NP 2 Flashcards by Sharahveille Sombrio

Situation: You are assigned in the Obstetric Ward of the hospital and is expected to be precise in maternal and child assessment.

A young-looking patient, Patient Nica, asked you whether she is pregnant or not and is noticeably anxious during the consultation. Which of the following could be taken as single entity and could easily indicate other conditions?
A. Serum laboratory tests
B. Amenorrhea
C. Periodic uterine tightening -
D. Ballotement

Ratio: easily indicate other conditions?—> least indicator = presumptive signs of pregnancy
A. Probable
C. Sign of labor
D, probable

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Patient Nica asked you about the accuracy of over-the-counter pregnancy kits as she was told to take one today by her friends. Which of the following will require further teaching if the patient would be taking the pregnancy kit today?
A. She knows that there is high degree of accuracy if instructions are followed exactly.
B. False positives may happen if a patient is taking anti-anxiety drugs.
C. The patient is taking oral contraceptives as the pregnancy is still not confirmed.
D. Advise the patient to repeat the test after 1 week if she still experiencing amenorrhea.

Ratio: stopped 5 days prior to testing

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One of the only three positive signs of pregnancy refer to detection of the fetal heart separate from the mother’s heart sounds. Using an ultrasonic monitoring system that convert ultrasonic frequencies to audible frequencies, it can usually detect fetal heart sound as early as which of the following?
A. 10th to 12th week of gestation
B. 8th to 10th week of gestation
C. 5th to 6th week of gestation
D. None of the above

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Systemic changes happen throughout the three trimesters.
Which of the following is not an observed physiologic change of pregnancy?
A. Increasing clotting factors
B. Decreased aldosterone levels
C. Pseudo-anemia
D. Lordosis

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As the patient continues her prenatal check-ups, it was unfortunately found that the embryo falled to develop beyond a primitive start. Which of the following would you not consider as a risk factor to this disease?
A. Low vitamin intake
B. Women older than 35 years of age
C. Blood group A women who marry blood group 0 men
D. Low protein intake

Ratio: Primitive start—> H. Mole, (-)
B. ✅
C. Rare
D. Needed for cell growth and division.

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Situation: You are assisting multiple cases involving different stages of labor.
6. During the last semester of pregnancy, it is essential to review signs of labor for them to easily recognize beginning signs.
People usually notice changes in a primipara’s body during fetal descent; this is because of which of the following?
A. Due to the presence of contractions
B. Dorito position, lower and more interior in the abdomen.
C. Due to the relief of breathing from increase in diaphragmatic pressure.
D. Due to the losse abdominal muscles in primipara

Ratio: [primipara]
A. After fetal decent
C. Irrelevant—> lightening
D. Loose abdominal muscles usually in multipara

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One patient asked you about what to watch out for as her estimated delivery date comes near. Which of the following will you exclude while discussing the characteristics of true labor contractions?
A. Felt first abdominally and remain confined to the abdomen and groin
B. Begin irregularly but become regular and predictable.
C. Continue no matter what the woman’s level of activity.
D. Felt first in lower back and sweep around to the abdomen in a wave

Ratio: definition of a FALSE labor

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How can you determine fetal presentation?
A. It denotes the body part that will first contact the cervix or be born first.
B. By determining the relationship of the presenting part of a fetus to the level of the ischial spines
C. By determining the relationship
between cephalocaudal axis of the fetal body and the cephalocaudal axis of a woman’s body.
D. By combination of fetal lie and the degree of fetal flexion.

Ratio: in degree of fetal flexion —> cephalic pressure
A. Fetal presentation
B. Engagement
C. Fetal lie

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A primipara patient has been worried as she was examined with 2 cm dilated last 12 noon and is seen to be at 2 cm still at
4PM. She is discouraged as she feels like nothing has happened, which of the following is the rationale behind the situation experienced by the patient?
A. Since effacement is accomplished before dilatation begins.
B. Since effacement is accomplished after dilatation begins.
C. Since dilatation may occur before effacement is complete.
D. None of the above.

Ratio: [primipara] (1). Effacement or thinning of cervix =100%. (2). Dilation

In multipara: Dilation —> effacement

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As you perform the hourly rounds of the postpartum mothers, which of the following will require you for further assessment?
A. 48 hours postpartum, fundal assessment at U-minus-1 level
B. Patient post-C-section with (+) lochia discharge
C. Patient post-vaginal delivery with (+) lochia discharge
D. None of the above - all are correct.

Ratio: abnormal, already 2 days.
—> Umbilicus minus 1cm down
Normally: 2 pp= U minus 2 level
Normal: 1 day pp= U minus 1 level

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Situation: Baseline present health of pregnant patients is important to be established during the first prenatal visit.

