NURSING PRACTICE I – COMMUNITY HEALTH the following is the nurse’s MOST helpful

NURSING intervention?
June 2, 2019
A. Facility achievement of normal developmental
Situation 1 – Boy George is a 15-year-old tasks of the family
adolescent who lives with his mother and father, B. Build the parents self-concept as coping
and several siblings. He is hospitalized in a patterns
provincial hospital after a suicide attempt. C. Teach the parents techniques of therapeutic
communication
1. When performing a family assessment, select D. Refer the parents to a support group
what the nurse must FIRST determine.
Situation 2 – Collaboration is being able to work
A. How the family expresses and manage cooperatively and efficient with co-workers and
emotions any other people the nurse may have to interact
B. The communication patterns between the with. This includes other health professionals,
patient and parents clients, and their families and communities.
C. Names and relationships among family
members 6. Which of the following is NOT recognized as
D. The meaning that the patients suicide attempt part of the nurse’s role as member of the health
has for team?

2. Which of the following is the BEST QUESTION A. Care manager and supervisor
for the nurse to ask to assess a family’s ability to B. Provider of care and educator
cope? C. Patient advocate and supporter
D. Performing physician’s functions with
A. “Do you think your family copes effectively” supervision
B. “What do you think of the current family
problem?’ 7. The health team has brainstormed for ideas in
C. “What strengths does your family have?” creating a more collaborative environment in a
D. “Can you describe how you successfully health care facility. Which idea or action would be
handled one family the BEST to develop further?

3. The mother of Boy George asks the nurse, A. Develop a plan for the different team members
“Why do you want to do a family assessment? My to follow and show impact of their work
teenager is the patient, not the rest of us. “What B. Emphasize that no one profession has all the
is the BEST response of the nurse” necessary competence to provide all care
C. Hold education sessions regarding
A. “Family dysfunction might have caused the collaboration for each unit
mental illness” D. Institute collaborative strategies that are
B. “Every family member’s perception of events traditionally practiced
is different and adds to the total picture”
C. “Family members provide more accurate 8. Which patient scenario describes the BEST
information than the patient” example of professional collaboration?
D. “Family assessment is a protocol for care of all
patients” A. The nurse, physician, and physical therapist
have all visited separately with the patient
4. Which information is the nurse MOST likely to B. The nurse mentions to the physical therapist
find when assessing the family of a patient with that the patient may benefit from a muscle
mental illness? strengthening evaluation
C. The nurse and physician discuss the patient’s
A. Power in the family is maintained in the muscle weakness and initiate a referral for
parental dyad and rarely delegated physical therapy
B. Several family members have serious problems D. The nurse, physical therapist, and physician
with their psychological health have all developed separate care plans for the
C. Stress that living with a mentally ill member patient
has challenged the family’s function
D. The family exhibits many characteristics of 9. Which activities are appropriate for the nurse
dysfunctional families to collaborate with a patient?

5. Parents of Boy George say, “We have never 1. Prescribing new medication
known anyone who was mentally ill. We have no 2. Health promotion activities
one to talk to because none of our friends 3. End-of-life comfort decisions
understand the problem we are facing. “Which of 4. interpreting laboratory results
5. Lifestyle changes to improve health D. Improve overall community functioning

A. 2, 3, 5 14. Nurse Roger adapts professional nursing skills

B. 2, 4, 5 in recognizing and meeting the physical and
C. 1, 4, 5 emotional needs resulting from a disaster. For
D. 1, 3, 4 people who are willing to talk ensuing a disaster,
which of the following is the MOST appropriate
10. The Rural Health Nurse and the Rural Health approach?
Physician are explaining home care that will be
needed by a patient with Tuberculosis. The A. “I am with you. It is good you are trying to
patient’s spouse states angrily that it will not be release your distress by crying. It will make you
possible to provide the care recommended. What feel better.”
is the BEST response by the nurse? B. “What you need to do now is to wait for
instructions and services to be provided.”
A. “I would like to listen to your concern about the C. “Don’t feel bad. Others are in the same
prescribed care” situation as yours.”
B. “It is important that you do what the physician D. “You need not cry. You need to move on and
has prescribed” build your life again.”
C. “I can come back after you talk with your
spouse about the care” 15. As he passed by the road going to an
D. “Let me review what is needed again, then I’ll evacuation center, Nurse Roger encountered a
talk to you later” flash flood. A flash flood:

Situation 3 – Nurse Roger is assigned in a A. Occurs suddenly and for a short duration
disaster-prone province in the Visayas. He is B. Is caused by the blocking of drains
aware that with the increase frequency of C. Is caused by heavy rains
disaster happening, he has to respond quickly D. Occurs in urban areas
and efficiently to assist the population affected by
calamities. Situation 4 – In public health service, good record
system is important delivery of quality care to
11. Which of the following BEST defines a clients. As a public health nurse, you have the
disaster? responsibility of assisting in the preparation,
maintenance of good records and reports.
A. Any event that results in multiple deaths
B. Devastation that covers a broad geographical 16. You want to distinguished between records
area and reports. As applied to health, the following
C. Devastation that cannot be relieved without are the type of RECORDS, EXCEPT:
assistance
D. The event results in multiple injuries, deaths A. Events such as births, illness, deaths
and property damage B. Analysis of a problem situation
C. Clinic consultation
12. Nurse Roger is guided by the ICN framework D. Written data on home visit
of disaster nursing competencies. This framework
consist of four areas in the continuum of disaster 17. REPORTS are prepared usually for
management that corresponds to the four stages administrative purposes. Which of these
of disaster. What consists of the FIRST stage? examples below is NOT a report?

A. Response A. Summary of service delivered

B. Preparedness B. Accomplishments and failures of service
C. Prevention C. Description of a program and planned services
D. Recovery D. Client information and profile

13. Nurse Roger has invited several agencies in 18. There are commonly used records and reports
the community to a meeting to discuss the in public health nursing practice. The individual
disaster plan for the community. Which of the clinical record contains which of the following
following BEST describes the purpose of this information?
meeting? To:
1. Socio-demographic characteristics
A. Enhance communication among agencies in 2. Patient’s chief complaint
the community 3. Physical examination findings
B. Increase stability in the community 4. Prescription of drugs
C. Manage response to disasters in the 5. Frequency of clinic check up
community 6. Attendance to community settings
A. 1, 3, 5, 6 A. Convenience to both parties to address needs
B. 1, 2, 3, 4 B. Degree of importance of the identified need
C. 1, 2, 4, 5 C. Availability of resources needed
D. 3, 4, 5, 6 D. Activities needed to meet the identified need

