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Situation 1 - Concerted work eIIorts among members oI the

surgical team is essential to the success oI the surgical procedure.

1. The sterile nurse or sterile personnel touch only sterile


supplies and instruments. When there is a need for sterile
supply which is not in the sterile field, who hands out these
items by opening its outer cover?

a. Circulating nurse
b. Anesthesiologist
c. Surgeon
d. Nursing aide

. The OR team performs distinct roles for one surgical


procedure to be accomplished within a prescribed time frame
and deliver a standard patient outcome. White the surgeon
performs the surgical procedure, who monitors the status of
the client like urine output, blood loss?

a. Scrub nurse
b. Surgeon
c. Anesthesiologist
d. Circulating nurse

. Surgery schedules are communicated to the OR usually a


day prior to the procedure by the nurse of the floor or ward
where the patient is confined. For orthopedic cases, what
department is usually informed to be present in the OR?

a. Rehabilitation department
b. Laboratory department
c. Maintenance department
d. Radiology department

. Minimally invasive surgery is very much into technology.


Aside from the usual surgical team who else to be present when
a client undergoes laparoscopic surgery?

a. InIormation technician
b. Biomedical technician
c. Electrician
d. Laboratory technicial

. In massive blood loss, prompt replacement of compatible


blood is crucial. What department needs to be alerted to
coordinate closely with the patient's family for immediate
blood component therapy?

a. Security Division
b. Chaplaincy
c. Social Service Section
d. Pathology department

Situation 2 - You are assigned in the Orthopedic Ward where


clients are complaining oI pain in varying degrees upon movement
oI body parts.

. Troy is a one day post open reduction and internal fixation


(ORIF) of the left hip and is in pain. Which of the following
observation would prompt you to call the doctor?

a. Dressing is intact but partially soiled


b. LeIt Ioot is cold to touch and pedal pulse is absent
c. LeIt leg in limited Iunctional anatomic position
d. BP 114/78, pulse oI 82 beats/minute

. There is an order of Demerol mg I.M. now and every


hours p r n. You injected Demerol at pm. The next dose of
Demerol mg I.M. is given:

a. When the client asks Ior the next dose


b. When the patient is in severe pain
c. At 11pm
d. At 12pm

. You continuously evaluate the client's adaptation to pain.


Which of the following behaviors-indicate appropriate
adaptation?

a. The client reports pain reduction and decreased activity


b. The client denies existence oI pain
c. The client can distract himselI during pain episodes
d. The client reports independence Irom watchers

. Pain in Ortho cases may not be mainly due to the surgery.


There might be other factors such as cultural or psychological
that influence pain. How can you alter these factors as the
nurse?

a. Explain all the possible interventions that may cause the client to
worry.
b. Establish trusting relationship by giving his medication on time
c. Stay with the client during pain episodes
d. Promote client's sense oI control and participation in pain
control by listening to his concerns

1. In some hip surgeries, an epidural catheter for Fentanyl


epidural analgesia is given. What is your nursing priority care
in such a case?

a. Instruct client to observe strict bed rest


b. Check Ior epidural catheter drainage
c. Administer analgesia through epidural catheter as prescribed
d. Assess respiratory rate careIully

Situation 3 - Records are vital tools in any institution and should be


properly maintained Ior speciIic use and time.

11. The patient's medical record can work as a double-edged


swords. When can the medical record become the
doctor's/nurse worst enemy?

a. When the record is voluminous


b. When a medical record is subpoenaed in court
c. When it is missing
d. When the medical record is inaccurate, incomplete, and
inadequate

1. Disposal of medical records in government


hospitals/institutions must be done in close coordination with
what agency?

a. Department oI Interior and Local Government (DILG)


b. Metro Manila Development Authority (MMDA)
c. Records Management Archives OIIice (RMAO)
d. Depart oI Health (DOH)

1. In the hospital, when you need-the medical record of a


discharged patient for research, you will request permission
through:

a. Doctor in charge
b. The hospital director
c. The nursing Service
d. Medical records section

1. You readmitted a client who was in another department a


month ago. Since you will need the previous chart, from whom
do you request the old chart?

a. Central supply section


b. Previous doctor's clinic
c. Department where the patient was previously admitted
d. Medical records section

1. Records Management and Archives Offices of the DOH is


responsible for implementing its policies on record, disposal.
You know that your institution is covered by this policy it;

a. Your hospital is considered tertiary


b. Your hospital is in Metro Manila
c. It obtained permit to operate Irom DOH
d. Your hospital is Philhealth accredited

Situation 4 - In the OR, there are saIety protocols that should be


Iollowed. The OR nurse should be well versed with all these to
saIeguard the saIety and quality to patient delivery outcome.

