Professional Documents
Culture Documents
June NP1
June NP1
SITUATIONAL
Situation 1 – Mr. Ibarra is assigned to the triage area and while on duty, he assesses
the condition of Mrs. Simon who came in with asthma. She has difficulty breathing
and her respiratory rate is 40 per minute. Mr. Ibarra is asked to inject the client
epinephrine 0.3 mg subcutaneously.
A. Reduce anaphylaxis
B. Relieve hypersensitivity to allergen
C. Relieve respiratory distress due to bronchial spasm
D. Restore client’s cardiac rhythm
2. When preparing the epinephrine injection from an ampule, the nurse initially:
A. Taps the ampule at the top to allow fluid to flow to the base of the ampule
B. Checks expiration date of the medication ampule
C. Removes needle cap of syringe and pulls plunger to expel air
D. Breaks the neck of the ampule with a gauze wrapped around it
A. Inject needle at a 15 degree angle over the stretched skin of the client
B. Pinch skin at the injection site and use airlock technique
C. Pull skin of patient down to administer the drug in a Z track
D. Spread skin or pinch at the injection site and inject needle at a 45-90
degree angle
4. When preparing for a subcutaneous injection, the proper size of syringe and
needle would be:
5. The rationale for giving medications through the subcutaneous route is:
Situation 2 – The use of massage and meditation to help decrease stress and pain
have been strongly recommended based on documented testimonials.
A. Applied research
B. Qualitative research
C. Basic research
D. Quantitative research
7. The type of research design that does not manipulate independent variable is:
A. Experimental design
B. Quasi-experimental design
C. Non-experimental design
D. Quantitative design
8. This research topic has the potential to contribute to nursing because it seeks to
10. Client’s rights should be protected when doing research using human subjects.
Martha identifies these rights as follows EXCEPT:
A. right of self-determination
B. right to compensation
C. right of privacy
D. right not to be harmed
11. Mario listens to Richard’s bilateral sounds and finds that congestion is in the
upper lobes of the lungs. The appropriate position to drain the anterior and posterior
apical segments of the lungs when Mario does percussion would be:
12. When documenting outcome of Richard’s treatment Mario should include the
following in his recording EXCEPT:
13. When assessing Richard for chest percussion or chest vibration and postural
drainage, Mario would focus on the following EXCEPT:
A. Amount of food and fluid taken during the last meal before treatment
B. Respiratory rate, breath sounds and location of congestion
C. Teaching the client’s relatives to perform the procedure
D. Doctor’s order regarding position restrictions and client’s tolerance for
lying flat
14. Mario prepares Richard for postural drainage and percussion. Which of the
following is a special consideration when doing the procedure?
15. The purpose of chest percussion and vibration is to loosen secretions in the lungs.
The difference between the procedures is:
A. Percussion uses only one hand while vibration uses both hands
B. Percussion delivers cushioned blows to the chest with cupped palms while
vibration gently shakes secretion loose on the exhalation cycle
C. In both percussion and vibration the hands are on top of each other and
hand action is in tune with client’s breath rhythm
D. Percussion slaps the chest to loosen secretions while vibration shakes the
secretions along with the inhalation of air
Situation 4 – A 61 year old man, Mr. Regalado, is admitted to the private ward for
observation after complaints of severe chest pain. You are assigned to take care of
the client.
16. When doing an initial assessment, the best way for you to identify the client’s
priority problem is to:
17. Upon establishing Mr. Regalado’s nursing needs, the next nursing approach
would be to:
A. Introduce the client to the ward staff to put the client and family at ease
B. Give client and relatives a brief tour of the physical set up the unit
C. Take his vital signs for a baseline assessment
D. Establish priority needs and implement appropriate interventions
18. Mr. Regalado says he has “trouble going to sleep”. In order to plan your nursing
intervention you will:
19. Mr. Regalado’s lower extremities are swollen and shiny. He has pitting pedal
edema. When taking care of Mr. Regalado, which of the following interventions would
be the most appropriate immediate nursing approach?