While interviewing your first patient about her health history, which of the following will not necessarily elicit additional concern if experienced by the patient in her first trimester?
A. Swelling of hands and face
B. Continuous bleeding
C. Bleeding
D. Frequent urination

Ratio: (normal) during trimester—> compression of the bladder
A. Abdormal, PIH
B & C. Abnormal need to check

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How do you document a patient who had two previous pregnancies, has given birth to two term children, had one miscarriage at 12 weeks, and is again pregnant at 10 weeks?
A. Gravida 3, Para 2
B. Gravida 4, Para 2
C. Gravida 3, Para 3
D. Gravida 4, Para 3

Ratio: pang 4 sya na buntis pero 2 and term children which is age of viability—> >24 wks

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During the physical examination, she observed to have (+) swollen optic disk identified on ophthalmoscopic examination, as well as seeing (+) spots before their eyes. Which of the following is the primary nursing action?
A. Refer the patient to an ophthalmologist for further investigation
B. Measure patient’s blood pressure and report to her attending physician
C. Administer oxygen support while waiting for the physician.
D. Ask the mother whether she experiences chloasma.

Ratio: if pt has swollen optic disk or pamamaga sa mata, it is a sign of PIH (pregnancy induced hypertension).
(+) spots before their eyes there is leakage of RBC

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One of the pregnant patients also reported visual changes of blurry vision and dry eyes,
however, upon further assessment, all parameters are evaluated to be normal. During the interview, you learned that she is works as an IT employee with long hours of computer screen time. Which of the following would be best to advise the patient?
A. Ask her employer about possible bedrest for 3 to 5 days for monitoring.
B. Instruct patient to have plenty of fruits and vegetables, whole grain, and low-fat dairy to avoid hypertension
C. Take a break every hour to not confuse sensations of eyestrain with actual pregnancy danger signs.
D. Refer to an ophthalmologist to assure the patient.

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Which of the following will you include in teaching the preparations necessary and what to expect for an abdominal ultrasound for patients on their first trimester?
A. Routine NPO for 8 to 12 hours before the exam
B. The patient can have medicine for pain for any contractions caused by the test
C. Place a towel under her left buttock to tip her body slightly during the procedure.
D. Drink a full glass of water every 15 minutes beginning 90 minutes before the procedure and not void until after the ultrasound.

D.
Ratio: reflect sound waves —> makes the uterus stable

A. Is wrong (NPO, 8-12 hrs)
B. No contractions
C. It should be in the right buttocks
|—> placing a towel on the right buttocks prevent supine hypotension syndrome

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Situation: One of the nursing roles in preparing families for childbearing and childrearing includes topics about the reproductive system, menstruation, and contraception.

Breast examinations should be routinely by women. Which of the following is considered untrue?
A. Breast tissues of women extend well into the axilla.
B. Women using combined oral contraceptives should return every two years for pelvic examination, Pap smear, and breast examinations, as long as they continue this type of contraceptive
C. Including the axilla during the breast examination is necessary to ensure completeness of the exam.
D. Breast self-examinations alone are no longer routinely recommended.

Ratio: its should be yearly

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The length of the average menstrual flow is usually 4 to 6 days, which of the following correctly states which initiates the menstrual cycle?
A. Release of GRH by hypothalamus
B. Increase in estrogen levels
C. Absorption of FSH
D. Decrease in progesterone levels

Ratio: Low of estrogen —> hypothalamus —> GnRH —> released APG — (1) FSH & (2) LH

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In symptothermal method of birth control, the client takes her temperature daily, analyzes her cervical mucus and observes: for other signs of ovulation. Which of the following accurately describes midcycle abdominal pain?
A. Dull and consistent pain felt on the lower side of the abdomen.
B. Sharp cramps felt on one side of the abdomen.
C. Sharp pain felt on one abdominal side accompanied by nausea, vomiting, and abdominal guarding.
D. Mittelschmertz pain cannot be relieved by pain relievers

Ratio: (midcycle abdominal pain)
Mittelschmertz —> a one sided abdominal pain.

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You are making a nursing care plan for an adolescent who is chief complain is dysmenorrhea. Which of the following should not be included in your client teaching?
A. Resting and effleurage may provide relief from dysmenorrhea.
B. Trying non-pharmacologic interventions such as yoga and exercise, as tolerated by the client.
C. Decrease sodium intake a few days before the expected menstrual flow.
D. Application of heat to the abdomen for abdominal pain

Ratio: dysmenorrhea— painful menses , (not be included)
D. Abdominal pain —> appendicitis (after not before)

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In explaining oral contraceptives to a group of clients, which of the following statements made by the student nurse will require further teaching?
A. If you think you might be pregnant, take one active pill for the day then consult your healthcare provider,
B. If you forget to take one of the active pills, take it as soon as you remember. Then, continue the following day with your usual schedule.
C. If you miss two consecutive active pills, take two pills as soon as you remember and two pills again the following day.
D. If you miss three or more pills in a row, throw out the rest of the pack and start a new pack of pills.

Ratio: stop taking contraceptives, if nalaman mo or nag suspect ka na ikaw ay buntis

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Situation: You are a community health nurse working with the local healthcare team.

. Since breast tumors are considered major type of neoplasm, women become suspicious of lumps felt in the breast area. One of your breastfeeding clients came to you with complaints of feeling a lump in one of her breasts. Which of the following will you respond with?
A. It’s okay to be paranoid but don’t worry so much about it, this is expected for breastfeeding clients.
B. Let’s refer you to your attending oncologist for further investigation.
C. This may be a distended gland from breastfeeding which persists not more than two breast feedings.
D. We’ll get you an ultrasound request from the physician.

