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PREBOARD EXAMINATION 2
Nursing Practice III: Care of Clients with Physiologic and
Psychosocial Alterations (Part A)
GENERAL INSTRUCTIONS:
1. This test questionnaire contains 100 test questions
2. Shade only one (1) box for each question on your answer sheets. Two or more boxes shaded will invalid your answer.
3. AVOID ERASURES.
4. Detach one (1) answer sheet from the bottom of your Examinee ID/Answer Sheet Set.
5. Write the subject title NURSING PRACTICE III on the box provided.

NURSING PRACTICE III: Care of Clients with Physiologic and Psychosocial Alterations (Part A)
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Situation: Nurse Katrina is assigned in the PostAnesthesia Care Unit of San Ildefonso Hospital. She
receives an average of 10 patients per shift of different
cases and operations.
1. One of Katrinas patients developed deep vein
thrombosis (DVT). Which of these would she not
include in her plan of care for the patient?
a. Adequate hydration postoperatively
b. Frequent assessment of the distal peripheral
pulses
c. Use of knee gatch on the affected leg
d. Avoiding rubbing or massaging of the
affected leg
2. Which of these would Nurse Katrina expect as a
normal amount of drainage postoperatively?
a. 1000mL/day of gastric contents in a
nasogastric tube
b. 1000mL/day of bile in a T-tube
c. 1,500mL/day for the first day from a Foley
catheter attached to a urine bag
d. 1L in the first 24 hours of ileostomy
3. A patient who underwent intestinal surgery tells
Nurse Kat, Something suddenly gave way in my
operative wound. Which of these should Nurse
Kat perform?
a. Instruct the patient to bend the knees with
the head of bed in Trendelenburg position
b. Keep the patient on absolute bed rest
c. Encourage pursed-lip breathing
d. Cover exposed wound with sterile dressings
moistened with alcohol
4. As Nurse Kat was monitoring the vital signs of
Patient Rina post-thyroidectomy, she noticed
that the patients pulse pressure was narrowed.
This would alarm the Nurse Kat for possible:
a. Increased intracranial pressure
b. Hypertensive crisis
c. Shock
d. Infection
5. The complication Patient Rina might experience
could be due to which of the following events
intraoperatively?
a. Severe blood loss
b. Failure to give antibiotics
c. Intravenous fluid overload
d. Poor aseptic handling of instruments
Situation: A 17-year-old patient comes into the
Emergency Department complaining of swelling of one
of her cervical lymph nodes. After several workups, she
was diagnosed with Lymphoma (HL). You are assigned to
this patient.
6. Pain, if present, on the site of tumor is usually
associated with which of these activities?
a. Bed rest
c. Alcohol intake
b. High-fat diet d. Physical activity
7. You note that the patient is developing the B
symptoms from the condition. These symptoms
include the following except:
a. Fever
c. Night sweats
b. Weight loss
d. Syncope
8. Your
patient
was
ordered
to
undergo
radiotherapy for her condition. With your
knowledge, you know that radiotherapy is most
effective during which stage of the cell cycle?
a. G1
c. Late S
b. M
d. All of the above
9. In ensuring that you are protected from the
radiation during therapy, you should consider all
of these but one:
a. Duration of exposure
b. Distance from the radioactive source
c. Shield from radiation exposure
d. Positioning of a patient who has a
radioactive source

