170 Nursezone Medical-surgical Nursing Application Exam Part 2 (76 To 100)

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  • 1/25 Questions

    SITUATION: Members of the public have become more knowledgeable about high blood pressure, are more likely to visit a health care provider for hypertension, and are more likely to follow medical advice   A 43 year old male client was rushed to the hospital by paramedics because of a malignant hypertension secondary to myocardial infarction. The client is complaining of midsternal pain. Nurse Gina is aware that the drug of choice to control pain associated with myocardial infarction is:

    • Morphine
    • Demerol
    • Xanax
    • Lidocaine
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About This Quiz

This exam, part 2 of the 170 NurseZone Medical-Surgical Nursing series, assesses knowledge in managing hypertension, recognizing myocardial infarction symptoms, and understanding medication impacts. It is essential for nursing professionals aiming to enhance their clinical skills.

170 Nursezone Medical-surgical Nursing Application Exam Part 2 (76 To 100) - Quiz

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  • 2. 

    SITUATION: An engineering instructor was brought to the emergency department after seeing him lying on the floor of the men’s comfort room. He is suspected of having a myocardial infarction   The nurse is aware that adequate oxygenation is essential during the early postoperative period after open heart surgery because:

    • An increased respiratory rate adds to postoperative pain

    • Hypoxia can stimulate dangerous dysrhythmias

    • Hypoxia can precipitate respiratory alkalosis

    • Clients have closed chest drainage in place

    Correct Answer
    A. Hypoxia can stimulate dangerous dysrhythmias
    Explanation
    During the early postoperative period after open heart surgery, adequate oxygenation is crucial because hypoxia, or low oxygen levels, can stimulate dangerous dysrhythmias. Dysrhythmias are abnormal heart rhythms that can be life-threatening. When the heart does not receive enough oxygen, it can lead to irregular electrical signals and disrupt the normal rhythm of the heart. Therefore, ensuring sufficient oxygen supply is essential to prevent the occurrence of dysrhythmias and promote the patient's recovery after open heart surgery.

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  • 3. 

    SITUATION: Mr. Baker, a computer analyst, came to the Philippines for a business trip. In the dining hall of his hotel he suddenly felt a pressure and burning on his chest. The symptoms were accompanied by indigestion   Which action should nurse Gemma take when administering a new blood pressure medication to a patient?

    • Administer the medication and inform the patient that the physician will later explain the medication

    • Inform the client about a new medication only if he asks about it

    • Inform the patient about the new medication, including its name, use, reason for the change

    • Administer the medication to the client after she explains its name and use

    Correct Answer
    A. Inform the patient about the new medication, including its name, use, reason for the change
    Explanation
    The correct answer is to inform the patient about the new medication, including its name, use, and reason for the change. This is important because the patient has the right to know what medication they are being given and why it is being prescribed to them. It is also important to provide this information so that the patient can give informed consent and understand any potential side effects or interactions with other medications they may be taking.

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  • 4. 

    SITUATION: Mr. Baker, a computer analyst, came to the Philippines for a business trip. In the dining hall of his hotel he suddenly felt a pressure and burning on his chest. The symptoms were accompanied by indigestion   Nurse Gemma asks about smoking history while conducting a hospital admission for a client with coronary artery disease. What is the most important element of the smoking history for this assessment?

    • Brand of cigarettes used

    • Number of pack years

    • Desire to quit smoking

    • Number of past attempts to quit smoking

    Correct Answer
    A. Number of pack years
    Explanation
    The most important element of the smoking history for this assessment is the number of pack years. This information helps to determine the extent of smoking exposure and the potential damage it may have caused to the client's coronary arteries. It provides a better understanding of the client's risk for coronary artery disease and helps in planning appropriate treatment and interventions.

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  • 5. 

    SITUATION: Mr. Toni, is a 60 year old male who is a chronic smoker and an alcoholic. He is brought to the emergency room due to a crushing chest pain. He is very anxious and is sweating profusely   The first several hours after cardiac catheterization, it is vital for the nurse to:

    • Monitor the client’s apical pulse and blood pressure frequently

    • Encourage the client to cough and deep breath every 2 hours

    • Check the client’s temperature every hour until it returns to normal

    • Keep the feet of the client elevated at 45 degrees

    Correct Answer
    A. Monitor the client’s apical pulse and blood pressure frequently
    Explanation
    After cardiac catheterization, it is important for the nurse to monitor the client's apical pulse and blood pressure frequently. This is because the client, Mr. Toni, is experiencing a crushing chest pain and is anxious. Monitoring the apical pulse and blood pressure can help assess the client's cardiovascular status and detect any abnormalities or changes that may require immediate intervention. This is especially important in the case of Mr. Toni, who is a chronic smoker and alcoholic, as these factors can increase the risk of cardiovascular complications.