1. Which of the following should be given highest priority


when receiving patient in the OR?

a. Assess level oI consciousness


b. VeriIy patient identiIication and inIormed consent
c. Assess vital signs
d. Check Ior jewelry, gown, manicure and dentures

1. Surgeries like I and D (incision and drainage) and


debribement are relatively short procedures but considered
dirty cases`. When are these; procedures best scheduled?

a. Last case
b. In between cases
c. According to availability oI anesthesiologist
d. According to the surgeon's preIerence

1. OR nurses should be aware that maintaining the client's


safety is the overall goal of nursing care during the
intraoperative phase. As the circulating nurse, you make
certain that throughout the procedure...

a. the surgeon greets his client beIore induction oI anesthesia


b. the surgeon and anestheriologist are in tandem
c. strap made oI strong non-abrasive material are Iastened securely
around the joints oI the knees and ankles and around the 2 hands
around an arm board
d. client is monitored throughout the surgery by the assistant
anesthesiologist

1. Another nursing check that should not be missed before the


induction of general anesthesia is:

a. check Ior presence underwear


b. check Ior presence dentures
c. check patient's
d. check baseline vital signs

. Some different habits and hobbies affect postoperative


respiratory function. If your client smokes packs of cigarettes
a day for the part 1 years, you will anticipate increased risk
for:

a. perioperative anxiety and stress


b. delayed coagulation time
c. delayed wound healing
d. postoperative respiratory Iunction

Situation 5 - Nurses hold a variety oI roles when providing care to


a perioperative patient.

1. Which of the following role would be the responsibility of


the scrub nurse?

a. Assess the readiness oI the client prior to surgery


b. Ensure that the airway is adequate
c. Account Ior the number oI sponges, needles, supplies, Used
during the surgical procedure
d. Evaluate the type oI anesthesia appropriate Ior the surgical client

. As a perioperative nurse, how can you best meet the safety


need of the client after administering preoperative narcotic?

a. Put side rails up and ask client not to get out oI bed
b. Send the client to ORD with the Iamily
c. Allow client to get up to go to the comIort room
d. Obtain consent Iorm

. It is the responsibility of the pre-op, nurse to do skin prep


for patients undergoing surgery. If hair at the operative site is
not shaved, what should be done to make suturing easy and
lessen chance of incision infection?

a. Draped
b. Pulled
c. Clipped
d. Shampooed

. It is also the nurse's function to determine when infection is


developing in the surgical incision. The perioperative nurse
should observe for what signs of impending infection?

a. Localized heat and redness


b. Serosanguinous exudates and skin blanching
c. Separation oI the incision
d. Blood clots and scar tissue are visible

. Which of the following nursing intervention is done when


examining the incision wound and changing the dressing?

a. Observe the dressing and type and odor oI drainage iI any


b. Get patient's consent
c. Wash hands
d. Request the client to expose the incision wound

Situation 6 - Carlo, 16 years old, comes to the ER with acute


asthmatic attack. RR is 46/min and he appears to be in acute
respiratory distress.

