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NURSING PRACTICE 1 Foundation of PROFESSIONAL Nursing Practice GENERAL INSTRUCTIONS: 1. 2. 3. 4.

. This test booklet contains 100 test questions Read INSTRUCTIONS TO EXAMINESS printed on your answer sheet. Shade only one (1) box for each question on your answer sheets. Two or more boxes shaded will invalidate your answer. AVOID ERASURES.

INSTRUCTIONS: 1. Detach one (1) answer sheet from the bottom of your Examinee ID/Answer Sheet Set. 2. Write the subject title Nursing Practice I on the box provided. 3. Shade Set Box A on your answer sheet if your test booklet is Set A; Set Box B if your test booklet is Set B. SITUATION: Nursing ethics is an important part of the nursing profession. As the ethical situation arises, so is the need to have an accurate and ethical decision making. 1. The purposes of having a nurses code of ethics is: A. B. C. D. 2. Delineate the scope and areas of nursing practice To help the public understand professional conduct expected of nurses To define the roles and functions of the health care givers, nurses, clients. Identify nursing action recommended for specific health care situations.

The principles that govern right and proper conduct of a person regarding life biology and the health professionals as referred to as: A. Morality B. Religion C. Values D. Bioethics

3.

According to the code of ethics, which of the following is the primary responsibility of the nurse? A. B. C. D. Assist towards peaceful death Preservation of health at all cost Health is a fundamental right Promotion of health, prevention of illness and restoration of health

4.

Which of following is TRUE about the Code of Ethics of Filipino Nurses? A. The Philippine Nurses Association for being the accredited, professional organization was given the privilege to formulate a Code of Ethics for Nurses which the Board of Nursing promulgated. B. Code for Nurse was first formulated in 1982 published in the Proceedings of the Third Annual Convention of the PNA House of the Delegates. C. The present code utilized the Code of Good Governance for the Professions in the Philippines. D. Certificates of Registration of registered nurses may be revoked or suspended for violations of any provisions of the Code of Ethics.

5.

Based on the Code of Ethics for Filipino Nurses, what is regarded as the hallmark of nursing responsibility and accountability? A. B. C. D. Health, being a fundamental right for every individual The privilege of being a registered professional nurses Human rights of clients regardless of creed and gender Accurate documentation of actions and outcomes

6.

Violation of the Code of Ethics might equate to the revocation of the nursing license. Who revokes the license? A. PRC B. BON C. DOH D. PNA

7.

Values are said to be the enduring believe about a worth of a person, ideas and belief. If values are going to be a part of a research, this is categorized under: A. Qualitative B. Quantitative C. Experiment D. Non-experimental

8.

Subject feeling about what is right or wrong is said to be:

A. 9.

Morality

B. Religion

C. Values

D. Bioethics

The most important nursing responsibility where ethical situations emerge in patient care is to: A. B. C. D. Act only when advised that the action is ethically sound Be accountable for his or her own actions Not takes sides, remain neutral and fair Assume that ethical questions are the responsibility of the health team.

10. Why is there an ethical dilemma? A. B. C. D. The choices involved do not appear to be clearly right or wrong Decision has to be made based on societal norms A clients legal right co-exist with the nurses professional obligation Decision has to be made quickly, often under stressful conditions.

SITUATION; Knowledge of the acid-base disturbance and the functions of the electrolytes is necessary to appropriate intervention and nursing actions; 11. Eddie with diabetes milletus has a blood glucose level of 844 mg/dl. The nurse interprets base imbalance? A. B. Respiratory acidosis Respiratory alkalosis. C. Metabolic acidosis D. Metabolic alkalosis that Eddie has which acid

12. In a client in the health care clinic, arterial blood has analysis gives the following result: ph 7.48, PCO 2 32 mmHg, PO2 94 mmHg, HCO3 24 mEq/L. The nurse interprets that the client has which acid base disturbance? A. B. Respiratory acidosis Respiratory alkalosis C. Metabolic acidosis D. Metabolic alkalosis

13. Rudy has an order for ABG analysis on radial artery specimens. The nurse ensures that which of the following has been performed or tested before the ABG specimens are drawn? A. Guthrie test B. Allens test C. Rombergs test D. Webers test

14. A nurse is reviewing that arterial blood gas values of client and notes that the pH is 7.31 PCO2 is 50 mmHg, and the bicarbonate is 27mEg/l. The nurse concludes that which acid base disturbance is present in this client? A. B. Respiratory acidosis Respiratory alkalosis C. Metabolic acidosis D. Metabolic alkalosis

15. Gerrys test checks the patency of the: A. Ulnar artery B. Radial artery C. Carotid artery D. Brachial artery

SITUATION: Beth G. Valencia, 45 years old is admitted to the hospital with diagnosis of renal calculi. She is experiencing severe flank pain with a temperature of 39 C.

16. Where would the nurse taps Beth G. Valencia indwelling catheter in order to reduce urethral irritation? A. B. To the patient inner thigh To the patient lower thigh C. To the patient buttocks D. To the patients lower abdomen

17. How will you prevent ascending infection to Beth G. Valencia who has an indwelling catheter? A. B. C. D. See to it that the drainage tubing touches the level of the urine See to it that the drainage tubing does not touch the level of the urine Change the catheter every eight hours Clean catheter may be used since urethral meatus is not a sterile area.

18.

Given the above assessment date, the most immediate goal of the nurse would be which of the following? A. B. Prevent urinary complication Maintains fluid and electrolytes C. Alleviating nausea D. Alleviate pain

19. After IVP a renal was confirmed, a left nephrectomy was done. Her post operative order includes, daily urine specimen to be sent to the laboratory. Beth G. Valencia has a foley catheter attached to a urinary drainage system. How will you collect the urine specimen? A. B. C. D. Disconnect the drainage from the collecting bag and allow the urine to flow from catheter into the specimen container Empty a sample urine from the collecting bag into the specimen container Remove urine from drainage tube with sterile needle and syringe and empty urine from the syringe into the specimen container Disconnect the drainage tube from the indwelling catheter and allow urine to flow from catheter into the specimen container

20. Which of the following menu is appropriate for one with low sodium diet? A. B. C. D. Canned soup, potato salad and diet soda Ham and cheese sandwich, fresh fruits and vegetables White chicken sandwich, vegetables salad and tea Instant noodles, fresh fruits and ice tea

SITUATION; Health care delivery system affects the health status of every Filipino. As a nurse, knowledge of this system is expected to ensure quality of life.

21. Which makes nursing dynamic? A. B. C. D. Every patient is a unique physical, emotional, social and spiritual being. The health status of the patient is constantly changing and the nurse must be cognisant and responsive to these changes. Nursing practice is expanding in the light of modern development that takes place The patient participation in the over all nursing care plan

22. When should rehabilitation commence. A. B. The day before discharge 24 hours after discharge C. When the patient desires D. Upon admission

23. This form of health insurance provides comprehensive prepaid health services to enrollees for a periodic payment. A. B. Health Maintenance Organization Hospital Maintenance Organization C. Philippine Health Insurance Act D. Medicare

24. What exemplified the preventive and promotive programs in the hospital? A. B. C. D. 25. Program for alcoholic and drug addicts Hospital as a center to prevent & control infection Program for smokers Hospital wellness center

Prevention is an important responsibility of the nurse in: A. Community B. Hospital C. Workplace D. All of the above

SITUATION; Recognition of normal values is vital in assessment of clients with various disorders. 26. As a nurse is reviewing the laboratory test result for a client with a diagnosis of severe dehydration. The nurse would expect the hematocrit level for this client to be which of the following? A. 60% B. 32% C. 45% D. 47%

27. Which of the following laboratory test result indicate presence of an infectious process? A. B. Iron 90 g/100ml White blood cells 18,000/mm C. Erythrocyte sedimentary rate is 12mm/hr D. Neutrophils 67%

28. A nurse is reviewing the electrolyte results of an assigned client and notes that the potassium level is 5.6mEq/L. Which of the following would the nurse expect to note on the ECG as a result of this laboratory value? A. ST Depression B. Inverted T wave C. Prominent U wave D. Tall peaked wave

29. A nurse is reviewing the electrolyte result of an assigned client and notes that the potassium level is 3.2 mEq/L. Which of the following would the nurse expect to note on the ECG as a result of this laboratory value? A. U waves B. Absent P wave C. Elevated wav D. Elevated ST segment

30. Erik, was underwent diagnostic test and the result of the blood examination are back. On reviewing the result the nurse notices which of the following as abnormal finding? A. B. Iron 75 mg/100ml Neutrophils 60% C. Erthrocyte sedimentary rate is 39mm/hr D. White blood cells (WBC) 9000/mm

SITUATION: Pleural effusion is the accumulation of fluid in the pleural space. Questions 31 to 35 refer to this. 31. Which of the following is a finding that the nurse will be able to asses in a client with Pleural effusion? A. B. C. D. Reduced or absent breath sound at the base of the lungs, dyspnea, tachypnea and shortness of breath. Hypoxemia, hypercapnea and respiratory acidosis Noisy respiration, crackles, stridor and wheezing Tracheal deviation towards the affected side, increased fremitus and loud breath sounds

32. Thoracentesis is performed to the client with effusion. The nurse knows that the removal of fluid should be slow. Rapid removal of fluid in thoracentisis might cause: A. B. Pneumothorax Pleurisy or Pleuritis C. Cardiovascular collapse D. Hypertension

33. 3 days after thoracentesis, the client again exhibited respiratory distress. The nurse will know that pleural effusion has reoccurred when she noticed a sharp stabbing pain during inspiration. The physician ordered a closed tube thoracotomy for the client, the nurse knows that the primary function of the chest tube is to: A. B. C. D. To visualize the intrathoracic content Restore negative intrathoracic pressure Restore positive intrathoracic pressure As a method of air administration via ventilator

34. The test tube is functioning properly if: A. B. C. D. There is an oscillation There is a continuous bubbling in the waterseal The sunction control bottle has a continuous bubbling There is no bubbling in the drainage bottle

35. In a client with pleural effusion the nurse is instructing appropriate breathing technique. Which of the following is included in the teaching? A. B. C. D. Hold the breath after each inspiration for 1 full minute Breath normally Practice abdominal breathing Inhale slowly and hold the breath for 3 to e seconds

SITUATION: Documentation and reporting are just important as providing patient care. As such, the nurse must be punctual and accurate to sure quality documentation and reporting. 36. Health care reports have different purposes. The availability of patients record to all health team members demonstrates which of the following purposes: A. B. Legal documentation Research C. Education D. Vehicle for communication

37. When a nurse commits medication error, she should accurately document clients response and her corresponding action. This is very important for which of the following purposes: A. B. 38. Nursing audit Research C. Legal documentation D. Vehicle for communication

POMR has been widely used in many teaching hospitals. One of its unique features is SOAPIE charting. The P in SOAPIE charting should include; A. B. C. D. Patients perception of ones illness Plan of care for patient Prescription of the doctor to the patients illness Nursing problem and nursing diagnosis

39. The medical records that are organizes into separate section from doctors or nurses has more disadvantages than advantages. This is classified as what type of recording? A. POMR B. SOAPIE C. Modified POMR D. SOMR

40. Which of the following is an advantage of SOMR or traditional recording? A. B. C. D. Increase efficiency in data gathering The care giver can easily locate proper section for making charting entries Reinforces the use of nursing process Enhances effective communication among health care members

SITUATION: Carl John Cruz is a 24 year old client with symptoms of dyspnea, absent breath sounds on the right lung and chest xray revealed pleural effusion. The physician will perform thoracentesis. 41. Thoracenhesis is useful in treating all of the following pulmonary disorder except: A. 42. Hydrothorax B. Tuberculosis C. Hemothorax D. Empyema

Before thoracentesis, the legal consideration you must check is: A. B. Consent is sign by the client Position of the client is correct C. Medicine preparation is correct D. Consent signed by relative & physician

43. Which of the following anaesthetics drug is used for thoracentesis? A. Procaine 2% B. Valium 250mg C. Demerol 75% D. Phenobarbital 50mg

44. Which of the following psychological preparation is not relevant for him? A. B. C. D. Telling him to keep still during the procedure to facilitate the insertion of the needle in the correct place Telling him that the gauge of the needle and anesthesia to be used Allow Carl to express his feelings and concerns Physicians explanation on the purpose of the procedure and how it will be done.

SITUATION: ENTEROSTOMAL THERAPY is now considered a specialty in nursing. You are participating in the OSTOMY CARE CLASS. 45. The nurse is teaching a client how to irrigate his stoma, which action indicates that the client needs more teaching? A. B. C. D. Filling the irrigation bag with 500 to 1,000 ml of lukewarm water. Washing hands with soap and water when finished Stopping irrigation for cramps and clamping the tubing until cramps pass Hanging the irrigation bag 24 to 36 (60 to 90 cm) above the sloma.

46. During colostomy irrigation the client complains of a cramping sensation with the fluid was introduce. Which of the following is a correct nursing action? A. B. C. Clamp the irrigating tube Pinch or kink the irrigating tube temporarily Continue the irrigation

D.

Temporarily stop the irrigation

47. The client ask the nurse, when is the best time to perform irrigation? The nurse would answer. A. B. C. D. Early morning before meals Early morning before meals upon arising Early morning after meals Early morning

48. When observing a return demonstration of a colostomy irrigation, you know that more teaching is required if : A. B. C. D. Clamps of the flow of fluid when filling uncomfortable Lubricates the tip of the catheter prior to inserting into the stoma Hangs the irrigating bag on the bathroom door cloth, hook during fluid insertion Discontinues the insertion of fluid after 500ml of fluid has been instilled.

49. You are aware that teaching about colostomy care is understood when client states, I will contact my physician and report: A. B. C. D. If I have any difficulty inserting the irrigating tub into the stoma If I noticed a loss of sensation to touch in the stoma tissue The expulsion of flatus while the irrigating fluid is running out When mucus is passed from the stoma between the irrigation

50. The physician orders a stool culture to help diagnose a client with prolonged diarrhea. The nurse who obtains the stool specimen from the colostomy stoma should: A. B. C. D. Take the specimen to the laboratory immediately Collect the specimen in a sterile container Collect the specimen in a clean container Perform a midstream clean catch collection

SITUATION: Lady Manahan is rush to the emergency room and you are his attending nurse. You are performing a vital sign assessment

51. All of the following are correct methods in assessment of the blood pressure: EXCEPT A. B. C. D. Take the blood pressure reading on both arms for comparison Observe procedures for infection control Pump the cuff to around 50 mmHg above the point where the pulse is obliterated Listen to and identify the phrases of korotkoffs sound

52. You attached a pulse oximeter to the client. you know that the purpose is to: A. B. C. D. Check level of clients tissue perfusion Detect oxygen saturation of arterial blood before symptoms of hypoxemia develops Measure the efficacy of the clients anti-hypertensive medication Determine if the clients hemoglobin level is low & if she needs blood transfusion

53. After a few hours in the Emergency Room, Lady Manahan is admitted to the ward with an order of hourly monitoring of blood pressure. The nurse finds that the cuff is too narrow and this will cause the blood pressure reading to be: A. B. Inconsistent Low systolic and high diastolic C. Higher than what the reading should be D. Lower than what the reading should be

54. Through Ladys health history you gather that Lady smokes and drinks coffee. When taking the blood pressure of Lady who recently smoked or drank coffee, how long should the nurse wait before taking Christines blood pressure for accurate reading? A. 15 minutes B. 30 minutes C. 15 seconds D. 1 to 2 minutes

55. While Lady Manahan has pulse oximeter on his fingertip, you notice that the sunlight is shining on the area where is the oximeter. Your action will be to: A. B. C. Change the location of the sensor every four hours Set and turn on the alarm of the oximeter Cover the fingertip sensor with a towel or bed sheet

D.

