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NURSING PRACTICE I: FOUNDATION OF NURSING PRACTICE

SITUATION: Nursing is a profession. The nurse should have a background on the


theories and foundation of nursing as it influenced what is nursing today.
1. Nursing is the protection, promotion and optimization of health and abilities,
prevention of illness and injury, alleviation of suffering through the diagnosis and
treatment of human response and advocacy in the care of the individuals, families,
communities and the population. This is the most accepted definition of nursing as
defined by the:
A. PNA
D. Henderson

B. ANA

C. Nightingale

2. Advancement in Nursing leads to the development of the Expanded Career Roles.


Which of the following is NOT an expanded career role for nurses?
A. Nurse practitioner
B. Clinical nurse specialist

C. Nurse Researcher
D. Nurse anaesthesiologist

3. The Board of Nursing regulated the Nursing profession in the Philippines and is
responsible for the maintenance of the quality of nursing in the country. Powers and
duties of the board of nursing are the following, EXCEPT:

A. Issue, suspend, revoke certificates of registration


B. Issue subpoena duces tecum, ad testificandum
C. Open and close colleges of nursing
D. Supervise and regulate the practice of nursing
4. A nursing student or a beginning staff nurse who has not yet experienced enough
real situations to make judgments about them is in what stage of Nursing Expertise?
A. Novice
D. Competent

B. Newbie

C. Advanced Beginner

5. Benners Proficient nurse level is different from the other levels in nursing
expertise in the context of having:
A. the ability to organize and plan activities
B. having attained an advanced level of education
C. a holistic understanding and perception of the client
D. intuitive and analytic ability in new situations

SITUATION: The nurse has been asked to administer an injection via Z TRACK
technique. Questions 6 to 10 refer to this.
6. The nurse prepares an IM injection for an adult client using the Z track technique.
4 ml of medication is to be administered to the client. Which of the following site will
you choose?
A. Deltoid

B. Rectus femoris

C. Ventrogluteal

D. Vastus lateralis

7. In infants 1 year old and below, which of the following is the site of choice for
intramuscular
Injection?
A. Deltoid
lateralis

B. Rectus femoris

C. Ventrogluteal

D. Vastus

8. In order to decrease discomfort in Z track administration, which of the following is


applicable?
A. Pierce the skin quickly and smoothly at a 90 degree angle
B. Inject the medication steadily at around 10 minutes per millilitre
C. Pull back the plunger and aspirate for 1 minute to make sure that the needle did
not hit a blood vessel
D. Pierce the skin slowly and carefully at a 90 degree angle
9. After injection using the Z track technique, the nurse should know that she needs
to wait for a few seconds before withdrawing the needle and this is to allow the
medication to disperse into the muscle tissue, thus decreasing the clients
discomfort. How many seconds should the nurse wait before withdrawing the
needle?
A. 2 seconds
seconds

B. 5 seconds

C. 10 seconds

D. 15

10. The rationale in using the Z track technique in an intramuscular injection is:
A. It decreases the leakage of discolouring and irritating medication into
the subcutaneous tissues
B. It will allow a faster absorption of the medication
C. The Z track technique prevent irritation of the muscle
D. It is much more convenient for the nurse
SITUATION: A Client was rushed to the emergency room and you are his attending
nurse. You are performing a vital sign assessment.
11. All of the following are correct methods in assessment of the blood pressure
EXCEPT:

A. Take the blood pressure reading on both arms for comparison


B. Listen to and identify the phases of Korotkoffs sound
C. Pump the cuff to around 50 mmHg above the point where the
pulse is obliterated
D. Observe procedures for infection control

12. You attached a pulse oximeter to the client. You know that the purpose is to:
A. Determine if the clients hemoglobin level is low and if he needs blood
transfusion
B. Check level of clients tissue perfusion
C. Measure the efficacy of the clients anti-hypertensive medications
D. Detect oxygen saturation of arterial blood before symptoms of
hypoxemia develops
13. After a few hours in the Emergency Room, The client is admitted to the ward
with an order of hourly monitoring of blood pressure. The nurse finds that the cuff is
too narrow and this will cause the blood pressure reading to be:
A.
B.
C.
D.

inconsistent
low systolic and high diastolic
higher than what the reading should be
lower than what the reading should be

14. Through the clients health history, you gather that the patient smokes and
drinks coffee. When taking the blood pressure of a client who recently smoked or
drank coffee, how long should the nurse wait before taking the clients blood
pressure for accurate reading?
A.
B.
C.
D.

15 minutes
30 minutes
1 hour
5 minutes

15. While the client has pulse oximeter on his fingertip, you notice that the sunlight
is shining on the area where the oximeter is. Your action will be to:
A.
B.
C.
D.

Set and turn on the alarm of the oximeter


Do nothing since there is no identified problem
Cover the fingertip sensor with a towel or bedsheet
Change the location of the sensor every four hours

16. The nurse finds it necessary to recheck the blood pressure reading. In case of
such re assessment, the nurse should wait for a period of:
A. 15 seconds
minutes

B. 1 to 2 minutes C. 30 minutes

D. 15

17. If the arm is said to be elevated when taking the blood pressure, it will create a:

A. False high reading


Indeterminate

B. False low reading

C. True false reading

D.

18. You are to assessed the temperature of the client the next morning and found
out that he ate ice cream. How many minutes should you wait before assessing the
clients oral temperature?
A. 10 minutes
minutes

B. 20 minutes

C. 30 minutes

D. 15

19. When auscultating the clients blood pressure the nurse hears the following:
From 150 mmHg to 130 mmHg: Silence, Then: a thumping sound continuing down
to 100 mmHg; muffled sound continuing down to 80 mmHg and then silence. What
is the clients blood pressure?
A. 130/80

B. 150/100

C. 100/80

D. 150/100

20. In a client with a previous blood pressure of 130/80 4 hours ago, how long will it
take to release the blood pressure cuff to obtain an accurate reading?
A. 10-20 seconds

B. 30-45 seconds C. 1-1.5 minutes

D. 3-3.5 minutes

Situation: Oral care is an important part of hygienic practices and promoting client
comfort.
21. An elderly client, 84 years old, is unconscious. Assessment of the mouth reveals
excessive dryness and presence of sores. Which of the following is BEST to use for
oral care?
A. lemon glycerine
B. hydrogen peroxide

C. Mineral oil
D. Normal saline solution

22. When performing oral care to an unconscious client, which of the following is a
special consideration to prevent aspiration of fluids into the lungs?
A. Put the client on a sidelying position with head of bed lowered
B. Keep the client dry by placing towel under the chin
C. Wash hands and observe appropriate infection control
D. Clean mouth with oral swabs in a careful and an orderly progression
23. The advantages of oral care for a client include all of the following, EXCEPT:
A. decreases bacteria in the mouth and teeth
B. reduces need to use commercial mouthwash which irritate the buccal
mucosa
C. improves clients appearance and self-confidence
D. improves appetite and taste of food
24. A possible problem while providing oral care to unconscious clients is the risk of
fluid aspiration to lungs. This can be avoided by:

A. Cleaning teeth and mouth with cotton swabs soaked with mouthwash to avoid
rinsing the buccal cavity
B. swabbing the inside of the cheeks and lips, tongue and gums with dry cotton
swabs
C. use fingers wrapped with wet cotton washcloth to rub inside the cheeks, tongue,
lips and ums
D. suctioning as needed while cleaning the buccal cavity

25. Your client has difficulty of breathing and is mouth breathing most of the time.
This causes dryness of the mouth with unpleasant odor. Oral hygiene is
recommended for the client and in addition, you will keep the mouth moistened by
using:
A. salt solution
B. water

C. petroleum jelly
D. mentholated ointment

Situation Ensuring safety before, during and after a diagnostic procedure is an


important responsibility of the nurse.
26. To help Fernan better tolerate the bronchoscopy, you should instruct him to
practice which
of the following prior to the procedure?
A. Clenching his fist every 2 minutes
B. Breathing in and out through the nose with his mouth open
C. Tensing the shoulder muscles while lying on his back
D. Holding his breath periodically for 30 seconds
27. Following a bronchoscopy, which of the following complains to Fernan should be
noted as a
possible complication:
A. Nausea and vomiting
B. Shortness of breath and laryngeal stridor
C. Blood tinged sputum and coughing
D. Sore throat and hoarseness
28. Immediately after bronchoscopy, you instructed Fernan to:
A. Exercise the neck muscles
B. Breathe deeply

C. Refrain from coughing and talking


D. Clear his throat

29. Thoracentesis may be performed for cytologic study of pleural fluid. As a nurse
your most important function during the procedure is to:
A. Keep the sterile equipment from contamination
B. Assist the physician
C. Open and close the three-way stopcock
D. Observe the patients vital signs

30. Right after thoracentesis, which of the following is most appropriate


intervention?
A. Instruct the patient not to cough or deep breathe for two hours
B. Observe for symptoms of tightness of chest or bleeding
C. Place an ice pack to the puncture site
D. Remove the dressing to check for bleeding

Situation: Knowledge of the acid-base disturbance and the functions of the


electrolytes is necessary to determine appropriate intervention and nursing actions.
31. A client with diabetes milletus has a blood glucose level of 644 mg/dL. The
nurse interprets that this client is at most risk for the development of which type of
acid-base imbalance?
A. Respiratory acidosis
B. Metabolic acidosis

C. Respiratory alkalosis
D. Metabolic alkalosis

32. In a client in the health care clinic, arterial blood gas analysis gives the following
results: pH 7.48, PCO2 32 mmHg, PO2 94 mmHg, HCO3 24 mEq/L. The nurse
interprets that the client has which acid base disturbance?
A. Respiratory acidosis
B. Respiratory alkalosis

C. Metabolic acidosis
D. Metabolic alkalosis

33. A client has an order for ABG analysis on radial artery specimens. The nurse
ensures that which of the following has been performed or tested before the ABG
specimens are drawn?
A. Guthrie test
B. Allens test

C. Rombergs test
D. Webers test

34. A nurse is reviewing the arterial blood gas values of a client and notes that the
ph is 7.31, Pco2 is 50 mmHg, and the bicarbonate is 27 mEq/L. The nurse concludes
that which acid base disturbance is present in this client?
A. Respiratory acidosis
B. Respiratory alkalosis

C. Metabolic acidosis
D. Metabolic alkalosis

35. Allens test checks the patency of the:


A. Ulnar artery
B. Radial artery

C. Carotid artery
D. Brachial artery

Situation: Hormones are secreted by the various glands in the body. Basic knowledge of
the endocrine system is necessary.
41. Somatocrinin or the Growth hormone releasing hormone is secreted by the:

A. Hypothalamus
B. Anterior pituitary gland

C. Posterior pituitary gland


D. Thyroid gland

42. All of the following are secreted by the anterior pituitary gland except:
A. Somatotropin/Growth hormone
B. Follicle stimulating hormone
releasing hormone

C. Thyroid stimulating hormone


D. Gonadotropin hormone

43. All of the following hormones are hormones secreted by the Posterior pituitary gland
except:
A. Vasopressin
B. Oxytocin

C. Anti diuretic hormone


D. Growth hormone

44. Calcitonin, a hormone necessary for calcium regulation is secreted in the:


A. Thyroid gland
B. Hypothalamus

C. Parathyroid gland
D. Anterior pituitary gland

45. While Parathormone, a hormone that negates the effect of calcitonin is secreted by
the:
A. Thyroid gland
B. Hypothalamus

C. Parathyroid gland
D. Anterior pituitary gland

Situation: The staff nurse supervisor requests all the staff nurses to brainstorm and learn
ways to instruct diabetic clients on self-administration of insulin. She wants to ensure that
there are nurses available daily to do health education classes.
46. The plan of the nurse supervisor is an example of
A.
B.
C.
D.

in service education process


efficient management of human resources
increasing human resources
primary prevention

47. When Mrs. Guevarra, a nurse, delegates aspects of the clients care to the nurse-aide
who is an unlicensed staff, Mrs. Guevarra
A.
makes the assignment to teach the staff member
B.
is assigning the responsibility to the aide but not the
accountability for those tasks
C.
does not have to supervise or evaluate the aide
D.
most know how to perform task delegated

48. Connie, the new nurse, appears tired and sluggish and lacks the enthusiasm she had
six weeks ago when she started the job. The nurse supervisor should
A.
B.
C.
D.

empathize with the nurse and listen to her


tell her to take the day off
discuss how she is adjusting to her new job
ask about her family life

49. Process of formal negotiations of working conditions between a group of registered


nurses and employer is
A.
grievance
B.
arbitration
C.
collective bargaining
D.
strike
50. You are attending a certification on cardiopulmonary resuscitation (CPR) offered and
required by the hospital employing you. This is
A.
B.
C.
D.

professional course towards credits


inservice education
advance training
continuing education

Situation: As a nurse, you are aware that proper documentation in the patient chart is your
responsibility.
51. Which of the following is not a legally binding document but nevertheless very
important in the care of all patients in any health care setting?
The
A. Bill of rights as provided in the Philippine constitution
B. Scope of nursing practice as defined by RA 9173
C. Board of nursing resolution adopting the code of ethics
D. Patients bill of rights
52. A nurse gives a wrong medication to the client. Another nurse employed by the same
hospital as a risk manager will expect to receive which of the following communication?
A. Incident report
B. Oral report

C. Nursing kardex
D. Complain report

53. Performing a procedure on a client in the absence of an informed consent can lead to
which of the following charges?
A. Fraud
B. Assault and battery

C. Harassment
D. Breach of confidentiality

54. Which of the following is the essence of informed consent?


A. It should have a durable power of attorney
B. It should have coverage from an insurance company
C. It should respect the clients freedom from coercion
D. It should disclose previous diagnosis, prognosis and alternative treatments available for
the client

55. Delegation is the process of assigning tasks that can be performed by a subordinate.
The RN should always be accountable and should not lose his accountability. Which of the
following is a role included in delegation?
A. The RN must supervise all delegated tasks
B. After a task has been delegated, it is no longer a responsibility of the RN
C. The RN is responsible and accountable for the delegated task in adjunct with
the delegate
D. Follow up with a delegated task is necessary only if the assistive personnel is not
trustworthy

Situation: When creating your lesson plan for cerebrovascular disease or STROKE. It is
important to include the risk factors of stroke.
56.

The most important risk factor is:

A.
B.

Cigarette smoking
Hypertension

C. binge drinking
D. heredity

57.
Part of your lesson plan is to talk about etiology or cause of stroke. The types of
stroke based on cause are the following EXCEPT:
A.
B.

Embolic stroke
Hemorrhagic stroke

C. diabetic stroke
D. thrombotic stroke

58.
Hemmorhagic stroke occurs suddenly usually when the person is active. All are
causes of hemorrhage, EXCEPT:
A.
B.

phlebitis
trauma

C. damage to blood vessel


D. aneurysm

59.
The nurse emphasizes that intravenous drug abuse carries a high risk of stroke.
Which drug is closely linked to this?
A.
B.

