NURSING PRACTICE I SITUATION : A Nurse utilizes the nursing process in managing patient care.

Knowledge of this process is essential to deliver high quality care and to focus on the clients response to their illness. 1. During the planning phase of the nursing process, which of the following is the product developed? A. Nursing care plan B. Nursing diagnosis C. Nursing history D. Nursing notes 2. Objective data are also known as? A. Covert data B. Inferences C. Overt data D. Symptoms 3. Data or information obtained from the assessment of a patient is primarily used by nurse to: A. Ascertain the patients response to health problems B. Assist in constructing the taxonomy of nursing intervention C. Determine the effectiveness of the doctors order D. Identify the patients disease process 4. What is an example of a subjective data? A. Color of wound drainage B. Odor of breath C. Respiration of 14 breaths/minute D. The patients statement of I feel sick to my stomach

SITUATION : Correct application of the Nursing Process is vital in providing quality care. The nurse must use her skills and knowledge in proper assessment, planning and evaluating to meet the patients need and address the priority response of the client to his or her illness. 5. Which statement is a difference between comprehensive and focused assessment? A. Comprehensive assessments cant include any focus assessments B. Focused assessments are more important than comprehensive assessments C. Focused assessments are usually ongoing and concerning specific problems D. Objective data are included only in comprehensive assessments 6. Two year old Bens mother states Ben vomited 8 ounces of his formula this morning. This statement is an example of: A. Objective data from a primary source B. Objective data from a secondary source C. Subjective data from a primary source D. Subjective data from a secondary source 7. Which expected outcome is correctly written? A. The patient will be less edematous in 24 hours B. The patient will drink an adequate amount of fluid daily C. The patient will identify 5 high-salt foods from prepared list by discharge D. The patient will soon sleep well through the night 8. An expected outcome on a patients care plan reads: Patient will state seven warning signs of cancer by discharge. When the nurse evaluates the patient progress, the patient is able to state that a change in wart or mole, a sore that doesnt heal and a change in bowel or bladder habits are warning signals of cancer. Which of the following would be an appropriate evaluative statement for the nurse to place on the patients nursing care plan? A. Patient understands the warning signals of cancer B. Goal met; Patient cited a change in wart of mole, sore that doesnt heal and a change in bowel or bladder habits as warning signals of cancer. C. Goal not met D. Goal partially met 9. A quality assurance nurse sends questionnaire to patients after discharge to determine their level of satisfaction with the nurse care they received in the facility. What type of nursing audit is this? A. Concurrent B. Outcome C. Terminal D. Retrospective 10. The nurse makes the following entry in the patients record: Goal not met; patient refuses to attend smoking cessation classes. Because this goal hasnt been met, the nurse should: A. Develop a completely new nursing care plan B. Assign the patient to a more experienced nurse C. Critique the steps involved in the development of the goal D. Transfer the patient to another facility SITUATION : Health care delivery system affects the health status of every filipino. As a Nurse, Knowledge of this system is expected to ensure quality of life. 11. When should rehabilitation commence? A. The day before discharge B. When the patient desires

C. Upon admission D. 24 hours after discharge 12. What exemplified the preventive and promotive programs in the hospital? A. Hospital as a center to prevent and control infection B. Program for smokers C. Program for alcoholics and drug addicts D. Hospital Wellness Center 13. Which makes nursing dynamic? A. Every patient is a unique physical, emotional, social and spiritual being B. The patient participate in the over all nursing care plan C. Nursing practice is expanding in the light of modern developments that takes place D. The health status of the patient is constantly changing and the nurse must be cognizant and responsive to these changes 14. Prevention is an important responsibility of the nurse in: A. Hospitals B. Community C. Workplace D. All of the above 15. This form of Health Insurance provides comprehensive prepaid health services to enrollees for a fixed periodic payment. A. Health Maintenance Organization B. Medicare C. Philippine Health Insurance Act D. Hospital Maintenance Organization SITUATION : Maslows hierarchy of needs is an integral component of prioritization. As a nurse, you must know the clients needs that request for an immediate action. 16. The client with history of pulmonary emboli is scheduled for insertion of an inferior vena cava filter. The nurse checks on the client 1 hour after the physician has explained the procedure and obtained consent from the client. The client is lying in bed, wringing the hands, and says to the nurse, Im not sure about this. What if it doesnt work, and Im just as bad off as before? The nurse addresses which of the following primary concerns of the client? A. Fear related to the potential risk and outcome of surgery B. Anxiety related to the fear of death C. Ineffective individual coping related to the therapeutic regimen D. Knowledge deficit related to the surgical procedure 17. A nurse is formulating a plan of care for a client receiving enteral feedings. The nurse identifies which nursing diagnosis as the highest priority for this client? A. Altered nutrition, less than body requirements B. High risk for aspiration C. High risk for fluid volume deficit D. Diarrhea 18. A home care nurse finds a client in the bedroom, unconscious, with pill bottle in hand. The pill bottle contained the SSRI Sertraline (Zoloft). The nurse immediately assesses the clients: A. Blood pressure B. Respirations C. Pulse D. Urine Output 19. A nurse is caring for a client admitted to the hospital for subclavian line placement. Which psychosocial area of assessment should the nurse address with the client? A. Strict restrictions of neck mobility B. Loss of ability to ambulate as tolerated C. Possible body image disturbance D. Continuous pain related to ongoing placement of the subclavian line 20. A hospitalized client who has a living will is being fed through a nasogastric tube. During a bolus feeding, the client vomits and begins choking. Which of the following actions is most appropriate for the nurse to take? A. Clear the clients airway B. Make the client comfortable C. Start CPR D. Stop feeding and remove the NG tube SITUATION: Health Promotion is the priority nursing reponsibility. The nurse should be able to promote the clients wellbeing and identify ways on improving the clients quality of life. 21. The nurse is caring for a 16 year old female client who isnt sexually active. The client asks if she needs a Papanicolau test. The nurse should reply: A. Yes, she should have a Pap test after the onset of menstruation B. No, because she isnt sexually active C. Yes, because shes 16 years old D. No, because she is not yet 21 years old 22. The nurse is assessing a client who complains of abdominal pain, nausea and diarrhea. When examining the clients abdomen, which sequence should the nurse use? A. Inspection, palpation, percussion, auscultation B. Inspection, auscultation, percussion, palpation C. Auscultation, inspection, percussion, palpation D. Palpation, auscultation, percussion, inspection

23. The nurse is speaking to a group of women about early detection of breast cancer. The average age of the women in the group is 45. Following the Philippine Cancer Society guidelines, the nurse should recommend that the women: A. Perform breast self examination annually B. Have a mammogram annually C. Have a hormonal receptor assay annually D. Have a physician conduct a clinical examination every 2 years 24. The school nurse is planning a program for a group of teenagers on skin cancer prevention. Which of the following instruction whould the nurse emphasize in her talk? A. Stay out of the sun between 1 p.m and 3 p.m B. Tanning booth are a safe alternative for those who wish to tan C. Sun exposure is safe, provided the client wears protective clothing D. Examine skin once per month, looking for suspicious lesions or changes in moles 25. An employer establishes a physical exercise area in the workplace and encourages all employees to use it. This is an example of which level of prevention? A. Primary prevention B. Secondary prevention C. Tertiary prevention D. Passive prevention SITUATION : Basic nursing skills are essential for they are vital in many nursing procedures. Such skills are needed in order to promote health, prevent illness, cure a disease and rehabilitate infirmities. 26. A nurse has just been told by the physician that an order has been written to administer an iron injection to a client. The nurse plans to give the medication in the: A. Gluteal muscle using Z-Track technique B. Deltoid muscle using an air lock C. Subcutaneous tissue of the abdomen D. Anterolateral thigh using 5/8-inch needle 27. A client has just been told by the physician that a cerebral angiogram will be obtained. The nurse then collects data from the client about which of the following pieces of information? A. Claustrophobia B. Excessive weight C. Allergy to eggs D. Allergy to iodine or shellfish 28. A client has an order for a wound culture to be performed with the next wound irrigation and dressing change. The nurse would plan to use which of the following solutions for irrigation before this particular procedure? A. Providone-iodine (Betadine) B. One-half-strength hydrogen peroxide C. Normal saline D. Acetic acid 29. Which of the following is the best indicator in determining that the clients airway needs suctioning? A. Oxygen saturation measurement B. Respiratory rate C. Breath sounds D. Arterial blood gas results 30. A nurse is planning to assist a diabetic client to perform self-monitoring of blood glucos levels. The nurse should incorporate which of the following strategies to best help the client obtain an adequate capillary sample? A. Cleanse the hands beforehand using cool water B. Let the arm hang dependently and milk the digit C. Puncture the center of the finger pad D. Puncture the finger as deeply as possible SITUATION : Mastery of Intravenous therapy and all aspects that address the response of the client to complication related to it will help the new nurse in providing quality care. 31. One hour after the IV was inserted, Nurse Net found out that the 1 liter of D5NSS was empty. Patient was in severe respiratory distress with pinkish frothy sputum. The most probable complication is: A. Speed shock B. Renal failure C. Congestive heart failure D. Pulmonary edema 32. When an IV of D5W is not infusing well on patient, it is best to first: A. Pinch the rubber part to flush out clogged blood B. Coil tube and squeeze hard C. Lower IV to check for return flow D. Restart the IV 33. The doctor ordered venoclysis of dextrose 5% in water one liter KVO for 24 hours as a vehicle for IV medications. How many drops per minute should the fluid be regulated? A. 20 drops per minute B. 5 drops per minute C. 10 drops per minute D. 15 drops per minute 34. The nurse is administering I.V fluids to an infant. Infants receiving I.V Therapy are particularly vulnerable to:

A. Hypotension B. Fluid overload C. Cardiac arrythmias D. Pulmonary emboli 35. A client with severe inflammatory bowel disease is receiving TPN. When administering TPN, the nusre must take care to maintain the prescribed flow rate because giving TPN too rapidly may cause: A. Hyperglycemia B. Air embolism C. Constipation D. Dumping syndrome SITUATION : Teaching and learning is a nursing responsibility. The ability of a nurse to educate and change the clients behavior through health teaching is one important goal of nursing. 36. A clients hypertension has been recently diagnosed. The nurse would plan to do which of the following as the first step in teaching the client about the disorder? A. Gather all available resource material B. Plan for the evaluation of the session C. Assess the clients knowledge and needs D. Decide on the teaching approach 37. A diabetic client who is performing self-monitoring of blood glucose at home asks a clinic nurse why a glycosylated hemoglobin level needs to be measured. The nurse should plan to incorporate which of the following into a response? A. This laboratory test is done yearly to predict likelihood of long term complication B. This laboratory test gives an indication of glycemic control over the last 3 months C. It is done as a method of verifying the accuracy of the meter used at Home D. It is done to predict risk of hypoglycemia with the current diet and medication regimen 38. In teaching the sister of a diabetic client about the proper use of a glucometer in determining the blood sugar level of the client, The nurse is focusing in which domain of learning according to bloom? A. Cognitive B. Affective C. Psychomotor D. Affiliative 39. Which of the following is the most important condition for diabetic client to learn how to control their diet? A. Use of pamphlets and effective teaching devices during health instruction B. Motivation to be symptom free C. Ability of the client to understand teaching instruction D. Language and appropriateness of the instruction 40. When you prepare your teaching plan for a group of hypertensive clients, you first formulate your learning objectives. Which of the following steps in the nursing process corresponds to the writing of learning objectives? A. Planning B. Implementing C. Evaluating D. Assessing SITUATION : Nursing is a science. It involves a wide spectrum of theoretical foundation applied in different health care situation. The nurse must use these theories in order to deliver the most needed quality care. 41. The theorist who believes that adaptation and manipulation of stressors are needed to foster change is: A. Betty Neuman B. Dorothea Orem C. Martha Rogers D. Sister Callista Roy 42. The theorist whose theory can be defined as the development of a science of humankind, incorporating the concepts of energy fields, openness, pattern and organization is: A. Dorothy Johnson B. Hildegard Peplau C. Martha Rogers D. Myra Levine 43. A theorist whose major theme is the idea of transcultural nursing and caring nursing is: A. Dorothea Orem B. Madeleine Leininger C. Sister Callista Roy D. Virginia Henderson 44. Florence Nightingale was born in A. Italy, May 12, 1840 B. Italy, May 12, 1820 C. England, May 12, 1840 D. England, May 12, 1820 45. Smith conceptualizes this health model as a condition of actualization or realization of persons potential. Avers that the highest aspiration of people is fulfillment and complete developmental actualization.

A. B. C. D. Eudaemonistic Model

Clinical Role Adaptive performance

Model Model Model

SITUATION : Oxygen is the most important physiologic requirement of the body. Absence of this vital element for over 6 minutes leads to irreversible brain damage. Measures that promotes oxygenation is integral in successfully managing clients response to illnesses. 46. The primary effect of oxygen therapy is to: A. Increase oxygen in the tissues and cells B. Increase oxygen carrying capacity of the blood C. Increase respiratory rate D. Increase oxygen pressure in the alveolar sac 47. A nurse suctions a client who has an endotracheal tube in place. Following the procedure, which of the following would indicate to the nurse that the client is experiencing an adverse effect of this procedure? A. Hypertension B. Cardiac Irregularities C. A reddish coloration in the clients face D. Oxygen saturation level of 95% 48. The GAUGE size in ET tubes determines: A. The external circumference of the tube B. The internal diameter of the tube C. The length of the tube D. The tubes volumetric capacity 49. The nurse is correct in performing suctioning when she applies the suction intermittently during: A. Insertion of the suction catheter B. Withdrawing of the suction catheter C. both insertion and withdrawing of the suction catheter D. When the suction catheter tip reaches the bifurcation of the trachea 50. The purpose of the cuff in Tracheostomy tube is to: A. Separate the upper and lower airway B. Separate trachea from the esophagus C. Separate the larynx from the nasopharynx D. Secure the placement of the tube SITUATION : To deliver a safe and quality care, Knowledge about wound care is necessary. The nurse will have to deal with different types of wound during practice. It is of outmost important to apply this knowledge to ensure optimum wound healing. 51. Based on the nurses knowledge of surgical wounds, simple surgical incisions heal by: A. Primary intention B. Secondary intention C. Tertiary intention D. Quarternary intention 52. The nurse documents that the wound edges are approximated. When the edges of an incision are said to be approximated, this means edges are: A. Brought together by sutures, tapes or staples B. Eythematous and swollen C. Gaping and draining D. Necrotic and draining 53. Which vitamin is most essential for collagen synthesis? A. Vitamin A B. Vitamin B C. Vitamin C D. Vitamin D 54. When assessing the clients wound for sign of infection, the nurse should look for the presence of which of the following? A. Granulation tissue B. Pink tissue C. Purulent drainage D. Well approximated edges 55. The nurse is changing dressing and providing wound care. Which activity should she perform first? A. Assess the drainage in the dressing B. Slowly remove the soiled dressing C. Wash hands thoroughly D. Put on latex gloves SITUATION : Physical examination and health assessment are important in rendering care. The nurse must use assessment knowledge in order to determine and prioritize clients response to his or her illness. 56. The component that should receive the highest priority before physical examination is the: A. Psychological preparation of the client B. Physical Preparation of the client C. Preparation of the Environment