Do nothing since there is no identified problem

56. The nurse finds it necessary to recheck the blood pressure reading. In case of such reassessment, the nurse should wait for a period of: A. 15 seconds B. 1 to 2 minutes C. 30 minutes D. 15 minutes

57. If the alarm is said to be elevated when taking the blood pressure reading, it will create: A. B. True false reading False low reading C. Indeterminate D. False high reading

58. You are to assessed the temperature of Lady Manahan, the next morning and found out that she ate ice cream. How many minutes should wait before assessing Christine oral temperature? A. 20 minutes B. 10 minutes C. 30 minutes D. 15 minutes

59. When auscultating the Ladys blood pressure the nurse hears the following. From 150 mmHg to 130 mmHg. Silence, then thumping sounds continuing down to 100 mmHg, muffled sound, continuing down to 80 mmHg and then silence. What is the Christines blood pressure? A. . 60. In a client with a previous blood pressure of 130/80, 4 hours ago. How long will it take to release the blood pressure cuff to obtain an accurate reading? A. 30-45 seconds B. 10-20 seconds C. 1-1.5 minutes D. 3-3.5 minutes 130/80 B. 150/100 C. 100/80 D. 130/100

SITUATION: As a profession, nursing is dynamic and its practices directed by various theoretical models. To demonstrate caring behavior, the nurse applies various nursing models in providing quality nursing care. 61. When you clean the bedside in it and regularly attend to the personal hygiene of the patient as well as in washing your hands before and after a procedure and it between patients, you intend to facilitate the bodys reparative process. Which of the following nursing theory are you applying in the above nursing action? A. B. Virginia Henderson Dorothea Orem C. Hildegard Peplau D. Florence Nightingale

62. A communication skills is one of the important competencies expected of a nurse. Interpersonal process is viewed as human to human relationship. The statement is an application of whose nursing model? A. Callista Roy B. Joyce Travelbee C. Martha Rogers D. Imogene King

63. The statement, the health status of an individual is constantly changing and the nurse must be cognizant and responsive to these changes best explains which of the following facts about nursing? A. Dynamic B. Client centered C. Holistic D. Art

64. Virginia Henderson professes that the goal of nursing is to work interdependently with other health care working in assisting the patient to gain interdependence as quickly as possible. Which of the following nursing actions best demonstrates this theory in taking care of a 94 year old client with dementia who is totally immobile? A. B. C. D. Feeds the patient, brushes the teeth, gives the sponges bath Put the patient in semi fowlers position, set the over bed table so the patient can eat by himself, brush his teeth and sponge himself Supervise the watcher in rendering patient his morning care Assist the patient to turn to his sides and allow him to brush and feed himself only when he feels ready

65. In the self care deficit theory by Dorothea Orem, nursing care becomes necessary when a patient is unable to fulfill his psychological and social needs. A pregnant client needing prenatal check is classified as: A. B. Partially compensatory Wholly compensatory. C. Supportive Educative D. Non-compensatory

SITUATION: The nurse has been asked to administer an injection via Z-track technique. Questions 17 to 21 refer to this.

66. The nurse prepares an IM injection for an adult client using Z-track technique, 4 ml of medication is to be administered to the client. which of the following site will be use? A. Rectus femoris B. Deltoid C. Ventrogluteal D. Vastus lateralis

67. In infants 1 year old and below, which of the following is the site of choice for intramuscular injection? A. Rectus femoris B. Deltoid C. Ventrogluteal D. Vastus lateralis

68. In order to decrease discomfort in Z-track technique, which of the following is applicable? A. B. C. D. Pierce the skin quickly and smoothly at a 90 degree angle Pierce the skin slowly and carefully at 90 degree angle Inject the medication steadily at around 10 minutes per milliliter Pull back the plunger and aspirate for 4 minutes to make sure that the needles did not hit a blood vessel

69. The rationale in using the Z-track technique in an intramuscular injection is: A. B. C. D. In decreases the leakage of discolouring and irritating medication into the subcutaneous tissues It allow a faster absorption of the medication The Z-track technique prevent irritation of the muscles It is much more convenient for the nurse

70. After injection using Z-track technique, the nurse should know that needs to wait for a few seconds before withdrawing the needle and this is to allow the medication to disperse into the muscle tissue, thus decreasing the clients discomfort. How many seconds should the nurse wait before withdrawing the needle? A. 2 seconds B. 5 seconds C. 10 seconds D. 15 seconds

SITUATION: Oral care is an important part of hygienic practices and promoting client comfort. 71. An elderly client, 85 years old, is unconscious. Assessment of the mouth reveals excessive dryness and presence of sores. Which of the following is BEST to use for oral care? A. B. Mineral oil Hydrogen peroxide C. Lemon Glycerine D. Normal saline solution

72. When performing oral care to an unconscious client, which of the following is a special consideration to prevent aspiration of fluids into the lungs? A. B. C. D. Wash hands and observe appropriate infection control Keep the client dry by placing towel under the chin Put the client on a side lying position with head of bed lowered Clean mouth with oral swabs in a careful and an orderly progression

73. The advantages of oral care for a client include all of the following, EXCEPT A. B. C. D. Improves client s appearance and self confidence Decreases bacteria in the mouth and teeth Reduces need to use commercial mouthwash which irritate buccal mucosa Improves appetite and taste of food

74. A possible problem while providing oral care to unconscious client is the risk of fluid aspiration to lungs. This can be avoided by: A. B. C. D. Use fingers wrapped with wet cotton wash cloth to rub inside the cheeks, tongue, lips and gums Swabbing the inside of the cheeks and lips, tongue and gums with dry cotton. Cleaning teeth and mouth with cotton swabs soaked with mouth wash to avoid rinsing the buccal cavity Suctioning as needed while cleaning the buccal cavity

75. Your client has difficult of breathing and is mouth breathing most of the time. This causes dryness of the mouth with unpleasant odor. Oral hygiene is recommended for the client and in addition, you will keep the mouth moistened by using: A. Salt solution B. Water C. Petroleum jelly D. Mentholated ointment

SITUATION: Ensuring safety before, during and after a diagnostic procedure is an important responsibility of the nurse. 76. To help Charlemagne better tolerate the bronchoscopy, you should instruct him to practice , which of the following prior to the procedure? A. B. C. D. Holding his breath periodically for 30 seconds Tensing the shoulder muscles while lying on his back Breathing in and out through the nose with his mouth open Cleansing his fist every 2 minutes

77. Right after thoracentesis, which of the following is most appropriate intervention? A. B. C. D. Place an ice pack to the puncture site Observe for symptoms of tightness of chest or bleeding Instruct the patient not to cough or deep breath for two hours Remove the dressing to check for bleeding

78. Following a bronchoscopy, which of the following complains to Charlemagne should be noted as possible complication: A. B. C. D. Blood tinged sputum and coughing Shortness of breath and laryngeal stridor Sore throat and hoarseness Nausea and vomiting

79. Immediately after bronchoscopy, you instructed Charlemagne to: A. B. Exercise the neck muscles Refrain from coughing and taking C. Breath deeply D. Clear hi throat

80. Thoracentesis may be performed for cytologic study of pleural fluid. As a nurse your most important function during the procedure is to: A. B. C. D. Open and close three-way stopcock Keep the sterile equipment from contamination Assist the physician Observe the patients vital sign

SITUATION: As a nurse, you are aware that proper documentation in the patient chart is your responsibility. 81. Which of the following is not a legally binding documents but nevertheless very important in the care of all patients in any health care setting? A. B. C. D. Board of nursing resolution adopting the code of ethics Bill of rights as provided in the Philippines constitution Scope of nursing practice as defined by RA 9173 Patients bill of rights

82. Delegation is the process of assigning tasks that can be performed by subordinates. The RN should always be accountable and should not lose the accountability. Which of the following is a role included in delegation? A. B. C. D. The RN is responsible and accountable for the delegated task in adjunct with the delegates After a task has been delegated, it is no longer a responsibility of the RN. Follow up with a delegated task is necessary only if the assistive personnel not trustworthy. The RN must supervise all delegated task.

83. A nurse gives a wrong medication to the client, another nurse employed by the same hospital as a risk manager will expected to receive, which of the following communication? A. Incident report B. Oral report C. Nursing kardex D. Complain report

84. Performing a procedure on a client in the absence of an informed concent can lead to which of the following charges? A. Harrasment B. Fraud C. Assault & battery D. Breach of confidentiality

85. Which of the following is the essence of informed concent? A. B. C. It should have coverage from an insurance company It should respect the clients freedom from coercion It should have a durable power of attorney

D.

It should disclose previous diagnosis, prognosis and alternative treatments available for the client.

SITUATION: Baby S. Singson, a staff nurse supervisor requests all the staff nurses to brainstorm and learn ways to instruct diabetic clients on administration of insulin. She wants to ensure that there are nurses available daily to do health education classes.

86. The plan of the nurse supervisor is an example of: A. B. C. D. Increasing human resources Efficient management of human resources In service education process Primary prevention

87. When Baby S. Singson, a nurse delegates aspects of the clients care to the nurse aide, who is unlicensed staff, Mrs. Baby S. Singson A. B. C. D. Is assigning the responsibility to the aide but not the accountability for those task Makes the assignment to teach the staff member Does not have to supervise or evaluate the aide Most know how to perform task delegated

88. Liza P. Guevarra, the new nurse appears tired and sluggist and lacks the enthusiasm, she had six weeks ago when she started the job. The nurse supervisor should: A. B. C. D. Emphatize with the nurse and listen to her Discuss how she is adjusting to her new job Tell her to take the day off Ask about her family life

89. Process of formal negotiations of working conditions between a group of registered nurses and employee is: A. Arbitration B. Grievance C. Collective bargaining D. Strike

90. You are attending a certification on cardio pulmonary resuscitation (CPR) offered and required by the hospital employee only. This is A. B. Professional course towards credit In-service education C. Advance training D. Continuing education

SITUATION: Hormones are secreted by the various glands in the body. Basic knowledge of the endocrine system is necessary. 91. Somatocrinin or the Growth hormone, releasing hormone is secreted by the: A. B. Posterior pituitary gland Hypothalamus C. Anterior pituitary gland D. Tyroid gland

92. All of the following are secreted by the anterior pituitary gland EXCEPT: A. B. C. D. Somatotropin / Growth hormone Follicle stimulating hormone Thyroid stimulating hormone Gonadotropin hormone releasing hormone

93. Calcitonin, a hormone necessary for calcium regulation is secreted in the: A. Thyroid gland B. Hypothalamus C. Parathyroid gland D. Anterior pituitary gland

94. While Parathormone, a hormone that negates the effect of calcitonin is secreted by the: A. Thyroid gland B. Hypothalamus C. Parathyroid gland D. Anterior pituitary

95. All of the following hormones secreted by the Posterior pituitary gland EXCEPT: A. Vasopressin B. Oxytocins C. Anti-diuretic hormone D. Growth hormone

SITUATION: When creating your lesson plan for cerebro vascular disease or STROKE. It is important to include the risk factor of stroke. 96. The most important risk factor of stroke is: A. Cigarette smoking B. Hypertension C. Binge drinking D. Heredity

97. Part of your lesson plan is to talk about etiology or cause of stroke. The types of stroke based on cause are the following EXCEPT: A. Embolic stroke B. Hemorrhagic stroke C. Diabetic stroke D. Thrombotic stroke

98. A participant in the STROKE class asks what is a risk factor of stroke. Your best response is: A. B. C. D. Increased RBC count in linked to high cholesterol More red blood cell increases hemoglobin content More red blood cell thicken blood and make clots more possible High RBC count increases blood pressure

99. The nurse emphasizes the intravenous drug abuse carrie a high risk of stroke. Your best response is: A. Amphetamines B. Cocaine C. Shabu D. Demerol

100. Hemorrhagic stroke occurs suddenly usually when person is active. All are causes of hemorrhage, EXCEPT: A. Damage to blood vessel B. Trauma C. Phlebitis D. Aneurysm

SUBMIT THIS TEST BOOKLET TOGETHER WITH THE ANSWER SHEET TO YOUR WATCHERS. BRINGING THE TEST BOOKLET OUT OF THE ROOM WILL BE A GROUND FOR CANCELLATION OF YOUR EXAMINATION. ***END*** NURSING PRACTICE II Community Health Nursing and Care of the Mother and Child GENERAL INSTRUCTIONS: 5. This test booklet contains 100 test questions

6. 7. 8.

Read INSTRUCTIONS TO EXAMINESS printed on your answer sheet. Shade only one (1) box for each question on your answer sheets. Two or more boxes shaded will invalidate your answer. AVOID ERASURES.

INSTRUCTIONS: 4. Detach one (1) answer sheet from the bottom of your Examinee ID/Answer Sheet Set. 5. Write the subject title Nursing Practice II on the box provided. 6. Shade Set Box A on your answer sheet if your test booklet is Set A; Set Box B if your test booklet is Set B. SITUATION: Nursing research is the term used to describe the evidence used to support nursing practice. Nursing, is the evidence based area of practice, has been developing since the time of Florence Nightingale to the present day, where many nurses now work as researcher based in universities as well as in the health care setting. 1. Mr. Edgar plans to undertake a research of Community 1 and 2 on how to manage their health, using Primary health care after an organization and training seminars. This type of research is: A. 2. Experimental B. Historical C. Descriptive D. Basic

The independent variable is: A. B. Primary health care Community 1 and 2 C. Organization and training seminars D. Management of their health

3.

In this design, the variable that is being manipulated is: A. B. Independent Dependent C. Management of their family health care D. Organization and training seminars

4.

In general, the research process follows the following ordered sequence: 1. Determination of design 2. Statement of the problem 3. Definition of variables 4. Collection and analysis of data 5. Review of related literature

A. 5.

2, 5, 3, 1, 4

B. 3, 5, 4, 1, 2

C. 2, 5, 3, 4, 1,

D. 2, 5, 1, 3, 4

Studies done in natural setting such as this one, possess difficulty of controlling which variable? A. Independent B. Extraneous C. Dependent D. Organismic

SITUATION: Jonas, 7 weeks old was brought by his mother to the health center because of DIARRHEA occurring 4 to 5 times a day. 6. Your assessment revealed that Jonas has sunken etes and he is restless and irritable. What will be your diagnosis? A. B. Some of dehydration No sign of dehydration C. Severe dehydration D. You need to assess him further to be able to make a diagnosis

7.

Based on your diagnosis, which of the following is best done for Jonas? A. B. C. D. Give Jonas mother instruction in home management Give Jonas 200-400 ml Oresol in 4 hours. Accompany Jonas to the nearest facility where iv fluids can be given Keep him in your health center for close observation.

8.

You know that the hallmark of nursing accountability is the: A. B. Fever of hypothermia C. Severe under nutrition The presence of blood on his stool D. All of these

9.

After your management of Jonas condition. Your assessment revealed that he has no more sign of dehydration. What instruction you give to Jonas mother? A. B. C. Continue breastfeeding him frequently Give him oresol 50-10 ml after every loose stool Observed him for danger sign

D.

All of these instruction

SITUATION: Roger and Ruby D. Duarte are couples asking you about methods of contraception. 10. Abstinence is perhaps the surest and the most effective way to prevent pregnancy, but obviously not the best. Educating the client about abstinence leads protection when it comes to sexual intercourse that leads to higher STD rates. Ruby asked you about a natural way to prevent pregnancy by checking her cervical mucus. This is known as:

A. B.

Cervical mucus method Symphothermal method

C. Billings method D. All of these

11. A more effective way than cervical mucus method alone, in this method Ruby will combine both BBT as well as cervical mucus method: A. 12. LAM B. Coitus interuptus C. Billings method D. Sympothermal method

AM is only effective during the first: A. Month B. Year C. 6 months D. 3 months

13. In selecting the BEST contraceptive methods, which of the following should be at the highest priority? A. B. 14. The culture of the couple The acceptance of the couple C. The religious belief of the couple D. The expert opinion of the nurse

If Ruby will have a record of the following length of menstrual cycle: cycle 1-26, cycle 3-26, cycle 4-29, cycle 6-29. When should she abstain sexual intercourse if she will use the calendar method? A. B. 7th to 18th day of menstrual cycle 8th to 18th day of menstrual cycle C. 6th to 17th day of menstrual cycle D. 9th to 19th day of menstrual cycle

15. Which of the following condition, if Ruby possesses might be a hindrance in IUD insertion? A. B. She is 30 years old History of having twin pregnancy C. Multiparity D. STD

SITUATION: Ear infections are the most common cause of deafness in low income areas. The nurse should be able to assess early signs and symptoms of ear infection in order to prevent hearing logs, which in turn, leads to learning problems. 16. Among the following, the most serious complication of ear infection is: A. Hearing loss B. Mastoiditis C. Pain D. Deafness leading to learning problems

17. Which of the following behavior best suggest that the child is experiencing ear pain? A. B. Frequent tugging of the ear Voracious appetite C. Irritability D. Sleepness

18. An ear infection for 15 days is classified as: A. Acute otitis media B. Chronic otitis media C. Mastoiditis D. Sub acute otitis

19. If the child present with swelling and tenderness behind the ear, how would you classify this child? 1. 2. 3. A. 1, 6 Green Yellow Pink B. 2, 5 4. Urgent referral plus a dose of antibiotic & paracetamol 5. Treat with the same 5 days antibiotic treatment as pneumonia 6. Dry the ear by wicking C. 1, 4 D. 3, 4

20. All of the following are danger signs that needs to be routinely checked in all children EXCEPT: A. Convulsions B. Lethargy C. Blood in the stool D. Vomiting

SITUATION: Promoting the clients health is one of the nurse priorities. If health promotion is not possible, the secondary and tertiary levels of prevention are utilized to render care. 21. Nursing is to assist an individual sick or well in the performance of activities that contributes to health and recovery is a definition based on the theory of: A. Virginia Anderson B. Dorothea Orem C. Madeleine Leininger D. Faye Abdellah

22. Which of the following questions by the nurse would be best fit the philosophy of the nursing, mutual participation, model participation, model of care (NMPMC)? A. B. C. D. Have you brushed your childs teeth today? How does your child look to you today? Where have you been all morning? Do you think your childs color is worse?

