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66. Mr. Y has just admitted, a 50.-years-old male client who has a serum B12 concentration of 700mg/ml Which of the following laboratory findings would cue the nurse to focus the client's history on the specific drug or alcohol abuse? A. Folate, 1.5ng/ml C. Serum creatinine, 0.5mg/dl B. Hemoglobin, 16g/dl D. Total bilirubin 0.3mg/dl 67. A 44-year-old man come to your office bringing his male infant who is bleeding . You suspected that the infant is having hemophilia. Which laboratory test will be abnormal and more indicative of the disease you suspected? A. Bleeding time B. Clot retraction test C. Partial thromboplastin time D. Hemoglobin level 68. You are assessing an electrocardiogram rhythm strip. The P waves and QRS complexes are regular. The PR interval is 0.16 seconds, and QRS complexes measure 0.06 seconds. The overall heart rate is 65 beats per minute . What will the interpretation result of cardiac rhythm be? A. First-degree heart block C. Sick sinus syndrome B. Normal sinus rhythm D. Sinus bradycardia 69. You are caring for a patient who has been diagnosed with a myocardial infraction?The client is experiencing symptoms of myocardial infarction . What will your first intervention be for this patient? A. Getting an ECG result C. Oxygen administration B. Morphine administration D. Sublingual nitroglycerin administration 70. Ms. X is caring for a patient with heart failure. She has taught the patient about all medications used for heart failure treatment . After 2 hrs. she asked the patient which classes of medications maximize her cardiac performance by increasing ventricular contractility. Which answer given by the patient is correct? A. Beta-adrenergic blockers C. Diuretics B. Calcium channel blockers D. Inotropic agents 71. The nurse assessing a client suspects acute renal failure. Which investigation is confirmatory? An A. An elevated potassium level B. An elevated creatinine level C. An elevated BUN level D. An elevated pH level

60. A 40-year-old female patient has deep partial thickness burns on the front and back of the right and left leg, front of right arm, and anterior trunk. The patient weighs 63 kg. Use the Parkland Burn Formula: What is the total volume of fluid to be administered within the first 8 hours? A. 8504 ml B. 7371 ml C. 3264 D. 4820 61. A patient is in the acute phase of burn management. The patient experienced full -thickness burns to the perineum and sacral area of the body. In the patient's plan of care , which nursing diagnosis is priority at this time? A. Altered nutrition B. Risk for fluid volume overload C. Risk for infection D. Ineffective coping 62. A patient arrives to the emergency due to experiencing burns in an enclosed space. Which assessment findings highly demonstrates inhalation injury? A. Bradycardia B. Clear sputum C. Fractured bone D. burn on the head and nose 63. A patient experienced I a full-thickness burn 72 hours ago. The patient's vital signs are within normal limits and urinary output is 50mL/hr This is known as what phase of burn management? A. Emergent B. Acute C. Rehabilitative D. Convalescence 64. A patient has a burn on the back that is extremely red and painful but no blisters are present . When the area is pressed, the skin blanches. You document this as a: A. superficial burn B. partial-thickness) burn C. full-thickness burn D. deep full-thickness burn 65. A patient has experienced full-thicknes s burns to the face and neck. What is the priority nursing action? A. Prevent hypothermia B. Assess the blood pressure C. Assess the airway D. Preventing infection

52. A nurse is developing a nursing care plan for a patient in the diuresis stage of Acute renal failure. What nursing diagnosis needs to be included in the care plan? A. Excess fluid volume B. Risk for electrolyte imbalance C. Urinary retention D. Acute pain 53. A 15-year-old patient is experiencing acute glomeruloneph ritis. What signs and symptoms is rare with this condition? A. Swelling in the face B . Hyperlipidemia C. Cola colored urine D. Elevated BUN and creatinine level 54. A patient who has difficulty voiding urine , explains that he has severe colicky excruciating pain at the lower quadrant of the abdomen which radiates to the scrotum . Which area is the most probable caliculi formation? A. Ureter B. Kidney C. Urethra D. Bladder 55. A nurse is providing discharge teaching to a female patient on how to prevent urinary tract infections. Which statement by the patient needs re -education? A. "Void immediately after sexual intercourse." B. "Avoid wearing tight fitting underwear." C. "Try to void every 2-3 hours" D. "Use perfumed tampons during menstruation." 56. A client has a full loss of skin tissue that extended to the subcutaneous tissue. What is the stage of pressure ulcer? A. I B. II C. III D. IV 57. A nurse assesses the skin of a patient who has been bed-ridden for long to find a full thickness tissue loss extending to the bone at the back. What is the stage of the bedsore? A. I B. II C. III D. IV 58. The burned area of a patient who has experienced a burn on the right leg contains small blisters which are extremely pinkish red and shiny.The patient reports severe pain.What is the degree of burn? A. 1st Degree (superficial) B. 2nd Degree (partial-thickness) C. 3rd Degree (full-thickness) D. 4th Degree (deep full-thickness) 59. A 58 -year-old female patient has superficial partial-thickness ; burns to the anterior head and neck, front and back of the left arm, front of the right arm, posterior trunk, front and back of the right leg, and back of the left leg. Using the Rule of Nines , calculate the total body surface area percentage that is burned. A. 63% B. 82% C 72% D. 54%

