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NURSING PRACTICE V

Situation 1: Nick, a 35-year-old employee was admitted to the hospital because of behavioral problems at the office. He started to be
bossy, claiming that he is the manager on the unit. On admission he was diagnosed to be having bipolar disorder, manic phase.

1.

Nicks condition is primarily a problem of

A.
B.
C.
D.
2.

Conscience

Minimal environmental stimuli


Strict isolation and withholding privileges
No limitation on his activities
Well lit and basically colored room

Take him away from the group until he manages to have control of himself
Restrain him and put him on isolation to protect other patients
Prevent him from becoming more furious by giving an extra PRN dose of sedative
Respond with, Nick, we dont favor anyone. Everybody in the ward is on equal fooling.

Therapeutic use self is essential in relating with psychiatric patients. This is best demonstrated by the nurse in

A.
B.
C.
D.
5.

Perception

During socialization Nick was provoked, became furious, started shouting and making personal demands. A therapeutic
intervention of the nurse is

A.
B.
C.
D.
4.

Thought

A therapeutic environment for Nick is

A.
B.
C.
D.
3.

Affect

Sympathizing with the miserable feelings of Nick


Suppressing her own feelings towards Nick
Engaging Nick in productive activity
Engaging Nick is introspective activity

The nurse may recommend in introspective thinking

A.
B.
C.
D.

Easily finishes projects given to him during occupational therapy


Takes his medications without reminding him
Demonstrates skills in activities of daily living
Complies with hospital rules and regulations

Situation 2: The nurse considers factors related to safety effectiveness in the planning and delivery of nursing services.

6.

The nurse notices that the comatose client starts to lighten. She is aware that without protection, the client could fall or be
injured. Which of the following is the least intervention?

A.
B.
C.
D.
7.

Give adequate support when turning or moving


Keep the side rails up in bed
Protect the clients head

Following hip replacement after 24 hours, the client asks for assistance onto bedpan. She is placed in an orthopedic bed and
to facilitate the use of the bedpan, how should the nurse assist the client?

A.
B.
C.
D.
8.

Restrain the client to prevent from falling

Pull on the trapeze to lift the pelvis extending both legs


Lifting the pelvis off the bed and turn gently toward the operative side
Assist the client in lifting the pelvis
Elevate the pelvis using the trapeze involving the unaffected extremity and unoperated leg

Bert, an elderly client is to be discharged after sustaining a sprain from fall while negotiating the last step of the stairs. The
daughter asks the nurse how to promote safety in the stairways and hallways in the home. The nurse recommends extra
lighting at the stairways and suggests repainting the hallways with

A.
B.
C.
D.
9.

Red and yellow


Blue and green
Black and white
Cream and white

Erna, 32 years old, has a problem with the olfactory nerve. They live in a thickly populated area and is concerned for the
safety of her 3 young children. What measure should the nurse recommend for home safety?

A.
B.
C.
D.

Install additional lighting for visibility


Mild water heater temperature
Participate in fire prevention training
Install a smoke detector device

10. Lola Andang, 76 years old, is living alone. Her married daughter visits her form time to time. She can do activities of daily
living with limited assistance and seems to be independent physically. Which of the following measure should be
recommended to reduce sensory deprivation?

A.
B.
C.
D.

Encourage acquaintances to come to the house for a chat


Redecorate the house and provide a separate room
Provide pictures of family members
Invite friends to share meals at home

Situation 3: Nurse encounter situations in which they must make decision based on the determination of what is right and wrong.
Professional nursing actions are both ethical and moral.

11. Mrs. Miriam, a middle-aged obese woman seeks medical help often for recurring lower back pain. She does not lose weight in
spite of medical advice. Which of the following questions should the nurse ask the client?

A.
B.
C.
D.

What do you think will happen to you if you dont follow medical advice?
Arent you bothered about your condition?
Are you considering other course of action?
Is it difficult to follow the medical advice?

12. A 75-year-old frail woman had a cervical disk disorder. Conservative management did not work and the client requires
surgery. The client insisted that she does not want surgery but the family and the surgeon insisted. The staff nurse assigned
to her decided not to help in the preparation of surgery. Using caring based reasoning, which of the following justify the
refusal nurse in the preparation of surgery?

