Professional Documents
Culture Documents
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NURSNG PRACTCE Foundation of PROFESSONAL Nursing Practice
GENERAL NSTRUCTONS:
1. This test booklet contains 100 test questions.
2. Read NSTRUCTONS TO EXAMNEES printed on your answer sheet.
3. Shade only one (1) box for each question on your answer sheets. Two or more boxes shaded
will invalidate your answer.
4. AVOD ERASURES.
5. This is PRC property. Unauthorized possession, reproduction, and/or sale of this test is
punishabIe by Iaw. Per RA 8981.
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NSTRUCTONS:
1. Detach one (1) answer sheet from the bottom of your Examinee D/Answer Sheet
Set .
2. Write the subject title "Nursing Practice I" on the box provided.
3. Shade Set Box "A on your answer sheet if your test booklet is Set A; Set Box "B if your test
booklet is Set B.
MULTPLE CHOCE
1. Nurse Suzie is administering 12:00 PM medication in Ward 4. Two patients have to receive
Lanoxin. What should Nurse Suzie do when one of the clients does NOT have a readable
identification band?
A. Ask the client if she is Mrs. Santos
B. Ask the cIient his name
C. Ask the room mate if the client is Mrs. Santos
D. Compare the D band with the bed tag
2. Lizette, a head nurse in a surgical unit, hears one of the staff nurses say that she does not
touch any client assigned to her unless she performs nursing procedures or conducts physical
assessment. To guide the staff nurse in the use of touch, which of the following would be
BEST response of Lizette?
A. "Use touch when the situation calls for it.
B. "Touch serves as a connection between the nurse and the patient".
C. "Use touch with discretion.
D. "Touch is used in physical assessment.
3. You are asked to teach the client, Mr. Lapuz, who has right sided weakness the use of a
cane.
Which observation will indicate that Mr. Lapuz is using the cane correctly?
A. The cane and one foot or both feet are on the fIoor at aII times
B. He advances the cane followed by the left leg
C. Client keeps the cane on the right side along the weak leg
D. Client leans to the left side which is stronger
4. George, a 43 year old executive is scheduled for cardiac bypass surgery. While being
prepared for the surgery, he says to the nurse " am not going to have the surgery. may die
because of the risk. Which response by the nurse is most appropriate?
A. "Without the surgery you will most likely die sooner.
B. "There are always risks involved with surgery.
C. "There is a client in the other room who had successful surgery and you can talk to
him.
. "This must be very frightening for you. TeI me how you feeI about the
surgery."
5. A client is ordered to take Lasix, a diuretic, to be taken orally daily. Which of the following is
an
appropriate instruction by the nurse?
A. Report to the physician the effects of the medication on urination.
B. Take the medicine earIy in the morning
C. Take a full glass of water with the medicine
D. Measure frequency of urination in 24 hours
6. Nurse Glenda gets a call from the neighbor who tells her that his 3 years old daughter has
been vomiting and has fever and asks for advice. Which of the following is the most
appropriate action of the nurse?
A. Observe the child for an hour. f the child does not improve, refer to the physician in
the neighborhood.
B. Recommend to bring the chiId immediateIy to the hospitaI
C. Assess the child, recommend observation and administer acetaminophen. f
symptoms continue, bring to the hospital.
D. Tell the neighbor to observe the child and give plenty of fluids. f the child does not
improve, bring the child to the hospital.
7. Wilfred, 30 years old male, was brought to the hospital due to injuries sustained from a
vehicular accident. While being transported to the X-ray department, he straps accidentally
broke and the client fell to the floor hitting to his head. n this situation, the nurse is:
A. not responsible because of the doctrine of respondent superior
B. free from any negligence that caused harm to the patient
C. IiabIe aIong with the empIoyer for the use of a defective equipment that
harms the cIient
D. totally responsible for the negligence
8. While going on evening round, Nurse Edna saw Mrs. Pascual meditating and afterwards
started singing prayerful hymns. What is the BEST response of Edna?
A. gnore the incidence
B. Report the incidence to the head nurse
C. Respect the cIient's actions as this provides structure and support to the
cIient
D. Call her attention so she can go to sleep
9. A client asks for advice on low cholesterol food. You advise the client to eat the following:
A. Chicken liver, cow liver, eggs
B. Lean beef and pork, egg ewhite, fish
C. Balut, salted eggs, duck and chicken egg
D. Pork liempo, cow brain, lungs and kidney
10. The code of ethics for nurses has an interpretative statement that provides:
A. continuity of care for the improvement of the client
B. guide for carrying out nursing responsibiIities that provide quaIity care and
for the ethicaI obIigation of the profession
C. standards of care in carrying out nursing responsibilities
D. identical care to all clients in any setting
11. Which of the following situations would possibly cause a nurse to be sued due to
negligence?
A. Nurse gave a cIient wrong medication, and an hour Iater, cIient compIained of
dyspnea
B. While preparing a medication, the nurse notices that instead of 1 tablet, she put two
tablets into the client's medicine cup
C. As the nurse was about to administer medication, the client questioned why the
medication is still given when in fact the physician discontinued it.
D. Nurse administered 2 tablets of analgesic instead of 1 tablet as prescribed. Patient
noticed the error and complained.
12. Your nurse supervisor asks you who among the following clients is most susceptible to
getting
infection if admitted to the hospital?
A. Diabetic client type2
B. Client with chronic obstructive pulmonary disease (COPD)
C. CIient with second degree burns
D. Client with psoriasis
13. Mr. Chris Martinez has been confined for three days. His wife helped take care of him and
he
has observed her to be "too involved in his care. He complained to the head nurse about this.
Which of the following would be the BEST response of the nurse?
A. "Don't worry. will call the attention of your wife.
B. "Your wife is just trying to help because she is worried about you.
C. "What are your thoughts about your wife's invoIvement in your care?"
D. "Your wife can assist you well in your care and recovery.
14. The nurse is in the hospital canteen and hears two staff nurses talking about the client
confined in Room 612. They mentioned his name and discussed details of his condition.
Which of the following actions should the nurse take?
A. Approach the two nurses and teII them that their actions are inappropriate
especiaIIy in a pubIic pIace
B. Wait till the nurses finish the discussion and report the situation to the supervisor
C. Say nothing to avoid embarrassing the staff nurses
D. Remain quiet and ignore the discussion
15. The son of Mr. Rosario, a 76 year old man, reports to the nurse in the community health
center that his father has been getting out of bed at night and walks around the house in the
early hours of the morning causing him to fall and injure himself. Which instruction would you
give?
A. Apply restraints during night hours only
B. Advise hospitalization to prevent future accidents
C. Keep a radio or TV for company and to orient the client
. Have someone check on the cIient frequentIy at night
SITUATIONAL
Situation 1 Preparation and administration of medications is a nursing function that
cannot be delegated. t is important that the nurse has a deep understanding
of this responsibility that is meant to save patient's lives.
16. You are to administer an intramuscular injection to Dulce, 1 year old girl. The most
appropriate site to administer the drug is:
A. dorso gluteal region C. vastus IateraIis
B. ventral forearm D. gluteal region
17. An infant is ordered to receive 500ml of D5NSS for 24 hours. The intravenous drip is
running
at 60 drops/minute. How many drops per minute should the flow rate be?
A. 60 drops per minute C. 30 drops per minute
B. 21 drops per minute D. 15 drops per minute
18. Following surgery, Henry is to receive 20 mEq (milliequivalent) of potassium chloride to be
added to 1000 ml of D5W to run for 8 hours. The intravenous infusion set is calibrated at 20
drops per milliliter. How many drops per minute should the rate be to infuse 1 liter of D5W for 8
hours?
A. 2 drops C. 60 drops
B. 20 drops D. 32 drops
19. Mr. Lagro is to receive 1 liter of D5LR to run for 12 hours. The drop factor of the V infusion
set is 10 drops per minute. Approximately how many drop per minutes should the V be
regulated?
A. 13-1 drops C. 10-12 drops
B. 17-18 drops D. 15-16 drops
20. The physician ordered Nembutal Na gr XX. The bottle contains 100mg/capsule. How many
capsule will be administered to the client?
A. 1 capsule C. 2 capsuIe
B. 1 capsule D. capsule
Situation 2 The nurse supervisor is observing the staff nurses in her hospital to see how
quality of care provided to clients can be improved.
21. The nurse supervisor is not satisfied with the bed bath that is provided by Nurse Arthur. To
improve the care provided to the patients in the unit by Nurse Arthur, the nurse supervisor
should:
A. tell the nurse how to give bed baths correctly
B. ask another staff nurse to do bed baths instead
C. provide a manual to be read on giving bed baths
. bring the staff nurse to a cIient's room and demonstrate
22. The staff nurse discusses with the novice nurse the type of wound dressing that is best to
use for a client. Together, they observe how well the dressings absorb the drainage. n what
step of the decision making process are they?
A. Testing options C. Defining the problem
B. Considering effects on results D. Making final decisions
23. To check if the nurses under her supervision use critical thinking, Mrs. David observes if the
nurses act responsibly when at work. Which of the following actions of the nurse demonstrates
the attitude of responsibility?
A. Thinking of alternative methods of nursing care
B. Sharing ideas regarding patient care
C. FoIIowing standards of practice
D. Planning other approaches for patient care
24. The nurse who makes clinical judgment can be depended upon to improve the quality of
care
of clients. Nurse Julie uses such good clinical judgment when she gives priority care to this
client:
A. Roman, a client who is ambulatory and for surgery tomorrow
B. A post operative cIient, Rey, who has a bIood pressure of 90/50 mmHg
C. Mr. Abad, a client who needs instructions for home medications
D. Fred, a client who received pain medications 5 minutes ago
25. A good nursing care plan is dependent on a correctly written nursing diagnosis. t defines a
client's problem and its possible cause. The following is an example of a well written nursing
diagnosis:
A. Acute pain related to altered skin integrity secondary to hysterectomy
B. Electrolyte imbalance related to hypocalcemia
C. AItered nutrition reIated to high fat intake secondary to obesity
D. Knowledge deficit related to proctosigmoidoscopy
Situation 3 You are taking care of Mrs. Leyba, 66 years old, who is terminally ill with
ovarian cancer stage V.
26. When caring for a dying client, you will perform which of the following activities?
A. Encourage the client to reach optimal health
B. Assist client perform activities of daily living
35. Which of the following supportive devices can be used most effectively by Nurse Arnold to
prevent external rotation of the right leg?
A. Sandbags C. Pillow
B. Firm mattress D. High foot board
Situation 5 - As you begin to work in the hospital where you are on probation, you are
tasked to take care of a few patients. The clients have varied needs and you
are expected to provide care for them.
36. An ambulatory client. Mr. Zosimo, is being prepared for bed. Which of the following nursing
actions promote safety for the client?
A. Turning off the lights to promote rest and sleep
B. nstructing the client about the use of call system
C. Raising the side raiIs
D. Placing the bed in high position
37. Mikka, a 25 year old female client, is admitted with right lower quadrant abdominal pain. The
physician diagnosed the client with acute appendicitis and an emergency appendectomy was
performed. Twelve hours following surgery, the patient complained of pain. Which of the
following is the most appropriate nursing diagnosis?
A. mpaired mobility related to pain secondary to an abdominal incision
B. mpaired movements related to pain due to surgery
C. mpaired mobility related to surgery
. Severe pain reIated to surgery
38. You are preparing a plan of care for a client who is experiencing pain related to incisional
swelling following laminectomy. Which of the following should be included in the nursing care
plan?
A. Encourage the cIient to Iog roII when turning
B. Encourage the client to do self-care
C. nstruct the client to do deep breathing exercises
D. Ambulate the client in ward premises every twenty minutes
39. Mr. Lozano, 50 year old executive, is recovering from severe myocardial infarction. For the
past 3 days, Mr. Lozano's hygiene and grooming needs have been met by the nursing staff.
Which of the following activities should be implemented to achieve the goal of independence
for Mr. Lozano?
A. nvolving family members in meeting client's personal needs
B. Meeting his needs till he is ready to perform self-care
C. Preparing a day to day activity list to be followed by client
. InvoIving Mr. Lozano in his care
40. Mr. Ernest Lopez is terminally ill and he choose to be at home with his family. What nursing
action are best initiated to prepare the family of Mr. Lopez?
A. Talk with the family members about the advantage of staying in the hospital for
proper care
B. Provide support to the famiIy members by teaching ways to care for their
Ioved one
C. Convince the client to stay in the hospital for professional care
D. Tell the client to be with his family
Situation 6 - Myrna, a researcher, proposes a study on the relationship between health
values and the health promotion activities of staff nurses in a selected college
of nursing.
41. n both quantitative and qualitative research, the used of a frame of reference is required.