20. Mr. Regalado will be discharged from your unit within the hour. Nursing actions
when preparing a client for discharge include all EXCEPT:
Situation 5 – Nancy, mother of 2 young kids, 36 years old, had a mammogram and
was told that she has breast cysts and that she may need surgery. This causes her
anxiety as shown by increase in her pulse and respiratory rate, sweating and feelings
of tension.
21. Considering her level of anxiety, the nurse can best assist Nancy by:
22. Nancy blames God for her situation. She is easily provoked to tears and wants to
be left alone, refusing to eat or talk to her family. A religious person before, she now
refuses to pray or go to church stating that God has abandoned her. The nurse
understands that Nancy is grieving for her self and is in the stage of:
A. bargaining
B. denial
C. anger
D. acceptance
23. The nurse visits Nancy and prods her to eat her food. Nancy replies “what’s the
use? My time is running out.” The nurse’s best response would be:
A. “The doctor ordered full diet for you so that you will be strong for surgery”
B. “I understand how you feel but you have to try for your children’s sake”
C. “Have you told your doctor how you feel? Are you changing your mind
about your surgery?”
D. “You sound like you are giving up.”
24. The nurse feels sad about Nancy’s illness and tells her head nurse during the end
of shift endorsement that “it’s unfair for Nancy to have cancer when she is still so
young and with two kids”. The best response of the head nurse would be:
A. Advise the nurse to “be strong and learn to control her feelings”
B. Assign the nurse to another client to avoid sympathy for the client
C. Reassure the nurse that the client has hope if she goes through all
treatments prescribed for her
D. Ask the other nurses what they feel about the patient to find out if they
share the same feelings
25. Realizing that she feels angry about Nancy’s condition, the nurse learns that
being self-aware is a conscious process that she should do in any situation like this
because:
Situation 6 – Mrs. Seva, 52 years old, asks you about possible problems regarding her
elimination now that she is in the menopausal stage.
A. Hold urine as long as she can before emptying the bladder to strengthen
her sphincter muscles
B. If burning sensation is experienced while voiding, drink pineapple juice
C. After urination, wipe from anal area up towards the pubis
D. Tell client to empty the bladder at each voiding
27. Mrs. Seva also tells the nurse that she is often constipated. Because she is aging,
what physical changes predispose her to constipation?
28. The nurse understands that one of these factors contributes to constipation:
A. excessive exercise
B. high fiber diet
C. no regular time for defecation daily
D. prolonged use of laxatives
29. Mrs. Seva talks about fear of being incontinent due to a prior experience of
dribbling urine when laughing or sneezing and when she has a full bladder. Your most
appropriate instruction would be to:
Situation 7 – Using Maslow’s need theory, Airway, Breathing and Circulation are the
physiological needs vital to life. The nurse’s knowledge and ability to identify and
immediately intervene to meet these needs is important to save lives.
31. Which of these clients has a problem with the transport of oxygen from the lungs
to the tissues:
32. You noted from the lab exams in the chart of M. Santos that he has reduced
oxygen in the blood. This condition is called:
A. Cyanosis
B. Hypoxia
C. Hypoxemia
D. Anemia
33. You will do nasopharyngeal suctioning on Mr. Abad. Your guide for the length of
insertion of the tubing for an adult would be:
34. While doing nasopharyngeal suctioning on Mr. Abad, the nurse can avoid trauma
to the area by:
A. Apply suction for at least 20-30 seconds each time to ensure that all
secretions are removed
B. Using gloves to prevent introduction of pathogens to the respiratory
system
C. Applying no suction while inserting the catheter
D. Rotating catheter as it is inserter with gentle suction
35. Myrna has difficulty breathing when on her back and must sit upright in bed to
breath effectively and comfortably. The nurse documents this condition as:
A. Apnea
B. Orthopnea
C. Dyspnea
D. Tachypnea
Situation 8 – You are assigned to screen for hypertension. Your task is to take blood
pressure readings and you are informed about avoiding the common mistakes in BP
taking that lead to false or inaccurate blood pressure readings.