A.
B.

I empathize with the client because of her age and her fear of not surviving surgery.

C.
D.

I feel that my responsibility with the client is protecting her rights and meeting her needs.

I strongly feel that surgery will cause her more suffering and probably will not survive and the family may even fell
guilty later.
I support the client since she has the right to decide on her medical treatment and management.

13. A community health nurse in her home visits encountered a 58-year-old woman who was depressed and tearful. She was
hospitalized before with glaucoma. She knows that she could be o help to the client by staying and talking to her longer for
another hour. However, she has still two client visits; one of them is Nelson who is in plaster cast of the leg and needs a
great deal of teaching and the other a 60-year-old female, hemiplegic needing assistance in performing activities of daily
living. Which of the following is the appropriate action of the nurse?

A.
B.
C.
D.

Weigh the facts carefully in order to divide her time justly among her clients
Tell the client she will come back after attending to the other clients
Ask one of the family members to attend to the client
Stay with the client to prevent further depression

14. Mrs. Marsha, a 40-year-old professional was confined after suffering mild stroke. She has been critical of the care she
received which she regarded as not of high quality. The following actions of the nurse are appropriate in addressing the
complains, except:

A.
B.
C.
D.

Provide client with knowledge of what constitutes good care


Provide client with the list of her rights
Ask the client what her expectations are
Give a list of evaluation criteria and ask the client to respond

15. The nurse demonstrates ethics of care when she plays the role of a

A.
B.
C.
D.

Teacher
Care provider
Guidance counselor
Client advocate

Situation4: Following are situations that are a concern for records management of nurses

16. A delusional patient said, I have no head, no stomach. The nurse would record this in which part of the mental status
assessment?

A.
B.
C.
D.

Content of thought
Emotional state
Characteristics of talk
Sensorium or orientation

17. For proper orientation and accountability of all entries to the clients chart, it is important for the nurse to inspect that
A.
B.
C.
D.

All notes must have signature and title of the person making the entry
The staff must not abbreviate SOAP
The nurse implements the use of problem-oriented progress notes
Clients problems in the medical record must bear the date of entry and numbers of clients problem

18. Which of the following statements about Process recording is not true?
A. It provides data from which nurses can assess their own behavior in interactions with clients
B. It is a tool for assessing nurse-client interactions
C. It is an important means of communication between nurses or nursing students and their clinical
supervisors/instructors about their peer relationship

D.

It acquaints the students/nurse with rudimentary applied research skills

19. Data: Client is pacing, crying, waving his hands, yelling at another staff and other patients. In the problem-oriented progress
notes, these data would be noted under

A.
B.
C.
D.

Assessment
Subjective
Objective
Plan

20. In order for the process recording to be an effective learning tool for nurses, data should be
A.
B.
C.
D.

Unedited and comprehensive


Salient points that are summarized
Brief and simple but focused on essentials
Edited and comprehensive

Situation 5: in todays health care environment, nurses are increasingly accepted as essential members of the interdisciplinary health
care team.

21. The nurse is working in a tertiary hospital for almost a year. In order to effectively participate and lead a health care team,
she must have which of the following traits?

A.
B.
C.
D.

Courteous and respectful to the health team and members


Committed in the exercise of duties and responsibilities to clients and co-workers
Knowledge of the most effective and reliable evidence-based approach to care
Good interpersonal relationship with clients and families and the health team

22. A staff nurse consulted a more experienced nurse and other health care providers whether aggressive ambulation expedites
the patients recovery or it requires too much energy. While this approach is extremely common, she is likely to obtain
clinical answers that are

A.
B.
C.
D.

Scientific
Evidence-based
Tradition-based
Routine

23. An experienced nurse is new in the work setting. Given this situation, what should the nurse do to conform to the
institutions expectations?

A.
B.
C.
D.

Pursue post-graduate course to enhance skills and competence


Participate in the in-service education program offered by the institution
Attend seminars, conference and national conventions related to the nursing profession
Learn new values, skills, attitude and social rules

24. Image makers provide the greatest number of visual images of nurses at work such as angels of mercy, love interest

particularly to the physicians, naughty nurse, handmaiden to the physician and others. Changing nurses image in the public
eye will not be easy. Which of the following strategies is/are needed to change nursing image in the mind of image makers?