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  • 6. 

    SITUATION: Peripheral arterial occlusive diseases are caused primarily by atherosclerosis. Other causes include embolism, thrombosis, trauma, vasospasm, inflammation, and autoimmunity   A nurse is performing an admission assessment on a client with a diagnosis of Reynaud’s disease. The nurse assesses for associated signs and symptoms by:

    • Checking for a rash on the digits

    • Palpating for diminished or absent peripheral pulses

    • Palpating for a rapid or irregular peripheral pulse

    • Observing for softening of the nails or nail beds

    Correct Answer
    A. Palpating for diminished or absent peripheral pulses
    Explanation
    The correct answer is palpating for diminished or absent peripheral pulses. This is because Reynaud's disease is a condition that affects the blood vessels, causing them to narrow and restrict blood flow to the extremities. Palpating for diminished or absent peripheral pulses can indicate poor circulation in the affected areas, which is a common symptom of Reynaud's disease. Checking for a rash on the digits, palpating for a rapid or irregular peripheral pulse, and observing for softening of the nails or nail beds are not specifically associated with Reynaud's disease.

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  • 7. 

    SITUATION: Members of the public have become more knowledgeable about high blood pressure, are more likely to visit a health care provider for hypertension, and are more likely to follow medical advice   After taking a client’s blood pressure twice, 10 minutes apart, in one hour while the client is seated, the nurse in the blood pressure screening clinic records the two blood pressures of 172/104 and 164/98. The nurse’s priority is to:

    • Place the client in recumbent position and call the paramedics for transport to the hospital

    • Refer the client to a nutritionist after providing health teaching about a low-sodium diet

    • Take the blood pressure in the other arm and then schedule a physician’s appointment for the client as soon as possible

    • Talk with the client to assess whether there is stress in the client’s life and refer to counseling service

    Correct Answer
    A. Take the blood pressure in the other arm and then schedule a physician’s appointment for the client as soon as possible
    Explanation
    The nurse's priority is to take the blood pressure in the other arm and then schedule a physician's appointment for the client as soon as possible. This is because the client's blood pressure readings of 172/104 and 164/98 are significantly elevated and indicate hypertension. Taking the blood pressure in the other arm will help confirm the accuracy of the readings. Scheduling a physician's appointment is important to further assess the client's condition and determine the appropriate course of treatment.

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  • 8. 

    SITUATION: An engineering instructor was brought to the emergency department after seeing him lying on the floor of the men’s comfort room. He is suspected of having a myocardial infarction   When preparing a client for cardiac catheterization, the nurse should advise the client that:

    • The client will be NPO 6 to 8 hours before the procedure

    • Complete sedation will be maintained during the procedure

    • It will take 15 minutes for the procedure

    • Ambulation will be permitted within one hour after the procedure

    Correct Answer
    A. The client will be NPO 6 to 8 hours before the procedure
    Explanation
    The client will be advised to be NPO (nothing by mouth) for 6 to 8 hours before the cardiac catheterization procedure. This is important because the procedure involves inserting a catheter into the blood vessels to examine the heart, and it is necessary for the client to have an empty stomach to reduce the risk of complications such as aspiration.

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  • 9. 

    SITUATION: Mr. Toni, is a 60 year old male who is a chronic smoker and an alcoholic. He is brought to the emergency room due to a crushing chest pain. He is very anxious and is sweating profusely   Mr. Toni returns from cardiac catheterization and is to remain supine position for 6 hours with the affected leg straight. These measures prevent:

    • Headache with disorientation

    • Orthostatic hypotension

    • Bleeding at the arterial puncture site

    • Infiltration of radiopaque dye into the tissue

    Correct Answer
    A. Bleeding at the arterial puncture site
    Explanation
    The correct answer is bleeding at the arterial puncture site. After cardiac catheterization, it is important for the patient to remain in a supine position with the affected leg straight for 6 hours. This helps to prevent bleeding at the arterial puncture site, as the pressure from the body weight helps to compress the site and promote clotting. Additionally, keeping the leg straight helps to prevent movement or bending at the puncture site, which could disrupt the clotting process and lead to bleeding.

