EXAMEN COUNCIL QUESTION JUIN 2019.pdf

Registration N°:
Page 4 of 28
12. Which statement best describes the differences between the characteristics of type 1 and type 2
diabetes:
Persons with type 1 diabetes can increase endogenous insulin production by taking oral
hypoglycemic agents.
Autoimmune factors are involved in the pathogenesis of type 1 but not type 2 diabetes.
Persons with type 1 diabetes rapidly develop chronic complications.
Persons with type 2 diabetes usually require lower doses of insulin than person. with type 1
diabetes because they have a milder form of diabetes.
13. A client attends the health center complaining for edema on lower limbs and pain. Among the
following statements, which one would be the cause of edema?
Decreased capillary hydrostatic pressure.
Increased capillary permeability.
Increased capillary osmotic pressure.
Decreased capillary permeability.
14. A client with cirrhosis is at risk for developing complications. Which condition is the most serious
and potentially life-threatening?
Esophageal varices.
Ascites.
Peripheral edema.
Asterixis (liver flap).
15. The patient is well prepared and the environment is safe to perform physical examination. Your client
reports that he has tenderness on the umbilical area and you decide to perform the abdominal
palpation. How are you going to proceed?
a. Immediately, ask the patient to locate the pain area and palpate it.
b. Begin your palpation from the distal painless location and then the proximal pain location at
the last moment.
c. Palpate from anywhere because this will help the patient to feel painless while palpating.
d. Begin your palpation at umbilical area and lastly to the painless area.
16. In caring for the patient with Acute Kidney Injury, what is the BEST nursing intervention for that
patient?
a. The protection of the patient from other individuals with infectious diseases is not necessary.
b. During the oliguric phase of Acute Kidney Injury, daily fluid intake is limited to 1000 mL
plus the prior days measured fluid loss.
c. Dietary sodium and potassium during the oliguric phase of Acute Kidney Injury are managed
according to the patient’s urinary output.
d. Taking accurate daily weights for managing fluid balance.
NATIONAL COUNCIL LICENSING EXAMINATION LEADING TO REGISTRATION
AS A GENERAL NURSE (ADVANCED DIPLOMA) – JUNE 2019
Candidate Registration N°:
Date of examination:
Signature:
EXAMINATION PAPER
Duration: 3hours
Total marks:
Instructions:
This paper comprises only one section of 150 Multiple Choice Questions.
 Respect the order of questions
 Tick clearly and avoid crossing out (erasure)
 Attempt all questions using a blue pen
 Choose and circle the letter corresponding to the BEST answer (1 mark each).
N.B. La version en Français se trouve à la fin du questionnaire en Anglais
/150 marks

Registration N°:
Page 4 of 28
diabetes:
Esophageal varices.
Ascites.
Peripheral edema.
the last moment.
patient?
Registration No
:
Page 2 of 28
1. Which of the following methods of fetal heart evaluation provides the MOST reliable, comprehensive
data?
a. Intermittent auscultation with a doptone or fetoscope.
b. Continuous monitoring with an external monitor.
c. Auscultation acceleration test with doptone or fetoscope.
d. Having the mother reporting that she feels regularly the fetal movements.
2. Which of the following is the BEST definition of fetal engagement?
a. When the widest diameter of the fetal presenting part is at the zero station.
b. When the lowermost part of the fetal presenting part has passed through the pelvic inlet.
c. When the lowermost part of the fetal presenting part is at zero station.
d. When the widest diameter of the fetal presenting part has passed through the pelvic inlet.
3. Which of the following landmarks of the fetal head would you use to determine station in a well-flexed,
cephalic presentation?
a. The parietal prominences.
b. The occipital bone.
c. The sagittal suture.
d. The temporal bone.
4. During what stage of labor does the majority of progressive descent of the fetal presenting part occur?
a. During the latent phase.
b. During the phase of maximum slope.
c. During the deceleration phase/transitional.
d. During the second stage.
5. Which of the following is the reasoning commonly used to keep women from eating too much solids
food during labor?
a. It will reduce the chances of vomiting and aspiration during the transition and second stage of
labor.
b. It will reduce the chances of aspiration in the event of need for a cesarean section.
c. It will reduce the chances of aspiration in the event of need for general anesthesia.
d. It will increase the chances of a sterile field for vaginal delivery.
6. According to the ministry of health in Rwanda, which of the following findings is considered the normal
range for fetal heart rate?
a. 100-160 beats per minute
b. 110-160 beats per minute
c. 120-160 beats per minute
d. 130-160 beats per minute
Registration N°:
Page 2 of 28
1. Client X is admitted at emergency Department for Gallstones’ diagnosis, which of the following
conditions is this client predisposed?
a. Hepatitis.
b. Pancreatitis.
c. Peptic ulcer disease.
d. Gastritis.
2. The edema that occurs in nephrotic syndrome is due to:
a. Increased hydrostatic pressure caused by sodium retention.
b. Decreased aldosterone secretion from adrenal insufficiency.
c. Increased ﬂuid retention caused by decreased glomerular filtration.
d. Decreased colloidal pressure caused by loss of serum albumin.
3. A client suffering for diabetes mellitus complains often for polydipsia and polyuria. What is the
primarily mechanism of these symptoms related to diabetes mellitus?
a. The release of ketones from cells during fat metabolism.
b. Fluid shifts resulting from the osmotic effect of hyperglycemia.
c. Damage to the kidneys from exposure to high levels of glucose.
d. Changes in RBCs resulting from attachment of excessive glucose to hemoglobin.
4. Pernicious anemia is related to which of the following elements?
a. Iron deficiency.
b. Cyanocobalamin acid deficiency.
c. Folate deficiency.
d. Pyridoxine deficiency.
5. A patient has been diagnosed for hemophilia. What are the characteristics of this condition?
a. Decreased bleeding time and clotting time.
b. Increased bleeding time and clotting time.
c. Normal bleeding time and increased clotting time.
d. Decreased bleeding time and increased clotting time.
6. Which of the following is the basic cause of diabetes insipidus?
a. High production of antidiuretic hormone.
b. Lack of antidiuretic hormone production.
c. Overproduction of oxytocin.
d. Overproduction of prostaglandins.
7. Ulcers are often a complication of a long lasting gastritis. During endoscopic exam, it is commonly
found in which of these regions of the gastrointestinal tract?
a. Small intestine.
b. Jejunum.
c. Duodenum.
d. Large intestine.

