Fundamentals of Nursing #NLE2023
a FORCE that gives a meaning to a person's life while Westerhoff
St. Catherine of Siena - 1st lady with the lamp
Florence Nightingale - founder of modern nursing
Mrs. Anastasia Giron - Tupas- Pioneer of Philippine Nursing &
founder of PNA.
Imogene King- health is a state in the life cycle and Illness is
any interference on this cycle.
ROY - Health is a state and process of becoming a WHOLE AND
INTEGRATED Person.
Pender - developed the concept of HEALTH PROMOTION
MODEL which postulated that an individual engages in health
promotion activities to increase well being and attain self
actualization.
Moses - the father of sanitation.
Nightingale - nursing as the utilization of the persons
environment to assist him towards recovery.
Nightingale- person as somebody who has a reparative
capabilities mediated and enhanced by factors in his environment.
Nightingale- environment as something that would facilitate
the person’s reparative process and identified different factors like
sanitation, noise, etc. that affects a person’s reparative state.
Dunn - High level wellness is the ability of an individual to
maximize his full potential with the limitations imposed by his
environment. According to him, An individual can be healthy or ill
in both favorable and unfavorable environment.
Your keyword in Primary nursing is the 24 hours.
Watson-Caring is healing, it is communicated through the
consciousness of the nurse to the individual being cared for. It
allows access to higher human spirit.
Jean Watson-Caring expands the limits of openess and allows
access to higher human spirit.
Peters- proposed the theory of morality based on PRINCIPLES.
Johnson-Conceptualized the BEHAVIORAL SYSTEM MODEL
Rogers- postulated the WHOLISTIC concept
that the totality is greater than sum of its parts.
Becker-Health belief model was formulated in 1975.
Schulman and Mekler- Morality is measured of how people
treat human being and that a moral child strives to be kind and
just.
DEMOGRAPHIC : Age, sex, race etc.
SOCIOPSYCHOLOGIC : Social and Peer influence.
STRUCTURAL : Knowledge about the disease and prior contact
with it and
CUES TO ACTION : sign and symptoms of the disease or advice
from friends, mass media and others that forces or makes the
individual seek help.
Remember the word “ THEOROYTICAL “ For Callista Roy,
Nursing is a theoretical body of knowledge that prescribes analysis
and action to care for an ill person. She introduced the
ADAPTATION MODEL and viewed person as a BIOSPSYCHOSOCIAL
BEING. She believed that by adaptation, Man can maintain
homeostasis.
Elizabeth-She was the daughter of Hungarian kings, who feed
300-900 people everyday in their gate, builds hospitals, and care
of the poor and sick herself.
fowler- described the development of faith. He suggested that
faith is a spiritual dimension that gives meaning to a persons life.
Faith according to him, is a relational phenomenon.
There are only 2 theorist of FAITH that might be asked in the
board examinations. Fowler and Westerhoff. What differs them is
that, FAITH of fowler is defined abstractly, Fowler defines faith as
defines faith as a behavior that continuously develops through
time.
Kohlberg - He proposed the theory of morality that is based on
MUTUAL TRUST.
Westerhoff - Postulated that FAITH is the way of behaving. He
developed four theories of faith and development based on his
experience.
Once you see the phrase BEHAVIORAL SYSTEM, answer
Dorothy Johnson.
According to Martha Rogers, Man is composed of 2 systems :
SUB which includes cells, tissues, organs and system and SUPRA
which includes our famly, community and society. She stated that
when any of these systems are affected, it will affect the entire
individual.
Weidenbach - Developed the CLINICAL NURSING – A HELPING
ART MODEL
Orem -defined health as the SOUNDNESS and WHOLENESS of
developed human structure and of bodily and mental functioning.
Martha Rogers states that HEALTH is synonymous with
WELLNESS and that HEALTH and WELLNESS is subjective
depending on the definition of one's culture.
Neuman believe that man is composed of subparts and when
this subparts are in harmony with the whole system, Wellness
results. Please do not confuse this with the SUB and SUPRA
systems of martha rogers.
This is Jean Watson's definition of Nursing as caring. This was
asked word per word last June 06' NLE. Benner defines caring as
something that matters to people. She postulated the
responsibility created by Caring in nursing. She was also
responsible for the PRIMACY OF CARING MODEL. Leininger defind
the 4 conservation principle while Swanson introduced the 5
processes of caring.
Erickson,Tomlin,Swain- Developed the ROLE MODELING and
MODELING theory
Myra Levin described the 4 Conservation principles which are
concerned with the Unity and Integrity of an individual.
These are ENERGY : Our output to facilitate meeting of our
needs.
STRUCTURAL INTEGRITY : We must maintain the integrity of
our organs, tissues and systems to be able to function and prevent
harmful agents entering our body. PERSONAL INTEGRITY :
These refers to our self esteem, self worth, self concept, identify
and personality.
SOCIAL INTEGRITY : Reflects our societal roles to our society,
community, family, friends and fellow individuals.
Bernard- Health is the ability to maintain and Internal Milieu
and Illness is the failure to maintain the internal environment.
Functional nursing -This patient care model works best when
there are plenty of patient but few nurses
Leininger-Caring is the essence and central unifying, a
dominant domain that distinguishes nursing from other health
disciplines. Care is an essential human need.
Clara louise Maas- She dies of yellow fever in her search for
truth to prove that yellow fever is carried by a mosquitoes.
According to the official PNA website, they are founded
September 02, 1922.
Florence Nightingale was born in Florence, Italy, May 12, 1820.
Studied in Germany and Practiced in England.
Henderson -The unique function of the nurse is to assist the
individual, sick or well, in the performance of those activities
contributing to health that he would perform unaided if he has
the necessary strength, will and knowledge, and do this in such a
way as to help him gain independence as rapidly as possible.
Betty Neuman asserted that nursing is a unique profession and
is concerned with all the variables affecting the individual's
response to stressors. These are INTRA or within ourselves, EXTRA
or outside the individual, INTER means between two or more
people. She proposed the HEALTH CARE SYSTEM MODEL which
states that by PRIMARY, SECONDARY and TERTIARY prevention,
The nurse can help the client maintain stability against these
stressors.
OPEN system theory is ROY.Fundamentals of nursing
kubler-Ross' Stages of dying : DABDA
Rigor mortis- stiffening of the body 2-4 hours after death.
Algor mortis- decrease in temperature after death
livor mortis- discoloration of the body after death.
Rectal temperature- (2-3 minutes)
Oral temperature-(3-5 minutes)
Axillary temperature-(6-9 minutes)
Tympanic temperature-(2-3 seconds)
Carotid pulse- assessed in cases of shock and arrest.
Weber test- lateralization of sound
Rinne test- compares air conduction and bone conduction.
Schwabach test- compares pt's hearing with that of the
examiner.
GCS score of 8 or less- coma
GCS score of 3- deep coma
Nosocomial infection- develops infection 48 hours after
admission.
Community acquired- if less than 48 hours.
After barium swallow- increase fluid intake
Respiratory acidosis- COPD and asthma
Respiratory alkalosis- hyperventilation
metabolic acidosis- prolonged diarrhea
metabolic alkalosis- prolonged vomiting and Cushing syndrome
0.9 NSS- the only solution compatible with blood transfusion.
x-ray- most accurate way to confirm placement of NGT.
Normal Urine output- at least 30 ml/hr.
Urine output- best indicator of cardiac output.
GUIDELINES IN ANSWERING THE BOARDS…
WHATEVER THE BOOK SAYS..IT SAYS
Longest choice could be the answer BECAUSE THEY CANNOT
SIMPLIFY THE MOST CORRECT ANSWER
All absolute statements with words like ALL and NEVER is
considered a negative statement and is therefore incorrect
Must answers are letter C..
