1.How is the production of T3 and T4 turned off when levels become too high?

A. T3 and T4 downregulate TRH and TSH.

B. T3 and T4 downregulate their own production
C. T3 and T4 downregulate thyrocalcitonin
D. TRH and TSH downregulate T3 and T4
2. Pt was diagnosed with brain tumor was scheduled for craniotomy. In preventing the development of
cerebral edema after surgery, the nurse should expect the use of:
A. Diuretics
B. Antihypertensive
C. Steroids
D. Anticonvulsants

3. A patient asks to be tested for Lyme disease. She had been bitten by a tick and removed it herself this
morning. what is the most appropriate action?
A. advise the patient to return in 4-6 weeks, when testing will yield reliable results
B. refer the patient to a physician for a precautionary administration of antibiotics
C. disinfect the skin around the bite area and instruct the patient to return if arthralgia other concerning
symptoms develop.

4. A nurse is aware the early indicator of hypoxia in the Unconscious client is?
A. Cyanosis
B. Increased respiration
C. Hypertension
D. Restlessness

5. Postpartum women comes to clinic for first newborn check up, ALL THINGS are NORMAL EXCEPT?
A. Faint rashes on the baby's arm
B. No bowel for 2 days
C. Baby over slept first 24 hours

6. A female patient, who speaks a dialect that is hard to understand, has emergency gallbladder surgery,
during discharge preparation, which nursing action would best help this patient understand wound care
instruction?
A. Asking frequently if the patient understands the instruction
B. Asking an interpreter to replay the instructions to the patient.
C. Writing out the instructions and having a family member read them to the patient
D. Demonstrating the procedure and having the patient return the demonstration

7. male patient who has diabetes and receives hemodialysis treatments sometimes drinks juice when his blood
sugar is low. Which of the following types of juice would be best for this patient, since it is lowest in
potassium?
A. Prune juice
B. Grapefruit juice
C. Vegetable juice cocktail (V-8)
D. Cranberry juice cocktail

8.  A pt on post hip replacemnt complains of pain uncontrolled by morphine. Assesmnt pale and cold, 
A. Compartment synd 
B. paralysis 
C. Dvt
9.  For pt insertiong of ngt, right except 
A. Use oil based Jelly 
B. measure from nose, earlobe and xiphoid 
C. rotate tubing if difficulty onsertion occurs 
D. Start in upright position

10. A mother is 28 weeks gestation is for indirect combs test, what consider to be a POSITIVE?
A. Maternal serum of + antibody
B. Maternal serum of - antibody
C. Fetal serum of + antibody
D. Fetal serum of – antibody

11. in the absence of pathology, the client's respiratory centr is stimulated by

A. 02
B. C02
C. lactic acid
D. calcium i0ns

12. Commonly affected body system in client with electrolyte imbalance 

A. Cardiovascular 
B. Renal 
C. Endocrine 
D. Neuromuscular (ito ung may pinakamaraming electorlytes at ito ung unang mg rereact if may imbalance.
.manifested by mostly "FATIGUE". kz the primary ions na nasa muscle is K+, sodium, )

13. What position to do if a pt coma with abdl pain bp110/80, pr 127 

A.high fowlers 
B.semi forlers 
C. Foot of bed elevated 
D. Flat with knees flexed

14.  Which of the following would be seen in a patient with celiac disease?
A. Distended abdomen
B. Salty sweat
C. Hypopigmentation of the iris
D. Choking and cyanosis after feeding

15. A patient is receiving furosemide. The nurse is aware that the action of this drug is to?
A. Act on the ascending loop of henle, excretes potassium
B. Act on the descending loop of henle ,excretes potassium, sodium and chloride
C. Act on the ascending loop of henle,excretes potassium, sodium and chloride
D. Act on the descending loop of henle ,excretes potassium

16.  While teaching a patient with Bacterial Pharyngitis. The nurse is correct in differentiating between Viral
and Bacterial Pharyngitis that Bacterial Pharyngitis has?
A. Painful swallowing
B. red swollen lymph nodes
C. Exudates in the tonsils (Bacterial pharyngitis usually produces a large amount of exudate. - springhouse )
D. Swollen lymph nodes
17. Which laboratory value should be closely monitored in a patient taking chloramphenicol?
A. Prothrombin time
B. Partial thromboplastine time
C. Complete blood count (Occasionally one sees hematopoietic toxicity with the use of systemic chloramphenicol,
and rarely with topical administration. This type of blood dyscrasia is generally a dose-related toxic effect onbone marrow
and is usually reversible on cessation of the drug. Rare cases of aplastic anemia have been reported with prolonged
(months to years) or frequent intermittent (over months and years) use of topical chloramphenicol. )
D. Serum potassium level

18. Which best describes Cheyne-stokes Breathing? 

A. This shallow-deep-shallow pattern is followed by periods of significant apnea that can last up
to 30 seconds or longer, and then the cycle starts over. 
B. A respiratory pattern characterized by periods or “clusters” of rapid respirations of near equal depth or
followedby regular periods of apnea.
C. Have a prolonged inspiratory phase followed by a prolonged expiratory phase commonly believed to be
apneic phases.
D. Completely irregularbreathing pattern with irregular pauses and increasing episodes of
apnea