52. A nurse is developing a nursing care plan for a patient in the diuresis stage of Acute renal failure. What nursing diagnosis needs to be included in the care plan? A. Excess fluid volume B. Risk for electrolyte imbalance C. Urinary retention D. Acute pain 53. A 15-year-old patient is experiencing acute glomerulonephr itis. What signs and symptoms is rare with this condition? A. Swelling in the face B . Hyperlipidemia C. Cola colored urine D. Elevated BUN and creatinine level 54. A patient who has difficulty voiding urine,explains that he has severe colicky excruciating pain at the lower quadrant of the abdomen which radiates to the scrotum . Which area is the most probable caliculi formation? A. Ureter B. Kidney C. Urethra D. Bladder 55. A nurse is providing discharge teaching to a female patien on how to prevent urinary tract infections. Which statement by the patient needs re-education? A. "Void immediately after sexual intercourse." B. "Avoid wearing tight fitting underwear." C. "Try to void every 2-3 hours" D. "Use perfumed tampons during menstruation." 56. A client has a full loss of skin tissue that extended to the subcutaneous tissue.What is the stage of pressure ulcer? A. I B. II C. III D. IV 57. A nurse assesses the skin of a patient who has been bed-ridden for long to find a full thickness tissue loss extending to the bone at the back. What is the stage of the bedsore? A. I B. II C. III D.IV 58. The burned area of a patient who has experienced a burn on the right leg contains small blisters which are extremely pinkish red and shiny.The patient reports severe pain .What is the degree of burn? A. 1st Degree (superficial) B. 2nd Degree (partial-thickness) C. 3rd Degree (full-thickness) D. 4th Degree (deep full-thickness) 59. A 58-year-old female patient has superficial partial -thickness burns to the anterior head and neck front and back of the left arm, front of the right arm posterior trunk front and back of the right leg , and back of the left leg. Using the Rule of Nines.calculate the total body surface area percentage that is burned. A. 63% D. 54%

39. A patient has been diagnosed with small bowel obstruction and admitted to the surgical ward, which nursing intervention has to come first? A. Prevent infection B. Maintained skin and tissue integrity C. Prevent nausea and vomiting D. Maintain fluid and electrolyte imbalance 40. The patient had colonoscopy which showed "cobble-stone'" appearance of GI lining , this is found in which of the following disease A. Ulcerative colitis B. Pancreatitis C. Crohn's disease D. Peritonitis 41. A patient has been newly diagnosed with acute pancreatitis and admitted to medical ward How should the nurse most likely explain pathophysiology of this patient's health problem? A. Toxins have accumulated and inflamed your pancreas B. Bactria likely migrated from intestines into pancreases and cause inflammation C. The enzyme that pancreas produces have damage the pancreas itself D. Chronic alcohol consumption damage functional cells of pancreas 42. Assume you are on duty in Hiwot Fana Specialized University Hospital, a female patient came with a diagnosis of chronic gastritis. She is treated with histamine receptor blocker (cimetidine). What is the mechanism of action of this drug? A. Help to neutralized the stomach acid production B. Reduced stomach acid production C. Inhibiting vague nerve stimulation D. Stimulate mucus production 43. Sr, Tayitu was caring for a patient in the emergency department with complain of acute abdominal pain, associated nausea , and vomiting. When palpating the patient's left lower quadrant, the patient complains pain in the right lower quadrant of the abdomen. For which physical examination did this patient is positive? A. Psoas Sign C. Obturator sign B. Rovsing's sign D. Rebound tenderness 44. A nurse is assessing a patient who has been diagnosed with cholecystitis and has localized abdominal pain. When assessing the characteristics of the patient's pain, the nurse should anticipate that it may radiate to what region? A. Left upper chest C. Inguinal region B. Right shoulder D. Neck or jaw