. Which of She following nursing actions should be initiated


first?

a. Promote emotional support


b. Administer oxygen at 6L/min
c. Suction the client every 30 min
d. Administer bronchodilator by nebulizer

. Aminophylline was ordered for acute asthmatic attack. The


mother asked the nurse, what its indication the nurse will say
is:

a. Relax smooth muscles oI the bronchial airway


b. Promote expectoration
c. Prevent thickening oI secretions
d. Suppress cough

. You will give health instructions to Carlo, a case of


bronchial asthma. The health instruction will include the
following EXCEPT:

a. Avoid emotional stress and extreme temperature


b. Avoid pollution like smoking
c. Avoid pollens, dust seaIood
d. Practice respiratory isolation

. The asthmatic client asked you what breathing technique


he can best practice when asthmatic attack starts. What will be
the best position?

a. Sit in high-Fowler's position with extended legs


b. Sit-up with shoulders back
c. Push on abdomen during exhalation
d. Lean Iorward 30-40 degrees with each exhalation

. As a nurse you are always alerted to monitor status


asthmaticus who will likely and initially manifest symptoms of:

a. metabolic alkalosis
b. respiratory acidosis
c. respiratory alkalosis
d. metabolic acidosis

Situation 7 - Joint Commission on Accreditation oI Hospital


Organization (JCAHP) patient saIety goals and requirements
include the care and eIIicient use oI technology in the OR arid
elsewhere in the healthcare Iacility.

1. As the head nurse in the OR, how can you improve the
effectiveness of clinical alarm systems?

a. limit suppliers to a Iew so that quality is maintained


b. implement a regular inventory oI supplies and equipment
c. Adherence to manuIacturer's recommendation
d. Implement a regular maintenance and testing oI alarm systems

. Over dosage of medication or anesthetic can happen even


with the aid of technology like infusion pump,
sphymomanometer, and similar devices/machines. As a staff,
how can you improve the safety of using infusion pumps?

a. Check the Iunctionality oI the pump beIore use


b. Select your brand oI inIusion pump like you do with your
cellphone
C. Allow the technician to set the; inIusion pump beIore use
d. VeriIy the Ilow rate against your computation

. 1CAHOs universal protocol for surgical and invasive


procedures to prevent wrong site, wrong person, and wrong
procedures/surgery includes the following EXCEPT:

a. Mark the operative site iI possible


b. Conduct pre-procedure veriIication process
c. Take a video oI the entire intra-operative procedure
d. Conduct time out immediately beIore starting the procedure

. You identified a potential risk of pre and post operative


clients. To reduce the risk of patient harm resulting from fall,
you can implement the following EXCEPT:

a. Assess potential risk oI Iail associated with the patient's the


Iollowing EXCEPT: medication regimen
b. Take action to address any identiIied risks through Incident
Report (IR)
c. Allow client to walk with relative to the OF?
d. Assess and periodically reassess individual client's risk Ior
Ialling

. As a nurse you know you can improve on accuracy of


patient's identification by patient identifiers, EXCEPT:

a. identiIy the client by his/her wrist tag and veriIy with Iamily
members
b. identiIy client by his/her wrist tag and call his/her by name
c. call the client by his/her case and bed number
d. call the patient by his/her name and bed number

Situation 8 - Team eIIorts is best demonstrated in the OR

. If you are the nurse in charge for scheduling surgical cases,


what important information do you need to ask the surgeon?

a. Who is your internist


b. Who is your assistant and anesthesiologist, and what is your
preIerred time and type oI surgery?
c. Who are your anesthesiologist, internist, and assistant
d. Who is your anesthesiologist.

. In the OR, the nursing tandem for every surgery is:

a. Instrument technician and circulating nurse


b. Nurse anesthetist, nurse assistant, and instrument technician
c. Scrub nurse and nurse anesthetist
d. Scrub and circulating nurses

. While team effort is needed in the OR for efficient and


quality patient care delivery, we should limit the number of
people in the room for infection control. Who comprise this
team?

a. Surgeon, anesthesiologist, scrub nurse, radiologist, orderly


b. Surgeon, assistants, scrub nurse, circulating nurse,
anesthesiologist
c. Surgeon, assistant surgeon, anesthesiologist, scrub nurse,
pathologist
d. Surgeon, assistant surgeon, anesthesiologist, intern, scrub nurse

. When surgery is on-going, who coordinates the activities


outside, including the family?

a. Orderly/clerk
b. Nurse supervisor
c. Circulating nurse
d. Anaesthesiologist

. The breakdown in teamwork is often times a failure in:

a. Electricity
b. Inadequate supply
c. Leg work
d. Communication

Situation 9 - Colostomy is a surgically created anus- It can be


temporary or permanent, depending on the disease condition.