Which of the following items serves as the purpose of a framework?
A. ncorporates theories into nursing's body of knowledge
B. Organizes the deveIopment of study and Iinks the findings to nursing's body
of knowIedge
C. Provides logical structure of the research findings
D. dentifies concepts and relationships between concepts
42. Myrna need to review relevant literature and studies. The following processes are
undertaken
in reviewing literature EXCEPT:
A. locating and identifying resources C. cIarifying a research topic
B. reading and recording notes D. using the library
43. The primary purpose for reviewing literature is to:
A. organize materials related to the problem of interest
B. generate broad background and understanding of information related to the
research problem of interest
C. select topics related to the problem of interest
. gather current knowIedge of the probIem of interest
44. n formulating the research hypotheses, researcher Myrna should state the research
question
as:
A. What is the response of the staff nurses to the health values?
B. How is variable "health value perceived in a population?
C. Is there a significant reIationship between heaIth vaIues and heaIth
promotion activities of the staff nurses?
D. How do health values affect health promotion activities of the staff nurses?
45. The proposed study shows the relationship between the variables. Which of the following is
the independent variable?
A. Staff nurses in a selected college of nursing
B. HeaIth vaIues
C. Health promotion activities
D. Relationship between health values and health promotion activities
Situation 7 - While working in a tertiary hospital, you are assigned to the medical ward.
46. Your client, Mr. Diaz, is concerned that he can not pay his hospital bills and professional
fees.
You refer him to a:
A. Nurse supervisor C. bookkeeping department
B. SociaI worker D. physician
47. Mr. Magno has lung cancer and is going through chemotherapy. He is referred by the
oncology nurse to a self-help group of clients with cancer to:
A. receive emotionaI support C. provide financial assistance
B. to be a part of a research study D. assist with chemotherapy
48. A diabetic hypertensive client, Mrs. Linao, needs a change in diet to improve her health
status.
She should be referred to a:
A. nutritionist C. physician
B. dietitian D. medical pathologist
49. When collaborating with other health team members, the best description of Nurse Rita's
role
is:
A. encourages the client's involvement in his care
B. shares and implements orders of the health team to ensure quality care
57. When performing oral care to an unconscious client, which of the following is a special
consideration to prevent aspiration of fluids into the lungs?
A. Put the cIient on a sideIying position with head of bed Iowered
B. Keep the client dry by placing towel under the chin
C. Wash hands and observe appropriate infection control
D. Clean mouth with oral swabs in a careful and an orderly progression
58. The advantages of oral care for a client include all of the following, EXCEPT:
A. decreases bacteria in the mouth and teeth
B. reduces need to use commerciaI mouthwash which irritate the buccaI
mucosa
C. improves client's appearance and self-confidence
D. improves appetite and taste of food
59. A possible problem while providing oral care to unconscious clients is the risk of fluid
aspiration to lungs. This can be avoided by:
A. Cleaning teeth and mouth with cotton swabs soaked with mouthwash to avoid
rinsing the buccal cavity
B. swabbing the inside of the cheeks and lips, tongue and gums with dry cotton swabs
C. use fingers wrapped with wet cotton washcloth to rub inside the cheeks, tongue,
lips and ums
. suctioning as needed whiIe cIeaning the buccaI cavity
60. Your client has difficulty of breathing and is mouth breathing most of the time. This causes
dryness of the mouth with unpleasant odor. Oral hygiene is recommended for the client and in
addition, you will keep the mouth moistened by using:
A. salt solution C. petroIeum jeIIy
B. water D. mentholated ointment
Situation 10 - Errors while providing nursing care to patients must be avoided and minimized at
all time. Effective management of available resources enables the nurse to provide
safe, quality patient care.
61. n the hospital where you work, increased incidence of medication error was identified as the
number one problem in the unit. During the brainstorming session of the nursing service
department, probable causes were identified. Which of the following is process related?
A. interruptions C. lack of knowledge
B. use of unofficial abbreviations . faiIure to identify cIient
62. Miscommunication of drug orders was identified as a probable cause of medication errors.
Which of the following is safe medication practice related to this?
A. Maintain medication in its unit dose package until point of actual administration
B. Note both generic and brand name of the medication in the Medication
Administration Method
C. OnIy officiaIIy approved abbreviations maybe used in prescription orders
D. Encourage clients to ask question about their medications.
63. The hospital has an ongoing quality assurance program. Which of the following indicates
implementation of process standards?
A. The nurses check cIient's identification band before giving medications
B. The nurse reports adverse reaction to drugs
C. Average waiting time for medication administration is measured
D. The unit has well ventilated medication room
64. Which of the following actions indicate that Nurse Jerome is performing outcome evaluation
of
quality care?
A. Interviews nurses for comments regarding staffing
B. Measures waiting time for client's per nurse's call
C. Checks equipment for its calibration schedule
D. Determines whether nurses perform skin assessment every shift
65. An order for a client was given and the nurse in charge of the client reports that she has no
experience of doing the procedure before. Which of the following is the most appropriate
action of the nurse supervisor?
A. Assign another nurse to perform the procedure
B. Ask the nurse to find way to learn the procedure
C. Tell the nurse to read the procedure manual
. o the procedure with the nurse
Situation 11 - Mr. Jose's chart is the permanent legal recording of all information that relates to
his health care management. As such, the entries in the chart must have accurate
data.
66. Mr. Jose's chart contains all information about his health care. The functions of records
include
all except:
A. means of communication that health team members use to communicate their
contributions to the client's health care
B. the client's record also shows a document of how much health care agencies will
be reimbursed for their services
C. educational resource for student of nursing and medicine
. recording of actions in advance to save time
67. An advantage of automated or computerized client care system is:
A. The nursing diagnoses for a client's data can be accurately determined
B. Cost of confinement will be reduced
C. Information concerning the cIient can b easiIy updated
D. The number of people to take care of the client will be reduced
68. nformation in the patient's chart is inadmissible in court as evidence when:
A. The client's family refuses to have it used
B. The cIient objects to its use
C. The handwriting is not legible
D. t has too many abbreviations that are "unofficial
69. Nursing audit aims to:
A. provide research data to hospital personnel
B. study client's illness and treatment regimen closely
C. compare actuaI nursing done to estabIished standards
D. provide information to health-care providers
70. A telephone order is given for a client in your ward. What is your most appropriate action?
A. Copy the order on to the chart and sign the physician's name as close to his
original signature as possible
B. Repeat the order back to the physician, copy onto the order sheet and
indicate that it is a teIephone order
C. Write the order in the client's chart and have the head nurse co-sign it
D. Tell the physician that you can not take the order but you will call the nurse
supervisor
Situation 12 - Nurse Roque, a newly hired nurse, is asked to take over an absent nurse in
another unit. She will take care of clients with various conditions.
71. Which of the following client conditions should be Miss Roque's priority in the pediatric unit?
A. The baby whose fantanelle is bulging and firm while asleep
B. The infant who is brought in for upper respiratory tract infection whose
temperature is sIightIy eIevated
C. A baby who is wailing after being awakened by the banging door
D. A baby boy whose circumcision has yellowish exudate
72. When suctioning the endotracheal tube, the nurse should:
A. Explain procedure to patient; insert catheter gently applying suction. Withdrawn
using twisting motion
B. Insert catheter untiI resistance is met, then withdraw sIightIy, appIying
suction intermittentIy as catheter is withdrawn
C. Hyperoxygenate client insert catheter using back and forth motion
D. nsert suction catheter four inches into the tube, suction 30 seconds using twirling
motion as catheter is withdrawn
73. Nurse Roque is giving instructions to Doris, the daughter of a comatose patient, to give a
sponge bath. While Doris is doing spone bath, what action of Doris needs correction?
A. Answering the phone while wearing gloves used for sponge bath
B. Rolling the patient like a log to do back rub
C. Lining the rubber mat with bed sheet as incontinence pad for the patient
D. Turning the patient on the left side with head slightly elevated
74. Dina sustained a fracture of the ulna and a cast will be applied. What nursing action before
cast application is most important for Nurse Roque to do?
A. Use baby powder to reduce irritation under the cast
B. Assess sensation of each arm
C. EvaIuate skin temperature in the area
D. Check radial pulses bilaterally and compare
75. To obtain specimen for sputum culture and sensitivity, which of the following instruction is
best?
A. Upon waking up, cough deepIy and expectorate into container
B. Cough after pursed lip breathing
C. Save sputum for two days in covered container
D. After respiratory treatment, expectorate into a container
Situation 13 - nfections are quite commonly the reasons for a client's hospitalization.
Appropriate
interpretation of diagnostic tests and measures for infection control are helpful in the
management of patient care.
76. Dorothy underwent diagnostic test and the result of the blood examination are back. On
reviewing the result the nurse notices which of the following as abnormal finding?
A. Neutrophils 60%
B. White blood cells (WBC) 9000/mm
C. Erythrocyte sedimentation rate (ESR) is 39 mm/hr
D. ron 75 mg/100 ml
77. Surgical sepsis is observed when:
A. inserting an intravenous catheter
B. disposing of syringes and needles in puncture proof containers
C. washing hands before changing wound dressing
D. placing dirty soiled linen in moisture resistant bags
78. A client with viral infection will most likely manifest which of the following during the illness
stage of the infection?
A. Client was exposed to the infection 2 days ago but without any symptoms
B. OraI temperature shows fever
C. Acute symptoms are no longer visible
D. Client "feels sick but can do normal activities
79. Which of the following laboratory test result indicate presence of an infectious process?
A. Erythrocyte sedimentation rate (ESR) 12 mm/hr
B. White bIood ceIIs (WBC) 18,000/mm3
C. ron 90 g/100ml
D. Neutrophils 67%
80. Among the clients you are assigned to take care of, who is the most susceptible to
infection?
A. Diabetic client C. client with pulmonary emphysema
B. CIient with burns D. client with myocardial infarction
Situation 1 - You are a newly hired nurse in a tertiary hospital. You have finished your
orientation program recently and you are beginning to assimilate the culture of the
profession.
81. Using Benner's stages of nursing expertise, you are a beginning nurse practitioner. You will
rank yourself as a/an:
A. competent nurse C. proficient nurse
B. novice nurse D. advanced beginner
82. Benner's "Proficient nurse level is different from the other levels in nursing expertise in the
context of having:
A. the ability to organize and plan activities
B. having attained an advanced level of education
C. a hoIistic understanding and perception of the cIient
D. intuitive and analytic ability in new situations
83. As you become socialized into the nursing "culture you become a patient advocate.
Advocacy is explained by the following EXCEPT:
A. respecting a person's right to be autonomous
B. demonstrating IoyaIty to the institution's rights
C. shared respect, trust and collaboration in meeting health needs
D. protecting and supporting another person's rights
84. Modern day nursing has led to the led development of the expanded role of the nurse as
seen
in the function of a:
A. CIinicaI nurse speciaIist C. community health nurse
B. Critical care nurse D. staff nurse
85. You join a continuing education program to help you:
A. Earn credits for license renewal
B. Get in touch with colleagues in nursing
C. Enhance your basic knowledge
. Update your knowIedge and skiIIs reIated to fieId of interest
Situation 15 - When creating your lesson plan for cerebrovascular disease or STROKE. t is
important to include the risk factors of stroke.
86. The most important risk factor is:
A. Cigarette smoking C. binge drinking
B. Hypertension D. heredity
87. Part of your lesson plan is to talk about etiology or cause of stroke. The types of stroke
based
on cause are the following EXCEPT:
A. Embolic stroke C. diabetic stroke
B. Hemorrhagic stroke D. thrombotic stroke
88. Hemmorhagic stroke occurs suddenly usually when the person is active. All are causes of
hemorrhage, EXCEPT:
A. phIebitis C. damage to blood vessel
B. trauma D. aneurysm
89. The nurse emphasizes that intravenous drug abuse carries a high risk of stroke. Which drug
is closely linked to this?
A. Amphetamines C. shabu
B. Cocaine D. Demerol
90. A participant in the STROKE class asks what is a risk factor of stroke. Your best response
is:
A. "More red bIood ceIIs thicken bIood and make cIots more possibIe."
B. "ncreased RBC count is linked to high cholesterol.
C. "More red blood cell increases hemoglobin content.
D. "High RBC count increases blood pressure.
Situation 16 - Accurate computation prior to drug administration is a basic skill all nurses must
have.
91. Rudolf is diagnosed with amoebiasis and is to received Metronidazole (Flagyl) tablets 1.5
gm
daily in 3 divided doses for 7 consecutive days. Which of the following is the correct dose of
the drug that the client will received per oral administration?
A. 1,000 mg tid C. 1,500 mg tid
B. 500 mg tid D. 50 mg tid
92. Rhona, a 2 year old female was prescribed to receive 62.5 mg suspension three times a
day.
