1
Q
SITUATION - Nurse Grace is assigned in a medical unit of a tertiary hospital where most of the patient admitted are suffering from Endoctine disorders. She is currently. assigned to patients: Claire, 54-year-old, married with hyperthyroidism, Aster 66, year old has an impression of Cushing syndrome while Sonia, 48-year-old is suffering from hypothyroidism.
- While you are doing physical assessment to patient Aster, she has been exhibiting a UNIQUE clinical manifestation different from patients Claire and Sonia which is characterized by
A. cyanosis, increasing growth of hands and feet. X
B. anemia, weight loss and present of ache.
C. moon faces, purple striae on trunk and buffalo hump
D. moon faces easy fatigability and peripheral edema
A
C
2
Q
- Which of the following diagnostic test do you expect NOT to be ordered by Dr. Lim to patient Aster who is suspected to have Cushing Syndrome?
A. 24-hour urine cortisol level
B. D-C reactive protein level
C. ACTH serum concentration
D. Computerized tomography on the brain, chest and abdomen
A
B
3
Q
- Which clinical manifestation should Nurse Grace watch for patient Claire if she is suffering from hyperthyroidism?
A. Cold extremities
B. Increased weight
C. Decreased bowel movement
D. Fine motor tremor
A
D
4
Q
- Patient Sonia who has hypothyroidism is given. Which one of the following drug therapy?
A. Iodine
B. Propranolo
C. Iron pills
D. Levothyroxine
A
D
5
Q
- Which of the following should be AVOIDED by patient
Sonia while she is being treated for hypothyroidism?
A. Use of warm blankets
B. Light activities done at home
C. Taking foods low in fiber hi
D. Exposure to cold temperature
A
D
6
Q
SITUATION - Nurse Elsa has just passed the board examination for nurses and set her goals for her nursing career to the next 5 vears. She is aspiring to become a diabetes Nurse Educator after completing her 2 years as a beside nurse.
- Which of the following can Nurse Elsa adopt to visualize her future?
A. Flow chart
B. Decision tree
C. Gantt chart
D. Decision arid
A
C
7
Q
- She is started to create her personal and professional portfolio as a preparation for her application to a university medical center in retro manila. Which of the following is NOT a major purpose of keeping a portfolio?
A. Keep on going records of skills development.
B. Create a system for documenting accomplishment
C. Set career and educational goals.
D. Set system for a possible shift to another job.
A
D
8
Q
- One area of the professional portfolio is to indicate one’s philosophy of life. Which of the following work place values should Nurse Elsa consider as NOT favorable to be written in her portfolio?
A. Customer service based on acceptance, empathy and selfless duty.
B. Time and compensation Limiting her pursuit of excellence in her job.
C. Commitment to continue life long and self-directed learning.
D. Challenge which can lead to growth, responsibility and accountability.
A
B
9
Q
- In order for Nurse Elsa to be active as bed side nurse, she has to comply with the renewal of PRC ID by undertaking continuing professional development (CPD) as mandated by the CPD law. The purposes of which are development (CPD) as mandated by the CPD law. The purpose of which are
I. promote and upgrade the practice of the professional
II. improve the competence of the professional
III. international alignment of competence
A. II & III
B. I, II, III
C. I, II, III, & IV
D. I, & II
A
B
10
Q
- Nurse Elsa is aware that her personal and professional portfolio has to include and keep up to date the following EXCEPT.
A. Certificate of CPD attended
B. Letters of reference
C, Photograph
D. Confidential information from past employers
A
D
11
Q
SITUATION - Mr. Reynaldo is tasked to conduct a study to determine the level of patient satisfaction on the care they received from the hospital. He doing so he plans to include; all adults patients admitted from May-October, first admission with an average length complication. of hospital confinement of 4-5 days, and with no complications.
- Which of the following is an EXTRANEOUS variable of the study?
A. Age of patient
B. Absence of complications
C. Length of stay 4-5 days.
D. Date of admission January-March.
A
A
12
Q
- Which of the following variable will he likely
EXCLUDE in his study?