Registration N°:
Page 4 of 28
diabetes:
Esophageal varices.
Ascites.
Peripheral edema.
the last moment.
patient?
Registration No
:
Page 3 of 28
7. As a final year midwife student on your last week of clinical practice at a district hospital, you were
requested by the senior midwife to explain to a group of year 1 midwives’ students what you understand
by second stage in one sentence?
a. Deceleration phase.
b. Pushing phase.
c. Expulsive phase.
d. Bearing down phase.
8. According to Friedman, what is the average length of second stage of labor for primigravidas?
a. 30 minutes
b. 60 minutes
c. 90 minutes
d. 120 minutes
9. External rotation accomplishes which of the following in a birth with cephalic presentation?
a. Substitutes the larger fetal head diameter for the smaller sub-occipitobregmatic diameter.
b. Untwist the fetal neck and brings the head into a right angle with the shoulder.
c. Brings the anteroposterior diameter of the fetal head into alignment with the anteroposterior
diameter of the maternal pelvis.
d. Brings the biacromial diameter of the fetus into alignment with the anteroposterior diameter of the
pelvic outlet.
10. Early decelerations are believed to be caused by which of the following conditions?
a. Uteroplacental insufficiency
b. Cord compression
c. Head compression
d. Transient fetal hypoxia
11. In addition to uterine contractions, which of the following mechanism is responsible for placental
separation?
a. The abrupt/sudden decrease in the size of the uterine cavity.
b. Tension placed on the cord by the birth of the baby.
c. Bleeding into the intervillous space which releases prostaglandins.
d. The constriction of blood vessels that provided circulation to the placenta.
12. Once you are sure that the placenta has separated, what is the next step you should take in managing the
delivery of the placenta?
a. Apply controlled cord traction.
b. Assess whether the uterus is contracted.
c. Apply fundal pressure to propel the placenta through the vaginal canal.
d. Administer a syntometrine agent to accelerate delivery of the placenta.
Registration N°:
Page 3 of 28
Read carefully the below scenario and answer the question number 8 and 9
A twenty years old boy is consulted with a history of edema of the face mostly in the morning. While doing
clinical examination you find that the blood pressure is normal but signs of ascites and pleural effusion are
found. The laboratory results are interpreted with hypoalbuminemia and hypercholesterolemia.
8. What is the medical diagnosis?
a. Chronic renal failure.
b. Nephrotic syndrome.
c. Glomerulonephritis.
d. Hypothyroidism.
9. Which exam is considered as FIRST line investigation for this pathology?
a. Urine for albumin test.
b. Liver function tests.
c. Echography.
d. Blood urea level test.
10. A high blood pressure is non communicable disease due to known or unknown factors. The
followings are among the risk factors of hypertension:
i. Age
ii. Obesity
iii. Gender
iv. Genetic link
Among the mentioned risk factors of hypertension, what are non-modifiable risk factors for primary
hypertension?
a. i,&ii
b. ii&iii
c. i &iii only
d. i,iii & iv
11. Which of the following confirmed values meet the diagnostic threshold for diabetes?
Fasting blood glucose ≥ 126 mg/dl.
Random glucose > 160 mg/dl.
2-hour post prandial glucose ≥ to 126 mg/dl.
Registration N°:
Page 3 of 28
d. Hypothyroidism.
c. Echography.
i. Age
ii. Obesity
iii. Gender
iv. Genetic link
hypertension?
a. i,&ii
b. ii&iii
c. i &iii only
d. i,iii & iv
Registration N°:
Page 3 of 28
d. Hypothyroidism.
c. Echography.
i. Age
ii. Obesity
iii. Gender
iv. Genetic link
hypertension?
a. i,&ii
b. ii&iii
c. i &iii only
d. i,iii & iv

Registration N°:
Page 4 of 28
diabetes:
Esophageal varices.
Ascites.
Peripheral edema.
the last moment.
patient?
Registration No
:
Page 4 of 28
13. A woman’s blood pressure, pulse and respirations should be monitored how often during the normal
fourth stage of labor?
a. At least every 15 minutes until stable at pre-labor levels.
b. At least every 30 minutes until stable at pre-labor levels.
c. Immediately after the birth of the placenta and then again, every 30 minutes for 4 hours.
d. At least every hour for 24 hours.
14. According to the Demographic Health Survey report (2015), what is the maternal mortality in rate in
Rwanda?
a. 210/100,000
b. 480/100,000
c. 110/100,000
d. 120/100,000
15. Which of the following BEST describes the trigger that causes lactogenesis (milk production) during the
first 3-4 postpartum days?
a. Fall in progesterone and estrogen.
b. Increase in human placental lactogen (HPL).
c. Suckling by the newborn.
d. Suppression of oxytocin release.
16. A midwifery student is reviewing the record of a client in the labor room and notes that the Midwife has
documented that the presenting part is at -1 station. At which level of pelvis the student midwife would
find out the presenting part?
a. 1 cm above the ischial spines.
b. 1 finger breath below the symphysis pubis.
c. 1 inch below the coccyx.
d. 1 inch below the iliac crest.
17. You conducted a vaginal delivery of a newborn neonate. After the delivering you observed that the
umbilical cord was lengthening and there was a spurt of blood from the vagina. These observations are
signs of which of the following:
a. Hematoma formation.
b. Placenta beginning to atrophy.
c. Placental forming a circumvallate.
d. Placental beginning to separate.
18. A primigravida mother presents to the maternity ward in the third trimester at 38 weeks of gestation with
the complaints of swollen feet and legs. Her blood pressure is 120/70mmgh. What are the most
appropriate interventions to be taken?
a. Refer the woman immediately to see a doctor and to be assessed at the hospital because this
swelling is not a sign of a health pregnancy.
b. Tell the woman she is drinking too much water and eating a lot of salt in her meal and if she
continues, the swelling may spread to her hands and face.
Registration N°:
Page 4 of 28
diabetes:
Esophageal varices.
Ascites.
Peripheral edema.
the last moment.
patient?

Registration N°:
Page 4 of 28
diabetes:
Esophageal varices.
Ascites.
Peripheral edema.
the last moment.
patient?
Registration No
:
Page 5 of 28
c. Ask the doctor to give the woman a medication to reduce the swelling. Her kidneys are not
working properly.
d. Tell the mother to put her feet up on the pillow at night and inform you if the swelling gets worse
or moves to her hands and face.
19. You are a student midwife working in the maternity and today you were requested to perform a physical
examination on the newborn baby in your postnatal ward who is 6 hours old. when you put the baby on
the examination table beside the mother’ bed, the baby throws out its arms, hands opened into the air and
begins to cry. The midwife interprets this reaction as indicative of which of the following reflexes?
a. Moro reflex.
b. Babinski’s reflex.
c. Grasping reflex.
d. Rooting reflex.
20. The uterine contraction for a woman who has just completed cervical dilatation to 10 cm dilatation but no
longer as intense as they were previously instead she falls into a deep sleep. Maternal and fetal
parameters are within normal limits. This pattern has been present for approximately 10 minutes and the
woman feels no urge to push. The woman’s labor progress has been normal to this point. Which of the
following is the BEST management option at this time?
a. Set up an intravenous infusion of pitocin augmentation immediately to reestablish an effective
contraction pattern.
b. Insert an intra-uterine pressure catheter to determine whether the contractions are adequate to
effect delivery.
c. Continue to monitor progress of labor to see if the pattern will change naturally using watchful
waiting approach.
d. Prepare for a probable instrumental delivery or cesarean section.
21. A multipara in first stage of labor has had no change in cervical dilatation due to inefficient uterine
activity in 3 hours. You have ensured maternal hydration, encouraged ambulation, and performed an
amniotomy which revealed clear amniotic fluid. If the above measures do not achieve progressive
cervical dilation, what is the MOST appropriate step to take next?
a. Prepare the woman for an instrument delivery.
b. Prepare the woman for a cesarean section.
c. Allow the woman to labor naturally, no intervention needed.
d. Augment with pitocin 10 units in intravenous infusion of normal saline.
22. You monitored a client throughout the stages of her labor progress. In the second stage of labor the client
delivers her baby and those were the data exhibited by the newborn at 1 minute following birth: Heart
rate of 88 beat per minute; Slow irregular breathing with grunting; Limp extremities; a grimace in
response to stimulus; pale color.
Based on the above data calculate the newborn’s APGAR score in 1 minute after birth?
a. 3
b. 4
c. 5
d. 6
Registration N°:
Page 5 of 28
17. What should the nurse do to prepare unconscious patient for a lumbar puncture?
a. Position the patient in supine position.
b. Position the patient in a lateral position with the hips, knees, and neck extended.
c. Have the patient sit on the side of the bed, leaning on a padded over-the-bed table.
d. Position the patient in a lateral recumbent position with the hips, knees, and neck flexed.
18. The patient with a history of heart failure and acute respiratory failure has thick secretions that she is
having difficulty coughing up. Which intervention would BEST help to fluidity her secretions?
a. Administer more IV fluid.
b. Nebulizer the patient by using the normal saline.
c. Perform postural drainage.
d. Nasopharyngeal suctioning.
19. The nurse is preparing the patient who has been diagnosed for pleural effusion for a diagnostic
procedure to remove pleural fluid for analysis. The nurse would prepare the patient for which test?
a. Thoracentesis.
b. Bronchoscopy.
c. Pulmonary angiography.
d. Septum culture and sensitivity.
20. A patient has been hospitalized two (2) days ago in the clinic for an episode of epistaxis, which was
controlled by placement of anterior nasal packing. During discharge teaching, what is the instruction
the nurse should educate to the patient?
a. Use aspirin for pain relief
b. Remove the packing later that day.
c. Skip the next dose of antihypertensive medication.
d. Avoid vigorously nose blowing and strenuous activity.
21. During the physical examination of the abdomen, the nurse should follow the following steps
respectively:
a. Inspection, palpation, percussion, auscultation.
b. Inspection, palpation, percussion, auscultation.
c. Inspection, auscultation, percussion, palpation.
d. Auscultation, inspection, palpation, percussion.
22. The nurse must insert a peripheral IV catheter for the patient who requires parenteral nutrition. In
order to decrease the risk of deep vein thrombosis or phlebitis, which vein does the nurse choose for
the infusion site?
a. Wrist.
b. Foot.
c. Forearm.
d. Antecubital.

