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Situation: Leo lives in the squatter area. He goes to nearby school.

He helps his mother gather


molasses after school. One day, he was absent because of fever, malaise, anorexia and abdominal
discomfort.

1. Upon assessment, Leo was diagnosed to have hepatitis A. Which mode of transmission
has the infection agent taken?
A. Fecal oral
B. Droplet
C. Airborne
D. Sexual contact

2. Which of the following must be emphasized during mother’s class to Leo’s mother?
A. Administration of immunoglobulin to families
B. Thorough hand washing before and after eating and toileting
C. Use of attenuated vaccines
D. Boiling of food especially meat

3. Disaster control should be undertaken when there are 3 or more hepatitis A cases. Which
of these measures is a priority?
A. Eliminate fecal contamination from foods
B. Mass vaccination of uninfected individuals
C. Health promotion and education to families and communities about the
disease it’s cause and transmission.
D. Mass administration of immunoglobulin

4. What is the average incubation period of Hepatitis A?


A. 30 days
B. 60 days
C. 50 days
D. 14 days

5. How about hepatitis C transmission?


a. Vectorborne b. foodborne c. airbone d. bloodborne

Situation : As a nurse researcher you must have a very good understanding of the common terms
of concept used in research.

6. The information that an investigator collects from the subjects or participants in a


research study is usually called:
A. Hypothesis
B. Data
C. Variable
D. Concept

7. Which of the following usually refers to the independent variables in doing research?
A. Result
B. Cause
C. Output
D. Effect

8. The recipients of experimental treatment is an experimental design or the individuals to


be observed in a non experimental design are called;
A. Setting
B. Subjects
C. Treatment
D. Sample

9. The device or techniques an investigator employs to collect data is called?


A. Sample
B. Instrument
C. Hypothesis
D. Concept

10. The use of another persons ideas or wordings giving appropriate credit results from
inaccurate attribution of materials to its sources. Which of the following is referred to
when another persons idea is inappropriate credited as one’s own?
A. Plagiarism
B. Quotation
C. Assumption
D. Paraphrase

Situation : Mrs. Pichay is admitted to your ward. The MD ordered “Prepare for thoracentesis
this pm to remove excess air from the pleural cavity.”

11. Which of the following nursing responsibilities is essential in Mrs. Pichay who will
undergo thoracentesis?
A. Support and reassure client during the procedure
B. Ensure that informed consent has been signed
C. Determine if client has allergic reaction to local anesthesia
D. Ascertain if chest x-rays and other tests have been prescribed and completed

12. Mrs. Pichay who is for thoracentesis is assigned by the nurse to which of the following
positions?
A. Trendelenburg position
B. Supine position
C. Dorsal Recumbent position
D. Orthopneic position

13. During thoracentesis, which of the following nursing intervention will be most crucial?
A. Place patient in a quiet and cool room
B. Maintain strict aseptic technique
C. Advice patient to sit perfectly still during needle insertion until it has been
withdrawn from the chest
D. Apply pressure over the puncture site as soon as the needle is withdrawn

14. To prevent leakage of fluid in the thoracic cavity, how will you position the client after
thoracentesis?
A. Place flat in bed
B. Turn on the unaffected side
C. Turn on the affected side
D. On bed rest

15. Chest x-ray was ordered after thoracentesis. When your client asks what is the reason for
another chest x-ray, you will explain:
A. to rule out pneumothorax
B. to rule out any possible perforation
C. to decongest
D. to rule out any foreign body

Situation : A computer analyst, Mr. Ricardo J. Santos, 25 was brought to the hospital for
diagnostic workup after he had experienced seizure in his office.

16. Just as nurse was entering the room, the patient who was sitting on his chair begins to
have a seizure. Which of the following must the nurse do first?
A. Ease the patient to the floor
B. Lift the patient and put him on the bed
C. Insert a padded tongue depressor between his jaws
D. Restrain patient’s body movement

17. Mr. Santos is scheduled for CT SCAN for the next day, noon time. Which of the
following is the correct preparation as instructed by the nurse?
A. Shampoo hair thoroughly to remove oil and dirt
B. No special preparation is needed. Instruct the patient to keep his head still
and stead.
C. Give a cleansing enema and give until 8 AM
D. Shave scalp and securely attach electrodes to it

18. Mr. Santos is placed on seizure precaution. Which of the following would be
contraindicated?
A. Obtain his oral temperature
B. Encourage to perform his own personal hygiene
C. Allow him to wear his own clothing
D. Encourage him to be out of bed.