D. Preparation of the Equipments 57. When inspecting a clients skin, the nurse finds a vesicle on the clients arm. Which description applies to a vesicle? A. A flat, nonpalpable, and colored B. Solid, elevated, and circumscribed C. Circumscribed, elevated, and filled with serous fluid D. Elevated, pus-filled, and circumscribed 58. When assessing a client with abdominal pain, the nurse should assess: A. Any quadrant first B. The symptomatic quadrant first C. The symptomatic quadrant last D. The sympomatic quadrant either second or third 59. To assess the client's dorsalis pedis pulse, the nurse should palpate the: A. Medial surface of the ankle B. Lateral surface of the ankle C. Ventral aspect of the top of the foot D. Medial aspect of the dorsum of the foot 60. Which of the following assessment would be a priority for a 2 year old after bronchoscopy? A. Cardiac rate B. Respiratory quality C. Sputum color D. Pulse pressure changes 61. The nurse checks the client's gag reflex. The recommended technique for testing the gag reflex is to: A. touch the back of the client's throat with a tongue depressor B. observe the client for evidence of spontaneous swallowing when the neck is stroked C. place a few milliliters of water on the client's tongue and note whether or not he swallows D. observe the client's response to the introduction of a catheter for endotracheal suctioning 62. The nurse is evaluating a clients lung sounds. Which of the following breath sounds indicate adequate ventilation when auscultated over the lung fields? A. Vesicular B. Bronchial C. Bronchovesicular D. Adventitious 63. The night nurse informs the primary nurse that a client receiving intermittent gavage feedings is not tolerating them. The primary nurse should first: A. Change the feeding schedule to omit nights B. Request that the type of solution be changed C. Observe the night nurse administering a feeding D. Suggest that the prescribed antiemetic be given first 64. A client has a chest tubes attached to a pleural drainage system. When caring for this client, the nurse should: A. Palpate the surrounding are for crepitus B. Clamp the chest tubes when suctioning the client C. Change the dressing daily using aseptic technique D. Empty drainage chamber at the end of the shift 65. The nurse, aware of a clients 25 year history of excessive alcohol use, would expect the physical assessment to reveal a: A. Liver infection B. Low blood ammonia C. Small liver with a rough surface D. High fever with a generalizedrash SITUATION : Nursing is a profession. Miss Linda is a newly appointed nurse in a hospital in Manila. Born May 1985, Her knowledge of nursings professional development is required in order to project the profession in a way that it lifts the standards of nursing. 66. Mrs. Linda defined nursing as one of the following except: A. Assisting individual, family and community in attaining health B. Assisting basic health needs C. Establishing nursing diagnosis and implementing nursing care D. Diagnosing, treating, prescribing medication and doing minor surgery 67. PNA was established in: 1. 2. 3. 4. 1922 1926 With Mrs. Rosario Delgado as first president With Mrs. Anastacia Tupas as first president

A. 1,3 B. 1,4 C. 2,3 D. 2,4 68. As a national nurses association, it is characterized as follows except:

A. Both a professional body and a labor union B. Affiliated with the International Council Of Nurses C. Advocating for improved work and life condition of Nurses D. Accrediting body for continuing education program 69. CPE Units per year is needed for license renewal. The number of CPE units per year should be: A. 20 units B. 30 units C. 60 units D. 100 units 70. As a nurse, R.A 1080 Exempts her from: A. Paying her professional tax B. Examination for civil service eligibility C. Qualifying for the CGFNS D. Paying business permit 71. In resigning for her job as a staff nurse, she must give advance notice of: A. 15 days B. 30 days C. 45 days D. 60 days 72. Why is there an ethical dilemma? A. Because the law do not clearly state what is right from what is wrong B. Because morality is subjective and it differs from each individual C. Because the patients right coincide with the nurses responsibility D. Because the nurse lacks ethical knowledge to determine what action is correct and what action is unethical 73. Who among the following can work as a practicing nurse in the Philippines without taking the Licensure examination? A. Internationally well known experts which services are for a fee B. Those that are hired by local hospitals in the country C. Expert nurse clinicians hired by prestigious hospitals D. Those involved in medical mission whos services are for free 74. The nurse is correct in determining that a License is: A. A personal property B. Can be revoked by the Board of Nursing C. A Right D. Can be revoked by the PNA 75. A License is renewed every: A. 1 year B. 2 years C. 3 years D. 4 years 76. Which of the following persons cannot have free access to a patients record? A. The patient B. The physical therapist C. The pharmacist D. The lawyer 77. Ms. Lindas license will expire in 2007, She must renew her license when? A. January 2007 B. December 2007 C. May 2007 D. May 2008 78. The practice of Nursing in the Philippines is regulated by: A. RA 9163 B. RA 9173 C. RA 7164 D. RA 7146 79. This quality is being demonstrated by a Nurse who raise the side rails of a confuse and disoriented patient? A. Autonomy B. Responsibility C. Prudence D. Resourcefulness 80. Nurse Joel and Ana is helping a 16 year old Nursing Student in a case filed against the student. The case was frustrated homicide. Nurse Joel and Ana are aware of the different circumstances of crimes. They are correct in identifying which of the following Circumstances that will be best applied in this case? A. Justifying B. Aggravating C. Mitigating D. Exempting

SITUATION : This is the first day of Mark, R.N. to report as a staff nurse in a tertiary hospital. As a morning duty nurse, she is about to chart her nursing care. 81. Which of the following is not an accepted medical abbreviation? A. NPO B. PRN C. OD D. NON 82. Communication is best undertaken if barriers are first removed. Considering this statement, which of the following is considered as deterrent factor in communication? A. Not universally accepted abbreviation B. Wrong Grammar C. Poor Penmanship D. Old age of the client 83. Which of the following chart entries are not acceptable? A. Patient complained of chest pain B. Patient ambulated to B/R C. Vital signs 130/70; 84; 20 D. Pain relieved by Nitrogylcerine gr 1/150 sublingually 84. Which of the following indicates narrative charting? A. Written descriptive nurses notes B. Date recorded on nurse activity sheet C. Use of checklist D. Use of flowsheet 85. Being a new staff nurse, Mark remembers that information needed for daily nursing care of clients are readily available in which of the following? A. Kardex B. Order sheet C. Admission notes D. Nurses notes SITUATION : Mr. Orlando is assigned to Mang Carlos, A 60 years old, newly diagnosed diabetes patient. He is beginning to write objectives for his teaching plan. 86. Which of the following is written in behavioral term? A. Mang Carlos will know about diabetes related foot care and the techniques and equipment necessary to carry it out B. Mang Carlos sister will be able to determine his insulin requirement based on blood glucose levels obtained from glucometer in two days C. Mang Carlos daugter should learn about diabetes milletus within the week D. Mang Carlos wife needs to understand the side effects of insulin 87. Which of the following is the best rationale for written objectives? A. Document the quality of care B. Facilitate evaluation of the performance of the nurse C. Ensure learning on the part of the nurse D. Ensure communication among staff members 88. Mang Carlos has been terminally ill for 5 years. He asked his wife to decide for him when he is no longer capable to do so. As a Nurse, You know that this is called: A. Last will and testament B. DNR C. Living will D. Durable Power of Attorney 89. Which of the following behavior of Mang Carlos least indicates readiness to learn? A. Talking with the nurse in charge and doctor B. Reading brochures and pamphlets about diabetes C. Inquiring about date of discharge D. Asking question about diabetes milletus 90. Which of the following behaviors best contribute to the learning of Mang Carlos regarding his disease condition? A. Drawing him into discussion about diabetes B. Frequent use of technical terms C. Loosely structured teaching session D. Detailed lengthy explanation SITUATION : Mrs. Purificacion is now the Chief nurse of a hospital in Manila. She is carefully reviewing different management styles and theories that will best help her in running the nursing services in the hospital. 91. Which leadership style best empower the staff towards excellence? A. Autocratic B. Situational C. Democratic D. Laissez Faire 92. As a Nurse Manager, DSJ enjoys his staff of talented and self motivated individuals. He knew that the leadership style to suit the needs of this kind of people is called: A. Autocratic B. Participative

C. Democratic D. Laissez Faire 93. A fire has broken in the unit of DSJ R.N. The best leadership style suited in cases of emergencies like this is: A. Autocratic B. Participative C. Democratic D. Laissez Faire 94. Mrs. Purificacion is thinking of introducing the Primary Nursing Model Approach. You understand that this nursing model is: A. The nurse manager assigns tasks to the staff members B. Critical paths are used in providng nursing care C. A single registered nurse is responsible for planning and providing individualized nursing care D. Nursing staff are led by an RN leader in providing care to a group of clients 95. Structure, Process and Outcome are components of which step of the management process? A. Planning B. Organizing C. Directing D. Controlling SITUATION : Nursing research is the term used to describe the evidence used to support nursing practice. Nursing, as an evidence based area of practice, has been developing since the time of Florence Nightingale to the present day, where many nurses now work as researchers based in universities as well as in the health care setting. 96. Mr. DSJ Plans to undertake a research of Community 1 and 2 on how they manage their health using Primary health care after an organization and training seminars. This type of research is: A. Experimental B. Historical C. Descriptive D. Basic 97. The independent variable is: A. Primary Health Care B. Community 1 and 2 C. Organization and training seminars D. Management of their health 98. In this design, the variable that is being manipulated is 1. 2. 3. 4. Independent Organization and training seminars Dependent Management of Primary Health Care

A. 1,2 B. 1,4 C. 2,3 D. 3,4 99. In general, the research process follows the ff. ordered sequence: 1. 2. 3. 4. 5. Determination of design Statement of the problem Definition of variables Collection and analysis of data Review of related literature

A. 2,5,3,1,4 B. 3,5,4,1,2 C. 2,5,3,4,1 D. 2,5,1,3,4 100. Studies done in natural setting such as this one, posses difficulty of controlling which variable? A. Independent B. Dependent C. Extraneous D. Organismic NURSING PRACTICE II Situation : Nurse Macarena is a Family Planning and Infertility Nurse Specialist and currently attends to FAMILY PLANNING CLIENTS AND INFERTILE COUPLES. The following conditions pertain to meeting the nursing needs of this particular population group. 1. Daphne, 19 years old, asks nurse Macarena how can pregnancy be prevented through tubal ligation. Which would be the best answer? A. B. C. D. Prostaglandins released from the cut fallopian tubes will lead to permanent closure of the vagina. Sperm can not enter the uterus because the cervical entrance is blocked. Sperm can no longer reach the ova, because the fallopian tubes are blocked The ovary no longer releases ova as there is no where for them to go.

2. The Dators are a couple undergoing testing for infertility. Infertility is said to exist when: A. B. A woman has no uterus A woman has no children

C. D.

A couple has been trying to conceive for 1 year A couple has wanted a child for 6 months

3. Another client named Cindy is diagnosed as having endometriosis. This condition interferes with fertility because: A. B. C. D. Endometrial implants can block the fallopian tubes The uterine cervix becomes inflamed and swollen The endometrial lining becomes inflamed leading to narrowing of the cervix. Inflammation of the endometrium causes release of substance P which kills the sperm.

4. Cindy submits herself to Fatima Medical Center and is scheduled to have a hysterosalphingogram. Which of the following instructions would you give her regarding this procedure? A. B. C. D. Menstruation will be irregular for few months as an effect of the dye but it is just normal The sonogram of the uterus will reveal any tumors present The women may experience some itchiness in the vagina as an after effect. Cramping may be felt when the dye is inserted

5. Cindys cousin on the other hand, knowing nurse Macarenas specialization asks what artificial insemination by donor entails. Which would be your best answer if you were Nurse Macarena? A. B. C. D. Donor sperm are introduced vaginally into the uterus or cervix Donor sperm are injected intra-abdominally into each ovary Artificial sperm are injected vaginally to test tubal patency The husbands sperm is administered intravenously weekly

Situation . Nurse Dee-Lan was a graduate of Our Lady of Fatima University, he started working as a nurse just right after he passed and topped the board exam. She was assigned to take care of a group of patients across the lifespan. 6. Pain in geriatric clients require careful assessment because they: A. experienced reduce sensory perception B. have increased sensory perception C. are expected to experience chronic pain D. have a increased pain sensitivity 7. Administration of aminoglycosides to the older persons requires careful patient assessment because older people: A. are more sensitive to drugs B. have increased hepatic, renal and gastrointestinal function C. have increased sensory perception D. mobilize drugs more rapidly 8. Elder clients are often at risk of having impaired skin integrity. One factor is that they often experience urinary incontinence. The elderly patient is at higher risk for urinary incontinence because of: A. increased glomerular filtration B. decrease elasticity of blood vessels C. decreased bladder capacity D. dilated urethra

9. Which of the following is the MOST COMMON sign of infection among the elderly? A. decreased breath sounds with crackles B. Increase body temperature C. pain D. Restlessness, confusion, irritability

10. Prioritization is important to test a nurses good judgment towards different situations. Priorities when caring for the elderly trauma patient: A. circulation, airway, breathing B. disability (neurologic), airway, breathing C. airway, breathing, disability (neurologic) D. airway, breathing, circulation

11. The nurse assessing newborn babies and infants during their hospital stay after birth will notice which of the following symptoms as a primary manifestation of Achalasia? A. Olive shaped mass on abdomen B. Failure to pass meconium during the first 24 to 48 hours after birth C. The skin turns yellow and then brown over the first 48 hours of life D. Effortless and non-projectile vomiting 12. A client is 7 months pregnant and has just been diagnosed as having a partial placenta previa. She is stable and has minimal spotting and is being sent home. Which of these instructions to the client may indicate a need for further teaching? A. B. C. D. Maintain bed rest with bathroom privileges Avoid intercourse for three days. Call if contractions occur. Stay on left side as much as possible when lying down.

13. Ms. Anna, a review assistant of the greatest nursing review center in the Philippines has been rushed to the hospital with ruptured membrane. Which of the following should the nurse check first? A. Check for the presence of infection B. Assess for Prolapse of the umbilical cord C. Check the maternal heart rate D. Assess the color of the amniotic fluid 14. The nurse notes that the infant is wearing a plastic-coated diaper. If a topical medication were to be prescribed and it were to go on the stomachs or buttocks, the nurse would teach the caregivers to: A. B. C. D. avoid covering the area of the topical medication with the diaper avoid the use of clothing on top of the diaper put the diaper on as usual apply an icepack for 5 minutes to the outside of the diaper

15. Which of the following factors is most important in determining the success of relationships used in delivering nursing care? A. B. C. Type of illness of the client Transference and counter transference Effective communication

D.