1.
2.
3.
4.

Restriction of the term nurse to mean licensed RN


Involvement in the political processes that shape their profession
Increased effort to publicly praise and value nursing
Emphasizes the contribution of nursing to patients, particularly on their desired health

A.
B.
C.
D.

1, 2, 3 and 4
1, 3, and 4
3 only
1 only

25. Nurses naturally work to effect policy in the work place. Which of the following actions can nurses take to increase their
influence in policy setting?

1.
2.
3.
4.

To be a member of a nursing organization


Write lobbying letters
Participate in coalitions of organizations
Get to know their elected officials

A.
B.
C.
D.

1, 2, 3, and 4
1, 3, and 4
3 only
1 only

Situation 6: Leonardo is a survivor or a tragic accident wherein his wife and child drowned when their boat sank due to stormy
weather. Within the next 6 months form the accident, he was observed to be detaching himself form others, unable to sleep and
concentrate and frequently would just be quiet and stare.

26. He tells you, It is my fault. What kind of husband and father am i? He is expressing
A.
B.
C.
D.

Depersonalization
Guilt
Inappropriate affect
Cognitive disturbance

27. The nurse can best intervene by mobilizing the clients relatives, friends, and people to provide
A.
B.
C.
D.

Spiritual support
Social support
Material support
Medical support

28. A therapeutic attitude the nurse can convey to the client while he talks about his loss is
A.
B.
C.
D.

Sympathy
Passivity
Acceptance
Optimism

29. The nurse encourages the client to communicate and socialize because internalized hostility can lead to
A.
B.
C.

Depression
Amok
Verbal assaultiveness

D.

Physical assaultiveness

30. The patient is having a


A.
B.
C.
D.

Post traumatic stress disorder


Psychotic breakdown
Development crisis
Personality dysfunction

Situation 7: Increasing problems of substance abuse continue to challenge the competencies of professional nurses

31. The Comprehensive Dangerous Drugs Act (RA 9165)


A.
B.
C.
D.

challenges the nurse in his role as a/an

Advocate
Counselor
Therapist
Health educator

32. The nurse is conducting parent education classes. Aware of the scope of nursing practice, the nurse recognizes the necessity
to network with other agencies to discuss this area

A.
B.
C.
D.

Communication skills appropriate for different ages


Constructive discipline
Normal and deviant child and adolescent behavior and development
Legal implications of illegal drug use

33. Which of these characteristics has the least potential success of treatment of drug dependency?
A.
B.
C.
D.

An addict who has reached bottom pit level of self-disgust and who wants help
An individual who became dependent on a drug before or during the teen years
Individuals who have access to support form intact family groups
A person who has began taking drug of choice for recreational or experimental reasons

34. The best model of drug abuse prevention supports


A.
B.
C.
D.

Programs focusing on means of dealing with problems and frustration of adolescents


Mandatory basic education transformation of society
An integrated program requiring development of both intellectual and effective health
The medical treatment of drug abuse utilizing less addictive drugs

35. A client says, I am not a substance user. I take drugs only when I am under stress. What defense mechanism is this client
employing?

A.
B.
C.
D.

Repression
Substitution
Compensation
Denial

Situation 8: Consumers of health care require improvement in health care. Nurses must deliver activities and behaviors and to do the
right things well and continue to strive to do better to meet and satisfy the diverse needs of clients.

36. Nurse Ethel observes the client with glaucoma while he instills his eye drops. The client looks up the ceiling and instills the

correct number of drops at the middle of the eyeball. The technique used by the client in the instillation of the medication is

A.
B.
C.
D.

Correct as this spreads the medication over the eyeball


Aimed to protect the eyeball from injury
Allowed so that the client is less likely to blink
Incorrect because it may damage the cornea

37. The client had cataract surgery. Shortly after, he complains of nausea. Which of the following course of action should be
given priority by the nurse?

A.