19. Usually, how does the patient behave after his seizure has subsided?
A. Most comfortable walking and moving about.
B. Becomes restless and agitated.
C. Sleeps for a period of time
D. Say he is thirsty and hungry.

20. Before, during and after seizure. The nurse knows that the patient is ALWAYS placed in
what position?
A. Low fowler’s
B. Modified trendelenburg
C. Side Lying
D. Supine

Situation: Mrs. Damian an immediate post op cholecystectomy and choledocholithotomy patient,


complained of severe pain at the wound site.

21. Choledocholithotomy is:


A. The removal of the gallbladder
B. The removal of the stones in the gallbladder
C. The removal of the stones in the common bile duct
D. The removal of the stones in the kidney

22. The simplest pain relieving technique is:


A. Distraction
B. Taking aspirin
C. Deep breathing exercise
D. Positioning

23. Which of the following statement on pain is true?


A. Culture and pain are not associated
B. Pain accomplished acute illness
C. Patient’s reaction to pain varies
D. Pain produces the same reaction such as groaning and moaning

24. In a pain assessment, which of the following condition is a more reliable indicator?
A. Pain rating scale of 1 – 10
B. Facial expression and gestures
C. Physiological responses
D. Patients description of the pain sensation

25. When a client complains of pain, your initial response is:


A. Record the description of pain
B. Verbally acknowledge the pain
C. Refer the complaint to the doctor
D. Change to a more comfortable position

Situation: You are assigned at the surgical ward and clients have been complaining of post pain
at varying degrees. Pain as you know is very subjective.
26. A one-day post operative abdominal surgery client has been complaining of severe
throbbing abdominal pain described as 9 in 1 – 10 pain rating. Your assessment reveals
bowel sounds on all quadrants and the dressing is dry and intact. What nursing
intervention would you take?
A. Medicate client as prescribed
B. Encourage client to do-imagery
C. Encourage deep breathing exercise
D. Call surgeon stat

27. Pentoxidone 5 mg IV every 8 hours was prescribed for post abdominal pain, which will
be your priority nursing action?
A. Check abdominal dressing for possible swelling
B. Explain the proper use of PCA to alleviate anxiety
C. Avoid overdosing to prevent
dependence/tolerance
D. Monitor VS, more importantly RR

28. The client complained of abdominal distention and pain. Your nursing intervention that
can alleviate pain is:
A. Instruct client to go to sleep and relax
B. Advice the client to close the lips and avoid deep breathing and talking
C. Offer hot and clear soup
D. Turn to sides frequently and avoid too much talking

29. Surgical pain might be minimized b which nursing action in the O.R.
A. Skill of surgical team and lesser manipulation
B. Appropriate preparation for the scheduled procedure
C. Use of modern technology in closing the wound
D. Proper positioning and draping of client.

30. Inadequate anesthesia is said to be one of the common cause of pain both in intra and
post-op patients. If general anesthesia is desired, it will involve loss of consciousness.
Which of the following are the 2 general types of GA?
A. Epidural and Spinal
B. Subarachnoid block and intravenous
C. Inhalation and Regional
D. Intravenous and inhalation

Situation : Nurse’s attitudes toward the pain influence the way they perceive and interact with
clients in pain.

31. Nurses should be aware of that older adults are at risk of underrated pain. Nursing
assessment and management of pain 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. Older patients do not believe in analgesics, they are tolerant.
D. Complaining of pain will lead to being labelled a bad patient

32. Nurses should understand that when a client responds favourably to a placebo, it is
known as the placebo effect. Placebos do not indicate whether or not a client has:
A. Conscience
B. Real pain
C. Disease
D. Drug tolerance

33. You are the nurse in the pain clinic where you have client who has difficulty specify the
location of pain. How can you assist such client?
A. The pain is vague
B. By charting-it hurts all over
C. Identifying the absence and presence of pain
D. Ask the client to point to the painful are by just one finger.