10. In giving instructions to your client on radiation


therapy, which of these should you not include in
your teaching?
a. You may wash the irradiated area each day
with warm water.
b. Make sure to wear soft clothing over the
skin at the radiation site
c. Never use your hand to wash the affected
area.
d. Use only patting motions in drying the area
with a soft cloth
Situation: Cardiovascular diseases are the leading cause
of mortality among Filipinos. You note the increasing
incidence of these kinds of diseases in the ICU. Your
supervisor expects you to have extensive knowledge on
the different diagnostic procedures on cardiovascular
conditions.
11. While auscultating the apical pulse of your
patient, you noticed a physiologic S2 split. You
know that this is usually observed during:
a. Ventricular contraction
b. Expiration
c. Atrial relaxation
d. Inspiration
12. One of your patients are under intra-arterial
blood pressure monitoring to continually assess
the arterial perfusion to the major organs. Which
parameter is being assessed for this perfusion
pressure?
a. Pulse pressure
b. Mean arterial pressure
c. Pulmonary wedge pressure
d. Cardiac index
13. A patient is to be inserted with a catheter in the
subclavian vein for central venous pressure
monitoring. Which nursing intervention should
you consider?
a. Using chlorhexidine gluconate as part of
preparation of site of insertion
b. Placing the patient in a high-fowlers position
during insertion.
c. Instructing the patient to exhale fully and
hold her breath immediately before insertion
d. Ensuring that the tip of the catheter is
placed at the level of the right atrium
14. How should a nurse position a patient who will
undergo transesophageal echocardiography?
a. Lithotomy position
b. Semi-Fowlers
c. Left lateral decubitus
d. Prone
15. While you are reviewing a patients chart, his
ECG tracing was noted to have sinus rhythm.
Which of these does not correspond to the said
finding?
a. Regular R-R and P-P interval
b. Presence of P wave for every QRS complex
c. QRS complex of <0.12sec
d. PR interval 0.12 0.20 second
Situation: Gerry, 49, is admitted to the medical ward for
Left Ventricular Failure. He claims to have dyspnea and
tachycardia even with just minimal activity. However,
these symptoms subside during his rest periods. He is
assigned under your care.
16. Using the patients history, which classification
of heart failure does Gerrys condition fall under?
a. I
c. III
b. II
d. IV
17. Which of these signs do you expect to assess in
Gerry?
a. Increased pulmonary artery pressure
b. Increased central venous pressure
c. Hepatomegaly

NURSING PRACTICE III: Care of Clients with Physiologic and Psychosocial Alterations (Part A)
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d. Jugular venous distention


18. The patient was prescribed with Digoxin. Which
of the following complaints related to Digoxin
toxicity will alert you to notify the physician?
a. Hypotension
c. Hypokalemia
b. Vision changes
d. Bradycardia
19. Part of your care is focused on the comfort and
emotional support of the patient. Which of these
would you not include in your care?
a. Bed rest with activity gradually increasing as
tolerated
b. Elevating extremities to increase venous
return
c. Elevating head of bed for maximal lung
expansion
d. Turning the patient every two hours to
prevent skin breakdown
20. Fluid management is also part of your care for
your patient with heart failure. Which of these is
an important nursing intervention for fluid
management?
a. Administering diuretics
b. Promoting bed rest
c. Elevating dependent extremities above heart
level
d. Obtaining daily weights
Situation: Aries, 23 years old, is brought to the
Emergency Department after a drug overdose. The
patient was restless and dyspneic upon arrival. Initial
vital signs were: HR 128 bpm, RR 23, BP 130/70, Temp
37.5, SpO2 75%. The diagnosis made was acute
respiratory failure. Aries was later on hooked to
mechanical ventilator via an endotracheal tube.
21. As Aries nurse, you know that Acute Respiratory
Failure differs from Chronic Respiratory Failure in
that the latter may be manifested with:
a. Hypoxemia
b. Hypercapnia
c. Bicarbonate retention
d. Rapid occurrence of symptoms
22. What should you primarily obtain in patients
suspected to have or with respiratory failure?
a. Urine output
b. FEV1/FVC ratio
c. Arterial blood gas levels
d. Chest x-ray
23. The
mechanical
ventilator
was
set
to
Assist/Control mode. This mode has the following
feature:
a. Provides a set number and volume of
breaths/minute and does not respond to the
patients own inspiratory efforts
b. Allows patient to breathe at his own rate and
volume spontaneously while a mandatory
breath is delivered periodically, in synchrony
with the patients inspiratory effort
c. Has a preset volume and rate which delivers
breaths when the patient does not initiate a
spontaneous breath, or breathe so weakly
d. Positive
pressure
is
applied
during
spontaneous breaths, with the rate and tidal
volume controlled by the patient
24. Ventilator-associated pneumonia (VAP) is a
common complication of mechanical ventilation.
As Aries nurse, which of these would you not
include in your plan of care on preventing VAP?
a. Change the ventilatory circuits routinely
b. Elevate the head of bed to 30 degrees or
higher
c. Use an endotracheal tube with continuous
suction above the cuff
d. None of the above
25. What should be at the bedside during
extubation?
a. T-piece
c. Resuscitation bag

b.