Amphetamines
Cocaine

C. shabu
D. Demerol

60.
A participant in the STROKE class asks what is a risk factor of stroke. Your best
response is:
A.
possible.
B.
C.
D.

More red blood cells thicken blood and make clots more
Increased RBC count is linked to high cholesterol.
More red blood cell increases hemoglobin content.
High RBC count increases blood pressure.

Situation: Recognition of normal values is vital in assessment of clients with various


disorders.
61. A nurse is reviewing the laboratory test results for a client with a diagnosis of severe
dehydration. The nurse would expect the hematocrit level for this client to be which of the
following?
A. 60%
D. 32%

B. 47%

C. 45%

62. A nurse is reviewing the electrolyte results of an assigned client and notes that the
potassium level is 5.6 mEq/L. Which of the following would the nurse expect to note on the
ECG as a result of this laboratory value?
A. ST depression
B. Inverted T wave

C. Prominent U wave
D. Tall peaked T waves

63. A nurse is reviewing the electrolyte results of an assigned client and notes that the
potassium level is 3.2 mEq/L. Which of the following would the nurse expect to note on the
ECG as a result of this laboratory value?
A. U waves
B. Absent P waves

C. Elevated T waves
D. Elevated ST Segment

64. Dorothy underwent diagnostic test and the result of the blood examination are back.
On reviewing the result the nurse notices which of the following as abnormal finding?
A.
B.
C.
D.

Neutrophils 60%
White blood cells (WBC) 9000/mm
Erythrocyte sedimentation rate (ESR) is 39 mm/hr
Iron 75 mg/100 ml

65. Which of the following laboratory test result indicate presence of an infectious
process?
A.
B.
C.
D.

Erythrocyte sedimentation rate (ESR) 12 mm/hr


White blood cells (WBC) 18,000/mm3
Iron 90 g/100ml
Neutrophils 67%

Situation: Pleural effusion is the accumulation of fluid in the pleural space. Questions 66 to
70 refer to this.
66. Which of the following is a finding that the nurse will be able to assess in a client with
Pleural effusion?
A. Reduced or absent breath sound at the base of the lungs, dyspnea,
tachpynea and shortness of breath
B. Hypoxemia, hypercapnea and respiratory acidosis

C. Noisy respiration, crackles, stridor and wheezing


D. Tracheal deviation towards the affected side, increased fremitus and loud breath sounds
67. Thoracentesis is performed to the client with effusion. The nurse knows that the
removal of fluid should be slow. Rapid removal of fluid in thoracentesis might cause:
A. Pneumothorax
B. Pleurisy or Pleuritis

C. Cardiovascular collapse
D. Hypertension

68. 3 Days after thoracentesis, the client again exhibited respiratory distress. The nurse
will know that pleural effusion has reoccurred when she noticed a sharp stabbing pain
during inspiration. The physician ordered a closed tube thoracotomy for the client. The
nurse knows that the primary function of the chest tube is to:
A. Restore positive intrathoracic pressure
B. Restore negative intrathoracic pressure
C. To visualize the intrathoracic content
D. As a method of air administration via ventilator
69. The chest tube is functioning properly if:
A. There is an oscillation
B. There is no bubbling in the drainage bottle
C. There is a continuous bubbling in the waterseal
D. The suction control bottle has a continuous bubbling
70. In a client with pleural effusion, the nurse is instructing appropriate breathing
technique. Which of the following is included in the teaching?
A. Breath normally
B. Hold the breath after each inspiration for 1 full minute
C. Practice abdominal breathing
D. Inhale slowly and hold the breath for 3 to 5 seconds after each inhalation
SITUATION : Health care delivery system affects the health status of every filipino. As a Nurse, Knowledge of this
system is expected to ensure quality of life.
71. When should rehabilitation commence?
A. The day before discharge
B. When the patient desires
C. Upon admission
D. 24 hours after discharge
72. What exemplified the preventive and promotive programs in the hospital?
A. Hospital as a center to prevent and control infection
B. Program for smokers
C. Program for alcoholics and drug addicts
D. Hospital Wellness Center
73. Which makes nursing dynamic?
A. Every patient is a unique physical, emotional, social and spiritual being
B. The patient participate in the over all nursing care plan

11

C. Nursing practice is expanding in the light of modern developments that takes place
D. The health status of the patient is constantly changing and the nurse must be cognizant and responsive
to these changes
74. Prevention is an important responsibility of the nurse in:
A. Hospitals
B. Community
C. Workplace
D. All of the above
75. This form of Health Insurance provides comprehensive prepaid health services to enrollees for a fixed periodic
payment.
A. Health Maintenance Organization
B. Medicare
C. Philippine Health Insurance Act
D. Hospital Maintenance Organization
Situation: Nursing ethics is an important part of the nursing profession. As the ethical situation arises, so is the need
to have an accurate and ethical decision making.
76. Which of the following mandates that health care institutions should have a bioethical review committee?
A. DOH

B. RA 9173

C. JCAHO

D. PNA

77. Which of the following is the purpose of the ethical review committee?
A.
B.
C.
D.

Promote implementation of general standards


Enhance health care providers liability
Increase individuals responsibility for decision making
Decrease public scrutiny of health care providers action

78. The principles that govern right and proper conduct of a person regarding life, biology
and the health professionals is referred to as:
A.
B.
C.
D.

Morality
Religion
Values
Bioethics

Situation: As a profession, nursing is dynamic and its practice is directed by various


theoretical models. To demonstrate caring behaviour, the nurse applies various nursing
models in providing quality nursing care.
86. When you clean the bedside unit and regularly attend to the personal hygiene of the
patient as well as in washing your hands before and after a procedure and in between
patients, you indent to facilitate the bodys reparative processes. Which of the following
nursing theory are you applying in the above nursing action?
A. Hildegard Peplau
B. Virginia Henderson

C. Dorothea Orem
D. Florence Nightingale

87. A communication skill is one of the important competencies expected of a nurse.


Interpersonal process is viewed as human to human relationship. This statement is an
application of whose nursing model?
A. Joyce Travelbee
B. Callista Roy

C. Martha Rogers
D. Imogene King

88. The statement the health status of an individual is constantly changing and the nurse
must be cognizant and responsive to these changes best explains which of the following
facts about nursing?
A. Dynamic
B. Holistic

C. Client centred
D. Art

89. Virginia Henderson professes that the goal of nursing is to work interdependently with
other health care working in assisting the patient to gain independence as quickly as
possible. Which of the following nursing actions best demonstrates this theory in taking
care of a 94 year old client with dementia who is totally immobile?
A. Feeds the patient, brushes his teeth, gives the sponge bath
B. Supervise the watcher in rendering patient his morning care
C. Put the patient in semi fowlers position, set the over bed table so the patient can eat
by himself, brush his teeth and sponge himself
D. Assist the patient to turn to his sides and allow him to brush and feed himself only when
he feels ready

90. In the self care deficit theory by Dorothea Orem, nursing care becomes necessary
when a patient is unable to fulfil his physiological, psychological and social needs. A
pregnant client needing prenatal check up is classified as:
A. Wholly compensatory
B. Partially compensatory

C. Supportive Educative
D. Non compensatory

Situation: Documentation and reporting are just as important as providing patient care, As
such, the nurse must be factual and accurate to ensure quality documentation and
reporting.
91. Health care reports have different purposes. The availability of patients record to all
health team members demonstrates which of the following purposes:
A. Legal documentation
B. Education

C. Research
D. Vehicle for communication

92. When a nurse commits medication error, she should accurately document clients
response and her corresponding action. This is very important for which of the following
purposes:
A. Research
B. Nursing Audit

C. Legal documentation
D. Vehicle for communication

93. POMR has been widely used in many teaching hospitals. One of its unique features is
SOAPIE charting. The P in SOAPIE charting should include:

A. Prescription of the doctor to the patients illness


B. Plan of care for patient
C. Patients perception of ones illness
D. Nursing problem and Nursing diagnosis
94. The medical records that are organized into separate section from doctors or nurses
has more disadvantages than advantages. This is classified as what type of recording?
A. POMR
B. SOAPIE

C. Modified POMR
D. SOMR

95. Which of the following is the advantage of SOMR or Traditional recording?


A. Increases efficiency in data gathering
B. Reinforces the use of the nursing process
C. The care giver can easily locate proper section for making charting entries
D. Enhances effective communication among health care team members
Situation: June is a 24 year old client with symptoms of dyspnea, absent breath sounds on
the right lung and chest x ray revealed pleural effusion. The physician will perform
thoracentesis.
96. Thoracentesis is useful in treating all of the following pulmonary disorders except:
A. Hemothorax
B. Tuberculosis

C. Hydrothorax
D. Empyema

97. Which of the following psychological preparation is not relevant for him?
A. Telling him that the gauge of the needle and anesthesia to be used
B. Telling him to keep still during the procedure to facilitate the insertion of the needle in
the correct place
C. Allow June to express his feelings and concerns
D. Physicians explanation on the purpose of the procedure and how it will be done
98. Before thoracentesis, the legal consideration you must check is:
A. Consent is signed by the client
B. Medicine preparation is correct
C. Position of the client is correct
D. Consent is signed by relative and physician
99. As a nurse, you know that the position for June before thoracentesis is:
A. Orthopneic
B. Knee-chest
side

C. Low fowlers
D. Sidelying position on the affected

100. Which of the following anaesthetics drug is used for thoracentesis?


A. Procaine 2%
B. Valium 250 mg

C. Demerol 75 mg
D. Phenobartbital 50 mg

NURSING PRACTICE II
Situation: Mariah is a 31 year old lawyer who has been married for 6 months. She consults
you for guidance in relation with her menstrual cycle and her desire to get pregnant.
1. She wants to know the length of her menstrual cycle. Her previous menstrual period is
October 22 to 26. Her LMB is November 21. Which of the following number of days will be
your correct response?
A. 29

B. 28

C. 30

D. 31

2. You advised her to observe and record the signs of Ovulation. Which of the following
signs will she likely note down?
1.
2.
3.
4.

A 1 degree Fahrenheit rise in basal body temperature


Cervical mucus becomes copious and clear
One pound increase in weight
Mittelschmerz

A. 1,2,4

B. 1,2,3

C. 2,3,4

D. 1,3,4
3. You instruct Mariah to keep record of her basal temperature everyday, which of the
following instructions is incorrect?
A. If coitus has occurred, this should be reflected in the chart
B. It is best to have coitus on the evening following a drop in BBT to become pregnant
C. Temperature should be taken immediately after waking and before getting out of bed
D. BBT is lowest during the secretory phase
4. She reports an increase in BBT on December 16. Which hormone brings about this
change in her BBT?
A. Estrogen
B. Progesterone

C. Gonadotropine
D. Follicle stimulating hormone

5. The following month, Mariah suspects she is pregnant. Her urine is positive for Human
chorionic gonadotrophin. Which structure produces Hcg?
A. Pituitary gland
B. Trophoblastic cells of the embryo
C. Uterine deciduas
D. Ovarian follicles
Situation: Mariah came back and she is now pregnant.
6. At 5 month gestation, which of the following fetal development would probably be
achieve?
A. Fetal movement are felt by Mariah
B. Vernix caseosa covers the entire body
C. Viable if delivered within this period
D. Braxton hicks contractions are observed
7. The nurse palpates the abdomen of Mariah. Now At 5 month gestation, What level of
the abdomen can the fundic height be palpated?

A. Symphysis pubis
B. Midpoint between the umbilicus and the xiphoid process
C. Midpoint between the symphysis pubis and the umbilicus
D. Umbilicus
8. She worries about her small breasts, thinking that she probably will not be able to
breastfeed her baby. Which of the following responses of the nurse is correct?
A. The size of your breast will not affect your lactation
B. You can switch to bottle feeding
C. You can try to have exercise to increase the size of your breast
D. Manual expression of milk is possible
9. She tells the nurse that she does not take milk regularly. She claims that she does not
want to gain too much weight during her pregnancy. Which of the following nursing
diagnosis is a priority?
A. Potential self esteem disturbance related to physiologic changes in pregnancy
B. Ineffective individual coping related to physiologic changes in pregnancy
C. Fear related to the effects of pregnancy
D. Knowledge deficit regarding nutritional requirements of pregnancies related
to lack of information sources
10. Which of the following interventions will likely ensure compliance of Mariah?
A. Incorporate her food preferences that are adequately nutritious in her meal
plan
B. Consistently counsel toward optimum nutritional intake
C. Respect her right to reject dietary information if she chooses
D. Inform her of the adverse effects of inadequate nutrition to her fetus
Situation: Overpopulation is one problem in the Philippines that causes economic drain.
Most Filipinos are against in legalizing abortion. As a nurse, Mastery of contraception is
needed to contribute to the society and economic growth.
16. Supposed that Dana, 17 years old, tells you she wants to use fertility awareness
method of contraception. How will she determine her fertile days?
A. She will notice that she feels hot, as if she has an elevated temperature.
B. She should assess whether her cervical mucus is thin, copious, clear and
watery.
C. She should monitor her emotions for sudden anger or crying
D. She should assess whether her breasts feel sensitive to cool air
17. Dana chooses to use COC as her family planning method. What is the danger sign of
COC you would ask her to report?
A. A stuffy or runny nose
B. Arthritis like symptoms

C. Slight weight gain


D. Migraine headache

18. Dana asks about subcutaneous implants and she asks, how long will these implants be
effective. Your best answer is:
A. One month
B. Twelve months

C. Five years
D. 10 years

19. Dana asks about female condoms. Which of the following is true with regards to
female condoms?
A. The hormone the condom releases might cause mild weight gain
B. She should insert the condom before any penile penetration
C. She should coat the condom with spermicide before use
D. Female condoms, unlike male condoms, are reusable
20. Dana has asked about GIFT procedure. What makes her a good candidate for GIFT?
A. She has patent fallopian tubes, so fertilized ova can be implanted on them
B. She is RH negative, a necessary stipulation to rule out RH incompatibility
C. She has normal uterus, so the sperm can be injected through the cervix into it
D. Her husband is taking sildenafil, so all sperms will be motile
Situation : Nurse Lorena is a Family Planning and Infertility Nurse Specialist and currently
attends to FAMILY PLANNING CLIENTS AND INFERTILE COUPLES. The following conditions
pertain to meeting the nursing needs of this particular population group.
21. Dina, 17 years old, asks you how a tubal ligation prevents pregnancy. Which would be
the best answer?
A.
Prostaglandins released from the cut fallopian tubes can kill sperm
B.
Sperm can not enter the uterus because the cervical entrance is
blocked.
C.
Sperm can no longer reach the ova, because the fallopian
tubes are blocked
D.
The ovary no longer releases ova as there is no where for them to go.

22. The Dators are a couple undergoing testing for infertility. Infertility is said to exist
when:
A.
B.
C.
D.

A woman has no uterus


A woman has no children
A couple has been trying to conceive for 1 year
A couple has wanted a child for 6 months

23. Another client named Lilia is diagnosed as having endometriosis. This condition
interferes with fertility because:
A.
B.
C.
D.

Endometrial implants can block the fallopian tubes


The uterine cervix becomes inflamed and swollen
The ovaries stop producing adequate estrogen
Pressure on the pituitary leads to decreased FSH levels

24. Lilia is scheduled to have a hysterosalphingogram. Which of the following instructions


would you give her regarding this procedure?
A.
B.