A. Salary of nurses
B. Caring attitude of nurse
C. Responsiveness of staff
D. Competence of nurses
A
A
13
Q
- He plans to use a like likert Scale to determine:
A. compliance to expected standards
B. degree of agreement and disagreement
C level of satisfaction
D. degree of acceptance
A
C
14
Q
- Which criterion refers to the ability of the instrument to detect fine differences among the subjects being studies?
A. Reliability
B. Sensitivity
C. Objectivity
D. Validity
A
B
15
Q
- This technique refers to the use of multiple referents to draw conclusions about what constitute the truth.
A. Delphi technique
B. Meta-analysis
C. Triangulation
D. Experiment
A
C
16
Q
SITUATION - Nurse Tarly, the research coordinator of a Tertiary hospital where there was a growing concern of patients and family complains that Nurses are “rude and cranky.” In response to this she organized a core group to conduct a study on the “caring behavior of staff nurses and Satisfaction of women with Ostomy.
- Based on the research statement, what is the independent variable in the study?
A. staff-nurse
B. caring behavior
C. women with ostomy population
D. satisfaction
A
B
17
Q
- What is the dependent variable in the study?
A. staff-nurse.
B. ostomy
C. degree of satisfaction
D. caring behavior
A
C
18
Q
- What are the relevant related literatures that Nurse
Tarly and her group mates can utllize in this study?
I. Caring behavior
II. ostomy pathogenesis *
III. contentment and satisfaction
IV. concept of body image *
A. IlI and IV
B. I, II and III
C. I and II
D. 1, II, IlI and IV
A
B
19
Q
- 1f Nurse Tarly and her core group decide to formulate a directional hypothesis it will be.
A. There is an increased relationship between the caring than staff nurses and degree satisfaction of ostomized patient
B. The caring behavior of staff of nurses is related to increased satisfaction of ostomized patient.
C The staff nurses’ behavior has an effect on the dirchad Patients, satisfaction on ostomized patient.
D. A significant of relationship exist between the caring of ostomized patients.
A
AB
20
Q
- Based on the research problem, what is the research design of the study?
perfed anguer
A. Quasi-experimental
B. Descriptive
c. Expost-facto
D. Experimental
A
B
21
Q
SITUATION - Nurse Virgo admits Benito, 67-year-old, due to severe abdominal and back pain and vomiting after attending a party he had positive alcohol breath and was tentatively diagnosed with pancreatitis. He was scheduled for diagnostic laparotomy to further confirm the diagnosis.
- Nurse Virgo gather more appropriate data from patient Benito. Which of the following APPROPRIATE question should Nurse Virgo asks?
- “can you describe your pain?”
- “is your urine yellow?”
- “‘Is your stool clay colored?
- “do you drink alcohol often?*
A. 2 and 4
B. 1 and 3
C. 1, 2, and 4
D. 1, 2, and 3
A
1&4
22
Q
- Patient Benito asks Nurse Virgo “Why can’t the surgeon just take out my pancreas?” The BEST response of Nurse Virgo is
preduce amylase a lipale
A, “your body needs function well with your pancreas
B. “your attack will soon be overcome when you are at rest”
C. “if your pancreas is removed, you can never eat fat and fried foods again”
D. “antibiotic will relieve sign of infection”
A
A
23
Q
- Before Surgery, patient Benito is on nothing per
formed status (NPO). She tells Nurse Virgo that he is thirsty and hungry. Which of the following is the BEST response of Nurse Virgo?
A. “You can sip only this amount of water to moisten your mouth.”
B. “An NGT will be inserted to removed gastric secretions and alleviate your thirst”
C. “I will aive vou ice stimulate your thirst” X
D. “oral and fluid intake stimulates pancreatic enzymes and pain”
A
D
24
Q
- Nurse Virgo asks Patient Benito how can help to reduced pain while waiting for his operation. Which is the most appropriate question of Nurse Virgo?
A. “Are vou ready for the operation? the pain will be soon over.”
B. “After operation everything will be alright”
C. “‘is your present position reducing pain?”
D. “Does exercise reduce your pain?”
A
C
25
25. Which of the following statement of patient Benito will If convince Nurse Virgo that is instruction for the prevention of pancreatitis were understood by the patient? I will
A. increase my intake of high protein products"
B. Try to stop drinking alcohol
C. "follow a high fat diet faithfully"
D. "be careful of exposing myself to infections"
B
26
SITUATION- The Department of health (DOH) an agency that set standards for safe and quality health care together with Philhealth insurance which take care accreditation and reimbursement of cost of health care service.