Mosquito

d. Scissors

Situation: Mang Bert, 56 years old, goes to the hospital


for a consultation after a really long time. He claims to
be a frequent alcohol drinker and had episodes of
epistaxis 1 months prior to consultation. He was
admitted for treatment for possible cirrhosis.
26. Mang Bert will have to undergo liver biopsy. In
your preoperative care, which of these will you
instruct the patient?
a. NPO should be observed within 4 hours prior
to procedure
b. Hold the breath for 10 seconds as the needle
is being inserted
c. Antibiotic prophylaxis should be taken at
least an hour prior to needle insertion
d. Low fat, low salt diet for 2 days before the
procedure
27. Which of these is likely the type of cirrhosis
Mang Bert developed?
a. Laennecs
c. Post-necrotic
b. Biliary
d. Cholestatic
28. Collateral
circulation
from
portal
to
gastrointestinal circulations in cirrhosis will be
manifested as which of the following?
a. Caput medusae
b. Facial edema
c. Thrombocytopenia
d. Encephalopathy
29. Which of these assessment findings would alert
you that Mang Bert is already developing severe
complications?
a. Hematemesis
c. Enlarged liver
b. Vascular spiders
d. Jaundice
30. Because of the decreased production of fatsoluble vitamins from the liver damage, the
extrinsic coagulation is compromised. Which of
these parameters would be affected?
a. Platelet count
c. aPTT
b. PT
d. RBC
Situation:
You are a perioperative nurse handling
patients of different conditions and cases. With the broad
considerations that are comprised in perioperative
nursing care, it is imperative for you to have as broad
knowledge to promote patient safety and wellness.
31. Sabrina, 32, will undergo cholecystectomy to
address her cholelithiasis. Which among these
will likely be the site of incision?
a. Right subcostal
b. Right paramedian
c. McBurney
d. Pfannenstein
32. Doms doctor ordered his thorax to be shaved
prior to his surgery. According to Centers for
Disease Control and Prevention, when should
shaving, as a preoperative intervention, be
done?
a. Night before surgery
b. One hour before surgery
c. Immediately before surgery
d. At least 24 hours prior to surgery
33. What is the role of the perioperative nurse in an
informed consent?
a. Witness to the fact that the patient is
informed
b. Providing detailed information regarding the
surgery
c. Confirms that the patients signature is
authentic
d. A & C
34. Diarrhea from Clostridium difficile infection
related to antibiotic use prior to surgery has
been found in researches. With this, the best
time to administer antibiotics pre-operatively is:
a. One hour prior to incision

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b. 30 minutes prior to induction of anesthesia


c. One hour before transfer to OR suite
d. One hour prior to skin preparation
35. During which stage of general anesthesia are
major surgeries started?
a. Stage I
c. Stage IV
b. Stage III
d. Stage II
Situation: One of your long-staying patients developed
cor pulmonale. His latest vital signs were PR 98 bpm, RR
25 cycles/min, T 37.4C.
36. In your understanding of the condition, which
among these probably caused the cor
pulmonale?
a. Emphysema
b. Liver cirrhosis
c. Stroke
d. Peripheral venous disease
37. Which among these do you not expect in
patients who developed cor pulmonale?
a. Flat jugular veins
b. Right ventricular hypertrophy
c. Bibasilar crackles
d. S2 split
38. Among the nursing interventions you planned for
the patient, which would necessitate your
supervisor to intervene?
a. Use
continuous
low-flow
oxygen
for
reduction of pulmonary bed pressure
b. Instruct the patient to decrease sodium
intake
c. Administer lorazepam to calm the patient
and reduce metabolic activity
d. Instruct the patient to avoid strenuous
physical activities until improvement is seen
39. If the patients cor pulmonale was secondary to
an obstructive lung condition, what is expected
in his FEV1/FVC ratio?
a. Increased c. Decreased
b. Normal
d. Unable to predict
40. What is a probable manifestation that is
primarily caused by hypercapnia in cor
pulmonale?
a. Hepatomegaly
b. Bibasilar crackles
c. Somnolence
d. Distended jugular veins
Situation: Nurse Danj admitted a new patient to the
Medicine Ward: Lianmuel, 35, complains of diarrhea for
more than two weeks prior to consultation. The diagnosis
made was Crohns Disease (CD). A plan of care was
made for Lianmuel.
41. Which of these assessments does Nurse Danj
expect to see in the patients records?
i. Weight gain of 1kg/day
ii. Arthralgia
iii. 10-20 liquid, bloody stools per day
iv. Tenesmus
v. Anorexia
vi. Crampy, intermittent pain
a. i, ii, iii, iv, v, vi
b. iii, iv, v, vi
c. i, ii, iii, iv, v
d. ii, iv, v, vi
42. All of the following laboratory results are
manifested by the patient, except:
a. Increased ESR
b. Increased albumin
c. Decreased RBCs
d. No exception
43. Nurse Danj should include which of the following
interventions for Lian?

