1
Q
Situation: Remedios, a 65-year-old housewife, has been diagnosed with rheumatoid arthritis in both hands and knees.
- At a clinic visit, a patient reports an onset of early symptoms of rheumatoid arthritis. What will be the nurse’s focused assessment during the patient interview
A. Enlarged Nodules
B. Early morning stiffness of lower extremities
C. Limited motion of joints of the upper extremities
D. Deformed joints of the hands
A
B
2
Q
- A nurse is teaching a patient with osteoarthritis about lifestyle changes. The nurse knows the patient understands the teaching when she states that she will A. abstain from school
B. avoid exercise
C. lose weight
D. restrict caffeine
A
C
3
Q
- A patient with osteoarthritis
develops coagulopathy secondary to long-term non-steroidal anti-inflammatory drug (NSAID) use. The coagulopathy is most likely the result of___
A. decreased platelet adhesiveness
B. blocked prothrombin conversion
C. impaired vitamin K synthesis
D. factor VIII destruction
A
A
4
Q
- For the patient in the acute phase of rheumatic arthritis, which of the following does the nurse identify as the lowest priority in the plan of care?
A.
Preserving joint function
B.
Preventing joint deformity
C.
Relieving pain
D.
Maintaining usual task
A
D
5
Q
- Patient Mahika complains that she cannot do household chores and her knees hurt whenever she walks-which nursing diagnosis would be MOST APPROPRIATE?
A.
Self-care deficit related to increasing joint pain.
B.
Activity intolerance related to fatigue and joint pain.
C.
Disturbed body image related to fatigue and joint pain.
D.
Ineffective coping related to increased joint pain.
A
B
6
Q
Situation: Mrs. Dole, a 70-year-old retired teacher, is diagnosed with dementia. She lives with her
24-year-old granddaughter. Nurse Saab attends to her when she goes for her OPD check-ups.
- Mrs. Dole must be aware that the MOST common chronic incidence that brings about injury among elderly persons is
A. rheumatic fever
B. Hip fracture
C. gallbladder
D. urinary tract infection
A
7
Q
- Which of the following is the MOST common cause of dementia among elderly persons?
A. Parkinson’s Disease
B. Alzheimer’s Disease
C. Amyotrophic Lateral Sclerosis
D. Multiple Sclerosis.
A
B
8
Q
- Which of the following symptoms is COMMON to both the presenile and senile dementias associated with Alzheimer’s Disease?
A. Increased appetite
B. Loss of short-term memory
C. Inappropriate behavior
D. Inability to provide self-care
A
B
9
Q
- Nurse Saab should recognize the MOST common psychogenic disorder among elderly persons is____
A. depression
B. sleep disturbances
C. decreased appetite
D. inability to concentrate
A
A
10
Q
- Patient with dementia suffers from “sundown syndrome.” Which nursing action should be included in this patient’s care plan?
A. Maintain a consistent schedule and sequence of daily activities.
B. Integrate the patient’s cultural preferences into the care provided.
C. Serve a warm beverage and a snack in the early evening
D. Provide opportunities for the patient to learn and to practice new skills.
A
A
11
Q
Situation: Mr. Dacs is diagnosed to have chronic schizophrenia.
11. To prevent lapses in schizophrenia with Mr. Dacs, which of the following should Nurse Anakin NOT encourage Mr. Dacs and his Family?
A. Keep any troubling side effects of medications from the nurses
B. Practice stress reduction technique
C. To follow the medication regimen accurately
D. Participate regularly in any other forms of treatment.
A
A
12
Q
- Which of the following identified abilities of Mr. Dacs effectively participate in rehabilitation?
A. Ability to concentrate
B. Ability to think
C. Ability to talk
D. Ability to listen.
A
A
13
Q
- Choose the LEAST nursing action while communicating with Mr. Dacs.
A.
“Please let me know if I can be helpful”.
B.
Check his order for PRN medication.
C.
“I’ll let you sit here quietly, and I will be at the nurse station”
D.
“I’m just checking in with you to see if there is anything you need right now”.
A
C
14
Q
- Choose one Nursing strategy Nurse Anakin should NOT use.
A. Speak in a low, calm tone of voice
B. Let him interact with you while hallucinating
C. Maintain a nonthreatening stance, keep a physical distance
D. Maintaining safety for herself and Mr. Dacs
A
B.
15
Q
- Which of the following strategies would the nurse instruct the patient to prevent relapse?
A. Report changes in sleeping, eating, and mood.
B. Block hallucinations during daily activities
C. Take additional medications on days when Mr. Rollan is “feeling bad”.
D. Take stress Management Class
A
A
16
Q
Situation: Rizal, a 45-year-old carpenter, went to work per usual. However, when he got home, his family noticed some changes in his behavior. After further investigation, the nurse found out that he had inhaled a volatile substance.
- Substance abuse affects not only the user but also the other members of the Family. Which of the following is the MOST APPROPRIATE diagnosis in the care of Rizal?