Administer the prescribed antiemetic

B.
C.
D.

Give ice chips to relieve nausea


Assure the client that this is expected following surgery
Report the complaint to the attending physician

38. The members of the nursing team were discussing about the activity of the client treated with detached retina during the
nursing rounds. Which of the following statements serves as guide for the client during the rehabilitation phase? The client

A.
B.
C.
D.

May resujme his activity with moderation the day after the treatment
May indulge in normal activities after the treatment
Must be restricted in bed for 1 week
May resume gradually her usual activities within 5-6 weeks

39. During the nursing conference, Nurse Ella shares with the team the concerns of the wife of a client with Menieres disease.

She is concerned about the change in the husbands social activities. To assist the wife in adjusting to the present situation,
the team should

A.
B.
C.
D.

Plan the course of action with the husband


Create an atmosphere of sense of belonging for the couple
Assist the wife to accept the condition of the husband
Explain to the wife that her husband is experiencing social isolation related to attacks of vertigo

40. The staff nurse performs ear irrigation on a client for removal of cerumen. What relevant information should the nurse share
withy the client at the start of the procedure?

A.

Experience a feeling of fullness, warmth and occasional discomfort when the fluids comes in contact with the
tympanic membrane

B.
C.
D.

Any medication needs to be withheld after the procedure and the physician must be notified
Ear irrigation requires cooperation from the client to facilitate the introduction of the solution
Assume lying position on the affected side after the procedure to facilitate drainage

Situation 9: Antonia, the mother of two children was cooking dinner and wondering why her husband was so late. Then she received a
telephone call from the police notifying that her husband had just been pulled from the river. Witnesses say her husband jumped from
a bridge in the locality.

41. Antonia, together with her children, walked a 10-block way to the funeral home to meet the medical examiner to identify the
body of her husband. Without a tear, she became focused on attending to her children and simply signed the necessary
paperwork. She is in state of

A.
B.
C.
D.

Integration
Recovery
Shock
Reality

42. In the following weeks after the death of her husband, Antonia struggled not only with finances but with confusion and rage
in response to her husbands actions and abandonment. The nursing diagnosis is

A.
B.
C.
D.

Spiritual distress
Powerlessness
Disturbed self-esteem
Social isolation

43. Unable to handle her emotions, Antonia hurls angry and explosive outburst toward those who are helpful to her. This
behavior is an example of

A.
B.
C.
D.

Sublimation
Displacement
Reaction formation
Introjection

44. Hostility is distinct form of anger in that the former is


A.
B.
C.
D.

Compatible with love


Growth-promoting
Destructive
Ego-syntonic

45. During nurse-patient interactions with Antonia, when she actively works out her rage which of the following is not
therapeutic?

A.
B.
C.
D.

Ask Antonia to describe what is the hardest part of the death for the family
Assure that death of husband is not her fault
An encouragement toward normalcy must be communicated
The nurse should be non-reactive

Situation 10: To produce a beneficial effect on eye medications, the nurse should make sure that the amount of medication reaches
the ocular site of action in sufficient concentration.

46. The nurse in the EENT unit is preparing the 6:00 am medication. She is fully aware that topical administration of ocular
medication results in how many percent rate of absorption?

A.
B.
C.
D.

21% to 25%
16% to 20%
105 to 16%
1% to 7%

47. The nurse is preparing ocular medications for topical route administration. The most common ocular medication is
administered through instilled eye drops and applied ointments. What is the advantage of ointment application from
installation of eye drops?

A.
B.
C.
D.

Self-administration, ease of absorption, and decreases risk of contamination


Extended retention time and provides a higher concentration
Easy to administer with reduced adverse reaction
Promotes efficiency, safety and distribution of solution evenly

48. The nurse is to administer an eye ointment to a patient. Which of the following guides the nurse in the administration of the
ointment?

A.
B.
C.
D.

Administer during naptime or bedtime


Inform the relative of the action of the drug
Explain the procedure to the patient
Check medical conditions that would contraindicate the use of the drug

49. Common ocular medications include topical anesthetic. In the application of topical anesthetics, the nurse must instruct the
patient which of the following measures?