Eliminate answer which are the highest and the lowest. Answer is
most often next to the lowest
Eliminate commonalities/similarities in the choices
All of the above answer in the choices is 80-90% correct than the
none of the above choice which is 40% correct
If questions have negative modifiers such as except, least likely,
inappropriate, needs further teaching, all
but one - choose a negative statement answer/choice with words
such as NO and NOT in the statement
Questions asking for most important
Choose statement showing more exclusivity and more beneficial
Statement of nurse with words “I am sure” - eliminate
Statement asking/with word “why” - eliminate especially if nurse
is asking patient. Exemption if nurse is
asking the significant others
Psyche = priority is SAFETY
CHN = priority is CLIENT CENTERED
*MS= ABC & pain
MASLOW’S HEIRARCHY OF NEEDS
Statements with not and another negative word in a statement,
choose positive statement I.e. not uncommon = common
If question is nurse centered, answer is based on nursing process
(start with assessment always)
Questions with words like INITIAL, PRIMARY and FIRST - choose
answers with words like assess, check,
determine and ask in the statement
For implementation questions, based your answers using
NURSING PROCESS showing NURSING ACTIONS
Evaluation questions, answers should state expected outcomes,
desired effects, and effect.
For signs and symptoms question - answer should be based on
prevention of complications
Read questions carefully, sometimes answers are found in the
question
Prioritizing intervention questions choose answers following this
sequence:
o Independent - nursing prescribed intervention
o Interdependent - collaborative approach
o Dependent - doctor prescribed
ACUTE VS CHRONIC, acute is priority
STABLE VS UNSTABLE, unstable is priority
***TRIAGE***
MASS DISASTER - priority people who can survive
Emergency - priority people with life threatening condition
Prioritizing intervention questions choose answers following this
sequence:
Fire situation
o RACE
3 levels of prioritizing
o LEVEL 1 - EMERGENT
o LEVEL 2 - STABLE OR URGENT
o LEVEL 3 - CHRONIC
INVASIVE VS NON INVASIVE, invasive is priority
TOO OLD AND TOO YOUNG SHOULD ALWAYS BE THE PRIORITY
TOO OLD VS TOO YOUNG (neonate or infants), too young is
priority
EARLY SIGNS VS LATE SIGNS, early signs is priority
MIXED NOTES | PALMAR NURSING
#palmarnursingnns
Manager – officially appointed, have people to WORK for them.
Leader – may or may not have official appointment, have people
to FOLLOW them.
LEWIN'S LEADERSHIP STYLE
▪︎Autocratic – ONLY the leader decides.
▪︎Democratic – leader consults his TEAM in decision-making.
▪︎Laissez‐faire – "no hands" the leader has a little or NO
INVOLVEMENT in decision making
most effective leadership style???— Democratic
5 M's of management — manpower, machine, materials, method,
money.
Fishbone diagram – cause-and-effect tool, helps figure out the
reasons for defects/problems.
Span of control – the area of activity and number of functions,
people, or things for which an individual or organization is
responsible.
Phenomenological research – focused on lived experiences (eg. A
study about challenges of being a nursing student)
Case study – in-depth examination and analysis of a person or RA 7432 - Senior Citizen Act
group. EO 51 - Milk Code
Ethnographical – study the meanings, patterns and experiments of EO 209 - Family Code
a defined cultural group. PD 603 - Child & Youth Welfare Code
Deductive – specific to general PD 442 - New Labor Code
Inductive – general to specific Parties to case:
Qualitative – uses inductive reasoning complainant vs defendant – CIVIL case
Quantitative – deductive reasoning plaintiff vs accused – CRIMINAL case
Qualitative – more on words and meanings
Quantitative – more on numbers and statistics.
Cross-sectional research design – data is collected at just ONE
point in time. BULLETS
Longitudinal designs – collected at TWO or more points in time.
3 major principles in research Not seen in RHF- PETECHIAE
▪︎beneficence – "being good" deviated fundus - empty bladder
▪︎respect to human dignity Not to be recycled - empty drug vials
▪︎justice – "fairness" VAWC act - 9262
▪︎mean – most reliable and stable study of statistic. Reproductive health act- 10354
▪︎median – divides the distribution at 50th percentile. Antihelmithic - niog niyogan
▪︎mode – number the occurs more frequently. Development of 6months old - 1st tooth bud eruption
▪︎Range – distance between the highest and lowest scores. Crime evidences - place in paper bag
▪︎Standard deviation – measures the spread of scores. Filariasis agent- Wuchereria Bancrofti
▪︎Variance – avg. distance of scores on an interval or ratio scale Father role in family - Caretaker
from the mean in squared units. Symbol of independent variable - X
T-test – commonly used statistical method user to examine the Toy for 8 months old baby - large blocks
statiscal difference between 2 means. PLAY OF INFANT- solitary play
Chi-square – descriptive measure of discrepancy values between Toy of 2 yrs old - wagon cart
observed frequency and expected frequency. Child always says NO - QUEST for autonomy
ANOVA – an inferential statistics method, used to compare the Negativism of toddler- provide choices
means of 2 or more groups of population. The most common pathogenic mechanism of acute pancreatitis is
Beneficence - being "good" ( eg. kindness, charity, mercy) Auto digestion of the pancreas.
Non-maleficence-- preventing harm (eg. raising the side rails) IUD prevents - implantation
Justice-- what is right and equal (eg. being fair) What does the nurse monitors for, in a patient with Acute Renal
Autonomy - self decision, (eg. freedom to choose) Failure?
Stewardship- care/duty (eg. valuing and respecting patients) Pulmonary edema and ECG changes.
Veracity - honesty, telling truth (eg. witness) A disease caused by Treponema pallidum is –
Fidelity - loyalty Syphilis.
Reciprocity - "I give what you may give" (eg. working/studying Which of the following is an important nursing intervention for a
abroad).. patient with Cushing Syndrome
Force majeure - "act of God" (eg. natural calamities, storm, Ans: Protect from infection.
earthquake) Involvement of which of the following structures will lead to right-
Res ipsa loquitur - "the thing speaks for itself" (eg. negligence) sided hemiplegia and aphasia?
Respondeat superior - "let the master answer" (the superior/head Ans: Left Middle Cerebral Artery
is also accountable).. Which one of the following is a common response expected in a
Subpoena deuces tecum - documents patient with stroke, to the change in body image?
Subpoena ad testificandum - witness (person) Ans: Depression.
License SDG target -2030
suspension - temporary removal A patient with early osteoporosis must be advised to-
revocation - permanent removal Stop smoking
Quasi-judicial - investigation (eg. suspension & revocation) For doing nasotracheal suctioning, during which of the following
Quasi-legislative - rules/regulation (eg. time and location of board patient activities, the catheter should be inserted?
exam) Ans: upon Inhaling
testator- a person who has made a will The simple most effective method for reducing the risks of stasis
Will - permits a person (testator) to make decisions on how his of pulmonary secretions is-
estate will be managed and distributed after his death - Two hourly position change.
Consent - agreement/permission Role of nursing is “having charge of somebody’s health” Whose
BON Chairman: Elsie A. Tee vision is environmental model is?
PRC Chairman: Teofilo S. Pilando -Florence Nightingale
DOH Secretary: Francisco Duque III Which of the following developmental stage corresponds to
tip: kahit yung apelyedo lang ang tandaan mo. infancy?
ESSENTIAL LAWS Ans: Trust Vs Mistrust
RA 7305 - Magna Carta for Public Health Workers Who proposed the nursing theory of self-care deficit?
