Part 1
Respiratory disorders include:
(A): Asthma, bronchitis and hypertension
(B): Bronchitis, pneumonia and asthma
(C): Asthma, eczema and psoriasis
(D): Pneumonia, copd and colitis
(B) Bronchitis, pneumonia and asthma.
Why this is correct
These are all respiratory disorders, meaning they affect the lungs and breathing system:
Bronchitis — inflammation of the bronchial tubes
Pneumonia — infection of the lungs
Asthma — chronic airway inflammation and narrowing
Why the other options are incorrect
(A) Hypertension is a cardiovascular disorder, not respiratory.
(C) Eczema and psoriasis are skin conditions.
(D) Colitis is a digestive disorder, not respiratory.
Older people should avoid fried and fatty foods because of:
(A): a decrease in saliva secretion
(B): Ill-fitting dentures or loss of teeth
(C): decreased amount of digestive juices
(D): decreased sense of taste
(C) decreased amount of digestive juices.
Why
As people age, the production of digestive enzymes and stomach acids decreases. This makes it harder to break down fried and fatty foods, which require more digestive effort. As a result, these foods can cause:
Indigestion
Gas and bloating
Discomfort
Slower digestion
Why the other options are incorrect
(A) Decrease in saliva — Affects chewing and swallowing, not specifically fatty‑food digestion.
(B) Ill‑fitting dentures or tooth loss — Makes chewing difficult but doesn’t explain why fatty foods should be avoided.
(D) Decreased sense of taste — May affect appetite, but not digestion of fats.
Palliative care:
(A): Haslens death
(B): Improves quality of life
(C): Results in fewer symptoms
(D): Both b and c
(D) Both B and C.
Why
Palliative care focuses on comfort, quality of life, and symptom relief for people with serious or life‑limiting illnesses. It does not try to hasten or delay death — it simply supports the person’s well‑being.
So palliative care:
Improves quality of life → ✔
Results in fewer symptoms (pain, shortness of breath, nausea, anxiety, etc.) → ✔
Why the other options are incorrect
(A) Hastens death — Absolutely not. Palliative care does not speed up dying.
(B) Improves quality of life — True, but incomplete.
(C) Results in fewer symptoms — True, but incomplete.
Because both B and C are correct, the best answer is (D).
Cachexia in the dying person is:
(A): Involuntary weight loss
(B): Voluntary weight loss
(C): The feeling of breathlessness
(D): A form of cancer
(A) Involuntary weight loss.
Why
Cachexia is a common condition in people who are dying or have advanced illness. It involves:
Involuntary weight loss
Loss of muscle and fat
Weakness and fatigue
Reduced appetite
It is not something the person chooses, and it cannot be reversed by simply eating more.
Why the other options are incorrect
(B) Voluntary weight loss — Cachexia is not voluntary.
(C) The feeling of breathlessness — That is dyspnea, not cachexia.
(D) A form of cancer — Cachexia is a syndrome, not a disease or cancer.
Mr. Ritchie, a 55-year-old male, has swollen feet and ankles and enlarged neck veins. Which of the follow cardiovascular system disorders does Mr. Ritchie likely have?
(A): Myocardial infarction
(B): Congestive heart failure
(C): Hypotension
(D): Arrhythmia
(B) Congestive heart failure.
Explanation
Mr. Ritchie’s symptoms point clearly toward right‑sided congestive heart failure (CHF):
Swollen feet and ankles → fluid buildup in the lower extremities
Enlarged neck veins (jugular vein distention) → blood backing up into the venous system
These are classic signs of heart failure, especially when the heart cannot pump effectively.
Why the other options are incorrect
(A) Myocardial infarction (heart attack)
Symptoms usually include chest pain, sweating, nausea, and shortness of breath — not swollen ankles and neck vein distention.
(C) Hypotension (low blood pressure)
Would cause dizziness, fainting, weakness — not swollen feet or neck veins.
(D) Arrhythmia (irregular heartbeat)
May cause palpitations or dizziness, but not the fluid buildup described.
: Which of the following is an autoimmune disorder? (A): multiple sclerosis
(B): hypothyroidism
(C): osteomyelitis
(D): gout
(A) multiple sclerosis.
Why
Multiple sclerosis (MS) is an autoimmune disorder in which the immune system mistakenly attacks the protective myelin sheath around nerve fibers in the central nervous system.
Why the other options are incorrect
(B) Hypothyroidism — Most cases are not autoimmune; only Hashimoto’s thyroiditis is autoimmune, but that is not listed here.
(C) Osteomyelitis — A bone infection, usually bacterial, not autoimmune.
(D) Gout
When a client has difficulty breathing:
(A): finish morning care quickly
(B): pace morning care, move slowly, and lake breaks as needed
(C): Encourage exercise
(D): Encourage visitors to help distract the person
(B) pace morning care, move slowly, and take breaks as needed.
