Situation: One of the realities that we are confronted with is our mortality. It is important for us nurses to be aware of how we view suffering, pain, illness, and even our death as well as its meaning. That way we can help our patients cope with death and dying.
1. Irma is terminally ill. She speaks to you in confidence. You now feel that Irma’s family could be helpful if they knew what Irma has told you. What should you do first?
a. Tell the physician who in turn could tell the family
b. Obtain Irma’s permission to share the information in the family
c. Tell Irma that she has to tell her family what she told you
d. Make an appointment to discuss the situation with the family
2. Ruby, who has been told she has terminal cancer, turns away and refuses to respond to you. You can best help her by:
a. Coming back periodically and indicating your availability if she would like you to sit with her.
b. Insisting that Ruby should talk with you because it is not good to keep everything inside
c. Leaving her alone because she is uncooperative and unpleasant to be with
d. Encourage her to be physically active as possible
3. Leo, who is terminally ill and recognizes that he is in the process of losing everything and everybody he loves, is depressed. Which of the following would best help him during his depression?
a. Arrange for visitors who might cheer him
b. Sit down and talk with him for a while
c. Encourage him to look at the brighter side of things
d. Sit silently with him
4. Which of the following statements would best indicate that Ruffy, who is dying, has accepted his impending death?
a. “I’m ready to go.”
b. “I have resigned myself to dying.”
c. “What’s the use?”
d. “I’m giving up.”
5. Marla, 90 years old, has planned ahead for her death—philosophically, socially, financially and emotionally. This is recognized as:
a. Acceptance that death is inevitable
b. Avoidance of the true situation
c. Denial with planning for continued life
d. Awareness that death will soon occur
Situation: Brain tumor, whether malignant or benign, has serious management implications. As a nurse, you should be able to understand the consequences of the disease and the treatment.
6. You are caring for Conrad who has a brain tumor and increased intracranial pressure (ICP). Which intervention should you include in your plan to reduce ICP?
a. administer bowel softener
b. position Conrad with his head turned toward the side of the tumor
c. provide sensory stimulation
d. encourage coughing and deep breathing
7. Keeping Conrad’s head and neck alignment results in:
a. increased intrathoracic pressure
b. increased venous outflow
c. decreased venous outflow
d. increased intra-abdominal pressure
8. Which of the following activities may increase intracranial pressure (ICP)?
a. raising the head of the bed
b. manual hyperventilation
c. use of osmotic diuretics
d. Valsalva maneuver
9. After you assess Conrad, you suspected increased ICP. Your most appropriate respiratory goal is to:
a. maintain partial pressure of arterial oxygen (PaO2) above 80 mmHg
b. lower arterial pH
c. prevent respiratory alkalosis
d. promote CO2 elimination
10. Conrad underwent craniotomy. As his nurse, you know that drainage on a craniotomy dressing must be measured and marked. Which findings should you report immediately to the surgeon?
a. foul-smelling drainage
b. greenish drainage
c. yellowish drainage
d. bloody drainage
Situation: As a nurse, you have specific responsibilities as a professional. You have to demonstrate specific competencies.
11. The essential components of professional nursing practice are all of the following EXCEPT:
a. Culture
b. Care
c. Cure
d. Coordination
12. You are assigned to care for four (4) patients. Which of the following patients should you give first priority?
a. Grace, who is terminally ill with breast cancer
b. Emy, who was previously lucid but is now unarousaable
c. Aris, who is newly admitted and is schedule for an executive check-up
d. Claire, who has cholelithiasis and is for operation on call
13. Brenda, the Nursing Supervisor of the intensive care unit (ICU) is not on duty when a staff nurse committed a serious medication error. Which statement accurately reflects the accountability of the nursing supervisor?
a. Brenda should be informed when she goes back on duty
b. Although Brenda is not on duty, the nursing supervisor on duty decides to call her if time permits
c. The nursing supervisor on duty will notify Brenda at home.
d. Brenda is not on duty therefore it is not necessary to inform her
14. Which barrier should you avoid to manage time wisely?
a. Practical planning
b. Pracrastination
c. Setting limits
d. Realistic personal expectation
15. You are caring for Vincent who has just been transferred to the private room. He is anxious because he fears he won’t be monitored as closely as he was in the Coronary Care Unit. How can you allay his fear?
a. Move his bed to a room far from the nurse’s station to reduce his anxiety
b. Assign the same nurse to him when possible
c. Allow Vincent uninterrupted period of time
d. Limit Vincent’s visitors to coincide with CCU policies
Situation: As a nurse in the oncology unit, you have to be prepared to provide safe, efficient and effective care to your patients.
16. Which one of the following nursing interventions would be MOST helpful in preparing the patient for radiation therapy?
a. offer tranquilizes and antiemetics
b. instruct the patient of the possibility of radiation burn
c. emphasis on the therapeutic value of the treatment
d. map out the precise course of the treatment
17. What side effects are most apt to occur to the patient during radiation therapy to the pelvis?
a. urinary retention
b. abnormal vaginal or perineal discharge
c. paresthesis of the lower extremities
d. nausea and vomiting and diarrhea
18. Which of the following can be used on the irradiate skin during a course or radiation therapy?
a. adhesive tape
b. mineral oil
c. talcum powder
d. zinc oxide ointment
19. Earliest sign of skin reaction to radiation therapy is:
a. desquamation
b. erythema
c. atrophy
d. pigmentation
20. What is the purpose of wearing a film badge while caring for the patient who is radioactive?
a. identify the nurse who is assigned to care for such a patient
b. prevent radiation-induced sterility
c. protect the nurse from radiation effects
d. measure the amount of exposure to radiation
Situation: In a disaster there must be a chain of command in place that defined the roles of each member of the response team. Within the health care group there are pre-assigned roles based on education, experience and training on disaster.
21. As a nurse, to which of the following groups are you BEST prepared to join?
a. Treatment group
b. Triage group
c. Morgue management
d. Transport group
22. There are important principles that should guide the triage team in disaster management that you have to know if you were to volunteer as part of the triage team. The following principles should be observed in disaster triage EXCEPT:
a. any disaster plan should have resources available to triage at each facility and at the disaster site if possible
b. make the most efficient use of available resources
c. training on the disaster is not important to the response in the event of a real disaster because each disaster is unique in itself
d. do the greatest good for the greatest number of casualties
23. Which of the following categories of conditions should be considered first priority in a disaster?
a. Intracranial pressure and mental status
b. Lower gastrointestinal problems
c. Respiratory infections
d. Trauma
24. A guideline that is utilized in determining priorities is to assess the status of the following EXCEPT:
a. perfusion
b. locomotion
c. respiration
d. mentation
25. The most important component of neurologic assessment is:
a. pupil reactivity
b. vital sign assessment
c. cranial nerve assessment
d. level of consciousness/responsiveness
Situation: You are going to participate in a Cancer Consciousness Week. You are assigned to take charge of the women to make them aware of cervical cancer. You reviewed its manifestations and management.
26. The following are risk factors for cervical cancer EXCEPT:
a. immunosuppressive therapy
b. sex at an early age, multiple partners, exposure to socially transmitted disease, male partner’s sexual habits
c. viral agents like the human papilloma virus (HPV)
d. smoking
27. Late signs and symptoms of cervical cancer include the following EXCEPT:
a. urinary / bowel changes
b. pain in pelvis, leg or flank
c. uterine bleeding
d. lymphedema of lower extremities
28. When a panhysterectomy is performed due to cancer of the cervix, which of the following organs are removed?
a. the uterus, cervix and one ovary
b. the uterus, cervix, and two-thirds of the vagina
c. the uterus, cervix, tubes and ovaries
d. the uterus and cervix
29. The primary modalities of treatment for Stage I and II-A cervical cancer include the following:
a. surgery, radiation therapy and hormone therapy
b. surgery
c. radiation therapy
d. surgery and radiation therapy
30. A common complication of hysterectomy:
a. thrombophlebitis of the pelvic and thigh vessels
b. diarrhea due to overstimulation
c. atelectasis
d. wound dehiscence
Situation: The body has regulatory mechanisms to maintain the needed electrolytes. However, there are conditions/surgical interventions that could compromise life. You have to understand how management of these conditions are done.
31. You are caring for Leda who is scheduled to undergo total thyroidectomy because of a diagnosis of thyroid cancer. Prior to total thyroidectomy, you should instruct Leda to:
a. Perform range and motion exercise on the head and neck
b. Apply gentle pressure against the incision when swallowing
c. Cough and deep breathe every 2 hours
d. Support head with the hands when changing position
32. As Leda’s nurse, you plan to set up an emergency equipment at her bedside following thyroidectomy. You should include:
a. An airway and rebreathing tue
b. A tracheostomy set and oxygen
c. A crash cart with bed board
d. Two ampules of sodium bicarbonate
33. Which of the following nursing interventions is appropriate after a total thyroidectomy?
a. Place pillows under your patient’s shoulders
b. Raise the knee-gatch to 30 degrees
c. Keep your patient in a high-Fowler’s position
d. Support the patient’s head and neck with pillows and sandbags
34. If there is an accidental injury to the parathyroid gland during a thyroidectomy, which of the following might Leda develop postoperatively?
a. Cardiac arrest
b. Dyspnea
c. Respiratory failure
d. Tetany
35. After surgery, Leda develops peripheral numbness, tingling and muscle twitching and spasm. What would you anticipate to administer?
a. Magnesium sulfate
b. Potassium iodide
c. Calcium gluconate
d. Potassium chloride
Situation: Nurses are involved in maintaining a safe and healthy environment. This is part of quality care management.
36. The first step in decontamination is:
a. to immediately apply a chemical decontamination foam to the area of contamination
b. a thorough soap and water wash and rinse of the patient
c. to immediately apply personal protective equipment
d. removal of the patient’s clothing and jewelry and then rinsing the patient with water
37. For a patient experiencing pruritus, you recommend which type of bath?
a. water
b. saline
c. colloidal (oatmeal)
d. sodium bicarbonate
38. Induction of vomiting is indicated for the accidental poisoning patient who has ingested:
a. rust remover
b. gasoline
c. toilet bowl cleaner
d. aspirin
39. Which of the following terms most precisely refers to an infection acquired in the hospital that was not present or incubating at the same time of hospital admission?
a. Secondary bloodstream infections
b. Nosocomial infection
c. Emerging infectious disease
d. Primary bloodstream infection
40. Which of the following guidelines is not appropriate to helping family members cope with sudden death?
a. Obtain orders for sedation of family members
b. Provide details of the factors attendant to the sudden death
c. Show acceptance of the body by touching it and giving the family permission to touch
d. Inform the family that the patient has passed away
Situation: As a nurse you are expected to participate in initiating or participating in the conduct of research studies to improve nursing practice. You have to be updated on the latest trends and issues affecting profession and the best practices arrived at by the profession.
41. You are interested to study the effects of meditation and relaxation on the pain experienced by cancer patients. What type of variable is pain?
a. Dependent
b. Correlational
c. Independent
d. Demographic
42. You would like to compare the support system of patients with chronic illness to those with acute illness. How will you BEST state your position?
a. A Descriptive Study to Compare the Support System of Patients with Chronic Illness and Those with Acute Illness in Terms of Demographic Data and Knowledge About Interventions
b. The Effect of the Type of Support System of Patients with Chronic Illness and Those with Acute Illness
c. A Comparative Analysis of the Support System of Patients with Chronic Illness and Those with Acute Illness
d. A Study to Compare the Support System of Patients with Chronic Illness and Those with Acute Illness
43. You would like to compare the support system of patients with chronic illness to those with acute illness. What type of research is this?
a. Correlational
b. Descriptive
c. Experimental
d. Quasi-Experimental
44. You are shown a Likert Scale that will be used in evaluating your performance in the clinical area. Which of the following questions will you not use in critiquing the Likert Scale?
a. Are the techniques to compete and score the scale provided?
b. Are the reliability and validity information on the scale described?
c. If the Likert Scale is to be used for a study, was the development process described?
d. Is the instrument clearly described?
45. In any research study where individual persons are involved, it is important that an informed consent for the study is obtained. The following are essential information about the consent that you should disclose to the prospective subjects EXCEPT:
a. consent to incomplete disclosure
b. descriptions of benefits, risks and discomforts
c. explanation of procedure
d. assurance of anonymity and confidentiality
Situation: Because severe burns can affect the person’s totality, it is important that you apply interventions focusing on the various dimensions of man. You also have to understand the rationale of the treatment.
46. What type of debridement involves proteolytic enzymes?
a. interventional
b. mechanical
c. surgical
d. chemical
47. Which topical antimicrobial is most frequently used in burn wound care?
a. Neosoporin
b. Silver nitrate
c. Silver sulfadiazine
d. Sulfamycin
48. Hypertrophic burn scars are caused by;
a. exaggerated contraction
b. random layering of collagen
c. wound ischemia
d. delayed epithelialization
49. The major disadvantage of whirlpool cleansing of burn wound is:
a. patient hypothermia
b. cross-contamination of wound
c. patient discomfort
d. excessive manpower requirement
50. Oral analgesics are most frequently used to control burn injury pain…
a. upon patient request
d. during the emergent phase
c. after hospital discharge
d. during the acute phase
Saturday, November 14, 2009
Q & A: Practice like the real thing! - ALL TOPICS : Lap 9 (50 questions)
Situation: You are working as a Pediatric Nurse in your own Child Health Nursing Clinic. The following cases pertain to assessment and care of the newborn-at-risk conditions.
1. Theresa, a mother with a 2-year old daughter asks, “At what age can I be able to take the blood pressure of my daughter as a routine procedure since hypertension is common in the family?” Your answer to this is:
a. At 2 years you may
b. As early as 1 year old
c. When she’s 3 years old
d. When she’s 6 years old
2. You typically gag children to inspect the back of their throat. When is it important NOT to elicit a gag reflex?
a. when a girl has a geographic tongue
b. When a boy has a possible inguinal hernia
c. When a child has symptoms of epiglottitis
d. When children are under 5 years of age
3. Baby John was given a drug at birth to reverse the effects of a narcotic given to his mother in labor. What drug is commonly used for this?
a. Naloxone (Narcan)
b. Morphine Sulfate
c. Sodium Chloride
d. Penicilllin G
4. Why are small-for-gestational age newborns at risk for difficulty maintaining body temperature?
a. They do not have as many fat stores as other infants
b. They are more active than usual so throw off covers
c. Their skin is more susceptible to conduction of cold
d. They are pre-term so are born relatively small in size
5. Baby John develops hyperbilirubinemia. What is a method used to treat hyperbilirubinemia in a newborn?
a. Keeping infants in a warm and dark environment
b. Administration of cardiovascular stimulant
c. Gentle exercise to stop muscle breakdown
Situation: You are the nurse in the Out-Patient Department and during your shift, you encountered multiple children’s condition. The following questions apply.
6. You assessed a child with visible severe wasting. He has:
a. edema
b. LBM
c. Kwashiorkor
d. Marasmus
7. Which of the following conditions is NOT true about contraindication to immunization?
a. Do not give DPT2 or DPT3 to a child who has had convulsions within 3 days of DPT
b. Do not give BCG if the child has known hepatitis
c. Do not give DPT to a child who has recurrent convulsion or active neurologic disease
d. Do not give BCG if the child has known AIDS
8. Which of the following statements about immunization is NOT true:
a. A child with diarrhea who is due for OPV should receive the OPV and make extra dose on the next visit
b. There is no contraindication to immunization if the child is well enough to go home
c. There is no contraindication to immunization if the child is well enough to go home and a child should be immunized in the health center before referral are both correct
d. A child should be immunized in the health center before referral
9. A child with visible severe wasting or severe palmar pallor may be classified as:
a. moderate malnutrition/anemia
b. severe malnutrition/anemia
c. not very low weight no anemia
d. anemia/very low weight
10. A child has some palmar pallor can be classified as:
a. moderate anemia/normal weight
b. severe malnutrition/anemia
c. anemia/very low weight
d. not very low weight no anemia
Situation: Nette, a nurse, palpates the abdomen of Mrs. Medina, a primigravida. She is unsure of the date of her last menstrual period. Leopold’s Maneuver is done. The obstetrician told her that she appears to be 20 weeks pregnant.
11. Nette explains this because the fundus is:
a. At the level of the umbilicus, and the fetal heart can be heard with a fetoscope
b. 18 cm, and the baby is just about to move
c. Is just over the symphysis, and fetal heart cannot be heard
d. 28 cm, and fetal heart can be heard with a Doppler
12. In doing Leopold’s Maneuver, which among the following is NOT considered a good preparation?
a. The woman should lie in a supine position with her knees flexed slightly
b. The hands of the nurse should be cold so that abdominal muscles would contract and tighten
c. Be certain that your hands are warm (by washing them in warm water first if necessary)
d. The woman empties her bladder before palpation
13. In her pregnancy, she experienced fatigue and drowsiness. This probably occurs because:
a. of high blood pressure
b. she is expressing pressure
c. the fetus utilizes her glucose stores and leaves her with a low blood glucose
d. of the rapid growth of the fetus
14. The nurse assesses the woman at 20 weeks gestation and expects the woman to report:
a. Spotting related to fetal implantation
b. Symptoms of diabetes as human placental lactogen is released
c. Feeling fetal kicks
d. Nausea and vomiting related to HCG production
15. Mrs. Medina comes to you for check-up on June 2. Her EDC is June 11. What do you expect during assessment.
a. Fundic height 2 fingers below xyphoid process, engaged
b. Cervix closed, uneffaced, fundic heigh midway between the umbilicus and symphysis pubis
c. Cervix open, fundic height 2 fingers below xyphoid process, floating
d. Fundic height at least at the leve of the xyphoid process, engaged
Situation: Please continue responding as a professional nurse in these varied health situations through the following questions.
16. Which of the following medications would the nurse expect the physician to order for recurrent convulsive seizures of a 10-year old child brought to your clinic?
a. Phenobarbital
b. Nifedipine
c. Butorphanol
d. Diazepam
17. RhoGAM is given to Rh-negative women to prevent maternal sensitization from occurring. The nurse is aware that in addition to pregnancy, Rh-negative women would also receive this medication after which of the following?
a. Unsuccessful artificial insemination procedure
b. Blood transfusion after hemorrhage
c. Therapeutic or spontaneous abortion
d. Head injury from a car accident
18. Which of the following would the nurse include when describing the pathophysiology of gestational diabetes?
a. Glucose levels decrease to accommodate fetal growth
b. Hypoinsulinemia develops early in the first trimester
c. Pregnancy fosters the development of carbohydrate cravings
d. There is progressive resistance to the effects of insulin
19. When providing prenatal education to a pregnant woman with asthma, which of the following would be important for the nurse to do?
a. Demonstrate how to assess her blood glucose levels
b. Teach correct administration of subcutaneous bronchodilators
c. Ensure she seeks treatment for any acute exacerbation
d. Explain that she should avoid steroids during her pregnancy
20. Which of the following conditions would cause an insulin-dependent diabetic client the most difficulty during her pregnancy?
a. Rh incompatibility
b. Placenta Previa
c. Hyperemesis Gravidarum
d. Abruptio Placenta
Situation: One important tool a community health nurse uses in the conduct of his/her activities is the CHN Bag. Which of the following best describes the use of this vital facility for our practice?
21. The community / Public Health Bag is:
a. a requirement for home visits
b. an essential and indispensable equipment of the community health nurse
c. contains basic medications and articles used by the community health nurse
d. a tool used by the Community health nurse in rendering effective nursing procedures during a home visit
22. What is the rationale in the use of bag technique during home visits?
a. It helps render effective nursing care to clients or other members of the family
b. It saves time and effort of the nurse in the performance of nursing procedures
c. It should minimize or prevent the spread of infection from individuals to families
d. It should not overshadow concerns for the patient
23. Which among the following is important in the use of the bag technique during home visit?
a. Arrangement of the bag’s contents must be convenient to the nurse
b. The bag should contain all necessary supplies and equipment ready for use
c. Be sure to thoroughly clean your bag especially when exposed to communicable disease cases
d. Minimize if not totally prevent the spread of infection
24. This is an important procedure of the nurse during home visits:
a. protection of the CHN bag
b. arrangement of the contents of the CHN bag
c. cleaning of the CHN bag
d. proper handwashing
25. In consideration of the steps in applying the bag technique, which side of the paper lining of the CHN bag is considered clean to make a non-contaminated work area?
a. The lower tip
b. The outer surface
c. The upper tip
d. The inside surface
Situation: As a Community Health Nurse relating with people in different communities, and in the implementation of health programs and projects, you experience vividly as well the varying forms of leadership and management from the Barangay Level to the Local Government / Municipal or City Levl.
26. The following statements can correctly be made about organization and management
A – An organization (or company) is people. Values make people persons; values give vitality, meaning and direction to a company. As the people of an organization value, so the company becomes.
B – Management is the process by which administration achieves its mission, goals, and objectives.
C – Management effectiveness can be measured in terms of accomplishment of the purpose of the organization while management efficiency is measured in terms of the satisfaction of individual motives.
D – Management principles are universal. Therefore, one need not be concerned about peoples, culture, values, traditions and human relations.
a. B and C only
b. A, B and D only
c. A and D only
d. B, A and C only
27. Management by Filipino values advocate the consideration of the Filipino goals trilogy according to the Filipino priority-values which are:
a. Family goals, national goals, organizational goals
b. Organizational goals, national goals, family goals
c. National goals, organizational goals, family goals
d. Family goals, organizational goals, national goals
28. Since the advocacy for the utilization of Filipino value-system in management has been encouraged, the Nursing sector is no exception. Management needs to examine Filipino values and discover its positive potentials and harness them to achieve:
a. Employee satisfaction
b. Organizational commitments, organizational objectives and employee satisfaction
c. Employee objectives/satisfaction, commitments and organizational objectives
d. Organizational objectives, commitments and employee objective/satisfaction
29. The following statements can correctly be made about an effective and efficient community or even agency managerial-leader
A - Considers the achievement and advancement of the organization she/he represents as well as his people
B - Considers the recognition of individual efforts toward the realization of organizational goals as well as the welfare of his people
C - Considers the welfare of the organization above all other consideration by higher administration
D - Considers its own recognition by higher administration for purposes of promotion and prestige
a. Only C and D are correct
b. A, C and D are correct
c. B, C and D are correct
d. Only A and B are correct
30. Whether management at the community or agency level, there are 3 essential types of skills managers must have. These are:
A - Human relation skills, technical skills and cognitive skills
B - Conceptual skills, human relation/behavioral skills and technical skills
C – Technical skills, budget and accounting skills, skills in fund-raising
D – Manipulative skills, technical skill, resource management skills
a. A and D are correct
b. B is correct
c. A is correct
d. C and D are correct
Situation: You are an actively practicing nurse who just finished your Graduate Studies. You learned the value of Research and would like to utilize the knowledge and skills gained in the application of research to Nursing service. The following questions apply to research.
