Research MCQs-Part-IV

Research Multiple choice questions with Key

151. The use of multiple data sources to help understand a phenomenon is one strategy that is used to promote qualitative research validity. Which of the following terms describes this strategy?
a. Data matching
b. Pattern matching
c. Data triangulation
d. Data feedback

152. What is another term that refers to a confounding extraneous variable?
a. Last variable
b. First variable
c. Third variable
d. Fourth variable

153. Which of the following refers to any systematic change that occurs over time in the way in which the dependent variable is assessed?
a. Instrumentation
b. Maturation
c. Testing
d. Selection

154. Which strategy used to promote qualitative research validity uses multiple research methods to study a phenomenon?
a. Data triangulation
b. Methods triangulation
c. Theory triangulation
d. Member checking

155. In study design threats, If Subjects’ behaviour may be affected by characteristics of the researchers is known as:
a. Measurement effect
b. Experimenter effect
c. Novelty effect
d. Expectancy effect

156. Which of the following in not one of the key threats to internal validity?
a. Maturation
b. Instrumentation
c. Temporal change
d. History

157. Which is not a direct threat to the internal validity of a research design?
a. History
b. Testing
c. Sampling error
d. Differential selection

158. Internal validity refers to which of the following?
a. The ability to infer that a causal relationship exists between 2 variables
b. The extent to which study results can be generalized to and across populations of persons, settings, and times
c. The use of effective measurement instruments in the study
d. The ability to generalize the study results to individuals not included in the study

159. The post-test-only design with non-equivalent groups is likely to control for which of the following threats to internal validity:
a. History
b. Differential selection
c. additive and interactive effects
d. differential attrition

160. Which of the following designs permits a comparison of pretest scores to determine the initial equivalence of groups on the pretest before the treatment variable is introduced into the research setting.
a. One-group pretest-posttest design
b. Pretest-posttest control group design
c. Posttest-only design with nonequivalent groups
d. Both b and c

 

161. Which of the following control techniques available to the researcher controls for both known and unknown variables?
a. Building the extraneous variable into the design
b. Matching
c. Random assignment
d. Analysis of covariance

162. The group that does not receive the experimental treatment condition is the ________.
a. Experimental group
b. Control group
c. Treatment group
d. Independent group

163. There are a number of ways in which confounding extraneous variables can be controlled. Which control technique is considered to be the best?
a. Random assignment
b. Matching
c. Counterbalancing
d. None of the above

164. In an experimental research study, the primary goal is to isolate and identify the effect produced by the ____.
a. Dependent variable
b. Extraneous variable
c. Independent variable
d. Confounding variable

165. Which one of the following research tests hypotheses and theories in order to explain how and why a phenomenon operates as it does?
a. Descriptive
b. Predictive
c. Explanatory
d. Exploratory

166. If a research finding is statistically significant, then ____.
a. The observed result is probably not due to chance
b. The observed result cannot possibly be due to chance
c. The observed result is probably a chance result
d. The null hypothesis of “no relationship” is probably true

167. When a researcher starts with the dependent variable and moves backwards, it is called.
a. Predictive research
b. Retrospective research
c. Exploratory research
d. Descriptive research

168. Which approach is the strongest for establishing that a relationship is causal?
a. Causal-comparative
b. Correlational
c. Experimental
d. Historical

169. Following are the threats to internal validity except one;
a. Novelty Effect
b. History
c. Selection
d. Maturation

170. The degree to which the components of the research reflect the theory, concept, or variable under study is termed as;
a. Design Validity
b. Threats to Validity
c. Internal validity
d. External validity

171. Which of the following is NOT a purpose of descriptive studies?
a. To serve as a starting point for hypothesis generation
b. To get rigorous control of the variables
c. To serve as a starting point for theory development
d. To observe, describe, & document aspects of a situation as it naturally occurs

172. Which of the following attempts to understand relationships among phenomena as they naturally occur, without any intervention?
a. Ex post facto research
b. Experimental research
c. Prospective design
d. Retrospective design

173. The nursing community’s interest in qualitative research began in;
a. Late 1910’s
b. Late 1930’s
c. Late 1950’s
d. Late 1970’s

174. Which of the following is characteristic of qualitative research?
a. Generalization to the population
b. Random sampling
c. Unique case orientation
d. Standardized tests and measures

175. Which of the following is a characteristic of qualitative research?
a. Design flexibility
b. Inductive analysis
c. Context sensitivity
d. All of the above

 

176. Which of the following is usually not a characteristic of qualitative research?
a. Design flexibility
b. Dynamic systems
c. Naturalistic inquiry
d. Deductive design

177. Which of the following focuses on individuals’ interpretation of their experience & the ways in which they express them?
a. Historical research
b. Phenomenological Research
c. Grounded theory
d. Ethnography Research

178. Which of the following is not phase of qualitative research?
a. Orientation and overview
b. Focused exploration
c. Conformation and Closure
d. Orientation and closure

179. A research is undertaken to answer questions about causes, effects, or trends relating to past events that may shed light on present behaviors or practices is called as;
a. Historical research
b. Phenomenological Research
c. Grounded theory
d. Ethnography Research

180. Following are the major types of triangulation EXCEPT ONE;
a. Data Triangulation
b. Time Triangulation
c. Method Triangulation
d. Theory Triangulation

181. Which of the following has contributed to the development of many middle range theories of phenomena relevant to nurses?
a. Historical research
b. Phenomenological Research
c. Grounded theory
d. Ethnography Research

182. Which of the following refers to use of more than one theoretical position in interpreting data?
a. Data Triangulation
b. Time Triangulation
c. Method Triangulation
d. Theory Triangulation

183. Phenomenology has its disciplinary origins in:
a. Philosophy
b. Anthropology
c. Sociology
d. Many disciplines

184. The primary data analysis approach in ethnography is:
a. Open, axial, and selective coding
b. Holistic description and search for cultural themes
c. Cross-case analysis
d. Identifying essences of a phenomenon

185. The term used to describe suspending preconceptions and learned feelings about a phenomenon is called:
a. Axial coding
b. Design flexibility
c. Bracketing
d. Ethnography

186. ________ is a study of human consciousness and individuals’ experience of some phenomenon.
a. Phenomenology
b. Ethnography
c. Grounded theory
d. Case study research

187. ________ is a general methodology for developing theory that is based on data systematically gathered and analysed.
a. Theory confirmation
b. Grounded theory
c. Theory deduction
d. phenomenology

188. In which qualitative research approach is the primary goal to gain access to individuals’ inner worlds of experience?
a. Phenomenology
b. Ethnography
c. Grounded theory
d. Case study

189. The type of qualitative research that describes the culture of a group of people is called;
a. Phenomenology
b. Grounded theory
c. Ethnography
d. Case study

190. What term refers to the insider’s perspective?
a. Ethnocentrism
b. Emic perspective
c. Etic perspective
d. Holism

191. A researcher studies a Kashmiri group for a six month period to learn all about them so he can write a book about that particular tribe. What type of research will he likely be conducting?
a. Ethnography
b. Phenomenology
c. Grounded theory
d. Collective case study

192. _________ is used to describe cultural scenes or the cultural characteristics of a group of people.
a. Phenomenology
b. Ethnography
c. Grounded theory
d. Instrumental case study

193. Which of the following is not one of the 4 major approaches to qualitative research?
a. Ethnography
b. Phenomenology
c. Case study
d. Nonexperimental

194. Which of the following is known as a clear statement of the specific aim or goal of the study
a. Research Question
b. Research objective
c. Research Purpose
d. Research Problem

195. Tuskegee Syphilis study was conducted in which of the following year.
a. 1930
b. 1940
c. 1932
d. 1942

196. Medical experiments conduct on prisoners of war and racially valueless persons is named as;
a. Jewish C.D Hospital Study
b. Nazi medical experience.
c. Tuskegee Syphilis study
d. Willow brook Study

197. A hypothesis which states the relationship among three or more variables is called as
a. Simple Hypothesis
b. Complex Hypothesis
c. Research Hypothesis
d. Non directional Hypothesis

198. Which of the following is not an element of the ethical research?
a. Protecting subjects rights
b. Obtaining informed consent
c. Obtaining institutional approval
d. Unbalancing the benefits and the risk in the study

199. Misinforming the subjects for the research purposes is called as follow?
a. Anonymity
b. Confidentiality
c. Scientific misconduct
d. Deception

200. A hypothesis that States the nature (positive or negative) of the interaction between two or more variables is called
a. Associated Hypothesis
b. Casual Hypothesis
c. Null Hypothesis
d. Directional Hypothesis

Research MCQs-Part-III

 

101. Which of the following is NOT concept of measurement theory?
a. Directness of measurement
b. Reliability
c. Feasibility
d. Measurement error

102. If a test measures a single construct then:
a. The items should correlate with the total score
b. The items should not correlate with the total score
c. The test should not correlate with other measures of the same construct
d. There must be a reliable alternative form.