34. What symptom more distressing than pain, should the nurse monitor when giving opioids
especially among elderly clients who are in pain?
A. Forgetfulness
B. Constipation
C. Drowsiness
D. Allergic reactions like pruritus

35. Physical dependence occurs in anyone who takes opiods 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. Indulge in recreational outdoor activities
C. Isolate opioid dependent to a restful resort
D. Instruct slow tapering of the drug dosage and alleviate physical withdrawal
symptoms.

Situation: The nurse is performing health education activities for Jovit Segovia, a 30
years old Dentist with Insulin dependent diabetes Mellitus.

36. Jovit is preparing a mixed dose of insulin. The nurse is satisfied with her performance
when she:
A. Draw insulin from the vial of clear insulin first
B. Draw insulin from the vial of the intermediate acting insulin first
C. Fill both syringes with the prescribed insulin dosage then shake the bottle
vigorously
D. Withdraw the intermediate acting insulin first before withdrawing the short acting
insulin first.

37. Jovit complains of nausea, vomiting, diaphoresis and headache. Which of the following
nursing intervention are you going to carry first?
A. Withhold the client’s next insulin injection
B. Test the client’s blood glucose level
C. Administer Tylenol as ordered
D. Offer fruit juice, gelatine and chicken bouillon

38. Jovit administered regular insulin at 7 A.M. and the nurse should instruct Jane to avoid
exercising at around:
A. 9 to 11 A.M.
B. After 8 hours
C. Between 8 A.M. to 9 A.M.
D. In the afternoon, after taking lunch.

39. Jovit was brought at the emergency room after four month because she fainted in her
clinic. The nurse should monitor which of the following test to evaluate the overall
therapeutic compliance of a diabetic patient?
A. Glycosylated Hemoglobin
B. Fasting blood glucose
C. Ketone levels
D. Uirne glucose level

40. Upon the assessment of HbA1C of Mrs. Segovia. The nurse has been informed of a 9 %
HbA1C result. In this case, she will teach the patient to:
A. Avoid infection
B. Take adequate food and nutrition
C. Prevent and recognize hypoglycaemia
D. Prevent and recognize hypoglycaemia

41. The nurse is teaching plan of care for Jane with regards to proper foot care. Which of the
following should be included in the plan?
A. Soak feet in hot water
B. Avoid using mild soap on the feet
C. Apply a moisturizing lotion to dry feet but not between the toes
D. Always have a podiatrist to cut your toe nails; never cut them yourself

42. Another patient was brought to the emergency room in an unresponsive state and a
diagnosis of hyperglycaemic hyperosmolar nonketotic syndrome is made. The nurse
immediately prepare to initiate which of the following anticipated physician’s order?
A. Endotracheal intubation
B. 100 units of insulin
C. Intravenous infusion of normal saline
D. Intravenous infusion of sodium bicarbonate

43. Jane eventually developed DKA and is being treated in the emergency room. Which
finding would the nurse expect to note as confirming this diagnosis?
A. Comatose state
B. Decreased urine output
C. Increased respiration and increase in pH
D. Elevated blood glucose level and plasma bicarbonate level

44. The nurse teaches Jane to know the difference between hypoglycaemia and ketoacidosis.
Jane demonstrates understanding of the teaching by stating that glucose will be taken of
which of the following symptoms develops?
A.double vision
B. Shakiness
C. Blurred vision
D. Foul breath odor

45. 45. Jane has been scheduled to have a FBS taken in the morning. The nurse tells Jane to
eat or drink after midnight. Prior to taking the blood specimen, the nurse noticed that Jane
is holding a bottle of distilled water. The nurse asked Jane if she drink any, and she said
yes. Which of the following is the best nursing action?
A. Administer syrup of ipecac to remove the distilled water from the stomach.
B. Suction the stomach content using NGT prior to specimen collection
C. Advice to physician to reschedule to diagnostic examination next day
D. Continue as usual and have the FBS analysis performed and specimen be
taken.

Situation: Elderly clients usually produce unusual signs when it comes to different diseases. The
ageing process is a complicated process and the nurse should understand that it is an inevitable
fact and she must be prepared to care for the growing elderly population.