RA 7875 - National Health insurance Act - Dorothea orem
RA 9173 - Nursing Law The head circumference of a normal infant is –33-35 cm
RA 8976 - Food Fortification Law Health centered SDG - #3
RA 7600 - Breast feeding Act The leading cause of death is –HEART DISEASES
RA 1054 - Health Occupational Act The legal definition of ‘death’ that facilitates organ donation is,
RA 10912 - CPD law cessation of –
RA 11332 - Mandatory Reporting of Notifiable Diseases Function of brain
The body temperature at which tissues and cells can best function Ans: Wrist
is – 36-38o C Who was the first president of the International Council of
.The mechanism by which body loses heat to the environment, Nurses?
without having direct contact is --? Fenwick
Radiation Which of the following minerals should be taken by a child
Which of the following structures controls heat loss? suffering from rickets?
hypothalamus (a)Potassium (b) Calcium (c) Sodium (d) Iron
Exposure of the body to subnormal temperature can lead to … Ans: Calcium
Frost-bite Food to prevent scurvy- fruits rich in vit. C
What is the equipment that indirectly measures arterial oxygen Who introduced antiseptic spray during surgery?
saturation? Joseph Lister
Pulse Oximeter Isolated the agent of TB - ROBERT Koch
What technique of assessment helps to determine ketoacidosis? Father of modern Epidemiology - John Snow
Olfaction John Snow is the epidemiologist of - Cholera in Soho london
BREATHING OF A diabetic client- kussmauls Which of the following drugs will be administered to treat
Fruity breath odor - DKA anaphylaxis?
Inflammation of skin at base of nail is? (a) Atropine (b) Sodium bicarbonate (c) Digoxin (d) Epinephrine
Paronychia Ans: Epinephrine
The most effective way to break the chain of infection is by? Which of the following is a vesicant drug?
Hand hygiene (a)Dactinomycin (b) Morphine (c) Azithrocin (d) Voveran
A patient who is receiving intravenous fluids develops tenderness, Ans: Dactinomycin
warmth, erythema and pain at the infusion site. Which of the Pain caused by damage to somatic tissue is known as –
following conditions will you suspect Nociceptive
-Phlebitis Which of the following immunoglobulin are responsible for
When providing oral hygiene to an unconscious patient, care must anaphylactic reactions?
be taken to prevent? (a) IgA (b) IgE (c) IgM (d) IgG
- Aspiration Ans: IgE
What is the intrinsic rate of the normal A-V node? What types of dressing is Duoderm?
40-60 per minute Hydrocolloid.
Which of the following structures is the pacemaker of the heart? What is the most common cause of secondary
Ans: S-A node immunodeficiencies?
What electrolyte abnormality is likely to develop in a patient with Drugs
vomiting? If a person is having an acute rejection of a transplanted organ,
Hypokalemia which of the following drugs would most likely to be used?
What is the primary cause of hyperkalemia? (a)Tacrolimus (b) Cyclosporine (c) Cellcept (d) Daclizumab.
Renal failure Ans: Daclizumab.
Which of the following is an isotonic solution? Which of the following should be watched for in a patient who has
(a)Lactated Ringers (b) Half –Normal Saline (c) One-third Normal just undergone a total thyroidectomy?
Saline (a)Weight gain (b) Depressed reflexes (c) Positive chvostek sign (d)
(d) Mannitol Personality changes.
Ans: Lactated Ringers Ans: Positive chvostek sign
Thousand ml. of Normal Saline is to be infused in 8 hours. What The cause of arcus senilis is?
should be the rate of flow per minute? Cholesterol deposits.
30 drops What is the cause of presbyopia?
A patient admitted with vomiting, has the following arterial blood Inflexible lens.
gas levels-pH 7.30; PaCO2 36 mm Hg; Pa O2 92mm Hg; and HCO3 Which of the following is an earliest manifestation of inadequate
18; what is the acid-base imbalance that is present? oxygenation?
Metabolic acidosis (a) Diaphoresis (b) Cyanosis (c) Restlessness (d) Hypotension
Which of the following is a first-line drug used for pain Ans: Restlessness
management? Which of the following helps to identify flail chest in a patient with
(a)Acetaminophen (b) Clonidine (c) Morphine (d) Ketamine chest trauma:
Ans: Acetaminophe (a)Multiple rib fractures seen in X-ray. (b)Decreased movement of
Which of the following is the organism that causes peptic ulcer chest wall
disease? (c)Tracheal deviation (d) Paradoxic chest movement during
(a) Staphylococcus (b) Coryne bacterium (c) Helicobacter pylori respiration.
(d) Streptococcus. Ans: Paradoxic chest movement during respiration.
Ans: Helicobacter pylori Which of the following is an intervention for a patient with chronic
TYpE OF PERSonNALITY common to PUD - type B obstructive pulmonary disease?
The stool discharged from an ostomy is called? (a) Pursed-lip breathing (b) Chronic steroid therapy (c) High flow
Effluent oxygen
Which of the following is a common cause of orthostatic (d)High Carbohydrate diet
hypotension in a bedridden Patient? Ans: Pursed-lip breathing
(a)Increased autonomic response 90. Which of the following is a normal finding obtained during a
(b) Decreased circulating blood volume lymph node palpation?
(c) Increased cardiac output (a) Hard, fixed node (b) Firm, mobile node (c) Enlarged tender
(d) Decreased blood pooling nodes
Ans: Decreased circulating blood volume. (d)Hard, nontender nodes
Which of the following body parts has a condyloid joint? Ans: Firm, mobile node
(a) Shoulder (b) Elbow (c) Wrist (d) Forearm Which is the most common type of leukemia seen in older adults?
Chronic lymphocytic.
The blood vessel that brings blood to the right atrium is ….
Inferior Venae Cavae
Which of the following conditions is caused by elevated intra
ocular pressure?
(a)Glaucoma (b) Cataract (c) Strabismus (d) Myopia.
Ans: Glaucoma.
Which of the following drugs provide relief of anxiety and
decreases both preload and after load?
(a) Amrinone (b) Morphine sulphate (c) Furosemide
(d)Dobutamine
Ans: Morphine sulphate
In a normal sinus rhythm, the measurement of an S.T.segment is.?
0.12 seconds
What is the usual treatment of Rayanaud’s Phenomenon?
Calcium Channel blockers.
Theophyline relieves - wheezes
Side effect of theophyline - diarrhea
PTSD - flashbacks
Pls take note guys
Autonomy - "Freedom to CHOOSE"
Beneficence - "Do only what's GOOD", respect, privacy
Nonmaleficience - "Do NO harm", e.g. side rails up
Veracity - "Tell the TRUTH"
Justice - "Be FAIR"
Fidelity - "Keep your word", keeping promises "LOYALTY"
MIDWIFERY ETHICS - the code governing the NURSE'S BEHAVIOR,
especially towards patients, employing authority and to the
profession.
Beneficence - any action that would BENEFIT others. The principle
that imposes upon the practitioner to seek the good for the
patients under all circumstances. Beneficence connotes positive
action toward preventing or removing harm and promoting good
such as:
(1) One ought to prevent evil or harm
(2) One ought to remove evil or harm
(3) One ought to do or promote good.
Nonmaleficence - states the idea to REFRAIN from inflicting harm.
"one ought NOT to inflict evil or harm. The admonition of
nonmaleficence is stated in the negative manner while the
beneficence is in the positive.
Justice - The basic principle that deals with FAIRNESS, just deserts,
and entitlements in the distribution of goods and services.
Some methods of distributing goods and services in our society
are as follows:
(1) To each, an equal share
(2) To each, according to need
(3) To each, according to effort
(4) To each, according to contribution
(5) To each, according to merit
(6) To each, according to ability to pay
Autonomy - In health care, it means the form of personal LIBERTY,
where the individual is free to choose and implement ones' own
decisions, free from deceit, duress, constraint, or coercion. Three
Basic elements involved:
(1) ability to decide
(2) power to act upon your decisions
(3) a respect for the individual autonomy of others.
Stewardship - refers to the actions made for by the health
practitioner IN BEHALF of the patient and for the greater benefit
of the patient.
Truth Telling/Veracity - The patient must tell the truth in order
that appropriate care can be provided. The health practitioner
needs to disclose FACTUAL INFORMATION so that the patient can
exercise personal autonomy.
Confidentiality - is also known as PRIVILEGED COMMUNICATION
which refers to any information obtained by the nurse or the
health team during the course of caring for the patient. The
information gathered may only be disclosed under the following:
(1) the patient agrees to divulge such information with written
consent
(2) the information is material in a criminal case investigation
(3) if public safety is jeopardized (communicable disease)
(4) such information is relevant to his care to be utilized by other
health team
Privileged Communication may be divided into two classes:
(1) Absolute privileged communication - is one made in the
interest of the public service or the due administration of justice
and is practically limited to legislative and judicial proceedings and
other actions of the state.