The available dose is 125 mg/ml. which of the following should Nurse Paolo prepare for each
oral dose?
A. 0.5 mI C. 2.5 ml
B. 1.5 ml D. 10 ml
93. The physician ordered Potassium Chloride (KCL) in D5W 1 liter to be infused in 24 hours for
Mrs. Gomez. Since Potassium Chloride is a high risk drug, Nurse Robert used an intravenous
pump. Which of the following should Nurse Robert do to safely administer this drug?
A. Check the pump setting every 2 hours
B. Teach the client how the infusion pump operates
C. Have another nurse check the infusion pump setting
D. Set the alarm of the pump loud enough to be heard
94. Baby Liza, 3 months old, with a congenital heart deformity, has an order from her physician:
"give 3.00 cc of Lanoxin today for 1 dose only. Which of the following is the most appropriate
action by the nurse?
A. CIarify order with the attending physician
B. Discuss the order with the pediatric heart specialist in the unit
15. Which of the following indicates the type(s) of acute renal failure?
A. Four types: hemorrhagic with and without clotting, and nonhemorrhagic with and
without clottings
B. One type: acute
C. Three types: prerenaI, intrarenaI and postrenaI
D. Two types: acute and subacute
16. A means of facilitating professional staff development is by building upon skills, abilities, and
of
experience of each practitioner is called:
A. the novice to expert modeI C. career enhancement
B. situational leadership model D. clinical ladder
17. Which of the following questions by the nurse would be best fit the philosophy of the nursing
mutual participation model of care (NMPMC)?
A. "Have you brushed your chiId's teeth today?"
B. "How does your child look to you today?
C. "Where have you been all morning?
D. "Do you think your child's color is worse?
18. There are numerous definitions of the word "health. Which definition below is from Florence
Nightingale?
A. A state or a process of being and becoming an integrated and whole person
B. The state of being free from illness or injury
C. Being weII and using every power the individuaI possesses to the fuIIest extent
D. A state of complete physical, social, and mental well-being and not merely the absence
of disease or infirmity
19. nformal communication takes place when individuals talk and is best described by saying
the
participants:
A. are involved in a preexisting informal relationship
B. talk with slang words
C. have no particuIar agenda or protocoI
D. are relaxed
20. Tertiary care by the home health nurse is directed toward children with:
A. probIems in mobiIity C. minor problems
B. short-term needs D. clinically apparent disease
21. The endometrium thickens during which phase of the menstrual cycle?
A. Secretory phase C. ProIiferative phase
B. Menstrual phase D. schemic phase
22. A measurement tool to articulate the nursing workload for a specific patient or groups of
patients over a specific period of time is called:
A. staffing pattern C. benchmarking
B. skill mix . patient cIassification
23. The mother of a 9 month-old infant is concerned that the head circumference of her baby is
greater than the chest circumference. The BEST response by the nurse is:
A. "These circumference normally are the same, but in some babies this just differs.
B. "Perhaps your baby was small for gestational age or premature.
C. "This is normaI untiI the age of 1 year, when the chest wiII be greater."
D. "Let me ask you a few questions, and perhaps we can figure out the cause of this
difference.
24. Which of the following approaches would work best when the nurse is communicating with
an
infant?
A. Use an adult voice just as you would for anyone.
B. Communicate through the caregivers.
C. AIIow the chiId time to warm up to the nurse.
D. Respond only after the child cries for a while.
25. Evidence-based care started in medicine as a way to:
A. promote technological advances in medicine
B. incorporate collaboration within all health care disciplines
C. integrate individuaI experience with cIinicaI research
D. teach medical students the art and science of medicine
26. The nurse assessing newborn babies and infants during their hospital stay after birth will
notice which of the following symptoms as a primary manifestation of Hirschsprung's disease?
A. A fine rash over the trunk
B. FaiIure to pass meconium during the first 2 to 8 hours after birth
C. The skin turns yellow and then brown over the first 48 hours of life
D. High-grade fever
27. A client is 7 months pregnant and has just been diagnosed as having a partial placenta
previa.
She is stable and has minimal spotting and is being sent home. Which of these instructions to
the client may indicate a need for further teaching?
A. Maintain bed rest with bathroom privileges
B. Avoid intercourse for three days.
C. Call if contractions occur.
D. Stay on left side as much as possible when lying down.
28. Which of the following groups of people in the world disproportionately represents the
homeless population?
A. Hispanics C. African Americans
B. Asians D. Caucasians
29. The nurse notes that the infant is wearing a plastic-coated diaper. f a topical medication
were
to be prescribed and it were to go on the stomachs or buttocks, the nurse would teach the
caregivers to:
A. avoid covering the area of the topicaI medication with the diaper
B. avoid the use of clothing on top of the diaper
C. put the diaper on as usual
D. apply an icepack for 5 minutes to the outside of the diaper
30. The nurse assessing a child or adolescent with a diagnosis of dysrhytmic disorder would
find
which of the following symptoms?
A. Labile mood and hyperactive thyroid with an increase in circulating thyroid hormones
and associated symptoms
B. Severe shaking of the hands when trying to hold a glass of water or other object
C. A depression that is deeper, more acute, and more likely to lead to suicide than major
depressive disorder
. A depressed or irritabIe mood for most of the day, on most days, for 2 or more
years and Iow energy or fatigue.
31. You were the nurse assigned to work with a child who has had whole brain radiation. You
have assessed the child to be sleeping up to 20 hours a day and is having some nausea,
malaise, fever and dysphasia. Based on this assessment, you are to work with the patients in
which of the following areas.
A. Accepting a reoccurrence of the tumor
B. eaIing with the side effects of radiation therapy
C. Caring for the dying child
D. Accepting the imminent death of their child
32. The nurse is planning interventions for a child who has inflammatory bowel disease (BD)
with
a nursing diagnosis of "Nutrition: Less than body requirements. Which of the following
interventions will be most helpful in resolving this nursing problem?
A. Two large meals a day instead of several minimeals and snacks
B. Special BD diet (diet that has been proven effective for treating BD)
C. Salt-free diet high in potassium, vitamins and minerals
. iet as toIerated with Iactose hydroIyzed miIk instead of miIk products, and
omission of highIy seasoned foods, and reduction of fiber
33. Emotional intelligence consists of a number of competencies. Some of these are listed
below.
Which is NOT a characteristic of emotional intelligence?
A. SeIf-esteem C. Empathy
B. Self-awareness D. Self-regulation
34. Data collection for driving and restraining forces, including costs, desirability and feasibility,
is
a:
A. people issue C. political issue
B. structuraI issue D. technology issue
35. One of four factors describing the experience of sexually abused children and the effect it
has
on their growth and development is stigmatization that occurs when:
A. a child blames him or herself for the sexual abuse and begins to withdraw and isolate
B. newspapers and the media don't keep sexual abuse private and accidentally or on
purpose reveal the name of the victim
C. the child has been blamed by the abuser for his or her sexual behaviors, saying that
the child asked to be touched or did not make the abuser to stop
. the chiId's agony is shared by other members of the famiIy or friends when the
sexuaI abuse becomes pubIic knowIedge
36. The painful phenomenon known as "back labor occurs in a client whose fetus in what
position?
A. Brow position C. Breech position
B. Right Occipito-Anterior Position . Left Occipito-Posterior
Position
37. FOCUS methodology stands for:
A. Focus, Organize, CIarify, Understand and SoIution
B. Focus, Opportunity, Continuous, Utilize, Substantiate
C. Focus, Organize, Clarify, Understand, Substantiate
D. Focus, Opportunity, Continuous (process), Understand, Solution
38. While community health nurses focus on the individual or the family, which of the following
do
they also have as their final objective?
A. The well-being of the chronically ill
B. The financial well-being of the family
C. The well-being of the extended family
47. n working with the caregivers of a client with an acute or chronic illness, the nurse would:
A. Teach care daiIy and Iet the caregivers do a return demonstration just before
discharge
B. Difficulty swallowing, diminished or absent gag reflex, and respiratory distress.
C. Difficulty sleeping, hypervigilant, and an arching of the back
D. Paradoxical irritability, diarrhea, and vomiting
48. Which of the following signs and symptoms would you most likely find when assessing and
infant with Arnold-Chiari malformation?
A. Weakness of the leg muscles, loss of sensation in the legs, and restlessness
B. ifficuIty swaIIowing, diminished or absent gag refIex, and respiratory distress
C. Difficulty sleeping, hypervigilant, and an arching of the back
D. Paradoxical irritability, diarrhea, and vomiting.
49. A parent calls you and frantically reports that her child has gotten into her famous ferrous
sulfate pills and ingested a number of these pills. Her child is now vomiting, has bloody
diarrhea, and is complaining of abdominal pain. You will tell the mother to:
A. call emergency medical services (EMS) and get the child to the emergency room
B. relax because these symptoms will pass and the child will be fine
C. administer syrup of ipecac
. caII the poison controI center
50. A client says she heard from a friend that you stop having periods once you are on the "pill.
The most appropriate response would be:
A. "The pill prevents the uterus from making such endometrial lining, that is why
periods may often be scant or skipped occasionally.
B. "f your friend has missed her period, she should stop taking the pills and get a
pregnancy test as soon as possible.
C. "The piII shouId cause a normaI menstruaI period every month. It sounds Iike
your friend has not been taking the piIIs properIy."
D. "Missed period can be very dangerous and may lead to the formation of precancerous
cells.
51. You are the nurse assigned to work with a child with acute glomerulonephritis. By following
the
prescribed treatment regimen, the child experiences a remission. You are now checking to
make sure the child does not have a relapse. Which finding would most lead you to the
conclusion that a relapse is happening?
A. Elevated temperature, cough, sore throat, changing complete blood count (CBC) with
diiferential
B. A urine dipstick measurement of 2+ proteinuria or more for 3 days, or the chiId
found to have 3-+ proteinutria pIus edema.
C. The urine dipstick showing glucose in the urine for 3 days, extreme thirst, increase in
urine output, and a moon face.
D. A temperature of 37.8 degrees (100 degrees F), flank pain, burning frequency, urgency
on voiding, and cloudy urine.
52. The nurse is working with an adolescent who complains of being lonely and having a lack of
fulfillment in her life. This adolescent shies away from intimate relationships at times yet at
other times she appears promiscuous. The nurse will likely work with this adolescent in which
of the following areas?
A. solation C. Lack of fulfillment
B. Loneliness . Identity
53. The use of interpersonal decision making, psychomotor skills, and application of knowledge
expected in the role of a licensed health care professional in the context of public health
welfare and safety is an example of:
A. delegation C. responsibility
B. supervision . competence
54. A child suffers a head injury in a tumbling accident in gym class. The nurse's best course of
action is to:
A. get the child up walking and make sure he or she stays awake
B. leave the child and go get help
C. leave the child in the care of an older child and go get help
. stay with the chiId, keep assessing, and have someone caII the caregivers
55. The American Academy of Pediatrics suggests that caregivers do which of the following
things
in regard to physical activities for preschoolers?
A. Push the child to practice sports activities while they are more flexible
B. Encourage a variety of physicaI activities in a noncompetitive environment
C. Have the child engage in competitive sports to see where they excel
D. Keep physical activities to a minimum until the child is in grade school.
56. Which of the following arrangements is generally considered to be best for the parents of
hospitalized infant or young child?
A. Rooming-in
B. Separate caregiver sleeping room on the unit
C. Day visits and sleeping at home
D. Staying at a nearby hotel or motel
57. When one person allows the conflict to be resolved at his or her own expense, this is
referred
to in conflict management as:
A. losing C. the win-Iose approach
B. winning while losing D. the lose-win approach
58. Which of the following statements best describes acquaintance rape?
A. Sexual intercourse when one person engaging in the activity is unsure about wanting
to do so
B. When two people don't love each other and engage in sexual activities
C. When someone on a date tricks the other person into having sexuaI intercourse
D. Sexual intercourse committed with force or the threat of force without a person's
consent.
59. The school nurse is teaching a health education and hygiene course to a group of high
school
males, which includes a number of young men who are on competitive sports teams. Which of
the following health practices would the nurse most stress in preventing the transmission of
human immunodeficiency virus (HV) virus in case any team member has HV or acquired
immunodeficiency syndrome (ADS)?
A. No sharing of underarm deodorant or shower soap
B. No sharing of razors or toothbrushes
C. Making certain towels have been washed in boiling water
D. Avoiding physical contact such as sports hugs or swats
60. At 17 weeks' gestation, a type 1 diabetic undergoes an ultrasound examination. What
information about the fetus at this time in pregnancy would be the results of this examination
provide?
A. Placental maturity C. Gestational age
B. Estimated fetaI weight D. Fetal lung maturity
61. Which of the following best describes a difference in communicating with school age
children
versus toddlers?