19. The Family Service and Progress Record 24. During the actual supervisory visit, which of
(FSPR) serves as a tool to operationalize the the following is NOT expected of Ms. Lontok? She
concept of the family as the unit of care. The
FSPR consists of four parts, the FIRST being A. Discusses the objective of the visit
B. Expresses appreciation and support given for
A. Health and nursing problems the visit
B. Nursing Care Plan C. Conveys a formal, strict approach to the
C. Assessment of the Family and the Environment midwives
D. Service and Progress Notes D. Explain the process and outcome of the visit

20. Which of the following relates to the family’s 25. After setting the objectives and selecting the
NURSING PROBLEM? activities, Ms. Lontok would need to identify the
indicators for evaluation. Which one is NOT
A. Inability to assume health tasks with respect to included?
health problems
B. Crisis situation or developmental deficit A. Needs met
C. Health threats, risk or hazards B. Performance increased
D. Strained relationships or disunity C. Promotion achieved
D. Quality of service improved
Situation 5 – Ms. Lontok, a Public Health Nurse
Supervisor, is preparing a supervisory plan for Situation 6 – As a public Health Nurse, Ms. Isay
midwives under her charge. A supervisory plan is intends to focus on a specific population to
a written document on how to organize and advocate, educate, collaborate with members
systematizes supervisory activities. from a community to improve health of the
people.
21. The need for supervision may arise from the
following: 26. Nurse Isay collects data and monitors the
health status of the population. Which of the
1. Lack of staff motivation following care Public Health functions is being
2. Conflict between personal and organizational implemented?
goals
3. Lack of knowledge and skills A. Assurance
4. Desire for promotion or job permanency B. Policy Development
5. Achieve health goals for the agency C. Assessment
D. Prevention
A. 2, 3, 4
B. 1, 4, 5 27. Nurse Isay included in her data collection the
C. 3, 4, 5 number and proportion of persons aged 25 or
D. 1, 2, 3 older with less than a high school education.
Which of the following BEST describes this data?
22. Ms. Lontok would require information
regarding the supervisory needs of the midwives A. Health Status data
which can be taken from which of the following? B. Health Care resource information
C. Health risk factors
1. Review of records and reports D. Sociodemographic data
2. Interview of the midwives
3. Review of literature 28. Working in the community with an
4. Observation of the midwives at work aggregate/population, who does Ms. Isay MOST
5. Results of survey among the staff likely to interact with?
A. 2, 3, 5
A. Students in a local high school
B. 1, 3, 4
B. Patients at the local hospital
C. 1, 2, 4
C. Residents who play basketball
D. 2, 4, 5
D. Christians in the community
23. Ms. Lontok prioritizes supervisory needs and
problems based on the following criteria, EXCEPT
29. Ms. Isay has a clear understanding of D. Advise the family that they have the right to
population-focused practice of the following ignore the living will as the patient cannot speak.
characteristics would she MOST likely display?
34. During a routine visit, the nurse noted that
A. Improving the effectiveness of care provided Perlita, 20-year old wife and mother, has several
B. Sponsoring a fund-raising project bruises at various stages of healing. She tells the
C. Volunteering for a community action nurse that she fell down. Failure to report your
D. Providing health interventions for individuals findings is an example of ____.

30. Ms. Isay is working to improve population- A. Malpractice

focused care in the community. Which of the B. Reasonable prudence
following BEST describes a key opportunity for C. Maleficence
nurses like her to accomplish this goal? D. Negligence

A. Assuming traditional nursing roles 35. Which of the following example would
B. Conduct community assessments indicate observance of clients confidentiality?
C. Specializing in community health practice
D. Influencing public health policy A. Reading a friend’s chart in another health care
facility.
Situation 7 – Ethical issues on a day-to-day basis B. Describing a difficulty with a client in a health
often involve patient communication and team conference.
advocacy. It may also include questions about C. Using a client’s name in a social conversation
end-of-life care. Nurses are often the ones D. Talking about the client’s symptoms in front of
working closest with patients and families while family members
administering care.
Situation 8 – Non communicable Disease (NCDs)
31. What is the appropriate approach for the remain to be the major health challenges in the
community/public health nurse in balancing Philippines and globally. The specific population
individual privacy and autonomy and the group that are mostly afflicted by these chronic
community’s needs for safety and security? conditions, such as diabetes and cardiovascular
diseases, are chose aged 60 and above.
A. Fulfill agency policies first.
B. Implement professional standards of nursing 36. When caring for a patient with type 2
practice. diabetes who has been discharged. Which topic
C. Remember that group needs outrank individual will be MOST important to include in your health
needs. teachings?
D. Seek a balance between individual needs and
the community’s needs. A. Impact of the patient’s family history on
likelihood of developing diabetes.
32. In regards to informed consent, which of the B. Symptoms indicating that the patient should
following statements is TRUE? contact the health care provider.
C. Effects of endogenous insulin on transportation
A. Client may not be told about costs and of glucose into cells
alternatives to treatment. D. Function of the liver in formation of glycogen
B. Consent must be voluntary. and gluconeogenesis
C. Only parents themselves should give consent
for minor children 37. To obtain the MOST complete information
D. Legally incompetent adults can give consent. when doing an assessment for 75-year-old
patient, you will _____.
33. The client has a “living will” in which he
states he does not want to be kept alive by A. Ask the patient to write down medical
artificial means even at home. The client’s family problems and medications
wants to disregard the client’s wishes and have B. Use a geriatric assessment instrument to
him maintained on artificial life support. The most evaluate the patient
appropriate initial course of action for the nurse C. Interview both the patient and the primary
would be to: patient caregiver
D. Reviews the patient’s chart for the history of
A. Allow the family to ventilate their feelings and medical problems.
concerns, while maintaining the roles of client
advocate. 38. Which information about the 77-year-old
B. Tell the family that they have no legal rights patient who is being assessed in the public health
C. Report the situation to the hospital’s Ethics and nurse is of UTMOST concern? The patient.
committee.
A. Says, “I don’t go on my daily walks since I had A. Cultural application
pneumonia two months ago.” B. Appropriate application
B. Tells the Nurse “I prefer to manage my life C. essential methodology
without much help from others.” D. community participation
C. Uses three different medications for chronic
heart and joint problems. 44. Nurse Magbanua recognizes that health
D. Organizes medications in a marked pillbox “so services offered are to in accordance to the
I don’t forget them.” prevailing beliefs and practices of the intended
clients of care. This PHC principle is known as
39. When caring for an older adult who lives in a _________.
rural areas, you will ______.
A. Availability
A. Ensure transportation to appointments with the B. Acceptability
health care provider C. Affordability
B. Assess the patient for chronic diseases that are D. Accessibility
unique to rural areas.
C. Obtain adequate medications for the patient to 45. Collaboration and cooperation is crucial to the
last for 4 to 6 months achievement of PHC goals. The referral system
D. Suggest that the patient move to an urban among the RHU, non-government organization,
area for better health care and local social welfare and development office is
classified as what type of relationship?
40. Which of these patients assigned to you is
MOST LIKELY to need planning for long-term A. Intra-sectoral collaboration
nursing management? B. Coalition building
C. Inter-sectoral collaboration
A. 71 year-old with appendicitis who has had an D. Network linkage
emergency appendectomy Situation 10- Assessment at the community-level
B. 60 year-old with bilateral knee osteoarthritis of care is a multidisciplinary undertaking that
who weighs 350lbs (159kgs) involves the member of the health team. The
C. 54 year-old with cholecystitis who has had a public health nurse uses data that have already
laparoscopic cholecystectomy been collected and are available and or gathers
D. 62 year-old with acute sinusitis who will primary data for community diagnosis.
require antibiotic therapy for 5 days.
46. Assessment is the first step in the nursing
Situation 9 – After passing the Nurses Licensure process. In the setting, which of the following
Examination, Nurse Magbanua takes her first job objectives of assessment by the public health
in a Rural Health Unit in Municipality Z. She nurse is NOT included?
reviews concepts and principles in Primary Health
Care (PHC). A. Identify specific risk factors related to health
and health problems.
41. The key global agency that initiated the Alma B. Define the nature of the health status and
Ata conference on Primary Health Care is the health-related problems
__________. C. Identify clients who should be given priority for
care.
A. World Bank D. Determine who should be referred to different
B. World Health Organization (WHO) health care facilities.
C. CARE International
D. United Nations Children’s Fund (UNICEF) 47. Conducting a community assessment leads to
a community diagnosis, its products consists of a
42. Which Asian country is considered among the profile of the community’s state of health. As a
FIRST to adopt the principle of PHC? process, the public health nurse actively
participates in community diagnosis. The MOST
A. Malaysia common method of data collection that is
B. Indonesia accurate and provides the biggest bulk of
C. Thailand community data is the ________.
D. Philippines
A. Observation
43. Nurse Magbanua is aware that she has to use B. Community census
“tools and methods that are suitable and C. Interview
acceptable to the families and communities” that D. Records review
she serve. This PHC principle is referred to as
__________. 48. The data on health and disease can be
gathered from different sources. Which of the
following sources provide a MOST accurate set of 53. What is the BEST method for nurses to
data? prepare for future professional practice?