A.
B.
C.
D.

Place the fingers on the sides of the nose to prevent medication from draining
Place the patient in supine position with the head slightly hyperextended
Close both eyes; gently move eyes
Refrain from rubbing the eyes to prevent corneal damage

50. The nurse is assessing a patient receiving mydriatic eye drops. The patient is sweating, complaining of blurred vi8sion and
drowsiness. These manifestations are indicative of

A.
B.
C.
D.

Fear and anxiety


Overdose of the medication
Allergic reaction
Systemic anticholinergic effect

Situation 11: Many clients in a psychiatric unit receive anti-psychotic medications, also referred to as neuroleptics.

51. Clients may be shifted form typical to atypical antiposychotic medications because of its minimal extrapyramidal side
effects. A common extrapyramidal symptom that is very unpleasant and intolerable to clients is called akathisia. This is

A.
B.
C.
D.

Upward rolling of the eyes


Inability to sit or stand
Pill rolling movement of the hands
Stiffening of the clients neck

52. Health instructions about Haloperidol (Haldol) have been given to Lester while in the hospital and before his discharge. The
client correctly understands the health teachings of the nurse when he says, I will

A.
B.
C.
D.

Immediately report any episodes of diarrhea or vomiting to my doctor.


Drink about 2 liters of fluid daily and expect to urinate frequently.
Wear long sleeve clothing and sun block when I go out.
Avoid pizza, any food with cheese and processed meat.

53. While giving Chlorpromazine (Thorazine) to a client, the nurse remembers that she should stop giving the medication when
she observes the side effect

A.
B.
C.
D.

Shuffling gait
Yellow sclera
Fine tremors
Facial grimacing

54. Another client in the ward is given Thorazine. This medication has several side effects. Which side effect should cause the
nurse to be most concerned?

A.
B.
C.
D.

Uncomfortable sunburns
Sore throat, fever, decreased WBC
Tremors, inability to stand still
Low blood pressure upon getting up from bed

55. Clients on antipsychotic medications usually receive antiparkinson drugs to reduce Parkinson-like side effects. What
medication would the nurse expect the client to receive?

A.
B.
C.
D.

Cogentin (Benztropine)
Nardil (Phenelzine)
Fluphenazine (Prolixin)
Fluoxetine (Prozac)

Situation 12: The following questions refer to nurses efforts to integrate in mental health community work.

56. The most important role of the nurse as a member of the team is to
A.
B.
C.
D.

Keep a 24-hour watch for the client


Meet the needs for the physical well-being of patients
Carry out medical orders
Coordinate the psychosocial care and management of clients

57. Activity therapy is a treatment that utilizes which of the following?


A.
B.
C.
D.

Psychotherapy
Behavioral therapy
Somatic therapy
Milieu therapy

58. Which of these nursing sections belong to the secondary level of preventive intervention?
A.
B.
C.
D.

Providing mental health education to members of the community


Providing mental health consultation to health care providers
Providing emergency psychiatric services
Being politically active in relation to mental health issues

59. When the nurse identifies a client who has attempt to commit suicide the nurse should
A.
B.
C.
D.

Refer the matter to the police


Refer the client to the psychiatrist
Call a priest
Counsel the client

60. The community health nurse was invited by the principal of an elementary school and was asked to give a talk to parents. An
appropriate topic would be

A.

The legal aspects of drug abuse

B.
C.
D.

Discipline of children at home and school


Marital crises
The problems of out of school youth

Situation 13: The nurse assigned in the neurology unit is taking care of a patient with medical diagnosis of increased intracranial
pressure

61. An intracranial pressure

monitor is in place and the patient is becoming lethargic. The nurse noted the intracranial pressure
is high. Which of the following should be the immediate action of the nurse?

A.
B.
C.
D.

Turn the patient to his left side with the back supported with pillows
Elevate the legs at 15 degrees with a pillow under the head
Elevate the head of the bed to 30 degrees
Raise the head of the bed to 90 degrees and the head supported with pillows

62. The nurse is monitoring the intracranial pressure of the patient. Which of the following nursing assessment would identify
the earliest indication of increasing intracranial pressure?

A.
B.
C.
D.

Widening pulse pressure


Change in level of consciousness
Cyanosis and hypotension
Increased body temperature

63. The nurse completed a nursing assessment. Which of the following data concludes that the patient is showing signs of
increased intracranial pressure?