1. Skin care around the stoma is critical. Which of the


following is not indicated as a skin care barriers?
a. Apply liberal amount oI mineral oil to the area
b. Use karaya paste and rings around the stoma
c. Clean the area daily with soap and water beIore applying bag
d. Apply talcum powder twice a day

. What health instruction will enhance regulation of a


colostomy (defecation) of clients?

a. Irrigate aIter lunch everyday


b. Eat Iruits and vegetables in all three meals
c. Eat balanced meals at regular intervals
d. Restrict exercise to walking only

. After ileostomy, which of the following condition is NOT


expected?

a. increased weight
b. Irritation oI skin around the stoma
c. Liquid stool
d. Establishment oI regular bowel movement

. The following are appropriate nursing interventions during


colostomy irrigation EXCEPT:

a. Increase the irrigating solution Ilow rate when abdominal


cramps is Ielt
b. Insert 2-4 inches oI an adequately lubricated catheter to the
stoma
c. Position client in semi-Fowler
d. Hand the solution 18 inches above the stoma

. What sensation is used as a gauge so that patients with


ileostomy can determine how often their pouch should be
drained?

a. Sensation oI taste
b. Sensation oI pressure
c. Sensation oI smell
d. Urge to deIecate

Situation 10 - As a beginner in research, you are aware that


sampling is an essential element oI the research process.

. What does a sample group represent?

a. Control group
b. Study subjects
c. General population
d. Universe

. What is the most important characteristics of a sample?

a. Randomization
b. Appropriate location
c. Appropriate number
d. Representativeness

. Random sampling ensures that each subject has:

a. Been selected systematically


b. An equal change oI selection
c. Been selected based on set criteria
d. Characteristics that match other samples

. Which of the following sampling methods allows the use of


any group of research subject?

a. Purposive
b. Convenience
c. Snow-bail
d. Quota

. You decided to include barangays in your municipality


and chose a sampling method that would get representative
samples from each barangay. What should be the appropriate
method for you to use in this care?

a. Cluster sampling
b. Random sampling
c. StratiIies sampling
d. Systematic sampling

Situation 11 -AIter an abdominal surgery, the circulating and scrub


nurses have critical responsibility about sponge and Instrument
count.

1. When is the first sponge/instrument count reported?

a. BeIore closing the subcutaneous layer


b. BeIore peritoneum is closed
c. BeIore dosing the skin
d. BeIore the Iascia is sutured

. What major supportive layer of the abdominal wall must


be sutured with long tensile strength such as cotton or nylon or
silk suture?

a. Fascia
b. Muscle
c. Peritoneum
d. Skin

. Like sutures, needles also vary in shape and uses. If you are
the scrub nurse for a patient who is prone to keloid formation
and has a low threshold of pain, what needle would you
prepare?

a. Round needle
b. A traumatic needle
c. Reverse cutting needle
d. Tapered needle

. Another alternative "suture" for skin closure is the use of


_______________:

a. Staple
b. Therapeutic glue
c. Absorbent dressing
d. invisible suture

. Like any nursing interventions, counts should be


documented. To whom does the scrub nurse report any
discrepancy of country so that immediate 'and appropriate
action in instituted?

a. Anesthesiologist
b. Surgeon
c. Or nurse supervisor
d. Circulating nurse

Situation 12 - As a nurse, you should be aware and prepared oI the


diIIerent roles you play.

. What role do you play, when you hold all clients`


information entrusted to you in the strictest confidence?

a. Patient's advocate
b. Educator
c. Patient's Liaison
d. Patient's arbiter

. As a nurse, you can help improve the effectiveness of


communication among healthcare givers

a. Use oI reminders oI what to do


b. Using standardized list oI abbreviations, acronyms, and symbols
c. One-on-one oral endorsement
d. Text messaging and e-mail

. As a nurse, your primary focus in the workplace is the


client's safety. However, personal safety is also a concern. You
can communicate hazards to your co-workers through the use
of the following EXCEPT:

a. Formal training
b. Posters
c. Posting IR in the bulletin board
d. Use oI labels and signs

