Situation 1 - Jimmy developed this goal for hospitalization. "To get a handle on my nervousness.

" The nurse is going to collaborate with him to reach his goal. Jimmy was admitted to the hospital because he called his therapist that he planned to asphyxiate himself with exhaust from his car but frightened instead. He realized he needed help.

1. The nurse recognized that Jimmy had conceptualized his problem and the next priority goal in the care plan is:

a. help the client find meaning in his experience b. help the client to plan alternatives c. help the client cope with present problem d. help the client to communicate

2. The nurse is guided that Jimmy is aware of his concerns of the "here and now" when he crossed out which item from this "list of what to know"

a. anxiety laden unconscious conflicts b. subjective idea of the range of mild to severe anxiety c. early signs of anxiety d. physiological indices of anxiety

3. While Jimmy was discussing the signs and symptoms of anxiety with his nurse, he recognized that complete disruption of the ability to perceive occurs in:

a. panic state of anxiety b. severe anxiety c. moderate anxiety d. mild anxiety

4. Jimmy initiates independence and takes an active part in his self care with the following EXCEPT:

a. agreeing to contact the staff when he is anxious b. becoming aware of the conscious feeling c. assessing need for medication and medicating himself d. writing out a list of behaviors that he identifies as anxious

5. The nurse notes effectiveness of Interventions in using subjective and objective data in the:

a. initial plans or order b. database c. problem list d. progress notes

Situation 2 - A research study was under taken in order to identify and analyze a disabled boy's coping reaction pattern during stress.

6. This study which is a depth study of one boy is a:

a. case study b. longitudinal study c. cross-sectional study d. evaluative study

7. The process recording was the principal tool for data collection. Which of the following is NOT a part of a process recording?

a. Non verbal narrative account b. Audio and interpretation c. Audio-visual recording d. Verbal narrative account

8. Which of these does NOT happen in a descriptive study?

a. Exploration of relationship between two or more phenomena b. Exploration of relationships between two or more phenomena c. Manipulation of phenomenon in real life context d. Manipulation of a variable

9. The investigator also provided the nursing care of the subject. The investigator is referred to as a/an.

a. Participant-observer b. Observer researcher c. Caregiver d. Advocate

10. To ensure reliability of the study, the investigator analysis and interpretations were:

a. subjected to statistical treatment b. correlated with a list coping behaviors

c. subjected to an inter-observe agreement d scored and compared standard criteria

Situation 3 - During the morning endorsement, the' outgoing nurse informed the nursing staff that Regina, 5 years old, was given Flurazepam (Dalmane) 15 mg at 10:00pm because she had trouble going to sleep. Before approaching Regina, the nurse read the observation of the night nurse.

11. Which of the following approaches of the nurse validates the data gathered?

a. "I learned that you were up till ten last night, tell me what happened before you were finally able to sleep and how was your sleep?" b. "Hmm...You look like you had a very sound sleep. That pill you were given last night is effective isn't it?" c. "Regina, did you sleep we!!?" d. "Regina, how are you?"

12. Regina is a high school teacher. Which of these information LE^ST communicate attention and care for her needs for information about her medicine?

a. Guided by a medication teaching plan go over with her the purpose, indications and special instructions, about the medication and provide her a checklist b. Provide a drug literature c. Have an informal conversation about the medication and its effects d. Ask her what time she would like to watch the informative video about the medication

13. The nurse engages Regina in the process of mutual inquiry to provide an opportunity for Regina to

a. face emerging problems realistically

b. conceptualize her problem c. cope with her present problem d. perceive her participation in an experience

14. Which of these responses indicate that Regina needs further discussion regarding special instructions?

a. "I have to take this medicine judiciously." b. "I know 1 will stop taking the medicine when there is an advice form the doctor for me to discontinue." c. "I will inform you and the doctor any untoward reactions I have." d. "I like taking this sleeping pill. It solves my problem of insomnia. I wish I can take it for life."

15. Regina commits to herself that she understood and will observe all the medicine precautions by;

a. affixing her signature to the teaching plan that she has understood the nurse b. committing what she learned to her memory c. verbally agreeing with the nurse d. relying on her husband to remember the precautions

Situation 4 - The nurse-patient relationship is a modality through which the nurse meets the client's needs.

16. The nurse's most unique tool in working with the emotionally ill client is his/her:

a. theoretical knowledge b. personality make up

c. emotional reactions d. communication skills

17. The psychiatric nurse who is alert to both the physical and emotional needs of clients is working from the philosophical framework that states:

a. All behavior is meaningful, communicating a message or a need b. Human beings are systems of interdependent and interrelated parts c. Each individual has the potential for growth and change in the direction of positive mental health d. There is a basic similarity among all human beings

18. One way to increase objectivity in dealing with ones fears and anxieties is through the process of:

a. observation b. intervention c. validation d. collaboration

19. All of the following response are non therapeutic. Which is the MOST direct violation of the concept, congruence of behavior?

a. Responding in a punitive manner to the client b. Rejecting the client as a unique human being c. Tolerating all behavior in the client d. Communicating ambivalent messages to the client

20. The rnentally ill person responds positively to the nurse who is warm and caring. This demonstration of the nurses role as:

a. counselor b. mother surrogate c. therapist d. socializing agent

Situation 5 - The nurse engages the client in a. nurse-patient interaction.

21. The best time to inform the client about terminating the nurse-patient relationship is

a. when the client asks, how long one relationship would be b. during the working phase c. towards the end of the relationship d. at the start of the relationship

22. The client says, "I want to tell you something but can you promise that you will keep this, a secret?" A therapeutic response of the nurse is:

a. "Yes, our interaction is confidential provided the information you tell me is not detrimental to your safety." b. "Of course yes, this is just between you and me. Promise!" c. "Yes, it is my principle to uphold my client's rights." d. "Yes, you have the right to invoke confidentiality of our interaction."

23. When the nurse respects the client's self-disclosure, this is a gauge for the nurse's:

a. trustworthiness b. loyalty c. integrity d. professionalism

24. Rapport has been established in the nurse-client interaction time. I am committed to have this time available for us while you are at the hospital and ends after your discharge."

a. "The best time to talk is during the nurse-client interaction time. I am committed to have this time available for us while you are at the hospital and ends after your discharge." b. "Yes, if you keep it confidential, this is part of privileged communication." c. "I am committed for your care." d. "I am sorry, though I would want to, it is against hospital policy."

25. The client has not been visited by relatives for months. He gives a, telephone number and requests the nurse to call. An appropriate action of the nurse would be:

a. Inform the attending psychiatric about the request of the client b. Assist the client to bring his concern to the attention of the social worker c. "Here (gives her mobile phone). You may call this number now." d. Ask the client what is the purpose of contacting his relatives

Situation 6 - Camila, 25 years old, was reported to be gradually withdrawing and isolating herself from friends and family members. She became neglectful of her personal hygiene. She was observed to be talking irrelevantly and incoherently. She was diagnosed as schizophrenia

26. The past history of Camila would most probably reveal that her premorbid personality is:

a. schizoid b. extrovert c. ambivert d. cycloid

27. Camila refuses to relate with others because she:

a. is irritable b. feels superior of others c. anticipates rejection d. is depressed

28. Which of the following disturbances in interpersonal relationships MOST often predispose, to the development of schizophrenia?

a. Lack of participation in peer groups b. Faulty family atmosphere and interaction c. Extreme rebellion towards authority figures d. Solo parenting

29. Camila's indifference toward the environment is a compensatory behavior to overcome:

a. Guilt feelings b. Ambivalence

c. Narcissistic behavior d. Insecurity feelings

30. Schizophrenia is a/an:

a. anxiety disorder b. neurosis c. psychosis d. personality/disorder

Situation 7 - Salome, 80 year old widow, has been observed to be irritable, demanding and speaking louder than usual. She would prefer to be alone and take her meals by herself, minimized receiving visitors al home and no longer bothers to answer telephone calls because of deterioration of her hearing. 'She was brought by her daughter to, the Geriatic clinic for assessment and treatment.

31. The nurse counsels Salome's daughter that Salome's becoming very loud and tendency to become aggressive is a/an:

a. beginning indifference to the world around her b. attempt to maintain authoritative role c. overcompensation for hearing loss d. behavior indicative of unresolved repressed conflict of the part

32. A nursing diagnosis for Salome is:

a. sensory deprivation b. social isolation

c. cognitive impairment d. ego despair

33. The nurse will assist Salome and her daughter to plan a goal which is:

a. adjust to the loss of sensory and .perceptual function b. participate in conversation and other social situations c. accept the steady loss of hearing that occurs with aging d. increase her self-esteem to maintain her authoritative role

34. The daughter understood, the following ways to assist Salome meet her needs and avoiding which of the following:

a. Using short simple sentences b. Speaking distinctly and slowly c. Speaking at eye level and having the client's attention d. Allowing her to take her meals alone

35. Salome was fitted a hearing aid. She understood the proper .use and wear of this device when she ways that the battery should be functional, the device is turned on and adjusted to a:

a. therapeutic level b. comfortable level c. prescribed level d. audible level

Situation 8 - For more than a month now, Cecilia is persistently feeling restless, worried and feeling as if something dreadful is going to happen. She fears being alone in places and situations where she thinks that no one might come to rescue her just in case something happens to her.

36. Cecilia is demonstrating:

a. acrophobia b. claustrophobia c. agoraphobia d. xenophobia

37. Cecilia's problem is that she always sees and thinks negative hence she is always fearful Phobia is a symptom described as:

a. organic b. psychosomatic c. psychotic d. neurotic

38. Cecilia has a lot of irrational thoughts: The goal of therapy is to modify her:

a. communication b. cognition c. observation d. perception

39. Cognitive therapy is indicated for Cecilia when she is already able to handle anxiety reactions. Which of the following should the nurse implement?

a. assist her in recognizing irrational beliefs, and thoughts b. help find meaning in her behavior c. provide positive reinforcement for acceptable behavior d. administer anxiolytic drug

40. After discharge, which of these behaviors indicate a positive result of being able to overcome her phobia?

a. she read a book in the public library b. she drives alone along the long expressway c. she watches television with the family in the recreation room d. she joint an art therapy group

Situation 9 - it is the first day of clinical experience of nursing students at the Psychiatry Ward- During the orientation, the nurse emphasizes that the team members including nursing students are legally responsible to safeguard patient's records from loss or destruction or from people not authorized to bead it.

