MISAMIS UNIVERSITY

Ozamiz City
College of Nursing & School
Of Midwifery
EXAMINATION PERIOD: Final EXAM

ID no.
Permit no.
Revision Status: 1
Revision Date: 15-Dec.-2013

Name

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Subject: NCM 107

Document Code : MU-NCM-EXQ
Class Schedule: TTH 7-11am
Instructor: Ms. Ginalyn C. Elmedulan
Check & Verified By:
Dr. Cynthia S. Superable

Date:
Proctor
Course & Year
Approved by:
VPAA

OATH OF HONESTY
Good old values are enduring. Diligence, hard work and honesty are some of these
which I should learn to practice in and out of school. I shall endeavor to practice honesty
today by answering the test question to the best of my ability and I will not enrich my score
by getting information or answers from any other student.
Students Signature
Situation: The Chief Nurse of a tertiary private hospital is having an orientation seminar to
newly-hired volunteer nurses. Part of the topic during the discussion is disciplinary action.
1. The chief nurse shared a situation about one of their staff nurse before who were not able
to document an intervention given to a patient. When reprimanded, the staff kept on
saying that she didnt know it was necessary. What should have been the most
appropriate intervention for this particular reason for violation?
A. Provide consistency when it comes to disciplinary action
B. Orient the staff during the first day of work about the importance of records and
notes
C. Conduct a thorough familiarization to the different equipments during orientation
D. Clear out the different standards that is expected when it comes to the ideal
outcomes of each unit
2. One of the staff nurses found a nursing attendant inserting a urinary catheter to one of the
elderly client. What should be the best course of action of the staff nurse on duty?
A. Report immediately to the head nurse for proper action
B. Call the attention of the nursing attendant and reprimand as needed
C. Provide a written admonishment for the nursing attendant
D. Do nothing because the procedure can be delegated to attendants
3. A case was also brought up about the most appropriate type of disciplinary action for a
minor violation done for the first time such as being late 20 minutes after the
endorsement time. The disciplinary action should be:
A. Oral reprimand
C. Layoff
B. Suspension with pay
D. Written reprimand
4. Head nurse Maria also raised one of the problems she encounters wherein the subordinate
refused to sign the written reprimand. What should be the most appropriate action of the
head nurse?
A. Terminate the employee on the grounds of insubordination
B. Write a request for dismissal to be approved by the chief nurse
C. Endorse to the incoming shift
D. Have another head nurse to sign as a witness
5. The chief nurse also emphasized that the written reprimand should be properly written
with complete details and information. All of the following should be included in the
written admonishment, except:
A. The nature of the violation and the cause for committing the violation
B. The signature of the person who violated and the superior
C. The physician who was involved on the violation of policy
D. The intervention taken by the manager to correct the situation
6. During the evaluation process, the supervisor noticed that there had been alteration and
loss of some equipments and discrepancies in the medication documentation the ER Unit.
In meeting the standards of the company, what is the initial action that the supervisor
should do?
A. Call the attention of the head nurse and the rest of the staff to be properly
reprimanded