Registration N°:
Page 4 of 28
diabetes:
Esophageal varices.
Ascites.
Peripheral edema.
the last moment.
patient?
Registration No
:
Page 6 of 28
23. Madam X delivered 4 hours ago. During your afternoon shift when you went to do the routine check on
madam X and her baby she complained that since her baby was delivered, the baby has not voided. What
is the maximum amount of time after birth that a newborn can go without voiding before referral to a
pediatric provider is needed?
a. 12 hours
b. 24 hours
c. 48 hours
d. 72 hours
24. You were delegated by the unit manager to work at the immediate postpartum unit for proper support and
surveillance of mothers following delivery. You then prepare yourself to assist madam Y who is a
primigravida to start breast feeding her baby with the breast milk. Which of the following would be the
BEST time for a healthy newborn to attempt breastfeeding for the first time?
a. Within the first 30 minutes.
b. After 120 minutes.
c. After 160 minutes.
d. Sometime between 48 -72 hours.
Use the below case scenario to answer question 25 and 26.
Baby N was delivered 90 minutes ago at 35 weeks’ gestation, her birth weight was >1500grams, and does not
show any abnormal signs. She looks healthy and active. You were requested to continue the immediate care
of the newborn including administering Vitamin K injection to the newborn.
25. Which of the following BEST describes the reasoning behind administration of Vitamin K to the
newborn?
a. Because the newborn liver, where clotting factors are manufactured is immature.
b. Because the trauma of birth quickly exhausts the available clotting factors in the newborn’s
reserve.
c. Because the newborn gut where Vitamin K is synthesized is immature.
d. Because Vitamin K protects against bacterial colonization of the newborn’s gut.
26. What is the dosage of Vitamin k to be administered to baby N and site of injection?
a. Dosage is 1mg at intramuscular at the back of mid-thigh.
b. Dosage is 0.5mg intramuscular in front, outside the mid-thigh.
c. Dosage is 1mg intramuscular in front, outside the mid-thigh.
d. Dosage 0.5 mg at the back of mid-thigh.
Registration N°:
Page 6 of 28
23. The nurse is assessing a patient with intravenous fluid therapy (normal saline) and identifies signs and
symptoms of infiltration. What is the FIRST action that the nurse implements for this patient?
a. Elevates the extremity.
b. Applies a sterile dressing if weeping from the tissue has occurred.
c. Removes the IV access.
d. Stops the infusion.
24. One of the most potentially hazardous procedures that the nurse faces is using and disposing of needle
and sharp. What is the measure the nurse should take to prevent the needle stick injuries?
a. Use appropriate puncture-proof disposal containers to dispose of uncapped needles and
sharps.
b. Throw the uncapped needles and sharps in the wastebaskets.
c. Put the uncapped needles and sharps over the first shelf of the trolley
d. Give the uncapped needles and sharps to the patient to throw them in dustbin.
25. What is included in nursing care that applies to the management of all urinary catheters in
hospitalized patients?
a. Measuring urine output every 1 to 2 hours to ensure patency.
b. Using strict sterile technique during insertion and obtaining culture specimens.
c. Turning the patient frequently from side to side to promote drainage.
d. Daily cleaning of the catheter insertion site with soap and water and application of lotion.
26. During an assessment of the patient with a hematologic disorder, the nurse finds a pale skin,
tachypnea, vertigo and increased heart rate. Which laboratory result would the nurse expect to see?
a. Neutrophils 45%.
b. Hemoglobin (Hb) of 5.6g/dl.
c. WBC count 13,500/µL.
d. Red blood cell (RBC) count 6.4 × 106/µL.
27. If a patient with blood type O Rh+
is given AB Rh–
blood, what would the nurse expect to happen?
a. The patient’s Rh factor will react with the RBCs of the donor blood.
b. The anti-A and anti-B antibodies in the patient’s blood will hemolysis the transfused blood.
c. The anti-A and anti-B antibodies in the donor blood will hemolyze the patient’s blood.
d. No adverse reaction is expected because the patient has no antibodies against the donor blood.
28. A patient has diagnosed with anemia and must receive 1 unit of red blood cells. During the blood
administration, the patient develops chills and a temperature of (39°C) and lumbar pain. What would
be first action of the nurse?
a. Notify the health care provider and the blood bank.
b. Stop the transfusion and instill normal saline.
c. Add a leukocyte reduction filter to the blood administration set.
d. Recognize this as a mild allergic transfusion reaction and slow the transfusion.

