MIFTAHI SERIES 1.

DAY 26

Question 1. A 6-month-old infant is brought with a history of severe diarrhea and

dehydration. The most appropriate initial treatment is:
A) Start intravenous fluids immediately.
B) Oral rehydration solution (ORS).
C) Administer anti-diarrheal medications.
D) Give antibiotics.

Answer: A) Start intravenous fluids immediately.

Rationale: Severe dehydration requires rapid restoration of fluid and electrolyte balance
through IV fluids. ORS is indicated in mild-to-moderate dehydration, but IV therapy is
critical in severe cases.

Q2. IDENTIFY THE POSITION SHOWN BELOW;

A. REVERSE TRENDELENBURG

B. REVERSE JACKKNIFE

C. JACKKNIFE

D. ORTHOPNIC

ANSWER; C
Q3. IDENTIFY THE IMAGE SHOWN BELOW;

A. DUCK’S SPECULUM

B. BALFOUR

C. KARMANS CANNULA

D. SIMS SPECULUM

ANSWER; A

CUSCO’S SPECULUM IS ASLO KNOWN AS DUCK’S SPECULUM.

Q4. A 40-year-old patient is scheduled for elective surgery. During the preoperative
assessment, you find that the patient has a Mallampati score of Class III. What does this
indicate?

A. Easy airway

B. Moderate difficulty in intubation

C. Difficult airway
D. Cannot assess the airway

Answer: C

Rationale: Mallampati Class III indicates that only the base of the uvula is visible,
suggesting a potentially difficult airway.

Q5.

A 6-week-old male infant presents with bilious vomiting and a distended abdomen. The
mother reports poor feeding and irritability. An abdominal X-ray shows a "double-bubble"
sign. What is the most likely diagnosis?
A) Intestinal malrotation with volvulus
B) Duodenal atresia
C) Pyloric stenosis
D) Hirschsprung disease

Answer: B) Duodenal atresia

Rationale: The "double-bubble" sign on X-ray is characteristic of duodenal atresia. Bilious
vomiting and abdominal distension in a neonate support this diagnosis. It typically requires
surgical correction.

Question 6

A 5-year-old girl presents with high-grade fever, red eyes, cracked lips, and a desquamating
rash on the palms and soles. She also has cervical lymphadenopathy. What is the most likely
diagnosis?
A) Scarlet fever
B) Kawasaki disease
C) Toxic shock syndrome
D) Measles

Answer: B) Kawasaki disease

Rationale: Kawasaki disease is characterized by prolonged fever, bilateral conjunctival
injection, changes in lips and oral mucosa (strawberry tongue), rash, and desquamation of
palms and soles. It requires early treatment with IVIG to prevent coronary artery
complications.
Q7. IDENTIFY THE MANEUVER BELOW;

A. RITGEN MANEUVER

B. CREDES MANEUVER

C. LOVSET MANEUVER

D. PINNARDS MANEUVER

ANSWER; A

RATIONALE; IN RITGEN MANEUVER ONE HAND IS USED TO CONTROL THE

SPEED OF DELIVERY WHILE AS OTHER HAND IS USED TO HOLD THE
BABY.THIS MANEUVER IS INTENDED TO PREVENT PERINEAL TEAR .

Q8. IDENTIFY THE SAFETY DEVICE BELOW;

A. FOOT BOARD
B. FOOT GUARD
C. FOOT SPLINT
D. KNEE REST
ANSWER; B
THIS IS POSSEYS HEAL GUARD….IT IS USED TO ISOLATE HEEL TO
PROTECT AGAINST HEEL ULCER..

Question 9

A patient presents to the emergency department (ED) with sudden onset chest pain radiating
to the left arm, diaphoresis, and shortness of breath. The initial management should include:
A) Administering aspirin and obtaining an ECG
B) Starting antibiotics and ordering a chest X-ray
C) Administering an anti-anxiety medication
D) Giving bronchodilators immediately

Answer: A) Administering aspirin and obtaining an ECG

Rationale: This presentation suggests acute coronary syndrome (ACS). Administering
aspirin helps prevent further clot formation, and an ECG is essential for diagnosis.