31. Which type of research inquiry investigates the issues of human complexity (e.g. understanding the human experience)?
a. Logical positivism
b. Naturalistic inquiry
c. Positivism
D. Quantitative research
32. Which of the following studies is based on quantitative research?
a. A study examining the bereavement process in spouses of clients with terminal cancer
b. A study exploring factors influencing weight control behavior
c. A study measuring the effects of sleep deprivation on wound healing
d. A study examining the client’s feeling before, during and after a bone marrow aspiration
33. Which of the following studies is based on qualitative research?
a. A study examining clients’ reactions to stress after open heart surgery
b. A study measuring nutrition and weight loss / gain in clients with cancer
c. A study measuring oxygen levels after endotracheal suctioning
d. A study measuring differences in blood pressure before, during and after a procedure
34. An 85-year old client in a nursing home tells a nurse, “I signed the papers for that research study because the doctor was so insistent and I want him to continue taking care of me.” Which client right is being violated?
a. Right to self-determination
b. Right to privacy and confidentiality
c. Right to full disclosure
d. Right not to be harmed
35. “A supposition or system of ideas that is proposed to explain a given phenomenon” best defines:
a. a paradigm
b. a concept
c. a theory
d. a conceptual framework
Situation: Nurse Michelle works with a Family Nursing Team in Calbayog Province specifically handling a UNICEF project for children. The following conditions pertain to care of the family with preschoolers.
36. Ronnie asks constant questions. How many does a typical 3-year old ask in a day’s time?
a. 1,200 or more
b. Less than 50
c. 100-200
d. 300-400
37. Ronnie will need to change to a new bed because his baby sister will need Ronnie’s old crib. What measure would you suggest that his parents take to help decrease sibling rivalry between Ronnie and his new sister?
a. Move him to the new bed before the baby arrives
b. Explain that new sisters grow up to become best friends
c. Tell him he will have to share with the new baby
d. Ask him to get his crib ready for the new baby
38. Ronnie’s parents want to know how to react to him when he begins to masturbate while watching television. What would you suggest?
a. They refuse to allow him to watch television
b. They schedule a health check-up for sex-related disease
c. They remind him that some activities are private
d. They give her “timeout” when this begins
39. How many words does a typical 12-month-old-infant use?
a. About 12 words
b. Twenty or more words
c. About 50 words
d. Two, plus “mama” and “papa”
40. As a nurse, you reviewed infant safety procedures with Bryan’s mother. What are two of the most common types of accidents among infants?
a. aspiration and falls
b. falls and auto accidents
c. poisoning and burns
d. drowning and homicide
Situation: Among common conditions found in children especially among poor communities are ear infections/problems. The following questions apply.
41. A child with ear problem should be assessed for the following EXCEPT;
a. Is there any fever?
b. Ear discharge
c. If discharge is present, for how long?
d. Ear pain
42. If the child does not have ear problem, using IMCI, what should you as the nurse do?
a. Check for ear discharge
b. Check for tender swellings behind the ear
c. Check for ear pain
d. Go to the next question, check for malnutrition
43. An ear discharge that has been present for more than 14 days can be classified as:
a. mastoiditis
b. chronic ear infection
c. acute ear infection
d. complicated ear infection
44. An ear discharge that has been present for less than 14 days can be classified as:
a. chronic ear infection
b. mastoiditis
c. acute ear infection
d. complicated ear infection
45. If the child has “severe” classification because of ear problem, what would be the best thing that you as the nurse can do?
a. instruct mother when to return immediately
b. refer urgently
c. give an antibiotic for 5 days
d. dry the ear by wicking
Situation: If the child with diarrhea registers one sign in the pink row and one in the yellow row in the IMCI chart…
46. We can classify the patient as:
a. moderate dehydration
b. some dehydration
c. no dehydration
d. severe dehydration
47. The child with no dehydration needs home treatment. Which of the following is NOT included in the rules for home treatment in this case?
a. continue feeding the child
b. give Oresol every 4 hours
c. know when to return to the health center
d. give the child extra fluids
48. A child who has had diarrhea for 14 days but has no sign of dehydration is classified as:
a. severe persistent diarrhea
b. dysentery
c. severe dysentery
d. persistent diarrhea
49. If the child has sunken eyes, drinking eagerly, thirsty and skin pinch goes back slowly, the classification would be”
a. no dehydration
b. moderate dehydration
c. some dehydration
d. severe dehydration
50. Carlo has had diarrhea for 5 days. There is no blood in the stool. He is irritable. His eyes are sunken. The nurse offers fluid to Carlo and he drinks eagerly. When the nurse pinched the abdomen, it goes back slowly. How will you classify Carlo’s illness?
a. severe dehydration
b. no dehydration
c. some dehydration
d. moderate dehydration
1. Theresa, a mother with a 2-year old daughter asks, “At what age can I be able to take the blood pressure of my daughter as a routine procedure since hypertension is common in the family?” Your answer to this is:
a. At 2 years you may
b. As early as 1 year old
c. When she’s 3 years old
d. When she’s 6 years old
2. You typically gag children to inspect the back of their throat. When is it important NOT to elicit a gag reflex?
a. when a girl has a geographic tongue
b. When a boy has a possible inguinal hernia
c. When a child has symptoms of epiglottitis
d. When children are under 5 years of age
3. Baby John was given a drug at birth to reverse the effects of a narcotic given to his mother in labor. What drug is commonly used for this?
a. Naloxone (Narcan)
b. Morphine Sulfate
c. Sodium Chloride
d. Penicilllin G
4. Why are small-for-gestational age newborns at risk for difficulty maintaining body temperature?
a. They do not have as many fat stores as other infants
b. They are more active than usual so throw off covers
c. Their skin is more susceptible to conduction of cold
d. They are pre-term so are born relatively small in size
5. Baby John develops hyperbilirubinemia. What is a method used to treat hyperbilirubinemia in a newborn?
a. Keeping infants in a warm and dark environment
b. Administration of cardiovascular stimulant
c. Gentle exercise to stop muscle breakdown
Situation: You are the nurse in the Out-Patient Department and during your shift, you encountered multiple children’s condition. The following questions apply.
6. You assessed a child with visible severe wasting. He has:
a. edema
b. LBM
c. Kwashiorkor
d. Marasmus
7. Which of the following conditions is NOT true about contraindication to immunization?
a. Do not give DPT2 or DPT3 to a child who has had convulsions within 3 days of DPT
b. Do not give BCG if the child has known hepatitis
c. Do not give DPT to a child who has recurrent convulsion or active neurologic disease
d. Do not give BCG if the child has known AIDS
8. Which of the following statements about immunization is NOT true:
a. A child with diarrhea who is due for OPV should receive the OPV and make extra dose on the next visit
b. There is no contraindication to immunization if the child is well enough to go home
c. There is no contraindication to immunization if the child is well enough to go home and a child should be immunized in the health center before referral are both correct
d. A child should be immunized in the health center before referral
9. A child with visible severe wasting or severe palmar pallor may be classified as:
a. moderate malnutrition/anemia
b. severe malnutrition/anemia
c. not very low weight no anemia
d. anemia/very low weight
10. A child has some palmar pallor can be classified as:
a. moderate anemia/normal weight
b. severe malnutrition/anemia
c. anemia/very low weight
d. not very low weight no anemia
Situation: Nette, a nurse, palpates the abdomen of Mrs. Medina, a primigravida. She is unsure of the date of her last menstrual period. Leopold’s Maneuver is done. The obstetrician told her that she appears to be 20 weeks pregnant.
11. Nette explains this because the fundus is:
a. At the level of the umbilicus, and the fetal heart can be heard with a fetoscope
b. 18 cm, and the baby is just about to move
c. Is just over the symphysis, and fetal heart cannot be heard
d. 28 cm, and fetal heart can be heard with a Doppler
12. In doing Leopold’s Maneuver, which among the following is NOT considered a good preparation?
a. The woman should lie in a supine position with her knees flexed slightly
b. The hands of the nurse should be cold so that abdominal muscles would contract and tighten
c. Be certain that your hands are warm (by washing them in warm water first if necessary)
d. The woman empties her bladder before palpation
13. In her pregnancy, she experienced fatigue and drowsiness. This probably occurs because:
a. of high blood pressure
b. she is expressing pressure
c. the fetus utilizes her glucose stores and leaves her with a low blood glucose
d. of the rapid growth of the fetus
14. The nurse assesses the woman at 20 weeks gestation and expects the woman to report:
a. Spotting related to fetal implantation
b. Symptoms of diabetes as human placental lactogen is released
c. Feeling fetal kicks
d. Nausea and vomiting related to HCG production
15. Mrs. Medina comes to you for check-up on June 2. Her EDC is June 11. What do you expect during assessment.
a. Fundic height 2 fingers below xyphoid process, engaged
b. Cervix closed, uneffaced, fundic heigh midway between the umbilicus and symphysis pubis
c. Cervix open, fundic height 2 fingers below xyphoid process, floating
d. Fundic height at least at the leve of the xyphoid process, engaged
Situation: Please continue responding as a professional nurse in these varied health situations through the following questions.
16. Which of the following medications would the nurse expect the physician to order for recurrent convulsive seizures of a 10-year old child brought to your clinic?
a. Phenobarbital
b. Nifedipine
c. Butorphanol
d. Diazepam
17. RhoGAM is given to Rh-negative women to prevent maternal sensitization from occurring. The nurse is aware that in addition to pregnancy, Rh-negative women would also receive this medication after which of the following?
a. Unsuccessful artificial insemination procedure
b. Blood transfusion after hemorrhage
c. Therapeutic or spontaneous abortion
d. Head injury from a car accident
18. Which of the following would the nurse include when describing the pathophysiology of gestational diabetes?
a. Glucose levels decrease to accommodate fetal growth
b. Hypoinsulinemia develops early in the first trimester
c. Pregnancy fosters the development of carbohydrate cravings
d. There is progressive resistance to the effects of insulin
19. When providing prenatal education to a pregnant woman with asthma, which of the following would be important for the nurse to do?
a. Demonstrate how to assess her blood glucose levels
b. Teach correct administration of subcutaneous bronchodilators
c. Ensure she seeks treatment for any acute exacerbation
d. Explain that she should avoid steroids during her pregnancy
20. Which of the following conditions would cause an insulin-dependent diabetic client the most difficulty during her pregnancy?
a. Rh incompatibility
b. Placenta Previa
c. Hyperemesis Gravidarum
d. Abruptio Placenta
Situation: One important tool a community health nurse uses in the conduct of his/her activities is the CHN Bag. Which of the following best describes the use of this vital facility for our practice?
21. The community / Public Health Bag is:
a. a requirement for home visits
b. an essential and indispensable equipment of the community health nurse
c. contains basic medications and articles used by the community health nurse
d. a tool used by the Community health nurse in rendering effective nursing procedures during a home visit
22. What is the rationale in the use of bag technique during home visits?
a. It helps render effective nursing care to clients or other members of the family
b. It saves time and effort of the nurse in the performance of nursing procedures
c. It should minimize or prevent the spread of infection from individuals to families
d. It should not overshadow concerns for the patient
23. Which among the following is important in the use of the bag technique during home visit?
a. Arrangement of the bag’s contents must be convenient to the nurse
b. The bag should contain all necessary supplies and equipment ready for use
c. Be sure to thoroughly clean your bag especially when exposed to communicable disease cases
d. Minimize if not totally prevent the spread of infection
24. This is an important procedure of the nurse during home visits:
a. protection of the CHN bag
b. arrangement of the contents of the CHN bag
c. cleaning of the CHN bag
d. proper handwashing
25. In consideration of the steps in applying the bag technique, which side of the paper lining of the CHN bag is considered clean to make a non-contaminated work area?
a. The lower tip
b. The outer surface
c. The upper tip
d. The inside surface
Situation: As a Community Health Nurse relating with people in different communities, and in the implementation of health programs and projects, you experience vividly as well the varying forms of leadership and management from the Barangay Level to the Local Government / Municipal or City Levl.
26. The following statements can correctly be made about organization and management
A – An organization (or company) is people. Values make people persons; values give vitality, meaning and direction to a company. As the people of an organization value, so the company becomes.
B – Management is the process by which administration achieves its mission, goals, and objectives.
C – Management effectiveness can be measured in terms of accomplishment of the purpose of the organization while management efficiency is measured in terms of the satisfaction of individual motives.
D – Management principles are universal. Therefore, one need not be concerned about peoples, culture, values, traditions and human relations.
a. B and C only
b. A, B and D only
c. A and D only
d. B, A and C only
27. Management by Filipino values advocate the consideration of the Filipino goals trilogy according to the Filipino priority-values which are:
a. Family goals, national goals, organizational goals
b. Organizational goals, national goals, family goals
c. National goals, organizational goals, family goals
d. Family goals, organizational goals, national goals
28. Since the advocacy for the utilization of Filipino value-system in management has been encouraged, the Nursing sector is no exception. Management needs to examine Filipino values and discover its positive potentials and harness them to achieve:
a. Employee satisfaction
b. Organizational commitments, organizational objectives and employee satisfaction
c. Employee objectives/satisfaction, commitments and organizational objectives
d. Organizational objectives, commitments and employee objective/satisfaction
29. The following statements can correctly be made about an effective and efficient community or even agency managerial-leader
A - Considers the achievement and advancement of the organization she/he represents as well as his people
B - Considers the recognition of individual efforts toward the realization of organizational goals as well as the welfare of his people
C - Considers the welfare of the organization above all other consideration by higher administration
D - Considers its own recognition by higher administration for purposes of promotion and prestige
a. Only C and D are correct
b. A, C and D are correct
c. B, C and D are correct
d. Only A and B are correct
30. Whether management at the community or agency level, there are 3 essential types of skills managers must have. These are:
A - Human relation skills, technical skills and cognitive skills
B - Conceptual skills, human relation/behavioral skills and technical skills
C – Technical skills, budget and accounting skills, skills in fund-raising
D – Manipulative skills, technical skill, resource management skills
a. A and D are correct
b. B is correct
c. A is correct
d. C and D are correct
Situation: You are an actively practicing nurse who just finished your Graduate Studies. You learned the value of Research and would like to utilize the knowledge and skills gained in the application of research to Nursing service. The following questions apply to research.
31. Which type of research inquiry investigates the issues of human complexity (e.g. understanding the human experience)?
a. Logical positivism
b. Naturalistic inquiry
c. Positivism
D. Quantitative research
32. Which of the following studies is based on quantitative research?
a. A study examining the bereavement process in spouses of clients with terminal cancer
b. A study exploring factors influencing weight control behavior
c. A study measuring the effects of sleep deprivation on wound healing
d. A study examining the client’s feeling before, during and after a bone marrow aspiration
33. Which of the following studies is based on qualitative research?
a. A study examining clients’ reactions to stress after open heart surgery
b. A study measuring nutrition and weight loss / gain in clients with cancer
c. A study measuring oxygen levels after endotracheal suctioning
d. A study measuring differences in blood pressure before, during and after a procedure
34. An 85-year old client in a nursing home tells a nurse, “I signed the papers for that research study because the doctor was so insistent and I want him to continue taking care of me.” Which client right is being violated?
a. Right to self-determination
b. Right to privacy and confidentiality
c. Right to full disclosure
d. Right not to be harmed
35. “A supposition or system of ideas that is proposed to explain a given phenomenon” best defines:
a. a paradigm
b. a concept
c. a theory
d. a conceptual framework
Situation: Nurse Michelle works with a Family Nursing Team in Calbayog Province specifically handling a UNICEF project for children. The following conditions pertain to care of the family with preschoolers.
36. Ronnie asks constant questions. How many does a typical 3-year old ask in a day’s time?
a. 1,200 or more
b. Less than 50
c. 100-200
d. 300-400
37. Ronnie will need to change to a new bed because his baby sister will need Ronnie’s old crib. What measure would you suggest that his parents take to help decrease sibling rivalry between Ronnie and his new sister?
a. Move him to the new bed before the baby arrives
b. Explain that new sisters grow up to become best friends
c. Tell him he will have to share with the new baby
d. Ask him to get his crib ready for the new baby
38. Ronnie’s parents want to know how to react to him when he begins to masturbate while watching television. What would you suggest?
a. They refuse to allow him to watch television
b. They schedule a health check-up for sex-related disease
c. They remind him that some activities are private
d. They give her “timeout” when this begins
39. How many words does a typical 12-month-old-infant use?
a. About 12 words
b. Twenty or more words
c. About 50 words
d. Two, plus “mama” and “papa”
40. As a nurse, you reviewed infant safety procedures with Bryan’s mother. What are two of the most common types of accidents among infants?
a. aspiration and falls
b. falls and auto accidents
c. poisoning and burns
d. drowning and homicide
Situation: Among common conditions found in children especially among poor communities are ear infections/problems. The following questions apply.
41. A child with ear problem should be assessed for the following EXCEPT;
a. Is there any fever?
b. Ear discharge
c. If discharge is present, for how long?
d. Ear pain
42. If the child does not have ear problem, using IMCI, what should you as the nurse do?
a. Check for ear discharge
b. Check for tender swellings behind the ear
c. Check for ear pain
d. Go to the next question, check for malnutrition
43. An ear discharge that has been present for more than 14 days can be classified as:
a. mastoiditis
b. chronic ear infection
c. acute ear infection
d. complicated ear infection
44. An ear discharge that has been present for less than 14 days can be classified as:
a. chronic ear infection
b. mastoiditis
c. acute ear infection
d. complicated ear infection
45. If the child has “severe” classification because of ear problem, what would be the best thing that you as the nurse can do?
a. instruct mother when to return immediately
b. refer urgently
c. give an antibiotic for 5 days
d. dry the ear by wicking
Situation: If the child with diarrhea registers one sign in the pink row and one in the yellow row in the IMCI chart…
46. We can classify the patient as:
a. moderate dehydration
b. some dehydration
c. no dehydration
d. severe dehydration
47. The child with no dehydration needs home treatment. Which of the following is NOT included in the rules for home treatment in this case?
a. continue feeding the child
b. give Oresol every 4 hours
c. know when to return to the health center
d. give the child extra fluids
48. A child who has had diarrhea for 14 days but has no sign of dehydration is classified as:
a. severe persistent diarrhea
b. dysentery
c. severe dysentery
d. persistent diarrhea
49. If the child has sunken eyes, drinking eagerly, thirsty and skin pinch goes back slowly, the classification would be”
a. no dehydration
b. moderate dehydration
c. some dehydration
d. severe dehydration
50. Carlo has had diarrhea for 5 days. There is no blood in the stool. He is irritable. His eyes are sunken. The nurse offers fluid to Carlo and he drinks eagerly. When the nurse pinched the abdomen, it goes back slowly. How will you classify Carlo’s illness?
a. severe dehydration
b. no dehydration
c. some dehydration
d. moderate dehydration
Q & A: Practice like the real thing! - ALL TOPICS: Lap 8 (50 questions)
Situation: Concerted work effort among members of the surgical team is essential to the success of the surgical procedure.
1. The sterile nurse or sterile personnel touch only sterile supplies and instruments. When there is a need for sterile supply which is not in the sterile field, who hands out these items by opening its outer cover?
a. circulating nurse
b. anesthesiologist
c. surgeon
d. nursing aide
2. The O.R. team performs distinct roles for one surgical procedure to be accomplished within a prescribed time frame and deliver a standard patient outcome. While the surgeon performs the surgical procedure, who monitors the status of the client (like urine output and blood loss)?
a. scrub nurse
b. surgeon
c. anesthesiologist
d. circulating nurse
3. Surgery schedules are communicated to the O.R. usually a day prior to the procedure by the nurse of the floor or ward where the patient is confined. For orthopedic cases, what department is usually informed to be present in the O.R.?
a. rehabilitation department
b. laboratory department
c. maintenance department
d. radiology department
4. Minimally invasive surgery is very much into technology. Aside from the usual surgical team, who else has to be present when a client undergoes laparoscopic surgery?
a. information technician
b. biomedical technician
c. electrician
d. laboratory technician
5. In massive blood loss, prompt replacement of compatible blood is crucial. What department needs to be alerted to coordinate closely with the patient’s family for immediate blood component therapy?
a. security division
b. chaplaincy
c. social service section
d. pathology department
Situation: You are assigned in the Orthopedic Ward where clients are complaining of pain in varying degrees upon movement of body parts.
6. Troy is a one day post-open reduction and internal rotation (ORIF) of the left hip and is in pain. Which of the following observation would prompt you to call the doctor?
a. Dressing is intact but partially soiled
b. Left foot is cold to touch and pedal pulse is absent
c. Left leg in limited functional anatomic position
d. BP 114/78, pulse of 82 beats/minute
7. There is an order of Demerol 50 mg I.M. now and every 6 hours prn. You injected Demerol at 5 pm. The next dose of Demerol 50 mg I.M. is given:
a. When the client asks for the next dose
b. When the patient is in severe pain
c. At 11 pm
d. At 12 pm
8. You continuously evaluate the client’s adaptation to pain. Which of the following behaviors indicate appropriate adaptation?
a. The client reports pain reduction and decreased activity
b. The client denies existence of pain
c. The client can distract himself during pain episodes
d. The client reports independence from watchers
9. 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. Explain all the possible interventions that may cause the client to worry
b. Establish trusting relationship by giving his medication on time
c. Stay with the client during pain episodes
d. Promote client’s sense of control and participation in control by listening to his concerns
10. In some hip surgeries, an epidural catheter for Fentanyl epidural analgesia is given. What is your nursing priority care in such a case?
a. Instruct client to observe strict bed rest
b. Check for epidural catheter drainage
c. Administer analgesia through epidural catheter as prescribed
d. Assess respiratory rate carefully
Situation: Records are vital tools in any institution and should be properly maintained for specific use and time.
11. The patient’s medical records can work as a double-edged sword. When can the medicl record become the doctor’s/nurse’s worst enemy?
a. When the record is voluminuous
b. When a medical record is subpoenaed in court
c. When it is missing
d. When the medical record is inaccurate, incomplete, and inadequate
12. Disposal of medical records in government hospitals/institutions must be done in close coordination with what agency?
a. Department of Interior and Local Government (DILG)
b. Metro manila Development Authority
c. Records Management Archives Office (RMAO)
d. Department of Health (DOH)
13. In the hospital, when you need the medical record of a discharged patient for research, you will request permission through:
a. Doctor in-charge
b. The hospital director
c. The nursing service
d. Medical records section
14. You readmitted a client who was in another department a month ago. Since you will need the previous chart, from whom do you request the old chart?
a. Central supply section
b. Previous doctor’s clinic
c. Department where the patient was previously admitted
d. Medical records section
15. Records Management and Archives Office of the DOH is responsible for implementing its policies on record disposal. You know that your institution is covered by this policy if:
a. Your hospital is considered tertiary
b. Your hospital is in Metro Manila
c. It obtained permit to operate from DOH
d. Your hospital is PhilHealth accredited
Situation: In the O.R., there are safety protocols that should be followed. The O.R. nurse should be well-versed with all these to safeguard the safety and quality of patient delivery outcome.