41. It is unethical to tell one's friends and family members data bout patients because doing so is violation of patients rights to:

a. Informed consent b. Confidentiality c. Least restrictive environment d. Civil liberty

42. The nurse must see to it that the written consent of mentally ill patients must be taken from:

a. Doctor b. Social worker c. Parents or legal guardian d. Law enforcement authorities

43. In an extreme situation and when no other resident or intern is available, should a nurse receive, telephone orders, the order has to be correctly written and signed by the physician within.

a. 24 hours b. 36 hours c. 48 hours d. 12 hours

44. The following are SOAP (Subjective - Objective - Analysis - Plan) statements on a problem: Anxiety about diagnosis. What is the objective data?

a. Relate patient's feelings to physician initiate and encourage her to verbalize her fears give emotional support by spending more time with patient, continue to make necessary explanations regarding diagnostic test. b. Has periods of crying, frequently verbalizes fear of what diagnostic tests will reveal c. Anxiety due to the unknown d. "Im so worried about what else they'll find wrong with me"

45. Nursing care plans provide very meaningful data for the patient profile and initial plan because the focus is on the:

a. Summary of chronological notations made by individuals health team members b. Identification of patient's responses to medical diagnosis and treatment c. Patient's responses to health: and illness as a total person in interaction with the environment d. Step procedures for the management of common problems

Situation 10 - Marie is 5 years old and described by the mother as bedwetting at night.

46. Which of the following is the MOST common physiological cause of night bedwetting?

a. deep sleep factors b. abnormal bladder development or structure problems c. infections familial and genetic factors

47. All of the following, EXCEPT one comprise the concepts of behavior therapy program:

a. reward and punishment b. extinction c. learning d. placebo as a form treatment

48. The help Marie who bed wets at night practice acceptable and appropriate behavior, it is important for the parents to be consistent with the following approaches EXCEPT:

a discipline with a king attitude b matter of fact in handling the behavior c. sympathize for the child d. be lowing yet firm

49. A therapeutic verbal approach that communicates strong disapproval is:

a. You are supposed to get up and go in the toilet when you feel you have to go and did not. The next time you bed wet, Ill tell your friends and hand your sheets out the window for them to see." b. "You are supposed to get up and go in the toilet when you feel you have to go and you did not. I expect you to from now on without fail." c. "If you bed wet, you will change your bed linen and wash the sheets." d. "If you don't make an effort to control your bedwetting, I'd be upset and disappointed."

50. During your conference, the parent inquires how to motivate Marie to be dry in the morning. Your response which is an immediate intervention would be:

a. Give a star each time she wakes up dry and every set of five stars, give a prize b. Tokens make her materialistic at an early age. Give praise and hugs occasionally c. What does you child want that you can give every time he/she wakes up dray in the morning d. Promise him/her a long awaited vacation after school is over.

Situation 11 - The nurse is often met with t-he following situations when clients become angry and hostile.

51. To maintain a therapeutic eye contact and body posture while interacting with angry and aggressive individual, the nurse should:

a. keep an eye contact while staring at the client b. keep his/her hands behind his/her back or in one's pocket c. fold his/her arms across his/her chest c. keep an "open" posture, e.g. Hands by sides but palms turned outwards

52. During the pre-interaction phase of the N-P relationship/the nurse recognizes this normal INITIAL reaction to an assaultive or potentially assaultive person.

a. To remain and cope with the incident b. Display empathy towards the patient c. To call for help from the other members of the team d. To stay and fight or run away

53. Which of the following is an accurate way of reporting and recording an incident?

a. "When asked about his relationship with his father, client became anxious." b. "When asked about his relationship with his father, client clenched his jaw/teeth made a fist and turned away from the nurse." c. "When asked about his relationship with his father, client was resistant to respond." d. "When asked about his relationship with his father, his anger was suppressed."

54. To encourage thought. Which of the following approaches is NOT therapeutic?

a. "Why do you feel angry?" b. "When do you usually feel angry?"

c. "How do you usually express anger?" d. "What situations provoke you to be angry?"

55. A patient grabs a chair and about to throw it. The nurse best responds saying.

a. "Stop! Put that chair down." b. "Don't be silly." c. "Stop, the security will be here in a minute." d. "Calm down."

Situation 12 - Nursing care for the elderly.

56. In planning care for a patient with Parkinson's disease, which of these nursing diagnoses should have priority?

a. potential for injury b. altered nutritional state c. ineffective coping d. altered mood state

57. A healthy adaptation to aging is primarily related to an individual.

a. Number of accomplishments b. Ability to avoid interpersonal conflict c. Physical health throughout life d. Personality development in his life span

58. The frequent use of the older client's name by the nurse is MOST effective in alleviating which of the following responses to old age?

a. Loneliness b. Suspicion c. Grief d. Confusion

59. An elderly confused client gets out of bed at night to go to the bathroom and tries to go to another bed when she returns. The MOST appropriate action the nurse would take is to:

a. Assign client to a single room b. Leave a light on all night c. Remind client to call the nurse when she wants to get up d. put side rails on the bed

60. An elderly who has lots of regrets, unhappy and miserable1 is experiencing:

a. Crisis b. Despair c. Loss d. Ambivalence

Situation 13 - Graciela 1 year old is admitted the hospital from the emergency room with a fracture of the left femur due to a Tall down a flight of stairs. Graciela is placed oh Bryant's traction.

61. While on Bryant's traction, which of these observations of Graciela and her traction apparatus would indicate a decrease in the effectiveness of her traction?

a. Graciela's buttocks are resting on the bed b. The traction weights are hanging 10 inches above the floor c. Graciela's legs are suspended at a 90 degree angle to her trunk d. The traction ropes move freely through the pulley

62. The nurse notes that the fall might also cause a possible head injury. She will be observed for signs of increased intracranial pressure which include:

a. Narrowing of the pulse pressure b. Vomiting c. Periorbital edema d. A positive Kernig's sign

63. Graciela is assessed to have no head injury. The Bryant's traction is removed. A plaster of Paris his spica is applied. Which of these finding as a concern of immediate attention that must be reported to the physician immediately?

a. Graciela is scratching the cast over her abdomen b. The toes of Graciela's left foot blanch when the nurse applies pressure on them c. Graciela's cast is still damp d. The nurse is unable to insert a finger under the edge of Graciela's cast on her left foot

64. Part of discharge plan is for the nurse to give instructions about the care of Graciela's cast to the mother. Which of these statements indicate that the mother understood an important aspect of case care?

a. I will use white shoe polish to keep the cast neat b. I will place plastic sheeting around the perineal area of the cast c. I will use cool water to wash the cast d. I will reinforce cracked areas on the cast with adhesive tape

65. The nurse counsels Graciela's mother ways to safeguard safety white providing opportunities of Graciela to develop a sense of:

a. Trust b. Initiative c. Industry d. Autonomy

Situation 14 - Jolina is an 18 year old beginning college student. Her mother observed that she is having problems relating with her friends. She is undecided about her future. She has lost insight, lost interest in anything and complained and complained of constant tiredness.

66. Jolina is out on antidepressant drugs. These drugs act on the brain chemistry, therefore they would be useful in which type of depression?

a. exogenous depression b. neurotic depression c. endogenous depression d. psychotic depression

67. This is a tricyclic antidepressant drug:

a. Venlafaxine (Effexor) c. Setraline (Zoloft) b. Flouxetine (Prozac) d. Imipramine (Tofranil)

68. After one week of antidepressant medication, Jolina still manifests depression. The nurse evaluates this as;

a. Unusual because action of antidepressant drug is immediate b. Unexpected because therapeutic effectiveness takes within a few days c. Expected because therapeutic effectiveness takes 2-4 weeks d. Ineffective result because perhaps the drug's dosage is inadequate

69. Jolina continues to verbalize feeling sad and hopeless. She is not mixing well with other clients. One of the nurse's important consideration for Jolina Initially is to:

a. Formulate a structured schedule so she is able to channel her energies externally b. Let her alone until she feels like mingling with others c. Encourage her to join socialization hour so she will start to relate with others d. Encourage her to join group therapy with other patients

70. During the predischarge conference, the nurse suggests vocational guidance because it should help Jolina to:

a. Find a good job b. Make some decision about her future

c. Realistically assess her assets and limitations d Solve her own problems

Situation 15 - Group Approach" in Nursing.

71. Membership dropout generally occurs in group therapy after a member:

a. Accomplishes his goal in joining the group b. Discovers that his feelings are shared by the group members c. Experiences feelings of frustration in the group d. Discusses personal concerns with group members

72. Which of the following questions illustrates the group role of encourager?

a. What were you saying? b. Who wants to respond next? c. Where do you go from here? d. Why haven't we heard from you?

73. The goal of remotivation therapy is to facilitate:

a. Insight b. Productivity c. Socialization d. Intimacy

74. The treatment of the family as a unit is based on the belief that the family:

a. is a social system and all the members are interrelated components of that system b. as a unit of society needs the opportunity to change its own destiny c. who has therapy together will tend to remain together d. is "contaminated" by the presence of deviant member and all members need treatment

75. The working phase in therapy group is usually characterized by which of the following?

a. Caution b. Cohesiveness c. Confusion d. Competition

Situation 16 - The mental health - psychiatric nurse functions in a variety of setting with different types of clients.