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B. Call a meeting with the unit personnel to identify the reasons for such problem
C. Gather additional data to support the problem that has been identified
D. Set immediate action to correct the situation
Situation: Communication is a necessary component of any aspect of our life. In health care
delivery, communication plays an important role in maintaining coordination among the health
care personnel.
7. The following are the different steps in communication process. Arrange accordingly:
I.
Transcribing the idea in an understandable structure
II.
Sending the message
III.
Decision to send a message
IV. Formulating the concept of the message to be sent
V. Responding, clarifying and/or confirming
VI.
Understanding the message, both verbal and kinesthetic
A. 3, 4, 1, 2, 6, 7, 5
B. 3, 4, 6, 7, 1, 2, 5
C. 3, 6, 4, 7, 2, 5, 1
D. 3, 4, 1, 6, 7, 2, 5
8. For the communication to be effective, one must realize that the person you converse
with is worth listening to. This attitude is termed as:
A. Assuming Responsibility
C. Assuming Authority
B. Assuming Value
D. Assuming Status
9. Communication has been part of our everyday life yet some of the people tend to neglect
the part wherein it is important to understand the content of the message being sent and
the nurse must learn to identify whether or not the patient fully understood the instruction
being given. In this aspect of the nurses competency, the nurse must know that the
feedback from the client is indeed understood. Which among the following is the most
effective type of feedback?
A. Nodding
B. Responding
C. Confirming
D. Requesting
10. Interference will always be a challenge in effective communication. Which among the
following is a type of barrier considered as an improperly structured message related to
limited content?
A. Faulty reasoning
C. Selective Perception
B. Filtering
D. Poorly Expressed Messages
11. Proper communication using active listening would lead to an effective exchange of both
verbal and non-verbal information. This characteristic would facilitate trust and mutual
understanding that will enable the nurse leader to achieve:
A. Authority
B. Power
C. Goal
D. Objectives
Situation: Staffing is one of the administrative functions of the nurse in the higher level of the
management hierarchy. However, it is also important for the entry-level nurse to know some
basic basis for the computation of ideal number of personnel necessary to provide quality care.
12. Which among the following is the key information tool necessary to divide appropriate
nursing care hours needed for each patient with specific care need?
A. Staffing Formula
C. Patient Classification System
B. Clinical Decision Making
13. The nurse received the patient sitting on the bed still with an IV line attached. Upon
nursing rounds, the patient was seen newly bathed, well-groomed and now brushing his
teeth. There was no other person in the room. How will the nurse classify the level of the
patient care needs?
A. Minimal
B. Moderate
C. Intensive D. Critical

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14. The other patient in another room was found lying on bed. Identified with cervical spine
injury and needed to be turned from side-to-side every 2 hours. This patient is classified
at what level of patient care need?
A. Level 1
B. Level 2
C. Level 3
D. Level 4
15. One evening, the nurses in the OB ward were alerted because one of the post-natal
mothers have undergone into sudden cardiac arrest. The medical team (residents and
junior interns) responded immediately. After 2 hours of emergent intervention, the clients
status was stabilized. The written order instructed that the patient should be monitored
every 15 minutes. The doctor-on-duty visits the ward frequently to change the order as
per instructed by the attending physician. How will the staff nurse classify the patient
according to PCS?
A. Moderate Level
C. Minimal Level
B. Intensive Level
D. Critical Level
16. Basing on the above situation, how many nursing care hours per day should be allotted to
the patient?
A. 3 NCH per day
C. 4.5 NCH per day
B. 1.5 NCH per day
D. 6 NCH per day
C.
Situation: One of the challenges that the managers face nowadays is the scheduling process.
17. What would be the most appropriate type of scheduling method ensures consistency on
the personnels task due to a routine pattern of shift for the whole duration of the
contract?
A. Centralized Method
C. Baylor Plan
B. Decentralized Method
D. Permanent Type
18. As a manager, you must fully understand that the major purpose of effective scheduling
is:
A. To ensure safe and quality nursing care
B. To guarantee that the departments maintain the standards while considering the
personnels welfare by providing rest periods
C. To make certain that there will be consistency in the working shift pattern to
prevent sudden overtime that would result to overhead expenses on the company
D. To assure that the personal interest of workers are given the highest priority
19. The Chief Nurse of the hospital has given the departmental supervisors overall authority
in formulating schedule for their own department. What will be the greatest benefit of this
decision?
A. It will somehow avoid work-related tardiness
B. It will empower the Chief Nurse in doing other administrative function
C. It will greatly influence the cost containment by preventing overtime pay by
avoiding extension of work period due to differentiation of schedule per
department
D. It will motivate the personnel to work better since the supervisor knows their
personal strength and weaknesses
20. During the scheduling updates, the head nurse noted one of the staff frequent absences.
When questioned by the head, the staff would always say that he doesnt feel much
effective on the shift assigned to her. What will be the initial course of action of the head
nurse?
A. Gather pertinent data
B. Analyze the issue why the nurse has difficulty with the assigned schedule
C. Impose a new amendment on the departments policy that the personnel must be
fined for sudden absences without excuse
D. Threaten the staff nurse not to be late again or be terminated right away
Situation: To prevent overlapping of responsibilities, it is important for the nurse manager to
make sure that a working environment would have clear roles and specified tasks that will
eventually lead to an organized and systematic workplace.