Registration N°:
Page 4 of 28
diabetes:
Esophageal varices.
Ascites.
Peripheral edema.
the last moment.
patient?
Registration No
:
Page 7 of 28
27. You were delegated to work from labor monitoring unit and you admit a client in labor. The woman
looks very excited, talkative and crying of labor pains that radiate from the back to front. She states that
she feels that her baby is coming. You decide to perform a vaginal examination, which reveals: cervix
three centimeters dilated, 80% effaced, vertex at zero station. The midwife determines the client to be in
which stage/phase of labor?
a. First stage, active phase.
b. Second stage, latent phase.
c. Third stage, transition phase.
d. First stage, latent phase.
28. You were posted to the health center by the director of nursing services to assist in the antenatal care
department for one week and then you planned to teach a class of expectant mothers about the cardinal
movement of the fetus as the fetus passes through the birth canal. Place the cardinal movements in the
correct order/sequence.
a. Decent, flexion, internal rotation head, extension of the head, restitution, internal rotation of
shoulders, and lateral flexion.
b. External rotation, internal rotation head, decent, flexion, restitution, internal rotation of shoulders
and lateral flexion.
c. Engagement of head, flexion, internal rotation, restitution, internal rotation of shoulders and
lateral flexion.
d. Engagement of head, decent, restitution, extension of head and internal rotation of shoulders.
29. You received a client at the antenatal care clinic where you were posted to perform your daily duties
during your clinical practice at a Health center. The pregnant client reports that she has a 3 years old child
at home who was born at term, had a miscarriage at 10 weeks’ gestation, delivered a set of twins at 28
weeks’ gestation that died within 24 hours of birth. How will you record the client’s status in the prenatal
file/record?
a. Gravida 2, para 1
b. Gravid 3, para 3
c. Gravid 4, para 2
d. Gravid 5, para 4
30. As a midwife working in antenatal clinic, you receive a client who is a primigravida, she has come to the
clinic for a scheduled prenatal visit. She is concerned about facial chloasma that has developed on her
face and neck areas of her skin. She requests the midwife to intervene immediately because she is an
actress and would not like to lose her beauty. What will be the MOST appropriate explanation from the
midwife?
a. You should apply facial skin bleach twice a day
b. Avoid sun exposure ay keep the pigmentation from getting worse and darker.
c. This is a permanent condition caused by hormonal changes. you may be able to cover it with a
makeup.
d. Increased pigmentation during pregnancy is a response to increased estrogen levels.
Registration N°:
Page 7 of 28
29. A nurse prepares a conscious patient for insertion of a nasogastric tube. The nurse positions the
patient in which of the following position?
a. Flat in bed.
b. On his or her right side.
c. In semi-Fowler’s position with his or her head turned to back.
d. In High-Fowler’s position.
30. Which IV therapy results in the GREATEST increase in oxygen-carrying capacity for a patient with
hypovolemic shock related to hemorrhage?
a. Lactate Ringer’s solution.
b. Hetastarch.
c. Fresh frozen plasma (FFP).
d. Packed red blood cells.
31. What should the nurse do to prepare a patient for a lumbar puncture?
a. Sedate the patient with medication before the test.
b. Withhold beverages containing caffeine for 8 hours.
c. Have the patient sit on the side of the bed, leaning on a padded over-the-bed table.
d. Position the patient in a lateral recumbent position with the hips, knees, and neck flexed.
32. A patient with an intracranial problem does not open his eyes to any stimulus, has no verbal response
except moaning and muttering when stimulated, and flexes his arm in response to painful stimuli.
What should the nurse record as the patient’s GCS score?
a. 6
b. 9
c. 7
d. 11
33. What is the MOST common anti-acid used for treating gastritis in Rwandan health centers?
a. Aluminum hydroxide.
b. Aluminum carbonate.
c. Calcium carbonate.
d. Sodium bicarbonate.
34. What is the pharmacological name of association of amoxicillin and clavulanic acid?
a. Ampicillin.
b. Fortified penicillin procaine.
c. Augmentin.
d. Methicillin.

Registration N°:
Page 4 of 28
diabetes:
Esophageal varices.
Ascites.
Peripheral edema.
the last moment.
patient?
Registration No
:
Page 8 of 28
31. Which of the following anatomical or physiological changes of pregnancy is thought to be caused by
increased levels of estrogen?
a. Hypertrophy of the uterine wall.
b. Hypertrophy of the basal body temperature.
c. Hypertrophy of the salivary gland.
d. Decrease in the vascular wall.
32. The fusion of the pronuclei of the sperm and ovum that happens with fertilization produces which of the
following?
a. The embryo
b. The zygote
c. The morula
d. The blastocyst
33. During an abdominal examination of a woman at term you feel the cephalic prominence on the same side
as the fetal parts. This is indicative of which of the following?
a. Face presentation
b. Vertex presentation
c. Brow presentation
d. Sinciput presentation
34. Which of the following is the smallest pelvic diameter to which the fetus has to accommodate as it moves
down during labor?
a. The obstetrical conjugate
b. The conjugate vera
c. The interspinous diameter
d. The intertuberous diameter
35. The anterior fontanel of the fetal skull is formed by the meeting of which sutures?
a. Frontal, sagittal, and coronal sutures.
b. Frontal, lambdoidal and coronal.
c. Frontal, sagittal and lambdoidal.
d. Frontal, sagittal and temporal.
36. Madam X, primigravida is in the first stage labor, how will you determine the station of the presenting
part?
a. By measuring the distance of the widest diameter of the fetal presenting part above or below the
ischial spine.
b. By measuring the distance of the lowermost part of the presenting part above or below ischial
spine.
c. By measuring the distance of the widest diameter of the fetal presenting part above or below the
pelvic inlet.
d. By measuring the distance of the lowermost part of the fetal presenting part above or below the
pelvic inlet.
Registration N°:
Page 8 of 28
35. The treatment of choice for simple malaria in Rwanda is Coartem. What are the pharmacological
components of this drug?
a. Artemether and quinine.
b. Artemether and coartem.
c. Zentel and artemether.
d. Artemether and lumefantrine
36. Which of the following describes the first-pass effect?
a. Inactivation of a drug as a result of the gastric acids.
b. Absorption of a drug through the duodenum.
c. Drug given orally is metabolized by the liver before entering the circulation.
d. Drug given IV accumulates quickly in the central nervous system (CNS).
37. On day duty, you admit a patient with fever, severe headache, nausea, vomiting, and nucheal rigidity.
On physical examination, you find that the patient cannot fully extend his knee while the hip is flexed
at 90 degrees. This is known as:
a. Trismus.
b. Opisthotonos attitude.
c. Positive Kernig’s sign.
d. Positive Brudzinski’s sign.
38. Which of the following is a disease that causes almost a constant number of people to become sick all
the time when there is balance between agent, host and environment?
a. Epidemic disease.
b. Endemic disease.
c. Pandemic disease.
d. Sporadic disease.
39. Which type of hepatitis is a DNA virus, can be transmitted via exposure to infectious blood or body
fluids, that requires hepatitis D virus to replicate, and increases the risk of the chronic carrier for
hepatocellular cancer?
a. Hepatitis A Virus (HAV).
b. Hepatitis B Virus (HBV).
c. Hepatitis C Virus (HCV).
d. Hepatitis E Virus (HEV).
40. Your patient is diagnosed with a latent tuberculosis infection. Which of the following statements
reflects this condition?
a. The patient will not need treatment unless it progresses to an active tuberculosis infection.
b. The patient is not contagious and will have no signs and symptoms.
c. The patient will have abnormal chest X-ray.
d. The patient’s sputum will test positive for mycobacterium tuberculosis.