16. Which of the following should be given HIGHEST priority when receinv patient in the O.R.?
a. assess level of consciousness
b. verify patient identification and informed consent
c. assess vital signs
d. check for jewelry, gown, manicure and dentures
17. Surgeries like I and D (incision and drainage) and debridement are relatively short procedures but are considered ‘dirty cases.’ When are these procedures best scheduled?
a. last case
b. in-between cases
c. according to availability of anesthesiologist
d. according to the surgeon’s preference
18. O.R. nurses should be aware that maintaining the client’s safety is the overall goal of nursing care during the intra-operative phase. As the circulating nurse, you make certain that throughout the procedure…
a. the surgeon greets his client before induction of anesthesia
b. the surgeon and anesthesiologist are in tandem
c. strap made of strong non-abrasive materials are fastened securely around the joints of the knees and ankles and around the two hands around an arm board
d. client is monitored throughout the surgery by the assistant anesthesiologist
19. Another nursing check that should not be missed before the induction of general anesthesia is:
a. check for presence of underwear
b. check for presence of dentures
c. check patient’s ID
d. check baseline vital signs
20. Some lifetime habits and hobbies affect post-operative respiratory function. If your client smokes 3 packs of cigarettes a day for the past 10 years, you will anticipate increased risk for:
a. peri-operative anxiety and stress
b. delayed coagulation time
c. delayed wound healing
d. post-operative respiratory function
Situation: Nurses hold a variety of roles when providing care to a peri-operative patient.
21. Which of the following roles would be the responsibility of the scrub nurse?
a. assess the readiness of the client prior to surgery
b. ensure that the airway is adequate
c. account for the number of sponges, needles, supplies used during the surgical procedure
d. evaluate the type of anesthesia for the surgical client
22. As a peri-operative nurse, how can you best meet the safety needs of the client after administering pre-operative narcotic?
a. put side rails up and ask the client not to get out of bed
b. send the client to the O.R. with the family
c. allow client to get up to go to the comfort room
d. obtain consent form
23. It is the responsibility of the pre-op nurse to do skin prep for patients undergoing surgery. If hair at the operative site is not shaved, what should be done to make suturing easy and lessen the chance of incision infection?
a. draped
b. pulled
c. clipped
d. shampooed
24. It is also the nurse’s function to determine when an infection is developing in the surgical incision. The peri-operative nurse should observe for what signs of an impending infection?
a. localized heat and redness
b. serosanguinous exudates and skin blanching
c. separation of the incision
d. blood clots and scar tissue are visible
25. Which of the following nursing interventions is done when examining the incision wound and changing the dressing?
a. observe the dressing and type and odor of drainage, if any
b. get patient’s consent
c. wash hands
d. request the client to expose the incision wound
Situation: Carlo, 16 years old, comes to the ER with acute asthmatic attack. RR is 46/min and he appears to be in acute respiratory distress.
26. Which of the following nursing actions should be initiated first?
a. Promote emotional support
b. Administer oxygen at 6 L/min
c. Suction the client every 30 min
d. Administer bronchodilator by nebulizer
27. Aminophylline was ordered for acute asthmatic attack. The mother asked the nurse, “What is its indication?” The nurse will say:
a. Relax smooth muscles of the bronchial airway
b. Promote expectoration
c. Prevent thickening of secretions
d. Suppress cough
28. You will give health instructions to Carlo, a case of bronchial asthma. The health instruction will include the following EXCEPT:
a. Avoid emotional stress and extreme temperature
b. Avoid pollution like smoking
c. Avoid pollens, dust, seafood
d. Practice respiratory isolation
29. The asthmatic client asked you what breathing techniques he can best practice when asthmatic attack starts. What will be the best position?
a. Sit in high-Fowler’s position with extended legs
b. St-up with shoulders back
c. Push on abdomen during exhalation
d. Lean forward 30-40 degrees with each exhalation
30. As a nurse, you are always alerted to monitor status asthmaticus that will likely and initially manifest symptoms of:
a. metabolic alkalosis
b. respiratory acidosis
c. respiratory alkalosis
d. metabolic acidosis
Situation: The Joint Commission on Accreditation of Hospitals Organization (JCAHO) patient safety goals and requirements include the care and efficient use of technology in the O.R. and elsewhere in the healthcare facility.
31. As the head nurse in the O.R., how can you improve the effectiveness of clinical alarm systems?
a. limit suppliers to a few so that quality is maintained
b. implement a regular inventory of supplies and equipment
c. adherence to manufacturer’s recommendation
d. implement a regular maintenance and testing of alarm systems
32. Overdosage of medication or anesthetic can happen even with the aid of technology like infusion pumps, sphygmomanometer and similar devices/machines. As a staff, how can you improve the safety of using infusion pumps?
a. check the functionality of the pump before use
b. select your brand of infusion pump, just like you do with your cellphone
c. allow the technician to set the infusion pump before use
d. verify the flow rate against your computation
33. JCAHO’s universal protocol for surgical and invasive procedures to prevent wrong site, wrong person and wrong procedure/surgery includes the following EXCEPT:
a. mark the operative site if possible
b. conduct pre-procedure verification process
c. take a video of the entire intra-operative procedure
d. conduct ‘time out’ immediately before starting the procedure
34. You identified a potential risk of pre- and post-operative clients. To reduce the risk of patient harm resulting from fall, you can implement the following EXCEPT:
a. assess potential risk of falls associated with the patient’s medication regimen
b. take action to address any identified risks through an incident report (IR)
c. allow client to walk with a relative to the O.R.
d. assess and periodically re-asses an individual client’s risk for falling
35. As a nurse, you know you can improve on the accuracy of a patient’s identification by two patient identifiers EXCEPT:
a. identify the client by his/her wrist tag and verify with family members
b. identify client by his/her wrist tag and call him/her by name
c. call the patient by his/her case and bed number
d. call the patient by his/her name and bed number
Situation: Team effort is best demonstrated in the O.R..
36. If you are the nurse in-charge for scheduling surgical cases, what important information do you need to ask the surgeon?
a. Who is your internist?
b. Who are your assistant and anesthesiologist, and what is your preferred time and type of surgery?
c. Who are your anesthesiologist, internist and assistant?
d. Who is your anesthesiologist?
37. In the O.R., the nursing tandem for every surgery is:
a. instrument technician and circulating nurse
b. nurse anesthetist, nurse assistant and instrument technician
c. scrub nurse and nurse anesthetist
d. scrub and circulating nurses
38. While team effort is needed in the O.R. for efficient and quality patient care delivery, we should limit the number of people in the room for infection control. Who comprises this team?
a. surgeon, anesthesiologist, scrub nurse, radiologist, orderly
b. surgeon, assistants, scrub nurse, circulating nurse, anesthesiologist
c. surgeon, assistant surgeon, anesthesiologist, scrub nurse, pathologist
d. surgeon, assistant surgeon, anesthesiologist, intern, scrub nurse
39. When surgery is ongoing, who coordinates the activities outside, including the family?
a. orderly / clerk
b. nurse supervisor
c. circulating nurse
d. anesthesiologist
40. The breakdown in teamwork is oftentimes a failure in:
a. electricity
b. inadequate supply
c. legwork
d. communication
Situation: Colostomy is a surgically created anus. It can be temporary or permanent, depending on the disease condition.
41. Skin care around the stoma is critical. Which of the following is NOT indicated as a skin care barrier?
a. Apply liberal amount of mineral oil to the area.
b. Use karaya paste and rings around the stoma.
c. Clean the area daily with soap and water before applying bag.
d. Apply talcum powder twice a day.
42. What health instruction will enhance regulation of a colostomy of clients (defecation)?
a. irrigate after lunch everyday
b. eat fruits and vegetables in all three meals
c. eat balanced meals at regular intervals
d. restrict exercise to walking only
43. After ileostomy, which of the following conditions is NOT expected?
a. increased weight
b. irritation of skin around the stoma
c. liquid stool
d. establishment of regular bowel movement
44. The following are appropriate nursing interventions during colostomy irrigation EXCEPT:
a. increase the irrigating solution flow rate when abdominal cramps are felt
b. insert 2-4 inches of an adequately lubricated catheter to the stoma
c. position client in semi-Fowler’s
d. hang the solution 18 inches above the stoma
45. What sensation is used as a gauge so that patients with ileostomy can determine how often their pouch should be drained?
a. sensation of taste
b. sensation of pressure
c. sensation of smell
d. urge to defecate
Situation: As a beginner in research, you are aware that sampling is an essential element of the research process.
46. What does a sample group represent?
a. control group
b. study subjects
c. general population
d. universe
47. What is the most important characteristic of a sample?
a. randomization
b. appropriate location
c. appropriate number
d. representativeness
48. Random sampling ensures that each subject has:
a. been selected systematically
b. an equal chance of selection
c. been selected based on a set criteria
d. characteristics that matches other samples
49. Which of the following methods allow the use of any group of research subject?
a. purposive
b. convenience
c. snow-ball
d. quota
50. You decided to include 5 barangays in your municipality and chose a sampling method that would get representative samples from each barangay. What should be the appropriate method for you to use in this case?
a. cluster sampling
b. random sampling
c. stratified sampling
d. systematic sampling
1. The sterile nurse or sterile personnel touch only sterile supplies and instruments. When there is a need for sterile supply which is not in the sterile field, who hands out these items by opening its outer cover?
a. circulating nurse
b. anesthesiologist
c. surgeon
d. nursing aide
2. The O.R. team performs distinct roles for one surgical procedure to be accomplished within a prescribed time frame and deliver a standard patient outcome. While the surgeon performs the surgical procedure, who monitors the status of the client (like urine output and blood loss)?
a. scrub nurse
b. surgeon
c. anesthesiologist
d. circulating nurse
3. Surgery schedules are communicated to the O.R. usually a day prior to the procedure by the nurse of the floor or ward where the patient is confined. For orthopedic cases, what department is usually informed to be present in the O.R.?
a. rehabilitation department
b. laboratory department
c. maintenance department
d. radiology department
4. Minimally invasive surgery is very much into technology. Aside from the usual surgical team, who else has to be present when a client undergoes laparoscopic surgery?
a. information technician
b. biomedical technician
c. electrician
d. laboratory technician
5. In massive blood loss, prompt replacement of compatible blood is crucial. What department needs to be alerted to coordinate closely with the patient’s family for immediate blood component therapy?
a. security division
b. chaplaincy
c. social service section
d. pathology department
Situation: You are assigned in the Orthopedic Ward where clients are complaining of pain in varying degrees upon movement of body parts.
6. Troy is a one day post-open reduction and internal rotation (ORIF) of the left hip and is in pain. Which of the following observation would prompt you to call the doctor?
a. Dressing is intact but partially soiled
b. Left foot is cold to touch and pedal pulse is absent
c. Left leg in limited functional anatomic position
d. BP 114/78, pulse of 82 beats/minute
7. There is an order of Demerol 50 mg I.M. now and every 6 hours prn. You injected Demerol at 5 pm. The next dose of Demerol 50 mg I.M. is given:
a. When the client asks for the next dose
b. When the patient is in severe pain
c. At 11 pm
d. At 12 pm
8. You continuously evaluate the client’s adaptation to pain. Which of the following behaviors indicate appropriate adaptation?
a. The client reports pain reduction and decreased activity
b. The client denies existence of pain
c. The client can distract himself during pain episodes
d. The client reports independence from watchers
9. 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. Explain all the possible interventions that may cause the client to worry
b. Establish trusting relationship by giving his medication on time
c. Stay with the client during pain episodes
d. Promote client’s sense of control and participation in control by listening to his concerns
10. In some hip surgeries, an epidural catheter for Fentanyl epidural analgesia is given. What is your nursing priority care in such a case?
a. Instruct client to observe strict bed rest
b. Check for epidural catheter drainage
c. Administer analgesia through epidural catheter as prescribed
d. Assess respiratory rate carefully
Situation: Records are vital tools in any institution and should be properly maintained for specific use and time.
11. The patient’s medical records can work as a double-edged sword. When can the medicl record become the doctor’s/nurse’s worst enemy?
a. When the record is voluminuous
b. When a medical record is subpoenaed in court
c. When it is missing
d. When the medical record is inaccurate, incomplete, and inadequate
12. Disposal of medical records in government hospitals/institutions must be done in close coordination with what agency?
a. Department of Interior and Local Government (DILG)
b. Metro manila Development Authority
c. Records Management Archives Office (RMAO)
d. Department of Health (DOH)
13. In the hospital, when you need the medical record of a discharged patient for research, you will request permission through:
a. Doctor in-charge
b. The hospital director
c. The nursing service
d. Medical records section
14. You readmitted a client who was in another department a month ago. Since you will need the previous chart, from whom do you request the old chart?
a. Central supply section
b. Previous doctor’s clinic
c. Department where the patient was previously admitted
d. Medical records section
15. Records Management and Archives Office of the DOH is responsible for implementing its policies on record disposal. You know that your institution is covered by this policy if:
a. Your hospital is considered tertiary
b. Your hospital is in Metro Manila
c. It obtained permit to operate from DOH
d. Your hospital is PhilHealth accredited
Situation: In the O.R., there are safety protocols that should be followed. The O.R. nurse should be well-versed with all these to safeguard the safety and quality of patient delivery outcome.
16. Which of the following should be given HIGHEST priority when receinv patient in the O.R.?
a. assess level of consciousness
b. verify patient identification and informed consent
c. assess vital signs
d. check for jewelry, gown, manicure and dentures
17. Surgeries like I and D (incision and drainage) and debridement are relatively short procedures but are considered ‘dirty cases.’ When are these procedures best scheduled?
a. last case
b. in-between cases
c. according to availability of anesthesiologist
d. according to the surgeon’s preference
18. O.R. nurses should be aware that maintaining the client’s safety is the overall goal of nursing care during the intra-operative phase. As the circulating nurse, you make certain that throughout the procedure…
a. the surgeon greets his client before induction of anesthesia
b. the surgeon and anesthesiologist are in tandem
c. strap made of strong non-abrasive materials are fastened securely around the joints of the knees and ankles and around the two hands around an arm board
d. client is monitored throughout the surgery by the assistant anesthesiologist
19. Another nursing check that should not be missed before the induction of general anesthesia is:
a. check for presence of underwear
b. check for presence of dentures
c. check patient’s ID
d. check baseline vital signs
20. Some lifetime habits and hobbies affect post-operative respiratory function. If your client smokes 3 packs of cigarettes a day for the past 10 years, you will anticipate increased risk for:
a. peri-operative anxiety and stress
b. delayed coagulation time
c. delayed wound healing
d. post-operative respiratory function
Situation: Nurses hold a variety of roles when providing care to a peri-operative patient.
21. Which of the following roles would be the responsibility of the scrub nurse?
a. assess the readiness of the client prior to surgery
b. ensure that the airway is adequate
c. account for the number of sponges, needles, supplies used during the surgical procedure
d. evaluate the type of anesthesia for the surgical client
22. As a peri-operative nurse, how can you best meet the safety needs of the client after administering pre-operative narcotic?
a. put side rails up and ask the client not to get out of bed
b. send the client to the O.R. with the family
c. allow client to get up to go to the comfort room
d. obtain consent form
23. It is the responsibility of the pre-op nurse to do skin prep for patients undergoing surgery. If hair at the operative site is not shaved, what should be done to make suturing easy and lessen the chance of incision infection?
a. draped
b. pulled
c. clipped
d. shampooed
24. It is also the nurse’s function to determine when an infection is developing in the surgical incision. The peri-operative nurse should observe for what signs of an impending infection?
a. localized heat and redness
b. serosanguinous exudates and skin blanching
c. separation of the incision
d. blood clots and scar tissue are visible
25. Which of the following nursing interventions is done when examining the incision wound and changing the dressing?
a. observe the dressing and type and odor of drainage, if any
b. get patient’s consent
c. wash hands
d. request the client to expose the incision wound
Situation: Carlo, 16 years old, comes to the ER with acute asthmatic attack. RR is 46/min and he appears to be in acute respiratory distress.
26. Which of the following nursing actions should be initiated first?
a. Promote emotional support
b. Administer oxygen at 6 L/min
c. Suction the client every 30 min
d. Administer bronchodilator by nebulizer
27. Aminophylline was ordered for acute asthmatic attack. The mother asked the nurse, “What is its indication?” The nurse will say:
a. Relax smooth muscles of the bronchial airway
b. Promote expectoration
c. Prevent thickening of secretions
d. Suppress cough
28. You will give health instructions to Carlo, a case of bronchial asthma. The health instruction will include the following EXCEPT:
a. Avoid emotional stress and extreme temperature
b. Avoid pollution like smoking
c. Avoid pollens, dust, seafood
d. Practice respiratory isolation
29. The asthmatic client asked you what breathing techniques he can best practice when asthmatic attack starts. What will be the best position?
a. Sit in high-Fowler’s position with extended legs
b. St-up with shoulders back
c. Push on abdomen during exhalation
d. Lean forward 30-40 degrees with each exhalation
30. As a nurse, you are always alerted to monitor status asthmaticus that will likely and initially manifest symptoms of:
a. metabolic alkalosis
b. respiratory acidosis
c. respiratory alkalosis
d. metabolic acidosis
Situation: The Joint Commission on Accreditation of Hospitals Organization (JCAHO) patient safety goals and requirements include the care and efficient use of technology in the O.R. and elsewhere in the healthcare facility.
31. As the head nurse in the O.R., how can you improve the effectiveness of clinical alarm systems?
a. limit suppliers to a few so that quality is maintained
b. implement a regular inventory of supplies and equipment
c. adherence to manufacturer’s recommendation
d. implement a regular maintenance and testing of alarm systems
32. Overdosage of medication or anesthetic can happen even with the aid of technology like infusion pumps, sphygmomanometer and similar devices/machines. As a staff, how can you improve the safety of using infusion pumps?
a. check the functionality of the pump before use
b. select your brand of infusion pump, just like you do with your cellphone
c. allow the technician to set the infusion pump before use
d. verify the flow rate against your computation
33. JCAHO’s universal protocol for surgical and invasive procedures to prevent wrong site, wrong person and wrong procedure/surgery includes the following EXCEPT:
a. mark the operative site if possible
b. conduct pre-procedure verification process
c. take a video of the entire intra-operative procedure
d. conduct ‘time out’ immediately before starting the procedure
34. You identified a potential risk of pre- and post-operative clients. To reduce the risk of patient harm resulting from fall, you can implement the following EXCEPT:
a. assess potential risk of falls associated with the patient’s medication regimen
b. take action to address any identified risks through an incident report (IR)
c. allow client to walk with a relative to the O.R.
d. assess and periodically re-asses an individual client’s risk for falling
35. As a nurse, you know you can improve on the accuracy of a patient’s identification by two patient identifiers EXCEPT:
a. identify the client by his/her wrist tag and verify with family members
b. identify client by his/her wrist tag and call him/her by name
c. call the patient by his/her case and bed number
d. call the patient by his/her name and bed number
Situation: Team effort is best demonstrated in the O.R..
36. If you are the nurse in-charge for scheduling surgical cases, what important information do you need to ask the surgeon?
a. Who is your internist?
b. Who are your assistant and anesthesiologist, and what is your preferred time and type of surgery?
c. Who are your anesthesiologist, internist and assistant?
d. Who is your anesthesiologist?
37. In the O.R., the nursing tandem for every surgery is:
a. instrument technician and circulating nurse
b. nurse anesthetist, nurse assistant and instrument technician
c. scrub nurse and nurse anesthetist
d. scrub and circulating nurses
38. While team effort is needed in the O.R. for efficient and quality patient care delivery, we should limit the number of people in the room for infection control. Who comprises this team?
a. surgeon, anesthesiologist, scrub nurse, radiologist, orderly
b. surgeon, assistants, scrub nurse, circulating nurse, anesthesiologist
c. surgeon, assistant surgeon, anesthesiologist, scrub nurse, pathologist
d. surgeon, assistant surgeon, anesthesiologist, intern, scrub nurse
39. When surgery is ongoing, who coordinates the activities outside, including the family?
a. orderly / clerk
b. nurse supervisor
c. circulating nurse
d. anesthesiologist
40. The breakdown in teamwork is oftentimes a failure in:
a. electricity
b. inadequate supply
c. legwork
d. communication
Situation: Colostomy is a surgically created anus. It can be temporary or permanent, depending on the disease condition.
41. Skin care around the stoma is critical. Which of the following is NOT indicated as a skin care barrier?
a. Apply liberal amount of mineral oil to the area.
b. Use karaya paste and rings around the stoma.
c. Clean the area daily with soap and water before applying bag.
d. Apply talcum powder twice a day.
42. What health instruction will enhance regulation of a colostomy of clients (defecation)?
a. irrigate after lunch everyday
b. eat fruits and vegetables in all three meals
c. eat balanced meals at regular intervals
d. restrict exercise to walking only
43. After ileostomy, which of the following conditions is NOT expected?
a. increased weight
b. irritation of skin around the stoma
c. liquid stool
d. establishment of regular bowel movement
44. The following are appropriate nursing interventions during colostomy irrigation EXCEPT:
a. increase the irrigating solution flow rate when abdominal cramps are felt
b. insert 2-4 inches of an adequately lubricated catheter to the stoma
c. position client in semi-Fowler’s
d. hang the solution 18 inches above the stoma
45. What sensation is used as a gauge so that patients with ileostomy can determine how often their pouch should be drained?
a. sensation of taste
b. sensation of pressure
c. sensation of smell
d. urge to defecate
Situation: As a beginner in research, you are aware that sampling is an essential element of the research process.
46. What does a sample group represent?
a. control group
b. study subjects
c. general population
d. universe
47. What is the most important characteristic of a sample?
a. randomization
b. appropriate location
c. appropriate number
d. representativeness
48. Random sampling ensures that each subject has:
a. been selected systematically
b. an equal chance of selection
c. been selected based on a set criteria
d. characteristics that matches other samples
49. Which of the following methods allow the use of any group of research subject?
a. purposive
b. convenience
c. snow-ball
d. quota
50. You decided to include 5 barangays in your municipality and chose a sampling method that would get representative samples from each barangay. What should be the appropriate method for you to use in this case?
a. cluster sampling
b. random sampling
c. stratified sampling
d. systematic sampling
Friday, November 13, 2009
Q & A: Practice like the real thing! - ALL TOPICS: Lap 7 (50 questions)
Situation: Because of the serious consequences of severe burns, management requires a multidisciplinary approach. You have important responsibilities as a nurse.