26. The professional conduct of doctors, nurses and other health care providers in the health facilities belong to which of the following quality standards?
A. Improving performance
B. Organizational ethics
C. Patient care standards
D. Leadership and management
C
27
27. The positive practice environment (PPE) is part of the quality standards of every health facility in the country today. Which of the following is NOT a component of PPE in the work setting?
A. waste management
B. peer view
C. electrical wires
D. infection control
C
28
28. When a health facility formulates its Vision-Mission to guide management and health personnel in the work place is what part of quality standards?
A. Human resource management
B. Patient care standards
c. Leadership and management
D. Organizational ethics
C
29
29. When Nurse Sarah distributed a patient satisfaction survey from to be filled by the consumer upon discharge in a hospital setting is in compliance to what quality standards?
A. Organizational structure standards
B. Identification of patient rights and welfare.
C. Improving performance of health care personnel.
D. Human resource management and staffing pattern.
C
30
30 When an accurate documentation whether manually or by electronic by what quality standards in a health care delivery system?
A. Patient care management
B. Information management
C. Leadership and management
D. Human resource management
B
31
SITUATION - Mr. Lam. a 44-year-old, male obese, married was rushed to the Emergency room because of feeling nauseated, with shortness of breath and severe chest bain radiating to the back.
31. As a nurse, what is your PRIORITY step to be done in this situation?
A Palpate the point of maximal impulse.
B. Inspect the nail bed if cvanotic
C. Peaked P wave
D. Minimal QRS wave
A
32
32. The physician confirmed that the patient is suffering from MI. she was advised to be hospitalized and was given streptokinase. Which of the following is the DESIRED effect of the drug?
A Dissolve clot formation
B. Reduce tissue damage of the heart.
C. Prevent dysrhythmia.
D. Reduce edema formation:
A
33
33. A 12 lead EKG was ordered by the physician. Which finding in the EKG is suggestive evidence that the patient has myocardial infarction (MI)?
A. Prominent segment elevation.
B. ST segment elevation.
C. Peaked P wave.
D. Minimal ORS wave.
B
34
34. As a nurse you are aware that a heart muscle damage after an attack without treatment becomes permanent within hours?
A. 7-9
B. 10-12
C. 4-6
D. 1-3
C
35
35. In designing a care plan, which modifiable risk factors have to be emphasized to the patient to prevent for another heart attack to happen?
1. Smoking
2. High blood pressure
3. High cholesterol
4. Overweight
A. 1, 2, & 3
B. 3 & 4
C 1&2
D. 1, 2, 3, &4
D
36
SITUATION - Ms. Nilda is a new graduate with a bachelor of science degree which the acquired from a university.
She is determined to pass the national Licensure Examination (NLE) to be administered by the board of nursing,
36. The licensure which is the administered by the professional Regulation Commission, Board of nursing given to
A. apply the theory learned from the class room to practice settings
B. protect the public from incompetent practitioners *
C.apply the scope of nursing practice
D. demonstrate expected competency standards
D
37
37. The PRC-Board of Nursing (PR-BON) has the power to regulate Nursing Practice in the Philippines. The regulatory function include the following except
A. enforce and monitor quality standards of nursing practice in the country
B. issue, suspend, revoke or reissue licensure in the country registered nurses.
C. ensure proper conduct of nurse's licensure in the country
D. Issue permit from the opening of nursing program in the country.
D
38
38.Ms. Sanchez is a new nursing graduate and in dire need for the hospitalization of her ailing mother. She is being offered to endorse a detergent product on TV commercial wearing a mini skirt and a plunging neckline shirt. In doing this performance Ms. Sanchez is violating the
A. oath of professional for a new nurse
B. nursing practice act 7164
C. code of ethic for nurses
D. core competency standards
C
39
39. Nurse Rey with the member of the team of a tertiary hospital is going for their annual outreach program
"Operation TULI". There were 300 patients who came in the morning with only 4 doctors, 3 nurses and 1 pharmacist. Due to the volume of patients Nurse Rey, was asked to participate in performing circumcision with the rest of the doctors. Nurse Rey can be Ilable of committing.