19. With diuretics administration, the nurse must be aware of?

A.Paresthesia and irritability
B.Muscle weakness and increase bp
C.Weak pulse

20.  VP shunt drainage is directly connected to?

A. heart
B. Peritoneum 
C. bladder
D. Hepatic vein

21. The client referred for a mammography questions the nurses about the cancer risks from radiation
exposure. What is the appropriate response by the nurse?
A. The radiation from a mammography is equivalent to 1 hour of sun exposure.
B. You have nothing to worry about; it is less than tanning in the nude
C. A chest x-ray gives you more radiation exposure
D. Exposure to mammography every 2 years is not dangerous

22. The nurse is providing diet instruction to the parents of a child with cystic fibrosis. The nurse would
emphasize that the diet should be
A. High calorie, low fat, low sodium
B. High protein, low fat, low carbohydrate
C. High protein, high calorie, unrestricted fat
D. High carbohydrate, low protein, moderate fat

23. A nurse reads in progress notes for a client with pneumonia that areas of the client's lungs being perfused
but- are not being ventilated. The nurse interprets as this concurrence as the presence of?
A. Anatomical dead space
B. Physiologic dead space
C. Shunt unit
D. Ventilation perfussion matching
24. Who is responsible for the nurses' competency ? 
A. Licensing board
B. Hospital
C. Supervisor
D. Nurse

25. a client had eaten a meal that c0ntains 13g of fat, 31 g of carbohydrates, and 5g of protein. what is this
client's total caloric intake for this meal?
A. 196 calories
B. 261 cal (Proteins and Carbohydrates provide 4 calories per gram. Fats provide 9 calories per gram. )
C. 286 cal
D. 351 cal

26. 72 hours a burn patient develops an infection. The nurse should place the patient under what
precaution/isolation? 
A. Standard 
B. Contact 
C. Reverse
D. Airborne

27. A client with acute kidney failure becomes confused and irritable. The nurse understands that the
most likely cause of this behavior is:
A. Hyperkalemia 
B. Hypernatremia
C. an elevated BUN
D. a limited fluid intake

28. The nurse is caring for a client who is receiving a unit of packed RBCs .Which finding leads the nurse
to suspect a transfusion reaction caused by incompatible blood?
A. Dyspnoea
B. Cyanosis
C. Backache (back ache signs acute hemolytic reaction nah immediate. den dapat tachypnea hindi dysnea...for acute
hemolytic.)
D. Bradycardia

29. ACCU nurse is caring for a clint admitted with acute MI...the nurse monitors for which most common
complication of MI?
A. cardiogenic shock
B. cardiac dysrythmias
C. chf
D. recurrent MI

30. When assessing a child with bronchiolitis, which finding would the nurse expect?
A. clubbed fingers
B. productive cough
C. barrel chest
D. barking cough and Stridor

31. What acid base abnormality does spironolactone cause?

A. Metabolic Alkalosis and Hypokalemic
B. Metabolic Acidosis and Hyperkalemic (ldactone is a potassium sparing diuretics. .xpect an upsurge of
potassium and bcuz it is a diuretics it will xcrete water.. the more we xcrete the water the more solute remains on serum
leading to dehydration (metabolic acidosis). )
 C. Respiratory Acidosis and Hypernatremic
D. Respiratory Alkalosis and Hyponatremic

32. Which of the following diseases is a chronic, degenerative, progressive disease of the central nervous
system characterized by the occurrence of small patches of demyelination in the brain and spinal cord?
A. Multiple sclerosis
B. Parkinson’s disease
C. Huntington’s disease
D. Creutzfeldt-Jakob’s disease

33. A pregnant client is making her first antepartum visit. She has a 2 year old son born at 40 weeks, a 5
year old daughter born at 38 weeks, and 7 year old twin daughters born at 35 weeks. She had a
spontaneous abortion 3 years ago at 10 weeks. Using GTPAL format, the nurse should identify and
document that the client is: 
A. G4 T3 P2 A1 L4
B. G5 T2 P2 A1 L4
C. G5 T2 P1 A1 L4
D. G4 T3 P1 A1 L4

34. Which of the following is the inotropic of choice for patient with septic shock?
A. Levophed (activates  SYMPATHO-ADRENAL MEDULLARY RESPONSE)
B. Epinephrine 
C. Dopamine
D. Dobutamine

35. A patient with ventricular dysrhythmia is admitted in the ICU for cardiac monitoring. While taking the
vital signs of the patient, the nurse suddenly noted an abnormal ECG tracing which is characterized the
waves twisting around the baseline. What medication is anticipated to be given to the patient?
A. MgSO4 
B. Cordarone
C. Verapamil
D. Lidocaine
*vtach din kasi ang torsades, there are 2 types of vtach monomorphic and polymorphic, ang torsades is polymorphic.
So as long as pulseless vtach yan defib tau pwede idefib yan although ang torsades is self terminating din pero it requres
defib pa din kasi pwede yan mag lead sa VF na. pag defib ang indication is pulseless vtach regardless kung mono or poly,
vfib pero treatment of choice pa din for torsades is mgso4 even normal ang magnesium level