Registration N°:
Page 4 of 28
diabetes:
Esophageal varices.
Ascites.
Peripheral edema.
the last moment.
patient?
Registration No
:
Page 9 of 28
37. Mrs. X G1P0 mother reports to your health facility, after examination she was noted to have a gynecoid
pelvis and this means that Mrs. X can have a normal vaginal birth if she is carrying a normal size fetus.
Considering Mrs. X pelvis, the most important obstetric Landmark on the brim of the pelvis may include
one of the followings?
a. Sacral promontory
b. Iliopectineal line
c. Ala or wing of the sacrum
d. Ilio pectineal eminence
38. Which of the following statement most accurately describes the MOST likely mechanism of action for
the copper 380A (ParaGard) intrauterine contraceptive device?
a. It prevents implantation of a fertilized ovum by creating a hostile uterine environment.
b. It prevents fertilization from occurring by altering fallopian tubes motility and incapacitating the
sperm.
c. It releases progesterone, which affects fallopian tube motility and alters the uterine lining.
d. It acts as a physical and mechanical barrier to the fallopian tubes, thus blocking the sperm from
reaching the ovum.
39. Madam D, 33 years old G3P2 comes to see you because she has missed her period and she thinks she
may be pregnant. She had an IUCD inserted 2 years ago and has never had any problem with it. Madam
D states that if she is pregnant, she and her husband desires to continue with the pregnancy. You perform
a pregnancy test that comes back positive. Upon speculum examination, you can visualize the IUCD
strings protruding from the cervical OS.
40. Which of the following is the MOST appropriate management of this situation?
a. Leave the IUCD in place because there is a high chance of inducing an abortion during the
removal.
b. Remove the IUCD immediately in order to reduce the risk of infection and abortion.
c. Obtain an ultrasound to determine the position of the IUCD before deciding whether to remove or
to leave it insitu.
d. Refer the woman immediately for specialist management.
41. Which of the following best describes when preconception counseling should take place?
a. 3-6 months before a pregnancy is planned.
b. 12 months before a pregnancy is planned.
c. When there is a special request from the couple.
d. At every visit with a woman of childbearing age.
42. A 32-year-old female with a reported history of normal monthly menses presents to the health center with
complaint of no menstrual cycle for 3 months. Which answer BEST describes the appropriate diagnosis
and action to be taken?
a. This is primary amenorrhea and hormone testing should be done.
b. This is normal and nothing should be done.
c. This is secondary amenorrhea, but pregnancy should 1st
be ruled out.
d. This is metrorrhagia and oral contraceptives should be offered for treatment.
Registration N°:
Page 9 of 28
41. In physiopathology of typhoid fever, which of the following toxins is released from killed bacteria?
a. Exotoxin
b. Cytotoxin
c. Endotoxin
d. Enterotoxin
42. A premarital blood test for syphilis reveals that a woman has a positive Venereal Disease Research
laboratory test. How should the nurse advise the patient?
a. A single dose of penicillin will cure syphilis.
b. She should question her fiancé about prior sexual contacts.
c. Additional testing to detect specific antitreponemal antibodies is necessary.
d. A lumbar puncture to evaluate cerebral spinal fluid is necessary to rule out active syphilis.
43. A 19-year-old boy with a long history of heartburn and dyspepsia presents to the primary care doctor
with severe mid-epigastric pain. He was initially treated with an H2 blocker twice a day. He
immediately had relief but his symptoms returned after two weeks. Which one of the following is the
MOST likely to cause for the relapse in his symptoms?
Outlet obstruction due to fibrous tissue repair.
Acute gastric ulcerations.
Giardia lamblia infection.
Helicobacter pylori infection.
44. The malaria due to Plasmodium falciparum is endemic in many African regions. Which one of the
following statement(s) regarding Plasmodium falciparum is true?
Is the only malarial parasite causing greater than 20% parasitaemia?
Is the only cause of cerebral malaria?
Is associated with recurrent relapses after initial treatment because of liver hypnozoites?
Causes benign tertian malaria.
45. A 30 years old man has had road accident on 27th August, 2016 and he had open fracture of tibia, is
hospitalized at Kabgayi hospital, today in the morning he had body temperature of 39.50
C, Sirius
sardonic, stiff neck, generalized contractures, the pulse was 136 beats per minute. In the following
communicable diseases which one do you think the old man is suffered?
Aseptic meningitis.
Tetanus.
Septicemia.
Trismus state.
46. Elephantiasis is caused by which of the following filarial infections?
a. Wuchereriasis.
b. Loasis.
c. Onchocerciasis.
d. The Guinea worm infection.

Registration N°:
Page 4 of 28
diabetes:
Esophageal varices.
Ascites.
Peripheral edema.
the last moment.
patient?
Registration No
:
Page 10 of 28
43. A group of secondary school students came to your family planning clinic on information regarding
coitus interruptus. They feel that it is safer and no introduction of hormones into the body. Which
information when given will be MOST appropriate regarding coitus interruptus?
a. Coitus interruptus should not be considered as a form of contraception as it potentially has a high
failure rate.
b. It involves the man to hold his breath strongly when he feels to ejaculate.
c. Its requires that the man should carefully monitor his body and understand the nervous system and
their functions.
d. The success of this method depends on the man’s level of education and exposure.
44. Among the following natural family planning methods, which is the MOST effective?
a. Sympto-thermal method.
b. The calendar /rhythm method.
c. The basal body temperature method.
d. The cervical mucus method.
45. In order to avoid pregnancy, the woman using the cervical mucus method of family planning should
avoid intercourse for a minimum of how many days following the” peak day” of her cycle?
a. 2 days
b. 3 days
c. 4 days
d. 5 days
46. At what point during the menstrual cycle should an intrauterine device be inserted?
a. During the menstruation when the cervical os is slightly dilated and the risk of inserting the IUCD
into a pregnant uterus is eliminated.
b. At the mid-cycle so that the risk of infection is reduced as long as pregnancy can be precluded.
c. During the first 7 days of the cycle to reduce the risk of inserting the IUCD into a pregnant uterus.
d. Anytime of the cycle as long as pregnancy and vaginitis /cervicitis can be precluded.
47. Which of the following pharmacological agent is MOST effective in the treatment of bacterial vaginosis?
a. Metronidazole oral tablets
b. Amoxicillin oral capsule
c. Clindamycin oral capsule
d. Tetracycline oral capsule
48. Which of the following drugs affects milk production and would be contraindicated for breastfeeding
mothers?
a. Bromocriptine
b. Beta blockers
c. NSAIDS
d. Methyldopa
Registration N°:
Page 10 of 28
47. The nurse is checking capillary refill on a patient. If it takes longer than 3 seconds for the color to
return when assessing capillary refill, the nurse would recognize that which of the following may be
indicated?
a. Decrease of arterial flow to the extremity.
b. Increase of arterial flow to the extremity.
c. Decrease of venous flow to the extremity
d. Increase of venous flow from the extremity.
48. The serous membrane lining the abdominal pelvic cavity and the viscera is referred to as:
a. visceral pleura
b. pericardium
c. visceral pericardium
d. peritoneum
49. What covers the larynx during swallowing?
a. Trachea
b. Epiglottis
c. Turbinates
d. Parietal pleura
50. After talking with the physician, the patient asks what the blood-brain barrier does. What is the BEST
description that the nurse can give to the patient?
a. Protects the brain from external trauma.
b. Protects against harmful blood-borne agents.
c. Provides for flexibility while protecting the spinal cord.
d. Forms the outer layer of protective membranes around the brain and spinal cord.
51. An appropriate nursing intervention for a patient with pneumonia with nursing diagnosis of
ineffective airway clearance related to thick secretions and fatigue would be to:
a. Perform postural drainage every hour.
b. Provide analgesics as ordered to promote patient comfort.
c. Administer O2 as prescribed to maintain optimal oxygen levels.
d. Teach the patient how to cough effectively to bring secretions to the mouth.
52. Patient A was admitted to the emergency room where you are a duty nurse with a blunt chest trauma
after a road traffic accident. what will be your first priority to save the patient’s life?
a. Encourage deep breathing and coughing.
b. Provide pain relief medication.
c. Assess the client's airway.
d. Secure the chest wall with a pillow.

