COMP PRACTICE WITH NOTES| FROM QUESTION TO
PERFECTION| STUDY WITH CONFIDENCE!
Course Code:
Course Title:
Programme:
Academic Year: 2026/2027
Duration: 2 Hours
Total Marks: 70%
Candidate Instructions:
1) Write your Registration Number on every answer booklet used.
2) Answer ALL questions in Section A and ANY TWO (2) questions in Section B.
3) Read each question carefully before answering.
4) Begin each question on a new page.
5) The marks for each question are indicated in brackets.
6) This paper consists of several printed pages, including this page.
7) Ensure your copy is complete before the examination begins.
8) Unauthorized materials and communication with other candidates are not permitted.
Turn Over.
APPHIA – Crafted with Care and Precision for Academic Excellence.
1
,The client returns to the provider's office 3 days later.
Exhibit 1: Nurses' Notes
Day 1, 0900:
Client is 65-year-old who reports pain and burning on urination.
Client states, "I am having trouble making it to the bathroom on time and I'm up throughout the
night needing to urinate."
Client alert and oriented x 3.
Bilateral breath sounds clear. Respirations even and unlabored.
S3 auscultated. Lower extremity edema +1. Radial and pedal pulses +2. Bowel sounds
normoactive. Client reports no nausea or vomiting.
Client has a history of type 2 diabetes mellitus, hypertension, and COPD.
3 days later, 0900:
Client returns to office due to orange-colored urine and diarrhea.
Client reports drinking a minimum of 3 L of fluids daily as instructed and states, "I'm still going
to the bathroom a lot, and I noticed that I am bruising more easily."
Exhibit 2: Vital Signs:
Day 1, 0900:
Temperature 37.2° C (99° F)
Heart rate 88/min
B Answer: The client's urine color, voiding pattern, oxygen saturation, and blood pressure are
expected findings and do not need to be reported to the provider.
A nurse is caring for a 5-year-old child
Exhibit 1: Physical Exam 15:10
Upon visual inspection, throat is inflamed, tonsils appear pink, reddened and epiglottis is
edematous and cherry red in appearance. Skin appears pale. Stridor noted upon inspiration with
diminished bilateral lung sounds
Exhibit 2: Nurses' Notes 15:10
Child accompanied to RD by caregiver. Caregiver states child has a sore throat and reports the
child has "pain on swallowing" and denies cough. Child is agitated and learning forward with
drooling noted.
Exhibit 3: Vital Signs 15:05
APPHIA – Crafted with Care and Precision for Academic Excellence.
2
,Axillary Temp: 102F
HR: 130/min
Resp: 28/min
BP: 99/58 mmHg
O2: 90% on room air
Exhibit 4: Medical History
Family history of asthma
Child seen 6 months ago for tonsillitis and treated with antibiotic therapy. Answer: Answer:
Condition: epiglottitis
Actions: droplet precautions and IV antibiotics
Monitor: Temp and breath sounds
A nurse is caring for a client who is on the spinal cord injury (SCI) unit.
Exhibit 1: Nurses' Notes
Day 3, 1700:
Client admitted to SCI unit 3 days ago following C7 injury. Skin is cool, pale, and dry to touch.
Respirations easy and unlabored. Lung sounds diminished to lower lobes. Abdomen soft and
nondistended with active bowel sounds. client passed a small amount of hard formed stool this
AM. Indwelling catheter draining clean, yellow urine. DTR are biceps 1+, Triceps 1+, patella 0,
and ankle 0 bilaterally. Client reports pain of 0.
Day 4, 0600
Client reports increasing coughing and SOB. Crackles auscultated in BLL. Face and neck
flushed, skin warm and moist. Client reports blurred vision and a headache as an 8/10 on pain
scale. Abd soft and mildly distended. hypoactive bowel sounds present. Urinary output 300mL
over last 8hr
Exhibit 2: Vital Signs
Day 3 1700:
Temp: 100.8F
HR: 74
Resp: 20
BP: 108/60 mmHg
O2: 96% Answer: The client is most likely experiencing manifestations of PNEUMONIA and
AUTONOMIC DYSREFLEXIA.
APPHIA – Crafted with Care and Precision for Academic Excellence.
3
, A nurse is caring for a client who has abdominal pain
Exhibit 1: Nurses' Notes
0900:
Client reports loss of appetite, weight loss, and fatigue for 1 week. Reports abdominal pain, 6 on
a scale from 0 to 10, for 2 days. Client is a perioperative nurse, returned 1 week ago from a 2-
week mission trip to an underdeveloped country.
1200:
Results of antibody studies obtained. Provider prescription for antiviral medication pending.
Exhibit 2: Physical Exam
0930:
Lung sounds clear bilaterally. Skin warm to touch and jaundiced. Dry skin noted on extremities.
Sclera yellow bilaterally. Bowel sounds normoactive in four quadrants. Client reports right
upper quadrant pain upon palpation. Urine specimen obtained for urinalysis, dark yellow in
color.
Exhibit 3: Vital Signs
0900:
Temp: 98.5F
HR: 84
Resp: 18
BP: 118/78 mmHg
O2: 98% on RA
Exhibit 4: Diagnostic Results
1100:
Aspartate aminotransferase (AST) 375 units/L (0 to 35 un Answer: Client's risk from
bloodborne transmission: Hep B, Hep C
Physical examination findings: Hep A, Hep B, Hep C
Client's risk from fecal-oral transmission: Hep A
Antiviral treatment: Hep B, Hep C
Laboratory results: Hep A, Hep B, Hep C
BC - ABC - A - BC - ABC
A nurse is caring for a client on a Med-Surge unit.
APPHIA – Crafted with Care and Precision for Academic Excellence.