36. The patient is brought to the ER known of pancreatic cancer. The patient arrested but no IV line is
started. On what route Epinephrine will be given?
A. IM
B. SC
C. IV
D. Endotracheal
* In cardiac arrest, there are 3 routes where epinephrine is given: IV, IM and ET. If it is given through
the ET tube, the dosage of epinephrine should be 2-2.5mg and is diluted with 10 cc PNSS or NSS. if
1:1000 - its Brochospasm management. If 1:10,000 - its for cardiac stimulation.

37. The patient who is has a renal failure has been admitted to the ICU from Medical ward. Initial BP was
taken by the ICU nurse which is 60/40, the physician ordered to start Dopamine drip at 5ug/kg/min. The
stock dose of dopamin premix is 200mg/250ml, and estimated body weight is 55kg. What is the flow rate
at cc/hr?
ANSWER : 21cc/hr
SOLUTION:  desired dose/concentration of solution x body weight x 60min/hr
200mg/250ml =800ug/ml concentration of solution
5ug/kg/min/800ug/ml x 55kg x 60min/hr
=20.625ml/hr or 21ml/hr.

38. What should the nurse include in the initial nursing plan of care for a 40 y/o client with the long
standing, obsessive compulsive behavior of hand and body washing?..
A. Denying the client for ritualistic behavior
B. Determining the purpose of the ritualistic behavior
C. Providing the client with a routine schedule of activities
D. Suggesting a symptom substition technique to refocus the behaviour

39. What is the primary cause of increase blood glucose level on a patient with renal failure?
A. Hyperinsulinemia
B. Glycogenolysis
C. Azotemia
D. Hyperlipidemia
*Azotemia is the main cause, since there is an upsurge or increase in blood sugar to patients who have
renal failure. There is an accumulation of metabolic waste products such as BUN, CREA and URIC ACID
since kidneys are no longer functioning well to excrete these products. These are products of CHON
metabolism, which will interfere both glucose and insulin and act like a coating effect.  binabalotan ni
azotemia c glucose at insulin para hindi magtagpo or magkita.. normaly Insulin meets glucose pra ma transport sa cell, dito
hindi makita ni insulin c glucose kz binabalotan ng waste product na c azotemia. leading to cause HYPERGLYCEMIA. . ang
utak ni pancrease nmn ay iniisip nya na kulang c INSULIN. kaya ng secrete na nmn sya ng more and more insulin leading to
"HYPERINSULENIMIA". . . ang punot dulo ay walang iba kundi c AZOTEMIA.

40. The patient was brought to ER who is having DOB and Chest pain. 12 L ECG is done to rule out MI.
ST elevation has been noted in leads V1 and V2. This signifies that the involved surface of the heart is:
A. Anterior wall
B. Lateral wall
C. Septal wall
D. Inferior wall

41. Upon knowing the 12L ECG of the patient, what medication is anticipated to be ordered by the
physician and prepared immediately?
A. Aspirin tab
B. Clopidogrel
C. Streptokinase
D. Enoxaparine

42. A client who has had bone pains of insidious onset for 4 months is suspected of having multiple
myeloma. the nurse understands that one of the diagnostic findings specific for multiple myeloma would
be:
A. low serium calcium levels
B. Bence-Jones protein in the urine (Bence-Jones proteins are rarely found in urine. If they are, it
is usually associated with multiple myeloma.)
C. occult and frank blood in the stool
D. positive bacterial culture of sputum

43. Patients on WARFARIN, they must regularly check? 

A. bleeding time
B. INR or PT
C. ESR
D. PTT
* The goal of warfarin therapy is to decrease the clotting tendency of blood, but not to prevent clotting completely.
Therefore, the blood's ability to clot must be carefully monitored while a person takes warfarin. The dose of warfarin is
adjusted, based on the results of periodic blood tests, to maintain the clotting time within a target range.
Prothrombin time (PT) — The most commonly used test to measure the effect of warfarin is the prothrombin time (called
pro time, or PT). The PT is a laboratory test that measures the time it takes for the clotting mechanism to progress. It is
particularly sensitive to the clotting factors affected by warfarin. The PT is also used to compute a value known as the INR
(or International Normalized Ratio).

International Normalized Ratio (INR) — The INR is a way of expressing the PT in a standardized way; this ensures that
results obtained by different laboratories can be reliably compared.

The longer it takes the blood to clot, the higher the PT and INR. The target INR range depends upon the clinical situation.
In most cases the target INR range will be 2 to 3, although other ranges may be chosen if there are special circumstances.

If the INR is below the target range (ie, under-anticoagulated), there is a risk of clotting. If, on the other hand, the INR is
above the target range (ie, over-anticoagulated), there is an increased risk of bleeding.

