Situation: Mr. Nerfty met a vehicular accident and has rushed to the b.

b. Shout loud enough for the patient to hear

orthopedic hospital. He was found to have a fracture of his right femur. He is c. Change the topic when you fee! You are not understood
scheduled for an open reduction. d. Restrict use of
1. Immobility is one of the problems encountered by patients with fractures. gesture
Immobility disrupts normal metabolism as evidence by which of the following
conditions? Situation: Marina is a 6 month old girl who is confined due to congenital clubfoot and is
a. Increased metabolic rate c. Decrease anabolic process scheduled for corrective serial casting
b. Decrease catabolic processes d. Increased nitrogen excretion 16. As the nurse approached Marina she cried very loud which indicates that she:
2. For clients whose mobility is restricted because they are confined in bed, a. Fears strangers c. Wants her mother to be with her
assessment of his mobility CANNOT be established temporarily in which of the b. Is in severe pain d. Is hungry
following area? 17. Which is the most common type of clubfoot?
a. Gait a. Talipes claeancus varus c. Talipes equino varus
b. (ROM) maximum amount of movement at the joint b. Talipes equino valgus d. Talipes calcaneus valgus
c. Exercise and activity 18. How can the deformity be detected at birth?
d. Body alignment a. A resistance is elicited when the toot is moved to the midline position
3. Clients who are in supine position most of the time will have pressure b. Asymmetry of both feet is observed
points which the nurse must be watchful for signs of developing pressure c. There is u restricted abduction of the affected foot
sores. Which of the following ate the possible unprotected pressure points d. One foot is longer than the other
for Mr. Nerfty? 19. Manipulation and casting of her feet is done Marina is exposed to potential
a. Lumbar, vertebrae, elbows and heels c. Ear, ilium and knees problems, which of the following is an appropriated diagnosis for her?
b. Toes, knees and elbows d. Sacrum’s, heels and elbows a. Alteration in the skin integrity
4. One of the concerns of the nurse when clients are immobilized is to maintain b. Potential for alteration in tissue perfusion related to constriction of the cast
the functional position of the hand. This means that the thumb is; c. Potential for infection related to incision
a. Abducted and the fingers are flexed d. Fear of stranger
b. Slightly adducted and the fingers are extended 20. The goals of care for Marina is directed towards"
c. Abducted and the lingers are extended a. Motion, circulation, respiration c. Induce vomiting
d. Slightly adducted and the fingers are slightly flexed b. Circulation, sensation and motion d. Desperation, skin integrity, motion
5. Immobility may bring about health hazards in the different areas or body Situation: Merl, a registered midwife, 45 years old returns from surgery for
systems. Which of the following hazards may affect the skeletal system? her fractured humerus.
a. Muscular atrophy, decreased stability and impaired mobility 21. After one has transferred to her bed, the most vital parameter for your
b. Orthostatic hypotension, thrombus format ion assessment in the;
c. Joint abnormalities, contractures and foot drops a. Result of the vital signs
d. Weakened respiratory muscles, decreased, ability to cough b. Ability to comprehend if given instruction
Situation: Mr. Delmar, 70 years old, suddenly could not lift his spoon nor c. Status of the surgical dressing
speak at breakfast. He was rushed to the hospital unconscious. His diagnosis d. Response to papillary reaction
is cardiovascular accident (CVA). 22. The client is inquisitive about her cast; the nurse should tell her that if
6. Which of the following is the most important assessment during the acute fracture is on the shoulder and humerus, the used is called:
stage of an unconscious patient like Mr. Delmar? a. Wedge cast c. Spica cast
a. Level of awareness and response to b. Hip spica cast d. Hanging cast
pain 23. You instruct her to keep the cast clean. Eventually, it is somewhat soiled.
b. Papillary re ilexes and response to sensory stimuli The surgeon orders the skin cleansed before applying another cast. Which
c. Coherence and sense of hearing of the following will you do as her nurse?
d. Patency of airway and adequacy of respiration a. Washed the skin with water only
7. Considering Mr. Delmar’s condition, which of t h e following is most b. Used Phisohex soap
important to include in preparing Mr. Delmar‘s bedside equipment? c. Rubbed the skin with cold cream or powdered with talc
a. Hand bell and extra bed linen c. Footboard arid splint d. Used mild soap and water
c. Sandbag and trochanter rolls d. Suction machine and gloves 24. You discuss with her that the requisites of a cost when applied are the
8. What is the rationale for giving Mr. Delmar frequent mouth care? following EXCEPT:
a. He will be thirsty considering that he is unable to take fluids a. Not too tight c. Light as possible
b. To remove dried blood when tongue is bitten during seizure b. No chafing d. Heavy as possible
c. The tactile stimulation during mouth care will hasten return to 25. Which of these are applied over sheet wadding?