A. Toddlers require more empathy and more touching and holding
B. For toddlers, preparation for procedures is just before the procedure and much earlier
for school-aged children.
C. Caregivers need less information when care involves a school aged child
. The number of words is more when communicating with a toddIer than it is with
a schooI aged chiIdren
62. Genetic testing should be performed on a child only if
A. the parents both want it performed
B. it is in the best interests of the chiId
C. it i9s necessary for the child to survive
D. no one objects
63. nfant head control is judged by the:
A. abiIity to hoId the head without support
B. presence or absence of head lag
C. rigidity of the neck and head
D. amount of neck wrinkling
64. Which of the following roles BEST exemplifies the expanded role of the nurse?
A. Circulating nurse in surgery
B. Medication nurse
C. Obstetrical nurse
. Pediatric nurse practitioner
65. The tone and pitch of the voice, volume, infection, speed, grunts and other vocalizations are
referred to by which of the following terms?
A. ParaverbaI cIues C. Third element
B. Ancillary speech D. Enhancements
66. The plan-do-study-act cycle begins with:
A. four stages C. three questions
B. five agendas D. two concepts
67. During your shift, you noted one of your pregnant clients considered as "waiting case
manifest
morning sickness and which later progressed. Which assessment finding may indicate
possible developing complication?
A. Maternal pulse 90 C. FHT 155
B. Trace glucose in the urine . 1+ ketones in the urine
68. The nurse is working with a child who is going to have a bone marrow aspiration. The
physician orders TAC (tetracaine, adrenaline and cocaine). Which of the following is the route
of administration?
A. appIication to the skin, covered with a dressing prior to the procedure
B. subcutaneous
C. V using a very slow drip over approximately 4 hours prior to procedure
D. Nasal inhalation
69. According to DeRosa and Kochura's (2006) article entitled "mplement Culturally Competent
Health Care in your workplace, cultures have different patterns of verbal and nonverbal
communication. Which difference does NOT necessarily belong?
A. Personal behavior C. Subject matter
B. Eye contact D. Conversational style
70. The nurse instructs the caregivers of a newborn to notch the diapers or fold them in such a
way as to expose the cord. The major purpose of exposing the cord is to:
A. remind caregivers to do cord care
B. keep the diaper from rubbing the cord
C. Has MArichu engaged in sexual activity during the fetal development state of her child.
. Has MArichu engaged in any detrimentaI activities during the fetaI deveIopment
stage e.g. smoking, drinking, taking drugs, a bad faII, or attempts to terminate
pregnancy.
79. Marichu is scheduled to have an ultrasound examination. What instruction would you give
her
before her examination?
A. You can have medicine for pain for any contractions caused by the test.
B. rink at Ieast 3 gIasses of fIuid before the procedure.
C. The intravenous fluid infused to dilate your uterus does not hurt the fetus.
D. Void immediately before the procedure to reduce your bladder size.
80. Marichu is scheduled to have an amniocentesis to test for fetal maturity. What instruction
would you give her before this procedure?
A. The X-ray used to reveal your fetus' position has no long term effects.
B. The intravenous fluid infused to dilate your uterus does not hurt the fetus.
C. No more amniotic fluid forms afterward, which is why only a small amount is removed.
. Void immediateIy before the procedure to reduce your bIadder size.
Situation 2 - Health instructions are essentially given to pregnant mothers.
81. A public health nurse would instruct a pregnant woman to notify the physician immediately if
which of the following symptoms occur during pregnancy?
A. Presence of dark color in the neck
B. ncreased vaginal discharge
C. SweIIing of the face
D. Breast tenderness
82. A woman who is 9 weeks pregnant comes to the Health Center with moderate bright red
vaginal bleeding. On physical examination, the physician finds the client's cervix 2 cm dilated.
Which term best describes the client's condition?
A. Missed abortion C. InevitabIe abortion
B. ncomplete abortion D. Threatened abortion
83. n a big government hospital, Nurse Pura is taking care of a woman with a diagnosis of
abruption placenta. What complication of this condition is of most concern to Nurse Pura?
A. Urinary tract infection
B. Pulmonary embolism
C. Hypocalcemia
. isseminated intravascuIar coaguIation
84. Which of the following findings on a newly delivered woman's chart would indicate she is at
risk for developing postpartum hemorrhage?
A. Post-term delivery C. Grand muItiparity
B. Epidural anesthesia D. Premature rupture of membrane
85. Mrs. Hacienda Gracia, 35 year old postpartum client is at risk of thrombophlebitis. Which of
the
following nursing interventions decreases her chance of developing postpartum
thrombophlebitis?
A. breastfeeding the newborn
B. earIy ambuIation
C. administration of anticoagulant postpartum
D. immobilization and elevation of the lower extremities
Situation 3 - With the increasing documented cases of CANCER the best alternative to
treatment still remains to be PREVENTON. The following conditions apply.
86. Which among the following is the primary focus of prevention of cancer?
A. EIimination of conditions causing cancer
B. Diagnosis and treatment
C. Treatment at early stage
D. Early detection
87. n the prevention and control of cancer, which of the following activities is the most important
function of the community health nurse?
A. Conduct community assembIies.
B. Referral to cancer specialist those clients with symptoms of cancer.
C. Use the nine warning signs of cancer as parameters in our process of detection,
control and treatment modalities.
D. Teach woman about proper/correct nutrition.
88. Who among the following are recipients of the secondary level of care for cancer cases?
A. Those under earIy case detection
B. Those under post case treatment
C. Those scheduled for surgery
D. Those undergoing treatment
89. Who among the following are recipients of the tertiary level of care for cancer cases?
A. Those under early treatment C. Those under early detection
B. Those under supportive care D. Those scheduled for surgery
90. n Community Health Nursing, despite the availability and use of many equipment and
devices
to facilitate the job of the community health nurse, the best tool any nurse should be wel be
prepared to apply is a scientific approach. This approach ensures quality of care even at the
community setting. This is nursing parlance is nothing less than the:
A. nursing diagnosis C. nursing research
B. nursing protocol . nursing process
Situation - Dengue hemmorhagic fever is a common health concern in Philippine
society. t does not only pose a threat to health but more so to the lives of both
young and old, and well as rich and marginalized sectors of the society.
91. An important role of the community health nurse in the prevention and control of Dengue
Hfever
includes:
A. advising the elimination of vectors by keeping water containers covered
B. conducting strong health education drives/campaign directed towards proper garbage
disposal
C. expIaining to the individuaIs, famiIies, groups and community the nature of the
disease and its causation
D. practicing residual spraying with insecticides
92. Community health nurses should be alert in observing a Dengue suspect. The following is
NOT an indicator for hospitalization of H-fever suspects?
A. Marked anorexia, abdominal pain and vomiting
B. ncreasing hematocrit count
C. Fever for more than 2 days
D. Persistent headache
93. The community health nurses' primary concern in the immediate control of hemorrhage
among
patients with dengue is:
A. advising low fiber and non-fat diet
B. providing warmth through light weight covers
9. The board of Nursing is vested with power to issue, suspend or revoke for cause the:
A. certificate of Good Moral Character C. certificate of Registration
B. certificate of Practice D. certificate of Employment
10. RA 7193 stipulates the removal examination of the nurse licensure examination shall be
taken:
A. Within 3 years after the last failed examination
B. Anytime the examinee wants to take the examination
C. Within 2 years after the Iast faiIed examination
D. Within the same year after the filed examination
Situation 3 - Pain is always associated to surgery
11. As a surgical nurse, which of the following nursing intervention will allay anxiety and pain
among?
surgical patients?
A. Asses the cIient for concerns especiaIIy those that can potentiaIIy cause pain
B. Verify that the operated permit is signed
C. Discourage the client from discussing the details of the surgical procedure
D. Ensure safety of client while in surgery
12. Rhizotomy is a condition surgical procedure to manage those that can potentially cause
pain.
What is the crucial in determining a good candidate for rhizotomy?
A. Pain which is resistant to non-pharmacologic for 6 month
B. Pain which is resistant to pharmacologic protocol for 12 months
C. LocaI pain with no radiating pain or signs of nervous compassion
D. Deep pain with obvious signs of peripheral nerve damage
13. Which of the following would be the nurse's appropriate response to a crying female client
scheduled for emergency surgery who is verbalizing fear of pain but afraid to go to sleep?
A. Let her cry and tell significant other to stand by.
B. Squeeze her hand and assure her that there will b no pain at all because she
will be given anesthesia.
C. Stand by her side and quietIy ask her to describe her feeIings.
D. Check her name tag and request anesthesiologist to sedate client
14. Which of the following clients statement indicates that he understands the nurse's instruction
about postoperative wound pain?
A. " shall call the nurse when my wound itches and smells.
B. "I shaII expect sIight pain and discomfort from the surgicaI incision".
C. " should call my doctor if my wound has no drainage and intact.
D. " should not touch my surgical wound
15. What do you think is an important responsibility related to pain that is subjective in nature?
A. Divert attention of client in pain
B. Leave the patient alone while in pain
C. BeIieve what the patient says about the pain
D. Assume responsibility to eliminate pain as described by the client
Situation -Nurse's attitudes toward the pain influence the way they perceive and interact with
clients
in pain.
16. Nurses should be aware that older adults are at risk of underrated pain. Nursing assessment
and
management of pin should address the following beliefs EXCEPT:
A. Older patients seldom tend to report pain than the younger ones
B. Pain is a sign of weakness
C. OIder patients do not beIieve in anaIgesics, they are toIerant
D. Complaining of pain will lead to being labeled a 'bad' patient
17. Nurses should understand that when a client responds favorably to a placebo, it is known as
the
'placebo effect'. Placebos do not indicate whether or not a client has:
A. Conscience C. Disease
B. ReaI pain D. Drug tolerance
18. You are the nurse in the pain clinic where you have client who has difficulty specifying the
location
of pain. How can you assist such client?
A. The pain is vague
B. By charting-it hurts all over
C. dentify the absence and presence of pain
. As the cIient to point to the painfuI are by just one finger
19. What symptom, more distressing than pain, should the nurse monitor when giving opioids
especially among elderly clients who are in pain?
A. Forgetfulness C. Drowsiness
B. Constipation D. Allergic reactions like pruritis
20. Physical dependence occurs in anyone who takes opioods over a period of time. What do
you tell
a mother of a 'dependent' when asked for advice?
A. Start another drug and slowly lessen the opioid dosage
B. ndulge in recreational outdoor activities
C. solate opioid dependent to a restful resort
. Instruct sIow tapering of the drug dosage and aIIeviate physicaI withdrawaI
symptoms
Situation 5- As a perioperative nurse, you are aware of the correct processing methods for
preparing
instruments and other devices for patient use to prevent infection.
21. tems that enter sterile tissue or vascular system are categorized as critical items and should
be:
A. Clean C. SteriIized
B. Decontaminated D. Disinfected
22. As an OR nurse, what are your foremost considerations for selecting chemical agents for
disinfection?
A. MateriaI compatibiIity and efficiency
B. Odor and availability
C. Cost and duration of disinfection process
D. Duration of disinfection and efficiency
23. Before you use a disinfected instrument it is essential that you:
A. Rinse with tap water followed by alcohol
B. Wrap the instrument with sterile water
C. Dry the instrument thoroughly
. Rinse with steriIe water
24. You have a critical heat labile instrument to sterilize and are considering touse high level
disinfectant. What should you do?
A. Cover the soaking vessel to contain the vapor
B. Double the amount of high level disinfectant
C. Test the potency of the high level disinfectant
. ProIong the exposure time according to manufacturer's direction
25. As a nurse, you know that intact skin acts as an effective barrier to most microorganisms.
Therefore, items that come in contact with the intact skin should be:
A. isinfected C. Clean
B. Sterile D. Alcoholized
Situation 6-The OR is divided into three zones to control traffic flow and contamination
26. What OR attires are worn in the restricted area?
A. Scrub suit, OR shoes, head cap
B. Head cap, scrub suit, mask, OR shoes
C. Mask, OR shoes, scrub suit
D. Cap, mask, gloves, shoes
33. Nursing intervention for a patient on low dose V insulin therapy includes the following,
EXCEPT:
A. EIevation of serum ketones to monitor ketosis
B. Vital signs including BP
C. Estimate serum potassium
D. Elevation of blood glucose levels
34. The doctor ordered to incorporate 1000u insulin to the remaining on going V. The strength
is
500 /ml. How much should you incorporate into the V solution?
A. 10 ml C. 0.5 ml
B. 2 mI D. 5 ml
35. Multiple vial-dose-insulin when in use should be
A. kept at room temperature C. kept in narcotic cabinet
B. kept in the refrigerator D. store in the freezer
Situation 8-Collaborative planning is essential if nursing and health care are to be made
available to
all people.