She will not be able to conceive for 3 months after the procedure
The sonogram of the uterus will reveal any tumors present

C.
D.

Many women experience mild bleeding as an after effect


She may feel some cramping when the dye is inserted

25. Lilias cousin on the other hand, knowing nurse Lorenas specialization asks what
artificial insemination by donor entails. Which would be your best answer if you were
Nurse Lorena?
A.
B.
C.
D.

Donor sperm are introduced vaginally into the uterus or cervix


Donor sperm are injected intra-abdominally into each ovary
Artificial sperm are injected vaginally to test tubal patency
The husbands sperm is administered intravenously weekly

Situation . You are assigned to take care of a group of patients across the lifespan.
26. Pain in the elder persons require careful assessment because they:
A. experienced reduce sensory perception
B. have increased sensory perception
C. are expected to experience chronic pain
D. have a decreased pain threshold
27. Administration of analgesics to the older persons requires careful patient assessment
because older people:
A. are more sensitive to drugs
B. have increased hepatic, renal and gastrointestinal function
C. have increased sensory perception
D. mobilize drugs more rapidly
28. The elderly patient is at higher risk for urinary incontinence because of:
A. increased glomerular filtration
B. diuretic use

C. decreased bladder capacity


D. dilated urethra

29. Which of the following is the MOST COMMON sign of infection among the elderly?
A. decreased breath sounds with crackles
C. pain
B. fever
D. change in mental status
30. Priorities when caring for the elderly trauma patient:
A. circulation, airway, breathing
(neurologic)
B. disability (neurologic), airway, breathing
circulation

C. airway, breathing, disability


D. airway, breathing,

31. Preschoolers are able to see things from which of the following perspectives?
A. Their peers
C. Their own and their mothers

B. Their own and their caregivers

D. Only their own

32. In conflict management, the win-win approach occurs when:


A.
B.
C.
D.

There are two conflicts and the parties agree to each one
Each party gives in on 50% of the disagreements making up the conflict
Both parties involved are committed to solving the conflict
The conflict is settled out of court so the legal system and the parties win

33. According to the social-interactional perspective of child abuse and neglect, four
factors place the family members at risk for abuse. these risk factors are the family
members at risk for abuse. These risk factors are the family itself, the caregiver, the child,
and
A. The presence of a family crisis
C. The national emphasis on sex
B. Genetics
D. Chronic poverty
34. Which of the following signs and symptoms would you most likely find when assessing
and infant with Arnold-Chiari malformation?
A. Weakness of the leg muscles, loss of sensation in the legs, and restlessness
B. Difficulty swallowing, diminished or absent gag reflex, and respiratory
distress
C. Difficulty sleeping, hypervigilant, and an arching of the back
D. Paradoxical irritability, diarrhea, and vomiting.
35. A parent calls you and frantically reports that her child has gotten into her famous
ferrous sulfate pills and ingested a number of these pills. Her child is now vomiting, has
bloody diarrhea, and is complaining of abdominal pain. You will tell the mother to:
A.
B.
C.
D.

Call emergency medical services (EMS) and get the child to the emergency room
Relax because these symptoms will pass and the child will be fine
Administer syrup of ipecac
Call the poison control center

36. A client says she heard from a friend that you stop having periods once you are on the
pill. The most appropriate response would be:
A. The pill prevents the uterus from making such endometrial lining, that is why periods
may often be scant or skipped occasionally.
B. If your friend has missed her period, she should stop taking the pills and get a
pregnancy test as soon as possible.
C. The pill should cause a normal menstrual period every month. It sounds like
your friend has not been taking the pills properly.
D. Missed period can be very dangerous and may lead to the formation of precancerous
cells.
37. The nurse assessing newborn babies and infants during their hospital stay after birth
will notice which of the following symptoms as a primary manifestation of Hirschsprungs
disease?
A. A fine rash over the trunk
B. Failure to pass meconium during the first 24 to 48 hours after birth
C. The skin turns yellow and then brown over the first 48 hours of life
D. High-grade fever

38. A client is 7 months pregnant and has just been diagnosed as having a partial placenta
previa. She is stable and has minimal spotting and is being sent home. Which of these
instructions to the client may indicate a need for further teaching?
A.
B.
C.
D.

Maintain bed rest with bathroom privileges


Avoid intercourse for three days.
Call if contractions occur.
Stay on left side as much as possible when lying down.
39. A woman has been rushed to the hospital with ruptured membrane. Which of the
following should the nurse check first?
A. Check for the presence of infection
B. Assess for Prolapse of the umbilical cord
C. Check the maternal heart rate
D. Assess the color of the amniotic fluid
40. The nurse notes that the infant is wearing a plastic-coated diaper. If a topical
medication were to be prescribed and it were to go on the stomachs or buttocks, the nurse
would teach the caregivers to:

A.
B.
C.
D.

avoid covering the area of the topical medication with the diaper
avoid the use of clothing on top of the diaper
put the diaper on as usual
apply an icepack for 5 minutes to the outside of the diaper
41. Which of the following factors is most important in determining the success of
relationships used in delivering nursing care?

A.
B.
C.
D.

Type of illness of the client


Transference and counter transference
Effective communication
Personality of the participants
42. Grace sustained a laceration on her leg from automobile accident. Why are lacerations
of lower extremities potentially more serious among pregnant women than other?
A. lacerations can provoke allergic responses due to gonadotropic hormone release
B. a woman is less able to keep the laceration clean because of her fatigue
C. healing is limited during pregnancy so these will not heal until after birth
D. increased bleeding can occur from uterine pressure on leg veins
43. In working with the caregivers of a client with an acute or chronic illness, the nurse
would:

A.
B.
C.
D.

Teach care daily and let the caregivers do a return demonstration just before
discharge
Difficulty swallowing, diminished or absent gag reflex, and respiratory distress.
Difficulty sleeping, hypervigilant, and an arching of the back
Paradoxical irritability, diarrhea, and vomiting
44. Which of the following roles BEST exemplifies the expanded role of the nurse?

A.
B.
C.
D.

Circulating nurse in surgery


Medication nurse
Obstetrical nurse
Pediatric nurse practitioner
45. According to DeRosa and Kochuras (2006) article entitled Implement Culturally
Competent Health Care in your workplace, cultures have different patterns of verbal and
nonverbal communication. Which difference does NOT necessarily belong?

A.
B.

Personal behavior
Eye contact

C. Subject matter
D. Conversational style

46. You are the nurse assigned to work with a child with acute glomerulonephritis. By
following the prescribed treatment regimen, the child experiences a remission. You are
now checking to make sure the child does not have a relapse. Which finding would most
lead you to the conclusion that a relapse is happening?
A. Elevated temperature, cough, sore throat, changing complete blood count (CBC) with
diiferential
B. A urine dipstick measurement of 2+ proteinuria or more for 3 days, or the
child found to have 3-4+ proteinutria plus edema.
C. The urine dipstick showing glucose in the urine for 3 days, extreme thirst, increase in
urine output, and a moon face.
D. A temperature of 37.8 degrees (100 degrees F), flank pain, burning frequency, urgency
on voiding, and cloudy urine.
47. The nurse is working with an adolescent who complains of being lonely and having a
lack of fulfillment in her life. This adolescent shies away from intimate relationships at
times yet at other times she appears promiscuous. The nurse will likely work with this
adolescent in which of the following areas?
A. Isolation
B. Loneliness

C. Lack of fulfillment
D. Identity

48. The use of interpersonal decision making, psychomotor skills, and application of
knowledge expected in the role of a licensed health care professional in the context of
public health welfare and safety is an example of:
A. Delegation
b. Supervision

C. Responsibility
D. Competence

49. The painful phenomenon known as back labor occurs in a client whose fetus in what
position?
A. Brow position
B. Right Occipito-Anterior Position

C. Breech position
D. Left Occipito-Posterior Position

50. FOCUS methodology stands for:


A.
B.
C.
D.

Focus, Organize, Clarify, Understand and Solution


Focus, Opportunity, Continuous, Utilize, Substantiate
Focus, Organize, Clarify, Understand, Substantiate
Focus, Opportunity, Continuous (process), Understand, Solution

SITUATION: The infant and child mortality rate in the low to middle income countries is ten
times higher than industrialized countries. In response to this, the WHO and UNICEF
launched the protocol Integrated Management of Childhood Illnesses to reduce the
morbidity and mortality against childhood illnesses.
51. If a child with diarrhea registers two signs in the yellow row in the IMCI chart, we can
classify the patient as:
A. Moderate dehydration
B. Some dehydration

C. Severe dehydration
D. No dehydration

52. Celeste has had diarrhea for 8 days. There is no blood in the stool, he is irritable, his
eyes are sunken, the nurse offers fluid to Celeste and he drinks eagerly. When the nurse
pinched the abdomen it goes back slowly. How will you classify Celestes illness?
A. Moderate dehydration
B. Some dehydration

C. Severe dehydration
D. No dehydration

53. A child who is 7 weeks has had diarrhea for 14 days but has no sign of dehydration is
classified as:
A. Persistent diarrhea
B. Severe dysentery

C. Dysentery
D. Severe persistent diarrhea

54. The child with no dehydration needs home treatment. Which of the following is not
included in the rules for home treatment in this case?
A. Forced fluids
B. When to return
C. Give vitamin A supplement
D. Feeding more

55. Fever as used in IMCI includes:


A. Axillary temperature of 37.5 or higher
B. Rectal temperature of 38 or higher
C. Feeling hot to touch
D. All of the above
E. A and C only
Situation: Prevention of Dengue is an important nursing responsibility and controlling its
spread is a priority once outbreak has been observed.

56. An important role of the community health nurse in the prevention and control of
Dengue H-fever includes:
A. Advising the elimination of vectors by keeping water containers covered
B. Conducting strong health education drives/campaign directed towards proper garbage
disposal
C. Explaining to the individuals, families, groups and community the nature of
the disease and its causation
D. Practicing residual spraying with insecticides
57. Community health nurses should be alert in observing a Dengue suspect. The following
is NOT an indicator for hospitalization of H-fever suspects?
A. Marked anorexia, abdominal pain and vomiting
B. Increasing hematocrit count
C. Cough of 30 days
D. Persistent headache
58. The community health nurses primary concern in the immediate control of hemorrhage
among patients with dengue is:
A. Advising low fiber and non-fat diet
B. Providing warmth through light weight covers
C. Observing closely the patient for vital signs leading to shock
D. Keeping the patient at rest
59. Which of these signs may NOT be REGARDED as a truly positive signs indicative of
Dengue H-fever?
A. Prolonged bleeding time
B. Appearance of at least 20 petechiae within 1cm square
C. Steadily increasing hematocrit count
D. Fall in the platelet count
60. Which of the following is the most important treatment of patients with Dengue Hfever?
A. Give aspirin for fever
B. Replacement of body fluids
C. Avoid unnecessary movement of patient
D. Ice cap over the abdomen in case of melena

Situation: Health education and Health promotion is an important part of nursing


responsibility in the community. Immunization is a form of health promotion that aims at
preventing the common childhood illnesses.
61. In correcting misconceptions and myths about certain diseases and their management,
the health worker should first:
A. Identify the myths and misconceptions prevailing in the community
B. Identify the source of these myths and misconceptions
C. Explain how and why these myths came about

D. Select the appropriate IEC strategies to correct them


62. How many percent of measles are prevented by immunization at 9 months of age?
A. 80%
B. 90%

C. 99%
D. 95%

63. After TT3 vaccination a mother is said to be protected to tetanus by around:


A. 80%
B. 85%

C. 99%
D. 90%

64. If ever convulsions occurs after administering DPT, what should the nurse best suggest
to the mother?
A. Do not continue DPT vaccination anymore
B. Advise mother to comeback after 1 week
C. Give DT instead of DPT
D. Give pertussis of the DPT and remove DT
65. These vaccines are given 3 doses at one month intervals:
A. DPT, BCG, TT
B. DPT, TT, OPV

C. OPV, HEP. B, DPT


D. Measles, OPV, DPT

Situation With the increasing documented cases of CANCER the best alternative to
treatment still remains to be PREVENTION. The following conditions
apply.
66. Which among the following is the primary focus of prevention of cancer?
A.Elimination of conditions causing cancer
B. Diagnosis and treatment
C. Treatment at early stage
D. Early detection

67. In the prevention and control of cancer, which of the following activities is the most
important function of the community health nurse?
A.
Conduct community assemblies.
B. Referral to cancer specialist those clients with symptoms of cancer.
C. Use the nine warning signs of cancer as parameters in our process of detection, control
and treatment
modalities.
D.
Teach woman about proper/correct nutrition.

68. Who among the following are recipients of the secondary level of care for cancer
cases?
A.
Those under early case detection
B. Those under post case treatment
C. Those scheduled for surgery
D.
Those undergoing treatment
69. Who among the following are recipients of the tertiary level of care for cancer cases?
A.
B.