A. Population health profile from school and A. Train other health care workers to whom
factory clinics. delegation of tasks can be given.
B. Births and death from city/municipality B. Understand and explore the issues involved in
registrar. professional practice
C. Morbidity data from filed personnel. C. Establish a coalition with professional health
D. Mortality cases from medical death organizations
certificates. D. Take additional courses in the use of
computers and telemetry
49. Data analysis involves qualification,
description and classification of data which would 54. What allows a nurse to exert legitimate power
reveal community health problems. An analysis of over a client when providing nursing care?
the social, economic, environmental and political
factors that influence health is categorized as: A. The ability to perform procedures to alleviate
patient’s discomfort
A. Health resources problems B. The ability to provide the client and family
B. Health status problems incentives and for self care
C. Health-related problems C. The power given to the nurse by reason of
D. Comprehensive problems licensure examination and registration
D. The establishment of a professional and
50. With the stated problems, the nurse and the personal relationship with the client
community prioritize these using a set of criteria.
Which of the following criteria refers to the 55. A nurse is employed by a health care agency
probability of reducing, controlling or eradicating that provides an informal training session on how
the problem? to properly use a new vital sign monitor. Which
type of education did the nurse receive?
A. Modifiability of the problem
B. Preventive potential A. Career counseling
C. Magnitude of the problem B. Continuing education
D. Nature of the problem C. Pre-employment education
D. In-service education
Situation 11 – Professional and personal
developments are required in order to maintain Section 12- The Public Health Foundation, an
and enhance professional standards and to NGO, defines quality improvement in public
provide quality, competent and safe patient care. health as “the use of a deliberate and defined
improvement process, such as the PDCA which is
51. Identify the element that is the BEST indicator focused on activities that are responsive to
of increasing accountability in the profession of community needs and improving population
Nursing: health.” Public Health Nurse Casuela learned this
management process during her undergraduate
A. Increasing salary scale for nurses. studies in Nursing.
B. Improved public image of nurses in social
media 56. The acronym PDCA stands for _______.
C. Increasing number of nurses with doctoral
degree A. Plan-Do-Check-Act
D. Demonstrate competency and high- quality B. Program-Design-Check-Act
care C. Plan-Draft-Certify-Act
D. Prepare-Do-Check-Achieve
52. Which of the following is the MOST important
element in nursing’s attempt to gain full 57. Nurse Casuela will use the PDCA when:
autonomy of practices?
1. Working towards continuous improvement
A. Maintaining the education system for nurses as 2. Implementing any change
it is now 3. Developing a new design of a process or
B. Economic well-being and welfare of nurses service
C. Restricting the latitude of decisions made by 4. Completing a designed project
nurses 5. Planning data collection and analysis to
D. Gaining and maintaining control of nursing prioritize problems
practice by nurses.
A. 1, 2, 4
B. 2, 3, 4
C. 1, 3, 4, 5 B. Walk-through, process and output reviews
D. 1, 2, 3, 5 C. Observation, focused group discussion
D. Racial background check
58. Using the PDCA cycle as a model for defining
most of the work processes the following are 63. The head of the health team creates a
some areas of its applications, EXCEPT workplace safety report for a new clinic. He
____________. makes a strict recommendation to ensure that
sharps are properly disposed in a puncture-proof
A. Needs analysis container to decrease the risk of needle-prick
B. Overall strategic planning injuries. This upholds safety under which of the
C. Staff goal setting and evaluation following categories?
D. Delegation of work to lower levels
A. Physical
59. Nurse Casuela knows that the purpose of B. Chemical
continuous quality improvement (CQI) is to C. Biological infections
_____________. D. Psychosocial

A. Provide opportunity for staff members to 64. The occupational nurse has advocated the
participate in self-governance use of ramps and assistive equipment for
B. Restructure health care delivery to improve physically challenged workers. This is good
cost savings example of which of the following levels of
C. Deliver appropriate nursing care at tertiary prevention?
level of service
D. Monitor processes involved in the provision of A. Health promotion
safe, effective client care B. Secondary
C. Tertiary
60. Nurse Casuela is implementing quality D. Primary
performance standards in a public health
department. Which of the following BEST 65. Every employee has right to privacy and
describes the importance of this action? Quality should be protected from unauthorized and
performance standards ___________. inappropriate disclosure of personal information.
Which situation does NOT provide exception to
A. Can be used as hiring guidelines for nurses employee’s right to privacy?
B. Are used to guide improvement in the public
health system A. Authorization by the employee to release
C. Guide administrators to monitor public health information
at the national level B. Life-threating emergencies
D. Rigidly control public health C. Compliance with government laws and
regulations
61. Occupational health services can make a D. Request from community leaders
significant contribution to government initiative.
These include the following, reducing: Situation 14- Public Health Nurse Manaog is a
member of the health Team that is tasked by the
1. Health insurance Rural Health Unit to identify, define and measure
2. Health inequalities major health problems of interest.
3. Social exclusion
4. Sickness absence 66. Public health surveillance includes the
5. Overall burden of ill health following activities, EXCEPT _________.