44. In withdrawing insulin, the nurse is correct in sequence when he said?

A.Withdraw Regular 1st , check another RN, then withdraw NPH
B.Withdraw Regular 1st then NPH and check by another RN
C.Withdraw NPH 1st then check another RN, then withdraw Regular
D.Withdraw NPH 1st then Regular and check by another RN

45. What laboratory exam is specific to support the diagnosis of CHF?

A. Trop I
B. LDH
C. BNP (Brain Nitriuretic Peptide is a substance secreted from the ventricles or lower chambers of the heart in
response to changes in pressure that occur when heart failure develops and worsens. The level of BNP in the blood
increases when heart failure symptoms worsen, and decreases when the heart failure condition is stable. )
D. AFP

46. Which is true about Endoscopic retrograde cholangiopancreatogrphy (ERCP)?SATA

I. Assess allergy to iodine
II. It act as treatment
III. Biopsy
A. I only
B. I and II
C. II and III
D. I, II, III
* Endoscopic retrograde cholangiopancreatography is a procedure that combines upper gastrointestinal
(GI) endoscopy and x rays to treat problems of the bile and pancreatic ducts. ERCP is also used to
diagnose problems, but the availability of non-invasive tests such as magnetic resonance
cholangiography has allowed ERCP to be used primarily for cases in which it is expected that treatment
will be delivered during the procedure.

47. The responsible for stimulation of kidney and act as reabsorption of calcium and excretion of
phosphorus?
A. Thymus gland
B. Thyrocalcitonin
C. Parathyroid hormone
D. Adrenal Gland

48. Patients on HEPARIN, must regularly check?

A. bleeding time
B. INR or PT
C. ESR
D. PTT
49. The nurse is reviewing an arterial blood gas report for a client with type 1 diabetes. the nurse
understands that the result that reflects diabetic ketoacidosis would be:
A. pH - 7.28, PCO2 - 28, HCO3 - 18
B. pH - 7.30, PCO2 - 54, HCO3 - 28
C. pH - 7.50, PCO2 - 49, HCO3 - 32
D. pH - 7.52, PCO2 - 26, HCO3 – 20

50. Which is true about pancreatitis? all of the following except.

A. common on old Age
B. Male is more prone than women
C. the cause its Autodigestion
D. Its commonly associated with alcohol
* It is common on MIDDLE AGE . . the hallmark of pancreatitis is "Autodigestion" . and it is associated with fatty foods,
ALCOHOL. and it more common in men than women.

51. Which of the ff drug should the nurse question if ordered in a pt diagnosed with UGIB secondary to
BPUD?
A. Arixtra
B. Omperazole
C. Pantoloc
D. Famotidine

52. The kidney produce a REF to stimulate bone marrow to increase precursor cells "RBC". what is the
component in making mature RBC ?
I. Iron
II. Vitamin M
III. Cobalamine
IV. Vitamin B9
A. I only
B. I and III
C. I II IV
D. I, II, III & IV
* Iron, Folate & B12 are the main component or ingredients para mag mature c RBC, pag may isang kulang jan
"ANEMIA" babagsak yan. for example . Nawala c b12 - its pernicious anemia, Nawala c Folate "megaloblastic" at nawala c
iron " IDA". . Folate also known as FOLACIN, B9, VITAMIN M,. marami pang name yan but ito lang mostly ginagamit. so II
and IV is iisa (Folate yan), B12 also known as Cobalamin or Cyanocobalamin.

53. A nurse is caring a patient with CLD secondary to Liver Cirrhosis and he noted that his pt is
experiencing changes in sensorium and episodes of gasping. What should the nurse do first?
A. refer to physician STAT
B. perform CBG
C. hook to ECG
D. monitor LOC further
* Pt with CLD due to Liver Cirrhosis is frequently manifesting hypoglycemia due to irreversible damage of the liver.
54. Risk factor for cholecystitis? SATA
I. Female
II. Using contraceptives
III. 4O years old and above men
A. I only
B. I and II
C. II and III
D. I, II & III
55. How would you assess a postive astrixis sign on liver cirrhosis?
A. Placing a Bp cuff and look for twitching of palms
B. Flexion of arms in a full minute and note a sudden drop
C. Ask the client to write his name
D. Ask the client to extend his arms and note liver flap (a.k.a "LIVER FLAP TEST")

56. Fats are needed to our body for what purposes?

I. Vitamin E, D, A & K transport
II. Allocation of Adipose tissue
III. Secondary sex characteristics
A. I only
B. I and II
C. II and III
D. I, II, III

57. client with a history of clots is receiving Lovenox (enoxaparin).

Which drug is given to counteract the effects of enoxaparin?
A. Calcium gluconate (given to counteract the effects of magnesium sulfate)
B. Aquamephyton (given to counteract the effects of sodium warfarin)
C. Methergine (given to increase uterine contractions following delivery)
D. Protamine sulphate (given to counteract the effects of enoxaparin as well as heparin.)