1. While Sergio was lighting a barbecue grill with a lighter fluid, his shirt burns into flames. The most effective way to extinguish the flames with as little further damage as possible is to:
a. log roll on the grass/ground
b. slap the flames with his hands
c. remove the burning clothes
d. pour cold liquid over the flames
2. Once the flames are extinguished, it is most important to:
a. cover Sergio with a warm blanket
b. give him sips of water
c. calculate the extent of his burns
d. assess Sergio’s breathing
3. Sergio is brought to the Emergency Room after the barbecue grill accident. Based on the assessment of the physician, Sergio sustained superficial partial thickness burns on his trunk, right upper extremities and right lower extremities. His wife asks what that means? Your most accurate response would be:
a. structures beneath the skin are damaged
b. dermis is partially damaged
c. epidermis and dermis are both damaged
d. epidermis is damaged
4. During the first 24 hours after the thermal injury, you should assess Sergio for:
a. hypokalemia and hypernatremia
b. hypokalemia and hyponatremia
c. hyperkalemia and hyponatremia
d. hyperkalemia and hypernatremia
5. Teddy, who sustained deep partial thickness and full thickness burns of the face whole anterior chest and both upper extremities two days ago begins to exhibit extreme restlessness. You recognize that this most likely indicates that Teddy is developing:
a. Cerebral hypoxia
b. Hypervolemia
c. Metabolic acidosis
d. Renal failure
Situation: You are now working as a staff nurse in a general hospital. You have to be prepared to handle situations with ethico-legal and moral implications.
6. You are in night duty in surgical ward. One of your patients, Martin, is a prisoner who sustained an abdominal gunshot wound. He is being guarded by policeman from the local police unit. During your rounds you heard a commotion. You saw the policeman trying to hit Martin. You asked why he was trying to hit Martin. He denied the matter. Which among the following activities will you do first?
a. Write an accident report
b. Call security officer and report the incident
c. Call your nurse supervisor and report the incident
d. Call the physician on duty
7. You are on morning duty in the medical ward. You have 10 patients assigned to you. During your endorsement rounds, you found that one of your patients was not in bed. The patient next to him informed you that he went home without notifying the nurses. Which among the following will you do first?
a. Make an incident report
b. Call security to report the incident
c. Wait for 2 hours before reporting
d. Report the incident to your supervisor
8. You are on duty in the medical ward. You were asked to check the narcotics cabinet. You found out that what is on records does not tally with the drugs used. Which among the following will you do first?
a. Write an incident report and refer the matter to the nursing direction
b. Keep your findings to yourself to yourself
c. Report the matter to your supervisor
9. Find out from the endorsement any patient who might have been given narcotics
9. You are on duty in the medical ward. The mother of your patient who is also a nurse, came running to the nurses’ station and informed you that Fiolo went into cardiopulmonary arrest.
a. Start basic life support measures
b. Call for the Code
c. Bring the crash cart to the room
d. Go to see Fiolo and assess for airway patency and breathing problems
10. You are admitting Jorge to the ward and you found out that he is positive for HIV. Which among the following will you do first?
a. Take note of it and plan to endorse this to next shift
b. Keep this matter to yourself
c. Write an incident report
d. Report the matter to your head nurse
Situation: Colorectal cancer can affect old and younger people. Surgical procedures and other modes of treatment are done to ensure quality of life. You are assigned in the cancer institute to care for patients with this type of cancer.
11. Larry, 55 years old, who is suspected of having colorectal cancer, is admitted to the cancer institute. After taking the history and vital signs, the physician does which test as a screening test for colorectal cancer?
a. barium enema
b. carcinoembryonic antigen (CEA)
c. annual digital rectal examination (DRE)
d. proctosigmoidoscopy
12. To confirm his impression of colorectal cancer, Larry will require which diagnostic study?
a. carcinoembryonic antigen (CEA)
b. proctosigmoidcoscopy
c. stool hematologic test
d. abdominal computed tomography (CT) test
13. The following are risk factors for colorectal cancer EXCEPT:
a. inflammatory bowels
b. high fat, high fiber diet
c. smoking
d. genetic factors – familial adenomatous polyps
14. Symptoms associated with cancer of the colon include:
a. constipation, ascites and mucus in the stool
b. diarrhea, heartburn and eructation
c. blood in the stools, anemia and “pencil-shaped” stools
d. anorexia, hematemesis and increased peristalsis
15. Several days prior to bowel surgery, Larry may be given sulfasuxidine and neomycin primarily to:
a. promote rest of the bowel by minimizing peristalsis
b. reduce the bacterial content of the colon
c. empty the bowel of solid waste
d. soften the stool by retaining water in the colon
Situation: Enterostomal therapy is now considered a specialty in nursing. You are participating in the ostomy care class.
16. You plan to teach Fermin how to irrigate the colostomy when:
a. the perineal wound heals and Fermin can sit comfortably on the commode
b. Fermin can lie on the side comfortably, about the 3rd postoperative day
c. The abdominal incision is closed and contamination is no longer a danger
d. The stools start to become formed, around the 7th postoperative day
17. When preparing to teach Fermin how to irrigate colostomy, you should plan to do the procedure…
a. when Fermin would have normal bowel movement
b. at least 2 hours before visiting hours
c. prior to breakfast and morning care
d. after Fermin accepts alteration in body image
18. When observing a return demonstration of a colostomy irrigation, you know that more teaching is required if Fermin…
a. lubricates the tip of the catheter prior to inserting it into the stoma
b. hangs the irrigating bag on the bathroom door hook during fluid insertion
c. discontinues the insertion of fluid after only 500 ml of fluid has been instilled
d. clamps the flow of fluid when feeling uncomfortable
19. You are aware that teaching about colostomy care is understood when Fermin states, “I will contact my physician and report…”
a. if I Have any difficulty inserting the irrigating tub into the stoma.”
b. if I noticed a loss of sensation to touch in the stoma tissue.”
c. the expulsion of flatus while the irrigating fluid is running out.”
d. when mucus is passed from the stoma between the irrigations.”
10. You would know after teaching Fermin that dietary instructions for him is effective when he states, “It is important that I eat...”
a. soft foods that are easily digested and absorbed by my large intestines.”
b. bland food so that my intestines do not become irritated.”
c. food low in fiber so that there is less stool.
d. everything that I ate before the operation, while avoiding foods that cause gas.”
Situation: Ensuring safety is one of your most important responsibilities. You will need to provided instructions and information to your clients to prevent complications.
21. Randy has chest tubes attached to a pleural drainage system. When caring for him you should:
a. empty the drainage system at the end of the shift
b. clamp the chest tube when suctioning
c. palpate the surrounding areas for crepitus
d. change the dressing daily using aseptic techniques
22. Fanny, came in from PACU after pelvic surgery. As Fanny’s nurse, you know that the sign that would be indicative of a developing thrombophlebitis would be:
a. a tender, painful area on the leg
b. a pitting edema of the ankle
c. a reddned area at the ankle
d. pruritus on the calf and ankle
23. To prevent recurrent attacks on Terry who has acute glumeronephritis, you should instruct her to:
a. seek early treatment for respiratory infections
b. take showers instead of tub bath
c. continute to take the same restrictions on fluid intake
d. avoid situations that involve physical activity
24. Herbert had a laryngectomy and he is now for discharge. He verbalized this concern regarding his laryngectomy tube being dislodged. What should you teach him first?
a. Recognize that prompt closure of the tracheal opening may occur
b. Keep calm because there is no immediate emergency
c. Reinsert another tubing immediately
d. Notify the physician at once
25. When caring for Larry after an exploratory chest surgery and pneumonectomy, your priority would be to maintain
a. supplementary oxygen
b. ventilation exchange
c. chest tube drainage
d. blood replacement
Situation: 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.
26. 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 househeld help. Your most appropriate response would be:
a. “Don’t worry your husband’s 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.”
27. Voltaire develops a nosocomial respiratory tract infection. He asks 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.”
28. 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 prenteral nutrition is:
a. stomatitis
b. hepatitis
c. dysrhythmia
d. infection
29. A solution used to treat Pseudomomonas wound infection is:
a. Dakin’s solution
b. Half-strength hydrogen peroxide
c. Acetic acid
d. Betadine
30. 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/uL
d. Gram stain testing
Situation: As a nurse you need to anticipate the occurrence of complications of stroke so that life-threatening situations can be prevented.
31. Wendy is admitted to the hospital with signs and symptoms of stroke. Her Glasgow Coma Scale is 6 on admission. A central venous catheter was inserted and an I.V. infusion was started. As a nurse assigned to Wendy, what will be your priority goal?
a. prevent skin breakdown
b. preserve muscle function
c. promote urinary elimination
d. maintain a patent airway
32. Knowing that for a comatose patient, hearing is the last sense to be lost, as Judy’s nurse what should you do?
a. Tell her family that probably she can’t hear them
b. Talk loudly so that Wendy can hear you
c. Tell her family who are in the room not to talk
d. Speak softly then hold her hands gently
33. Which among the following interventions should you consider as the highest priority when caring for June who has hemiparesis secondary to stroke?
a. Place June on an upright lateral position
b. Perform range of motion exercises
c. Apply antiembolic stockings
d. Use hand rolls or pillows for support
34. Ivy, age 40, was admitted to the hospital with a severe headache, stiff neck and photophobia. She was diagnosed with a subarachnoid hemorrhage secondary to ruptured aneurysm. While waiting for surgery, you can provide a therapeutic environment by doing which of the following?
a. honoring her request for a television
b. placing her bed near the window
c. dimming the light in her room
d. allowing the family unrestricted visiting privileges
35. When performing a neurologic assessment on Walter, you find that his pupils are fixed and dialed. This indicated that he:
a. probably has meningitis
b. is going to be blind because of trauma
c. is permanently paralyzed
d. has received a significant brain injury
Situation: With the improvement in life expectancies and the emphasis in the quality of life it is important to provide quality care to our older patients. There are frequently encountered situations and issues relevant to the older patients.
36. Hypoxia may occur in the older patients because of which of the following physiologic changes associated with aging:
a. Ineffective airway clearance
b. Decreased alveolar surfaced area
c. Decreased anterior-posterior chest diameter
d. Hyperventilation
37. The older patient is at higher risk for incontinence because of:
a. dilated urethra
b. increased glomerular filtration rate
c. diuretic use
d. decreased bladder capacity
38. Merle, age 86, is complaining of dizziness when she stands up. This may indicate:
a. dementia
b. a visual problem
c. functional decline
d. drug toxicity
39. Cardiac ischemia in an older patient usually produces:
a. ST-T wave changes
b. Very high creatinine kinase level
c. Chest pain radiating to the left arm
d. Acute confusion
40. The most dependable sign of infection in the older patient is:
a. change in mental status
b. fever
c. pain
d. decreased breath sounds with crackles
Situation: A disaster is a large-scale emergency—even a small emergency left unmanaged may turn into a disaster. Disaster prepared is crucial is everybody’s business. There are agencies that are in charge of ensuring prompt response. Comprehensive Emergency Management (CEM) is an integrated approach to the management of emergency programs and activities for all four emergency phases (mitigation, preparedness, response, and recovery) for all types of emergencies and disasters (natural, man-made and attack) and for all levels of government and the private sector.
41. Which of the four phases of emergency management is defined as “sustained action that reduces or eliminates long-term risk to people and property from natural hazards and their effects”?
a. Recovery
b. Mitigation
c. Response
d. Preparedness
42. You are a community healthy nurses collaborating with the Red Cross and working with disaster relief following a typhoon which flooded and devastated the whole province. Finding safe housing for survivors, organizing support for the family, organizing counseling, debriefing sessions and securing physical care are the services you are involved with. To which type of prevention are these activities included:
a. Tertiary prevention
b. Primary prevention
c. Aggregate care prevention
d. Secondary prevention
43. During the disaster you see a victim with a green tag, you know that the person:
a. has injuries that are significant and require medical care but can wait hours with threat to life or limb
b. has injuries that are life-threatening but survival is good with minimal intervention
c. indicates injuries that are extensive and chances of survival are unlikely even with definitive care
d. has injuries that are minor and treatment can be delayed from hours to days
44. The term given to a category of triage that refers to life-threatening or potentially life-threatening injury or illness requiring immediate treatment:
a. Immediate
b. Emergent
c. Non-acute
d. Urgent
45. Which of the following terms refer to a process by which the individual receives education about recognition of stress reaction and management strategies for handling stress which may be instituted after a disaster?
a. Clinical incident stress management
b. Follow-up
c. Debriefing
d. Defusion
Situation: As a member of the health and nursing team, you have a crucial role to play in ensuring that all the members participate actively in the various tasks agreed upon.
46. While eating his meal, Matthew accidentally dislodges his IV lines and bleeds. Blood oozes on the surface of the overbed table. It is most appropriate that you instruct the housekeeper to clean the table with:
a. Acetone
b. Alcohol
c. Ammonia
d. Bleach
47. you are a member of the infection control team of the hospital. Based on a feedback during the meeting of the committee there is an increased incidence of pseudomonas infection in the Burn Unit (3 out of 10 patients had positive blood and wound culture). What is your priority activity?
a. Establish policies for surveillance and monitoring.
b. Do data gathering about the possible sources of infection (observation, chart review, interview).
c. Assign point persons who can implement policies.
d. Meet with the nursing group working in the burn unit and discuss problem with them.
48. Part of your responsibility as a member of the diabetes core group is to get referrals from the various wards regarding diabetic patients needing diabetes education. Prior to discharge today, 4 patients are referred to you. How would you start prioritizing your activities?
a. Bring your diabetes teaching kit and start your session, taking into consideration their distance from your office.
b. Contact the nurse-in-charge and find out from her the reason for the referral
c. Determine their learning needs then prioritize
d. involve the whole family in the teaching class
49. you have been designated as a member of the task force to plan activities for the Cancer Consciousness Week. Your committee has 4 months to plan and implement the plan. You are assigned to contact the various cancer support groups in your hospital. What will be your priority activity?
a. Find out if there is a budget for this activity
b. Clarify objectives of the activity with the task force before contacting the support groups
c. Determine the VIPs and Celebrities who will be invited
d. Find out how many suppor groups there are in the hospital and get the contact number of their president
50. You are invited to participate in the medical mission activity of your alumni association. In the planning stage everybody is expected to identify what they can do during the medical mission and what resources are needed. You thought it is also your chance to share what you can do for others. What will be your most important role where you can demonstrate the impact of nursing in health?
a. Conduct health education on healthy lifestyle
b. Be a triage nurse
c. Take the initial history and document findings
d. Act as a coordinator
1. While Sergio was lighting a barbecue grill with a lighter fluid, his shirt burns into flames. The most effective way to extinguish the flames with as little further damage as possible is to:
a. log roll on the grass/ground
b. slap the flames with his hands
c. remove the burning clothes
d. pour cold liquid over the flames
2. Once the flames are extinguished, it is most important to:
a. cover Sergio with a warm blanket
b. give him sips of water
c. calculate the extent of his burns
d. assess Sergio’s breathing
3. Sergio is brought to the Emergency Room after the barbecue grill accident. Based on the assessment of the physician, Sergio sustained superficial partial thickness burns on his trunk, right upper extremities and right lower extremities. His wife asks what that means? Your most accurate response would be:
a. structures beneath the skin are damaged
b. dermis is partially damaged
c. epidermis and dermis are both damaged
d. epidermis is damaged
4. During the first 24 hours after the thermal injury, you should assess Sergio for:
a. hypokalemia and hypernatremia
b. hypokalemia and hyponatremia
c. hyperkalemia and hyponatremia
d. hyperkalemia and hypernatremia
5. Teddy, who sustained deep partial thickness and full thickness burns of the face whole anterior chest and both upper extremities two days ago begins to exhibit extreme restlessness. You recognize that this most likely indicates that Teddy is developing:
a. Cerebral hypoxia
b. Hypervolemia
c. Metabolic acidosis
d. Renal failure
Situation: You are now working as a staff nurse in a general hospital. You have to be prepared to handle situations with ethico-legal and moral implications.
6. You are in night duty in surgical ward. One of your patients, Martin, is a prisoner who sustained an abdominal gunshot wound. He is being guarded by policeman from the local police unit. During your rounds you heard a commotion. You saw the policeman trying to hit Martin. You asked why he was trying to hit Martin. He denied the matter. Which among the following activities will you do first?
a. Write an accident report
b. Call security officer and report the incident
c. Call your nurse supervisor and report the incident
d. Call the physician on duty
7. You are on morning duty in the medical ward. You have 10 patients assigned to you. During your endorsement rounds, you found that one of your patients was not in bed. The patient next to him informed you that he went home without notifying the nurses. Which among the following will you do first?
a. Make an incident report
b. Call security to report the incident
c. Wait for 2 hours before reporting
d. Report the incident to your supervisor
8. You are on duty in the medical ward. You were asked to check the narcotics cabinet. You found out that what is on records does not tally with the drugs used. Which among the following will you do first?
a. Write an incident report and refer the matter to the nursing direction
b. Keep your findings to yourself to yourself
c. Report the matter to your supervisor
9. Find out from the endorsement any patient who might have been given narcotics
9. You are on duty in the medical ward. The mother of your patient who is also a nurse, came running to the nurses’ station and informed you that Fiolo went into cardiopulmonary arrest.
a. Start basic life support measures
b. Call for the Code
c. Bring the crash cart to the room
d. Go to see Fiolo and assess for airway patency and breathing problems
10. You are admitting Jorge to the ward and you found out that he is positive for HIV. Which among the following will you do first?
a. Take note of it and plan to endorse this to next shift
b. Keep this matter to yourself
c. Write an incident report
d. Report the matter to your head nurse
Situation: Colorectal cancer can affect old and younger people. Surgical procedures and other modes of treatment are done to ensure quality of life. You are assigned in the cancer institute to care for patients with this type of cancer.
11. Larry, 55 years old, who is suspected of having colorectal cancer, is admitted to the cancer institute. After taking the history and vital signs, the physician does which test as a screening test for colorectal cancer?
a. barium enema
b. carcinoembryonic antigen (CEA)
c. annual digital rectal examination (DRE)
d. proctosigmoidoscopy
12. To confirm his impression of colorectal cancer, Larry will require which diagnostic study?
a. carcinoembryonic antigen (CEA)
b. proctosigmoidcoscopy
c. stool hematologic test
d. abdominal computed tomography (CT) test
13. The following are risk factors for colorectal cancer EXCEPT:
a. inflammatory bowels
b. high fat, high fiber diet
c. smoking
d. genetic factors – familial adenomatous polyps
14. Symptoms associated with cancer of the colon include:
a. constipation, ascites and mucus in the stool
b. diarrhea, heartburn and eructation
c. blood in the stools, anemia and “pencil-shaped” stools
d. anorexia, hematemesis and increased peristalsis
15. Several days prior to bowel surgery, Larry may be given sulfasuxidine and neomycin primarily to:
a. promote rest of the bowel by minimizing peristalsis
b. reduce the bacterial content of the colon
c. empty the bowel of solid waste
d. soften the stool by retaining water in the colon
Situation: Enterostomal therapy is now considered a specialty in nursing. You are participating in the ostomy care class.
16. You plan to teach Fermin how to irrigate the colostomy when:
a. the perineal wound heals and Fermin can sit comfortably on the commode
b. Fermin can lie on the side comfortably, about the 3rd postoperative day
c. The abdominal incision is closed and contamination is no longer a danger
d. The stools start to become formed, around the 7th postoperative day
17. When preparing to teach Fermin how to irrigate colostomy, you should plan to do the procedure…
a. when Fermin would have normal bowel movement
b. at least 2 hours before visiting hours
c. prior to breakfast and morning care
d. after Fermin accepts alteration in body image
18. When observing a return demonstration of a colostomy irrigation, you know that more teaching is required if Fermin…
a. lubricates the tip of the catheter prior to inserting it into the stoma
b. hangs the irrigating bag on the bathroom door hook during fluid insertion
c. discontinues the insertion of fluid after only 500 ml of fluid has been instilled
d. clamps the flow of fluid when feeling uncomfortable
19. You are aware that teaching about colostomy care is understood when Fermin states, “I will contact my physician and report…”
a. if I Have any difficulty inserting the irrigating tub into the stoma.”
b. if I noticed a loss of sensation to touch in the stoma tissue.”
c. the expulsion of flatus while the irrigating fluid is running out.”
d. when mucus is passed from the stoma between the irrigations.”
10. You would know after teaching Fermin that dietary instructions for him is effective when he states, “It is important that I eat...”
a. soft foods that are easily digested and absorbed by my large intestines.”
b. bland food so that my intestines do not become irritated.”
c. food low in fiber so that there is less stool.
d. everything that I ate before the operation, while avoiding foods that cause gas.”
Situation: Ensuring safety is one of your most important responsibilities. You will need to provided instructions and information to your clients to prevent complications.
21. Randy has chest tubes attached to a pleural drainage system. When caring for him you should:
a. empty the drainage system at the end of the shift
b. clamp the chest tube when suctioning
c. palpate the surrounding areas for crepitus
d. change the dressing daily using aseptic techniques
22. Fanny, came in from PACU after pelvic surgery. As Fanny’s nurse, you know that the sign that would be indicative of a developing thrombophlebitis would be:
a. a tender, painful area on the leg
b. a pitting edema of the ankle
c. a reddned area at the ankle
d. pruritus on the calf and ankle
23. To prevent recurrent attacks on Terry who has acute glumeronephritis, you should instruct her to:
a. seek early treatment for respiratory infections
b. take showers instead of tub bath
c. continute to take the same restrictions on fluid intake
d. avoid situations that involve physical activity
24. Herbert had a laryngectomy and he is now for discharge. He verbalized this concern regarding his laryngectomy tube being dislodged. What should you teach him first?
a. Recognize that prompt closure of the tracheal opening may occur
b. Keep calm because there is no immediate emergency
c. Reinsert another tubing immediately
d. Notify the physician at once
25. When caring for Larry after an exploratory chest surgery and pneumonectomy, your priority would be to maintain
a. supplementary oxygen
b. ventilation exchange
c. chest tube drainage
d. blood replacement
Situation: 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.
26. 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 househeld help. Your most appropriate response would be:
a. “Don’t worry your husband’s 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.”
27. Voltaire develops a nosocomial respiratory tract infection. He asks 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.”
28. 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 prenteral nutrition is:
a. stomatitis
b. hepatitis
c. dysrhythmia
d. infection
29. A solution used to treat Pseudomomonas wound infection is:
a. Dakin’s solution
b. Half-strength hydrogen peroxide
c. Acetic acid
d. Betadine
30. 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/uL
d. Gram stain testing
Situation: As a nurse you need to anticipate the occurrence of complications of stroke so that life-threatening situations can be prevented.