Ratio: it resolves after 1-2 breastfeeding

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In teaching the clients about breast self-examination, what type of prevention does BSE technique employ?
A. Primary
B. Secondary
C. Tertiary
D. Prevention

Ratio: early detection

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In teaching BSE, when is the most appropriate time for the technique to be done?
A. Anytime since lumps can appear suddenly.
B. 3 days before expected menstrual flow.
C. During taking a bath for complete inspection
D. 3 to 5 days after menstruation

Ratio: breast are less likely swollen/ tender

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According to the cancer society, what is the recommended age for women to be taught with breast self-examination?
A. 16 years old
B. 20 years old
C. 30 years old
D. 40 years old

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In breastfeeding mothers, profuse blood supply to the breast is beneficial for bringing nutrients to the milk glands. Which of the following is considered as a disadvantage of this mechanism? A. Decreased risks of developing breast tumors. B. Possible blockages at the internal mammary, and intercostal arterles. C. Aids in metastasis of breast cancer if undiagnosed. D. None of the above.

Situation: You are the assigned nurse for a patient to be scheduled for mastectomy. As the primary nurse, you are expected to care for her before and after surgery. Before the mastectomy operation is done, which of the following is most important to be secured or acquired? A. Allergies, especially for antibiotics and anesthetics B. Informed consent. C. Secured funds for payment. D. MRI of the affected breast.

During the surgery, the anesthesiologist asked for an arm board to place on the operative side of the bed. As a nurse, you know that you will place the arm at what angle? A. 30 degrees B. 45 degrees C. 90 degrees D. Extended above the head, exposing the axilla

After the surgery, you are taking care of the patient at the recovery area. Upon looking at the chart, the patient underwent mastectomy with breast reconstruction. Which of the following would be the best arm placement of the affected side? A. You should not lift your arm above shoulder level until cleared by your plastic surgeon В. Perform shoulder range of motion as tolerated, even while the drains are in C. Do not move the affected side of the arm as much as possible. D. No arm restrictions.

A Ratio: stretching of sutures, dislodged of drainage

For patients who underwent breast surgery with an axillary node dissection, which of the following is the best placement of the affected arm post-surgery during the night? A. Any shoulder/arm movement and placement. B. Pillow to elevate the arm, putting it between your arm and your side. C. Any arm movement but do not move the shoulder on the surgical side. D. Folded arm of the surgical side, putting It in an arm cast.

In other cases, some breast surgeries require arm and shoulder exercises. Which of the following is not included among the post-operative exercises of breast surgery for the first following days? A. Shoulder rolls В. Arm saw C. Back scratch D. Lifting light welghts

D. Ratio: can cause strain in healing tissue disrupt of suture

Situation: Your nursing role does not end with maternal labor and delivery but extends to the care of newborn. In the assessment of the newborn, which of the following would need a follow-up assessment once measured by the nurse? A. Head circumference of 34 cm B. Chest circumference of 35 cm C. Heart rate of 135 bpm D. Weight of 3.0 kg

The temperature of a newborn is about 37.2 C at birth, however, body temperature quickly falls below normal due to heat loss and immature temperature-regulating mechanisms. What happens if heat is loss when the newborn is placed on a cold base of a warming unit? A. Radiation B. Conduction C. Evaporation D. Convection

B Ratio: skin contact with direct surface A. Indirect cintact C. Liquid to vapor D. Air

During the first week of life, newborns are at risk for bleeding disorders because of their sterile GI tract at birth. You are tasked to administer vitamin K to a newborn, which of the following is correct? A. 1.5 mg of Vit K, Subcutaneous B. 1.0 to 1.5 mg of Vit K, Intramuscular C. 0.5 to 1.0 mg of Vit K, Subcutaneous D. 0.5 to 1.0 mg of Vit K, Intramuscular

D. Ratio: tinuturok sa vastus lateralis

APGAR scoring are as follows during the first minute: HR at 75, Irregular cry, flaccid, grimace in response to slap to sole of foot, and blue extremities with normal body pigment. What is the score? A. 3 B. 4 C. 5 D. 2

Which of the following is the highest priority assessment in newborn care? А. Heart rate B. Respiratory function C. Temperature regulating mechanisms D. All of the above.

B Ratio: ensure the oxygenation to vital organs

Situation: In the pediatric ward, for us to provide appropriate Interventions, we must be knowledgeable about the common congenital anomalies. 36. One of the pediatric patients is observed to have abnormally tight frenulum. The parents are worried about the child's condition, which of the following is incorrect to include in the health teaching? A. Surgical procedures to release the tongue tie is required to be done before the child exceeds the age of learning to speak. v B. This is called as Ankyloglossia which is an abnormal restriction of the tongue. C As the anterior portion of the tongue grows the frenulum should be located farther back in normal cases. D. This condition rarely causes speech difficulty or destructive pressure on gingival tissue.

