COC for Degree Nurse in Ethiopia

1. A37 year’s old female patient was admitted in surgical ward with head injury following on activity. On
physical examination the patient was drowsy, restless, irritable and discomforted. She had difficulty to
follow command, no response for painful stimuli and abnormal percvice. She had wide pulse pursuer,
usual, and hyperthermia and raised blood pressure. What is the most likely nursing diagnosis for this
patient?

A. Restless for enhanced knowledge of risk factors

B, Decreased intracranial adaptive capacity

C. Ineffective breathing pattern

D. Disturbed body image

2.A 29 years old female patient came to adult OPD with complaint of nuchal rigidity, vomiting and
seizure .physical examination finding indicated positive kerning sign and Brdunswick sign and petechial
spread over the body.labratory findings show that CSF appears cloudy, decreased glucose concentration,
elevated protein levels and elevated WBC and RBC counts. What is the most likely medical diagnosis for
this patient?

A. Mengiococoal encephalitis

B, Mengiococoal meningitis

C, Viral meningitis

D, Viral encephalitis
3.A39 year’s female patient was admitted to medical ward with complaint of fever and vomiting for
three days. On physical examination the patient had nuchal rigidity, positive kernig s sign dry mucus
membrane and small petechial over the upper torso and abdomen. Patient’s temperature was 40 after
the first two hours of care, patient’s level of consciousness decreased. What priority nursing action
should be taken for this patient?

A, Provide sponge baths if temperature continue to rise

B, Measure and compare intake and output every 2 hours

C, Perform neurological assessment every 2to 4 hours

D, Administer prescribed intravenous antibiotics

4.A 35 years old female patient came to hospital with complaint of recurrent bronchial asthma the
patient angrily asked the nurse, why it become recurrent.

What is the most appropriate answer for patients concern?

A, Intolerance of medication

B, Poor medication adherence

C, Low potency of the medication

D, Difficulty to avoid triggering agents

5.A 40 years old HIV positive woman came to ART Clinic with complaint of intense itching on physical
examination the patient had firm papule with variable stage of development on her trunk and face.
What is the most likely explanation for this finding?

A, Cellulitis

B, Prurigo

C, Herpes simplex

D, Molluscum contagiousum

6. A 27 years old male patient was linked to ART clinic to start HAART from TB clinic, the patient was on
anti TB treatment and his CD4 count is 500 cells/mm3.

What is the most preferred drug regimen for this patient?

A, TDF+3TC+EFV

B, AZT +3TC +EFV

C, TDF +3TC+NVP

D, TDF +3TC _+DTG

7. A34 year’s old male patient came to ENT clinic with purulent discharge in the right ear after foreign
body removed two month ago. The nurse examined his middle ear using otoscope to assess the
condition of tympanic membrane.

What could be the most likely assessment finding of this patient?

A, Red and inflamed

B, Perforation and cholesteatoma

C, Appear dull and has air bubbles

D, Pearly gray and bulged to outside

8. A36 year old man underwent middle ear surgery for the management of chronic otitis media after
surgery, the duty nurse prepared a teaching plan about postoperative instruction for the patient.

What is the most appropriate instruction the nurse should develop?

A, Avoid physical exercise 2 to 3weeks after surgery

B, Tinnitus sensation is normal up to 5weeks after surgery

C, Take soft and nonreasoned meals 1to 4 weeks after surgery

D, Sneeze and cough with the mouth open 2-3 weeks after surgery
9. A chronic male alcoholic patient was admitted to medical ward with end stage liver cirrhosis the
patient had stage one hepatic encephalophaty.he had unexplained epistaxis and spider angioma.a nurse
prepared a care plan and gave patient centered care.

What is the most appropriate nursing care that should be given for this patient?

A, Administer supplemental vitamin K

B, Assist and selection of desired exercise

C, Keep patient’s fingernail short and smooth

D, Provide diet high in carbohydrate and protein

10.Nurse prepared patient for surgery by inserting NG tube. After inserting the tube, the nurse
confirmed whether the tube is in the stomach.