Personality of the participants

16. Grace sustained a laceration on her leg from automobile accident. Why are lacerations of lower extremities potentially more serious among pregnant women than other? A. lacerations can provoke allergic responses due to gonadotropic hormone release B. a woman is less able to keep the laceration clean because of her fatigue C. healing is limited during pregnancy so these will not heal until after birth D. increased bleeding can occur from uterine pressure on leg veins 17. You are the nurse assigned to work with a child with acute glomerulonephritis. By following the prescribed treatment regimen, the child experiences a remission. You are now checking to make sure the child does not have a relapse. Which finding would most lead you to the conclusion that a relapse is happening? A. Elevated temperature, cough, sore throat, changing complete blood count (CBC) with diiferential B. A urine dipstick measurement of 2+ proteinuria or more for 3 days, or the child found to have 3-4+ proteinutria plus edema. C. The urine dipstick showing glucose in the urine for 3 days, extreme thirst, increase in urine output, and a moon face. D. A temperature of 37.8 degrees (100 degrees F), flank pain, burning frequency, urgency on voiding, and cloudy urine. 18. The painful phenomenon known as back labor occurs in a client whose fetus in what position? A. Brow position B. Right Occipito-Anterior Position C. Breech position D. Left Occipito-Posterior Position treatment still remains to be PREVENTION. The

Situation With the increasing documented cases of CANCER the best alternative to following conditions apply. 19. Which among the following is the primary focus of prevention of cancer? A. B. C. D. Elimination of conditions causing cancer Diagnosis and treatment Treatment at early stage Early detection

20. In the prevention and control of cancer, which of the following activities is the most important function of the community health nurse? A. Conduct community assemblies. B. Referral to cancer specialist those clients with symptoms of cancer. C. Use the nine warning signs of cancer as parameters in our process of detection, control and treatment modalities. D. Teach woman about proper/correct nutrition. 21. Who among the following are recipients of the secondary level of care for cancer cases? A. B. C. D. Those Those Those Those under early case detection under post case treatment scheduled for surgery undergoing treatment

22. Who among the following are recipients of the tertiary level of care for cancer cases? A. B. Those under early treatment Those under supportive care C. Those under early detection D. Those scheduled for surgery

23. Being a community health nurse, you have the responsibility of participating in protecting the health of people. Consider this situation: Vendors selling bread with their bare hands. They receive money with these hands. You do not see them washing their hands. What should you say/do? A. Miss, may I get the bread myself because you have not washed your hands B. All of these C. Miss, it is better to use a pick up forceps/ bread tong D. Miss, your hands are dirty. Wash your hands first before getting the bread Situation : The following questions refers to common clinical encounters experienced by an entry level nurse. 24. A female client asks the nurse about the use of a cervical cap. Which statement is correct regarding the use of the cervical cap? A. B. C. D. It may affect Pap smear results. It does not need to be fitted by the physician. It does not require the use of spermicide. It must be removed within 24 hours.

25. The major components of the communication process are: A. B. C. D. Verbal, written and nonverbal Speaker, listener and reply Facial expression, tone of voice and gestures Message, sender, channel, receiver and feedback

26. The school nurse notices a child who is wearing old, dirty, poor-fitting clothes; is always hungry; has no lunch money; and is always tired. When the nurse asks the boy his tiredness, he talks of playing outside until midnight. The nurse will suspect that this child is: A. B. C. D. Being raised by a parent of low intelligence quotient (IQ) An orphan A victim of child neglect The victim of poverty Mike 16 y/o has been diagnosed to have AIDS, he worked as entertainer in a cruise ship;

Situation:

27. Which method of transmission is common to contract AIDS: A. Syringe and needles B. Body fluids A. Sexual contact B. Transfusion

28. Causative organism in AIDS is one of the following; A. Fungus B. Bacteria C. retrovirus D. Parasites

29. You are assigned in a private room of Mike. Which procedure should be of outmost importance; A. Alcohol wash B. Universal precaution C. Washing Isolation D. Gloving technique

30. What primary health teaching would you give to mike; A. Daily exercise B. Prevent infection C. reverse isolation D. Proper nutrition

31. Exercise precaution must be taken to protect health worker dealing with the AIDS patients . which among these must be done as priority: A. Boil used syringe and needles B. Use gloves when handling specimen C. Label personal belonging D. Avoid accidental wound Situation: Michelle is a 6 year old preschooler. She was reported by her sister to have measles but she is at home because of fever, upper respiratory problem and white sports in her mouth. 32. Rubeola is an Arabic term meaning Red, the rash appears on the skin in invasive stage prior to eruption behind the ears. As a nurse, your physical examination must determine complication especially: A. Otitis media B. Bronchial pneumonia C. Inflammatory conjunctiva D. Membranous laryngitis

33. To render comfort measure is one of the priorities, Which includes care of the skin, eyes, ears, mouth and nose. To clean the mouth, your antiseptic solution is in some form of which one below? A. Water B. Sulfur C. Alkaline D. Salt

34. As a public health nurse, you teach mother and family members the prevention of complication of measles. Which of the following should be closely watched? A. Temperature fails to drop B. Inflammation of the conjunctiva C. Inflammation of the nasophraynx D. Ulcerative stomatitis

35. Source of infection of measles is secretion of nose and throat of infection person. Filterable virus of measles is transmitted by: A. Water supply B. Droplet C. Food ingestion D. Sexual contact

36. Method of prevention is to avoid exposure to an infection person. Nursing responsibility for rehabilitation of patient includes the provision of: A. Terminal disinfection B. Injection of gamma globulin C. Immunization D. Comfort measures

SITUATION: Sexually Transmitted Diseases are important to identify during pregnancy because of their potential effect on the pregnancy, fetus, or newborn. The following questions pertain to STDs. 37. Ms. Reynaldita is a promiscuous woman in Manila submits herself to the clinic for certain examinations. She is experiencing vaginal irritation, redness, and a thick cream cheese vaginal discharge. As a nurse, you will suspect that Ms. Reynaldita is having what disease? A. Gardnerella Vaginalis B. Candida Albicans C. Treponema Pallidum D. Moniliasis 38. As a knowledgeable nurse, you know that the doctor may prescribe a certain medications for Ms. Reynaldita. What is the drug of choice for Reynalditas infection? A. haloperidol B. miconazole C. benzathine penicillin D. metronidazole 39. Based on your learnings, you know that the causative agent of Reynalditas infection is: A. Monistat Candida B. Candida Albicans C. Albopictus Candidiasis D. Monakiki 40. The microorganism that causes Reynalditas infection is a: A. Bacteria B. Protozoa C. Fungus D. Virus 41. Another client in the Maternal Clinic was Ms. Celbong. Her doctor examined Ms. Celbongs vaginal secretions and found out that she has a Trichomoniasis infection. Trichomoniasis is diagnosed through which of the following method? A. Vaginal secretions are examined on a wet slide that has been treated with potassium hydroxide. B. Vaginal speculum is used to obtain secretions from the cervix. C. A lithmus paper is used to test if the vaginal secretions are infected with trichomoniasis. D. Vaginal secretions are examined on a wet slide treated with zephiran solution. 42. Daphne who is on her first trimester of pregnancy is also infected with trichomoniasis. You know that the drug of choice for Daphne is: A. Flagyl B. Clotrimazole (topical) C. Monistat D. Zovirax 43. Syphilis is another infection that may impose risk during pregnancy. Since we are under the practice of health science, you know that Syphilis is caused by: A. Treponema Syphilis

B. Neisseria gonorrhoeae C. Chlamydia Trachomatis D. Treponema Pallidum 44. What type of microorganism is the causative agent of syphilis? A. Spirochete B. Fungus C. Bacteria D. Protozoan 45. Under the second level of prevention, you know that one of the focuses of care is the screening of diseases. What is the screening test for syphilis? A. VDRL B. Western blot C. PSA D. ELISA 46. Jarisch-Herxheimer reaction may be experienced by the client with syphilis after therapy with benzathine penicillin G. The characteristic manifestations of JarischHerxheimer reaction are: A. Rashes, itchiness, hives and pruritus B. Confusion, drowsiness and numbness of extremities C. sudden episode of hypotension, fever, tachycardia, and muscle aches D. Episodes of nausea and vomiting, with bradypnea and bradycardia 47. A pregnant woman is in the clinic for consultation with regards to STDs. She inquires about Venereal warts and asks you about its specific lesion appearance. Which of the following is your correct response to the client? A. Why are you asking about it? You might be a prostitute woman. B. The lesions appear as cauliflower like lesions. C. It appears as pinpoint vesicles surrounded by erythema. D. The lesions can possibly obstruct the birth canal. 48. Based on your past learnings in communicable diseases, you know that the causative agent of venereal warts is: A. Chlamydia Trachomatis B. Candida Moniliasis C. Human Papilloma Virus D. Staphylococcus Aureus 49. As a nurse in charge for this woman, you anticipate that the doctor will prescribe what medication for this type of infection? A. Podophyllum (Podofin) B. Flagyl C. Monistat D. Trichloroacetic acid 50. Cryocautery may also be used to remove large lesions. The healing period after cryocautery may be completed in 4-6 weeks but may cause some discomforts to the woman. What measures can alleviate these discomforts? A. Kegels Exercise B. Cool air C. Topical steroids D. Sitz baths and lidocaine cream 51. In order to prevent acquiring sexually transmitted diseases, what is the BEST way to consider? A. Condom use B. Withdrawal C. vasectomy D. Abstinence SITUATION: The Gastrointestinal System is responsible for taking in and processing nutrients for all parts of the body, any problem can quickly affect other body systems and, if not adequately treated, can affect overall health, growth, and development. The following questions are about gastrointestinal disorders in a child. 52. Mr. & Mrs. Alcaras brought their son in the hospital for check up. The child has failure to thrive and was diagnosed with pyloric stenosis. Which among the following statements are the characteristic manifestations of pyloric stenosis? A. Vomiting in the early morning B. Bile containing vomitus immediately after meal C. sausage shaped mass in the abdomen D. Projectile vomiting with no bile content 53. The exact cause of pyloric stenosis is unknown, but multifactorial inheritance is the likely cause. Being knowledgeable about this disease, you know that pyloric stenosis is more common in which gender? A. Male B. Female C. Incidence is equal for both sexes D. None of the above 54. To rule out pyloric stenosis, the definitive diagnosis is made by watching the infant drink. After the infant drinks, what will be the characteristic sign that will describe pyloric stenosis? A. An olive-size lump can be palpated B. There is gastric peristalsic waves from left to right across the abdomen C. A hypertrophied sphincter can be seen on ultrasound. D. A tingling sensation is felt on the lower extremities 55. Shee Jan Long a 10 months old infant was admitted to the hospital for severe abdominal pain. The doctor found out that the distal ileal segment of the childs bowel has invaginated into the cecum. The nurse will suspect what disease condition? A. Intussusception B. Pyloric stenosis C. Hirschprungs disease D. Vaginismus 56. In intussusceptions, children suddenly draw up their legs and cry as if they are in severe pain and possibly vomit. Another manifestation of such disease is the presence of blood in the stool. What is the characteristic stool of client with intussuscepton? A. Coffee ground B. Black and Tarry C. Currant jelly stool D. Watery stool

57. A 4-year-old child is hospitalized because of persistent vomiting. As a nurse, you must monitor the child closely for: A. Diarrhea B. Metabolic Acidosis C. Metabolic Alkalosis D. Hyperactive bowel sounds 58. A nurse is monitoring for signs of dehydration in a 1-year-old child who has been hospitalized for diarrhea. The nurse prepares to take the childs temperature and avoids which method of measurement? A. Tympanic B. Axillary C. Rectal D. Electronic 59. A home care nurse provides instructions to the mother of an infant with cleft palate regarding feeding. Which statement if made by the mother indicates a need for further instructions? A. I will use a nipple with a small hole to prevent choking. B. I will stimulate sucking by rubbing the nipple on the lower lip. C. I will allow the infant time to swallow. D. I will allow the infant to rest frequently to provide time for swallowing what has been placed in the mouth. 60. An infant has just returned to the nursing unit following a surgical repair of a cleft lip located at the right side of the lip. The nurse places the infant in which most appropriate position? A. On the right side B. On the left side C. Prone D. Supine 61. A clinic nurse reviews the record of an infant seen in the clinic. The nurse notes that a diagnosis of esophageal atresia with tracheoesophageal fistula (TEF) is suspected. The nurse expects to note which most likely sign of this condition documented in the record? A. Severe projectile vomiting B. Coughing at night time C. Choking with feedings D. Incessant crying SITUATION: Human development is one of the important concepts that a nurse should learn to be able to deal appropriately with their clients of different developmental stages. 62. Which statement best describes when fertilization occurs? A. When the spermatozoon passes into the ovum and the nuclei fuse into a single cell. B. When the ovum is discharged from the ovary near the fimbriated end of the fallopian tube. C. When the embryo attaches to the uterine wall. D. When the sperm and ova undergo developmental changes resulting in a reduction in the number of chromosomes. 63. A pregnant client asks you about fetal development. At approximately what gestational age does the fetuss single chambered heart begin to pump its own blood cells through main blood vessels? A. 10 weeks B. 8 weeks C. 5 weeks D. 3 weeks 64. At 17 weeks gestation, a fetus isnt considered to be ballotable. Ballotment means that: A. The examiner feels rebound movement of the fetus. B. The examiner feels fetal movement. C. The client feels irregular, painless uterine contractions. D. The client feels fetal movement. 65. Which hormone stimulates the development of the ovum? A. Follicle stimulating hormone (FSH) B. Human Chorionic Gonadotropin (HCG) C. Luteinizing Hormone (LH) D. Gonadotropin Releasing Hprmone (GnRH) 66. How long is the gestational period of a full term pregnancy? A. Ranging from 245 days to 259 days B. around 5,554 hours to 5,880 hours C. More than 294 days D. Averaging of 266 to 294 days 67. An 18 year old woman in her 18th week of pregnancy is being evaluated. Which positive sign of pregnancy should the nurse expect to be present? A. Fetal heart tones detectable by Doppler stethoscope B. Fetal movement detectable by palpation C. Visualization of the fetus by ultrasound examination. D. Fetal heart tones detectable by a fetoscope. 68. During her prenatal visit, a 28 year old client expresses concern about nutrition during pregnancy. She wants to know what foods she should be eating to ensure the proper growth and development of her baby. Which step should the nurse take first? A. Give the client a sample diet plan for a 2,400 calorie diet. B. Emphasize the importance of avoiding salty and fatty foods. C. Instruct the client to continue to eat a normal diet. D. Assess the clients current nutritional status by taking a diet history. 69. A nurse is teaching a class about the reproductive system. She explains that fertilization most often takes place in the: A. Ovary B. Fallopian tubes C. Uterus D. vagina 70. A large number of neural tube defects may be prevented if a pregnant woman includes which supplement in her diet? A. Vit. A B. Vit. E

C. Vit. D D. Vit. B9 71. A 22 year old client is at 20 weeks gestation. She asks the nurse about the development of her fetus at this stage. Which of the following developments occurs at 20 weeks gestation? A. The pancreas starts producing insulin and the kidneys produce urine. B. The fetus follows a regular schedule of turning, sleeping, sucking, and kicking. C. Swallowing reflex has been mastered, and the fetus sucks its thumb. D. Surfactant forms in the lungs. SITUATION: Developing countries such as the Philippines suffer from high infant and child mortality rates. Thus, as a management to the existing problem, the WHO and UNICEF launched the IMCI. 72. A 6 month old baby Len was brought to the health center because of fever and cough for 2 days. She weighs 5 kg. Her temperature is 38.5 taken Axillary. Further examination revealed that she has general rashes, her eyes are red and she has mouth ulcers non deep and non extensive, There was no pus draining from her eyes. Most probably Baby Len has: a. Severe complicated measles d. Measles b. Fever: No MALARIA e. Measles with eye or mouth complications c. Very severe febrile disease 73. The dosage of Vit. A supplement given to Baby Len would be: d. 100,000 IU d. 200,000 IU e. 10,000 IU e. 20,000 IU 74. Using IMCI Chart, this child can be manage with: f. Treat the child with paracetamol and follow up in 2 days if the fever persist g. Give the first dose of antibiotic, give Vit. A, apply Gentian Violet for mouth ulcers and refer urgently to hospital h. Give100, 000 international units of Vit. A i. Give200, 000 international units of Vit. A e. Give Vit. A, apply Gentian violet for mouth ulcers and follow up in 2 days 75. The following are signs of severe complicated measles: j. Clouding of the cornea k. Deep or extensive mouth ulcers l. Pus draining from the eyes m. A and b only n. All of the above 76. If the child is having 2 weeks ear discharges, how would you classify and treat the child: 1. Green 5. Dry the ear by wicking 2. Yellow 6. 5 days antibiotic 3. Pink 7. Urgent referral with first dose of antibiotic 4. Red a. 4,7 b. 2,5,6 c. 1,5 d. 3,7 e. 2,5

