86.

Pericardial friction rub can be heard in position: orthopneic position (sitting and leaning forward)

87. Abd throbbing and persistent pain, with pulsating mass and systolic bruit: (AAA)

 Appendix : RLQ
 Diverticulitis: LLQ
 Hernia: refer to GERD

88. Measure cardiac output: stroke volume and heart rate (SV X HR = CO) (N) 4 – 6L/min

89. Inappropriate prior PCI with angioplasty: no medications, with hold for 48 hours prior and after
(may cause: lactic acidosis/ nephropathy)

90. Left sided heart failure: low intake sodium diet no more than 2g/day (to prevent water retention)

91. No atrial impulse is conducted through AV node: Third degree AV block: complete heart block

 First degree AV block: delayed – prolonged PR

 Second degree AV block type 1: lengthening delay
 Second degree type 2: constant delay
 Third degree AV block: complete heart block

90. Low heart rate and BP with sensorium: atropine sulfate (increases HR and BP)

 Adenosine: tachycardia
 Propanolol and diltiazem: lows HR

91. Absolute contraindications to thrombolytic administration: chest pain less than 12 hours with ECG
consisten a STEMI (ischemic)

- Bawal sa may bleeding problems

92. Tx of choice during cardiac arrest ventricular fibrillation: defibrillation

 cardioversion: A. Fib
 Transcutaneous pacing: bradycardia
 Pacemaker: arrhythmia

93. Thoracentesis and pleural effusion with patient that can’t sit upright and lean: side lying towards
unaffected site (need i-access ang affected site)

- Insertion: mid axillary

94. Avoid set of food while taking isoniazid: red wine, aged cheese and tuna (tyramine rich food) same
with MAOI

 Salmon, pistachio avocado – levedopa

 Liver, shellfish, cauliflower – gout
 Barley, oatmeal, wheat – celiac

95. Late sign of tension pneumothorax: air in pleural space increasing intrapleural pressure: tracheal
deviation towards unaffected side

96. After pneumonectomy position: operative side (inc. expansion)

 Lobectomy
 Unaffected
 Pneumonectomy
 Affected

97. Incorrect statement regarding HAP (hospital acquired pneumonia): occurs less than 48 hours after
hospital admission (CAP)

98. Barrel – shaped chest Anteroposterior to transverse diameter changes in emphysema is

characterized by: AP diameter to transverse diameter is 1:1 (pumantay)

99. Drugs adm together with theophylline (bronchodilator) can result to cardiac dysrhythmias:
albuterol (causing tachy tachy)

100. ARDS, all of the following are benefits of using PEEP, except: promote alveolar collapse
- PEEP: continuous expansion of alveoli (prevent Atelectasis)

101. Most common organs involved in sequestration (pooling of blood in organs) crisis in adult: Liver
and lungs

 Spleen: common in CHILDREN

102. Iron chealation therapy was initiated by the administration of which drug: deferoxamine

 hydroxyurea: BM suppressant
 Prednisone: steroid
 Erythropoietin: anemia

103. Prevent occurrence of varicose veins (weak valves) inc. blood in legs: all except 3 (wear
constrictive socks)

104. Polycythemia Vera to relieve pruritus (itchiness), except: vigorously use a towel after bathing
(should be gentle and pat dry)

105. All but one are appropriate interventions during bleeding episodes for patient with hemophilia:
provide heat compress during bleeding episode (cold compress dapat)

106. (Posterior iliac crest) which of the following should she perform if bleeding is present after a bone
marrow aspiration: have the patient lie flat and supine (application of pressure to stop bleeding)

107. (Patient with leukemia) prevent infection, which of the following should not be done: include raw
fruits and veggies in diet

108. Iron supplementation, following are instructions are considered inappropriate health teaching,
except: dark stools and constipation are expected side effects

109. Pernicious Anemia: due to inadequate vitamin B12 intake or lack of intrinsic factor (IM
administration)

110. Thalassemia Minor (autosommal recessive, 2 traits to manifest disease) if isa lang ka trait =
carrier / minor (no symptoms): one thalassemic gene and one normal gene + patients are asymptomatic

111. Following statements is deemed incorrect when it comes to nephritic syndrome: increase in
oncotic pressure

Pathophysiology: Kidney injury: high permeability (enlarged filter = proteinuria) = low albumin,
compensate liver = inc. lipoprotein = decrease oncotic pressure (fluid shiting) = interstitial = edema
(anasarca) = low blood volume = high viscosity blood = clotting

112. Following condition lead to post renal AKI: BPH

 pre renal – dec. blood flow

 Intra renal – injury
 Post renal – obstruction of urine

113. Urolothiasis (kidney stone) describes colicky pain with renal stones: pain is acute with tenderness
over costovertebral area

