NRSG265 Question Bank PDF

NRSG265 QUESTION BANK MODULE 1 -- 7 Q'S Which of the following risk factors can increase the risk of a person developing Type 2 diabetes? a. Having both parents and a maternal grandmother diagnosed with Type 2 DM (ANSWER) b. Consuming a diet high in sugar over 2 weeks c. Age over 30 year...

NRSG265 QUESTION BANK MODULE 1 -- 7 Q'S Which of the following risk factors can increase the risk of a person developing Type 2 diabetes? a. Having both parents and a maternal grandmother diagnosed with Type 2 DM (ANSWER) b. Consuming a diet high in sugar over 2 weeks c. Age over 30 years  d. BMI \< 25 All of the following contribute to an increased insulin resistance and decreased insulin production in Type 2 diabetes, EXCEPT: a. decreased insulin production in the pancreas b. hypertrophy of the beta cells in the Islet of Langerhans (RATIONALE: As Type 2 diabetes is a progressive disease, over time, this will cause destruction of beta cells and will reduce their overall numbers and ability to release insulin.) (ANSWER) c. a reduction in the number of insulin binding sites d. a decrease in the amount of insulin binding to the receptors Which of the following are considered first line treatment options for Type 2 diabetes?  a. Increasing physical activity. (RATIONALE: First line management options for Type 2 diabetes include exercise, healthy eating and monitoring BGL.) (ANSWER) b. Maintaining a sedentary lifestyle c. Commencing on SC insulin d. Commencing a high carbohydrate diet Which of the following are considered appropriate options as a fast-acting carbohydrate to manage a hypoglycaemic episode? a. Jelly beans (ANSWER) Or (POSSIBLE ANSWER) - Glucose tablets - Fruit juice - Sugary soft drink - Sugar The role of insulin includes all of the following, EXCEPT: a. Stimulates protein synthesis b. Stimulates gluconeogenesis (ANSWER) c. Inhibits liver production of glucose d.  Allows glucose uptake into the cells for ATP production The following can all cause hypoglycaemia, EXCEPT: a. Exercise  b. Consuming a pasta dish for lunch (ANSWER) c. Excess alcohol consumption d. Insulin overdose The clinical manifestations of Type 1 diabetes can include all of the following, EXCEPT: a. Abdominal pain b. Weight gain (ANSWER) c. Polyuria d. Blurred vision MODULE 2 -- 8 Q'S Ideally, how often should a person with diabetes have their HbA1C levels checked?  a. Every 6 months b. Once a year c. Every 3 months. (RATIONALE: This is set to assess long term control of diabetes. It forms irreversibly from glucose and haemoglobin and is used as a measure of the average blood glucose levels throughout the lifespan of red blood cells (120 days or 3 months) (ANSWER) d. Every month A person with poorly controlled diabetes has an increased risk of infection due to: a. an increase in glycated haemoglobin which enhances the release of oxygen to the tissues b. a hyperglycaemic environment which supports microbial growth (RATIONALE: the presence of a high glucose environment is excellent for sustaining microorganism growth) (ANSWER) c. impaired vision due to neuronal damage d. nerve damage which enhances the pain sensation The following are all possible signs and symptoms of diabetic peripheral neuropathy, EXCEPT: a. erectile dysfunction (ANSWER) b. increased pain sensation c. burning sensation within the soles of the feet d. numbness in the extremities All of the following are microvascular complication of diabetes EXCEPT? a. Nephropathy b. Myocardial Infarction (ANSWER) c. Retinopathy d. Peripheral Neuropathy Sulphonylureas are used in type 2 diabetes mellitus to lower blood glucose.  Which of the following is the PRIMARY action of this group of drugs? a. Increases in the rate of glucose absorption from the small intestine b. Increase in insulin production by the pancreas. (ANSWER) c. Increase in glucose uptake by muscle and fat cells. d. Decrease in C peptide levels Which one of the following is MOST likely to contribute to the development of cardiovascular disease in a person with type 2 diabetes mellitus? a. Decreased plasminogen activator inhibitor levels b.  