A Ratio: only done if functional problems arise

Once a cleft. lip is diagnosed upon birth, the necessary Interventions and therapeutic management are started to minimize the complications and problems from the condition. Which of the following is the priority Intervention for the first days of a child with cleft lip? Ar Surgery to repair a cleft lip B. Speech assessment: C. Feeding assistance D. Orthodontic treatment

C. Ratio: proper nutrition (1) special bottles/nipples (2) proper positioning —> choking/ aspiration (3) Frequent small feeding Surgery: 3-6 months

Before the surgery of cleft lip or palate, which of the following will you consider as the top priority nursing diagnosis? A. Risk for Ineffective airway clearance related to oral surgery B. Risk for impaired parenting related to the birth of an infant who is physically challenged C. Risk for situational low self-esteem D. Risk for imbalanced nutrition, less than body requirements, related to feeding problem caused by cleft lip or palate

D. Priority: nutrition Ratio: difficulty of sucking

Upon assessment of one of the infants, Leslie, you noticed enlarged fontanelles, separated suture lines, prominent scalp veins, lethargy, and increased head circumference. Which of the following will you most likely assess in the patient's vital signs? A. Decreased pulses, decreased RR, Increased BP B. Increased pulses, decreased RR, decreased BP C. Decreased pulses, increased RR, increased BP D. Fever, decreased pulses, increased RR, decreased BP

A. Called as Cushing triad—> increase ICP

A ventriculoperitoneal shunt insertion was advised by the physician for Leslie's treatment. Which of the following is not accurate in explaining the treatment? A. Ventriculoperitoneal shunt removes excessive cerebrospinal fluid from the ventricles and shunts it to the peritoneum B. Ventriculoperitoneal shunt is a two-way valve is present in the tubing behind the ear. C. Ventriculoperitoneal shunt is replaced as the child grows. D. After a shunt is inserted, the infant's bed is usually left flat or raised only about 30 degrees.

B. Ratio: one way valve

Situation: Poor nutrition, especially a diet low in folic acid, appears to be a major contributing factor in the formation of neural tube disorders in utero. In one of the prenatal check-ups, it was confirmed that the baby has anencephaly. During the consultation, the mother asked whether she would see her baby alive or not after the delivery. Your response would depend on which rationale? A. No, due to absence of cerebral hemispheres. - B. Yes, for only a few days because the respiratory and cardiac centers are in the intact medulla. C. No, due to absence of cerebral function. D. Yes, for only a few months, due to advancement of technology in medicine

B. Anencephaly— absence of cerebral hemisphere—> ne cerebral function and no respiratory and cardiac center

One of the infants were observed to have (+) dimpling, abnormal tufts of hair at the lower part of his back. You know that this condition is caused by which of the following? A. It occurs when the upper end of the neural tube fails to close in early intrauterine life B. It occurs when the spinal cord and the meninges protrude through the vertebrae that affects the motor and sensory function. C. It occurs when the posterior laminae of the vertebrae fail to fuse. D. It occurs when the meninges covering the spinal cord herniates through unformed vertebrae.

C Ratio: if it has a (+) dimpling this is a spina Bifida Occulta A. Anencephaly B. Myelomenigucele D. Meningucele

Before the surgery for the myelomeningocele, proper positioning is essential to avoid drying and pressure on the exposed membrane. Sterile gloves and sterile linens are used when caring for the patient and positioned correctly. Which of the following is the correct preoperative positioning of the patient? A. Supine position, with a rolled sterile linen adjacent to the exposed membrane to tilt the body. B. Side-lying position, with rolled blanket in front of the patient C Side-lying, with rolled blanket behind their back above the disorder and another rolled blanker below the disorder. D. Comfort of the patient is more important, position the patient however they want.

C. (Best position Prone) Ratio: to prevent compression of our myelomeningocele

You notice a seepage of clear fluid from the defect, which of the following will confirm that the fluid is CSF leakage? A. Check for evidence of glucose B. Check for smell and appearance C. Check for evidence of protein D. Report to physician

A. Ratio: if protien (B) urine and mucus, but kapag- glucose na yung nade-detect its fluid. It is kore likely CSF leakage.

Even after the surgery and management of neural tube disorders, impaired bladder elimination is likely to be observed depending on the affected level of the defect. One of your interventions include strengthening the parents' confidence and understanding of clean intermittent catheterization for the patient. Which of the following will require additional teaching when said or done by the patient? (- A. Always use sterile equipment and catheterize at least every 4 hours B. Wash around your child's urinary meatus with a clean washcloth or paper towel and warm, soapy water. C. Coat the tip of a clean catheter with water-soluble lubricant D. To reuse the catheter, clean it with soap and water, rinse with clear water.

Clue: clean intermittent catheterization A. Ratio: Clean technique not sterile

Situation: You encounter different ages of pediatric patients in the outpatient clinic you are working for. To understand your patients better, you review on different theoretical foundations of development. In psychosocial development by Freud, which of the following is true about ages 1 to 3 years old? A. Preferred method of oral gratification affects the child's personality development B. The climate surrounding toilet training can have lasting effects on children's personalities. C. The genitalia become an interesting and sensitive area of the body. D. Centers around the controversial issues of the Oedipus and Electra complexes.