36. Perioperative examples of collaboration are the following EXCEPT:
A. Communicate with other members of the health profession to improve the
integrity
B. Communicate with health officials the incidence of Hepatitis B among OR
personnel
C. CoIIaboration with other OR personneI regarding the practices of surgeons
coIIecting exorbitant professionaI fees
D. Collaborate with DOH regarding disposal or specimens
37. The nurses collaborate with other members of the health profession to improve the integrity
of the
hospital working environment the following ways EXCEPT
A. Joining barangay health club projects
B. Joining the Mayo Uno Labor Union
C. Joining labor day rally to increase wages of healthcare workers and improve
dilapidated health centers
D. Affiliating with The Healthcare Alliance
38. An example of collaborating effort on public service particularly during summer is:
A. Boto mo, patrol mo C. Clean and Green
B. Operation Linis . Operation TuIi
39. When does a nurse reject the interdependence of providers and patients in achieving
access to
health care?
A. "Our hospitaI does not honor visiting doctors"
B. When the nurse replies to the client's relative "You have the best doctor in town
C. When the nurse communicates to the attending physician the desire of the patient
to be seen by a urologist
D. "The doctor is not on duty today
40. ndividual patients and society as a whole benefit from nursing participation in decisions
made
about health care. This is exemplified in:
A. Supporting poIiticaI candidates that advance nursing care issues
B. Bringing the NCLEX in Philippines
C. Supporting the proliferation of colleges of nursing in the country
D. Following the decision of CGFNS to retake Test and V to validate the visa
screen for the U.S.
Situation 9-pain management is not limited to pharmacological means:
41. Ronald one of your clients who is being worked out for ADS tells you that he has been
using
acupuncture to help with his pain. You questioned his treatment because:
A. Acupuncture uses needIes to stimuIate certain points on the body to treat
pain
B. Acupuncture uses variety of herbs and oils from wild plants
C. Acupuncture uses manipulation of the skeletal muscles to relieve stress and pain
D. Acupuncture uses pressure from the fingers and hands to stimulate body
responses
42. Your younger brother came home with right black eye. He asked you for an eye ointment to
relieve the pain and swelling. You should offer:
A. ice pack over the right eye B. hot compress over the right eye
C. tetracycline ophthalmic ointment D. ice cold drinks
45. Menstrual pain and discomfort account for absences in schools and offices. A
nonpharmacological
remedy for menstrual pain is:
A. regular bowel movement
B. knee-chest exercise before menstruation and hot water bag appIication
over Iower abdomen during onset
C. warm shower during onset of menstrual period
D. diet restriction on fatty foods and liberal fluid intake
Situation 10 One learns by doing especially when you practice the best methods.
46. Which action by a new nurse signifies a need for further teaching in infection control?
A. The nurse places the side rails the time to an unconscious patient
B. The nurse elevates the head of the bed to check the BP.
C. The nurse uses her bare hands to change the dressing
D. The nurse applies oxygen catheter to the mouth.
47. You are on PM shift and about 5 patients are of discharge. You noted that the orderly was
looking
through the items of one of the patients. Which action should you pursue?
A. CaII the attention of the orderIy in private
B. gnore the situation because you are busy
C. Report this behavior to the nurse in charge
D. Monitor the situation and note whether any other items are reported missing.
48. What appropriate action should you do when you overhear the nursing attendant speaking
harshly
to an elderly patient?
65. Rosie, 57, who is diabetic is for debridement if incision wound. When the circulating nurse
checked the present V fluid, she found out that there is no insulin incorporated as ordered.
What
should the circulating nurse do?
A. oubIe check the doctor's order and caII the attending M
B. Communicate with the ward nurse to verify if insulin was incorporated or not
C. Communicate with the client to verify if insulin was incorporated
D. ncorporate insulin as ordered.
Situation 14 Technology and patient's education has dramatically improved the management
of the
diabetic client.
66. The current insulin pumps available in the market have the following capability, EXCEPT:
A. Prevent unexpected saving in blood glucose measurements.
B. etect signs and symptoms of hypogIycaemia and hypercaIcemia.
C. Deliver a pre-meal bolus dose of insulin before each meal.
D. Deliver a continuous basal rate of insulin at 5.0 units to 2.0 units per hour
67. Discharge plan of diabetic clients include injection-site-rotation. You should emphasize that
the
space between sites should be:
A. 6 cm
B. 5 cm
C. 2.5 cm
D. 4 cm
68. t is critical also that a diabetic client should be educated in the possible sites if regular
insulin
injection. The fastest absorption rate happens at the tissue areas of:
A. Gluteal area
B. Deltoid area
C. Anterior area
. AbdominaI area
69. Self-monitoring of blood glucose (SMBG) is recommended for patient's use. You will
recommend
this technology in the following diabetic patients, EXCEPT:
A. CIient with proIiferative retinopathy
B. Unstable diabetes
C. Hypoglycemia without warning
D. Abdominal renal glucose threshold
70. t is necessary for a diabetic client to exercise regularly. What is the effect of regular
exercise to a
diabetic client?
A. t burns excess glucose
B. t improves insulin utilization and lowers blood glucose
C. It Iowers gIucose, improves insuIin utiIization; decrease totaI trigIyceride
IeveIs
D. t will make you fit and energized
Situation 15- RN's should always be conscious that the contents in charting are admissible in
court
as evidence.
71. f there is any deviation from normal practice or procedure e.g. streptomycin was given by V
not
M, this should documented in the:
A. Progress notes
B. Incident report
C. Nurse's not
D. Patient's chart
72. The documentation of all nursing activities performed is legally and professionally vital.
B. Eyewear
C. Gloves
D. Face shields
95. Traffic patterns in the OR suite should.
A. Prevent unauthorized personnel from entering the OR
B. Prevent transmission of pathogenic microorganisms
C. Assure that the personnel walk in the same direction
D. Allows personnel to move freely between restricted and unrestricted areas
Situation 20- Nokia is so powerful to "connect people from the continent to continent, all
through
communication via the cellphone. Other ways of communicating to relay information or
instructions exist even in the healthcare setting.
96. An anesthesiologist is preparing to do a spinal anesthesia to a 220 lb, 30 year old athlete
she
request the circulating nurse to prepare a pink spinal set with another blue set as stand by.
What
gauge spinal sets will make available in the OR suite?
A. Gauge 16 and 22
B. Gauge 18 and 16
C. Gauge 16 and 20
D. Gauge 5 and 22
97. Medical gases are used a lo9t in the OR. Some gases are used to operate equipment and
some
are used to administer general anesthesia through inhalation. What is the identifying color of the
tank which contains 'laughing gas'?
A. Yellow
B. Green
C. Black
. BIue
98. On the traffic light, yellow means "proceed with caution. n the field of healthcare, where do
you
discard your used tissue papers?
A. YeIIow bin
B. Orange bin
C. Green bin
D. Black bin
99. An instrument tray with black striped autoclave/steam chemical indicator tape communicates
that
the instrument tray...
A. s clean
B. s ready for use in surgery
C. s sterile
. Has undergone the steriIization process
100. n health care when lad apron is required in any procedure like orthosurgery, there is
danger of
exposure to:
A. Water and blood splashes
B. Pseudomonas
C. Radiation
D. Bone fragments
SUBMIT THIS TEST BOOKLET TOGETHER WITH THE ANSWER SHEET TO YOUR
WATCHERS. BRINGING THE TEST BOOKLET OUT OF THE ROOM WILL BE A
GROUN FOR CANCELLATION OF YOUR EXAMINATION.
***END***
NURSING PRACTICE IV SET A
______________________________________________________________________
__
NURSNG PRACTCE V Foundation of PROFESSONAL Nursing Practice
GENERAL NSTRUCTONS:
16. This test booklet contains 100 test questions.
17. Read NSTRUCTONS TO EXAMNEES printed on your answer sheet.
18. Shade only one (1) box for each question on your answer sheets. Two or more boxes shaded
will invalidate your answer.
19. AVOD ERASURES.
20. This is PRC property. Unauthorized possession, reproduction, and/or sale of this test is
punishabIe by Iaw. Per RA 8981.
______________________________________________________________________
__
NSTRUCTONS:
10. Detach one (1) answer sheet from the bottom of your Examinee D/Answer Sheet
Set .
11. Write the subject title "Nursing Practice IV" on the box provided.
12. Shade Set Box "A on your answer sheet if your test booklet is Set A; Set Box "B if your test
booklet is Set B.
MULTPLE CHOCE
101. You are the nurse in an Adult Care Unit. You over0hear one of your co-staff nurse
assigned to Aling Josie who is 78 years old say, that if she refuses to take her medications,
she will not be given her favorite dessert. You report your co-staff's behavior as:
A. Battery C. Negligence
B. AssauIt D. Malpractice
102. Jake is in the Post Anesthesia Care Unit follwing a colorectal resection. He has an V
of Dextrose 5% Lactated Ringers Solution. Upon assessment you observe that he is exhibiting
sudden onset of crackles in the lungs, moist respiration and tachypnea. Which of the following
will you do FRST?
A. Notify anesthesiologist C. Place on Fowler's position
B. ncrease O2 flow rate . Reduce IV rate
103. As a head nurse of the unit, which of the following sources should you take into
consideration when making effective assignments for the next shift?
A. seniority preferences
B. recent performance evaluation
C. personality traits
. cIient cIassification data
104. Four clients injured in an automobile accident enter the emergency department (ED) at
the same time and are immediately seen by a triage nurse. As the triage nurse, you would
assign the HGHEST priority to the client with the:
A. severe head injury and no blood pressure
B. maxiIIofaciaI injury and gurIing respirations
C. second trimester pregnancy with premature labor
D. lumbar spinal cord injury and lower extremity paralysis
105. When a nurse volunteers to work in a hospital setting and she commits a mistake, who
is legally responsible?
A. voIunteer nurse, hospitaI and the nurse in charge
B. the professional organization which the volunteer nurse represents
C. hospital
D. volunteer nurse because there is no employer employee relationship
106. Daniel with multiple myeloma complains of deep bone pain. As his nurse, which of the
following will you do FRST?
A. Assess bone pain
B. Administer prescribed analgesic
C. Teach pain relief strategies
D. Support position with pillow
107. You are reviewing the laboratory results of Clare who has rheumatoid arthritis. Which
laboratory result should you expect to find?
A. ncreased platelet count
B. Altered blood urea nitrogen (BUN) and creatinine levels
C. Electrolyte imbalance
. EIevated erythrocyte sedimentation rate (ESR)
108. Mrs. Paras is receiving total parenteral nutrition (TPN). f you will evaluate her
nutritional status, which of the following indicators will tell you that TPN was effective?
A. laboratory work up
B. adequate hydration
C. weight gain
D. diminish episode of nausea and vomiting
109. While Jayvee, a burn patient is being transferred from the burn unit to the operating
room, the V bottle fell on Jayvee's head. He sustained a laceration on his forehead. The nurse
was proven guilty of negligence. Which of the following did the nurse fail to do?
A. Hold the V bottle
B. Check the V stand
C. PIace the IV stand on the foot part of the stretcher
D. Restrain Jayvee
110. While Mrs. Enriquez is receiving chemotherapy which of the following will you include
in the plan of care to address her nutritional needs?
A. administer Compazine before meaIs
B. enrich diet with red meats
C. serve hot soup and food
D. increase the amount of spice in the diet
111. Nurses working in the 35 bed Female Medical Unit were noted to implement new and
innovative client care activities long before other units in the hospital. Which of the following
leadership characteristics exhibited by the nurse manager best describes this strength?
A. Communication skills C. Vision and passion
B. Knowledge and skills D. nterpersonal abilities
112. Olga is receiving D5W 1 liter regulated at 30 drops/min to be consumed in 8 hrs. t was
started at 8am. At 10am, her relative informed you that the bottle is empty. Which of the
following will you do first?
A. refer to nurse manager
B. assess Olga and check level of fluid left in the bottle
D. Client's needs are assessed and individualized care plan are developed for each
client.
120. Because of increase incidents of medication error due to wrong transcription of
physician medication orders by the nurse, a tertiary hospital utilized a computerized
medication order system. Which of the following procedures may be done through the said
system?
A. Correct errors in the physician medication order
B. Eliminate drug interaction
C. Provide a list of drugs with their generic name
D. Document drug administration
SITUATIONAL
Situation 1 - P. Cruz, 65 years old, was admitted in the Telemetry because of signs and
symptoms of acute myocardial infarction. You are expected to recognize
electrocardiographic readings on the cardiac monitor.
121. Which of the following appear abnormal on an EKG when ischemia and injury occur in
the myocardium?