A. 2, 3, 4, and 5 A. Data analysis

B. 1, 3, and 4 B. Data collection
C. 2, 4, and 5 C. Disease control
D. 1, 2, 3, and 4 D. Data interpretation

62. The nurse is a key figure involved in 67. Public Health surveillance can be BEST
delivering quality occupational health services. described PRIMARILY as which of the following
She/He works independently or as part of a larger
interprofessional health team. She performs, A. A system for collecting health-related
along with others a job safety analysis. In doing information
such, the following methods may be employed, B. A method to monitor occurrences of public
EXCEPT: health problems
C. A program to control disease outbreaks
A. Review of records, interviews, surveys
D. A system for monitoring persons who have A. malaria
been exposed to a communicable disease B. Bacillary dysentery
C. typhoid fever
68. Which of the following is NOT a criterion for D. pulmonary tuberculosis
prioritizing health problems for surveillance?
73. The eggs of Taenia solium or taenia saginata
A. Incidence of the problem may be ingested by the pigs or cattle who serve
B. Number of previous studies of the problem as intermediate hosts. Which of the following
C. Social and economic impact of the problem measures will PREVENT access of animals from
D. Public concern about the problem ingesting Taenia eggs?

69. Current public health surveillance targets the A. quarantine or isolate the animals Foods
following. Which one is NOT included? B. Feeding the pigs and cattle with clean foods.
C. Proper disposal of human feces
A. Chronic disease D. Protect the animals by giving them vitamins.
B. Population migration
C. Communicable disease 74. Prevention of Infection from Entamoeba
D. Occupation Hazards histolytica is BEST done through which of the
following practices?
70. Common uses and application of public health
surveillance include which of the following A. Eating only organic vegetables
examples? B. Washing food very well
C. Cooking food properly
1. Detecting individual persons with malaria so D. Boiling of water from questionable source.
that they can receive prompt and appropriate
treatment. 75. Giardiasis is a disease caused by a flagellated
2. Helping public health officials decide how to protozoan and its prevalence is associated with
allocate their disease control resource. which of the following conditions?
3. Identifying changes over time in the proportion
of children with elevated blood levels in a 1. Poor environmental sanitation
community. 2. Poor hygiene
4. Documenting changes in varicella (chicken 3. Improper cooking of food
pox) incidence, after a law mandating varicella 4. Overcrowding
vaccination in the Expanded Program of 5. Malnutrition
Immunization took effect.
A. 2, 4, 5
A. 1, 2, 3 and 4 B. 1, 3, 4
B. 1 and 2 C. 1, 2, 4
C. 1, 2, and 3 D. 2, 3, 5
D. 2 and 4
Situation 16 – Public health nurse Criselda wants
Situation 15 – You are a newly-assigned Rural to increase her knowledge and familiarity with
Health Nurse and you have the based on the the elements of research publication.
latest health information of the municipality,
food- and water- transmitted parasitic infections 76. Nurse Criselda is analyzing a research article.
are prevalent. What section in the article can she expect to find
the research question and study purpose?
71. The factors that contribute to the occurrence
of food-transmitted diseases are the following, A. Discussion
EXCEPT ___________. B. Results
C. Methods
A. consumption of improperly cooked food D. Introduction
B. eating habits of the population such as eating
raw food 77. Nurse Criselda is looking for a description of
C. lack of fuel for cooking food the type of measurement used in the study. She
D. overconsumption of locally available food will find this which section of the article?

72. Paragonimus westermani or the oriental lung A. Conclusion

fluke causes in the human population by eating B. Introduction
inadequately cooked crabs. Patients with C. Results
paragonimiasis are usually misdiagnosed to have D. Methods
___________.
78. A brief explanation of data collection and B. Recognition of the leader who speaks for the
analysis procedure is found in which section of family.
the article? C. Description of the social and economic status
of the family.
A. Abstract D. Identification of the geographic location of
B. Conclusion resources for the family.
C. Discussion
D. Introduction 84. The nurse discusses with the family some
actions that needed to be taken and refers to the
79. Nurse Criselda wants to go over the list of wife in the family as an outstanding organizer.
references used in the study which can be found Which of the following goals is the nurse trying to
____________. achieve by making this statement?

A. at the end of the article A. Making then husband proud that he had
B. in the results section married his wife.
C. as part of the literature review B. Reinforcing for the family some of the
D. in the introduction strengths of one of their family members.
C. Encouraging the wife to volunteer to follow
80. Nurse Criselda believes that research is through on all the needed actions.
significant to the nursing profession, hence, the D. Making the wife feel very complimented and
study results should be disseminated. This is proud.
because research allows _________.
85. In implementing family-centered care, the
A. a specialized body of knowledge to be public health nurse _____________.
generated for use in health care delivery.
B. the scope of nursing practice to be expanded A. works with clients to help them accept
into areas formerly reserved for other disciplines. limitations for their actions.
C. nursing responsibility to be more specifically B. assists family members to assume dependent
defined roles
D. liability within the practice of nursing to be C. offers information about necessary self-care
decreased abilities.
D. provides his or her own beliefs on how to solve
Situation 17 – The family Nursing Care Plan is problems
designed to provide ways in solving health-
related problems of the family as a whole. The Situation 18 – The Department of Health has
nursing process is used to make this type of care vowed to end Neglected Tropical Diseases (NTDs)
plan. by 2030. In the Philippines, the NTDs that are
prevalent include leprosy and rabies. One of the
81. In conducting a family assessment, which strategies to address this goal is through conduct
source of data would be MOST helpful? of HEALTH EDUCATION program.
A. Input from other members of the health team.
B. Information from other cooperating health care 86. Public Health Nurse Gabriela is educating a
agencies. group of residents in Community X about RABIES.
C. Review of family members’ charts and medical A participant asks, “How can you get the virus?”
record data. The Nurse explains that the virus can be
D. Observation and interaction with the family transmitted by which source?
members.
A. Saliva
82. In completing a family assessment, the public B. Blood
health nurse should BEGIN by ___________. C. Urine
D. Stool
A. gathering the health data from all family
members 87. She emphasized that the bites, which are
B. Testing the family’s ability to cope responsible for nearly 99 percent of human rabies
C. evaluating communication patterns infections, are those of the infected __________.
D. Identification of the geographic location of
resources for the family. A. monkeys
B. dogs
83. Which of the following would be better C. bats
understood by the nurse after using a FAMILY D. cats
MAP?

