Name: ______________________________________ Date:__________________Score

MULTIPLE CHOICE:
Use black pen in filling up other data. Read carefully and
analyze your answer.
Circle the letter that corresponds to your correct answer. Erasures are not
allowed.

(RLE) PERI-OPERATIVE NURSING

SITUATION: You are a new nurse in the operating room. Your OR
supervisor oriented you of the set-up and standard operating procedures
done in the area.
1. The supervisor informed you that all elective cases scheduled for the next
day are written in the OR schedule board. You understand that elective cases
or surgical procedures are those operations:
a. that are done within 24-48 hours to prevent further tissue damage.
b. done immediately to preserve the life of the patient.
c. that are scheduled in advance based on the patients choice, because
delay of the surgery has no ill effects to the patient.
d. that are done within 7 days after admission, to prevent complications.
2. Meanwhile, in the Esophagogastroduodenoscopy room (EGD), only
diagnostic procedures are done in there, according to the supervisor.
Diagnostic tests include:
a. Amputation
b. Appendectomy
c. Laparoscopy
d. Anastomosis
3. Elective cases such as the repair of a cleft palate is also done in the OR said
the supervisor. This type of surgery when classified based on purpose belongs
in what category?
a. Diagnostic
b. Constructive
c. Ablative
d. Reconstructive
4. Patients who need immediate treatment, such as those suffering from stab
wounds or gunshot wounds are immediately brought to the OR and classified
based on urgency as _______ type of operation said the supervisor.
a. Emergency
b. Urgent
c. Elective
d. Major
5. On the other hand, operations based on the degree of risk are those major
and minor operations. Minor operations done in the OR include which of the
following?
a. Explore laparotomy
b. Appendectomy
c. Cesarean section
d. IJ catheter insertion

SITUATION: The following questions refer to the different types of

anesthesia used in the operating room.
6. A general anesthetic agent is given for specific purposes during a surgical
procedure. Which one of the following purposes is not included?
a. Loss of consciousness
b. Relaxation of skeletal muscles
c. Reduction of reflex action
d. Localized loss of sensation
7. Regional anesthesia is accomplished through the following methods EXCEPT:
a. Peripheral nerve blocks
b. Epidural anesthesia
c. Spinal Anesthesia
d. Endotracheal intubation
8. The anesthesia method used in an operation composes of 3 phases, you
would know that the patient is now in the INDUCTION phase if:
a. The anesthetic agent is administered to the patient
b. The doctor starts the operation
c. The patient begins to emerge from the anesthesia
d. The patient is ready to be wheeled to the PACU
9. The common side effects of general anesthesia include which of the
following:
a. Hypotension
b. Nausea and vomiting
c. Shivering
d. Numbness
10.During an on-going cesarean section the patient complained of pain on the
operative site, as you recall the complications of spinal anesthesia the patient
is experiencing:
a. Post spinal headache
b. High spinal anesthesia
c. Inadequate block
d. Nerve damage
SITUATION: Mr. J.M. was scheduled to undergo cholecystectomy with
common bile duct exploration. Ms. M.E.D. was the staff nurse on duty in
the operating room who received Mr. J.M. from the ward nurse.
11.Nurse M.E.D. was the circulating nurse assigned to Mr. J.M.s surgery. Her role
in the operating room (OR) include all of the following EXCEPT:
a. Preparing the OR for the procedure
b. Receiving endorsement from the ward nurse
c. Documents the procedure
d. Assisting the surgeon during the surgery
12.As the circulating nurse, Nurse M.E.D. accomplished the WHO Surgical safety
checklist which includes three parts: Surgical sign in, time-out and Sign-out.
You are aware that the purpose of such checklist is to:
a. Prevent or avoid errors in the OR such as wrong patient, wrong
operative site
b. Document accurately and completely the entire procedure
c. Serve as guide for the OR nurses functions in the OR
d. Enhance efficiency of the OR team