A.
B.
C.
D.

Decrease in pulse pressure, increased in heart rate, irregular breathing pattern


Dilatation of the pupil, decreased blood pressure, and increased level of consciousness
Increase in heart rate and respiratory rate, and decreased level of consciousness
Slowing of the heart rate, increase in pulse pressure, and irregular breathing pattern

64. In preparing the plan of care, the nurse should prioritize which of the following nursing and medical measures?
A.
B.
C.
D.

High back rest to prevent Valsalvas maneuver and promote venous drainage
Turning every 2 hours with logrolling movement to maintain proper position
Elevating the head of the bed and keeping the head in proper alignment
Proper positioning and frequent change in position

65. The nurse plan of care includes preventing environmental stimuli that may stimulate an increase in intracranial pressure.
Which of the following measures should the nurse include in the nursing care plan?

1.
2.
3.
4.

Keeping lights on low setting


Keeping noise at a minimum
Providing a calm and restful environment
Having a cooling blanket available

A.
B.
C.
D.

1, 2, 3, and 4
1, 2, and 3
1 and 2
2, 3, and 4

Situation 14: the stress of hospitalization can lead to difficulties between nurses and patients. Following are situations that nurses
presented during a monthly nursing circle.

66. Neil asked the nurse to have an out on pass privilege for the weekend but his request was not granted by the nurse. He
remarked, I thought you really liked me. A therapeutic response of the nurse would be

A.
B.
C.
D.

I understand, you feel bad but of course, I like you.


Say as a matter-of-fact, Your behavior did not meet the criteria for out-on-pass privilege
Ignore Neils remark
Be transparent and express disapproval openly, You upset me with your remark.

67. The dynamics of behavior underlying manipulative behavior explains that it is a behavior of
A.

A sense of security and control

B.
C.
D.

Exhibiting uncooperative and hostile behavior


Reducing patients anxiety
Sensing fear of other people

68. Victoria, an elderly client idealizes some nurses as terrific, the best, or so understanding, but refers to others as
mean, incompetent, or indifferent. This behavior can be understood by the staff as

A.
B.
C.
D.

Avoiding taking responsibility for her own behavior and underlying feelings
An understandable behavior of an elderly that must not be taken seriously
An invitation to have a social and intimate relationship with the nurse
Immature and childish behavior

69. A patient with delirium touches the nurse appropriately. The therapeutic response of the nurse would be
A.
B.
C.
D.

Ask for the patients name and if whether he is aware where he is


Remove the patients hand while saying calmly, Im the nurse and this is a hospital.
Say nothing and just go on with the usual nursing interventions
Say her name,Im Cathy, Im your nurse.

70. The staff nurses have differing emotional reactions to the use of limit setting. Some staff view it as unprofessionally punitive
and uncaring. The most appropriate approach to address this nursing concern is through

A.
B.
C.
D.

Counseling with the nursing supervisor


Nursing conference
Seminar-workshop
Brainstorming session

Situation15: Mrs. Samson is an 85-year-old woman who was hospitalized due to urinary tract infection and dehydration. She has
Alzheimers disease, osteoporosis and a tendency to wander. She has an IV in her left forearm which was difficult to establish.
Concerned that Mrs. Samson might pull her IV out and wander off the floor, the staff is considering the possibility of using restraint on
her.

71. The staff is considering the possibility of using restraint on Mrs. Samson, however, she repeatedly declares that she does not
want to be restrained. The staff is faced with an ethical dilemma of autonomy versus

A.
B.
C.
D.

Beneficence
Fairness
Veracity
Justice

72. With a history of osteoporosis and a tendency to wander, which of the following should be a priority?
A.
B.
C.
D.

Request for a sitter


Wheelchair privilege
Prevention of fall
Provision of a bedside commode

73. Which of the following would be least appreciated by Mrs. Samson?


A.
B.
C.
D.

Playing a table board game


Singing to or with her
Going through family picture album
Listening to old familiar music

74. The nurse aims at highest level of self care. Which of the following will the nurse minimize?
A.
B.
C.
D.

Providing mouth swabs


Hand and body lotion
Using clothing with buttons and zippers
Labeling clothing items

75. Mrs. Samson has a dietary privilege of food preferences. Which question is most effective to communicate with her?

A.
B.
C.
D.

Which way would you want your egg done? Scrambled? Sunny side up? With vegetable mix? Or boiled?
Do you want fried egg or boiled egg?
How would you want to have your egg done?
What is your favorite egg recipe?