A. Roles and relationship within the family

88. Nurse Gabriela explains that there are
situations which increase the risk of rabies. These A. Professional education, experience, and
are ________. specific conduct.
B. Professional experience, but not education or
A. stray of dogs conduct.
B. All of these C. Professional conduct, but not experience or
C. unprovoked bites education
D. animals display abnormal behavior D. Professional education, but not experience or
conduct.
89. In another health education session, Nurse
Gabriela explains about LEPROSY. Which of the 94. The board of nursing has brought action
following should be included? against a nurse’s license based upon violation of
a regulation. What is TRUE about this scenario?
1. leprosy is curable
2. not all leprosy patients are infectious A. Rules and Regulations are internal to the
3. leprosy is hereditary Board, not the nurse.
4. casual contact with a patient causes leprosy B. Rules and regulations are only suggested
5. regular and adequate treatment is essential standards or care and do not have to be followed.
C. These rules and regulations have the force of
A. 1, 3, 5 law.
B. 2, 4, 5 D. Violation of a rule and regulation is not the
C. 1, 2, 5 same as violation of the nursing Practice Act.
D. 2, 3, 4
95. The patient, injured at work, was seen by the
90. Nurse Gabriela stated that a definitive factory occupational nurse. The nurse treated the
diagnosis of leprosy is obtained through _________. wound and instructed the patient to get a tetanus
antitoxin injection at the City Health Center. The
A. blood examinations patient failed to follow instructions, developed
B. tuberculin testing tetanus, and subsequently filed a suit against the
C. skin smears/ biopsies nurse. What is the most likely result of the
D. nasal smears ensuing trial? The nurse is __________.

Situation 19 – Nurses perform duties that require A. liable, because there was no follow-up to
physical assessments, critic thinking, and ensure that the patient receive the injection
collaborative treatment plans, to name a few. B. not liable for damages, because the nurse has
Thus, nurses must understand the laws that a right to expect that instructions will be followed.
affect their practice, as well as their legal C. liable, because tetanus is easily treatable after
responsibilities in their professional roles. diagnosis
D. not liable, because tetanus is a reportable
91. A nurse must follow laws that protect public disease and the health center should have
health, safety, and welfare. Which law is the insisted ten treatment.
nurse following?
Situation 20 – The ability to communicate is a
A. Code of Ethics very important skill for every nurse to have. The
B. Standards of Practice nurse must do so in an effective, caring and
C. Continuing Professional Development professional manner, especially when
D. Nursing Practice Act communicating with patients and their families.

92. Which situation supports the charge of 96. A nurse wants to present information about
malpractice against a professional nurse? influenza immunization to the older adults in the
community. Which type of communication should
A. A failure on the part of the nurse to establish a the nurse use?
therapeutic relationship with the patient.
B. A failure on the part of the nurse to ensure that A. signified meaning is wrong
patients only receive care for which they could B. affect is appropriate
pay. C. personal space was violated
C. A failure on then part of then nurse to exercise D. vocabulary is poor
reasonable and prudent care in treating a patient.
D. A failure on the part of the nurse to allay a 97. A nurse is standing beside then patient’s bed.
patient’s fears about an upcoming procedure. Nurse: “how are you doing?” Patient: “I don’t feel
good.” Which of the following communication
93. What does the court consider in determining ELEMENTS is categorized as feedback?
the nurse’s liability for standards of care?
A. “How are you doing?” 3. Eliza complains of “afterpains”. What should be
B. “I don’t feel good.” the nurse IMMEDIATE action?
C. Nurse is standing
D. Patient in bed A. Advise her to stop breast-feeding for a day
B. Encourage her to drink more water
98. A smiling patient angrily states, “I will not C. Assess vital signs and pain level
cough and deep breathe.” How will the nurse D. Administer an analgesic STAT
interpret the finding? The patient’s ___________.
4. Eliza is to be discharge 3 days after CS
A. signified meaning is wrong delivery. Which of the following observations of
B. affect is inappropriate the nurse would cause the delay of her discharge
C. personal space was violated and would warrant notification to the physician?
D. vocabulary is poor
A. Moderate amount of lochia rubra
99. BEFORE meeting the patient, a nurse talks to B. Fundus is firm at umbilicus
other caregivers about the patient. Which phase C. Pulse rate of 61 beats/minute taken in 24
of the helping relationship is the nurse in with this hours
patient? * D. Five voidings totaling 240 cc in 12 hours

A. Termination 5. On the third postpartum day, Eliza reports that

B. Pre-interaction she has voided five times that morning. What
C. Working should the nurse INITIALLY do?
D. Orientation
A. Insert a Foley catheter
100. During the INITIAL home visit, the nurse lets B. Collect the next voiding and measure the urine
the patient know that the visits are expected to amount
end in about a month. Which phase of the helping C. Catheterize the client to check for residual
relationship is the nurse in with this patient? urine
D. Call the physician
A. Working
B. Preinteraction Situation 2 – Nurses Flor and Imelda are doing
C. Orientation research on, “The common errors regarding
D. Termination Standard of Nursing Documentation in the
Obstetrics Ward of Medical Center.”

NURSING PRACTICE II – CARE OF HEALTHY 6. Which could be the MAJOR Purpose of the
MOTHER/CHILD study? To __________.
June 2, 2019
A. Improve the clarity of documentation
Situation 1 – This is the first postoperative day for B. Duplicate the study in other hospitals
patient Eliza who delivered by caesarean section C. Reduce, if not eliminate, errors in
(CS). Nurse Ivy a newly hired staff was assigned documentation
to her. D. Protect the hospital and staff from being sued

