 6. [a] 7. [c] 8. [d] 9. [d] 10. [b] 35. Melanin is secreted in: 11. [b] 12. [a] 13. [d] 14. [d] 15. [d] (a) Corneum layer (b) Germinative layer 16. [b] 17. [b] 18. [d] 19. [d] 20. [b] (c) Granulosum layer 21. [a] 22. [c] 23. [a] 24. [a] 25. [d] (d) Dermis layer 26. [b] 27. [a] 28. [b] 29. [c] 30. [a] 36. Which of the following could NOT be part of an 31. [d] 32. [a] 33. [d] 34. [d] 35. [b] acinus? 36. [c] 37. [a] 38. [a] 39. [d] 40. [c] (a) Alveolar sacs (b) Alveolar ducts 41. [d] 42. [d] 43. [d] (c) Terminal bronchioles (d) Respiratory bronchiole ❑❑❑ -:: 3 ::- MEDICAL SURGICAL NURSING BLOOD 13. The artery which supply blood to head and neck is 1. Prothrombin is produced by: (a) Coronary artery (a) Blood (b) Liver (b) Carotid artery (c) Ovary (d) Spleen (c) Mesenteric artery 2. A primary central organ of the lymphatic (d) Intracostal artery system, plays vital in immunity: 14. Blood groups were first discovered by: (a) Liver (b) Spleen (a) Robert Koch (c) Thymus (d) Tonsils (b) Karl Landsteiner 3. Which of the following immunoglobulin is (c) Paul Ehrlich involved in allergic reaction? (d) Anton von Leeuwenhoek (a) Ig A (b) Ig D 15. The color of the RBC’s is given by: (c) Ig G (d) Ig E (a) Actin (b) Globin 4. During clotting, the Prothrombin is changed to (c) Chyme (d) Heme thrombin in the presence of? 16. Prothrombin time is increased in (a) Calcium ions and fibrinogen (a) Heparin therapy (b) Thromboplastin and Vitamin K (b) Obstructive Jaundice (c) Calcium ion and Vitamin K (c) Haemorrhagic disease of newborn (d) Calcium ion and Thromboplastin (d) All of the Above 5. A failure in lymphatic system to return body 17. All increase the chances of deep vein fluids adequately results in? thrombosis except (a) Swelling of hands and legs (a) Oral contraceptive pills (b) Swelling of face and hands (b) Hypertension (c) Oedema in spleen (c) Superficial thrombophlebitis (d) Swelling of tissues as oedema (d) Myocardial Infarction 6. Carbonic anhydrase occurs in? 18. Lymphatic’s are found in (a) Lymphocytes (b) Blood plasma (a) Brain (b) Choroid (c) RBC (d) Leucocytes (c) Vertebrae (d) Dermis of skin 7. Clotting can be prevented by using? 19. Bilirubin is a breakdown product of which of (a) Antiemetic (b) Antibiotics the following (c) Anticoagulants (d) Analgesics (a) WBC (b) RBC 8. Which artery supplies oxygenated blood to the (c) Enzymes (d) Platelets stomach? 20. Precursor cells of RBC are (a) Carotid artery (b) Gastric artery (a) Reticulocyte (c) Celiac artery (d) Cephalic artery (b) Band Forms 9. Tunica adventitia is a layer of: (c) Myelocytes (a) Blood vessels (b) Uterus (d) Melanomyelocytes (c) Testis (d) Lungs 21. PCR stands for 10. A largest organ in abdominal cavity that filters (a) Polymerase reaction blood is? (b) Polymerase circular reaction (c) Polymerase chain reagent (a) Lymph nodes (b) Palatine Tonsils (d) Polymerase chain reaction (c) Spleen (d) None of the Above 22. Low Prothrombin levels in absence of jaundice 11. The abnormal dilatation of the wall of an indicates? artery is referred as? (a) Serious damage to liver (a) Phlebitis (b) Aneurysm (b) Serious damage to Kidney (c) Hemisphere (d) Atherosclerosis (c) Portal Hypertension (d) IHD 12. The normal value of Hb in female is 23. Arterial supply of uveal tract (a) 8-10 gm% (a) Anterior Ciliary arteries (b) 12-14 gm% (b) Long posterior ciliary arteries (c) 10-12 gm% (c) Short posterior arteries (d) 16-18 gm% (d) All of the Above -:: 4 ::- MEDICAL SURGICAL NURSING 24. Who is the carrier of Haemophilia? 35. Smallest veins are known as (a) Female (a) Vena - cava (b) Capillaries (b) Male (c) Venules (d) Arterioles (c) Both Male and Female 36. Where the AV node is situated (d) None of the Above (a) In the wall of atrioventricular septum 25. Leukopenia is? (b) In the wall of ventricles (a) Reduced number of WBC (c) In the wall of ventricular septum (b) Increased number of WBC (d) In the wall of atrial septum (c) Reduced number of RBC 37. In human heart impulses are originated from- (d) Increased number of RBC (a) Purkinje fibers 26. Fetal blood cell formation takes place in: (b) AV node (a) Spleen (b) Bone marrow (c) SA Node (c) Liver (d) All of the Above (d) Bundle of his 27. What colour is oxygenated blood 38. The first heart sound ‘lubb’ is heard due to (a) Red (b) Blue (a) Opening of the aortic and pulmonary valves (c) Purple (d) White (b) Opening of the atrioventricular valves 28. In Kawasaki's disease, you will probably NOT see (c) Closure of the aortic and pulmonary valves (a) Enlarged lymph nodes containing granulomas (d) Closure of the atrioventricular valves (b) Erythema of the palms 39. The second heart sound 'dubb' is heard due to (c) Fever (a) Closure of the aortic and pulmonary valves (b) Opening of the atrioventricular valves (d) Reddening of the oral mucosa (c) Closure of the atrioventricular valves 29. What's the major risk factor for Buerger's (d) Opening of the aortic and pulmonary valves Thromboangiitis obliterans? 40. In ECG the wave arises during sweeping of (a) Alcohol abuse (b) Cocaine use impulses over the atria from the SA node, is (c) Old age (d) Smoking named as 30. Which of the following is the longest vein in the (a) T wave (b) QRS complex body? (c) P wave (d) U wave (a) Femoral vein 41. In ECG relaxation of ventricular muscles is (b) Superior vena cava represented by (c) Inferior vena cava (a) T wave (b) QRS complex (d) Great saphenous vein (c) P wave (d) U wave 31. Which of the following is the largest vein in the 42. Mesenteric/Auerbach's plexus is found in: body? (a) Muscle layer (a) Great saphenous vein (b) Hair (b) Inferior vena cava (c) Gastric Mucosa layer (c) Sephanous vein (d) Sub mucosa layer (d) Femoral vein 43. Acromion process is located on: 32. Which of the following statements about Hb is (a) Ilium (b) Scapula FALSE? (c) Humerus (d) Ulna (a) A higher P50 than normal means that the O2 binds 44. Great Sephanous vein which is the longest vein in less tightly to Hb human body is found in (b) An increase in 2, 3-DPG shifts the 02 uptake curve (a) Upper limb (b) Thoracic region to the left. (c) Brain (d) Lower limb (c) An increase in PCO2 causes a right shift of the O2 45. The fibrous tissue connecting bone to bone is uptake curve. called? (d) A decrease in pH increases P50. (a) Cartilage (b) Tendon 33. Vitamin-K is synthesized in human body by? (c) Muscle (d) Ligament (a) Bacteria in colon 46. Which Muscle is located on the anterior part of (b) Liver the thigh? (c) Spleen (a) Vastus lateralis (b) Rectus femoris (c) Vastus medialis (d) Sartorius (d) Muscle fibres 47. The type of membrane that lines the knee joint: 34. Smallest arteries are known as (a) Mucous (b) Epithelial (a) Collateral arteries (b) Venules (c) Serous (d) Synovial (c) Capillaries (d) Arterioles -:: 5 ::- MEDICAL SURGICAL NURSING 48. The strongest joint in the body is: 62. the most serious complication of fracture is (a) Shoulder joint (b) Knee joint (a) Infection (b) Fat embolism (c) Sacroiliac joint (d) Hip joint (c) Hemorrhage (d) Air embolism 49. Mobile bone of skull? 