(2) Qualified privileged communication - is a slanderous statement
uttered in good faith, and made on a proper occasion, from a
proper motive, based upon a probable cause and in honest belief
that such statement is true.
MORAL PRINCIPLES
· GOLDEN RULE - " Do unto others what you would like others do
unto you". It is a basic moral principle that if you want others to
respect you, you must also accord respect to them.
· THE TWO FOLD-EFFECT - facing a situation which would have
good and bad effects requires the following basis for arriving a
decision:
a. that the action must be morally good
b. that the good effect must be willed and the bad effect merely
allowed
c. that the good effect must not come from an evil action but from
initial action itself directly; and
d. that the good effect must be greater than the bad effect.
THE PRINCIPLE OF TOTALITY - states that the whole is always
greater than its parts. To save the patients' life as a whole, it is
justified under this principle to surgically cut-off a disease body
part of the patient.
EPIKIA - "exception to the general rule". It is reasonable
presumption that the authority making the law will not wish to
bind a person in some particular case, even though the case is
covered by the letter of the law.
If a mentally ill patient becomes berserk and the doctor could not
be contacted, the patient may be restrained by virtue of epikia.
Another example of this is allowing a relative to see a seriously ill
patient who expresses the desire the relative although it is not yet
visiting hours
THE END DOES NOT JUSTIFY THE MEANS - giving a sleeping tablet
to a chronically ill person so he/she can de in peace is morally
wrong.
THE GREATEST GOOD FOR THE GREATEST NUMBER - during an
epidemic, immunization against communicable diseases is
administered to the people. Although there may be some who
may have slight reactions to the vaccine, the greater majority of
the population shall be considered.
NO ONE IS HELD TO THE IMPOSSIBLE - the doctors and nurses are
not guarantors of life. They cannot be held liable as long as they
have done everything that modern medicine can afford to save a
patient from dying.
THE MORALITY OF COOPERATION - formal cooperation in an evil
act is never allowed. A nurse shall not participate upon immoral
operations such as abortion even if the doctor commands it.
PRINCIPLE RELATING TO THE ORIGIN AND DESTRUCTION OF LIFE -
mercy killing or euthanasia is not allowed because it will lessen
the incentive to medical research. The state recognizes the
sanctity of life. It shall protect the life of the mother and the
unborn since conception.
Any direct attack on the life of a fetus for whatever cause is
immoral. A fetus shall be buried in consecrated grounds. If it is
dead and came from dead mother, it shall be buried with the
mother.
Privacy - the right to be left alone or be apart from others. This
right is guaranteed by most civilized state laws and enshrined also
in the patients' bill of rights. The patient has the right to every
consideration of his privacy concerning his own medical care
program. Case discussion, consultation, examination and
treatment are confidential and should be conducted discreetly.
Those not directly involved in his care must have the permission of
the patient to be present. This right also includes privacy of one's
thoughts, opinions and physical presence and privacy of one's
records.
Informed Consent -The patient UNDERSTANDS the reason for the
proposed intervention, with its benefits and risks, and agrees to
the treatment by affixing his signature in the consent form. It
generally contains the following elements:
(1) disclosure
(2) understanding
(3) voluntariness
(4) competence
(5) permission giving
· In our present jurisdiction under the 1987 Constitution, the age
of majority is 18 years old. It means that only 18 years old and
above can sign for themselves in legal matters such as the signing
of consent (hospital admission, contracts, will etc..)
Beneficence- compassion; taking positive action to help others;
desire to do good -- CBQ
Non maleficence- to do NO HARM; core of medical oath and
nursing ethics.
Autonomy - agreement to respect another's right to self-
determine a course of action
- support of independent decision making.
- CBQ
Example: In clinical situations nurses respect a patient’s
autonomy, where the patient is
allowed the freedom of choice regarding treatment, such as in
decition
STEWARDSHIP- refers to the actions made for by the health
practitioner IN BEHALF of
the patient and for the greater benefit of the patient.
- Taking good care of oneself
Ethics – part of philosophy that deals with systematic approaches
to questions of morality.
- A term for the study of how we make judgments regarding right
and wrong.
- A system of MORAL PRINCIPLES or moral standards governing
conduct.
CODE OF ETHICS
· Fundamental responsibilities of nurse
· Governing Rule of Conduct
· Guides the nurse in order to pursue and maintain high level of
ethical nursing practice
· A set of guideline to guide the behavior of professional nurses
· Rules, principles that guide decisions or conduct in terms of the
rightness or wrongness of that decisions or actions.
Serves the purpose of governing conduct to ensure the protection
of individual’s rights
Unprofessional Ethics – Violation to the code of conduct/ethics -
CBQ
Epikia – There is always an exemption to the rule
10 commandments- set of guidelines for all ages and all times
• Confidentiality - is also known as PRIVILEGED COMMUNICATION
which refers to any information obtained by the nurse or the
health team during the course of caring for the patient.
PRIVILEGED COMMUNICATION may only be disclosed under the
following: - CBQ
a. patient agrees to divulge with written consent
b. information is material in a criminal case investigation
c. required by court to serve and justify the end of justice
d. if public safety is jeopardized (communicable disease)
e. such information is relevant to his care to be utilized by other
health team
Medical Records
- As a record of illness and treatment, it saves duplication in future
cases and aids in prompt treatment
- It serves as a legal protection for the hospital, doctor, and nurse
by reflecting the disease or condition of patient and its
management.
- “If it was not charted, it was not observed or done.”
- nurses have the responsibility of keeping the patient’s right to
confidentiality.
- Permission has to be taken from the Medical Records Division of
the Hospital.
Documentation error :
- nurses should avoid using the words “error”, “incident” or
“accident” in the documentation - CBQ
a. The content in question must remain clearly visible or
retrievable so that the purpose and content of the correction is
clearly understood.
Paper-based documentation error:
· do not make entries between lines
· do not remove anything (e.g., monitor strips, lab reports,
requisitions, checklists)
· do not erase or use correction products, stickers or felt pens to
hide or obliterate
Who owns the medical chart? Answer: Hospital
Who owns the communication in the medical chart-- Answer:
Doctor and Patient
Incident report (also called occurrence reports)
- is an event which is not consistent with the routine operations of
the unit or of client care
- used by organizations for risk management, to track trends in
systems and client care and to justify changes to policy, procedure
and/or equipment
Examples of incidents include patient falls, medication errors,
needle stick injuries, or any circumstances that places clients or
staff at risk of injury.
Incidents are generally recorded in two places, in the client’s
medical record and in an incident report, which is separate from
the chart.
With whom may you share your report?
A. Your supervisor
RA 10912 --- 　CPD act
CPD : For Renewal of expired License , the nurse is required to
present at least 45 units of CPD/CPE
New
Requirement is 15 units
Continuing Professional Development (CPD) or Continuing
Professional Education (CPE)
- Can be obtained by attending trainings and seminars accredited
by CPE council in PRC
Extension for Renewal without surcharge : is at the 20th day of
the next month from the expiration date - CBQ
Example: if the license expiration date is Nov. 6, 2016 and it is the
birthdate of the bearer or registrant he/she can extend his/her
renewal until the 20th day of the next month from the expiration
date which is December 20, 2016
Note: Non renewal beyond the extension date – additional 25%
surcharge from the renewal fee
Non renewal beyond 5 consecutive years - delisting of name from
the roster or list of professionals - CBQ
Paternalism- This principle is heavily laden as an
application of power over the patient
RES IPSA LOQUITOR- Prima Facie Evidences
- “The thing speaks for itself.”
- the nature of the wrongful act or injury is suggestive of
negligence
- sufficient proof of negligent act is present
MALPRACTICE- “you do things beyond your scope of practice”
- doing practices not specified in your scope of practice
Example:
- prescription of medication(antibiotics)
- I.V. insertion without training
- suturing 3rd and 4rth degree laceration
Assault
· attempt or threat to touch another person unjustifiably
Example:
o A person who threatens someone with a club or closed fist.
o Threatening a client with an injection after refusing to take oral
meds.