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  • 10. 

    SITUATION: Peripheral arterial occlusive diseases are caused primarily by atherosclerosis. Other causes include embolism, thrombosis, trauma, vasospasm, inflammation, and autoimmunity   A male client is admitted to the hospital for the care of leg ulcers. He is homeless. He has large irregularly shaped ulcers. It is located in the lower outer leg and it has a beefy red base. What type of ulcer is present?

    • Arterial ulcers

    • Both venous and arterial ulcers

    • Venous stasis ulcers

    • None of the above

    Correct Answer
    A. Venous stasis ulcers
    Explanation
    Based on the given information, the client is homeless and has large irregularly shaped ulcers located in the lower outer leg with a beefy red base. These characteristics are consistent with venous stasis ulcers. Venous stasis ulcers are typically caused by poor blood circulation due to venous insufficiency, which can be a result of long periods of standing or sitting, obesity, or deep vein thrombosis. In this case, the ulcers are likely caused by the client's homeless situation and lack of access to proper healthcare and hygiene, leading to poor blood circulation and the development of venous stasis ulcers.

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  • 11. 

    SITUATION: An engineering instructor was brought to the emergency department after seeing him lying on the floor of the men’s comfort room. He is suspected of having a myocardial infarction   Nurse Remy notes a bilateral +2 edema in the lower extremities of a client with myocardial infarction who was admitted 2 days ago. The nurse would plan to do which of the following next?

    • Request a sodium restriction of 1 g/day from the physician

    • Change the time of diuretic administration from morning to evening

    • Order daily weights starting on the following morning

    • Review the intake and output records for the last 2 days

    Correct Answer
    A. Review the intake and output records for the last 2 days
    Explanation
    The correct answer is to review the intake and output records for the last 2 days. Edema in the lower extremities can be a sign of fluid retention, which is common in patients with myocardial infarction. By reviewing the intake and output records, the nurse can assess the fluid balance of the patient and determine if there has been an increase in fluid intake or a decrease in fluid output. This information can help guide further interventions, such as adjusting diuretic therapy or implementing a sodium restriction if necessary.

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  • 12. 

    SITUATION: An engineering instructor was brought to the emergency department after seeing him lying on the floor of the men’s comfort room. He is suspected of having a myocardial infarction   Nurse Flora will assess for which of the following elevations in isoenzyme values reported with the creatinine kinase level?

    • BB

    • MM

    • MB

    • MK

    Correct Answer
    A. MB
    Explanation
    The correct answer is MB. In the context of a suspected myocardial infarction, Nurse Flora would assess for elevations in isoenzyme values reported with the creatinine kinase (CK) level. CK-MB is a specific isoenzyme of CK that is found predominantly in the heart muscle. An elevated CK-MB level indicates damage to the heart muscle, which is consistent with a myocardial infarction. Therefore, assessing for elevations in the MB isoenzyme is important in diagnosing and managing a suspected heart attack.

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  • 13. 

    SITUATION: An engineering instructor was brought to the emergency department after seeing him lying on the floor of the men’s comfort room. He is suspected of having a myocardial infarction   A client has been transferred from a coronary care unit to a general medical unit with cardiac monitoring via telemetry. A nurse plans to allow for which of the following client activities?

    • Ad lib activities because the client is monitored

    • Bathroom privileges and self-care activities

    • Strict bed rest for 24 hours after transfer

    • Unsupervised hallway ambulation with distances under 200 feet

    Correct Answer
    A. Bathroom privileges and self-care activities
    Explanation
    The correct answer is "Bathroom privileges and self-care activities." This is because the client has been transferred to a general medical unit with cardiac monitoring, indicating that their condition is stable and they can engage in activities such as using the bathroom and taking care of themselves. The other options, such as strict bed rest or unsupervised hallway ambulation, may not be appropriate for a client with a suspected myocardial infarction.

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  • 14. 