36. When taking blood pressure reading the cuff should be:
A. deflated fully then immediately start second reading for same client
B. deflated quickly after inflating up to 180 mmHg
C. large enough to wrap around upper arm of the adult client 1 cm above
brachial artery
D. inflated to 30 mmHg above the estimated systolic BP based on palpation
of radial or bronchial artery
37. Chronic Obstructive Pulmonary Disease (COPD) in one of the leading causes of
death world wide and is a preventable disease. The primary cause of COPD is
A. tobacco hack
B. bronchitis
C. asthma
D. cigarette smoking
38. In your health education class for clients with diabetes you teach them the areas
for control of Diabetes which include all EXCEPT
39. You teach your clients the difference between, Type I (IDDM) and Type II (NDDM)
diabetes. Which of the following is true?
A. both types diabetes mellitus clients are all prone to developing ketosis
B. Type II (NIDDM) is more common and is also preventable compared to
Type I (IDDM) diabetes which is genetic in etiology
C. Type I (IIDM) is characterized by fasting hyperglycemia
D. Type II (NIDDM) is characterized by abnormal immune response
40. Lifestyle-related diseases in general share areas common risk factors. These are
the following except:
A. physical activity
B. smoking
C. genetics
D. nutrition
Situation 9 – Nurse Rivera witnesses a vehicular accident near the hospital where she
works. She decides to get involved and help the victims of the accident
44. The nurse applies dressing on the bleeding site. This intervention is done to:
45. After the treatment, the client is sent home and asked to come back for follow-up
care. Your responsibilities when the client is to be discharged include the following
EXCEPT:
Situation 10 – While working in the clinic, a new client, Geline, 35 years old, arrives
for her doctor’s appointment. As the clinic nurse, you are to assist the client fill up
forms, gather data and make an assessment.
A. Record pertinent information in the client’s chart for health team to read
B. Assist the client find solutions to he her health concerns
C. Understand her lifestyle, health needs and possible problems to develop a
plan of care
D. Make nursing diagnoses for identified health prob;ems
47. While interviewing Geline, she starts to moan and doubles up in pain. She tells
you that this pain occurs about an hour after taking black coffee without breakfast for
a few weeks now. You will record this as follows:
48. Geline tells you that she drinks black coffee frequently within the day to “have
energy and be wide awake” and she eats nothing for breakfast and eats strictly
vegetable salads for lunch and dinner to lose weight. She has lost weight during the
past two weeks. In planning a healthy balanced diet with Geline, you will:
A. Start her off with a cleansing diet to free her body of toxins then change to
a vegetarian diet and drink plenty of fluids
B. Plan a high protein diet, low carbohydrate diet for her considering her
favorite food.
C. Instruct her to attend classes in nutrition to find food rich in complex
carbohydrates to maintain daily high energy level.
D. Discuss with her the importance of eating a variety of food from major
food groups with plenty of fluids.
49. Geline tells you that she drinks 4-5 cups of black coffee and diet cola drinks. She
also smokes up to a pack of cigarettes daily. She confesses that she is in her 2nd
month of pregnancy but does not want to become fat that is why she limits her food
intake. You warn or caution her about which of the following?