13.Nurse M.E.D.s partner Nurse A.A. was the scrub nurse for Mr. J.M., his major
function intra-operatively is to:
a. Assist the anesthesiologist during induction of anesthesia
b. Serve the appropriate OR instruments needed by the surgeon
c. Perform surgical skin preparation of the operative site
d. Perform the Surgical sign-in and time-out
14.When preparing the sterile field. Your partner Nurse A.A. accidentally
contaminated the field and only the two of you saw it. What would be your
appropriate action?
a. Keep it a secret between the two of you and continue preparing the
sterile field
b. Report your partner to your supervisor and make an incident report
c. Consider the field unsterile and prepare a new one
d. Pour alcohol to disinfect the contaminated area
15.Members of the surgical team who are sterile are the only persons allowed to
touch the sterile field. Nurse M.E.D. would be correct if she did not allow this
person to touch the sterile field:
a. Surgeon
b. Anesthesiologist
c. Assistant surgeon
d. Scrub nurse

MedSurg Ward
1. The nurse counts an adults apical heart beat at 110 beats per minute. The nurse
describes this as:
A. asystole.
B. bigeminy.
C. tachycardia.
D. bradycardia.
2. A prothrombin time test should be performed regularly on persons who are
taking which
medication?
A. Heparin
B. Warfarin
C. Phenobarbital
D. Digoxin
3. A low-sodium, low-cholesterol, weight-reducing diet is prescribed for an adult
with heart
disease. The nurse knows that he understands his diet when he chooses which of
the following
meals?
A. Baked skinless chicken and mashed potatoes
B. Stir-fried Chinese vegetables and rice
C. Tuna fish salad with celery sticks
D. Grilled lean steak with carrots
4. An older adult is admitted to the hospital with symptoms of severe dyspnea,
orthopnea, diaphoresis, bubbling respirations, and cyanosis. He states that he is
afraid something bad is about to happen. How should the nurse position this
client?
A. Sitting upright

B. Head lower than feet

C. Supine
D. Prone
5. An adult client is to have a sputum for culture. When is the best time for the
nurse to collect the
specimen?
A. In the morning right after he awakens
B. Immediately after breakfast
C. Two hours after eating
D. Shortly before he retires for the evening
6. A thoracentesis was performed on an adult client. After the procedure, the client
has hemoptysis and
a pulse of 80, respirations of 28, and temperature of 99F. Which of these is of
greatest concern to the nurse?
A. Hemoptysis
B. Respirations of 28
C. Pulse of 80
D. Temperature of 99F
7. An adult man has a tracheostomy tube in place. Which of the following actions is
most appropriate
for the nurse to take when suctioning the tracheostomy?
A. Use a sterile tube each time and suction for 30 seconds
B. Use sterile technique and turn the suction off as the catheter is introduced
C. Use clean technique and suction for 10 seconds
D. Discard the catheter at the end of every shift
8. A client comes to the clinic with a bloody nose. Which instruction is most
appropriate?
A. Sit up with your head tilted forward. Grasp the soft part of your nose firmly
between your thumb and forefinger.
B. Lay down and tilt your head backward. Grasp the end of your nose between
your fingers.
C. Sit up and lean backwards. Put pressure on the side of your nose with your
hand.
D. Lie down with your head lower than your feet. Grasp as much of your nose
as possible between your fingers.
9. A 79-year-old client is admitted to the hospital with a diagnosis of pneumococcal
pneumonia.
The client has dyspnea. The clients temperature is 102F., respirations are 36, and
pulse is 92. Bed
rest is ordered for this client primarily to:
A. promote thoracic expansion.
B. prevent the development of atelectasis.
C. decrease metabolic needs.
D. prevent infection of others.
10. An adult has a chest drainage system. Several hours after the chest tube was
inserted, the nurse
observes that there is no bubbling in the water seal chamber. What is the most
likely reason for the
absence of bubbling?

A.
B.
C.
D.

The clients lungs have reexpanded.