58. What should the nurse advise a DM patient regarding insuli use?
A. Small meal - Exercise - Insulin
B. Insulin - Sleep - Exercise
C. Sleep - Exercise – Insulin

59. Liver Cirrhosis management except?

A. Senstaken blakemore tube
B. Chronulac
C. Lasix
D. Neomycin

60. In Pancreatitis who is the responsible of the multi organ damage and responsible for autodigestion?
A. Amylase
B. Lipase
C. Trypsin
D. Cholecystokinin

61. A patient is extemely nauseous and vomits following a chemotherapy. Which of the following would be the
most approriate actions of the nurse:
A. Offer him fluids and provide emotional support
B. Give him privacy until the symptoms subside
C. Place the patient in supine position
D. Give oral hygiene

62. Bladder cancer risk factors – SATA

a. Ulcerative colitis
b. Long term catheterization
c. Smoking
d. all

63. What is given to patient preoperatively to decrease vascularity and decrease the size of the thyroid?
A. Propylthiouracil 
 B. Potassium Iodide Solution
C. Methimazole
D. Inderal

64. Before giving Digoxin, what Must the nurse do?

A. Assess the BP
B. Assess the RR
C. Assess the HR
D. assess the O2 saturation

65. For FBS test,advise given to pt is:

A. take lot of fluid before day of test
B. take small meal at 6am and do test at 10am
C. avoid smoking for 1week

66. A client arrives in the emergency room with a possible fractured femur. The nurse should anticipate an
order for: 
A. Trendelenburg position
B. Ice to the entire extremity
C. Buck’s traction
D. An abduction pillow

67. Which of the following is used in osteoporosis for decreasing bone resorption and increasing bone
formation. 
A. Teriparat ide 
B. Calcitonin 
C. Strontium
D. Bisphosphonate
* Bisphosphonates are pyrophosphate compounds and are the drugs used to build bone mass. These act by reducing the
resorption while stimulating the osteoblasts. Teripartide is 1 -34 o f a mino acid sequence of parathormone prepared by
recombinant technology. The drug stimulates new bone formation lead ing to increas e in new bone format ion. 
Strontium is a radiopharmaceutical agent that is used for bone pain secondary to metastatic metastasis. However, ca citonin
i s the drugs of choice for bone pain of metastasis type

68. What is the meaning of PRICE?

A. protection, rest, immobilize, compress, elevate
B. protection, rest, ice, compress, elevate
C. provide, rest, immobilize, compress, elevate
D. provide, rest, ice, compress, elevate

69. During NG feeding, why is it supposed to be done slowly (by gravity)?

A. Because the patient may develop diarrhea
B. Because the patient may develop abdominal distention 
C. Because it will lead to erosion of the stomach lining
D. Because it will lead to indigestion

70. With no contraindication on postural drainage what will you first?

A. Deep breathing
B. Cupping
C. Vibration

71. How would you know that your target goal for patient care was achieved?
a. Check if the patient’s condition has improvement. 
b. Evaluate the outcome of care against your goal 
c. Collaborate with your co-nurses regarding the patient’s response.
72. Cranial nerve responsible for swallowing difficulty?
A. Nine
B. Ten (Vagus)
C. Twelve
D. eleven

73. What should you advice a patient to increase on his diet if he had parathyroidectomy?
A. Calcium 
B. Potassium
C. Magnesium
D. Phosphorus

74. The MOsT effective method of delivering pain medication during emergent phase
A.IM
B.SQ.
C.Orally
D.IV

75. All of the ff are indicated for forceps delivery except. 

A. Face presentation 
B. Incomplete dilatation of cervix 
C. Cord prolapse 
D. Breech

76. You are about to assist an EENT doctor on assessment, which of the following is not included on your
preparation, SATA:
A. Local anesthesia spray 
B. Otoscope
C. Tunning fork
D. Pen light

77. Patient is prone of having bed sores, what would be the best nursing intervention you could do?
A. Massage the bony prominences
B. Use moisturizing lotion on dry skin
C. Move the patient on sliding motion
D. Wash the skin with warm water and soap

78. Which of the following manifestations would a nurse expect to identify when assessing a patient who
has atrial fibrillation?
A. Pounding headache 
B. Visual disturbances 
C. Irregular radial pulse 
D. Elevated blood pressure

79. Quickening when was the peak you experience?

A. Six month
B. 4th month
C. 5th month
D. 7th month

80.  A geriatric 78 year old patient asked you about what his optha meant that his “lenses have lost
elasticity”. He currently has blurry vision and is unable to focus a certain object. 
A. Astigmatism
B. Myopia
 C. Presbyopia
D. Strabismus

81.  Who is candidate for receiving Tetanus injection?

A. patient who received one tetanus injection
B. patient who received three tetanus injections
C. patient who has not received tetanus on past 4 years
D. patient who has not received injection on the past 10 years

82. How to clearly auscultate the heart sounds?

A. Normal breathing through nose
B. Normal breathing through mouth
C. Breathe deeply through nose
D. Breathe deeply through mouth