a.

Increase physical activity to promote


intestinal activity
b. Instruct the patient to increase intake of raw
fruits and vegetables
c. Include high-fiber food choices following the
acute phase of the condition
d. Provide Sitz bath for the skin excoriation
from bowel movements
44. Which of the following signs and symptoms may
suggest
presence
of
megacolon
from
antidiarrheal drug use?
a. Leukopenia c. Bradypnea
b. Fever
d. Hypothermia
45. If Lian were a geriatric client, which of these is
the first indication of dehydration from fluid
volume depletion?
a. Tachycardia
b. Altered mentation
c. Decreased blood pressure
d. Fever
Situation:
Glenda was brought to Capitol Hospital
because of observed changes in mental status. After
Nurse Ian conducted nursing history and physical
examination, he notes problems in the voiding pattern
and fluid status of the patient.
46. Suspecting diabetes insipidus (DI), what is the
expected characteristic of Glendas urine or
voiding pattern?
a. Tea-colored urine
b. Urine specific gravity 1.5
c. Anuria
d. Urine osmolality 50 mOsm/kg
47. Which hormone is affected in diabetes insipidus?
a. Insulin
c. Vasopressin
b. PTH
d. Aldosterone
48. Chlorpropamide was prescribed by the physician.
Which of these should Nurse Ian include in his
instructions to the patient?
a. Have a candy ready in your pocket at all
times.
b. It is common to have a persistent headache
while taking the drug.
c. We expect a rapid increase in weight gain
to say that the drug is therapeutically
effective
d. You may take this drug as an inhalant.
49. Most drugs addressing diabetes insipidus cause
water retention and fluid overload. Which should
you teach your patients to monitor to best
monitor for this?
a. Heart rate
c. Weight
b. Blood pressure
d. SaO2
50. Which type of diabetes insipidus (DI) involves
poor water reabsorption with production of the
hormone in normal quantities?
a. Primary DI
c. Secondary DI
b. Nephrogenic DI
d. Idiopathic DI
Situation: Fred is a patient endorsed to you for your
afternoon shift. Newly admitted, Fred is diagnosed with
hypothyroidism and is manifesting signs and symptoms
of its complications.
51. Increase in which hormone causes goiter among
patients with primary hypothyroidism?
a. PTH
c. T4
b. T3
d. TSH
52. Synthetic T4 was prescribed to Fred. Which these
should you assess for at the initiation of therapy?
a. Oliguria
c. Weight loss
b. Dyspnea
d. Altered LOC
53. Which of these statements made by Fred, who is
on thyroid hormone therapy, indicates that
further teaching is required?

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a.