A. Impaired Social Interactions
B. Impaired Parenting
C. Dysfunctional family processes
D. Ineffective coping
A
C
17
Q
- The predisposing factor in Rizal’s case is his
A. Age
B. Occupation
C.mHome environment
D. Community
A
B
18
Q
- Severe intoxication to volatile substances may lead to unconsciousness or even death. The PRIORITY nursing intervention in caring for the patient is monitoring the ____
A. Mental status
B. Neurological functions
C. Nutritional status
D. Vital Signs
A
D.
19
Q
- The nurse heard Rizal saying, “My mother visited me last night and reminded me to take care of myself.” This is a manifestation of ____
A. auditory hallucination
B. visual hallucination
C. delusion
D. reaction formation
A
B
20
Q
- Volatile Substance abuse is considered the most dangerous among abused psychoactive substances because of the risk of ____
A. Violence
B. Developing schizophrenia
C. irreversible damage to the bone marrow, brain, liver, and kidneys
D. malnutrition
A
C
21
Q
Situation: Nurse Marimar is assigned to Nika, a junior high school student, who is treated for her
Bulimia.
- Bulimia is best defined as a/ an
A. disorder of unknown origin associated with starving oneself.
B. pathological disorder of binging and vomiting
C. phobic disorder of fear of obesity
D. eating disorder associated with vomiting
A
B
22
Q
- Amitriptyline, an antidepressant, is the drug of choice in treating Bulimia. What is the COMMON side effect of this drug?
A .Anticholinergic Effects
B Cholinergic Effects
C. Urinary Frequency
D. Diarrhea.
A
A
23
Q
- Endocrine changes often result in a bulimic patient. Which of the following would be expected to change in Nika?
A. Delayed thyroid-stimulating Hormone response to Hormone replacement Therapy.
B. Increased production of Follicle Stimulating Hormone
C. Hypopituitarism
D. Decreased Adrenocorticotropic Hormone in response to cortisone..
A
A
24
Q
- Which of the following conditions may lead to death in a bulimic patient like Nika?
A, Hypokalemia and cardiac arrhythmias, and arrest
B. Metabolic Acidosis and Renal Failure
C. Hyponatremia and circulatory collapse
D. Hyponatremia and congestive heart failure
A
A.
25
25. What condition is NOT likely to develop in Nika?
A. Hyperkalemia
B. Tooth Decay
C. Gastric Ulcer
D. Rectal Bleeding.
A
26
Situation: Eighteen-year-old Sarah and her father came to the clinic for possible depression. She has several fears of getting sick and dying from COVID-19. She eats less and sleeps restlessly. She has not taken a bath for a week, and always talks about her missing mother, who died due to COVID-19 infection .
26. Three days after the admissions of Sarah, the nurse observed that she had taken a bath, worn a clean dress, and combed her hair. What is the APPROPRIATE reaction of the nurse to the behavioral change in Sarah?
A. "Something is different about you today. What is it?"
B. "Oh, I'm so pleased that you finally put on a clean dress".
C. I see that you have worn a clean dress and have combed your hair."
D. "That's good. You have on a clean dress and combed your hair".
C
27
27. Sarah was admitted to the hospital for treatment of her depression. Which antidepressant drug is COMMONLY used?
A. Norframin - TCA
B. Elavil - TCA
C. Prozac
D. Tofranil - TCA.
C
28
28. To prevent the recurrence of depression, how long should the patient take the antidepressant drugs?
A. Six months to two years
B. Two months to 1 year
C. one year to three years
D. one to three months
A
29
29. Early identification and treatment are essential to prevent long-term depression. Preventive measures do NOT include
A. medication as a treatment alone
B. providing a stable home life
C. practicing open and honest communication
D. facilitating a strong sense of self-trust, resilience, and self-esteem
A
30
30. Working with depressed Sarah, the nurse should understand that depression is MOST directly related to a person's
A. remembering her childhood
B. stage in life
C. having experienced a sense of loss
D. experiencing poor interpersonal relationships with others.
C.
31
Situation: Emily, a new staff nurse, was assigned to the psychiatric unit. A depressed patient assigned to her fell from the bed. Her head nurse asked her to submit an Incident Report (IR)
31. What guideline is IMPORTANT in relation to incident report (IR) it is ____?
A. not made part of the patient's chart
B. placed in the 201 nurse's file
C. filed in the nurses' station
D. filed in the records section of the hospital
A
32
32. Which of the following would prove that the nursing action carried out met the standards of care on falls?
A. Utilizing the nursing process in providing safe, quality nursing care.
B. Documenting the procedures done.
C. Carrying out the Doctor's order
D. Performing physical assessment
A
33
33. The purpose why the head nurse asked Nursed Rosie to submit an IR is to
A.
Note patterns from incidents in the same unit.
B.
Place it in Nurse Rosie's 201 file.
C.
Document immediately the incident.
D.
Evaluate Nurse Rosie's performance.