103. An ordinal scale is used to rank order people, objects, or characteristics.
a. True
b. False

104. Which scale is the simplest form of measurement?
a. Nominal
b. Ordinal
c. Interval
d. Ratio

105. Let’s say that a test accurately indicates participants’ scores on a future criterion (e.g., the PSAT is used to indicate high-school GPA scores). This test would clearly have which of the following?
a. Face validity
b. Concurrent validity
c. Predictive validity
d. Content validity

106. If a baseball coach calculates batting averages, what scale would be used?
a. Interval scale
b. Ratio scale
c. Nominal scale
d. Ordinal scale

107. Most of the outcome/dependent variable characteristics and attributes measured on educational characteristics probably exist at the ______________ level of measurement.
a. Nominal
b. Ordinal
c. Interval
d. Ratio

108. Reliability is most simply known as which of the following?
a. Consistency or stability
b. Appropriateness of interpretations on the basis of test scores
c. Ways in which people are the same
d. A rank order of participants on some characteristic

109. An ordinal scale is:
a. The simplest form of measurement
b. A rank-order scale of measurement
c. A scale with equal intervals between adjacent numbers
d. A scale with an absolute zero point
e. A categorical scale

110. Which of the following is not a type of reliability?
a. Test-retest
b. Split-half
c. Content
d. Internal consistency

111. Which is the process of gathering evidence supporting inferences based test scores?
a. Validation
b. Validity
c. Reliability
d. Prediction

112. Which of these is not a method of data collection?
a. Questionnaires
b. Interviews
c. Experiments
d. Observations

113. Which of the following statements accurately describes test-retest reliability?
a. Measure of consistency of test scores over time
b. Measure of consistency of scores obtained from two equivalent halves of same test
c. Measure of consistency with which a test measures a single construct or concept
d. Measure of degree of agreement between two or more scorers, judges, or raters

114. Which of the following types of reliability refers to the consistency of test scores over time?
a. Equivalent forms reliability
b. Split-half reliability
c. Test-retest reliability
d. Inter-scorer reliability

115. Which one most closely refers to a judgment of the extent to which scores from a test can be used to infer, or predict, the examinees’ performance in some activity:
a. Content reliability
b. Face validity
c. Criterion-related validity
d. Inference validity

116. Which of the following is the correct order of Stevens’ four levels of measurement?
a. Ordinal, nominal, ratio, interval
b. Nominal, ordinal, interval, ratio
c. Interval, nominal, ordinal, ratio
d. Ratio, interval, nominal, ordinal

117. When evaluating tests and assessments, “reliability” refers to asking ourselves which of the following questions?
a. Does it measure what it is supposed to measure?
b. Are there ways to avoid subjective judgments when measuring something?
c. Does it give consistent results?
d. Does it measure multiple constructs?

118. Which type of reliability refers to the consistency of a group of individuals’ scores on two equivalent forms of a test designed to measure the same characteristic?
a. Split-half
b. Test-retest
c. Split-forms
d. Equivalent forms

119. Which one is refers to how well the particular sample of behaviors used to measure a characteristic reflects the entire domain of behaviors that constitutes that characteristic.
a. Construct validity evidence
b. Criterion-related validity evidence
c. Content validity evidence
d. Face validity evidence

120. Secondary/existing data may include which of the following?
a. Official documents
b. Personal documents
c. Archived research data
d. All of the above

121. Which of the following terms best describes data that were originally collected at an earlier time by a different person for a different purpose?
a. Primary data
b. Secondary data
c. Experimental data
d. Field notes

122. Open-ended questions provide primarily ______ data.
a. Confirmatory data
b. Qualitative data
c. Predictive data
d. None of the above

123. Which of the following types of sampling involves the researcher determining the appropriate sample sizes for the groups identified as important, and then taking convenience samples from those groups?
a. Proportional stratified sampling
b. Quota sampling
c. One-stage cluster sampling
d. Two-stage cluster sampling

124. When each member of a population has an equally likely chance of being selected, this is called:
a. A nonrandom sampling method
b. A quota sample
c. A snowball sample
d. A Random Sample

125. Researchers use both open-ended and closed-ended questions to collect data. Which of the following statements is true?
a. Open-ended questions directly provide quantitative data based on the researcher’s predetermined response categories
b. Closed-ended questions provide quantitative data in the participant’s own words
c. Open-ended questions provide qualitative data in the participant’s own words
d. Closed-ended questions directly provide qualitative data in the participants’ own words

126. Which of the following techniques yields a simple random sample?
a. Choosing volunteers from an introductory psychology class to participate
b. Listing the individuals by ethnic group and choosing a proportion from within each ethnic group at random.
c. Numbering all the elements of a sampling frame and then using a random number table to pick cases from the table.
d. Randomly selecting schools, and then sampling everyone within the school.

127. Which of the following is not true about stratified random sampling?
a. It involves a random selection process from identified subgroups
b. Proportions of groups in the sample must always match their population proportions
c. Disproportional stratified random sampling is especially helpful for getting large enough subgroup samples when subgroup comparisons are to be done
d. Proportional stratified random sampling yields a representative sample

128. Which of the following statements are true?
a. The larger the sample size, the greater the sampling error
b. The more categories or breakdowns you want to make in your data analysis, the larger the sample needed
c. The fewer categories or breakdowns you want to make in your data analysis, the larger the sample needed
d. As sample size decreases, so does the size of the confidence interval

129. Which of the following formulae is used to determine how many people to include in the original sampling?
a. Desired sample size/Desired sample size + 1
b. Proportion likely to respond/desired sample size
c. Proportion likely to respond/population size
d. Desired sample size/Proportion likely to respond

130. Which of the following is not a form of probability sampling?
a. Simple random sampling
b. Systematic sampling
c. Purposive sampling
d. Cluster sampling

131. Which of the following is not a form of nonrandom sampling?
a. Snowball sampling
b. Stratified sampling
c. Quota sampling
d. Purposive sampling

132. People who are available, volunteer, or can be easily recruited are used in the sampling method called ______.
a. Simple random sampling
b. Cluster sampling
c. Systematic sampling
d. Convenience sampling

133. Which of the following will give a more “accurate” representation of the population from which a sample has been taken?
a. A large sample based on the convenience sampling technique
b. A small sample based on simple random sampling
c. A large sample based on simple random sampling
d. A small cluster sample

134. Sampling in qualitative research is similar to which type of sampling in quantitative research?
a. Simple random sampling
b. Systematic sampling
c. Quota sampling
d. Purposive sampling

135. Which of the following would generally require the largest sample size?
a. Cluster sampling
b. Simple random sampling
c. Systematic sampling
d. Proportional stratified sampling

136. In which of the following nonrandom sampling techniques does the researcher ask the research participants to identify other potential research participants?
a. Snowball
b. Convenience
c. Purposive
d. Quota

137. If we took the 500 nursing students attending a school in Karachi, divided them by gender, and then took a random sample of the males and a random sampling of the females, the variable on which we would divide the population is called the _____.
a. Independent variable
b. Dependent variable
c. Stratification variable
d. Sampling variable

138. The type of sampling in which each member of the population selected for the sample is returned to the population before the next member is selected is called _________.
a. Sampling without replacement
b. Sampling with replacement
c. Simple random sampling
d. Systematic sampling

139. Which of the following would usually require the smallest sample size because of its efficiency?
a. One stage cluster sampling
b. Simple random sampling
c. Two stage cluster sampling
d. Quota sampling

140. The process of drawing a sample from a population is known as _________.
a. Sampling
b. Census
c. Survey research
d. None of the above

141. Which of the following sampling methods is the best way to select a group of people for a study if you are interested in making statements about the larger population?
a. Convenience sampling
b. Quota sampling
c. Purposive sampling
d. Random sampling