I should not switch brands of synthetic


levothyronine
because
I
may
have
unexpected responses to different brands.
b. I have to consult my doctor first if I want to
change the schedule of my hormone therapy.
c. I will have to take sedatives at night before
retreating to bed to prevent accidents during
daytime.
d. I should not discontinue my replacement
hormone unless it is prescribed by my
doctor.
54. A 60-second ECG rhythm strip was ordered.
Which of these is expected in patients with
hypothyroidism?
a. ST segment elevation
b. Sinus tachycardia
c. Peaked T waves
d. Low-voltage QRS
55. Which of these manifestations indicate that the
patient might be receiving underdosage of the
hormone replacement therapy?
a. Difficulty sleeping c. Jittering
b. Fatigue
d. Palpitations

a. Blood stasis in the iliofemoral vein


b. Dislodged embolus in the pulmonary bed
c. Decreased SvO2
d. Constriction of the vena cavae
63. ABG analyses taken at different times will reveal
different results. What result will a nurse expect
if the patients systemic organs rely on anaerobic
respiration related to long-standing hypoxia?
a. Respiratory alkalosis
b. Respiratory acidosis
c. Metabolic alkalosis
d. Metabolic acidosis
64. In caring for the patient, which of these actions
of the staff nurse needs further teaching from
the supervisor?
a. Monitoring changes in the VS q1h
b. Placing the patient in high-Fowlers position
c. Reassuring the patient that the correct
measures are being taken
d. Administering prescribed Enoxaparin IM
65. What is the antidote for alteplase?
a. Protamine sulfate c. Vitamin K
b. Aminocaproate
d. Heparin

Situation: A number of changes happen to the body as


one ages; and for people, these changes present
themselves at varying times and ages. However, it
remains to be an important point for nurses to be able to
assess and differentiate well the normal findings in an
adult from those in aging and older people.
56. According to the United Nations as cited by the
World Health Organization, what is the definitive
age for geriatric clients?
a. 65 years old and above
b. 55 years old and above
c. 60 years old and above
d. 60 years old and above for males, 65 years
old and above for females
57. The age according to birth date/birth years is
referred to as:
a. Biological age
b. Chronological age
c. Functional age
d. Psychological age
58. Which among these can a nurse use to assess
the functional ability of a geriatric patient?
a. Barthel Index
b. Folsteins Test
c. Geriatric depression scale
d. Mini-Cog examination
59. Which of these tools can be used for screening
for dementia among the geriatric clients?
a. Barthel Index
c. Katz Index
b. Folsteins Test
d. Tineti Gait
60. Which among these is not a normal change in
pulmonary function in aging?
a. Decreased total lung capacity
b. Decreased clearance of mucus and foreign
bodies
c. Increased residual volume
d. Increased functional residual capacity

Situation: Arterial blood gases (ABG) are frequently


monitored in critically-ill patients. Proper understanding
and interpretation are important competencies expected
of a nurse to be able to provide the correct management
to the acid-base problem.
66. A 6-foot, 6-inch tall 38-year-old man is being
mechanically ventilated at a tidal volume of 500
mL and a respiratory rate of 16 breaths per
minute. His most recent arterial blood gas results
are: pH = 7.33; P aO2 = 85 mmHg; PaCO2 = 55
mmHg. What is the nurses interpretation of
these results?
a. There is adequate ventilation to maintain
oxygenation
b. There is excessive ventilation resulting to
respiratory alkalosis
c. There is inadequate ventilation resulting to
respiratory acidosis
d. Ventilation status cannot be determined from
the information presented
67. A patients ABG results are endorsed to you with
the following values: pH = 7.49; P aO2 = 90
mmHg; PaCO2 = 32 mmHg; HCO3 = 24 mEq/L.
What will be the correct ABG interpretation?
a. Respiratory acidosis
b. Respiratory alkalosis
c. Metabolic acidosis
d. Metabolic alkalosis
68. Patients with COPD experience which kind of the
following acid-base imbalance?
a. Respiratory acidosis related to actual acid
excess
b. Relative respiratory acidosis
c. Relative respiratory alkalosis
d. Metabolic acidosis related to H+ ion
underelimination
69. A patient with ABG results of pH = 7.32; PaO2 =
80 mmHg; PaCO2 = 54 mmHg; HCO3 = 29 mEq/L
will likely have which ECG tracing?
a. Flattened T waves
b. Shortened PR interval
c. Widened QRS complex
d. U wave
70. A patient with respiratory acidosis from chronic
CO2 retention is under your care. Which of these
observations will necessitate further actions?
a. O2 via nasal cannula at 10L/min
b. RR 11 breaths/min
c. Wheezes not heard
d. Decreased respiratory effort

Situation: While caring for Chris in the ward post-op,


Yana noticed the patients SpO2 decreasing. Chris is
having dyspnea and was put on oxygen therapy. He is
suspected to have pulmonary embolism.
61. Which of the following factors is not related to
the triad that contribute to thrombogenesis?
a. Increased venous blood flow velocity
b. Increased retrograde pressure in the venous
system
c. Use of oral contraceptives
d. Dehydration
62. The nurse knows that the dyspnea of the patient
is DIRECTLY related to which pathophysiologic
event of pulmonary embolism?