. As a nurse, what is one of the best way to reconcile


medications across the continuum of care?

a. Endorse on a case-to-case basis


b. Communication a complete list oI the patient's medication to the
next provider oI service
c. Endorse in writing
d. Endorse the routine and 'stat' medications every shiIt

. As a nurse, you protect yourself and co-workers from


misinformation and misrepresentations through the following
EXCEPT:

a. Provide inIormation to clients about a variety oI services that


can help alleviate the client's pain and other conditions
b. Advising the client, by virtue oI your expertise, that which can
contribute to the client's well-being
c. Health education among clients and signiIicant others regarding
the use oI chemical disinIectant
d. Endorsement thru trimedia to advertise your Iavorite disinIectant
solution

1. A one-day postoperative abdominal surgery client has been


complaining of severe throbbing abdominal pain described as
in a 1-1 pain rating. Your assessment reveals bowel sounds
on all quadrants and the dressing is dry and intact. What
nursing intervention would you take?

a. Medicate client as prescribed


b. Encourage client to do imagery
c. Encourage deep breathing and turning
d. Call surgeon stat

. Pentoxicodone mg IV every hours was prescribed for


post abdominal pain. Which will be your priority nursing
action?

a. Check abdominal dressing Ior possible swelling


b. Explain the proper use oI PCA to alleviate anxiety
c. Avoid overdosing to prevent dependence/tolerance
d. Monitor VS, more importantly RR .

. The client complained of abdominal and pain. Your


nursing intervention that can alleviate pain is:

a. Instruct client to go to sleep and relax


b. Advice the client to close the lips and avoid deep breathing and
talking
c. OIIer hot and clear soup
d. Turn to sides Irequently and avoid too much talking

. Surgical pain might be minimized by which nursing action


in the OR:

a. Skill oI surgical team and lesser manipulation


b. Appropriate preparation For the scheduled procedure
c. Use oI modem technology in closing the wound
d. Proper positioning and draping oI clients

. One very common cause of postoperative pain is:

a. ForceIul traction during surgery


b. Prolonged surgery
c. Break in aseptic technique
d. Inadequate anesthetic

Situation 14 - You were on duty at the medical ward when Zeny


came in Ior admission Ior tiredness, cold intolerance, constipation,
and weight gain. Upon examination, the doctor's diagnosis was
hypothyroidism.

. Your independent nursing care for hypothyroidism


includes:

a. administer sedative round the clock


b. administer thyroid hormone replacement
c. providing a cool, quiet, and comIortable environment
d. encourage to drink 6-8 glasses oI water

. As the nurse, you should anticipate to administer which of


the following medications to Zeny who is diagnosed to be
suffering from hypothyroidism?

a. Levothyroxine
b. Lidocaine
c. Lipitor
d. Levophed

. Your appropriate nursing diagnosis for Zeny who is


suffering from hypothyroidism would probably include which
of the following?

a. Activity intolerance related to tiredness associated with disorder


b. Risk to injury related to incomplete eyelid closure
c. Imbalance nutrition related to hypermetabolism
d. DeIicient Iluid volume related to diarrhea

. Myxedema coma is a life threatening complication of long


standing and untreated hypothyroidism with one of the
following characteristics.

a. Hyperglycemia
b. hypothermia
c. hyperthermia
d. hypoglycemia

. As a nurse, you know that the most common type of goiter


is related to a deficiency

a. thyroxine
b. thyrotropin
c. iron
d. iodine

Situation 15 - Mrs. Pichay is admitted to your ward. The MD


ordered "Prepared Ior thoracentesis this pm to remove excess air
Irom the pleural cavity."