63. the most common injury among elderly persons (a) Maxilla (b) Mandible is (c) Ethmoid (d) Sphenoid (a) Atherosclerotic changes in the blood vessels 50. A condition characterized by moving of bones out (b) Increased incidents of gallbladder disease joint: (c) Urinary tract infection (a) Fracture (b) Sprain (d) Hip fracture (c) Strain (d) Dislocation 64. Which is the most important muscle to produce 51. Abnormal lateral deviation of vertebral column upwards rotation of the scapula? is? (a) Serratus anterior (b) Trapezius (a) Osteoporosis (b) Lordosis (c) Levator Scapulae (d) Deltoid (c) Kyphosis (d) Scoliosis 65. A bone embedded within a tendon or a muscle is 52. Acetabulum is the part of? called? (a) Humerus (b) Radius (a) Sesamoid (b) Ethmoid (c) Scapula (d) Femur (c) Platypoid (d) None of the Above 53. Skull consists of: 66. The commonest deformity at hip in post-polio (a) 18 bones (b) 22 bones residual paralysis is: (c) 12 bones (d) 14 bones (a) Flexion deformity 54. A junction between two or more bones or (b) Extension deformity cartilage: (c) Flexion adduction deformity (a) Synovial joint (b) Sutures (d) Flexion abduction deformity (c) Joint (d) Fontanelle 67. What types of anaesthetic is used for minor 55. The outermost covering of the bone is: procedure? (a) Pericardium (b) Periosteum (a) Systemic (b) Local (c) Peritoneum (d) Perimetrium (c) None (d) Both A and B 56. Head of the femur articulates with the: 68. KF ring seen in (a) Obturator foramen (a) Wilson disease (b) Blunt trauma (b) Foramen magnum (c) Chemical injury (d) Thermal injury (c) Acetabulum 69. Burst fracture is seen in? (d) Cerebellum (a) Talus fracture 57. Facilitated diffusion of glucose takes place in all (b) Vertebral fracture sites except? (c) Femoral head fracture (a) Skeletal muscle (d) Scaphoid (b) Adipose tissue 70. Which bone is also known as 'collar bone?' (c) Insulin dependent tissues (a) Clavicle (b) Scapula (d) Renal tubules (c) Radius (d) Humerus 58. A physical therapist performs a manual muscles ANSWER KEY test on the primary hip abductor. The therapist 1. [b] 2. [c] 3. [d] 4. [d] 5. [c] should perform the test while palpating the: 6. [c] 7. [c] 8. [c] 9. [a] 10. [c] (a) Rectus femoris (b) Gluteus medius 11. [b] 12. [b] 13. [b] 14. [b] 15. [d] 16. [d] 17. [c] 18. [c] 19. [b] 20. [a] (c) Sartorius (d) Gluteus minimums 21. [d] 22. [a] 23. [d] 24. [a] 25. [a] 59. Locking is a feature of..............injury? 26. [d] 27. [a] 28. [a] 29. [d] 30. [d] (a) Collateral ligament 31. [b] 32. [b] 33. [a] 34. [d] 35. [c] (b) Meniscus 36. [d] 37. [c] 38. [d] 39. [a] 40. [c] (c) Cruciates 41. [a] 42. [a] 43. [b] 44. [d] 45. [d] (d) All of the Above 60. Which of the following bones is considered a 46. [b] 47. [d] 48. [c] 49. [b] 50. [d] Sesamoid bone? 51. [d] 52. [d] 53. [b] 54. [c] 55. [b] (a) Sternum (b) Ethmoid 56. [c] 57. [d] 58. [b] 59. [b] 60. [d] (c) Phalanx (d) Patella 61. [c] 62. [b] 63. [d] 64. [b] 65. [a] 61. There are..............long bones in hand 66. [d] 67. [b] 68. [a] 69. [b] 70. [a] (a) 15 (b) 17 (c) 19 (d) 22 ❑❑❑ -:: 6 ::- MEDICAL SURGICAL NURSING 10. All of the following can cause tachycardia CARDIAC SYSTEM except 1. If pericardial fluid exceed above 50 ml. This is (a) Fever known as - (b) Exercise (a) Pericardial oedema (c) Sympathetic nervous system stimulation (b) Pericardial transudate (d) Parasympathetic nervous system stimulation (c) Cardiac tamponade 11. the most important parameter of APGAR score (d) Cardiac asthma is 2. Which of the following represents the correct (a) Heart rate (b) Respiratory rate pathway for conduction of an action potential (c) Grimace (d) Reflex through the heart? 12. What is the normal cardiac output? (a) AV node, AV bundle, SA node, Purkinje fibers, (a) 1 litres/minute (b) 2 litres/minute bundle branches (c) 4 litres/minute (d) 5 litres/minute (b) SA node, bundle of his, bundle ranches, AV 13. What is the initial reaction of cryotherapy? node, purkinje fibers (a) Vasodilatation (c) SA node, AV node, bundle of his, bundle (b) Vasoconstriction branches, purkinje fibers (c) Increased blood flow (d) AV node, bundle branches, bundle of His, SA (d) Reduced metabolic rate node, purkinje fibers 14. The systemic effects of cryotherapy is? 3. Each normal heart beat is initiated by which of (a) Increased blood pressure the following? (b) Decreased blood pressure (a) Sino atrial Node (c) Decreased cardiac output (b) Bundle of His (d) None of the Above (c) Cardiac center of Medulla 15. Drop of QRS complex is found in? (d) Sympathetic nerves (a) 1st degree heart block 4. Which of the following is the largest and most (b) 2nd degree heart blocks vascular chamber of the heart (c) 3rd degree heart block (a) Right atrium (d) Both A & B (b) Right ventricle 16. The instrument that is used for measuring BP (c) Left atrium is known as: (d) Left ventricle (a) Thermometer (b) Cardio scope 5. Permanent pacemaker is indicated in which of (c) Bronchoscope (d) Sphygmomanometer the following dysrhythmias? 17. Baroreceptors are related to (a) Ventricular fibrillation (a) Stimulating hunger (b) Asymptomatic bradycardia (b) Vision (c) Atrial fibrillation (c) Activity of thyroid gland (d) Third degree heart block (d) Maintaining BP 6. Which valve prevents backward flow of blood 18. The highest blood pressure is found in the? into the left atrium? (a) Venules (b) Aorta (a) Aortic valve (b) Pulmonary valve (c) Arteries (d) Veins (c) Tricuspid valve (d) Mitral valve 19. Walls are thickest in the? 7. Where is cardiac sphincter located? (a) Right atrium (b) Right ventricle (a) Lungs (b) Liver (c) Left atrium (d) Left ventricle (c) Stomach (d) Heart 20. Where would you find valves? 