Increased inflammatory state (ANSWER) c. Increased viscosity of blood d. The effect of elevated insulin levels on the vessel wall Advanced glycation end-products are produced in poorly controlled diabetes. This toxic metabolite will lead to all of the following, EXCEPT: a. Loss of nitric oxide b. Increased inflammatory state c. Reduced oxidative stress (ANSWER) d. Increased platelet aggregation The BEST indicator of a patient\'s current diabetes management is: a. a fasting glucose level b. a glycated haemoglobin level (ANSWER) c. analysis for microalbuminuria d. the patient's verbal report of their symptoms MODULE 3 -- 8 Q'S The following drug classes are considered PREVENTATIVE therapy for patients with asthma, EXCEPT: a. Leukotriene receptor antagonists b. short acting beta 2 agonists (ANSWER) c. long-acting beta 2 agonists d. inhaled corticosteroids A client with a history of COPD complains of increased shortness of breath and has wheezing noted upon auscultation. The client is administered a nebulizer treatment of salbutamol and ipratropium. Which evaluation would indicate a therapeutic response to this treatment? a. Decrease in heart rate b. Decrease in shortness of breath (ANSWER) c. Pink frothy sputum d. Increase in wheezing upon auscultation Possible complications of COPD include pulmonary hypertension and right-sided heart failure a. True (ANSWER) b. False Asthma is characterised by all of the following, EXCEPT: a. Reversible bronchoconstriction b. Audible crackles (ANSWER) c. Mucous hypersecretion d. Oedema of the airways COPD is characterised by the all of the following, EXCEPT: a. Destruction of lung parenchyma b. Gas trapping in the smaller airways c. Mucous hypersecretion d. Reduced airway resistance (ANSWER) Fluticasone belongs to which drug class: a. Leukotriene receptor antagonists b. Corticosteroids (ANSWER) c. Long acting ß2 adrenergic agonists d. Mast cell stabilisers Adverse effects of prednisolone can include: a. Tachycardia b. Nausea and increased blood glucose (ANSWER) c. Oral thrush d. Voice hoarseness and gastric ulcers Which of the following is NOT true about short acting ß2 adrenergic agonists? a. They begin to take effect within 5-15 minutes of being administered b. They are used as first line medications in the management of asthma for their anti-inflammatory effects (ANSWER) c. The adverse effects occur as a result of stimulation of ß1 adrenergic receptors d. Adverse effects can include tachycardia, palpitations and headaches MODULE 4 -- 5 Q'S Respiratory rate and depth are controlled by: a. pneumoreceptors and chemoreceptors in the medulla oblongata b. compliance of the alveoli c. degree of bronchoconstriction a.  apneustic and pneumotaxic centres in the pons (ANSWER) Why is monitoring respiratory status a nursing priority when a client with COPD is receiving oxygen? a. Sudden increase in arterial oxygen can precipitate diaphragmatic spasm. b. Hyperventilation leading to respiratory alkalosis and loss of consciousness is a risk. c. Decreased arterial oxygen is the stimulus for breathing in a client with COPD. (RATIONALE: Decreased oxygen in the blood is the stimulus for breathing in a client with COPD. Therefore, if oxygen is administered there is the risk that respiratory arrest will occur because high oxygen saturation levels in the blood eliminate the stimulus for breathing. This is a particular risk with the administration of 100% oxygen. The normal stimulus to breathe is an increase in CO2 in the blood but the client with COPD has become insensitive to CO2 because of long-term elevated levels associated with the COPD. Oxygen administration does not cause hyperventilation; nor does it precipitate diaphragmatic spasm or bronchospasm.) (ANSWER) d. Oxygen administration can trigger reflex bronchospasm Which of the following are NOT clinical manifestations of pneumonia? a. Purulent sputum b. Glucosuria (ANSWER) c. Dyspnoea d. Pleuritic Pain What is the most common cause of chronic obstructive pulmonary disease (COPD)? a. Bronchiectasis b. Pollution c. Tobacco smoking (ANSWER) d. Chronic bronchitis Which of the following are NOT usually considered in the prevention or treatment of pneumonia? a. Short acting beta 2 agonists (ANSWER) b. Physiotherapy c. Pneumococcal vaccination d. Antibiotics MODULE 5 -- 6 Q'S What is the mechanism of action of glyceryl trinitrate when given to manage angina?  