76. Poverty as reflected in prevalence of communicable diseases, malnutrition and social ills such as street children, homeless and prostitution is a predisposing factor to mental illness. A community approach to cope with this problem is for the nurse to support:

a. aggressive family planning methods b. provision of social welfare benefits for the poor c. social action d. free clinics and more hospitals

77. The MOST cost effective way to meet the mental health needs of the public is through programs with a priority goal of:

a. treatment b. prevention c. rehabilitation d. research

78. Lorelle upon discharge was referred to a volunteer group where she has learned to read patterns, cut out fabric and use a sewing machine to make simple outfits that will help her earn in the future. What type of activity therapy is this?

a. Recreational therapy b. Art therapy c. Vocational therapy d. Educational therapy

79. In a residential treatment home for adolescent girl's the clients were becoming increasingly tense and upset because of shortening of their recreation time. To die escalate possible anger and aggression among the clients it is BEST to play:

a. religious music b. relaxation music c. dance music d. rock music

80. The parents of special children who are behaviorally disturbed need mental health education. Which of these topics would the school nurse consider as priority for their parents class?

a. Drug education b. Child abuse c. Effective parenting d. Sex education

Situation 17 - Nurse's in all practice areas are likely to come in contact with clients suffering from acute or chronic drug abuse.

81. The psychodynamic therapy of substance abuse is based upon the premise that drug abuse is:

a. a common problem brought about by socioeconomic deprivation b. caused by multiplicity of factors c. predisposed by an inability to develop appropriate psychological resources to manage developmental stresses d. due to biochemical factors

82. Being in contact with reality and the environment is a function of the:

a. conscience b. ego c. id d. super ego

83. Substance abuse is different from substance dependence is than, substance dependence:

a. includes characteristics of adverse consequences and repeated use b. requires long term treatment in a hospital based program c. produces less severe symptoms than that of abuse d. includes characteristics of tolerance and withdrawal

84. During the detoxification stage, it is a priority for the nurse to:

a. teach skills to recognize and respond to health threatening situations b. increase the client's awareness of unsatisfactory protective behaviors c. implement behavior modification d. promote homeostasis and minimize the clients withdrawal symptoms

85. Commonly known as "shabu" is:

a. Cannabis Sativa b. Lysergic add diethylamide c. Methylenedioxy, methamphetamine d. Methamphetamine hydrochloride

Situation 18 - It is common that client ask the nurse personal questions.

86. Anticipation of personal questions is given adequate attention during which phase of the nurse patient relationship?

a. Orientation phase b. Working phase

c. Pre-interaction phase d. Termination phase

87. The client asks for the nurse's telephone number, which of these responses is NOT appropriate?

a. "it is confidential I just don't give it to anyone." b. "What would you do with my number if I give it to you?" c. "If I say. No to your request, what are your thoughts about it? d. "Are you asking for an official number of the hospital/clinic for your reference?"

88. When the client asks about the family of the nurse the MOST appropriate response is:

a. Avoid the situation and redirect the client's attention b. Give a brief and simple response and focus on the client c. "Why don't we talk about your family instead?" d. Introduce another topic like the client's interests

89. When the nurse is asked a personal question, which of these reactions indicate a need her to introspect?

a. The client is simply curious b. His/her right to privacy is being intruded c. The client knows no other way to begin a conversation d. Some patients are like children in seeking recognition from the nurse

90. It is 10 o'clock of your watch. The client asks, "What time is it?" The nurse's appropriate response is:

a. "Are you bored?" b. "It is 10 oclock." c. "Why do you ask?" d. "Guess, what time is it?"

Situation 19 - Ricky is a 12 year old-boy with Downs syndrome. He stands 5' " and weight 100 lbs. He is slim and walks sluggishly with a limp. He wears a neck brace as support for his neck. X - ray of cervical spine showed "subluxation of CI in relation to C2 with cord compression." He attends a school for special education.

91. The classroom teacher consults the school for guidance on how to take care of Ricky while inside the, classroom. The nurse considers as priority, Ricky's:

a. Physiological needs b. Need for self-esteem c. Needs for safety and Security d. Needs for belonging

92. Ricky's mother visited the school nurse. She asked, " What should I do when Ricky fond his genitalia?" Appropriate response of the nurse is for the mother to:

a. Divert Ricky's attention and engage him in satisfying activities b. Tell Ricky that it is wrong to keep fondling his genitalia c. Ignore Ricky's behavior because he will outgrow it later d. Engage him in computer TV games that engage his hands

93. The nurse has one on one health education sessions with Ricky's mother. The mother understood that for her son to learn to cope and be independent, she should constantly provide activities for Ricky to be able to:

a. socialize with people b. eventually go to school alone c. select and prepare his own food d. do activities of daily living

94. All of the following activities are appropriate for Ricky EXCEPT:

a. Working with clay b. Competitive sports c. Preparing and cooking simple menu d. Card and table games

95. Ricky's IQ falls within the range of 50-55. He can be expected to:

a. Profit from vocational training with moderate supervision b. Live successfully in the community c. Perform simple tasks in closely supervised settings d. Acquire academic skills of 6th grade; level

Situation 20 - The abuse of dangerous drug is a serious public health concern that nurses need to address,

96. The nurse should recognize that the unit primarily responsible for education and awareness of the members of the family on the ill effects of dangerous drugs is the:

a. law enforcement agencies b. school c. church d. family

97. A drug dependent utilizes this defense mechanism and enables him to forget shame and pain.

a. repression b. rationalization c. projection d. sublimation

98. This drug produces mirthfulness, fantasies, flight of ideas, loss of train of thought, distortion of size, distance and time, and "bloodshot eyes", due to dilated pupils.

a. Opiates b. LSD c. Marijuana d. Heroin

99. The nurse evaluates that-.her health teaching to a group of high school boys is effective if these students recognize which of the following dangers of inhalant abuse.

a. Sudden death from cardiac or respiratory depression

b. Danger of acquiring hepatitis or AIDS c. Experience of "blackout" d. Psychological dependence after prolonged use

100. The mother of a drug dependent would never consider referring her son to a drug rehabilitation agency because she fears her son might just becomes worse while relating with other drugs users. The mother's behavior can be described as:

a. Unhelpful b. Codependent c. Caretaking d. Supportive

ANSWER KEY: 1. C 2. C 3. B 4. A 5. D 6. A 7. C 8. D 9. D 10. A 11. A

12. D 13. D 14. D 15. A 16. D 17. C 18. B 19. 20. 21. 22. 23. 24. 25. A 26. A 27. A 28. B 29. C 30. C 31. A 32. A 33. A 34. D 35. D 36. C

37. D 38. B 39. A 40. A 41. B 42. C 43. A 44. B 45. C 46. 47. 48. 49. 50. 51. D 52. B 53. B 54. A 55. A 56. A 57. C 58. D 59. A 60. B 61. A

62. B 63. D 64. D 65. D 66. B 67. D 68. C 69. C 70. C 71. C 72. B 73. B 74. A 75. B 76. B 77. B 78. C 79. B 80. C 81. B 82. B 83. D 84. D 85. D 86. B

87. A 88. B 89. D 90. B 91. C 92. 93. D 94. B 95. C 96. D 97. A 98. B 99. A 100. A

Situation 1 - Concerted work efforts among members of the surgical team is essential to the success of the surgical procedure.

1. The sterile nurse or sterile personnel touch only sterile supplies and instruments. When there is a need for sterile supply which is not in the sterile field, who hands out these items by opening its outer cover?

a. Circulating nurse b. Anesthesiologist c. Surgeon d. Nursing aide

2. The OR team performs distinct roles for one surgical procedure to be accomplished within a prescribed time frame and deliver a standard patient outcome. White the surgeon performs the surgical procedure, who monitors the status of the client like urine output, blood loss?

a. Scrub nurse b. Surgeon c. Anesthesiologist d. Circulating nurse

3. Surgery schedules are communicated to the OR usually a day prior to the procedure by the nurse of the floor or ward where the patient is confined. For orthopedic cases, what department is usually informed to be present in the OR?

a. Rehabilitation department b. Laboratory department c. Maintenance department d. Radiology department

4. Minimally invasive surgery is very much into technology. Aside from the usual surgical team who else to be present when a client undergoes laparoscopic surgery?

a. Information technician b. Biomedical technician c. Electrician d. Laboratory technicial

5. In massive blood loss, prompt replacement of compatible blood is crucial. What department needs to be alerted to coordinate closely with the patient's family for immediate blood component therapy?

a. Security Division b. Chaplaincy c. Social Service Section d. Pathology department

Situation 2 - You are assigned in the Orthopedic Ward where clients are complaining of pain in varying degrees upon movement of body parts.

6. Troy is a one day post open reduction and internal fixation (ORIF) of the left hip and is in pain. Which of the following observation would prompt you to call the doctor?

a. Dressing is intact but partially soiled b. Left foot is cold to touch and pedal pulse is absent c. Left leg in limited functional anatomic position d. BP 114/78, pulse of 82 beats/minute

7. There is an order of Demerol 50 mg I.M. now and every 6 hours p r n. You injected Demerol at 5 pm. The next dose of Demerol 50 mg I.M. is given:

a. When the client asks for the next dose b. When the patient is in severe pain c. At 11pm d. At 12pm

8. You continuously evaluate the client's adaptation to pain. Which of the following behaviors-indicate appropriate adaptation?

a. The client reports pain reduction and decreased activity b. The client denies existence of pain c. The client can distract himself during pain episodes d. The client reports independence from watchers

9. Pain in Ortho cases may not be mainly due to the surgery. There might be other factors such as cultural or psychological that influence pain. How can you alter these factors as the nurse?

a. Explain all the possible interventions that may cause the client to worry. b. Establish trusting relationship by giving his medication on time c. Stay with the client during pain episodes d. Promote client's sense of control and participation in pain control by listening to his concerns

10. In some hip surgeries, an epidural catheter for Fentanyl epidural analgesia is given. What is your nursing priority care in such a case?

a. Instruct client to observe strict bed rest b. Check for epidural catheter drainage c. Administer analgesia through epidural catheter as prescribed d. Assess respiratory rate carefully

Situation 3 - Records are vital tools in any institution and should be properly maintained for specific use and time.