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21. This type of tool is commonly used to provide a detailed roles and responsibilities of
specific personnel. Which of the following is referred by the preceding statement?
A. Job Analysis
C. Job Description
B. Job Order
D. Job Assessment
22. Which among the following nursing care modalities enables the nurse to acquire the
highest form of autonomy and accountability for a single patient or group of patients for
the whole duration of hospitalization?
A. Primary Nursing
C. Team Nursing
B. Case Method
D. Functional Nursing
Situation: In any allied health institution, nurse managers are not expected to handle all of the
tasks in taking care of both nursing interventions and administrative function. In this scenario,
delegation would be the best alternative for each manager.
23. You are a nurse who is taking care of implementing interventions for a critically-ill
cancer patient. Due to time constraints, you obviously could not handle all of your
nursing functions. Which among the following interventions can you delegate to your
nursing attendant?
A. Administration of chemotherapeutic medications
B. Routine chest physiotherapy
C. Patient teaching with regards importance of compliance to medications
D. Administration of antiemetic drugs
24. Before delegating the task, the nurse must consider certain criteria of the person to whom
you would delegate the job. Which among the following should be given the highest
priority?
A. Enthusiasm of the person to do the job
B. Amount of knowledge and past experience of the person in doing the task
C. Ability of the delegator to provide recognition after the work is done
D. Capability of the person to understand and comprehend the instructions given
25. The staff nurse hesitates to delegate task because of insecurity and fear that others may
think that she could not handle the position she has. This particular cause will lead to
which of the following mistake in delegation?
A. Underdelegation
C. Improper delegation
B. Overdelegation
D. Biased delegation
26. The nurse on duty assigns a routine task to the nursing attendant. Upon accomplishment
of the delegated task, the nurse-on-duty found a lot of errors done by the nursing
attendant. What will be the best course of action that the nurse is supposed to do?
A. Reprimand the nursing attendant and provide a detailed written admonishment
B. Write an incident report on behalf of the nursing attendant
C. Check the severity of error before deciding on the next action
D. Report to the Head Nurse on duty
Situation: Proper allocation of financial resources should be considered when managing a health
care facility. This would allow the balance between the quality of services rendered and at the
same time generating income for the company.
27. This type of budgeting method is done by forecasting the tendency of the market price to
consistently increase annually. What is this called?
A. Zero-Based Budgeting
C. Fixed Cost Containment
B. Incremental Budgeting
D. Absolute Increase Method
28. Head nurse Julia is currently preparing the budget proposal for this month. She knows
that this type of budget is allocated either monthly or semiannually and done together
with the operational planning and tackles all the rotational finances necessary to maintain
the companys existence. What is the term given for this type of budget?

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A. Capital expenditure
B. Operational budget

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C. Cash Disbursement
D. Revenue Budget

