Clinical Nursing COC Exam
41. A two-year-old female child was brought to a health center with difficulty of feeding and fever of three days duration. On examination, she has rash around the face and neck and the clinician suspected measles.
What could be the pathognomonic sign to substantiate this diagnosis?
(A) Red eyes
(B) Rose spots
(C) Runny nose
(D) Koplik spots
42. An infant with confirmed hemophilia B developed hematuria and admitted to the hospital.
The nurse provided the appropriate amount of maintenance fluid with bed rest but
hematuria continued for consecutive days.
What is the most appropriate next step in the management of this infant?
(A) Giving 201U/kg factor IX
(B) Giving 40IU/kg factor IX
(C) Giving 40IU/kg factor VIII
(D) Giving 201U/kg factor VIII
43. A three-year-old male child goes to supermarket with his mother and asked his mother to buy him extra chocolate. The mother told him that she didn’t have sufficient money and promised him to buy next time. However, the baby didn’t agree, dropped to the floor and started crying, screaming and kicking in rage at the middle of the supermarket.
What is the most likely behavioral characteristic of this child?
(D) Temper Tantrums
44. A three-year-old child with the complaints of change in social interaction and repetitive behavior came to a hospital. On assessment, the child loves to play alone, used multiple nonverbal behaviors, plays with the same toys and did not speak words appropriately.
What is the most likely diagnosis of this child?
(A) Attention deficit
(B) Down syndrome
(C) Autism spectrum disorders
(D) Childhood depression disorder
45. A 20-year-old woman came to a clinic and reported that she has not been getting asleep for
one week. She was more talkative than usual. On mental status examination, she is
uncooperative, easily annoyed, and seductive and has flight of idea.
What is the most important mental status finding to support her diagnosis?
(C) Flight of idea
46. A 25-year-old woman came to a clinic and complained about persistent feeling of sadness, hopelessness, sleep disturbance and loss of interest. The mental status examination revealed that she had difficulty to sustain attention.
What are the core symptoms in the diagnosis of the above patient?
(A) Hopelessness and/or distractibility
(B) Loss of interest and/or hopelessness
(C) Distractibility and/or sleep disturbance
(D) Depressed mood and/or loss of interest
47. A 17-year-old boy gets 5 mg of haloperidol to control his aggression. After an hour of his first injection, he starts to experience brief contractions of muscles that result in obviously abnormal movements, tongue protrusion and difficulty of swallowing.
What is the most likely diagnosis of the above patient?
48. A 19-year-old married woman, recently diagnosed with bipolar I disorder manic episode,
came to a clinic crying loudly. Her nose bleed and there is visible laceration on her face.
Her mother reports that her husband has beaten her due to her unacceptable behavior with other man.
What is the priority nursing action for the above case?
(A) Tell her she has to avoid such behavior in the future
(B) Report to legal service unit for necessary investigation
(C) Stop bleeding and reassure her she will be safe at hospital
(D) Calm the patient and call her husband for further communication
49. A 65-year-old patient from middle income family, with a diagnosis of dementia, was brought to a clinic by his daughter. She reports that despite she has been giving prescribed medication timely, his behavior is becoming worse. Currently, he lives alone and smokes three pieces of cigarette/day.
What is the best predictor of risk for poor adherence in this patient?
(C) Substance use
(B) No insight
50. A 55-year-old woman came to a clinic for psychiatric evaluation. At the start of the interview, she focuses on issues that the nurse consider irrelevant.
What is the next best step that the nurse should follow?
(A) Ask her if she understood what he is asking her
(B) Guide the patient to come to direction of his point
(C) Tell her he will give another time to talk the details
(D) Listen for a while even things he doesn’t want to hear
51. A35-year-old patient with a diagnosis of delusional disorder was brought to a hospital. He stopped his hazardous drinking habit before one year. Despite his false belief which interferes with his functioning, he performs well during the mental status examination. He has never been met criteria for schizophrenia.
What is the most appropriate explanation for his diagnosis?
(A) He has abnormal false belief
(B) He has functional impairment
(C) He has history of excessive alcohol use
(D) He has never met criteria for schizophrenia
52. A 17-year-old student has persistent fear of speaking in front of his class mates. He fears that he will act in a way that will be negatively evaluated by his colleagues. Because of his fear, he failed to score good mark in class activities for the last one year.
What is the most likely diagnosis?
(A) Specific phobia
(B) Social anxiety disorder
(C) Separation anxiety disorder
(D) Generalized anxiety disorder
53. A 32-year-old soldier saw terrorist attack on television and starts to experience feelings of panic. The panic disappeared within a few hours; however, for the next few nights, he had night mares with frequent thoughts about dying. Before 10 years, he survived ambush which killed three of his close friends in front of him.
What is the most likely diagnosis for the above case?
(A) Complicated grief
(B) Acute stress disorder
(C) Adjustment disorder
(D) Post traumatic stress disorder
54. The nurse working in university students clinic meet a 19-year-old fresh student fulfilling the diagnostic criteria for adjustment disorder with depressed mood. He occasionally had difficulty of sleeping but function optimally.
What is the most appropriate nursing intervention for this case?
(A) Give medication to help him sleep well
(B) Tell him to come back if symptoms worsen
(C) Reassure and advise to contact counseling unit
(D) Reassure him symptoms will subside with time
55. A 54-year-old man had been able to stop drinking many times. Currently, he is
experiencing tremor, anxiety, and problems sleeping in his trial for one more times. He is typically self-medicating these symptoms with three 10-mg tablets of diazepam per day.
What is the most likely diagnosis of the above case?