A. assault
B. invasion of privacy
C. tort
D. malpractice
D
40
40. Which of the following actions is likely to constitute Negligence?
A. Complied with the request of a bedridden patient not to be turned because of pain.
B A nasogastric feeding not given on time because patient is feeling nauseated.
C. A patient suffering from bleeding to report to the attending physician.
D. Urine output that has not been measured because of an emergency admission.
B
41
SITUATION - Documentation is a basic competency expected of a graduate nurse when performing her role in the clinical setting.
41. Mr. Rey had his insulin therapy on the day of his admission. On the second day he developed allergic reactions do you expect the nurse to administration.
What clinical manifestations do you expect the nurse to write in her documentation as a reaction to this drug?
1. Redness
2. Swelling
3. Tenderness
4. Induration
A. 1, 2, 83
B. 2 8 4
C. 1, 2, 3, 4
D. 1 & 2
C
42
42. Mr. Rey has been anxious regarding is diagnosis as well as the recent reaction to overcome this anxiety behavior is to
A. conduct a family conference for the concern of the patient
B. refer to the physician for an order of tranquilizer
C. express your empathy and respect for his feelings
D. take time to explain his disease process and effects of 2. insulin
C
43
43. When a patient a suffering from Ketoacidosis, you expect that the entry of nurses assessment findings in the chart will include the following clinical manifestations
EXCEPT
A. kussmaul's
B. cheyne strokes breathing
C. lethargy
D. acetone breath odor
B
44
44. Nurse Gladys who is on morning shift was making her sounds when she observed Mr. Joe, who is suffering from congestive heart failure is complaining of heaviness of his legs. She observed the patient to have an edema of his lower extremities. If the edema is 3 plus, what do you expect the nurse to write in her assessment findings?
A. Deeper pit, in 30 seconds.
B. Barely the pit is not perceptible.
C. Deeper pit, rebounds in only few seconds.
D. Deep pit, rebounds in 10-20 seconds.
A
45
45. When auscultating the breath sounds of patient with respiratory disorder they are instructed to breathe thru their mouth. A possible complain the nurse has to watch and be written in her documentation when performing this procedure is which of the following?
A. Palpitation.
B. Dizziness
C. Tachycardia
D. Bradycardia
C
46
SITUATION - Mary, a hairstylist is experiencing peri-umbilical pain feeling feverish and nauseated while at work. She was rushed to the hospital as the pain incoming intense at the right lower quadrant of the abdomen. She was advised by the ER physician to be admitted for further work-up.
46. Nurse Ella admitted the patient and started to do her assessment. What sign is elicited by the nurse when a deep palpation of the left iliac fossa is done and causes pain on the right illac fossa of the patient?
A. Obturator sign
B. Blumberg sign
C. Psoas sign
D. Rovsing sign
D
47
47. After a thorough physical examination, laboratory and diagnostic test the physician ordered an emergency open appendectomy due to prevent which of the following, MAJOR complication?
A. Thrombosis
B. Sepsis
C. Perforation
D. Bleeding
B
48
48. The Nurse prepares the patient for surgery. The overall goals by the surgical team for the patient going for operation include which of the following?
1. Relief of pain
2. Preventing fluid volume deficit
3. Eliminating infection
4. Reducing anxiety reaction
A. I, II, III, & IV
B. 1, 11, & HI
C. II, & IV
D. I. gETT
A
49
49. As a safety alert, which of the following nursing measures should be AVOIDED by the nurse prior to appendectomy?
A. Observe nothing by mouth
B. Administration of enema
C. Removal of nail polish
D. Instruct to urine.
B
50
50. In wound care management, the nurse is aware NOT to perform which of the following intervention?
A Allow the wound to drain freely.
B. Maintenance of an acidic or neutral
C, Application of cold pack solutions.
D. Maintenance for a moist wound environment
C
51
SITUATION - Ethical and moral issues are becoming a common scenario in practice setting so heal care providers have to be equipped with this competency.