1. Eliza asks the nurse why she has to get up and 7. Which of the following could be the BEST
walk the day after surgery. Which of the following Method to gather the research data?
is the BEST response of the nurse? Walking
hastens _________. A. Nursing Audit
B. Focus Group Discussion
A. Hastens lactation C. Phenomenological
B. Relieves pain D. Survey
C. Heals wounds
D. Fast recovery from anesthesia 8. What is the term used to describe the
arrangement of statistical data that exhibits the
2. Which laboratory finding should the nurse number of times the values of a variable occurs?
assess on the patient 24 hours after caesarian
section delivery upon doctor’s request? A. Frequency distribution
B. Frequency
A. Trace 1+ proteinuria C. Skewness
B. Hematocrit 35% D. Survey
C. White blood cell count 20,000/cu.mm
D. Hemoglobin 7.0 g/dL 9. In statistics, what is the definition of
percentage? It is __________.
A. Whole population 14. The patient complained that every morning,
B. A value on a scale of 100 she becomes nauseated and oftentimes, she
C. A share of profits would vomit excessively. “What could be the
D. Part of a whole expressed in hundredths cause of this,” she asked? The nurse’s answer is:
“It is due to increase level of ________.”
10. Based from the study’s findings, to whom are
the study’s recommendations generally A. Heart burn
addressed? Using the situation a forecited, the B. Estrogen
recommendation should be addressed to C. heart rate
_________. D. Progesterone

I. Nursing educators 15. The nurse advised patient Carlita to report to

II. Staff nurses her physician which of the following MOST
III. Nursing Service Administrators important sign, if ever she will suffer from it?
IV. Hospital Administrators
A. Cough
A. I, II, III B. Vaginal bleeding
B. I, III, IV C. Headache
C. C. I, II, III, IV D. strong fetal movement
D. D. II, III, IV
Situation 4 – As a newly-hired staff nurse of the
Situation 3 – Patient Carlita, 19 years old, is in her hospital, Erlyn learned that the hospitals have an
first trimester of pregnancy. Because it is her first in-service training for its staff. The in-service
pregnancy, she went for her prenatal check-up trainings conducted are based on hospital and
with her mother. She asked a lot of questions staff’s needs. One of the identified needs was on
which she expects the nurse to answer her. knowledge deficit of Mother and Baby Friendly
Hospital Initiative (MBFHI).
11. The nurse asked for the personal data of the
patient which, to some, Carlita did not like to 16. What is the FIRST step among the ten steps
answer. And so she asked: “Why do you need to for successful breastfeeding?
know if I am married?” what should be a good
response of the nurse? “I asked your marital A. Have a written breastfeeding policy that is
status because _________. routinely communicated to all staff.
B. Inform all pregnant women about the benefits
A. If you do not have a husband, then that can and management of breastfeeding.
pose a big problem for you.” C. Foster the establishment of breastfeeding
B. If you are married then your husband will also support groups.
suffer from discomforts like you.” D. Train all health care staff in skills necessary to
C. You need your husband to accompany you implement the policy.
every prenatal check-up.”
D. Your husband is your best support system 17. When practicing rooming-in, how long should
during your pregnancy.” the baby stay with the mother? ______ hours.

12. The patient asked what is the term for signs A. 8

such as breast changes, urinary frequency, B. 24
fatigue, morning sickness and amenorrhea? C. 12
D. 10
A. Probable signs
B. Presumptive signs 18. What is the CORRECT time for which the
C. Possible signs mother should initiate breastfeeding? It should be
D. Positive signs _______ hours after birth.

13. The patient asked what causes newborn A. ½

babies with total absence of extremities. The B. 1
nurse answered that the cause for Amelia is C. 3
intake of which of the following medications D. 2
during pregnancy ___________.
19. Erlyn learned that newborn infants should
A. Anti-emetics ONLY be given, which of the following?
B. Antibiotics
C. Analgesics A. Fruit juice
D. Anti-bacterials B. Breastmilk
C. water
D. cow’s milk 1. Rubella
2. Rheumatic fever
20. Which is the LAST part of the initiative, as 3. Anemia
recommended by WHO and UNICEF, for the 4. Chronic hypertension
MBFHI external team to do before its final
designation as MBFHI Hospital? A. 1, 2, 3
B. 1, 2, 3, 4
A. Assess business facilities if they follow the 10 C. 1, 2, 4
steps for successful breastfeeding. D. 2, 3, 4
B. Develop a research on the benefits of
breastfeeding within the institution. 25. Nurse Nilda advised the couple that the BEST
C. Disseminate the benefits of breastfeeding to way to check the condition of the mother and the
communities. baby is to have _________.
D. Follow up mothers if they are exclusively
breastfeeding. A. Regular well-selected exercise
B. Regular prenatal check-up
Situation 5 – Jane is 23 years old. She and her C. Music therapy
boyfriend, Kevin, are planning to get married in a D. Good food
couple of months. Thereafter, they plan to have
three babies. For this reason they sought Situation 6 – A hospitalized adolescent Robbie
reproductive health counseling for their benefit suddenly has a seizure while his family is visiting.
and the proper growth and development of their Nurse Karen notes whole body rigidity followed by
future children. Nurse Nilda was there to help general jerking movements. Robbie vomits
them. immediately after seizure.

