Professional Documents
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(Part 1) Fundamentals of Nursing Pre Board
(Part 1) Fundamentals of Nursing Pre Board
Situation 1 – Mr. Ibarra is assigned to the triage area and while on duty, he assesses the condition of
Mrs. Simon who came in with asthma. She has difficulty breathing and her respiratory rate is 40 per
minute. Mr. Ibarra is asked to inject the client epinephrine 0.3mg subcutaneously
a. Reduce anaphylaxis
2. When preparing the epinephrine injection from an ampule, the nurse initially:
a. Taps the ampule at the top to allow fluid to flow to the base of the ampule
a Inject needle at a 15 degree angle’ over the stretched skin of the client
d. Spread skin or pinch at the injection site and inject needle at a 45-90 degree angle
4. When preparing for a subcutaneous injection, the proper size of syringe and needle would
be:
5. The rationale for giving medications through the subcutaneous route is:
Situation 2 – The use of massage and meditation to help decrease stress and pain have been strongly
recommended based on documented testimonials.
6. Martha wants to do a study on, this topic. “Effects of massage and meditation on stress and
pain.” The type of research that best suits this topic is:
a. applied research
b. qualitative research
c. basic research
d. quantitative research
7. The type of research design that does not manipulate independent variable is:
a. experimental design
b. quasi-experimental design
c. non-experimental design
d. quantitative design
8. This research topic has the potential to contribute to nursing because it seeks to:
10. Client’s rights should be protected when doing research using human subjects. Martha
identifies these rights as follows EXCEPT:
a. right of self-determination
b. right to compensation
c. right of privacy
Situation 3 – Richard has a nursing diagnosis of ineffective airway clearance related to excessive
secretions and is at risk for infection because of retained secretions. Part of Nurse Mario’s nursing
care plan is to loosen and remove excessive secretions in the airway,
11. Mario listens to Richard’s bilateral sounds and finds that congestion is in the upper lobes of
the lungs. The appropriate position to drain the anterior and posterior apical segments of the
lungs when Mario does percussion would be:
a. Client lying on his back then flat on his abdomen on Trendelenburg position
b. Client seated upright in bed or on a chair then leaning forward in sitting position then flat on his
back and on his abdomen
c. Client lying flat on his back and then flat on his abdomen
12. When documenting outcome of Richard’s treatment Mario should include the following in
his recording EXCEPT:
13. When assessing Richard for chest percussion or chest vibration and postural drainage
Mario would focus on the following EXCEPT:
a. Amount of food and fluid taken during the last meal before treatment
d. Doctor’s order regarding position restriction and client’s tolerance for lying flat
14. Mario prepares Richard for postural drainage and percussion. Which of the following is a
special consideration when doing the procedure?
15. The purpose of chest percussion and vibration is to loosen secretions in the lungs. The
difference between the procedure is:
a. Percussion uses only one hand white vibration uses both hands
b. Percussion delivers cushioned blows to the chest with cupped palms while gently shakes secretion
loose on the exhalation cycle
c. In both percussion and vibration the hands are on top of each other and hand action is in tune with
client’s breath rhythm
d. Percussion slaps the chest to loosen secretions while vibration shakes the secretions along with the
inhalation of air
Situation 4 – A 61 year old man, Mr. Regalado, is admitted to the private ward for observation after
complaints of severe chest pain. You are assigned to take care of the client.
16. When doing an initial assessment, the best way for you to identify the client’s priority
problem is to:
a. Interview the client for chief complaints and other symptoms
17. Upon establishing Mr. Regalado’s nursing needs, the next nursing approach would be to:
a. introduce the client to the ward staff to put the client and family at ease
b. Give client and relatives a brief tour of the physical set up the unit
18. Mr. Regalado says he has “trouble going to sleep”. In order to plan your nursing
intervention you will.
19. Mr. Regalado’s lower extremities are swollen and shiny. He has pitting pedal edema. When
taking care of Mr. Regalado, which of the following intervention would be the most
appropriate immediate nursing approach.
20. Mr. Regalado will be discharged from your unit within the hour. Nursing actions when
preparing a client for discharge include all EXCEPT:
Situation 5 – Nancy, mother of 2 young kids. 36 years old, had a mammogram and was told that she
has breast cysts and that she may need surgery. This causes her anxiety as shown by increase in her
pulse and respiratory rate, sweating and feelings of tension.