There is an obstruction in the tubing coming from the client.
There is a mechanical problem in the pump.
Air is leaking into the drainage apparatus.

Patient A. L. 63 y.o. male had been admitted in the medical unit with the
case of pneumonia
11. You would assess the patient for the following manifestations:
A. fever, cough
B. lose bowel movement and fever
C. dizziness and pallor
D. tingling sensation of fingers, stuporous
12. What diagnostic test/lab test confirm the diagnosis of pneumonia for patient A.L.
A. urinalysis
B. stool exam
C. ultrasound
D. Chest X-ray
13. The physician ordered PNSS 1L to run for 10 hours. How many drops per
minute?
A. 25 gtts
B. 35
C. 15
D. 20
14. Which blood test results would confirm a diagnosis of appendicitis?
A. WBC of 13,000
B. RBC of 4.5 million
C. Platelet count of 300,000
D. Positive heterophil antibody test
15. A client returns from having had abdominal surgery. Her vital signs are stable.
She says she is thirsty. What should the nurse give her initially?
A. Orange juice
B. Milk
C. Ice chips
D. Mouth wash
Leo, a 70 year old man with history of hypertension, has a diagnosis of blunt
abdominal trauma due to mauling. He underwent exploratory laparotomy. He is
transferred from the Recovery room to the medical-surgical unit. The client has
midline incision, a Jackson Pratt tube attached to drain and a folley catheter
16. The nurse took the vital signs, and she found out that the client is hypertensive
with BP of 150/100mmHg. The nurse should?
A. Inform the attending physician right away.
B. Observe the client and watch out for seizure.
C. Record the findings and re-check after 30 minutes before.
D. Ask the client if he is maintaining anti-hypertensive medications.
17. The client has a temperature of 39.5C. The nurse should?
A. Perform tepid sponge bath.
B. Inform the attending physician.

C. Give Paracetamol 300mg/ampule IVTT.

D. Wait for 1 hour and re-check the clients temperature
18. The morning shift nurse, found out that the post-operative site dressing is
soaked with blood and needs to be changed. The nurse should?
A. Prepare the dressing materials.
B. Inform the attending physician.
C. Secure materials and immediately change the dressing.
D. Make sure the materials are complete, inform the attending physician that
the clients dressing needs to be changed.
19. The clients urine output is being monitored hourly. His output for the first hour
is 60ml and 50ml on the second. This means__________.
A. The client has polyuria.
B. The client has oliguria
C. The urine output is adequate.
D. The urine output is inadequate.
Diego, 25 years old is admitted for ruptured appendicitis and needs to
undergo appendectomy.
20. The nurse needs to start venoclysis with PLR 1 liter to run for 10 hours. How
many drops per minute should the nurse regulate the IV fluids.
A.
B.
C.
D.

25
20
30
32

drops
drops
drops
drops

per
per
per
per

minute
minute
minute
minute

21. The clients street clothes should be changed to OR gown. Upon assisting the
client, it would be best if the nurse____________
A. Allow the client to wear his jewelries.
B. Instruct the client not to remove his dentures.
C. Ask the client to remove any metal objects from the body.
D. All of the above.
22. Three hours post-op, the client is transferred to the Medical-Surgical ward. Upon
receiving the client, the nurses initial action would be?
A. Check for the urine output.
B. Check if the client is awake and conscious.
C. Check for the post-operative wound for bleeding.
D. Instruct the client not to take anything by mouth.
Nursing Management and Leadership
23. Henry is a Unit Manager I the Medical Unit. He is not satisfied with the way
things are going in his unit. Patient satisfaction rate is 60% for two consecutive
months and staff morale is at its lowest. He decides to plan and initiate changes
that will push for a turnaround in the condition of the unit. Which of the following
actions is a priority for Henry?

A. Call for a staff meeting and take this up in the agenda.

B. Seek help from her manager.
C. Develop a strategic action on how to deal with these concerns.
D. Ignore the issues since these will be resolved naturally.