Question 10

A patient is brought in with signs of anaphylaxis after a bee sting. What is the first-line drug
for management?
A) Diphenhydramine
B) Epinephrine
C) Hydrocortisone
D) Ranitidine

Answer: B) Epinephrine
Rationale: Epinephrine is the first-line treatment for anaphylaxis as it counteracts
bronchoconstriction, hypotension, and laryngeal edema effectively.

Question 11

A nurse notices a patient with a head injury showing unequal pupil sizes and altered mental
status. What is the priority nursing action?
A) Elevate the head of the bed to 30 degrees
B) Administer pain medication
C) Perform a lumbar puncture
D) Notify the physician immediately

Answer: D) Notify the physician immediately

Rationale: Unequal pupils and altered mental status indicate increased intracranial pressure
or possible brain herniation, requiring immediate medical intervention.
Question 12

A 50-year-old patient arrives at the ED with severe shortness of breath and wheezing.
Oxygen saturation is 88% on room air. What is the priority nursing intervention?
A) Administering a bronchodilator via nebulizer
B) Initiating high-flow oxygen therapy
C) Starting an IV line for medication
D) Requesting a chest X-ray

Answer: A) Administering a bronchodilator via nebulizer

Rationale: The immediate goal is to relieve airway obstruction. A nebulized bronchodilator
(e.g., albuterol) helps relax airway muscles and improve oxygenation.

Question 13

A patient with a stab wound to the chest is in respiratory distress, and the trachea is deviated
to the left. What is the next immediate step?
A) Perform needle decompression
B) Obtain a chest X-ray
C) Administer oxygen therapy
D) Start IV fluids

Answer: A) Perform needle decompression

Rationale: Tracheal deviation with respiratory distress suggests tension pneumothorax,
requiring immediate needle decompression to release trapped air.

Question 14

A patient in the ED is found to have a Glasgow Coma Scale (GCS) score of 8. What is the
nurse's priority action?
A) Obtain a CT scan of the head
B) Intubate the patient
C) Administer IV fluids
D) Check blood glucose levels

Answer: B) Intubate the patient

Rationale: A GCS score of 8 or less indicates a severe brain injury and inability to protect
the airway, requiring immediate intubation.

Question 15
A patient experiencing a tonic-clonic seizure in the ED should be managed by:
A) Placing a padded tongue blade in their mouth
B) Turning the patient to their side
C) Restraining the patient to prevent injury
D) Administering a muscle relaxant

Answer: B) Turning the patient to their side

Rationale: Turning the patient to their side prevents aspiration of secretions and promotes
airway patency. Padded tongue blades or restraints should never be used during a seizure.

Question 16

A patient with suspected spinal cord injury is being transported to the ED. What is the
priority nursing intervention?
A) Immobilize the cervical spine
B) Perform a neurological assessment
C) Administer pain medication
D) Start IV fluids

Answer: A) Immobilize the cervical spine

Rationale: Immobilizing the cervical spine prevents further damage to the spinal cord during
transportation and initial evaluation.

Question 17

A patient with severe burns is admitted to the ED. The most critical initial assessment
includes:
A) Estimating the total body surface area (TBSA) affected
B) Assessing airway and breathing
C) Evaluating the depth of burns
D) Monitoring for signs of infection

Answer: B) Assessing airway and breathing

Rationale: In burn patients, airway management is the first priority, especially if there is
evidence of inhalation injury or respiratory compromise.

Question 18

A patient presents with sudden unilateral weakness, slurred speech, and facial droop. What is
the most critical nursing action?
A) Perform a stroke scale assessment
B) Administer aspirin immediately
C) Start IV fluids
D) Schedule a CT scan within the next hour

Answer: A) Perform a stroke scale assessment

Rationale: A stroke scale assessment (e.g., NIHSS) helps determine the severity of the
stroke. Timely identification of stroke symptoms is critical for determining treatment
eligibility (e.g., thrombolysis).

Q19. THE IMAGE SHOWN BELOW IS USED FOR MENSTRUAL REGULATION AND
ENDOMETRIAL ASPIRATION. IDENTIFY THE IMAGE;

A. DEPTH GUAGE

B. KARMANS CANULLA

C. TUBAL LIGATOR

D. MVA SYRINGE

ANSWER; B

Q20. Which of the following nutrients is most important to promote wound healing in
patients with pressure ulcers?