51 in the clinical setting, when nurses are confronted with ethical dilemmas the BEST practical guide, she can use of is
A. PRC oath for professionals
B. code of ethics
C. theological doctrine
D. Florence Nightingale oath
B
52
52. Mr. Rad is admitted to the hospital complaining of chest pain due to clogged in his coronary arteries. He is diabetic hypertensive and considered by the physician to be a high risk for cardiovascular surgery. What PRIORITY actions should the members of the health team do in this situation?
A. Consult the family members and let them give their decision.
B. Proceed with the planned surgery, as this will save the patient.
C. Consult the Ethics committee on what to do with the patient.
D. Discuss with Mr. RAD his health status & let him decide
D
53
83. Mrs. Agnes, 77-year-old is suffering from dementia and demonstrate unruly behavior. When Nurse Gigi described the patients in her shift report, as "That awful, Dirty old woman in bed 14" is an example of what ethical behavior being employed by the nurse?
A. Stigma
B. Ageism
C. Gender bias
D. Depersonalization
B
54
59Mr. Rey, who is on an end-stage of life has an order of "Do Not Resuscitate" and passed away in your shift. He was dedared dead by his physician at 8:30 AM. What should be your PRIORITY nursing action in this situation.
A. Prepare the death certificate for the physician to sign
B. Request your nurse attendant to all the funeral parlor at once.
C. Allow the family to have private moments with the deceased.
D. Clean the body and remove all the IV lines, tubes and other appliances,
D
55
55. When a nurse is in full support of patient's care and safety personal rights throughout her hospital stay, she is implementing what ethical principle?
A. Responsibility
B. Empathy
C. Advocacy
D. Accountability
C
56
SITUATION - A manager of an accounting firm is admitted to the hospital due to an acute abdominal pain and passing out of bloody stools. After several diagnostic and laboratory examinations the physician ordered him to exploratory laparotomy. You are the nurse on duty day.
56. While performing your assessment you are guided that the organs found in the epigastrium include which of the following?
A. Portion of duodenum & jejunum, left kidney, appendix & ovary
B. Duodenum, pancreas, portion of the liver and pyloric end of the stomach.
C. Stomach, spleen, tail, pancreas and adrenal gland.
D. Gallbladder, duodenum and portion of the right kidney
B
57
57. When conducting the nursing history on the health perception, health management pattern of function what is the APPROPRIATE question to be asked pre-operatively?
A. Do you experience your wounds to heal quickly?
B. Do you have shortness of breath when exercising?
C. Are you aware of risk factors for your disease?
D. Have you experience weight change in the past?
C
58
58. Patient was visited by the anesthesiologist and explained the anesthesia for his surgery. Which of the following type of anesthesia would you expect to be ordered?
A. Spinal
B. Caudal
C. Local
D. General
D
59
59. There are pre-operative medications given to the patient. Which of the following drugs are given in order to decrease intra-operative anesthesia requirements and pain?
A. Celebrex (Celecoxib)
B. Ibuprofen (Motrin)
C. Acetaminophen (Tylenon)
D. Demerol (Meperidine HC1)
D
60
60. The goals for patient's safety in the operating room is imperative for all members of the given in order to decrease intra-operative anesthesia requirements and pain?
1. Patient's identity
II. Surgical procedure
Ill. Surgical site
IV. Surgical equipment
A. I & 111
B. 1 & TI
C. I, 11 & IV
D. I, IL, & III
1234
61
SITUATION - Grisostomo, a 40 years old emplovee has been complaining of difficult painful urination for almost a week now. He saw some fresh blood in his urine but was afraid to see physician, instead he went to his neighbor who is herbalist. After a week his condition worsen and his wife brought him to a community clinic.
61. A community dinic does primary care for patients.
Most often the one who manage this is which of the following?
A. Physician
B. Barangay health workers
C. Nurse
D. Midwife
A
62
62. Upon assessment, the patient was referred immediately to a 25-bed-capacity hospital, which does not have any capacity to do intensive diagnostic examinations. You are a nurse in this hospital, which you know is at level
A. 3
B. 1
C. 4
D. 2
B
63
63. In the tertiary where the patient was again referred, he was considered an emergency case. The nurse immediately calls for a specialist who is_
A. Neurologist
B. Urologist
C. Phlebotomist
D. Nephrologist
B
64
64. After a thorough assessment by the physician-specialist, an order for an immediate sonogram was made. The nurse was instructed to call which of the following section of the hospital?