Why this is correct
When a client has difficulty breathing, the priority is to reduce their effort and conserve energy. Moving slowly, pacing care, and allowing rest breaks helps prevent shortness of breath from worsening.
Why the other options are incorrect
(A) Finishing care quickly can increase the client’s breathing difficulty.
(C) Encouraging exercise is unsafe when someone is already struggling to breathe.
(D) Visitors may cause stimulation or anxiety, making breathing harder.
When an adult child asks you "How much longer does my father have to live?" it is most supportive to respond: (A): that is a really important question, I would like to as the nurse to talk with you about that (B): I am a PSW and I don’t answer those types of questions
(C): No one can say
(D): Only god knows when someone will die
The most supportive and professional response is (A) “That is a really important question, I would like to ask the nurse to talk with you about that.”
Why this is the best answer
As a PSW, you cannot predict how long someone will live, but you can acknowledge the family’s concern and make sure they get accurate information. Option A does exactly that:
It validates the family member’s feelings
It shows respect and compassion
It ensures the question is answered by the appropriate healthcare professional
It keeps communication open rather than shutting the person down
Why the other options are not appropriate
(B) Sounds dismissive and unsupportive
(C) Although true, it does not offer help or guidance
(D) Is a personal belief and not a professional response
Conversations with the person about their values, beliefs, hopes and plans for care in the event that the person is no longer able to speak for they is called: (A): Continued power of attorney
(B): Last will and testament
(C): Advance care planning
(D): Certificate of life birth
(C) Advance care planning.
Why
Advance care planning is the process of talking with a person about:
Their values and beliefs
Their wishes for future health care
Their hopes and goals
What they would want if they could no longer speak for themselves
These conversations help guide future decisions and ensure care aligns with the person’s preferences.
Why the other options are incorrect
(A) Continued power of attorney — Not a real term; you may be thinking of Power of Attorney for Personal Care, which is a legal document, not a conversation.
(B) Last will and testament — Deals with property and finances after death, not health‑care wishes.
(D) Certificate of live birth — A birth record, unrelated to end‑of‑life planning.
: Narcotics affect oxygen needs because they do which of the following?
(A): A cause brain damage
(B): depress the respiratory centre in the brain
(C): decrease heart rate and blood flow
(D): cause swelling of the mucous membranes in the upper airway
(B) depress the respiratory centre in the brain.
Explanation
Narcotics (opioids) affect breathing because they:
Slow down the respiratory centre in the brainstem,
Reduce the body’s drive to breathe,
Lower the rate and depth of respirations.
This is why monitoring breathing is essential when someone is taking narcotics.
Why the other options are incorrect
(A) Cause brain damage → Not true; narcotics do not directly damage the brain.
(C) Decrease heart rate and blood flow → Not the main concern related to oxygen needs.
(D) Cause swelling of mucous membranes → This is not an effect of narcotics.
Congestive heart failure would not affect which of the following? (A): The right side of the heart
(B): The liver
(C): the left side of the heart
(D): both sides of the heart
(B) The liver.
Why
Congestive heart failure (CHF) affects the heart itself — the right side, the left side, or both sides. When the heart cannot pump effectively, blood backs up into the lungs or the body.
However, the question asks which of the following would NOT be affected.
Right‑sided heart failure → causes blood to back up into the body, including the liver, leading to liver congestion and swelling.
Left‑sided heart failure → affects the lungs.
Both sides can be affected in advanced CHF.
Since the liver is affected in CHF, and both sides of the heart can be affected, the only option that does not fit is:
When caring for a resident who is dying, the PSW must (A): allow only one visitor in the room at a time
(B): keep the room dark at all times
(C): record and report any changes in the resident's condition to the nurse/supervisor
(D): wear gloves, mask, and shoe covers when giving personal care
(C) record and report any changes in the resident's condition to the nurse/supervisor.
Why this is correct
When caring for someone who is dying, the PSW’s role is to:
Provide comfort
Maintain dignity
Observe carefully
Report any changes immediately (breathing, skin colour, responsiveness, pain, agitation, etc.)
This ensures the nurse can adjust the care plan and provide appropriate support to the resident and family.
Why the other options are incorrect
(A) Families may visit freely; limiting visitors is not appropriate unless the resident or family requests it.
(B) The room should be kept comfortable, not dark unless the resident prefers it.
(D) Standard precautions apply; full PPE (gloves, mask, shoe covers) is not required unless there is a specific infection control reason.
The difference between delirium and dementia:
(A): Dementia is sudden onset and is reversible
(B): Dementia is sudden onset and not reversible
(C): Delirium is sudden onset and may be reversible (D): Delirium is sudden onset and is never reversible
(C) Delirium is sudden onset and may be reversible.
Why this is correct
Delirium comes on suddenly, often over hours or days.