a. The bi-product nitric oxide immediately increases heart rate b. The bi-product nitric oxide induces a calming sense of euphoria c. The bi-product nitric oxide activates the sympathetic nervous response d. The bi-product nitric oxide vasodilates coronary arteries (ANSWER) The nurse is reviewing the laboratory results of a client who is being observed for possible myocardial infarction. Which laboratory result would be most important for the nurse to discuss with the medical practitioner? a. Increased haemoglobin b.  Decreased creatine kinase c. increased troponin (ANSWER) d. High serum potassium A 56-year-old male is diagnosed with coronary artery disease. Which of the following modifiable risk factors would the nurse suggest the patient change? a. Following a ketogenic diet b. Reduce cigarette smoking (ANSWER) c. Drinking tomato juice d. Eating less meat The "sclerotic" component of the term atherosclerosis refers to: a. Dislodgment of plaque into the blood stream b. Stiffening of arterial vessel walls (ANSWER) c. Thrombus formation in the arterial lumen d. Foam cell accumulation in plaque Which antihypertensive drug group should be avoided when a person has a pre-existing respiratory condition such as asthma? a. Beta-blockers (ANSWER) b. Diuretics c. ACE inhibitors d. Calcium channel antagonists Beta-blockers are commonly used to manage hypertension. The following are all potential adverse effects of beta-blockers, EXCEPT:  a. Nightmares b. Hypotension c. Tachycardia (ANSWER) d. Bronchospasms MODULE 6 -- 6 Q'S What kind of electrical activity does an electrocardiogram (ECG) record? a. The flow of blood through the heart b. The mechanical contraction and relaxation of the atria and ventricles c. The depolarization and repolarization of the atria and ventricles d. The transmission of electrical impulses responsible for initiating depolarization of the atria and ventricles (ANSWER) Atrial fibrillation (AF) arises as a result of multiple electrical impulses firing from both atria, and not just the SA node a. True (ANSWER) b. False Ventricular fibrillation (VF) is a shockable rhythm a. True (ANSWER) b. False This condition is the result of disorganised, non-coordinated, electrical firing in heart. The condition must be taken seriously but is not generally immediately life threatening. What is it? a. Ventricular bradycardia b. Atrial tachycardia c. Ventricular fibrillation d. Atrial fibrillation (ANSWER) Patients at risk of forming atrial thromboembolisms might be given which of the following medications? a. Digoxin b. Apixaban (ANSWER) c. Beta-blocker d. Loop diuretic All of the following are characteristics of the ECG for atrial fibrillation, EXCEPT: a. Undulating baseline b. Sinus Rhythm (ANSWER) c. No p waves d. Irregularly irregular rhythm MODULE 7 -- 6 Q'S The normal glomerular filtration rate (GFR) is approximately: a. 300ml/min b. 25ml/min c. 125ml/min (ANSWER) d. 50ml/min Which of the following about the renin angiotensin aldosterone system (RAAS) system is **TRUE**? a. RAAS works actively to lower systemic blood pressure b. Angiotensin I is an active hormone in the blood c. Angiotensin II is activated directly by renin d. Renin is an enzyme released from the kidneys in response to a drop in blood pressure (ANSWER) All of the following increase serum creatinine **EXCEPT:**  a. renal impairment b. malnutrition (ANSWER) c. a diet high in meat d. dehydration Which of the following is **NOT** a function of the kidneys? Regulation of: a. extracellular volume b. plasma insulin concentration (ANSWER) c. arterial blood pressure