21. Jane asks what she must do in order to be 26. Which of the following would be the PRIORITY
healthy in case she becomes pregnant. Which nursing diagnosis for Robbie?
among the answers of Nurse Nilda should NOT be
followed by Jane? A. Fluid volume deficit related to vomiting. Risk
for fluid volume deficit
A. Get support from husband and family. B. Altered family processes related to chronic
B. May have a massage from a lay midwife. illness.
C. To readily accept her pregnancy. C. High risk for infection related to vomiting.
D. Early prenatal check-up D. Risk for aspiration related to loss of
consciousness.
22. Kevin asks what possible contribution he
could give for the normal development of the 27. Which of the following would be the LEAST
baby. Nurse Jane agreed that his BEST PRIORITY nursing care for a child with seizure
contribution would be the following EXCEPT disorder?
__________.
A. Observation and recording all seizures.
A. Stroke Jane’s abdomen and talk to baby B. Ensuring safety and protection from injury.
B. Provide Jane nutritious food and drinks C. Teaching the family about anticonvulsant drug
C. Join wife during prenatal check-up therapy: indication, dosage, route and effects.
D. May smoke once in a while D. Assessing for signs and symptoms of Increased
Intracranial Pressure.
23. For the normal developmental of the fetus,
Nurse Nilda taught the couple that Jane should 28. Robbie will be taking phenytoin (Dilantin)
prevent Folic Acid Deficiency anemia by good regularly for seizure control. Which of the
diet, correct way of cooking vegetables and following will be the MOST important teaching to
taking Folic Acid supplements. Which of the Robbie’s family?
following is NOT included among the outcomes of
folic acid deficiency to the baby? A. Administer acetaminophen to promote sleep.
B. Serve a diet that is high in iron
A. Cleft lip C. Maintain good oral hygiene and dental care
B. Cleft palate D. Omit medication if the child is seizure free.
C. Neural tube defect
D. Fractures of all types 29. After teaching the parents about their child’s
unique psychological needs related to a seizures
24. Jane asks the nurse what possible diseases disorder and possible stressors, which of the
should she avoid that would guarantee health for following concerns voiced by them would indicate
the baby? These are:
the need for additional teaching? The child’s 34. A woman, 33 weeks pregnant, with preterm
___________. rupture of membranes had blood work ordered
daily. Which laboratory report would be MOST
A. Feeling different from peers important to read daily?
B. Cognitive delays
C. Poor self-image A. Serum creatinine
D. Dependency B. Red blood cell count
C. Sodium and potassium levels
30. Which of the following is NOT a focus for D. White blood cell count
teaching plan for an adolescent with a seizure
disorder? 35. An 18 –year –old delivers to an 8 –pound –
baby after 10 hours of labor. In the post-partal
A. Obtaining a driver’s license period, which of the following would be a
B. Increase risk for infections PRIORITY concern to assess for by the nurse?
C. Peer pressure
D. Drug and alcohol use A. Endometritis
B. Thrombophlebitis
Situation 7 – Any pregnancy may pose a risk. A C. Bleeding
pregnant woman must therefore submit herself D. Amniotic embolus
for regular pre-natal consultation in any health
facility near her place of abode. A nurse can play Situation 8 – Patient Fe, 15 years old, G0P1, AOG
an important role in making these pregnant 39 weeks, has been admitted at 6:30 in the
women aware of these risks in all stages of morning for lumbo-sacral pains and strong
pregnancy. uterine contractions every 10 minutes. Nurse
Jocele was there to admit her. She uses Focus,
31. What CHIEF ingredient of the prenatal vitamin Data, Action and Response (FDAR) as the form of
for pregnancy nutrition that the patient should charting.
look for?
36. In any type of charting or documentation,
A. Vitamin B12 which of the following should the nurse refer to
B. Potassium and use to generate and describe the status of
C. Vitamin C patient Fe? Nursing __________.
D. Folic Acid.
A. Assessment
32. A woman in labor is at risk for abruptio B. Process
placenta. Which of the following assessments C. actions
would MOST convince you and the pregnant D. diagnosis
woman to believe that this has happened?
37. Which of the following are the purposes of
A. Painless vaginal bleeding and downward trend documentation? To ________.
of BP.
B. And increased blood pressure and scanty I. Ensure the development of organized
urination. comprehensive care plan
C. Pain at the lower quadrant and increased pulse II. Have a clear and accurate record of what was
rate. done to the patient.
D. Sharp fundal pain and discomfort between III. Have an evidence of the health care member’s
contractions. accountability in giving care
IV. Detect patients who are clinically deteriorating
33. A woman 2 ½ months pregnant calls you by *
telephone because she passed out some “berry-
like” blood clots and now has continued dark A. II, III, IV
brown vaginal bleeding. Which of the following is B. I, II, III, IV
the BEST instruction you should give her? C. I, II, III
D. I, III, IV
A. “Continue normal activity but take your pulse
and respiratory rate every 4 hours.” 38. Which of the following is the CORRECT
B. “Come to the health facility if uterine definition of focus charting?
contractions start.”
C. “Come to the health facility with any vaginal A. It is an electronically form of documentation of
material passed out.” nursing care done to a patient by a registered
D. “Maintain bedrest and count the number of nurse.
perineal pads used every hour.”
B. It is a note, written or electronically generated, A. “On my 6 months of pregnancy, I saw a rabbit
to provide documentation related to a specific with the same case of my son.”
focus. B. “I am asthmatic and I usually take steroids.”
C. It is a nurse-centered way of documentation C. “My mother- in- law doesn’t like me, that’s why
that describes the patient status and nursing care she cursed me.”
rendered. D. “I believe my enemy did some forms of
D. It is a nurse-centered approach to witchcraft on me.”
documentation.
44. For an infant born with a unilateral cleft lip
39. In the given situation, which is the FOCUS? and palate, which of the following type of feeding
will be BEST to use?
A. Jocele as the admitting nurse
B. Lumbo-sacral pains and strong uterine A. Rubber-tipped syringe or medicine dropper.
contractions B. Full breast feeding.
C. 15 years old, G0P1, AOG of 36 weeks C. IV fluids on limited number of ounces.
D. Admission at 6:30 in the morning D. Cross-cut rubber nipple.

40. What is the term used to describe the 45. Which of the following is the number ONE
patient’s data or assessment, the action done consideration in the care of an infant after the
based on the assessment and response based on surgical repair of a cleft lip?
the action made:
A. Preventing the infant from crying
A. Progress Note B. Feeding the infant with a spoon for 2 days after
B. Flow sheets surgery
C. Standard of Care C. Placing the infant in a semi-sitting position
D. Focus Format D. Keeping the infant NPO for 1 say after surgery.

Situation 9 – Head nurse Carmen supervises Situation 10 – Miel, on her 35 weeks of gestation,
Nurse Donna who is assigned to take care of a is admitted because of hypertension, BP of
newborn baby boy named Henrich with a cleft 185/110, severe headache and blurred vision.
palate. She was placed on imposed bedrest without toilet
privileges. The physician orders MgSo4. Erika is
41. The mother asks the head nurse why the the nurse assigned to her.
pediatrician recommended that closure of the
palate should be done before he is 6 months old. 46. Which of the following would Nurse Erika
She asked Nurse Donna to answer her. Which of anticipate in then patient’s maternal history?
the following is Nurse Donna’s APPROPRIATE
response? A. On and off vaginal spotting
B. Esophageal discomfort is experienced after a
A. “After age 2, surgery is very frightening and heavy meal.
should be avoided if possible.” C. Weight gain of 20lbs in the 1st and 2nd
B. “The eruption of the 2-year molars often Trimester
complicates the surgical procedure.” D. Fetus moves very frequently
C. “Surgery should be performed before the child
starts to use faulty speech patterns.” 47. When a patient is on an imposed bedrest,
D. “As he gets older the palate gets wider and which of the following can help the patient cope?
more difficult to repair.” These are the following, EXCEPT __________.

