Q & A: Practice like the real thing! - ALL TOPICS : Lap 10 (50 questions)

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