d. sodium and potassium concentration Renal function tests include measurement of all the following **EXCEPT:** a. glucose levels (ANSWER) b. creatinine clearance c. blood urea nitrogen d. eGFR Impaired blood supply to the kidney may result in acute kidney injury (AKI) which causes: a. postrenal AKI b. perirenal AKI c. intrarenal AKI d. prerenal AKI (ANSWER) MODULE 8 -- 6 Q'S Frusemide (Lasix) inhibits the Na+Cl- K+ transporter in the: a. descending limb of the loop of Henle b. distal convoluted tubule c. ascending limb of the loop of Henle (ANSWER) d. proximal convoluted tubule Which of the following diets are suitable for a person with chronic kidney disease (CKD)? a. Low calorie/kilojoule; limited protein; low carbohydrate b. Limited protein; low carbohydrate; adequate calorie intake (ANSWER) c. Adequate calorie/kilojoule; high carbohydrate, limited protein d. High protein; high carbohydrate; low calorie/kilojoule A 27-year-old male has a severe kidney obstruction leading to removal of the affected kidney. Which of the following would the nurse expect to occur in the weeks following removal of the affected kidney? a.  Renal failure b.  Compensatory function of the remaining kidney (ANSWER) c. Atrophy of the remaining kidney d. Dysplasia in the remaining kidney In chronic kidney disease (CKD) metabolic acidosis occurs due to the kidneys' inability to excrete: a. urea and creatinine b. excess hydrogen ions (H+) and reabsorb bicarbonate (HCO3-) (ANSWER) c. sodium (Na+) and potassium (K+) d. bicarbonate (HCO3-) and reabsorb hydrogen ions (H+) What is the cause of the anaemia in a person with chronic kidney disease (CKD)? a. Red blood cells are destroyed by increased toxins in the blood. b. Inadequate absorption of iron from the gastrointestinal tract. c. Red blood cells are filtered by the kidneys causing low haemoglobin. d. Inadequate production of erythropoietin by the kidneys. (ANSWER) The most important nutrition goals for patients with chronic kidney disease (CKD) include: a. limit sodium intake b. limit potassium intake c. all of the choices are correct (ANSWER) d. reduce protein intake MODULE 9 -- 6 Q'S In haemorrhagic stroke the following medications are used   a. Low dose heparin, ACE inhibitors and diuretics b. Low dose heparin, aspirin and diuretics c. Thrombolytics, beta Blockers and diuretics d. ACE inhibitors, beta Blockers and diuretics (ANSWER) Which of the following is TRUE about ischaemic stroke? a. The damage that occurs is reversible b. Occurs after the rupture of a cerebral aneurysm c. It is caused by a vascular occlusion secondary to thromboembolic disease (ANSWER) d. It is caused by a vascular occlusion leading to haemorrhage into the brain parenchyma B.E.F.A.S.T. is a common acronym used to help determine if a patient has had a stroke. What does the acronym B. E.F.A.S.T stand for? a. Balance, Eyes, Face. Arrhythmia. Speech. Time b. Blood Pressure, Eyes, Face. Arms. Slurred. Time c. Blood Pressure, Eyes, Face. Arms. Speech. Thrombolytic therapy d. Balance, Eyes, Face. Arms. Speech. Time (ANSWER) Which of the following statements about seizures is INCORRECT? a. The two main types are focal onset and generalised onset b. Alcohol and drug use can trigger seizure activity c. A seizure occurs when abnormal electrical activity in the brain causes an involuntary change in body movement, sensation, awareness, or behaviour d. They are always preceded by an aura (ANSWER) Absence seizures are a type of focal onset seizure a. True b. False (RATIONALE: Absence seizures are generalised seizures, and causes a loss of consciousness which is sudden but transient) (ANSWER) All of the following are potentially causes of acquired brain injury (ABI), EXCEPT: a. Drugs and alcohol b. Parkinson's Disease c. Congenital cerebral palsy (ANSWER) d. Trauma ACUTE KIDNEY INJURY --12 Q'S True or False: Low urine output is potentially a sign of Acute Kidney Injury. a. True (ANSWER) b. False If the kidneys cannot filter out the H+ ions the blood\...