46. Hypoxia may occur in the older patients because of which of the following physiologic
changes associated with aging.
A. Ineffective airway clearance
B. Decreased alveolar surfaced area
C. Decreased anterior-posterior chest diameter
D. Hyperventilation

47. The older patient is at higher risk for incontinence because of:
A. dilated urethra
B. increased glomerular filtration rate
C. diuretic use
D. decreased bladder capacity

48. Merle, age 86, is complaining of dizziness when she stands up. This may indicate:
A. dementia
B. a visual problem
C. functional decline
D. drug toxicity

49. Cardiac ischemia in an older patient usually produces:


A. ST-T wave changes
B. Very high creatinine kinase level
C. Chest pain radiating to the left arm
D. Acute confusion

50. The most dependable sign of infection in the older patient is:
A. change in mental status
B. fever
C. pain
D. decreased breath sounds with crackles

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

51. Which of the following should be given highest priority when receiving patient in the
OR?
A. Assess level of consciousness
B. Verify patient identification and informed consent
C. Assess vital signs
D. Check for jewelry, gown, manicure, and dentures

52. Surgeries like I and D (incision and drainage) and debridement are relatively short
procedures but considered ‘dirty cases’. When are these procedures best scheduled?
A. Last case
B. In between cases
C. According to availability of anaesthesiologist
D. According to the surgeon’s preference

53. OR nurses should be aware that maintaining the client’s safety is the overall goal of
nursing care during the intraoperative phase. As the circulating nurse, you make certain
that throughout the procedure…
A. the surgeon greets his client before induction of anesthesia
B. the surgeon and anesthesiologist are in tandem
C. strap made of strong non-abrasive materials are fastened securely around
the joints of the knees and ankles and around the 2 hands around an arm
board.
D. Client is monitored throughout the surgery by the assistant anaesthesiologist

54. Another nursing check that should not be missed before the induction of general
anesthesia is:
A. check for presence underwear
B. check for presence dentures
C. check patient’s ID
D. check baseline vital signs

55. Some lifetime habits and hobbies affect postoperative respiratory function. If your client
smokes 3 packs of cigarettes a day for the past 10 years, you will anticipate increased risk
for:
A. perioperative anxiety and stress
B. delayed coagulation time
C. delayed wound healing
D. postoperative respiratory function

Sterilization is the process of removing ALL living microorganism. To be free of ALL living
microorganism is sterility.

56. It is important that before a nurse prepares the material to be sterilized, A chemical
indicator strip should be placed above the package, preferably, Muslin sheet. What is the
color of the striped produced after autoclaving?
A. Black
B. Blue
C. Gray
D. Purple

Situation– Nurses hold a variety of roles when providing care to a perioperative patient.
57. Which of the following role would be the responsibility of the scrub nurse?
A. Assess the readiness of the client prior to surgery
B. Ensure that the airway is adequate
C. Account for the number of sponges, needles, supplies, used during the
surgical procedure.
D. Evaluate the type of anesthesia appropriate for the surgical client

58. As a perioperative nurse, how can you best meet the safety need of the client after
administering preoperative narcotic?
A. Put side rails up and ask the client not to get out of bed
B. Send the client to OR with the family
C. Allow client to get up to go to the comfort room
D. Obtain consent form

59. It is the responsibility of the pre-op nurse to do skin prep for patients undergoing\
surgery. If hair at the operative site is not shaved, what should be done to make suturing
easy and lessen chance of incision infection?
A. Draped
B. Pulled
C. Clipped
D. Shampooed

60. It is also the nurse’s function to determine when infection is developing in the surgical
incision. The perioperative nurse should observe for what signs of impending infection?
A. Localized heat and redness
B. Serosanguinous exudates and skin blanching
C. Separation of the incision
D. Blood clots and scar tissue are visible

61. Which of the following nursing interventions is done when examining the incision wound
and changing the dressing?
A. Observe the dressing and type and odor of drainage if any
B. Get patient’s consent
C. Wash hands
D. Request the client to expose the incision wound

Situation The preoperative nurse collaborates with the client significant others, and healthcare
providers.