Battery - CBQ
· Willful touching of a person
· touching was done without permission
· Example:
o injection without client’s consent
o slapping newborns buttocks to initiate crying
o Forceful Restraint
LIBEL– defamation by means of print, writing or picture or any
means of distributed materials
- CBQ
Example:
- writing in the chart that the doctor is incompetent
SLANDER- defamation by the spoken word stating unprivileged
(not legally protected) or false word by which a reputation is
damaged
JUS SOLI- Citizenship based on place of birth
False Imprisonment- Illegal detention Act
- Limitation of persons liberty
· Unjustifiable detention of a person without legal warrant to
confine the person
Example:
o Telling a client no to leave the hospital until bill is paid
o Use of physical or chemical restraints
RA 9439 - Act prohibiting the detention of patients in hospitals
and medical clinics on grounds of nonpayment of hospital bills or
medical expenses
Parricide – (also Parenticide) the killing of one's mother or father
or other close relative. - CBQ
Infanticide – the act of killing a child under 3 days old of its life. -
CBQ
Perjury- lying under affidavit of oath
Take the professional oath-- final step to become professional
nurse
Common Board Questions (CBQ) in Nurse Licensure Examination
(CARDIOVASCULAR SYSTEM)
CBQ no. 1 How do clients experiencing angina? Describe that pain.
Answers: Described as squeezing, heavy, burning, radiates to left
arm or shoulder, transient or prolonged.
CBQ no. 2 Develop a teaching plan for the client taking
nitroglycerin.
Answers: Take at first sign of anginal pain. Take no more than 3,
five minutes apart. Call for emergency attention if no relief in 10
minutes.
CBQ no. 3 List the parameters of blood pressure for diagnosing
hypertension.
Answers: >140/90
CBQ no. 4 Differentiate between essential and secondary
hypertension.
Answers: Essential has no known cause while secondary
hypertension develops in response to an identifiable mechanism.
CBQ no. 5 Develop a teaching plan for the client taking
antihypertensive medications.
Answers: Explain how and when to take med, reason for med,
necessary of compliance, need for follow-up visits while on med,
need for certain lab tests, vital sign parameters while initiating
therapy.
CBQ no. 6 Describe intermittent claudication.
Answers: Pain related to peripheral vascular disease occurring
with exercise and disappearing with rest.
CBQ no. 7 Describe the nurse’s discharge instructions to a client
with venous peripheral vascular disease.
Answers: Keep extremities elevated when sitting, rest at first sign
of pain, keep extremities warm (but do NOT use heating pad),
change position often, avoid crossing legs, wear unrestrictive
clothing.
CBQ no. 8 What is often the underlying cause of abdominal aortic
aneurysm?
Answers: Atherosclerosis.
CBQ no. 9 What lab values should be monitored daily for the client
with thrombophlebitis who is undergoing anticoagulant therapy?
Answers: PTT, PT, Hgb, and Hct, platelets.
CBQ no. 10 When do PVCs (premature ventricular contractions)
present a grave danger?
Answers: When they begin to occur more often than once in 10
beats, occur in 2s or 3s, land near the T wave, or take on multiple
configurations.
CBQ no. 11 Differentiate between the symptoms of left-sided
cardiac failure and right-sided cardiac failure.
Answers: Left-sided failure results in pulmonary congestion due to
back-up of circulation in the left ventricle. Right-sided failure
results in peripheral congestion due to back-up of circulation in
the right ventricle.
CBQ no. 12 List 3 symptoms of digitalis toxicity.
Answers: Dysrhythmias, headache, nausea and vomiting
CBQ no. 13 What condition increases the likelihood of digitalis
toxicity occurring?
Answers: When the client is hypokalemic (which is more common
when diuretics and digitalis preparations are given together).
CBQ no. 14 what life style changes can the client who is at risk for
hypertension initiate to reduce the likelihood of becoming
hypertensive?
Answers: Cease cigarette smoking if applicable, control weight,
exercise regularly, and maintain a low-fat/low-cholesterol diet.
CBQ no. 15 What immediate actions should the nurse implement
when a client is having a myocardial infarction?
Answers: Place the client on immediate strict bedrest to lower
oxygen demands of heart, administer oxygen by nasal cannula at
2-5 L/min., take measures to alleviate pain and anxiety (administer
prn pain medications and anti-anxiety medications).
CBQ no. 16 What symptoms should the nurse expect to find in the
client with hypokalemia?
Answers: Dry mouth and thirst, drowsiness and lethargy, muscle
weakness and aches, and tachycardia.
CBQ no. 17 Bradycardia is defined as a heart rate below ___ BPM.
Tachycardia is defined as a heart rate above ___ BPM.
Answers: bradycardia 60 bpm; tachycardia 100 bpm
CBQ no. 18 What precautions should clients with valve disease
take prior to invasive procedures or dental work?
Answers: Take prophylactic antibiotics.
Common Board Questions (CBQ)
in Nurse Licensure Examination
(RENAL SYSTEM)
CBQ no. 1 Differentiate between acute renal failure and chronic
renal failure.
Answers: Acute renal failure: often reversible, abrupt
deterioration of kidney function. – Chronic renal failure:
irreversible, slow deterioration of kidney function characterized by
increasing BUN and creatinine. Eventually dialysis is required.
CBQ no. 2 During the oliguric phase of renal failure, protein should
be severely restricted. What is the rationale for this restriction?
Answer: Toxic metabolites that accumulate in the blood (urea,
creatinine) are derived mainly from protein catabolism.
CBQ no. 3 Identify 2 nursing interventions for the client on
hemodialysis.
Answer: Do NOT take BP or perform venipunctures on the arm
with the A-V shunt, fistula, or graft. Assess access site for thrill or
bruit.
CBQ no. 4 What is the highest priority nursing diagnosis for clients
in any type of renal failure?
Answer: Alteration in fluid and electrolyte balance.
CBQ no. 5 A client in renal failure asks why he is being given
antacids. How should the nurse reply?
Answer: Calcium and aluminum antacids bind phosphates and
help to keep phosphates from being absorbed into blood stream
thereby preventing rising phosphate levels, and must be taken
with meals.
CBQ no. 6 List 4 essential elements of a teaching plan for clients
with frequent urinary tract infections.
Answer: Fluid intake 3 liters/day; good handwashing; void every 2-
3 hours during waking hours; take all prescribed medications;
wear cotton undergarments.
CBQ no. 7 What are the most important nursing interventions for
clients with possible renal calculi?
Answer: Strain all urine is the MOST IMPORTANT intervention.
Other interventions include accurate intake and output
documentation and administer analgesics as needed.
CBQ no. 8 What discharge instructions should be given to a client
who has had urinary calculi?
Answer: Maintain high fluid intake 3-4 liters per day. Follow-up
care (stones tend to recur). Follow prescribed diet based in calculi
content. Avoid supine position.
CBQ no. 9 Following transurethral resection of the prostate gland
(TURP), hematuria should subside by what post-op day?
Answer: Fourth day
CBQ no. 10 After the urinary catheter is removed in the TURP
client, what are 3 priority nursing actions?
Answer: Continued strict I&O; continued observations for
hematuria; inform client burning and frequency may last for a
week.
CBQ no. 11 After kidney surgery, what are the primary
assessments the nurse should make?
Answer: Respiratory status (breathing is guarded because of pain);
circulatory status (the kidney is very vascular and excess bleeding
can occur); pain assessment; urinary assessment most
importantly, assessment of urinary output.
Common Board Questions (CBQ)
in Nurse Licensure Examination
(RESPIRATORY SYSTEM)
CBQ n0. 1 List 4 common symptoms of pneumonia the nurse
might note on a physical exam.
Answer: Tachypnea, fever with chills, productive cough, bronchial
breath sounds.
CBQ no. 2 State 4 nursing interventions for assisting the client to
cough productively.