\... a. Maintains its pH balance b. Becomes more alkalotic c. Becomes more acidic (ANSWER) Which of the following could be a cause of Acute Kidney Injury that would be classified as post-renal? a. Hypotension b. Prostate cancer (ANSWER) c. Nephrotoxic medications d. Tubular damage (necrosis) Which one of the following is a specific sign of metabolic acidosis? a. Distended jugular vein, bounding pulse, oedema and hypertension b. Headache, drowsiness, nausea, visual disturbances, stiff neck c. Respiratory systems compensates by increasing breathing rate and depth to remove carbon dioxide (CO2) (ANSWER) What is the most important Nursing assessment strategy for a patient with Acute Kidney Injury? a. Cardiac assessment b. Fluid assessment (ANSWER) c. Anxiety assessment d. Respiratory assessment True or False: You consider a diagnosis of acute kidney injury likely if your patient had a sudden drop in their urine output and a normal creatine level. A. True B. False (ANSWER) Yes or No: In determining the phase of Acute Kidney Injury. Patients in the failure stage have less than 0.3 mL/kg/hr x 24 hours. Your patient weighs 100kg and has had average of 24 mL/hr of urine output. Are they in the Failure stage of Acute Kidney Injury? a. Yes (ANSWER) b. No What is the reason creatine levels rise in Acute Kidney Injury? a. Acute Kidney Injury results in impaired kidney function and the kidneys are unable to clear the creatine from the blood effectively. (ANSWER) b. Acute Kidney Injury causes a release of creatine from the kidneys in response to the nephron damage. c. Acute Kidney Injury causes a breakdown in muscle mass where creatine is stored resulting in excess creatine released into the blood. Your patient with chronic heart failure has gone into Acute Kidney Injury (AKI), before diagnosis they were showing the signs of jugular vein distention and leg oedema. You therefore suspect the cause of the AKI is\... a. Nephrotoxicity b. Decreased peripheral vascular resistance c. Tubular damage d. Decreased cardiac output (ANSWER) Your patient has a urine output of \< 0.5 mL/Kg/hr for the past 12 hours plus an increase in the serum creatine level twice their baseline level. What stage of Acute Kidney Injury are they in? a. Injury (ANSWER) b. Failure c. Loss d. Risk Your patient with Acute Kidney Injury (AKI) secondary to post operative hypovolaemia has a treatment plan for a fluid bolus. Which of the following would be a correct scenario. a. Patient shows no signs of excess fluids in lungs/legs. Fluid bolus of 500 mL of Hartmanns to stabilise fluid volume. (ANSWER) b. Patient shows no signs of excess fluids in lungs/legs. Most likely fluid is 500 mL bolus of 0.9% NaCl with Potassium to stabilise fluid volume and likely hypokalaemia. c. Patient has a BP of 92/56, signs of leg oedema. Fluid bolus of 500 mL of 0.45% NaCl to move fluid back into circulatory system. Your patient has Acute Kidney Injury secondary to chronic heart failure. They have signs of leg oedema and Jugular vein distension. Select the likely treatment and supportive nursing care. a. Treat urinary obstruction. Strict fluid monitoring, reassess fluid status regularly. b. 500 mL Fluid bolus over 15 minutes. Strict fluid balance chart, reassess fluid status regularly. c. Eliminate nephrotoxic antibiotics. Strict fluid balance chart, monitor vital signs. d. Diuretic medication, sodium and fluid restriction, monitor potassium levels, reassess fluid status regularly. (ANSWER) Your patient has Acute Kidney Injury secondary to chronic heart failure. They have signs of leg oedema and Jugular vein distension. Select the likely treatment and supportive nursing care. a. Diuretic medication, sodium and fluid restriction, monitor potassium levels, reassess fluid status regularly. (ANSWER) b. Treat urinary obstruction. Strict fluid monitoring, reassess fluid status regularly. c. 500 mL Fluid bolus over 15 minutes. Strict fluid balance chart, reassess fluid status regularly. d. Eliminate nephrotoxic antibiotics. Strict fluid balance chart, monitor vital signs.