1. Which of the following nursing responsibility is essential in


Mrs. Pichay who will undergo thoracentesis?

a. Support, and reassure client during the procedure


b. Ensure that inIormed consent has been signed
c. Determine iI client has allergic reaction to local anesthesia
d. Ascertain iI chest x-rays and other tests have been prescribed
and completed

. Mrs. Pichay who is for thoracentesis is assisted by the nurse


to any of the following positions, EXCEPT:

a. straddling a chair with arms and head resting on the back oI the
chair
b. lying on the unaIIected side with the bed elevated 30-40
degrees
c. lying prone with the head oI the bed lowered 15-30 degrees
d. sitting on the edge oI the bed with her Ieet supported and arms
and head on a padded overhead table

. During thoracentesis, which of the following nursing


intervention will be most crucial?

a. Place patient in a quiet and cool room


b. Maintain strict aseptic technique
c. Advice patient to sit perIectly still during needle insertion until it
has been withdrawn Irom the chest
d. Apply pressure over the puncture site as soon as the needle is
withdrawn

. To prevent leakage of fluid in the thoracic cavity, how wilt


you position the client after thoracentesis?

a. Place Ilat in bed


b. Turn on the unaIIected side
c. Turn on the aIIected side
d. On bed rest

. Chest x-ray was ordered after thoracentesis. When you


client asks what is the reason for another chest x-ray, you will
explain:

a. to rule out pneumothorax


b. to rule out any possible perIoration
c. to decongest
d. to rule out any Ioreign: body

Situation 16 - In the hospital, you are aware that we are helped by


the .use oI a variety oI equipment/devices to enhance quality
patient care delivery;

. You are initiate an IV line to your patient, Kyle, , who is


febrile. What IV administration set will you prepare?

a. Blood transIusion set


b. Macroset
c. Volumetric chamber
d. Microset

. Kyle is diagnosed to have measles. What will your


protective personal attire include?

a. Gown
b. Eyewear
c. Face mask
d. Gloves

. What will you do to ensure that Kyle, who is febrile, will


have a liberal oral fluid intake?

a. Provide a glass oI Iruit every meal


b. Regulate his IV to 30 drops per minute
c. Provide a calibrated pitcher oI drinking water and juice at the
bedside and monitor intake and output
d. Provide a writing pad to record his intake

. Before bedtime, you went to ensure Kyle's safety in 'bed.


You will do which of the following:

a. Put the lights on


b. Put the side rails up
c. Test the call system
d. Lock the doors

. Kyle's room is fully mechanized. What do you teach the


watcher and Kyle to alert the nurse for help?

a. How to lock side rails


b. Number oI the telephone operator
c. Call system
d. Remote control

Situation 17 - Tony, 11 years old, has 'kissing tonsils' and is


scheduled Ior tonsillectomy and adenoidectomy or T and A.

1. You are the nurse of Tony who will undergo T and A in the
morning. His mother asked you if Tony will be put to sleep.
Your teaching will focus on:

a. spinal anesthesia
b. anesthesiologist`s preIerence
c. local anesthesia
d. general anesthesia

. Mothers of children undergoing tonsillectomy and


adenoidectomy usually ask what food prepared and give their
children after surgery. You as the nurse will say:

a. balanced diet when Iully awake


b. hot soup when awake
c. ice cream when Iully awake
d. soIt diet when Iully awake

. The RR nurse should monitor for the most common


postoperative complication of:

a. hemorrhage
b. endotracheal tube perIoration
c. esopharyngeal edema
d. epiglottis

. The PACU nurse will maintain postoperative T and A


client in what position?

a. Supine with neck hyperextended and supported with pillow


b. Prone with the head on pillow and tuned to the side
c. Semi-Fowler's with neck Ilexed
d. Reverse trendelenburg with extended neck

. Tony is to be discharged in the afternoon of the same day


after tonsillectomy and adenoidectomy. You as the RN will
make sure that the family knows to:

a. oIIer osteorized Ieeding


b. oIIer soIt Ioods Ior a week to minimize discomIort while
swallowing
c. supplement his diet with vitamin C rich juices to enhance
heating
d. oIIer clear liquid Ior 3 days to prevent irritation

Situation 18 - Rudy was diagnosed to have chronic renal Iailure.


Hemodialysis is ordered that an A-V shunt was surgically created.

