CNA253 Professional Practice 2: Nursing MCQs and Scenarios at UTAS

This document presents a collection of multiple-choice questions (MCQs) and short-answer scenarios covering key areas of nursing practice, including the nervous system, nutrition, and bone health. The MCQs test knowledge of various conditions, assessments, and interventions related to neurological disorders, nutritional imbalances, and musculoskeletal issues. The short-answer scenarios require application of nursing principles to patient care, such as assessing cerebral perfusion, managing ileostomy complications, and addressing compartment syndrome risks. The assignment provides a valuable resource for nursing students to review and apply their knowledge in preparation for exams and clinical practice. It also covers relevant topics for CNA253 Professional Practice 2 at the University of Tasmania.

Running head: NURSING MCQ AND SCENARIOS
Nursing MCQ and scenarios
Name of the student:
Name of the university:
Author note:

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NURSING MCQ AND SCENARIOS
Table of Contents
Part A:..........................................................................................................................................................1
MCQ:.......................................................................................................................................................1
Short answer questions:..........................................................................................................................1
Part B:..........................................................................................................................................................1
MCQ:.......................................................................................................................................................1
Short answer questions:..........................................................................................................................1
Part C:..........................................................................................................................................................1
MCQ:.......................................................................................................................................................1
Short answer questions:..........................................................................................................................1

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NURSING MCQ AND SCENARIOS
Part A:
MCQ:
Question 1:
Answer: B (consciousness)
Question 2:
Answer: D (CNIII)
Question 3:
Answer: B (spinal cord)
Question 4:
Answer: A (Paraplegia)
Question 5:
Answer: D (A blood clot formed in the heart that travels to and blocks a cerebral artery)
Question 6:
Answer: A (The difference between the mean arterial pressure and intracranial pressure)
Question 7:
Answer: B (Increased Systolic BP, Bradycardia, and Wide Pulse Pressure)
Question 8:

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NURSING MCQ AND SCENARIOS
Answer: D (Nail bed pressure)
Question 9:
Answer: D (Face, arm, speech, time)
Question 10:
Answer: A (Wernicke’s receptive dysphasia)
Short answer questions:
Question1;
A transient ischemic attack (TIA) is like a stroke and produces similar symptoms.
However, it only lasts for about a few minutes and produces no permanent damage. These
usually serve as warning situations of underlying deep rooted anomalies which need immediate
medical attention. In TIA there is temporary blockage of blood supply to the brain resulting in a
situation such as stroke. The plaguing of the arteries supplying blood to the brain with
cholesterol containing fatty acids can contribute to the development of TIA. The TIA could be
characterized by the presence of a number of condition such as –
- Numbness or weakness of the face, arms or legs
- Severe headache
- Loss of balance or coordination
The clot develops in the blood vessel supplying the brainstem cutting the normal flow of
blood. A clot in the brainstem can impair several important functions of the body such as
swallowing, breathing, speech, hearting and eye movements. It is also the centre for balance and
coordination. Therefore, damage to the brainstem can be life threatening condition resulting
drooping face in one direction, partial or transient loss of body movements etc. It can also lead to