A. Operation room
C. Intervention
B. Laboratory
D. Imagery
D
65
65. After the procedure, the patients were ordered for unrosive lithotripsy, under spinal anesthesia. The nurse has call to the department of
A. Internal medicine
B. Anesthesia
C. Surgery
D. Imagery
B
66
SITUATION - An alert 67-year-old woman with diabetes mellitus is discharge from the hospital. A referral is made to a community nursing agency. You are asked to reinforced the teaching program started in the hospital.
The patient is using sulfonylurea compound tolbutamide (Orinase).
66. When the patient turned 69-year-old orinase was discontinued and PH insulin is prescribed for her. After several months, she is determined to be suffering from the somogyi effects which of the following condition with most likely result when the patient is receiving too much insulin?
A. Developing an elevation of the blood glucose level
B. Producing even more insulin
C. Becoming resistant to insulin
D. Conserving excessive amount of fluid
A
67
67. A few days later the patients come into the emergency department via ambulance stretcher and reveal à work-up of a blood sugar level at 800mg/dI, ketones are absent in the urine, she is dehydrated, and has an altered mental status. Based on the data, the patient is most likely suffering from what specific medical condition?
A. Hyperosmolar nonketotic coma (HINKC)
B. Diabetic retinopathy
C. Acute renal failure
D. Diabetic ketoacidosis (DKA).
A
68
68. Upon interview, the patient reported that she often felt nauseated, restless, perspired a lot felt fatigued and was often hungry when she was younger. What do these signs indicate?
cold clan my
A. Diabetic nephropathy
B. Hyperglycemia
C. Hypoglycemia
D. Diabetic retinopathy
C
69
69 Upon further assessment you noticed had many scratches on her right ankle, a resulting infection, and cellulitis. When you ask her about the scratches the patients state "Oh my cat must have been using my leg as a scratching post again and did not even feel it." Which diabetic complication suspect the patient to have?
A, Neuropathy
"B. Macroangiopathy
C. Retinopathy
D. Ephropathy
A
70
70. You should check the patient for suspect disturbed thought processes related to depressed metabolism and altered cardiovascular and respiratory status. What is the rational for orienting the patient to time, place, date and events?
A Show improved cognitive functioning
B. Provides reality orientation to patient
C. Permits evaluation of the effectiveness of treatment
D. Let's the patient identify the time, place, date, and events correctly
B
71
SITUATION - Nurse Pat is a newly hired Registered Nurse together with 5 licensed graduate nurses coming from different regions. It is their first day of orientation in a big health facility. The continuing nurse educator started the session by projecting the organizational structure of the comman-medical center.
71. Which of the following is the MAJOR PURPOSE of an organizational structure? It is the
A. blueprint representing committees for delegation of roles and function
B. flow chart shows interaction among members of major and minor groups
C. framework of relationship of units, departments and channels of communication
D. design that identifies roles, collaboration, interdependence between functions of people
C
72
72. Line and staff function are identified in the presented organizational Chart. What does line authority mean?
A. Staff relationship in the organization is advisory in nature
B. Staff mix of personnel reporting to the "BOSS"
C. Decisions are made from bottom to top in an organization,
D. Design that identifies roles, collaboration, interdependence between functions of people
B
73
73, Which of the following statements is CORRECT of nursing service system in health care?
A. Informed leaders are more effective than formal and with less autonomy.
B. A shared governance tends to controlling and with less autonomy
C. Institutional policies are more powerful tool in nursing practice than laws and regulations. or portol
D. A situational leadership style provides effective means in achieving patient outcome.
D
74
75. Budgeting is an important aspect of financial management. When a unit manager allocates expenses yin for unit supplies, stocks and medical-surgical supplies.
This is considered
A, cash buster ed
B. operational budget
C. capital budget
D. flexible budget
B
75
SITUATION - Mely 68 years old was admitted, to the hospital because of decrease appetite, easy fatigability, dehydration and weight loss of about 15lbs for the past week. She was examined by the physician and advised to be admitted. You are the nurse assigned to take care of her.
76. The physician ordered to starts Ms. Mely on total parenteral Nutrition (TP). What is your INITIAL step to be undertaken PRIOR to this intervention?