142. Which one is a set of elements taken from a larger population according to certain rules?
a. Sample
b. Population
c. Statistic
d. Element

143. Determining the sample interval (represented by k), randomly selecting a number between 1 and k, and including each kth element in your sample are the steps for which form of sampling?
a. Simple Random Sampling
b. Stratified Random Sampling
c. Systematic Sampling
d. Cluster sampling

144. The nonrandom sampling type that involves selecting a convenience sample from a population with a specific set of characteristics for your research study is called _____.
a. Convenience sampling
b. Quota sampling
c. Purposive sampling
d. Snowball sampling

145. When an extraneous variable systematically varies with the independent variable and influences the dependent variable, it is called:
a. Another dependent variable
b. A confounding variable
c. A moderating variable
d. An unreliable variable

146. Which type of validity refers to the degree to which you can infer that the relationship between two variables is causal?
a. Internal validity
b. Population validity
c. Ecological validity
d. Statistical conclusion validity

147. An extraneous variable that systematically varies with the independent variable and also influences the dependent variable is known as a _______________.
a. Confounding variable
b. Third variable
c. Second variable
d. Both a and b are correct

148. The use of multiple observers to allow cross-checking of observations to make sure that the investigators agree with what took place is known as
a. Interpretive validity
b. Researcher bias
c. Multiple operationalism
d. Investigator triangulation

149. Which one refers to physical or mental changes that may occur within individuals over time, such as aging, learning, boredom, hunger, and fatigue?
a. Instrumentation
b. History
c. Maturation
d. Testing

150. What type of validity refers to the extent to which the results of a study can be generalized across time?
a. Ecological validity
b. External validity
c. Internal validity
d. Temporal validity

Research MCQs-Part-II

51. Which of the following can best be described as a categorical variable?
a. Age
b. Annual Income
c. Grade Point Average
d. Religion

52. In research, something that does not “vary” is called a ___________.
a. Variable
b. Method
c. Constant
d. control group

53. The strongest evidence for causality comes from which of the following research methods?
a. Experimental
b. Causal-comparative
c. Correlational
d. Ethnography

54. good qualitative problem statement:
a. Defines the independent and dependent variables
b. Conveys a sense of emerging design
c. Specifies a research hypothesis to be tested
d. Specifies the relationship between variables that the researcher expects to find

55. Sometimes a comprehensive review of the literature prior to data collection is not recommended by grounded theorists.
a. True
b. False

56. The research participants are described in detail in which section of the research plan?
a. Introduction
b. Method
c. Data analysis
d. Discussion

57. The statement of purpose in a research study should:
a. Identify the design of the study
b. Identify the intent or objective of the study
c. Specify the type of people to be used in the study
d. Describe the study

58. A qualitative research question:
a. Asks a question about some process, or phenomenon to be explored
b. Is generally an open-ended question
c. both a and b are correct
d. None of the above

59. According to the text, which of the following orders is the recommended in the flowchart of the development of a research idea?
a. Research topic, research problem, research purpose, research question, hypothesis
b. Research topic, research purpose, research problem, research question, hypothesis
c. Research topic, research problem, research purpose, research question, hypothesis
d. Research topic, hypothesis, research problem, research question, research purpose

60. One step that is not included in planning a research study is:
a. Identifying a researchable problem
b. A review of current research
c. Statement of the research question
d. Conducting a meta-analysis of the research
e. Developing a research plan

61. Sources of researchable problems can include:
a. Researchers’ own experiences as educators
b. Practical issues that require solutions
c. Theory and past research
d. All of the above

62. Which of the following is a function of theory?
a. Integrating and summarizing current knowledge
b. Making predictions
c. Explaining phenomena
d. All of the above are important functions of theory

63. A review of the literature prior to formulating research questions allows the researcher to do which of the following?
a. To become familiar with prior research on the phenomenon of interest
b. To identify potential methodological problems in the research area
c. To develop a list of pertinent problems relative to the phenomenon of interest
d. All of the above

64. Computer database searches can be done:
a. With a computer with CD-ROM drive
b. At the library
c. Online
d. All of the above

65. What is the primary approach that is used by the IRB to assess the ethical acceptability of a research study?
a. Utilitarianism
b. Deontology
c. Ethical skepticism
d. Comparativeism

66. The feasibility of a research study should be considered in light of:
a. Cost and time required to conduct the study
b. Skills required of the researcher
c. Potential ethical concerns
d. All of the above

67. A formal statement of the research question or “purpose of research study” generally;
a. Is made prior to the literature review
b. Is made after the literature review
c. Will help guide the research process
d. b and c

68. Research hypotheses are ______.
a. Formulated prior to a review of the literature
b. Statements of predicted relationships between variables
c. Stated such that they can be confirmed or refuted
d. b and c

69. Hypotheses in qualitative research studies usually _____.
a. Are very specific and stated prior to beginning the study
b. Are often generated as the data are collected, interpreted, and analyzed
c. Are never used
d. Are always stated after the research study has been completed

70. A research plan _____.
a. Should be detailed
b. Should be given to others for review and comments
c. Sets out the rationale for a research study
d. All of the above

71. The Method section of the research plan typically specifies EXCEPT;
a. The research participants
b. The results of prior studies that address the phenomena of interest
c. The apparatus, instruments, and materials for the research study
d. The planned research procedures

72. The Introduction section of the research plan
a. Gives an overview of prior relevant studies
b. Contains a statement of the purpose of the study
c. Concludes with a statement of the research questions &, for quantitative research, it includes the research hypothesis
d. All of the above

73. Which of the following is necessary in obtaining informed consent?
a. A description of the statistical analyses that will be carried out
b. A description of the purpose of the research
c. A description of the reliability and validity of test instruments
d. A list of publications that the researcher has had in the last ten years

74. Which of the following need(s) to be obtained when doing research with children?
a. Informed consent from the parent or guardian
b. Assent from the child if he or she is capable
c. Informed consent from the child
d. Both a and b

75. Ideally, the research participant’s identity is not known to the researcher. This is called:
a. Anonymity
b. Confidentiality
c. Deception
d. Desensitizing

76. Which of the following is true about the use of deception in research?
a. It should never be used
b. It can be used anytime
c. If there is deception in a study, the participants may need to be debriefed
d. The use of deception must be outweighed by other benefits of the study
e. Both c and d are true

77. Which of the following is not an ethical guideline for conducting research with humans?
a. Getting informed consent of the participant
b. Telling participants they must continue until the study has been completed
c. Keeping participants’ identity anonymous
d. Telling participants they are free to withdraw at any time

78. ________ means that the participant’s identity, although known to the researcher, is not revealed to anyone outside of the researcher and his or her staff.
a. Anonymity
b. Confidentiality

79. Which of the following is not true?
a. Misrepresenting and creating fraudulent data is dishonest
b. Misrepresenting data is very easy to detect
c. Misrepresenting data can be difficult to detect
d. Breaking confidentiality is not a problem

80. What is it called when the participants are not revealed to any one but researcher and staff?
a. Confidentiality
b. Anonymity
c. Ethics
d. Discretion

81. Research participants must give what before they can participate in a study?
a. Guidelines
b. A commitment
c. Informed consent
d. Private information

82. Identify the term that refers to a post study interview in which all aspects of the study are revealed, reasons for the use of deception are given, and the participants’ questions are answered?
a. Desensitizing
b. Debriefing
c. Dehoaxing
d. Deploying

83. A set of principles to guide and assist researchers in deciding which goals are most important and in reconciling conflicting values when conducting research is called ____.
a. Research ethics
b. Deontological approach
c. Utilitarianism
d. None of the above

84. IRB is an acronym for which of the following?
a. Internal Review Board
b. Institutional Rating Board
c. Institutional Review Board
d. Internal Request Board

85. The act of publishing the same data and results in more than one journal or publication refers to which of the following professional issues:
a. Partial publication
b. Duplicate publication
c. Deception
d. Full publication

86. Which term refers to publishing several articles from the data collected in one large study?
a. Duplicate publication
b. Partial publication
c. Triplicate publication
d. None of these

87. Which of the following is a right of each participant in research?
a. Deception
b. Utilitarianism
c. Freedom to withdraw
d. Participants have no rights

88. The use of statistics to make assumptions concerning some unknown aspect of a population from a sample of that population is known as follow;
a. Inferential Statistics
b. Parameter
c. Descriptive Statistics
d. Sampling