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NURSING MCQ AND SCENARIOS
a condition known as locked in syndrome where the entire body excepting the eye muscles are
paralysed. Here, the patient Mr. Maisy depicted unintelligible speech, weakness of face and right
ataxic arm.
Question 2:
1. Assessment of the decreased cerebral perfusion leading to loss of consciousness, this will help in
discovering the extent of the neurological deficit and will determine and influence the
interventions to follow.
2. Assessing and monitoring neurological functions frequently and elevating HOB at nights.
Assessment of the trends in the level of consciousness will help in discovering potential for
increased ICP and will help in determining the extent and progression of damage. The elevation
will aid in increasing the gravitational blood flow.
3. Improving the consciousness of the patient to resist further cerebral perfusion, persistent
cerebral perfusion will lead to facilitate the paralysis and enhance the possibility of whole body
paralysis.
4. Assisting in self care activities and changing lying position every two hours, this will prevent the
extent of fatigue and will help in avoiding overexertion. it will help in preventing blood stasis and
will therefore avoid the occurrence of pressure ulcer
5. Provide comfort measure and non-pharmacological interventions for pain and assisting the
patient in the measures. Activity intolerance and resultant pain is very common due to
neurovascular impairments. The comforting measures will help in relieving the patient from the
discomfort and pain.
Question 2:
1. Elevated blood pressure: As the blood pressure of the patient had ranged between 160/80 to
180/70 in the facility, it is a very important risk factor for stroke. As an intervention, that will be
needed to be administered antihypertensive medications such as calcium channel blockers and
ACE inhibitors to reduce the blood pressure to ward off the risk of stroke in the future.
2. Smoking: As prolonged smoking can damage the blood vessels and lead to arterial blockages it is
a grave risk factor for stroke. The intervention for the patient will be to educate him on the
consequences of smoking on his health, especially the cardiac healthy and the possibility of
stroke.
3. Type 2 diabetes: As having prolonged type two diabetes doubles the risk of stroke the patient
will need to maintain a strict diet and will have to reduce body weight to avoid further risk of
arteriosclerosis.

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NURSING MCQ AND SCENARIOS
4. Arterial fibrillation: Arterial fibrillation leads to frequent blood clot formation in the arteries
enhancing the risk of stroke. The intervention will be educating the patient to do deep breathing
exercises, blood circulation improving physiotherapy, and follow a strict low cholesterol diet.
5. Genetic predisposition: As the patient had his father die of stroke, his chances of developing
arterial diseases are very high. The intervention in this case will be to educate the patient the
importance of regular checkups and using cardiac health resources like the stroke foundation.

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NURSING MCQ AND SCENARIOS
Part B:
MCQ:
11. C) Lipids
12. B) waist circumference > 80 cm
13. C) Pancreatitis
14. D) Electrolyte imbalance and dehydration
15 C) increasing the motility and secretion
16. D) All of the above
17. A) iron deficiency
18. B) obese
19. C) X-Ray
20. A) tip of the nose to the top tip of the ear to the xyphoid process
Short answer questions:
Question 4:
In this context, the patient was found vomiting undigested content and was in pain. on
further inspection the patient was suggested ileostomy. In ilesotomy an opening is made
surgically in the abdominal wall. The surgeon passes the ileum through the opening and stitches
it into place. The ileostomy needs to be performed in the patient’s case as she was suffering from

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NURSING MCQ AND SCENARIOS
improper colon function and unable to pass faeces. This could be further attributed to injuries or
accidents that involve the intestines.
Question 5:
Mrs. Baily had an output of ostomy equivalent to 1. 8 litres in the last two days. This
should have been a serious cause of concern for the nurses attending the patient as the normal
urine output should have been within the range of 4 -8 litres. The low urine input could be a
signal that there is less s water absorption from the digestive content as the patient is unable to
hold food within the ileum pouches.The patient depicted same stoma output since the last two
days which signified that the body of the patient had become toxic due to the accumulation of
the nitrogenous waste.
Question 6:
The less output though the ostomy could be related to drop in blood pressure, as the
patient is not able to absorb sufficient water from the food through the intestinal wall , it
results in situation of drop in the orthostatic pressure of the patient.
The plasma solute concentrations have been responsible for maintaining effective blood
pressure. These are again absorbed in the blood through the food. However, since the ileum is
unable to hold the food after the injury, the patient is unable to retain or absorb the required
amount of nutrients affecting the orthostatic pressure.
Question 7:
Therefore, based upon the present conditions depicted by the patient a number of nursing
interventions could be suggested for the patient such as –