77. The following are treatments for acute ear infections: a. Dry the ear by wicking d. A and c only b. Give antibiotics for 5 days e. All of the above c. Follow up in 5 days 78. A child with ear problem should be assessed for the following, except: a. Ear pain b. If discharge is present for how long? c. Ear discharge d. Is there any fever? e. None of the above 79. If the child does not have ear problem, using IMCI, what should you do as a nurse? a. Go to the next question, check for malnutrition b. Check for ear pain c. Check for tender swelling behind the ear d. Check for ear discharge 80. An ear discharge that has been present for more than 14 days can be classified as: a. Complicated ear infection c. Chronic ear infection b. Acute ear infection d. Mastoiditis 81. An ear discharge that has been present for less than 14 days can be classified as: a. Complicated ear infection c. Chronic ear infection b. Acute ear infection d. Mastoiditis 82. If the child has severe classification because of ear problem, what would be the best thing that you should do as a nurse? a. Dry the ear by wicking b. Give an antibiotic for 5 days c. Refer urgently d. Instruct mother when to return immediately Situation: Primary Health Care (PHC) is defined by the WHO as essential health care made universally accessible to individuals, families and communities. 83. The WHO held a meeting in this place where Primary health Care was discussed. What is this place? A. Alma Ata B. Russia C. Vienna D. Geneva Situation: The national objective for maintaining the health of all Filipinos is a primary responsibility of the DOH. 84. The following are mission of the DOH except: a. Ensure accessibility b.Quality of health care c.Health for all Filipinos d.Quality of Life of all Filipinos e. None of the above 85. The basic principles to achieve improvement in health include all BUT: a. Universal access to basic health services must be ensured b. The health and nutrition of vulnerable groups must be prioritized c. Performance of the health sector must be enhanced d. Support the frontline workers and the local health system e. None of the above

86. Which of the following is not a primary strategy to achieve health goals: a. b. c. d. e. Support of local health system development Development of national standards for health Assurance of health care for all Support the frontline workers None of the above

87. According to the WHO health is: A. state of complete physical, mental and social well being not merely the absence of disease B. A science and art of preventing disease and prolonging life C. A science that deals the optimum level of functioning of the Individual, family and community D. All of the above 88. Assistance in physical therapy of a trauma patient is a: Primary level of prevention B. Secondary level of prevention C. Tertiary level of prevention D. Specialized level of prevention 89. Local health boards were established at the provincial, city and municipal levels. At the municipal level,the chairman of the board is the: A.Rural Health physician B.Governor C.Mayor D.Chairman of the Committee on Health 90. The emphasis of community health nursing is on: A. Treatment of health problems B. Preventing health problems and promoting optimum health C. Identification and assessment of health problems D. Illness end of the wellness-illness continuum. 91. In a. b. c. d. e. asking the mother about her childs problem the following communication skills should be used except: Use words that the mother understand Give time for the mother to answer the questions Listen attentively Ask checking questions None of the above

92. Which of the following is the principal focus of the CARI program of the Department of Health? a. Teach other community health workers how to assess patients b. Mortality reduction through early detection c. Teach mothers how to detect signs and where to refer d. Enhancement of health team capabilities 93. You were able to identify factors that lead to respiratory problems in the community where your health facility serves. Your primary role therefore in order to reduce morbidity due to pneumonia is to? a. Seek assistance and mobilize the BHWs to have a meeting with mothers b. Refer cases to hospitals c. Make home visits to sick children d. Teach mothers how to recognize early signs and symptoms of pneumonia 94. Which of the following is the most important responsibility of a nurse in the prevention of unnecessary deaths from pneumonia and other severe disease? a. Weighing of the child b. Provision of careful assessment c. Taking of the temperature of the sick child d. Giving of antibiotics 95. A 4-month-old child was brought to your clinic because of cough and colds. Which of the following is your primary action? a. Teach the mother how to count her childs breathing? b. Refer to the doctor c. Assess the patient using the chart on management of children with cough d. Give cotrimoxazole tablet or syrup e. All of the above 96. In responding to the care concerns to children with severe disease, referral to the hospital is of the essence especially if the child manifests which of the following? a. Stopped feeding well c. Wheezing b. Fast breathing d. Difficulty to awaken Elvira Magalpok is a 26 year old woman you admit to a birthing room. Shes been having contractions 45 seconds long and 3 minutes apart for the last 6 hours. She tells you she wants to have her baby naturally without any analgesia or anesthesia. Her husband is in the Army and assigned overseas, so he is not with her. Although her sister lives only two blocks from the hospital, Elvira doesnt want her called. She asks if she can talk to her mother on the telephone instead. As you finish assessing contractions, she screams with pain and shouts, Ginagawa ko na ang lahat ng makakaya ko! Kailan ba matatapos ang paghihirap kong ito? 97. Elvira didnt recognize for over an hour that she was in labor. A sign of true labor is: A. Sudden increase energy from epinephrine release B. Nagging but constant pain in the lower back. C. Urinary urgency from increased bladder pressure. D. Show or release of the cervical mucus plug. 98. Elvira asks you which fetal position and presentation are ideal. Your best answer would be: A. Right occipitoanterior with full flexion. B. Left transverse anterior in moderate flexion. C. Right occipitoposterior with no flexion. D. Left sacroanterior with full flexion. 99. Elvira is having long and hard uterine contractions. What length of contraction would you report as abnormal? A. Any length over 30 seconds. B. A contraction over 70 seconds in length. C. A contraction that peaks at 20 seconds. D. A contraction shorter than 60 seconds. 100. You assess Elviras uterine contractions. In relation to the contraction, when does a late deceleration begin? A. Forty-five seconds after the contraction is over. B. Thirty seconds after the start of a contraction. C. After every tenth or more contraction. D. After a typical contraction ends. NURSING PRACTICE III

SITUATION: Mang Roberto was long diagnosed with chronic renal failure. You are his nurse and the following question assesses your knowledge in the different fluid and electrolyte imbalances that are associated with chronic renal failure. 1. Disequilibrium syndrome is always a risk in all clients undergoing hemodialysis for chronic renal failure. The nurse should assess Mang Roberto for which of the following sign and symptom associated with Disequilibrium syndrome? A. Hypertension, Tachycardia and Fever B. Imbalance, gait abnormality and inability to stand up C. Restlessness, irritability and generalized weakness D. Headache, deteriorating level of consciousness and twitching 2. After Mang Roberto completed his hemodialysis, The nurse should use which indicators to evaluate the clients status after dialysis? A. Potassium level and weight B. Vital signs and Blood Urea Nitrogen C. Blood Urea Nitrogen and Creatinine level D. Vital signs and weight

3. Mang Robertos chronic renal failure was caused by a crush injury to the lower leg right after an accident. The acute renal failure progresses to chronic renal failure until now, his case is irreversible. The nurse is correct in determining that the cause of Mang Robertos Acute renal failure before was: A. Pre renal B. Post renal C. Renal D. Extra renal

4. Mang Roberto misses 2 sessions of hemodialysis. Blood was drawn and is sent for analysis. Which electrolyte disturbance is expected in a client with chronic renal failure? A. Hypernatremia B. Hyperkalemia C. Hypokalemia D. Alkalemia

5. In Mang Robertos ECG tracing, you would expect to find: A. Depressed T wave B. Presence of U wave 6. The main indicator of the need for hemodialysis is: A. Ascites B. Acidosis C. Hypertension D. Hyperkalemia C. A peaked T wave D. Inverted T wave

7. To gain access to the vein and artery, an AV shunt was used for Mang Roberto. The most serious problem with regards to the AV shunt is: A. Septicemia B. Clot formation C. Exsanguination D. Vessel sclerosis

8. When caring for Mang Robertos AV shunt on his right arm, you should: A. Cover the entire cannula with an elastic bandage B. Notify the physician if a bruit and thrill are present C. User surgical aseptic technique when giving shunt care D. Take the blood pressure on the right arm instead 9. Mang Roberto Complains of tingling in the finger and twitching of the muscles. This is caused by: A. Acidosis B. Potassium retention C. Calcium Depletion D. Sodium chloride depletion

10. Which of the following is an appropriate instruction for Mang Roberto? A. Follow a high potassium diet B. Strictly follow the hemodialysis schedule C. Use salt substitute instead of the normal table salt D. Use alcohol on the skin to clean it due to integumentary changes SITUATION: Mang Robertos condition continues to worsen and the doctor suggested Kidney Transplantation. 11. Mang Roberto has just received a renal transplant and has started cyclosporine therapy to prevent graft rejection. Which of the following condition is a major complication of this drug therapy? A. Depression B. Hemorrhage C. Infection D. Peptic ulcer disease

12. Which of the following is the rationale why Azathioprine (Imuran), Prednisone or Cyclosporine (SandImmune) is given in a client that has undergone Kidney Transplantation? A. To enhance the immune system preventing rejection B. To suppress the immune system preventing rejection C. To enhance kidney function D. To protect the newly transplanted kidney from invading pathogens 13. Immunosuppression following Kidney transplantation is continued: A. For life B. 24 hours after transplantation C. A week after transplantation D. Until the kidney is not anymore rejected

14. Steroids, if used following kidney transplantation would cause which of the following side effects? A. Alopecia B. Increase Cholesterol Level C. Orthostatic Hypotension D. Increase Blood Glucose Level

15. Mang Roberto was readmitted to the hospital with acute graft rejection. Which of the following assessment finding would be expected? A. Hypotension B. Normal Body Temperature C. Decreased WBC D. Elevated BUN and Creatinine

SITUATION: Nanette was rushed to the hospital due to burns. Witnesses told the emergency team that Nanette fell asleep while she is holding her cigarette thus, burning the bed sheets and herself. 2nd and 3rd degree burns are on the face, neck, anterior and posterior trunk as well as the anterior of the left leg and the whole right arm was burned. First degree burns are located on the anterior portion of the right leg and the anterior portion of the right and left arm. Nanette is a 110 lbs female client. 16. The priority nursing intervention for Nanette is to: A. Assess airway, breathing and circulation B. Check Nanettes Vital Signs C. Apply ointment over the burned surface D. Administer oxygen inhalation

17. Using the rule of nine, the percentage of the burned area on Nanettes skin is: A. 63% B. 81% C. 90% D. 72%

18. The rationale in giving IV fluids for Miss Nanette is to prevent: A. Cardiogenic shock B. Septic Shock 19. A second degree burn on Nanette is characterized by: A. Eschars B. Broken skin with fat exposed C. Blisters and Edema D. Insensate wound draining purple fluid C. Hypovolemic shock D. Neurogenic Shock

20. During the first 48 hours, Burn victims is observed for metabolic acidosis resulting from loss of bicarbonate ions that arises from: A. Potassium loss B. Calcium loss C. Sodium loss D. Magnesium loss

21. IV fluid that is commonly used in clients with dehydration, diarrhea and burns is: A. Lactated Ringers B. D5 NSS C. Normal Saline Solution D. NSS Plus potassium

22. The doctor uses Parkland/Baxter formula in computing the amount of fluid needed for Nanettes resuscitation. You would expect that the doctor will order how many milliliters of IV fluids? A. 6 liters during the first 8 hours, 3 liters on the next 8 hours and another 3 liters on another 8 hours. B. 12 liters during the first 8 hours and another 12 liters on the succeeding 16 hours C. 8 liters during the first 8 hours, 4 liters on the next 8 hours and another 8 liters on another 8 hours D. 10 liters during the first 8 hours and another 10 liters on the succeeding 16 hours 23. During the emergent phase of burn, which of the following is an expected finding on Nanette? A. Decreased heart rate B. Elevated hematocrit levels C. Increased blood pressure D. Increased urinary output

24. Which electrolyte disturbance is the most lethal in client with burn? A. Hyponatremia B. Hypercalcemia C. Hyperkalemia D. Hypokalemia

25. The priority consideration for Nanette during the early phase of burn is: A. Pain B. Body Image C. Fluid status D. Infection of the wound

SITUATION: Joanna Marie, a 40 year old client was diagnosed with breast cancer. 26. The nurse is instruction Joanna about breast self examination. The nurse instructs Joanna to perform Breast Self Examination: A. At the onset of menstruation B. 1 week after menstruation begins C. Every month during ovulation D. Weekly at the same time each day

27. Joanna is taking Adriamycin together with tamoxifen. You know that Adriamycin works by: A. Inhibiting DNA Synthesis B. Preventing Folic acid synthesis C. Changing the osmotic gradient of the cell D. Increase cell wall permeability

28. Joannas tumor is said to be ERP+. You know that Estrogen receptor positive tumor is: A. A good indicator of the possibility of breast reconstruction B. A good indicator for giving an estrogen replacement therapy to decrease the tumor size C. An indicator that the client might respond to tamoxifen D. An indicator that metastasis has already occured 29. Which of the following maybe use to her post operatively? A. Cystoclysis bottle B. 3 way bottle system C. Jackson Pratt Drain D. Pleural drainage

30. All of the following are applicable nursing diagnosis for Joanna except: A. Pain upon lying down B. Body Image Disturbance C. Potential for sexual dysfunction D. Self care deficit r/t immobility of the arm

31. Rationale for elevating the arm of Joanna post operatively is to: A. Improve coping ability C. Improve Edema

B. Prevent infection

D. Decrease bleeding and drainage

32. After Modified radical mastectomy, which assessment finding indicates that Joanna is experiencing a complication related to surgery? A. Sanguineous drainage in the Jackson Pratt drain B. Pain at the incision site C. Complaints of decrease sensation in the operative site D. Arm edema on the operative arm 33. Allowing Joanna to perform deep breathing exercise will prevent: A. Pneumonia B. Bronchitis C. Atelectasis D. Lymph edema

34. The nurse is teaching the sisters of Joanna about Mammography, The nurse tells the client that: A. Mammography takes about 1 hour B. To avoid the use of deodorant, powders and creams on the day of the test C. There is no discomfort associated with the procedure D. To maintain an NPO status 8 hours before the procedure 35. Joanna was brought to the hospice. During your visit, Joanna expresses that If I can just live a little longer to see my 3 sons finish college, I will be ready to die. Which phase of the grieving process Is Joanna experiencing? A. Denial B. Bargaining C. Depression D. Anger

36. In the Philippines, The use of this method is strongly suggested and recommended than any other methods to decrease death due to breast cancer: A. BSE B. Mammography C. Breast Biopsy D. Sugery

37. The nurse is teaching a group of women to perform breast self-examination. The nurse should explain that the purpose of performing the examination is to discover: A. Thickness and Fullness B. Malignant or Benign Lumps C. changes from previous self-examinations. D. Fibrocystic masses 38. Anita, Joannas sister is performing BSE and she stands in front of the Mirror. The rationale for standing in front of the mirror is to check for: A. Unusual discharges coming out from the breast B. Any obvious malignancy C. The Size and Contour of the breast D. Thickness and lumps in the breast 39. The nurse puts a folded towel under the Left shoulder of the Client to be examined for clinical BSE. Why is this so? A. To make the left shoulder nearer to the hands of the clinician for palpation B. To make the pectoralis muscle prominent, toning the breast tissue for better palpation C. To put the breast in a more lateral position to better ease the palpation D. To balance and spread the breast tissue thus easing palpation 40. 30. A 52-year-old female tells the nurse that she has found a painless lump in her right breast during her monthly self-examination. Which assessment finding would strongly suggest that this client's lump is cancerous? 1. 2. 3. 4. Non capsulated mass Fixed, irregular and hard Presence of Orange peel skin Soft and mobile B. 1,2 C. 1,2,4 D. 1,3,4

A. 1,2,3

SITUATION: Agnes, a client with Leukemia is in the clinic for her routine check up. 41. Which finding is unlikely when assessing Agnes? A. Small abdomen B. Bruises and Petechiae C. Increased WBC Counts D. Dyspnea during exercise or exertion

42. The most appropriate diagnostic examination for Agnes is: A. RBC Exam B. WBC Count C. Complete Blood Count D. Bone Marrow Aspiration

43. What should you encourage her to use in order to maintain her oral hygiene? A. Use regular toothbrush B. Gargle with mouthwash only C. Use cotton pledget only D. Use soft toothbrush

44. Which of the following complications are the three main consequence of leukemia? A. Bone deformities, Infection and Anemia B. Anemia, Infection and Bleeding tendencies C. Leukopenia, Thrombocytopenia and Anemia D. Leukocytosis, Thrombocytosis and Polycythemia 45. You noticed that Agnes nose is bleeding, You would instruct Agnes to: A. lie supine with his neck extended. B. sit upright, leaning slightly forward. C. blow his nose and then put lateral pressure on his nose. D. hold his nose while bending forward at the waist.