A. QRS interval C. P wave
B. ST segment D. PR interval
122. From an ECG reading, a QRS complex represents:
A. VenticuIar depoIarization C. End of ventricular
depolarization
B. Ventricular repolarization D. Atrial depolarization
123. Which of the following represents ventricular repolarization?
A. T wave C. QRS complex
B. ST segment D. PR interval
124. t is important that the nurse measures intervals of QRS complex. Which of the
following represent the normal interval of QRS complex?
A. greater than .20 sec C. .10 sec
B. .20 sec D. .12 sec to .20 sec
125. Later in the acute phase of Myocardial nfarction, which of the following typically
appears as the first sign of tissue death?
A. ST segment suppression C. Prolonged PR interval
B. Short T wave . PathoIogic Q wave
Situation 2 - To be able to help our clients with their psychological concerns, we have to
explore how they view themselves and their body image.
126. When assessing patient's body image, which of the following would be most important
to ask?
A. What are your hobbies?
B. What kind of work did you do prior to this illness?
C. Are your living accommodation all on one level?
D. What kind of food do you like?
127. The most appropriate nursing intervention to facilitate client's acceptance of a change
in body image would be to:
A. encourage dependence
B. estabIish a therapeutic reIationship
Situation 7 - Mang Felix, a 79 year old man who is brought to the Surgical Unit from PACU
after a transurethral resection. You are assigned to receive him. You noted
that he has a 3-way indwelling urinary catheter for continuous fast drip
bladder irrigation which is connected to a straight drainage.
151. mmediately after surgery, what would you expect his urine to be?
A. Light yellow C. Bright red
B. Amber . Pinkish to red
152. The purpose of the continuous bladder irrigation is to:
A. allow continuous monitoring of the fluid output status
B. provide continuous fIushing of cIots and debris from the bIadder
C. allow for proper exchange of electrolytes and fluid
D. ensure accurate monitoring of intake and output
153. Mang Felix informs you that he feels som discomfort on the hypogastric area and he
has to void. What will be your most appropriate action?
A. Remove his catheter then allow him to void on his own
B. rrigate his catheter
C. tell him to "Go ahead and void. You have an indwelling catheter.
. assess coIor and rate of outfIow, if there is a change refer to uroIogist for
possibIe irrigation.
154. You decided to check on Mang Felix's V fluid infusion. You noted a change in flow
rate, pallor and coldness around the insertion site. What is your assessment finding?
A. Phlebitis
B. InfiItration to subcutaneous tissue
C. Pyrogenic reaction
D. Air embolism
155. Knowing that proper documentation of assessment findings and interventions are
important responsibilities of the nurse during first post operative day, which of the following is
the LEAST relevant to document in the case of Mang Felix?
A. Chest pain and vital signs
B. ntravenous infusion rate
C. Amount, color, and consistency of bladder irrigation drainage
. Activities of daiIy Iiving started
Situation 8 - Many hospitals form bioethical review committees to ensure better quality of
life of patients. You are invited by the nursing service department to
participate in their bioethical review committee. You are expected to know the
purpose and apply bioethical principles.
156. Which of the following is the purpose of the ethical review committee?
A. Promote impIementation of generaI standards
B. Enhance health care provider's liability
C. ncrease individuals responsibility for decision making
D. Decrease public scrutiny of health care provider's action
157. Daria who is admitted to the hospital with autoimmune thrombocytopenia and a platelet
count of 20,000/L develops epistaxis and melena. Treatment with corticosteroids and
immunoglobulin has not been successful. Her physician recommended splenectomy. Daria
states " don't need surgery. This will go away on its own. n considering your response to
Daria, you must depend on the ethical principle of:
A. Beneficence C. Autonomy
B. Justice D. Advocacy
158. Zorayda is terminally ill and is experiencing severe pain. She as bone and liver
metastasis. She has been on morphine for several months now. Zorayda is aware that they
are having financial problems. She decides to sign a DNR form. What ethical principle did
Zorayda and her family utilize as basis for their decision to sign a DNR.
A. Justice C. Beneficence
B. Autonomy D. Advocacy
159. Tricia, a staff nurse working in a cancer unit, is considered a role model not only by her
colleagues but also by her patients. She goes out of her way to help other. She is very active
in their professional organization and she practices what she teaches. What ethical principles
is she practicing?
A. Beneficence C. Advocacy
B. Autonomy D. Justice
160. You are commuting to work riding the LRT. An older person collapsed and nobody
seem to notice her. The security guard tried to make her sit down but she remained
unconscious. You saw what happened and you decided to help. With help, you brought the
patient to the nearest hospital. You learned later that woman was diabetic. She was on her
way to the diabetes clinic to have her fasting blood sugar tested. She developed
hypoglycemia. You were able to save a life. You felt good. What principle was applied?
A. Advocacy C. Justice
B. Beneficence D. Autonomy
Situation 9 - Ensuring safety before, during and after a diagnostic procedure is an
important responsibility of the nurse.
161. To help Fernan better tolerate the bronchoscopy, you should instruct him to practice
which of the following prior to the procedure?
A. clenching his fist every 2 minutes
B. breathing in and out through the nose with his mouth open
C. tensing the shoulder muscles while lying on his back
D. holding his breath periodically for 30 seconds
162. Following a bronchoscopy, which of the following complains to Fernan should be noted
as a possible complication:
A. nausea and vomiting
B. shortness of breath and IaryngeaI stridor
C. blood tinged sputum and coughing
D. sore throat and hoarseness
163. mmediately after bronchoscopy, you instructed Fernan to:
A. exercise the neck muscles
B. breathe deepIy
C. retrain from coughing and talking
D. clear his throat
164. Thoracentesis may be performed for cytologic study of pleural fluid. As a nurse your
most important function during the procedure is to:
A. keep the sterile equipment from contamination
B. assist the physician
C. open and close the three-way stopcock
. observe the patient's vitaI signs
165. Right after thoracentesis, which of the following is most appropriate intervention?
A. instruct the patient not to cough or deep breathe for two hours
B. observe for symptoms of tightness of chest for bIeeding
C. place an ice pack to the puncture site
D. remove the dressing to check for bleeding
Situation 10 - As a nurse you are expected to be competent in utilizing the nursing process
in the care of your clients.
166. Getty is receiving chemotherapy for cancer. You review Getty's laboratory report and
note that he has anemia. To which nursing diagnosis should you give the highest priority?
A. Activity intolerance
B. mpaired oral mucous membrane
C. Impaired tissue perfusion, cerebraI, cardiovascuIar, gastrointestinaI
D. mpaired tissue integrity
167. An immediate objective for nursing care of an overweight mildly hypertensive client
with ureteral colic and hematuria is to decrease:
A. Hypertension C. hematuria
B. Pain D. weight
168. A difficult problem to deal with when caring for a patient with a partial-thickness burns
sustained 3 days ago is:
A. alteration in body image C. frequent dressing change
B. maintenance of sterility . severe pain
169. Which outcome criterion would be most appropriate for a client with a nursing
diagnosis of ineffective airway clearance?
A. Continued use of oxygen when necessary
B. Breath sounds cIear on auscuItation
C. Respiratory rate of 24/min
D. Presence of congestion
170. Which assessment would be most supportive of the nursing diagnosis, impaired skin
integrity related to purulent wound drainage.
A. Heart rate of 88 beats/min C. OraI temperature of 38.8 deg C
B. Dry and intact wound dressing D. Wound healing by first intention
Situation 11 - Nurses have important responsibilities when caring for hospitalized acutely ill
patients.
171. Domingo, 80 years old diabetic and hypertensive is admitted in the private ward for
degenerative neurological changes. His physician was considering dementia. Side rails were
placed to ensure that he will not fall from bed. At 2:00 AM, the call light at his room was on.
You came in and saw Domingo slumped on the floor moaning. His daughter told you that he
got out of bed to go to the toilet. He climbed over the side rail but his foot got caught in the
beddings. He has an open wound on his forehead. Which among the following will you do
FRST?
A. Transfer him to bed
B. Apply restraints
C. Ensure airway, breathing, circuIation
D. Call his physician
172. Aimee has chest pain and decides to take nitroglycerine en route to the hospital. Based
on the ECG obtained on admission at the ER and clinical findings, the physician gave a
diagnosis of myocardial infarction (M) and prescribed V morphine to relieve continuing pain.
A primary goal of nursing care for Aimee is to recognize life-threatening complications of M.
As Aimee's nurse, you have to anticipate occurrence of complications. Take note that the
major cause of death after an M is:
A. Cardiac arrhythmias C. Cardiogenic shock
B. Heart failure D. Pulmonary embolism
173. The cardiac monitor indicates that Cedric's heart rate has increased to 150 beats per
minute. Shortly after this increase, you notice Cedric is in ventricular tachycardia. after
reporting this to the physician, you anticipate that the physician will order.
A. intracardiac epinephrine
B. insertion of a pacemaker
C. boIus of Lidocaine
D. manual cardiopulmonary resuscitation
174. Hermie with a left-sided heart failure complains of increasing shortness of breath and is
agitated and coughing up of pink-tinged foamy sputum. You should recognize this as signs
and symptoms of:
A. cardiogenic shock C. acute puImonary edema
B. right-sided heart failure D. pneumonia
175. You are caring for Lulu has acute pulmonary edema. To immediate promote
oxygenation and relief of dyspnea, you should first:
A. perform chest physiotherapy
B. have her take deep breaths and cough
C. pIace LuIu on high fowIer's position
D. administer oxygen
Situation 12 - Acute respiratory distress is life threatening. Your presence and critical
decision making as a nurse are important.
176. Frank is admitted to the ntensive Care Unit with a diagnosis of acute respiratory
distress syndrome. When assessing Frank you would expect to find:
A. facilitate Frank's verbal communication
B. maintain sterility of the ventilation system
C. assess his response to the equipment
D. prepare him for emergency surgery
E. yspnea, FIaring of the Nares
177. Frank's respiratory status necessitates endotracheal intubation and positive pressure
ventilation. Your most immediate nursing intervention for Frank at this time would be to:
A. facilitate Frank's verbal communication
B. maintain sterility of the ventilation system
C. assess his response to the equipment
. prepare him for emergency surgery
178. Tiger with a pulmonary embolus is intubated and placed on mechanical ventilation.
When suctioning the endotracheal tube, you should:
A. apply suction while inserting the catheter
B. use short and jabbing movements of the catheter to loosen secretions
C. hyperoxygenate with 100% oxygen before and after suctioning
D. suction two to three timed in quick succession to remove all secretions
179. As a nurse, you should observe Bernard, who has a restrictive airway disease, for early
indications of respiratory acidosis, which include:
A. light-headedness C. bradycardia
B. bradypnea . restIessness
180. The physician orders low concentration oxygen to be given continuously for Kenneth
who has a chronic obstructive pulmonary disease to prevent:
A. an excessive drying of the respiratory mucosa
B. depression of the respiratory center
C. rupture of emphysematous bullae
D. a decrease in red blood cell formation
Situation 13 - As a nurse you have to be prepared to care for patients receiving blood
transfusion. The physician has ordered 3 units of whole blood to be
transfused to Diego following following a repair of a dissecting aneurysm of
the aorta.
181. You are preparing a unit of whole blood for transfusion. From the time you obtain it
from the blood bank how long should you infuse it?
A. hours C. 2 hours
B. 1 hour D. 6 hours
182. What should you do FRST before you administer blood transfusion?
A. Check V site and use appropriate BT set and needle
B. Verify physician's order
C. Verify client identity and blood product blood product, serial number, blood type,
cross matching results, expiration date with another nurse
D. Verify client identity and blood product, serial number, blood type, cross matching
results, expiration date
183. As Diego's nurse what will you do after the transfusion has been started?
A. Discontinue the primary V of Dextrose 5% water
B. Stay with iego for 15 minutes to note for any possibIe BT reaction
C. Check his vital signs every 15 minutes
D. Add the total amount of the blood to be transfused to the intake and output
184. Diego is undergoing blood transfusion of the first unit. The earliest signs of transfusion
reactions are:
A. oliguria and jaundice
B. urticaria and wheezing
C. hypertension and flushing
. headache, chiIIs, fever
185. n case Diego will experience an acute hemolytic reaction, what will be your priority
intervention?
A. mmediately stop the blood transfusion, infuse dextrose 5% in water and call the
physician
B. Slow the blood transfusion and monitor the patient closely
C. mmediately stop the blood transfusion, notify the blood bank and administer
antihistamines
. ImmediateIy stop the bIood transfusion, infuse normaI saIine soIution, caII
the physician, notify the bIood bank
Situation 1 - Based on studies of nurses working in special units like the intensive care unit
and
coronary care unit, it is important for nurses to gather as much information to be able to
address their needs for nursing care.