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Ginny is a nurse in the Cardiovascular Unit in Magsaysay


Hospital. She receives a patient with dilated
cardiomyopathy (DCM). Ginny reviews the essentials
about the pathology, assessment, and interventions for
the condition.
71. Which of these is observed as a consequence of
the
dilated
ventricles
in
the
patients
cardiomyopathy?
a. Decreased end-systolic volume
b. Increased cardiac output
c. Decreased ejection fraction
d. All of the above
72. All of these manifestations indicate that DCM has
progressed except:
a. Hepatomegaly
b. Pitting edema on legs
c. Diastolic murmurs
d. Crackles
73. To determine the structural problem in the heart,
what diagnostic procedure will Ginny expect the
doctor to order?
a. Electrocardiogram
b. Coronary angiogram
c. 2-D Echocardiogram
d. Cardiac catheterization
74. Which of these enzymes has high cardiac
specificity?
a. CK-MB
c. Myoglobin
b. CK
d. Troponin I
75. How will Ginny position the client to reduce the
preload?
a. Flat in bed
b. Sitting with legs down
c. Left lateral decubitus
d. Modified Trendelenburg
Belle is a student nurse who is currently rotating in
different areas of Metropolitan Hospital. This week, she
learned that she will be having her duty in the ECG
(Electrocardiogram) clinic. She reinforces her knowledge
on the different concepts of ECG.
76. The doctor orders for a 60-second rhythm strip.
Belle gives the correct strip if she provides
readings in which ECG lead?
a. II
c. aVF
b. V1
d. I
77. The negative electrode of the rhythm strip is
located at which extremity?
a. Left arm
c. Right arm
b. Left leg
d. Right leg
78. Which limb electrode serves as the ground
electrode?
a. Left arm
c. Right arm
b. Left leg
d. Right leg
79. In placing the electrodes, which among these
would be incorrect?
a. Rubbing alcohol on the site of placement
before putting on the electrode
b. Applying KY jelly on the electrode for better
reading of the conduction
c. Placing V2 on 5th ICS left parasternal border
d. Placing V8 on the posterior chest
80. Which of these measures time during which a
depolarization wave travels from the atria to the
ventricles?
a. PR interval c. QT interval
b. ST segmentd. P wave
Frida comes in to the clinic and tells you of her plans for
rhytidectomy (facelift). She says she is too conscious of
her aging features so she was recommended to undergo
the operation. Her medical history shows she is a smoker
and a hypertensive and is currently on anti-hypertensive
medications. You answer her questions regarding the
procedural care.