    SITUATION: Mr. Baker, a computer analyst, came to the Philippines for a business trip. In the dining hall of his hotel he suddenly felt a pressure and burning on his chest. The symptoms were accompanied by indigestion   Nurse Gemma auscultates the patient’s heart. During auscultation, she would expect the first heart sound (S1) to be the loudest at the:

    • Right lateral border

    • Left lateral border

    • Apex of the heart

    • Top of the heart

    Correct Answer
    A. Apex of the heart
    Explanation
    Nurse Gemma would expect the first heart sound (S1) to be the loudest at the apex of the heart. The apex is the lower tip of the heart and is located at the left side of the chest. This is where the mitral valve is located, which is responsible for producing the S1 sound. The sound is louder at the apex because the mitral valve is closer to the chest wall in this area.

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  • 15. 

    SITUATION: Peripheral arterial occlusive diseases are caused primarily by atherosclerosis. Other causes include embolism, thrombosis, trauma, vasospasm, inflammation, and autoimmunity   The nurse is caring for a client with a stump. She notes that the stump has redness and blistering. Which statement of the client will denote that he hasn’t understood the teaching reading stump care?

    • “Why did these blisters develop? I examine my foot religiously in the morning”

    • “I always clean my stump with mild soap, and I make sure that I put some alcohol in it before I put my stump socks”

    • “Upon arising in the morning, I immediately put on the prosthesis and keep it on all day”

    • “I exercise regularly to prevent weakness on my extremities”

    Correct Answer
    A. “I always clean my stump with mild soap, and I make sure that I put some alcohol in it before I put my stump socks”
    Explanation
    The correct answer is "I always clean my stump with mild soap, and I make sure that I put some alcohol in it before I put my stump socks." This statement indicates a lack of understanding about stump care because cleaning the stump with alcohol can be too harsh and drying, which can lead to redness and blistering. Mild soap and water should be used instead.

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  • 16. 

    SITUATION: Mr. Toni, is a 60 year old male who is a chronic smoker and an alcoholic. He is brought to the emergency room due to a crushing chest pain. He is very anxious and is sweating profusely   A nurse places cardiac monitoring leads on a client who is at risk for premature ventricular contractions (PVCs). The nurse assesses the client’s heart rhythm to detect PVCs by looking for:

    • QRS complexes that are short and narrow

    • Inverted P waves before the QRS complex

    • A P wave preceding every QRS complex

    • Premature beats followed by a compensatory pause

    Correct Answer
    A. Premature beats followed by a compensatory pause
    Explanation
    Premature beats followed by a compensatory pause indicate the presence of premature ventricular contractions (PVCs). In this situation, Mr. Toni is at risk for PVCs due to his age, smoking, and alcohol consumption. PVCs are extra, abnormal heartbeats that originate in the ventricles instead of the normal heart's electrical system. They can cause a feeling of skipped or extra beats and may be accompanied by chest pain. The compensatory pause occurs after the premature beat to allow the heart to reset before the next normal beat. This pattern can be detected by assessing the client's heart rhythm using cardiac monitoring leads.

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  • 17. 

    SITUATION: Mr. Toni, is a 60 year old male who is a chronic smoker and an alcoholic. He is brought to the emergency room due to a crushing chest pain. He is very anxious and is sweating profusely   After 30 minutes of lying in bed, the patient post cardiac catheterization complains of tingling sensations in the affected leg. The nurse’s priority intervention would be to:

    • Evaluate the affected leg for signs of inflammation

    • Compare the femoral, popliteal, and pedal pulses in both legs

    • Obtain the temperature, pulse, respirations, and blood pressure

    • Assess for bleeding in the catheter insertion site

    Correct Answer
    A. Compare the femoral, popliteal, and pedal pulses in both legs
    Explanation
    The correct answer is to compare the femoral, popliteal, and pedal pulses in both legs. This is the priority intervention because the patient is experiencing tingling sensations in the affected leg after cardiac catheterization. Comparing the pulses in both legs will help determine if there is adequate blood flow to the affected leg and if there is a potential complication such as a blockage or clot. This assessment is crucial in identifying any vascular compromise and ensuring prompt intervention to prevent further complications.

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  • 18. 