B. Ratio: A. Oral stage —> 0-1 y/o C &D phallic stage — 3 to 6 y/o

According to Erikson's psychosocial development, what age group does a child develop a conscience in which they are no longer guided only by the outsiders, but they have an inner voice that warns? A. 6 to 12 years old B. 1 to 3 years old C. 3 to 6 years old D. 12 to 18 years old

C. Ratio: Initiative vs guilt A. Industry vs inferiority B. Autonomy vs shame and doubt D. Identity vs role confusion

According to Piaget's cognitive development, 5-year-old Emma now thinks that all women who has big bellies are pregnant after she asked her mother why her Aunt Hera has a big belly. The mother responded that her Aunt Hera has a baby inside of her belly. Which of the following reflects this kind of reasoning? A. Transductive B. Intuitive C. Inductive D. Egocentric

A. Ratio: A. Connecting 2 events —> illogical connection B. Based imagination C. Specific to general D. Self focused

According to Kohlbrg, how does an individual reach the most advanced level of moral development? A. When correct behavior is defined in terms of general, individual rights and the standards that have been examined and agreed on by the entire society. B. When behavior meets with approval and pleases helps other and is considered good C. When one in which self choosen an ethical principles guide decision decisions of conscience D. There is no “ most advanced level” of moral development since it is ever evolving and abstract

C. Ratio: A. Morality based on societal rules B. People- pleasers D. Meron!!

Which of the following correctly describes self-concept? A. Refers to a personal, subjective judgment of one's worthiness derived from and influenced by the social groups in the immediate environment B. Refers to value that an individual places on oneself and refers to an overall evaluation of oneself C. Refers to the subjective concepts and attitudes that individuals have toward their own bodies. D. Includes all of the notions, beliefs, and convictions that constitute an individual's self-knowledge

D. Ratio: kung paano dini describe ang kanyang sarili A &B: self- esteem C. Body image

Situation: Children who are admitted to hospitalization are susceptible to stressors because of the presence of change and the limited coping mechanisms to resolve the stressors. When a child experiences separation anxiety, which of the following is the introductory stage observed in the child? A. Stage of protest B. Stage of despair C. Stage of detachment D. Stage of denial:

During the following days of hospitalization, you notice that your patient appears to have finally adjusted to being in the hospital. She appears to form new relationships with the hospital staff, becomes more interested in the surroundings, and plays with others. She becomes more withdrawn when the parents are around. Which of the following will you advise the parents? A. Parents to stay for short but intimate periods with the patient. B. Scold the child for the negative behavior C. Increase interaction of the hospital staff that the patient has already formed new relationships with D. Explain to the parents about the stage of detachment, encourage parent-child interaction

D. Ratio: withdrawn— coping mechanism not permanent.

For non-critical admitted pediatric patients, how can you best minimize disruption in the child's routine? A.Write down a daily schedule in collaboration with the patient, parent, and the nurse. B. Preserve parent-child interaction at all times. C. Do not limit the number of times a parent can visit the child. D. Keep the child in cribs or play yards.

How can you best reassure a preschool child after blood extraction? A. Explain to the child about how bleeding would stop after needle is removed and applied pressure. B. Draw how the bleeding stops after the needle is removed. C. Let the parent remove the needle instead. D. Apply a band-aid to the site of removal.

D. Best reassure: concrete, visible reassurance Ratio: closure of the woud — increased sense of security and comfort. Procedure over

Which of the following will you not include in educating the parents about supporting siblings of the patients during hospitalization? A. Trade off staying at the hospital with spouse or have a surrogate who knows the siblings well stay in the home. B. Withheld information about the child's condition to young siblings to not scare them. C. Arrange for children to visit their brother or sister if possible D. Encourage phone visits and mail between brothers and sisters v

B. Ratio: breaks trust

Situation: School-age children require different interventions and approaches from the earlier years. You are a school nurse in one of the public elementary schools. How can you describe the Erikson’s developmental step to be achieved during this age group? A.Learning how to do things B. Learning how to do things well C. Achievement of curiosity D. Achievement of inferiority

B Goal: (1) sense of competence Ratio: completing task If repeated criticism/ failure— inferiority

Karen, a 9-year-old, has been forming clubs among her classmates. A usual characteristic of "clubs" for this age in children is: A. The club has formal activities and rules B. The club is designed to help children socialize among one another C. The club is designed to exclude another child D. Both girls and boys are welcome in the club

C. “Clubs” - (1) define boundaries (2) sense of belongingness

For 6-year-old schoolers, who do they often see as the final authority on all subjects? A. Parents B. Teacher C Classmate / Best friend D. Father

Carlito, a 7-year-old, replied "But Sam's parents do not make him fix his bed in the morning, his nanny does it for him Instead," when asked to do this chore in the morning. As a nurse, how will you advise the parent in replying to these kinds of situation? A. "There are all kinds of ways to do things, but in our house, the rule is to make your bed after sleeping on it." B. "In this house, you are to follow me all the time." C. "Then well get you your own nanny. Good idea!' D. "How about I'll help you do this every day?"