31. Wendy is admitted to the hospital with signs and symptoms of stroke. Her Glasgow Coma Scale is 6 on admission. A central venous catheter was inserted and an I.V. infusion was started. As a nurse assigned to Wendy, what will be your priority goal?
a. prevent skin breakdown
b. preserve muscle function
c. promote urinary elimination
d. maintain a patent airway
32. Knowing that for a comatose patient, hearing is the last sense to be lost, as Judy’s nurse what should you do?
a. Tell her family that probably she can’t hear them
b. Talk loudly so that Wendy can hear you
c. Tell her family who are in the room not to talk
d. Speak softly then hold her hands gently
33. Which among the following interventions should you consider as the highest priority when caring for June who has hemiparesis secondary to stroke?
a. Place June on an upright lateral position
b. Perform range of motion exercises
c. Apply antiembolic stockings
d. Use hand rolls or pillows for support
34. Ivy, age 40, was admitted to the hospital with a severe headache, stiff neck and photophobia. She was diagnosed with a subarachnoid hemorrhage secondary to ruptured aneurysm. While waiting for surgery, you can provide a therapeutic environment by doing which of the following?
a. honoring her request for a television
b. placing her bed near the window
c. dimming the light in her room
d. allowing the family unrestricted visiting privileges
35. When performing a neurologic assessment on Walter, you find that his pupils are fixed and dialed. This indicated that he:
a. probably has meningitis
b. is going to be blind because of trauma
c. is permanently paralyzed
d. has received a significant brain injury
Situation: With the improvement in life expectancies and the emphasis in the quality of life it is important to provide quality care to our older patients. There are frequently encountered situations and issues relevant to the older patients.
36. Hypoxia may occur in the older patients because of which of the following physiologic changes associated with aging:
a. Ineffective airway clearance
b. Decreased alveolar surfaced area
c. Decreased anterior-posterior chest diameter
d. Hyperventilation
37. The older patient is at higher risk for incontinence because of:
a. dilated urethra
b. increased glomerular filtration rate
c. diuretic use
d. decreased bladder capacity
38. Merle, age 86, is complaining of dizziness when she stands up. This may indicate:
a. dementia
b. a visual problem
c. functional decline
d. drug toxicity
39. Cardiac ischemia in an older patient usually produces:
a. ST-T wave changes
b. Very high creatinine kinase level
c. Chest pain radiating to the left arm
d. Acute confusion
40. The most dependable sign of infection in the older patient is:
a. change in mental status
b. fever
c. pain
d. decreased breath sounds with crackles
Situation: A disaster is a large-scale emergency—even a small emergency left unmanaged may turn into a disaster. Disaster prepared is crucial is everybody’s business. There are agencies that are in charge of ensuring prompt response. Comprehensive Emergency Management (CEM) is an integrated approach to the management of emergency programs and activities for all four emergency phases (mitigation, preparedness, response, and recovery) for all types of emergencies and disasters (natural, man-made and attack) and for all levels of government and the private sector.
41. Which of the four phases of emergency management is defined as “sustained action that reduces or eliminates long-term risk to people and property from natural hazards and their effects”?
a. Recovery
b. Mitigation
c. Response
d. Preparedness
42. You are a community healthy nurses collaborating with the Red Cross and working with disaster relief following a typhoon which flooded and devastated the whole province. Finding safe housing for survivors, organizing support for the family, organizing counseling, debriefing sessions and securing physical care are the services you are involved with. To which type of prevention are these activities included:
a. Tertiary prevention
b. Primary prevention
c. Aggregate care prevention
d. Secondary prevention
43. During the disaster you see a victim with a green tag, you know that the person:
a. has injuries that are significant and require medical care but can wait hours with threat to life or limb
b. has injuries that are life-threatening but survival is good with minimal intervention
c. indicates injuries that are extensive and chances of survival are unlikely even with definitive care
d. has injuries that are minor and treatment can be delayed from hours to days
44. The term given to a category of triage that refers to life-threatening or potentially life-threatening injury or illness requiring immediate treatment:
a. Immediate
b. Emergent
c. Non-acute
d. Urgent
45. Which of the following terms refer to a process by which the individual receives education about recognition of stress reaction and management strategies for handling stress which may be instituted after a disaster?
a. Clinical incident stress management
b. Follow-up
c. Debriefing
d. Defusion
Situation: As a member of the health and nursing team, you have a crucial role to play in ensuring that all the members participate actively in the various tasks agreed upon.
46. While eating his meal, Matthew accidentally dislodges his IV lines and bleeds. Blood oozes on the surface of the overbed table. It is most appropriate that you instruct the housekeeper to clean the table with:
a. Acetone
b. Alcohol
c. Ammonia
d. Bleach
47. you are a member of the infection control team of the hospital. Based on a feedback during the meeting of the committee there is an increased incidence of pseudomonas infection in the Burn Unit (3 out of 10 patients had positive blood and wound culture). What is your priority activity?
a. Establish policies for surveillance and monitoring.
b. Do data gathering about the possible sources of infection (observation, chart review, interview).
c. Assign point persons who can implement policies.
d. Meet with the nursing group working in the burn unit and discuss problem with them.
48. Part of your responsibility as a member of the diabetes core group is to get referrals from the various wards regarding diabetic patients needing diabetes education. Prior to discharge today, 4 patients are referred to you. How would you start prioritizing your activities?
a. Bring your diabetes teaching kit and start your session, taking into consideration their distance from your office.
b. Contact the nurse-in-charge and find out from her the reason for the referral
c. Determine their learning needs then prioritize
d. involve the whole family in the teaching class
49. you have been designated as a member of the task force to plan activities for the Cancer Consciousness Week. Your committee has 4 months to plan and implement the plan. You are assigned to contact the various cancer support groups in your hospital. What will be your priority activity?
a. Find out if there is a budget for this activity
b. Clarify objectives of the activity with the task force before contacting the support groups
c. Determine the VIPs and Celebrities who will be invited
d. Find out how many suppor groups there are in the hospital and get the contact number of their president
50. You are invited to participate in the medical mission activity of your alumni association. In the planning stage everybody is expected to identify what they can do during the medical mission and what resources are needed. You thought it is also your chance to share what you can do for others. What will be your most important role where you can demonstrate the impact of nursing in health?
a. Conduct health education on healthy lifestyle
b. Be a triage nurse
c. Take the initial history and document findings
d. Act as a coordinator
Q & A: Practice like the real thing! - ALL TOPICS (Lap 6)
Situation: Nurse Minette is an independent Nurse Practitioner following-up referred clients in their respective homes. Here she handles a case of post-partal mother and family focusing on home care.
1. Nurse Minette needs to schedule a first home visit to OB client Leah. When is a first home-care visit typically made?
a. within 4 days after discharge
b. within 24 hours after discharge
c. within 1 hour after discharge
d. within 1 week of discharge
2. Leah is developing constipation from being on bed rest. What measures would you suggest she take to help prevent this?
a. eat more frequent small meals instead of three large ones daily
b. walk for at least half an hour daily to stimulate peristalsis
c. drink more milk, increased calcium intake prevents constipation
d. drink eight full glasses of fluid such as water daily
3. If you were Minette, which of the following actions would alert you that a new mother is entering a post-partal taking-hold phase?
a. she urges the baby to stay awake so that she can breast-feed him or her
b. she tells you she was in a lot of pain all during labor
c. she says that she has not selected a name for the baby as yet
d. she sleeps as if exhausted from the effort of labor
4. At 6-week postpartum visit what should this postpartal mother’s fundic height be?
a. inverted and palpable at the cervix
b. six fingerbradths below umbilicus
c. no longer palpable on her abdomen
c. one centimeter above the symphysis pubis
5. This postpartal mother wants to loose the weight she gained in pregnancy, so she is reluctant to increase her caloric intake for breast- feeding. By how much should a lactating mother increase her caloric intake during the first 6 months after birth?
a. 350 kcal/day
b. 500 kcal/day
c. 200 kcal/day
d. 1000 kcal/day
Situation: As the CPE is applicable for all professional nurses, the professional growth and development of nurses with specialties shall be addressed by a Specialty Certification Council. The following questions apply to these special groups of nurses.
6. Which of the following serves as the legal basis and statute authority for the Board of Nursing to promulgate measures to effect the creation of a Specialty Certification Council and promulgate professional development programs for this group of nurse professionals?
a. R.A. 7610
b. P.D. 223
c. R.A. 9173
d. R.A. 7164
7. By force of law, therefore, the PRC Board of Nursing released Resolution No. 14 Series of 1999 entitled: “Adoption of a Nursing Specialty Certification Program and Creation of Nursing Specialty Certification Council.” This rule-making power is called:
a. Quasi-Judicial Power
b. Regulatory Power
c. Quasi-Legislative Power
d. Executive / Promulgating Power
8. Under the PRC-Board of Nursing Resolution promulgating the adoption of a Nursing Specialty Certification Program and Council, which two of the following serves as the strongest for its enforcement?
A - Advances made in science and technology have provided the climate for specialization in almost all aspects of human endeavor; and
B - As necessary consequence, there has emerged a new concept known as globalization which seeks to remove barriers in trade, industry and services imposed by the national laws of countries all over the world; and
C – Awareness of this development should impel the nursing sector to prepare our people in the services sector to meet the above challenge; and
d. Current trends of specialization in nursing practice recognized by the International Council of Nurses (ICN) of which the Philippines is a member for the benefit of the Filpinos in terms of deepening and refining nursing practice and enhancing the quality of nursing care.
a. b & c are strong justifications
b. a & b are strong justifications
c. a & c are strong justifications
d. a & d are strong justifications
9. Which of the following is NOT a correct statement as regards Specialty Certification?
a. The Board of Nursing intended to create the Nursing Specialty Certification Program as a means of perpetuating the creation of an elite force of Filipino Nurse Professionals.
b. The Board of Nursing shall oversee the administration of the NSCP through the various Nursing Specialty Boards which will eventually be created.
c. The Board of Nursing at the time exercised their powers under R.A. 7164 in order to adopt the creation of the Nursing Specialty Certification Council and Program
d. The Board of Nursing consulted nursing leaders of national nursing associations and other concerned nursing groups which later decided to ask a special group of nurses of the program for nursing specialty certification.
10. The NSCC was created for the purpose of implementing the Nursing Specialty policy under the direct supervision and stewardship of the Board of Nursing. Who shall comprise the NSCC?
a. A chairperson who is the current President of the APO; a member from the Academe, and the last member coming from the Regulatory Board
b. The Chairperson and members of the Regulatory Board ipso facto acts as the CPRE council
c. A chairperson, chosen from among the Regulatory Board members; a Vice Chairperson appointed by the BON at-large; two other members also chosen at-large; and one representing the consumer group;
d. A Chairperson who is the President of the Association from the Academe; a member from the Regulatory Board; and the last member coming from the APO
Situation: Nurse Anna is a new BSN graduate and has just passed her Licensure Examination for Nurses in the Philippines. She has likewise been hired as a new Community health Nurse in one of the Rural Health units in their city, which of the following conditions may be acceptable TRUTHS applied to Community Health Nursing Practice?
11. Which of the following is the primary focus of community health nursing practice?
a. Cure of illnesses
b. Prevention of illnesses
c. Rehabilitation back to health
d. Promotion of health
2. In community health nursing, which of the following is our unit of service as nurses?
a. The community
b. The extended members of every family
c. The individual members of the Barangay
d. The Family
13. A very important part of the Community Health Nursing Assessment Process includes:
a. the application of professional judgment in estimating importance of facts to family and community
b. evaluation structures and qualifications of health center team
c. coordination with other sectors in relation to health concerns
d. carrying out nursing procedures as per plan of action.
14. In community health nursing it is important to take into account the family health data coupled with an equally important need to perform ocular inspection of the area as activities which are powerful elements of:
a. evaluation
b. assessment
c. implementation
d. planning
15. The initial step in the PLANNING process in order to engage in any nursing project or activities at the community level involves
a. goal-setting
b. monitoring
c. evaluation of data
d. provision of data
Situation: Please continue responding as a professional nurse in these other health situations through the following questions.
16. Transmission of HIV from an infected individual to another person occurs:
a. most frequently in nurses with needlesticks
b. only if there is a large viral load in the blood
c. most commonly as a result of sexual contact
d. in all infants born to women with HIV infection
17. The medical record of a client reveals a condition in which the fetus cannot pass through the maternal pelvis. The nurse interprets this as:
a. contracted pelvis
b. maternal disproportion
c. cervical insufficiency
d. fetopelvic disproportion
18. The nurse would anticipate a caesarian birth for a client who has which infection present at the onset of labor?
a. Herpes-simplex virus
b. Human papilloma virus
c. Hepatitis
d. Toxoplasmosis
19. After a vaginal examination, the nurse determines that the client’s fetus is in an occiput posterior position. The nurse would anticipate that the client will have:
a. a precipituous birth
b. intense back pain
c. frequent leg cramps
d. nausea and vomiting
20. The rationales for using a prostaglandin gel for a client prior to the induction of labor is to:
a. soften and efface the cervix
b. numb cervical pain receptors
c. prevent cervical lacerations
d. stimulate uterine contractions
Situation: Nurse Lorena 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.
21. Dina, 17 years old, asks you how a tubal ligation prevents pregnancy. Which would be the best answer?
a. Prostaglandins released form the cut fallopian tubes can kill sperm
b. Sperm can not enter the uterus because the cervical entrance is blocked
c. Sperm can no longer reach the ova, because the fallopian tubes are blocked
d. The ovary no longer releases ova as there is no where for them to go
22. The Dators are a couple undergoing testing for infertility. Infertility is said to exist when:
a. a woman has no uterus
b. a woman has no children
c. a couple has been trying to conceive for 1 year
d. a couple has wanted a child for 6 months
23. Another client named Lilia is diagnosed as having endometriosis. This condition interferes with fertility because:
a. endometrial implants can block the fallopian tubes
b. the uterine cervix becomes inflamed and swollen
c. the ovaries stop producing adequate estrogen
d. pressure on the pituitary leads to decreased FSH levels
24. Lilia is scheduled to have a hysterosalphingogram. Which of the following instructions would you give her regarding this procedure?
a. She will not be able to conceive for 3 months after the procedure
b. The sonogram of the uterus will reveal any tumors present
c. Many women experience mild bleeding as an after effect
d. She may feel some cramping when the dye is inserted
25. Lilia’s cousin on the other hand, knowing Nurse Lorena’s specialization asks what artificial insemination by donor entails. Which would be your best answer if you were Nurse Lorena?
a. Donor sperm are introduced vaginally into the uterus or cervix
b. Donor sperm are injected intra-abdominally into each ovary
c. Artificial sperm are injected vaginally to test tubal patency
d. The husband’s sperm is administered intravenously weekly
Situation: There are other important basic knowledge in the performance of our task as community health nurse in relation to immunization. These include:
26. The correct temperature to store vaccines in a refrigerator is:
a. between -4 deg C and +8 deg C
b. between 2 deg C and +8 deg C
c. between -8 deg C and 0 deg C
d. between -8 deg and +4 deg C
27. Which of the following vaccines is not done by intramuscular (IM) injection?
a. measles vaccine
b. DPT
c. Hepa-B vaccine
d. Tetanus toxoids
28. This vaccine content is derived from RNA recombinants.
a. measles
b. Tetanus toxoid
c. Hepatitis B vaccines
d. DPT
29. This is the vaccine needed before a child reaches 1 year in order for him/her to qualify as a fully immunized child:
a. DPT
b. Measles
c. Hepatitis B
d. BCG
30. Which of the following dose of tetanus toxoid is given to the mother to protect her infant from neonatal tetanus and likewise provide 10 years protection for the mother?
a. Tetanux toxoid 3
b. Tetanux toxoid 2
c. Tetanux toxoid 1
d. Tetanux toxoid 4
Situation: Records contain those comprehensive descriptions of patient’s health conditions and needs and at the same serve as evidences of every nurse’s accountability in the care giving process. Nursing records normally differ from institution to institution nonetheless they follow similar patterns of meeting needs for specific types of information. The following pertains to documentation / records management.
31. This special form is used when the patient is admitted to the unit. The nurse completes the information in this record particularly his/her basic personal data, current illness, previous health history, health history of the family, emotional profile, environmental history as well as physical assessment together with nursing diagnosis on admission. What do you call this record?
a. Nursing Kardex
b. Nursing Health History and Assessment Worksheet
c. Medicine and Treatment Record
d. Discharge Summary
32. These are sheets/forms which provide an efficient and time-saving way to record information that must be obtained repeatedly at regular and/or short intervals of time. This dos not replace the progress notes; instead this record of information on vital signs, intake and output, treatment, postoperative care. Postpartum care and diabetic regimen, etc. This is used whenever specific measurements or observations are needed to be documented repeatedly. What is this?
a. Nursing Kardex
b. Graphic Flow Sheets
c. Discharge Summary
d. Medicine and Treatment Record
33. These records show all medications and treatment provided on a repeated basis. What do you call this record?
a. Nursing Health History and Assessment Worksheet
b. Discharge Summary
c. Nursing Kardex
d. Medicine and Treatment Record
34. This flip-over card is usually kept in a portable file at the Nurse’s Station. It has 2 parts: the activity and treatment section and a nursing care plan section. This carries information about basic demographic data, primary medical diagnosis, current orders of the physician to be carried out by the nurse, written nursing care plan, nursing orders, scheduled tests and procedures, safety precautions in patient care and factors related to daily living activities. This record is used in the change-of-shift reports or during the bedside rounds or walking rounds. What record is this?
a. Discharge Summary
b. Medicine and Treatment Record
c. Nursing Health History and Assessment Worksheet
d. Nursing Kardex
35. Most nurses regard this conventional recording of the date, time and mode by which the patient leaves a health care unit but this record includes importantly, directs of planning for discharge that starts soon after the person is admitted to a healthcare institution. It is accepted that collaboration or multidisciplinary involvement (of all members of the health team) in discharge results in comprehensive care. What do you call this?
a. Discharge Summary
b. Nursing Kardex
c. Medicine and Treatment Record
d. Nursing Health History and Assessment Worksheet
Situation: As Filipino Professional Nurses we must be knowledgeable about the Code of Ethics for Filipino Nurse and practice these by heart. The next questions pertain to this Code of Ethics.
a. The Philippine Nurses Association for being the accredited professional organization was given the privilege to formulate a Code of Ethics for Nurses which the Board of Nursing promulgated.
b. Code for Nurses was first formulated in 1982 published in the Proceedings of the Third Annual Convention of the PNA House of Delegates
c. The present code utilized the Code of Good Governance for the Professions in the Philippines
d. Certificates of Registration of registered nurses may be revoked or suspended for violations of any provisions of the Code of Ethics.
37. Based on the Code of Ethics for Filipino Nurses, what is regarded as the hallmark of nursing responsibility and accountability?
a. human rights of clients, regardless of creed and gender
b. the privilege of being registered professional nurses
c. health, being a fundamental right of every individual
d. accurate documentation of actions and outcomes
38. Which of the following nurse’s behavior is regarded as a violation of the Code of Ethics of Filipino Nurses?
a. A nurse withholding harmful information to the family members of a patient
b. A nurse declining commission sent by a doctor for her referral
c. A nurse endorsing a person running for congress
d. Nurse Reviewers and/or nurse review center managers who pays a considerable amount of cash for reviewees who would memorize items from the licensure exams and submit these to them after the examination
39. A nurse should be cognizant that professional programs for specialty certification by the Board of Nursing accredited through the:
a. Professional Regulation Commission
b. Nursing Specialty Certification Council
c. Association of Deans of Philippine College of Nursing
d. Philippine Nurse Association
40. Mr. Santos, R.N. works in a nursing home, and he knows that one of his duties is to be an advocate for his patients. Mr. Santos knows a primary duty of an advocate is to:
a. act as the patient’s legal representative
b. complete all nursing responsibilities on time
c. safeguard the well being of every patient
d. maintain the patient’s right to privacy
Situation: Nurse Joanna works as an OB-Gyne nurse and attends to several high-risk pregnancies, particularly women with preexisting or newly acquired illness. The following conditions apply.
41. Bernadette is a 22-year old woman. Which condition would maker her more prone than others to developing a Candida infection during pregnancy?
a. Her husband plays golf 6 days a week
b. She was over 35 when she became pregnant
c. She usually drinks tomato juice for breakfast
d. She has developed gestational diabetes
42. Bernadette develops a deep vein thrombosis following an auto accident and is prescribed heparin sub-Q. What should Joanna educate her about in regard to this?
a. some infants will be born with allergic symptoms to heparin
b. her infant will be born with scattered petechiae on his trunk
c. heparin can cause darkened skin in newborns
d. heparin does not cross placenta and so does not affect a fetus
43. The cousin of Bernadette with sickle-cell anemia alerted Joanna that she may nee further instruction on prenatal care. What statement signifies this fact?
a. I’ve stopped jogging so I don’t risk becoming dehydrated.
b. I take an iron pill every day to help grow new red blood cells.
c. I am careful to drink at least eight glasses of fluid every day.
d. I understand why folic acid is important for red cell formation.
44. Bernadette routinely takes acetylsalicylic acid (aspirin) for arthritis. Why should she limit or discontinue this toward the end of pregnancy?
a. aspirin can lead to deep vein thrombosis following birth
b. newborns develop a red rash from salicylate toxicity
c. newborns develop withdrawal headaches from salicylates
d. salicylates can lead to increased maternal bleeding at childbirth
45. Bernadette received a laceration on her leg from her automobile accident. Why are lacerations of lower extremities potentially more serious in pregnant women than others?
a. lacerations can provoke allergic responses because of gonadotrophic hormone
b. increased bleeding can occur from uterine pressure on leg veins
c. a woman is less able to keep the laceration clean because of her fatigue
d. healing is limited during pregnancy, so these will not heal until after birth
Situation: Still in your self-managed Child Health Nursing Clinic, you encounter these cases pertaining to the care of children with pulmonary afflictions.
46. Josie brought her 3-month old child to your clinic because of cough and colds. Which of the following is your primary action?
a. give cotrimoxazole tablet or syrup
b. assess the patient using the chart on management of children with cough
c. refer to the doctor
d. teach the mother how to count her child’s breathing
47. In responding to the care concerns of children with severe disease, referral to the hospital is of the essence especially if the child manifests which of the following?
a. wheezing
b. stop feeding well
c. fast breathing
d. difficulty to awaken
48. Which of the following is the most important responsibility of a nurse in the prevention of unnecessary deaths from pneumonia and other severe diseases?
a. giving antibiotics
b. taking the temperature of the sick child
c. provision of careful assessment
d. weighing the sick child
49. You were able to identify factors that lead to respiratory problems in the community where your health facility serve. Your primary role therefore in order to reduce morbidity due to pneumonia is to:
a. teach mothers how to recognize early signs and symptoms of pneumonia
b. make home visits to sick children
c. refer cases to hospitals
d. seek assistance and mobilize the BHWs to have a meeting with mothers
50. Which of the following is the principal focus of the CARI program of the Department of Health?
a. enhancement of health team capabilities
b. teach mothers how to detect signs and where to refer
c. mortality reduction through early detection
d. teach other community health workers how to assess patients
1. Nurse Minette needs to schedule a first home visit to OB client Leah. When is a first home-care visit typically made?
a. within 4 days after discharge
b. within 24 hours after discharge
c. within 1 hour after discharge
d. within 1 week of discharge
2. Leah is developing constipation from being on bed rest. What measures would you suggest she take to help prevent this?
a. eat more frequent small meals instead of three large ones daily
b. walk for at least half an hour daily to stimulate peristalsis
c. drink more milk, increased calcium intake prevents constipation
d. drink eight full glasses of fluid such as water daily
3. If you were Minette, which of the following actions would alert you that a new mother is entering a post-partal taking-hold phase?
a. she urges the baby to stay awake so that she can breast-feed him or her
b. she tells you she was in a lot of pain all during labor
c. she says that she has not selected a name for the baby as yet
d. she sleeps as if exhausted from the effort of labor
4. At 6-week postpartum visit what should this postpartal mother’s fundic height be?
a. inverted and palpable at the cervix
b. six fingerbradths below umbilicus
c. no longer palpable on her abdomen
c. one centimeter above the symphysis pubis
5. This postpartal mother wants to loose the weight she gained in pregnancy, so she is reluctant to increase her caloric intake for breast- feeding. By how much should a lactating mother increase her caloric intake during the first 6 months after birth?
a. 350 kcal/day
b. 500 kcal/day
c. 200 kcal/day
d. 1000 kcal/day
Situation: As the CPE is applicable for all professional nurses, the professional growth and development of nurses with specialties shall be addressed by a Specialty Certification Council. The following questions apply to these special groups of nurses.