8. The outer covering of the heart is: (a) Arterioles (b) Capillaries (a) Peritoneum (b) Pleura (c) Veins (d) Lungs (c) Pericardium (d) Myocardium 21. Absolute refractory period in the heart 9. The volume of blood pumped from the left (a) Corresponds to the duration of relaxation ventricle during each systolic contraction is (b) Lasts till half of cardiac contraction termed: (c) Shorter than refractory period in skeletal (a) Circulatory volume (b) Stroke volume muscle (c) Cardiac output (d) Cardiac response (d) Lasts till cardiac contraction -:: 7 ::- MEDICAL SURGICAL NURSING 22. Positive bathmotropic effect on heart is 29. What is the normal stroke volume? produced by (a) 60 ml (a) Stimulation of vagus nerve (b) 55 ml (c) 80 ml (b) Stimulation of sympathetic nerves (d) 70 ml (c) Atropine 30. Which is most likely to produce tricuspid valve (d) Sectioning of vagus stenosis? 23. What is the Amount of cardiac output in a (a) Carcinoid heart disease healthy adult? (b) Ebstein's anomaly (a) 4 L/min (c) Endocarditis from IV drug use (b) 10 Lit/min (d) Severe atherosclerosis (c) 6 Lit/min 31. In cardiac cycle duration of atrial systole, (d) 5 Lit/min ventricular systole and complete cardiac diastole 24. Which of the following conducting systems has are respectively the slowest conducting velocity (a) 0.1 sec, 0.3 sec & 0.4 sec (a) SA Node (b) 0.4 sec, 0.3 sec & 0.1 sec (b) Atrial muscle (c) 0.3 sec, 0.1 sec & 0.4 sec (c) Purkinje fibres (d) 0.3 sec, 0.4 sec & 0.1 sec (d) AV Node 32. Which of the following is the largest serous 25. When a Pheochromocytoma suddenly membranes of the body? discharges a large amount of epinephrine into (a) Pericardium (b) Peritoneum the circulation the patient’s heart rate would (c) Myometrium (d) None of them be expected to 33. What is the Location of SA node in the heart? (a) Increase because epinephrine has a direct (a) In the wall of right ventricle chronotropic effect on the heart (b) In the wall of left atrium (b) Increase because of increased (c) In the wall of right atrium parasympathetic discharge to the heart (d) In the wall of left ventricle (c) Decrease because the increase in blood 34. Total period of one cardiac cycle is pressure stimulates the carotid and aortic (a) 0.5 sec (b) 1 sec baroreceptors (c) 1.2 sec (d) 0.8 sec (d) Decrease because of increased tonic 35. What's the eponym for angina caused by coronary spasm? parasympathetic discharge to heart (a) Buerger's (b) Ebstein's 26. Which is LEAST likely to cause high-output heart (c) Heberden’s (d) Prinzmetal's failure? 36. A healthy, sedentary adult's heart usually weighs (a) Anemia no more than (b) High fever (a) 150 gm (b) 250 gm (c) Hypertrophic cardiomyopathy (c) 350 gm (d) 450 gm (d) Hyperthyroidism 37. Most "unstable angina” is probably due to 27. What is the Stroke volume? (a) A thrombus forming and lysing (a) Pressure exerted by blood on the walls of (b) Extreme hypercholesterolemia and rapid vessels atherogenesis (b) Amount of blood ejected by each (c) Multiple emboli to the coronaries (d) Serial haemorrhages within a plaque contraction of the atrium 38. Which is most likely to produce Dextrocardia (a (c) Amount of blood ejected by each heart on the right side instead of the left)? contraction of the ventricles (a) Down's syndrome (d) Total amount of blood ejected by heart (b) Fetal alcohol syndrome (c) Immotile cilia syndrome during a beat (d) Rubella in the unborn child 28. What is the formula of cardiac output? 39. Which of the following structure is known as (a) CO = stroke volume x heart rate pacemaker of heart (b) CO = stroke volume - heart rate (a) Purkinje's fibers (b) AV node (c) CO = stroke volume/heart rate (c) Bundle of his (d) SA node (d) CO = stroke volume + heart rate -:: 8 ::- MEDICAL SURGICAL NURSING 40. Which is LEAST LIKELY to give you a dilated 48. Uncomplicated hypertension and diabetes are cardiomyopathy? most likely to produce what change at the (a) Amyloid cardiomyopathy level of the arterioles? (b) Autoimmune cardiomyopathy (a) Amyloidosis (c) Chagas’s cardiomyopathy (b) Atherosclerosis (d) Duchene’s cardiomyopathy (c) Hyaline sclerosis 41. Which of the following event takes place when (d) Intimal onion skinning ventricles are contracted in heart 49. A newborn infant presents with cyanotic heart (a) The atrioventricular valves open disease and fails to thrive. On examination of the (b) The pressure in the atrium rises heart, it was revealed that the aorta arouse from (c) The atrioventricular valves remain unchanged the right ventricle and the pulmonary trunk arouse (d) The atrioventricular valves close from the left ventricle. What is the name given to 42. You are LEAST LIKELY to see hyper plastic this type of cardiac malformation? arteriolar sclerosis as a result of (a) Transposition of the great vessels (a) Hemolytic-uremic syndrome from E. coli (b) Ventricular septal defect (VSD) (b) Malignant hypertension (c) Atrial-septal defect (ASD) (c) Scleroderma (d) Tetralogy of Fallot (d) Severe diabetes 50. If you increased the left atrial pressure from 5 43. The myocardial hypertrophy seen in patients mmHg to 15 mmHg, what effect would that have on with aortic stenosis, which is often extreme pulmonary circulation? but which usually allows the heart to empty (a) It would force blood the opposite direction. adequately, is considered an example of: (b) It would increase the speed at which blood moves through the pulmonary circulation. (a) Concentric hypertrophy (c) No change. (b) Eccentric hypertrophy (d) Blood flow would almost or completely stop. (c) Egocentric hypertrophy 51. Which of the following known as pulse regulation (d) Hypertrophic cardiomyopathy center? (a) SA Node (b) Bundle of His 44. Which of the following blood vessels link the (c) Purkinje fibers (d) AV Node artery and vein? 52. Which of the following is NOT a portion of the (a) Coronary artery (b) Aorta peritoneum? (c) Capillaries (d) Arterioles (a) Mesocolon (b) Mesentery (c) Hiatus (d) Greater omentum 45. Mitral valve is found 53. Heart is situated in? (a) B/w a left atrium & ventricle in the heart (a) Cranial (b) Pelvic (b) Between oesophagus & stomach (c) Abdominal (d) Thoracic 54. The right atrioventricular valve in the heart is (c) B/w right atrium & ventricle in the heart (a) Bicuspid valve (b) Monocuspid valve (d) Between stomach & small intestine (c) Tetracuspid valve (d) Tricuspid valve 46. What's the common cardiac malformation in ANSWER KEY fetal alcohol syndrome? 