A. Ratio: hindi niya iniinvalidate B. Authoritarian C. Ignores teaching responsibility D. Doesn’t promote independence

During one of the check-ups, a parent of a 7-year-old casually narrate how her child skillfully stole loose change from her wallet. Upon further investigation, this happened more than once, and the parent asked you how to deal with this. How will you respond to this situation? A. Do not mind since this is normal for their age group and it is not within your responsibility. B. Tell the parent that this early childhood stealing must be dealt without a great deal of emotion and explain to the child about the importance of property rights. C. Recommend possible counseling from her attending physician as they should have progressed beyond this normal developmental step by this age. D. Ask the parent if they are modelling someone with the same behavior.

B. Take note: it the child is >9 y/o tapos nag nanakaw parin. Required counseling

Situation: You are applying for a researcher position at a tertiary hospital, you want to refresh on nursing research before you go to the interview. 61. At the most basic level, research topics originate from which of the following? A. Researcher's interest B. Population's interest C. Population's problem D. Researcher's problem

In creating a problem statement for quantitative studies, which is not a component in the construction of a good problem statement? A. Problem identification B. Scope of the problem C. Knowledge gaps D. None of the above

D. (1) problem identification (2) background (3) scope of the problem (4) consequences of the problem (5) knowledge gaps (6) proposed solutions

In this research hypothesis: Elle and the researchers hypothesized that patients diagnosed with venous insufficiency disease who participated in a 14-week low intensity walking intervention, compared to patients who did not participate, would have improved autonomic function. What is the independent variable? A. Participation in the walking intervention B. 14-week low intensity walking intervention C. Autonomic function D. Participation in the program is related to subsequent autonomic function

A. * patients diagnosed with venous insufficiency disease — is the population C. Autonomic function — is the outcome/ dependent variable

Hypotheses are formally tested through statistical analysis. Which of the following is untrue? A. Statistical analysis does not offer proof. B. Having <0.05 corresponds to a high probability of being correct. C. Hypotheses are proved or disproved through statistical analysis. D. Hypotheses come to be increasingly supported with evidence from multiple studies

C. Ratio: hypotheses are never proved/disproved. Supported/ rejected

A thematic analysis involves observing patterns and regularities, as well as inconsistencies. Which of the following refers to whether it can be applied to other populations, situations or contexts beyond the specific study sample? A. Substantive themes B. Subsumed themes C. Generalized themes D. Generalizability themes

D. Ratio: A. Main theme B. Less prominent—> not applicable to other populations C. Walang tinatawag na generalized themes

Situation: Clinical trials are undertaken to evaluate an innovative therapy. 66. Which of the following refers to the pilot test of treatment effectiveness? A. Phase I' B. Phase II C. Phase III D. Phase IV

B. Ratio: Phase I - test safety , dosage , side effects Phase II - efficacy and further safety Phase III - clinical trial —> random assignment Phase IV - long term safety and effectiveness

Which phase involves studies of the effectiveness of an Intervention in the general population? A. Phase II B. Phase III C. Phase IV D. Phase V

C Ratio: Phase I - test safety , dosage , side effects Phase II - efficacy and further safety Phase III - clinical trial —> random assignment Phase IV - long term safety and effectiveness

Which phase is designed to establish safety, tolerance, and dose with a simple design? A. Phase I B. Phase II C. Phase III D. Phase IV

A. Ratio: Phase I - test safety , dosage , side effects Phase II - efficacy and further safety Phase III - clinical trial —> random assignment Phase IV - long term safety and effectiveness

Situation: You plan to implement a Quality Improvement project in your designated ward. 69. The most widely used QI model in health care is PDSA which stands for? A. Performance - Do intervention - Sort - Act B. Perform assessment - Do intervention - Sort data - Act results C. Plan-Do-Study-Act D. Plan-Designate-Sort-Act

Which of the following does not describe the PDSA model? A. This model relies on multiple rapid cycles of investigating and acting on a problem B. The model tries to implement an improvement strategy on a small scale. C. The model is implemented through series of cycles until there is confidence in the effectiveness of the change. D. The model provides the team to test strategies in a randomized manner

D. Ratio: not randomized but it should be in a controlled manner

Situation: You are a newly recruited registered nurse working in an ambulatory surgery center. During the admission of the patient, while interviewing the patient, he still wants to proceed with his scheduled surgery and signed the consent. Before wheeling in, Amanda, the legal wife of the patient, has been refusing to consent to surgery since she read an article who died from being under anesthesia. She went to the nurse's station and verbalized withdrawing consent. Whose decision will you honor? A. Patient, the husband B. The wife of patient C. Attending physician D. Housekeeper

A. Ratio: because the patient is conscious/ mentally competent

The post-operative patient verbalized a 6/10 pain on the operative site. While carrying out orders from the anesthesiologist, you are unable to read one of the prescribed intravenous pain medications and its corresponding dosage. Which of the following will do? A. Ask your senior nurse on the usual medications ordered by the anesthesiologist. B. Follow and administer the medication based on what you can understand. C. Call the anesthesiologist and read it back to clarify. D. Ask the patient about the usual pain medications they use then give it to them.