6. Which of the following serves as the legal basis and statute authority for the Board of Nursing to promulgate measures to effect the creation of a Specialty Certification Council and promulgate professional development programs for this group of nurse professionals?
a. R.A. 7610
b. P.D. 223
c. R.A. 9173
d. R.A. 7164
7. By force of law, therefore, the PRC Board of Nursing released Resolution No. 14 Series of 1999 entitled: “Adoption of a Nursing Specialty Certification Program and Creation of Nursing Specialty Certification Council.” This rule-making power is called:
a. Quasi-Judicial Power
b. Regulatory Power
c. Quasi-Legislative Power
d. Executive / Promulgating Power
8. Under the PRC-Board of Nursing Resolution promulgating the adoption of a Nursing Specialty Certification Program and Council, which two of the following serves as the strongest for its enforcement?
A - Advances made in science and technology have provided the climate for specialization in almost all aspects of human endeavor; and
B - As necessary consequence, there has emerged a new concept known as globalization which seeks to remove barriers in trade, industry and services imposed by the national laws of countries all over the world; and
C – Awareness of this development should impel the nursing sector to prepare our people in the services sector to meet the above challenge; and
d. Current trends of specialization in nursing practice recognized by the International Council of Nurses (ICN) of which the Philippines is a member for the benefit of the Filpinos in terms of deepening and refining nursing practice and enhancing the quality of nursing care.
a. b & c are strong justifications
b. a & b are strong justifications
c. a & c are strong justifications
d. a & d are strong justifications
9. Which of the following is NOT a correct statement as regards Specialty Certification?
a. The Board of Nursing intended to create the Nursing Specialty Certification Program as a means of perpetuating the creation of an elite force of Filipino Nurse Professionals.
b. The Board of Nursing shall oversee the administration of the NSCP through the various Nursing Specialty Boards which will eventually be created.
c. The Board of Nursing at the time exercised their powers under R.A. 7164 in order to adopt the creation of the Nursing Specialty Certification Council and Program
d. The Board of Nursing consulted nursing leaders of national nursing associations and other concerned nursing groups which later decided to ask a special group of nurses of the program for nursing specialty certification.
10. The NSCC was created for the purpose of implementing the Nursing Specialty policy under the direct supervision and stewardship of the Board of Nursing. Who shall comprise the NSCC?
a. A chairperson who is the current President of the APO; a member from the Academe, and the last member coming from the Regulatory Board
b. The Chairperson and members of the Regulatory Board ipso facto acts as the CPRE council
c. A chairperson, chosen from among the Regulatory Board members; a Vice Chairperson appointed by the BON at-large; two other members also chosen at-large; and one representing the consumer group;
d. A Chairperson who is the President of the Association from the Academe; a member from the Regulatory Board; and the last member coming from the APO
Situation: Nurse Anna is a new BSN graduate and has just passed her Licensure Examination for Nurses in the Philippines. She has likewise been hired as a new Community health Nurse in one of the Rural Health units in their city, which of the following conditions may be acceptable TRUTHS applied to Community Health Nursing Practice?
11. Which of the following is the primary focus of community health nursing practice?
a. Cure of illnesses
b. Prevention of illnesses
c. Rehabilitation back to health
d. Promotion of health
2. In community health nursing, which of the following is our unit of service as nurses?
a. The community
b. The extended members of every family
c. The individual members of the Barangay
d. The Family
13. A very important part of the Community Health Nursing Assessment Process includes:
a. the application of professional judgment in estimating importance of facts to family and community
b. evaluation structures and qualifications of health center team
c. coordination with other sectors in relation to health concerns
d. carrying out nursing procedures as per plan of action.
14. In community health nursing it is important to take into account the family health data coupled with an equally important need to perform ocular inspection of the area as activities which are powerful elements of:
a. evaluation
b. assessment
c. implementation
d. planning
15. The initial step in the PLANNING process in order to engage in any nursing project or activities at the community level involves
a. goal-setting
b. monitoring
c. evaluation of data
d. provision of data
Situation: Please continue responding as a professional nurse in these other health situations through the following questions.
16. Transmission of HIV from an infected individual to another person occurs:
a. most frequently in nurses with needlesticks
b. only if there is a large viral load in the blood
c. most commonly as a result of sexual contact
d. in all infants born to women with HIV infection
17. The medical record of a client reveals a condition in which the fetus cannot pass through the maternal pelvis. The nurse interprets this as:
a. contracted pelvis
b. maternal disproportion
c. cervical insufficiency
d. fetopelvic disproportion
18. The nurse would anticipate a caesarian birth for a client who has which infection present at the onset of labor?
a. Herpes-simplex virus
b. Human papilloma virus
c. Hepatitis
d. Toxoplasmosis
19. After a vaginal examination, the nurse determines that the client’s fetus is in an occiput posterior position. The nurse would anticipate that the client will have:
a. a precipituous birth
b. intense back pain
c. frequent leg cramps
d. nausea and vomiting
20. The rationales for using a prostaglandin gel for a client prior to the induction of labor is to:
a. soften and efface the cervix
b. numb cervical pain receptors
c. prevent cervical lacerations
d. stimulate uterine contractions
Situation: Nurse Lorena 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.
21. Dina, 17 years old, asks you how a tubal ligation prevents pregnancy. Which would be the best answer?
a. Prostaglandins released form the cut fallopian tubes can kill sperm
b. Sperm can not enter the uterus because the cervical entrance is blocked
c. Sperm can no longer reach the ova, because the fallopian tubes are blocked
d. The ovary no longer releases ova as there is no where for them to go
22. The Dators are a couple undergoing testing for infertility. Infertility is said to exist when:
a. a woman has no uterus
b. a woman has no children
c. a couple has been trying to conceive for 1 year
d. a couple has wanted a child for 6 months
23. Another client named Lilia is diagnosed as having endometriosis. This condition interferes with fertility because:
a. endometrial implants can block the fallopian tubes
b. the uterine cervix becomes inflamed and swollen
c. the ovaries stop producing adequate estrogen
d. pressure on the pituitary leads to decreased FSH levels
24. Lilia is scheduled to have a hysterosalphingogram. Which of the following instructions would you give her regarding this procedure?
a. She will not be able to conceive for 3 months after the procedure
b. The sonogram of the uterus will reveal any tumors present
c. Many women experience mild bleeding as an after effect
d. She may feel some cramping when the dye is inserted
25. Lilia’s cousin on the other hand, knowing Nurse Lorena’s specialization asks what artificial insemination by donor entails. Which would be your best answer if you were Nurse Lorena?
a. Donor sperm are introduced vaginally into the uterus or cervix
b. Donor sperm are injected intra-abdominally into each ovary
c. Artificial sperm are injected vaginally to test tubal patency
d. The husband’s sperm is administered intravenously weekly
Situation: There are other important basic knowledge in the performance of our task as community health nurse in relation to immunization. These include:
26. The correct temperature to store vaccines in a refrigerator is:
a. between -4 deg C and +8 deg C
b. between 2 deg C and +8 deg C
c. between -8 deg C and 0 deg C
d. between -8 deg and +4 deg C
27. Which of the following vaccines is not done by intramuscular (IM) injection?
a. measles vaccine
b. DPT
c. Hepa-B vaccine
d. Tetanus toxoids
28. This vaccine content is derived from RNA recombinants.
a. measles
b. Tetanus toxoid
c. Hepatitis B vaccines
d. DPT
29. This is the vaccine needed before a child reaches 1 year in order for him/her to qualify as a fully immunized child:
a. DPT
b. Measles
c. Hepatitis B
d. BCG
30. Which of the following dose of tetanus toxoid is given to the mother to protect her infant from neonatal tetanus and likewise provide 10 years protection for the mother?
a. Tetanux toxoid 3
b. Tetanux toxoid 2
c. Tetanux toxoid 1
d. Tetanux toxoid 4
Situation: Records contain those comprehensive descriptions of patient’s health conditions and needs and at the same serve as evidences of every nurse’s accountability in the care giving process. Nursing records normally differ from institution to institution nonetheless they follow similar patterns of meeting needs for specific types of information. The following pertains to documentation / records management.
31. This special form is used when the patient is admitted to the unit. The nurse completes the information in this record particularly his/her basic personal data, current illness, previous health history, health history of the family, emotional profile, environmental history as well as physical assessment together with nursing diagnosis on admission. What do you call this record?
a. Nursing Kardex
b. Nursing Health History and Assessment Worksheet
c. Medicine and Treatment Record
d. Discharge Summary
32. These are sheets/forms which provide an efficient and time-saving way to record information that must be obtained repeatedly at regular and/or short intervals of time. This dos not replace the progress notes; instead this record of information on vital signs, intake and output, treatment, postoperative care. Postpartum care and diabetic regimen, etc. This is used whenever specific measurements or observations are needed to be documented repeatedly. What is this?
a. Nursing Kardex
b. Graphic Flow Sheets
c. Discharge Summary
d. Medicine and Treatment Record
33. These records show all medications and treatment provided on a repeated basis. What do you call this record?
a. Nursing Health History and Assessment Worksheet
b. Discharge Summary
c. Nursing Kardex
d. Medicine and Treatment Record
34. This flip-over card is usually kept in a portable file at the Nurse’s Station. It has 2 parts: the activity and treatment section and a nursing care plan section. This carries information about basic demographic data, primary medical diagnosis, current orders of the physician to be carried out by the nurse, written nursing care plan, nursing orders, scheduled tests and procedures, safety precautions in patient care and factors related to daily living activities. This record is used in the change-of-shift reports or during the bedside rounds or walking rounds. What record is this?
a. Discharge Summary
b. Medicine and Treatment Record
c. Nursing Health History and Assessment Worksheet
d. Nursing Kardex
35. Most nurses regard this conventional recording of the date, time and mode by which the patient leaves a health care unit but this record includes importantly, directs of planning for discharge that starts soon after the person is admitted to a healthcare institution. It is accepted that collaboration or multidisciplinary involvement (of all members of the health team) in discharge results in comprehensive care. What do you call this?
a. Discharge Summary
b. Nursing Kardex
c. Medicine and Treatment Record
d. Nursing Health History and Assessment Worksheet
Situation: As Filipino Professional Nurses we must be knowledgeable about the Code of Ethics for Filipino Nurse and practice these by heart. The next questions pertain to this Code of Ethics.
a. The Philippine Nurses Association for being the accredited professional organization was given the privilege to formulate a Code of Ethics for Nurses which the Board of Nursing promulgated.
b. Code for Nurses was first formulated in 1982 published in the Proceedings of the Third Annual Convention of the PNA House of Delegates
c. The present code utilized the Code of Good Governance for the Professions in the Philippines
d. Certificates of Registration of registered nurses may be revoked or suspended for violations of any provisions of the Code of Ethics.
37. Based on the Code of Ethics for Filipino Nurses, what is regarded as the hallmark of nursing responsibility and accountability?
a. human rights of clients, regardless of creed and gender
b. the privilege of being registered professional nurses
c. health, being a fundamental right of every individual
d. accurate documentation of actions and outcomes
38. Which of the following nurse’s behavior is regarded as a violation of the Code of Ethics of Filipino Nurses?
a. A nurse withholding harmful information to the family members of a patient
b. A nurse declining commission sent by a doctor for her referral
c. A nurse endorsing a person running for congress
d. Nurse Reviewers and/or nurse review center managers who pays a considerable amount of cash for reviewees who would memorize items from the licensure exams and submit these to them after the examination
39. A nurse should be cognizant that professional programs for specialty certification by the Board of Nursing accredited through the:
a. Professional Regulation Commission
b. Nursing Specialty Certification Council
c. Association of Deans of Philippine College of Nursing
d. Philippine Nurse Association
40. Mr. Santos, R.N. works in a nursing home, and he knows that one of his duties is to be an advocate for his patients. Mr. Santos knows a primary duty of an advocate is to:
a. act as the patient’s legal representative
b. complete all nursing responsibilities on time
c. safeguard the well being of every patient
d. maintain the patient’s right to privacy
Situation: Nurse Joanna works as an OB-Gyne nurse and attends to several high-risk pregnancies, particularly women with preexisting or newly acquired illness. The following conditions apply.
41. Bernadette is a 22-year old woman. Which condition would maker her more prone than others to developing a Candida infection during pregnancy?
a. Her husband plays golf 6 days a week
b. She was over 35 when she became pregnant
c. She usually drinks tomato juice for breakfast
d. She has developed gestational diabetes
42. Bernadette develops a deep vein thrombosis following an auto accident and is prescribed heparin sub-Q. What should Joanna educate her about in regard to this?
a. some infants will be born with allergic symptoms to heparin
b. her infant will be born with scattered petechiae on his trunk
c. heparin can cause darkened skin in newborns
d. heparin does not cross placenta and so does not affect a fetus
43. The cousin of Bernadette with sickle-cell anemia alerted Joanna that she may nee further instruction on prenatal care. What statement signifies this fact?
a. I’ve stopped jogging so I don’t risk becoming dehydrated.
b. I take an iron pill every day to help grow new red blood cells.
c. I am careful to drink at least eight glasses of fluid every day.
d. I understand why folic acid is important for red cell formation.
44. Bernadette routinely takes acetylsalicylic acid (aspirin) for arthritis. Why should she limit or discontinue this toward the end of pregnancy?
a. aspirin can lead to deep vein thrombosis following birth
b. newborns develop a red rash from salicylate toxicity
c. newborns develop withdrawal headaches from salicylates
d. salicylates can lead to increased maternal bleeding at childbirth
45. Bernadette received a laceration on her leg from her automobile accident. Why are lacerations of lower extremities potentially more serious in pregnant women than others?
a. lacerations can provoke allergic responses because of gonadotrophic hormone
b. increased bleeding can occur from uterine pressure on leg veins
c. a woman is less able to keep the laceration clean because of her fatigue
d. healing is limited during pregnancy, so these will not heal until after birth
Situation: Still in your self-managed Child Health Nursing Clinic, you encounter these cases pertaining to the care of children with pulmonary afflictions.
46. Josie brought her 3-month old child to your clinic because of cough and colds. Which of the following is your primary action?
a. give cotrimoxazole tablet or syrup
b. assess the patient using the chart on management of children with cough
c. refer to the doctor
d. teach the mother how to count her child’s breathing
47. In responding to the care concerns of children with severe disease, referral to the hospital is of the essence especially if the child manifests which of the following?
a. wheezing
b. stop feeding well
c. fast breathing
d. difficulty to awaken
48. Which of the following is the most important responsibility of a nurse in the prevention of unnecessary deaths from pneumonia and other severe diseases?
a. giving antibiotics
b. taking the temperature of the sick child
c. provision of careful assessment
d. weighing the sick child
49. You were able to identify factors that lead to respiratory problems in the community where your health facility serve. Your primary role therefore in order to reduce morbidity due to pneumonia is to:
a. teach mothers how to recognize early signs and symptoms of pneumonia
b. make home visits to sick children
c. refer cases to hospitals
d. seek assistance and mobilize the BHWs to have a meeting with mothers
50. Which of the following is the principal focus of the CARI program of the Department of Health?
a. enhancement of health team capabilities
b. teach mothers how to detect signs and where to refer
c. mortality reduction through early detection
d. teach other community health workers how to assess patients
Thursday, November 12, 2009
Q & A: Practice like the real thing! - ALL TOPICS: Lap 5 (100 questions)
Situation: Jimmy developed this goal for hospitalization: “To get a handle on my nervousness.” The nurse is going to collaborate with him to reach his goal. Jimmy was admitted to the hospital because he called his therapist that he planned to asphyxiate himself with exhaust form his car but got frightened instead. He realized he needed help.
1. The nurse recognized that Jimmy had conceptualized his problem and the next priority goal in the care plan is:
a. help the client find meaning in his experience
b. help the client to plan alternatives
c. help the client cope with the present problem
d. help the client to communicate
2. The nurse is guided that Jimmy is aware of his concerns of the “her and now” when he crossed out which item from this list of “what to know?”
a. anxiety-laden unconscious conflicts
b. subjective idea of the range of mild to severe anxiety
c. early signs of anxiety
d. physiologic indices of anxiety
3. While Jimmy was discussing the signs and symptoms of anxiety with his nurse, he recognized that complete disruption of the ability to perceive occurs in:
a. panic state of anxiety
b. severe anxiety
c. moderate anxiety
d. mild anxiety
4. Jimmy initiates independence and takes an active part in his self-care with the following EXCEPT:
a. agreeing to contact the staff when he is anxious
b. becoming aware of the conscious feeling
c assessing need for medication and medicating himself
d. writing out a list of behaviors that he identified as anxious
5. The nurse notes effectiveness of interventions in using subjective and objective data in the:
A. initial plans or orders
b. database
c. problem list
d. progress notes
Situation: A research study was undertaken in order to identify and analyze a disabled boy’s coping reaction pattern during stress.
6. This study which is an in-depth study of one boy is a:
a. case study
b. longitudinal study
c. cross-sectional study
d. evaluative study
7. The process recording was the principal tool for data collection. Which of the following is NOT part of process recording?
a. non-verbal narrative account
b. analysis and interpretation
c. audio-visual recording
d. verbal narrative account
8. Which of these does NOT happen in a descriptive study?
a. exploration of relationship between two or more phenomena
b. explanation of relationship between two or more phenomena
c. investigation of a phenomenon in real-life context
d. manipulation of variable
9. One way to increase objectivity in dealing with one’s fears and anxieties is through the process of:
a. observation
b. intervention
c. validation
d. collaboration
10. All of the following responses are non-therapeutic. Which is the MOST direct violation of the concept of “congruence of behavior”?
a. responding in a punitive manner to the client
b. rejecting the client as a unique human being
c. tolerating all behavior in the client
d. communicating ambivalent messages to the client
Situation: During the morning endorsement, the outgoing nurse informed the nursing staff that Regina, 35 years old, was given flurazepam (Dalmane) 15 mg at 10:00 pm because she had trouble going to sleep. Before approaching Regina, the nurse read the observation of the night nurse.
11. Which of the following approaches of the nurse validates the date gathered?
a. “I learned that you were up till ten last night, tell me what happened before you were finally able to sleep and how was your sleep?”
b. “Hmm... You look like you had a very sound sleep. That pill you were given last night is effective, isn’t it?
c. “Regina, did you sleep well?”
d. “Regina, how are you?”
12. Regina is a high school teacher. Which of these information LEAST communicates attention and care for her need for information about her medicine?
a. Guided by a medication teaching plan, go over with her the purpose, indications and special instructions about the medication and provide her a checklist.
b. Provide a drug literature.
c. Have an informal conversation about the medication and its effects
d. Ask her what time she would like to watch the informative video about the medication.
13. The nurse engages Regina in the process of mutual inquiry to provide an opportunity for Regina to:
a. face emerging problems realistically
b. conceptualize her problem
c. cope with her present problem
d. perceive her participation in an experience
14. Which of these responses indicate that Regina needs FURTHER DISCUSSION regarding special instructions?
a. “I have to take this medicine judiciously.”
b. “I know I will stop taking the medicine when there is advice from the doctor for me to discontinue.”
c. “I will inform you and the doctor any untoward reactions I have.”
d. “I like taking this sleeping pill. It solves my problem of insomnia. I wish I can take it for life.”
15. Regina commits to herself that she understood and will observe all the medicine precautions by:
a. affixing her signature to the teaching plan that she has understood the nurse
b. committing what she learned to her memory
c. verbally agreeing with the nurse
d. relying on her husband to remember the precautions
Situation: The nurse-patient relationship is a modality through which the nurse meets the client’s needs.
16. The nurse’s MOST unique tool in working with the emotionally ill client is his/her”
a. theoretical knowledge
b. personality make-up
c. emotional reactions
d. communication skills
17. The psychiatric nurse who is alert to both the physical and emotional needs of clients is working from the philosophical framework that states:
a. All behavior is meaningful, communicating a message or need.
b. Human beings are systems of interdependent and interrelated parts.
c. Each individual has the potential for growth and change in the direction of positive mental health.
d. There is a basic similarity among all human beings.
18. One way to increase objectivity in dealing with one’s fears and anxieties is through the process of:
a. observation
b. intervention
c. validation
d. collaboration
19. All of the following responses are non-therapeutic. Which is the MOST direct violation of the concept of “congruence of behavior?”
a. responding in a punitive manner to the client
b. rejecting the client as a unique human being
c. tolerating all behavior in the client
d. communicating ambivalent messages to the client
20. The mentally ill person responds positively to the nurse who is warm and caring. This is a demonstration of the nurse’s role as:
a. counselor
b. mother surrogate
c. therapist
d. socializing agent
Situation: The nurse engages the client in a nurse-patient interaction.
21. The best time to inform the client about terminating the nurse-patient relationship is:
a. when the client asks how long the relationship would be
b. during the working phase
c. towards the end of the relationship
d. at the start of the relationship
22. The client says, “I want to tell you something but can you promise that you will keep this a secret?”
a. “Yes, our interaction is confidential provided the information you will tell me is not detrimental to your safety.”
b. “Of course yes, this is just between you and me. Promise!”
c. “Yes, it is my principle to uphold my client’s rights.”
d. “Yes, you have the right to invoke confidentiality of our interaction.”
23. When the nurse respects the client’s self-disclosure, this is a gauge for the nurse’s…
a. trustworthiness
b. loyalty
c. integrity
d. professionalism
24. Rapport has been established in the nurse-client relationship. The client asks to visit the nurse after his discharge. The appropriate response of the nurse would be:
a. “The best time to talk is during the nurse-client interaction time. I am committed to have this time available for us while you are at the hospital and ends after your discharge.”
b. “Yes, if you keep it confidential. This is part of privileged communication.”
c. “I am sorry; though I would want to, it is against hospital policy.”
d. “I am committed to your care.”