89. Which of the following is not an assumption underlying testing and measurement?
a. Various approaches to measuring aspects of the same thing can be useful
b. Error is rarely present in the measurement process
c. Present-day behavior predicts future behavior
d. Testing and assessment benefit society

90. Systematic error is associated with:
a. Reliability
b. Validity

91. Which of the following generally cannot be done in qualitative studies conducted in the field?
a. Getting informed consent
b. Keeping participants from physical harm
c. Maintaining consent forms
d. Having full anonymity rather than just confidentiality

92. Which of the following is a type of criterion–related validity evidence?
a. Concurrent evidence
b. Predictive evidence
c. Internal consistency
d. Both a and b are correct answers

93. The actual population of study participants selected from a larger population is known as:
a. Target population
b. Accessible population
c. Population
d. Cluster

94. Sampling criteria may be used by Nurse to develop the desired sample. Characteristics those must be present for a subject to be included in the sample is called:
a. Inclusion criteria
b. Exclusion criteria
c. Representativeness
d. Consent

95. Selection of sample in this study is an important step in doing research. A good sample is:
a. One that includes both male and female nurses
b. One that shows a balance in the number of nurses from hospital and school
c. One that is representative of the population from which it was selected
d. One that can be manipulated and controlled

96. A study in which we see the nurse’s level of education is classified in which level of measurement?
a. Nominal-scale
b. Ordinal scale
c. Interval scale
d. Ratio-scale

97. Which one of the following supports “reasoning moves from general to specific situation or conclusion”?
a. Scientific reasoning
b. Deductive reasoning
c. Inductive reasoning
d. None of the above

98. Which one of the following is a type of nonparametric test?
a. t-test
b. Chi-squire
c. z-test
d. f-test

99. Which one of the following is consists of rules for assigning numbers to objects to represent quantities of attributes?
a. Reliability
b. Measurement
c. Measurement error
d. Validity

100. Following are the elements of research critique EXCEPT ONE;
a. Methodological dimensions
b. Practical dimensions
c. Ethical dimensions
d. Interpretive dimensions

Research MCQs-Part-1

1. In terms of reasoning, which of the following research is dialectic & inductive?
a. Outcome research
b. Qualitative research
c. Quantitative research
d. None of the above

2. Which of the following research utilizes statistics to make generalization?
a. Outcome research
b. Qualitative research
c. Quantitative research
d. a and b only

3. Following are the elements of qualitative research except one;
a. Reductionist
b. Holistic
c. Subjective
d. Develop theory

4. The major reason for conducting research is to:
a. Provide nursing care to the clients
b. Promote the growth of nursing profession
c. Document the cost-effectiveness of care
d. Ensure accountability for nursing practice

5. Research Does Not means to;
a. Search again
b. Examine carefully
c. Create problem
d. Method of problem solving

6. Which of the following is NOT characteristic of a nursing research?
a. Development of theories, principles, and generalizations
b. Uses chaotic method of problem-solving
c. Requires full skill of writing report
d. Involves precise observation and accurate description

7. Which of the following type of research also called as a feasibility study or pilot Study?
a. Descriptive
b. Exploratory
c. Correlational
d. Explanatory

8. Which of the following is Not a part of research

a. Diligent study
b. Unsystematic inquiry
c. Refine existing knowledge
d. Validate the knowledge
9. History of nursing research began with Florence Nightingale in;
a. 1858
b. 1850
c. 1852
d. 1855

10. In 1859, Florence initial research activities which looked at the importance of leading environment in;
a. Promoting physical well being
b. Promoting social well being
c. Promoting physical and mental well being
d. All of the above

11. Nursing research priorities are ;
a. To improve nursing as profession
b. To improve patient’s illness
c. To improve patients’ outcome
d. To improve nursing practice

12. First nursing journal “ American Journal of nursing” published in;
a. 1950
b. 1960
c. 1900
d. 1920

13. American Nurses Association (ANA) initiated 5 years study of nursing functions & activities in;
a. 1950
b. 1960
c. 1900
d. 1920

14. Which of the following is Not a type of Qualitative research in nursing?
a. Phenomenological research
b. Grounded theory
c. Cross sectional research
d. Historical research

15. Which of the following is Not type of Quantitative research nursing?
a. Ethnography research
b. Descriptive research
c. Quasi experimental
d. Experimental research

16. Which of the following is focused to examine the end results of care or finding the changes in
Patient’s health status?
a. Experimental research
b. Outcome research
c. Quasi experimental research
d. Cross sectional research

17. What is the basis of the Scientific Method?
a. To test hypotheses in conditions that are conducive to its success
b. To formulate a research problem and disprove the hypothesis
c. To formulate a research problem, test the hypothesis in carefully controlled conditions that challenge the hypothesis.
d. To test hypotheses and if they are disproved, they should be abandoned completely

18. Mrs. S.K is writing her daily observations of a student and writes, without interpretation, that the student is not completing the class work and is constantly speaking out of turn. Which of the following objectives does she appear to be using?
a. Prediction
b. Description
c. Explanation
d. Exploration

19. The development of a solid foundation of reliable knowledge typically is built from which type of research?
a. Basic Research
b. Action Research
c. Evaluation Research
d. Orientation Research

20. Which form of reasoning is the process of drawing a specific conclusion from a set of premises?
a. Rationalism
b. Deductive Reasoning
c. Inductive Reasoning
d. Probabilistic

21. Research that is done to examine the findings of someone else using the “same variables but different people” is which of the following?
a. Exploration
b. Hypothesis
c. Replication
d. Empiricism

22. What are the five key objectives of science?
a. prediction, summary, conclusion, explanation, description
b. influence, prediction, questions, exploration, answers
c. exploration, description, explanation, prediction, influence
d. questions, answers, prediction, explanation, summary

23. ________________ is the idea that knowledge comes from experience.
a. Rationalism
b. Deductive Reasoning
c. Logic
d. Empiricism

24. In which of the following study Children deliberately infected with hepatitis?
a. Jewish C.D Hospital Study
b. Nazi medical experience.
c. Tuskegee Syphilis study
d. Willow brook Study

25. Research never occurred, but data reported is an example of?
a. Anonymity
b. Confidentiality
c. Scientific misconduct
d. Deception

26. Which of the following is NOT source of research problem?
a. Experience
b. Theories
c. Poor knowledge
d. Social issues

27. To obtain the desired data in a study, which of the following types of definition is most essential?
a. Theoretical
b. Conceptual
c. Operational
d. Dictionary

28. A researcher designs an experiment to test how variables interact to influence how well children learn spelling words. In this case, the main purpose of the study was:
a. Explanation
b. Description
c. Influence
d. Prediction

29. Which of the following is/are the characteristic of a good theory or explanation?
a. It is parsimonious
b. It is testable
c. It is general enough to apply to more than one place, situation, or person
d. All of the above

30. Which “scientific method” follows these steps: 1) observation/data, 2) patterns, 3) theory?
a. Inductive
b. Deductive
c. retrospective
d. Top down

31. Which scientific method is a top-down or confirmatory approach?
a. Deductive method
b. Inductive method
c. Hypothesis method
d. Pattern method

32. Which scientific method is a bottom-up or generative approach to research?
a. Deductive method
b. Inductive method
c. Hypothesis method
d. Pattern method

33. Which scientific method focuses on testing hypotheses developed from theories?
a. Deductive method
b. Inductive method
c. Hypothesis method
d. Pattern method

34. Which scientific method often focuses on generating new hypotheses and theories?
a. Deductive method
b. Inductive method
c. Hypothesis method
d. Pattern method

35. Which of the following statements is true of a theory?
a. it most simply means “explanation”
b. it answers the “how” and “why” questions
c. it can be a well-developed explanatory system
d. all of the above

36. Which type of research provides the strongest evidence about the existence of cause-and-effect relationships?
a. Nonexperimental Research b. Experimental Research

37. Which research paradigm is least concerned about generalizing its findings?
a. Quantitative Research
b. Qualitative Research
c. Mixed Research
d. None of The Above

38. Which of the following best describes quantitative research?
a. the collection of non-numerical data
b. an attempt to confirm the researcher’s hypotheses
c. research that is exploratory
d. research that attempts to generate a new theory

39. A condition or characteristic that can take on different values or categories is called ___.
a. A Constant
b. A Variable
c. A Cause-and-Effect Relationship
d. A Descriptive Relationship