SITUATION: Mr. Ramos is a 60 year old male client admitted to the hospital with the diagnosis of pneumonia. He complains of pain when coughing. 46. What action should the nurse take in assisting Mr. Ramos in doing deep breathing and coughing exercise? A. Recognize that the patient is too sick to cough at this time B. Splint the patients chest while he coughs C. Turn Mr. Ramos to the unaffected side and ask him to cough D. Encourage her to cough and then give her pain medication as ordered 47. A sputum specimen was collected from Mr. Ramos for culture and sensitivity. This study is to ascertain which of the following facts? A. The virulence of microorganism involved B. The antibiotics which would be most helpful C. The patients probably reaction to the causative microorganism D. The patients sensitivity to antibiotics 48. Laboratory reports shows RBC : 2,000,000, WBC: 5,000 and Platelets : 300,000. Considering the above findings which of the following clinical manifestation is the most likely manifestation Mr. Ramos is to exhibit? A. Decrease respiration and increase pulse B. Normal Respiration and increase pulse C. Increase respiration and normal pulse D. Increase pulse and increase respiration

49. Because of these laboratory findings, the nurse is aware that her most appropriate action is to prevent which of the following? A. Infections and cross contamination C. Injury might lead to bleeding B. Over activity that might lead to exhaustion D. Hypercoagulation that might lead to thrombus formation 50. Upon discharge, the health teaching of the nurse to Mr. Ramos should include which of the following except: A. Avoid fatigue B. Maintain hygiene C. Maintain the usual exercise D. Avoid drafts

SITUATION: Blood transfusion was ordered for Andre after an episode of severe bleeding. 51. Before blood transfusion, The nurse priority is to assess Andre for which of the following? A. Clotting time B. Vital Signs C. Sodium D. Weight

52. Before administering the transfusion, The nurse must start an IV infusion of which of the following? A. Sterile water B. NSS C. D5W D. D5LR

53. Which of the following is an appropriate needle for Blood transfusion? A. A butterfly needle B. An 18 gauge angiocatheter C. A 25 gauge angiocatheter D. A 21 gauge angiocatheter

54. Which of the following is not expected to be done by the nurse in case of a whole blood transfusion? A. Assess the venipuncture for any signs of bleeding or hematoma B. Prepare the blood transfusion using a microdrip tubing C. Assess the patient closely for any reaction D. Make sure that the drip chamber of the IV fluid is partially filled with blood 55. Which of the following is the recommended flow rate for the first 20 minutes of blood transfusion? A. 10 B. 20 C. 40 D. 60

56. Solutions that are said to be compatible with the osmolarity of the body are called: A. Isotonic B. Hypotonic C. Normosol D. Hypertonic 57. Which of the following are signs of hemolytic reaction during blood transfusion? A. Itching, urticaria and wheezing B. Cough, dyspnea, pulmonary congestion C. High fever and chills D. Fever and backache 58. In any event of an adverse hemolytic reaction during blood transfusion, Nursing intervention should focus on: A. Slow the infusion, Call the physician and assess the patient B. Stop the infusion, Assess the client, Send the remaining blood to the laboratory and call the physician C. Stop the infusion, Call the physician and assess the client D. Slow the confusion and keep a patent IV line open for administration of medication 59. The nurse knows that after receiving the blood from the blood bank, it should be administered within: A. 1 hour B. 2 hours C. 4 hours D. 6 hours

60. During blood administration, the nurse should carefully monitor adverse reaction. To monitor this, it is essential for the nurse to: A. Stay with the client for the first 15 minutes of blood administration

B. Stay with the client for the entire period of blood administration C. Run the infusion at a faster rate during the first 15 minutes D. Tell the client to notify the staff immediately for any adverse reaction SITUATION : John Mark is a 21 year old male client who was rushed following an automobile accident. He is very anxious, dyspneic and in severe pain. 61. The nurse notices that Johns chest tube was dislodged from the chest. The most appropriate nursing intervention is to: A. Notify the physician B. Cover the insertion site with petrolatum gauze C. Immersed the tube into a bottle of sterile water D. Clamp the tube 62. To ensure that the system is functioning effectively, the nurse should: A. Observe for intermittent bubbling in the water seal chamber B. Flush the chest tube with 30 to 60 ml of NSS every 4 hours C. Maintain the client in a sidelying position always D. Strip the chest tube in the direction towards the client 63. JMs chest tube is said to be functioning correctly when which of the following is observed? A. Continuous bubbling in the water seal chamber B. Fluctuation in the water seal chamber C. Suction tubing attached to the wall unit D. Vesicular breath sounds heard in all lung fields 64. He is intubated with an endotracheal tube and is placed on a mechanical ventilator. Which findings alerts the nurse to an additional problem with regards to the respiratory function? A. Dull of percussion in the 3rd to 5th intercostals space, midclavicular line B. Decreased paradoxical motion C. Louder breath sounds on the right chest D. Vesicular breath sound heard at the lung bases 65. The right chest wall of peter moves in during inspiration and balloons out when he exhales. He is very dyspneic. The nurse understands that this symptom is indicative of: A. Hemothorax B. Flail Chest C. Atelectasis D. Pleural effusion

SITUATION : Rene is a 3 y/o boy brought to the health center for fever and cough. You noted grayish pinpoint dots located at the buccal mucosa. A maculopapular rash was noted on his face. Questions 20-25 refer to this. 66. The patients disease is most likely: A. Rubeola B. Diptheria 67. The lesion in his buccal mucosa is called: A. Forchheimers spot B. Pseudomembrane 68. What is the exanthem of measles? A. Maculopapular rash B. Pseudomembrane B. Forchheimers spot D. Kopliks spot C. Ghons tubercle D. Kopliks spot C. Rubella D. Pneumonia

69. The nurse knows that the most common complication of Measles is: A Pneumonia and larynigotracheitis B. Encephalitis C. Otitis Media D. Bronchiectasis 70. Measles vaccine is given at how many months? A. At birth B. 1 months C. 6 months D. 9 months

71. All of the following are necessary household management in preventing the spread of Measles at home except: A. Boil foods that are not eaten by the patient B. Separate eating utensils of the patient from that of other members of the family C. Isolate the patient when symptoms start to appear D. Children should be watch out for complications of the disease 72. A client suspected of having tetanus asks the nurse about immunizations against tetanus. The nurse explains that the major benefit in using tetanus antitoxin is that it: A. Stimulates plasma cells directly B. Provides a high titer of antibodies C. Provide immediate active immunity D. Stimulates long-lasting passive immunity 73. Miss Kate is a bread vendor and you are buying a bread from her. You noticed that she receives and changes money and then hold the bread without washing her hand. As a nurse, What will you say to Miss Kate? A. Miss, Dont touch the bread Ill be the one to pick it up B. Miss, Please wash your hands before you pick up those breads C. Miss, Use a pick up forceps when picking up those breads D. Miss, Your hands are dirty I guess Ill try another bread shop

74. The Causative agent of Tuberculosis is said to be: A. Mycobacterium Tuberculosis B. Hansens Bacilli C. Bacillus Anthraces D. Group A Beta Hemolytic Streptococcus 75. A client who was exposed to hepatitis A is given gamma globulin to provide passive immunity which: A. Increases the production of short lived antibodies B. Provides antibodies that neutralize the antigen C. Accelerates antigen-antibody union at the hepatic sites D. Stimulates the lymphatic system to produce large number of antibodies 76. They are the proteins in the body that are produced in response to the invasion to pathogens and microorganisms. A. Antigen B. Amino Acids C. Agglutinogen D. Antibody 77. A nursing instructor asks a nursing student to describe human immunoglobulin. The student correctly states that these types of vaccine are: A. Vaccine that have their virulence diminished so as to not produce a full blown clinical illness B. Vaccine that contains pathogens made inactive by either chemicals or heat C. Bacterial toxins that have been made inactive by either chemicals or heat D. Vaccines collected from pooled blood of people and provide antibodies to variety of diseases 78. Mode of transmission of leprosy aside from skin contact is by: A. Oral fecal B. Sexual contact 79. Which of the following is not a late sign and symptoms of leprosy? A. Paralysis B. Contractures C. Madarosis D. Gynecomastia C. Borrowing utensil D. Droplet infection

80. Which among the following person is most susceptible to leprosy? A. Mark, 21 year old athlete B. Arvinn, 16 year old student C. JC, 12 year old student D. Clarence, 9 year old student 81. The nurse is documenting her care for a client with iron deficiency anemia. Which of the following nursing diagnoses is most appropriate? A. Impaired gas exchange B. Deficient fluid volume C. Ineffective airway clearance D. Ineffective breathing pattern

82. The nurse walks into the room of a client who has had surgery for testicular cancer. The client says that he'll be undesirable to his wife, and he becomes tearful. He expresses that he has spoiled a happy, satisfying sex life with his wife, and says that he thinks it might be best if he would just die. Based on these signs and symptoms, which nursing diagnosis would be most appropriate for planning purposes? A. Situational low self-esteem B. Unilateral neglect C. Social isolation D. Risk for loneliness

83. A 92-year-old client with prostate cancer and multiple metastases is in respiratory distress and is admitted to a medical unit from a skilled nursing facility. His advance directive states that he doesn't want to be placed on a ventilator or receive cardiopulmonary resuscitation. Based on the client's advance directive, the nursing plan of care should include which intervention? A. Check on the client once per shift. B. Provide mouth and skin care only if the family requests it. C. Turn the client only if he's uncomfortable. D. Provide emotional support and pain relief. 84. Which of these findings is an early sign of bladder cancer? A. Painless Hematuria B. Occasional Polyuria C. Nocturia D. Dysuria

85. During a late stage of acquired immunodeficiency syndrome (AIDS), a client demonstrates signs of AIDS-related dementia. The nurse should give the highest priority to which nursing diagnosis? A. Bathing or hygiene self-care deficit B. Ineffective cerebral tissue perfusion C. Dysfunctional grieving D. Risk for injury

86. When assessing a client with partial thickness burns over 60% of the body, which of the following should the nurse report immediately? A. Complaints of intense thirst B. Moderate to severe pain C. Urine output of 70 ml the 1st hour D. Hoarseness of the voice

87. A client with a solar burn of the chest, back, face, and arms is seen in urgent care. The nurse's primary concern should be: A. fluid resuscitation. B. infection. C. body image. D. pain management.

88. client is admitted to the hospital following a burn injury to the left hand and arm. The client's burn is described as white and leathery with no blisters. Which degree of severity is this burn? A. First degree burn B. Second degree burn C. Third degree burn D. Fourth degree burn

89. A client with end-stage liver cancer tells the nurse he doesn't want extraordinary measures used to prolong his life. He asks what he must do to make these wishes known and legally binding. How should the nurse respond to the client? A. Tell him that it's a legal question beyond the scope of nursing practice. B. Give him a copy of the client's bill of rights. C. Provide information on active euthanasia. D. Discuss documenting his wishes in an advance directive. 90. A client is admitted to the hospital with an exacerbation of her chronic systemic lupus erythematosus (SLE). She gets angry when her call bell isn't answered immediately. The most appropriate response to her would be: A. "You seem angry. Would you like to talk about it?" B. "Calm down. You know that stress will make your symptoms worse." C. "Would you like to talk about the problem with the nursing supervisor?" D. "I can see you're angry. I'll come back when you've calmed down." SITUATION: Consider the following hypothesis: The Job turnover rate and job dissatisfaction levels of graduate nurses who have worked less than 2 years is higher than for those graduate nurses who have worked for more than 2 years 91. A systematic, objective, process of analyzing phenomena importance to nursing is termed as: A. Nursing research B. Research 92. The major reason for conducting nursing research is to: A. Improve nursing care for clients B. Promote the growth of the nursing profession C. Document to cost effectiveness of nursing care D. Ensure accountability of nursing practice 93. Which is you independent variable? A. Job dissatisfaction B. Job turn over rate 94. Which is your dependent variable? A. Job dissatisfaction B. Job turn over rate C. Job dissatisfaction and Job turn over rate D. Length of employment C. Job dissatisfaction and Job turn over rate D. Length of employment C. Scientific research D. Research process

95. The type of hypothesis in this situation is classified as: A. Simple, Directional B. Simple, Non Directional C. Complex, Directional D. Complex, Research

96. The problem that a researcher would like to give emphasis Is there a relationship between timing of the administration of psychological support and feelings of wellbeing among terminally ill patients. The appropriate null hypothesis for this problem is: A. Feelings of wellbeing of terminally ill patients who received psychological support is similar to the feelings of wellbeing of those terminally ill patients who did receive said psychological support. B. There is no relationship between the timing of administration of psychological support and feelings of well-being among terminally ill patients C. Factors are not appropriate to determine any desired results D. There is no relationship between the timing of the administration of psychological support and feelings of adequacy among terminally ill patients 97. In the above number, your dependent variable is: A. Terminally ill patients B. Feelings of wellbeing C. Timing of psychological support D. Time

98. In the recent technological innovations, which of the following describe researches that are made to improve and make human life easier? A. Pure research B. Applied research C. Basic research D. Experimental research

99. After the researcher has determined and read relevant literature, she has to: A. Write down the review B. Organized the relevant literature C. Analyze potential literature D. Integrate the review of literature 100. The final product of review of related literature is: A. Pool of related literature B. Organized relevant literature C. Analyzed potential literature D. Written review of literature NURSING PRACTICE IV Situation : Cancer of the prostate is the leading cancer in Men other than skin cancer. The following questions will assess your knowledge and theoretical foundation in dealing with clients with prostate cancer.