What is the most appropriate sign used for conformation

A, The color of litmus paper is not changed after GI aspiration was applied

B, There is no air bubble from the tip of NG tube in a cup of water

C, There is no gurgle sound auscultated over abdomen

D, There is no central cyanosis and shortness of breath

11.A54 year’s old male patients came to an emergency department with left leg femoral bone fracture
due to falling accident and he was admitted to orthopedic ward after surgery. The patient history
indicate that he used cigarette and excess alcohol for 40 years. Assessment finding showed that
patient’s lung sound diminished. The nurse realized that the patient is at greater risk for cerebrovascular
accident.

What additional assessment finding is most likely relevant for this patient?

A, Ask the patient family history of cerebrovascular accident

B, Check patients chart for history of valvular disease

C, Check patients chart for history of encephalitis

D, Check patients chart for history of brain injury

12.A29 year old male patient came to medical OPD with complaint of vomiting nuchal rigidity and sever
headache of two days duration. Assessment findings indicate that the patient was positive for brudinski
and kernig sign and he had ptosis, photophobia and facial puresis.

What is the most likely nursing diagnosis for this patients?

A, Risk for ineffective airway clearance

B, Risk for ineffective breathing pattern

C, Risk for impaired gas exchange

D, Risk for caregiver role strain

13.A 29 years old male patient came to emergency room with complaint of generalized lower abdominal
pain later on the pain was more localized to right lower quadrant with nausea and vomiting. Then the
surgeon made diagnosis of appendicitis and scheduled for surgery.

What is the most likely surgical complication that may happen in this patient?

A, Dehydration

B , Septicemia

C, Sever bleeding

D, Abdominal abscess

14.A 23 years old male patient came to an emergency department with complaint of low grade fever
and epigastric pain progress to right lower quadrant. On abdominal examination the nurse identifies
local tenderness and positive rovsing sign.

What would be the priority nursing intervention for this patient?

A, Perform frequent palpation of abdomen

B, Administer analgesics with cation

C, Administer laxative or enema

D, Maintain NG tube patency

15.A24 year’s old patient came to a hospital with complaint of anorexia, heartburn after eating, nausea
and vomiting .after through assessment and physical examination, the nurse diagnosed that the patient
had auto immune chronic gastritis.

Which additional manifestation led the nurse for this conclusion?

A, Anemia

B, Dehydration

C, Epigastric pain

D, Blood vomiting

16. A67 year’s old male patient came to adult OPD with complaint of abdominal pain sensation Of
incomplete emptying and rumbling of one month duration. He was taking narcotic drug, antacid with
aluminum preparation and low amount of fluid and fiber. The nurse prepared to administer cleansing
enema.

What is the most likely indication to decide this procedure?

A, Psychotic disorder

B, Neurologic disorder
C, Orthopedic disorder

D, Chronic constipation

17.A nurse was taking care of 34 years old woman who was diagnosis with acute gastritis secondary to
stress. The nurse prepared a nursing care plan of patient’s outcome after intervention.

What is the most appropriate patient outcome predicted by the nurse?

A, Report feeding less anxiety

B, Eat scheduled meals regularly

C, Take medication as prescribed

D, Avoid irritating food and beverages

18.A mother who has been lactating for six month came to a family planning clinic upon return of
menstrual period. The nurse discussed about contraception options their side effects and benefits with
the mother and she prefers the injectable method of contraception.

What is the appropriate site of administration of the contraception the chose?

A, Ventro gluteal muscle

B, Deltoid muscle
C, Gluteal muscle

D, Pectoral muscle

19.A postpartum woman came to a clinic seeking for non-hormonal and long acting contraceptive as she
does not need more children .the nurse explained about the benefit and side effects of the
contraceptive method requested and planned to provide the service for the woman.

What is the most appropriate time to provide this contraception after delivery?

A, 45 days

B, 48 hours

C, Six months

D, Nine month

20.A woman who has been using IUCD for six month came to clinic with complaint of lower abdominal
pain and pain during sexual intercourse. On vaginal examination uterine and cervical tenderness were
identified.