consciousness a. Foain rubbers c. Stockinet
d. Mouth breathing in the case of most comatose patient causes oral b. Webrils d. Fiet pads
mucosa to be dry and cracked Situation: Silvia Porla, RN experiencing Meneire's Syndrome, which comes on and off. This
9. One of the complications of prolonged bed rest is decubitus ulcer. Which time was admitted to Neuroward.
of the following can BEST prevent is occurrence? 26. The following are your findings in assessing her condition, EXCEPT:
a. Massage reddened areas with oil/lotion a. Presence of true vertigo c. Tinnitus
b. Turn patient frequently every 2 hours b. Nausea and vomiting d. Feeling of pressure in the eyes
c. Use special water mattress 27. There are several ways of diagnosing Meniere's disease. One is by
d. Keep skin clean and dry means of inducing cold water into the external auditory canal; this test is;
10. In positioning the patient with CVA, which is the CORRECT rational basis?
a. Flexor muscles are generally stronger than extensors a. Electrocephalography (EEG) c. Caloric
b. Extensors muscles are generally stronger that flexors b. Electronystagomography (ENG) d. Babinski
c. A footboard w i l l prevent footdrop 28. All of the following are the medications of Meniere’s syndrome;
d. Fingers should be tightly flexed to the functional EXCEPT:
11. Which of the following group of patients have the LEAST risk for sensory a. Diuril c. Diamox
alterations during hospitalization? b. Prednisone d. Dramamine
a. Clients isolated because of illness or occupation 29. Which of the following measures is essential while caring for Silvia Porla,
b. Immobilized clients who is having acute attack?
c. Older adults a. Avoid taking directly to
d. Ambulatory her
12. Which of the following communication methods is not appropriate for b. Encourage her to drink warm water
clients with aphasia? c. Allow more ventilation inside her room
a. Using short, simple sentence d. Prevent jarring her bed
b. Using non-verbal clues 30. Your initial management during the attack of her disease;
c. Speaking loudly and articulating clearly a. Let her convulse
d. Allowing time for the patient to respond b. Elevate her head twenty degrees
13. After a severe cardiovascular disorder, a patient sometimes is unable to angle
name common objects or express simple ideas in word or i n writing. This is
best classified as what type of aphasia? c. Go and secure assistance
a. Global c. Expressive d. Restrain her
b. Receptive d. Mental Situation: Josie, a registered nurse, is newly employed in the orthopedic
14. Patients who are on chemotherapy experience sensory aberration affecting taste ward of a big general hospital. She found out that in t h i s ward are difficult
perception. Which of the following interventions will NOT enhance taste perception? types of patients with various modalities.
a. Chewing food thoroughly c. Blending or mixing foods 31. One of the patients is Mang Cosme who is diagnosed to have a cerebro-
b. Good oral hygiene d. Seasoning food vascular accident in the left cerebral hemisphere. The nurse in which part of
15. Which of the following communication methods is most appropriate for clients with the body;
hearing impairment? a. On the left side of the body
a. Speak slowly and clearly using normal tone of voice and intonation b. Bilaterally in the upper extremities

1
 c. On the right side of the body d. All of the above
d. Bilaterally in the lower extremities e. None of the above
32. Another patient, Mang Domeng, has led leg paralysis after a stroke. 42. Nurse Ariel is scheduled to teach his client who had undergone
Which assistive walking device would be appropriate? below-the-knee amputation regarding skin care to prevent
a. Auxiliary (wooden) crutch c. Quad breakdown. Which important point about skin care should Nurse
b. Straight - legged cane d. Forearm crutch Ariel include?
33. While walking down corridor you met a patient with a companion a. The stumped socket should be changed at least twice a
assisting him to ambulate with a single straight legged cane. You were week and it must be worn at all times
alarmed and rushed towards them because the patient is not using which of b. The residual limb (stump) is washed and dried gently
the following correct guidelines for ambulation? every other day
a. The cane should be kept on the weaker side of d ie body c. The socket of the prosthesis needs to be washed daily
b. The stronger leg should be moved forward first using a strong bactericidal agent
c. The cane should be placed forward about 6 to 10 inches before d. The socket of the prosthesis must be dried carefully
moving the legs before using it.