23. These are numerous definitions of the word HEALTH. Which definition below is from Florence Nightingale? A. B. C. D. A state or a process of being and becoming an integrated and whole person The state of being free from illness or injury Being well and using every power the individual possesses to the fullest extend A state of complete physical, social and mental well being and not merely the absence of disease or infirmity

24. Informal communication takes place when individual talk and is best described by saying the participants. A. B. Are involved in pre-existing informal relationship Have no particular agenda or protocol C. Talk with slang words D. Are relaxed

25. Tertiary care by the home health nurses is directed toward children with: A. Problem in mobility B. Short-term needs C. Minor problems D. Clinically apparent disease

26. The endometrium thickens during which phrase of the menstrual cycle? A. Secretory phase B. Menstrual phase C. Proliferative phase D. Ischemic phase

27. The nurse is preparing to auscultate fetal heart tones in a pregnant client. abdominal palpation reveals a hard, round mass under the left side of the rib cage, a softer, round mass just above the symphysis pubis, small irregular shapes in the right side of the abdomen, and a long firm mass on the left side of the abdomen. Based on these findings, what is the best plce to auscultate fetal heart tones? A. B. Right lower abdominal quadrant Right upper abdominal quadrant C. Left upper abdominal quadrant D. left lower abdominal quadrant

28. A measurement tool to articulate the nursing workload for a specific patient or groups of patients over a specific period of time is called? A. Staffing pattern B. Skill mix C. Benchmarking D. Patient classification

29. The mother of a 9 month old infant is concerned that the head circumference of her baby is greater than the chest circumference. The BEST response by the nurse is: A. B. C. D. These circumferences are normally the same, but in some babies this just differs. Perhaps your baby was small for gestational age or premature This is normal until age of 1 year, when the chest will be greater. Let me ask you a questions, and perhaps we can figure out the cause of this differences

30. Vicky, a 28 year old post hysterectomy client has come to the health center. She inquired about BSE and asked when BSE should be performed. You answered her that BSE is best performed. A. B. 7 days after menstruation At the same day each month C. During menstruation D. Before menstruation

SITUATION: Baby John is a 2 year old boy, you see at a pediatric clinic. His mother tells you that he has changed completely in the past 6 months, from the easy-to-care for a baby into a MONSTER who refuses to do anything she asks. The only word he says

anymore is to. He has a temper tantrum every night at dinner over some type of food. She tells you this has changed parenting front FUN to a Real Chore. Baby John has a sister Maria, a toddler. 31. What kind of sentence should Baby John a 2 year old have master. A. Red ripe tomatoes B. Daddy come C. Old McDonald D. Please, please

32. Baby John answer every request of his mother by saying No!. How can he minimize this? A. B. C. D. Tell John he doesnt want him to say no anymore. Answer all Johns questions by saying No! Reduce the number of questions she ask John Explain he is not using good communication skills

33. Baby John mother uses timeout for punishment. What is a good rule for this? A. B. C. D. The child should sit still for as many minutes as his age The child should sit still for as many minutes as he misbehaved Timeout activities can include quiet play or reading books Children are not ready for timeout until school-age.

SITUATION: Diagnostic examinations perform in pregnant client are useful in determining the health of the unborn child. The following questions refer this. 34. After the procedure, the woman is instructed the rest quietly for a period of: A. 8 hours B. 15 minutes C. 4 hours D. 80 minutes

35. Instruction to mother prior to amniocentesis includes: A. B. Instruct to lie in left lateral position Tell her that 30 ml of amniotic fluid will be taken C. Ask the woman to void D. Ask the woman to drink

36. Amniocentesis reveal a low value, the physician might suspect genetic or chromosomal abnormality such as Down syndrome. Genetic testing is another viable option for the family. The nurse should know that genetic testing should only be done if: A. B. It is necessary for the child to survive It is in the best interest of the child C. Both parents want it performed D. No one object

37. The rationale of avoiding prior to amniocentesis is to: A. B. Prevent puncture to the vagina Promote comfort during the procedure C. Prevent vena cava syndrome D. Prevent puncture to the bladder

38. Amniocentesis be done at early as: A. 6-8th weeks B. 14-16th weeks C. 11-12th weeks D. 18-20th weeks

39. May is admitted in active labor. The nurse locates fetal heart sounds in the upper left quadrant of the mothers abdomen. The nurse would recognize which of the following? A. B. C. D. May will provably deliver very quickly and without problems The fetus is in the most common anterior fetal position This indicates May will probably have a breech delivery This position is referred to as being left antenopelvic

SITUATION: Immunization is necessary in order to save lives not only for children but also for mother. 40. In population of 77,500. What is your estimate of the population of pregnant woman needing tetanus toxoid vaccination? A. 2712.5 B. 2713 C. 2325 D. 2332

41. Tetanus vaccination is given to the mother. How many years will TT4 last. A. 3 years B. 5 years C. 10 years D. life

42. TT1 will give how many percent of protection to the mother? A. 75% B. 80% C. 90% D. 99%

43. Sylvia receives DPT 3 during infancy. The first TT vaccination for her will provide: A. B. 5 years protection 10 years protection C. 3 years protection D. no protection until the 2nd TT vaccination

44. Which of the following is an activated toxin? A. BCG B. Measles C. Tetanus D. Hepatitis B

45. TT administration uses what route? A. IV B. IM C. SQ D. Oral

46. Measles vaccination provides at least how many % of protection in children age 9 months. A. 50 % B. 75 % C. 99 % D. 80 %

47. The most common fatal complication of measles is usually associated with: A. Pneumonia B. Diarrhea C. LTB D. Seizures

48. Which of the following immunization is a plasma derivative? A. BCG B. Measles C. Hepatitis B D. Tetanus toxoid

SITUATION: Two children were brought to you. One with chest in drawing and the other had diarrhea. The following questions apply: 49. Using Integrated Management and Childhood Illness (IMCI) approach, how would you classify the 1 st child? A. B. Bronchopneumonia Severe pneumonia C. Pneumonia D. No pneumonia cough or cold

50. The child who is 13 months has fast breathing using IMCI approach, how would you classify the 1 st child A. B. 40 breath per minute or more 50 minutes per breath C. 30 breaths per minute or more D. 60 breaths per minute

51. Joseph, the 2nd child has a diarrhea for 5 days. There is no blood in stool. He is irritable and his eyes are sunken. The nurse offered fluids and the child drinks eagerly. How would you classify Joseph illness? A. Some dehydration B. Dysentery C. Severe dehydration D. No dehydration

52. Joseph treatment should include the following EXCEPT: A. B. C. D. Give in the health center the recommended amount of ORS for 4 hours. Do not give any other foods to the child for home treatment Reassess the child and classify him for dehydration For infants under 8 months old who are not breastfed, give 100-200ml clean water as well during this period.

53. While o treatment, Joseph 18 months old weight 18 kgs and her temperature registered at 37 DC. His mother says he develop cough 3 days ago. Joseph has no general danger signs. He has 45 breaths per minute, no chest in-drawing, no stridor. How would you classify Joseph manifestation? A. No pneumonia B. Severe pneumonia C. Pneumonia D. Bronchopneumonia

SITUATION: There are other important basic knowledge in the performance of our task as Community Health Nurse in relation to immunization these include. 54. The correct temperature to store vaccines in a refrigerator is:

A. B.

Between -4 deg and +8 deg C Between 2 deg and +8 deg C

C. Between -8 deg and 0 deg C D. Between -8 deg and +4 deg C

55. Which of the following vaccine is not done by intramuscular (IM) injection? A. Measles vaccine B. DPT C. Hepatitis B vaccine D. Tetanus toxoids

56. This vaccines content derived from RNA recombinants. A. Measles vaccine B. DPT C. Hepatitis B vaccine D. Tetanus toxoids

57. This is the vaccine needed before a child reaches (1) year in order for him/her to quality as a Fully Immunized Child. A. 58. DPT B. Measles vaccine C. Hepatitis B D. BCG

Which of the following dose of tetanus toxoid is given to the mother to p[rotect her infant from neonatal tetanus and likewise provide 1o years protection for the mother? A. Tetanus toxoid 3 B. Tetanus toxoid 2 C. Tetanus toxoid 4 D. Tetanus toxoid 1

59. The nurses instruct the caregivers of a newborn to notch the dipers or fold them in such a way as to expose the cord. The major purpose of exposing the cord is to: A. B. Remind caregivers to do cord care Keep the diaper from rubbing the cord C. Provide air circulation for the cord D. Allow visualization.

60. The level of health of an individual, family group population or community is called? A. Health assets B. Health status C. Quality of life D. Health needs

61. The nurse is teaching a group of expectant mothers about the prevention of diaper dermatitis. The nurse explain that one of the preventive measures is the use of: A. B. Absorbent disposable diaper Baby powder or cornstarch C. Plastic panties over diaper D. Cloth diaper

62. The code of nurses. A. B. C. D. Delineates all obligations and responsibilities Is a binding oath, which tells nurses how to make ethical decision Assists the nurse in formulating a person belief system Supports the concept of respect for all persons.

63. The obligation to correctly perform ones assigned duties is: A. Delegation B. Assignment C. Responsibility D. Accountability

SITUATION: You are working as a Pediatric Nurse in your own Child Health Nursing Clinic. The following cases pertain to ASSESSMENT AND CARE OF THE NEWBORN AT RISK conditions. 64. Arlene, a mother with a 2 year old daughter ask, at what age can I be able to take the blood pressure of my daughter as a routine procedure since hypertension is common in the family? Your answer to this is: A. B. When shes 3 years old As early as 1 year old C. at 10 years old you may D. when shes 6 years old

65. Baby Jean was given a drug at birth to reverse the effects of a narcotic given this mother in labor. What drug is commonly used for this? A. Naloxone (Narcan) B. Morphine sulfate C. Sodium Chloride D. Penicillin

66. Why are small-for-gestational age newborns at risks for difficult maintaining body temperature? A. B. C. D. They do not have as many fats stores as other infants They are more active than usual so throw off covers Their skin is more susceptible to conduction of cold They are preterm so are born relatively small in size

67. Baby Jean develops hyper bilirubinemia. What is a method used to treat hyper bilibrubinemia in a new born? A. B. C. D. Keeping infants in a warm and dark environment Administration of cardiovascular stimulant Gentle exercise to stop muscle breakdown Early feeding to speed passage of meconium.

68. The nurse manager wishes to implement a new way of determining the vacation schedule for the staff. The senior staff opposes the change while the new staff seems more accepting of the change. An effective strategy for resolving this differences in acceptance would be to: A. B. C. D. Explain that the change will occur as designed regardless of the staffs preference Tell the staff that if they really do not want the changes, it will not be implemented. Provide extensive and detailed rationale for the proposed changes Encourage each side to share their view with each other.

69. The following are the duties of the Public Health Nurse EXCEPT: A. B. C. D. Provision of nursing care to the sick and well individuals Provision of technical and administrative support to rural health midwives Leave to the BHW the responsibilities of educating the community Conduct of pre and past consultation conference for clinic patients

70. An 8 months old baby has fast breathing if he has? A. 40 breath per min B. 55 breath per min. C. 38 breath per min. D. 45 breath per min.

71. The following are the concerns of the Public Health Nurse on the third trimester of pregnancy, EXCEPT: A. B. Advice for the mother to take oral contraceptive Proper timing in the separation of mother to other siblings C. Type of feeding D. Where to give birth

72. When a child with persistent diarrhea returns for follow-up after 5 days, the nurse should ask the mother if the diarrhea has stop when: A. B. The child has less than 3 loose bowels per day The child has 4 semi formed stool C. The child has 5 formed stools D. The child has 3 loose stools / day

73. Barangay Mayamot, one of the identified problems in unavailability of toilet facility for the resident. The appropriate intervention is: A. B. Secure donations in the form of toilet bowls C. ask help from the local government Conduct a community assembly, discuss the problem D. None of the above

74. A home visit is a professional interaction between the community health nurse and his patient or the family. Where could the nurse get available information about the patient or the family to be visited? A. Documents file B. Records and reports C. Doctors file D. Family health record

75. In planning a home visit, the nurse considers the individual needs. Which of the following is priority? A. B. Follow-up of medication & treatment Clinic schedules after home visit C. Needs recognized by the family D. Needs of family member

76. Which of the following is the FIRST action of the nurse during a home visit: A. B. Greet the client or the household member Inquire about the health condition of the client C. State the purpose or objective of visit D. Give necessary health teaching.

77. Which factor must be considered by the nurse as vital to determine the frequency of home visit? A. B. Available resources Acceptance of the family C. Policy of the agency D. Past nursing services

SITUATION: In the toddler period, enormous changes take place in a child and consequently, in a family. As a nurse, we must support the childs growing independence with patience and sensitivity, and learn methods of handing the childs frustrations that arise from the quest, for autonomy the following questions are about the care of the toddler patient. 78. Which assessment finding is an early sign of hearth failure in toddler? A. B. Increased respiratory rate Decreased weight C. Increased urine output D. decreased heart rate

79. The physician prescribes digoxin (Lanoxin) elixir for a toddler with heart failure, immediately before administering this drug, the nurse must check the toddlers: A. Serum sodium level B. Urine output C. Weight D. Apical pulse

80. A 2-year-old child with a low blood level of the immunosuppressive drug cyclosporine comes to a liver transplant clinic, for her appointment. The mother says the child hast been vomiting and hasnt had diarrhea, but she admit that her child doest like taking the liquid medication. Based on knowledge of the drug, which of the following would the nurse instruct the mother to do? A. B. C. D. Let your child take her medication only when she wants it, she miss some doses Offer the medication diluted with regular milk, chocolate or juice to make it more palatable Insert a nasogastric (NG) tube and administer the medication using the tube Give the ordered dose a little bit at time over 2 hours to ensure administration of the drug.

81. A toddler is hospitalized with multiple injuries. Although the parent states that the child fell down the stairs, the childs history and physical findings suggest abuse as the cause of the injuries. What should the nurse do first? A. B. C. D. Refer the parent to a support group such as Parents Anonymous. Report the incident to the proper authorities Prepare the child for poster care placement Restrict the parent from the childs room

82. The mother of a hospitalized 3-year-old child, expresses concern because her child is wetting the bed. What should the nurse tell her? A. B. C. D. Its common for a child to exhibit regressive behavior when anxious or stressed Your child is probably angry about being hospitalized. This is her way acting out Dont worry, its common for a 3-year-old child to not be fully toilet-trained The nurses probably havent been answering the call button soon enough

83. A 2-year-old child is brought to the emergency department with a history of upper airway-infection, has worsened over the last 2 days. The nurse suspects the child has croup: Signs of croup include a hoarse voice inspiratory stridor and: A. Barking cough B. High fever C. Sudden onset D. Dysphagia

84. A toddler with bacterial meningitis is admitted to the inpatient unit. Which infection control measure should the nurse be prepared to use? A. Reverse isolation B. Strict hand washing C. Standard precaution D. Respiratory isolation

85. An 18 month old male child is admitted to the pediatric unit with a diagnosis of celiac disease. What finding would the nurse expect in this child? A. B. Concave abdomen A protuberant abdomen C. Bulges in the groin area D. A. Palpable abdominal mass

86. A toddler with a ventricular septal defect (VSD) is receiving digoxin (lanoxin) to treat heart failure. The nurse should monitor the child for early signs of digoxin toxicity, which includes: A. Bradycardia B. Tachycardia C. hypertension D. Hyperactivity

87. For a child with a circumferential chest bum, what is the most important factor for the nurse to asses? A. Breathing pattern B. Heart rate C. Body temperature D. Wound characteristics

SITUATION: Mrs. Karen Guevarra is asking questions during labor and deliver.

88. Karen didnt recognize for over an hour that she was in labor. A sign of true labor is: A. B. C. D. Sudden increase energy from epinephrine release Nagging but constant pain in the lower back Urinary urgency from increased bladder pressure Show or release of the cervical mucus plug

89. Karen asks you which fetal position and presentation are ideal. Your best answer would be: A. B. C. D. Right Occipito-anterior with full flexion Left transverse anterior in moderate flexion Right occipitoposterior with no flexion Left sacroanterior with full flexion

90. Karen is having long and hard uterine contraction. What length of contraction would you report as abnormal? A. B. Any length over 30 seconds C. A contraction that peaks at 20 seconds A contraction over 70 seconds in length D. A contraction shorter than 60 seconds

91. You assess Mrs. Karen uterine contraction. In relation to the contraction, when does a late deceleration begin? A. B. 45 seconds after the contraction is over C. After every 10th or more contraction 30 seconds after the start of a contraction D. After a typical contraction ends

92. Mrs. Karen has an amniotomy. After this procedure, which of the following would be an important nursing assessment? A. B. C. D. Ask her if her pain level is tolerable post procedure Assess maternal heart rat to detect possible bleeding Assess fetal heart rate to detect possible cord prolapsed Document the amount of amniotic fluid that has been lost

SITUATION: Carol is a client in labor.