Answer: Deep breathing, fluid intake increased to 3 liters/day, use
humidity to loosen secretions, suction airway to stimulate
coughing.
CBQ no. 3 What symptoms of pneumonia might the nurse expect
to see in an older client?
Answer: Confusion, lethargy, anorexia, rapid respiratory rate.
CBQ no. 4 What should the O2 flow rate be for the client with
COPD?
Answer: 1-2 liters per nasal cannula, too much O2 may eliminate
the COPD client’s stimulus to breathe, a COPD client has hypoxic
drive to breathe.
CBQ no. 4 How does the nurse prevent hypoxia during suctioning?
Answer: Deliver 100% oxygen (hyperinflating) before and after
each endotracheal suctioning.
CBQ no. 5 During mechanical ventilation, what are three major
nursing intervention?
Answer: Monitor client’s respiratory status and secure
connections, establish a communication mechanism with the
client, keep airway clear by coughing/suctioning.
CBQ no. 6 When examining a client with emphysema, what
physical findings is the nurse likely to see?
Answer: Barrel chest, dry or productive cough, decreased breath
sounds, dyspnea, crackles in lung fields.
CBQ no. 7 What is the most common risk factor associated with
lung cancer?
Answeer: Smoking
CBQ no. 8 Describe the pre-op nursing care for a client undergoing
a laryngectomy.
Answer: Involve family/client in manipulation of tracheostomy
equipment before surgery, plan acceptable communication
method, refer to speech pathologist, discuss rehabilitation
program.
CBQ no. 9 List 5 nursing interventions after chest tube insertion.
Answer: Maintain a dry occlusive dressing to chest tube site at all
times. Check all connections every 4 hours. Make sure bottle III
or end of chamber is bubbling. Measure chest tube drainage by
marking level on outside of drainage unit. Encourage use of
incentive spirometry every 2 hours.
CBQ no. 10 What immediate action should the nurse take when a
chest tube becomes disconnected from a bottle or a suction
apparatus? What should the nurse do if a chest tube is
accidentally removed from the client?
Answer: Place end in container of sterile water. Apply an
occlusive dressing and notify physician STAT.
CBQ no. 11 What instructions should be given to a client following
radiation therapy?
Answer: Do NOT wash off lines; wear soft cotton garments, avoid
use of powders/creams on radiation site.
CBQ no. 12 What precautions are required for clients with TB
when placed on respiratory isolation?
Answer: Mask for anyone entering room; private room; client
must wear mask if leaving room.
CBQ no. 13 List 4 components of teaching for the client with
tuberculosis.
Answer: Cough into tissues and dispose immediately into special
bags. Long-term need for daily medication. Good handwashing
technique. Report symptoms of deterioration, i.e., blood in
secretions.
Common Board Questions (CBQ)
in Nurse Licensure Examination
(ENDOCRINE SYSTEM)
CBQ. no 1. What diagnostic test is used to determine thyroid
activity?
Answers: T3 and T4
CBQ. no 2. What condition results from all treatments for
hyperthyroidism?
Answers: Hypothyroidism, requiring thyroid replacement
CBQ. no 3. State 3 symptoms of hyperthyroidism and 3 symptoms
of hypothyroidism.
Answers: Hyperthyroidism: weight loss, heat intolerance, diarrhea.
Hypothyroidism: fatigue, cold intolerance, weight gain.
CBQ. no 4. List 5 important teaching aspects for clients who are
beginning corticosteroid therapy.
Answers: Continue medication until weaning plan is begun by
physician, monitor serum potassium, glucose, and sodium
frequently; weigh daily, and report gain of >5lbs./wk; monitor
BP and pulse closely; teach symptoms of Cushing’s syndrome
CBQ. no 5. Describe the physical appearance of clients who are
Cushinoid.
Answers: Moon face, obesity in trunk, buffalo hump in back,
muscle atrophy, and thin skin.
CBQ. no 6. Which type of diabetic always requires insulin
replacement?
Answers: Type I, Insulin-dependent diabetes mellitus (IDDM)
CBQ. no 7. What type of diabetic sometimes requires no
medication?
Answers: Type II, Non-insulin dependent diabetes mellitus
(NIDDM)
CBQ. no 8. List 5 symptoms of hyperglycemia.
Answers:Polydipsia, polyuria, polyphagia, weakness, weight loss
CBQ. no 9. List 5 symptoms of hypoglycemia.
Answers: Hunger, lethargy, confusion, tremors or shakes, sweating
CBQ. no 10. Name the necessary elements to include in teaching
the new diabetic.
Answers: Teach the underlying pathophysiology of the disease, its
management/ treatment regime, meal planning, exercise
program, insulin administration, sick-day management, symptoms
of hyperglycemia (not enough insulin)
CBQ. no 11. In less than ten steps, describe the method for
drawing up a mixed dose of insulin (regular with NPH).
Answers: Identify the prescribed dose/type of insulin per physician
order; store unopened insulin in refrigerator. If opened, may be
kept at room temperature for up to 3 months. Draw up regular
insulin FIRST. Rotate injection sites. May reuse syringe by
recapping and storing in refrigerator.
CBQ. no 12. Identify the peak action time of the following types of
insulin: rapid-acting regular insulin, intermediate-acting, long-
acting.
Answers: Rapid-acting regular insulin: 2-4 hrs. Immediate-acting:
6-12 hrs. Long-acting: 14-20 hrs.
CBQ. no 13. When preparing the diabetic for discharge, the nurse
teaches the client the relationship between stress, exercise,
bedtime snacking, and glucose balance. State the relationship
between each of these.
Answers: Stress and stress hormones usually increase glucose
production and increase insulin need; exercise can increase the
chance for an insulin reaction, therefore, the client should always
have a sugar snack available when exercising (to treat
hypoglycemia); bedtime snacking can prevent insulin reactions
while waiting for long-acting insulin to peak.
CBQ. no 14. When making rounds at night, the nurse notes that an
insulin-dependent client is complaining of a headache, slight
nausea, and minimal trembling. The client’s hand is cool and
moist. What is the client most likely experiencing?
Answers: Hypoglycemia/insulin reaction.
CBQ. no 1. Identify 5 foot-care interventions that should be taught
to the diabetic client.
Answers: Check feet daily & report any breaks, sores, or blisters to
health care provider, wear well-fitting shoes; never go barefoot or
wear sandals, never personally remove corns or calluses, cut or
file nails straight across; wash daily with mild soap & warm water.
Common Board Questions (CBQ)
in Nurse Licensure Examination
(NEUROLOGICAL SYSTEM)
CBQ. no 1. What are the classifications of the commonly
prescribed eye drops for glaucoma?
Answers: Parasympathominetics for pupillary constriction. Beta-
adrenergic receptor-blocking agents to inhibit formation of
aqueous humor. Carbonic anhydrase inhibitors to reduce aqueous
humor production, and prostaglandin agonists to increase
aqueous humor outflow.
CBQ. no 2. Identify 2 types of hearing loss.
Answers: Conductive (transmission of sound to inner ear is
blocked) and sensorineural (damage to 8th cranial nerve)
CBQ. no 3. Write 4 nursing interventions for the care of the blind
person and 4 nursing interventions for the care of the deaf
person.
Answers: Care of the blind: announce presence clearly, call by
name, orient carefully to surroundings, guide by walking in front
of client with his/her hand in your elbow. Care of deaf: reduce
distraction before beginning conversation, look and listen to
client, give client full attention if they are a lip reader, face client
directly.
CBQ. no 4. In your own words describe the Glasgow Coma Scale.
Answers: An objective assessment of the level of consciousness
based on a score of 3 to 15, with scores of 7 or less indicative of
coma.
CBQ. no 5. List 4 nursing diagnoses for the comatose client in
order of priority.
Answers: Ineffective breathing pattern, ineffective airway
clearance, impaired gas exchange, and decreased cardiac output.
CBQ. no 6. State 4 independent nursing interventions to maintain
adequate respirations, airway, and oxygenation in the
unconscious client.