40. The outcome that investigator is interested in understanding explaining, or predicting is described as:
a. Situational variable
b. Dependent variable
c. Independent variable
d. Extraneous variable

41. A variable that is presumed to cause a change in another variable is called a(n):
a. categorical variable
b. dependent variable
c. independent variable
d. intervening variable

42. All of the following are common characteristics of experimental research except:
a. It relies primarily on the collection of numerical data
b. It can produce important knowledge about cause and effect
c. It uses the deductive scientific method
d. It rarely is conducted in a controlled setting or environment

43. Qualitative research is often exploratory and has all of the following characteristics except:
a. It is typically used when a great deal is already known about the topic of interest
b. It relies on the collection of non-numerical data such as words and pictures
c. It is used to generate hypotheses and develop theory about phenomena in the world
d. It uses the inductive scientific method

44. The correlation between intelligence test scores and grades is:
a. Positive
b. Negative
c. Perfect
d. They are not correlated

45. It is essential that you evaluate the quality of internet resources because information obtained via the internet ranges from very poor to very good.
a. True
b. False
46. What is the key defining characteristic of experimental research?
a. Extraneous variables are never present
b. Positive correlation usually exists
c. A negative correlation usually exists
d. Manipulation of the independent variable

47. Research that is done to understand an event from the past is known as _____?
a. Experimental Research
b. Historical Research
c. Replication
d. Archival Research

48. ______ research occurs when the researcher manipulates the independent variable.
a. causal-comparative research
b. experimental research
c. ethnography
d. correlational research

49. Which of the following includes examples of quantitative variables?
a. Age, Temperature, Income, Height
b. Grade Point Average, Anxiety Level, Reading Performance
c. Gender, Religion, Ethnic Group
d. Both a and b

50. Which correlation is the strongest?
a. +.10
b. -.95
c. +.90
d. – 1.00 (Rational “either strongest positive or strongest negative”)

MULTIPLE SCLEROSIS

Multiple sclerosis (MS) is a chronic demyelinating disease that affects the myelin sheath of neurons in the CNS.

Multiple-Sclerosis-Infographic Multiple sclerosis is a disease that causes vision problems, numbness and tingling, muscle weakness, and other problems. It happens when the body’s infection-fighting system attacks and damages nerve cells and their connections in the brain and spinal cord.
When the body’s infection-fighting system, called the “immune system,” attacks the body’s own cells, it is called an “autoimmune response.” It causes damage to myelin, the protective coating around the nerves. When myelin is damaged, messages can no longer be clearly transmitted from the brain and spinal cord to other parts of the body. Many people refer to multiple sclerosis as “MS.”

INCIDENCE

  • Onset occurs between 20-40 years of age.
  • Women are more affected than men. (AANN, 2011).
  • Whites are more affected than Hispanics, blacks, or Asians.
  • Most prevalent in colder climates of North America & Europe.
  • Migration.

ETIOLOGY & RISK FACTORS

  • Exact cause is not known yet.
  • Most theories suggest that MS is an immunogenetic viral disease (with Epstein Barr virus).

 

Risk factors are:

  • Age (most of the time between 20-40 yrs).
  • Sex (women have more chance).
  • Family history (genetic susceptibility).
  • Certain infections (like Epsteinbarr virus).
  • Climate (more in cold climate areas).
  • Certain auto-immune diseases (higher risks with thyroid disease, type-1 DM or IBD).
  • Smoking.
  • Stress, fatigue.
  • Physical injury.
  • Pregnancy (may relating to stress to labour, or puerperium).

 

PATHOPHYSIOLOGY

Due to etiological factors
Activated T-cells (which recognise self Ag) expressed in CNS, &
Macrophages (B-cells) enters the brain from peripherral circulation
Production of inflammatory cytokines & reactive O2 species
Inflammation
Then activated T-cells & B-cells cause demyelination and destruction of oligodendrocytes
Formation of plaque Causes scarring & destruction of sheath
Compensatory system starts causing subsidation of edema & inflammation
After that some remyelination process occurs which is often incomplete Multiple sclerosis.

 

CLINICAL MANIFESTATIONS

The course of illness varies from person to person.

  1. Fatigue is the lack of physical and mental energy that impacts daily tasks. Fatigue can be physical or mental and is not correlated to how much rest or sleep a person gets. It is one of the most common symptoms and impacts about 80 percent of people living with MS. It can be http://nursingfile.com/wp-content/uploads/2013/12/multiple-sclerosis-249x300.jpg the most debilitating factor, even for those who have minimal physical restrictions, and is one of the leading causes for people leaving the workforce.
  2. Heat intolerance in MS is a temporary worsening of symptoms with elevated body temperatures including hot and humid weather, exercising, sunbathing, or fevers. A small rise in body temperature (a quarter to a half a degree) can cause increased fatigue, tingling, blurry vision, or even the inability to walk. Most people living with MS have to avoid outdoor activity and/or use cooling garments to complete simple, daily activities due to this intolerance.
  3. Cognitive dysfunction affects high-level brain functions such as memory, attention/concentration, the ability to solve daily problems, understand and use language, and process information from different senses. Impaired cognition affects 50-65 percent of those living with MS and is another major reason for leaving the workforce early.
  4. Pain/abnormal sensation is a common symptom with MS and can be directly related to neuropathic pain (the disease process itself) or from musculoskeletal pain (changes to the body and immobility). The pain experience is unique to each person and can greatly limit his or her ability to participate in and enjoy socialization and activities. Those living with MS can also experience various abnormal sensations such as numbness and tingling, prickling, sharp/stabbing pains, hot/cold sensations, and burning pains which can also impact movement and daily function.
  5. Depression comes in various forms and can be one of the most common symptoms in MS, more common in people with MS than the general population. Depression can happen to anyone at any time during the disease course and does not correlate to disease severity, however it can greatly impact someone’s quality of life and ability to participate in daily activities.

 

COMPLICATIONS

People with multiple sclerosis may also develop:

  • Muscle stiffness or spasms
  • Paralysis, typically in the legs
  • Problems with bladder, bowel or sexual function
  • Mental changes, such as forgetfulness or mood swings
  • Depression
  • Epilepsy

DIAGNOSTIC EVALUATION

  • There is no definitive test for MS.
  • Detailed history of episodes of neurologic dysfunction
  • Physical examination.

Other tests include:-

  • CSF evaluation (for presence of IgG antibody or oligoclonal bonding)
  • Evoked potentials of optic pathways & auditory system to assess presence of slowed nerve conduction.
  • MRI of brain and spinal cord (to determine the presence of MS plaques)
  • CT scan (to detect areas of demyelination, but with less detail as by MRI).

 

MEDICAL MANAGEMENT

• No exact cure.

• Aim is to prevent or postpone the long term disability (often evolves slowly over many years).

• The treatment falls into 3 categories:-

1. Treatment of acute relapses.

2. Treatment aimed at disease management.

3. Symptomatic treatment.

1. Treatment of acute relapse:-

  • Corticosteroid therapy ( anti-inflammatory & immunosuppressive property )
  • For example:
  • Methyl-prednisolone , (given I.V. or orally)
  • Azathioprine & cyclophosphamide (in severe cases)

2. Treat exacerbations:- (treatment aimed at disease management)

  • Interferon-Beta 1b
    • Betaseron, given subcutaneously. (antiviral & immuno-regulatory) (For ambulatory clients with relapsing –remitting).
  • Interferon Beta 1a
    • Avonex, (for treating replasing form of MS).
  • Glatiramer acetate
    • Copaxane, (for relapsing re-emitting MS).

3. Symptomatic treatment:-

  • For bladder dysfunction:
    • oxybutynin, propantheline.
  • For constipation:
    • psyllium hydrophilic mucilloid, suppositories.
  • For fatigue:
    • amantadine, modafinil .
  • For spasticity:
    • baclofen, diazefen, dantrolone.
  • For Tremor :
    • propanolol, phenobarbital, clonazepam.
  • For dysesthesias & trigeminal neurolgia:
    • carbamazepine, phenytoin, amitriptyline.
  • For dysesthesias:
    • Transcutaneous electrical nerve stimulation (TENS) is also helpful.

4. Nutritional therapy:-

  • Megavitamin therapy (cobalamin/vit. B12 and vit. C)
  • Low fat diet.
  • high roughage diet (to relieve constipation)

5. Other therapies:- (to improve neurological functioning)

  • Physical and speech therapies.
  • Exercise.
  • Water exercise.