It is usually caused by something treatable, such as infection, dehydration, medication effects, or metabolic imbalance.
Because the cause can often be corrected, delirium may be reversible.
Why the other options are incorrect
(A) Dementia is not sudden and not reversible.
(B) Dementia is not sudden; it develops slowly over months or years.
(D) Delirium can be reversible, so saying it is “never reversible” is incorrect.
Common symptoms experienced by the dying include all of the following except:
(A): Pain
(B): Nausea and vomiting
(C): dyspnea
(D): Increased energy
(D) Increased energy
Explanation:
As the body approaches the end of life, most systems begin to slow down. This leads to less energy, more sleep, and decreased responsiveness. The body is conserving its remaining energy for essential functions.
The other options are common symptoms in the dying process:
Pain — very common and often requires careful management
Nausea and vomiting — may occur due to medications, slowed digestion, or organ failure
Dyspnea (difficulty breathing) — extremely common as breathing patterns change
Increased energy does NOT occur at the end of life. In fact, the opposite is true — energy levels drop significantly.
Mr. Smith, 88, has sever circulatory issues. You should do the following:
(A): ignore his complaints of discomfort
(B): follow the care plan
(C): plan physically demanding activities
(D): allow him to carry heavy bags
(B) follow the care plan.
Explanation
Mr. Smith has severe circulatory issues, which means his heart and blood vessels are not working efficiently. This can put him at risk for:
Swelling
Fatigue
Shortness of breath
Poor tolerance for activity
Because of this, the safest and most professional action for a PSW is to follow the care plan, which is created by the nurse or healthcare team to protect his health.
Why the other options are incorrect
(A) Ignore his complaints of discomfort
Never appropriate. Complaints must be taken seriously and reported.
(C) Plan physically demanding activities
This could worsen his condition and put him at risk of collapse or injury.
(D) Allow him to carry heavy bags
Unsafe. Heavy lifting increases strain on the heart and circulation.
Which of the following areas is a common site for arterial ulcers? (A): on the scalp
(B): on top of the nose
(C): on the outer side of the ankle
(D): behind the knee
(C) on the outer side of the ankle.
Why this is correct
Arterial ulcers occur where blood flow is poorest. They typically appear on:
The outer (lateral) ankle
The feet or toes
Areas with bony prominences and minimal tissue padding
These ulcers are caused by poor arterial circulation, often due to peripheral arterial disease.
Why the other options are incorrect
(A) Scalp — Not a site for arterial ulcers.
(B) Top of the nose — Not associated with arterial insufficiency.
(D) Behind the knee — Not a common location for arterial ulcers.
Non-verbal behaviours that might indicate that a person is in pain include:
(A): resisting care, facul grimacing, and change in behavior
(B): Rapid treating and hot dry skin
(C): Yelling and screaming
(D): Decreased blinking and skin rash
(A) resisting care, facial grimacing, and change in behavior.
Why this is correct
People—especially older adults or those who cannot communicate well—often show non‑verbal signs of pain, such as:
Resisting care (pulling away, guarding an area)
Facial grimacing (frowning, tightening the face)
Changes in behavior (restlessness, withdrawal, irritability)
These are classic indicators that someone may be experiencing pain.
Why the other options are incorrect
(B) Rapid breathing and hot, dry skin — These may indicate fever, dehydration, or medical distress, not specifically pain.
(C) Yelling and screaming — These are verbal, not non‑verbal behaviors.
(D) Decreased blinking and skin rash — Not associated with pain.
The Substitute Decision Maker
(A): is chosen by the client
(B): is chosen by the family
(C): Makes decisions based on what the Substitute Decision Maker would want for himself or herself
(D): only makes financial decisions
The correct answer is (C) Makes decisions based on what the Substitute Decision Maker would want for himself or herself — BUT this is actually a trick.
Let me clarify it properly so you understand the rule:
✅ Correct answer: (C)
A Substitute Decision Maker (SDM) must make decisions based on what the client would want, not what the SDM personally wants. This is called “substituted judgment.”
Why the other options are incorrect
(A) is chosen by the client — Not always. If the client is incapable, the SDM is chosen according to the legal hierarchy (spouse, child, parent, etc.).
(B) is chosen by the family — No, families do not choose; the law determines the order.
(D) only makes financial decisions — No, SDMs make health‑care decisions, not financial ones.
Which of the following is the correct term for respirations fewer than 12 per minute?
(A): Apnoea
(B): Bradypnea
(C): Orthopnoea
(D): Tachypnea
(B) Bradypnea
Explanation:
The question asks for the term used when a person has fewer than 12 respirations per minute. In adults, this is considered abnormally slow breathing.
Bradypnea means slow breathing.
Adult normal rate: 12–20 breaths per minute
Below 12 = bradypnea
Why the other options are incorrect:
(A) Apnoea → means no breathing at all.