What is the priority nursing diagnosis for this woman?

A, Risk for injury

B, Risk for infection

C, Risk for bleeding

D, Risk for trauma

Exit Exam for Nursing students in Ethiopia

Exit Exam for Nursing students in Ethiopia

21. A zonal health administration wants to increase utilization of health insurance in all the
woreda.during the course of their activities members of the public asked to have scheme which does
not rely much on local or national social solidarity and stable formal labor market.

What is the most appropriate evaluation type for this scenario?

A, Social health insurance

B, Individual health insurance

C, Voluntary health insurance

D, Community based health insurance

22. Nurse working as manager of a project agreed with a funding organization to assess the immediate
obsevavele effect that leads to the successfulness of a program which was implemented a year before in
the implementation area.
What is the most appropriate evaluation type for this scenario?

A, Process evaluation

B, Impact evaluation

C, Formative evaluation

D, Summative evaluation

23. A28 year’s old female patient was admitted to a medical ward with the diagnosis of hepatitis B.after
nurses counselling the patient agreed to share her information to her family.

What ethical principle applied by the nurse?

A, Advocacy

B, Privacy

C, Confidentiality

D, Informed consent

24. In a cardiac center of a hospital, more than 5000 children and other cardiac patients are on waiting
list for cardiac surgery because of resource scarcity. Along with solving the budget constraint and
training of health professional the hospital management team decided to give service in their order to
visit.
What is the most appropriate principle applied in this context?

A, Justice

B, Autonomy

C, Beneficence

D, Non maleficence

25.A39 year’s old female patient came to a medical emergency OPD with complaint of rigors, myalgia
and constipation. A nurse suspected of an infection caused by salmonella typhi.

What is the definitive laboratory test for diagnosis the case?

A, widal test

B, Blood culture

C, Urine analysis

D, Stool examination

26. Nurse working in health center noticed the presence of epidemic of bacillary dysentery in his
catchment area. He planned to control the epidemic and prevent further occurrence of the diseases.
What is the most effective method the nurse should follow?

A, Case detection and treatment

B, Teaching about proper excreta disposal

C, Teaching about cleaning and cooking of foods

D, Teaching about effective hand washing practice

27.A34 year’s old woman with headache, malaise, generalized edema, flank pain and cola colored urine
was referred to renal unit. On laboratory investigation her urine protein level was 4g/day, serum BUN
level 25 mg/dl.(normal range 10-20 mg/dl) and serum creatinine level is 1.1 mg/dl (normal range ,0.6-
1.2 mg/dl).

What is the most likely diagnosis of this woman?

A, Nephrotic syndrome

B, Glomerulonephritis

C, Pyelonephritis

D, Urolithiasis

28.A43 years old man with sever dehydration and persistent diarrhea was admitted to medical ICU.on
assessment ,he had metabolic acidosis and his blood pressure was 80/40mmhg ,the serum potassium
level was 7meq/l(normal range 3.5-5.5 meq/l).serum BUN level is 35 mg /dl (normal range
10-20mg/dl)and creatinine level was 1.9 mg/dl (normal range 0.6-1.2 mg/dl).

What is the most appropriate treatment for this patient?

A, Intravenous fluid transfusion

B, Infusion of albumin

C, Regular insulin

D, Hemodialysis

29. A 45 years old anemic woman came to emergency department with complaint of headache, featgue
and edema. After examination, it is confirmed that 80%of her kidney’s failed with the serum creatinine
level of 1.8mg/dl (normal range 0.6 -1.2 mg/dl).

What is the most likely pathophysiological stage of the patient?

A, Renal insufficiency

B, Reduced renal reserve

C, End stage renal failure

D, Retention of nitrogenous wastes

30.A patient with renal stone was admitted to renal unit of medical ward. The nurse in charge sent the
urine sample of the patient to the laboratory. The result of laboratory investigation revealed the
presences of uric acid calculi.

What is the best nursing management for this patient?