Registration N°:
Page 4 of 28
diabetes:
Esophageal varices.
Ascites.
Peripheral edema.
the last moment.
patient?
Registration No
:
Page 11 of 28
49. Which of the following treatments for vulvovaginal candidiasis is contraindicated in pregnancy?
a. Clotrimazole (Gyne-Lotrimin) vaginal tablet.
b. Miconazole (Monistat)vaginal suppository.
c. Fluconazole (Diflucan) oral tablets.
d. Terconazole(terazole) vaginal cream.
50. Which of the following ethical principles BEST relates to the issues of patient’s preferences?
a. Beneficence
b. Non-maleficence
c. Autonomy
d. Justice
51. Which one of the ethical issues that a professional midwife should uphold?
a. Privacy and non-maleficence.
b. Justice and fairness.
c. Patience and empathy.
d. Confidentiality and integrity.
52. A 22 years old, G2 P1 A0 had her last menstrual period 8 weeks ago. She presents with bleeding and
passage of some tissue in the vaginal accompanied with lower abdominal pain. The MOST likely
diagnosis is:
a. Ectopic pregnancy
b. Incomplete abortion
c. Threatened abortion
d. Inevitable abortion
53. Ms X, G5P4 on her 7th
day post-partum reports to the Health Centre where you are working complaining
of profuse foul smelling lochia. On abdominal examination the uterus is tender on touch and feels larger
than expected for post-delivery and temperature is 38º c. What is the RIGHT diagnosis for this scenario?
a. Secondary postpartum hemorrhage.
b. Endometritis.
c. Retained products of the uterus.
d. Endometriosis.
54. A 32-year-old G3P2 36weeks of gestation has a twin pregnancy; the first twin is breech presentation and
the second twin is cephalic presentation. What is the MOST appropriate mode of delivery that you
recommend this woman to have?
a. Spontaneous vaginal delivery.
b. Vaginal delivery after internal manual rotation of the first twin.
c. Caesarian section.
d. Assisted delivery.
Registration N°:
Page 11 of 28
53. What is the end result of data analysis during the assessment in nursing process?
a. Actualization of the plan of care.
b. Determination of the patient’s responses to care.
c. Collection and analysis of data.
d. Identification of actual or potential health problems.
54. After determining a nursing diagnosis of acute pain, what is an appropriate client-centered goal that
the nurse may develop?
a. Encourage client to implement none pharmacological method of pain relieve
b. Determine effect of pain intensity on client function.
c. Administer analgesic 30 minutes before physical therapy treatment.
d. The patient will report pain intensity as 3 or less during hospital stay.
55. During the night duty, you admit an adult man who was brought by his wife, after being called by
maid who saw the husband drinking pesticide, however the man says that he was not intoxicated. The
nurse identifies that the client is exhibiting symptoms of:
a. Denial.
b. Reaction formation.
c. Projection.
d. Transference.
56. A withdrawn and isolated patient is MOST likely suffering from which of the following stressors on
basic human needs?
a. Physiologic needs.
b. Safety and security needs.
c. Self-esteem needs.
d. Love and belonging needs.
57. Some of the following symptoms should be reported by the client with posttraumatic stress disorder
(PTSD):
i. Inability to relax
ii. Recurrent, unwanted distressing memories of the traumatic event.
iii. Flashbacks.
iv. Talking about problems to friends.
v. Nightmares about traumatic event.
vi. Increased alcohol consumption.
vii. Trying to avoid or talking about traumatic event
viii. Significant interactive with others.
ix. Hopeless of the future.
When you are assessing a suspected patient of PTSD, which of the aforementioned symptoms would you
expect?
a. i,ii,iii & iv
b. i,iii,v & vi
c. ii,iii, v,vii &ix
d. i,ii,iii,iv ,viii & v
Registration N°:
Page 11 of 28
53. What is the end result of data analysis during the assessment in nursing process?
a. Actualization of the plan of care.
b. Determination of the patient’s responses to care.
c. Collection and analysis of data.
d. Identification of actual or potential health problems.
54. After determining a nursing diagnosis of acute pain, what is an appropriate client-centered goal that
the nurse may develop?
a. Encourage client to implement none pharmacological method of pain relieve
b. Determine effect of pain intensity on client function.
c. Administer analgesic 30 minutes before physical therapy treatment.
d. The patient will report pain intensity as 3 or less during hospital stay.
55. During the night duty, you admit an adult man who was brought by his wife, after being called by
maid who saw the husband drinking pesticide, however the man says that he was not intoxicated. The
nurse identifies that the client is exhibiting symptoms of:
a. Denial.
b. Reaction formation.
c. Projection.
d. Transference.
56. A withdrawn and isolated patient is MOST likely suffering from which of the following stressors on
basic human needs?
a. Physiologic needs.
b. Safety and security needs.
c. Self-esteem needs.
d. Love and belonging needs.
57. Some of the following symptoms should be reported by the client with posttraumatic stress disorder
(PTSD):
i. Inability to relax
ii. Recurrent, unwanted distressing memories of the traumatic event.
iii. Flashbacks.
iv. Talking about problems to friends.
v. Nightmares about traumatic event.
vi. Increased alcohol consumption.
vii. Trying to avoid or talking about traumatic event
viii. Significant interactive with others.
ix. Hopeless of the future.
When you are assessing a suspected patient of PTSD, which of the aforementioned symptoms would you
expect?
a. i,ii,iii & iv
b. i,iii,v & vi
c. ii,iii, v,vii &ix
d. i,ii,iii,iv ,viii & v

Registration N°:
Page 4 of 28
diabetes:
Esophageal varices.
Ascites.
Peripheral edema.
the last moment.
patient?
Registration No
:
Page 12 of 28
55. Which of the following statement is TRUE about post term pregnancy?
a. Routine Scans increase the incidence induction of labor for postdates.
b. Perinatal mortality and morbidity rise sharply after 42 weeks of gestation.
c. A pregnancy is prolonged if it is on 40 weeks’ plus three days of gestation.
d. Fetal distress and neonatal illness are less common.
56. A 15-year-old primigravida is admitted with a tentative diagnosis of HELLP syndrome. Which laboratory
finding is associated with HELLP syndrome?
a. Elevated blood glucose.
b. Elevated platelet count.
c. Elevated creatinine clearance.
d. Elevated hepatic enzymes.
57. You finish conducting delivery of the mother, placenta and its membranes delivered complete. You
noticed that the mother is bleeding, uterus is well retracted, no tear on the perineum and vaginal wall.
What do you think can be the cause of that bleeding?
a. Uterine atony.
b. A big baby.
c. Bladder is full of urine.
d. Cervical tear/laceration.
58. A woman presenting at 26 weeks ‘gestation with a blood pressure of 164/98mmHg and proteunuria of 2+.
What diagnosis would you suspect?
a. Pre-eclampsia
b. Severe pre-eclampsia
c. Epilepsia
d. Eclampsia
59. A woman presents for the first time to your clinic at 30 weeks with a blood pressure of 144/92mmHg and
3+ proteinuria. When should you retake her blood pressure to see if she has pre-eclampsia?
a. 1 hour
b. 2 hours
c. 4 hours
d. 12 hours
60. Which of the following BEST describes a late fetal heart rate (FHR) deceleration?
a. Deceleration starts after uterine contraction begins, reaches lowest point after peak of uterine
contraction, resolves to baseline after uterine contraction is over.
b. Deceleration begins with uterine contraction, reaches lowest point at peak of uterine contraction,
returns to baseline at end of uterine contraction.
c. Deceleration starts before the uterine contraction, reaches lowest point at peak of uterine
contraction, returns to the normal at the end of the contraction.
d. Deceleration may begin of the uterine contraction and ends during uterine contraction.
Registration N°:
Page 12 of 28
58. Which one of the following plan of continuing care for a moderately depressed client should the nurse
include?
Allowing the client time to be alone to decide in which activities to engage.
Offering the client an opportunity to make some decisions.
Making all decisions to relieve the client of this responsibility.
Encouraging the client to decide how to spend leisure time.
59. When an ethical dilemma arises, which is the MOST important nursing responsibilities in managing
client care situations among the following?
a. Be able to defend the morality of one owns’ action.
b. Remain neutral and detached when making an ethical decision.
c. Ensure that a team is responsible for deciding ethical questions.
d. Follow the client and family wishes exactly.
60. The nurse has to protect the access, control, and dissemination of patient information. Which of the
following ethical principle matches to above statement?
a. Autonomy.
b. Balancing the harms and benefits.
c. Minimizing the harms.
d. Privacy and confidentiality.
61. A patient is brought to the emergency department with an injured lower left leg following a fall while
he was climbing tree. The nurse identifies the presence of a fracture based on what cardinal sign of
fracture?
a. Muscle spasms.
b. Edema and swelling.
c. Pain and tenderness.
d. Obvious deformity.
62. What is a disadvantage of open reduction and internal fixation of a fracture compared to closed
reduction?
a. Infection.
b. Skin irritation.
c. Nerve impairment.
d. Complications of immobility.
63. A patient with a fractured tibia accompanied by extensive soft tissue damage initially has a splint
applied and held in place with an elastic bandage. What early sign should alert the nurse that the
patient is developing compartment syndrome?
a. Paralysis of the toes.
b. Absence of peripheral pulses.
c. Distal pain unrelieved by opioid analgesics.
d. Skin over the injury site is blanched when the bandage is removed.