A. Caffeine products affect the central nervous system and may cause the
mother to have a “nervous breakdown”
B. Malnutrition and its possible effects on growth and development problems
in the unborn fetus
C. Caffeine causes a stimulant effect on both mother and the baby
D. Studies show conclusively that caffeine causes mental retardation
50. Your health education plan for Geline stresses proper diet for a pregnant woman
and the prevention of non-communicable diseases that are influenced by her
lifestyle. These include the following EXCEPT:
A. Cardiovascular diseases
B. Cancer
C. Diabetes Mellitus
D. Osteoporosis
52. Your head nurse in the unit believes that the staff nurses are not capable of
decision making so she makes the decisions for everyone without consulting
anybody. This type of leadership is:
53. When the head nurse in your ward plots and approves your work schedules and
directs your work, she is demonstrating:
A. Responsibility
B. Delegation
C. Accountability
D. Authority
54. The following tasks can be safely delegated by a nurse to a non-nurse health
worker EXCEPT:
55. You made a mistake in giving the medicine to the wrong client. You notify the
client’s doctor and write an incident report. You are demonstrating:
A. Responsibility
B. Accountability
C. Authority
D. Autocracy
Situation 12 – Mr. Dizon, 84 years old, brought to the Emergency Room for complaint
of hypertension, flushed face, severe headache, and nausea. You are doing the initial
assessment of vital signs.
56. You are to measure the client’s initial blood pressure reading by doing all of the
following EXCEPT:
58. After a few hours in the Emergency Room, Mr. Dizon is admitted to the ward with
an order of hourly monitoring of blood pressure. The nurse finds that the cuff is too
narrow and this will cause the blood pressure reading to be:
A. inconsistent
B. low systolic and high diastolic
C. higher than what the reading should be
D. lower than what the reading should be
59. Through the client’s health history, you gather that Mr. Dizon smokes and drinks
coffee. When taking the blood pressure of a client who recently smoked or drank
coffee, how long should the nurse wait before taking the client’s blood pressure for
accurate reading?
A. 15 minutes
B. 30 minutes
C. 1 hour
D. 5 minutes
60. While the client has pulse oximeter on his fingertip, you notice that the sunlight is
shining on the area where the oximeter is. Your action will be to:
61. The principles that govern right and proper conduct of a person regarding life,
biology and the health professionals is referred to as:
A. Morality
B. Religion
C. Values
D. Bioethics
63. The most important nursing responsibility where ethical situations emerge in
patient care is to:
64. You inform the patient about his rights which include the following EXCEPT:
65. This principle states that a person has unconditional worth and has the capacity
to determine his own destiny:
A. Bioethics
B. Justice
C. Fidelity
D. Autonomy
Situation 14 – Your director of nursing wants to improve the quality of health care
offered in the hospital. As a staff nurse in that hospital you know that this entails
quality assurance programs.
66. The following mechanisms can be utilized as part of the quality assurance
program of your hospital EXCEPT:
67. The use of the Standards of Nursing Practice is important in the hospital. Which of
the following statements best describes what it is?
68. you are taking care of critically ill client and the doctor in charge calls to order a
DNR (do not resuscitate) for the client. Which of the following is the appropriate
action when getting DNR order over the phone?
69. To ensure client safety before starting blood transfusions the following are
needed before the procedure can be done EXCEPT:
Situation 15 – During the NUTRITION EDUCATION class discussion a 58 year old man,
Mr. Bruno, shows increased interest.
71. Mr. Bruno asks what the “normal” allowable salt intake is. Your best response to
Mr. Bruno is:
72. Your instructions to reduce or limit salt intake include all the following EXCEPT:
73. Teaching strategies and approaches when giving nutrition education is influenced
by age, sex and immediate concerns of the group. Your presentation for a group of
young mothers would be best if you focus on:
Situation 16 – You are assigned to take care of 10 patients during the morning shift.
The endorsement includes the IV infusion and medications for these clients.
76. Mr. Felipe, 36 years old is to be given 2700 ml of D5LR to infuse for 18 hours
starting at 8 am. At what rate should the IV fluid be flowing hourly?
77. Mr. Atienza is to receive 150 ml/hour of D% W IV infusion for 12 hours for a total
of 1800ml. He is also losing gastric fluid which must be replaced every two hours.
Between 8 am and 10 am, Mr. Atienza has lost 250 ml of gastric fluid. How much fluid
should he receive at 11 am?