21. Considering her level of anxiety, the nurse can best assist Nancy by:
d. Giving her clear but brief information at the level of her understanding
22. Nancy blames God for her situation. She is easily provoked to tears and wants to be left
alone, refusing to eat or talk to her family. A religious person before, she now refuses to pray or
go to church stating that God has abandoned her. The nurse understands that Nancy is
grieving for her self and is in the stage of:
a. bargaining
b. denial
c. anger
d. acceptance
23. The nurse visits Nancy and prods her to eat her food. Nancy replies “what’s the use? My
time is running out. The nurse’s best response would be:
a. “The doctor ordered full diet for you so that you will be strong for surgery.”
b. “I understand how you fee! but you have 1o try for your children’s sake.”
c. “Have you told your, doctor how you feel? Are you changing your mind) about surgery?”
a. Advise the nurse to “be strong and learn to control her feelings”
b. Assign the nurse to another client to avoid sympathy for the client
c. Reassure the nurse that the client has hope if she goes through all statements prescribed for her
c. Ask the other nurses what they feel about the patient to find out if they share the same feelings
25. Realizing that she feels angry about Nancy’s condition, the nurse sees that being self-aware
is a conscious process that she should do in any situation like this because:
b. The nurse is a role model for the client and should be strong
C. How the nurse thinks and feels affect her actions towards her client and her work
d. The nurse has to be therapeutic at all times and should not be affected
Situation 6 – Mrs. Seva, 32 years old, asks you about possible problems regarding her elimination
now that she is in the menopausal stage.
26. Instruction on health promotion regarding urinary elimination is important. Which would
you include?
a. Hold urine, as long as she can before emptying the bladder to strengthen her sphincters muscles
27. Mrs. Seva also tells the nurse that she is often constipated. Because she is aging, what
physical changes predispose her to constipation?
28. The nurse understands that one of these factors contributes to constipation:
a. excessive exercise
29. Mrs. Seva talks about rear of being incontinent due to a prior experience of dribbling urine
when laughing or sneezing and when she has a full bladder. Your most appropriate .instruction
would be to:
30. Mrs. Seva asked for instructions for skin care for her mother who has urinary incontinence
and is almost always in bed. Your instruction would focus on prevention of skin irritation and
breakdown by
b. Drying the skin with baby powder to prevent or mask the smell of ammonia
c. Thorough washing, rising and during of skin area that get wet with urine
d. Making sure that linen are smooth and dry at all times
Situation 7 – Using Maslow’s need theory, Airway, Breathing and Circulation are the physiological
needs vital to life. The nurse’s knowledge and ability to identify and immediately intervene to meet
these needs is important to save lives.
31. Which of these clients has a problem with the transport of oxygen from the lungs to the
tissues:
32. You noted from the lab exams in the chart of Mr. Santos that he has reduced oxygen in the
blood.
a. Cyanosis
b. Hypoxia
c. Hypoxemia
d. Anemia
33. You will nasopharyngeal suctioning Mr. Abad. Your guide for the length of insertion of the
tubing for an adult would be:
b. the distance from the tip of the nose to the middle of the cheek
c. the distance from the tip of the nose to the tip of the ear lobe
34. While doing nasopharyngeal suctioning on .Mr. Abad, the nurse can avoid trauma to the
area by:
a. Apply suction for at least 20-30 seconds each time to ensure that all secretions are removed
35. Myrna has difficulty breathing when on her back and must sit upright in bed to breath,
effectively and comfortably. The nurse documents this condition as:
a. Apnea
b. Orthopnea
c. Dyspnea
d. Tachypnea
Situation 8 – You are assigned to screen for hypertension: Your task is to take blood pressure
readings and you are informed about avoiding the common mistakes in BP taking that lead to ‘false
or inaccurate blood pressure readings.
36. When taking blood pressure reading the cuff should be:
a. deflated fully then immediately start second reading for same client
c. large enough to wrap around upper arm of the adult client 1 cm above brachial artery
d. inflated to 30 mmHg above the estimated systolic BP based on palpation of radial or bronchial
artery
37. Chronic Obstructive Pulmonary Disease (COPD) in one of the leading causes of death
worldwide and is a preventable disease. The primary cause of COPD is:
a. tobacco hack
b. bronchitis
c. asthma
d. cigarette smoking
38. In your health education class for clients with diabetes you teach, them the areas, for
control . Diabetes which include all EXCEPT:
c. prevention nutrition
d. proper nutrition
39. You teach your clients the difference between, Type I (IDDM) and Type II (NDDM)
Diabetes. Which of the following is true?