Registration N°:
Page 4 of 28
diabetes:
Esophageal varices.
Ascites.
Peripheral edema.
the last moment.
patient?
Registration No
:
Page 13 of 28
61. Which of the following statements BEST describes hyperemesis gravidarum?
a. Severe anemia leading to an electrolyte, metabolic, and nutritional imbalances in the absence of
other medical problems.
b. Severe nausea and vomiting leading to an electrolyte, metabolic, and nutritional imbalances in
the absence of other medical problems.
c. Loss of appetite and continuous vomiting that commonly results in dehydration and ultimately
decreasing maternal nutrients.
d. Severe nausea and diarrhea that can cause gastrointestinal irritation and possibly internal bleeding.
62. Which of the following may happen if the uterus becomes over stimulated by oxytocin during the
induction/augmentation of labor?
a. Weak contraction prolonged to more than 70 seconds.
b. Titanic contractions prolonged to more than 90 seconds.
c. Increased pain with bright red vaginal bleeding.
d. Increased restlessness and anxiety.
63. Which of the following BEST describes preterm labor?
a. labor that begins after 15 weeks’ gestation and before 37 weeks’ gestation.
b. labor that begins after 20 weeks’ gestation and before 37 weeks’ gestation.
c. labor that begin after 24 weeks’ gestation and before 42 weeks’ gestation.
d. labor that begins after 28 weeks’ gestation and before 40 weeks’ gestation.
64. Which of the following amount of blood loss following birth marks the criterion for describing
postpartum hemorrhage?
a. More than 400 ml
b. More than 300 ml
c. More than 200 ml
d. More than 500 ml
65. Which of the following assessment findings would the midwife expect if the client develops Deep vein
thrombosis?
a. Chills, fever, stiffness, and pain occurring 10 to 14 days after delivery.
b. Midcalf pain, tenderness and redness along the vein.
c. Chills, fever, malaise, occurring 2 weeks after delivery.
d. Muscle pain the presence of Homans sign, and swelling in the affected limb.
66. Mrs. Angela, G1P00, 26 years old 12 weeks’ pregnant comes to the emergency department with
abdominal cramping and moderate vaginal bleeding. Vaginal examination reveals 3 cm cervical dilation.
The midwife would document these findings as which of the following?
a. Threatened abortion
b. Inevitable abortion
c. Complete abortion
d. Missed abortion
Registration N°:
Page 13 of 28
64. A client is admitted in surgical department after road traffic accident presenting pain and swelling on
left lower limb, decreased sensation on left toes, tingling and cyanosis, the surgeon confirm
compartment syndrome. What is the FIRST surgical treatment required for this client?
a. Fasciotomy.
b. Amputation.
c. Internal fixation.
d. Release of tendons.
65. The patient asks the nurse why she needs to have surgery for a femoral, strangulated hernia. What is
the BEST explanation the nurse can give the patient?
a. The surgery will relieve her constipation.
b. The abnormal hernia must be replaced into the abdomen.
c. The surgery is needed to allow intestinal flow and prevent necrosis.
d. The hernia is because the umbilical opening did not close after birth as it should have.
66. What can patients at risk for renal lithiasis do to prevent the stones?
a. Lead an active lifestyle.
b. Limit protein and acidic foods in the diet.
c. Drink enough fluids to produce dilute urine.
d. Take prophylactic antibiotics to control urinary tract infections (UTIs).
67. A patient with chronic osteomyelitis has been hospitalized for a surgical debridement procedure.
What does the nurse explain to the patient as the rationale for the surgical treatment?
a. Removal of the infection prevents the need for bone and skin grafting.
b. Formation of scar tissue has led to a protected area of bacterial growth.
c. The process of depositing new bone improves the vascular supply to the bone.
d. Antibiotics are effective against microorganisms that cause chronic osteomyelitis
68. After abdominal surgical intervention, a male client was admitted in recovery room where he has to
receive closed monitoring by the nurse and the care giver. After 4 hours, the nurse who was very busy
with other clients return to see the client and found him shock status. What is the most common cause
of shock in a surgical patient?
a. Anaphylaxis.
b. Sepsis.
c. Hypovolemia.
d. Cardiac failure.
69. The aspiration pneumonia is the one of the surgical complication. When this complication occurs in
patients who is in supine position, which of the following lung lobes is mostly affected?
a. Right upper lobe.
b. Right lower lobe.
c. Left upper lobe.
d. Left lower lobe.