114. Inappropriate regarding renal stones: include mushroom, shellfish and organ meats in diet (purine
= uric acid stone)

115. All of the following as manifestations of rejection (kidney transplant), except: weight loss (dapat
weight gain 1kg – 1.5kg) high creatinine

- Immune response (fever, malaise, inc. wbc)

- Inflammatory: pain / tenderness
- Renal failure (oliguric)

116. Glomerulonephritis, urine among patient with disorder: cola colored urine

 cola colored urine (hematuria (nephritic injury)

117. Most common contributing factor to the occurrence of UTI among females: anatomical
characteristic of urethra (short)
118. Healthy stoma: pink or beefy red stoma

119. Most accurate indicator of fluid loss or gain in patient who are acutely ill: WEIGHT (1kg = 1Liter)

120. End Stage Renal disease is characterized by which of the following parameters? GFR below 15
ml/min

Stages:

 risk: 90
 mild: 60 - 90
 moderate: 30 - 60
 severe: 15 - 30
 esRD: below 15

121. Only type of shock with bradycardia (no sympathetic response): Neurogenic shock

122. Organ damage doesn’t respond to treatment and cannot survive (last stage: irreversible):
refractory

 compensatory: 1st
 progressive: 2nd

123. Ph 7.27 (low acid) Hco3 17 (low acid) pco2 48 (high acid): metabolic acidosis

124. Shock, position to respond in IV fluid bolus challenge (assess if the px will respond to fluid
replacement): passive leg raise (modified tredelenburg)

125. Correct metabolic acidosis (DOC: bicarbonate) fluid of choice: LR (lactate converts into
bicarbonate)

126. Cardiac catheterization (puncture only). You understand that this procedure is under which
anesthesia: IV sedation with local anesthesia

 General anesthesia – major (long and painful)

 Caudal – procedure below umbilicus
 Spinal – below abdomen

127. Cataract removal surgery position: semi – fowler’s position

128. Tracheostomy procedure, primary concern: bubbling secretions in the mouth and nose (risk for
aspiration)

129. Not expected in tracheostomy: can’t eat

 Expected: can’t speak, breath through nose and mouth

130. Most important to reiterate to the client’s family for a child with a tracheostomy in place
(function): tracheostomy is the client’s source of breathing

131. Post – laryngectomy procedure, expected to be observed EXCEPT: can’t eat

131. Severe sharp pain on the operated eye after a cataract surgery: glaucoma

 Hemorrhage – floater
 Retinal detachment – certain like

132. Avoid following to prevent increased IOP: coughing

133. Laminectomy (WOF bleeding and CSF leak) surgery involving lower back, what position should
the patient be in the recovery area? Flat on bed for the irst 6 – 8 hours (application of pressure)

134. Serosanguinous discharge that fully saturates the gauze dressing (post surgery: done by the
doctor): reinforce the dressing with pressure then notify the physician

135: Oral hygiene to unconscious client, needs to be educated further: use supine lying for patient who
can’t tolerate semi –fowlers

136. Priority after laryngectomy: ineffective airway clearance

137. Rash spread downward, the rashes on face began to clear: rubella virus (german measles)
  Chicken pox: no fading of rashes

138. Late manifestations of RA: ulnar deviation of the joints in the hand

OA

 Joint pain worse towards the end of the day

 Morning stiffness lasts not more than 30 mins in the morning

139. Cannot bathe properly, let alone hold her comb properly to brush her hair without worsening her
joint pain. Appropriate nursing dx: self care deficit related to increasing joint pain

140. Acute phase of RA, lowest priority: maintain usual task

141. NSAIDs, coagulopathy was most likely the result of: decreased platelet adhesiveness

142. Localized (contact) shingles (second infection of chicken pox / varicella), indicates the teaching
was effective: if I have open sores that spread to multiple areas (disseminated: airborne), I may need to
be placed in a special room (negative pressure room)

143. Patients with influenza A, appropriate isolation precaution: DROPLET

 Airborne: MTV

144. Conditions require contact precautions: Clostridium difficile (GI infection)

145. Highest concern for patient with nephritic syndrome: INFECTION

Px: proteinuria = low albumin (liver compensate = inc. lipids) dec immunoglobulin (antibodies = high risk
for infection)

146. Discharge instructions should be included for a client dx with atopic dermatitis (eczema): addition
of humidity to the dry air cause by dry heat during cold season

147. Myeloid (BM: stem cell, myeloid and lymphoid) Leukemia, understand that there is ab
proliferation of plasma cells in which part of the body generally: BONE MARROW

148. Plasma Cells (lymphocytes: agranulocytes): WBC

149. Don’t need further instruction, ab profileration (increase) of plasma cells will lead to: increase in
immature blood cells