    SITUATION: Members of the public have become more knowledgeable about high blood pressure, are more likely to visit a health care provider for hypertension, and are more likely to follow medical advice   A nurse is obtaining a medical history of a client with secondary hypertension. The client stated all modifiable risk factors that he has. These modifiable risk factors are the following, except:

    • Non-consumption of dairy products, and most fruits like banana, apple and some green leafy vegetables

    • The client is a male American who grew in the Philippines

    • He has a pear shaped built and is overweight

    • He has a type A personality

    Correct Answer
    A. The client is a male American who grew in the Philippines
    Explanation
    The client being a male American who grew in the Philippines is not a modifiable risk factor for hypertension. Modifiable risk factors are those that can be changed or controlled, such as diet, physical activity, and stress levels. Being a male or the client's nationality and place of growth are not factors that can be modified to reduce the risk of hypertension.

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  • 19. 

    SITUATION: Members of the public have become more knowledgeable about high blood pressure, are more likely to visit a health care provider for hypertension, and are more likely to follow medical advice   The patient with hypertension is taking hydrochlorothiazide. The following nursing assessment indicate effectiveness of the medication, except:

    • A blood pressure reading of 105/86 mmHg

    • Edema grade of 1 compared to the baseline which is grade 3

    • Tenting of skin when pinched gently

    • Potassium level of 4.5 mEq/L

    Correct Answer
    A. Tenting of skin when pinched gently
    Explanation
    The patient's blood pressure reading of 105/86 mmHg, edema grade of 1 compared to the baseline which is grade 3, and potassium level of 4.5 mEq/L indicate effectiveness of the medication. However, tenting of the skin when pinched gently is not a relevant assessment for the effectiveness of hydrochlorothiazide in treating hypertension.

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  • 20. 

    SITUATION: Mr. Baker, a computer analyst, came to the Philippines for a business trip. In the dining hall of his hotel he suddenly felt a pressure and burning on his chest. The symptoms were accompanied by indigestion   Mr. Baker is a white, obese, male client. He was brought to the emergency room and was diagnosed with hypercholesterolemia. Besides his race and gender, the nurse determines the client’s other major risk factor for Coronary Artery Disease (CAD). The nurse should assess for:

    • A history of diabetes mellitus

    • Elevated high-density lipoprotein (HDL) levels

    • A history of ischemic heart disease

    • Alcoholism

    Correct Answer
    A. A history of diabetes mellitus
    Explanation
    Based on the given information, Mr. Baker is diagnosed with hypercholesterolemia, which is an elevated level of cholesterol in the blood. Diabetes mellitus is a major risk factor for Coronary Artery Disease (CAD) because it can lead to the development of atherosclerosis, a condition where the arteries become narrowed and hardened due to the buildup of plaque. This can increase the risk of CAD, as it restricts blood flow to the heart. Therefore, the nurse should assess for a history of diabetes mellitus as a potential risk factor for CAD in Mr. Baker.

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  • 21. 

    SITUATION: Mr. Toni, is a 60 year old male who is a chronic smoker and an alcoholic. He is brought to the emergency room due to a crushing chest pain. He is very anxious and is sweating profusely   Specifically, cardiac catheterization is performed to, except:

    • Obtain a clear picture of cardiac anatomy before heart surgery

    • Obtain pressures within the heart chambers and the great vessels

    • Obtains endocardial biopsy specimens

    • To differentiate ischemia from dilated cardiomyopathy

    Correct Answer
    A. To differentiate ischemia from dilated cardiomyopathy
    Explanation
    Cardiac catheterization is not performed to differentiate ischemia from dilated cardiomyopathy. It is a procedure used to obtain a clear picture of cardiac anatomy before heart surgery, obtain pressures within the heart chambers and the great vessels, and obtain endocardial biopsy specimens. Ischemia and dilated cardiomyopathy are typically diagnosed through other methods such as electrocardiogram (ECG), echocardiogram, and cardiac MRI.

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  • 22. 

    SITUATION: Mr. Baker, a computer analyst, came to the Philippines for a business trip. In the dining hall of his hotel he suddenly felt a pressure and burning on his chest. The symptoms were accompanied by indigestion   The nurse assesses the patient’s pain. Which statement by the client is most suggestive of angina pectoris?

    • “The pain worsened when I took a deep breath”

    • “The pain resolved after I ate a sandwich”

    • “The pain lasted for about 45 minutes”

    • “The pain occurred after my meal”

    Correct Answer
    A. “The pain occurred after my meal”
    Explanation
    The statement "The pain occurred after my meal" is most suggestive of angina pectoris because angina is chest pain or discomfort that occurs when the heart muscle does not receive enough blood. This lack of blood flow to the heart muscle can be triggered by physical exertion or emotional stress, but it can also be triggered by a heavy meal. Therefore, experiencing chest pain after a meal could indicate that the pain is related to angina pectoris.