83. A 10 yr-old with hemophilia A has slipped on the ice and bumped his knee.The nurse should prepare
to administer an:
A.injection of factor x
B.intravenous of infusion of iron
C.intravenous infusion of factor VIII
D.intramascular injection of iron using the Z-track method

84. Patient arrived in the ER department with acute attack of hyperthyroidism. What would be the most
significant physical finding you could notice?
A. Exopthalmia and arrhythmia
B. Hyperthermia and signs of heart failure

85.  A patient who has disseminated intravascular coagulation (DIC) is administered heparin sodium.
Which of the following responses, if identified in the patient, would indicate that the heparin is effective?
A. Breath sounds clear to auscultation 
B. Stools negative for occult blood 
C. Pupils equal and reactive to light 
D. Oral mucosa pink and moist

86.  Which of the following shows that a nurse is a patient advocate?

A. Actively speaking the patients concerns during staff endorsement.
B. Making decisions to improve patient care.
C. Planning innovative nursing procedure.
D. Sharing nursing interventions done to patients.

87. Which of da ff. dsease is 90% asociated to scleroderma?

A. Sle
B. asperger syndrme
C. raynauds phenomenon
D. munchausen syndrome

88. Why breastfeeding is advised on a newly delivered mother on the 1st hour after birth?
A. To stimulate the release of colostrum for the baby’s immunity.
B. To stimulate the release of oxytocin which will promote uterine contraction.

89. Patient with pilonidal sinus infection check where?

A. base of the spine
B. anal area
C. groin area
D. lower extremities

90. Which of the following COPD would most probably show barrel chest?
A. Asthma
B. Bronchitis
C. Pneumonia
D. Emphysema

91. How would you position the child patient with Cystic Fibrosis on the upper posterior lobes of the lungs
for postural drainage?
A. Leaning forward with face resting on pillows
B. Sitting on the bed with the arms extended
C. Supine with the foot of the bed elevated
D. Lateral side lying with head of bed elevated

92. A 78 year old diagnosed with loss of lens elasticity:

A. Presbyopia
B. Myopia
C. Strabismus 
D. Astigmatism

93. A 10 yr-old with hemophilia A has slipped on the ice and bumped his knee.The nurse should preparento
administer an:
A.injection of factor x
B.intravenous of infusion of iron
C.intravenous infusion of factor VIII
D.intramascular injection of iron using the Z-track method

94.  A patient who has disseminated intravascular coagulation (DIC) is administered heparin sodium. Which of
the following responses, if identified in the patient, would indicate that the heparin is effective?
A. Breath sounds clear to auscultation 
B. Stools negative for occult blood 
C. Pupils equal and reactive to light 
D. Oral mucosa pink and moist

95. Patient whose is overly obese was positive with Cullen’s sign, what should you advice the patient?
A. Advise patient to decrease fat on his diet and avoid codeine
B. Advise patient to increase fat on his diet
C. Advise patient to decrease fat on his diet and exercise
D. Advise patient to eat green leafy vegetables

96. Why breastfeeding is advised on a newly delivered mother on the 1st hour after birth?
a. To stimulate the release of colostrum for the baby’s immunity.
b. To stimulate the release of oxytocin which will promote uterine contraction.

97. Patient is referred to PT for the proper use of crutches. What would be the best collaborative intervention
you can do as a nurse?
a. Measure the length of the crutches to be used.
b. Teach the patient how to use the crutches.
c. Call the manufacturer to order the crutches.
d. Teach the patient upper extremity exercise.
98. The nurse is assessing a clients pulse. W/c pulse features shud d nurse document?
A. timing in d cycle
B. amplitude
C. Pitch
D. intensity

99. We tend to pull the child’s pinna back and down because the ear canal is:
A. Short and curve
B. Straight and horizontal 
C. Downward
D. Upward

100. Patient was in skeletal traction and complained of extreme pain, what should you do?
A. Remove the traction and immediately call the physician.
B. Move the patient’s body on a different position while maintaining the traction, then call AP. 
C. Decrease the weight of one of the tractions and administer pain medication.
D. Put the traction weight on the floor and call the doctor.

101. A nurse knows dat d major clinical use of Dobutamine is to:

A. increase cardiac outpt
B. prevent sinus bradycardia
C. treat hypotension
D. treat hypertension

102. W/c class od medication protects d ischemic myocardium by blocking catecholamines and sympathetic
nerve stimulation?
A. beta- adrenergic blockers ( Beta adrenergic blockers… works by blocking beta receptors in d myocardium, reducing d
response 2 catecholamines & sympathetic nerve stimulation. They protect d myocardium, helping 2 reduce d risk of another
infarction by decreasing myocardial O2 demand)
B. Ca. channel blockers
C. opioids
D. nitrates

103. A nurse is teaching a client about Theophyline toxicity. W/c sign or Sx. of Theophyline toxicity?
A. bradycardia
B. constipation
C. nausea (theophylline toxicity causes GI disturbances such as N/V, abdl cramps, epigastric pain, anorexia or diarrhea. It also
produces CNS reactions H/A, irritability, restlessness, anxiety, insomnia, and dizziness (rarely). )
D. dysuria

104. 3% solution - 60mg/ml stock - how much to give?...dito ko to nakuha sa isang file, panu na kuha ung 2
ml na answer?.