A. Determine if the family can afford the whole treatment.
B. Evaluate the tolerance of the patient to glucose.
c. Identify allergies to the supplemental nutrition.
D. Assess the basic understanding of the patient regarding TPN.
B
76
77, Choose from the following the primary goals of TPN?
I. promote weight gain
II. maintain muscle mass
Ill. establish nitrogen balance
IV. enhance healing process
A. I, I, & III
B. I, II, III, & IV
C. I, II
D. I, II, III, IV, & V
C
77
78. When a patient is undergoing TPN, you have to monitoring closely for the
A. serum creatinine level
B. potassium level
C. serum glucose level
D. sodium level
C
78
79.While on Mr. Mely is on TPN she suddenly complained of slight chest pain, dyspnea and appears cyanotic. You suspect that she is experiencing what possible
IMMEDIATE complication?
A. Sepsis due to IV line
B. Air embolism
C. Hyperglycemia
D. Allergic reaction to TPN
B
79
80 What PRIORITY nursing action should you do with the presenting clinical manifestations of the patient?
A. Report to the physician status of the patient at once.
B. take blood pressure and respiratory rate.
C. Stop temporarily the total parental nutritional
D. Administer inhalation.
C
80
SITUATION- Ms. Monina is a retired community health nurse in barangay San Pablo. Due to her commitment to the nursing profession, she has volunteered in their community conduct health education classes. One Saturday morning, several patients who are hypertensive and with pulmonary health problems attended her session.
81. Mang Luis is a newly diagnosed patient with chronic obstructive lung disease (COD). Which of the following PRIORITY teaching instruction should be given in relation to his condition?
A. He should assume supine position when resting.
B. know early signs of respiratory infection.
C.He has to be taught how a bronchial tapping
B. Family should be advised that patient should sleep in a warm room.
C
81
82. Which of the following health intervention should be included in your teaching plan for Mang Luis?
A. Be on prolonged corticosteroid therapy.
B. Lung exercises must be done with longer inhalation that exhalation - lorior
C. Reduce risk for infection.
D. have a high flow of oxygen administration.
C
82
83. Pulmonary Rehabilitation for COPD has a duration of at least 4 to 12 weeks. Which of the following should be avoided while patient is having this program?
A. Pursed lip breathing
B. Smoking cessation
C. Aerobic, upper and lower body conditioning
D. Peripheral muscle wasting
D
83
84. Weight loss and malnutrition are commonly observed among patient with COPD. They should be taught to avoid
A, have full stomach even when in dyspneic condition
B. keeping body mass between 21-25 kg./m
G, a high caloric and a high protein diet
D. exercise one hour before and after eating
A
84
85. Which of the following energy conserving strategies should NOT be done by COPD patient?
A. Exhale when pushing or exerting effort when doing daily activities
B. Assume tripod position with elbow supported on the table when shaving or combing
C. Inhale when resting, sitting and lying down.
D. Stand in front of the mirror while shaving or combing hair
D
85
SITUATION
-A housewife, appearing jaundice,
complaining of abdominal pain, nausea and bloated sensation was rush to the hospital. The patient was examined by the physician and ordered for admission due to suspected stone in the gall bladder. You are the nurse on duty that day.
86. When performing an interview, which is the best initial question should you ask when a patient is on pain?
A. How often do vou feel the pain?
B. How would you describe your pain?
C. Did you take any drug to relieve the pain?
D. When did you first feel the abdominal pain?
B
86
87 Which of the following imaging test that use transducer will be likely be ordered by the physician to detect gallstones?
A. Computed tomography
B. Abdominal X-ray
C. Abdominal Ultrasound
D. Doppler sonography
C
87
88. The test revealed presence of gallstone and inflamed gall bladder. The patient was advised to undergo open cholecystectomy. This operation compared to laparoscopic cholecystectomy are
I. Invasive
Il. Less pain
more
TIL. Longer recover
IV. Shorter hospital stay longer
A. I I & IV
B. I, II
C. I, II & HI
D.I & III
D
88
89. After 2 hours post- operatively the nurse observed reddish drainage from the operative area of the patient. walk which of the following nursing action should you performed FIRST?