 

SURGICAL MANAGEMENT

  • Deep brain stimulation:-
    • if other options have failed then a device is implanted that stimulates an area of brain. (in case of severe tremor in limbs).
  • Implantation of a drug catheter or pump:
    • a catheter is placed in lower spinal area to deliver a constant flow of drug like baclofen. (in case of severe pain or spasticity).

 

NURSING DIAGNOSIS:

    • Impaired physical mobility related to fatigue & weakness
    • Activity intolerance r/t weakness, dizziness, and unsteady gait
    • Self-esteem disturbance r/t loss of health & lifestyle changes

NURSING MANAGEMENT

    1. Promotes physical mobility – activity and rest
  • no vigorous physical exercise
  • frequent rest periods
  • walking and gait exercises
  • minimize spasticity and contractures – warm packs, daily muscle stretching
  • activities: swimming, stationary bike, progressive wt bearing
  • Minimize effects of immobility; skin integrity; cough and deep breathing exercises.
    1. Prevent injury – walk with feet wide apart, environment awareness and modification, gait training. Use of assistive devices – walker, cane etc.
    2. Promote bladder & bowel control – Urinal/bedpan readily available, po fluids intake schedule/voiding schedule, increase fiber in diet, intermittent self-catheterization
    3. Improve sensory and cognitive function:
  • Vision – eye patch for diplopia; prism glasses for reading; talking books
  • Speech – slurred, low volume, problems with phonation – speech therapist
  • Cognitive & emotional responses – forgetfulness, easily distracted, emotionally labile, social activities; hobbies.
    1. Development of coping strengths – education about diseases process; stress relief; network of services – social, speech, PT, psychological, homemaker/meal on wheels
    2. Improve self-care – assistive devices, raised toilet seat, shower bench, reached tongs, decrease physical and emotional stress, decrease exposure of extreme temperatures
    3. Adapting to sexual dysfunction – counseling, plan sexual activity, willingness to experiment.

Pediatrics Nursing Paper/MCQs

Basis of Pediatrics Nursing

Student Name: ___________S/O_____________ Roll No: ________

Maximum Marks: 100   Passing Marks: 50  Time: 3 Hours Date:

A. OBJECTIVE SECTION

MCQs

Note: Circle the one best answer.

  1. Which cell type is responsible for the early asthmatic response?
    1. Basophil
    2. Eosinophil
    3. Mast cell
    4. Neutrophil
  2. Congenital cyanotic heart disease includes:
    1. VSD.
    2. Patent Ductus Arteriosus.
    3. Fallot tetralogy.
    4. ASD
  3. Fallot tetralogy include:
    1. Pulmonary stenosis
    2. Ventricular septal defect
    3. Over riding aorta
    4. All of the above
  4. Serious complications of Fallot tetralogy includes
    1. Eisenminger syndrome
    2. Recurrent pneumonia
    3. Brain abscess
    4. Pulmonary hypertension
  1. Major manifestations of Rheumatic fever include all the following, Except:
    1. Carditis
    2. Arthralgia
    3. Chorea
    4. Erthema nodosa
  2. All the following are true about acute bronchiolitis, Except:
  • Most cases are under two years old.
  • Most cases are caused by respiratory syncytial virus.
  • Antibiotics are recommended in infants below three months age.
  • Steroids maybe helpful in some cases.
  1. Bronchial asthma is characterized by all the following, Except:
  • Hyper active air way
  • Clubbing
  • Spasmodic cough
  • Bilateral chest wheezes
  1. All of the following cause acute wheezing, Except:
  • Bronchitis
  • Bronchiolitis
  • Bronchiaectasis
  • Bronchial asthma
  1. All of the following are common causes of bacterial pneumonia, Except:
  • Staphylococci.
  • Hemophillus influenza.
  • Pseudomonas.
  • Klepsiella.
  1. All of the following are common causes of empyema, Except:
  • Staphylococcal pneumonia
  • Lung abscess
  • Measles
  • Chest injury
  1. The organ of gas exchange in the fetus is the
    1. Amniotic fluid
    2. Umbilical cord
    3. Placenta
    4. Lungs
  2. Commonest cause of bacterial pneumonia in infancy:
    1. H.. influenza
    2. Streptococcus
    3. Staphylococcus
    4. Pneumococcus
  3. Serious complications of staphylococcal pneumonia include all the following Except :
    1. Lung abscess
    2. Bronchitis
    3. Empyema
    4. Lung collapse
  4. Asthma triggers include all the following Except :
    1. Viral respiratory infections
    2. Tobacco smoke
    3. House dust mite
    4. Steroids
  5. Which of the following statement is not true about Breast milk
  • It contains carbohydrates  7.0 gm %.
  • It contains proteins  4.0 gm %.
  • It contains water 87.5 %.
  • It contains less calcium than cow milk.
  1. Non nutritional marasmus may be caused by.
  • Acute gastroenteritis.
  • Staphylococcal pneumonia.
  • V.S.D.
  • Urinary tract infections
  1. All the following are causes vitamin D deficiency rickets, Except:
  • Low calcium in diet.
  • Prolonged breast feeding
  • Lack of sun exposure.
  • Non response of bone receptors to vitamin D
  1. Colostrum is privileged by having.
  • High iron.
  • High antibodies.
  • High vitamin D.
  • High calcium
  1. The important reflex necessary for breast feeding:
  • Moro reflex
  • Grasp reflex
  • Rooting reflex
  • Cough reflex
  1. The clinical signs of kwashiorkor include the following, Except:
    1. Edema
    2. Skin changes
    3. Hair changes
    4. Bone changes
  2. The complications of rickets include all of the following, Except:
    1. Tetany
    2. Tetanus
    3. Respiratory infection
    4. Fractures
  3. Breast milk contains all of the following nutritional constituents, Except:
    1. 7.2 gm fats
    2. l.2 gm proteins
    3. 7.0 gm carbohydrates
    4. 87.5% water
  4. A fourth degree marasmus infant is characterized by .
    1. Loss of buccal pad of fats.
    2. Skin changes
    3. Edema.
    4. Bowed legs
  5. Breast milk contains all of the following nutritional constituents, Except:
    1. 3.5 gm fats
    2. 1.2 gm proteins
    3. 3.5gm carbohydrates
    4. 87.5% water
  6. Recommended basic requirement of vitamin D for infants is:
    1. 400 u Ikg
    2. 800 ulkg
    3. 200 ulkg
    4. 100 u/kg
  7. Breast milk in the first three days after delivery shows all the following, Except:
    1. Called colostrum
    2. Rich in proteins
    3. High vitamin K content
    4. High caloric value
  8. The clinical signs of kwashiorkor include the following except
    1. Edema
    2. Skin changes
    3. Hair changes
    4. Bone changes
  9. Colostrum is Breast milk secreted in the first post-natal :
    1. 2-3 days
    2. One week.
    3. 3-5 days
    4. One month
  10. Which of the following is not a compulsory vaccine given in the first year of life:
    1. Measles Vaccine.
    2. BCG Vaccine.
    3. Meningitis vaccine.
    4. Polio vaccine.
  11. All the following infectious diseases are essentially associated with rash, Except:
    1. German measles.
    2. Chickenpox.
    3. Mumps.
    4. Roseola infantum
  12. The incubation period of chickenpox is:
    1. One week
    2. 2 to 3 weeks
    3. 2 to 3 months
    4. 3 days
  13. Oral polio vaccine is.
    1. Live attenuated vaccine.
    2. Killed vaccine.
    3. Given at birth.
    4. Given at 4,8,12 months of age
  14. Paroxysmal stage of pertussis persists for:
    1. 2 weeks
    2. 4 weeks
    3. 3 weeks
    4. 8 weeks
  1. The incubation period of measles is :
    1. 2 weeks
    2. 4 weeks
    3. 3 weeks
    4. 8 weeks
  2. The incubation period of Chickenpox is :
    1. 3 weeks
    2. 4 weeks
    3. 8 weeks
    4. 1 week
  3. Rash of measles is characterized by all the following Except:
    1. Starts behind the ears.
    2. Spread from above downwards
    3. May be hemorrhagic in immunocompromised children
    4. May be vesicular
  4. The manifestations of rubella syndrome include the following except
    1. Mental retardation
    2. Microcephaly
    3. Cardiac defects
    4. Macrocephaly
  5. The virus causing chicken pox
    1. Rubella
    2. Varicella
    3. Herpes simplex
    4. None
  6. Paroxysmal stage of pertussis persists for :
    1. 2 weeks
    2. 3 weeks
    3. 4 weeks
    4. 6 weeks
  7. Measles rash begins :
    1. On chest and back
    2. Behind ear
    3. Behind neck
    4. On the face
  8. Complications of diphtheria include all the following Except :
    1. Squint
    2. Flaccid paraplegia
    3. Heart failure
    4. Ataxia
  9. The most common cause of hypovolemic shock is .
    1. Acute renal failure.
    2. Heart failure.
    3. Gastro enteritis.
    4. Toxic. coma
  10. The most common cause for recurrent abdominal pains in children is.
    1. Renal stones.
    2. Familial Mediterranean fever
    3. Intestinal parasites.
    4. Inflammatory bowel disease.
  11. Serious complications of gastroenteritis include:
    1. Dehydration
    2. Acidosis
    3. Shock
    4. All of the above
  12. Hypertonic dehydration is characterized by:
    1. Moist tongue
    2. Lost skin elasticity
    3. High serum sodium
    4. Drowsiness
  13. All of the following are correct about physiological jaundice, Except:
    1. It is a conjugated hyperbilirubinemia
    2. The baby looks healthy and feeds well
    3. Doesn’t exceed 12 mg/dl
    4. It doesn’t persist more than 7 days
  14. All of the following are true about phototherapy, Except:
    1. Reduce serum unconjugated bilirubin level.
    2. Can cause watery stools.
    3. Increase fluid requirement.
    4. Can be a substitute for Exchange transfusion in small preterm with hyperbilirubinemia.
  15. Neonatal period extends up to:
    1. 21 days.
    2. 28 days.
    3. 30 days.
    4. 35 days.
  16. Moro reflex in normal neonates disappear at
    1. 1 week
    2. 3 weeks
    3. 6 weeks
    4. 3 months
  17. The umbilical cord contains
    1. One artery and one vein
    2. One artery and two capillaries
    3. Two arteries and one vein
    4. Two veins and one artery
  18. Persistence of Moro reflex at 12 weeks indicate :
    1. Brain damage
    2. Normal child
    3. Hungry child
    4. Irritable child
  19. Atelectasis due to intra-bronchial obstruction may be due to:
    1. Foreign body
    2. Mucus plug
    3. Both
    4. None
  20. Common presentations of chronic renal failure in children include :
    1. Anemia
    2. Bone deformity
    3. Hypertension
    4. All of the above
  21. The cause of death in spinal polio is:
    1. Paralysis of respiratory muscles
    2. Cardiac arrest
    3. Cranial nerve paralysis
    4. Urinary complications
  22. All of the following might be causes of cerebral palsy ,Except:
    1. Kernicterus.
    2. Toxoplasmosis.
    3. Congenital hypothyroidism.
    4. Tuberous sclerosis
  23. Cerebral palsy is characterized by
    1. Mental retardation
    2. Motor disability
    3. Curable
    4. Sensory loss
  24. The fatal poliomyelitis is :
    1. Bulbar polio
    2. Spinal polio
    3. Encephalitis
    4. Cerebral polio
  25. Delayed puberty may be due to:
    1. Growth hormone deficiency
    2. Malnutrition
    3. Hypothyroidism
    4. All of the above
  26. The site of lesions in myasthenia gravis:
    1. Spinal cord
    2. Neuromuscular junction
    3. Cranial nerves
    4. All of the above
  27. An infant sits without support by….. Month.
    1. 5 month.
    2. 7 month.
    3. 8 month.
    4. 9 month.
  28. The head circumference ,by the end of the second year equals:
    1. 35 cm.
    2. 45 cm.
    3. 50 cm.
    4. 60 cm .
  29. Infants body weight is tripled by the age of:
    1. 5 months
    2. 24 months
    3. 12 months
    4. 18 months
  30. Short stature may be due to:
    1. Growth hormone deficiency
    2. Malnutrition
    3. Hypothyroidism
    4. All the above
  31. An infant supports his head by … … months
    1. 2 months
    2. 4 months
    3. 8 months
    4. 10 months
  32. Weight gain in the first four months of age increase by
    1. 250 gm/month.
    2. 500 gm/ month
    3. 800 gm/ month
    4. 1500 gm/ month
  33. Grasp reflex in normal neonates is present since.
    1. 1 week
    2. 3 weeks
    3. Birth
    4. 3 months
  34. The first deciduous tooth appears by
    1. 3-4 months
    2. 4-5 months
    3. 8-9 months
    4. 5-7 months
  35. The faster weight gain is seen at
    1. First year and puberty
    2. Second year and puberty
    3. Puberty
    4. Infancy
  36. A child starts crawling
    1. 5 months
    2. 7 months
    3. 8 months
    4. 9 months
  37. The average monthly weight gain in the first 4 months :
    1. 250 gm.
    2. 500 gm.
    3. 750 gm.
    4. 1000 gm