1. Among the following population group, who has a higher risk in the development of prostate cancer? A. African-American B. Caucasian 2. Which among the following is NOT a risk factor for prostate cancer? A. A family member with prostate cancer B. Advancing age C. High fat and diet high in red meats D. Smoking C. Asian D. Hispanics

3. Mr. Juan Jose Rodrigo has been diagnosed with prostate cancer just a few hours ago. Which of the following sign would alert the nurse that the cancer is already advanced? A. I have difficulty starting my urination B. My backs and hips are painful and my right leg is slightly larger than the other C. My urine is bloody D. My urine is bouncing 4. At the initial sign and symptoms of prostate cancer, before diagnosis, the physician can perform a screening test to detect a characteristic STONY HARD prostate and nodules at the prostate area using: A. Cytoscopy B. PSA 5. To diagnose the presence of prostate cancer, the physician will perform: A. Transrectal needle biopsy of the prostate B. Test to identify the PSA levels C. Transrectal ultrasound D. Radiolabeled monoclonal antibody capromab penetide with indium-111 6. After the removal of the prostate tissue, The physician soaked the solution in formaldehyde in a sterile specimen container and asked you to send the specimen immediately. Which of the following is a correct nursing action? A. Dr. Ruiz, I dont think this specimen is acceptable. Please redo the procedure and do not soak the specimen in any medium. B. Dr. Ruiz, I just want you to know that you soaked the specimen in formaldehyde wherein, it should not be soaked in any medium at all. C. Accept the specimen because there is nothing wrong with the physicians action D. Dr. Ruiz, it should be soaked in NSS not formaldehyde. I am going to report you to the board of medicine for this could lead to a false result. 7. In any biopsy, the specimen is sent to the: A. Radiologist B. Nearest of Kin C. Pathologist D. Medical Technologist C. DRE D. MRI

8. PSA is used not for the detection but to know if the cancer is responding to treatment or advancing. The nurse knows that the abbreviation PSA stands for: A. Prostate specific antibody B. Prostate specific antigen 9. In testing for the PSA, the nurse will collect which specimen? A. Blood B. Urine C. Feces D. Prostatic fluid C. Prostate specified antibody D. Prostate specified antigen

10. Mr. Rodrigo said that he has difficulty voiding. Which of the following is the best nursing action to encourage voiding in any clients with voiding difficulties? A. Encourage the client to drink plenty of fluids to promote urination B. Bring the client to the bathroom and stay with him when the sensation to void is felt by the client C. Catheterize the client D. Encourage the use of bathroom or commode rather than bedpans Situation : Care of clients with tracheotosmy is often a challenge to a beginning nurse. The following questions will test your knowledge on Tracheostomy and its related care. 11. You know that when rendering tracheotosmy care, the priority consideration is always to keep the airway patent and also to prevent infection at the site. The nurse knows the technique used in rendering Tracheostomy care is: A. Clean B. Disinfected C. Sterile D. Medical

12. Prior to the suctioning or removal of the inner cannula, the nurse knows that the client is prepared and positioned in: A. High fowlers B. Semi fowlers position C. Left side lying D. Sims

13. In cleaning the inner cannula or other parts of the tracheotosmy tube, The best cleansing mediums are: A. Hydrogen peroxide and Sterile NSS B. Providone Iodine and Sterile NSS C. Alcohol and Sterile NSS D. Alcohol and Hydrogen Peroxide 14. In contrary with Tracheostomy tubes, sizes of chest tubes are expressed in terms of: A. French B. Gauge C. M2 D. Diameter

15. Which of the following is NOT true with regards to securing the Tracheostomy? A. The cuff provides sufficient securing B. The Tracheostomy can be sutured in place C. The Tracheostomy can be stapled in place D. Tie or Velcro tie are used to generally secure the Tracheostomy around the client 16. The nurse knows that in Tracheostomy creation, 1% Lidocaine and 1:100,000 Epinephrine is injected at the incision site. The purpose of Lidocaine is mainly to provide anesthetic effect while the Epinephrine is needed to:

A. Relax the bronchus and dilate the airway for easier insertion B. To promote faster healing C. To prevent the Vasovagal reflex that might cause bradycardia D. For Hemostasis 17. Which of the following is not considered as a regular part of a Tracheostomy tube? A. The outer cannula B. The inner cannula C. The obturator D. The cuff

18. Which of the following is the reason why will a surgeon select a cuffed tube over a non cuffed Tracheostomy tube? A. Cuffed tube offers efficient securing B. Cuffed tube is mainly used to prevent coughing C. Cuff tube offers excellent attachment D. For mechanical ventilation

19. The size of the Tracheostomy tube is denoted in terms of: A. French B. Gauge 20. The function of the obturator is: A. To direct the outer cannula to traverse the curvature of the trachea for easier insertion B. In cases of emergency, when outer cannula accidentally dislodges C. To facilitate dilation of the stoma for the insertion of the outer cannula D. To prevent too much pressure on the jugular vein after the tie has been placed Situation : Organ donation is a new form of treatment that provides multiple complication such as rejection. 21. Organ donation to save life was initially with the first transplant done by: A. B. C. D. Dr. Christian Barnard of the Union of South Africa Dr. Christian of the U.S.A. Dr. Christian Barnard of Soviet Union Dr. Christian Barnard of U.K. C. Units D. Size / mmID

22. In 1983, The FDA approved the first anti-rejection drug by the name of: A. Cyclosporine B. Prednisone C. Imuran D. Azathioprine

23. You would expect that in cases of organ donation, you would expect that the immunosuppressant medications such as Cyclosporine, Prednisone and Imuran are taken: A. For 2 years B. When the suture heals C. When rejection is not anymore viable D. For the rest of the clients life

24. Which of the following is a sign that the transplanted kidney is being rejected? A. Fever and Weight Gain B. Fever and Weight Loss C. Chills, Fever, Polyuria D. Anuria, Fever, Weight Gain and Hematuria

25. Among children candidates for organ transplant, when all selected children have appropriate tissue matches for the same donated organ, the basis for the decision as to which child gets the organ is given to the child who: A. B. C. D. will receive the most benefit from the new organ is most likely to die without the transplant is selected by the lottery system for available organs is at the top of the list and has waited the longest time

Situation: In a client with widespread colon cancer, A colectomy is the surgical procedure of choice instead of an Abdominal perineal resection. 26. Ileostomy is performed after a colectomy. The nurse will expect that the stool of the client will be: A. Mushy B. Spicy C. Liquid D. Soft

27. When should the teaching about ileostomy care commence? A. Immediately after the operation, when the anesthesia is wearing off B. 72 hours after operation C. When readiness and interest is observed D. As soon as the patient is admitted 28. Which of the following indicates a need for further teaching in clients with ileostomy? A. I am expecting a change in my diet. B. I can remove the appliance during sleep. C. I can still swim D. I am prone to dehydration because of the ileostomy 29. For the clients stool to be more formed which of the following food are added to the clients diet? A. Boiled rice B. Spaghetti and macaroni C. Cheese D. Bran 30. An expert nurse in the field of colostomy and ileostomy is called as a/an: A. Enterostomal Therapy Nurse B. Ostomy nurse C. Nurse oncologist D. Nurse Enterostomist

Situation: During surgical operation, it is inevitable to utilize sutures. The nurse should know the basic principles in suturing as well as knowledge in selecting sutures and caring for clients with sutures. 31. Steel has the highest tensile strength among sutures in the non absorbable category. When you say tensile strength, it refers to:

A. The amount of weight or force necessary to break the suture B. The cross sectional size of the suture C. The ability of the suture to absorb fluid D. The force necessary to cause the knot to slip 32. In suturing the internal organs such as kidneys, liver, spleen, pancreas and stomach, the nurse knows that the type of suture material that the physician will most likely use is: A. Steel B. Vicryl C. Cotton D. Silk

33. If the suture is removed to soon, the nurse knows that it could lead to failed healing of the wound as well as infection. If the suture is removed too late, which of the following can occur? A. Itching B. Swelling C. Scarring D. Pain

34. The nurse noticed that there are yellow and brown crustings around the area of the suture. Which of the following is the best cleansing medium to remove such crusting? A. Hydrogen Peroxide B. Providone Iodine C. NSS D. Alcohol

35. If the suture is performed on the clients face. The nurse will reinforce the teaching that the client should return when for suture removal? A. After 7 days B. After 3 to 4 Days C. After 10 days D. The next day

36. Sizes of sutures denotes the diameter. The physician will perform a corneal transplant and will suture the eye. The nurse will prepare which of the following suture size? A. 7 B. 5 C. 3 D. 9-0

37. Who holds the packet flaps of sutures to open it and place it in the sterile table for use? A. Scrub nurse B. Circulating nurse C. Assistant surgeon D. Surgeon

38. Non absorbable suture material such as cotton, nylon and silk are best used in suturing which of the following abdominal layer? A. Skin B. Peritoneum C. Fascia D. Muscle

39. When least amount of trauma is desired, or when the client is prone to keloid formation, the nurse should prepare which type of the needle? A. Swaged B. Round C. Blunt D. Taper

40. Another alternative suture for skin closure is the use of ____________ A. Staple B. Therapeutic glue C. Absorbent dressing D. Invisible suture Situation: The following are questions with regards to the OPERATING ROOM. 41. The operating room is divided into three areas, The unrestricted, the semi restricted and the restricted areas. Where is the operating room? A. Restricted B. Unrestricted C. Semi restricted D. PACU

42. What OR attires are worn in the restricted area?

es, head cap it, mask, OR shoes es, scrub suit gloves, shoes 43. What OR attires are worn in the semi-restricted area? A. scrub suit only B. scrub suit, shoe cover, mask C. scrub suit and head cap, with or without the shoe cover D. head cap, mask, shoe cover only 44. One of the hidden dangers in the OR is missing instruments. What is the appropriate approach to this happening? A. correct labeling B. a place for everything and everything in its place C. install a flush sterilizer in the OR D. increase instrument inventory 45. PACU Vital signs monitoring is performed every: A. 5 minutes B. 10 minutes C. 15 minutes D. 30 minutes

46. Mr. T.O. has undergone surgery for lyses of adhesions. He is transferred from Post Anesthesia Care Unit (PACU) to the Surgical floor, the nurse should obtain blood pressure, pulse and respiration every: A. 3 minutes B. 30 minutes C. 15 minutes D. 20 minutes

47. Another worthy study is the compliance to the principles of aseptic technique among the sterile OR team. Who does NOT belong to the sterile OR team? A. scrub nurse B. assistant surgeon C. x-ray technician D. surgeon

48. The patient demonstrates knowledge of the psychological response to the operation and other invasive procedure when she asks about: A. Who will be with me in the OR? B. How is the post operative pain over the site like? C. Will I be naked during the operation? D. Is it cold inside the? 49. Endoscopic minimally invasive surgery has evolved from diagnostic modality to a widespread surgical technique. What department should the nurse collaborate which is unusual in conventional surgery?

A. engineering department B. x-ray department

C. blood bank services D. linen section

50. When the client is discharged from the hospital and is not capable of doing the needed care services, the following can assume the role, EXCEPT: A. family members B. chaplain C. significant others D. responsible caregiver

Situation: Anesthesia is used even during the Ancient times. In its evolution, modern marvels in the use of anesthesia enables the nurses to develop a more competitive approach in patient care. 51. An anesthesia delivered directly to the spinal canal is known as: A. Epidural B. Intrathecal C. General D. Local

52. After spinal anesthesia, 30% of the patient develops spinal headache. This is due to: A. Severe hypotension associated with Vasodilation due to the anaesthetics. B. Increase volume of the cerebrospinal fluid due to anesthesia induction. C. Cerebral edema due to rapid absorption of the anaesthetics. D. CSF leakage due to the puncture created by the spinal needle in the membrane that surrounds the spinal cord. 53. Before the induction of spinal anesthesia, the client is placed in which of the following preferred position to widen the vertebral space: A. Quasi fetal position B. Prone position C. Flat on bed supine position D. Sidelying position affected side

54. After spinal anesthesia, to prevent spinal headache, the client is placed on which of the following position? A. Sitting position B. Sidelying position affected side C. Flat on bed, supine D. Flat on bed, prone

55. Another way to prevent spinal headache is by the use of the correct needle gauge. If the client is an adult client, the anaesthesiologist might order a pink spinal set. The nurse knows that the pink spinal set has a gauge of: A. 12 B. 16 C. 22 D. 26

Situation: The nurse utilizes the theoretical foundation basic to perioperative nursing in the various nursing scenarios: 56. In medical and nursing practice, code means a call for: A. DNR state B. call to order C. clinical case D. cardiopulmonary resuscitation

57. The OR team collaborates from the first to the last surgical procedure. Who monitors the activities of each OR suite? A. scrub nurse B. anesthesiologist C. circulating nurse D. surgeon

58. In patients with acute pancreatitis, the administration of the analgesic morphine may cause: A. addiction B. urinary retention C. paralytic ileus D. spasms of the sphincter of Oddi

59. Who is responsible in daily monitoring the standards of safe, nursing practice in the operating suite? A. surgeon B. perioperative nurse 60. During surgery, movement of personnel should be: A. kept to a minimum B. restricted C. monitored D. eliminated when possible C. OR nurse supervisor D. chief nurse

61. The patient has a right to information regarding the operation or other invasive procedure and potential effects. This right is achieved through: A. Enlightened Consent B. preoperative visit 62. Which statement about a persons character is evident in the OR team? A. it assists in the control of feelings, thoughts and emotions in the face of difficulty B. it reflects the moral values and beliefs that are used as guides to personal behavior and actions C. it encourages the constructive use of the pleasure of the senses D. it refers to the quality of being righteous, correct, fair and impartial 63. You continuously evaluate the clients adaptation to pain. Which of the following behaviors indicate appropriate adaptation? A. B. C. D. The client reports pain reduction and decreased activity The client denies existence of pain The client can distract himself during pain episodes The client reports independence from watchers C. charting D. doctors rounds

64. Pain in ortho cases may not be mainly due to the surgery. There might be other factors such as cultural or psychological that influence pain. How can you alter these factors as the nurse? A. B. Explain all the possible interventions that may cause the client to worry Establish trusting relationship by giving his medication on time

C. D.

Stay with the client during pain episodes Promote clients sense of control and participation in control by listening to his concerns

65. In some hip surgeries, Fentanyl analgesia is given. What is your nursing priority care in such a case? A. B. C. D. Instruct client to observe strict bed rest Check for epidural catheter drainage Administer analgesia through epidural catheter as prescribed Assess respiratory rate carefully

Situation: Mrs. Diaz is assigned in the female surgical ward. While on duty, an 15 year old client, married, was admitted for CS. The informed consent for the operation has to be obtained. 66. The person legally responsible for taking the informed consent is: A. The OR nurse who is going to assist with the operation B. Any doctor assigned with the team C. The doctor who is going to perform the procedure D. The ward nurse where the patient stayed before the operation 67. Mr. Diaz has to remember the following with regard to the IC: A. Because the patient is a minor, the parents should be asked to sign the consent. B. The informed consent should be signed either by the patient or her 20 year old husband if patient is unconscious C. Nurses has the responsibility to obtain the informed consent prior to surgery D. Legal guardian should sign the consent since the client is 15 year old 68. The medical intern who assisted in the operation gave post operative orders. In this case, Mrs.Diaz should: A. Validate the order from the surgeon and request him to counter sign B. Follow the order as long as they are within the scope of nursing practice C. Clarify from the medical intern those that are ambiguous D. Refuse to follow the order because it is not legal 69. After one year, Mrs. Diaz was rotated to the delivery room. As a DR Nurse, the Obstetrician ordered her to administer spinal anesthesia because the anaesthesiologist did not arrive at the scene. The nurse would: A. Give the anesthesia if the supervising nurse approves it B. Give the anesthesia if the OB supervises her C. Give the anesthesia if the doctor writes the order D. Do not follow 70. Which of the following should the nurse remember when a doctor requests them to administer anesthesia? A. The nurse has the right to refuse it, if the doctors order is unlawful B. Doctors order should always be written C. The nurse may render medical procedure if the doctor supervises him D. The staff nurse can be accused of insubordination if she does not follow the doctors order Situation: Miss Matias, found out that Mang Carding, newly admitted patient, has terminal cancer and that his nurse has not yet informed him of the diagnosis. 71. Initially, Miss Matias should: A. Tell the doctor the Mang Carding hinted that he feels he has Cancer B. Be available to listen when the patient decides to discuss his illness C. Call in the family and the team to prepare Mang Carding about his impending death D. Inform Mang Carding about his Diagnosis 72. On the second day, the wife of Mang Carding shows signs of grieving, The stages of Grieving identified by Elizabeth Kubler-Ross Are: A. Numbness, Anger, Resolution and Reorganization B. Denial, Anger, Bargaining, Disorganization, Acceptance C. Denial, Anger, Bargaining, Depression, Resolution D. Denial, Anger, Bargaining, Depression, Detachment 73. Which of the following will be the most helpful therapy for the Grieving family? A. Watching the video of the dying client over and over to encourage moving on B. A course on death and dying C. Psychotherapy D. Group meeting with other grieving families 74. the nurse, when dealing with the relatives of a dying patients must be sensitive to their emotional reactions. A family member who blames herself for the condition of the dying patient indicates that she: A. Has major issues B. is oversensitive C. Has neurotic tendencies D. Is potentially risk for suicide 75. In caring of a dying client during post mortem, the most important thing that the nurse should remember is: A. Treat the body with outmost dignity B. Close the eyes immediately before the onset of rigor mortis C. Verify that the client is really dead by checking the ABC and double checking the death notice D. Close the mouth, straighten the body, elbows and knees before the onset of rigor mortis