Those under early treatment


Those under supportive care

C. Those under early detection


D. Those scheduled for surgery

70. In Community Health Nursing, despite the availability and use of many equipment and
devices to facilitate the job of the community health nurse, the best tool any nurse should
be wel be prepared to apply is a scientific approach. This approach ensures quality of care
even at the community setting. This is nursing parlance is nothing less than the:
A.
nursing diagnosis
B. nursing protocol

C. nursing research
D. nursing process

Situation Two children were brought to you. One with chest indrawing and the other had
diarrhea. The following questions apply:
71.
Using Integrated Management and Childhood Illness (IMCI) approach,
how would you classify the 1st child?
A. Bronchopneumonia
B. No pneumonia : cough or cold

C. Severe pneumonia
D. Pneumonia

72.
The 1st child who is 13 months has fast breathing using IMCI
parameters he has:
A. 40 breaths per minute or more
B. 50 breaths per minute
C. 30 breaths per minute or more
D. 60 breaths per minute
73.
Nina, the 2nd child has diarrhea for 5 days. There is no blood in the
stool. She is irritable, and her eyes are sunken. The nurse offered fluids and and the child
drinks eagerly. How would you classify Ninas illness?
A. Some dehydration
C. Severe dehydration
B. Dysentery
D. No dehydration
74. Ninas treatment should include the following EXCEPT:
A. reassess the child and classify him for dehydration
B. for infants under 6 months old who are not breastfed, give 100-200 ml clean water as
well during this period
C. Give in the health center the recommended amount of ORS for 4 hours.
D. Do not give any other foods to the child for home treatment
74.
While on treatment, Nina 18 months old weighed 18 kgs. and her
temperature registered at 37 degrees C. Her mother says she developed cough 3 days

ago. Nina has no general danger signs. She has 45 breaths/minute, no chest in-drawing,
no stridor. How would you classify Ninas manifestation.
A. No pneumonia
B. Severe pneumonia

C. Pneumonia
D. Bronchopneumonia

76. Carol is 15 months old and weighs 5.5 kgs and it is her initial visit. Her mother says
that Carol is not eating well and unable to breastfeed, he has no vomiting, has no
convulsion and not abnormally sleepy or difficult to awaken. Her temperature is 38.9 deg
C. Using the integrated management of childhood illness or IMCI strategy, if you were the
nurse in charge of Carol, how will you classify her illness?
A. a child at a general danger sign
B. very severe febrile disease

C. severe pneumonia
D. severe malnutrition

77. Why are small for gestational age newborns at risk for difficulty maintaining body
temperature?
A. their skin is more susceptible to conduction of cold
B. they are preterm so are born relatively small in size
C. they do not have as many fat stored as other infants
D. they are more active than usual so they throw off comes
78. Oxytocin is administered to Rita to augment labor. What are the first symptoms of
water intoxication to observe for during this procedure?
A. headache and vomiting
B. a swollen tender tongue

C. a high choking voice


D. abdominal bleeding and pain

79. Which of the following treatment should NOT be considered if the child has severe
dengue hemorrhagic fever?
A. use plan C if there is bleeding from the nose or gums
B. give ORS if there is skin Petechiae, persistent vomiting, and positive tourniquet test
C. give aspirin
D. prevent low blood sugar
80. In assessing the patients condition using the Integrated Management of Childhood
Illness approach strategy, the first thing that a nurse should do is to:
A. ask what are the childs problem
C. check for the four main
symptoms
B. check the patients level of consciousness
D. check for the general danger signs
81. A child with diarrhea is observed for the following EXCEPT:
A. how long the child has diarrhea
B. skin Petechiae

C. presence of blood in the stool


D. signs of dehydration

82. The child with no dehydration needs home treatment. Which of the following is NOT
included in the care for home management at this case?
A. give drugs every 4 hours
B. continue feeding the child

C. give the child more fluids


D. inform when to return to the health center

83. Ms. Jordan, RN, believes that a patient should be treated as individual. This ethical
principle that the patient referred to:
A. beneficence
B. nonmaleficence

C. respect for person


D. autonomy

84. When patients cannot make decisions for themselves, the nurse advocate relies on the
ethical principle of:
A. justice and beneficence
B. fidelity and nonmaleficence

C. beneficence and nonmaleficence


D. fidelity and justice

85. Being a community health nurse, you have the responsibility of participating in
protecting the health of people. Consider this situation: Vendors selling bread with their
bare hands. They receive money with these hands. You do not see them washing their
hands. What should you say/do?
A. Miss, may I get the bread myself because you have not washed your hands
B. All of these
C. Miss, it is better to use a pick up forceps/ bread tong
D. Miss, your hands are dirty. Wash your hands first before getting the bread
Situation : The following questions refers to common clinical encounters experienced by
an entry level nurse.
86. A female client asks the nurse about the use of a cervical cap. Which statement is
correct regarding the use of the cervical cap?
A.
B.
C.
D.

It may affect Pap smear results.


It does not need to be fitted by the physician.
It does not require the use of spermicide.
It must be removed within 24 hours.
87. The major components of the communication process are:
A.
Verbal, written and nonverbal
B.
Speaker, listener and reply
C.
Facial expression, tone of voice and gestures
D.
Message, sender, channel, receiver and feedback
88. The extent of burns in children are normally assessed and expressed in terms of:
A.
B.

The amount of body surface that is unburned


Percentages of total body surface area (TBSA)

C.
D.

How deep the deepest burns are


The severity of the burns on a 1 to 5 burn scale.

89. The school nurse notices a child who is wearing old, dirty, poor-fitting clothes; is
always hungry; has no lunch money; and is always tired. When the nurse asks the boy his
tiredness, he talks of playing outside until midnight. The nurse will suspect that this child
is:
A.
B.
C.
D.

Being raised by a parent of low intelligence quotient (IQ)


An orphan
A victim of child neglect
The victim of poverty

90. Which of the following indicates the type(s) of acute renal failure?
A.
Four types: hemorrhagic with and without clotting, and
nonhemorrhagic with and without clottings
B.
One type: acute
C.
Three types: prerenal, intrarenal and postrenal
D.
Two types: acute and subacute
Situation: Mike 16 y/o has been diagnosed to have AIDS, he worked as entertainer in a
cruise ship;
91. Which method of transmission is common to contract AIDS:
A. Syringe and needles
B. Body fluids

A. Sexual contact
B. Transfusion

92. Causative organism in AIDS is one of the following;


A. Fungus
B. Bacteria

C. retrovirus
D. Parasites

93. You are assigned in a private room of Mike. Which procedure should be of outmost
importance;
A. Alcohol wash
B. Universal precaution

C. Washing Isolation
D. Gloving technique

94. What primary health teaching would you give to mike;


A. Daily exercise
B. Prevent infection

C. reverse isolation
D. Proper nutrition

95. Exercise precaution must be taken to protect health worker dealing with the AIDS
patients . which among these must be done as priority:
A. Boil used syringe and needles
B. Use gloves when handling specimen

C. Label personal belonging


D. Avoid accidental wound
Situation: Michelle is a 6 year old preschooler. She was reported by her sister to have
measles but she is at home because of fever, upper respiratory problem and white sports
in her mouth.
96. Rubeola is an Arabic term meaning Red, the rash appears on the skin in invasive stage
prior to eruption behind the ears. As a nurse, your physical examination must determine
complication especially:
A. Otitis media
B. Bronchial pneumonia

C. Inflammatory conjunctiva
D. Membranous laryngitis

97. To render comfort measure is one of the priorities, Which includes care of the skin,
eyes, ears, mouth and nose. To clean the mouth, your antiseptic solution is in some form
of which one below?
A. Water
B. Sulfur

C. Alkaline
D. Salt

98. As a public health nurse, you teach mother and family members the prevention of
complication of measles. Which of the following should be closely watched?
A. Temperature fails to drop
nasophraynx
B. Inflammation of the conjunctiva

C. Inflammation of the
D. Ulcerative stomatitis

99. Source of infection of measles is secretion of nose and throat of infection person.
Filterable virus of measles is transmitted by:
A. Water supply
B. Droplet

C. Food ingestion
D. Sexual contact

100. Method of prevention is to avoid exposure to an infection person. Nursing


responsibility for rehabilitation of patient includes the provision of:
A. Terminal disinfection
B. Injection of gamma globulin

C. Immunization
D. Comfort measures

NURSING PRACTICE III

Situation: Leo lives in the squatter area. He goes to nearby school. He helps his mother
gather molasses after school. One day, he was absent because of fever, malaise, anorexia
and abdominal discomfort.
1. Upon assessment, Leo was diagnosed to have hepatitis A. Which mode of transmission
has the infection agent taken?
A. Fecal oral

B. Droplet

C. Airborne

D. Sexual contact

2. Which of the following is concurrent disinfection in the case of Leo?


A. Investigation of contact
B. Sanitary disposal of faeces, urine and blood
C. Quarantine of the sick individual
D. removing all detachable objects in the room, cleaning lighting and air duct surfaces in
the ceiling, and cleaning everything downward to the floor
3. Which of the following must be emphasized during mothers class to Leos mother?
A. Administration of Immunoglobulin to families
B. Thorough hand washing before and after eating and toileting
C. Use of attenuated vaccines
D. Boiling of food especially meat
4. Disaster control should be undertaken when there are 3 or more hepatitis A cases.
Which of these measures is a priority?
A. Eliminate faecal contamination from foods
B. Mass vaccination of uninfected individuals
C. Health promotion and education to families and communities about the
disease its cause and transmission
D. Mass administration of Immunoglobulin
5. What is the average incubation period of Hepatitis A?
A. 30 days

B. 60 days

C. 50 days

D. 14 days

Situation: As a nurse researcher you must have a very good understanding of the
common terms of concept used in research.
6. The information that an investigator collects from the subjects or participants in a
research study is usually called;
A. Hypothesis
C. Variable
B. Data
D. Concept
7. Which of the following usually refers to the independent variables in doing research
A. Result

C. output

B. Cause

D. Effect

8. The recipients of experimental treatment is an experimental design or the individuals


to be observed in a non experimental design are called;
A. Setting
B. Subjects

C. Treatment
D. Sample

9. The device or techniques an investigator employs to collect data is called;


A. Sample
B. Instrument

C. hypothesis
D. Concept

A. The use of another persons ideas or wordings without giving appropriate credit results
from inaccurate or incomplete attribution of materials to its sources. Which of the
following is referred to when another persons idea is inappropriate credited as ones own;
A. Plagiarism
B. Quotation

C. assumption
D. Paraphrase

Situation Mrs. Pichay is admitted to your ward. The MD ordered Prepare for
thoracentesis this pm to remove excess air from the pleural cavity.
11. Which of the following nursing responsibilities is essential in Mrs. Pichay who will
undergo thoracentesis?
A.
Support and reassure client during the procedure
B.
Ensure that informed consent has been signed
C.
Determine if client has allergic reaction to local anesthesia
D.
Ascertain if chest x-rays and other tests have been prescribed
and completed
12. Mrs. Pichay who is for thoracentesis is assigned by the nurse to which of the following
positions?
A.
B.
C.
D.

Trendelenburg position
Supine position
Dorsal Recumbent position
Orthopneic position

13. During thoracentesis, which of the following nursing intervention will be most crucial?
a.
Place patient in a quiet and cool room
b.
Maintain strict aseptic technique
c.
Advice patient to sit perfectly still during needle insertion until it
has been withdrawn from the chest
d.
Apply pressure over the puncture site as soon as the needle is withdrawn
14. To prevent leakage of fluid in the thoracic cavity, how will you position the client after
thoracentesis?

A.
B.
C.
D.

Place flat in bed


Turn on the unaffected side
Turn on the affected side
On bed rest

15. Chest x-ray was ordered after thoracentesis. When your client asks what is the reason
for another chest x-ray, you will explain:
A.
B.
C.
D.

To rule out pneumothorax


To rule out any possible perforation
To decongest
To rule out any foreign body

Situation: A computer analyst, Mr. Ricardo J. Santos, 25 was brought to the hospital for
diagnostic workup after he had experienced seizure in his office.
16. Just as the nurse was entering the room, the patient who was sitting on his chair
begins to have a seizure. Which of the following must the nurse do first?
A. Ease the patient to the floor
B. Lift the patient and put him on the bed
C. Insert a padded tongue depressor between his jaws
D. Restraint patients body movement
17. Mr. Santos is scheduled for CT SCAN for the next day, noon time. Which of the
following is the correct preparation as instructed by the nurse?
A. Shampoo hair thoroughly to remove oil and dirt
B. No special preparation is needed. Instruct the patient to keep his head still
and stead
C. Give a cleansing enema and give fluids until 8 AM
D. Shave scalp and securely attach electrodes to it
18. Mr. Santos is placed on seizure precaution. Which of the following would be
contraindicated?
A. Obtain his oral temperature
B. Encourage to perform his own personal hygiene
C. Allow him to wear his own clothing
D. Encourage him to be out of bed
19. Usually, how does the patient behave after his seizure has subsided?
A. Most comfortable walking and moving about
B. Becomes restless and agitated
C. Sleeps for a period of time
D. Say he is thirsty and hungry

20. Before, during and after seizure. The nurse knows that the patient is ALWAYS placed in
what position?

A. Low fowlers
B. Modified trendelenburg

C. Side lying
D. Supine

Situation: Mrs. Damian an immediate post op cholecystectomy and choledocholithotomy


patient, complained of severe pain at the wound site.
21. Choledocholithotomy is:
A. The removal of the gallbladder
B. The removal of the stones in the gallbladder
C. The removal of the stones in the common bile duct
D. The removal of the stones in the kidney
22. The simplest pain relieving technique is:
A. Distraction
B. Taking aspirin

C. Deep breathing exercise


D. Positioning

23. Which of the following statement on pain is TRUE:


A. Culture and pain are not associated
B. Pain accompanies acute illness
C. Patients reaction to pain Varies
D. Pain produces the same reaction such as groaning and moaning
24. In pain assessment, which of the following condition is a more reliable indicator?
A. Pain rating scale of 1 to 10
B. Facial expression and gestures
C. Physiological responses
D. Patients description of the pain sensation
25. When a client complains of pain, Your initial response is:
A. Record the description of pain
B. Verbally acknowledge the pain
C. Refer the complaint to the doctor
D. Change to a more comfortable position
Situation: You are assigned at the surgical ward and clients have been complaining of post
pain at varying degrees. Pain as you know, is very subjective.
26. A one-day postoperative abdominal surgery client has been complaining of severe
throbbing abdominal pain described as 9 in a 1-10 pain rating. Your assessment reveals
bowel sounds on all quadrants and the dressing is dry and intact. What nursing
intervention would you take
A.
Medicate client as prescribed
B.
Encourage client to do imagery
C.
Encourage deep breathing and turning
D.
Call surgeon stat
27. Pentoxidone 5 mg IV every 8 hours was prescribed for post abdominal pain. Which will
be your priority nursing action?

A.
B.
C.
D.

Check abdominal dressing for possible swelling


Explain the proper use of PCA to alleviate anxiety
Avoid overdosing to prevent dependence/tolerance
Monitor VS, more importantly RR

28. The client complained of abdominal distention and pain. Your nursing intervention that
can alleviate pain is:
A.
B.
C.
D.

Instruct client to go to sleep and relax


Advice the client to close the lips and avoid deep breathing and talking
Offer hot and clear soup
Turn to sides frequently and avoid too much talking

29. Surgical pain might be minimized by which nursing action in the O.R.
A.
B.
C.
D.

Skill of surgical team and lesser manipulation


Appropriate preparation for the scheduled procedure
Use of modern technology in closing the wound
Proper positioning and draping of clients

30. Inadequate anesthesia is said to be one of the common cause of pain both in intra and
post op patients. If General anesthesia is desired, it will involve loss of consciousness.
Which of the following are the 2 general types of GA?
A. Epidural and Spinal
B. Subarachnoid block and Intravenous
C. Inhalation and Regional
D. Intravenous and Inhalation
Situation: Nurses attitudes toward the pain influence the way they perceive and interact
with clients in pain.
31. Nurses should be aware that older adults are at risk of underrated pain. Nursing
assessment and management of pain should address the following beliefs EXCEPT:
A.
B.
C.
D.

Older patients seldom tend to report pain than the younger ones
Pain is a sign of weakness
Older patients do not believe in analgesics, they are tolerant
Complaining of pain will lead to being labeled a bad patient

32. Nurses should understand that when a client responds favorably to a placebo, it is
known as the placebo effect. Placebos do not indicate whether or not a client has:
A. Conscience
B. Real pain

C. Disease
D. Drug tolerance

33. You are the nurse in the pain clinic where you have client who has difficulty specifying
the location of pain. How can you assist such client?
A.
B.