Answers: Position for maximum ventilation (prone or semi-prone
and slightly to one side), insert airway if tongue obstructing;
suction airway efficiently, monitor arterial pO2 and pCO2 and
hyperventilate with 100% oxygen before suctioning.
CBQ. no 7. Who is at risk for cerebral vascular accidents?
Answers: Persons with history of hypertension, previous TIAs,
cardiac disease (atrial flutter/fibrillation), diabetes, oral
contraceptive use, and the elderly.
CBQ. no 8. Complications of immobility include the potential for
thrombus development. State 3 nursing interventions to prevent
thrombi.
Answers: Frequent range of motion exercises, frequent (q2h)
position changes, and avoidance of positions which decrease
venous return.
CBQ. no 9. List 4 rationales for the appearance of restlessness in
the unconscious client.
Answers: Anoxia, distended bladder, covert bleeding, or a return
to consciousness
CBQ. no 10. What nursing interventions prevent corneal drying in
a comatose client?
Answers: Irrigation of eyes PRN with sterile prescribed solution,
application of opthalmic ointment q8h, close assessment for
corneal ulceration/drying.
CBQ. no 11. When a comatose client on IV hyperalimentation
begin to receive tube feedings instead?
Answers: When peristalsis resumes as evidenced by active bowel
sounds, passage of flatus or bowel movement.
CBQ. no 12. What is the most important principle in a bowel
management program for a neurologic client?
Answers: Establishment of REGULARITY
CBQ. no 13. Define cerebral vascular accident.
Answers: A disruption of blood supply to a part of the brain, which
results in sudden loss of brain function.
CBQ. no 14. A client with a diagnosis of CVA presents with
symptoms of aphasia, right hemiparesis, but no memory or
hearing deficit. In what hemisphere has the client suffered a
lesion?
Answer: Left
CBQ. no 15. What are the symptoms of spinal shock?
Answers: Hypotension, bladder and bowel distention, total
paralysis, lack of sensation below lesion.
CBQ. no 16. What are the symptoms of autonomic dysreflexia?
Answers: Hypertension, bladder and bowel distention,
exaggerated autonomic responses, headache, sweating, goose
bumps, and bradycardia
CBQ. no 17. What is the most important indicator of increased
ICP?
Answers: A change in the level of responsiveness
CBQ. no 18. What vital sign changes are indicative of increased
ICP?
Answers: Increased BP, widening pulse pressure, increased or
decreased pulse, respiratory irregularities and temperature
increase.
CBQ. no 19. A neighbor calls the neighborhood nurse stating that
he was knocked hard to the floor by his very hyperactive dog. He
is wondering what symptoms would indicate the need to visit an
emergency room. What should the nurse tell him to do?
Answers: Call his physician now and inform him/her of the fall.
Symptoms needing medical attention would include vertigo,
confusion or any subtle behavioral change, headache, vomiting,
ataxia (imbalance), or seizure.
CBQ. no 20. What activities and situations should be avoided that
increase ICP?
Answers: Change in bed position, extreme hip flexion,
endotracheal suctioning, compression of jugular veins, coughing,
vomiting, or straining of any kind.
CBQ. no 21. How do Hyperosmotic agents (osmotic diuretics) used
to treat intracranial pressure act?
Answers: Dehydrate the brain and reduce cerebral edema by
holding water in the renal tubules to prevent reabsorption, and by
drawing fluid from the extravascular spaces into the plasma.
CBQ. no 22. Why should narcotics be avoided in clients with
neurologic impairment?
Answers: Narcotics mask the level of responsiveness as well as
pupillary response.
CBQ. no 23. Headache and vomiting are symptoms of many
disorders. What characteristics of these symptoms would alert
the nurse to refer a client to a neurologist?
Answers: Headache which is more severe upon awakening and
vomiting not associated with nausea are symptoms of a brain
tumor.
CBQ. no 24. How should the head of the bed be positioned for
post-craniotomy clients with infratentorial lesions?
Answers: Infratentorial – FLAT; Supratentorial – elevated
CBQ. no 25. Is multiple sclerosis thought to occur because of an
autoimmune process?
Answer: YES
CBQ. no 26. Is paralysis always a consequence of spinal cord
injury?
Answer: NO
CBQ. no 27. What types of drugs are used in the treatment of
myasthenia gravis?
Answers: Anticholinesterase drugs, which inhibit the action of
cholinesterase at the nerve endings to promote the accumulation
of acetylcholine at receptor sires, which should improve neuronal
transmission to muscles.
Common Board Questions (CBQ)
in Nurse Licensure Examination
(GASTROINTESTINAL SYSTEM)
CBQ n0. 1 List 4 nursing interventions for the client with a hiatal
hernia.
Answer: Sit up while eating and one hour after eating. Eat small,
frequent meals. Eliminate foods that are problematic.
CBQ n0. 2 List 3 categories of medications used in the treatment
of peptic ulcer disease.
Answer: Antacids, H2 receptor-blockers, mucosal healing agents,
proton pump inhibitors.
CBQ no. 3 List the symptoms of upper and lower gastrointestinal
bleeding.
Answer: Upper GI: melena, hematemesis, tarry stools. Lower GI:
bloddy stools, tarry stools. Similar: tarry stools.
CBQ n0. 4 What bowel sound disruptions occur with an intestinal
obstruction?
Answer: Early mechanical obstruction: high-pitched sounds; late
mechanical obstruction: diminished or absent bowel sounds.
CBQ n0. 5 List 4 nursing interventions for post-op care of the client
with a colostomy.
Answer: Irrigate daily at same time; use warm water for
irrigations; wash around stoma with mild soap/water after each
colostomy bag change; pouch opening should extend at least 1/8
inch around the stoma.
CBQ n0. 6 List the common clinical manifestations of jaundice.
Answer: Sclera-icteric (yellow sclera), dark urine, chalky or clay-
colored stools
CBQ n0. 7 What are the common food intolerances for clients with
cholelithiasis?
Answer: Fried/spicy or fatty foods.
CBQ n0. 8 List 5 symptoms indicative of colon cancer.
Answer: Rectal bleeding, change in bowel habits, sense of
incomplete evacuation, abdominal pain with nausea, weight loss.
CBQ n0. 9 In a client with cirrhosis, it is imperative to prevent
further bleeding and observe for bleeding tendencies. List 6
relevant nursing interventions.
Answer: Avoid injectons, use small bore needles for IV insertion,
maintain pressure for 5 minutes on all venipuncture sites, use
electric razor, use soft-bristle toothbrush for mouth care, check
stools and emesis for occult blood.
CBQ n0. 10 What is the main side effect of lactulose, which is used
to reduce ammonia levels in clients with cirrhosis?
Answer: Diarrhea.
CBQ n0. 11 List 4 groups who have a high risk of contracting
hepatitis.
Answer: Homosexual males, IV drug users, recent ear piercing or
tattooing, and health care workers.
NLE Reviewer Tips
1. Beneficence - doing good
2. Non-maleficence-- no harm
3. Justice-- what is right and equal
4. Autonomy - informed consent
5. Stewardship- care
6. Truth Telling- veracity
7. Confidentiality- of information
8. Privacy
9. Informed Consent
10.Patient’s Bill of Rights
11. Code of Ethics in Nursing
12. Standards of Nursing Practice
13. Nursing Audit
14. Quality Assurance
15. Bureaucratic leadership is one of the leadership styles
postulated by Max Weber in 1947.
16. Bureaucratic leadership is a leadership style that assumes that
individuals are motivated by external forces; the leader trusts
neither followers nor self to make decisions, and therefore relies on
organizational policies and rules.
17. Martha Rogers's nursing theory, known as the Science of
Unitary Human Beings
18. Belmont Report - primary purpose is to protect subjects and
participants in clinical trials or research studies. This report
consists of 3 principles: beneficence, justice, and respect for
persons.