Situation : The patients chart is a legal documentation the is admissible in the court. In working with the client, The protection of the information on the chart and patients privacy is one of the priority. You are caring for Ana, a 12 year old grade 6 pupil from manila and is one of the daughters of Maria, A 38 year old mother of 12. 76. Who cannot access the clients chart? A. Maria B. The patient C. Member of the health care team D. The nurse from the nearby hospital

77. Who owns the patient chart? A. The patient B. The doctor in charge C. The hospital D. The government

78. If the court issues an investigation necessitating the utilization of Anas chart, you know that the chart will not be admissible IF: A. Maria refuses B. Ana refuses C. The chart is not legible D. The chart is missing

79. The research teams from other countries are interested in investigating Anas case. They want to read and gather information about Ana and the manifestation of her condition. For the sake of improving knowledge and the development of a cure, the nurse knows that research is very important. Permission in this case will be taken from: A. Ana B. Maria C. The hospital management D. The doctor in charge

80. If Ana reaches the age of majority, 18 years of age, and Maria asks for her chart, which of the following is the best nursing action? A. Ignore Marias request B. Decline Marias request C. Give the chart to the Mother of Ana D. Tell Maria to ask permission from Ana

Situation 6 Infection can cause debilitating consequences when host resistance is compromised and virulence of microorganisms and environmental factors are favorable. Infection control is one important responsibility of the nurse to ensure quality of care. 81. Honrad, who has been complaining of anorexia and feeling tired, develops jaundice, after a workup he is diagnosed of having Hepatitis A. his wife asks you about gamma globulin for herself and her household help. Your most appropriate response would be: A. Dont worry your husbands type of hepatitis is no longer communicable B. Gamma globulin provides passive immunity for hepatitis B C. You should contact your physician immediately about getting gammaglobulin. D. A vaccine has been developed for this type of hepatitis 82. Voltaire develops a nosocomial respiratory tract infection. He ask you what that means? Your best response would be: A. You acquired the infection after you have been admitted to the hospital. B. This is a highly contagious infection requiring complete isolation. C. The infection you had prior to hospitalization flared up. D. As a result of medical treatment, you have acquired a secondary infection. 83. As a nurse you know that one of the complications that you have to watch out for when caring for Omar who is receiving total parenteral nutrition is: A. stomatitis B. hepatitis C. dysrhythmia D. infection 84. A solution used to treat Pseudomonas wound infection is: A. Dakins solution B. Half-strength hydrogen peroxide C. Acetic acid D. Betadine 85. Which of the following is the most reliable in diagnosing a wound infection? A. Culture and sensitivity B. Purulent drainage from a wound C. WBC count of 20,000/L D. Gram stain testing Situation : Respiration is one of the most important vital sign. This is usually the first Vital sign to be assessed more than anything for it is easily altered by the patients consciousness. The nurse should be aware of the different changes and alteration in respiration. 86. Another name for an abnormal breath sound is: A. Adventurous breath sound B. Excursion C. Adventitious breath sound D. Dyspnea 87. In a client with diabetic ketoacidosis, Kussmauls respiration is exhibited. This is evidence that there is the presence of: A. Respiratory acidosis B. Metabolic acidosis C. Respiratory alkalosis D. Metabolic alkalosis 88. If the nurse will auscultate the base of the lungs, it is expected that she will hear: A. Bronchovesicular 89. The respiratory center is found in the: A. Pons B. Hypothalamus C. Medulla D. Lungs B. Tubular C. Vesicular D. Crackles

90. Initially in asthma, you are expecting that the clients acid base disturbance is: A. Respiratory acidosis B. Metabolic acidosis C. Respiratory alkalosis D. Metabolic alkalosis Situation: Carbon Monoxide poisoning is said to be the 2nd leading cause of poison death. It is said to be the leading cause of inhalation poisoning. Mang edgardo was rushed to the hospital after being unconscious inside an enclosed parking lot. Carbon monoxide poisoning is suspected. 91. The pulse oximetry reading of Mang edgardo is 100%. This suggests that:

A. There is no danger of hypoxia B. There is no carbon monoxide poisoning, it should be ruled out C. This is not a reliable sign to rule out carbon monoxide poisoning, further assessment is required D. That the client has an improved chance of surviving, since the client is well oxygenated 92. Which of the following is a sign the nurse will expect to see on Mang edgardo? A. Cherry-red skin B. Pale skin C. Cyanotic D. Restlessness 93. Initially, in patient with suspected inhalation poisoning, the most important intervention at the scene of poisoning is: A. Assess the patients airway breathing and circulation B. Conduct a head to toe physical assessment C. Administer oxygen and loosen the clients clothing D. Carry the client on the fresh air immediately opening all windows and doors if this is enclosed 94. Which of the following laboratory result is constantly checked in clients undergoing treatment for carbon monoxide poisoning? A. Oxygen saturation B. RBC count C. Skin color D. Carboxyhemoglobin level

95. If a client demonstrates psychoses, visual disturbance, ataxia, amnesia and confusion even after completion of resuscitation and the return of normal oxygenation, this will indicate that: A. The client suffered from an irreversible brain damage B. That the client still needs to be evaluated for this is evidence that resuscitation is not yet complete C. That the client will need a longer rehabilitation to go back to the previous functioning D. That the client is exhibiting secondary gains Situation: The physician has ordered 3 units of whole blood to be transfused to WQ following a repair of a dissecting aneurysm of the aorta. 96. You are preparing the first unit of whole blood for transfusion. From the time you obtain it from the blood bank, how long should you infuse it? A. 6 hours B. 1 hour C. 4 hours D. 2 hours

97. What should you do FIRST before you administer blood transfusion? A. verify client identity and blood product, serial number, blood type, cross matching results, expiration date B. verify client identity and blood product serial number, blood type, cross matching results, expiration date with another nurse C. check IV site and use appropriate BT set and needle D. verify physicians order 98. As WQs nurse, what will you do AFTER the transfusion has started? A. add the total amount of blood to be transfused to the intake and output B. discontinue the primary IV of Dextrose 5% Water C. check the vital signs every 15 minutes D. stay with WQ for 15 minutes to note for any possible BT reactions 99. WQ is undergoing blood transfusions of the first unit. The EARLIEST signs of transfusion reactions are: A. oliguria and jaundice B. urticaria and wheezing C. hypertension and flushing D. headache, chills, fever

100. In case WQ will experience an acute hemolytic reaction, what will be your PRIORITY intervention? A. immediately stop the blood transfusion, infuse Dextrose 5% in Water and call the physician B. stop the blood transfusion and monitor the patient closely C. immediately stop the BT, infuse NSS, call the physician, notify the blood bank D. immediately stop the BT, notify the blood bank and administer antihistamines NURSING PRACTICE V Situation : Mrs. Andres brought his son, Juanito, age 3 to the Pediatric clinic. She noticed that her son is not speaking and tend to repeat everything she says. The mother also told the nurse that Juanito prefers to be alone, will cry when someone will come near him and tend to rock himself from morning till he will fell asleep. 1. An essential clinical feature of autistic disorder is: A. Inability to concentrate in any task B. Easily Distracted C. Stereotyped motor behaviors D. Poor motor skills 2. Headbanging is a common manifestation of an autistic child. A relevant nursing diagnosis would be: A. Activity intolerance B. Impaired physical mobility 3. According to freud, Juanity is at what psychosexual stage? A. Anal B. Oral C. Phallic D. Latency C. Risk for Injury D. Impaired skin integrity

4. Typically, if there is a change in the environment, the child will manifest which of the following? A. Clinging behavior B. Temper tantrums C. Suicide D. Talks incoherently

5. The best treatment approach for autistic children is encouraging their desired behavior through positive reinforcement. This is: A. Milieu Therapy B. Psychoanalysis C. Play Therapy D. Behavior Therapy

6. There is no definite cause identified for autism, but a strong link has been found on: A. Environmental factors B. Genetic factors 7. Which of the following is true about Autism? A. Autism is common among boys than girls B. Autism is common among girls than boys C. MMR vaccination has been strongly linked in the development of Autism D. Autistic children usually develops normal social skills 8. The mother of Juanito asked the nurse, When is autism diagnose? The nurse will respond: A. Autism is diagnosed after 3 years old B. Autism is diagnosed after 6 years old C. At 4 years old, Autism is diagnosed D. Autism is diagnosed before 3 years old 9. If a child with autism develops destructive behavior, The drug of choice that the nurse will expect that the physician will give to control self injury is: A. Chlorpromazine [Thorazine] B. Methylphenidate [Ritalin] C. Time-out D. Valium, Librium or other Anxiolytic C. Upbringing D. MMR vaccination

10. Chlorpromazine was given to the child. Which is true with regards to this medication? A. Expect that the child will be unusually alert and hyperactive during the therapeutic period B. The mother should decrease the fluid intake of the child as this drug causes fluid retention C. That the drug is given in order to decrease the childs hyperactivity D. The mother should avoid overexposing the child to sunlight for the child might develop rashes due to photosensitivity Situation : Mastery of Psychotropic medications is necessary for the therapeutic improvement in the health of the psychiatric clients. 11. Lithium is only given: A. P.O B. IM C. IV D. SQ

12. The nurse should expect that a client who cheeks the medication is a non-complaint patient. Knowing the non compliance is the single most important factor for exacerbation and rehospitalisation, the doctor ordered Prolixin [Fluphenazine Decanoate]. The nurse knows that is it given: A. Orally B. Sublingually C. IV D. IM

13. Which of the following is an antidepressant? A. B. C. D. Serenace (Haloperidol) Valium (Diazepam) Tofranil (Imipramine HCl) Trilaton (Pherpenazine)

14. The nurse knows that the relationship between sodium and lithium is that: A. When lithium increases, sodium also increases B. When sodium increases, lithium also increases C. They are inversely proportional D. They are directly proportional 15. Which of the following class of antidepressant is the least sedating? A. SSRI B. MAOI C. TCA D. Neuroleptics

Situation : Mang Cardo, Age 72, is a widower with moderate Alzheimers disease. Was brought to the home for the Aged by his married daughter. On admission, she says to the nurse, I never thought this would happen to us. I really feel guilty about bringing him here, I cant bear to part with him. 16. The nurses therapeutic response to Mang Carlos daughter is: A. You have indeed made a sound decision, Your father needs professional care which you cannot provide at home. B. Why are you feeling guilty bringing him here? C. I know that his has been a difficult time for you. You seemed troubled about bringing him here. D. You have done well everything for your father, Do not be upset. We will take care of him. 17. Initially, the nursing diagnosis would be: A. Impaired communication B. Impaired social interaction C. Altered thought process D. Altered family process

18. To guide the nurse in planning activities for Mang Carlos, The nurse should prioritize soliciting which information? A. Support system from the significant others B. Coping mechanism C. Routine activities at home D. The extent of memory impairment 19. Cardo appears to be awake and restless throughout the night, Which of the following is the medication you are expecting to be given? A. Diazepam [Valium] B. Chlorpromazine [Thorazine] C. Imipramine [Tofranil] D. Lithium [Lithane]

20. One morning, Mang Cardo has difficulty putting his pyjamas. In Alzheimers disease, this is known as: A. Aphasia B. Agnosia C. Apraxia D. Anomia

21. Which of the following is the cause of Dementia of the Alzheimers type? A. Unknown B. Decreased Acetylcholine C. Increasing Age D. Senile plaques deposition

22. The initial sign of Dementia is: A. Aphasia B. Forgetfullness C. Confusion D. Restlessness

23. Mang Cardo has been talking about how he got his scratch on his left arm, he told you that it was caused by a shard of glass that touches his skin accidentally. The next day, he told you that the scratch was caused by a knife he did not see that it fell from the table towards his arms. The next day, he said it was bitten by an ant and he scratched it because it was itchy. This is a symptom seen in Dementia known as: A. Confusion B. Altercation C. Aphasia D. Confabulation

24. Tacrine was given to the client and the nurse knows that which of the following enzyme is periodically checked? A. ALT B. Creatinine C. AST D. BUN

25. A client with Alzheimer's disease mumbles incoherently and rambles in a confused manner. To help redirect the client's attention, the nurse should encourage the client to: A. fold towels and pillowcases. B. participate in a game of charades. C. play cards with another client. D. perform an aerobic exercise.

Situation : A nurse is working with an aggressive client in the psychiatric unit. 26. All of the following concepts are true EXCEPT: A. Hostility is destructive B. Frustration develops in response to unmet needs, wants and desire C. Anger is always incompatible with love D. Aggression can be expressed in a constructive as well as a destructive manner. 27. Carlo is acting out hostile and aggressive feeling by kicking the chairs in the room. the MOST effective way to deal with Carlos behavior is initially to: A. B. C. D. Set limits on the behavior by verbal command Administer PRN tranquilizer Remove the chairs from the room Restrain the patient and place him in the Isolation Room

28. Mrs. Dizon was visiting her son at the Psychiatry Ward. Which of the following items will the nurse not allow to be brought inside the ward? A. String rosary bracelet B. Box of cake C. Bottle of coke D. Rubber shoes

29. Which of the following will probably be most therapeutic for a patient on a behavioral modification ward? A. B. C. D. If the client is agitated, discuss the feelings especially anger Insist to stop obscene language by verbal reprimand Give client support and positive feedback for controlling use of obscene language Provide a punching bag as an alternative to express upset emotions

30. Which of the following must be considered while planning activities for the depressed patient? A. B. C. D. Activities which require exertion of energy Challenging activities to get him out of his depression Structured activities that the client can participate Variety of unstructured activities

31. To maintain a therapeutic eye contact and body posture while interacting with angry and aggressive individual, the nurse should: A. B. C. D. keep an eye contact while staring at the client keep his/her hands behind his/her back or in ones pockets fold his/her arms across his/her chest keep an open posture, e.g. Hands by sides but palms turned outwards

32. A patient in the ward suddenly slapped you in the face and spitted on your face and is obviously agitated and violent. Which of the following is the best nursing action? A. Tell the client: Because of that, you are not going to eat your lunch, dinner and breakfast anymore. B. Slap the client back and say I am your nurse, you are a patient and you have no right to hurt me. C. Prepare a 5 member team to restraint the client D. Respond by saying You are losing control of yourself, you slapped me and you spitted on me and you are way out of control 33. Which of the following is an accurate way of reporting and recording an incident? A. B. C. D. When When When When asked about his relationship with asked about his relationship with asked about his relationship with asked about his relationship with his father, client became anxious. his father, client clenched his jaw/teeth, made a fist and turned away from the nurse. his father, client was resistant to respond his father, his anger was suppressed

34. To encourage thought, which of the following approaches is NOT therapeutic? A. B. C. D. Why do you feel angry? When do you usually feel angry? How do you usually express anger? What situations provoke you to be angry?