1. [b] 2. [c] 3. [a] 4. [d] 5. [d] (a) Chiari meshwork 6. [d] 7. [c] 8. [c] 9. [b] 10. [d] (b) Ebstein's anomaly 11. [a] 12. [d] 13. [b] 14. [a] 15. [b] (c) Patent ductus arteriosus 16. [d] 17. [d] 18. [b] 19. [d] 20. [c] 21. [d] 22. [b] 23. [d] 24. [c] 25. [a] (d) Ventricular septal defect 26. [c] 27. [c] 28. [a] 29. [d] 30. [a] 47. A very widely patent foramen ovale, causing 31. [a] 32. [b] 33. [c] 34. [d] 35. [d] an atrial septal defect, is described as 36. [c] 37. [a] 38. [c] 39. [d] 40. [a] (a) Lutembacher's syndrome 41. [d] 42. [d] 43. [d] 44. [c] 45. [a] (b) Ostium primum defect 46. [b] 47. [c] 48. [b] 49. [a] 50. [d] (c) Ostium secundum defect 51. [d] 52. [c] 53. [d] 54. [d] (d) Roger's disease -:: 9 ::- MEDICAL SURGICAL NURSING 4. It is essential for the nurse to ask the patient BLOOD PRESSURE & HYPERTENSION about any allergy to iodine or which of the 1. Which of the following is the correct time for assess following other substance before the cardiac the diastolic blood pressure reading? catheterization? (a) When the loud knocking sounds become muffled (a) Eggs (b) When the whooshing sound becomes loud (b) Morphine (c) When the swishing sound becomes faint (d) When the last loud knocking sound is heard (c) Shellfish 2. Which of the following finding suggests (d) Aminophenol hypertension? 5. Which of the following position the nurse must (a) Unexplained nosebleeds and Dizziness keep the affected leg after the cardiac (b) Heart palpitations catheterization through the femoral artery? (c) Frequency of urination (d) Hypoxia and noisy respiration (a) Flexed (b) Abducted 3. Which of the following finding is the best indication (c) Extended (d) Adducted for sustained Hypertension? 6. What should the nurse do first in recovery (a) The patient has a strong SA heart sound room after the femoral artery has been (b) The patient has an arrhythmia (c) The patient's heart is moderately enlarged. cannulised for cardiac catheterization? (d) The patient's heart rate is 80 beats/minute. (a) Observe for cyanosis 4. The patient after a severe road accident becomes (b) Auscultated the patient's heart and breathe pulseless. The nurse gets no response from patient, and activates the emergency medical response sounds. system. Which nursing action becomes the next (c) Inspect the skin integrity in the patient's groin. priority? (d) Palpate the patient's distal peripheral pulses. (a) Administer a single blow to the sternum. 7. Which of the following assessment finding of (b) Give two quick breaths that make the chest visibly rise. patient should be reported immediately to the (c) Begin chest compressions. physician after the percutaneous transluminal (d) Administer an epinephrine (Adrenalin) injection. coronary angioplasty (PTCA) procedure? (a) Urine output of 40 mL/hour ANSWER KEY (b) Chest pain 1. [b] 2. [b] 3. [c] 4. [c] (c) Blood pressure of 106/66 mm Hg (d) Dry mouth 8. which of the following is the most common CORONARY ARTERY DISEASE (CAD) blood vessel used in CABG surgery? & CARDIAC CATHETERIZATION (a) The iliac artery (b) The Sephanous vein 1. Which of the following patient is at risk for developing Coronary Artery Disease? (c) The popliteal vein (a) Weighing above normal (d) The femoral artery (b) Rheumatic fever during childhood 9. Which of the following not true for assessing (c) History of mitral valve repair the Patient's pulse rate accurately? (d) Drinking hot soup 2. Which of the following diet is suitable for a patient (a) Places a thumb over the radial artery. with cardiovascular disease except? (b) Rests the patient's arm on the abdomen. (a) Whole milk with oatmeal (c) Counts the pulse rate for a full minute. (b) Tuna fish with a small apple (d) Presses the radial artery against the bone. (c) Garden salad with olive oil 10. After the CABG surgery, which of the following (d) Soluble fiber cereal with skim milk assessment provides the best evidence that 3. Which of the following statement correct about cardiac catheterization? circulation at the donor graft site is adequate? (a) Patient will be anesthetized and will not feel any (a) The patient moves the operative leg easily. discomfort." (b) The patient's heart rate remains regular. (b) Patient will feel a heavy sensation all over his body." (c) The patient is free from chest pain. (c) Patient will be able to hear his heart beating in his chest.” (d) The patient's toes are warm and non- (d) Patient feel a warm sensation as the dye is instilled” oedematous. -:: 10 ::- MEDICAL SURGICAL NURSING 11. After a cardiac catheterization an adult MYOCARDIAL INFRACTION & patient complains of numbness and pain in the ANGINA PECTORIS left foot. What action should the nurse take first? 1. Which of the following health problem the (a) Take the patient's blood pressure, nurses identify as the priority? (b) Check the patients Apical pulses. (a) Abdominal pain (c) Call the health care provider. (b) Fractured femur (d) Check the patients pedal pulses (c) Ventricular fibrillation 12. What response should the nurse consider the (d) Head injury priority when assessing cardiac catheterized 2. A patient who has angina pectoris, the chest patient? pain is best relieved by which of the following (a) Hematoma formation nursing measure? (a) Rubbing the chest (b) Acute pain (b) Resting in a chair (c) Impaired swallowing (c) Applying heat pad on chest (d) Immobilized the affected leg (d) Taking a deep breath 13. What is the primary cause of the pain 3. Which blood level will increase first if a patient experienced by a patient with a coronary has had a myocardial infarction? blockage? (a) ALT (a) Blocking of the Coronary artery (b) Total LDH (b) Heart muscle ischemia (c) AST (c) Arterial spasm (d) Troponin T (d) Both A and B 4. Which of the following complications asses by 14. Which of the following infection can cause risk nurse during care of a patient with myocardial for Endocarditis? infarction has pulse and respiration rate are (a) Beta-haemolytic Streptococcal infection increasing and B.P.is decreasing? (b) Gonococcus infection (a) Cardiogenic shock (c) E. coli (b) Anaphylactic shock (d) Arbo virus infection (c) Pulmonary embolism 15. Which of the following is a physiologic effect of (d) Cardiac tamponade nicotine? 5. A patient with severe chest pain is evaluated (a) Constriction of the superficial vessels dilates and a tentative diagnosis of myocardial the deep vessels. infarction. Which of the following assessment (b) Constriction of the peripheral vessels finding is most closely correlated with increases the force of flow. myocardial infarction? (c) Dilation of the peripheral vessels causes reflex (a) Profuse sweating constriction of visceral vessels. (b) Severe headache (d) Dilation of the superficial vessels causes (c) Coughing up pink-tinged mucus constriction of collateral circulation. (d) Flushing the face 6. Which of the following classical signs should ANSWER KEY the nurse assess when a patient developing 1. [a] 2. [a] 3. [d] 4. [c] 5. [c] cardiogenic shock? 