A. Check if stiches from the operation have come apart.
B. Check where is the source of possible bleeding
C. Cover the operative are with sterile gauze bandage.
D. Put hand as a pressure on the operative are.
B
89
90. After several days in the hospital, the physician ordered for the patient to be discharge. Which of the following is the PRIORITY restriction that you should emphasize when he goes home?
A. Stool softener to induce bowel elimination. *
B. Driving if not using narcotic drug. - drowns
G. Take shower even if still with surgical drain.
D. Lifting of objects more than 10 lbs.
D
90
SITUATION - Sarah 38-year-old a teller from a bank is admitted to a tertiary hospital due to hypertension and frequent hematoma of the lower extremities every time she bumps herself in the workplace. The physician who examined her gave an impression of Cushing disease.
91. Which of the following characteristic of Cushing disease is TRUE?
I. The disease occurs in women between 20 to 40-vear of age
II. The use of Corticosteroids for multiple immune conditions is a caused of the disease process.
III. Condition is aggravated by excessive production of ACTH.
IV. The surgical of treatment of choice is Transphenoidal Hypophysydectomy
A. II , III
B. I, II, & III
C. I, II, III & IV
D. I & II
B
91
92. When one has a Cushing disease the focal structure affected is the
A. hypothalamus
B. pituitary gland
C. adrenal gland
D. para thyroid gland
B
92
93. Which of the following clinical manifestation will NOT be a complaint from Sarah's condition?
A. Edema of the extremities
B. Poor wound healing
C. Decreased libido
D. Absence of growth in the public area
D
93
94. The attending physician ordered a Magnetic Resonance Imaging (MRI) to patient sarah in order to validate the medical impression. This imaging technique is done to detect
A. hemorrhagic injury in the brain
B. Electrical impulse in the brain
C. level of oxygen in the brain
D. non-hemorrhagic injury in the brain
A
94
95. While patient Sarah is confined in the hospital, the safety measure to be observe by the nurses is prevention from fall. This is brought about by the patient being prone to fracture as a result of
A. aging process
C. osteoporosis -
B. change in vision
D. hematologic condition
C
95
SITUATION - Mr. Alda 50-year-old company driver is admitted to the emergency room (ER) because of the pain of the left chest and difficultly of pack of cigarette per day especially when he goes on overtime. Vital signs: BP is 150/90, PR - 110bpm, RR 38cm. Has clammy perspiration and quite restless. The physician ordered chest X-ray and revealed patient has Pneumothorax. You are the nurse in charge of the patient.
96. As a nurse you are guided that pain is usually described BEST as a phenomenon WHICH is a
A. neurologic activation of norciceptors
B. subiective unpleasant experience
G. adaptive mechanism to a stimulus
D. creation of one's imagination
A
96
97. When a patient has a pneumothorax, the nurse assessment findings will likely reveal
I. absent breath sounds on an affected side Y II. decreased chest expansion unilaterally
IlI. sharp chest pain
IV. burning chest heard burn
A.I, II, III
C. I. IL IV
B. III, IV
D. I, II
A
97
98. Which of the following statement is NOT true of
-Preumothorax?
A. Atmospheric air within pleural space a result to a rise in intra thoracic pressure and reduce vital capacity in the lungs
B. The loss of positive intra-pleural pressure can produce
pneumothorax
C. The loss of negative intra pleural pressure can result to collapse of the lungs.
D. A spontaneous pneumothorax can occur with the rupture of pulmonary bleb.
B
98
99. The physician inserted a chest tube drainage to Mr.
Alda in orderito help re-expand the lungs. Which of the following should you prepare FIRST as a nurse in case of emergency when the tube is accidentally disconnected?
A. sterile clamps
h. Another chest tube
C. Sterile dressing
D.A bottle of sterile water
A
99
100. In order to relieve Mr. Alda of pain the physician prescribed morphine So4 2mg/IV PRN for untolerable pain. The goal of the health care professional is to provide adequate control to the patient can breathe easily. Which of the following would indicate successful attainment of this goal?
A. Anxiety level of patient will be reduced.
B. Respiratory rate will be decrease to 20 breaths/min.
C. Oxygen saturation is at 76% level.
D. Pain scale will show 1-to 2, in a rating scale of 10 (highest, O,- lowest).
D