25. The client has not been visited by relatives for months. He gives a telephone number and requests the nurse to call. An appropriate action of the nurse would be:
a. inform the attending psychiatrist about the requests of the client
b. assist the client to bring his concern to the attention of the social worker
c. “Here (gives her mobile phone). You may call this number now.”
d. ask the client what is the purpose of contacting his relatives
Situation: Camila, 25 years old, was reported to be gradually withdrawing and isolating herself from friends and family members. She became neglectful of her personal hygiene. She was observed to be talking irrelevantly and incoherently. She was diagnosed with SCHIZOPHRENIA.
26. The past history of Camila would MOST PROBABLY reveal that her premorbid personally is:
a. schizoid
b. extrovert
c. ambivert
d. cycloid
27. Camila refuses to relate with others because she:
a. is irritable
b. feels superior to others
c. anticipates rejection
d. is depressed
28. Which of the following disturbances in interpersonal relationships MOST OFTEN predispose to the development of schizophrenia?
a. lack of participation in peer groups
b. faulty family atmosphere and interaction
c. extreme rebellion towards authority figures
d. solo parenting
29. Camila’s indifferenc toward the environment is a compensatory behavior to overcome:
a. guilt feelings
b. ambivalence
c. narcissistic behavior
d. feelings of insecurity
30. Schizophrenia is a/an:
a. anxiety disorder
b. neurosis
c. psychosis
d. personality disorder
Situation: Salome, an 80-year old widow, has been observed to be irritable, demanding and speaking louder than usual. She would prefer to be alone and take her meals by herself, minimize receiving visitors at home and no longer bothers to answer telephone calls because of deterioration of hearing. She was brought by her daughter to the geriatric clinic for assessment and treatment.
31. The nurse counsels Salome’s daughter that Salome is becoming very loud and has the tendency to become aggressive is a/an…
a. a beginning indifference to the world around her
b. an attempt to maintain authoritative role
c. an overcompensation for hearing loss
d. a behavior indicative of unresolved repressed conflict of the past
32. A nursing diagnosis for Salome is:
a. sensory deprivation
b. social isolation
c. cognitive impairment
d. ego despair
33. The nurse will assist Salome and her daughter to plan a goal which is for Malou to:
a. adjust to the loss of sensory and perceptual function
b. participate in conversation and other social situations
c. accept the steady loss of hearing that occurs with aging
d. increase her self-esteem to maintain her authoritative role
34. The daughter understood the following ways to assist Salome meet her needs and avoiding which of the following?
a. using short simple sentences
b. speaking distinctly and slowly
c. speaking at eye level and having the client’s attention
d. allowing her to take her meals alone
35. Salome was fitted a hearing aid. She understood the proper use and wear of this device when she says that the battery should be functional, the device is turned on and adjusted to a…
a. therapeutic level
b. comfortable level
c. prescribed level
d. audible level
Situation: For more than a month now, Cecilia is persistently feeling restless, worried and feeling as if something dreadful is going to happen. She fears being alone in places and situations where she thinks that no one might come to rescue her just in case something happens to her.
36. Cecilia is demonstrating:
a. acrophobia
b. claustrophobia
c. agoraphobia
d. xenophobia
37. Cecilia’s problem is that she always sees and thinks negative things, hence she is always fearful. A phobia is a symptom described as:
a. organic
b. psychosomatic
c. psychotic
d. neurotic
38. Cecilia has a lot of irrational thoughts. The goal of therapy is to modify her…
a. communication
b. cognition
c. observation
d. perception
39. Cognitive therapy is indicated for Cecilia when she is already able to handle anxiety reactions. Which of the following should the nurse implement?
a. assist her in recognizing irrational beliefs and thoughts
b. help find meaning in her behavior
c. provide positive reinforcement for acceptable behavior
d. administer anxiolytic drugs
40. After discharge, which of these behaviors indicate a positive result of being able to overcome her phobia?
a. she reads a book in the public library
b. she drives alone along the long expressway
c. she watches television with the family in the recreation room
d. she joins an art therapy group
Situation: It is the first day of clinical experience of nursing students at the psychiatry ward. During the orientation, the nurse emphasize that the team members (including nursing students) are legally responsible to safeguard patient’s records from loss or destruction, or from people who are not authorized to read them.
41. It is unethical to tell one’s friends and family members data about patients because doing so is a violation of a patient’s right to:
a. informed consent
b. confidentiality
c. least restrictive environment
d. civil liberty
42, The nurse must see to it that the written consent of mentally ill patients must be taken from the:
a. doctor
b. social worker
c. parents or legal guardian
d. law enforcement authorities
43. In an extreme situation and when no other resident or intern is available, should a nurse receive telephone orders, the order has to be correctly written and signed by the physician within:
a. 24 hours
b. 36 hours
c. 48 hours
d. 12 hours
44. The following are SOAP (Subjective – Objective – Analysis – Plan) statements on a problem: anxiety. What is the objective data?
a. Relate patients feelings to physician, initiate and encourage her to verbalize her fears, give emotional support by spending more time with patient, continue to make necessary explanations regarding diagnostic tests.
b. “has periods of crying, frequently verbalizes fear of what diagnostic tests will reveal”
c. Anxiety due to unknown
d. “I’m worried about what else they’ll find wrong with me.”
45. Nursing care plans provide very meaningful data for the patient profile and initial plan because the focus is on the:
a. summary of chronological notations made by individual health team members
b. identification of patient’s responses to medical diagnoses and treatment
c. patient’s responses to health and illness as a total person in interaction with the environment
d. step-by-step procedures for the management of common problems
Situation: Marie is 5 1/2 years old and is described by the mother as bedwetting at night.
46. Which of the following is the MOST common physiological cause of night bed wetting?
a. deep sleep factors
b. abnormal bladder development
c. infections
d. familial and genetic factors
47. All of the following, EXCEPT ONE, compromise the concepts of behavior therapy program:
a. reward and punishment
b. extinction
c. learning
d. placebo as a form of treatment
48. To help Marie who bed wets at night practice acceptable and appropriate behavior, it is important for the parents to be consistent with the following approaches EXCEPT:
a. discipline with a kind attitude
b. matter-of-fact in handling the behavior
c. sympathize for the child
d. be loving yet firm
49. A therapeutic verbal approach that communicates strong disapproval is:
a. “You are supposed to get up and go in the toilet when you feel you have to go and did not. The next time you bed wet, I’ll tell your friends and hang your sheets out the window for them to see.”
b. “You are supposed to get up and go in the toilet when you feel you have to go and did not. I expect you to from now on without fail.”
c. “If you bed wet, you will change your bed linen and wash the sheets.”
d. “If you don’t make an effort to control your bedwetting, I’d be upset and disappointed.
50. During your conference, the parent inquires how to motivate Marie to be dry in the morning. Your response which is an immediate intervention would be:
a. Give a star each time she wakes up dry and every set of five stars, give a prize.
b. Tokens make her materialistic at an early age. Give praise and hugs occasionally.
c. What does your child want that you can give every time he/she wakes up dry in the morning?
d. Promise him/her a long awaited vacation after school is over.
Situation: The nurse is often met with the following situations when clients become angry and hostile.
51. To maintain therapeutic eye contact and body posture while interacting with an angry and aggressive individual, the nurse should:
a. keep an eye contact while staring at the client
b. keep his/her hands behind his/her back or in one’s pockets
c. fold his/her arms across his/her chest
d. keep an “open” posture e.g. hands by sides but palms turned outwards
52. During the pre-interaction phase of the nurse-patient relationship, the nurse recognizes this normal initial reaction to an assaultive or potentially assaultive person. What is this normal initial reaction?
a. to remain and cope with the incident
b. to display empathy towards the patient
c. to call for help from the other members of the team
d. to stay and fight or run away
53. Which of the following is an accurate way of reporting and recording an incident?
a. “When asked about his relationship with his father, client became anxious.”
b. “When asked about his relationship with his father, client clenched his jaw / teeth, made a fist and fumed away from the nurse.”
c. “When asked about his relationship with his father, client was resistant to respond.”
d. “When asked about his relationship with his father, his anger was suppressed.”
54. To encourage thought, which of the following approaches is NOT therapeutic?
a. “Why do you feel angry?”
b. “When do you usually feel angry?”
c. “How do you usually express anger?”
d. “What situations provoke you to be angry?”
55. A patient grabs a chair and is about to throw it. The nurse best responds by saying:
a. “Stop! Put that chair down.”
b. “Don’t be silly.”
c. “Stop! The security will be here in a minute.”
d. “Calm down.”
Situation: Nursing care for the elderly.
56. In planning care for a patient with Parkinson’s disease, which of these nursing diagnoses should have PRIORITY?
a. Potential for injury
b. Altered nutritional state
c. Ineffective coping
d. Altered mood state
57. A healthy adaptation to aging is primarily related to an individual’s:
a. number of accomplishments
b. ability to avoid interpersonal conflict
c. physical health throughout life
d. personality development in his life span
58. The frequent use of the older client’s name by the nurse is MOST EFFECTIVE in alleviating which of the following responses to old age?
a. loneliness
b. suspicion
c. gried
d. confusion
59. An elderly confused client gets out of bed at night to go to the bathroom and tries to go to another bed when she returns. The MOST APPROPRIATE action the nurse would take is to:
a. assign client to a single room
b. leave a light on all night
c. remind client to call the nurse when she wants to get up
d. put side rails on the bed
60. An elderly who has lots of regrets, unhappy and miserable is experiencing:
a. crisi
b. despair
c. loss
d. ambivalence
Situation: Graciela is 1 1/2 year old is admitted to the hospital from the emergency room with a fracture of the left femur due to a fall down a flight of stairs. Graciela is place on Bryant’s traction.
61. While on Bryant’s traction, which of these observations of Graciela and her traction apparatus would indicate a decrease in the effectiveness of her traction?
a. Graciela’s buttocks are resting on the bed.
b. The traction weights are hanging 10 inches above the floor.
c. Graciela’s legs are suspended at a 90 degree angle to her trunk.
d. The traction ropes move freely through the pulley.
62. The nurse notes that the fall might also cause a possible head injury. She will be observed for signs of increased intracranial pressure which include:
a. narrowing of the pulse pressure
b. vomiting
c. periorbital edema
d. a positive Kernig’s sign
63. Graciela is assessed to have no head injury. The Bryant’s traction is removed. A plaster of Paris hip spica applied. Which of these findings is a concern of immediate attention that must be reported to the physician immediately?
a. Graciela is scratching the cast over her abdomen.
b. The toes of Graciela’s left foot blanch when the nurse applies pressure on them.
c. Graciela’s cast is still damp.
d. The nurse is unable to insert a finger under the edge of Graciela’s cast on her left foot.
64. Part of discharge plan is for the nurse to give instructions about the care of Graciela’s cast to the mother. Which of these statements indicate that the mother understood an important aspect of cast care?
a. “I will use white shoe polish to keep the cast neat.”
b. “I will place plastic sheeting around the perineal area of the cast.”
c. “I will use cool water to wash the cast.”
d. “I will reinforce cracked areas on the cast with adhesive tape.”
65. The nurse counsels Graciela’s mother ways to safeguard safety while providing opportunities to develop a sense of:
a. trust
b. initiative
c. industry
d. autonomy
Situation: Jolina is an 18-year old beginning college student. Her mother observed that she is having problems relating with her friends. She is undecided about her future. She has lost insight, lost interest in anything and complained of constant tiredness.
66. Jolina is put on antidepressant drugs. These drugs act on the brain chemistry, therefore they would be useful in which type of depression?
a. exogenous depression
b. neurotic depression
c. endogenous depression
d. psychotic depression
67. This is a tricyclic antidepressant drug:
a. venlafaxine (Effexor)
b. fluoxetine (Prozac)
c. sertraline (Zoloft)
d. imipiramine (Tofranil)
68. After one week of antidepressant medication, Jolina still manifests depression. The nurse evaluates this as:
a. unusual because action of antidepressant is immediate
b. unexpected because therapeutic effectiveness takes within a few days
c. expected because therapeutic effectiveness takes 2-4 weeks
d. ineffective result perhaps because the drug’s dosage is inadequate
69. Jolina continues to verbalize feeling sad and hopeless. She is not mixing well with other clients. One of the nurse’s important considerations for Jolina INITIALLY is:
a. formulate a structured schedule so she is able to channel her energies externally
b. let her alone until she feels like mingling with others
c. encourage her to join socialization hour so she will start to relate with others
d. encourage her to join group therapy with other patients
70. During the pre-discharge conference, the nurse suggests vocational guidance because it should help Jolina to:
a. find a good job
b. make some decisions about her future
c. realistically assess her assets and limitations
d. solve her own problems
Situation: Group approach in nursing.
71. Membership drop out generally occurs in group therapy after a member:
a. accomplishes his goal in joining the group
b. discovers that his feelings are shared by the group members
c. experiences feelings of frustration in the group
d. discusses personal concerns with group members
72. Which of the following questions illustrates the group role of encourager?
a. “What were you saying?”
b. “Who wants to respond nest?”
c. “Where do you go from here?”
d. “Why haven’t we heard from you?”
73. The goal of remotivation therapy is to facilitate:
a. insight
b. productivity
c. socialization
d. intimacy
74. The treatment of the family as a unit is based on the belief that the family:
a. is a social system and all the members are inter-related components of that system
b. as a unit of society needs the opportunity to change its own destiny
c. who has therapy together will tend to remain together
d. is “contaminated” by the presence of deviant members and all members need treatment
75. The working phase in a therapy group is usually characterized by which of the following?
a. caution
b. cohesiveness
c. confusion
d. competition
Situation: The mental health-psychiatric nurse functions in a variety of settings with different types of clients.
76. Poverty as reflected in prevalence of communicable diseases, malnutrition and social ill such as street children, homeless and prostitution is a predisposing factor to mental illness. A community approach to cope with this problem is for the nurse to support:
a. aggressive family planning methods
b. provision of social welfare benefits for the poor
c. social action
d. free clinics and more hospitals
77. The MOST cost-effective way to meet the mental health needs of the public is through programs with a PRIORITY goal of:
a. treatment
b. prevention
c. rehabilitation
d. research
78. Lorelie, upon discharge, was referred to a volunteer group where she has learned to read patterns, cut out fabric and use a sewing machine to make simple outfits that will help her earn in the future. What type of therapy is this?
a. recreational therapy
b. art therapy
c. vocational therapy
d. educational therapy
79. In a residential treatment home for adolescent girls, the clients were becoming increasingly tense and upset because of shortening of their recreation time. To de-escalate possible anger and aggression among the clients, it is BEST to play:
a. religious music
b. relaxation music
c. dance music
d. rock music
80. The parents of special children who are behaviorally disturbed need mental health education. Which of these topics would the school nurse consider as PRIORITY for their parent’s class?
a. drug education
b. child abuse
c. effective parenting
d. sex education
Situation: Nurses in all practice areas are likely to come in contact with clients suffering from acute and chronic drug abuse.
81. The psychodynamic therapy of substance abuse is based on the premise that drug abuse is:
a. a common problem brought about by socioeconomic deprivation
b. caused by a multiplicity of factors
c. predisposed by an inability to develop appropriate psychological resources to manage developmental stresses
d. due to biochemical factors
82. Being in contact with reality and the environment is a function of the:
a. conscience
b. ego
c. id
d. superego
83. Substance abuse is different from substance dependence in that substance dependence…
a. includes characteristics of adverse consequences and repeated use
b. requires long-term treatment in a hospital-based program
c. produces less severe symptoms than that of abuse
d. includes characteristics of tolerance and withdrawal
84. During the detoxification stage, it is a priority for the nurse to:
a. teach skills to recognize and respond to health-threatening situations
b. increase the client’s awareness of unsatisfactory protective behaviors
c. implement behavior modification
d. promote homeostasis and minimize the client’s withdrawal symptoms
85. Commonly known as “shabu” is:
a. cannabis sativa
b. lysergic acid diethylamide
c. methlylene dioxymethamphetamine
d. methamphetamine hydrochloride
Situation: It is common that clients ask the nurse personal questions.
86. Anticipation of personal questions is given adequate attention during which phase of the nurse-patient relationship?
a. orientation phase
b. working phase
c. pre-interaction phase
d. termination phase
87. If the client asks for the nurse’s telephone number, which of these responses is NOT appropriate?
a. “It is confidential. I just don’t give it to anyone.”
b. “What would you do with my number if I give it to you?”
c. “If I say ‘NO’ to your request, what are your thoughts about it?
d. “Are you asking for an official number of the hospital / clinic for your reference?”
88. When the client asks about the family of the nurse, the MOST APPROPRIATE response is:
a. avoid the situation and redirect the client’s attention
b. give a brief and simple response and focus on the client
c. “Why don’t we talk about your family instead?”
d. introduce another topic like the client’s interests
89. When the nurse is asked a personal question, which of these reactions indicate a need for to introspect?
a. the client is simply curious
b. his/her right to privacy is being intruded
c. the client knows no other way to begin a conversation
d. some patients are like children in seeking recognition from the nurse
90. It is 10 o’ clock on your watch. The client asks, “What time is it?” The nurse’s APPROPRIATE response is:
a. “Are you getting bored?”
b. “It is 10 o’ clock.”
c. “Why do you ask?”
d. “Guess what time is it?”
Situation: Ricky is a 12-year old boy with Down’s syndrome. He stands 5’ 1/2" and weights 100 lbs. He is slim and walks sluggishly with a limp. He wears a neck brace as a support for his neck. X-ray of his cervical spine showed “subluxation of C1 in relation to C2 with cord compression.” He attends a school for special education.
91. The classroom teacher consults the school nurse for guidance on how to take care of Ricky while inside the classroom. The nurse considers as priority Ricky’s…
a. physiological needs
b. needs for self-esteem
c. needs for safety and security
d. need for belonging
92. Ricky’s mother visited the school nurse. She asked, “What should I do when Ricky fondles his genitalia?” An appropriate response of the nurse is for the mother to:
a. divert Ricky’s attention and engage him in satisfying activities
b. tell Ricky that it is wrong to keep fondling his genitalia
c. ignore Ricky’s behavior because he will outgrow it later
d. engage him in computer games that will engage his hands
93. The nurse had one-on-one health education sessions with Ricky’s mother. The mother understood that for her son to learn to cope and be independent, she should constantly provide activities for Ricky to be able to:
a. socialize with people
b. eventually go to school alone
c. select and prepare his own food
d. do activities of daily living
94. All of the following activities are appropriate for Ricky EXCEPT:
a. working with clay
b. competitive sport
c. preparing and cooking simple menu
d. card and table games
95. Ricky’s IQ falls within the range of 50-55. He can be expected to:
a. profit from vocational training with moderate supervision
b. live successfully in the community
c. perform simple tasks in closely supervised settings
d. acquire academic skills of 6th grade level
Situation: The abuse of dangerous drugs is a serious public health concern that nurses need to address.
96. The nurse should recognize that the unit primarily responsible for education and awareness of the members of the family on the ill effects of dangerous drugs is the:
a. law enforcement agencies
b. school
c. projection
d. sublimation
97. A drug dependent utilizes this defense mechanism and enables him to forget shame and pain:
a. repression
b. rationalization
c. projection
d. sublimation
98. This drug produces mirthfulness, fantasies, flight of ideas, loss of train of thought, distortion, of size, distance and time and “bloodshot eyes” due to dilated pupils.
a. opiates
b. LSD
c. marijuana
d. heroin
99. The nurse evaluates that her health teaching to a group of high school boys is effective if these students recognize which of the following dangers of inhalant abuse?
a. sudden death from cardiac or respiratory depression
b. danger of acquiring hepatitis or AIDS
c. experience of “blackout”
d. psychological dependence after prolonged use
100. The mother of a drug dependent would never consider referring her son to a drug rehabilitation agency because she fears her son might just become worse while relating with other drug users. The mother’s behavior can be described as:
a. unhelpful
b. co-dependent
c. caretaking
d. supportive
1. The nurse recognized that Jimmy had conceptualized his problem and the next priority goal in the care plan is:
a. help the client find meaning in his experience
b. help the client to plan alternatives
c. help the client cope with the present problem
d. help the client to communicate
2. The nurse is guided that Jimmy is aware of his concerns of the “her and now” when he crossed out which item from this list of “what to know?”
a. anxiety-laden unconscious conflicts
b. subjective idea of the range of mild to severe anxiety
c. early signs of anxiety
d. physiologic indices of anxiety
3. While Jimmy was discussing the signs and symptoms of anxiety with his nurse, he recognized that complete disruption of the ability to perceive occurs in:
a. panic state of anxiety
b. severe anxiety
c. moderate anxiety
d. mild anxiety
4. Jimmy initiates independence and takes an active part in his self-care with the following EXCEPT:
a. agreeing to contact the staff when he is anxious
b. becoming aware of the conscious feeling
c assessing need for medication and medicating himself
d. writing out a list of behaviors that he identified as anxious
5. The nurse notes effectiveness of interventions in using subjective and objective data in the:
A. initial plans or orders
b. database
c. problem list
d. progress notes
Situation: A research study was undertaken in order to identify and analyze a disabled boy’s coping reaction pattern during stress.
6. This study which is an in-depth study of one boy is a:
a. case study
b. longitudinal study
c. cross-sectional study
d. evaluative study
7. The process recording was the principal tool for data collection. Which of the following is NOT part of process recording?
a. non-verbal narrative account
b. analysis and interpretation
c. audio-visual recording
d. verbal narrative account
8. Which of these does NOT happen in a descriptive study?
a. exploration of relationship between two or more phenomena
b. explanation of relationship between two or more phenomena
c. investigation of a phenomenon in real-life context
d. manipulation of variable
9. One way to increase objectivity in dealing with one’s fears and anxieties is through the process of:
a. observation
b. intervention
c. validation
d. collaboration
10. All of the following responses are non-therapeutic. Which is the MOST direct violation of the concept of “congruence of behavior”?
a. responding in a punitive manner to the client
b. rejecting the client as a unique human being
c. tolerating all behavior in the client
d. communicating ambivalent messages to the client
Situation: During the morning endorsement, the outgoing nurse informed the nursing staff that Regina, 35 years old, was given flurazepam (Dalmane) 15 mg at 10:00 pm because she had trouble going to sleep. Before approaching Regina, the nurse read the observation of the night nurse.
11. Which of the following approaches of the nurse validates the date gathered?
a. “I learned that you were up till ten last night, tell me what happened before you were finally able to sleep and how was your sleep?”
b. “Hmm... You look like you had a very sound sleep. That pill you were given last night is effective, isn’t it?
c. “Regina, did you sleep well?”
d. “Regina, how are you?”
12. Regina is a high school teacher. Which of these information LEAST communicates attention and care for her need for information about her medicine?
a. Guided by a medication teaching plan, go over with her the purpose, indications and special instructions about the medication and provide her a checklist.
b. Provide a drug literature.
c. Have an informal conversation about the medication and its effects
d. Ask her what time she would like to watch the informative video about the medication.