03 * 60mg/ml = 1.8 round off to d nearest choices since wlang 1.8 , 2mg raq sagot

105. A primigravida, age 42, is 6 weeks pregnant. Based on the client’s age, her infant is at risk for: 
A. Down syndrome 
B. Respiratory distress syndrome 
C. Turner’s syndrome 
D. Pathological jaundice

106. The following order is written for a client with deep vein thrombosis: Heparin 20,000 units in 1000ml D5W
to infuse at 1000 units of heparin per hour. How many ml of D5W solution should be administered per hour?
A. 20 
B. 42 
C. 50 (1000u/20000*1000ml)
D. 66
107. The physician has ordered an intravenous infusion of Pitocin for the induction of labor. When caring for
the obstetric client receiving intravenous Pitocin, the nurse should monitor for: 
A. Maternal hypoglycemia 
B. Fetal bradycardia 
C. Maternal hyperreflexia 
D. Fetal movement

108. A client keeps her insulin in the refrigerator in the summer because her house is not air- conditioned.
When the nurse removes the NPH insulin from the refrigerator, the vial was frozen. Which of the following
actions should the nurse take?
A. Place the insulin vial in a container of warm water 
B. Put the insulin in the microwave on the defrost setting 
C. Discard the vial and replace it with another for the needed dose 
D. Gently rotate the vial in the palms of the hands to mix it as it thaws

109. Patient with colostomy. The nurse instructs him to eat which foods?
A. cabbage, lettuce, banana
B. tea, milk, fish
C. bread, toast, cucumber
D. raddish, asparagus, dried beans

110.  What nursing measures you will take while giving bed bath to an unconscious patient? 
A. take the help from relatives 
B. lower the bed 
C. while turning the patient raise the opposite side railing

111. Penrose drain is in place on the first postoperative day in a client who has undergone a cholecystectomy
procedure. Serosanguineous is noted on the dressing covering the drain, which of the following nursing
intervention is appropriate?
A. Notify the physician 
B. Change the dressing
C. Use the pen to circle the amount of drainage on the dressing.
D. Continue to monitor the drainage

112. Situation: A 14 year old male was admitted to a medical ward due to bronchial asthma after learning that
his mother was leaving soon for U.K. to work as nurse. The client has which of the following developmental
focus: 
A. Establishing relationship with the opposite sex and career planning. 
b. Parental and societal responsibilities. 
C. Establishing ones sense of competence in school. 
D. Developing initial commitments and collaboration in work

113. Post cholecystectomy the nurse saw an oozing of blood in the dressing. The nurse should immediately:
A. Change dressing 
B. Mark with pen and check for change in size

114. The nurse exemplifies awareness of the rights of a client whose anger is escalating by: 
a. Taking a directive role in verbalizing feelings 
b. Using an authoritarian, confrontational approach 
c. Putting the client in a seclusion room 
d. Applying mechanical restraints

115. Child CPR ratio: 

a. 2:30 
b. 1:10 
116. When a nurse sees a patient chocking, what will be the nurse's immediate response? 
a. Ask the patient to cough 
b. ask are you chocking (If the patient can still cough meaning its still above the epiglottis. But if the patient is unable to
speak, or cough out then you have to do heimlich maneuver because the trachea is blocked. ) 
c. do abdominal thrust 
d. call for help

117. Diet for cystic fibrosis?

a. high calorie, low fat, low sodium
b. high chon, low fat, low carb
c. high chon, high calorie, unrestricted fat
d. high carb, low chon, moderate fat

118. Patient with HIV, what test confirmed the Diagnosis?

a. WBC 3800
b. ESR 60
c. CD4 200 (CD4 cells are a type of white blood cell that's specifically targeted and destroyed by HIV. A healthy person's CD4
count can vary from 500 to more than 1,000. Even if a person has no symptoms, HIV infection progresses to AIDS when his or her
CD4 count becomes less than 200.)

119. Baby is diagnosed as tetrology of fall to what defects you can find? 
a. clubbing of fingers 
b. puffy face 
c. protruded eye balls

120. A patient is diagnosed as CHF and on Frusemide( lasix),what should be his dietary plan? 
a. increase intake of sodium 
b. include banana and rye 
c. take plenty of oral fluids

121. Patient with C.H.F which position you will keep the patient? 
a. High Fowlers 
b. Low Fowlers 
c. Supine 
d. Trendlenburg

122. When a patient is to be shifted in a wheel chair with a continuous bladder drainage, the urinary bag
should be kept: 
a. on his lap 
b. below the bladder level 
c. kept clamped

123.  After 4hours of delivery, if a client is having shift of uterus to one side of abdomen. What is the nursing
management? 
a. Massage the uterus 
b. Empty the bladder 
c. Document the findings 
d. Call the doctor