C. Ratio: accurate information

A long weekend is scheduled to happen in the month of November. You plan to go back to your province during the holidays. When you asked for a vacation leave on those days, the manager mocked you for having the audacity to ask for a long weekend when you are a new hire. She made sure that other co-workers were hearing it and has been telling the others that you are an ineffective nurse. Which of the following can you complain with? A. Disrespect of co-worker B. Grave insult C. Slander D. Libel

C. Ratio: because the libel is for writing/ broadcast

The following are traits of leadership, except which of the following? A. Based on influence and shared meaning B. An achieved position C. Requires initiative and independent thinking D. A formally designated role

D. Ratio: for manager only

Which of the following style refers to believing that people have value as people, not just as workers? A. Human Relations-Based Management B. Servant Leadership C. Effective Management D. Position Relations-Based Leadership

B Ratio: inuuna natin ang mga taohan natin, basta we are caring for the people as people, hindi tayo nagki-care as workers A. Theory X and Theory Y C &D. Is not a type of leadership

Nursing documentation, especially for circulating nurses in the OR, needs to be legally credible. Documentation is credible when it is the following below, except? A. Contemporaneous B. Accurate C. Periodic D. Appropriate

C. Take note: documents should be documented in a timely manner. A. In a timely manner

Situation: You are a newly assigned manager of the unit and is training under the direction of the previous manager. You become familiar with the managerial duties of the unit. You are planning a budget that quantifies day-to-day expenses of a nursing unit that includes budget for electricity and water, office supplies, and salary of part-time employees. A. Capital budget B. Master budget C. Overall budget D. Operational budget

D. Ratio: A. Longterm equipment/ major renovation, pricey B &C. Irrelevant

In planning to buy a brand-new anesthesia machine, you discovered that there's an outstanding obligation that needs to be paid within a one-year time period. Which of the following refers to this component to the budget process? A. Assets B. Current liability C. Equity Dr Long-term liability

B. Ratio: one year time period If long term liability— more than a year

As you proceed with the budgeting process for the ward, you start with the collection of relevant data for the budget development. After collecting the data, which of the following will you next do? A. Planning of services B. Planning of activities C. Reviewing the relevant data D. Monitoring the budget

A. Steps in budget development: (1) collect the data (2) planning of services (3) planning of activities (4) implementing the plan (5) monitoring the budget

During your managerial training, two of your staff members got into conflict about scheduling their rest day on the same date. Upon checking, the scheduled cases that day, only one staff nurse can be granted their off day to avoid lack in workforce. You were tasked to resolve the conflict. You tried to find the best solution after gathering the ideas with the involved parties. Which type of conflict-resolution strategy was used? A. Majority rule B. Compromise C. Collaboration D. Brainstorming

C. Ratio: involving other parties A. Kung ano ang gusto ng nakararami yung ang desisyon natin B. Each parties give up something D. Not a method of a conflict resolution

Situation: a client died in a car motor vehicle accident surely after being discharged from an ambulatory surgery center. he underwent colonoscopy and intravenous sedation. The family sued the center for permitting the client to go home after the procedure. You are the nurse who carried the patient in the recovery area. You are served with a complaint, which of the following is your priority action? A. File a written answer to the complaint B. Seek help from the nursing manager C. Review the documentation needed for defense D. All of the above

A. Ratio: need a formal response— to protect ur legal rights

The documentation revealed that the client verbalized that he will be driven by a designated driver after the procedure and was discharged accordingly by the recovery nurse. After the accident, the client was revealed to not have a designated driver as opposed to what he stated. He was alert, fully awake, with stable vital signs. Which of the following is true? A. The nurse should have seen the designated driver before completing the discharge of the client. B. The nurse may be negligent for not double checking the competency of the client before the discharge. C. The nurse had the option to call the client for a taxi instead. D. The nurse discharged the client according to the standards of practice and thus, not solely responsible for the accident.

D. Ratio: no responsibility after discharge

Upon investigation, it has been found that there was a healthcare worker who responded at the scene of the accident. Which of the following laws refer to being protected from civil liability as long as they behave in the same manner as an ordinary, reasonable, and prudent professional in the same or similar circumstances? A. Good Professional Conduct B. Good Samaritan Laws C. Healthcare Emergency Care Rules D. Nursing Emergency Care Conduct

Situation: A set of nurses is caring for patients with immunologic conditions. The following questions apply. 84. A patient is administered an NSAID for acute inflammation. Which molecular target is most directly inhibited, preventing further amplification of the inflammatory response? A. Arachidonic acid B. Cytokines C. Cyclooxygenase D. Prostaglandin receptors

C. Cycloixygenase (COX) — convert the arachidonic acid —> prostaglandins —> considered as inflammatory mediation

Which immunoglobulin is primarily responsible for mucosal defense and exists predominantly in secretory dimeric form? A. IgM B. IgA C. IgG D. IgE

B. Ratio: found in our mucosal secration IgG- more on our serum long term immunity

In which stage of inflammation do macrophages stimulate bone marrow to accelerate leukocyte production through colony-stimulating factor (CSF)? A. Stage II - Cellular exudate B. Stage III - Tissue repair C. Stage I - Vascular response D. Stage IV - Resolution