186. Critically ill patients frequently complain about which of the following when
hospitalized?
A. Hospital food C. Lack of privacy
B. Lack of blankets D. nadequate nursing staff
187. Who of the following is at greatest risk of developing sensory problem?
A. Female patient C. Transplant patient
B. Adoloscent . Unresponsive patient
188. Which of the following factors may inhibit learning in critically ill patients?
A. gender
B. medication
C. educational level
D. previous knowledge of illness
189. Which of the following statements does not apply to critically ill patients?
A. Majority need extensive rehabilitation
B. AII have been hospitaIized previousIy
C. Are physically unstable
D. Most have chronic illness
190. Families of critically ill patients desire which of the following needs to be met first by the
nurse?
A. Provision of comfortable space
B. EmotionaI support
C. Updated information on client's status
D. Spiritual counseling
Situation 15 - Pain is the most common reasons why people consult their physicians. t is now
regarded as the 5th vital sign. This strategy is used to give emphasis on how pain
should be managed. You have collaboration as well as independent nursing
interventions for pain.
191. The WHO Analgesic ladder provides the health professional with:
A. pharmacologic and nonpharmacologic pain management choices
B. generaI pain management choices based on IeveI of pain
C. nonpharmacologic interventions based on level of pain
D. specific pain management choices based on severity of pain
192. As a nurse caring for patients in pain, you should evaluate for opioid side effects which
include the following EXCEPT:
A. physicaI dependence C. Respiratory depression
B. pruritus D. constipation
193. Which of the following statements about cancer pain is NOT TRUE:
A. undertreatment of pain is often due to a clinician's failure to evaluate the severity of
the client's problem
B. adjuvant medication such as steroids, anticonvuIsants, non-steroidaI antiinfIammatory
drugs enhance pain perception
C. opioids are drug of choice for severe pain
D. pain associated with cancer and the terminal phase of the disease occurs in
majority of patients
194. Jack has been on morphine on a regular basis for several weeks. He is now
complaining that the usual dose he has been receiving is no longer relieving his pain as
effectively. Assuming that nothing has changed in his condition, you would suspect that Jack
is:
A. becoming psychologically dependent
B. needing to have morphine discontinued
C. deveIoping toIerance to morphine
D. exaggerating his level of pain
195. The guidelines for choosing appropriate nonpharmacologic interventions for pain
include all of the following EXCEPT:
A. pain problem identification
B. type of opioid being used
C. skill of health professional
D. effectiveness for patient
Situation 16 - The nurse's accurate assessment is very crucial in preventing complication
during
the severe post burn period.
196. Dino sustained circumferential thermal burns of the left upper extremity and chest. You
noted that pulse could not be appreciated in his injured extremity. Which of the following will
you do FRST?
A. Elevate the injured extremity to increase blood flow to the heart
B. Remove the dead tissues which impede circulation
C. Try to take the pulse in the uninjured extremity
. Notify the physician immediateIy as this requires emergency intervention
197. While unloading containers with chemicals from a truck, Mark accidentally spilled the
whole can of corrosive chemicals all over his body. Which of the following would you consider
as the priority intervention in the emergency management of Mark?
A. Maintain a patent airway
B. Wash the chemical off with cool water
C. Assess for associated injuries
. Remove aII cIothing containing the chemicaI
198. You are assigned in the Burn Unit and you are going to evaluate the status of
Raymond who sustained a burn injury 12 hours ago and has a urinary output of 200 ml since
the injury. Which of the following will you do FRST?
A. ncrease the rate of the V fluid
B. Administer the prescribed Furosemide (Lasix)
C. Check catheter for kinks
D. ncrease the oral intake to 30/hr
199. Kathy, who has partial-thickness burns on the face, inquiries about skin care after
discharge. Which of the following should you include in your discharge teaching?
A. Continue to eat high caloric high food for the next month
B. Wear a pressure garment daily for one year
C. Avoid sunIight for the next three months
D. Avoid facial makeup for at least a year
200. You are caring for Lenard who sustained severe burn injury and he is in the emergent
phase of burn injury. As his nurse, you gathered the following: Hemoglobin 13.5 g/100 ml,
Hematocrit 50%, serum Na 130 mEq/L. How will you explain the laboratory results?
A. These are due to hemodilution from rapid V fluid replacement
B. All the laboratory tests are within normal rage
C. They are slightly abnormal but will normalize once V fluids have been started
. These are due to a Ioss of serum and interstitiaI fIuid through the burn
wound.
SUBMIT THIS TEST BOOKLET TOGETHER WITH THE ANSWER SHEET TO YOUR
WATCHERS. BRINGING THE TEST BOOKLET OUT OF THE ROOM WILL BE A
GROUN FOR CANCELLATION OF YOUR EXAMINATION.
***END***
NURSING PRACTICE V SET A
______________________________________________________________________
__
NURSNG PRACTCE V Foundation of PROFESSONAL Nursing Practice
GENERAL NSTRUCTONS:
21. This test booklet contains 100 test questions.
22. Read NSTRUCTONS TO EXAMNEES printed on your answer sheet.
23. Shade only one (1) box for each question on your answer sheets. Two or more boxes shaded
will invalidate your answer.
24. AVOD ERASURES.
25. This is PRC property. Unauthorized possession, reproduction, and/or sale of this test is
punishabIe by Iaw. Per RA 8981.
______________________________________________________________________
__
NSTRUCTONS:
13. Detach one (1) answer sheet from the bottom of your Examinee D/Answer Sheet
Set .
14. Write the subject title "Nursing Practice V" on the box provided.
15. Shade Set Box "A on your answer sheet if your test booklet is Set A; Set Box "B if your test
booklet is Set B.
MULTPLE CHOCE
SITUATIONAL
Situation 1 - The following questions refer to nurse's efforts to do collaboration and teamwork.
Select
the best answer.
1. The most important role of the nurse as a member of the team is to:
A. carry out medical orders
B. meet the needs for the physical well being of patients
C. coordinate the psychoIogicaI care and management of cIients
D. keep a 24 hour watch for the patients
2. A biological/medical approach to patient care utilizes which of the following?
A. Million therapy C. Behavioral therapy
B. Somatic therapy D. Psychotherapy
3. Which of these nursing actions belong to the secondary level of preventive intervention?
Situation 3 - Mr. Sison has been diagnosed as having early chronic glaucoma. He has been
admitted to the hospital for treatment.
11. The nurse identified a nursing problem of disturbed sensory perception: visual impairment
characterized by:
A. sudden loss of eyesight
B. loss of night vision
C. Ioss of peripheraI vision
D. loss of central vision
12. n order to understand the rationale for drug therapy, it is important for the nurse to know
that glaucoma is usually caused by:
A. opacity in the lens
B. gradual diminution of the retina
C. damage to the proteins in the lens
. increase production of aqueous fIuid
13. Diamox is a drug used in the treatment of glaucoma. Which of these is the effect of this
drug?
A. Constricts the pupil
B. Acts as osmotic diuretic
C. Reduces the production of aqueous humor
D. Facilitates outflow of aqueous humor
14. Public health nurses should identify which of these patients as a risk group for
development of glaucoma, hence the need for annual eye examinations:
A. Patient with Parkinson's disease
B. Cancer patients
C. iabetic and hypertensive patients
D. Patient with COPD
15. The appropriate method of instilling eye drops is: nstilling into an opened eye, with the
head held back and with the eye looking:
A. Upward C. aggressiveness
B. downward D. suspiciousness
Situation - SEXUAL DSORDER
16. A hospitalized male adolescent flirts with and is sexually provocative toward a female
nurse. The nurse can respond MOST therapeutically by doing which of the following?
A. Telling him she is married and too old for him
B. ntroducing him to female clients his own age
C. Encouraging him to watch TV in his room
. Ignoring his fIirtatious and provocative behaviors
17. The premorbid personality of a person with a non-psychotic maladaptive response to
anxiety may most accurately be described as:
A. unpredictable, impulsive and aggressive
B. rigid, insecure and conforming
C. dependent, pessimistic and moody
. anxious, insensitive and seIf-absorbed
18. An oral-dependent personality is characterized by which of the following?
A. Helplessness C. Aggressiveness
B. Hopelessness . Suspiciousness
27. n order to assess "Reliability as a behavioral characteristic, the nurse would ask herself
which of the following questions regarding her recording:
A. Did the history of the present problem correlate with the review of growth and
development?
B. How long did it take to complete the nursing data base?
C. s the nursing data base complete?
. Are the nursing history and psychosociaI assessment accurate?
28. All of these are the advantages of peer review EXCEPT:
A. Demands accountability for nursing actions
B. Has the possibility of enhancing intra professional respect
C. It requires the deveIopment of standards for quaIity care
D. Provide an evaluation of the nurse's abilities
29. The nursing team leader wants to involve all the nurses in participating in their own
personal and professional growth through a brainstorming session. One of the most
important ground rules is:
A. Follow the problem solving approach
B. o not pass judgment on the ideas presented
C. deas must be feasible
D. Suggestions must be cost effective
30. "Did the nurse perform in the best possible manner without waste? aims to describe the
nurse's:
A. thoroughness C. efficiency
B. reliability D. analytic sense
Situation 7 - A nurse was interested to study the research question: "What are the
differences and similarities between aggressive and non-aggressive cognitively
impaired, elderly, institutionalized people?
31. nvestigation of cognitively impaired individual presented some ethical dilemmas. Which of
the following protocol would be considered unethical?
A. Recording interaction with the elderly with their permission
B. VerbaI permission from the subject is unnecessary
C. Data coded and recorded solely by the investigation
D. A written consent from the institution and a significant other
32. A semi-structured interview was conducted. This means that:
A. nterview is conducted precisely in the same manner
B. nterviewer is not held to any specific question
C. Subject is allowed to express without any suggestion from interviewer
. Interviewer is free to probe beyond a number of specific major questions
33. The type of study conducted is:
A. escriptive C. experimental
B. Quasi-experimental D. case study
34. The review of literature included reference to retrospective studies. Such studies have the
advantages EXCEPT:
A. Data are inexpensive to obtain
B. PossibiIity of memory bias and distortion of fact
C. There is much material available
D. t is easy to get data
35. The average age of the respondents was 86. this represents:
A. the sum ages divided by totaI number of participants
B. the youngest participant is 86 years old
C. the oldest participant is 86 years old
D. most of the number participant is 86 years old
Situation 8 - Mr. David is brought to the hospital due to pain radiating to the hip and leg. He is
diagnosed with a herniated lumbar disk. H is scheduled for myelogram.
36. After the procedure, the nurse must include which of th following nursing action in his
care?
A. Assess for movement and sensation of the lower extremity
B. Place the client in most comfortable position
C. Lying supine with heels flexed
. Bed rest with bed eIevated at 5 degrees
37. Mr. David is scheduled for lumbar laminectomy. Post operatively the nurse should:
A. Logroll the client with the help of another nurse
B. nform the client that he should be in supine position
C. Assess the sensory Ioss in his Iegs
D. nstruct the patient to move from side to side
38. Trimethobenzamine Hydrochloride (Tigan) was administered postoperatively. The action of
this drug is effective when it:
A. ControIs nausea C. controls muscle spasm
B. Controls pain D. controls edema
39. Mr. David is to ambulate for the first time following surgery. What nursing action should be
BEST when the client begins to faint?
A. Get another nurse for help
B. Maneuver the client to a sitting position
C. Get back to his bed and place in side lying position
. Assist the cIient to form a wide base of support and Iean against the nurse
40. Mr. David has to wear back brace. Which position is recommended when the brace is
applied?
A. Sitting position C. lying on his side in bed
B. Standing position . supine position in bed
Situation 9 - Through the nurse-patient relationship, the nurse intervenes utilizing effective
communication techniques. The following are varied situations in a psychiatry
ward.
41. The patient verbalizes, "Masama and pakiramdam ko. Hindi ako nakatulog kagabi."A
therapeutic response of the nurse would be:
A. "Baka ini-istorbo ka na naman ng mga boses."
B. ,Sinabi mo sana sa nars nabigyan ka ng sedative mo."
C. Relax lang! Huwag ka masyadong mag-iisip ng mga problema mo."
'Maari mo bang sabihin sa akin and mga naiisip at nararamdaman mo?'
42. Soledad is terminally ill of cancer. Looking sad, she expresses, "Wala na yata akong
pagasang
mabuhay pa," A response which fosters hope is:
"Mukhang napakabigat ang dinaramdam ninyo ndito po ako at puwede
tayong mag-usap'
B. "Huwag po ninyong isipin ang sakit ninyo. Bale wala yon. Andito naman ako para
makausap ninyo."