The pain is vague


By charting-it hurts all over

C. Identify the absence and presence of pain


D. As the client to point to the painful are by just one finger
34. What symptom, more distressing than pain, should the nurse monitor when giving
opioids especially among elderly clients who are in pain?
A. Forgetfulness
B. Constipation

C. Drowsiness
D. Allergic reactions like pruritis

35. Physical dependence occurs in anyone who takes opiods over a period of time. What
do you tell a mother of a dependent when asked for advice?
A. Start another drug and slowly lessen the opioid dosage
B. Indulge in recreational outdoor activities
C. Isolate opioid dependent to a restful resort
D. Instruct slow tapering of the drug dosage and alleviate physical withdrawal
symptoms
Situation: The nurse is performing health education activities for Janevi Segovia, a 30 year
old Dentist with Insulin dependent diabetes Miletus.
36. Janevi is preparing a mixed dose of insulin. The nurse is satisfied with her performance
when she:
A. Draw insulin from the vial of clear insulin first
B. Draw insulin from the vial of the intermediate acting insulin first
C. Fill both syringes with the prescribed insulin dosage then shake the bottle vigorously
D. Withdraw the intermediate acting insulin first before withdrawing the short acting
insulin first
37. Janevi complains of nausea, vomiting, diaphoresis and headache. Which of the
following nursing intervention are you going to carry out first?
A. Withhold the clients next insulin injection
B. Test the clients blood glucose level
C. Administer Tylenol as ordered
D. Offer fruit juice, gelatine and chicken bouillon
38. Janevi administered regular insulin at 7 A.M and the nurse should instruct Jane to avoid
exercising at around:
A. 9 to 11 A.M
B. After 8 hours

C. Between 8 A.M to 9 A.M


D. In the afternoon, after taking lunch

39. Janevi was brought at the emergency room after four month because she fainted in her
clinic. The nurse should monitor which of the following test to evaluate the overall
therapeutic compliance of a diabetic patient?
A. Glycosylated hemoglobin
B. Fasting blood glucose

C. Ketone levels
D. Urine glucose level

40. Upon the assessment of Hba1c of Mrs. Segovia, The nurse has been informed of a 9%
Hba1c result. In this case, she will teach the patient to:

A. Avoid infection
hyperglycaemia
B. Take adequate food and nutrition

C. Prevent and recognize


D. Prevent and recognize hypoglycaemia

41. The nurse is teaching plan of care for Jane with regards to proper foot care. Which of
the following should be included in the plan?
A. Soak feet in hot water
B. Avoid using mild soap on the feet
C. Apply a moisturizing lotion to dry feet but not between the toes
D. Always have a podiatrist to cut your toe nails; never cut them yourself
42. Another patient was brought to the emergency room in an unresponsive state and a
diagnosis of hyperglycaemic hyperosmolar nonketotic syndrome is made. The nurse
immediately prepare to initiate which of the following anticipated physicians order?
A. Endotracheal intubation
B. 100 unites of NPH insulin
C. Intravenous infusion of normal saline
D. Intravenous infusion of sodium bicarbonate
43. Jane eventually developed DKA and is being treated in the emergency room. Which
finding would the nurse expect to note as confirming this diagnosis?
A. Comatose state
B. Decreased urine output
C. Increased respiration and an increase in pH
D. Elevated blood glucose level and low plasma bicarbonate level
44. The nurse teaches Jane to know the difference between hypoglycaemia and
ketoacidosis. Jane demonstrates understanding of the teaching by stating that glucose will
be taken if which of the following symptoms develops?
A. Polyuria

B. Shakiness

C. Blurred Vision

D. Fruit breath odor

45. Jane has been scheduled to have a FBS taken in the morning. The nurse tells Jane not
to eat or drink after midnight. Prior to taking the blood specimen, the nurse noticed that
Jane is holding a bottle of distilled water. The nurse asked Jane if she drink any, and she
said yes. Which of the following is the best nursing action?
A. Administer syrup of ipecac to remove the distilled water from the stomach
B. Suction the stomach content using NGT prior to specimen collection
C. Advice to physician to reschedule to diagnostic examination next day
D. Continue as usual and have the FBS analysis performed and specimen be
taken

Situation: Elderly clients usually produce unusual signs when it comes to different
diseases. The ageing process is a complicated process and the nurse should understand
that it is an inevitable fact and she must be prepared to care for the growing elderly

population.
46. Hypoxia may occur in the older patients because of which of the following physiologic
changes associated with aging.
A. Ineffective airway clearance
B. Decreased alveolar surfaced area
C. Decreased anterior-posterior chest diameter
D. Hyperventilation
47. The older patient is at higher risk for incontinence because of:
A. Dilated urethra
B. Increased glomerular filtration rate
C. Diuretic use
D. Decreased bladder capacity
48. Merle, age 86, is complaining of dizziness when she stands up. This may indicate:
A. Dementia
B. A visual problem

C. Functional decline
D. Drug toxicity

49. Cardiac ischemia in an older patient usually produces:


A. ST-T wave changes
B. Very high creatinine kinase level

C. Chest pain radiating to the left arm


D. Acute confusion

50. The most dependable sign of infection in the older patient is:
A. Change in mental status
B. Fever
C. Pain
D. Decreased breath sounds with crackles
Situation: Basic knowledge on Intravenous solutions is necessary for care of clients with
problems with fluids and electrolytes.
76. A client involved in a motor vehicle crash presents to the emergency department with
severe internal bleeding. The client is severely hypotensive and unresponsive. The nurse
anticipates which of the following intravenous solutions will most likely be prescribed to
increase intravascular volume, replace immediate blood loss and increase blood pressure?
A. 0.45% sodium chloride
B. Normal saline solution

C. 0.33% sodium chloride


D. Lactated ringers solution

77. The physician orders the nurse to prepare an isotonic solution. Which of the following
IV solution would the nurse expect the intern to prescribe?
A. 5% dextrose in water
B. 10% dextrose in water

C. 0.45% sodium chloride


D. 5% dextrose in 0.9% sodium chloride

78. The nurse is making initial rounds on the nursing unit to assess the condition of
assigned clients. The nurse notes that the clients IV Site is cool, pale and swollen and the
solution is not infusing. The nurse concludes that which of the following complications has
been experienced by the client?
A. Infection B. Phlebitis

C. Infiltration

D. Thrombophelibitis

79. A nurse reviews the clients electrolyte laboratory report and notes that the potassium
level is 3.2 mEq/L. Which of the following would the nurse note on the electrocardiogram
as a result of the laboratory value?
A. U waves

B. Absend P waves C. Elevated T waves

D. Elevated ST segment

80. One patient had a runaway IV of 50% dextrose. To prevent temporary excess of
insulin or transient hyperinsulin reaction what solution you prepare in anticipation of the
doctors order?
A. Any IV solution available to KVO
B. Isotonic solution
C. Hypertonic solution
D. Hypotonic solution
81. An informed consent is required for:
A. closed reduction of a fracture
B. insertion of intravenous catheter

C. irrigation of the external ear canal


D. urethral catheterization

82. Which of the following is not true with regards to the informed consent?
A. It should describe different treatment alternatives
B. It should contain a thorough and detailed explanation of the procedure to be
done
C. It should describe the clients diagnosis
D. It should give an explanation of the clients prognosis
83. You know that the hallmark of nursing accountability is the:
A. accurate documentation and reporting
B. admitting your mistakes
C. filing an incidence report
D. reporting a medication error

84. A nurse is assigned to care for a group of clients. On review of the clients medical
records, the nurse determines that which client is at risk for excess fluid volume?
A. The client taking diuretics

B. The client with renal failure


C. The client with an ileostomy
D. The client who requires gastrointestinal suctioning
85. A nurse is assigned to care for a group of clients. On review of the clients medical
records, the nurse determines that which client is at risk for deficient fluid volume?
A. A client with colostomy
B. A client with congestive heart failure
C. A client with decreased kidney function
D. A client receiving frequent wound irrigation
Situation: As a perioperative nurse, you are aware of the correct processing methods for
preparing instruments and other devices for patient use to prevent infection.
86. As an OR nurse, what are your foremost considerations for selecting chemical agents
for disinfection?
A.Material compatibility and efficiency
B.Odor and availability
C.Cost and duration of disinfection process
D.Duration of disinfection and efficiency
87. Before you use a disinfected instrument it is essential that you:
A.Rinse with tap water followed by alcohol
B.Wrap the instrument with sterile water
C.Dry the instrument thoroughly
D.Rinse with sterile water
88. You have a critical heat labile instrument to sterilize and are considering to use high
level disinfectant. What should you do?
A.Cover the soaking vessel to contain the vapor
B.Double the amount of high level disinfectant
C.Test the potency of the high level disinfectant
D.Prolong the exposure time according to manufacturers direction
89. To achieve sterilization using disinfectants, which of the following is used?
A. Low level disinfectants immersion in 24 hours
B. Intermediate level disinfectants immersion in 12 hours
C. High level disinfectants immersion in 1 hour
D. High level disinfectant immersion in 10 hours

90. Bronchoscope, Thermometer, Endoscope, ET tube, Cytoscope are all BEST sterilized
using which of the following?
A. Autoclaving at 121 degree Celsius in 15 minutes
B. Flash sterilizer at 132 degree Celsius in 3 minutes
C. Ethylene Oxide gas aeration for 20 hours

D. 2% Glutaraldehyde immersion for 10 hours


Situation: The OR is divided into three zones to control traffic flow and contamination
91. What OR attires are worn in the restricted area?
A.Scrub suit, OR shoes, head cap
B.Head cap, scrub suit, mask, OR shoes
C.Mask, OR shoes, scrub suit
D.Cap, mask, gloves, shoes
92. Nursing intervention for a patient on low dose IV insulin therapy includes the
following, EXCEPT:
A.Elevation of serum ketones to monitor ketosis
B.Vital signs including BP
C.Estimate serum potassium
D.Elevation of blood glucose levels
93. The doctor ordered to incorporate 1000u insulin to the remaining on going IV. The
strength is 500 /ml. How much should you incorporate into the IV solution?
A. 10 ml
B. 2 ml

C. 0.5 ml
D. 5 ml

94. Multiple vial-dose-insulin when in use should be


A. Kept at room temperature
B. Kept in the refrigerator

C. Kept in narcotic cabinet


D. Store in the freezer

95. Insulins using insulin syringe are given using how many degrees of needle insertion?
A. 45
B. 180
C. 90
D. 15
Situation : Maintenance of sterility is an important function a nurse should perform in any
OR setting.
96. Which of the following is true with regards to sterility?
A. Sterility is time related, items are not considered sterile after a period of 30 days of
being not use.
B. for 9 months, sterile items are considered sterile as long as they are covered with
sterile muslin cover and stored in a dust proof covers.
C. Sterility is event related, not time related
D. For 3 weeks, items double covered with muslin are considered sterile as long as they
have undergone the sterilization process
97. 2 organizations endorsed that sterility are affected by factors other than the time
itself, these are:
A. The PNA and the PRC
B. AORN and JCAHO

C. ORNAP and MCNAP


D. MMDA and DILG
98. All of this factors affect the sterility of the OR equipments, these are the following
except:
A. The material used for packaging
B. The handling of the materials as well as its transport
C. Storage
D. The chemical or process used in sterililzing the material
99. When you say sterile, it means:
A. The material is clean
B. The material as well as the equipments are sterilized and had undergone a rigorous
sterilization process
C. There is a black stripe on the paper indicator
D. The material has no microorganism nor spores present that might cause an
infection
100. In using liquid sterilizer versus autoclave machine, which of the following is true?
A. Autoclave is better in sterilizing OR supplies versus liquid sterilizer
B. They are both capable of sterilizing the equipments, however, it is necessary
to soak supplies in the liquid sterilizer for a longer period of time
C. Sharps are sterilized using autoclave and not cidex
D. If liquid sterilizer is used, rinsing it before using is not necessary
NURSING PRACTICE IV
Situation: After an abdominal surgery, the circulating and scrub nurses have critical
responsibility about sponge and instrument count.
1. Counting is performed thrice: During the preincision phase, the operative phase and
closing phase. Who counts the sponges, needles and instruments?
A. The scrub nurse only
B. The circulating nurse only
C. The surgeon and the assistant surgeon
D. The scrub nurse and the circulating nurse

2. The layer of the abdomen is divided into 5. Arrange the following from the first layer
going to the deepest layer:
1. Fascia

2.
3.
4.
5.

Muscle
Peritoneum
Subcutaneous/Fat
Skin

A. 5,4,3,2,1
B. 5,4,2,1,3

C. 5,4,1,3,2
D. 5,4,1,2,3

3. When is the first sponge/instrument count reported?


A.
B.
C.
D.

Before closing the subcutaneous layer


Before peritoneum is closed
Before closing the skin
Before the fascia is sutured

4. Like any nursing interventions, counts should be documented. To whom does the scrub
nurse report any discrepancy of counts so that immediate and appropriate action is
instituted?
A.
B.
C.
D.

Anaesthesiologists
Surgeon
OR nurse supervisor
Circulating nurse

5. Which of the following are 2 interventions of the surgical team when an instrument was
confirmed missing?
A. MRI and Incidence report
B. CT Scan, MRI, Incidence report
C. X-RAY and Incidence report
D. CT Scan and Incidence report
Situation: An entry level nurse should be able to apply theoretical knowledge in the
performance of the basic nursing skills.
6. A client has an indwelling urinary catheter and she is suspected of having urinary
infection. How should you collect a urine specimen for culture and sensitivity?
A. clamp tubing for 60 minutes and insert a sterile needle into the tubing above the clamp
to
aspirate urine
B. drain urine from the drainage bag into the sterile container
C. disconnect the tubing from the urinary catheter and let urine flow into a sterile
container
D. wipe the self-sealing aspiration port with antiseptic solution and insert a
sterile needle into the self sealing port

7. To obtain specimen for sputum culture and sensitivity, which of the following instruction
is best?
A. Upon waking up, cough deeply and expectorate into container
B. Cough after pursed lip breathing
C. Save sputum for two days in covered container
D. After respiratory treatment, expectorate into a container
8. The best time for collecting the sputum specimen for culture and sensitivity is:
A. Before retiring at night
C. Anytime of the day
B. Upon waking up in the morning D. Before meals
9. When suctioning the endotracheal tube, the nurse should:
A. Explain procedure to patient; insert catheter gently applying suction. Withdrawn using
twisting motion
B. Insert catheter until resistance is met, then withdraw slightly, applying
suction intermittently as catheter is withdrawn
C. Hyperoxygenate client insert catheter using back and forth motion
D. Insert suction catheter four inches into the tube, suction 30 seconds using twirling
motion as catheter is withdrawn
10. The purpose of NGT IMMEDIATELY after an operation is:
A. For feeding or gavage
B. For gastric decompression
C. For lavage, or the cleansing of the stomach content
D. For the rapid return of peristalsis
Situation - Mr. Santos, 50, is to undergo cystoscopy due to multiple problems like scantly
urination,
hematuria and dysuria.
11. You are the nurse in charge in Mr. Santos. When asked what are the organs to be
examined
during cystoscopy, you will enumerate as follows:
A.
B.
C.
D.

Urethra, kidney, bladder, urethra


Urethra, bladder wall, trigone, ureteral opening
Bladder wall, uterine wall, and urethral opening
Urethral opening, ureteral opening bladder

12. In the OR, you will position Mr. Santos who is cystoscopy in:
A.
B.
C.
D.

Supine
Lithotomy
Semi-fowler
Trendelenburg

13. After cystoscopy, Mr. Santos asked you to explain why there is no incision of any kind.
What do you tell him?
A.
Cystoscopy is direct visualization and examination by urologist.
B.
Cystoscopy is done by x-ray visualization of the urinary tract.
C.
Cystoscopy is done by using lasers on the urinary tract.
D.
Cystoscopy is an endoscopic procedure of the urinary
tract.
14. Within 24-48 hours post cystoscopy, it is normal to observe one the following:
A.
B.
C.
D.