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NURSING MCQ AND SCENARIOS
- Non-pharamacological pain management where the patient could be counselled with
behavioural modifications to change her attitude towards her present health condition which
could reduce the anxiety and the panic associated with pain and make the patient more
resilient.
- Monitoring of the blood pressure of the patient on a regular basis which could help in
monitoring the anomalies in the orthostatic pressure maintenance which is related to plasma
solute concentration
- Assessment of the urine output in the patient along with faecal output which will help in
understanding the normal body functioning of the patient
- The patient should not be made to remain in a lying down position as it may affect the
normal bowel movement within the patient
- Monitoring the body temperature of the patient which will signify any other anomalies present
within the body of the patient.
Question 8:
The number of complications that could arise to Miss Bailey’s stoma are:-
- necrosis due to tissue death or injury in the region
- The stoma complications could further result in a prolapsed stage by increasing the chances
of bacterial and viral infections in the region manifold times
- It could lead to parastomal hernias , which are incisional hernias in the area of the abdominal
musculature that was incised to bring the intestine though the abdominal wall to from the
stoma
- It could lead to edema in the long run which often become the site of secondary infections
- Additioinally, the necrosis of the tissues in the adjacent areas adjacent to the colon may
enhance the fungal and pathogen activity leading to the development of conditions such as
urine continence within the patient.

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NURSING MCQ AND SCENARIOS
Part C:
MCQ:
Question 21:
Answer: A (there is reduced weight-bearing stimulation of bone formation)
Question 22:
Answer: C (Compression of the fascia)
Question 23:
Answer: B (Dislocation)
Question 24:
Answer: B (Gouty arthritis)
Question 25:
Answer: A (Anticholinesterase)
Question 26:
Answer: A (Dorsalis pedis and posterior tibialis)
Question 27:
Answer: C (Fasciotomy)
Question 28:

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NURSING MCQ AND SCENARIOS
Answer: D (Peripheral circulation)
Question 29:
Answer: D (Oedema)
Question 30:
Answer: D (Female sex, age greater than 55, history of early menopause, low calcium intake,
sedentary lifestyle, smoking, reduced vitamin D levels)
Short answer questions:
Question 9:
As the patient has had a surgery previously and also had a fracture realignment done for
the patient, the chances of the patient suffering from a compartment syndrome is very high.
Along with that the pain score of the patient had been 10/10 and she had been slightly febrile and
with extremely low blood pressure which can be due to circulatory resistance. Hence, it can be
deduced that the post operative complications that the patient had been suffering from had been
post surgical acute compartment syndrome
Despite the fact the patient had been given the pain medication, compartment syndrome
can easily lead to acute pain. The most plausible pathophysiology of the patient acquiring the
compartment syndrome is the acute pressure produced by the fracture realignment which must
have led to fascial oedema. the increased pressure due to the fracture within a limited space can
compromise the circulation and function of the tissues within, resulting in tissue ischaemia,
necrosis and nerve damage, which in turn leads to acute limb compartment syndrome. Hence the

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NURSING MCQ AND SCENARIOS
patient had been feeling acute pain even after being administered pain medication due to her
progressing compartment syndrome.
Question 10:
Age: As the over the age of 50 the risk of compartment syndrome and related complications are
considerably higher. The age being 57 is a serious risk factor for the patient. The intervention
will be to refer the patient to occupational therapist and physiotherapist for exercises port
fascioctomy.
Gender: Females are at a greater risk of developing this condition, especially after a certain age
and hence the patient will be further encouraged for regular check-ups as an intervention to avoid
risk of further complications.
Smoking: As smoking enhances the risk of acute limb compartment syndrome to some extent as
well, the intervention will be to educate and encourage the patient to cease smoking.
Sedentary lifestyle: The immobility is another great risk factor for gaining acute limb
compartment syndrome. The intervention will be encourage her for mild exercises throughout
the day
Fracture realignment: The realignment increased the chances of compartment syndrome due to
fascial pressure. Intervention will be to assessment and medication administration.
Question 11:
Pallor: as it is a good indicator of extremity being perfuse this assessment will be performed first.