A, Restrict alcohol and salt

B, Restrict chocolates and tea

C, Restrict organ meats and shellfish

D, Restrict dairy products and poultry

31.A nurse was caring and preparing nursing care plan for patient with end stage renal
disease .physician prescribed oral furosemide (Lasix) to be added to the therapy.

What is the most likely expected serious risk of the above drug?

A, Hypernatremia

B, Hyponatremia

C, Hypokalemia

D, Hyperkalemia
32.A researcher finding on diarrhea status among children 6-23 months showed 47%million Diarrhea,
36%moderate diarrhea and 17%severe diarrhea .finally the researcher wants to present the data in
graphs.

What is the most likely type of graph to be used by this researcher?

A, Bar graph

B, Line graph

C, Histogram

D, Ogive curve

34.A nurse working in district with total population of 45,000.in the area, there was an acute epidemic
of acute watery diarrhea that lasts for three consecutive weeks. The nurse observed 26 cases in the first
week, 10 cases in 2nd and 5 cases in the 3rd week and 4 deaths over the three weeks.

Calculate attack rate of AWD over the three weeks?

A, 89 AWD cases per 1,00,0000 people at risk

B, 911 AWD cases per 1,00,0000 people at risk

C, 587 AWD cases per 1,00,0000 people at risk

D, 333 AWD cases per 1,00,0000 people at risk

35. A nurse was assigned in aworeda health office where immigration and out migration of the people is
high from different parts of the country. Monthly health report of the office indicated that tuberculosis
incidence is stable. But, the prevalence of tuberculosis increased highly in the woreda.

What is the most likely reason for increment of tuberculosis patients in the woreda?

A, Out migration of cases

B, Improved cure rate of disease

C, Out migration of healthy people

D, High case fatality rate from disease

coc examination in ethiopia

coc examination in ethiopiacoc examination in ethiopiacoc examination in ethiopia

36. The nurse wants to test whether the mean age of adult who visited the youth friendly services is not
different from 25 years. The nurse took sample of 196 adult patients from population. The mean age of
sampled adult was 20 years and the given population standard deviation was 6years.

What is the most appropriate statically test used for the given hypothesis?

A, Paired t-test

B, Student t-test
C, Chi-squire test

D, Standard normal Z-test

37.A nurse works in district where health service is 100% available and with more than 80%expected
coverage of rotavirus vaccination among under five children, however, at the end of the year rotavirus
vaccination coverage in the district was found to be 16%.

What is the most likely research problem needed to study in the district?

A, Expected rotavirus vaccination coverage for under –five children

B, Availability of rotavirus vaccination for under –five children

C, Rotavirus vaccination coverage among under –five children

D, Factor influencing low rotavirus vaccination coverage

38. Researcher wants to conduct a study on the prevalence and associated factors of trachoma among
under-five children in a destrict.then the researcher wants to set appropriate objectives.

What is the most likely specific objective of this research?

A, To study the prevalence of trachoma among under five children

B, To appreciate the prevalence of trachoma among under five children

C, To understand associated factors of trachoma among under five children

D, To determine factors associated with trachoma among under five children

39.Researcher wants to conduct a study among 867 sample of households to determine accesses to safe
water supply in a destrict.the district has 10,000house holds ,of which 20%are from urban and 80%from
rural households.

What is the most likely sampling technique the researcher will uses?

A, Systematic sampling

B, Stratified sampling

C, Multi stage sampling

D, Simple random sampling

40.A nurse working in ART Clinic of a hospital wants to summarize CD4 T-cell counts for 13 HIV positive
patients who were treated with highly active antiretroviral therapy (HAART) for the last 6 month is .their
CD4 T-cell counts were 230,205,313,207,227,245,173,58,103,181,105,301 and 169.

Calculate the median cd T- Cell counts of these HIV positive patients/

A, 173
B, 181

C, 205

D, 207

41.A 48 years old male patient who was diagnosed with hypovolemic shock refused blood transfusion
irrespective of repeated counselling by the nurse in charge

What is the most appropriate legal frame work in dealing with this patient?