Pink-tinged urine
Distended bladder
Signs of infection
Prolonged hematuria

15. Leg cramps are NOT uncommon post cystoscopy. Nursing intervention includes:
A.
B.
C.
D.

Bed rest
Warm moist soak
Early ambulation
Hot sitz bath

Situation Mang Felix, a 79 year old man who is brought to the Surgical Unit from PACU
after a transurethral resection. You are assigned to receive him. You noted that he has a 3way indwelling urinary catheter for continuous fast drip bladder irrigation which is
connected to a straight drainage.
16. Immediately after surgery, what would you expect his urine to be?
A. Light yellow
B. Amber

C. Bright red
D. Pinkish to red

17. The purpose of the continuous bladder irrigation is to:


A. Allow continuous monitoring of the fluid output status
B. Provide continuous flushing of clots and debris from the bladder
C. Allow for proper exchange of electrolytes and fluid
D. Ensure accurate monitoring of intake and output
18. Mang Felix informs you that he feels some discomfort on the hypogastric area and he
has to void. What will be your most appropriate action?
A. Remove his catheter then allow him to void on his own
B. Irrigate his catheter
C. Tell him to Go ahead and void. You have an indwelling catheter.
D. Assess color and rate of outflow, if there is a change refer to urologist for
possible irrigation.

19. You decided to check on Mang Felixs IV fluid infusion. You noted a change in flow rate,
pallor and coldness around the insertion site. What is your assessment finding?
A. Phlebitis
B. Infiltration to subcutaneous tissue
C. Pyrogenic reaction
D. Air embolism
20. Knowing that proper documentation of assessment findings and interventions are
important
responsibilities of the nurse during first post operative day, which of the following is the
LEAST relevant to document in the case of Mang Felix?
A. Chest pain and vital signs
B. Intravenous infusion rate
C. Amount, color, and consistency of bladder irrigation drainage
D. Activities of daily living started
Situation: Melamine contamination in milk has brought world wide crisis both in the milk
production sector as well as the health and economy. Being aware of the current events is
one quality that a nurse should possess to prove that nursing is a dynamic profession that
will adapt depending on the patients needs.
21. Melamine is a synthetic resin used for whiteboards, hard plastics and jewellery box
covers due to its fire retardant properties. Milk and food manufacturers add melamine in
order to:
A. It has a bacteriostatic properties leading to increase food and milk life as a way of
preserving the foods
B. Gives a glazy and more edible look on foods
C. Make milks more tasty and creamy
D. Create an illusion of a high protein content on their products
22. Most of the milks contaminated by Melamine came from which country?
A. India

B. China

C. Philippines

D. Korea

23. Which government agency is responsible for testing the melamine content of foods
and food products?
A. DOH

B. MMDA

C. NBI

D. BFAD

24. Infants are the most vulnerable to melamine poisoning. Which of the following is NOT a
sign of melamine poisoning?
A. Irritability, Back ache, Urolithiasis
B. High blood pressure, fever
C. Anuria, Oliguria or Hematuria
D. Fever, Irritability and a large output of diluted urine
25. What kind of renal failure will melamine poisoning cause?

A. Chronic, Prerenal
B. Acute, Postrenal

C. Chronic, Intrarenal
D. Acute, Prerenal

Situation: Leukemia is the most common type of childhood cancer. Acute Lymphoid
Leukemia is the cause of almost 1/3 of all cancer that occurs in children under age 15.
26. The survival rate for Acute Lymphoid Leukemia is approximately:
A. 25%

B. 40%

C. 75%

D. 95%
27. Whereas acute nonlymphoid leukemia has a survival rate of:
A. 25%

B. 40%

C. 75%

D. 95%
28. The three main consequence of leukemia that cause the most danger is:
A. Neutropenia causing infection, anemia causing impaired oxygenation and
thrombocytopenia leading to bleeding tendencies
B. Central nervous system infiltration, anemia causing impaired oxygenation and
thrombocytopenia leading to bleeding tendencies
C. Splenomegaly, hepatomegaly, fractures
D. Invasion by the leukemic cells to the bone causing severe bone pain
29. Gold standard in the diagnosis of leukemia is by which of the following?
A. Blood culture and sensitivity
B. Bone marrow biopsy
C. Blood biopsy
D. CSF aspiration and examination
30. Adriamycin,Vincristine,Prednisone and L asparaginase are given to the client for long
term therapy. One common side effect, especially of adriamycin is alopecia. The child
asks: Will I get my hair back once again? The nurse best respond is by saying:
A. Dont be silly, ofcourse you will get your hair back
B. We are not sure, lets hope itll grow
C. This side effect is usually permanent, But I will get the doctor to discuss it for you
D. Your hair will regrow in 3 to 6 months but of different color, usually darker
and of different texture
Situation: Breast Cancer is the 2nd most common type of cancer after lung cancer and 99%
of which, occurs in woman. Survival rate is 98% if this is detected early and treated
promptly. Carmen is a 53 year old patient in the high risk group for breast cancer was
recently diagnosed with Breast cancer.
31. All of the following are factors that said to contribute to the development of breast
cancer except:
A. Prolonged exposure to estrogen such as an early menarche or late menopause,
nulliparity and childbirth after age 30
B. Genetics
C. Increasing Age
D. Prolonged intake of Tamoxifen (Nolvadex)

32. Protective factors for the development of breast cancer includes which of the following
except:
A. Exercise
B. Prophylactic Tamoxifen

C. Breast feeding
D. Alcohol intake

33. A patient diagnosed with breast cancer has been offered the treatment choices of
breast conservation surgery with radiation or a modified radical mastectomy. When
questioned by the patient about these options, the nurse informs the patient that the
lumpectomy with radiation:
A. reduces the fear and anxiety that accompany the diagnosis and treatment of cancer
B. has about the same 10-year survival rate as the modified radical mastectomy
C. provides a shorter treatment period with a fewer long term complications
D. preserves the normal appearance and sensitivity of the breast.

34. Carmen, who is asking the nurse the most appropriate time of the month to do her
self-examination of the breast. The MOST appropriate reply by the nurse would be:
A. the 26th day of the menstrual cycle
B. 7 to 8 days after conclusion of the menstrual period
C. during her menstruation
D. the same day each month
35. Carmen being treated with radiation therapy. What should be included in the plan of
care to minimize skin damage from the radiation therapy?
A.
B.
C.
D.

Cover the areas with thick clothing materials


Apply a heating pad to the site
Wash skin with water after the therapy
Avoid applying creams and powders to the area

36. Based on the DOH and World Health Organization (WHO) guidelines, the mainstay for
early detection method for breast cancer that is recommended for developing countries is:
A. a monthly breast self examination (BSE) and an annual health worker breast
examination (HWBE)
B. an annual hormone receptor assay
C. an annual mammogram
D. a physician conduct a breast clinical examination every 2 years
37. The purpose of performing the breast self examination (BSE) regularly is to discover:
A. fibrocystic masses
B. cancerous lumps

C. areas of thickness or fullness


D. changes from previous BSE

38. If you are to instruct a postmenopausal woman about BSE, when would you tell her to
do BSE:

A. on the same day of each month


B. right after the menstrual period

C. on the first day of her menstruation


D. on the last day of her menstruation

39. During breast self-examination, the purpose of standing in front of the mirror it to
observe the breast for:
A. thickening of the tissue
C. lumps in the breast tissue
B. axillary lymphnodes
D. change in size and contour
40. When preparing to examine the left breast in a reclining position, the purpose of
placing a small folded towel under the clients left shoulder is to:
A. bring the breast closer to the examiners right hand
B. tense the pectoral muscle
C. balance the breast tissue more evenly on the chest wall
D. facilitate lateral positioning of the breast
Situation Radiation therapy is another modality of cancer management. With emphasis
on multidisciplinary management you have important responsibilities as nurse.
41. Albert is receiving external radiation therapy and he complains of fatigue and malaise.
Which of the following nursing interventions would be most helpful for Albert?
A. Tell him that sometimes these feelings can be psychogenic
B. Refer him to the physician
C. Reassure him that these feelings are normal
D. Help him plan his activities
42. Immediately following the radiation teletherapy, Albert is
A. Considered radioactive for 24 hrs
B. Given a complete bath
C. Placed on isolation for 6 hours
D. Free from radiation
43. Albert is admitted with a radiation induced thrombocytopenia. As a nurse you should
observe the following symptoms:
A. Petechiae, ecchymosis, epistaxis
B. Weakness, easy fatigability, pallor
C. Headache, dizziness, blurred vision
D. Severe sore throat, bacteremia, hepatomegaly
44. What nursing diagnosis should be of highest priority?
A. Knowledge deficit regarding thrombocytopenia precautions
B. Activity intolerance
C. Impaired tissue integrity
D. Ineffective tissue perfusion, peripheral, cerebral, cardiovascular, gastrointestinal, renal
45. What intervention should you include in your care plan?

A. Inspect his skin for petechiae, bruising, GI bleeding regularly


B. Place Albert on strict isolation precaution
C. Provide rest in between activities
D. Administer antipyretics if his temperature exceeds 38C
Situation: ENTEROSTOMAL THERAPY is now considered a specialty in nursing. You are
participating in the OSTOMY CARE CLASS.
61. You plan to teach Fermin how to irrigate the colostomy when:
A. The perineal wound heals And Fermin can sit comfortably on the commode
B. Fermin can lie on the side comfortably, about the 3 rd postoperative day
C. The abdominal incision is closed and contamination is no longer a danger
D. The stools starts to become formed, around the 7th postoperative day
62. When preparing to teach Fermin how to irrigate colostomy, you should plan to do the
procedure:
A. When Fermin would have normal bowel movement
B. At least 2 hours before visiting hours
C. Prior to breakfast and morning care
D. After Fermin accepts alteration in body image
63. When observing a return demonstration of a colostomy irrigation, you know that more
teaching is required if Fermin:
A. Lubricates the tip of the catheter prior to inserting into the stoma
B. Hangs the irrigating bag on the bathroom door cloth hook during fluid
insertion
C. Discontinues the insertion of fluid after 500 ml of fluid has been instilled
D. Clamps of the flow of fluid when felling uncomfortable
64. You are aware that teaching about colostomy care is understood when Fermin states,
I will contact my physician and report:
A. If I have any difficulty inserting the irrigating tub into the stoma.
B. If I noticed a loss of sensation to touch in the stoma tissue.
C. The expulsion of flatus while the irrigating fluid is running out.
D. When mucus is passed from the stoma between the irrigations.
65. You would know after teaching Fermin that dietary instruction for him is effective
when he states, It is important that I eat:
A. Soft food that is easily digested and absorbed by my large intestines.
B. Bland food so that my intestines do not become irritated.
C. Food low in fiber so that there are fewer stools.
D. Everything that I ate before the operation, while avoiding foods that cause
gas.
Situation: Based on studies of nurses working in special units like the intensive care unit
and coronary care unit, it is important for nurses to gather as much information to be able
to address their needs for nursing care.

66. Critically ill patients frequently complain about which of the following when
hospitalized?
A. Hospital food
B. Lack of blankets

C. Lack of privacy
D. Inadequate nursing staff

67. Who of the following is at greatest risk of developing sensory problem?


A. Female patient
B. Adoloscent

C. Transplant patient
D. Unresponsive patient

68. Which of the following factors may inhibit learning in critically ill patients?
A. Gender
B. Medication

C. Educational level
D. Previous knowledge of illness

69. Which of the following statements does not apply to critically ill patients?
A. Majority need extensive rehabilitation
B. All have been hospitalized previously
C. Are physically unstable
D. Most have chronic illness
70. Families of critically ill patients desire which of the following needs to be met first by
the nurse?
A. Provision of comfortable space
B. Emotional support
C. Updated information on clients status
D. Spiritual counselling
Situation: Johnny, sought consultation to the hospital because of fatigability, irritability,
jittery and he has been experiencing this sign and symptoms for the past 5 months.
71. His diagnosis was hyperthyroidism, the following are expected symptoms except:
A. Anorexia
B. Palpitation

C. Fine tremors of the hand


D. Hyper alertness

72. She has to take drugs to treat her hyperthyroidism. Which of the following will you NOT
expect that the doctor will prescribe?
A. Colace (Docusate)
B. Cytomel (Liothyronine)

C. Tapazole (Methimazole)
D. Synthroid (Levothyroxine)

73. The nurse knows that Tapazole has which of the following side effect that will warrant
immediate withholding of the medication?
A. Death

C. Hyperthermia

B. Sore throat

D. Thrombocytosis

74. You asked questions as soon as she regained consciousness from thyroidectomy
primarily to assess the evidence of:
A. Thyroid storm
B. Mediastinal shift

C. Damage to the laryngeal nerve


D. Hypocalcaemia tetany

75. Should you check for haemorrhage, you will:


A. Slip your hand under the nape of her neck
B. Check for hypotension
C. Apply neck collar to prevent haemorrhage
D. Observe the dressing if it is soaked with blood
76. Basal Metabolic rate is assessed on Johnny to determine his metabolic rate. In
assessing the BMR using the standard procedure, you need to tell Johnny that:
A. Obstructing his vision
B. Restraining his upper and lower extremities
C. Obstructing his hearing
D. Obstructing his nostrils with a clamp
77. The BMR is based on the measurement that:
A. Rate of respiration under different condition of activities and rest
B. Amount of oxygen consumption under resting condition over a measured
period of time
C. Amount of oxygen consumption under stressed condition over a measured period of
time
D. Ratio of respiration to pulse rate over a measured period of time
78. Her physician ordered lugols solution in order to:
A. Decrease the vascularity and size of the thyroid gland
B. Decrease the size of the thyroid gland only
C. Increase the vascularity and size of the thyroid gland
D. Increase the size of the thyroid gland only
79. Which of the following is a side effect of Lugols solution?
A. Hypokalemia
B. Nystagmus

C. Enlargement of the Thryoid gland


D. Excessive salivation

80. In administering Lugols solution, the precautionary measure should include:


A. Administer with glass only
B. Dilute with juice and administer with a straw
C. Administer it with milk and drink it

D. Follow it with milk of magnesia

Situation : Pharmacological treatment was not effective for Johnnys hyperthyroidism and
now, he is scheduled for Thyroidectomy.
81. Instruments in the surgical suite for surgery is classified as either CRITICAL, SEMI
CRITICAL and NON CRITICAL. If the instrument are introduced directly into the blood
stream or into any normally sterile cavity or area of the body it is classified as:
A. Critical
B. Semi Critical

B. Non Critical
D. Ultra Critical

82. Instruments that do not touch the patient or have contact only to intact skin is
classified as:
A. Critical
B. Semi Critical