d. The stronger leg should never be advanced past the cane 43. Alex, a client who has been newly diagnosed with angina pectoris
34. Which of the following statements regarding developmental changes and asks the Nurse Benjo how to prevent future angina attacks. Nurse
immobility is correct? Benjo plans to incorporate which important instruction in the
a. Immobilized children should be placed with children of the same age teaching session?
who are immobilized a. For efficient digestion you should larger meals twice a
b. Environmental stimuli should be minimized for older inactive patient day
c. Care plan for older patients may require more frequent range of b. Your activity should all be done during early morning so
motion (ROM) and position changes that you don’t get easily tired
d. Immobility rarely influences normal development c. You drink your medicine until your symptoms disappear
35. Which of the following principles is correct about Range motion d. Pick clothing that is appropriate for the weather. You
Exercises? should dress appropriately in very cold or very hot
a. Nurses should support the joint and extremity being exercised weather
b. Nurses should gently force a joint s l i g h t l y beyond i t s capacity 44. Nurse Lyn, a home care nurse is preparing a plan of care for
c. Passive ROM should begin 4 8 hours after the a b i l it y to move an Soledad, a client with Meniere’s Disease who is experiencing
extremity or joint is lost severe vertigo. Which nursing intervention would the Nurse Lyn
d. Each movement should be performed thrice during the exercise include in the plan of care to assist Soledad in controlling the
A cast is rigid external immobilizing device molded to contours of the body. vertigo?
A physical assessment of the part to be immobilized must include a. Encourage the client to increase daily fluid intake
assessment of the neurovascular status of the body, degree and location of b. Encourage the client to avoid sudden head movements
swelling, bruising and skin abrasions. c. Instruct the client to stop smoking as soon as possible
36. A nurse has conducted teaching with a client in an arm cast about d. Instruct the client to eat foods high in sodium
signs and symptoms of compartment syndrome. The nurse 45. Nurse Dina is preparing her postoperative instructions for her
determines that the client understands the information if the client who is scheduled to have mastoid surgery. Which of the
clients states that he or she should report which of the following following instructions should be included in the plan?
early symptoms of compartment syndrome? a. If the postauricular suture line becomes wet, rub the
a. Cold, bluish-colored fingers area and cover it with a thin layer of antibiotic ointment
b. Numbness and tingling in the fingers b. You may shampoo the hair 2-3 days postoperatively if
c. Pain and tightness in the area that increases when the the ear is protected from water by saturating a cotton
arm is dependent ball with a water insoluble substance and loosely
d. Pain relieved only by aspirin placing it in the ear
37. Nurse Nate is teaching a client how to stand on crutches. The c. Report any popping and crackling sensations in the
nurse tells the client to place the crutches. operative ear to the physician
a. 5 inches to the front and side of the toes d. Heavy lifting ( > 5 lbs), straining and bending over for a
b. 10 inches to the front and side of the toes week after surgery is avoided
c. 15 inches to the front and side of the toes e. All of the above
d. 20 inches to the front and side of the toes
38. Three days after the fracture of his femur, Rich a 25-year-old
client suddenly complains of precordial chest pain, tachycardia
and dyspnea. The nurse also notes large amounts of thick white
sputum and an elevated temperature. Arterial blood gas values
show the partial pressure of oxygen (PaO2) = 58 mmHg, chest x-
ray reveals a typical “snowstorm” infiltrate. Base on theses
assessment findings, the nurse suspects which of the following
complications?
a. Osteomyelitis
b. Complex regional pain syndrome
c. Venous thromboembolism
d. Fat embolism syndrome
39. Steven, a 30-year-old client is hospitalized with a fractured femur,
a skeletal tractions is applied. Nurse Vanna is evaluating the pin
insertion site, which of the following signs would be indicative of a
complication?
a. Pin moved slightly at the insertion site
b. Presence of crusts around the pin insertion site
c. Client does not feel pain at the insertion site
d. Serous drainage on the dressing
Musculoskeletal disorders, particularly the impairment of the spine and
back, are leading health problems and causes of disability, mainly in people
during their employment years.
40. Carlo, 50-year-old client with low back pain asks the nurse which
type of exercise will best strengthen the lower back muscles. The
nurse tells the client to participate in which low-stress aerobic
exercise?
a. Tennis
b. Diving
c. Bowling
d. Swimming
41. Stef, a 24-year-old athlete is treated in the emergency room for a
sprained ankle after a fall. Radiographic examination has ruled
out a fracture. All of the following are correct teaching about
things he should do in the next 24 hours after the client is sent
home, EXCEPT:
a. Heating pad should be applied once in a while
b. An elastic compression bandage should be applied
c. When client is lying down or sitting he should elevate
the ankle on a pillow