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Nursing Practice III

Nursing Practice III

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Published by: stuffednurse on Nov 18, 2008
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NURSING PRACTICE III – Care of Clients with Physiologic and Psychosocial Alterations(Part A)SITUATIONALSituation 1 – Concerted work efforts among members of the surgical team is essentialto 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 outthese items by opening its outer cover?A.Circulating NurseB.AnaesthesiologistC.SurgeonD.Nursing Aide2. The OR team performs distinct roles for one surgical procedure to be accomplishedwithin a prescribed time frame and deliver a standard patient outcome. While thesurgeon performs the surgical procedure, who monitors the status of the client likeurine output, blood loss?A.Scrub NurseB.SurgeonC.AnaesthesiologistD.Circulating Nurse3. Surgery schedules are communicated to the OR usually a day prior to theprocedure by the nurse of the floor or ward where the patient is confined. Fororthopedic cases, what department is usually informed to be present in the OR?A.Rehabilitation departmentB.Laboratory departmentC.Maintenance departmentD.Radiology department4. Minimally invasive surgery is very much into technology. Aside from the usualsurgical team, who else has to be present when a client undergoes laparoscopicsurgery?A.Information technicianB.Biomedical technicianC.ElectricianD.Laboratory technician5. In massive blood loss, prompt replacement of compatible blood is crucial. Whatdepartment needs to be alerted to coordinate closely with the patient’s family forimmediate blood component therapy?A.Security DivisionB.ChaiplaincyC.Social Service SectionD. Pathology department
Situation 2 – You are assigned in the Orthopedic Ward where clients are complainingof 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 andis in pain. Which of the following observation would prompt you to call the doctor?A.Dressing is intact but partially soiledB.Left foot is cold to touch and pedal pulse is absentC.Left leg in limited functional anatomic positionD.BP 114/78, pulse of 82 beats/minute7. There is an order of Demerol 50 mg I.M. now and every 6 hours p r n. You injectedDemerol at 5 pm. The next dose of Demerol 50 mg I.M. is given:A.When the client asks for the next doseB.When the patient is in severe painC.At 11 pmD.At 12 pm8. You continuously evaluate the client’s adaptation to pain. Which of the followingbehaviors indicate appropriate adaptation?A.The client reports pain reduction and decreased activityB.The client denies existence of painC.The client can distract himself during pain episodesD.The client reports independence from watchers9. Pain in ortho cases may not be mainly due to the surgery. There might be otherfactors such as cultural or psychological that influence pain. How can you alter thesefactors as the nurse?A.Explain all the possible interventions that may cause the client to worryB.Establish trusting relationship by giving his medication on timeC.Stay with the client during pain episodesD.Promote client’s sense of control and participation in control by listening tohis concerns10. In some hip surgeries, an epidural catheter for Fentanyl epidural analgesia isgiven. What is your nursing priority care in such a case?A.Instruct client to observe strict bed restB.Check for epidural catheter drainageC.Administer analgesia through epidural catheter as prescribedD.Assess respiratory rate carefullySituation 3 – Records are vital tools in any institution and should be properlymaintained for specific use and time.11. The patient’s medical record can work as a double edged sword. When can themedical record become the doctor’s/nurse’s worst enemy?A.When the record is voluminousB.When a medical record is subpoenaed in courtC.When it is missingD.When the medical record is inaccurate, incomplete, and inadequate
12. Disposal of medical records in government hospitals/institutions must be done inclose 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.Department of Health (DOH)13. In the hospital, when you need the medical record of a discharged patient forresearch you will request permission through:A.Doctor in chargeB.The hospital directorC.The nursing serviceD.Medical records section14. You readmitted a client who was in another department a month ago. Since youwill need the previous chart, from whom do you request the old chart?A.Central supply sectionB.Previous doctor’s clinicC.Department where the patient was previously admittedD.Medical records section15. Records Management and Archives Office of the DOH is responsible forimplementing its policies on record disposal. You know that your institution is coveredby this policy if:A.Your hospital is considered tertiaryB.Your hospital is in Metro ManilaC.It obtained permit to operate from DOHD.Your hospital is PhilHealth accreditedSituation 4 – In the OR, there are safety protocols that should be followed. The ORnurse should be well versed with all these to safeguard the safety and quality of patient delivery outcome.16. Which of the following should be given highest priority when receiving patient inthe OR?A.Assess level of consciousnessB.Verify patient identification and informed consentC.Assess vital signsD.Check for jewelry, gown, manicure, and dentures17. Surgeries like I and D (incision and drainage) and debridement are relatively shortprocedures but considered ‘dirty cases’. When are these procedures best scheduled?A.Last caseB.In between casesC.According to availability of anaesthesiologistD.According to the surgeon’s preference

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