124. After gastroscopy, what is the nursing management before starting oral fluids? 
a. gag reflex 
b. check the bowel sounds 
c. look for dehydration
125.  If a patient comes in emergency ward with Hypoglycemia what will you look? 
a. Profuse sweating 
b. High Glucose Level 
c. Acetone smell

126. Gastritis is caused by which of following foods? 

a. Dairy products 
b. Carbonated drinks 
c. Orange juice

127.  How will you give a wound care for a dry wound? 
a. Hydrogen peroxide 
b. normal saline 
c. 5% dextrose 
d. liquid paraffin

128. What is the use of humidified Oxygen? 

a. Gives the soothing effect 
b. It makes dry of respiratory mucous membrane 
c. It gives more concentrated Oxygen

129. In severe burns, you would expect the ff to be elevated.SATA

a. gluccose
b. potassium
c. sodium
d. calcium

130. Post op patient in 24 hours what is the most common stress response?
A. Hyperventilation
B. Tachycardia
C. Fever
D. bradycardia

131. why we do dressing?

A. to keep warm
B. to keep moist
C to keep dry
D. to prevent necrosis

132. A patient report to nurse that he is always taking laxative everyday at a regular time. This type of patient
will likely develop?
a. Tolerance
b. Habituation
c. Synergism
d. Addiction

133. When assessing a client for risk of hyperphosphatemia, which piece of information is most important for
the nurse to obtain? 
A. A history of radiation treatment in the neck region
B. A history of recent orthopedic surgery
C. A history of minimal physical activity
D. A history of the client’s food intake
134. A client is admitted to the acute care unit. Initial laboratory values reveal serum sodium of 170meq/L.
What behavior changes would be most common for this client? 
A. Anger
B. Mania
C. Depression
D. Psychosis

135. Halfway through the administration of blood, the female client complains of lumbar pain. After stopping
the infusion the Nurse should:
A. Increase the flow of normal saline
B. Assess the pain further
C. Notify the blood bank
D. Obtain vital signs

136. patient with SLE; SATA

I)avoid sunlight
II.avoid hairspray
III.avoid hair colour
A. I and II
B. I and II
C. II and II
D. I, II , III

137. A patient who jump on bus window was seeing pacing at side of the road. he is diaphoretic, tachypneic
and uttering in-comprehensive words “ IM NOT READY TO DIE SOON” . this patient falls under what category?
A. Black
B. Green 
C. Yellow
D. Red

138. ns. dx. as priority for pt. with renal calculi.

A. fluid vol. deficit
B. pain
C. risk for bleeding
D. risk for oliguria

139. Which of the following conditions most commonly results in CAD?

A. Atherosclerosis
B. DM
C. MI
D. Renal failure

140. Why tetracycline is contraindicated under 12 y/o?

a. gingival hyperplasia
b. teeth staining
c. liver damage

141. A female client with cancer is scheduled for radiation therapy. The nurse knows that radiation at any
treatment site may cause a certain adverse effect. Therefore, the nurse should prepare the client to expect:
a. hair loss
b. Stomatitis
c. Fatigue
d. Vomiting
142. Postoperative complication
A. Absence Gag reflex
B. Urine output <25ml/hour 
C. Faint bowel sounds
D. Decrease sensation of lower extremities

143. 16wks pregnant in ultrasound, what is the indication ? 

a. determined sex of baby
b. chromosomal abnormalities
c. detects maturity and progress of baby

144. Obese have pressure ulcer in sacral area, what is appropriate Dx?
a. risk for infection r/t ulcer
b. impaired skin integrity r/t ulcer

145. Nurse monitoring for a pt. who is taking Lanoxin for adverse effect. Which is characteristic of digoxin
toxicity.
i. Tremors and diarrhea
ii. Irritability and N/V
iii. Blurred vision and Headache
a. i and ii
b. ii and iii
c. iii only
d. i and iii

146. What position, the patient should be placed after LP? Flat on bed/Supine
147. Positive Estrogen receptor test in breast cancer patients indicates?
A. Need for hormonal treatment
B. shows reaction to estrogen
C. Defines margin of cancer
D. it has receptors for estrogen

148. Postpartum mother comes to clinic for the first newborn checkup, All are normally manifested by newborn
except:
A. Faint rashes on the baby’s arm
B. No bowel for 2 days
C. Baby is over slept first 24 hour
D. Bluish discoloration of hands and feet

149. What precautionary measure the nurse should take after giving pre-medication? 
a. Remove denture 
b. Empty the bladder 
c. Raise the railing of the bed

150. After the subtotal thyroidectomy, what is the complication? 

a. Tetany 
b. Hyper Parathyroidism 
c. Muscle Lethargy

151.  Symptoms of meningitis include 

a. urinary incontinence 
b. stiff neck 
c. hydrocephalus 
d. spina bifida
152.  Transmittal through sexual contact 
a. Hept C 
b. Hept B 
c. Hept A

153.