Situation 16: Nurse Kim engaged clients in a group exercise for medication education. Students are paired with clients to play a game
and exchange knowledge about medications and disorders. Participants play with a game board and color-coded game cards which
bear questions on five categories of psychotropic medications. Game questions include the five categorized namely: antipsychotic
medications, antidepressants, mood stabilizers, anti anxiety medications, and medications for drug abuse.

76. An opening comment about the purpose of the group encouraged clients to gather around the table and select small toy cars
to move playfully around the racetrack game board. The aim of this affective learning approach is for the clients to

A.
B.
C.
D.

Meet diverse learning needs


Satisfy clients level of functioning
Share common feelings about medications
Maximize the likelihood of compliance

77. One objective of this group experience is for the clients to describe the impact of these medications on their symptoms and
to day activities. Immediate discussion and interaction about daily life utilizes the principle of

A.
B.
C.
D.

Reinforcement
Efficiency
Appropriateness
Flexibility

78. Which of the following client behaviors demonstrates that interpersonal learning occurred?
A.
B.
C.
D.

One client advised another client that he should get a pill box so he would remember to take medications
Clients shared a sense of we-ness
Clients said they were all in the same boat
One client said, I feel that way

79. One client shared her very infrequent experiences with alcohol, which she knew to repeat this. This experience included
which of these therapeutic factors?

A.
B.
C.
D.

Altruism
Universality
Impairing information
Group cohesiveness

80. Which of the following least contributes to creating a therapeutic learning environment?
A.
B.
C.
D.

Heterogeneous composition of participants


Use of alternative teaching strategies that fit the needs of the group
Development of pre-determined, absolute group goals
Flexibility in accommodating the number of players

Situation 17: A team of researchers is conducting a study on the effect of high dose corticosteroids in improving the motor and
sensory outcomes of patients with spinal cord injuries within 6 weeks if administered within 8 hours after injury. The study covers a
three-month period.

81. On the basis of the nature of the investigation, which one of the designs listed below would allow the researchers to have the
most confidence that the corticosteroid is effective in improving the motor and sensory outcomes of patients with spinal cord
injury?

A.
B.
C.
D.

Quasi or semi-experimental design


Non-experimental design
Experimental design
Retrospective-prospective study design

82. Which of the following is present in conducting the above study?


A.
B.

Experimental group
Variables

C.
D.

Subjects
Control group

83. The target participants of the intended study are homogenous in the variables being measured. In determining the sample
size the researchers should include how many participants in this study?

A.
B.
C.
D.

10
30
30
500

84. In the above study, the researchers manipulate the variable under study. Which of the following variables is sufficient for the
effect to occur?

A.
B.
C.
D.

Clients with spinal cord injury


Injection of corticosteroids within 8 hours after injury
Research methodology
Motor and sensory outcomes of patients with spinal cord injuries

85. The manipulated variable to the experimental group is the


A.
B.
C.
D.

Improved recovery and lessened hospitalization period


Questionnaire in gathering pertinent data
Improved motor and sensory outcomes
Injection of corticosteroids within 8 hours after injury

Situation 19: Jorge, 19-year-old second year college student, is seeking assistance in coping with school related stressors and sleep
disturbances. During the initial evaluation of the psychiatric nurse, he reports he is ashamed and embarrassed by a mistake he made
in his class oral report and feels like his classmates are going to look down on him. He reports that he failed a practical exam a year
ago. Although he has made up for this, he cannot get this out of his mind.

86. When the nurse asked Jorge about his physical experience, which of these assessment data are appropriate?
A.
B.
C.
D.

I do not know what to do.


I am tense, nervous and exhausted all the time.
I feel helpless and depressed.
I am worried and thinking a lot.

87. Jorge admits that he says always been wound up just like his father and that he has negative thoughts of himself. He is
having a problem of

A.
B.
C.
D.

Inferiority
Stagnation
Mistrust
Role confusion

88. The nurse teaches a non-pharmacologic ways to induce sleep. Which of these would she caution Jorge to avoid?
A.
B.
C.
D.