6. [d] 7. [b] 8. [b] 9. [a] 10. [d] (a) Decrease pulse rate 11. [d] 12. [a] 13. [d] 14. [a] 15. [b] (b) Ventricular dysrhythmias (c) Falling central venous pressure (d) Increase diastolic blood pressure 7. The chest pain of myocardial infarction (MI), radiates to which area? (a) Groin (b) Shoulder (c) Abdomen (d) Flank -:: 11 ::- MEDICAL SURGICAL NURSING 8. Which of the following is a common 14. The nurse is reviewing an electrocardiogram complication of myocardial infarction? rhythm strip. The P waves and QRS complexes (a) Anaphylactic shock are regular. The PR interval is 0.14 second, and (b) Hypokalemia QRS complexes measure 0.08 second. The (c) Cardiac enlargement heart rate is 68 beats/min. Which of the (d) Dysrhythmias following would be a correct interpretation 9. A patient complains that the angina pain is based on these characteristics? severe and prolonged induced by exercise and (a) Normal sinus rhythm relieved by rest How would the nurse describe (b) Sick sinus syndrome this type of pain? (c) Sinus bradycardia (a) Variant angina (d) First-degree heart block (b) Non-Anginal pain 15. The client complains of having acute pain in (c) Unstable angina the incisional area. The nurse would expect (d) Stable angina the pain to have which possible effect on the 10. Which of the following description of chest vital signs? pain is most characteristic of myocardial (a) Temperature may be elevated infarction? (b) Pulse rate may become rapid (a) “The pain has remained continuous." (c) Respiratory rate may slow. (b) “The pain came on slowly." (d) Blood pressure may fall. (c) “The pain comes and goes.” 16. A client with a dysrhythmia is admitted to (d) “The pain is tingling in nature.” hospital for observation. In the morning the 11. Which of the following prescribed medication client asks for a cup of coffee. What is the nurse’s would be most helpful for myocardial best response? infarction pain? (a) "Hot drinks such as coffee are not good for your (a) A non-salicylate such as acetaminophen heart." (b) A non-steroidal anti-inflammatory drug such (b) "Coffee is not permitted on the diet that was as ibuprofen ordered for you." (c) A salicylate such as aspirin (c) "You cannot have coffee. I can bring you a cup of (d) An Opioid such as morphine sulphate tea if you like." 12. Which of the following laboratory results to be (d) "Coffee has caffeine that can affect your heart. It elevated if the patient had a myocardial should be avoided" infarction? ANSWER KEY (a) Isoenzymes and troponin 1. [c] 2. [b] 3. [d] 4. [a] 5. [a] 6. [b] 7. [b] 8. [d] 9. [d] 10. [a] (b) RBC and WBC 11. [d] 12. [a] 13. [b] 14. [a] 15. [b] (c) Sodium and potassium 16. [d] (d) Plasminogen 13. When a client develops ventricular fibrillation in a coronary care unit, what is the responsibility of the first person reaching the client? (a) Administer oxygen. (b) Initiate defibrillation. (c) Initiate cardiopulmonary resuscitation. (d) Administer sodium bicarbonate intravenously. -:: 12 ::- MEDICAL SURGICAL NURSING 8. Which of the following technique is most HEART FAILURE & CPR & ECG appropriate for the nurse to use to open the 1. Which of the following priority nursing action if a airway of a victim who is not breathing? patient had heart failure? (a) Jaw thrush maneuver. (a) Collect the health history from patient. (b) Head tilt and Lift the chin. (b) Collect the patient's blood specimen for (c) Abdominal thrust electrolytes. (d) Clear the mouth. (c) Assess the patient's heart and lung sounds. 9. Which of the following is the best method for (d) Monitor the patient's temperature. determining if the victim requires rescue 2. A patient's ECG shows atrial and ventricular rates breathing? of 110 beats/min. The PR interval is 0.16 second, (a) Feel for pulsations at the neck. the QRS complex measures 0.06 second, and the (b) Observe the victim's skin color. PP and RR intervals are regular. How should the (c) Check for absence of normal breathing. nurse correctly interpret this rhythm? (d) Blow air into the victim's mouth. (a) Sinus tachycardia (b) Sinus bradycardia 10. Which of the following technique the nurse (c) Normal sinus rhythm (d) Sinus dysrhythmias deliver an effective volume of air into the lungs 3. Which of the following electrocardiogram (ECG) of a victim who is not breathing? changes occur in myocardial infarction? (a) Remove the victim's dentures. (a) Elevated ST segment (b) Press on the victim's trachea. (b) Inverted P wave (c) Pinch the victim's nose shut. (c) Widened QRS complex (d) Ventilate with Ambu bag. (d) Prolonged PR interval 11. The nurse assesses the client, who is unresponsive 4. Which of the following ECG change to be assessed and pulse less. Then nurse call for help then the on cardiac monitor during care of a patient with nurse begins chest compressions. Where is the a bundle branch block? correct placement for the nurse's hands before (a) Widening of QRS complexes to a minimum of administering cardiac compressions? (a) Over the costal cartilage 0.12 second (b) Below the tip of the xiphoid process (b) Absence of P wave configurations (c) Directly above the Manubrium (c) Sagging ST segments (d) On the lower half of the sternum (d) Inverted T waves following each QRS complex 12. During cardiopulmonary resuscitation, the nurse 5. A patient is on a continuous cardiac monitor, compresses the chest of an adult victim at which which begins to sound its alarm and there is no rate? electrocardiographic complexes on the monitor. (a) Average 60 compressions per minute Which of the following should be the priority (b) Average 80 compressions per minute action of the nurse? (c) Average 40 compressions per minute (a) Call the physician. (d) Average 100 compressions per minute (b) Check the patient status and lead placement. 