11. The patient's medical record can work as a double-edged swords. When can the medical record become the doctor's/nurse worst enemy?

a. When the record is voluminous b. When a medical record is subpoenaed in court c. When it is missing d. When the medical record is inaccurate, incomplete, and inadequate

12. Disposal of medical records in government hospitals/institutions must be done in close coordination with what agency?

a. Department of Interior and Local Government (DILG) b. Metro Manila Development Authority (MMDA) c. Records Management Archives Office (RMAO) d. Depart of Health (DOH)

13. In the hospital, when you need-the medical record of a discharged patient for research, you will request permission through:

a. Doctor in charge b. The hospital director c. The nursing Service d. Medical records section

14. You readmitted a client who was in another department a month ago. Since you will need the previous chart, from whom do you request the old chart?

a. Central supply section b. Previous doctor's clinic

c. Department where the patient was previously admitted d. Medical records section

15. Records Management and Archives Offices of the DOH is responsible for implementing its policies on record, disposal. You know that your institution is covered by this policy it;

a. Your hospital is considered tertiary b. Your hospital is in Metro Manila c. It obtained permit to operate from DOH d. Your hospital is Philhealth accredited

Situation 4 - In the OR, there are safety protocols that should be followed. The OR nurse should be well versed with all these to safeguard the safety and quality to patient delivery outcome.

16. Which of the following should be given highest priority when receiving patient in the OR?

a. Assess level of consciousness b. Verify patient identification and informed consent c. Assess vital signs d. Check for jewelry, gown, manicure and dentures

17. Surgeries like I and D (incision and drainage) and debribement are relatively short procedures but considered dirty cases. When are these; procedures best scheduled?

a. Last case b. In between cases c. According to availability of anesthesiologist

d. According to the surgeon's preference

18. OR nurses should be aware that maintaining the client's safety is the overall goal of nursing care during the intraoperative phase. As the circulating nurse, you make certain that throughout the procedure...

a. the surgeon greets his client before induction of anesthesia b. the surgeon and anestheriologist are in tandem c. strap made of strong non-abrasive material are fastened securely around the joints of the knees and ankles and around the 2 hands around an arm board d. client is monitored throughout the surgery by the assistant anesthesiologist

19. Another nursing check that should not be missed before the induction of general anesthesia is:

a. check for presence underwear b. check for presence dentures c. check patient's d. check baseline vital signs

20. Some different habits and hobbies affect postoperative respiratory function. If your client smokes 3 packs of cigarettes a day for the part 10 years, you will anticipate increased risk for:

a. perioperative anxiety and stress b. delayed coagulation time c. delayed wound healing d. postoperative respiratory function

Situation 5 - Nurses hold a variety of roles when providing care to a perioperative patient.

21. Which of the following role would be the responsibility of the scrub nurse?

a. Assess the readiness of the client prior to surgery b. Ensure that the airway is adequate c. Account for the number of sponges, needles, supplies, Used during the surgical procedure d. Evaluate the type of anesthesia appropriate for the surgical client

22. As a perioperative nurse, how can you best meet the safety need of the client after administering preoperative narcotic?

a. Put side rails up and ask client not to get out of bed b. Send the client to ORD with the family c. Allow client to get up to go to the comfort room d. Obtain consent form

23. It is the responsibility of the pre-op, nurse to do skin prep for patients undergoing surgery. If hair at the operative site is not shaved, what should be done to make suturing easy and lessen chance of incision infection?

a. Draped b. Pulled c. Clipped d. Shampooed

24. It is also the nurse's function to determine when infection is developing in the surgical incision. The perioperative nurse should observe for what signs of impending infection?

a. Localized heat and redness b. Serosanguinous exudates and skin blanching c. Separation of the incision d. Blood clots and scar tissue are visible

25. Which of the following nursing intervention is done when examining the incision wound and changing the dressing?

a. Observe the dressing and type and odor of drainage if any b. Get patient's consent c. Wash hands d. Request the client to expose the incision wound

Situation 6 - Carlo, 16 years old, comes to the ER with acute asthmatic attack. RR is 46/min and he appears to be in acute respiratory distress.

26. Which of She following nursing actions should be initiated first?

a. Promote emotional support b. Administer oxygen at 6L/min c. Suction the client every 30 min d. Administer bronchodilator by nebulizer

27. Aminophylline was ordered for acute asthmatic attack. The mother asked the nurse, what its indication the nurse will say is:

a. Relax smooth muscles of the bronchial airway b. Promote expectoration c. Prevent thickening of secretions d. Suppress cough

28. You will give health instructions to Carlo, a case of bronchial asthma. The health instruction will include the following EXCEPT:

a. Avoid emotional stress and extreme temperature b. Avoid pollution like smoking c. Avoid pollens, dust seafood d. Practice respiratory isolation

29. The asthmatic client asked you what breathing technique he can best practice when asthmatic attack starts. What will be the best position?

a. Sit in high-Fowler's position with extended legs b. Sit-up with shoulders back c. Push on abdomen during exhalation d. Lean forward 30-40 degrees with each exhalation

30. As a nurse you are always alerted to monitor status asthmaticus who will likely and initially manifest symptoms of:

a. metabolic alkalosis b. respiratory acidosis c. respiratory alkalosis d. metabolic acidosis

Situation 7 - Joint Commission on Accreditation of Hospital Organization (JCAHP) patient safety goals and requirements include the care and efficient use of technology in the OR arid elsewhere in the healthcare facility.

31. As the head nurse in the OR, how can you improve the effectiveness of clinical alarm systems?

a. limit suppliers to a few so that quality is maintained b. implement a regular inventory of supplies and equipment c. Adherence to manufacturer's recommendation d. Implement a regular maintenance and testing of alarm systems

32. Over dosage of medication or anesthetic can happen even with the aid of technology like infusion pump, sphymomanometer, and similar devices/machines. As a staff, how can you improve the safety of using infusion pumps?

a. Check the functionality of the pump before use b. Select your brand of infusion pump like you do with your cellphone C. Allow the technician to set the; infusion pump before use d. Verify the flow rate against your computation

33. JCAHOs universal protocol for surgical and invasive procedures to prevent wrong site, wrong person, and wrong procedures/surgery includes the following EXCEPT:

a. Mark the operative site if possible b. Conduct pre-procedure verification process c. Take a video of the entire intra-operative procedure d. Conduct time out immediately before starting the procedure

34. You identified a potential risk of pre and post operative clients. To reduce the risk of patient harm resulting from fall, you can implement the following EXCEPT:

a. Assess potential risk of fail associated with the patient's the following EXCEPT: medication regimen b. Take action to address any identified risks through Incident Report (IR) c. Allow client to walk with relative to the OF? d. Assess and periodically reassess individual client's risk for falling

35. As a nurse you know you can improve on accuracy of patient's identification by 2 patient identifiers, EXCEPT:

a. identify the client by his/her wrist tag and verify with family members b. identify client by his/her wrist tag and call his/her by name c. call the client by his/her case and bed number d. call the patient by his/her name and bed number

Situation 8 - Team efforts is best demonstrated in the OR

36. If you are the nurse in charge for scheduling surgical cases, what important information do you need to ask the surgeon?

a. Who is your internist b. Who is your assistant and anesthesiologist, and what is your preferred time and type of surgery? c. Who are your anesthesiologist, internist, and assistant d. Who is your anesthesiologist.

37. In the OR, the nursing tandem for every surgery is:

a. Instrument technician and circulating nurse b. Nurse anesthetist, nurse assistant, and instrument technician c. Scrub nurse and nurse anesthetist d. Scrub and circulating nurses

38. While team effort is needed in the OR for efficient and quality patient care delivery, we should limit the number of people in the room for infection control. Who comprise this team?

a. Surgeon, anesthesiologist, scrub nurse, radiologist, orderly b. Surgeon, assistants, scrub nurse, circulating nurse, anesthesiologist c. Surgeon, assistant surgeon, anesthesiologist, scrub nurse, pathologist d. Surgeon, assistant surgeon, anesthesiologist, intern, scrub nurse

39. When surgery is on-going, who coordinates the activities outside, including the family?

a. Orderly/clerk b. Nurse supervisor c. Circulating nurse d. Anaesthesiologist

40. The breakdown in teamwork is often times a failure in:

a. Electricity b. Inadequate supply c. Leg work d. Communication

Situation 9 - Colostomy is a surgically created anus- It can be temporary or permanent, depending on the disease condition.

41. Skin care around the stoma is critical. Which of the following is not indicated as a skin care barriers? a. Apply liberal amount of mineral oil to the area b. Use karaya paste and rings around the stoma c. Clean the area daily with soap and water before applying bag d. Apply talcum powder twice a day

42. What health instruction will enhance regulation of a colostomy (defecation) of clients?

a. Irrigate after lunch everyday b. Eat fruits and vegetables in all three meals c. Eat balanced meals at regular intervals d. Restrict exercise to walking only

43. After ileostomy, which of the following condition is NOT expected?

a. increased weight b. Irritation of skin around the stoma c. Liquid stool d. Establishment of regular bowel movement

44. The following are appropriate nursing interventions during colostomy irrigation EXCEPT:

a. Increase the irrigating solution flow rate when abdominal cramps is felt b. Insert 2-4 inches of an adequately lubricated catheter to the stoma c. Position client in semi-Fowler d. Hand the solution 18 inches above the stoma

45. What sensation is used as a gauge so that patients with ileostomy can determine how often their pouch should be drained?

a. Sensation of taste b. Sensation of pressure c. Sensation of smell d. Urge to defecate

Situation 10 - As a beginner in research, you are aware that sampling is an essential element of the research process.

46. What does a sample group represent?

a. Control group

b. Study subjects c. General population d. Universe

47. What is the most important characteristics of a sample?

a. Randomization b. Appropriate location c. Appropriate number d. Representativeness

48. Random sampling ensures that each subject has:

a. Been selected systematically b. An equal change of selection c. Been selected based on set criteria d. Characteristics that match other samples

49. Which of the following sampling methods allows the use of any group of research subject?

a. Purposive b. Convenience c. Snow-bail d. Quota

50. You decided to include 5 barangays in your municipality and chose a sampling method that would get representative samples from each barangay. What should be the appropriate method for you to use in this care?

a. Cluster sampling b. Random sampling c. Stratifies sampling d. Systematic sampling

Situation 11 -After an abdominal surgery, the circulating and scrub nurses have critical responsibility about sponge and Instrument count.