A
34
34. In writing the IR, which of the following is NOT included?
A. Who was/ were involved?
B. What daily medications are given to the patient?
C. What happened?
D. Who witnessed the incident?
B
35
35. Should the investigation of the fall go further, which of the following is the best source of factual information?
A. Incident report
B. Nurse's note in the chart
C. Anecdotal record
D. process recording
A
36
Situation: Nurses inform the patients taking antipsychotic medications about the types of side effects that may occur. She encourages patients to report first instead of discontinuing the medications. The following are related to patient teaching.
36. When taking antianxiety drugs like benzodiazepines, which APPROPRIATE health teaching should the nurse emphasize?
A.
Antianxiety drugs can treat the underlying problem.
B.
Patient should not drink alcohol because it potentiates its effect.
C.
Patient can discontinue the drug abruptly, even without orders.
D.
Patient can still drive his car cause of delayed response time.
B
37
37. When taking SSRI (Selective Serotonin Reuptake Inhibitors), which APPROPRIATE health teaching should the nurse emphasize?
A. Aged cheese may be allowed.
B Patient should take the drug first thing in the morning.
C. Peanuts are allowed.
D. Tyramine-free diet can lower blood pressure...
B
38
38. Which of the following does NOT signify extrapyramidal symptoms (EPS) in a patient taking Haldol?
A. Acute dystonia.
B. Akathisia
C. Dystoria
D. Increased libido
D.
39
39. When taking anticonvulsant drugs like Lithium, which APPROPRIATE HEALTH TEACHING should the nurse emphasize?
A. Time of the last dose must be accurate so that blood level monitoring is accurate.
B. Patient can take drugs even without food intake.
C. Patient will not experience polyuria and polydipsia.
D. Patient will have constipation; thus, he has to increase fluid intake.
A.
40
40. The patient often appears restless, anxious, agitated, with a rigid posture and lack of spontaneous gestures. Which of the following describes this patient who has an intense need to move?
A. Withdrawal
B. Dyskinesia
C. Dystonia
D. Akathisia
C
41
Situation: Mrs. Labrador 75 years old is in the clinic for the treatment of acute closed-angle glaucoma.
41. The physician would like to measure the intraocular pressure with a non-contact (air puff) tonometer. While preparing patient for her examination, the nurse informs the patient that____
A. after the examination, a slight pain will be experienced
B. before the examination, a medication will be given
C. it is a painless procedure that has no side effects
D. during the ocular fundoscopy, atropine eye drops will be instilled.
C
42
42. The physician has prescribed pilocarpine one percent eye drops every six hours. The expected OUTCOME for this medication is to ____
A. Dilate the pupil by paralyzing the ciliary muscle
B. Prevent dryness of the cornea and conjunctiva
C. Promote drainage of aqueous humor from the anterior chamber
D. reduce inflammation of the iris and choroid
C
43
43. Which of these nursing diagnoses should the nurse give PRIORITY for an elderly patient who has impaired vision due to glaucoma?
A.
High risk for injury
B.
Impaired Physical Mobility
C.
Grooming self-care deficit
D.
Feeding self-care Deficit
A
44
14. The physician recommends a peripheral iridectomy to relieve intraocular pressure. He prescriber neperidine Hydrochloride (Demerol) 50mg and atropine sulfate 0.3mg IM as preoperative medications The nurse should____
A.recognized that atropine sulfate is given preoperatively to dilate the pupil
B. recognize this as a usual preoperative medication and administer it
C. realize that the atropine sulfate is being given to dry up the secretion
D. notify the physician and question the order
D
45
45. Which symptoms are ASSOCIATED with acute closed-angle glaucoma?
A. Diplopia and Photophobia
B. Blurred vision and colored rings around lights
C. Episodic Blindness and no pain
D. Sensation of a curtain drawn across the vision field.
B
46
Situation: Nurses provide their patient's information they need to have informed consent, only if it is within their scope of nursing practice and nursing knowledge. Consent is the patient's acknowledgement and acceptance of medical treatment.
46. Which of the following are essential components of informed consent?
I. Explanation of procedures and alternatives of the procedure
II. Discussion of the potential risks and benefits of the procedures
III. Confirmation that the patient understands the risks, benefits, and any alterations
A. I, III
B. I, II
C. II, III
D. I, II, III
D
47
47. Bioethical issue should be described as____
A. The withholding of food and treatment at the request of the patient in a written advance
directive given before a patient acquired permanent brain damage from an accident.
B. The physician makes all the decisions of client management without getting the
input from the patient.
C. After the patient gives permission, the physician discloses all the information to the family for
their support in the management of the patient.
D. A research project that included all regular employed personnel and not treating all the casual
employed to compare the outcome of specific drug therapy
B.
48
48. In an emergency, when a patient is unable to give consent for life-saving treatment, what type of consent allows for the assumption of appropriate medical treatment?
A. Implied consent
B. Informed consent
C. Express consent
D. Involuntary Consent
A
49
49. Treatment of a patient without a consent can constitute_____ which is defined as intentional and unwanted touching.
A. Battery
B. Slander
C. Negligence
D. Tort
A
50
50. Whose responsibility is it to obtain informed consent?
A. Nurse Manager
B. Anesthesiologist
C. Physician
D. Midwife
C
CLOSE DOOR PART A & B
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