Situation: Planning is important for each endeavor that the manager takes. It is a proactive
approach that enables the nurse to prevent potential failure in the future.
29. This type of planning allows the higher level of the management to forecast a long-range
goal. Usually done every three to five years, this road map enables the manager to
continuously strive towards the achievement of the institutional goal and at the same time
update its program to adapt with the current demands in its services. What is this type of
planning called?
A. Operational Planning
C. Super Planning
B. Strategic Planning
D. Grand Prix Method
Situation: The management process is a complex yet effective way of understanding the whole
concept of the administration to effectively balance the quality of service without compromising
the income. Controlling is the final phase and it enables the nurse to assess whether the
institution achieved its goal and meets its standards or failed in carrying out its plan.
Furthermore, identify the need for a continuous evolution of the companys quality services.
30. Basically, the nurse manager understands that she needs assess the ability of her
subordinate to be able to identify their individual strengths and weaknesses. The
necessary tool for this situation would be:
A. Nursing Audit
C. Performance appraisal
B. Total Quality management
D. Quality assurance
31. Nurse Chris, the son of Mr. Clark Kent (the owner of the hospital where you work as a
head nurse), committed a medication error that resulted to minor headache of the patient.
You are hesitant to give disciplinary action because you are greatly influenced by which
of the following?
A. Chris connection power
C. Chris enigmatic power
B. Chris charismatic power
D. Chris expert power
32. The following task can be safely delegated by nurse to a non-nurse health worker except:
A. Transfer a client from bed to chair C. Irrigation of an NGT
B. Change IV infusions
D. Take vital signs
33. The plan of care for diabetic client includes all of the following interventions. All
interventions should not be delegated to the nursing assistant except:
A. Check and make sure that the patients bath water is not too hot
B. Discuss community resources for diabetic out patient care
C. Instruct the patient to perform daily foot inspections
D. Check the patients technique for drawing insulin into a syringe
34. The physicians order for Mr. J., include assisting the client with meals. To whom should
you delegate this task?
A. Physical therapist
C. Dietician
B. Nursing assistant
D. Nutritional therapist
35. In preparing a client for a colonoscopy procedure, which task is most suitable to delegate
to the nursing assistant?
A. Explain the needs for clear liquids 1-3 days prior to procedure
B. Reinforce NPO status 8 hours prior to procedure
C. Administer laxatives 1-3 days prior to procedure
D. Administer an enema the night before the procedure
Situation: Nurse Justin was appointed to lead his ward. He must know some basic principles in
nursing management.

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36. If he assigns his task to his staff and aides during a shift, he is performing management
principle of?
A. Delegation
C. Span of control
B. Accountability
D. Supervision of task
37. He knows that the management style to be used during crisis or peak patient admission is:
A. Autocratic
B. Democratic
C. Permissive
D. Situational
38. He knows that in his institution, the person who is always in a proper position to give
decision regarding patient care is:
A. Head nurse B. Physician on duty C. Family and relatives
D. Patient
39. The nurse is aware no physician has visited a hospitalized client for 3 consecutive days.
Reporting this information to a nursing superior, the nurse serves which of the following
principles?
A. Direct care provides
C. Client educator
B. Case manager
D. Client advocate
40. Although the nurse has assigned ancillary personnel to take vital signs that appear
inaccurate. This repetition of activity indicates the nurse understands which of the
following principles?
A. Accountability
C. Delegation
B. Obligation
D. The highest level of empowerment
41. Managers used to play different roles. Which of the following shows a decisional role of
the manager?
A. As a liaison between outside contracts such as community, suppliers, and the
organization
B. As a negotiator when conflicts arise
C. As a spokesperson or representative of the organization
D. As one who hires, fires, trains
42. The pre-determining of a course of action in order to arrive at a desired result is known as
the:
A. Assessment
C. Planning
B. Diagnosis
D. Implementation
43. A nurse is aware that a manager who assigns specific tasks to workers is using which
element of directing?
A. Supervision
C. Leading
B. Delegation
D. Communicating
44. In a delegation process, which of the following questions must be answered for the right
person?
A. Is the person able and willing to do this specific task?
B. Is the prospective delegatee a willing and able employee?
C. How often will you need to provide direct observation?
D. Does the delegatee know what and when to report?
45. The manager who closely monitors current trends and correlates them can forecast an
accurate picture and offer some direction to the change. This is one of the expectation of
the nurse manager that describes:
A. Learn to read the direction of change.
B. Do not predict the future, for none of us can know it with certainty.
C. Constant translation of meaning of information is necessary.
D. Assist staff members to learn self-management.
46. There is little or no communication when this one is lacking:
A. Communication skill
C. Knowledge
B. Feedback
D. Body Language
47. The nurse manager has implemented a change in the method of the nursing delivery
system from functional to team nursing. A nursing assistant is resistant to the change and
is not taking an active part in facilitating the process of change. Which of the following
would be the best approach in dealing with the nursing attendant?
A. Ignore the resistance.

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B. Exert coercion with the nursing assistant.