24. He knows that there are external forces that influence changes in his unit. Which
of the following is NOT an external force?
A. Memo from the CEO to cut down on electrical consumption
B. Demands of the labor sector to increase wages
C. Low morale of staff in his unit
D. Exacting regulatory and accreditation standards
25. After discussing the possible effects of the low patient satisfaction rate, the staff
started to list down possible strategies to solve the problems head-on. Should they
decide to vote on the best change strategy, which of the following strategies is
referred to this?
A. Collaboration
B. Majority rule
C. Dominance
D. Compromise
26. One staff suggests that they review the pattern of nursing care that they are
using, which is described as a:
A. job description
B. system used to deliver care
C. manual of procedure
D. rules to be followed
27. Which of the following is TRUE about functional nursing?
A. Concentrates on tasks and activities
B. Emphasizes use of group collaboration
C. One-to-one nurse-patient ratio
D. Provides continuous, coordinated and comprehensive nursing services
28. Functional nursing has some advantages, which one is an EXCEPTION?
A. Psychological and sociological needs are emphasized.
B. Great control of work activities.
C. Most economical way of delivering nursing services.
D. Workers feel secure in dependent role

29. He raised the issue on giving priority to patient needs. Which of the following
offers the best way for setting priority?
A. Assessing nursing needs and problems
B. Giving instructions on how nursing care needs are to be met
C. Controlling and evaluating the delivery of nursing care
D. Assigning safe nurse: patient ratio
30. Which of the following is the best guarantee that the patients priority needs are
met?
A. Checking with the relative of the patient
B. Preparing a nursing care plan in collaboration with the patient
C. Consulting with the physician
D. Coordinating with other members of the team
31. When Henry uses team nursing as a care delivery system, he and his team need
to assess the priority of care for a group of patients, which of the following should
be a priority?
A. Each patient as listed on the worksheet
B. Patients who needs least care
C. Medications and treatments required for all patients
D. Patients who need the most care
32. He is hopeful that his unit will make a big turnaround in the succeeding months.
Which of the following actions of Henry demonstrates that he has reached the third
stage of change?
A. Wonders why things are not what it used to be
B. Finds solutions to the problems
C. Integrate the solutions to his day-to-day activities
D. Selects the best change strategy
33. Joey is a newly-appointed nurse manager of The Holy Spirit Medical Center, a
tertiary hospital located within the heart of the metropolis. He thinks of scheduling
planning workshop with his staff in order to ensure an effective and efficient
management of the department. Should he decide to conduct a strategic planning
workshop, which of the following is NOT a characteristic of this activity?
A. Long-term goal-setting
B. Extends to 3-5 years in the future
C. Focuses on routine tasks
D. Determines directions of the organization
34. Which of the following statements refer to the vision of the hospital?
A. The Holy Spirit Medical Center is a trendsetter in tertiary health care in the next
five year
B. The officers and staff of The HS Medical Center believe in the unique nature of
the human person
C. All the nurses shall undergo continuing competency training program.
D. The Holy Spirit Medical Center aims to provide a patient-centered care in a total
healing environment.

35. The statement, The Holy Spirit Medical Center aims to provide patient-centered
care in a total healing environment refers to which of the following?
A. Vision
B. Goal
C. Philosophy
D. Mission

ANSWER KEY
(RLE) PERI-OPERATIVE NURSING
1. C
2. C
3. B
4. A
5. D
6. D
7. D
8. A
9. B
10.
11.
12.
13.
14.
15.

C
D
A
B
C
B

MedSurg, Nursing Mngt and Leadership

1. C
2. B
3. A
4. A
5. A
6. A
7. B
8. A
9. C
10.
11.
12.
13.

23.
24.
25.
26.
27.
28.
29.
30.
31.
B
A
D
A

A
C
B
B
A
A
A
B
D
32.
33.
34.
35.

C
C
A
B

14.
15.
16.
17.
18.
19.
20.
21.
22. B

A
C
C
A
D
D
D
C