B.  Read each statement carefully and circle the correct answer as true or false. (10 Marks)

  1. Humans serve as a reservoir for meningococcal meningitis.
    1. True
    2. False
  2. Currently there is no vaccine for meningococcus.
    1. True
    2. False
  3. Tetanus is nearly always fatal.
    1. True
    2. False
  4. Viral meningitis (“aseptic meningitis”) is usually far more severe and deadly than bacterial or fungal meningitis.
    1. True
    2. False
  5. The common cold is caused by one virus.
    1. True
    2. False
  6. Mycobacterium tuberculosis can survive up to 10 years suspended in fine aerosols.
    1. True
    2. False
  7. Meningitis refers to inflammation of the brain.
    1. True
    2. False
  8. Is meningitis contagious?
    1. True
    2. False
  9. Spina bifida is the deformity of the brain.
    1. True
    2. False
  10. Cleft lip and palate occurs always unilaterally.
    1. True
    2. False

SUBJECTIVE SECTION (20 Marks)

Attempt any five of the following questions. All questions carry equal marks.

Q.No. 01 List the causes of birth defects and explain any one of them: (04 Marks)

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Q.No. 02 Define the Mylomeningocele along with sign and symptoms. (04 Marks)

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Q.No. 03 Write 10 most common accidents of children age with their preventive measures. (04 Marks)

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Q.No. 04 Define tetanus. Explain nursing management of tetanus case. (04 Marks)

______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Q.No. 05 Enlist the responsibilities of a pediatric nurse. (04 Marks)

______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Q.No. 06 Write down the difference between diarrhea and dysentery. (04 Marks)

______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Q.No. 07 Define Down Syndrome and elaborate its nursing management. (04 Marks)

__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

………..THE END………….

OSTEOMALACIA AND RICKETS

  • Decalcification and softening of bones.
  • Due to a lack of vitamin D or a problem with the body’s ability to break down and use this vitamin.
  • Rickets in children.
  • In adults, the condition is called osteomalacia; and in children, it’s known as rickets. Each one is a condition where prolonged and excessive vitamin D deficiency causes bones to soften, weaken, and easily fracture.

Rickets

  • Disease of growing bones of children (in it epiphyseal plate not closed) in which defective mineralization occurs in both bone and cartilage of epiphyseal growth plate.

Osteomalacia

  • Disorder of mature bones in adult (after epiphyseal plate closure) in which mineralization of new osteoid bone is inadequate or delayed

RISK FACTORS

  • Chronic diarrhea
  • GIT malabsorption
  • Lack of exposure to sunlight
  • Pregnancy
  • Avoidance of milk
  • Sedentary lifestyle
  • Renal disease
  • Use of strong sunscreen

CLINICAL/DIAGNOSTIC MANIFESTATION

  • Fractures
  • Persistent and diffuse skeletal pain
  • Progressive deformities of bones
      1. Bowed legs
      2. Knock knees
      3. Rachitic rosary
      4. Enlarged wrists and ankles
      5. Pigeon breast
  • Progressive muscle weakness
  • Decreased serum levels of Calcium (44-107 IU/L)
  • Looser zones on X-ray.
  • Roentgenograms shows bone demineralization and multiple bone deformities. (white: more dense; otherwise: black)
  • Elevated serum alkaline phosphatase.