a. both types diabetes mellitus clients are all prone to developing ketosis
b. Type II (NIDDM) is more common and is also preventable compared to Type I (IDDM) diabetes
which is genetic in etiology
40. Lifestyle-related diseases in general share areas common risk factors. These are the
following except
a. physical activity
b. smoking
c. genetics
d. nutrition
Situation 9 – Nurse Rivera witnesses a vehicular accident near the hospital where she works. She
decides to get involved and help the victims of the accident.
b. Ryan who has chest injury, is pate and with difficulty of breathing
43. In the emergency room, Nurse Rivera is assigned to attend to the client with .lacerations on
the arms, while assessing the extent of the wound the nurse observes that the wound is now
starting to bleed profusely. The most immediate nursing action would be to:
a. Apply antiseptic to prevent infection
44. The nurse applies pressure dressing on the bleeding site. This intervention is done to:
d. Promote hemostasis
45. After the treatment, the client is sent home and asked to come back for follow-up care.
Your responsibilities when the client is to be discharged include the following EXCEPT:
c. Instructing the client to see you after discharge for further assistance
Situation 10 – While working in the clinic, a new client, Geline, 35 years old, arrives for her doctor’s
appointment. As the clinic nurse, you are to assist the client fill up forms, gather data and make an
assessment.
a. Record pertinent information in the client chart for health team to read
c. Understand her lifestyle, health needs and possible problems to develop a plan of care
47. While interviewing Geline, she starts to moan and doubles up in pain, She tells you that this
pain occurs about an hour after taking black coffee without breakfast for a few weeks now.
You will record this as follows:
a. Claims to have abdominal pains after intake of coffee unrelieved by analgesics
d. Client reported abdominal pain an hour after drinking black coffee for three weeks now
48. Geline tells you that she drinks black coffee frequently within the day to “have energy and
be wide awake” and she eats nothing for breakfast and eats strictly vegetable salads for lunch
and dinner to lose weight. She has lost weight during the past two weeks, in planning a healthy
balanced diet with Geline, you will:
a. Start her off with a cleansing diet to free her body of toxins then change to a vegetarian, diet and
drink plenty of fluids
b. Plan a high protein, diet, low carbohydrate diet for her considering her favorite food
c. Instruct her to attend classes in nutrition to find food rich in complex carbohydrates to maintain
daily high energy level
d. Discuss with her the importance of eating a variety of food from the major food groups with plenty
of fluids
49. Geline tells you that she drinks 4-5 cups of black coffee and diet cola drinks. She also
smokes up to a pack of cigarettes daily. She confesses that she is in her 2nd month of pregnancy
but she does not want to become fat that is why she limits her food intake. You warn or caution
her about which of the following?
a. Caffeine products affect the central nervous system and may cause the mother to have a “nervous
breakdown”
b. Malnutrition and its possible effects on growth and development problems in the unborn fetus
c. Caffeine causes a stimulant effect on both the mother and the baby
50. Your health education plan for Geline stresses proper diet for a pregnant woman and the
prevention of noncommunicable diseases that are influenced by her lifestyle these include of
the following EXCEPT:
a. Cardiovascular diseases
b. Cancer
c. Diabetes Mellitus
d. Osteoporosis
Situation 11 – Management of nurse practitioners is done by qualified nursing leaders who have had
clinical experience and management experience.
52. Your head nurse in the unit believes that the staff nurses are not capable of decision making
so she makes the decisions for everyone without consulting anybody. This type of leadership is:
b. Democratic leadership
c. Autocratic leadership
d. Managerial leadership
53. When the head nurse in your ward plots and approves your work schedules and directs
your work, she is demonstrating:
a. Responsibility
b. Delegation
c. Accountability
d. Authority
54. The following tasks can be safely delegated’ by a nurse to a non-nurse health worker
EXCEPT:
55. You made a mistake in giving the medicine to the wrong client You notify the client’s
doctor and write an incident report. You are demonstrating:
a. Responsibility
b. Accountability
c. Authority
d. Autocracy
Situation 12 – Mr. Dizon, 84 years old, is brought to the Emergency Room for complaint of
hypertension flushed face, severe headache, and nausea. You are doing the initial assessment of vital
signs.
56. You are to measure the client’s initial blood pressure reading by doing all of the following
EXCEPT:
c. Pump the cuff up to around 50 mmHg above the point where the pulse is obliterated
a. Determine if the client’s hemoglobin level is low and if he needs blood transfusion
58. After a few hours in the Emergency Room, Mr. Dizon is admitted to the ward with an order
of hourly monitoring of blood pressure. The nurse finds that the cuff is too narrow and this will
cause the blood pressure reading to be:
a. Inconsistent
59. Through the client’s health history, you gather that Mr. Dizon smokes and drinks coffee.
When taking the blood pressure of a client who recently smoked or drank coffee, how long
should be the nurse wait before taking the client’s blood pressure for accurate reading?
a. 15 minutes
b. 30 minutes
c. 1 hour
d. 5 minutes
60. While the client has the pulse oximeter on his fingertip, you notice that the sunlight is
shining on .the area where the oximeter is. Your action will be to:
Situation 13 – The nurse’s understanding of ethico-legal responsibilities will guide his/her nursing
practice.