(A) Alcohol abuse
(B) Alcohol dependency
(C) Alcohol intoxication
(D) Alcohol withdrawal
56. A group of patients with substance use disorder were admitted to substance rehabilitation center. Most of them deny their problem. The nurse is preparing a teaching plan for them to help their recovery.
What is the most appropriate information to be included in the nursing plan?
(A) Communicate one can use substance for their stress relieving effect
(B) Focus on change in the patient’s motivation probably has the best impact
(C) Persons with substance-related problems can recover without formal treatment
(D) Communicate that substance use is a problem not related to individual weakness
57. A 67-year-old woman was brought to a hospital due to progressive deterioration of memory and language ability in the last two years. Her son reports that she couldn’t stay at home, wandering on the street and often miss to return to home. During examination, she is alert, has memory problem and talks alone appearing as if discussing with someone.
What is the most likely outcome of treating this patient?
(A) Peaceful death within a short period of time
(B) Eventual full return to pre morbid level of functioning
(C) Eventual partial return of pre morbid level of functioning
(D) Behavioral control with delaying of cognitive deterioration
58. A 50-year-old dementia patient was admitted to a hospital. On assessment, he had forgetfulness, fluctuating mood and impaired decision making ability. His son is struggling to prevent him from removing the IV line.
What is the most expected immediate outcome to be achieved after hours of intervention?
(A) Improved memory
(B) Reduced disturbance
(C) Reduced mood fluctuation
(D) Improved ability to make own decision
59. A nurse who is working as a ward head in a hospital developed annual plan with hospital staff teams. However, they failed to achieve the plan because of inability of mobilizing the human and material resources from the hospital.
What is the most likely management function that causes low achievement of this ward?
60. A university board assigned a committee in order to review curriculum vitae of applicants for a managerial position as president of a university, the committee understands that an applicant is experienced in analyzing the external environment of institutions and engaging in problem solving activities that can bring major changes.
What is the most appropriate managerial skill the applicant had based on this scenario?
(A) Technical Skill
(B) Conceptual Skill
(C) Human relation Skill
(D) Communication skill
61. A Head of the health center and planning team decided to develop a plan. The planning team developed a plan which will be used in case when unexpected problems and events occurred even if the health center developed its annual plan.
What is the most appropriate type of planning developed by the team?
(A) Strategic planning
(B) Tactical planning
(C) Operational planning
(D) Contingency planning
62. A newly appointed head of the health center had discussion with catchment kebele leaders to identify real health problems that occurred in the community. The head identified trachoma as major health problem following poor latrine utilization though they have constructed latrine.
What would be the most appropriate good care delivery approach used by the head?
(A) Disease control programs
(B) Conventional care in clinics
(C) People-centered primary care
(D) Convectional care in referral hospitals
63. A newly appointed CEO of a hospital decides to decentralize activities to subordinates after performing situational analysis. The process was done using the service regulations and consistent discussion with community members in the catchment area.
What is the most likely health service building block focused by the CEO?
(C) Human resource
(D) Service delivery
64. Job Evaluation Grading (JEG) implementation committee in zonal health administration works in the new staff job appointment. During the course, a nurse who is working in disease prevention directorate raised complains about his current appointment and takes the case to the court. The court accepted employee’s complaint and ordered the organization to cancel the decision.
What is the most likely conflict resolution used in this scenario?
(A) Win- Lose
65. Head of a health center lead a staff meeting on the issue of improving latrine utilization of the community in the catchment area. Participants of the meeting arrived at their own conclusion and stated that the head frequently relinquish responsibility and had minimal involvement in this activity.
What is the most likely leadership style the head used?
(A) Authoritarian leadership
(B) Democratic leadership
(C) Laissez faire leadership
(D) Transformational leadership
66. An experienced public health expert comes to Ethiopia from abroad and wants information about the current health delivery system of the country. During their discussion, the woreda health manager explained about the current health care tier system used by the nation.
What is the most likely explanation expected from the manager?
(A) Ethiopia has four tier system
(B) Primary hospital serves 15,000-25,000 people
(C) General hospitals are grouped under tertiary level
(D) Specialized Hospital serves 3.5-5.0 million people
67. A hospital board discusses with the management team on how to mobilize a resource to provide quality health service. They decided to improve income by collecting service cost from health care, diagnostic services, consultancies and trainings.
What is the most likely part of health care financing reform used by the board?
(A) Health Insurance
(B) Revenue Retention
(C) Fee Waiver System
(D) Exemption System
68. The Ministry of health organized a review meeting with representatives of health professionals. On the meeting, nurses from different hospitals discussed on the difference between monitoring and evaluation but they could not reach an agreement.
What is the most likely characteristic that differentiate the two concepts?
(A) Monitoring is continuous, where as evaluation is periodic
(B) Monitoring is intermittent, where as evaluation is continuous
(C) Monitoring can be done after a project ends, but not evaluation
(D) Monitoring used to have a lesson, where as evaluation prevent distraction
69. A 28-year-old female patient was diagnosed with ovarian cancer and the oncologist
decided the need for radiation therapy. The nurse in charge explained the risk of infertility secondary to radiation therapy. She refused radiation therapy and at the same time she had strong desire to have children. The procedure was done to save her life; she was cured of ovarian cancer and develop infertility
What ethical principle most likely forced the health care team’s action?
70. A 28-year-old female patient was admitted to surgical ward with ovarian cyst. The preoperative assessment identified hepatitis B infection. To prevent professionals, a nurse in charge communicated with all health care providers who might take care of the patient.
The patient volunteered to share information about diagnosis and blood screening finding.
What principle is most likely at risk of violation?
(C) Informed Consent
Ethiopian Nursing COC Exam part 1
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