B. Non Critical
D. Ultra Critical

83. If an instrument is classified as Semi Critical, an acceptable method of making the


instrument ready for surgery is through:
A. Sterilization
C. Disinfection
B. Decontamination
D. Cleaning
84. While critical items and should be:
A. Clean
B. Decontaminated

C. Sterilized
D. Disinfected

85. As a nurse, you know that intact skin acts as an effective barrier to most
microorganisms. Therefore, items that come in contact with the intact skin or mucus
membranes should be:
A. Disinfected
B. Sterile

C. Clean
D. Alcoholized

86. You are caring for Johnny who is scheduled to undergo total thyroidectomy because of
a diagnosis of thyroid cancer. Prior to total thyroidectomy, you should instruct Johnny to:
A. Perform range and motion exercise on the head and neck
B. Apply gentle pressure against the incision when swallowing
C. Cough and deep breath every 2 hours
D. Support head with the hands when changing position
87. As Johnnys nurse, you plan to set up an emergency equipment at her bedside
following thyroidectomy. You should include:

A. An airway and rebreathing tube


B. A tracheostomy set and oxygen
C. A crush cart with bed board
D. Two ampules of sodium bicarbonate
88. Which of the following nursing interventions is appropriate after a total thyroidectomy?
A. Place pillows under your patients shoulders.
B. Raise the knee-gatch to 30 degrees
C. Keep you patient in a high-fowlers position.
D. Support the patients head and neck with pillows and sandbags.
89. If there is an accidental injury to the parathyroid gland during a thyroidectomy which
of the following might Leda develop postoperatively?
A. Cardiac arrest
B. Dyspnea

C. Respiratory failure
D. Tetany

90. After surgery Johnny develops peripheral numbness, tingling and muscle twitching and
spasm. What would you anticipate to administer?
A. Magnesium sulfate
B. Calcium gluconate

C. Potassium iodide
D. Potassium chloride

Situation: Budgeting is an important part of a nurse managerial activity. The correct


allocation and distribution of resources is vital in the harmonious operation of the financial
balance of the agency.
91. Which of the following best defines Budget?
A. Plan for the allocation of resources for future use
B. The process of allocating resources for future use
C. Estimate cost of expenses
D. Continuous process in seeing that the goals and objective of the agency is met
92. Which of the following best defines Capital Budget?
A. Budget to estimate the cost of direct labour, number of staff to be hired and necessary
number of workers to meet the general patient needs
B. Includes the monthly and daily expenses and expected revenue and expenses
C. These are related to long term planning and includes major replacement or
expansion of the plant, major equipments and inventories.
D. These are expenses that are not dependent on the level of production or sales. They
tend to be time-related, such as salaries or rents being paid per month

93. Which of the following best described Operational Budget?


A. Budget to estimate the cost of direct labour, number of staff to be hired and necessary
number of workers to meet the general patient needs
B. Includes the monthly and daily expenses and expected revenue and expenses
C. These are related to long term planning and includes major replacement or expansion
of the plant, major equipments and inventories.
D. These are expenses that are not dependent on the level of production or sales. They
tend to be time-related, such as rent
94. Which of the following accurately describes a Fixed Cost in budgeting?
A. These are usually the raw materials and labor salaries that depend on the production or
sales
B. These are expenses that change in proportion to the activity of a business
C. These are expenses that are not dependent on the level of production or sales.
They tend to be time-related, such as rent
D. This is the summation of the Variable Cost and the Fixed Cost
95. Which of the following accurately describes Variable Cost in budgeting?
A. These are related to long term planning and include major replacement or expansion of
the plant, major equipments and inventories.
B. These are expenses that change in proportion to the activity of a business
C. These are expenses that are not dependent on the level of production or sales. They
tend to be time-related, such as rent
D. This is the summation of the Variable Cost and the Fixed Cost
Situation: Survey and Statistics are important part of research that is necessary to explain
the characteristics of the population.
96. According to the WHO statistics on the Homeless population around the world, which
of the following groups of people in the world disproportionately represents the homeless
population?
A.
B.

Hispanics
Asians

C. African Americans
D. Caucasians

97. All but one of the following is not a measure of Central Tendency:
A. Mode
B. Variance

C. Standard Deviation
D. Range

98. In the value : 87, 85, 88, 92, 90; What is the mean?
A. 88.2

B. 88.4

C. 87

D. 90

99. In the value : 80, 80, 80, 82, 82, 90, 90, 100; What is the mode?

A. 80

B. 82

C. 90

D. 85.5

100. In the value: 80,80,10,10,25,65,100,200; What is the median?


A. 71.25

B. 22.5

C. 10 and 25

D. 72.5

NURSING PRACTICE V
Situation : Understanding different models of care is a necessary part of the nurse patient
relationship.
1. The focus of this therapy is to have a positive environmental manipulation, physical and
social to effect a positive change.
A. Milieu

B. Psychotherapy

C. Behaviour

D. Group

2. The client asks the nurse about Milieu therapy. The nurse responds knowing that the
primary focus of milieu therapy can be best described by which of the following?
A. A form of behavior modification therapy
B. A cognitive approach of changing the behaviour
C. A living, learning or working environment
D. A behavioural approach to changing behaviour
3. A nurse is caring for a client with phobia who is being treated for the condition. The
client is introduced to short periods of exposure to the phobic object while in relaxed state.
The nurse understands that this form of behaviour modification can be best described as:
A. Systematic desensitization
B. Aversion Therapy

C. Self control therapy


D. Operant conditioning

4. A client with major depression is considering cognitive therapy. The client say to the
nurse, How does this treatment works? The nurse respond by telling the client that:
A. This type of treatment helps you examine how your thoughts and feelings
contribute to your difficulties
B. This type of treatment helps you examine how your past life has contributed to your
problems.
C. This type of treatment helps you to confront your fears by exposing you to the feared
object abruptly.
D. This type of treatment will help you relax and develop new coping skills.
5. A Client state, I get down on myself when I make mistake. Using Cognitive therapy
approach, the nurse should:
A. Teach the client relaxation exercise to diminish stress
B. Provide the client with Mastery experience to boost self esteem

C. Explore the clients past experiences that causes the illness


D. Help client modify the belief that anything less than perfect is horrible
6. The most advantageous therapy for a preschool age child with a history of physical and
sexual abuse would be:
A. Play

B. Psychoanalysis

C. Group

D. Family

7. An 18 year old client is admitted with the diagnosis of anorexia nervosa. A cognitive
behavioural approach is used as part of her treatment plan. The nurse understands that
the purpose of this approach is to:
A. Help the client identify and examine dysfunctional thoughts and beliefs
B. Emphasize social interaction with clients who withdraw
C. Provide a supportive environment and a therapeutic community
D. Examine intrapsychic conflicts and past events in life
8. The nurse is preparing to provide reminiscence therapy for a group of clients. Which of
the following clients will the nurse select for this group?
A. A client who experiences profound depression with moderate cognitive impairment
B. A catatonic, immobile client with moderate cognitive impairment
C. An undifferentiated schizophrenic client with moderate cognitive impairment
D. A client with mild depression who exhibits who demonstrates normal
cognition
9. Which intervention would be typical of a nurse using cognitive-behavioral approach to a
client experiencing low self esteem?
A. Use of unconditional positive regard
B. Classical conditioning
patterns

C. Analysis of free association


D. Examination of negative thought

10. Which of the following therapies has been strongly advocated for the treatment of post
traumatic stress disorders?
A. ECT

B. Group Therapy

C. Hypnotherapy

D. Psychoanalysis

11. The nurse knows that in group therapy, the maximum number of members to include
is:
A. 4

B. 8

C. 10

D. 16

12.The nurse is providing information to a client with the use of disulfiram (antabuse) for
the treatment of alcohol abuse. The nurse understands that this form of therapy works on
what principle?
A. Negative Reinforcement

C. Operant Conditioning

B. Aversion Therapy

C. Gestalt therapy

13. A biological or medical approach in treating psychiatric patient is:


A. Million therapy
C. Behavioral therapy
B. Somatic therapy
D. Psychotherapy
14. Which of these nursing actions belong to the secondary level of preventive
intervention?
A.
B.
C.
D.

Providing mental health consultation to health care providers


Providing emergency psychiatric services
Being politically active in relation to mental health issues
Providing mental health education to members of the community

15. When the nurse identifies a client who has attempt to commit suicide the nurse
should:
A. call a priest
B. counsel the client
C. refer the client to the psychiatrist
D. refer the matter to the police
Situation: Rose seeks psychiatric consultation because of intense fear of flying in an
airplane which has greatly affected her chances of success in her job.
16. The most common defense mechanism used by phobic clients is:
A. Supression
B. Rationalization

C. Denial
D. Displacement

17. The goal of the therapy in phobia is:


A. Change her lifestyle
B. Ignore tension producing situation
C. Change her reaction towards anxiety
D. Eliminate fear producing situations
18. The therapy most effective for clients with phobia is:
A. Hypnotherapy
B. Group therapy

C. Cognitive therapy
D. Behavior therapy

19. The fear and anxiety related to phobia is said to be abruptly decreased when the
patient is exposed to what is feared through:
A. Guided Imagery
B. Systematic desensitization
C. Flooding
D. Hypotherapy
20. Based on the presence of symptom, The appropriate nursing diagnosis is:
A. Self esteem disturbance

B. Activity intolerance
C. Impaired adjustment
D. Ineffective individual coping
Situation: Mang Jose, 39 year old farmer, unmarried, had been confined in the National
center for mental health for three years with a diagnosis of schizophrenia.
21. The most common defense mechanism used by a paranoid client is:
A. Displacement
B. Suppression

C. Rationalization
D. Projection

22. When Mang Jose says to you: The voices are telling me bad things again! The best
response is:
A. Whose voices are those?
B. I doubt what the voices are telling you
C. I do not hear the voice you say you hear
D. Are you sure you hear these voices?

23. A relevant nursing diagnosis for clients with auditory hallucination is:
A. Sensory perceptual alteration
B. Altered thought process
C. Impaired social interaction
D. Impaired verbal communication
24. During mealtime, Jose refused to eat telling that the food was poisoned. The nurse
should:
A. Ignore his remark
B. Offer him food in his own container
C. Show him how irrational his thinking is
D. Respect his refusal to eat
25. When communicating with Jose, The nurse considers the following except:
A. Be warm and enthusiastic
B. Refrain from touching Jose
C. Do not argue regarding his hallucination and delusion
D. Use simple, clear language
Situation: Gringo seeks psychiatric counselling for his ritualistic behavior of counting his
money as many as 10 times before leaving home.
26. An initial appropriate nursing diagnosis is:
A. Impaired social interaction
B. Ineffective individual coping
C. Impaired adjustment
D. Anxiety Moderate

27. Obsessive compulsive disorder is BEST described by:


A. Uncontrollable impulse to perform an act or ritual repeatedly
B. Persistent thoughts
C. Recurring unwanted and disturbing thought alternating with a behavior
D. Pathological persistence of unwilled thought, feeling or impulse
28. The defense mechanism used by persons with obsessive compulsive disorder is
undoing and it is best described in one of the following statements:
A. Unacceptable feelings or behavior are kept out of awareness by developing the opposite
behavior or emotion
B. Consciously unacceptable instinctual drives are diverted into personally and socially
acceptable channels
C. Something unacceptable already done is symbolically acted out in reverse
D. Transfer of emotions associated with a particular person, object or situation to another
less threatening person, object or situation
29. To be more effective, the nurse who cares for persons with obsessive compulsive
disorder must possess one of the following qualities:
A. Compassion
B. Consistency

C. Patience
D. Friendliness

30. Persons with OCD usually manifest:


A. Fear
Anxiety

B. Apathy

C. Suspiciousness

D.

Situation : The patient who is depressed will undergo electroconvulsive therapy.


31. Studies on biological depression support electroconvulsive therapy as a mode of
treatment. The rationale is:
A. ECT produces massive brain damage which destroys the specific area containing
memories related to
the events surrounding the development of psychotic condition
B. The treatment serves as a symbolic punishment for the client who feels guilty and
worthless
C. ECT relieves depression psychologically by increasing the norepinephrine
level
D. ECT is seen as a life-threatening experience and depressed patients mobilize all their
bodily defenses
to deal with this attack.
32. The preparation of a patient for ECT ideally is MOST similar to preparation for a
patient for:
A. electroencephalogram

C. general anesthesia

B. X-ray

D. electrocardiogram

33. Which of the following is a possible side effect which you will discuss with the patient?
A. hemorrhage within the brain
B. encephalitis
C. robot-like body stiffness
D. confusion, disorientation and short term memory loss
34. Informed consent is necessary for the treatment for involuntary clients. When this
cannot be obtained, permission may be taken from the:
A. social worker
B. doctor

C. next of kin or guardian


D. chief nurse

35. After ECT, the nurse should do this action before giving the client fluids, food or
medication:
A. assess the gag reflex
B. assess the sensorium

C. next of kin or guardian


D. check O2 Sat with a pulse oximeter

Mrs. Ethel Agustin 50 y/o, teacher is afflicted with myasthenia gravis.