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  • 23. 

    SITUATION: Peripheral arterial occlusive diseases are caused primarily by atherosclerosis. Other causes include embolism, thrombosis, trauma, vasospasm, inflammation, and autoimmunity   Jack, a diagnosed diabetic, has just had a below-the-knee amputation. He is a 28 year old single male patient. He eats only a little portion of his meals and avoids interactions especially with female visitors and medical staff. Nurse Joy makes a diagnosis of ineffective individual coping related to a reaction or response to change in body image. The following are appropriate interventions for this diagnosis, except:

    • Listen to the client, and comfort misconceptions about the rehabilitation

    • Your stump looks healthy. You know you could use aesthetic prosthetics when the stump heals completely” as stated by the nurse

    • If possible, arrange for the client to meet with an amputee

    • The nurse listens to the client as he says, “I will never be accepted on my previous job” and the nurse suggests the advantages of prosthetics

    Correct Answer
    A. Your stump looks healthy. You know you could use aesthetic prosthetics when the stump heals completely” as stated by the nurse
    Explanation
    The given answer is incorrect because it does not address the client's coping mechanism or provide any support or intervention related to the client's body image and self-esteem. The nurse should focus on listening to the client, comforting any misconceptions, arranging for the client to meet with an amputee, and discussing the advantages of prosthetics to help the client cope with the change in body image.

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  • 24. 

    SITUATION: Members of the public have become more knowledgeable about high blood pressure, are more likely to visit a health care provider for hypertension, and are more likely to follow medical advice   A nurse is preparing a health teaching for a client who has just recovered from a hypertensive crisis. Which statement of the client denotes understanding of the teaching regarding calorie-restriction diet?

    • “I can eat while doing something else. Multitasking is a good habit”

    • “I never eat something before going to parties”

    • “I drink one to two glasses of water before drinking an alcoholic beverage”

    • “I am restricted from drinking coffee or tea”

    Correct Answer
    A. “I drink one to two glasses of water before drinking an alcoholic beverage”
    Explanation
    The correct answer is "I drink one to two glasses of water before drinking an alcoholic beverage." This statement demonstrates understanding of the teaching regarding calorie-restriction diet because it shows awareness of the importance of hydration and making healthier choices when consuming alcoholic beverages. Drinking water before drinking alcohol can help to prevent overconsumption and dehydration, which can be beneficial for someone following a calorie-restriction diet.

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  • 25. 

    SITUATION: Peripheral arterial occlusive diseases are caused primarily by atherosclerosis. Other causes include embolism, thrombosis, trauma, vasospasm, inflammation, and autoimmunity   The health care provider prescribes bed rest for a client in whom a deep vein thrombosis  develops after a surgery. Form the following list, select all appropriate nursing interventions to include in this client’s plan of care: 1. Place in Fowler’s position for eating; 2. Encourage increased oral intake of water daily; 3. Encourage coughing with deep breathing; 4. Place thigh-length elastic stockings on the client; 5. Encourage the intake of dark, green leafy vegetables; 6. Place sequential compression boots on the client

    • 2, 3, 4

    • 1, 2, 6

    • 2, 3, 4

    • 1, 2, 3

    Correct Answer
    A. 2, 3, 4
    Explanation
    The correct answer is 2, 3, 4. These interventions are appropriate for a client with deep vein thrombosis. Encouraging increased oral intake of water helps prevent dehydration, which can contribute to blood clot formation. Encouraging coughing with deep breathing helps prevent the pooling of blood in the lower extremities and promotes circulation. Placing thigh-length elastic stockings on the client helps promote venous return and prevent blood clot formation. Placing the client in Fowler's position for eating is not specifically related to preventing deep vein thrombosis. Encouraging the intake of dark, green leafy vegetables is not directly related to preventing deep vein thrombosis. Placing sequential compression boots on the client is not mentioned as an appropriate intervention for preventing deep vein thrombosis.

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  • Feb 18, 2024
    Quiz Edited by
    ProProfs Editorial Team
  • Jan 02, 2012
    Quiz Created by
    Nsgzonemedsurg
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