13. A patient is found unconscious, pulse less and (c) Call a code blue. unresponsive. What should the nurse do first? (a) Check for a radial pulse. (d) Give oxygen inhalation by mask (b) Initiate a code blue or call for help. 6. Which of the following breath sounds would the (c) Compress the lower sternum. nurse anticipate when auscultated a patient with (d) Give four full lung inflations. myocardial infarction shows signs of pulmonary 14. When two rescuers perform CPR on an adult, what edema? is the ratio of compressions to ventilations? (a) Crackles (a) 30 compressions to 2 breaths (b) 15 compression to 1 breath (b) Stridor (c) 10 compressions to 1 breath (c) Rales (d) 1 compression to 5 breaths (d) Diminished breath sounds 15. Which of the following finding best indicates that 7. What is the most effective method for restoring cardiac compressions can be stopped? circulation in a pulse less victim? (a) The pupils become dilated (a) Keeping the airway open (b) The victim's color improves (b) Performing chest compressions (c) A pulse can be palpated (c) Using an automated external defibrillator (AED) (d) The victim begins to talking (d) Give oxygen inhalation -:: 13 ::- MEDICAL SURGICAL NURSING 16. Which of the following body position is most 25. Which of the following highest priority to the correct after the successfully resuscitated to the nurse while caring a patient with cardio version? patient? (a) Assess the Status of airway (b) Oxygen inhalation to the patient (a) Flat with the knees extended (c) Assess patient for Blood pressure (b) On the side upper knee flexed (d) Level of consciousness (c) Prone with the head lowered 26. Which of the following finding indicates that the (d) Supine with the head elevated cardio version procedure has been successful? 17. What should the nurse do to best reduce ankles (a) The pulse pressure is approximately 40 mm Hg. edema? (b) Patient body temperature will 98 degree (a) Apply elastic bandages. Fahrenheit. (b) Elevate the legs. (c) The apical heart rate equals the radial rate. (c) Restrict fluids. (d) Normal sinus cardiac rhythm is restored. (d) Elevate the head end of bed. 27. Where the permanent pacemaker battery has 18. Which of the following is the earliest symptom of been implanted? left sided heart failure? (a) Below the right clavicle (a) Nausea (b) Headaches (b) Near the brachial artery (c) Loss of appetite (d) Dyspnea (c) In the fifth intercostals area 19. Which of the following changes responsible for (d) In the midstream area the pitting edema of a patient with right sided 28. Which of the following manifestation will be heart failure:- present in a patient with chronic cardiac (a) Decrease in the plasma colloid osmotic pressure diseases? (b) Increase in tissue colloid osmotic pressure (a) Beau symptoms (b) Barrel-shaped chest (c) Increase in plasma hydrostatic pressure (c) Clubbed fingertips (d) Chest pain (d) None of them 29. Which of the following assessment finding is 20. Which of the following position is most beneficial related to the patient with reduced cardiac for the patient with congestive heart failure? stroke volume? (a) Side-lying on the right side (a) The patient has a bounding pulse. (b) Supine with knees flexed inside (b) The patient manifests Cyanosis (c) Left lateral position (c) The patient develops hypertension. (d) Semi-Fowler's position (d) The patient faints with activity. 21. Which emotional response is related to the 30. A client has edema in the lower extremities development of heart failure? during the day, which disappears at night. With (a) Anger (b) Euphoria which medical problem does the nurse conclude (c) Depression (d) Anxiety this clinical finding is consistent? 22. Which of the following assessment finding is the (a) Pulmonary edema best indication that oxygen therapy is effective (b) Myocardial infarction in Congestive Heart Failure patient? (c) Right ventricular heart failure (a) The apical pulse is less bounding. (d) Chronic obstructive lung disease (b) Capillary refill is 5 seconds. (c) The patient's face is flushed ANSWER KEY (d) Patient feels better 1. [c] 2. [a] 3. [a] 4. [a] 5. [b] 23. Which of the following value should be 6. [a] 7. [c] 8. [b] 9. [c] 10. [d] monitored if the patient receiving large doses of 11. [d] 12. [d] 13. [c] 14. [a] 15. [c] diuretics? 16. [b] 17. [b] 18. [d] 19. [c] 20. [d] (a) Chloride level is 98 mEq/L 21. [d] 22. [d] 23. [b] 24. [a] 25. [a] (b) Potassium level is 2.5 mEq/L 26. [d] 27. [a] 28. [c] 29. [d] 30. [c] (c) Sodium level is 139 mEq/L (d) Bicarbonate level is 26 mEq/L 24. Which of the following assessment would support the possibility of right-sided heart failure? (a) Jugular vein distention (b) Flushed, red face (c) Dry, hacking cough (d) Bradycardia -:: 14 ::- MEDICAL SURGICAL NURSING NERVOUS SYSTEM 10. The junction at which an impulse travels from one neuron to another is called? 1. Factors influencing inhibition of growth and (a) Synapse (b) Stimulus destruction of microorganisms include? (c) Nerve message (d) Axon I. Temperature and contact 11. The total volume of CSF is? II. Absence of organic material (a) 50 ml (b) 100 ml III. Time (c) 150 ml (d) 275 ml IV. Spore formation 12. All are motor nerve except? (a) II, III and IV (b) I, II and IV (a) Accessory (b) Abducent (c) I, III and IV (d) I, II and III (c) Trochlear (d) Trigeminal 2. What is the correct order from outer side to 13. The central nervous system consists of? inner side of blood vessels? (a) The brain and spinal cord (a) T. adventitia, T. media and T. intima (b) Spinal nerves only (b) T. adventitia, T. intima & T. media (c) The brain stem and cerebellum (c) T. media, T. adventitia & T. intima (d) The cerebellum and the spinal column (d) Tunica intima, T. media & T. adventitia 14. The 10th cranial nerve is: 3. The autonomic nervous system regulates (a) Hypoglossal (b) Abdu cent visceral activities such as? (c) Vagus (d) Facial (a) Respiration 15. The middle layer of meninges is: (b) Contraction of smooth muscles (a) Choroid Plexus (b) Dura mater (c) Gastrointestinal motility (c) Piamater (d) Arachnoids mater (d) All the Above 16. What is the outer most layer of blood vessels? 4. Which part of the brain is concerned with (a) Tunica media (b) Tunica mucosa hearing, short term memory and sense of (c) Tunica intima (d) Tunica adventitia smell? 17. The micturition reflex center is located in the (a) Temporal lobe (b) Parietal lobe (a) Sacral plexus (b) Midbrain (c) Cerebellum (d) Hypothalamus (c) Lumbar plexus (d) Pons 5. Hypoglossal nerve is 18. Part of brain that helps in maintaining posture (a) 6th cranial nerve and equilibrium is: (b) 7th cranial nerve (a) Medulla (b) Cerebellum (c) 12th cranial nerve (c) Cerebrum (d) Thalamus (d) 9th cranial nerve 19. Neurons that release acetylcholine are refer 6. One of the functions of cerebellum is to: as: (a) Serve as a passage between spinal cord and (a) Adrenergic (b) Cholinergic brain (c) Dopaminergic (d) None of the Above (b) Maintain balance, coordination and muscular 20. Which nerve form an important part of the control parasympathetic nervous system? (c) Conduct nerve impulse (a) Facial nerve (b) Trigeminal nerve (d) Maintain area of reason, thought, memory (c) Abducent nerve (d) Vagus nerve and sensation 21. The paralysis of both upper and lower 7. Anterior 2/3 of the tongue carries taste extremities is known as? sensation with the help of (a) Quadriplegia (b) Hemiplegic (a) Glossopharyngeal (b) Vagus (c) Paraplegia (d) Monoplegia (c) Hypoglossal (d) Facial 22. 