36. Looking at Mrs. Agustin, your assessment would include the ff except;
A. Nystagmus
B. Difficulty of hearing
C. Weakness of the levator palpebrae
D. Weakness of the ocular muscle
37. In an effort to combat complications which might occur relatives should he taught;
A. Checking cardiac rate
B. Taking blood pressure reading
C. Techniques of oxygen inhalation
D. Administration of oxygen inhalation
38. The drug of choice for her condition is;
A. Prostigmine
B. Morphine
C. Codeine
D. Prednisone
39. As her nurse, you have to be cautious about administration of medication, if she is
undermedicated this can cause;
A. Emotional crisis
B. Cholinergic crisis

C. Menopausal crisis
D. Myasthenia crisis

40. If you are not extra careful and by chance you give over medication, this would lead
to;
A. Cholinergic crisis
B. Menopausal crisis
C. Emotional crisis
D. Myasthenia crisis
Rosanna 20 y/o unmarried patient believes that the toilet for the female patient in
contaminated with AIDS virus and refuses to use it unless she flushes it three times and
wipes the seat same number of times with antiseptic solution.
41. The fear of using contaminated toilet seat can be attributed to Rosannas inability
to;
A. Adjust to a strange environment
B. Express her anxiety
C. Develop the sense of trust in other person
D. Control unacceptable impulses or feelings
42. Assessment data upon admission help the nurse to identify this appropriate nursing
diagnosis
A. Ineffective denial
B. Impaired adjustment
C. Ineffective individual coping
D. Impaired social interaction
43. An effective nursing intervention to help Rosana is;
A. Convincing her to use the toilet after the nurse has used it first
B. Explaining to her that AIDS cannot be transmitted by using the toilet
C. Allowing her to flush and clear the toilet seat until she can manage her
anxiety
D. Explaining to her how AIDS is transmitted
44. The goal for treatment for Rosana must be directed toward helping her to;
A. Walk freely about her past experience
B. Develop trusting relationship with others
C. Gain insight that her behaviour is due to feeling of anxiety
D. Accept the environment unconditionally

45. Psychotherapy which is prescribed for Rosana is described as;


A. Establishing an environment adapted to an individual patient needs
B. Sustained interaction between the therapist and client to help her develop
more functional behaviour
C. Using dramatic techniques to portray interpersonal conflicts
D. Biologic treatment for mental disorder
Dennis 40 y/o married man, an electrical engineer was admitted with the diagnosis of
paranoid disorders. He has became suspicious and sitrustful 2 months before admission.
Upon admission, he kept on saying, my wife has been planning to kill me.
46. A paranoid individual who can not accept the guilt demonstrate one of the following
defense mechanism;
A. Denial
B. Projection
C. Rationalization
D. Displacement
47. One morning, Dennis was seen tilting his head as if he was listening to someone. An
appropriate nursing intervention would be;
A. Tell him to socialize with other patient to divert his attention
B. Involve him in group activities
C. Address him by name to ask if he is hearing voices again
D. Request for an order of antipsychotic medicine
48. When he says, this voices are telling me my wife is going to kill me. A therapeutic
communication of the nurse is which one of the following;
A. i do not hear the voices you say you hear
B. are you really sure you heard those voices?
C. I do not think you heard those voices?
D. Whose voices are those?
49. The nurse confirms that Dennis is manifesting auditory hallucination. The appropriate
nursing diagnosis she identifiesis;
A. Sensory perceptual alteration
B. Self esteem disturbance
C. Ineffective individual coping
D. Defensive coping
50. Most appropriate nursing intervention for a client with suspicious behavior is one of the
following;

A. Talk to the client constantly to reinforce reality


B. Involve him in competitive activities
C. Use Non Judgmental and Consistent approach
D. Project cheerfulness in interacting with the patient

Situation: Clients with Bipolar disorder receives a very high nursing attention due to the
increasing rate of suicide related to the illness.
51. The nurse is assigned to care for a recently admitted client who has attempted suicide. What should the
nurse do?
A. Search the client's belongings and room carefully for items that could be used to attempt
suicide.
B. Express trust that the client won't cause self-harm while in the facility.
C. Respect the client's privacy by not searching any belongings.
D. Remind all staff members to check on the client frequently.
52. In planning activities for the depressed client, especially during the early stages of hospitalization, which
of the following plan is best?
A. Provide an activity that is quiet and solitary to avoid increased fatigue such as working on a puzzle and
reading a book.
B. Plan nothing until the client asks to participate in the milieu
C. Offer the client a menu of daily activities and ask the client to participate in all of them
D. Provide a structured daily program of activities and encourage the client to participate
53. A client with a diagnosis of major depression, recurrent with psychotic features is admitted to the mental
health unit. To create a safe environment for the client, the nurse most importantly devises a plan of care that
deals specifically with the clients:
A. Disturbed thought process
B. Self Care Deficit

C. Imbalanced nutrition
D. Deficient Knowledge

54. The client is taking a Tricyclic anti depressant, Which of the following is an example of TCA?
A. Paxil
C. Nardil
B. Zoloft
D. Pamelor
55. A client visits the physician's office to seek treatment for depression, feelings of hopelessness, poor
appetite, insomnia, fatigue, low self-esteem, poor concentration, and difficulty making decisions. The client
states that these symptoms began at least 2 years ago. Based on this report, the nurse suspects:
A. cyclothymic disorder.
B. major depression.

C. Bipolar disorder
D. dysthymic disorder.

56. The nurse is planning activities for a client who has bipolar disorder, which aggressive social behaviour.
Which of the following activities would be most appropriate for this client?
A. Ping Pong

B. Linen delivery

C. Chess

D. Basketball

57. The nurse assesses a client with admitted diagnosis of bipolar affective disorder, mania. The symptom
presented by the client that requires the nurses immediate intervention is the clients:

A. Outlandish behaviour and inappropriate dress


B. Grandiose delusion of being a royal descendant of king arthut
C. Nonstop physical activity and poor nutritional intake
D. Constant incessant talking that includes sexual topics and teasing the staff

58. A nurse is conducting a group therapy session and during the session, A client with mania consistently
talks and dominates the group. The behaviour is disrupting the group interaction. The nurse would initially:
A. Ask the client to leave the group session
B. Tell the client that she will not be allowed to attend any more group sessions
C. Tell the client that she needs to allow other client in a group time to talk
D. Ask another nurse to escort the client out of the group session
59. A professional artist is admitted to the psychiatric unit for treatment of bipolar disorder. During the last 2
weeks, the client has created 154 paintings, slept only 2 to 3 hours every 2 days, and lost 18 lb (8.2 kg).
Based on Maslow's hierarchy of needs, what should the nurse provide this client with first?
A. The opportunity to explore family dynamics
B. Help with reestablishing a normal sleep pattern
C. Experiences that build self-esteem
D. Art materials and equipment
60. The physician orders lithium carbonate (Lithonate) for a client who's in the manic phase of bipolar
disorder. During lithium therapy, the nurse should watch for which adverse reactions?
A. Anxiety, restlessness, and sleep disturbance
B. Nausea, diarrhea, tremor, and lethargy
C. Constipation, lethargy, and ataxia
D. Weakness, tremor, and urine retention

Situation Annie has a morbid fear of heights. She asks the nurse what desensitization
therapy is:
61. The accurate information of the nurse of the goal of desensitization is:
A. To help the clients relax and progressively work up a list of anxiety
provoking situations through imagery.
B. To provide corrective emotional experiences through a one-to-one intensive
relationship.
C. To help clients in a group therapy setting to take on specific roles and reenact in front
of an audience, situations in which interpersonal conflict is involved.
D. To help clients cope with their problems by learning behaviors that are more functional
and be better equipped to face reality and make decisions.
62. It is essential in desensitization for the patient to:
A. Have rapport with the therapist
B. Use deep breathing or another relaxation technique
C. Assess ones self for the need of an anxiolytic drug
D. Work through unresolved unconscious conflicts

63. In this level of anxiety, cognitive capacity diminishes. Focus becomes limited and
client experiences tunnel vision. Physical signs of anxiety become more pronounced.
A. Severe anxiety
B. Panic

C. Mild anxiety
D. Moderate anxiety

64. Antianxiety medications should be used with extreme caution be cause long term use
can lead to:
A. Parkinsonian like syndrome
B. Hypertensive crisis

C. Hepatic failure
D. Risk of addiction

65. The nursing management of anxiety related with post traumatic stress disorder
includes all of the following EXCEPT:
A. Encourage participation in recreation or sports activities
B. Reassure clients safety while touching client
C. Speak in a calm soothing voice
D. Remain with the client while fear level is high
SITUATION: You are fortunate to be chosen as part of the research team in the hospital. A
review of the following IMPORTANT nursing concepts was made.
66. As a professional, a nurse can do research for varied reason except:
A. Professional advancement through research participation
B. To validate results of new nursing modalities
C. For financial gains
D. To improve nursing care
67. Each nurse participants was asked to identify a problem. After the identification of the
research problem, which of the following should be done?
A. Methodology
B. Review of related literature

C. Acknowledgement
D. Formulate hypothesis

68. Which of the following communicate the results of the research to the readers. They
facilitate the description of the data.
A. Hypothesis
B. Statistics

C. Research problem
D. Tables and Graphs

69. In Quantitative date, which of the following is described as the distance in the scoring
unites of the variable from the highest to the lower?
A. Frequency

C. Median

B. Mean

D. Range

70. This expresses the variability of the data in reference to the mean. It provides as with
a numerical estimate of how far, on the average the separate observation are from the
mean:
A. Mode
C. Median
B. Standard deviation
D. Frequency
Situation 10: As a beginner in research, you are aware that sampling is an essential
element of the research process.
71. What does a sample group represent?
A. Control group
B. Study subjects

C. General population
D. Universe

72. What is the most important characteristic of a sample?


A. Randomization
B. Appropriate location

C. Appropriate number
D. Representativeness

73. Random sampling ensures that each subject has:


A. Been selected systematically
B. An equal chance of selection

C. Been selected based on set criteria


D. Characteristic that match other sample

74. Which of the following sampling method allows the use of any group of research
subject?
A. Purposive
B. Convenience

C. Snowball
D. Quota

75. You decided to include 5 barangays in you municipality and chose a sampling method
that would get representative sample from each barangay. What should be the appropriate
method for you to use in this case?
A. Cluster
B. Random

C. Stratified
D. Systematic

76. Draw Lots, Lottery, Table of random numbers or a sampling that ensures that each
element of the population has an equal and independent chance of being chosen is called:
A. Cluster
B. Simple

C. Stratified
D. Systematic

77. An investigator wants to determine some of the problems that are experienced by
diabetic clients when using an insulin pump. The investigator went into a clinic where he

personally knows several diabetic clients having problem with insulin pump. The type of
sampling done by the investigator is called:
A. Probability
B. Purposive

C. Snowball
D. Incidental

78. If the researcher implemented a new structured counselling program with a


randomized group of subject and a routine counselling program with another randomized
group of subject, the research is utilizing which design?
A. Quasi experimental
B. Experimental

C. Comparative
D. Methodological

79. Which of the following is not true about a Pure Experimental research?
A. There is a control group
B. There is an experimental group
C. Selection of subjects in the control group is randomized
D. There is a careful selection of subjects in the experimental group
80. The researcher implemented a medication regimen using a new type of combination
drugs to manic patients while another group of manic patient receives the routine drugs.
The researcher however hand picked the experimental group for they are the clients with
multiple episodes of bipolar disorder. The researcher utilized which research design?
A. Quasi-experimental
B. Pure experimental

C. Phenomenological
D. Longitudinal

Situation 19: As a nurse, you are expected to participate in initiating or participating in the
conduct of research studies to improve nursing practice. You to be updated on the latest
trends and issues affected the profession and the best practices arrived at by the
profession.
81. You are interested to study the effects of mediation and relaxation on the pain
experienced by cancer patients. What type of variable is pain?
A. Dependent
B. Correlational

C. Independent
D. Demographic

82. You would like to compare the support system of patient with chronic illness to those
with acute illness. How will you best state your problem?
A. A descriptive study to compare the support system of patients with chronic illness and
those with acute illness in terms of demographic data and knowledge about intervention.
B. The effects of the types of support system of patients with chronic illness and those
with acute illness.
C. A comparative analysis of the support system of patients with chronic illness and those
with acute illness.

D. A study to compare the support system of patients with chronic illness and those with
acute illness.
E. What are the differences of the support system being received by patient
with chronic illness and patients with acute illness?
83. You would like to compare the support system of patients with chronic illness to those
with acute illness. Considering that the hypothesis was: Clients with chronic illness have
lesser support system than clients with acute illness. What type of research is this?
A. Descriptive
C. Experimental

B. Correlational, Non experimental


D. Quasi Experimental

84. In any research study where individual persons are involved, it is important that an
informed consent of the study is obtained. The following are essential information about
the consent that you should disclose to the prospective subjects except:
A. Consent to incomplete disclosure
B. Description of benefits, risks and discomforts
C. Explanation of procedure
D. Assurance of anonymity and confidentiality
85. In the Hypothesis: The utilization of technology in teaching improves the retention
and attention of the nursing students. Which is the dependent variable?
A. Utilization of technology
B. Improvement in the retention and attention
C. Nursing students
D. Teaching
Situation: You are actively practicing nurse who has just finished you graduate studies. You
learned the value of research and would like to utilize the knowledge and skills gained in
the application of research to the nursing service. The following questions apply to
research.
86. Which type of research inquiry investigates the issues of human complexity (e.g
understanding the human expertise)?
A. Logical position
B. Naturalistic inquiry

C. Positivism
D. Quantitative research

87. Which of the following studies is based on quantitative research?


A. A study examining the bereavement process in spouse of clients with terminal cancer
B. A study exploring the factors influencing weight control behaviour
C. A Study measuring the effects of sleep deprivation on wound healing
D. A study examining clients feelings before, during and after bone marrow aspiration.
88. Which of the following studies is based on the qualitative research?
A. A study examining clients reaction to stress after open heart surgery

B. A study measuring nutrition and weight loss/gain in clients with cancer


C. A study examining oxygen levels after endotracheal suctioning
D. A study measuring differences in blood pressure before, during and after procedure
89. An 85 year old client in a nursing home tells a nurse, I signed the papers of that
research study because the doctor was so insistent and I want him to continue taking care
for me Which client right is being violated?
A. Right of self determination
B. Right to privacy and confidentiality

C. Right to full disclosure


D. Right not to be harmed

90. A supposition or system of ideas that is proposed to explain a given phenomenon best
defines:
A. A paradigm
B. A Concept

C. A theory
D. A conceptual framework

Situation: Mastery of research design determination is essential in passing the NLE.


91. Ana wants to know if the length of time she will study for the board examination is
proportional to her board rating. During the June 2008 board examination, She studied for
6 months and gained 68%, On the next board exam, she studied for 6 months again for a
total of 1 year and gained 74%, On the third board exam, She studied for 6 months for a
total of 1 and a half year and gained 82%. The research designed she used is:
A. Comparative
B. Correlational

C. Experimental
D. Qualitative

92. Anton was always eating high fat diet. You want to determine if what will be the effect
of high cholesterol food to Anton in the next 10 years. You will use:
A. Comparative
B. Correlational

C. Historical
D. Longitudinal

93. Community A was selected randomly as well as community B, nurse Edna conducted
teaching to community A and assess if community A will have a better status than
community B. This is an example of:
A. Comparative
B. Correlational

C. Experimental
D. Qualitative

94. Ana researched on the development of a new way to measure intelligence by creating
a 100 item questionnaire that will assess the cognitive skills of an individual. The design
best suited for this study is:
A. Historical
B. Methodological

C. Survey
D. Case study

95. Gen is conducting a research study on how mark, an AIDS client lives his life. A design
suited for this is:
A. Historical
B. Case Study

C. Phenomenological
D. Ethnographic

96. Marco is to perform a study about how nurses perform surgical asepsis during World
War II. A design best for this study is:
A. Historical
B. Case Study

C. Phenomenological
D. Ethnographic

97. Tonyo conducts sampling at barangay 412. He collected 100 random individuals and
determine who is their favourite comedian actor. 50% said Dolphy, 20% said Vic Sotto,
while some answered Joey de Leon, Allan K, Michael V. Tonyo conducted what type of
research study?
A. Phenomenological
B. Case Study

C. Non experimental
D. Survey

98. Jane visited a tribe located somewhere in China, it is called the Shin Jea tribe. She
studied the way of life, tradition and the societal structure of these people. Jane will best
use which research design?
A. Historical
B. Case Study

C. Phenomenological
D. Ethnographic

99. Anjoe researched on TB. Its transmission, Causative agent and factors, treatment sign
and symptoms as well as medication and all other in depth information about tuberculosis.
This study is best suited for which research design?
A. Historical
B. Case Study

C. Phenomenological
D. Ethnographic

100. Diana is to conduct a study about the relationship of The number of family members
in the household and the electricity bill. Which of the following is the best research design
suited for this study?
1.
2.
3.
4.
5.
6.

Descriptive
Exploratory
Explanatory
Correlational
Comparative
Experimental

A. 1,4

B. 2,5

C. 3,6

D. 1,5

E. 2,4

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