62. To control environmental hazards in the OR, the nurse collaborates with the following
departments EXCEPT:
A. Biomedical division
B. Chaplancy services
C. Infection control committee
D. Pathology department

63. Tess, the PACU nurse discovered that Malou, who weights 110 lbs prior to surgery, is in
severe pain 8 hours after cholecystectomy. Upon checking the chart, Malou found out
that she has an order of Demerol 100 mg I.M. prn for pain. Tess should verify the order
with:
A. Nurse supervisor
B. Anesthesiologist
C. Surgeon
D. Intern on duty

64. Rosie, 57, who is diabetic is for debridement if incision wound. When the circulating
nurse checked the present IV fluid, she found out that there is no insulin incorporated as
ordered. What should the circulating nurse do?
A. Double check the doctor’s order and call the attending MD
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. Incorporate insulin as ordered

65. The documentation of all nursing activities performed is legally and professionally vital.
Which of the following should NOT be included in the patients chart?
A. Presence of prosthetic devices such as dentures, artificial limbs hearing aid, etc.
B. Baseline physical, emotional, and psychosocial data
C. Arguments between nurses and residents regarding treatment
D. Observed untoward signs and symptoms and interventions including contaminant
intervening factors.

Situation– Team efforts is best demonstrated in the OR.


66. In the OR, the nursing tandem for every surgery is:
A. Instrument technician and circulating nurse
B. Nurse anesthetist, nurse assistant, and instrument technician
C. Scrub nurse and nurse anesthetist
D. Scrub and circulating nurses

67. While team effort is needed in the OR for efficient and quality patient care delivery, we
should limit the number of people in the room for infection control. Who comprise this
team?
A. Surgeon, anesthesiologist, scrub nurse, radiologist, orderly
B. Surgeon, assistants, scrub nurse, circulating nurse, anesthesiologist
C. Surgeon, assistant surgeon, anesthesiologist, scrub nurse, pathologist
D. Surgeon, assistant surgeon, anesthesiologist, intern, scrub nurse

68. Who usually act as an important part of the OR personnel by getting the wheelchair or
stretcher, and pushing/pulling them towards the operating room?
A. Orderly/clerk
B. Nurse Supervisor
C. Circulating Nurse
D. Anesthesiologist

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


A. Electricity
B. Inadequate supply
C. Leg work
D. Communication
70. After a successful operation of the client, the one responsible to endorse the patient in the PACU is the ?
A. Scrub nurse
B. Circulating nurse
C. Surgeon
D. Anesthesiologist

71. Like any nursing intervention, counts should be documented. To whom does the scrub nurse report any
discrepancy of counts so that immediate and appropriate action is instituted?
A. Anaesthesiologist
B. Surgeon
C. OR nurse supervisor
D. Circulating nurse

Situation: Basic knowledge on Intravenous solutions is necessary for care of clients with
problems with fluids and electrolytes.

72. A client involved in a motor vehicle crash presents to the emergency department with
severe internal bleeding. The client is severely hypotensive and unresponsive. The nurse
anticipates which of the following intravenous solutions will most likely be prescribed to
increase intravascular volume, replace immediate blood loss and increase blood pressure?
A. 0.45 % sodium chloride
B. Normal saline solution
C. o.33% sodium chloride
D. Lactated ringer’s solution

73. The physician orders the nurse to prepare an isotonic solution. Which of the following IV
solution would the nurse expect the intern to prescribe?
A. 5 % dextrose in water
B. 10 % dextrose in water
C. 0.45 % sodium chloride
D. 0.5 % dextrose in 0.9% sodium chloride

74. The nurse is making initial rounds on the nursing unit to assess the condition or assigned
clients. The nurse notes that the client’s IV site is cool, pale and swollen and the solution
is not infusing. The nurse concludes that which of the following complications has been
experienced by the client?
A. Infection
B. Phlebitis
C. Infiltration
D. Thrombophlebitis

75. A nurse reviews the client’s electrolytes laboratory report and notes that the potassium
level is 3.2 mEq/L. Which of the following would the nurse note on the lectrocardiogram
as a result of the laboratory value?
A. U waves
B. pathologic Q waves
C. Elevated T waves
D. Elevated ST segment

76. One patient has a runaway IV of 50 % dextrose. To prevent temporary excess of insulin
or transient hyperinsulin reaction what solution you prepare in anticipation of the doctor’s
order?
A. Any IV solution available to KVO
B. Isotonic solution
C. Hypertonic solution
D. Hypotonic solution