7th cranial nerve is? 8. Muscle of tongue is mainly supplied - (a) Facial (b) Oculomotor (a) IX CN. (b) X CN. (c) Glossopharyngeal (d) Abducent (c) XI CN. (d) XII CN. 23. Circle of Willis is related with circulation of 9. The neurotransmitter serotonin is derived (a) Heart (b) Brain from which precursor amino acid? (c) Kidney (d) Liver (a) Dopamine 24. Which of the following extraocular muscles is (b) Tryptophan not supplied by third cranial nerve? (c) Tyrosine (a) Superior oblique (b) Inferior oblique (d) Glutamine (c) Superior rectus (d) Inferior rectus -:: 15 ::- MEDICAL SURGICAL NURSING 25. Wrist drop is caused by all except 38. Deep tendon reflex is exaggerated in lesion? (a) Lead poisoning (a) Upper motor neuron (b) Radial nerve palsy (b) Lower motor neuron (c) Ulnar nerve palsy (c) Peripheral nerve injury (d) Both A and B (d) None of the Above 26. Neurotransmitters 39. Which of the Following are the examples of (a) Are electrical impulse mixed cranial nerves except? (b) Are found only in neuron with myelin sheath (a) Hypoglossal nerve (c) Are signal molecules released at synapse (b) Facial nerve (d) Are produced by muscles (c) Vagus nerve 27. Which of the following is the largest cranial (d) Trigeminal nerve nerve? 40. In Parkinsonism, the lesion is due to (a) Vagus nerve (b) Optic nerve (a) Lateral thalamus (b) Substantia nigra (c) Facial nerve (d) Trigeminal nerve (c) Caudate nucleus (d) Sub thalamic nucleus 28. Reflex are functions at the level of 41. Treatment of acute anterior uveitis includes (a) Cerebellum (b) Cerebral hemispheres (a) Topical steroids (b) Cycloplegic (c) Medulla (d) Spinal cord (c) Both (d) None 29. Erb's palsy effects 42. Which nerve supplies the diaphragm? (a) Lumbar plexus (a) Radial (b) Peroneal (b) Sacral plexus (c) Phrenic (d) Intercostal (c) Brachial plexus 43. Damage to Nerve of bell results in (d) Cranial nerves (a) CTEV (b) Winging of the scapula 30. Which cranial nerve carries sensation of smell? (c) Claw hand (d) Policeman's tip hand (a) Optic nerve (b) Vagus nerve 44. What is the Total number of cervical nerves? (c) Facial nerve (d) Olfactory nerve (a) 7 (b) 5 31. Vagus is which cranial nerve? (c) 12 (d) 8 (a) X (b) IX 45. Which of the following is the largest nerve in (c) VII (d) V the body, 32. The endocrine system is quicker than the (a) Pudendal (b) Peroneal nervous system (c) Sciatic (d) Tibial (a) True (b) False 46. The space between arachnoid & pia matter is (c) May be true (d) Don't know called 33. Treatment of aphakia is (a) Epidural (b) Subdural (a) Spectacles (b) Intraocular lens (c) Subarachnoid (d) Extradural (c) Contact lens (d) All of the Above 47. The relay center of brain is 34. Which of the following is a carbonic anhydrase (a) Medulla (b) Pons inhibitor (c) Brain stem (d) Thalamus (a) Mannitol (b) Acetazolamide 48. Neurotransmitter involved in pain relief is: (c) Pilocarpine (d) Latanoprost (a) Acetylcholine (b) Norepinephrine 35. Which extrinsic muscle of the eye is not (c) Serotonin (d) Endorphins supplied by Oculomotor Nerves? 49. the most common inhibitory (a) Superior rectus neurotransmitter in the human brain is: (a) (b) Superior oblique muscles Acetylcholine (b) Serotonin (c) Inferior rectus (c) GABA (d) Dopamine (d) Medial rectus 50. Thick band of neurons that connects the right 36. Lateral rectus supplied by and left cerebral hemispheres is: (a) Trochlear nerve (a) Corpus callosum (b) Hippocampus (b) Abducent nerve (c) Fornix (d) Amygdala (c) Oculomotor nerve 51. The fat-covered membrane protecting the SI (d) Trigeminal nerve and LI anteriorly is 37. All are seen in 3rd nerve palsy except (a) Meninges (b) Pleura (a) Ptosis (b) Diplopia (c) Peritoneum (d) Mesentery (c) Meiosis (d) Outwards eye deviation -:: 16 ::- MEDICAL SURGICAL NURSING 52. What is the Total number of cranial nerves? 64. Which is related to maintenance of body (a) 7 pairs (b) 31 pairs balance? (c) 12 pairs (d) 33 pairs (a) Cerebrum (b) Medulla oblongata 53. The area of the brain which is involved in the (c) Pons (d) Cerebellum understanding of meaning is: 65. What is the Total number of spinal nerves? (a) Broca's area (b) Association areas (a) 12 pairs (b) 33 pairs (c) Wernicke's area (d) Motor speech area (c) 7 pairs (d) 31pairs 54. Which of these vessels does not have 66. Which of the following supplies the muscles of sympathetic control the perineum? (a) Cerebral (b) Splanchnic (a) Pudendal nerve (b) Sciatic nerve (c) Cardiac (d) Cutaneous (c) Femoral nerve (d) Tibial nerve 55. Which of the following is NOT an effector of 67. Which of the following eye muscles rotates the respiration? eye downward and away from midline? (a) Heart (b) Diaphragm (a) Inferior oblique (b) Superior oblique (c) Intercostals (d) Trapezius. (c) Inferior rectus (d) Superior rectus 56. An area of neurons running through the 68. Which of the following eye muscles rotates the middle of the medulla and pons, and is eye upward and toward midline? responsible for keeping people alert and (a) Inferior oblique (b) Superior oblique aroused as well selective attention to certain (c) Inferior rectus (d) Superior rectus information: 69. Olfactory nerve is: (a) Cerebellum (b) Hypothalamus (a) Both Sensory and Motor (c) Limbic system (d) Reticular system (b) Purely Sensory 57. Loss of sense of smell is known as: (c) Mainly Motor (a) Agnosia (b) Aphasia (d) None of the Above (c) Apraxia (d) Anosmia 70. Damage to cranial nerve results in inability to 58. Which of the following is a specific shrug and weak head movement. investigation to detect seizures? (a) Vagus nerve (a) CT scan (b) MRI scan (b) Accessory nerve (c) EEG (d) BEAP (c) Glossopharyngeal nerve 59. Which of the following pairs is INCORRECT (d) Facial nerve concerning central nervous systems and a 71. Fourth cranial nerve is: factor they respond to by affecting (a) Trigeminal (b) Abducent respiration? (c) Trochlear (d) Facial (a) Cerebellum: Mechanoreceptor input 72. A cranial nerve with maximum branches in the (b) Limbic system: emotional states body is: (c) Cerebral cortex: voluntary control (a) Trigeminal (b) Auditory (d) Cerebral motor cortex: exercise (c) Facial (d) Vagus 60. The part of the neuron that receive messages 73. What is Acalculia? from other cells is called: (a) Inability to do mathematical calculations (a) Axon (b) Soma (b) Inability to recognize sensory input (c) Schwann cell (d) Dendrites (c) Visual aphasia 61. Which sensory area is found in Temporo (d) Inequality in size of the pupils Parietal lobe of cerebrum? 