93. Carol asks you what is the purpose of a doula in labor. Your best answer is would be: A. B. C. D. She times contractions and keeps them from becoming too lengthy She can cook for a woman in labor to keep her from becoming dehydrated She can serve as a support person and coach during labor She replaces the husband as a womans support person

94. Carol asks you if she could use warm water for tub bathing during labor. Your best answer would be: A. B. C. D. No, no one is allowed to tub bath during labor Yes , as long as her membranes are not ruptured No, because warm water can diminish labor contractions Yes, as long as the warm water doesnt raise her temperature

95. Carol chooses to have epidural anesthesia. What are the two risks associated with this? A. B. C. D. Hypotension and prolonged second stage of labor Severe headache and coldness of all extremities Hypertension and a reduced red blood cell count Continued back pain and short stage of labor

96. There is no reason to think that Carol will need a general anesthetic. If she did, what type of drug is usually prescribed to minimize the risk of aspirant of vomitus? A. B. C. D. Oxytocins to increase the effectiveness of labor A nerve relaxant such as Phenobarbital An anticonvulsant such as diazepam (Valium) Metaclopramide (Reglan) to speed gastric emptying.

97. Carol reports in early labor, she isnt having much pain. You assess that her contractions are also not strong. What position usually promotes efficient uterine contractions in any labor? A. Sitting or standing B. Lying supine C. Lying prone D. Side lying position

98. It is malformation caused by an overgrowth of the neutral tube in weeks 16-20 of fetal life. A. Arnold chiari detormiti B. Anencephaly C. Spina bifida occulta D. Pectus excavatum

99. NARS trainees are ought to receive a monthly allowance of how much during her training period? A. 8 thousand B. 10 thousand C. 12 thousand D. 15 thousand

100. A.

Who is the chairman of the Municipal Health Board? Public Health Nurse B. Municipal Health Officer C. Any qualified physician D. May

SUBMIT THIS TEST BOOKLET TOGETHER WITH THE ANSWER SHEET TO YOUR WATCHERS. BRINGING THE TEST BOOKLET OUT OF THE ROOM WILL BE A GROUND FOR CANCELLATION OF YOUR EXAMINATION. ***END*** NURSING PRACTICE III Care of Clients with Physiologic and Psychosocial Alterations (Part A) GENERAL INSTRUCTIONS: 9. 10. 11. 12. This test booklet contains 100 test questions Read INSTRUCTIONS TO EXAMINESS printed on your answer sheet. Shade only one (1) box for each question on your answer sheets. Two or more boxes shaded will invalidate your answer. AVOID ERASURES.

INSTRUCTIONS: 7. 8. 9. Detach one (1) answer sheet from the bottom of your Examinee ID/Answer Sheet Set. Write the subject title Nursing Practice III on the box provided. Shade Set Box A on your answer sheet if your test booklet is Set A; Set Box B if your test booklet is Set B.

SITUATION: As a nurse researcher, you must have a very good understanding of the common terms of concept used in research. 1. The information that a investigator collects form the subjects or participants in a research study is usually called?

A. Data

B. Hypothesis

C. Variable

D. Concept

2. Which of the following usually refers to the independent variables in doing research? A. Results B. Output C. Effect D. Cause

3. The recipients of experimental treatment is an experimental design of the individuals to be observed in a non-experimental design are called: A. Setting B. Treatment C. Subject D. Sample

4. The device or technique an investigator employs to collect data is called: A. Sample B. Hypothesis C. Instrument D. Concept

SITUATION: A computer analyst, Mr. Mario Herrera, 26 was brought to the hospital for diagnostic workup after he had experienced seizure in his office. 5. Just as the nurse was entering the room, the patient who was sitting on his chair begins to have seizure. Which of the following must the nurse do first? A. Insert a padded tongue depressor between his jaws C. Ease the patient to the floor B. Lift the patient and put him on bed D. Restraint patients body movement 6. Mr. Herrera is scheduled for CT SCAN for the next day, noon time. Which of the following is the correct preparation as instructed by the nurse? A. B. C. D. Shampoo hair thoroughly to remove oil and dirt Insert a padded tongue depressor between his jaws Shave scalp and securely attach electrodes to it. No special preparation is needed. Instruct the patient to keep his head still and steady.

7. Mr. Herrera is placed on seizure precaution. Which of the following would be contraindicated? A. Allow him to wear his own clothing B. Encourage to perform his own personal hygiene C. Obtain his oral temperature D. Encourage him to be out of bed

8. Usually, how does the patient behave after his seizure has subsided? A. Sleeps for a period of time B. Becomes restless and agitated C. Most comfortable walking and moving about D. Say he is thirsty and hungry

9. Before and after seizure. The nurse knows that the patient is ALWAYS placed in what position? A. Low fowlers B. Side lying C. Modified trendelenburg D. Supine

SITUATION: Mrs. Karla Manahan an immediate post-op cholecystectomy and choledocholithotomy patient complained of severe pain at the wound site. 10. Choledocholithotomy is: A. The removal of the stones in the common bile duct B. The removal of the stones in the gallbladder C. The removal of the gallbladder D. The removal of the stones in the kidney 11. The simplest pain relieving technique is: A. Distraction B. Taking aspirin C. Positioning D. Deep breathing exercise

12. Which of the following statement on pain is TRUE? A. Culture and pain are not associated B. Pain accompanies acute illness C. Patients reaction to pain varies D. Pain procedures the same reaction such as groaning and moaning. 13. Which of the following condition is a more reliable indicator? A. Pain rating scale of 1 to 10 C. Physiological responses B. Facial expression and gestures D. Patients description of the pain sensation SITUATION: You are assigned at the surgical ward and clients have been complaining of post pain at varying degrees. Pain as you know, is very subjective. 14. A one day postoperative abdominal surgery client has been complaining of severe throbbing abdominal pain described as 9 in a 1-10 pain rating. Your assessment reveals bowel sounds on all quadrants and the dressing is dry and intact. What nursing intervention would you take? A. Encourage deep breathing and turning B. Encourage client to do imagery C. Medicate client as prescribed D. Call surgeon stat

15. Petoxidone 5mg IV every 8 hours was prescribed for post abdominal pain. Which will be your priority nursing action? A. Check abdominal dressing for possible swelling B. Explain the proper use of PCA to alleviate anxiety C. Medicate client as prescribed D. Call surgeon stat

16. The client complained of abdominal distention and pain. Your nursing intervention that can alleviate pain is: A. Instruct client to sleep and relax B. Turn to sides frequently and avoid too much talking C. Advice the client to close the lips and avoid deep breathing and talking D. Offer hot and clear soup. 17. Surgical Pain might be minimized by which nursing action in the OR A. Skill of surgical team and lesser manipulation B. Appropriate preparation of the scheduled procedure C. Use of modern technology in closing the would D. Proper positioning and draping of clients. 18. Inadequate anesthesia is said to be one of the common cause of the pain both in intra and post-op patients. If general anesthesia is desired, it will involve loss of consciousness. Which of the following are the 2 general types of GA? A. Epidural and Spinal B. Subarachnoid block and Intravenous C. Inhalation and Regional D. Intravenous and inhalation

SITUATION: Mrs. Maria de Luna is admitted to your ward. The MD ordered Prepare for thoracentesis this pm to remove excess air from the pleural cavity. 19. Which of the following nursing responsibilities is essential in Mrs. Michelle Ocampo who will undergo thoracentesis? A. Support and reassure client during the procedure B. Ascertain if chest x-rays and other tests have been prescribed and completed C. Ensure that informed consent has been signed D. Determine if client has allergic reaction to local anesthesia 20. Mrs. Maria de Luna who is for thoracentesis is assigned by the nurse to which of the following positions? A. Trendelenburg position C. Dorsal Recumbent position

B. Supine position

D. Orthopneic position

21. During thoracentesis, which of the following nursing intervention will be most crucial? A. Advice patient to sit perfectly still during needle insertion until it has been withdrawn B. Place patient in a quiet and cool room. C. Maintain strict aseptic technique D. Apply pressure over the puncture site as soon as the needle is withdrawn.

22. To prevent leakage of fluid in the thoracic cavity, how will you position the client after thoracentesis? A. Place flat in bed B. On bed rest C. Turn on the affected side D. Turn on the unaffected side

23. Chest x-ray was ordered after thoracentesis. When your client asks what the reason for another chest x-ray is, you will explain; A. To decongest B. To rule out any possible perforation C. To rule out pneumothorax D. To rule out any foreign body

SITUATION: Nurses attitudes toward the pain influence the way they perceive and interact with clients in pain. 24. Nurses should be aware that older adults are at risk of underrated pain. Nursing assessment and management of pain should address the following belief EXCEPT? A. Older patients seldom tend to report pain than the younger ones B. Older patients do not believe in analgesics, they are tolerant C. Pain is a sign of weakness D. Complaining of pain will lead to being labeled a bad patient. 25. Nurses should understand that when a client responds favorably to a placebo, it is known as the placebo effect. Placebos do not indicate whether or not a client has: A. Conscience B. Disease C. Real pain D. Drug tolerance

26. You are the nurse in the pain clinic where you have a client who has difficulty specifying the location of pain. How can you assist such client? A. The pain is vague B. By charting it hurts all over C. Identify the absence and presence of pain D. As the client to point to the painful are by just one finger

27. What symptom more distressing than pain, should the nurse monitor when giving opioids especially among elderly clients who are in pain? A. Allergic reactions like purities B. Forgetfulness C. Identify the absence & presence of pain D. As the client to point the painful just one finger

28. Physical dependence occurs in anyone who takes opioids over a period of time. What do you tell a mother of a dependent| when asked for advised? A. Start another drug and slowly lessen the opioid dosage B. Indulge in recreational outdoor activities C. Isolate opioid dependent to a restful resort D. Instruct slow tapering of the drug dosage and alleviate physical withdrawal symptoms. SITUATION: Elderly clients usually produce unusual signs, when it comes to different diseases. The ageing process is a complicated process and the nurse should understand that it is an inevitable fact and she must be prepared to care for the growing elderly population. 29. Hypoxie may occur in the older patients because of which of the following physiologic changes associated with aging?

A. Ineffective airway clearance B. Decreased alveolar surface area

C. Decreased anterior-posterior chest diameter D. Hyperventilation

30. The older patient is at higher risk for incontinence because of: A. Dilated urethra B. Increased glomerular filtration rate C. Diuretic use D. Decreased bladder capacity

31. Thomas age 86 is complaining of dizziness when he stands up. This indicates: A. Dementia B. Visual problem C. Functional decline D. Drug toxicity

32. Cardiac ischemia in an older patient usually produces: A. ST-T waive changes B. Very high Creatinine kinase level 33. The most dependable sign of infection in the older patient is: A. Change in mental status B. Fever C. Pain D. Decreased breath sounds with crackles C. Chest pain radiating to the left arm D. Acute confusion

SITUATION: IN the OR, there are safety protocols that should be followed. The OR nurse should be well versed with all these to safeguard the safety and quality of patient delivery outcome. 34. Which of the following should be given highest priority when receiving patient in the OR? A. Asses level of consciousness B. Verify patient identification and informed consent C. Assess vital signs D. Check for jewelry, gown, manicure and dentures 35. Surgeries like I and D (incision and drainage) and debridement are relatively short procedures but considered dirty cases. When these procedures are best scheduled? A. Last case B. In between cases C. According to availability of anesthesiologist D. According to the surgeons preference

36. OR nurses should be aware that maintaining the clients safety the overall goal of nursing care during the intra-operative phase. As the circulating nurse you make certain that throughout the procedure. A. The surgeon greets his client before induction of anesthesia B. The surgeon and anesthesiologist are in tandem C. Strap made of strong non-abrasive materials are fastened secure around the joints of the knee and ankles and around the 2 hand around the arm board. D. Client is monitored throughout the surgery by the assistant anesthesiologist 37. Another nursing check that should not be missed before the induction of general anesthesia is: A. Check for presence underwear B. Check of presence dentures C. Check patients ID D. Check baseline vital signs

38. Some lifetime habits and hobbies affect postoperative respiratory function of general anesthesia is: A. Perioperative anxiety and stress B. Delayed coagulation time C. Delayed wound healing D. Postoperative respiratory infection

SITUATION: Sterilization is the process of removing ALL living microorganism. To be free of ALL living microorganism is sterility.

39. Some lifetime habits and hobbies affect postoperative respiratory function of general anesthesia is: A. Steam sterilization B. Physical sterilization C. Chemical sterilization D. Sterilization by boiling

40. Autoclave or steam under pressure is the most common method of sterilization in the hospital. The nurse knows that the temperature and time is set to the optimum level to destroy not only the microorganism, but also the spores. Which of the following is the ideal setting of the autoclave machine? A. 10,000 degree Celsius for 1 hour B. 5,000 degree Celsius for 30 minutes C. 37 degree Celsius for 15 minutes D. 121 degree Celsius for 15 minutes

41. It is important that before a nurse prepares the material to be sterilized. A chemical indicator strip should be plated above the package, preferably, Muslin sheet. What is the color of the striped produced after autoclaving? A. Blue B. Black C. Gray D. Purple

42. If a nurse will sterilized a heat and moisture labile instruments. It is according to APRN recommendation to use which of the following method of sterilization? A. Autoclaving B. Flash sterilizer C. Alcohol immersion D. Ethylene oxide gas

43. A client is to undergo an exploratory laparotomy for vague abdominal discomforts that has led to abdominal rigidity and severe pain. As the surgeon opens the clients abdomen, which of the following instruments should the nurse anticipate the surgeon to be use? A. Mixtner B. Kelly C. Kocher D. Army navy

44. Surgical closure of the skin surfaces usually involves the use of which type of needle? A. Straight B. Curved C. Rounded D. Eye Less

45. Following cataract surgery, which aspect of nursing care is the highest priority of the nurse? A. Nutrition B. Airway C. Safety D. Fluids

46. To facilitate drainage of secretions from the operative site, the nurse should: A. Turn the client to the unoperative side every 2-3 hours B. Turn the client to the operative side every 2-3 hours C. Keep the client supine until the wound is healed D. Place the client on semi-fowlers position at least once during every shift. SITUATION: Nurses hold variety of roles when providing care to a preoperative patient. 47. Which of the following role would be the responsibility of the scrub nurses? A. Assess the readiness of the client prior to surgery B. Ensure that the airway is adequate C. Evaluate the type of anesthesia appropriate for the surgical client. D. Account for the number of sponges, needles, supplies used during the surgical procedure 48. As a preoperative nurse, how can you best meet the safety need of the client after administering preoperative narcotic? A. Send the client to OR with the family B. Obtain the consent form C. Allow client to get up to go to the comfort room D. Put side rails up and ask the client to get out of bed

49. It is 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

50. It is also the nurses function to determine when infection is developing in the surgical incision. The perioperative nurse should observe for what signs of impending infection? A. Blood clots and scar tissue are visible B. Serosanguinois exudates and skin bleaching C. Localized heat and redness D. Separation of the incision

51. Which of the following nursing interventions is done when examining the incision would and changing the dressing? A. Get patients consent C. Request the client to expose the incision wound B. Wash hands D. Observed the dressing and type of odor of drainage SITUATION: The preoperative nurse collaborates with the client significant others, and healthcare providers. 52. To control environmental hazards in the OR, the nurse collaborates with the following departments, EXCEPT: A. Chaplaincy services B. Biomedical department C. Pathology department D. Infection control communities

53. An air crash occurred near the hospital leading to a surge of trauma patients. One of the last patients will need surgical amputation but three are no sterile surgical equipments. In this case, which of the following will the nurse expect? A. Forwarding the trauma client to the nearest hospital that has available sterile equipments is appropriate. B. The nurse will need to sterilize the item before using it to the client using the regular sterilization setting of 121 degree Celsius in 15 minutes C. In such cases, flash sterilize will be use at 132 degree Celsius in 3 minutes D. Equipment needed for surgery not be sterilize if this is an emergency necessitating life saving measures 54. Carlo, the PACU nurse, discovered that Jack, who weight 110 lbs. prior to surgery, is in severe pain in 3 hours after cholystectomy. Upon checking the chart, Jack found out that he has an order of Demerol 100 mg IM pm to pain, Carlo should verify the order with: A. Surgeon B. Intern on duty C. Anesthesiology D. Nurse supervisor

55. Nolan, 57 who diabetic is for debridement if incision wound. When the circulating nurse checked the present IV fluid, she found out that there is no insulin incorporated as ordered. What should the circulating nurse do? A. Communicate with the client to verify if insulin was incorporate B. Communicate with the ward nurse to verify if insulin was incorporated C. Incorporate insulin as ordered D. Double check the doctors order and call the attending physician 56. The documentation of all nursing activities performed is legally and professionally vital. Which of the following should NOT be included in the patients chart? A. Baseline physical, emotional and psychological B. Arguments between nurses and residents regarding treatments C. Presence of prosthetoid devices such as dentures, artificial limb, hearing aids, etc. D. Observed untoward signs, symptom and intervention including contaminant factors. SITUATION: Team effort is best demonstrated in the OR. 57. 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 anesthesiologist? B. Who is your internist? C. Who is your assistant and anesthesiologist, what is your preferred time and type of surgery D. Who are your anesthesiologist, internist and assistant. 58. While team efforts are 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, assistant, scrub, nurse, circulating nurse, anesthesiologist B. Surgeon, anesthesiologist, scrub nurse, radiologist, orderly C. Surgeon, assistant surgeon, anesthesiologist, scrub nurse, pathologist D. Surgeon, assistant surgeon, anesthesiologist, scrub nurse 59. In the OR, the nursing tandem for every surgery is: . A. Instrument technician and circulating Nurse B. Scrub nurse and nurse anesthetist C. Scrub and circulating nurse D. Nurse anesthetist, assistant and technician