Registration N°:
Page 4 of 28
diabetes:
Esophageal varices.
Ascites.
Peripheral edema.
the last moment.
patient?
Registration No
:
Page 14 of 28
67. Upon assessment, the midwife found the following: fundus at 2 finger breadths above the umbilicus, last
menstruation period (LMP) 5 months ago, fetal heart beat not audible on auscultation. Which of the
following is the MOST possible diagnosis of this condition?
a. Missed abortion.
b. hydatid form mole.
c. Pelvic inflammatory disease.
d. Ectopic pregnancy
68. Before giving a repeat dose of magnesium sulfate to a pre-eclamptic woman, the midwife should assess
the woman’s condition. Which of the following conditions will require the midwife to temporarily
suspend a repeat dose of magnesium sulfate?
a. Knee jerk reflex is (+) 2.
b. 100 cc, urine output in 4 hours.
c. Respiratory rate of 16/min.
d. Serum magnesium level is 10mEg/L.
69. You are a midwife in the labor room and you are monitoring a woman with dysfunctional labor for signs
of maternal or fetal compromise. Which of the following assessment findings would alert you to think a
fetal compromise?
a. Maternal fatigue.
b. coordinated uterine contractions.
c. Meconium in the amniotic fluid.
d. Progressive changes in the cervix.
70. While a midwife is assessing a G2P2 woman who had a normal spontaneous vaginal delivery 45 minutes
ago, you note a large amount of red vaginal bleeding. What would be the initial priority nursing action?
a. Monitor vital signs.
b. Notify the physician.
c. Encourage to breast-feed soon after birth.
d. check if the uterus is soft and provide fundal massage.
71. Which of the following lists contain the three main causes of bleeding after birth?
a. Soft uterus, a retained placenta, and perineal tearing.
b. Soft uterus, malaria, and dehydration.
c. Retained placenta, malaria, and perineal tearing.
d. Soft uterus, twins, and perineal tearing.
72. The goal of antihypertensive medication is to maintain diastolic blood pressure within what range?
a. Between 80 and 100 mmHg
b. Between 90 and 100 mmHg
c. Between 100 and 110 mmHg
d. Between 70 and 100 mmHg
Registration N°:
Page 14 of 28
70. A patient is brought to hospital for lower limb pain and discoloration and the patient is diagnosed
with gas gangrene. A nurse takes this case as an emergency because of which of the following
reasons?
Gas gangrene is usually caused by clostridium perfringens bacteria.
The infection spreads rapidly as the gases produced by the bacteria expand and infiltrate the
healthy tissue in the vicinity.
Gas gangrene can cause necrosis and sepsis.
The gas gangrene is caused by saprogenic microorganisms which cause tissue to swell and
emit fetid smell.
71. Which of the following microorganisms is the causative agents of the most abscess?
a. Streptococcus species.
b. Staphylococcus aureus.
c. Klebsiella.
d. Entamoeba coli.
72. The term “hemorrhoid” refers to swollen veins which vascularize the anus and lower rectum that lead
to pain during defecation. What factors predisposes to development of that pathology?
a. Increased intra-abdominal pressure and infection
b. Infection and Repetitive straining
c. Repetitive straining and increased intra-abdominal pressure
d. Constipation and frequent use of stool softeners
73. In order to preserve function and the ability to perform activities of daily living (ADLs), what should
the nurse teach the patient with Osteoarthritis (OA)?
a. Avoid exercise that involves the affected joints.
b. Maintain normal activities during an acute episode to prevent loss of function.
c. Plan and organize task performance to be less stressful to joints.
d. Use mild analgesics to control symptoms when performing tasks that cause pain.
74. A patient has fallen in the bathroom of the hospital room and reports pain in the upper right arm and
elbow. Before splinting the injury, the nurse knows that the priority management of a possible
fracture should include which action?
a. Neurovascular checks below the site of the injury.
b. Elevation of the arm with a pillow.
c. Application of anti-inflammatory cream.
d. Report the case to the health care provider.
75. When the nurse brings the consent form to the client before surgical intervention, the client expresses
fear of pain due to intervention. In order to help the client to cope with fear of pain, what would be
the nursing intervention?
a. Describe the degree of pain expected.
b. Divert the client when talking about pain.
c. Inform the client of the frequency of pain medication.
d. Explain the availability of pain medication.

Registration N°:
Page 4 of 28
diabetes:
Esophageal varices.
Ascites.
Peripheral edema.
the last moment.
patient?
Registration No
:
Page 15 of 28
73. What are the gestational ages between which you would give antenatal corticosteroids (such as
dexamethasone) to improve neonatal outcomes?
a. Between 28 and 36 weeks.
b. Between 22 and 34 weeks.
c. Between 34 and 36 weeks.
d. Between 24 and 34 weeks.
74. Which of the following would the midwife most likely expect to find when assessing a pregnant woman
with abruption placenta?
a. Excessive vaginal bleeding.
b. Rigid, board-like abdomen.
c. Titanic uterine contractions.
d. Premature rupture of membranes.
75. A G1P000 at 38 weeks’ gestation is admitted in labor ward with painless, bright red bleeding and mild
contractions every 7 to 10 minutes. Which of the following assessments should be avoided?
a. Maternal vital sign.
b. Contraction monitoring.
c. Fetal heart rate monitoring.
d. Vaginal examination.
76. If the placenta has not delivered within 30 minutes and the mother is not bleeding too much, what action
a midwife can do?
a. Wait until placenta delivered spontaneously.
b. Give another dose of oxytocin 10UI/IM.
c. Give ergometrine 0,2 mg IV.
d. Give Ampicillin.
77. If available, which laboratory tests should be done on women with suspected pre-eclampsia?
a. CBC (Complete Blood Count) with platelet count, serum creatinine, and uric acid.
b. CBC with platelet count, liver enzymes, and serum creatinine.
c. CBC with platelet count, liver enzymes, and hemoglobin.
d. CBC with platelet count, liver enzymes, hemoglobin and HIV.
78. How often should you monitor a woman receiving Magnesium Sulfate (MgSO4)?
a. Every 120minutes.
b. Every 60 minutes.
c. Every 30 minutes,
d. Every 15 minutes
79. What reason would make you withhold the next scheduled dose of Magnesium Sulfate (MgSO4)?
a. Blood pressure is 140/80 mmHg.
b. Patellar reflexes are absent.
c. Respiratory rate is 16 breaths per minute.
d. Pulse rate is 90 beats per minutes.
Registration N°:
Page 15 of 28
76. The patient is admitted from home with a stage II pressure ulcer. What is the nurse likely to observe
when she does her wound assessment?
a. Serosanguinous drainage.
b. Adherent gray necrotic tissue.
c. Creamy ivory to yellow-green exudate.
d. Clean, moist granulating tissue.
77. What type of dressing will the nurse most likely use for the patient with stage II of pressure ulcers?
a. Dry, sterile dressing.
b. Absorptive dressing.
c. Negative pressure wound therapy.
d. Telfa dressing with antibiotic ointment.
78. By priority of action, what is the most important nursing intervention for the prevention and treatment
of pressure ulcers?
a. Using pressure-reduction devices.
b. Massaging pressure areas with lotion.
c. Repositioning the patient, a minimum of every 2 hours.
d. Using lift sheets and trapeze bars to facilitate patient movement.
79. To prevent airway obstruction in the postoperative patient who is unconscious or semiconscious, what
will the nurse do?
a. Encourage deep breathing.
b. Elevate the head of the bed.
c. Administer oxygen per mask.
d. Position the patient in a side-lying position.
80. The patient has persistent and continuous pain at Mc Burney’s point. The nursing assessment reveals
rebound tenderness and muscle guarding with the patient preferring to lie still with the right leg
flexed. What should be the nursing interventions for this patient include?
a. To oblige the patient to take the drugs to move the constipated bowel.
b. To oblige the patient to keep nothing per oral (NPO) status in preparation for possible
appendectomy.
c. Provide parenteral fluids and antibiotic therapy for 6 hours before surgery.
d. Insert Nasogastric tube to decompress the stomach and prevent aspiration pneumonia.
81. A 34-year-old male patient with confirmed oesophageal varices on endoscopy presents with massive
haematemesis. Which of the following modes of therapy is relatively contraindicated?
a. Propranolol tablets.
b. Nasogastric tube insertion.
c. IV administration of Vasopressin
d. Endoscopic sclerotherapy.

EXAMEN COUNCIL QUESTION JUIN 2019.pdf

EXAMEN COUNCIL QUESTION JUIN 2019.pdf

Recommandé

Recommandé

Contenu connexe

Similaire à EXAMEN COUNCIL QUESTION JUIN 2019.pdf

Similaire à EXAMEN COUNCIL QUESTION JUIN 2019.pdf (18)

Plus de RBGroup

Plus de RBGroup (20)

Dernier

Dernier (20)

EXAMEN COUNCIL QUESTION JUIN 2019.pdf