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

a. Before closing the subcutaneous layer b. Before peritoneum is closed c. Before dosing the skin d. Before the fascia is sutured

52. What major supportive layer of the abdominal wall must be sutured with long tensile strength such as cotton or nylon or silk suture?

a. Fascia b. Muscle c. Peritoneum d. Skin

53. Like sutures, needles also vary in shape and uses. If you are the scrub nurse for a patient who is prone to keloid formation and has a low threshold of pain, what needle would you prepare?

a. Round needle b. A traumatic needle c. Reverse cutting needle d. Tapered needle

54. Another alternative "suture" for skin closure is the use of _______________:

a. Staple b. Therapeutic glue c. Absorbent dressing d. invisible suture

55. Like any nursing interventions, counts should be documented. To whom does the scrub nurse report any discrepancy of country so that immediate 'and appropriate action in instituted?

a. Anesthesiologist b. Surgeon c. Or nurse supervisor d. Circulating nurse

Situation 12 - As a nurse, you should be aware and prepared of the different roles you play.

56. What role do you play, when you hold all clients information entrusted to you in the strictest confidence?

a. Patient's advocate b. Educator c. Patient's Liaison d. Patient's arbiter

57. As a nurse, you can help improve the effectiveness of communication among healthcare givers

a. Use of reminders of what to do b. Using standardized list of abbreviations, acronyms, and symbols c. One-on-one oral endorsement d. Text messaging and e-mail

58. As a nurse, your primary focus in the workplace is the client's safety. However, personal safety is also a concern. You can communicate hazards to your co-workers through the use of the following EXCEPT:

a. Formal training b. Posters c. Posting IR in the bulletin board d. Use of labels and signs

59. As a nurse, what is one of the best way to reconcile medications across the continuum of care?

a. Endorse on a case-to-case basis b. Communication a complete list of the patient's medication to the next provider of service c. Endorse in writing

d. Endorse the routine and 'stat' medications every shift

60. As a nurse, you protect yourself and co-workers from misinformation and misrepresentations through the following EXCEPT:

a. Provide information to clients about a variety of services that can help alleviate the client's pain and other conditions b. Advising the client, by virtue of your expertise, that which can contribute to the client's well-being c. Health education among clients and significant others regarding the use of chemical disinfectant d. Endorsement thru trimedia to advertise your favorite disinfectant solution

61. 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

62. Pentoxicodone 5 mg IV every 8 hours was prescribed for post abdominal pain. Which will be your priority nursing action?

a. Check abdominal dressing for possible swelling b. Explain the proper use of PCA to alleviate anxiety c. Avoid overdosing to prevent dependence/tolerance d. Monitor VS, more importantly RR .

63. The client complained of abdominal and pain. Your nursing intervention that can alleviate pain is:

a. Instruct client to go to sleep and relax b. Advice the client to close the lips and avoid deep breathing and talking c. Offer hot and clear soup d. Turn to sides frequently and avoid too much talking

64. Surgical pain might be minimized by which nursing action in the OR:

a. Skill of surgical team and lesser manipulation b. Appropriate preparation For the scheduled procedure c. Use of modem technology in closing the wound d. Proper positioning and draping of clients

65. One very common cause of postoperative pain is:

a. Forceful traction during surgery b. Prolonged surgery c. Break in aseptic technique d. Inadequate anesthetic

Situation 14 - You were on duty at the medical ward when Zeny came in for admission for tiredness, cold intolerance, constipation, and weight gain. Upon examination, the doctor's diagnosis was hypothyroidism.

66. Your independent nursing care for hypothyroidism includes:

a. administer sedative round the clock b. administer thyroid hormone replacement c. providing a cool, quiet, and comfortable environment d. encourage to drink 6-8 glasses of water

67. As the nurse, you should anticipate to administer which of the following medications to Zeny who is diagnosed to be suffering from hypothyroidism?

a. Levothyroxine b. Lidocaine c. Lipitor d. Levophed

68. Your appropriate nursing diagnosis for Zeny who is suffering from hypothyroidism would probably include which of the following?

a. Activity intolerance related to tiredness associated with disorder b. Risk to injury related to incomplete eyelid closure c. Imbalance nutrition related to hypermetabolism d. Deficient fluid volume related to diarrhea

69. Myxedema coma is a life threatening complication of long standing and untreated hypothyroidism with one of the following characteristics.

a. Hyperglycemia

b. hypothermia c. hyperthermia d. hypoglycemia

70. As a nurse, you know that the most common type of goiter is related to a deficiency

a. thyroxine b. thyrotropin c. iron d. iodine

Situation 15 - Mrs. Pichay is admitted to your ward. The MD ordered "Prepared for thoracentesis this pm to remove excess air from the pleural cavity."

71. Which of the following nursing responsibility 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

72. Mrs. Pichay who is for thoracentesis is assisted by the nurse to any of the following positions, EXCEPT:

a. straddling a chair with arms and head resting on the back of the chair b. lying on the unaffected side with the bed elevated 30-40 degrees

c. lying prone with the head of the bed lowered 15-30 degrees d. sitting on the edge of the bed with her feet supported and arms and head on a padded overhead table

73. 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

74. To prevent leakage of fluid in the thoracic cavity, how wilt you position the client after thoracentesis?

a. Place flat in bed b. Turn on the unaffected side c. Turn on the affected side d. On bed rest

75. Chest x-ray was ordered after thoracentesis. When you client asks what is the reason for another chest x-ray, you will explain:

a. to rule out pneumothorax b. to rule out any possible perforation c. to decongest d. to rule out any foreign: body

Situation 16 - In the hospital, you are aware that we are helped by the .use of a variety of equipment/devices to enhance quality patient care delivery;

76. You are initiate an IV line to your patient, Kyle, 5, who is febrile. What IV administration set will you prepare?

a. Blood transfusion set b. Macroset c. Volumetric chamber d. Microset

77. Kyle is diagnosed to have measles. What will your protective personal attire include?

a. Gown b. Eyewear c. Face mask d. Gloves

78. What will you do to ensure that Kyle, who is febrile, will have a liberal oral fluid intake?

a. Provide a glass of fruit every meal b. Regulate his IV to 30 drops per minute c. Provide a calibrated pitcher of drinking water and juice at the bedside and monitor intake and output d. Provide a writing pad to record his intake

79. Before bedtime, you went to ensure Kyle's safety in 'bed. You will do which of the following:

a. Put the lights on b. Put the side rails up c. Test the call system d. Lock the doors

80. Kyle's room is fully mechanized. What do you teach the watcher and Kyle to alert the nurse for help?

a. How to lock side rails b. Number of the telephone operator c. Call system d. Remote control

Situation 17 - Tony, 11 years old, has 'kissing tonsils' and is scheduled for tonsillectomy and adenoidectomy or T and A.

81. You are the nurse of Tony who will undergo T and A in the morning. His mother asked you if Tony will be put to sleep. Your teaching will focus on:

a. spinal anesthesia b. anesthesiologists preference c. local anesthesia d. general anesthesia

82. Mothers of children undergoing tonsillectomy and adenoidectomy usually ask what food prepared and give their children after surgery. You as the nurse will say:

a. balanced diet when fully awake b. hot soup when awake c. ice cream when fully awake d. soft diet when fully awake

83. The RR nurse should monitor for the most common postoperative complication of:

a. hemorrhage b. endotracheal tube perforation c. esopharyngeal edema d. epiglottis

84. The PACU nurse will maintain postoperative T and A client in what position?

a. Supine with neck hyperextended and supported with pillow b. Prone with the head on pillow and tuned to the side c. Semi-Fowler's with neck flexed d. Reverse trendelenburg with extended neck

85. Tony is to be discharged in the afternoon of the same day after tonsillectomy and adenoidectomy. You as the RN will make sure that the family knows to:

a. offer osteorized feeding b. offer soft foods for a week to minimize discomfort while swallowing c. supplement his diet with vitamin C rich juices to enhance heating d. offer clear liquid for 3 days to prevent irritation

Situation 18 - Rudy was diagnosed to have chronic renal failure. Hemodialysis is ordered that an A-V shunt was surgically created.

86. Which of the following action would be of highest priority with regards to the external shunt?

a. Avoid taking BP or blood sample from the arm with shunt b. Instruct the client not to exercise the arm with the shunt c. Heparinize the shunt daily d. Change dressing of the shunt daily

87. Diet therapy for Rudy, who has acute renal failure, is tow-protein, low potassium and sodium. The nutrition instruction should include:

a. Recommend protein of high biologic value like eggs, poultry and lean meat b. Encourage client to include raw cucumbers, carrot, cabbage, and tomatoes c. Allowing the client cheese, canned foods, and other processed food d. Bananas, cantaloupe, orange and other fresh fruits can be included in the diet

88. Rudy undergoes hemodialysis for the first time and was scared of disequilibrium syndrome. He asked you how this can be prevented. Your response is:

a. maintain a conducive comfortable and cool environment b. maintain fluid and electrolyte balance c. initial hemodialysis shall be done for 30 minutes only so as not to rapidly remove the waste from the blood than from the brain d. maintain aseptic technique throughout the hemodialysis

89. You are assisted by a nursing aide with the care of the client with renal failure. Which delegated function to the aide would you particularly check?

a. Monitoring and recording I and O b. Checking bowel movement c. Obtaining vital signs d. Monitoring diet

90. A renal failure patient was ordered for creatinine clearance. As the nurse you will collect

a. 48 jour urine specimen b. first morning urine c. 24 hour urine specimen d. random urine specimen

Situation 19 - Fe is experiencing left sharp pain and occasional hematuria. She was advised to undergo IVP by her physician.