35. A patient grabs and about to throw it. The nurse best responds saying. A. B. C. D. Stop! Put that chair down. Dont be silly. Stop! The security will be here in a minute. Calm down.

Situation: In your professional nursing role, it is essential to establish a meaningful nurse-patient relationship. 36. A helping nurse patient relationship is characterized by which of the following?

A. Recovery promoting B. Growth facilitating

C. Mutual interaction D. Health enhancing

37. Demonstrating a helping relationship enables you to establish in the patient: A. Compliance to treatment B. Positive response to illness C. Gratitude to your services D. Some sense of trust in you 38. Therapeutic communication begins with: A. Knowing the patient B. Trust C. Interacting with the patient D. Knowing yourself

39. Which of the following approaches will most likely make your patient accept your help? A. Attending to all his needs B. Calling him by first name C. Demonstrating a relaxed and attending attitude D. Asking personal questions for health information

40. The client said I am troubled that my Son is starting to use drugs. The nurse replied, Its troubling and painful for you, I feel sorry about this. The nurses reply is an example of: A. Empathy B. Sympathy C. Telepathy D. Self awareness

41. Preparation for termination of the nurse-patient relationship begins during the: A. Termination phase B. Working phase C. Pre-orientation phase D. Orientation phase

42. The clients past reactions to ending relationships is withdrawal. The nurse assists her to practice better ways of coping termination by providing opportunities to: A. Test new patterns of behavior B. Plan for alternatives C. Conceptualize her problem D. Value and find meaning in experience

9. A male nurse reminds the client that is already time for group activities, The client responded by yelling to the nurse You are always telling me what to do! Just like my father! This is an example of: A. Symbolization C.Reaction Formation B. Transference D. Counter Transference 44. The longest and the most productive phase of the NPR is: A. Termination phase B. Working phase C. Pre-orientation phase D. Orientation phase

45. The objection of the nurse-patient relationship is to provide an opportunity of the patient to: A. Clarify problems B. Develop insights C. Have a corrective emotional experience D. Develop interpersonal relationship

Situation: Mental Retardation is an increasingly common childhood disorder that impairs learning. 46. Mental retardation is: A. a delay in normal growth and development caused by an inadequate environment B. a lack of development of sensory abilities C. a condition of subaverage intellectual functioning that originates during the developmental period and is associated with impairment in adaptive behavior D. a severe lag in neuromuscular development and motor abilities 47. An important principle for the nurse to follow in interacting with retarded children is: A. seen that if the child appears contented, his needs are being met B. provide an environment appropriate to their development task as scheduled C. treat the child according to his chronological age D. treat the child according to his developmental level 48. The child was classified as having an IQ of 55. This is said to be: A. Mild Mental Retardation B. Moderate Mental Retardation C. Severe Mental Retardation D. Profound Mental Retardation

49. Which of the following is true with regards to Mild Mental Retardation? A. Trainable, Can reach up to 2nd grade and can reach the maturity of a 7 year old B. Custodial and barely trainable C. Requires total care throughout life, Mental age of a young infant D. Educable, can reach up to grade 6 and has a maturity of a 12 year old 50. A child with an IQ of 35-49 is: A. Barely trainable B. Trainable C. Educable D. Requires total care

51. Which of the following is true with regards to mental retardation? A. Mental retardation is always accompanied by physical features B. Hereditary and perinatal factors do not result to mental retardation C. Mental retardation is a mental illness

D. Hereditary and perinatal factors are known to result to impaired intellectual functioning 52. The onset of mental retardation is before the child reaches what particular age? A. 17 B. 16 C. 15 D. 18

53. The possible nursing diagnosis for a mentally retarded child who is hyperactive is: A. Impaired physical mobility B. Potential for injury C. Impaired social adjustment D. Ineffective coping 54. A tranquilizing agent given in calming a hyperactive mentally retarded is: A. Chlorpromazine [Thorazine] B. Haloperidol [Haldol] C. Imipramine [Tofranil] D. Diazepam [Valium]

55. This form of psychotherapy allows the child to experience and express intense or troubling emotion in a safe environment with a caring individual: A. Play therapy B. Milieu therapy C. Behavior therapy D. Gestalt therapy

Situation : Margie has been diagnosed with Bipolar I disorder. The client demonstrates extreme psychomotor agitation, flight of ideas, loud talking and elated mood. 56. Which of the following is true about manic reaction? A. It is an expression of destructive impulse B. A means of coping with frustrations and disappointments C. A means of ignoring reality D. An attempt to ward of feelings of underlying depression 57. Nursing care plan for a client with Mania like Margie should give priority to: A. Discourage him from manipulating the staff B. Prevent him from assaulting other patient C. Protect him against suicidal attempts D. Provide adequate food and fluid intake 58. During a nurse patient interaction, Margie jumps rapidly from one topic to another, This is known as: A. Flight of Ideas B. Clang association C. Ideas of reference D. Neologism

59. Which of the following is a suitable activity that a nurse should assign for a Manic client? A. delivering supply of linen to other rooms B. conducting a drama workshop C. engaging in activity therapy and group exercises D. painting a mural with other patients 60. The doctor ordered lithium. You know that this is indicated in patients with: A. Depression B. Mania 61. Lithium has a narrow therapeutic range of: A. 0.1 to 1.0 mEq/L B. 0.6 to 1.2 mEq/L 62. Which of the following is a side effect of lithium toxicity? A. Anuria B. Oliguria C. Sudden burst of muscle strength D. Polyuria C. 10 to 50 mEq/L D. 50 to 100 mEq/L C. Schizophrenia D. Anxiety disorders

63. What specimen is taken from a client when checking the lithium level of the body? A. Blood B. Stool C. Urine D. Sweat

64. Which of the following is NOT a drug use to augment lithium toxicity? A. Urea B. Mannitol C. Aminophylline D. Acetylcysteine

65. The nurse has a standing order of Lithium for Margie. If the lithium level is 1.5 mEq/L, the nurse knows that she should: A. Administer the next dose and continue monitoring the client B. Report this to the physician C. Recheck the lithium level and validate first before doing any action D. Withhold the next dose and notify the physician Situation : Nursing informatics is a way of using information technology, computers and the internet in the improvement of nursing care. The first nursing informatics conference was held during 1977. 66. The ANA recognized nursing informatics heralding its establishment as a new field in nursing during what year? A. 1992 B. 1994 C. 2001 D. 2004

67. When is the first certification of nursing informatics given? A. 1992-1993 B. 1994-1995 C. 2001-2002 D. 2004-2005

68. Which of the following is the 3 integrated components of the nursing informatics? 1. Nursing science 2. Computer science 3. Health science 4. Information science

A. 1,2,3

B. 1,3,4

C. 1,2,4

D. 3,4,5

69. A textbook publisher wants to store large amount of data in a computer format that cannot be changed by other people. Which of the following would best serve this purpose? A. CD ROM B. Floppy disk C. RAM D. Network

70. The challenge most associated with the utilization of an electronic record system is which of the following? A. Cost B. Accuracy C. Privacy D. Curability

71. A client insists that the practitioner use a treatment method discovered on an internet data base. Which of the following response is most appropriate? A. The treatment must be examine to see if it is appropriate B. Most website treatments have not been studied or researched C. The person establishing the website is the only one who can use it on clients D. Websites are like advertising, they are biased and may not be legitimate. 72. This is a type of a computerized recording system that enables hospitals to organize various data such as admission, records, clinical laboratory, pharmacy, inventory and finance. A. Management information system B. Hospital information system C. University information system D. Government information system 73. A nurse, who is proficient in computers and information technology that uses these advantages to promote effective and secured use of computerized record is referred to as: A. Information technician B. Nursing IT C. Nursing information technician D. Nurse Informaticist

74. One advantage of a computerized recording system is that: The nursing diagnoses for a clients data can be accurately determined Cost of confinement will be reduced Information concerning the client can be easily updated The number of people to take care of the client will be reduced 75. You are to research the different types of oxygen delivery system. From the nasal cannula up to the venturi mask. Using nursing informatics, you found out different sources of information. One of the question that needs to be answered in your research is What type of oxygen delivery system is the most comfortable? you will answer: A. Nasal cannula, according to the American journal of nursing and medicine B. Face masks, according to a nursing blog site C. Venturi mask, according to Wikipedia D. Oxygen tents, according to a personal website from yahoo search engine Situation: Celina age 25, a ramp model, suddenly became blind after her boyfriend broke off with her. A thorough work up did not reveal any pathological findings. 76. The loss or alteration of physical functioning without organize cause bit is an expression of a psychological needs is known as: A. Somatization B. Depersonalization C. Hypochondriasis D. Conversion

77. Initially, the relevant nursing diagnosis the nurse includes in her care plan is: A. Self esteem disturbance B. Impaired adjustment C. Ineffective individual coping D. Ineffective denial 78. The defense mechanism commonly used by these clients is: A. Projection B. Rationalization 79. An appropriate nursing intervention which can help Celina is: A. Establishing a trusting relationship B. Encourage her to verbalize her feelings C. Reinforce reality D. Accept her limitation as a person 80. An effective modality of treatment for Celina would be: A. Milieu therapy B. Systematic desensitisation C. Cognitive-Behavioral therapy D. Psychopharmacology Situation : Records and Records management is one of the core of professional nursing practice. 81. The National Archives of the Phils. (NAP) is mandated by R.A. 9470 of 2007 to plan, formulate and implement records management and archival administration program for the efficient action, utilization, maintenance, retention, preservation, conservation and disposal of public records including the adoption of security measures and vital records protection program for the government and give technical assistance to all branches of government. Hospitals should safe keep their record and coordinate with which of the following agency for its disposal? A. National Archives of the Philippines B. Metropolitan Manila Development Authority C. Record Management and Archive Office D. Department Of Health 82. If The research team finished the research about Anas case and they are done disseminating data and after the report has been completed and written, Pre-processed data about Ana should be: C. Repression D. Sublimation

A. Preserved B. Destroyed by Burning or Shredding

C. Stored for future use D. Keep in a private file nobody can access

83. All of the following are purposes of the chart EXCEPT: A. To document the quality of care B. A vehicle for communication C. For the prerecording of nursing actions D. For research and education 84. What is an example of a subjective data? A. Color of wound drainage B. Odor of breath C. Respiration of 14 breaths/minute D. The patients statement of I feel sick to my stomach 85. Charting should be legible and include only standard abbreviations. Which of the following is NOT a standard abbreviation? A. PRN B. OD C. NNO D. NPO

Situation: A nurse should be aware that some problems in the emergency setting are not always physiologic. Sometimes, Crisis can affect the patient in an emergency setting. 86. Which of the following statements best describes acquaintance rape? A. Sexual intercourse when one person engaging in the activity is unsure about wanting to do so B. When two people dont love each other and engage in sexual activities C. When someone on a date tricks the other person into having sexual intercourse D. Sexual intercourse committed with force or the threat of force without a persons consent 87. Male to male rape is also another problem that a nurse can encounter. The nurse knows that in male to male rape, The perpetrator is usually: A. An effeminate male homosexual B. A young, newcomer heterosexual male C. A heterosexual who believes that he is superior D. A passive homosexual male

88. An 18 year old male client was rushed to the hospital due to burns, bruises and cuts on the face and body. The teenager confessed that he was raped by 4 of his classmates, all of which are also male. Male to male rape also occurs and the nurse must know that: A. If there is an erection, the male victim also consents to the rape itself. B. That all male to male rape cases occurs at home, which is statutory most of the time. C. That male rape victims are usually homosexuals. Which are very much deserving to be raped. D. Most victims of male to male rapes never dare to report the incident. 89. One of four factors describing the experience of sexually abused children and the effect it has on their growth and development is stigmatization. Stigma will occur when: A. A child blames him or herself for the sexual abuse and begins to withdraw and Isolate B. Newspapers and the media dont keep sexual abuse private and accidentally or on purpose reveal the name of the victim C. The child has been blamed by the abuser for his or her sexual behaviors, saying that the child asked to be touched or did not make the abuser to stop D. The childs agony is shared by other members of the family or friends when the sexual abuse becomes public knowledge 90. Which of the following is an example of hostile environment in terms of sexual harassment? A. the boss assures you of a big promotion if you go out on a couple of dates with him B. your supervisor makes masturbatory gestures every time you walk pass him C. the personnel manager hints that the job will be yours if you cooperate sexually with him D. your boss suggests that your raise is dependent upon having sex with him Situation : You are a nurse working in the medical ward. 91. Mr. E.O. age 52 had a laryngectomy due to cancer of the larynx. Discharge instructions are given to Mr.F.O. and his family. Which response by written communication from Mr. F.O. or verbal response from the family, will be a signal to the nurse that the instructions need to be reclarified? a. it is acceptable to take over-the-counter medications now that condition is stable b. the suctioning at home must be a clean procedure, not sterile. c. report swelling, pain or excessive drainage d. cleans skin around stoma BID, use hydrogen peroxide and rinse with water, pat dry. 92. Dr. Tuazon scheduled Mrs. Poe for a right breast mass incision with frozen section and possible mastectomy on Monday, first case. As the nurse in-charge for scheduling you will collaborate with the following departments EXCEPT: a. pathology b. dietary c. anesthesia d. surgery

93. A mother who is pregnant and has ovarian cancer has to undergo surgery to treat the cancer. In the process the fetus died. The doctrine that justifies the death of the fetus is: a. justice b. anatomy c. exception to the role d. double effect

94. A nurse is waiting for a report to be sent by fax. The machine activates but instead of the report, the nurse received a sexually oriented photograph. The MOST appropriate nursing action is to: a. call the nursing supervisor and report the incident b. cut the photograph and throw it away. c. call the police d. call the unit who sent it and ask for the name of person who sent the photograph 95. Ms. F.X.. has been admitted with right upper quadrant pain and has been placed on a low fat diet. Which of the following trays would be acceptable for her? a. liver, fried potatoes and avocado b. whole milk, rice and pastry c. ham, mashed potatoes, cream peas

d. skim milk, lean fish, tapioca pudding Situation : Some equipments and materials in our hospital are color coded, this is to increase the safety and proficiency of rendering patients care. 96. If a nurse has been ordered to prepare a spinal set gauge 16, the nurse knew that the color for that spinal set is coded at: A. Red B. Pink C. Yellow D. Blue

97. If the anaesthesiologist asked for a 22 gauge spinal set, the nurse knew that the color of the set that she will obtain is: A. Red B. Pink C. Yellow D. Blue

98. For pediatric patients, the spinal set is coded with color: A. Red B. Pink C. Yellow D. Blue

99. An anesthesiologist is preparing to do a spinal anesthesia to a 220 lb, 30 year old athlete she request the circulating nurse to prepare a pink spinal set with another blue set as stand by. What gauge spinal sets will make available in the OR suite? A. Gauge 16 and 22 B. Gauge 18 and 16 C. Gauge 16 and 20 D. Gauge 5 and 22 100. Medical gases are used a lot in the OR. Some gases are used to operate equipment and some are used to administer general anesthesia through inhalation. What is the identifying color of the tank which contains laughing gas? A. Yellow B. Green C. Black D. Blue