NURSING INTERVENTIONS

  1. Assess posture and gait, note ability to walk with or without aid.
  2. Note ability to walk requested distances.
  3. Check bony prominence for pressure sores.
  4. Assess shapes of bones throughout the body.
  5. Administer prescribed diet.
    • Rich in Calcium
    • Rich in Vitamin D (tuna, salmon, mackerel)
  6. Discuss purpose of physical therapy.
  7. Assist to a position of comfort.
  8. Administer prescribed analgesics.
  9. Gentle back massage.
  10. Instruct regarding home safety.
  11. Teach family the effects of Calcium and Vitamin D on the body and the factors affecting absorption.
  12. Teach client on the signs of fracture.
  13. Follow up care as needed.

Difference Between Osteoporosis & Osteomalacia

  • Osteoporosis refers to the degeneration of already constructed bone, making them brittle,
  • While osteomalacia is an abnormality in the building process of bone, making them soft.

OSTEOPOROSIS

  • Decrease in the bone mass and density with a change in bone structure.
  • May be ASYMPTOMATIC until the bones become fragile and a minor injury or movement causes a fracture.
  • A disease of the bone characterized by a decrease in the bone mass and density with a change in bone structure
  • METABOLIC BONE DISORDERS
  • Osteoporosis is a metabolic bone disease that involves an imbalance between new bone formation and bone resorption.

Primary osteoporosis is the most common type; occurs most often in women after menopause because low levels of estrogen are associated with an increase in bone resorption.

Bone loss occurs predominantly in the vertebral bodies of the spine, the femoral neck in the hip, and the distal radius of the arm. Bone mass declines, leaving the bones brittle and weak.

PATHOPHYSIOLOGY

  • Normal homeostatic bone turnover is altered rate of bone RESORPTION is greater than bone FORMATION reduction in total bone mass reduction in bone mineral density prone to FRACTURE.

Low bone mass/

impaired bone quality

Inadequate peak bone mass

Early menopausal bone loss

Decrease in bone mass/bone quality

Calcium/

vitamin D deficiency

Other

factors

Fractures

TYPES:

Primary

    • advanced age
    • post-menopausal

Secondary

    • Steroids use
      • will inhibit formation of bones
      • decrease absorption of Calcium
      • increase urine Calcium loss
    • Alcohol overuse
    • Renal failure

RISK FACTORS

  • Sedentary lifestyle
  • Age
  • Diet: caffeine, alcohol, low Calcium and Vitamin D
  • Post-menopausal
  • Genetics : Caucasian and Asian
  • 49066f5deac14678b1afb8fc16ed0142 Immobility

“FAST ACCESS”

  • Family history of osteoporosis 
  • Age
  • Surgical menopause following hysterectomy with or without oophorectomy
  • Thyrotoxicity
  • Alcohol
  • Corticosteroids
  • Calcium deficiancy (low intake)
  • Eostrogen deficiency
  • Smoking
  • Sedentary Lifestyle

ASSESSMENT FINDINGS

  • Low stature (stooping)
  • Fracture (usually long bones)
  • Bone pain

LABORATORY FINDINGS

  1. DEXA-scan
  • Provides information about bone mineral density

T-score is at least 2.5 SD below the young adult mean value

  1. X-ray studies

MEDICAL MANAGEMENT

  1. Diet therapy with Calcium and Vitamin D.
  2. Hormone replacement therapy.
  3. Moderate weight bearing exercise.
  4. Management of fractures.
  5. Medications.
      1. Calcium supplements: daily intake of calcium should be approximately 1000 mg for men and 1500 mg for postmenopausal women.
      2. Vitamin D supplements (800 to 1000 IU recommended daily for postmenopausal women and older adults) to enhance utilization of calcium; spending 20 minutes daily in the sun will provide adequate vitamin D.
  6. Surgical
    1. Kyphoplasty
    • Balloon creates a cavity in vertebral body in which to inject cement
    • Restores vertebral body height in 70%
    • Reduces fracture
    • Partially corrects kyphosis
    1. Vertebroplasty
    • Fluoroscopic procedure where cement is injected into vertebral body
    • Prevents further collapse, does not restore height
    • Pain relief within 48 hours generally, effective in 75-90%

NURSING INTERVENTIONS

  1. Promote understanding of osteoporosis and the treatment regimen.
  • Provide adequate dietary supplement of Calcium and Vitamin D.
  • Instruct to employ a regular program of moderate exercises and physical activity.
  • Manage the constipating side effect of Calcium supplements.
  • Take Calcium supplements with meals.
  • Avoid alcohol and coffee if under Calcium Therapy.
  • Instruct on intake of hormonal replacement.
  • Other medications:
    1. Selective Estrogen Receptor Modulators [SERMs] (Evista)
  • Drugs that block the naturally circulating estrogen in breast tissues and other estrogensensitive tissues in the body.

Alendrolate sodium

  • A synthetic drug analog of pyrophosphate that acts primarily on bone to inhibit its resorption and is used to treat and prevent osteoporosis in postmenopausal women.
  • Used together with vitamin D.

Calcitonin

  1. Relieve pain.
  • Suggest that knee flexion will cause relaxation of back muscles.
  • Heat application may provide comfort.
  • Encourage good posture and body mechanics.
  • Instruct to avoid twisting and heavy lifting.
  1. Improve bowel elimination.
  • Constipation is a problem of Calcium supplements and immobility.
  • Advise intake of high fiber diet and increase fluids.
  1. Prevent injury.
  • Instruct to use isometric exercise to strengthen the trunk muscles.
  • Avoid sudden bending strenuous lifting.
  • Provide a safe environment.

OSTEOMYELITIS

  • Infection of the bone and the bone marrow.
  • Caused by direct invasion from an open wound or a systemic infection.
  • Caused by lowered body resistance and decreased blood flow to the bones
  • Osteomyelitis is an infection of the bone, bone marrow, and surrounding soft tissue.
  • The most common causative organism is Staphylococcus aureus.
  • Inflammatory response occurs initially, with increased vascularization and edema.

ETIOLOGIES

  • Escherichia coli
  • Neisseria gonorrhea
  • Salmonella typhi
  • Staphylococcus aureus (most common)

CLINICAL & DIAGNOSTIC FINDINGS

  • Fever (systemic and local)
  • Pain and lack of desire to use affected limb
  • Culture of drainage revealing infectious microorganism
  • Elevated WBC and neutrophils (WBC: 5000-10000/mm3; Neutrophils: 50-70 %)
  • Weakness, headache, nausea and vomiting
  • Redness, edema and inflammation
  • History of trauma

DIAGNOSTIC STUDIES

  • CBC- WBC may be elevated (indicates presence of active infection).
  • ESR (erythrocyte sedimentation rate)may be elevated (indicates inflammatory process).
  • Bone Scan (indicates infected bone).

  • Bone lesion biopsy or culture (may reveal the causative organism).

NURSING INTERVENTIONS

  1. Assess site of inflammation.
  2. Assess drainage from irrigating tube.
  3. Assist in positioning to comfort.
  4. Maintain bed rest.
  5. Assist in obtaining blood specimen for culture.
  6. Administer antibiotics and pain medications.
  7. Offer fluids and monitor fluid status.
  8. Provide divertional activities.

TREATMENT

  1. Intensive intravenous (IV) antibiotics; oral antibiotic therapy for 6 to 8 weeks.
  2. Immobilization of affected area.
  3. Surgical debridement may be necessary.
  4. Hyperbaric oxygen therapy to stimulate circulation and healing.

TEACHINGS

  1. Teach self-care.
  2. Wound care.
  3. Self-administration of antibiotics analgesics.
  4. Use of ambulatory aids.
  5. Complete continuity of care.

BURSITIS

– Inflammation of the bursa.

ETIOLOGIES

  • Excessive trauma
  • Excessive friction
  • Rheumatoid arthritis

MANIFESTATIONS

  • Point tenderness
  • Limited ROM
  • Calcified bursa
  • History of repeated trauma

NURSING INTERVENTIONS

  1. Assess bursal area and surrounding tissues for ROM limitations.
  2. Apply moist compress to the area.
      • warm: decrease swelling
      • cold: prevent swelling
  3. Support inflamed tissues.
  4. Arm support/sling if shoulder bursa is affected.
  5. Administer prescribed medications.
  6. Arrange follow up visits.
  7. Refer to physical therapist for exercise regimen.