91. Fe was so anxious about the procedure and particularly expressed her low pain threshold. Nursing health instruction will include:

a. assure the client that the pain is associated with the warm sensation during the administration of the Hypaque by IV b. assure the client that the procedure painless c. assure the client that contrast medium will be given orally d. assure the client that x-ray procedure like IVP is only done by experts

92. What will the nurse monitor and instruct the client and significant others, post IVP?

a. Report signs and symptoms for delayed allergic reactions b. Observe NPO for 6 hours c. Increase fluid intake d. Monitor intake and output

93. Post IVP, Fe should excrete the contrast medium. You instructed the family to include more vegetables in the diet and

a. increase fluid intake b. barium enema c. cleansing enema d. gastric lavage

94. The IVP reveals that Fe has small renal calculus that can be passed out spontaneously. To increase the chance of passing the stones, you instructed her to force fluids and do which of the following?

a. Balanced diet b. Ambulance more c. Strain all urine d. Bed rest

95. The presence of calculi in the urinary tract is called:

a. Colelithiasis b. Nephrolithiasis c. Ureterolithiasis d. Urolithiasis

Situation 20 - At the medical-surgical ward, the nurse must also be concerned about drug interactions.

96. You have a client with TPN. You know that in TPN, like blood transfusion, there should be no drug incorporation. However, the MD's order read; incorporate insulin to present TPN. Will you follow the order?

a. No, because insulin will induce hyperglycemia in patients with TPN b. Yes, because insulin is chemically stable with TPN and can enhance blood glucose level c. No, because insulin is not compatible with TPN d. Yes, because it was ordered by the MD

97. The RN should also know that some drugs have increased absorption when infused in PVC container. How will you administer drugs such as insulin, nitroglycerine hydralazine to promote better therapeutic drug effects?

a. Administer by fast drip b. Inject the drugs as close to the IV injection site c. Incorporate to the IV solution d. Use volumetric chamber

98. One patient has a 'runaway' IV of 50% dextrose. To prevent temporary excess of insulin transient hyperinsulin reaction, what solution should you prepare in anticipation of the doctors order?

a. Any IV solution available to KVO b. Isotonic solution c. Hypertonic solution d. Hypotonic solution

99. How can nurse prevent drug interaction including absorption?

a. Always flush with NSS after IV administration b. Administering drugs with more diluents c. Improving on preparation techniques d. Referring to manufacturer's guidelines

100. In insulin administration, it should be understood that our body normally releases insulin according to our blood glucose level. When is insulin and glucose level highest?

a. After excitement b. After a good night's rest c. After an exercise d. After ingestion of food

CARE OF CLIENTS WITH PHYSIOLOGIC AND PSYCHOSOCIAL ALTERATIONS

Situation 1 - Because of the serious consequences of severe burns management requires a multi disciplinary approach. You have important responsibilities as a nurse.

1. While Sergio was lighting a barbecue grill with a lighter fluid, his shirt burst into flames. The most effective way to extinguish the flames with as little further damage as possible is to:

a. log roll on the grass/ground b. slap the flames with his hands c. remove the burning clothes d. pour cold liquid over the flames

2. Once the flames are extinguished, it is most important to:

a. cover Sergio with a warm blanket b. give him sips of water c. calculate the extent of his burns d. assess the Sergio's breathing

3. Sergio is brought to the Emergency Room after the barbecue grill accident. Based on the assessment of the physician, Sergio sustained superficial partial thickness bums on his trunk, right upper extremities ad right lower extremities. His wife asks what that means. Your most accurate response would be:

a. Structures beneath the skin are damaged b. Dermis is partially damaged c. Epidermis and dermis are both damaged d. Epidermis is damaged

4. During the first 24 hours after thermal injury, you should assess Sergio for

a. hypokalemia and hypernatremia

b. hypokalemia and hyponatremia c. hyperkalemia and hyponatremia d. hyperkalemia and hypernatremia

5. Teddy, who sustained deep partial thickness and full thickness burns of the face, whole anterior chest and both upper extremities two days ago, begins to exhibit extreme restlessness. You recognize that this most likely indicates that Teddy is developing:

a. Cerebral hypoxia b. Hypervolemia c. Metabolic acidosis d. Renal failure .

Situation 2 - You are now working as a staff nurse in a general hospital. You have to be prepared to handle situations with ethico-legal and moral implications.

6. You are on night duty in the surgical ward. One of our patients Martin is prisoner who sustained an abdominal gunshot wound. He is being guarded by policemen from the local police unit. During your rounds you heard a commotion. You saw the policeman trying to hit Martin. You asked why he was trying to hurt Martin. He denied the matter. Which among the following activities will you do first?

a. Write an incident report b. Call security officer and report the incident c. Call your nurse supervisor and report the incident : d. Call the physician on duty

7. You are on morning duty in the medical ward. You have 10 patients assigned to you. During your endorsement rounds, you found out that one of your patients was not in bed. The patient next to him

informed you that he went home without notifying the nurses. Which among the following will you do first?

a. Make and incident report b. Call security to report the incident c. Wait for 2 hours before reporting d. Report the incident to your supervisor

8. You are on duty in the medical ward. You were asked to check the narcotics cabinet. You found out that what is on record does not tally with the drugs used. Which among the following will you do first?

a. Write an incident report and refer the matter to the nursing director b. Keep your findings to yourself c. Report the matter to your supervisor d. Find out from the endorsement any patient who might have been given narcotics

9. You are on duty in the medical ward. The mother of your patient who is also a nurse came running to the nurse station and informed you that Fiolo went into cardiopulmonary arrest. Which among the following will you do first?

a. Start basic life support measures b. Call for the Code c. Bring the crush cart to the room d. Go to see Fiolo and assess for airway patency and breathing problems

10. You are admitting Jorge to the ward and you found out that he is positive for HIV. Which among the following will you do first?

a. Take note of it and plan to endorse this to next shift b. Keep this matter to your self c. Write an incident report d. Report the matter to your head nurse

Situation 3 - Colorectal cancer can affect old and younger people. Surgical procedures and other modes of treatment are done to ensure quality of life. You are assigned in the Cancer institute to care of patients with this type of cancer.

11. Larry, 55 years old, who is suspected of having colorectal cancer, is admitted to the CI. After taking the history and vital signs the physician does which test as a screening test for colorectal cancer.

a. Barium enema b. Carcinoembryonig antigen c. Annual digital rectal examination d. Proctosigmoidoscopy

12. To confirm his impression of colorectal cancer, Larry will require which diagnostic study?

a. carcinoembryonic antigen b. proctosigmoidbscopy c. stool hematologic test d. abdominal computed tomography (CT) test

13. The following are risk factors for colorectal cancer, EXCEPT:

a. inflammatory bowels b. high fat, high fiver diet c. smoking d. genetic factors-familial adenomatous polyposis

14. Symptoms associated with cancer of the colon include:

a. constipation, ascites and mucus in the stool b. diarrhea, heartburn and eructation c. blood in the stools, anemia, and pencil-shaped, stools d. anorexia, hematemesis, and increased peristalsis

15. Several days prior to bowel surgery, Larry may be given sulfasuxidine and neomycin primarily to:

a. promote rest of the bowel by minimizing peristalsis b. reduce the bacterial content of the colon c. empty the bowel of solid waste d. soften the stool by retaining water in the colon

Situation 4 - ENTEROSTOMAL THERAPY is now considered especially in nursing. You are participating in the OSTOMY CARE CLASS.

16. 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 3rd postoperative day

c. The abdominal incision is close and contamination is no longer a danger d. The stool starts to become formed, around the 7th postoperative day

17. When preparing to teach Fermin how to irrigate his 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

18. When observing a rectum demonstration of 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. Hands the irrigating bag on the bathroom door doth hook during fluid insertion c. Discontinues the insertion of fluid after only 500 ml of fluid had been insertion d. Clamps off the flow of fluid when feeling uncomfortable

19. 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 notice 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 irrigation."

20. You would know after teaching. Fermin that dietary instruction for him is effective when he states, "It is important that I eat:

a. Soft foods that are easily digested and absorbed by my large intestine." b. Bland food so that my intestines do not become irritate." c. Food low in fiber so that there is less stool." d. Everything that I ate before the operation, while avoiding foods that cause gas."

Situation 5 - Ensuring safety is one of your most important responsibilities. You will need to provide instructions and information to your clients to prevent complications.

21. Randy has chest tubes attached to a pleural drainage system. When caring for him you should:

a. empty the drainage system at the end of the shift b. clamp the chest tube when auctioning c. palpate the surrounding areas for crepitus d. change the dressing daily using aseptic techniques

22. Fanny came in from PACU after pelvic surgery. As Fanny's nurse you know that the sign that would be indicative of a developing thrombophlebitis would be:

a. a tender, painful area on the leg b. a pitting edema of the ankle c. a reddened area at the ankle d. pruritus on the calf and ankle

23. To prevent recurrent attacks on Terry who has acute glumerulonephritis, you should instruct her to:

a. seek early treatment for respiratory infections b. take showers instead of tub bath c. continue to take the same restrictions on fluid intake d. avoid situations that involve physical activity

24. Herbert has a laryngectomy and he is now for discharge. Re verbalized his concern regarding his laryngectomy tube being dislodged. What should you teach him first?

a. Recognize that prompt closure of the tracheal opening may occur b. Keep calm because there is no immediate emergency c. Reinsert another tubing immediately d. Notify the physician at once

25. When caring for Larry after an exploratory chest surgery and pneumonectomy, your priority would be to maintain:

a. supplementary oxygen b. ventilation exchange c. chest tube drainage d. blood replacement

Situation 6 - Infection can cause debilitating consequences when host resistance is compromised and virulence of microorganisms and environmental factors are favorable. Infection control is one important responsibility of the nurse to ensure quality of care.