150. Least Observe in her condition: Elimination Problem

Leukemia: anemia, bleeding and infection

151. Treatment regimen, during basic induction regimen: CYTSRSBINE

- 7 + 3 regimen (7 days continuous infusion of Cytarabine + 3 days continuous infusion of

anthracycline)

152. Laryngeal cancer: SMOKING

153. Earliest manifestation of laryngeal cancer (caution us): hoarseness of voice that lasts a few weeks

154. Total laryngectomy, require further reinforcement: avoid showers and will bathe in deep waters
instead

155. Carcinoma in Situ: cancer cells are found only in the place where they first formed

156. Damage copies of BRCA1 and 2, braca1 (prevents cancer) normally do in the body: acts as a tumor
suppressor gene

157. Further teaching: p53 is an oncogene (dapat tumor suppressant)

158. Ace inhibitor medication, when will you adm the medication if she has a scheduled morning
dialysis session: on return from the dialysis session (after)

159. External AV shunt for her hemodialysis session, what is the priority action of the nurse for this
type of shunt: ensure small clamps are attached to AV shunting dressing (disconnection = bleeding)
160. Dialysis complained of headache, nausea, and is assessed to be restless (disequilibrium syndrome
= inc. ICP): stop and report (notify physician)

161. CKD complains of mouth ulcer, which is the cause of GI manifestation: increased ammonia form
bacterial breakdown of urea

162. AKI oliguric phase, priority nursing intervention (dec. GFR px water retention, FVE, high UREA, inc.
K+): restrict fluids according to previous daily loss

163. BPH and is scheduled for TURP (retrograde ejaculation) px sterility: erectile px seldom happen, but
retrograde ejaculation may occur

164. BPH prevention, priority for his question: help by dec. butter and margarine in your diet as well as
increasing intake of fruits (high saturated fats = high risk in BPH)

165. Enlarged prostate and PSA level elevated. The nurse will expect to teach about: transrectal
ultrasonography (TRUS)

 Next step: Differentiate cancer vs. BPH

166. Visual laser ablation of the prostate (VLAP: reduce size of prostate: manage indwelling urinary
catheter (1 week)

Advantage:

- minimal bleeding
- Effect several weeks

167. Urine incontinence: perform pelvic floor muscle training

Ca has a CURE

C – chemotherapy
U – upera
R – radiation
E – emotional support

168. Differentiate between acromegaly and gigantism: epiphyseal plate (gigantism occurs before
ipiphyseal plate close, while acromegaly occurs after they close)

169. insulin: extracts insulin from clean insulin vial initially

- Short: regular insulin (Clear)

- Intermediate: NPH (cloudy)

170. Ensure their insulin pen remain effective througouht the trip. Proper store insulin: room
temperature during travel

- frozen – dec. effectivitiy

171. Medications for hyperthyroidism except: liothyronine (hypo)

Hyper – everything is high, fast and wet except menses: inc T3 and T4 (wt loss)
Hypo – every is low, slow, and dry except menses (dec T3 and T4) (weight gain and obese)

172. Thyroid disorder,. Ff is a manifestation of hypothyroidism: Obesity

173. prolonged used of corticosteroids: monitor sx of infection

Corticosteroids: immunisupression: risk for infection

174. Addison’s disease: Hypotension

Dec SSS – sugar salt and sex hormone

175. Hyperthyroidism diet: Low residue diet

- high fiber (constipation)

- low residue diet (diarrhea)

176. s and sx of characteristics of hypoparathyroidism: tetany, numbness and muscle spasms

(chvosteks: cheesk, and trousseau: BP cuff braso)

Hypoparathyroidism – dec. PTH = hypocalcemia

177. DI – ihi ng ihi Rx vasopressin = inc. water absorption: hyponatremia and water intoxication

178: SIADH: demeclocycline (DOC) dec. action of ADH

179. pheochromocytoma not used dx evaluation: serum aldosterone level (cushing’s / addisons)

- pheochromocytoma: inc. catecholamines (epi and norepi)

180. Pheochromocytoma, not typically observed in this condition: hypoglycemia

Pheochromocytoma:

5H

 hypertension
 headache
 hyperhyrdrosis
 hypermetabolism
 hyperglycemia

181. Foods to avoid in pancreatitis and promote healing: high fat and fried

Amylase: CHO – first to elevate

Trypsin: most damagine

182. Hx of cholecystitis. Potential complication: bleeding

- altered absorption of ADEK (vit k = clotting)

183. Colonoscopy: enema administration: clear visualization

184. Hepatic encephalopathy (ammonia deposition in the brain: dec. LOC and asterixis aka liver flaps):
extend arms, flex wrist and spread fingers wide

185. Chronic pancreatitis laboratory result: low serum ca level

 dec. metabolism of calcum

186. liver cirrhosis is most common: laennec’s (alcoholism) most common