C. "Lakasan ang loob ninyo. Lahat naman po tayo ay doon ang patutunguhan."
D. "Gagaling din po kayo. Huwag po kayong mag-aalala."
43. Camilia verbalizes, "Pinag-uusapan nila ako. Ayaw nila ako." A therapeutic response is:
A. "Nalulungkot ba ang pakiramdam mo?"
B. "Hayaan mo sila. Ang mahalaga ay ang palagay mo sa sarili mo."
C. 'Sino ang 'nila' na tinutukoy mo?"
D. "Huwag mong isipin yan. Hindi tama yan."
44. During socialization, Nicanor was provoked, became furious and started shouting "Walang
hiya kayo! Ako ang bida dito!" The nurse's action is:
A. Take him away form the group untiI he manages to have controI of himseIf.
B. mmediately restrain him and put him on isolation to protect other patients.
C. Prevent him from becoming more furious by giving an extra PRN dose of sedative.
D. Respond with, "Nicanor, pare-pareho lang kayo ng mga ibang pasyente dito."
45. Nicanor becomes verbally assaultive to the nurse. He says, "Ikaw, nurse, wala kanga lam!
Marunong pa ako sa iyo e. Ano ba ang ipinagmamalaki mo!" The nurse responds
therapeutically by:
A. admonishing him with, "Ako ang nurse dito. Dapat sumunod ka sa akin."
B. Acknowledging his behavior, however, put him in his right senses ; respond with,
"Oo nga, galit ka sa nurse pero hindi tama na naninigaw ka."
AcknowIedging his behavior and respond, 'Nagagalit ka sa nurse at
nawawala ka ng control sa sarili mo"
D. gnoring the behavior of the patient
Situation 10 - Nicanor was discharged form the hospital and recovered from a manic episode
of Bipolar Disorder. Ncanor was readmitted with an entirely different behavior.
he was very depressed.
46. The defense mechanism utilized by manic patients to cover up depression is:
A. reaction formation C. displacement
B. compensation D. denial
47. The psychodymanics of depression is:
A. lax super-ego
B. weak super-ego
C. internaIized hostiIity feeIings
D. narcissistic personality
48. Which of these drugs is likely to indicated to Nicanor?
A. Serenace (Haloperidol)
B. Valium (Diazepam)
C. TofraniI (Imipramine HCI)
D. Trilaton (Pherpenazine)
49. Therapeutic use of self is essential in relating with psychiatric patients. This is BEST
demonstrated in:
A. sympathizing with the miserable feelings of Nicanor
B. engaging Nicanor in productive activity
C. engaging Ncanor in introspective thinking
. suppressing her own feeIings toward NIcanor
50. After three days of antidepressant medication, Nicanor still manifests depression. The
nurse evaluates this as:
58. Which of these nursing approaches is MOST appropriate for the nurse to begin with?
A. Engage Marina for at least one hour in a one-to-one interaction daily
B. nvite her to socialize with other patients
C. Make seIf avaiIabIe whiIe maintaining distance untiI patient shows readiness
to interact
D. Refer her for activity therapy
59. When she resists to take her medication, it is best to:
A. let her read the drug literature to convince her that it is therapeutic
B. force her to take the drug to maintain therapeutic effectiveness of the drug
C. have the same nurse, who she interacts with reguIarIy, administer the drug
D. request the doctor to give her medication
60. Another reason why she refuses to take Thorazine is because she complains of robot like
movement and slurred speech. The nurse's action is:
A. decrease the dosage of thorazine
B. expIain the extrapyramidaI side effects and administer BenadryI
C. avoid giving foods that are rich in tyramine
D. withhold medication until referral is made to the doctor
Situation 13 - The supervising nurse received report that a staff nurse is displaying frequent
irritation, anger, and even indifference toward clients and co-workers.
61. The initial action of the supervisor would be to:
A. post guidelines on proper decorum of nurses in the bulletin board
B. write a memo of warning to the nurse
C. request anecdotal report form nurse's co-workers
. caII the nurse for a one on one conference
62. The nurse expressed increasing feelings of dissatisfaction. The supervising nurse
intervenes therapeutically by taking the role of:
A. administrator by relieving her of responsibilities
B. therapist by delving into the nurse's internal conflicts
C. counseIor by activeIy Iistening
D. educator by reorienting her of her role as a nurse
63. Coupled with poor work performance, mental and physical fatigue and actual withdrawal
from client contact and nursing duties, the nurse can be said to be suffering from:
A. psychotic anxiety
B. staff burnout
C. personality maladjustment
D. neurotic depression
64. A priority in the nurse's personal development would be to:
A. address her physical well-being
B. boost her self-confidence
C. provide social support
. heIp her find vaIue and meaning in her work
65. The most relevant professional program for her would be:
A. assertiveness training
B. stress management
C. group dynamics and team building
D. behavior modification
Situation 1 - The purpose of the nursing care plan is to identify the care for an individual
patient based on his problems. The nurse writes a nursing care plan for a
patient based on nursing care standards.
66. Given this example of a problem, "Anxiety due to a job interview. The "due to or the
reason for the problem should be included if it is known. The initial step in identifying
problems is:
A. gather data about the patient
B. determine if the problems are usual or unusual
C. analyze the data
D. analyze the problems as concisely as possible
67. Given this example of an expected outcome: "Openly verbalize anxiety about job
interview. dentify how he can prepare for the job interview. Which of these is not a
criterion of expected outcomes?
A. An expected outcome is stated in terms of what the patient will do
B. An expected outcome is stated in terms of what the nurse wiII do
C. Every outcome must be measurable
D. Every outcome answers the question "How will you know when the problem is
resolved?
68. The following are reasons for setting deadlines within which to achieve outcomes of care
EXCEPT:
A. ndicate specific times to review progress or lack of progress
B. oes not aIIow pIans to be changed
C. Allow plans the need to be changed
D. Set the time by which the expected outcome should be reached
69. Which of these is not a relevant nursing order?
A. Ask the patient any untoward side effects of medications he is taking
B. Have patient role play interview situation
C. Discuss with a patient with specific means he might prepare for the job interview
D. Ask the patient what he is feeling about the job interview
70. Which of these practices on evaluation support nursing care? Review of care plan is:
A. a nursing team responsibiIity
B. the sole responsibility of the primary nurse
C. the responsibility of peers
D. the sole responsibility of the supervisor
Situation 15 - A nurse assigned in the neurologic unit is taking care of clients with varying
degrees of degenerative disorders.
71. Ma. A with myasthenia gravis is having difficulty speaking. What communication strategies
should the nurse avoid when interacting with Mr. A?
A. Repeating what the client says for better understanding
B. Using paper and pencil in communicating with the client
C. Encouraging the client to speak slowly
. Encouraging the cIient to speak quickIy
72. When planning for nursing care for Mr. B who has Parkinson's disease, which of the
following goals would be MOST appropriate?
A. to improve muscle tone
B. to start rehabilitation as much as possible
C. to treat the disease
B. Hypertensive crisis
C. Hepatic failure
D. Risk of addiction
80. The nursing management of anxiety related with post traumatic stress disorder includes all
of the following EXCEPT:
A. encourage participation in recreation or sports activities
B. reassure client's safety while touching client
C. speak in a calm soothing voice
D. remain with the client while fear level is high
Situation 17 - For personal and professional development, the nursing staff decided to hold a
staff development program, "Self-enhancement through Assertiveness.
81. An appropriate assessment tool to maximize gathering of needs of nurses is through:
A. interview of nurses C. observation
B. survey D. brainstorming session
82. A priority objective of the program is:
A. develop the art of public speaking
B. project a positive image of the nursing profession
C. deveIop art and skiIIs of therapeutic use of seIf
D. earn continuing education units
83. The most effective way to practice assertiveness skills is through:
A. written evaluation form C. descriptive report
B. process recording . roIe pIay
84. The least satisfactory method to evaluate the effectiveness of the program is through:
A. group discussion and report
B. return demonstration
C. attendance
D. individual interviews
85. Which of these feedback from individual participants indicate maximum gain from the staff
development program?
A. " will write a plan for personal development program.
B. " feel very good. The program inspired me a lot.
C. " learned a lot. hope to have more seminars of its kind.
. "I have a "o it Now" project for myseIf i.e. to approach my cIinicaI
supervisor reguIarIy to discuss nursing care of our cIients."
Situation 18 - A vehicle hit some pedestrians while waiting for a bus ride. Some of the victims
suffered injuries in the different part of their bodies. The victims were brought to
the nearby hospital. One of the victims, Josephine was confirmed to have a
fractured left arm. While waiting for the plaster cast to be applied, Josephine
appears to be anxious.
86. To reduce anxiety, the nurse teaches the procedure to the client. which of the following
topics should NOT be included in the teaching plan?
A. Leave the cast uncovered to promote drying.
B. Bear weight on the pIaster cast for one hour. A stockinet wiII be pIaced over
the Ieft arm to be pIaced in cast.
C. Handle hardening cast with palm of hands
D. Trim and reshape finish cast with knife or cutter.
87. Cast was applied on Josephine's left arm. n assessing the neurovascular status of the
client, which of the following assessment findings should be reported to the physician?
A. Pain on the left arm
B. Swelling of the fingers
C. Skin abrasions on the edges of the plaster cast
. NaiI bed capiIIary refiII time of 10 seconds
88. One of the victims, a sixty year old woman sustained hip fracture. Prior to surgery, a
Buck's extension traction is to be applied. The rationale of traction is primarily based on the
understanding that Buck's extension traction:
A. reduces muscIe spasms and heIps to immobiIize the fracture
B. allows reduction of the fracture site for bone healing.
C. Secures the fracture site to prevent damage to the muscle tissues
D. Secures the fracture site for rigid immobilization
89. Phillip was placed in skeletal leg traction with an overbed frame. He is not allowed move
from side to side. Which of the following nursing interventions is useful in maintaining
effective traction?
A. Assist the client by holding the trapeze and raising the hips off the bed.
B. Check the apparatus, that weights hang free and knots in the rope are tied
secureIy
C. Suspend the trapeze within easy reach of the client
D. Support the affected extremity while the weights are removed.
90. To prevent complications when a child is in Buck's traction, the nurse should
A. clean the extremity and keep the skin dry
B. assess any skin and circuIatory disturbances
C. clean the pin sites as necessary
D. provide high fiber small meals
91. All of the following concepts are true EXCEPT:
A. Hostility is destructive
B. Frustration develops in response to unmet needs, wants and desire
C. Anger is incompatibIe with Iove
D. Aggression can be expressed in a constructive as well as a destructive manner.
92. Carlo is acting out hostile and aggressive feeling by kicking the chairs in the room. the
MOST effective way to deal with Carlo's behavior is initially to:
A. set Iimits on the behavior by verbaI command
B. administer PRN tranquilizer
C. remove the chairs from the room
D. restrain the patient and place him in the "solation Room
93. Mrs. Dizon was visiting her son at the Psychiatry Ward. Which of the following items will
the nurse not allow to be brought inside the ward?
A. string rosary bracelet C. bottIe of coke
B. box of cake D. rubber shoes
94. Which of the following will probably be most therapeutic for a patient on a behavioral
modification ward?
A. if the client is agitated, discuss the feelings especially anger
B. insist to stop obscene language by verbal reprimand
C. give cIient support and positive feedback for controIIing use of obscene
Ianguage
D. Provide a punching bag as an alternative to express upset emotions
95. Which of the following must be considered while planning activities for the depressed
patient?
A. activities which require exertion of energy
B. challenging activities to get him out of his depression
C. variety of structured activities
D. variety of unstructured activities
Situation 20 - Jim, age 25, recalled that his problem began around age 15-16. He would
count pencils in a mug over and over with the thought that stopping could result
in something bad happening.
96. There are many things Jim seems he has to do to keep himself from feeling:
A. confused C. excited
B. suspicious . anxious
97. He has change clothes 20 times before work, chew each bite he east 24 times and go up
and down the stairs four to five times before it feels right. He is demonstrating:
A. ideas of reference
B. denial and projection
C. obsession and compuIsion
D. rationalization and over reaction
98. The objective of nursing care for Jim is to develop or increase feelings of:
A. seIf-mastery C. self-actualization
B. self worth D. self-determination
99. All of these are therapeutic interventions EXCEPT:
A. impose limits every time the behavior becomes repetitive
B. establish a routine for him
C. assign task that can be done repetitiveIy
D. facilitate self-expression
100. Jim is aware of his behavior yet realizes that it is very disturbing to him. This is a
pattern of:
A. personality disorder C. neurosis
B. psychosis D. habitual disorder
SUBMIT THIS TEST BOOKLET TOGETHER WITH THE ANSWER SHEET TO YOUR
WATCHERS. BRINGING THE TEST BOOKLET OUT OF THE ROOM WILL BE A
GROUN FOR CANCELLATION OF YOUR EXAMINATION.
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