77. An informed consent is required for:


A. Closed reduction of a fracture
B. Insertion of intravenous catheter
C. Irrigation of the external ear canal
D. Urethral catheterization

78. Which of the following is not true with regards to the informed consent?
A. It should describe different treatment alternatives
B. It should contain a thorough and detailed explanation of the procedure to be
done
C. It should describe the client’s diagnosis
D. It should given an explanation of the client’s prognosis

79. You know that the hallmark of nursing accountability is the:


A. Accurate documentation and reporting
B. Admitting your mistakes
C. Filing an incidence report
D. Reporting a medication error

80. A nurse is assigned to care for a group of clients. On review of the client’s medical
records the nurse determines that which client is at risk for excess fluid volume?
A. The client taking diuretics
B. The client with renal failure
C. The client with an ileostomy
D. The client who requires gastrointestinal suctioning

81. A nurse is assigned to care for a group of clients. On review of the client’s medical
records, the nurse determines that which client is at risk for deficient fluid volume?
A. A client with colostomy
B. A client with congestive heart failure
C. A client with decreased kidney function
D. A client receiving frequent wound irrigation

Situation As a perioperative nurse, you are aware of the correct processing methods for
preparing instruments and other devices for patient use to prevent infection.

82. As an OR nurse, what are your foremost considerations for selecting chemical agents for
disinfection?
A. Material compatibility and efficiency
B. Odor and availability/
C. Cost and duration of disinfection process
D. Duration of disinfection and efficiency

83. Before you used disinfected instrument it is essential that you:


A. Rinse with tap water followed by alcohol
B. Wipe the instrument with sterile water
C. Dry the instrument thoroughly
D. Rinse with sterile water

Situation: The OR is divided in three zones to control traffic flow and contamination.

84. . 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
85. The doctor ordered to incorporate 1000 “u” insulin to the remaining on going IV. The
strength is 500/ml. How much should you incorporate into the IV solution?
A. 10 ml
B. 2 ml
C. 0.5 ml
D. 5 ml

86. Multiple vial-dose-insulin when in use should be:


A. Kept at room temperature
B. Kept in the refrigerator
C. Kept in narcotic cabinet
D. Store in the freezer

87. Insulin using insulin syringe are given using how many degrees of needle insertion?
A. 45
B. 180
C. 90
D. 15

Situation : Maintenance of sterility is an important function a nurse should perform in any


OR setting.

88. Which of the following is true with regards to sterility?


A. Sterility is time related items are not considered sterile after a period of 30 days of
being not in use.
B. for 9 months sterile items are considered sterile as long as they are covered with
sterile muslin cover and stored in a dust proof covers.
C. Sterility is event related, not time related.
D. For 3 weeks, items double covered with muslin are considered sterile as long as
they have undergone the sterilization process

89. All of these factors affect the sterility of the OR equipments, these are the following
except:
A. The material used for packaging
B. The handling of the materials as well as its transport
C. Storage
D. The chemical or process used in sterilizing the material

Situatuon: Johnny, sought consultation to the hospital before

90. His diagnosis was hyperthyroidism, the following are expected symptoms except:
A. Anorexia
B. Palpitation
C. Fine tremors of the hand
D. Hyper alertness

91. He has to take drugs to treat hyperthyroidism, which of the following will you not expect that the doctor
will prescribe?
A. Colace (Docusate)
B. Cytomel (Llothyronine)
C. Tapazole (
D. (Levothyroxine)

92. The nurse knows that Tapazole has which of the following side effect that will warrant immediate
withholding of the medication?
A. Death
B. Sore throat
C. Hyperthermia
D. Thrombocytosis

93. You asked questions as soon as she regained consciousness from thyroidectomy primarily to assess the
evidence of:
A. Thyroid storm
B. Mediastinal shift
C. Damage to the laryngeal nerve
D. Hypocalcemia tetany

94. Should you check for haemorrhage, you will:


A. Slip your hand under the nape of her neck
B. Check for hypotension
C. Apply neck collar to prevent haemorrhage
D. Observe the dressing if is soaked with blood