A. 350 ml/hour
B. 275 ml/hour
C. 400 ml/hour
D. 200 ml/hour
78. You are to apply a transdermal patch of nitoglycerin to your client. The following
are important guidelines to observe EXCEPT:
A. Apply to hairless clean area of the skin not subject to much wrinkling
B. Patches may be applied to distal part of the extremities like forearm
C. Change application and site regularly to prevent irritation of the skin
D. Wear gloves to avoid any medication on your hand
79. You will be applying eye drops to Miss Romualdez. After checking all the
necessary information and cleaning the affected eyelid and eyelashes, you
administer the ophthalmic drops by instilling the eye drops:
80. When applying eye ointment, the following guidelines apply EXCEPT:
A. squeeze about 2 cm of ointment and gently close but not squeeze the eye
B. apply the ointment from the inner canthus going outward of the affected
eye
C. discard the first bead of the eye ointment before application because the
tube is likely to expel more than desired amount of ointment
D. hold the tube above the conjunctival sac, do not let tip touch the
conjunctiva
Situation 17 – The staff nurse supervisor requests all the staff nurses to “brainstorm”
and learn ways to instruct diabetic clients on self-administration of insulin. She wants
to ensure that there are nurses available daily to do health education classes.
83. Connie, the new nurse, appears tired and sluggish and lacks the enthusiasm she
had six weeks ago when she started the job. The nurse supervisor should
A. grievance
B. arbitration
C. collective bargaining
D. strike
Situation 18 – There are various developments in health education that the nurse
should know about:
86. The provision of health information in the rural areas nationwide through
television and radio programs and video conferencing is referred to as:
87. A nearby community provides blood pressure screening, height and weight
measurement, smoking cessation classes and aerobics class services. This type of
program is referred to as
A. outreach program
B. hospital extension program
C. barangay health program
D. wellness program
88. Part of teaching client in health promotion is responsibility for one’s health. When
Danica states she needs to improve her nutritional status this means:
A. Marriage counseling
B. Self-examination for breast cancer
C. Identifying complication of diabetes
D. Poison Control
90. Mrs. Ostrea has a schedule for Pap Smear. She has a strong family history of
cervical cancer. This is an example of
A. tertiary prevention
B. secondary prevention
C. health screening
D. primary prevention
Situation 19 – Ronnie was in a vehicular accident where he sustained injury to his left
ankle. In the Emergency Room, you notice how anxious he looks.
91. You establish rapport with him and to reduce his anxiety you initially:
92. While doing your assessment, Ronnie asks you “Do I have a fracture? I don’t want
to have a cast.” The most appropriate nursing response would be:
93. Ronnie is very anxious and is unaware of the extent of his injury. The nurse can
best assist him by:
A. Asking the doctor to give an order for a sedative to call him down
B. Informing him that he is being treated by a very competent health team so
he has nothing to worry about
C. Identifying his level of anxiety to determine how much information he can
understand
D. Allaying his anxiety by telling him that he only sustained a minor injury
94. After cleaning the abrasions and applying antiseptic, the nurse applies cold
compress to the swollen ankle as ordered by the physician. This statement shows
that the nurse has correct understanding of the use of cold compress:
95. After receiving prescription for pain medication, Ronnie is instructed to continue
applying 30 minute cold at home and start 30 minute hot compress the next day. You
explain that the use of hot compress:
96. She instructed the interviewees not to tell the interviewees that the data
gathered are for her own research project for publication. This teacher has violated
the student’s right to:
A. Not be harmed
B. Disclosure
C. Privacy
D. Self-determination
97. A nurse preceptor observes that many clients are being readmitted in the ward
for post-operative infections. She suggests to the students that they do a research on
this topic. What research activity is this?
98. Quantitative research involves numerical data. Which of the following is based on
quantitative research?
99. Before the nurse researcher starts her study, she analyzes how much time,
money, materials and people she will need to complete the research project. This
analysis prior to beginning the study is called:
A. Validity
B. Feasibility
C. Reliability
D. Researchability
100. Data analysis is to be done and the nurse researcher wants to include
variability. These include the following EXCEPT:
A. Variance
B. Range
C. Standards of Deviation
D. Mean