81. In general, what is the most important preoperative nursing action for patients who will
undergo surgeries?
a. Instructing them about the different signs
and symptoms of the complications of
surgeries
b. Obtaining an informed consent
c. Teaching them what to do before and after
the surgery
d. Assessing their knowledge on the surgery
82. Frida is afraid that her surgery might be
deferred. Which among these must she observe
to avoid it?
a. Switch to nicotine patches from cigarette
sticks prior to surgery
b. Maintain compliance to anti-hypertensive
medication
c. Avoid applying face creams before the
surgery
d. Avoid taking NSAIDs for several weeks
before the procedure
83. Which instruction from the physician would you
expect in preparing Frida for rhytidectomy?
a. Wash the hair with anti-bacterial soap
repeatedly
b. Standing up is a contraindication after
surgery
c. Apply face cream prior to surgery
d. Because it is only the face involved, activity
restriction post-operatively is unnecessary
84. To reduce edema, how you would you position
Frida post-operatively?
a. Semi-Fowlers
c. Trendelenburg
b. Litothomy
d. Lateral Sims
85. What will you not instruct Frida to do postoperatively?
a. Increase facial movements to increase
circulation
b. Maintain an upright position
c. Avoid Valsalva maneuver
d. Bending over and blowing the nose will have
to be prevented
Tim is a 45-year-old patient was brought to the hospital
from a serious accident. The patient was having severe
hemorrhage and myocardial infarction from the blood
clots formed. You are assigned to care for the patient.
86. Which among these shock complications would
likely be caused by the patients recent
myocardial infarction?
a. Hypovolemic shock
b. Cardiogenic shock
c. Neurogenic shock
d. Septic shock
87. Because of severe hemorrhage, the patient is
developing shock. Fluid replacement is ordered.
Which of these would you expect to administer
to the patient?
a. Dextran
c. Lactated Ringers
b. D5NSS
d. 0.45 NaCl
88. Which among these would be the earliest
manifestation of shock?
a. Tachycardia
b. Decreased urine output
c. Bradypnea
d. Somnolence
89. After giving the treatment for the hypovelmic
shock, which among these would indicate that
the therapy is effective?
a. Increased jugular venous pressure
b. Edema
c. Markedly distended jugular veins
d. Diastolic murmurs

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90. A patient with cardiogenic shock with history of


MI is complaining of severe chest pain. Which of
these will best address the problem?
a. Place the patient in Trendelenburg.
b. Give morphine as ordered.
c. Obtain arterial access for hemodynamic
monitoring.
d. Reassure the patient.
Situation: A student nurse was assigned to Alden who
has thromboangiitis obliterans. Because it was a
relatively new case for her, her buddy staff nurse assists
her in caring for the patient.
91. What will the student nurse find in the patients
history that is a possible cause of the condition?
a. Illicit drug use
b. Smoking
c. Alcoholism
d. Early intercourse
92. Which among these would be the first
manifestation of thromboangiitis obliterans?
a. Varicose veins
b. Claudication
c. Cyanosis of the upper extremity
d. Tachycardia
93. What is the characteristic of pain that patients
with early-stage thrombonagiitis obliterans
experience?
a. Unilateral, relieved by rest
b. Bilateral, assymetrical pain
c. Symmetric, bilateral pain unrelieved by
resting
d. Bilateral pain with focal lesions
94. In positioning the patient with thromboangiitis
obliterans, which of these will only enhance pain
in the affected extremity?
a. Elevating above the level of the heart
b. Placing it in parallel to the heart
c. Placing in dependent position
d. Dangling both extremities at the side of the
bed
95. Post-endarterectomy, which of these would alert
you to notify the physician?
a. Absent pulse distal to the graft
b. Edema
c. Capillary refill time 2 seconds
d. Absence of poikolithermia

Situation: Hypertension is a common morbidity among


Filipinos, and is currently one of the major causes of
cardiovascular conditions. As a nurse, you are expected
to know how hypertension is detected, how it affects the
functioning of other body systems, and its management.
96. Which among these BP findings would indicate
pre-hypertension?
a. 110/70
b. 120/80
c. 145/90
d. 160/110
97. Which of these are determinants of blood
pressure?
i.
Systemic vascular resistance
ii.
Stroke volume
iii.
Heart rate
a. i, iii
b. i, ii
c. ii, iii
d. i, ii, iii
98. Which among these is not part of the
recommendations in managing hypertension by
the Joint National Committee 8?
a. Maintain normal BMI.
b. Reduce sodium intake to no more than
10g/day
c. Engage in aerobic physical activity for
30mins/day in most days of the week
d. Limit consumption to no more than 2 drinks
in most men.
99. Which of these anti-hypertensive medications
have high alpha-receptor affinity?
a. Metoprolol
b. Terazosin
c. Atenolol
d. Acebutolol
100.
In Beers Criteria, which among these
anti-hypertensive
drugs
would
produce
significant adverse effects to geriatric clients?
a. Clonidine
b. Metoprolol
c. Nicardipine
d. Captopril

NURSING PRACTICE III: Care of Clients with Physiologic and Psychosocial Alterations (Part A)
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