4
PERFECTION| STUDY WITH CONFIDENCE!
Course Code:
Course Title:
Programme:
Academic Year: 2026/2027
Duration: 2 Hours
Total Marks: 70%
Candidate Instructions:
1) Write your Registration Number on every answer booklet used.
2) Answer ALL questions in Section A and ANY TWO (2) questions in Section B.
3) Read each question carefully before answering.
4) Begin each question on a new page.
5) The marks for each question are indicated in brackets.
6) This paper consists of several printed pages, including this page.
7) Ensure your copy is complete before the examination begins.
8) Unauthorized materials and communication with other candidates are not permitted.
Turn Over.
APPHIA – Crafted with Care and Precision for Academic Excellence.
1
,The client returns to the provider's office 3 days later.
Exhibit 1: Nurses' Notes
Day 1, 0900:
Client is 65-year-old who reports pain and burning on urination.
Client states, "I am having trouble making it to the bathroom on time and I'm up throughout the
night needing to urinate."
Client alert and oriented x 3.
Bilateral breath sounds clear. Respirations even and unlabored.
S3 auscultated. Lower extremity edema +1. Radial and pedal pulses +2. Bowel sounds
normoactive. Client reports no nausea or vomiting.
Client has a history of type 2 diabetes mellitus, hypertension, and COPD.
3 days later, 0900:
Client returns to office due to orange-colored urine and diarrhea.
Client reports drinking a minimum of 3 L of fluids daily as instructed and states, "I'm still going
to the bathroom a lot, and I noticed that I am bruising more easily."
Exhibit 2: Vital Signs:
Day 1, 0900:
Temperature 37.2° C (99° F)
Heart rate 88/min
B Answer: The client's urine color, voiding pattern, oxygen saturation, and blood pressure are
expected findings and do not need to be reported to the provider.
A nurse is caring for a 5-year-old child
Exhibit 1: Physical Exam 15:10
Upon visual inspection, throat is inflamed, tonsils appear pink, reddened and epiglottis is
edematous and cherry red in appearance. Skin appears pale. Stridor noted upon inspiration with
diminished bilateral lung sounds
Exhibit 2: Nurses' Notes 15:10
Child accompanied to RD by caregiver. Caregiver states child has a sore throat and reports the
child has "pain on swallowing" and denies cough. Child is agitated and learning forward with
drooling noted.
Exhibit 3: Vital Signs 15:05
APPHIA – Crafted with Care and Precision for Academic Excellence.
2
,Axillary Temp: 102F
HR: 130/min
Resp: 28/min
BP: 99/58 mmHg
O2: 90% on room air
Exhibit 4: Medical History
Family history of asthma
Child seen 6 months ago for tonsillitis and treated with antibiotic therapy. Answer: Answer:
Condition: epiglottitis
Actions: droplet precautions and IV antibiotics
Monitor: Temp and breath sounds
A nurse is caring for a client who is on the spinal cord injury (SCI) unit.
Exhibit 1: Nurses' Notes
Day 3, 1700:
Client admitted to SCI unit 3 days ago following C7 injury. Skin is cool, pale, and dry to touch.
Respirations easy and unlabored. Lung sounds diminished to lower lobes. Abdomen soft and
nondistended with active bowel sounds. client passed a small amount of hard formed stool this
AM. Indwelling catheter draining clean, yellow urine. DTR are biceps 1+, Triceps 1+, patella 0,
and ankle 0 bilaterally. Client reports pain of 0.
Day 4, 0600
Client reports increasing coughing and SOB. Crackles auscultated in BLL. Face and neck
flushed, skin warm and moist. Client reports blurred vision and a headache as an 8/10 on pain
scale. Abd soft and mildly distended. hypoactive bowel sounds present. Urinary output 300mL
over last 8hr
Exhibit 2: Vital Signs
Day 3 1700:
Temp: 100.8F
HR: 74
Resp: 20
BP: 108/60 mmHg
O2: 96% Answer: The client is most likely experiencing manifestations of PNEUMONIA and
AUTONOMIC DYSREFLEXIA.
APPHIA – Crafted with Care and Precision for Academic Excellence.
3
, A nurse is caring for a client who has abdominal pain
Exhibit 1: Nurses' Notes
0900:
Client reports loss of appetite, weight loss, and fatigue for 1 week. Reports abdominal pain, 6 on
a scale from 0 to 10, for 2 days. Client is a perioperative nurse, returned 1 week ago from a 2-
week mission trip to an underdeveloped country.
1200:
Results of antibody studies obtained. Provider prescription for antiviral medication pending.
Exhibit 2: Physical Exam
0930:
Lung sounds clear bilaterally. Skin warm to touch and jaundiced. Dry skin noted on extremities.
Sclera yellow bilaterally. Bowel sounds normoactive in four quadrants. Client reports right
upper quadrant pain upon palpation. Urine specimen obtained for urinalysis, dark yellow in
color.
Exhibit 3: Vital Signs
0900:
Temp: 98.5F
HR: 84
Resp: 18
BP: 118/78 mmHg
O2: 98% on RA
Exhibit 4: Diagnostic Results
1100:
Aspartate aminotransferase (AST) 375 units/L (0 to 35 un Answer: Client's risk from
bloodborne transmission: Hep B, Hep C
Physical examination findings: Hep A, Hep B, Hep C
Client's risk from fecal-oral transmission: Hep A
Antiviral treatment: Hep B, Hep C
Laboratory results: Hep A, Hep B, Hep C
BC - ABC - A - BC - ABC
A nurse is caring for a client on a Med-Surge unit.
APPHIA – Crafted with Care and Precision for Academic Excellence.
4