61. The principles that .govern right and proper conducts of a person regarding life, biology
and the health professions is referred to as:
a. Morality
b. Religion
c. Values
d. Bioethics
d. To define the roles and functions of the health caregiver, nurses, clients
63. The most important nursing responsibility where ethical situations emerge in patient care is
to:
c. Assume that ethical questions are the responsibility: of the health team
64. You inform the patient about his rights which include the following EXCEPT:
d. Right to expect that the records about his care will be treated as confidential
65. The principle states that a person has unconditional worth and has the capacity to
determine his own destiny.
a. Bioethics
b. Justice
c. Fidelity
d. Autonomy
Situation 14 – Your director of nursing wants to improve the quality of health care offered in the
hospital. As a staff nurse in that hospital you know that this entails quality assurance programs.
66. The following mechanisms can be utilized as part of the quality assessment program of your
hospital EXCEPT:
a. Patient satisfaction surveys provided
67. The nurse of the Standards of Nursing Practice is important in the hospital. Which of the
following statements best describes what it is?
a. These are statements that describe the maximum or highest level of acceptable performance in
nursing practice.
c. It is a license issued by the Professional Regulation Commission to protect the public from
substandard nursing practice.
d. The Standards of care includes the various steps of the nursing process and the standards of
professional performance.
68. You are taking care of critically ill client and the doctor in charge calls to order a DNR (do
not resuscitate) for the client. Which of the following is the appropriate action when getting
DNR order over the phone?
a. Have the registered nurse, family spokesperson, nurse supervisor and doctor sign
b. Have two nurses validate the phone order, both nurses sign the order and the doctor should sign his
order within 24 hours.
c. Have the registered nurse, family and doctor sign the order
d. Have 1 nurse take the order and sign it and have the doctor sign it within 24 hours
69. To ensure the client safety before starting blood transfusion the following are needed before
the procedure can be done EXCEPT:
b. blood should be warmed to room temperature for 30 minutes before blood transfusion is
administered
c. have two nurses verify client identification, blood type, unit number and expiration date of blood
d. get a consent signed for blood transfusion
70. Part of standards of care has to do with the use of restraints. Which of the following
statements is NOT true?
c. Check client’s pulse, blood pressure and circulation every four hours
Situation 15 – During the NUTRITION EDUCATION class discussion a 58 year old man, Mr. Bruno
shows increased interest.
71. Mr. Bruno asks what the “normal” allowable salt intake is. Your best response to Mr.
Bruno is:
72. Your instructions to reduce or limit salt intake include all the following EXCEPT:
73. Teaching strategies and approaches when giving nutrition education is influenced by age,
sex and immediate concerns of the group. Your presentation for a group of young mothers
would be best if you focus on:
Situation 16 – You are assigned to take care of 10 patients during the morning shift. The
endorsement includes the IV infusion and medications for these clients.
76. Mr. Felipe, 36 years old is to be given 2700 ml of D5RL to infuse for 18 hours starting at
8am. At what rate should the IV fluid be flowing hourly?
a. 100 ml/hour
b. 210 ml/hour
c. 150 ml/hour
d. 90 ml/hour
77. Mr. Atienza is to receive 150 mg/hour of D5W IV infusion for 12 hours for a total of 1800
ml. He is also losing gastric fluid which must be replaced every two hours. Between 8am to
10am. Mr. Atienza has lost 250 ml of gastric fluid. How much fluid should he receive at 11am?
a. 350 ml/hour
b. 275 ml/hour
c. 400 ml/hour
d. 200 ml/hour
78. You are to apply a transdermal patch of nitroglycerin to your client. The following
important guidelines to observe EXCEPT:
a. Apply to hairlines clean are of the skin not subject to much wrinkling
79. You will be applying eye drops to Miss Romualdez. After checking all the necessary
information and cleaning the affected eyelid and eyelashes you administer the ophthalmic
drops by instilling the eye drops.