95. . Basal Metabolic rate is assessed on Johnny to determine his metabolic rate. In assessing the BMR using
the standard procedure, you need to tell Johnny that:
A. Obstructing his vision
B. Restraining his upper and lower extremities
C. Obstructing his hearing
D. Obstructing his nostril with a clamp

96. . The BMR is based on the measurement that:


A. Rate of respiration under different condition of activities and rest
B. Amount of oxygen consumption under resting condition over a measured period of time
C. Amount of oxygen consumption under stressed condition over a measured period of time
D. Ratio of respiration to pulse rate over a measured period of time

97. . Her physician ordered lugol’s solution in order to:


A. Decrease the vascularity and size of the thyroid gland
B. Decrease the size of the thyroid gland only
C. Increase the vascularity and size of the thyroid gland
D. Increase the size of the thyroid gland only

98. . Which of the following is a side effect of lugol’s solution?


A. Hypokalemia
B. Nystagmus
C. Enlargement of the Thyroid gland
D. Excessive salivation

99. . In administering Lugol’s solution, the precautionary measure should include:


A. Administer with glass only
B. Dilute with juice and administer with a straw
C. Administer it with milk and drink it
D. Follow it with milk of magnesia

Situation: Pharmacological treatment was not effective for Johnny’s hyperthyroidism and now he is scheduled for
Thyroidectomy.

100. . Instruments in the surgical suite for surgery is classified as either CRITICAL, SEMI CRITICAL and NON
CRITICAL. If the instrument are introduced directly into the blood stream or into any normally sterile
cavity or area of the body it is classified as:
A. Critical
B. Semi critical
C. Non critical
D. Ultra critical

101. . Instruments that do not touch the patient or have contact only to the intact skin is classified as:
A. Critical
B. Semi critical
C. Non critical
D. Ultra critical

102. . If an instrument is classified as Semi Critical an acceptable method of making the instrument ready for
surgery is through:
A. Sterilization
B. Decontamination
C. Disinfection
D. Cleaning

103. . While critical items and should be:


A. Clean
B. Decontaminated
C. Sterilized
D. Disinfected

104. . As a nurse, you know that intact skin as an effective barrier to most microorganisms. Therefore, items
that come in contact with the intact skin or mucous membranes should be:
A. Disinfected
B. Sterile
C. Clean
D. Alcoholized

105. . You are caring for Johnny who is scheduled to undergo total thyroidectomy because of a diagnosis of
thyroid cancer. Prior to total thyroidectomy, you should instruct Johnny to:
A. Perform range and motion exercise on the head or neck
B. Apply gentle pressure against the incision when swallowing
C. Cough and deep breathe every hours
D. Support head with the hands when changing position

Situation – Andrea is admitted to the ER following an assault where she was hit on the face and head. She was
brought to the ER by a police woman. Emergency measures were stated.

106. . Andrea’s respiration is described as waxing and waning. You know that this rhythm of respiration is
defined as:
A. Biot’s
B. Kussmaul’s
C. Cheyne Stokes
D. Eupnca

107. . What do you call the triad of sign and symptoms seen in a client with increasing ICP?
A. Virchow’s Triad
B. The Chinese triad
C. Cusching’s Triad
D. Charcot’s Triad

108. . Which of the following is true with the Cushing’s Triad seen in head injuries?
A. Narrowing of Pulse Pressure, Cheyne strokes respiration, Tachycardia
B. Widening Pulse pressure, Irregular respiration, Bradycardia
C. Hypertension, Kussmaul’s respiration, Tachycardia
D. Hypotension, Irregular respiration, Bradycardia

109. . In a client with a Cheyne stokes respiration, which of the following is the most appropriate nursing
diagnosis?
A. Ineffective airway clearance
B. Ineffective breathing pattern
C. Impaired gas exchange
D. Activity Intolerance

110. . You know the apnea is seen in client’s with cheyne stoke respiration, APNEA is defined as:
A. Inability to breath in a supine position so the patient sits up in bed to breathe.
B. The patient is dead, the breathing stops
C. There is an absence of breathing for a period of time usually 15 seconds or more
D. A period of hypercapnea and hypoxia due to cessation of respiratory effort inspite of normal respiratory
functioning