19. Anthrax biochemical weapon
20. Position of patient under radium implant supine
21. Position to relieve edema in pregnancy layeral recumbent
22. GBS history of viral infection
23. SASS score of newborn is 10 - severe respiratory distress
24. To Decrease ammonia level elimination by lactulose
25. Right Ventriculo shunt - position to Left side lying
26. Repair of cleft lip --- between 6-8 months
27. First food to infant - rice receals
28. Vaccine given at birth -- hepatitis B
29. Room in up to -- 24 hours
30. Not to be delegated -- medicine administration
31. Safe to be delegated - taking height and weight
32. Hospital to buy new Equipment--Capital budget
33. Lax supervision - laizze fairre
34. Strict supervision - authocratic
35. In case of fire evacuation - horizontal
36. Priority in burn victim- airway
37. Priority in seizure - safety
38. Priority in anaphylaxis - airway
39. Priority in buergers - rest period when pain occurs
40. Sign of buergers - intermittent claufication 92. Earliest sign of developing uterine myoma
41. Buergers is most common in MALES --- painless vaginal bleeding
42. THROMBOANGITIS OBLITERANS -- buergers 93. Hallmark of nephrotic syndrome --- generalized edema
43. Priority in reynauds - avoid exposure to cold environment /anasarca
44. Test for Brain electrical activity-- EEG 94. Furosemide ---- hypokalemia
45. deadmom telling the patient ti kill her 2 children is ---- auditory 95. RA 10912 --- CPD LAW
command hallucination 96. how to earn units-- attend conventions, seminars, trainings
46. inflammatory ng pid - oviducts 97. CPD earned units good up to --- 3 years only
47. Cause of pid - chlamydia 98.bNon renewal more than 5 years , what will be PRC action-----
48. Cause of hepa C - bloodborne removal of name in roster of professionals
49. Tool for survey - questionnaires 99. Power of the board to promulgate rules and regulations ---
50. connection between to atria- foramen ovale legislative power
51. March 30 ovulation occurs at march 16 100. Writen defamation like noting in chart that colleague is
52. Leukorrhea due to progesterone incompetent is---- LIBEL
53. Position to close foramen ovale and ductus arteriousus- right 101.bEarly sign of resp. distress
side lying -- restless and irritable
54. Coffee syndrome--- more than 3 cups a day 102.bDifference between delirium and dementia
55. Caffeine withdrawal -- poor concentration, headache, --Delirium is abrupt onset while dementia is insidious
drowsiness 103. Dehydrated patient having delirium pointing floor snake
56. What age can legally toget married snake, even theres no snake in the floor
B. 18-18 ---- hallucination
57. Legitimacy of child(RA 9255) 104. Patient said She was visited by her dead mom last night -
--father signs Birth cert or recognizes child as visual hallucination
His own 105. F ire in the ward what to do---- activate fire alarm(if walang
58. Birth registration within 30 days after birth rescue)
59. Who will sign the birth--- the birth attendant during delivery 106. Bee sting -- remove sting by scraping
60. Masturbation why do they do it--- relieves tension 107. Bee sting insect bites-- anaphylaxis
61. Colleague commit mistake other nurse report it to supervisor 108. Anaphylaxis-- airway priority
but the supervisor didn't take heed brcause they are understaff 109. Anaphylaxis give EPINEPHRINE
- moral dilemma 110. Legally blind..nrevoke n license tpos nkta nung nurse ng ilang
62. HIV condition breach of confidentiality who will file a case?--- beses n ngdadrive parin at one time nakita papunta sa grocery ---
patient 111. Furosemide causes metabolic alkalosis and hypokalemia
63. Hiv least transmission - dermis of skin NP4
64. Gloves in OR Sterile gloves withOUT powder 112. Disaster--- an occurrence disrupting the normal conditions of
65. NOT early symptom acoustic neuroma ------hearing loss(kasi existence and causing a level of suffering that exceeds the capacity
gradual sya) of adjustment of the affected community.
66. Affected part of the ear ---- inner ear 113. Republic Act 10121
67. Compartment syndrome CHECK PULSE ---- distal part
fracture “The Philippine Disaster Risk Reduction and Management Act of
68. radiation therapy ---lie on comfortable position 2010”
69. cervical cancer highest factor ----sex partner more than one 114. S.T.A.R.T, is an acronym for-----
70. U Wave tracing in ecg --- hypokalemia Simple Triage And Rapid Treatment
71. Angina pectoris cause 115. Respect for Person: This value states that each person is a
72. incubation period of chicken pox --10-21 days unique individual and is to be valued despite gender, ethnicity, age,
73. Affected in 3rd degree burn? Fatty tissues religion, social status, economic value or any other variable.
74. Blood trans. What to check. Sata 116. Solidarity: Each person makes a commitment not only to
Blood type,crossmatching,rh incompalibility,exp.date,tapos lot no. family and loved ones but also to the community.
--- all of these 117. Tagging triage
75. Right person to administer blood prod. ---physician RED--- immediate
76. Affected sa acoustic neuropathy - inner ear Airway obstruction
77. Otosclerosis affects the STAPES ( middle Open pneumothorax (sucking chest wound) with respiratory
Ear) distress:
78. dying patient wants to commit suicide,nurse put the patient to Tension pneumothorax（　deviated trachea）
suicidal prec. But the other nurse opposed since its a dying Hypovolemic (hemorrhagic) shock
patient---------call a multidisciplinary meeting 118. Green -Minimal
79. Menniers ds. Affected site (inner ear）　 Superficial wounds
80. Yung patient d5w infusing 100ml/hr develops pulmonary Minor lacerations, abrasions
emboli. What is the priority Contusions
---Slow down the rate Sprains and strains:
81. Adrenal Medulla-- epinephrine. Minor combat stress
82. Right way sign 119. Black ---expectant
-to prevent traffic congestion --Agonal respirations
83. Therapy after patient discharge ----occupational therapy si pt. 110. Disturbances in Fluids and Electrolytes
84. 33 days cycle ovulation ---19 b. Inflammatory and Infectious Disturbances like
85. Sign of fertile --- elastic and clear 111. HIV or AIDS
86. Who owns chart --- hospital ---Co-HIV infection is TB
87. Posses most of the right to access patient chart c. Psoriasis
--- patient herself d. Disturbances in Cellular functioning
88. Pid best activity --- sitting CANCERS
89. DIC sign and symptoms that will indicate DIC -- LUNG
HEMATURIA CERVICAL
90. Treatment of early DIC - HEPARIN IV COLORECTAL -4th in 2010
91. How to diagnose secondary amenorrhea? Breast- 1st in 2010
---No menses for 3 months 2. Client Biologic Crisis
Hyper thyroidism tx: PTU
Pheochromocytoma tx: Phentolamine mesylate
3. Emergency and Disaster Nursing
Emergent diseases (EBOLA and Anthrax)
Triage tagging
Referral
Anaphylaxis
after sting bite 50% recurrence chance
Principles and Styles of Leadership
Autocratic - emergency
Goal in emergency nursing: do the greatest good to the greatest
number
Reverse triage: priority is green code
NP5
1. Disturbances in Perception and Coordination
a. Neurologic Disorders
b. Sensory Disorders
c. Musculo-skeletal Disorders
d. Degenerative Disorders
2. Maladaptive Patterns of Behavior
a. Anxiety Response and Anxiety Related Disorders
b. Psycho-physiologic Responses, Somatoform, and Sleep
Disorders
c. Abuse and Violence
d. Emotional Responses and Mood Disorders
e. Schizophrenia and Other Psychotic and Mood Disorders
f. Social Responses and Personality Disorders
g. Substance related Disorders
h. Eating Disorders
i. Sexual Disorders
j. LEVELSOF PREVENTION
Nursing Administration and Management
Concepts and Principles of Organization
Patient Care Classification- functional nursing
Nursing Care Systems
Delegation and Accountability
Bipolar
Schizophreia
Depresion
Records Management
A. Anecdotal Report
B. Incident Reports
E. Documentation
VIII. Quality Improvement
A. Standards of Nursing Practice
D. Quality Assurance
IX. Research
A. Problem Identification
B. Ethics and Science of Research
C. The Scientific Approach
D. Research Process
E. Research Designs and Methodology
1. Qualitative
2. Quantitative