60. Who usually act as an important part of the OR personnel be getting the wheelchair or stretcher, and pushing/pulling them towards the operating room? A. Orderly/clerk B. Nurse supervisor C. Circulating nurse D. Anesthesiologist

61. The breakdown in teamwork is open times a failure in: A. Electricity B. Leg work C. Communication D. Inadequate supply

SITUATION: Basic knowledge on intravenous solution is necessary to care of clients with problems with fluids and electrolytes. 62. A client involved in a motor vehicle crash presents to the emergency department with severe internal bleeding. The client is severely hypotensive and unresponsive. The nurse anticipates which of the following intravenous solutions will most likely be prescribed to increase intravenous intravascular volume, replace immediate blood and increase blood pressure? A. Normal saline solution B. 0.45% sodium chloride C. 0.33% sodium chloride D. Lactated Ringers solution

63. The physician orders the nurse to prepare an isotonic solution. Which of the following IV solution would the nurse expect the intern to prescribe? A. 5% dextrose in 0.95 sodium chloride B. 0.45% sodium chloride B. 10% dextrose in water D. 5% dextrose in water

64. The nurse is making initial rounds on the nursing unit to assess the condition of assigned clients. The nurse notes that the clients IV site is cool, pale and swollen and the solution is not infusing. The nurse concludes that the following complication has been experienced by the client? A. Infection phlebitis C. Infiltration D. Thrombophlebitis

65. A nurse reviews the clients electrolyte laboratory report, notes that the potassium level is 3.2mEq/L. Which of the following would the nurse note on electrocardiogram as a result of the Lab? A. Elevated ST segment B. Elevated T waves C. Absent P waves D. U waves

66. One patient had a runaway IV or 50% dextrose. To prevent temporary excess of insulin or transient hyper-insulin reaction, what solution you prepare in anticipation of the doctors order? A. Isotonic solution B. Hypertonic solution C. Hypotonic solution D. Any IV solution available

67. An informed consent is required for: A. Insertion of intravenous catheter C. Urethral catheterization B. Irrigation of the external ear canal D. Closed reduction of a fracture 68. Which of the following is not true with regards to the informed consent? A. It should described the clients diagnosis B. It should give an explanation of the clients prognosis C. It should describe different treatment alternative D. It should contain a thorough and detailed explanation of the procedure to be done 69. You know that the hallmark of nursing accountability is the: A. Reporting a medication error B. Filling an incident report C. admitting your mistakes D. Accurate documentation and reporting

70. A nurse is assigned to care for a group of clients. On review of the client a medical records, the nurse determines that which client is at risk for excess fluid volume? A. The client taking diuretics B. The client with renal failure C. The client with an Ileostomy D. A client requires gastrointestinal suctioning

71. A nurse assigned to care for a group of clients. On review of the client medical records, the nurse determines that which client is at risk for deficient fluid volume? A. A client with decrease kidney function B. A client with colostomy C. A client with congestive heart failure D. A. client receiving frequent wound irrigation

SITUATION: As a preoperative nurse, you are aware of the correct processing methods for preparing instruments and other devices for patient use to prevent infection. 72. As an OR nurse, what are your foremost considerations for selecting chemical agents for disinfection? A. Duration of disinfection and efficiency B. Material compatibility and efficiency C. Odor and availability D. Cost and duration of disinfection process

73. Before you use a disinfectant instrument it is essential that you: A. Wrap the instrument with sterile water B. Rinse with tap water followed by alcohol C. Rinse with sterile water D. Dry the instrument thoroughly

74. You have a critical heat labile instrument to sterilize and are considering using high level disinfectant. What should you do? A. High level disinfectants immersion in 10 hours B. Low level disinfectants immersion in 24 hours C. Intermediate level disinfectant immersion in 12 hours D. High level disinfectants immersion in 1 hour 75. Bronchoscopy, thermometer, endoscope, ET tube, cytoscope are all BEST sterilized using which of the following: A. Flash sterilized at 132 degree Celsius in 3 minutes B. Ethylene oxide gas aeration for 20 hours C. 2% Glutaraldehyde immersion for 10 hours D. Autoclaving at 121 degree Celsius in 15 minutes SITUATION: The OR is divided into three zones to control traffic flow and contamination.

76. Nursing intervention for a patient on low dose IV insulin therapy includes the following EXCEPT: A. Elevation of blood glucose levels B. Eliminate serum potassium C. Vital sign including BP D. Elevation of serum ketones to monitor kelosis

77. The doctor ordered to incorporate 1000u insulin to the remaining on going IV. The strength is 500/ml. How much should you incorporate into the IV solution. A. 10 ml B. 2 ml C. 0.5 ml D. 5 ml

78. Multiple vial-dose-insulin when in use should be: A. Store in the freezer B. Keep I narcotic cabinet C. Keep at room temperature D. Keep in the refrigerator

79. Insulin, using insulin syringe is given, using how many degrees of needle insertion? A. 180 B. 45 C. 90 D. 15

80. All this factor effect the sterility of the OR equipment, there are the following EXCEPT: A. The material used for packaging B. Storage 81. When you say sterile, it means: A. The material as well as the equipment are sterilize B. The materials is clean C. There is a black stripe on the paper indicator D. The material has no micro organism nor spores 82. All this factors affect the sterility of the OR equipments, these are the following EXCEPT: A .Autoclave is better in sterilizing OR supplies versus liquid sterilizer B. They are both capable of sterilizing the equipment C. Sharps are sterilized using autoclave and noticidex D. If liquid sterilizer is used, rinsing it before using SITUATION: Alfredo lives in the squatter area. He goes to nearby school. He helps his mother gather molasses after school. One day, he was absent because of fever, malaise, anorexia and abdominal discomfort. 83. Upon assessment, Alfredo was diagnosed to have hepatitis A. which mode of transmission has the infection agent taken? A. Fecal oral B. Droplet C. Airborne D. Sexual contact C. The handling of the materials as well as its transport D. The chemical or process used in sterilizing the materials

84. Which of the following is concurrent disinfection in the case of Alfredo? A. Sanitary disposal of feces, urine and blood B. Investigation of contact C. Quarantine of the sick individuals D. Removing all detachable objects in the room 85. Which of the following must be emphasized during mothers class to Alejandros mother? A. Administration of immunoglobulin to families C. Use Of attenuated vaccine B. Through hand washing before and after eating D. Boiling of food especially meat 86. What is the average incubation period of hepatitis A. A. 30 days B. 60 days C. 50 days D. 14 days

SITUATION: Diabetes Mellitus is the most common endocrine disorder that accounts for the majority of non-traumatic amputation as well as the third leading cause of death by disease. 87. Which of the following is true with regards to the TYPE 2 diabetes mellitus? A. Ketosis is common B. Onset is usually at early 20s C. Usually thin at diagnosis with recent weight loss D. There is no islet cells antibodies.

88. Who among the following has the highest risk in acquiring diabetes mellitus? A. An old man, 58 year old with a BMI of 30 B. Paulo, 19 year old African American C. An old man, 62 year old with a diabetic mother D. Mr. Santos, with a diabetic mother and sister

89. The primary treatment in clients with Type 1 DM is: A. Weight loss B. OHA C. Insulin D. Exercise

SITUATION: Darren, 19 years old, comes to the ER with acute asthmatic attack. RR is 46/mm and appears to be in acute respiratory distress. 90. Which of the following nursing action should be initiated first? A. Administer oxygen at 6L/min C. Administer bronco dilatory by nebulizer B. Suction the client every 30 min D. Promote emotional support 91. Amino phylline was ordered for acute asthmatic attack. The mother asked the nurse, what it is indication, the nurse will say: A. Prevent thickening of secretions B. Suppress cough C. Promote expectoration D. Relax smooth muscles of the bronchial airway

92. You will give health instruction to Jay, a case of bronchial asthma. The health instruction will include the following, EXCEPT: A. Avoid pollution like smoking B. Practice respiratory isolation C. Avoid pollens, dust and seafood D. Avoid emotional stress & extreme temperature

SITUATION: Sonny 11 year old has kissing tonsils and is scheduled for tonsillectomy or T and A. 93. Sonny 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. Offer soft foods for a week to minimize discomfort while swallowing B. Supplement his diet with vitamin C rich juices to enhance healing C. Offer clear liquid for 3 days to prevent irritation D. Offer osterized feeding 94. You are the nurse of Sonny who will undergo T and A in the morning. His mother asked you if Sonny will put to sleep. Your teaching will focus on: A. Anesthesiologists preference B. Spinal anesthesia C. General anesthesia D. Local anesthesia

95. Mothers of children undergoing tonsillectomy and adenoidectomy usually ask what food to prepare and give their children after surgery. You as the nurse will say? A. Balanced diet when fully awake B. Ice cream when fully awake C. Soft diet when fully awake D. Hot soup when awake

SITUATION: Mr. Mike Jimenez, R.N. is assigned to the medical ward. Several clients are admitted for treatment of various conditions.

96. Which of the following characteristics of pain indicates gall bladder disease? A. Right lower quadrant pain with bloody diarrhea B. Right upper quadrant pain that radiates to the shoulder blade C. Lower sterna pain that resembles indigestion D. Left epigastric pain with Cullens sign

97. The hallmark sign for the diagnosis of diabetes mellitus is the presence of: A. Ketonuria B. Acetone odor of breath C. Kussmauls breathing D. Hyperglycemia

SITUATION: Sonny was diagnosed to have chronic renal failure. Hemodialysis is ordered so that an A-V shunt was surgically created. 98. Which of the following action would be of highest priority with regards to the external shunt? A. Instruct the client not to exercise the arm with the shunt B. Avoid taking BP or blood sample from the arm with the shunt C. Change dressing of the shunt D. Hepannize the shunt daily 99. Diet therapy for Sonny, who has acute renal failure, is low protein, low potassium and low sodium. The nutrition instruction should include: A. Encourage client to include raw cucumbers, carrots, cabbage and tomatoes B. Allowing the client cheese, canned foods and other processed food C. Recommended protein of high biologic value like eggs, poultry and lean meat D. Bananas, cantaloupe, orange and other fresh fruits can be included in the diet 100. A renal failure patient was ordered for Creatinine clearance. As the nurse you will collect: A. First morning urine B. Random urine specimen C. 24 hour urine specimen D. 48 hour urine specimen

SUBMIT THIS TEST BOOKLET TOGETHER WITH THE ANSWER SHEET TO YOUR WATCHERS. BRINGING THE TEST BOOKLET OUT OF THE ROOM WILL BE A GROUND FOR CANCELLATION OF YOUR EXAMINATION. ***END*** NURSING PRACTICE IV Care of Clients with Physiologic and Psychosocial Alterations (Part B) GENERAL INSTRUCTIONS: 13. 14. 15. 16. This test booklet contains 100 test questions Read INSTRUCTIONS TO EXAMINESS printed on your answer sheet. Shade only one (1) box for each question on your answer sheets. Two or more boxes shaded will invalidate your answer. AVOID ERASURES.

INSTRUCTIONS: 10. Detach one (1) answer sheet from the bottom of your Examinee ID/Answer Sheet Set. 11. Write the subject title Nursing Practice IV on the box provided. 12. Shade Set Box A on your answer sheet if your test booklet is Set A; Set Box B if your test booklet is Set B.

SITUATION: Mrs. Katie Miranda, 70 years old, asks you about possible problems regarding her elimination, now that she is in the Later stage of her life. 1. Mrs. Miranda has UTI. Which of the following is the correct teaching in UTI? A. B. Advise to eat alkali ash diet Encourage large intake of milk C. Wear cotton underwear D. Wash perineal area from back to front

2. Age-related changes in the heart and blood vessels (loss of their elasticity and their increasing tendency to accumulate cholesterol plaque) can signify reduce circulation to the tissues because: A. B. 3. The blood becomes thicker The heart decreases circulation C. Of the lowering of the blood pressure D. Of the narrowing size of the lumen

A person with limited mobility are more likely to have breathing and circulation problems because: A. B. C. D. The client has diminished bowel activity and may cause constipation Less likely to be thirsty Mucus secretion ambulatory can pool in the lungs & may lead to respiratory infection. Fear of taking cardiac and respiratory drugs

4.

The cardinal symptoms of ALZHEIMERs disease is: A. B. C. D. Inability to transform thoughts into action Problems expressing speech or understanding sounds Significant forgetfulness Inability to recognize objects

5.

In meeting physiological and physical needs of an elderly, the nurse should: 1. 2. 3. 4. 5. A. Keep client ambulatory as long as possible Maintain optimal nutritional/vitamin status Expose to sources of infection Institute safety measures Maintain bowel and bladder elimination 1, 2 B. 3, 4 C. all but 3 D. 4, 5

6. Which of the following factors is NOT modifiable? A. Cigarette smoking B. Behavioral C. Alcohol D. Age

7. The oral health program for older persons by the DOH in 2007 are: A. Gum treatment and relief of pain C. Health instruction and advice C. Oral examination & extraction of un savable tooth D. All of the above

8. Population aging is a demographic phenomenon indicated by a steady increase in the number and proportion of the elderly and a corresponding decline in the proportion of younger age groups. This is due to, EXCEPT: A. An increase in life expectancy B. Fertility reduction brought about by improved socio-economic conditions C. Mortality reduction that are brought by advances is medical care D. In decrease in public awareness regarding health care delivery system 9. The leading cause of mortality and morbidity among older person from DOH 2007 are: A. Infectious and musculoskeletal disease B. Degenerative and communicable disease C. Sexually transmitted infections diseases D. Endocrine and digestive diseases

10. The goals of DOH 2007 are to reduce morbidity and mortality of older persons and improve their quality of life. Strategic Thrusts 2005-2010 are the following: 1. Ensure and redefine the minimum health care package for older person. The package should consist of health services tied up with pre-financed sources of care. 2. Licensing and accreditation requirements, building facilities, equipment and personnel standards appropriate for care older person. 3. Develop community based and institution based models of health care for older people. 4. Encourage supportive care for older persons by building the capacity of human health resources. 5. R.A. 9257 or the Expanded Senior Citizen Act of 2003 Implementation. A. 1 only B. 1 and 3 C. 2 and 4 D. 1, 2, 3, 4, 5

11. Which of the following is NOT included in Essential Health Care Package For Older Persons by DOH 2007? A. Counseling on substance abuse, sexuality and reproductive tract infection B. Provision of total assistance and free medication to a;; elderly C. Adequate nutrition and diet counseling D. Behavioral screening & management of lifestyle related & other degenerative diseases 12. The view that older people withdraw from society is: A. The disengagement theory B. The absence of theory C. The parting theory D. The adios theory

SITUATION: Ensuring safety is one of your most important responsibilities. You will need to provide instructions and information to your clients to prevent complication. 13. Which of the following things in the environment can cause the greatest safety hazard to older person? A. Complete kitchen cleaning B. Soft mechanical diet C. The use of walker and cane D. Partially open door

14. Which of the following colors do older people see BEST? A. Black & white B. Pink & blue C. Red, yellow & orange D. Blue, green & purple

15. The client with CVA is being assessed with Paronychia. Which of the following is a sign of paronychia? A. Glossy, beefy red tongue B. Cold finger nails C. Paresthesia of legs D. Swelling and pus in the nails beds

16. The law passed by congress to help Filipino older persons by giving them discounts to senior citizens on specific goods and services such as medicines, transportation and entertainment is: A. R.A. 7432 B. R.A. 7876 C. R.A. 7610 D. P.D. 825

17. The best activity for the elder person is: A. Picking up and tasting curious objects B. Listening to rock music in L.S. Radio C. Referral to reminiscence group D. Bar hopping in Eastwood

SITUATION: Cancer ranks the 3rd consistency in the ten leading causes of mortality. It is common in all age groups and both sexes with the highest number of deaths among males (Philippine Health Statistic DOH 1999-2003) 18. As a nurse in the oncology unit, you have to be prepared to provide safe, efficient and effective care to your patients. In assessing clients to early signs of cancer, which of the following findings reported to the nurse would indicate a priority to follow-up? A. Lingering cough one week after a cold B. Bowel movement twice a day for the past 5 years C. Mole that has become larger in the past four weeks

D. Monthly breast self-exam 19. Which of the following nursing intervention would be most helpful in preparing the patient for chemotherapy? A. Encourage to take alcohol based mouthwash to promote oral hygiene B. Explore clients feelings about chemotherapy, its therapeutic value and side effects. C. Suggested to change the diet from solid to liquid D. Discuss the cost of the treatment cycle.