74. What instruction is most appropriate in (a) Olfactory (b) Auditory patient with trigeminal neuralgia to prevent (c) Speech (d) All of the Above triggering the pain? 62. Which of the following is the largest part of brain? (a) Drink iced foods (a) Cerebellum (b) Midbrain (b) Avoid oral hygiene (c) Medulla oblongata (d) Cerebrum (c) Apply warm compresses 63. Brain stem is formed by: (d) Chew on the unaffected side (a) Pons 75. The cranial nerve which innervates superior (b) Midbrain oblique muscle is: (c) Medulla oblongata (a) Optic (b) Trochlear (d) All of the Above (c) Facial (d) Abducent nerve -:: 17 ::- MEDICAL SURGICAL NURSING 76. Wernicke's area found in temporal lobe, also 85. Brain stem is formed by except known as (a) Midbrain (a) Sensory taste visual area (b) Cerebellum (b) Sensory taste area (c) Pons (c) Sensory olfactory area (d) Medulla oblongata (d) Sensory speech area 86. Which is the largest part of brain 77. The receptors with which norepinephrine, (a) Cerebellum epinephrine, or other adrenomimetic drugs (b) Spinal cord combine are called: (c) Medulla oblongata (a) Cholinergic receptors (d) Cerebrum (b) Adrenoreceptors 87. The auditory sensory area of cerebral cortex is (c) Nicotinic receptors found in (d) None of the Above (a) Frontal lobe 78. The nerves which take impulses away from the (b) Occipital lobe brain towards affected organ is known as (c) Parietal lobe (a) Sensory nerves (b) Neurones (d) Temporal lobe (c) Mixed nerves (d) Motor nerves 88. The olfactory area of cerebral cortex is found 79. Nodes of Ranvier are found in in (a) Axon (a) Frontal lobe (b) Dendrites (b) Parietal lobe (c) Cell body (c) Temporal lobe (d) Microglia (d) Occipital 80. What is the place where the nerve impulse 89. The visual area is found in passes from one neuron to another is known (a) Occipital lobe as (b) Temporal lobe (a) Myelin sheath (c) Parietal lobe (b) Node of Ranvier (d) Frontal lobe (c) Synapse (d) Neuroglia ANSWER KEY 81. Arrange the correct order from outer to inner 1. [d] 2. [a] 3. [d] 4. [a] 5. [c] side of meninges? 6. [b] 7. [d] 8. [d] 9. [b] 10. [a] (a) Duramater - arachnoidmater - Piamater 11. [c] 12. [d] 13. [a] 14. [c] 15. [d] (b) Duramater - Piamater - arachnoidmater (c) Pericardium - myocardium - endocardium 16. [d] 17. [d] 18. [b] 19. [b] 20. [d] (d) Piamater - arachnoidmater - Duramater 21. [a] 22. [a] 23. [b] 24. [a] 25. [c] 82. What is the Total volume of CSF secreted in 24 26. [c] 27. [d] 28. [d] 29. [c] 30. [d] hours? 31. [a] 32. [b] 33. [d] 34. [b] 35. [b] (a) 500 ml 36. [b] 37. [c] 38. [a] 39. [a] 40. [b] (b) 200 ml (c) 1200 ml 41. [c] 42. [c] 43. [b] 44. [d] 45. [c] (d) 2000 ml 46. [c] 47. [d] 48. [d] 49. [c] 50. [a] 83. Which of the following part of brain which 51. [c] 52. [c] 53. [c] 54. [a] 55. [d] plays an important role in maintaining CSF 56. [d] 57. [d] 58. [c] 59. [a] 60. [d] pressure? 61. [d] 62. [d] 63. [d] 64. [d] 65. [d] (a) Arachnoid Villi (b) Flax cerebra 66. [a] 67. [b] 68. [d] 69. [b] 70. [b] (c) Septum Lucidum 71. [c] 72. [d] 73. [a] 74. [d] 75. [b] (d) Piamater Villi 76. [d] 77. [b] 78. [d] 79. [a] 80. [c] 84. CSF is found in 81. [a] 82. [a] 83. [a] 84. [a] 85. [b] (a) Subarachnoid space 86. [d] 87. [d] 88. [c] 89. [a] (b) Subdural space (c) Epidural space (d) All -:: 18 ::- MEDICAL SURGICAL NURSING 3. What should be avoided a patient with MENINGITIS multiple sclerosis? 1. Which of the following clinical symptoms are (a) Rainy season (b) Hot weather relevant with meningitis? (c) Dry environments (d) Cold temperatures (a) Photophobia (b) A stiff neck 4. When preparing the patient for an EEG, which (c) Fever (d) All of the Above nursing action is most appropriate? 2. Which of the following clinical manifestation (a) Assist with shampooing the patient's hair. of meningitis? (b) NBM patient before procedure (a) A positive Kerning sign (c) Administer a sedative before the test. (b) Presence of nuchal rigidity (d) Take the patient's blood pressure while lying (c) A positive Brudzinski's sign and sitting (d) All of the above 5. If the patient begins to have a seizure, which action should the nurse take first? ANSWER KEY (a) Place the patient in a side-lying position. 1. [d] 2. [d] (b) Measure the blood pressure and pulse. (c) Check the patient's pupils. (d) Administer oxygen by nasal Cannula. LUMBAR PUNCTURE 6. Which of the following is a priority action, 1. Which of the following intervention is most when assessing the patient with a head injury? important after the lumbar puncture? (a) Pupillary responses (a) Keep the patient flat for several hours. (b) Clarity of speech (b) Assist the patient into a sitting position. (c) Mobility of fingers (c) Withhold food and fluids for 1 hour. (d) Inability to swallow (d) Keep the patient in a side-lying position. 7. Which finding should be reported to the 2. Which of the following assessment indicates physician immediately when assessing a patient has spinal shock? patient with head injury? (a) Flaccid paralysis (a) The patient headache (b) Positive gag reflexes (b) The patient leaves most of the food on the (c) Reflex emptying of the bowel dietary tray. (d) Hyperreflexia (c) Orientation related problem (d) The patient is difficult to arouse with ANSWER KEY stimulation. 1. [d] 2. [d] 8. Which of the following actions would be contraindicated if a patient experiencing seizure activity? SEIZURE (a) Positioning the patient to the side, if possible, with the head flexed forward 1. When a nurse documenting a seizure patient, (b) Loosening restrictive clothing which information is most important to (c) Removing the pillow and raising padded side include? rails (a) The time the seizure started (d) Restraining the patient's limbs (b) The patient previous emotion 9. What is the priority nursing action in the post (c) The duration of the seizure phase of a seizure? (d) The patient's comments after the seizure (a) Assess the patient's level of arousal. 2. Which of the following interventions are (b) Provide feeding to patient essential when a patient having a tonic-clonic (c) Reorient the patient to the surroundings.