(C) Orthopnoea → difficulty breathing unless sitting upright; common in heart failure.
(D) Tachypnea → fast breathing, usually over 20 breaths per minute.
You notice your client massaging his abdomen. After his bowel movement, you observe that the faces are black and tarry. After reporting this observation to your supervisor, you see an order for a stool specimen to be collected from the client. What is the purpose of this procedure?
(A): To rule out colon cancer
(B): To test the stool for blood
(C): To rule out hemorrhoids
(D): To rule out ulcers
(B) To test the stool for blood.
Explanation
Black, tarry stool is called melena, and it usually means there is digested blood coming from the upper gastrointestinal (GI) tract — often the stomach or small intestine.
When the supervisor orders a stool specimen after you report black, tarry stool, the purpose is to:
Check for occult (hidden) blood in the stool
Help determine if there is internal bleeding
Why the other options are incorrect
(A) To rule out colon cancer
A stool test alone cannot rule out colon cancer; further tests like colonoscopy are needed.
(C) To rule out hemorrhoids
Hemorrhoids cause bright red blood, not black tarry stool.
: Oxygen and carbon dioxide are exchanged:
(A): in branch
(B): between arteriole and capillaries
(C): between lungs and the pleura
(D): in the trachea
(B) between arteriole and capillaries.
Why
Gas exchange — the swapping of oxygen (O₂) and carbon dioxide (CO₂) — happens in the capillaries, specifically at the level where arterioles transition into capillary networks. This is where blood is closest to body tissues and where diffusion can occur efficiently.
Why the other options are incorrect
(A) in branch — Not a physiological term related to gas exchange.
(C) between lungs and the pleura — The pleura is a protective membrane; no gas exchange occurs there.
(D) in the trachea — The trachea only conducts air; no exchange happens in the airway tubes.
Common physical changes in the last hours include: (A): Irregular breathing and reduced intake
(B): Regular breathing and increased intake
(C): Irregular breathing, watery eyes
(D): Decreased fatigue
(A) Irregular breathing and reduced intake.
Why this is correct
In the final hours of life, the body begins to slow down. Common physical changes include:
Irregular breathing (Cheyne–Stokes pattern, pauses, shallow breaths)
Reduced food and fluid intake
Cool or mottled skin
Decreased responsiveness
These are normal signs that the body is shutting down.
Why the other options are incorrect
(B) Regular breathing and increased intake do not occur at the end of life.
(C) Watery eyes can happen, but reduced intake is a more consistent and expected change than watery eyes alone.
(D) Fatigue actually increases, not decreases.
When a person is in pain, it is important for the PSW to ask, record and report, which of the following questions?
(A): when did it start
(B): can you rate your pain on a scale of 0-10
(C): what makes it better or worse
(D): all of the above
(D) all of the above.
Why
When a person reports pain, the PSW must gather clear, useful information so the nurse can assess and treat it properly. This includes asking:
When did it start? → helps identify cause and urgency
Can you rate your pain on a scale of 0–10? → measures severity
What makes it better or worse? → helps guide treatment
When Mr. Coelho was given his diagnosis, he was told that he has a malignant tumor. This means he has which of the following?
(A): cancer
(B): metastasis
(C): a tumor that grows slowly
(D): death of tissue
(A) cancer.
Explanation
A malignant tumor means:
It is cancerous
It can grow quickly
It can invade nearby tissues
It may spread to other parts of the body (metastasize)
Why the other options are incorrect
(B) Metastasis → This means the cancer has already spread, which is not guaranteed just because a tumor is malignant.
(C) A tumor that grows slowly → Slow‑growing tumors are usually benign, not malignant.
(D) Death of tissue → That is necrosis, not malignancy.
You have just finished taking the vital signs of Mrs. Santos, who is 75 years old. Her temperature is 36’C, her blood pressure is 140/90 mm Hg, her pulse rate is 95 beats per minute, and the oximeter registered a reading of 90%. Which finding do you need to report to your supervisor?
(A): Pulse rate of 95 beats per minute
(B): Oximeter madding of 190
(C): Blood pressure of 160/90 mm ng
(D): Temperature of 36 C
Correct Answer: (B)
Explanation
Let’s look at each vital sign:
Temperature: 36°C
Normal for an older adult.
Nothing to report.
Blood pressure: 140/90 mm Hg
Elevated, but not an emergency unless new or symptomatic.
Not the most urgent finding.
Pulse: 95 beats per minute
Slightly high but still acceptable for a 75‑year‑old.
Not dangerous.
Oxygen saturation: 90%
This is the only urgent and abnormal finding.
Normal SpO₂ is 95–100%.
A reading of 90% indicates hypoxia, meaning the body is not getting enough oxygen.
This requires immediate reporting to prevent respiratory distress.