A, Continue patient rescstation

B, Take verbal consent and let him go.

C, Have written consent and let him go.

D, Look for family permission and let him go.

42. A32 years old female patient came to hospital with sudden onset of sharp knife like chest pain
accompanied by her family. On assessment, she pronounced dyspnea and central cyanosis. The
physician and the nursing team in charge performed emergency surgery .the patient and her family
presented the case to court because she developed iatrogenic pleural effusion as complication.

What nursing action most likely prevent accusation?

A, Keep fidelity
B, Take consent

C, Keep veracity

D, Assess patient capacity

43. An experienced nurse who was not happy with the working environment, accepted a 56 years old
male patient that came with complaint of joint. The nurse looks at the eye of the patient, listen and feels
the pain of the patient. The nurse touches the patients shoulder while teaching and reassuring him
about the case. The patient was happy with the nurse approaches.

What is the most likely principle of compassion the nurse lacks?

A, Affection

B, Attention

C, Acceptance

D, acknowledgment

44. A 32 years old female patients came to health center for wound care. A nurse in charge provided the
wound care. The patient developed infection and referred to a hospital.in the hospital, she got treated
and cured. After six years, she informed that the infection she developed in the health center was due to
inappropriate dressing. The patient filed malpractice act against the nurse in health center and
prosecuted the nurse for malpractice act.
What is the first things nurse’s attorney should have as a defense?

A, Assumption of risk

B, Comparative negligence

C, Contributory negligence

D, Statute of limitation

45. A 42 year’s old male patient was admitted to surgical ward with chest drainage tube patients pulse
rate 110 min, respiratory rate 28 min, blood pressure 80/60 mmhg temperature 37.8 0c and oxygen was
80 %( normal 95%-100 %).

What is the priority nursing diagnosing for this patient?

A, Acute pain related to drainage tube

B, Hyperthermia related to diseases process

C, Fluid volume deficit related to the incision

D, Impaired gas exchange related to lung impairment

46.A 45 years old chronic glomurlonephreites patient was admitted to medical ward the nurse assessed
the patient for edema by pressing the index finger over the bony promince of tibia the nurse found very
deep pitting with about 8mm depression that lasts 2to 3 min.
What is the most likely grade of edema for this patients?

A, Grade -I

B, Grade -II

C, Grade -III

D, Grade -IV

47.A62 Year’s old obese diabetic woman with renal calculi came to a renal unit seeking advice on the
prevention of renal failure a nurse prepared counselling session for the woman by considering her case.

What advice is appropriate for this woman?

A, Increase intake of water

B, Prevent toxic drugs for the kidney

C, Prevent and treat infection promptly

D, Increase intake of calcium contain foods

48.A 56 years old patient was admitted to a hospitals four days ago after she presented with sever supra
pubic secondary to renal calculus. On morning assessment a nurse identified that the patient was
lethargic and absence of urine over the urine bag for the last 12 hours. The serum creatinine and blood
urea nitrogen are also raised above the normal value.

What is the appropriate nursing action for this patient?

A, Checking the patency of catheter

B, Initiating diuretics to promote urination

C, Changing patients position to maximize comfort

D, Consulting a physician for further intervention

49.A60 years old male hypertensive patient who was otherwise healthy ,deteriorates with in hour after
admission for an elective surgery .occasionally he become confused his current medication include
enalapriel 10mg po/day and furosemide 20 mg IV bid he drank three standard drinks of alcohol every
day but no history of psychiatric disorder.

What is the most likely diagnosis of the above case?

A, Delirium

B, Dementia

C, Amnesia

D, Depression
50.A nurse is taking care of 52 years old male patient hospitalized with diagnosis of dementia.in contrary
to the reality, the patient believes and argue that the nurse is his daughter and currently he is at his
office chairing a meeting with his workmates.

What is the best nursing intervention to deal with the patient’s belief?

A, Attempt to challenge his delusion logically

B, Accept his idea and advise to evaluate yours

C, Tell him that his false idea is due to the illness

D, Acknowledgement his feeling and reinforce reality