20. Which of the following is classified as an alkylating agent? A. Cytoxan (Cyclophospamide) B. Doxorubicin (Adriamycin) C. Tamoxifen (Nolvadex) D. Methotrexate ( Rheumatrex)

21. Nausea and vomiting are common adverse effects of radiation and chemotherapy. When should a nurse administer antiemetics? A. Immediately after nausea begins B. When therapy is completed C. 30 minutes before chemotherapy D. With the administration of chemotherapy

22. Which of the following needs further teaching in client receiving chemotherapy? A. Avoiding crowds and contact sports B. Use of normal saline in buccal mucosa C. Using manual razor D. Minimizing intrusive procedure

23. What side effect to the hair follicies is most apt to occur to patient during chemotherapy? A. Male pattern baldness B. Permanent alopecia C. Temporary alopecia D. Mucositis

SITUATION: Cancer is major public health threat worldwide. It is a killer disease when not detected early and poses burden on patient, families, communities, sectors of the society, and the national development of the country. Every year, 6 million worldwide suffer with cancer pain. Many Filipinos suffer from cancer pain, in spite of the availability of well established, simple and cost effective methods of cancer pain relief. 24. Myrna, 55 years old, who is suspected of having a colorectal cancer, is admitted to the CI. After taking the history of the client you will analyze that the following are risk factors for colorectal cancer, EXCEPT. A. High fat, high intake of beef B. Age between 15-39 C. Genetic factors familiar adenomatous D. Previous colon cancer

25. Symptoms associated with cancer of the colon include: A. Diarrhea, heartburn and eructation B. Blood in stools anemia and pencil-shaped stool C. Constipation, ascites and mucus in the stool D. Anorexia, hematemesis and increased peristalsis SITUATION: Brain tumor, whether malignant or benign, has serious management implications. As a nurse, you should be able to understand the consequences of the disease and treatment> 26. Which of the following activities may increase intracranial pressure(ICP)? A. Manual hyperventilation B. Use of osmotic diuretics C. Valsalvas maneuver D. Raising the head of the bed

27. You are caring for Larry who has a brain tumor and increased intracranial pressure(ICP). Which of the intervention should you in clue in your plan to reduce ICP?

A. Administer bowel softener C. Position with his head turned towards the side of the tumor B. Provide sensory stimulation D. Encourage coughing and deep breathing SITUATION: Lung cancer ranks the highest cancer site among males and breast cancer among females. The highest number of cancer site cases among males is lung cancer while breast cancer for females. 28. According from the research result of the Philippine Cancer Society, the cardinal warning sign of lung cancer or Bronchogenic carcinoma is: A. Hemoptysis B. Smoking C. Night sweats D. Diminishing breath sounds

29. As the age of mans progress, hi is facing a higher risk for the development of Prostate cancer. Which of the following factors is not related with prostate cancer? A. Decrease intake of animal fat B. Family history of cancer C. Age above 65 D. Smoking

30. Juan has also diagnosed with prostate cancer and he will undergo external radiation therapy. External radiation is also known as: A. Radiotherapy B. Brachytherapy C. Teletherapy D. Nuclear therapy

31. Roger has prostate cancer and the treatment modality he has choosen is surgery. He will undergo radical prostatectomy. This procedure is described as: A. A liner accelerator will be applied directly to the tumor cells w/o affecting the healthy cells. B. Removal of prostatic tissue by instrument (resectoscope) introduced through the uretha. C. Removal of the prostate gland through an abdominal incision. D. Removal of the prostate and seminal vesicles. 32. A client with uterine cancer will undergo internal radiation of intracavitary cesium. Which of the following is important for the nurses to remember when utilizing radiation precaution? A. STD- shielding, timing and distance B. AAA- approach, assess and administer C. DDD- drug, diet and diversional activities D. PPP- position, pulse and provide fluids

33. Radiation side effects are cumulating and tend to appear when the total dose exceeds the bodys natural capacity to repair the damage caused by radiation. Radiation enteritis and cystitis are manifested by, EXCEPT: A. Abdominal cramping and dysuria B. Urinary frequency, urgency 34. The symptom of Hodgkins lymphoma is: A. Alternating diarrhea and constipation B. Painless cervical lymph node C. A sore throat that does not heal D. unusual bleeding or discharge C. Constipation and uliguria D. Diarrhea

35. Healthy Lifestyle Promotion is the major intervention to avoid the common risk factors causing the development of the diseases such as cancer. These common risk factors are unhealthy diet and nutrition, physical inactivity, smoking and excessive use of alcohol. Early detection through screening of high risks individual is the primary concern to halt the progress of cancer. The best time to recommend Testicular self examination is: A. After a satisfying sexual intercourse B. Monthly after a warm bath or shower C. As per requested by the nurse D. Every early morning

36. Genetics and advancing age are risks for the development of breast cancer. Which of the following is a cardinal symptom in the breast cancer of an advancing maternal age? A. Dimpling or peau d orange in the breast B. Enlargement of the arecia C. Engorgement of the breast D. Absence of nipple discharge

37. The client with a breast adenocarcinoma will undergo modified radical mastectomy (MRM). Which of the following is correct about the procedure? A. MRM is the surgical removal of one (!) breast B. MRM is the removal of the entire breast, pectoral muscles and axillary muscles. C. MRM is the surgical removal of the entire breast and the axillary lymph nodes D. MRM is the removal of the tumor and surrounding tissues. 38. Which of the following schedule is correct about BSE in menstruating women? A. BSE is performed monthly every morning after a warm bath or shower B. BSE is performed seven days after menstruation C. BSE is performed same date each month D. BSE is performed when there is an urge 39. Which of the following is the recommended exercise after mastectomy? A. Rugby for six consecutive years B. Bunjee jumping continuously C. Arm exercise as prescribed D. Bowling unceasingly

SITUATION: As a nurse you need anticipate the occurrence of complications of stroke so that life threatening situations can be prevented. 40. Baby is admitted to the hospital with signs and symptoms of stroke. Her Glasgow coma scale is six on admission. A central venous catheter was inserted an IV infusion was started. As a nurse assigned to Baby what will be your priority goal? A. Promote urinary elimination B. Prevent skin breakdown C. Maintain a patent airway D. Preserve muscle function

41. Knowing that for a comatose patient hearing is the last sense to be lost as Babys nurse what should you do? A. Speak softly then hold her hands gently C. Tell her family that probably she cant hear them B. Talk loudly so that Baby can hear you D. Tell her family who are in the room not to talk

42. Which among the following intervention should you consider as the highest priority when caring for Baby who has hemiparesis, secondary to stroke? A. Use hand rolls or pillows for support C. Perform range of exercise B. Place baby on an upright lateral position D. Apply anti-embolic stockings 43. When performing a neurologic assessment on client, you find that his pupils are fixed and dilated. This indicated that he: A. Is going to be blind because of trauma B. Probably has meningitis C. Has received a significant brain injury D. Is he permanent paralyzed

SITUATION: Rudy, 18 year old male, is admitted following an automobile accident. He is very anxious, dyspneic, and in severe pain. 44. To ensure that the system function effectively, they should: A. Maintain the client in an extreme lateral position B. Flush the chest tubes with 30 to 60 of NSS every 4 to 6 hours

C. Observe intermittent bubbling in the water seal chamber D. Strip chest tubes in the direction of the client 45. Rudy has had a test tube inserted and connected to water seal drainage. The nurse determines the drainage system is functioning correctly, when which of the following is observed? A. Vesicular breath sound throughout the lung field B. Continuous bubbling in the water sealed chamber C. Fluctuation in the water sealed chamber D. Suction tubing attached to a wall unit 46. He is intubated with an endotracheal tube and placed on a mechanical ventilator (control mode, positive pressure). Which physician finding alerts the nurse to an additional problem in respiratory function? A. Decrease paradoximal motion B. Louder breath sounds on the right C. Dullness of percussion in the 3rd to 5th intercostals space D. None of the above

SITUATION: With the improvement in life expectancies and the emphasis in the quality of life, it is important to provide quality care to our older patients. There are frequently encountered situation and issues relevant to the older patients. 47. Which of the following statements addresses correct information about Gerontology? A. Medical specialist dealing with senior citizens B. Study of all aspects of the aging process and its consequences C. It is the provision of care to elder clients regardless of the clients race D. Is the branch of medicine that focuses on health promotion and prevention, treatment of diseases, disability in later life. 48. The elderly face stress from various situations, which are different from those that are faced by adults. They are at stage in life in where they may face extended and critical health problems. Stress is augmented further by the fact that the ability of the elderly people to face stressful situations weakens over time. A. The nervous and endocrine B. The digestive and cardiovascular C. The urinary and immunologic D. The respiratory and endocrine

49. In making assessment of a depressed elderly, the nurse recognizes which of the following as most notable symptoms of later life depression? A. Fast speech and movement B. Forgetfulness and aphasia C. Continued 8-hour sleep pattern D. Loss of appetite

50. The nurse understands that the clients ability to handle stresses of old age is determined by: A. Number of stresses she experienced during her lifetime B. How well she adapted to changes in earlier years C. Availability of financial support D. Her genetic make up SITUATION: The structure and function of the Nervous system change with advanced age and reduction in cerebral blood flow. The loss of nerve cells contributes to a progressive loss of brain mass and the synthesis and metabolism of the major neurotransmitters are also reduced.

51. Carla, 68 year old is admitted in Medical City with diagnosis of organic brain syndrome. The nurse noticed personality changes and judgment impairment. Which of the following lobes of the brain is the seal for these changes? A. Temporal Lobe B. Parietal Lobe C. Frontal D. Occipital

52. Susan has receptive aphasia. As a nurse in her unit, you will communicate by means of: A. Buttocks movement B. Pantomime C. Request for a professional interpreter D. Wink of an eye

53. John, 73 year old is admitted in a community hospital with complained of difficult of sleeping and awakes at 2 in the morning. To improve clients sleeping pattern, the nurse should put the LAST priority to which of the following nursing measures? A. Increase physical activity in late PM and early evening B. Lessen need to awaken client for medication C. Use if sedatives and anxiolytics D. Limit napping during the day SITUATION: As a nurse you need to anticipate the occuracy of complication of stroke so that the threatening situations can be prevented. 54. Charlene loves to eat Lechon Manok. On his way home, she has develop left sided weakness, slurred speech and inability to recognized family members. She was rushed to Philippine Heart Center. The admitting diagnosis is Cerebrovascular accident. As a nurse assigned to client what will be your priority goal? A. Promote urinary elimination by inserting of foley catheter B. Obtain blood pressure and application of pulse oximetry C. Complete cognitive assessment D. Maintain a patent way 55. Charlene developed dysphagia. Before feeding the client the nurse will check the clients: A. Cranial nerve # 4&6 B. Cranial nerve # 11&12 C. Cranial nerve # 1&2 D. Cranial nerve # 9&10

56. Gary is admitted in PGH with tentative diagnosis of Bacterial Meningitis secondary to Pneumucoccal Pneumonia. The nurse is completing his neurological assessment. The nurse noticed signs of meningeal irritations. Which of the following is expected in Garys meningitis? A. (-) Opisthotonus B. (-) Brudzinski C. (-) Kernigs D. (-) Nuchal rigidity

57. Jerry, 72, is admitted in a nearby General Hospital with a tentative diagnosis of Angina Pectoris. He is complaining of chest pain for several minutes. The nurse is assessing his level of pain. According from the WHO the nurse must assess the ladder of the clients pain scale. Jerry cannot speak. Which of the following assessment should the RN use? A. Ask him the level of his pain from 0-10 B. Call the nurse supervisor to convince Jerry to speak C. Refer to Jerrys wife to assess his pain D. Use face scale or Mr. Grimace 58. Emma, an elderly client in the neurologic unit is being prepared for EEG. The client has hearing difficulty. Which of the following nursing actions can be of help in establishing communications with her? A. Keep interview long and fast B. Enhance lip movement to allow her to use lip reading C. Talk loudly D. Decrease background noise and speak in a low pitched of voice 59. Paul is admitted in the emergency department with neurologic deficits. The nurse is assessing his level of consciousness. The most subtle way in determining the level of consciousness is the: A. Monitoring of VS B. Checking of DTRs C. Use of Glasgow Coma Scale D. Leveling of pain scale

60. Grace, 45 married and has 4 children, was diagnose with diabetes mellitus. Her food and nutritional assessment reveal high fat diet and increase in salt. Her dietary history places her risk of developing hyperglycemia. Which of the following may also results to type II DM. 1. Family history of DM 2. Age above 40 A. 1 and 2 only 3. Incidence of Gestetional DM 4. Obesity B. 1, 2, and 3 C. 1 only D. 1, 2, 3, 4,

61. She asked to increase her dietary fiber. Which of the following is high in fiber? A. Chicken liver and lean meat B. Malunggay and pechay C. Century egg and milk D. Luncheon meat

62. The home care nurse visited Capitan John Para. Capitan John Para had no bowel movement for five days now. Which of the following question can elicit information on Capitan Paras coping ability to deal with his problem? A. What have you done to relieve constipation? B. Have you consulted a doctor for your problem? C. Did you take any constipation pills? D. Do you have problem defecating?

63. As a nurse you should be able to address problems and discomfort experienced by the acutely ill older persons. Expert in the field of pain management have conducted that if pain perception is diminished in the elderly person. It is most likely secondary to a: A. Development process B. Diseases process 64. Which of the following is NOT laxative? A. Lactulose B. Diatabs C. Metamucil D. Dulcolax C. Chronic intake of medication D. Mental process

65. Gerry is your 69 years old patient, who often wears mismatched clothes and suffers from falls. You understand that these are some evidence of related changes in the sense of elderly. The ability to feel differences in temperature is decrease in the elderly because of : A. Illness effect B. Decreases ability of discrimination 66. This is characteristic of aging skin: A. Aging spot or senile lentigo B. Softening of nails C. Improve capillary refill D. Increases vascularity C. Deficient diaphoresis mechanism D. inefficient heat regulating mechanism

67. These most common effect of sensory deprivation is: A. Fall and other accidents B. Malnutrition C. Memory loss D. Fecal impaction

68. Ensuring safety before, during and after a diagnostic procedure is an important responsibility of the nurse especially to elder clients. Gerry has undergone femoral angiogram. Which of the following will be emphasized after the test? A. Early ambulation just after the test to prevent DVT. B. Apply warm compress to the puncture site C. Increase fluids after the test D. Assess apical pulse 69. A theory in aging in which there is a decline in the function of thymus gland as well as decrease in the production of bone marrow is: A. Neuroendocrine theory B. Cross linking theory C. Immune system theory D. Free radical theory

70. An elderly client with dementia Alzheimers type has a decrease of thymus gland as well as decrease in the production of bone marrow is: A. Acetylcholine B. Serotonin C. Acetylcholine D. Gamma amino butyric acid

71. Factors that effect individual aging are the following: A. Diet and environmental working condition B. Recreations and attitude towards life C. All of the above D. Exposure to stress and lifestyle

72. The principal cause of death among older persons and poses the greatest risk to elderly population is? A. Diarrheal disease B. Infectious disease like scabies C. Carbuncle and boil D. Heart disease

73. What will be the possible implications of high prevalence of chronic diseases in an order population? A. Decreased burden on the age productive group B. Increase productivity C. Lessen the incidence of depression D. Decrease productivity

74. Which of the following is NOT included in the framework of life course? A. Depression B. Struggle C. Legacy D. Acquisition

75. The major factors that deter the elders psychosocial development are: A. Neglected & abandonment experience B. Bad adult models during their early childhood C. Deprived childhood needs D. All of these

76. Which of the following is included in the reason to illness under reporting in the elderly? A. Thinking that their symptoms are all part of growing old B. All of them are forgetful C. They are too busy to visit a doctor D. They dont know the clinics address 77. Bone disease common among elderly is: A. Osteomyelitis B. Osteoporosis C. Scoliosis D. Bone cancer

78. Which of the following measures prevent bone loss in the elderly? A. Reducing smoking and increase caffeine B. Bone medication and sedentary lifestyle C. Physical therapy and low calcium diet D. Diet rich in calcium & weight bearing exercise

79. Julio, 70 year old, is a retiree from government office. He has spent 30 years in the Department of finance. In assessing health status of Julio, the most important information to obtain for a teaching plan in his: A. Psychological changes B. Health belief and practices C. Medication in physical activity D. Retirement plan

80. In establishing goals of nursing care for an elderly client you will get priority to: A. Referring the social services, when necessary B. Submitting for physical examination regularly C. Maintaining independence as much as possible D. Select variety of recreational activities

SITUATION: Using Marlows need theory, Airway, Breathing and Circulation are the physiological needs vital to life. The nurses knowledge and ability to identify and immediately intervene to meet these needs is vital to have a quality of life. 81. Completion of assigned tasks and performing ADLs are important to an elderly client. which of the following is the most important for the nurse to remember? A. Physiologic needs and safety of the elderly B. Number of relatives C. Abundance of financial sources D. The support from the family