13. The nurse engages Regina in the process of mutual inquiry to provide an opportunity for Regina to:
a. face emerging problems realistically
b. conceptualize her problem
c. cope with her present problem
d. perceive her participation in an experience
14. Which of these responses indicate that Regina needs FURTHER DISCUSSION regarding special instructions?
a. “I have to take this medicine judiciously.”
b. “I know I will stop taking the medicine when there is advice from the doctor for me to discontinue.”
c. “I will inform you and the doctor any untoward reactions I have.”
d. “I like taking this sleeping pill. It solves my problem of insomnia. I wish I can take it for life.”
15. Regina commits to herself that she understood and will observe all the medicine precautions by:
a. affixing her signature to the teaching plan that she has understood the nurse
b. committing what she learned to her memory
c. verbally agreeing with the nurse
d. relying on her husband to remember the precautions
Situation: The nurse-patient relationship is a modality through which the nurse meets the client’s needs.
16. The nurse’s MOST unique tool in working with the emotionally ill client is his/her”
a. theoretical knowledge
b. personality make-up
c. emotional reactions
d. communication skills
17. The psychiatric nurse who is alert to both the physical and emotional needs of clients is working from the philosophical framework that states:
a. All behavior is meaningful, communicating a message or need.
b. Human beings are systems of interdependent and interrelated parts.
c. Each individual has the potential for growth and change in the direction of positive mental health.
d. There is a basic similarity among all human beings.
18. One way to increase objectivity in dealing with one’s fears and anxieties is through the process of:
a. observation
b. intervention
c. validation
d. collaboration
19. All of the following responses are non-therapeutic. Which is the MOST direct violation of the concept of “congruence of behavior?”
a. responding in a punitive manner to the client
b. rejecting the client as a unique human being
c. tolerating all behavior in the client
d. communicating ambivalent messages to the client
20. The mentally ill person responds positively to the nurse who is warm and caring. This is a demonstration of the nurse’s role as:
a. counselor
b. mother surrogate
c. therapist
d. socializing agent
Situation: The nurse engages the client in a nurse-patient interaction.
21. The best time to inform the client about terminating the nurse-patient relationship is:
a. when the client asks how long the relationship would be
b. during the working phase
c. towards the end of the relationship
d. at the start of the relationship
22. The client says, “I want to tell you something but can you promise that you will keep this a secret?”
a. “Yes, our interaction is confidential provided the information you will tell me is not detrimental to your safety.”
b. “Of course yes, this is just between you and me. Promise!”
c. “Yes, it is my principle to uphold my client’s rights.”
d. “Yes, you have the right to invoke confidentiality of our interaction.”
23. When the nurse respects the client’s self-disclosure, this is a gauge for the nurse’s…
a. trustworthiness
b. loyalty
c. integrity
d. professionalism
24. Rapport has been established in the nurse-client relationship. The client asks to visit the nurse after his discharge. The appropriate response of the nurse would be:
a. “The best time to talk is during the nurse-client interaction time. I am committed to have this time available for us while you are at the hospital and ends after your discharge.”
b. “Yes, if you keep it confidential. This is part of privileged communication.”
c. “I am sorry; though I would want to, it is against hospital policy.”
d. “I am committed to your care.”
25. The client has not been visited by relatives for months. He gives a telephone number and requests the nurse to call. An appropriate action of the nurse would be:
a. inform the attending psychiatrist about the requests of the client
b. assist the client to bring his concern to the attention of the social worker
c. “Here (gives her mobile phone). You may call this number now.”
d. ask the client what is the purpose of contacting his relatives
Situation: Camila, 25 years old, was reported to be gradually withdrawing and isolating herself from friends and family members. She became neglectful of her personal hygiene. She was observed to be talking irrelevantly and incoherently. She was diagnosed with SCHIZOPHRENIA.
26. The past history of Camila would MOST PROBABLY reveal that her premorbid personally is:
a. schizoid
b. extrovert
c. ambivert
d. cycloid
27. Camila refuses to relate with others because she:
a. is irritable
b. feels superior to others
c. anticipates rejection
d. is depressed
28. Which of the following disturbances in interpersonal relationships MOST OFTEN predispose to the development of schizophrenia?
a. lack of participation in peer groups
b. faulty family atmosphere and interaction
c. extreme rebellion towards authority figures
d. solo parenting
29. Camila’s indifferenc toward the environment is a compensatory behavior to overcome:
a. guilt feelings
b. ambivalence
c. narcissistic behavior
d. feelings of insecurity
30. Schizophrenia is a/an:
a. anxiety disorder
b. neurosis
c. psychosis
d. personality disorder
Situation: Salome, an 80-year old widow, has been observed to be irritable, demanding and speaking louder than usual. She would prefer to be alone and take her meals by herself, minimize receiving visitors at home and no longer bothers to answer telephone calls because of deterioration of hearing. She was brought by her daughter to the geriatric clinic for assessment and treatment.
31. The nurse counsels Salome’s daughter that Salome is becoming very loud and has the tendency to become aggressive is a/an…
a. a beginning indifference to the world around her
b. an attempt to maintain authoritative role
c. an overcompensation for hearing loss
d. a behavior indicative of unresolved repressed conflict of the past
32. A nursing diagnosis for Salome is:
a. sensory deprivation
b. social isolation
c. cognitive impairment
d. ego despair
33. The nurse will assist Salome and her daughter to plan a goal which is for Malou to:
a. adjust to the loss of sensory and perceptual function
b. participate in conversation and other social situations
c. accept the steady loss of hearing that occurs with aging
d. increase her self-esteem to maintain her authoritative role
34. The daughter understood the following ways to assist Salome meet her needs and avoiding which of the following?
a. using short simple sentences
b. speaking distinctly and slowly
c. speaking at eye level and having the client’s attention
d. allowing her to take her meals alone
35. Salome was fitted a hearing aid. She understood the proper use and wear of this device when she says that the battery should be functional, the device is turned on and adjusted to a…
a. therapeutic level
b. comfortable level
c. prescribed level
d. audible level
Situation: For more than a month now, Cecilia is persistently feeling restless, worried and feeling as if something dreadful is going to happen. She fears being alone in places and situations where she thinks that no one might come to rescue her just in case something happens to her.
36. Cecilia is demonstrating:
a. acrophobia
b. claustrophobia
c. agoraphobia
d. xenophobia
37. Cecilia’s problem is that she always sees and thinks negative things, hence she is always fearful. A phobia is a symptom described as:
a. organic
b. psychosomatic
c. psychotic
d. neurotic
38. Cecilia has a lot of irrational thoughts. The goal of therapy is to modify her…
a. communication
b. cognition
c. observation
d. perception
39. Cognitive therapy is indicated for Cecilia when she is already able to handle anxiety reactions. Which of the following should the nurse implement?
a. assist her in recognizing irrational beliefs and thoughts
b. help find meaning in her behavior
c. provide positive reinforcement for acceptable behavior
d. administer anxiolytic drugs
40. After discharge, which of these behaviors indicate a positive result of being able to overcome her phobia?
a. she reads a book in the public library
b. she drives alone along the long expressway
c. she watches television with the family in the recreation room
d. she joins an art therapy group
Situation: It is the first day of clinical experience of nursing students at the psychiatry ward. During the orientation, the nurse emphasize that the team members (including nursing students) are legally responsible to safeguard patient’s records from loss or destruction, or from people who are not authorized to read them.
41. It is unethical to tell one’s friends and family members data about patients because doing so is a violation of a patient’s right to:
a. informed consent
b. confidentiality
c. least restrictive environment
d. civil liberty
42, The nurse must see to it that the written consent of mentally ill patients must be taken from the:
a. doctor
b. social worker
c. parents or legal guardian
d. law enforcement authorities
43. In an extreme situation and when no other resident or intern is available, should a nurse receive telephone orders, the order has to be correctly written and signed by the physician within:
a. 24 hours
b. 36 hours
c. 48 hours
d. 12 hours
44. The following are SOAP (Subjective – Objective – Analysis – Plan) statements on a problem: anxiety. What is the objective data?
a. Relate patients feelings to physician, initiate and encourage her to verbalize her fears, give emotional support by spending more time with patient, continue to make necessary explanations regarding diagnostic tests.
b. “has periods of crying, frequently verbalizes fear of what diagnostic tests will reveal”
c. Anxiety due to unknown
d. “I’m worried about what else they’ll find wrong with me.”
45. Nursing care plans provide very meaningful data for the patient profile and initial plan because the focus is on the:
a. summary of chronological notations made by individual health team members
b. identification of patient’s responses to medical diagnoses and treatment
c. patient’s responses to health and illness as a total person in interaction with the environment
d. step-by-step procedures for the management of common problems
Situation: Marie is 5 1/2 years old and is described by the mother as bedwetting at night.
46. Which of the following is the MOST common physiological cause of night bed wetting?
a. deep sleep factors
b. abnormal bladder development
c. infections
d. familial and genetic factors
47. All of the following, EXCEPT ONE, compromise the concepts of behavior therapy program:
a. reward and punishment
b. extinction
c. learning
d. placebo as a form of treatment
48. To help Marie who bed wets at night practice acceptable and appropriate behavior, it is important for the parents to be consistent with the following approaches EXCEPT:
a. discipline with a kind attitude
b. matter-of-fact in handling the behavior
c. sympathize for the child
d. be loving yet firm
49. A therapeutic verbal approach that communicates strong disapproval is:
a. “You are supposed to get up and go in the toilet when you feel you have to go and did not. The next time you bed wet, I’ll tell your friends and hang your sheets out the window for them to see.”
b. “You are supposed to get up and go in the toilet when you feel you have to go and did not. I expect you to from now on without fail.”
c. “If you bed wet, you will change your bed linen and wash the sheets.”
d. “If you don’t make an effort to control your bedwetting, I’d be upset and disappointed.
50. During your conference, the parent inquires how to motivate Marie to be dry in the morning. Your response which is an immediate intervention would be:
a. Give a star each time she wakes up dry and every set of five stars, give a prize.
b. Tokens make her materialistic at an early age. Give praise and hugs occasionally.
c. What does your child want that you can give every time he/she wakes up dry in the morning?
d. Promise him/her a long awaited vacation after school is over.
Situation: The nurse is often met with the following situations when clients become angry and hostile.
51. To maintain therapeutic eye contact and body posture while interacting with an angry and aggressive individual, the nurse should:
a. keep an eye contact while staring at the client
b. keep his/her hands behind his/her back or in one’s pockets
c. fold his/her arms across his/her chest
d. keep an “open” posture e.g. hands by sides but palms turned outwards
52. During the pre-interaction phase of the nurse-patient relationship, the nurse recognizes this normal initial reaction to an assaultive or potentially assaultive person. What is this normal initial reaction?
a. to remain and cope with the incident
b. to display empathy towards the patient
c. to call for help from the other members of the team
d. to stay and fight or run away
53. Which of the following is an accurate way of reporting and recording an incident?
a. “When asked about his relationship with his father, client became anxious.”
b. “When asked about his relationship with his father, client clenched his jaw / teeth, made a fist and fumed away from the nurse.”
c. “When asked about his relationship with his father, client was resistant to respond.”
d. “When asked about his relationship with his father, his anger was suppressed.”
54. To encourage thought, which of the following approaches is NOT therapeutic?
a. “Why do you feel angry?”
b. “When do you usually feel angry?”
c. “How do you usually express anger?”
d. “What situations provoke you to be angry?”
55. A patient grabs a chair and is about to throw it. The nurse best responds by saying:
a. “Stop! Put that chair down.”
b. “Don’t be silly.”
c. “Stop! The security will be here in a minute.”
d. “Calm down.”
Situation: Nursing care for the elderly.
56. In planning care for a patient with Parkinson’s disease, which of these nursing diagnoses should have PRIORITY?
a. Potential for injury
b. Altered nutritional state
c. Ineffective coping
d. Altered mood state
57. A healthy adaptation to aging is primarily related to an individual’s:
a. number of accomplishments
b. ability to avoid interpersonal conflict
c. physical health throughout life
d. personality development in his life span
58. The frequent use of the older client’s name by the nurse is MOST EFFECTIVE in alleviating which of the following responses to old age?
a. loneliness
b. suspicion
c. gried
d. confusion
59. An elderly confused client gets out of bed at night to go to the bathroom and tries to go to another bed when she returns. The MOST APPROPRIATE action the nurse would take is to:
a. assign client to a single room
b. leave a light on all night
c. remind client to call the nurse when she wants to get up
d. put side rails on the bed
60. An elderly who has lots of regrets, unhappy and miserable is experiencing:
a. crisi
b. despair
c. loss
d. ambivalence
Situation: Graciela is 1 1/2 year old is admitted to the hospital from the emergency room with a fracture of the left femur due to a fall down a flight of stairs. Graciela is place on Bryant’s traction.
61. While on Bryant’s traction, which of these observations of Graciela and her traction apparatus would indicate a decrease in the effectiveness of her traction?
a. Graciela’s buttocks are resting on the bed.
b. The traction weights are hanging 10 inches above the floor.
c. Graciela’s legs are suspended at a 90 degree angle to her trunk.
d. The traction ropes move freely through the pulley.
62. The nurse notes that the fall might also cause a possible head injury. She will be observed for signs of increased intracranial pressure which include:
a. narrowing of the pulse pressure
b. vomiting
c. periorbital edema
d. a positive Kernig’s sign
63. Graciela is assessed to have no head injury. The Bryant’s traction is removed. A plaster of Paris hip spica applied. Which of these findings is a concern of immediate attention that must be reported to the physician immediately?
a. Graciela is scratching the cast over her abdomen.
b. The toes of Graciela’s left foot blanch when the nurse applies pressure on them.
c. Graciela’s cast is still damp.
d. The nurse is unable to insert a finger under the edge of Graciela’s cast on her left foot.
64. Part of discharge plan is for the nurse to give instructions about the care of Graciela’s cast to the mother. Which of these statements indicate that the mother understood an important aspect of cast care?
a. “I will use white shoe polish to keep the cast neat.”
b. “I will place plastic sheeting around the perineal area of the cast.”
c. “I will use cool water to wash the cast.”
d. “I will reinforce cracked areas on the cast with adhesive tape.”
65. The nurse counsels Graciela’s mother ways to safeguard safety while providing opportunities to develop a sense of:
a. trust
b. initiative
c. industry
d. autonomy
Situation: Jolina is an 18-year old beginning college student. Her mother observed that she is having problems relating with her friends. She is undecided about her future. She has lost insight, lost interest in anything and complained of constant tiredness.
66. Jolina is put on antidepressant drugs. These drugs act on the brain chemistry, therefore they would be useful in which type of depression?
a. exogenous depression
b. neurotic depression
c. endogenous depression
d. psychotic depression
67. This is a tricyclic antidepressant drug:
a. venlafaxine (Effexor)
b. fluoxetine (Prozac)
c. sertraline (Zoloft)
d. imipiramine (Tofranil)
68. After one week of antidepressant medication, Jolina still manifests depression. The nurse evaluates this as:
a. unusual because action of antidepressant is immediate
b. unexpected because therapeutic effectiveness takes within a few days
c. expected because therapeutic effectiveness takes 2-4 weeks
d. ineffective result perhaps because the drug’s dosage is inadequate
69. Jolina continues to verbalize feeling sad and hopeless. She is not mixing well with other clients. One of the nurse’s important considerations for Jolina INITIALLY is:
a. formulate a structured schedule so she is able to channel her energies externally
b. let her alone until she feels like mingling with others
c. encourage her to join socialization hour so she will start to relate with others
d. encourage her to join group therapy with other patients
70. During the pre-discharge conference, the nurse suggests vocational guidance because it should help Jolina to:
a. find a good job
b. make some decisions about her future
c. realistically assess her assets and limitations
d. solve her own problems
Situation: Group approach in nursing.
71. Membership drop out generally occurs in group therapy after a member:
a. accomplishes his goal in joining the group
b. discovers that his feelings are shared by the group members
c. experiences feelings of frustration in the group
d. discusses personal concerns with group members
72. Which of the following questions illustrates the group role of encourager?
a. “What were you saying?”
b. “Who wants to respond nest?”
c. “Where do you go from here?”
d. “Why haven’t we heard from you?”
73. The goal of remotivation therapy is to facilitate:
a. insight
b. productivity
c. socialization
d. intimacy
74. The treatment of the family as a unit is based on the belief that the family:
a. is a social system and all the members are inter-related components of that system
b. as a unit of society needs the opportunity to change its own destiny
c. who has therapy together will tend to remain together
d. is “contaminated” by the presence of deviant members and all members need treatment
75. The working phase in a therapy group is usually characterized by which of the following?
a. caution
b. cohesiveness
c. confusion
d. competition
Situation: The mental health-psychiatric nurse functions in a variety of settings with different types of clients.
76. Poverty as reflected in prevalence of communicable diseases, malnutrition and social ill such as street children, homeless and prostitution is a predisposing factor to mental illness. A community approach to cope with this problem is for the nurse to support:
a. aggressive family planning methods
b. provision of social welfare benefits for the poor
c. social action
d. free clinics and more hospitals
77. The MOST cost-effective way to meet the mental health needs of the public is through programs with a PRIORITY goal of:
a. treatment
b. prevention
c. rehabilitation
d. research
78. Lorelie, upon discharge, was referred to a volunteer group where she has learned to read patterns, cut out fabric and use a sewing machine to make simple outfits that will help her earn in the future. What type of therapy is this?
a. recreational therapy
b. art therapy
c. vocational therapy
d. educational therapy
79. In a residential treatment home for adolescent girls, the clients were becoming increasingly tense and upset because of shortening of their recreation time. To de-escalate possible anger and aggression among the clients, it is BEST to play:
a. religious music
b. relaxation music
c. dance music
d. rock music
80. The parents of special children who are behaviorally disturbed need mental health education. Which of these topics would the school nurse consider as PRIORITY for their parent’s class?
a. drug education
b. child abuse
c. effective parenting
d. sex education
Situation: Nurses in all practice areas are likely to come in contact with clients suffering from acute and chronic drug abuse.
81. The psychodynamic therapy of substance abuse is based on the premise that drug abuse is:
a. a common problem brought about by socioeconomic deprivation
b. caused by a multiplicity of factors
c. predisposed by an inability to develop appropriate psychological resources to manage developmental stresses
d. due to biochemical factors
82. Being in contact with reality and the environment is a function of the:
a. conscience
b. ego
c. id
d. superego
83. Substance abuse is different from substance dependence in that substance dependence…
a. includes characteristics of adverse consequences and repeated use
b. requires long-term treatment in a hospital-based program
c. produces less severe symptoms than that of abuse
d. includes characteristics of tolerance and withdrawal
84. During the detoxification stage, it is a priority for the nurse to:
a. teach skills to recognize and respond to health-threatening situations
b. increase the client’s awareness of unsatisfactory protective behaviors
c. implement behavior modification
d. promote homeostasis and minimize the client’s withdrawal symptoms
85. Commonly known as “shabu” is:
a. cannabis sativa
b. lysergic acid diethylamide
c. methlylene dioxymethamphetamine
d. methamphetamine hydrochloride
Situation: It is common that clients ask the nurse personal questions.
86. Anticipation of personal questions is given adequate attention during which phase of the nurse-patient relationship?
a. orientation phase
b. working phase
c. pre-interaction phase
d. termination phase
87. If the client asks for the nurse’s telephone number, which of these responses is NOT appropriate?
a. “It is confidential. I just don’t give it to anyone.”
b. “What would you do with my number if I give it to you?”
c. “If I say ‘NO’ to your request, what are your thoughts about it?
d. “Are you asking for an official number of the hospital / clinic for your reference?”
88. When the client asks about the family of the nurse, the MOST APPROPRIATE response is:
a. avoid the situation and redirect the client’s attention
b. give a brief and simple response and focus on the client
c. “Why don’t we talk about your family instead?”
d. introduce another topic like the client’s interests
89. When the nurse is asked a personal question, which of these reactions indicate a need for to introspect?
a. the client is simply curious
b. his/her right to privacy is being intruded
c. the client knows no other way to begin a conversation
d. some patients are like children in seeking recognition from the nurse
90. It is 10 o’ clock on your watch. The client asks, “What time is it?” The nurse’s APPROPRIATE response is:
a. “Are you getting bored?”
b. “It is 10 o’ clock.”
c. “Why do you ask?”
d. “Guess what time is it?”
Situation: Ricky is a 12-year old boy with Down’s syndrome. He stands 5’ 1/2" and weights 100 lbs. He is slim and walks sluggishly with a limp. He wears a neck brace as a support for his neck. X-ray of his cervical spine showed “subluxation of C1 in relation to C2 with cord compression.” He attends a school for special education.
91. The classroom teacher consults the school nurse for guidance on how to take care of Ricky while inside the classroom. The nurse considers as priority Ricky’s…
a. physiological needs
b. needs for self-esteem
c. needs for safety and security
d. need for belonging
92. Ricky’s mother visited the school nurse. She asked, “What should I do when Ricky fondles his genitalia?” An appropriate response of the nurse is for the mother to:
a. divert Ricky’s attention and engage him in satisfying activities
b. tell Ricky that it is wrong to keep fondling his genitalia
c. ignore Ricky’s behavior because he will outgrow it later
d. engage him in computer games that will engage his hands
93. The nurse had one-on-one health education sessions with Ricky’s mother. The mother understood that for her son to learn to cope and be independent, she should constantly provide activities for Ricky to be able to:
a. socialize with people
b. eventually go to school alone
c. select and prepare his own food
d. do activities of daily living
94. All of the following activities are appropriate for Ricky EXCEPT:
a. working with clay
b. competitive sport
c. preparing and cooking simple menu
d. card and table games
95. Ricky’s IQ falls within the range of 50-55. He can be expected to:
a. profit from vocational training with moderate supervision
b. live successfully in the community
c. perform simple tasks in closely supervised settings
d. acquire academic skills of 6th grade level
Situation: The abuse of dangerous drugs is a serious public health concern that nurses need to address.
96. The nurse should recognize that the unit primarily responsible for education and awareness of the members of the family on the ill effects of dangerous drugs is the:
a. law enforcement agencies
b. school
c. projection
d. sublimation
97. A drug dependent utilizes this defense mechanism and enables him to forget shame and pain:
a. repression
b. rationalization
c. projection
d. sublimation
98. This drug produces mirthfulness, fantasies, flight of ideas, loss of train of thought, distortion, of size, distance and time and “bloodshot eyes” due to dilated pupils.
a. opiates
b. LSD
c. marijuana
d. heroin
99. The nurse evaluates that her health teaching to a group of high school boys is effective if these students recognize which of the following dangers of inhalant abuse?
a. sudden death from cardiac or respiratory depression
b. danger of acquiring hepatitis or AIDS
c. experience of “blackout”
d. psychological dependence after prolonged use
100. The mother of a drug dependent would never consider referring her son to a drug rehabilitation agency because she fears her son might just become worse while relating with other drug users. The mother’s behavior can be described as:
a. unhelpful
b. co-dependent
c. caretaking
d. supportive
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