C. Ratio: Stage I- signals Bone marrow—> production of WBC—> increases blood and immune cells in the injured area Stage II - WBC —> attacks bacteria, viruses etc. Stage III- healing Stage IV- Tissue (fully healed)

Which cell type is primarily responsible for acute cellular rejection in solid organ transplantation? A. B-lymphocytes B. Cytotoxic T-cells C. Mast cells D. Macrophages

B. Ratio Transplant organ—> donor antigens —> detect cytotoxic T cells —> kills the donor antigens/ cells —> organ inflammation/ dysfunction —> that can lead to acute cellular rejection

A renal transplant patient develops signs of rejection within minutes post-surgery. What mechanism best explains this event? A. Preformed antibodies causing complement activation and vascular thrombosis B. Delayed hypersensitivity mediated by T-helper cells C. Activation of NK cells against donor MHC antigens D. Cytotoxic T-cell infiltration of graft parenchyma

A. Ratio: B, C & D= nang- yayari within days/wks post transplant

Which of the following drugs prevent T cell activation by binding to IL-2 receptor site on activated T- lymphocytes? A. Basiliximab B. Tacrolimus C. Prednisone D. Mycophenolate

A. Ratio: Basiliximab—<0> binds with IL -2 receptors—> no T cells proliferation IL-2 — interleukin 2 —> stimulates T cells proliferation

In chronic rejection, the progressive loss of graft function is primarily due to: A. Massive neutrophil infiltration B. Immediate antibody binding and complement activation C. Fibrosis from chronic ischemia and vascular injury D. Excessive production of IgE

C. Ratio: Damage of blood vessels—> chronic ischemia—> fibrosis of the graff/ tissue —> decreased loss of fxn A&B = acute rejection D. Allergic reaction

The drug tacrolimus is effective in transplant immunosuppression by: A. Enhancing neutrophil migration to the graft B. Inhibiting IL-2 transcription in helper T-cells C. Binding complement factors to block membrane attack complex D. Promoting macrophage clearance of dead graft tissue

B. Take note: tacrolimus —> calcineurin inhibitor

Which clinical presentation would most strongly differentiate diffuse systemic sclerosis from systemic lupus erythematosus in the early stage? A. Butterfly rash B. Polyarthritis of small joints C. Bilateral hand and forearm edema D. Pericarditis

C. Ratio: ABD = manifest to the patient with SLE

A patient with HIV presents with headache, blurred vision, and stiff neck. Which opportunistic infection should be suspected? A. Candida albicans B. Pneumocystis jiroveci pneumonia C. Cryptococcus neoformans D. Toxoplasma gondil

C. Ratio: A. Cause Oral thrush B. Causes pneumonia D. Causes toxoplasmosis

A nurse is assessing a patient with SLE who complains of worsening hip pain and difficulty walking. There is no recent trauma. Which is the most likely cause? A. Polyarthritis flare B. Osteonecrosis C. Myositis D. Lupus vasculitis

B. Ratio: kapag chronic of used in corticosteroids—> decreased blood flow —> bone death

Which of the following would be a distinguishing feature of discold lupus erythematosus (DLE) rather than systemic lupus erythematosus (SLE)? A. Pericarditis B. Butterfly facial rash C. Polyarthritis D. Coin-like scarring lesions

Which manifestation would be the strongest clinical indicator of an acute lupus flare? A. Fever B. Alopecla C. Proteinuria D: Joint stiffness

A. Ratio: a classic hallmark sign of acute lupus flare

A patient with advanced HIV Is experiencing persistent diarrhea with massive fluld loss and significant weight loss. Which opportunistic infection is most likely responsible? A. Cryptosporidium spp. B. Candida albicans C Toxoplasma gondil D. Mycobacterium avium complex

A. Ratio: B. Oral thrush C. Responsible for toxoplasmosis D. Fever, night sweats, weight loss

A patient with systemic sclerosis presents with calcium deposits in fingers, esophageal reflux, and red telangiectatic lesions on the face. This constellation is best described as: A. CREST syndrome B. Diffuse SSc C. Acute cutaneous lupus D. Vasculitic overlap syndrome

A Ratio: CREST is a group of symptoms

Which laboratory or diagnostic finding best supports a diagnosis of SLE rather than systemic sclerosis in a patient with overlapping features? A. Presence of CREST syndrome B. Antinuclear antibodies targeting DNA and RNA C. Early fibrosis of skin and organs D. Hand and forearm edema

B. Ratio : antinuclear antibodies this are the proteins, indicative of an autoimmune disease

A patient presents with severe hypotension, bronchospasm, and widespread urticarla minutes after receiving IV contrast dye. Which immunologic process is most responsible for these findings? A. IgE-mediated degranulation of mast cells B. Activation of CD8+ cytotoxic T lymphocytes C. Deposition of immune complexes in vascular walls D. Formation of autoantibodies targeting thyroid receptors

A. Ratio: allergic reaction.

NP 2 Flashcards

(100 cards)