82. Tessie, a 75-year-old retiree is admitted in the hospital with Rheumatoid arthritis. She complained of joint pains in her knee. Which of the following activity will reduce the pain? A. Walking or jogging regularly B. Continuous program of physical activity C. Membership in a physical fitness club D. Rest and support inflamed joints

83. Elderly client get irritated of their chronic system disease. To help clients in their inflamed joints due to rheumatoid arthritis, the initial mainstay treatment is: A. Immunosuppressants B. Aspirin C. Gold therapy D. Steroids

84. In one of theories of aging, this type of theory is compared to a p[iece of cloth that gets thorn through constant and continuous wearing. A good example is OSTEOARHRITIS this theory is known as: A. Wear and tear B. Adaptation C. Somatic mutation D. Deprivation

85. Which of the following remarks will most likely create a positive attitude? A. Rehabilitation is positive health and will promote an individual optimal functioning B. Life goes on even after hospitalization. Remember we have our ups and down C. Hospitalization is only temporary so it is cost effective D. Where there is life is hope 86. Larry is a 75-year-old paralytic patient and bedridden. What would be the primary nursing goal to maintain skin integrity of Larry? A. Regular turning from side to side B. Prevention of pressure in ulcer C. Proper positioning D. Keep patient dry

87. Rudy Manahan, a 78 year old was admitted with Coronary Artery Disease is expressing concern about forthcoming discharge and home health care. What would be the most effective intervention you would do first? A. Ask what concerns her and options about cost effective measures B. Request attending physician to reassure her C. Teach family about home care D. Refer her to social worker 88. In the physical assessment of an elderly male client you do NOT expect to find which of the following condition: A. Absence of bowel sounds B. Diminish lung expansion C. Enlarge prostate D. Presbyopia

89. Elder persons are upset when they could not find their things and where they plce them. This is generally common among the elderly: A. Prone to eye irritation B. Unable to see far C. Presence of floating spots in her line of vision D. Sensitive to glare

90. These most common cause of adult blindness is: A. Diabetic therapy B. Retinal detachment C. Glaucoma D. Cataracts

91. Which of the following will promote good eyesight or vision in the elderly? A. Encourage the older person to have regular biannual check-up for visual functioning B. Use wide brimmed hat and sunglass when expose to sun rays C. Avoid prolonged exposure to UVA D. All of the above 92. Nutritional requirements for older adults are planned to counter age related changes. Why should caloric needs odd older adults be reduced? A. Because of decrease physical activity and a slower metabolic rate B. Because of increased body metabolism C. Because of inability to digest food D. Because of lack of appetite

93. Which of the following factors will NOT post a risks to bowel elimination problems? A. Psychosocial factors such as nervousness, agitation and depression B. Older person have lessened thirst experience and therefore do not drink enough fluids C. Increase amounts of digestive enzymes and gastric acids D. Poor dentition 94. An elderly is given a lower dose of DURAMORPH (Morphine sulfate). Which assessment is important for the nurse to report? A. Blood pressure of 120/70 B. Respiratory rate of 8 C. Apical pulse rate 80 D. Drowsiness

95. Which of the following manifestations would suggest PRESBYCUSIS or SENSORINERAL hearing loss? A. The usually talks loudly because she cannot hear her own voice B. The presence of impacted ear wax in the otoscope C. The elderly usually rub her ear and has frequent headaches D. She usually presents SITUATION: Like most developing nations, the Philippines is a country in transition in socio-economic development, demography, epidemiology. Population aging is demographic phenomenon indicated by a steady increase in the number and proportion of the corresponding decline in the proportion of younger age groups. You are now working as a staff nurse in a geriatric unit of a general hospital. Have to be prepared to handle situations with neurological diseases and disorders. 96. Tony Perez has Parkinsons disease. The client has pill rolling and impulsive gait. Which of the following areas of the brain is responsible for balance and general motors? A. Pons B. Cerebellum C. Limbic system D. Pituary gland

97. Mr. Tony Perez, has been prescribed to receive an antiparkinsons drug. Which of the following is not antiparkinson? A. Bromocriptive B. Carbidopa-Levodopa C. Descending pathway D. Amantadine

98. Dong is complaining of pain. Which of the site in the central nervous system is for conduction in sensation in pain? A. Cervical spinal nerve B. Ascending pathway C. Descending pathway D. Temporal lobe

SITUATION: Older people take longer and react because nerve impulses are conducted more slowly. 99. Robert is admitted in the Geriatric ward with severe anxiety, nervousness, agitation, tachycardia and perspiration. Which division of autonomic nervous system is activated? A. Cholinergic B. Sympatholytic C. Parasympathetic D. Sympathetic

100. Marvin, 70, is admitted in orthopedic hospital due to spinal cord injury. He presented severe respiratory failure. Which of his spinal nerves has been involved? A. Sacral 1-5 B. Thoracic 2-12 C. Cervical 1-4 D. Lumbar 1-5

SUBMIT THIS TEST BOOKLET TOGETHER WITH THE ANSWER SHEET TO YOUR WATCHERS. BRINGING THE TEST BOOKLET OUT OF THE ROOM WILL BE A GROUND FOR CANCELLATION OF YOUR EXAMINATION. ***END***

NURSING PRACTICE V Care of Clients with Physiologic and Psychosocial Alterations (Part C) GENERAL INSTRUCTIONS: 17. 18. 19. 20. This test booklet contains 100 test questions Read INSTRUCTIONS TO EXAMINESS printed on your answer sheet. Shade only one (1) box for each question on your answer sheets. Two or more boxes shaded will invalidate your answer. AVOID ERASURES.

INSTRUCTIONS: 13. Detach one (1) answer sheet from the bottom of your Examinee ID/Answer Sheet Set. 14. Write the subject title Nursing Practice V on the box provided. 15. Shade Set Box A on your answer sheet if your test booklet is Set A; Set Box B if your test booklet is Set B. SITUATION: Tess and Rick in their late 40s have been married for 20 years and at the peak of their careers, Suddenly, Tess discovered that her husband was falling in love with another woman shaken by this situation, she started to have problems sleeping and could not function well at work and at the risk of losing her job. Rick asked forgiveness and regret very much the hurt his wife was going through and suffered guilt feelings. 1. Tess and Rick are going through a: A. Both developmental and situational crisis B. Developmental crisis 2. All of these are characteristics of crisis EXCEPT: A. Anxiety or depression continue to increase. B. A hazardous or threatening event occurs C. It has a growth promoting potential D. Usual problem solving methods and coping mechanisms produce a solution 3. The nurse employs this approach in crisis intervention: A. Problem solving B. Nurse patient relationship C. Behavior modification D. Role playing C. Anticipated crisis D. Situational crisis

4. Assessment data of a nurse include all of the following EXCEPT: A. Situational support B. Coping mechanism C. Repressed problem D. Perception of the event

5. The duration of crisis usually lasts several days and usually: A. 1-2 weeks B. 1-2 months C. 1-6 weeks D. 2-4 weeks

SITUATION: Jamaica has a ritualistic pattern of constantly washing her hands with soap and water followed by rubbing alcohol: 6. The behavioral is categorized as: A. Normal B. Psychotic C. Neurotic D. Delutional

7. A therapeutic intervention in this situation is: A. Avoid limits on her behavior to release her anxiety B. Provide alternative behaviors to deal with increased anxiety C. Ignore her behavior totally D. Call attention to her ritualistic pattern 8. The anxiety of Jamaica is disabling and interferes with her job performance, interpersonal relationships and other activities of daily living. To minimized such problems, she is likely to be given: A. Haroperidol B. Imipramine Hcl C. Chlorpromazine D. Diazepam

9. Jamaica understands the effects of her medicine when expresses: A. I should watch out for signs of sore lips or sore throat. B. I should not drive or operate machines C. I might feel changes in my body temperature D. I might have constipation 10. The level of anxiety that Jamaica is experiencing: A. Severe B. Panic C. Moderate D. Mild

11. Which of the following is the difference between obsession and compulsion? A. Compulsions are recurrent, persistent intrusive and unwanted thoughts images or impulses while obsessions are ritualistic and repetitive behaviors or action. B. Obsession are recurrent, persistent, intrusive and unwanted thoughts images or impulses while compulsions are ritualistic and repetitive behaviors or actions C. Obsession is not repetitive while compulsion is repetitive D. The patient can control obsession but cannot control the compulsion 12. Which psycho modality is recommended for client with OCD? A. Systematic desensitization B. Aversion therapy C. Cognitive therapy D. Behavior therapy

13. Which of the following drug of choice for people suffering from OCD? A. Chlordiazepoxide (Librium) B. Diazepam (valium) C. Clomipramine (anafranil) D. Oxazepam (serax)

14. The performance of rituals is a mechanism that a person with OCD uses in order to protect him from feelings of: A. Loneliness B. Anxiety C. Stress D. Inadequacy

15. All of these are therapeutic interventions EXCEPT:

A. Impose limits every time the behavior becomes repetitive B. Assign task that can be done repetitively C. Establish a routine for him D. Facilitate self expression SITUATION: Mr. Diaz has been diagnosed as having early chronic glaucoma. He has been admitted to the hospital for treatment. 16. The nurse identified a nursing problem of disturbed sensory perception, visual impairment characterized by: A. Loss of peripheral vision B. Loss of night vision C. Loss of central vision D. Sudden loss of eyesight

17. In order to understand the rationale for drug therapy, it is important for the nurse to know that glaucoma is usually caused by: A. Increase production of aqueous fluid B. Damage to the proteins in the lens C. Gradual diminution of the retina D. Opacity in the lens

18. Diamox is a drug used in the treatment of glaucoma. Which of these is the effect of this drug? A. Facilitates outflow of aqueous B. Reduces the production of aqueous fluid C. acts as osmotic diuretic D. Constricts the pupil

19. Public health nurses should identify which of these patients as a risks group for development of glaucoma, hence the need for annual eye examinations: A. Patient with COPD B. Cancer patients C. Diabetic and hypertensive patients D. Patients with Parkinsons disease

20. The appropriate method of instilling eye drop is instilling into an opened eye with the head held back and with the eye looking: A. Downward B. Aggressiveness C. Suspiciousness D. Upward

SITUATION: A nurse was interested to study the research question: What are the differences and similarities between aggressive and non aggressive cognitively impaired, elderly, institutionalized people? 21 Investigation of cognitively impaired individual presented some ethical dilemmas. Which of the following protocol would be considered unethical? A. Verbal permission from the subject is necessary B. Data coded and recorded solely by the investigation C. A written consent from the institution and a significant other D. Recording interaction with the elderly with their permission 22. Semi-instructed interview was conducted. This means that: A. Interviewer is not held to any specific questions B. Subject is allowed to express w/o any suggestion from interviewer C. Interview is conduct precisely in the same manner D. Interviewer is free to probe beyond a number of specific major questions 23. The type of study conducted is: A. Quasi-experimental B. Experimental C. Case study D. Descriptive

24. The view of literature included reference to retrospective studies. Such studies have the advantages EXCEPT: A. Possibility of memory bias and distortion of facts B. Data are inexpensive to obtain 25. The average age of the respondents was 86, this represent: A. Most of the number participants is 86 years old B. The oldest participant is 86 years old C. The sum ages divided by total number of participants D. The youngest participant is 86 years old SITUATION: Knowledge of anesthetic is required in providing safe and efficient operative care. C. It is easy to get data D. There is much material available

26. Where will the spinal anesthesia be injected? A. It is injected directly into the CSF within subarachnoid space B. it is injected into the epidural space C. It is injected directly on the spinal cord to provide immediate effect D. It is directly injected between the dura and the pia matter 27. The nurse knows that in both spinal and epidural anesthesia the patient is placed in what position? A. Prone position B. Knee-chest position C. Trendelenburg position D. Sims position

28. The most common side effect of both the epidural and spinal anesthesia is: A. Post spinal B. Nausea and vomiting C. Hypotension D. Total spinal anesthesia

29. A regional anesthesia technique especially useful in labor and delivery is: A. Nerve block B. Epidural C. Intravenous block D. Spinal

30. Epinephrine is used in adjunct with different local anesthetic. Why is this so? A. It produces vasoconstriction effect, leading to control bleeding B. To prevent the respiratory depression cause by anesthesia C. To increase the clients blood pressure thereby preventing hypotension D. To prevent shock from bradycardia. SITUATION: Nina Reyes a graduate students, will submit a research proposal related to the presentation of falls among elderly clients in the medical ward where she works. She has observed that most of the clients who fells from their beds belong to the age group 65 and above.

31. Given the research question: what are the risk factors for falls among the elderly clients in the medical ward, which of the following statement is correct? A. Risk factor is the ordinal level of measurement B. Age is the dependent variable C. This is an epidemiological study D. This is a Quantitative research 32. Nina found a risk assessment scale for fans that includes parameters such as age, mental status, elimination, history of falling, gait and balance and medication. If tool is used, how will the data on the client level of risk be summarized and presented? A. Chi-square B. Percentage C. Range D. Frequency polygon

33. In this study, Nina will gain access to the clients charts. Which of the following ethical principles may be violated? A. Fidelity B. Justice C. Stewardship D Clients autonomy

34. Nina is interested in comparing the male and the female study subjects. How will she graphically present the results of data collection using the risk assessment scale for falls? A. Histogram B. Line graph C. Bar graph D. Frequency polygon

35. Which of the following is correct about the parameters history of falling? A. Pie graph can be used to present this data on all subject B. An observation checklist be used to collect data C. Mean can be used to summarize the data D. This is an example of ratio data SITUATION: A nurse was interested to study the research question. What are the differences and similarities between aggressive and non aggressive cognitively impaired, elderly, institutionalized people. 36. Which of the following gear is expected that the nurse should wear in the semi-restricted area? A. Head cap, scrub suit, mask, OR shoes C. Cap, mask, globes, shoes

B. Scrub suit, or shoes, head cup 37. What OR attire are worn in the restricted area? A. Scrub suit, OR shoes, Head cap B. Mask, OR shoes, scrub suit

D. mask, Or shoes, scrub suit

C. Head cap, scrub suit, mask, OR shoes D. Cap, mask, gloves, shoes

38. According to the three concept zone of the surgical suite design, the dressing rooms are located in the: A. Clean area B. Restricted area C. Semi-restricted area D. Non-restricted area

39. The following techniques illustrates the concept confine and contain EXCEPT: A. Contaminated items like sponges are handled using gloves. B. All blood tissue and body fluid specimens should be placed in proof container C. Surgeons conduct their patients rounds in scrub suit D. Prompt cleanup of accidental spills of contaminated debris e.g. blood, body fluids.

40. The OR is a restricted area where OR attire is worn. Temperature and humidity are set for patients and personnel safety and reduce bacterial contamination. During the surgery, movement of personnel including the circulating nurse is: A. Kept to minimum B. Monitored C. Restricted D. Eliminated when possible

41. The humidity in the operating room is set in the recommended level to reduce contamination. The range of humidity is always set at: A.20-25 % B. 2-10 % C. 90-100 % D. 50-55 %

42. Which of the following is NOT a PPE? A. Gloves B. Cover gown C. Face shields D. Eye wear

SITUATION: The patient who is depressed will undergo electroconvulsive therapy. 43. The preparation of a patient for ECT ideally is most similar to preparation for a patient for: A. Electrocardiogram B. General Anesthesia C. Electroencephalogram D. X-ray

44. Studies on biological depression support electroconvulsive therapy as a mode of treatment. The rationale is: A. ECT relieves depression psychologically by increasing the norepinehhrine level B. ECT is seen as a life threatening experience and depressed patients mobilized all their bodily defenses to deal with this attack C. The treatment serves as a symbolic punishment for the client who feels guilty & worthless D. ETC produces massive brain damage which destroys the specific area containing memories related to the event supporting the development of psychotic condition. 45. Which of the following is a possible side effect which you will discuss with the patient? A. Robot like body stiffness B. Encephalitis C Hemorrhage within the brain D. Confusion, disorientation & short term memory

46. After ECT the nurse should do this action giving the client fluids, food or medication. A. Assess the sensorium B. Next of kin or guardian C. Assess the gag reflex D. Chief nurse

47. Informed the consent is necessary for the treatment for involuntary clients. When this cannot be obtained permission may be taken from the: A. Next of kin or guardian B. Doctor C. Social worker D. Chief nurse

SITUATION: A nurse assigned in the neurologic unit is taking care of clients with varying degrees of degenerative disorders. 48. Mr. Alejandro with myasthenia gravis is having difficulty speaking. What communication strategies should the nurse avoid when interacting Mr. Alejandro?