. Which of the following action would be of highest priority


with regards to the external shunt?

a. Avoid taking BP or blood sample Irom the arm with shunt


b. Instruct the client not to exercise the arm with the shunt
c. Heparinize the shunt daily
d. Change dressing oI the shunt daily

. Diet therapy for Rudy, who has acute renal failure, is tow-
protein, low potassium and sodium. The nutrition instruction
should include:

a. Recommend protein oI high biologic value like eggs, poultry


and lean meat
b. Encourage client to include raw cucumbers, carrot, cabbage, and
tomatoes
c. Allowing the client cheese, canned Ioods, and other processed
Iood
d. Bananas, cantaloupe, orange and other Iresh Iruits can be
included in the diet

. Rudy undergoes hemodialysis for the first time and was


scared of disequilibrium syndrome. He asked you how this can
be prevented. Your response is:

a. maintain a conducive comIortable and cool environment


b. maintain Iluid and electrolyte balance
c. initial hemodialysis shall be done Ior 30 minutes only so as not
to rapidly remove the waste Irom the blood than Irom the brain
d. maintain aseptic technique throughout the hemodialysis

. You are assisted by a nursing aide with the care of the


client with renal failure. Which delegated function to the aide
would you particularly check?

a. Monitoring and recording I and O


b. Checking bowel movement
c. Obtaining vital signs
d. Monitoring diet

. A renal failure patient was ordered for creatinine


clearance. As the nurse you will collect

a. 48 jour urine specimen


b. Iirst morning urine
c. 24 hour urine specimen
d. random urine specimen

Situation 19 - Fe is experiencing leIt sharp pain and occasional


hematuria. She was advised to undergo IVP by her physician.

1. Fe was so anxious about the procedure and particularly


expressed her low pain threshold. Nursing health instruction
will include:

a. assure the client that the pain is associated with the warm
sensation during the administration oI the Hypaque by IV
b. assure the client that the procedure painless
c. assure the client that contrast medium will be given orally
d. assure the client that x-ray procedure like IVP is only done by
experts

. What will the nurse monitor and instruct the client and
significant others, post IVP?

a. Report signs and symptoms Ior delayed allergic reactions


b. Observe NPO Ior 6 hours
c. Increase Iluid intake
d. Monitor intake and output

. Post IVP, Fe should excrete the contrast medium. You


instructed the family to include more vegetables in the diet and

a. increase Iluid intake


b. barium enema
c. cleansing enema
d. gastric lavage

. The IVP reveals that Fe has small renal calculus that can
be passed out spontaneously. To increase the chance of passing
the stones, you instructed her to force fluids and do which of
the following?

a. Balanced diet
b. Ambulance more
c. Strain all urine
d. Bed rest

. The presence of calculi in the urinary tract is called:

a. Colelithiasis
b. Nephrolithiasis
c. Ureterolithiasis
d. Urolithiasis

Situation 20 - At the medical-surgical ward, the nurse must also be


concerned about drug interactions.

. You have a client with TPN. You know that in TPN, like
blood transfusion, there should be no drug incorporation.
However, the MD's order read; incorporate insulin to present
TPN. Will you follow the order?

a. No, because insulin will induce hyperglycemia in patients with


TPN
b. Yes, because insulin is chemically stable with TPN and can
enhance blood glucose level
c. No, because insulin is not compatible with TPN
d. Yes, because it was ordered by the MD

. The RN should also know that some drugs have increased


absorption when infused in PVC container. How will you
administer drugs such as insulin, nitroglycerine hydralazine to
promote better therapeutic drug effects?

a. Administer by Iast drip


b. Inject the drugs as close to the IV injection site
c. Incorporate to the IV solution
d. Use volumetric chamber

. One patient has a 'runaway' IV of dextrose. To


prevent temporary excess of insulin transient hyperinsulin
reaction, what solution should you prepare in anticipation of
the doctors order?

a. Any IV solution available to KVO


b. Isotonic solution
c. Hypertonic solution
d. Hypotonic solution

. How can nurse prevent drug interaction including


absorption?

a. Always Ilush with NSS aIter IV administration


b. Administering drugs with more diluents
c. Improving on preparation techniques
d. ReIerring to manuIacturer's guidelines

1. In insulin administration, it should be understood that our


body normally releases insulin according to our blood glucose
level. When is insulin and glucose level highest?

a. AIter excitement
b. AIter a good night's rest
c. AIter an exercise
d. AIter ingestion oI Iood

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