26. Honrad, who has been complaining of anorexia and feeling tired, develops jaundice. After a workup he is diagnosed of having Hepatitis A. His wife asks you about gamma globulin for herself and her household help. Your most appropriate response would be:

a. "Don't worry your husband's type of hepatitis is no longer communicable" b. "Gamma globulin provides passive immunity for Hepatitis B" c. "You should contact your physician immediately about getting gamma globulin." d. "A vaccine has been developed for this type of hepatitis"

27. Voltaire develops a nosocomial respiratory tract infection. He asks you what that means.

a. "You acquired the infection after you have been admitted to the hospital." b. "This is a highly contagious infection requiring complete isolation." c. "The infection you had prior to hospitalization flared up." d. "As a result of medical treatment, you have acquired a secondary infection.''

28. As a nurse you know that one of the complications that you have to watch out for when caring for Omar who is receiving total parenteral nutrition is:

a. stomatitis b. hepatitis c. dysrhythmia d. infection

29. A solution used to treat Pseudomonas would infection is:

a. Dakin's solution

b. Half-strength hydrogen peroxide b. Acetic acid d. Betadine

30. Which of the following is most reliable in diagnosing a wound infection?

a. Culture and sensitivity b. Purulent drainage from a wound c. WBC count of 20,000/pL d. Gram stain testing

Situation 7 - As a nurse you need to anticipate the occurrence of complications of stroke so that life threatening situations can be prevented.

31. Wendy is admitted to the hospital with signs and symptoms of stroke. Her Glasgow Coma Scale is 6 on admission. A central venous catheter was inserted and an I.V. infusion was started. As a nurse assigned to Wendy what will he your priority goal?

a. Prevent skin breakdown b. Preserve muscle function c. Promote urinary elimination d. Maintain a patent airway

32. Knowing that for a comatose patient hearing is the best last sense to be lost, as Judy's nurse, what should you do?

a. Tell her family that probably she can't hear them

b. Talk loudly so that Wendy can hear you c. Tell her family who are in the room not to talk d. Speak softly then hold her hands gently

33. Which among the following interventions should you consider as the highest priority when caring for June who has hemiparersis secondary to stroke?

a. Place June on an upright lateral position b. Perform range of motion exercises c. Apply antiembolic stocking d. Use hand rolls or pillows for support

34. Ivy, age 40, was admitted to the hospital with a severe headache, stiff neck and photophobia. She was diagnosed with a subarachnoid hemorrhage secondary to ruptured aneurysm. While waiting for surgery, you can provide a therapeutic by doing which of the following?

a. honoring her request for a television b. placing her bed near the window c. dimming the light in her room d. allowing the family unrestricted visiting privileges

35. When performing a neurological assessment on Walter, you find that his pupils are fixed and dilated. This indicated that he:

a. probably has meningitis b. is going to be blind because of trauma c. is permanently paralyzed

d. has received a significant brain injury

Situation 8 - With the improvement in life expectancies and the emphasis in the quality of life it is important to provide quality care to our older patients. There are frequently encountered situations and issues relevant to the older, patients.

36. Hypoxia may occur in the older patients because of which of the following physiologic changer associated with aging.

a Ineffective airway clearance b. Decreased alveolar surface area c. Decreased anterior-posterior chest diameter d. Hyperventilation

37. The older patient is at higher risk for in inconvenience because of:

a. dilated urethra b. increased glomerular filtration rate c. diuretic use d. decreased bladder capacity

38. 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

39. 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

40. The most dependable sign of infection in the older patient is:

a. change in mental status pain b. fever c. pain d. decreased breath sound with crackles

Situation 9 - A "disaster" is a large-scale emergencyeven a small emergency left unmanaged may turn into a disaster. Disaster preparedness is crucial and is everybody's business. There are agencies that are in charge of ensuring prompt response. Comprehensive Emergency Management (CEM) is an integrated approach to the management of emergency program and activities for all four emergency phases (mitigation, preparedness, response, and recovery), for all type of emergencies and disasters (natural, man-made, and attack) and for all levels of government and the private sector.

41. Which of the four phases of emergency management is defined as "sustained action that reduces or eliminates long-term risk to people and properly from natural hazards and the effect"?

a. Recovery b. Mitigation c. Response

d. Preparedness

42. You are a community health nurse collaborating with the Red Cross and working with disaster relief following a typhoon which flooded and devastated the whole province. Finding safe housing for survivors, organizing support for the family, organizing counseling debriefing sessions and securing physical care are the services you are involved with. To which type of prevention are these activities included.

a. Tertiary prevention b. Primary prevention c. Aggregate care prevention d. Secondary prevention

43. During the disaster you see a victim with a green tag, you know that the person:

a. has injuries that are significant and require medical care but can wait hours will threat to life or limb b. has injuries that are life threatening but survival is good with minimal intervention c. indicates injuries that are extensive and chances of survival are unlikely even with definitive care d. has injuries that are minor and treatment can be delayed from hours to days

44. The term given to a category of triage that refers to life threatening or potentially life threatening injury or illness requiring immediate treatment:

a. Immediate b. Emergent c. Non-acute d. Urgent

45. Which of the following terms refer to a process by which the individual receives education about recognition of stress reactions and management strategies for handling stress which may be instituted after a disaster?

a. Critical incident stress management b. Follow-up c. Defriefing d. Defusion

Situation 10 - As a member of the health and nursing team you have a crucial role to play in ensuring that all the members participate actively is the various tasks agreed upon,

46. While eating his meal, Matthew accidentally dislodges his IV line and bleeds. Blood oozes on the surface of the over-bed table. It is most appropriate that you instruct the housekeeper to clean the table with:

a. Acetone b. Alcohol c. Ammonia d. Bleach

47. You are a member of the infection control team, of the hospital. Based on a feedback during the meeting of the committee there is an increased incidence of pseudomonas infection in the Burn Unit (3 out of 10 patients had positive blood and wound culture). What is your priority activity?

a. Establish policies for surveillance and monitoring b. Do data gathering about the possible sources of infection (observation, chart review, interview)

c. Assign point persons who can implement policies d. Meet with the nursing group working in the burn unit and discuss problem with them feel

48. Part of your responsibility as a member of the diabetes core group is to get referrals from the various wards regarding diabetic patients needing diabetes education. Prior to discharge today 4 patients are referred to you. How would you start prioritizing your activities?

a. Bring your diabetes teaching kit and start your session taking into consideration their distance from your office b. Contact the nurse-in-charge and find out from her the reason for the referral c. Determine their learning needs then prioritize d. involve the whole family in the teaching class

49. You have been designated as a member of the task force to plan activities for the Cancer Consciousness Week. Your committee has 4 months to plan and implement the plan. You are assigned to contact the various cancer support groups in your hospital. What will be your priority activity?

a. Find out if there is a budget for this activity b. Clarify objectives of the activity with the task force before contacting the support groups c. Determine the VIPs and Celebrities who will be invited d. Find out how many support groups there are in the hospital and get the contact number of their president

50. You are invited to participate in the medical mission activity of your alumni association. In the planning stage everybody is expected to identify what they can do during the medical mission and what resources are needed. You though it is also your chance to share what you can do for others. What will be your most important role where you can demonstrate the impact of nursing health?

a. Conduct health education on healthy lifestyle

b. Be a triage nurse c. Take the initial history and document findings d. Act as a coordinator

Situation 11 - One of the realities that we are confronted with is'6w mortality. It is important for us nurses to be aware of how we view suffering, pain, illness, and even our death as well as its meaning. That way we can help our patients cope with death and dying.

51. Irma is terminally ill she speaks to you in confidence. You now feel that Irma's family could be helpful if they knew what Irma has told you. What should you do first?

a. Tell the physician who in turn could tell the family b. Obtain Irma's permission to share the information with the family c. Tell Irma that she has to tell her family what she told you d. Make an appointment to discuss the situation with the family

52. Ruby who has been told she has terminal cancer turns away aha refuses to respond to you. You can best help her by:

a. Coming back periodically and indicating your availability if she would like you to sit with her b. Insisting that Ruby should talk with you because it is not good to Keep everything inside c. Leaving her atone because she is uncooperative and unpleasant to be with d. Encouraging her to be physically active as possible

53. Leo who is terminally ill and recognizes that he is in the process of losing, everything and everybody he loves, is depressed. Which of the following would best help him during depression?

a. Arrange for visitors who might cheer him b. Sit down and talk with him for a while c. Encourage him to look at the brighter side of things d. Sit silently with him

54. Which of the following statements would best indicate that Ruffy; who is dying has accepted this impending death?

a. "I'm ready to do." b. "I have resigned myself to dying" c. "What's the use"? d: "I'm giving up"

55. Maria, 90 years old has planned ahead for her-death-philosophically, socially, financially and emotionally. This is recognized as:

a. Acceptance that death is inevitable b Avoidance of the true sedation c. Denial with planning for continued life d. Awareness that death will soon occur

Situation 12 - Brain tumor, whether malignant or benign, has serious management implications nurse, you should be able to understand the consequences of the disease and the treatment.

56. You are caring for Conrad who has a brain tumor and increased intracranial Pressure (ICP). Which intervention should you include in your plan to reduce ICP?

a. Administer bowel! Softener b. Position Conrad with his head turned toward the side of the tumor c. Provide sensory stimulation d. Encourage coughing and deep breathing

57. Keeping Conrad's head and neck in alignment results in:

a. increased intrathoracic pressure b. increased venous outflow c. decreased venous outflow d. increased intra abdominal pressure

58. Which of the following activities may increase intracranial pressure (ICP)?

a. Raising the head of the bed b. Manual hyperventilation c. Use of osmotic Diuretics d. Valsava's maneuver

59. After you assessed Conrad, you suspected increased ICP! Your most appropriate respiratory goal is to:

a. maintain partial pressure of arterial 02 (PaO2) above 80 mmHg b. lower arterial pH c. prevent respiratory alkalosis d. promote CO2 elimination

60. Conrad underwent craniotomy. As his nurse; you know that drainage on a craniotomy dressing must be measured and marked. Which findings should you report immediately to the surgeon?

a. Foul-smelling drainage b. yellowish drainage c. Greenish drainage d. Bloody drainage

Situation 13 -As a Nurse, you have specific responsibilities as professional. You have to demonstrate specific competencies.