A. Encouraging the client to speak quickly B. Using paper and pencil in communicating with the client C. Reporting what the client says for better understanding D. Encouraging the client to speak slowly 49. When planning nursing care for Mr. Alejandro who has Parkinsons disease, which of the following goals would be MOST appropriate? A. To obtain optimal body function B. To treat the disease C. To improve muscle tone D. To start rehabilitation as much as possible

50. On his second day of hospitalization, Mr. Alejandro was unable to stand and having difficulty swallowing and talking. Which of the following is the priority of the nurse in assisting Mr. Alejandro? A. To prevent bladder distention B. To prevent decubitus ulcer C. To prevent aspiration pneumonia D. To prevent contracture

51. Tess wife of rick a seventy one- year, male with a diagnosis of Alzheimers disease, begins to cry and tells the nurse, I do not understand my husband anymore. He has changed drastically. Which of the following responses of the nurse is most apropriate: A. This has been a difficult time for you. Let us walk and find a quiet place where we talk B. The physician and the staff will make sure that your husband will be comfortable & safe C. You need not to worry, we are doing the best we could do D. He will soon recover in his condition 52. For the past 12 years, Lady 45 years old has had multiple sclerosis. Clients with multiple sclerosis experience many different symptoms. As part of the rehabilitation planned for, the nurse suggested therapy and hobbies to help her. A. Strengthen muscle coordination C. Establish good health habits B. Develop perseverance and motivation D. Establish routine SITUATION: A nurse working with an aggressive client in the psychiatric unit. 53. All of he following concept are true: EXCEPT. A. Frustration develops in response to an meet needs, wants and desire. B. Aggression can be expresses in a constructive as well as a destructive manner C. Anger is always incompatible with love D. Hostility is destructive 54. Mrs. Villegas was visiting her son at the psychiatric ward. Which of the following items will the nurse not allow to be brought inside the ward? A. Box of cake B. Bottle of coke C. Rubber shoes D. String rosary

55. Which of the following will probably be most therapeutic care patient on behavioral modification ward? A. Insist to stop obscene language by verbal reprimand B. Provide a punching bag as an alternative to express upset emotion C. If the client is agitated, discuss the feeling specially anger D. Give the client support and positive feedback for controlling use of obscene language 56. Which of the following must be considered while planning activities for their pressed patient? A. Challenging activities to get him out of the depression B. Structured activities that the client can participate C. Variety of unstructured activities D. Activities which required exertion of energy 57. To maintain a therapeutic eye contact and body posture, while interacting, while angry and aggressive individual the should : A. Keep his/her hands behind his/her back in one pockets B. Fold his/her arms across his/her chest C. Keep an eye contact while staring at the client D. keep an open posture e.g. hands by side 58. Paulo, a patient in the ward, suddenly slapped you in the face and spitted on your face and is obviously agitated and violent. Which of the following is the best nursing action?

A. Slap the client back & say Im your nurse, you are a patient, you have no right to hurt me. B. Tell the client:Because of that, you are not going to eat your lunch, dinner and breakfast C. Prepare as 5 member team to restrain the client D. Respond by saying You are losing control of yourself, you slapped me and you spitted on me and you are way out of control. 59. Which of the following is an accurate way of reporting and recording an incident? A. When asked about his relationship w/ his father client was resistant to respond B. When asked about his relationship w/ his father his anger was suppressed C. When asked about his relationship w/ his father, client became anxious D. When asked about his relationship with his father, client clenched his jaw/teeth, made a fist and turned away from the nurse 60. To encourage thought, which of the following approaches is NOT therapeutic? A. When do you usually feel angry? B. How do you usually express anger? C. What situations provoke you to be angry? D. Why do you feel angry?

61. Patient grabs and about to throw it. The nurse best responds saying: A. Calm down B. Dont be silly C. Stop! Put down the chair D. Stop! The security will be here in minute

SITUATION: Client government is essential and building the foundation of improving the patients adaptation to different environmental settings. 62. In psychiatric hospital setting, a community means: A. People sharing same beliefs, attitude and values B. Group of families led by group patients as officers C. It consist of staff, patients or student nurses on duty in the treatment setting D. The whole hospital staff, patients, students, nurses, guards and everyone that makes the hospital is safe and living environment. 63. Which of the following accurately describes the client government? A. These are communities led by staff nurses and physicians as officer B. These are communities led by group of patients as officers C. This is form of the manipulation of the physical environmental setting D. Officials from the Barangay or municipality lead patients in the therapeutic milieu. 64. Which of the following determines the success of client government groups? A. Means to acquire a variety of social skills B. Opportunity to learn democratic living C. A way of permitting clients provide themselves with a more creative and wholesome life D. Willingness of psychiatric professional to be open and receptive to clients suggestions

65. The heart of the client government as well as the therapeutic milieu is? A. Survey B. Observation C. Community meeting D. Selective interview

66. The nurse is aware that identifying the aspects of general patient management and identifying intervention for meeting these basic needs are distinctions of: A. Therapeutic milieu B. Pharmacotherapy C. Behavior therapy D. Psychotherapy

67. In order to get active participation of the client to carry out the objective of the program, it is BEST for the nurse to conduct a/an: A. Selective interview of patient B. Community survey C. Observation D. Survey

68. Through the nurse role modeling of effective communication, the clients learned new ways od dealing with authority figures. This gives the clients a venue to: A. Socialize B. Identify the problems C. Test new patterns D. Communicate

69. Which of the following is basic and the most important quality that therapeutic milieu should possess as in client government?

A. Consistency, trust and efficacy B. Contract, rules and regulation

C. Safely D. Communication and good relationship

70. The nurses style of leadership in milieu therapy is: A. Laissez-faire B. Democratic C. Autocratic D. Benevolent

71. In a client government therapy, which of the following best describes, re-motivation therapy? A. It is reward and punishment therapy. B. It is focused on teaching acceptable social behavior such as dressing, conversation, initiation, paying bills and other activities. C. This therapy focuses on enhancing the patients social skills such as communication skills, jokes, developing non verbal social skills and developing listening skills D. Helping the client achieve sense of accomplishment by making handicrafts like wallet or bags to distract themselves from self defeating skills. SITUATION: A group of adult chronic schizophrenic patients were recommended to undergo social skill training. 72. The following are the objective of a social skill training programs, EXCEPT: A. Exposure deep seated intrapsychic conflicts. practice general coping skill C. Help builds self esteem and self confidence D. Practice skills in relating with people 73. Social skill training is not primary indicated for psychiatric patient who are: A. Having difficulties starting and maintaining interpersonal relationship B. Having chronic episodes of stress and anxiety while interacting with others C. In acute stage of illness recurrence of symptoms in front of particular people or in general 74. The focuses of the group interaction is here and now. An appropriate topic would be: A. How to spend the summer vacation B. An unforgettable experience as a child C. How to tell a joke D. Ways to celebrate valentines day B. Develop and

D. Experiencing

75. An appropriate technique for the participants to practice how to communicate effectively is: A. Seminar B. lecture C. Role play D. Orientation phase

76. Considering that it is BEST to learn example, it is MOST practical to: A. Invite a resource person B. Watch a movie C. Relate successful pass experience. D. Model good social skill throughout the session

SITUATION: The nurse work with Ricky to help her work through termination of the nurse-patient relationship. 77. Preparation for termination of the nurse-patient relationship begins during the: A. Pre-orientation phase B. Working phase C. Termination phase D. Orientation phase

78. Rickys fast reaction to ending relationships is withdrawal. The nurse assist her to practice better ways of coping termination by providing opportunities to: A, Value and find meaning in experience B. Test new patterns of behavior C. Plan of alternative D. Conceptualize her problems

79. During the early part of the interaction, the nurse asked after a period of silence, Perhaps we would talk about my leaving. The nurse utilized which communication technique. A. Suggesting B. Understanding C. Encouraging D. Focusing

80. The longest and the most productive phase of the NPR is: A. Working phase B. Orientation phase C. Termination phase D. Pre-orientation phase

81. The objection of the nurse-patient relationship is to provide an opportunity of the patient to:

A. Develop insight B. Clarify problem

C. Develop interpersonal relationship D. Have a corrective emotional experience

SITUATION: Mr. Alfonso is brought to the hospital due to pain radiating to the hip and leg. He is diagnosed with a herniated lumbar disk. He is scheduled for myelogram . 82. After the procedure, the nurse must include which of the following nursing action in his care? A. Place the client in most comfortable position B. Bed rest with bed elevated as 45 decrees C. Lying supine with heels flexed D. Assess for movement and sensation of the lower extremity 83. Mr. Alfonso is scheduled for lumbar laminectomy. Post operatively the nurse should: A. Assess the sensory loss in his legs B. Inform the client that he should be in supine position C. Instruct the patient to move from side to side D. Logroll the client with the help of another nurse 84. Trimethobenzamine Hydrochloride was administered postoperatively. The action on this drug is effective when it: A. Controls pain B. Control muscle spasm C. Control edema D. Control nausea

85. Mr. Alfonso is to ambulate for the first time following surgery. What nursing action should be BEST when the client begins to faint? A. Assist the client to form a wide base of support and lean against the nurse B. Get back to his bed and place in side lying position C. Maneuver the client to a sitting position D. Get another nurse to help

86. Mr. Alfonso has to wear back brace. Which position is recommended when the brace is applied? A. Standing position B. Sitting position C. Supine position D. Lying on his side in bed

SITUATION: Nursing care for the elderly. 87. Which of the following statement about elderly clients is NOT true? A. Elderly clients has difficulty distinguishing blue and green color. B. Elderly clients seem to have decreased frequency of several intercourses C. Continuous stimulation of the elderly through frequent rearrangement of room D. Yellow or red bulbs are best suited for the room of an elderly patient 88. In planning care for a patient with Parkinsons disease, which of these nursing diagnoses should have priority? A. Altered nutritional state B. Ineffective coping C Potential for injury D. Altered mood

89. The frequent use of the elderly clients name by the nurse is MOST effective in alleviating which of the following responses to old ages? A. Confusion B. Suspicion C. Loneliness D. Grief

90. In elderly who has lots of regrets, unhappy and miserable is experiencing: A. Loss B. Despair C. Ambivalence D. Crisis

91. The premorbid personality of an schizophrenic elderly client is: A. Extrovert 92. Schizophrenia is a/an: A. Anxiety disorder B. Psychosis C. Neurosis D. Personality disorder B. Ambivert C. Cycloid D. Schizoid

SITUATION: Maria has been diagnosed with Bipolar1 disorder. The client demonstrates extreme psychomotor agitation, flight of ideas, loud talking and elated mood.

93. The doctor ordered lithium. You know that this is indicated in patient with: A. Anxiety disorder B. Schizophrenia C. Depression D. Mania

94. Lithium has a narrow therapeutic range of: A. 0.6 to 1.2 mEq/l B. 10 to 50 mEq/L C. 0.1 to 1.0 mEq/l D. 50 to 100 mEq/L

95. Which of the following is a side effect of lithium toxicity? A. Anuria B. Oliguria C. Polyuria D. Sudden burst of muscle strength

96. What specimen is taken from a client when checking the lithium level of the body? A. Urine B. Stool C. Blood D. Sweat

97. Which of the following is NOT drug use to augment lithium toxicity? A. Acetylcysteine B. Mannitol C. Urea D. Aminophylline

SITUATION: The global economic slowdown has been identified as a probable reason for the increase in the incidence of suicide. 98. Suicide risk assessment should consider all of the following factors EXCEPT: A. A client who is at high risk for suicide is one who plans a violent death and has the means to carry it out. B. Ambivalence is one of the most common characteristics of suicidal client C. Elderly suicidal clients are more likely to succeed on their first suicide attempt D. Suicide risk increases as depression becomes more severe. 99. Which of the following behaviors indicates the greatest danger of suicide? A. The client reveals that family member committed suicide in the past year B. The client has a history of previous suicide attempt C. The client has a definite plan to committing suicide D. The client expresses suicidal thoughts 100. Which one of the following is the highest priority of the nurse when providing care for a dying client? A. Facilitating the clients expression of feelings and ensuring safety. B. Providing comfort and managing the clients physical symptoms. C. Involving the clients family and friends in his/her care. D. Listening to the client and his/her familys concern.

SUBMIT THIS TEST BOOKLET TOGETHER WITH THE ANSWER SHEET TO YOUR WATCHERS. BRINGING THE TEST BOOKLET OUT OF THE ROOM WILL BE A GROUND FOR CANCELLATION OF YOUR EXAMINATION. ***END***

ANSWER KEY TEST I 2010

1. B 2. A 3. A 4. A 5. C 6. B 7. C 8. B 9. A 10. D

11. D 12. D 13. C 14. B 15. C 16. D 17. C 18. A 19. B 20. D

21. D 22. A 23. B 24. D 25. C 26. A 27. C 28. B 29. A 30. A

31. A 32. C 33. C 34. A 35. B 36. B 37. D 38. C 39. C 40. D

41. A 42. C 43. D 44. B 45. B 46. B 47. C 48. C 49. B 50. B

51. A 52. D 53. A 54. C 55. C 56. B 57. C 58. C 59. C 60. C

61. D 62. B 63. D 64. D 65. B 66. C 67. D 68. A 69. D 70. B

71. B 72. C 73. D 74. C 75. B 76. B 77. A 78. A 79. B 80. A

81. A 82. C 83. D 84. A 85. B 86. C 87. A 88. A 89. C 90. C ANSWER KEY Test II 2010

91. C 92. C 93. B 94. C 95. C 96. B 97. B 98. C 99. C 100. B

1. A 2. D 3. B 4. C 5. C 6. A 7. A 8. C 9. C 10. A

11. C 12. D 13. C 14. C 15. C 16. D 17. D 18. C 19. A 20. C

21. A 22. D 23. B 24. A 25. C 26. B 27. D 28. D 29. B 30. D

31. D 32. D 33. A 34. B 35. A 36. C 37. D 38. A 39. B 40. A

41. C 42. C 43. A 44. D 45. A 46. D 47. B 48. A 49. C 50. C

51. C 52. C 53. D 54. C 55. B 56. A 57. A 58. A 59. B 60. D

61. A 62. C 63. D 64. A 65. A 66. B 67. A 68. B 69. B 70. D

71. 72. 73. 74. 75. 76. 77. 78. 79. 80.

B C A C A B A C C C

81. D 82. D 83. B 84. D 85. B 86. B 87. D 88. C 89. A 90. C ANSWER KEY Test III 2010

91. A 92. D 93. B 94. C 95. B 96. B 97. B 98. D 99. C 100. B

1. C 2. A 3. A 4. A 5. A 6. C 7. A 8. D 9. D 10. C

11. 12. 13. 14. 15. 16. 17. 18. 19. 20.

B C B A C B B C A C

21. B 22. C 23. D 24. A 25. C 26. B 27. C 28. C 29. C 30. C

31. D 32. B 33. C 34. C 35. B 36. A 37. C 38. B 39. B 40. A

41. D 42. A 43. C 44. C 45.C 46. B 47. D 48. B 49. A 50. D

51. A 52. C 53. D 54. A 55. B 56. A 57. B 58. C 59. C 60. D

61. C 62. A 63. A 64. B 65. D 66. B 67. B 68. D 69. A 70. B

71. B 72. D 73. A 74. C 75. A 76. C 77. B 78. B 79. B 80. B

81. D 82. C 83. D 84. D 85. A 86. D 87. B 88. B 89. A 90. C ANSWER KEY Test IV 2010

91. D 92. D 93. A 94. B 95. B 96. D 97. D 98. C 99. B 100. A

1. C 2. A 3. A 4. B 5. B 6. D 7. D 8. B 9. C 10. D

11. D 12. D 13. A 14. D 15. A 16. D 17. D 18. A 19. C 20. A

21. D 22. A 23. D 24. C 25. D 26. A 27. C 28. A 29. A 30. C

31. C 32. D 33. D 34. D 35. C 36. B 37. D 38. A 39. B 40. A

41. B 42. D 43. C 44. D 45. A 46. B 47. D 48. D 49. B 50. D

51. D 52. B 53. C 54. B 55. A 56. B 57. A 58. B 59. A 60. A

61. C 62. B 63. C 64. A 65. A 66. C 67. C 68. B 69. B 70. C

71. B 72. B 73. B 74. D 75. C 76. D 77. B 78. D 79. B 80. D

81. A 82. C 83. B 84. A 85. B 86. B 87. B 88. B 89. D 90. B ANSWER KEY Test V 2010

91. A 92. B 93. D 94. A 95. D 96. C 97. B 98. D 99. B 100. C

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

11. B 12. C 13. C 14. A 15. C 16. A 17. A 18. D 19. C 20. B

21. C 22. D 23. A 24. B 25. A 26. C 27. D 28. A 29. C 30. A

31. D 32. A 33. B 34. B 35. D 36. C 37. B 38. B 39. C 40. A

41. D 42. C 43. D 44. C 45. B 46. B 47. B 48. A 49. D 50. C

51. A 52. C 53. D 54. A 55. B 56. A 57. B 58. C 59. B 60. C

61. D 62. A 63. D 64. B 65. A 66. A 67. D 68. A 69. B 70. C

71. 72. 73. 74. 75. 76. 77. 78. 79. 80.

B C A B B A A A C A

81. A 82. C 83. C 84. D 85. A 86. C 87. A 88. D 89. B 90. C 91. C 92. D 93. A 94. A 95. B 96. A 97. D 98. B

99. A 100. C

NURSING PRACTICE I SET B