C. Provide a positive reward system for the nursing assistant.
D. Confront the nursing assistant to encourage verbalization of feelings regarding the
change.
Situation: Nurses are expected to assess contribute and preserve work environment that supports
fulfilling their ethical responsibility. The following questions apply to this.
48. The nurse attending to a client brought to the emergency department for treatment of
acute abdominal pain. Which of the following action to the nurse demonstrate respect of
clients autonomy?
A. Complying when the physician attempts to delegate obtaining informed consent
B. Facilitating and supporting clients choices regarding treatment options
C. Describing the risks and benefits of the reasonable alternative to treatments
D. Notifying appropriate parties if a patient has not given adequate information
49. Which of the following statement is correct regarding informed consent?
A. Nurses may not be legally liable if they know that informed consent was not
obtained
B. It is ethical or legal for nurses to obtain informed consent for procedures that are
to be informed by a physician
C. It is an ethical responsibility of nurses to provide with opportunities to give
informed consent
D. It is not within a nurses domain of responsibility to notify the health team of his
client has not given an informed consent for the procedure
50. The nurse is taking the blood pressure of a male client and noted a reading of 180/100.
When asked, the nurse avoids telling the client that his blood pressure is elevated because
she believes this information will upset the client and consequently further elevates the
blood pressure. This situation illustrates an example of:
A. Beneficence
B. Paternalism
C. Self-determination
D. autonomy
51. Accountability is best defined as
A. being reliable, dependable, and obliged to accomplish work at an acceptable level
B. justifying actions to supervisors
C. Being responsible and liable for decisions and actions
D. Knowing how to move up the chain of command
52. Which of the following is true about accountability?
A. It is hallmark of the health care professions
B. It seldom involves legal liability
C. It is separate from achieving care objectives
D. It must involve shared leadership
53. For all care scenarios, nurses are accountable for all of the following, except
A. Exhibiting ethical behavior
B. Providing competent care
C. Demonstrating intuitive thinking skills
D. Practicing leadership
54. Nurses are accountable for maintaining quality-of-life issues such as stress management
to which of the following constituents?
A. Patients
B. Government
C. Community organizations
D. Themselves
55. Nurses are accountable to the government agencies that regulate health care by
A. Holding colleagues accountable for following codes of conduct

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B. Working for continuous improvement of the health care system

C. Helping underserved populations access health care
D. Providing ways for health care professionals to enhance their skills
56. An organizational structure in which several individuals jointly hold responsibility for
achieving the organizations goals is called
A. Shared leadership
B. Hierarchy
C. Chain of command
D. Authority-responsibility matrix
57. Which of the following is true about an organizations chain of command?
A. It allows nurses to question orders and consult with the hierarchy of the
organization
B. It is used only for nursing issues and does not apply to physicians
C. It prevent nurses from moving more than one level above the nurses level of
employment
D. It does not require that the nurse reveal specific patient information
58. Which of the following is a component of active listening?
A. Paying close attention to the speaker
B. Providing advice to help the speaker solve his or her problem
C. Inviting others to join the conversation to clarify issues
D. Focusing on the words spoken
59. An example of rephrasing would be
A. Yes, I hear you.
B. So when you say a lot you mean twice a day?
C. What I hear you say is. . .
D. I dont understand you
60. The active listening skill of clarifying allow the listener to
A. Tell the speaker what to do
B. Restate what the speaker previously said
C. Accurately process information that maybe disorganized or confusing
D. Interrupt the speaker
61. The three essential steps for dealing with conflict are
A. Identify, understand, and resolve the problem
B. Listen actively, provide solution, and suppress any anger
C. Restate, question, and clarify the speakers statement
D. Identify, negotiate, and rephrase the listeners response
62. Putting yourself in another persons place is called
A. Delineation
B. Active listening
C. Feedback
D. Empathy
63. The advanced communication skill of keeping a conversation on track is also known as
A. Rephrasing
B. Focusing
C. Humor
D. Reassuring
64. Assertive behavior is characterized by:
A. Apologizing frequently
B. Sarcasm
C. Standing up for ones rights
D. Blaming others
65. Communication barriers can consist of:
A. Cultural, emotional, or gender issues
B. Overuse of I statements
C. Respecting and following other peoples cultural preferences