61. The essential components of professional nursing practice are all the following EXCEPT:

a. Culture b. Care c. Cure d. Coordination

62. You are assigned to care for four (4) patients. Which of the following patients should you give first priority?

a. Grace, who is terminally ill with breast cancer b. Emy, who was previously lucid but is now unarousable c. Aris, who is newly admitted and is scheduled for an executive check-up d. Claire, who has cholelithiasis and is for operation on call

63. Brenda, the Nursing Supervisor of the intensive care unit (ICU) is not on duty when a staff nurse committed a serious medication error. Which statement accurately reflects the accountability of the nursing supervisor?

a. Brenda should be informed when she goes back on duty b. Although Brenda is not on duty, the nursing supervisor on duty decides to call her if time permits c. The nursing supervisor on duty will notify Brenda at home d. Brenda is not duty therefore it is not necessary to inform her

64. Which barrier should you avoid, to manage your time wisely?

a. Practical planning b. Procrastination c. Setting limits d. Realistic personal expectation

65. You are caring for Vincent who has just been transferred to the private room. He is anxious because he fears he won't be monitored as closely as he was in the Coronary Care Unit. How can you allay his fear?

a. Move his bed to a room far from nurse's station to reduce b. Assign the same nurse to him when possible c. Allow Vincent uninterrupted period of time d. Limit Vincent's visitors to coincide with CCU policies

Situation 14 - As a nurse in the Oncology Unit, you have to be prepared to provide efficient and effective care to your patients.

66. Which one of the following nursing interventions would be most helpful in preparing the patient for radiation therapy?

a. Offer tranquilizers and antiemetics b. Instruct the patient of the possibility of radiation burn c. Emphasis on the therapeutic value of the treatment d. Map out the precise course of treatment

67. What side effects are most apt to occur to patient during radiation therapy to the pelvis?

a. Urinary retention b. Abnormal vaginal or perineal discharge c. Paresthesia of the lower extremities d. Nausea and vomiting and diarrhea

68. Which of the following can be used on the irradiated skin during a course of radiation therapy?

a. Adhesive tape b. Mineral oil c. Talcum powder d. Zinc oxide ointment

69. Earliest sign of skin reaction to radiation therapy is:

a. desquamation

b. erythema c. atrophy d. pigmentation

70. What is the purpose of wearing a film badge while caring for the patient who is radioactive?

a. Identify the nurse who is assigned to care for such a patient b. Prevent radiation-induced sterility c. Protect the nurse from radiation effects d. Measure the amount of exposure to radiation

Situation 15 - In a disaster there must be a chain of command in place that defines the roles of each member of the response team. Within the health care group there are pre-assigned roles based on education, experience and training on disaster.

71. As a nurse to which of the following groups are you best prepared to join?

a. Treatment group b. Triage group c. Morgue management d. Transport group

72. There are important principles that should guide the triage team in disaster management that you have to know if you were to volunteer as part of the triage team. The following principles should be observed in disaster triage, EXCEPT:

a. any disaster plan should have resource available to triage at each facility and at the disaster site if possible b. make the most efficient use of available resources c. training on disaster is not important to the response in the event of a real disaster because each disaster is unique in itself d. do the greatest good for the greatest number of casualties

73. Which of the following categories of conditions should be considered first priority in a disaster?

a. Intracranial pressure and mental status b. Lower gastrointestinal problems c. Respiratory infection d. Trauma

74. A guideline that is utilized in determining priorities is to assess the status of the following, EXCEPT?

a. perfusion b. locomotion c. respiration d. mentation

75. The most important component of neurologic assessment is:

a. pupil reactivity b. vital sign assessment c. cranial nerve assessment

d. level of consciousness/responsiveness

Situation 16 - You are going to participate in a Cancer Consciousness Week. You are assigned to take charge of the women to make them aware of cervical cancer. You reviewed its manifestations and management.

76. The following are risk factors for cervical Cancer EXCEPT:

a. immunisuppressive therapy b. sex at an early age, multiple partners, exposure to socially transmitted diseases, male partner's sexual habits c. viral agents like the Human Papilloma Virus d. smoking

77. Late signs and symptoms of cervical cancer include the following EXCEPT:

a. urinary/bowel changes b. pain in pelvis, leg of flank c. uterine bleeding d. lymph edema of lower extremities

78. When a panhysterectomy is performed due to cancer of the cervix, which of the following organs are moved?

a. the uterus, cervix, and one ovary b. the uterus, cervix, and two-thirds of the vagina c. the uterus, cervix, tubes and ovaries

d. the uterus and cervix

79. The primary modalities of treatment for Stage 1 and IIA cervical cancer include the following:

a. surgery, radiation therapy and hormone therapy b. surgery c. radiation therapy d. surgery and radiation therapy

80. A common complication of hysterectomy is:

a. thrombophlebitis of the pelvic and thigh vessels b. diarrhea due to over stimulating c. atelectasis d. wound dehiscence

Situation 17 - The body has regulatory mechanism to maintain the needed electrolytes. However there are conditions/surgical interventions that could compromise life. You have to understand how management of these conditions are done.

81. You are caring for Leda who is scheduled to undergo total thyroidectomy because of a diagnosis of thyroid cancer. Prior to total thyroidectomy, you should instruct Leda to:

a. Perform range and motion exercises 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

82. As Leda's nurse, you plan to set up an emergency equipment at her beside 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

83. Which of the following nursing interventions is appropriate after a total thyroidectomy?

a. Place pillows under your patient's shoulders b. Raise the knee-gatch to 30 degrees c. Keep your patient in a high-fowler's position d. Support the patient's head and neck with pillows and sandbags

84. If there is an accidental injury to the parathyroid gland during a thyroidectomy which of the following might Leda develops postoperative?

a. Cardiac arrest b. Dyspnea c. Respiratory failure d. Tetany

85. After surgery Leda develops peripheral numbness, tingling and muscle twitching and spasm. What would you anticipate to administer?

a. Magnesium sulfate b. Calcium gluconate c. Potassium iodine d. Potassium chloride

Situation 18 - NURSES are involved in maintaining a safe and health environment. This is part of quality care management.

86. The first step in decontamination is:

a. to immediately apply a chemical decontamination foam to the area of contamination b. a thorough soap and water was and rinse of the patient c. to immediately apply personal protective equipment d. removal of the patients clothing and jewelry and then rinsing the patient with water

87. For a patient experiencing pruritus, you recommend which type of bath:

a. Water b. colloidal (oatmeal) c. saline d. sodium bicarbonate

88. Induction of vomiting is indicated for the accidental poisoning patient who has ingested.

a. rust remover b. gasoline

c. toilet bowl cleaner d. aspirin

89. Which of the following term most precisely refer to an infection acquired in the hospital that was not present or incubating at the time of hospital admission?

a. Secondary bloodstream infection b. Nosocomial infection c. Emerging infectious disease d. Primary bloodstream infection

90. Which of the following guidelines is not appropriate to helping family members cope with sudden death?

a. Obtain orders for sedation of family members b. Provide details of the factors attendant to the sudden death c. Show acceptance of the body by touching it and giving the family permission to touch d. Inform the family that the patient has passed on

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 have to be updated on the latest trends and issues affecting profession and the best practices arrived at by the profession

91. You are interested to study the effects of meditation and relaxation on the pain experienced by cancer patients. What type of variable is pain?

a. Dependant

b. Correlational c. Independent d. Demographic

92. You would like to compare the support system of patients 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 interventions b. The effect of the Type 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

93. You would like to compare the support, system of patients with chronic illness to those with acute illness. What type of research it this?

a. Correlational b. Descriptive c. Experimental d. Quasi-experimental

94. You are shown a Likert Scale that will be used in evaluating your performance in the clinical area. Which of the following questions will you not use in critiquing the Likert Scale?

a. Are the techniques to complete and score the scale provided? b. Are the reliability and validity information on the scale described?

c. If the Likert Scale is to be used for a study, was the development process described? d. Is the instrument clearly described?

95. In any research study where individual persons are involves, it is important that an informed consent for 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,

Situation 20 - Because severe burn can affect the person's totality it is important that you apply interventions focusing on the various dimensions of man. You also have to understand the rationale of the treatment.

96. What type of debribement involves proteolytic enzymes?

a. Interventional b. Mechanical c. Surgical d Chemical

97. Which topical antimicrobial is most frequently used in burn wound care?

a. Neosporin b. Silver nitrate

c. Silver sulfadiazine d. Sulfamylon

98. Hypertrophic burns scars are caused by:

a. exaggerated contraction b. random layering of collagen c. wound ischemia d. delayed epithelialization

99. The major disadvantage of whirlpool cleansing of burn wounds is:

a. patient hypothermia b. cross contamination of wound c. patient discomfort d. excessive manpower requirement

100. Oral analgecis are most frequently used to control burn injury pain:

a. upon patient request b. during the emergent phase c. after hospital discharge d. during the cute phase

ANSWER KEY:

1. A 2. D 3. D 4. B 5. D 6. A 7. B 8. A 9. D 10. A 11. B 12. B 13. B 14. C 15. B 16. C 17. C 18. C 19. A 20. C 21. C 22. A 23. A

24. D 25. A 26. D 27. A 28 D 29. C 30. D 31. D 32. D 33. B 34. C 35. D 36. B 37. D 38. B 39. C 40. C 41. B 42. C 43. D 44. D 45. A 46. D 47. A 48. C

49. B 50. A 51. C 52. A 53. D 54. A 55. D 56. A 57. B 58. B 59. D 60. A 61. A 62. B 63. A 64. B 65. B 66. C 67. A 68. D 69. B 70. C 71. B 72. C 73. D

74. B 75. D 76. A 77. B 78. C 79. D 80. A 81. C 82. B 83. C 84. D 85. B 86. C 87. B 88. D 89. B 90. A 91. A 92. C 93. A 94. A 95. A 96. D 97. B 98. A

99. A 100. C