d. from the inner canthus going towards the side of the eye
80. When applying eye ointment, the following guidelines apply EXCEPT:
a. squeeze about 2 cm of ointment and gently close but not squeeze eye
b. apply ointment from the inner canthus going outward of the affected eye
c. discard the first bead of the eye ointment before application because the tube likely to expel more
than desired amount of ointment
d. hold the tube above the conjunctival sac do not let tip touch the conjunctiva
Situation 17 – The staff nurse supervisor request all the staff nurses to “brainstorm” and learn ways
to instruct diabetic clients on self-administration of insulin. She wants to ensure that there are nurses
available daily to do health education classes.
d. primary prevention
82. When Mrs. Guevarra, a nurse, delegates aspects of the clients care to the nurse-aide who is
an unlicensed staff, Mrs. Guevarra.
b. is assigning the responsibility to the aide but not the accountability for those tasks
83. Connie, the-new nurse, appears tired and sluggish and lacks the enthusiasms she give six
weeks ago when she started the job. The nurse supervisor should:
84. Process of formal negotiations of working conditions between a group of registered nurses
and employer is:
a. grievance
b. arbitration
c. collective bargaining
d. strike
85. You are attending a certification program on cardiopulmonary resuscitation (CPR) offered
and required by the hospital employing you. This is:
b. in-service education
c. advance training
d. continuing education
Situation 18 – There are various developments in health education that the nurse should know about.
86. The provision of health information in the rural areas nationwide through television and
radio programs and video conferencing is referred to as:
b. Telehealth program
c. Wellness program
87. A nearby community provides blood pressure screening, height and weight measurement
smoking cessation classes and aerobics class services. This type of program is referred to as:
a. outreach program
d. wellness center
88. Part of teaching client in health promotion is responsibility for one’s health. When Danica
states she need to improve her nutritional status this means:
b. Goals and intervention developed by nurse and client should be approved by the doctor
c. Nurse will decide goals and, interventions needed to meet client goals
d. Client will decide the goals and interventions required to meet her goals
a. Marriage counseling
90. Mrs. Ostrea has a schedule for Pap Smear. She has a strong family history of cervical
cancer. This is an example of:
a. tertiary prevention
b. secondary prevention
c. health screening
d. primary prevention
Situation: 19 – Ronnie has a vehicular accident where he sustained injury to his left ankle. In the
Emergency Room, you notice how anxious he looks.
91. You establish rapport with him and to reduce his anxiety you initially
b. Identify yourself and state your purpose in being with the client
92. While doing your assessment, Ronnie asks you “Do I have a fracture? I don’t want to have
a cast.” The most appropriate nursing response would be:
b. “Why do you sound so scared? It is just a cast and it’s not painful”
93. A technique in physical examination that is use to assess the movement of air through the
tracheobronchial tree:
A. Palpation
B. Auscultation
C. Inspection
D. Percussion
A. Percussion-hammer
B. Audiometer
C. Stethoscope
D. Sphygmomanometer
D. Drum-like
A. Prone
B. Sim’s
C. Knee-chest
D. Lithotomy
A. Gait
B. Range of motion
D. Hopping
98. The nurse asked the client to read the Snellen chart. Which of the following is tested:
A. Optic
B. Olfactory
C. Oculomotor
D. Trochlear
A. Genu-dorsal
B. Genu-pectoral
C. Lithotomy
D. Sim’s
100. The nurse prepares an IM injection that is irritating to the subcutaneous tissue. Which of
the following is the best action in order to prevent tracking of the medication
Answers
Here are the answers for the exam. Unfortunately, rationales are not given. If you need clarifications
or disputes, please direct them to the comments section and we’ll be glad to give you an explanation.
1. C
2. B
3. D
4. D
5. B
6. B
7. C
8. D
9. B
10. B
11. B
12. C
13. C
14. D
15. A
16. A
17. C
18. B
19. A
20. C
21. D
22. C
23. D
24. D
25. C
26. D
27. C
28. D
29. D
30. C
31. B
32. C
33. C
34. C
35. B
36. D
37. D
38. B
39. B
40. C
41. D
42. B
43. D
44. D
45. C
46. C
47. D
48. D
49. B
50. D
51. D
52. C
53. D
54. B
55. B
56. C
57. D
58. C
59. B
60. C
61. D
62. C
63. D
64. C
65. D
66. D
67. A
68. D
69. D
70. C
71. B
72. B
73. D
74. D
75. B
76. C
77. B
78. B
79. B
80. C
81. C
82. B
83. C
84. C
85. B
86. B
87. A
88. D
89. C
90. B
91. B
92. C
93. B
94. C
95. A
96. C
97. A
98. A
99. B
100. D