A) Vitamin D
B) Vitamin C
C) Vitamin B12
D) Calcium

Answer: B) Vitamin C
Rationale: Vitamin C is essential for collagen synthesis, which is crucial for wound healing.
It also has antioxidant properties that protect tissues from oxidative damage. While other
nutrients like protein and zinc are also important, Vitamin C plays a key role in skin repair
and regeneration.
Question 21

What is the hallmark symptom of acute appendicitis?

A) Generalized abdominal pain
B) Pain in the right lower quadrant (RLQ)
C) Sharp pain in the upper abdomen
D) Pain radiating to the back

Answer: B) Pain in the right lower quadrant (RLQ)

Rationale: Acute appendicitis typically presents with RLQ pain, often localized to
McBurney's point. This is due to inflammation of the appendix.

Question 22

Which electrolyte imbalance is most commonly associated with chronic kidney disease?
A) Hyperkalemia
B) Hypocalcemia
C) Hypernatremia
D) Hypomagnesemia

Answer: A) Hyperkalemia
Rationale: Chronic kidney disease leads to reduced excretion of potassium, causing
hyperkalemia, which can result in cardiac dysrhythmias.

Question 23

What is the first-line treatment for a patient experiencing acute chest pain suspected to be
myocardial infarction?
A) Administering nitroglycerin sublingually
B) Providing oxygen therapy
C) Giving aspirin
D) Starting an IV infusion of heparin

Answer: C) Giving aspirin

Rationale: Aspirin is administered immediately to inhibit platelet aggregation and reduce the
risk of clot progression in myocardial infarction.

Question 24

Which of the following is a characteristic finding in patients with Cushing's syndrome?

A) Moon face
B) Hyperpigmentation
C) Muscle wasting in lower limbs only
D) Hypoglycemia

Answer: A) Moon face

Rationale: Moon face, central obesity, and buffalo hump are classic features of Cushing’s
syndrome due to excessive cortisol.

Question 25

A patient with liver cirrhosis develops confusion and lethargy. What is the likely cause?
A) Hyperkalemia
B) Hepatic encephalopathy
C) Hypoglycemia
D) Portal hypertension

Answer: B) Hepatic encephalopathy

Rationale: Confusion and lethargy in liver cirrhosis patients are typically due to hepatic
encephalopathy caused by elevated ammonia levels.

Question 26

What is the priority nursing intervention for a patient having a tonic-clonic seizure?
A) Restrain the patient to prevent injury
B) Place the patient on their side
C) Insert a padded tongue blade
D) Administer IV anticonvulsants immediately

Answer: B) Place the patient on their side

Rationale: Turning the patient to their side prevents aspiration of secretions and helps
maintain an open airway during a seizure.

Question 27

What is the definitive diagnostic test for tuberculosis?

A) Tuberculin skin test (TST)
B) Sputum culture for Mycobacterium tuberculosis
C) Chest X-ray
D) Interferon-gamma release assay (IGRA)

Answer: B) Sputum culture for Mycobacterium tuberculosis

Rationale: Sputum culture is the gold standard for diagnosing active tuberculosis because it
directly identifies the causative organism.
Question 28

Which of the following is the most reliable indicator of fluid volume status in a critically ill
patient?
A) Blood pressure
B) Skin turgor
C) Central venous pressure (CVP)
D) Urine output

Answer: D) Urine output

Rationale: Urine output provides a direct and reliable measure of kidney perfusion and fluid
status in critically ill patients.

Question 29

A patient with diabetes is unconscious, and their blood glucose level is 45 mg/dL. What is the
initial management?
A) Administer IV dextrose 50%
B) Start an insulin infusion
C) Provide oral glucose
D) Recheck blood glucose in 15 minutes

Answer: A) Administer IV dextrose 50%

Rationale: In an unconscious hypoglycemic patient, IV dextrose is administered immediately
to raise blood glucose levels.

Question 30

Which of the following is a sign of left-sided heart failure?

A) Peripheral edema
B) Ascites
C) Pulmonary congestion
D) Jugular venous distension

Answer: C) Pulmonary congestion

Rationale: Left-sided heart failure leads to pulmonary congestion and symptoms such as
dyspnea and orthopnea due to impaired left ventricular function.