Warm milk
Classical music
Coffee after dinner
A warm bath

89. Which of these describes the characteristic of free floating anxiety?


A.
B.
C.
D.

It is not conditioned by a specific trigger


It creates panic
There is an easily recognizable stressor that provokes anxiety
It results in selective attention/inattention

90. A generalized anxiety disorder is distinguished by


A.

Experience of anxiety after exposure to a life-threatening event

B.
C.
D.

Presence of excessive anxiety for a period of 6 months or more


Irrational thoughts and actions
Fear of losing control thus avoid crowds

Situation19: The nurse works in an institution that shelters street children. She encounters varies family histories and presenting
behavior patterns of these clients.

91. At night when the children are being prepared to go to sleep, the nurse hears from a frightened child, Ayaw ko matulog
mag-isa! May multo! (I dont want to sleep alone. Theres a ghost!) The nurse conveys acceptance with which of these
responses?

A.

Gusto mong i-kwento kung ano pa ang naiisip at nararmdaman mo (Would you like to tell me more about your
thoughts and feelings?

B.
C.
D.

Talaga? Anong itsura ng multo? (Really? How does the ghost look like?)
Nakaktakot nga ang pakiramdam na ganyan. (That must really be scary
Huwag kang matakot. Babantayan kita. (Dont be afraid. Ill keep watch over you.)

92. Most street children come from broken families. The nurse is most therapeutic in meeting their needs by being a
A.
B.
C.
D.

Activity therapist
Mother surrogate
Child therapist
Teacher

93. With adequate rest, food, cleanliness, shelter, warmth and safety, the child
A.
B.
C.
D.

Develops a sense of competence


Acquires a sense of personal power
Develops a separate identity
Learns to trust in self and in others

94. Preventive interventions for children at risk are best achieved through
A.
B.
C.
D.

Family therapy for the dysfunctional families


Non-government organizations and other workers paying attention to victims in conflict ridden communities
Support and caring to children during family crisis situation
Play and activity therapies for children

95. Vina was a frequent witness to domestic violence. Her father would always come home drunk and beat up Vinas mother. As
an effect of this experience she had nightmares, speechless for weeks, inability to sleep, tension and palpitations lasting for
more than a month. Vina is experiencing anxiety due to

A.
B.
C.
D.

Adjustment in growing up
Fear of phobic proportion
An identifiable traumatic stress
Imagined loss of parental love

Situation 20: Mrs. Corteza, 65 years old, has an acute attack of pain, soreness and swelling on both knees. She is diagnosed with
rheumatoid arthritis.

96. Nurse Nerissa is assessing the client. Which of the following is most likely to be assessed?
A.
B.
C.
D.

Early morning stiffness


Nodules along the knees
Joint deformities
Limited motions of joints

97. The client is in the acute phase of rheumatoid arthritis. In addition to the prescribed medication, the physician orders
application of heat and cold to manage arthritis pain. Which of the following statements indicate that the client lacks
understanding in the application of heat and cold?

A.
B.
C.
D.

Cold application is applied for 20 minutes, then 20 minutes off.


Hot water pad should be covered with flannel to prevent burns.
Heat and cold can be applied as needed.
Heat producing liniments can be used while applying heat or cold.

98. Nurse Nerissa is helping the client who is immobilized by pain towards self-reliance and independence. The nurse should
approach the problem with which of the following?

A.
B.
C.
D.

Set a specific goal


Set a positive attitude toward an eventful outcome
Need for a member of the family during the pain episode
Recognize that little can be accomplished

99. The nurse should know that a client with rheumatoid arthritis will most often have pain and limited movements of the joints.
A.
B.
C.
D.
100.

Resulting from non-adherence to prescribed diet


After assistive exercise
Because of inactivity upon awakening in the morning
During cold weather
To prevent deformities, the nurse includes inn the nursing care plan

A.
B.
C.
D.

Massaging the joint with oil liniment


Implementation of strictly prescribed diet
Performing isometric exercises twice a day
Alternate rest periods with active exercises