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D. Paying attention to what people say

66. The communication barrier that occurs when a person is categorized according to his or
her gender, cultural, or racial traits is called;
A. Blaming
B. Conflict
C. Inattention
D. Stereotyping
67. A voluntarily and planned change in a job position or obtaining credentials such as
training or education is an example of:
A. Personal change
B. Professional change
C. Organizational change
D. Resistance to change
68. When people in control enforce changes in an organization and others in the organization
have no input into these changes, this is an example of which of the following change
strategies?
A. Normative-reeducative
B. Power-coercive
C. Change-stabilization
D. Rational-empirical
69. The change strategy that assumes that people act more in accordance with social values
and are less likely to change based on information or rational arguments is called the:
A. Stabilization-evaluation strategy
B. Power-coercive strategy
C. Normative-reeducative strategy
D. Rational-empirical strategy
70. Unfreezing, moving to a new level, and refreezing are steps that make up which of the
following theories/models of change?
A. Lewins Force-Field Model
B. Lippitts Phases of Change
C. Havelocks Six-Step Change Model
D. Rogers Diffusion of Innovations
71. According to this change theory, efforts to implement change may be rejected at first and
accepted later; thus an initial rejection is not the final word. Which theory is this?
A. Lewins Force-field model
B. Lippitts phases of change
C. Havelocks six-step change model
D. Rogers Diffusion of Innovations
72. This theory says that organizations often undergo a series of rapid changes, and then
stabilize until the next round of rapid changes occurs.
A. Lippitts phases of change theory
B. Havelocks six-step change theory
C. Chaos theory
D. Learning organization theory
73. In Bushys theory about peoples reaction to change, the people who enjoy the status quo
but who will adopt change earlier than average to avoid being left behind are called:
A. Innovators
B. Laggards
C. Early majority
D. Early adopters
74. Identifying the problem or opportunity and collecting or analyzing data about a possible
change are activities of which step of the change process?
A. Assessment
B. Planning
C. Implementation

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D. Stabilization
75. The final step needed to complete the change process is called:
A. Assessment
B. Planning
C. Implementation
D. Stabilization
Test II Matching Type
Instruction: Match the Presidential Decrees/Republic Acts/Letter of Instruction/Executive Orders
in column A with the description in column B. Enter the capital letter of your answers in the
sheet provided (25 items).
Set A. Presidential Decree
Column A
76. PD 825
77. PD 143
78. PD 965
79. PD 603
80. PD 996

Column B
A. Child and Youth Welfare Code
B. Penalty for improper garbage disposal
C. Compulsory immunization of children under 8 years
D. Family Planning and Responsible Parenthood
E. A Woman and Child Labor Law (no child below 1 shall
be employed)
Set B. Republic Act/Letter of Instruction
Column A
81. RA 9173
82. RA 2328
83. RA 1612
84. RA 1082
85. RA 5901
86. RA 3573
87. RA 6675
88. RA 6713
89. RA 6758
90. RA 7305
91. RA 8344
92. RA 349
93. RA 7170
cases
94. RA 6425
95. LOI 949
Set C. Executive Order
Column A
96. EO 209
97. EO 51
98. EO 180
99. EO 174
100.
EO 857

Column B
A. Philippine Nursing Act of 2002
B. Organ Donation
C. Salary Standardization Law
D. Legalized use of human organs for scientific purposes
E. Reporting of Communicable Disease
F. 40 hours/week for nurses in with 100-bed capacity.
G. Code of Conduct and Ethical Standards for Public
Officials/employees
H. Generics Act of 1988
I. Salary Standardization Law
J. Magna Carta for Public Health Workers
K. Dangerous Drugs Act
L. Rural Health Units all over the Philippines
M. An act penalizing the refusal of hospital & medical
treatment & support in emergency or serious
N. Philippine Medical Act
O. Preference given to members accredited professional
organization for employment & seminars

A.
B.
C.
D.
E.

Column B
Milk Code
Compulsory Dollar Remittance Law
Family Code
Government workers CBA
National Drug Policy (availability, affordability or safe,
effective, quality drugs)