42. The head nurse continued to ask Nurse A. Let the patient lie on her side to allow more
Donna, “A cleft lip predispose an infant to blood to the uterus.
infections PRIMARILY because of which of the B. Increase fluid intake to 8 glasses a day to
following reasons?” prevent constipation.
C. Discourage participation of family in patient
A. Waste products that accumulate along the care to prevent further anxiety.
defect. D. Use relaxation techniques to help cope with
B. Inadequate circulation in the defective area. stress such as music and books.
C. Deficient nutrition from ineffective feeding.
D. Mouth breathing that dries the oropharyngeal 48. MgSo4 injections are painful to the patient.
mucous membranes. Which of the following is the BEST route for
injection to prevent such negative experience for
43. Which SIGNIFICANT statement of the mother patient Miel?
predisposes her son to cleft lip or palate?
A. Intravenous injection at the main IV line.
B. Intravenous injection given through “piggy I. Unlawful destruction
back”. II. Alteration
C. Intramuscular on each of the deltoid muscle. III. Disclosure
D. Deep intramuscular using z-track technique on IV. Unlawful processing.
buttocks.
A. I, II, III
49. The nurse must be alert to MgSo4 toxicity. B. II, III, IV
Which of the following in NOT included? C. I, II, III, IV
D. I, III, IV
A. Fetal bradycardia
B. Urine output of <30 ml per hour 53. To erase the doubt of Cathlyn as to whether
C. Respiration of <12 per min she has been infected with HIV by her BF, what is
D. Increase in maternal pulse rate the BEST advice of the nurse?

50. Which of the following hospital environment A. Wait until you have access to the diagnosis of
will be MOST conducive to Miel’s condition? A your BF.
room that is / with ____________. B. Submit herself for Elisa Test considering
window period.
A. Bright and well-ventilated C. Wait until the baby is born.
B. 2 or three other patients D. Go for Elisa Test immediately
C. Quiet and non-stimulating
D. A call button for watcher’s use. 54. In case the personal data of Cathlyn’s BF has
been accessed accidentally by “somebody”, who
Situation 11 – Cathlyn is 19 years old, a grade 12 has the right to file a complaint?
student. She recently confessed to Nurse Patty
that she had sexual intercourse with her A. Cathlyn’s BF
boyfriend (BF), 18 years old classmate of hers. B. The other guy
She believes that she is pregnant because she C. the parents
missed menstruating for 3 months. She also D. Cathlyn
related that her BF has recently been confined for
pneumonia after an on and off flu-like symptoms. 55. How long should personal data of an HIV
She suspects he has HIV because of his patient be stored on laptops or other portable
“closeness to a guy who has overtly expressed devices which permits his identification? For as
his feelings on him.” long as __________.

51. Cathlyn wants to know his BF’s real diagnosis A. The patient likes
even through a private message in Facebook. The B. His doctor likes
following information that all employees are C. It is needed as part of an international or
enjoined to observe strictly. In terms of legalities, national research
which of the following should Nurse Patty explain D. It is necessary for the purpose for which it was
t Cathlyn? collected and processed

I. Operate and hold diagnosis under strict Situation 12 – Mrs. Geminy, 20 years old, visited
confidentiality the prenatal clinic with her husband George.
II. Sign a non-disclosure agreement between Nurse Connie noted that the fundus is at the level
nurses and their patients. of the umbilicus. Being her first pregnancy, the
III. Abide with the institution’s privacy and patient asks the clinic nurse about pregnancy and
security policies. childbearing.
IV. Disclose only the result of the best to the
patient himself. 56. Based from the assessment of the nurse,
what would be the estimated age of gestation, in
A. II, III, IV WEEKS, if then fundus is at the level of the
B. I, II, III umbilicus
C. C. I, II, III, IV
D. D. I, II, IV A. 8
B. 10
52. Nurse Patty can also explain the purpose of C. 6
security measures for data protection which is to D. 12
maintain the availability, integrity and E. NONE OF THE ABOVE
confidentiality of personal data of all patients.
Which of the following actions of anybody is 57. When is the placenta, which is the source of
against personal data protection? estrogen and progesterone, fully developed? It is
on the __________ weeks of pregnancy?
 C. intra- operative
A. 8 D. post- operative
B. 20
C. 16 64. Before bringing the child to the operating
D. 28 room, what condition of the patient needs
immediate notification of the surgeon by the
58. Mrs. Geminy related that she oftentimes feel nurse that will warrant suspension of surgery?
nauseated in the afternoon. Which of the
following should Nurse Connie advise her to do? A. Colic
B. Atopic dermatitis
A. Eat sky flakes and follow it up with water C. nasopharyngitis
B. Drink iced carbonated drinks D. eye deviation
C. Drink hot chocolate or coffee
D. Eat frequent but small amount of foods. 65. Include in the post-op plan of care is
collaboration and referral of the patient with cleft
59. Which of the following periods of pregnancy palate to which of the following APPROPRIATE
does organogenesis occur? health care provider?

A. Third A. Speech therapist

B. First B. Dentist
C. Second C. dietetian
D. Fourth D. gynecologist

60. What sign of pregnancy is morning sickness Situation 14 – The giving of medication to a
characterized by nausea? pediatric patient is a serious responsibility of a
nurse. The need for accuracy in giving medication
A. Probable, subjective is greater than with adult patients. Nurse mimi
B. Presumptive, subjective has just been assigned to the Pediatric Wards.
C. Probable, objective
D. Presumptive, objective 66. Dosage, when giving medicine to pediatric
Situation 13 – A mother in her first trimester of patients, varies according to which of the
pregnancy is asthmatic and has taken steroids. following? Select all that apply
This resulted to her baby with cleft lip and cleft 1. Size
palate. 2. Surface area
3. Age of child
61. While assessing a newborn with cleft lip, the 4. Height
nurse should be alerted on which of the following
that will MOST likely be compromised? A. 3 only
B. 1 and 2
A. Locomotion C. 1, 2, 3
B. Respiratory status D. 1, 2, 3, 4
C. GI function
D. Sucking ability 67. Nurse Mimi is being reviewed by her
Headnurse on administering oral medication on
62. What is the MOST APPROPRIATE response of pediatric patients. Which of the following
the nurse to the mother’s question as to when statements below is CORRECT?
the child will be ready for a cleft palate repair?
Cleft palate repair is usually done _______. A. The child should be told to place the tablet in
the middle of his tongue and to drink water, fruit
A. When a large-holed feeding bottle is ineffective juice, milk in order to wash down the tablet.
for his feeding B. A child’s reaction to a dose ordered by a
B. When the child is completely weaned from physician is not less predictable than adult’s
bottle feeding reaction.
C. Prior to the development of speech C. When giving oral medication, the child as
D. After the child has been toilet trained young as two years of age CANNOT be taught to
swallow drugs.
63. Elbow restraints are the choice during the D. The possibility of error is greater in the giving
patient’s operation. When is the right time to of medication to children than to adults.
introduce the use of these restraints? It should be
during the _________ phase. 68. In children and infants, which part is often
used for intramuscular injection to reduce the risk
A. Pre-operative of vascular and peripheral nerve (sciatic) injuries?
B. Rehabilitative
A. Deltoid muscle C. 3-5 minutes
B. Gluteus maximus D. 1 to 2 minutes
C. Dorsogluteal
D. Vastus lateralis 73. After washing her hands and gently cleaning
any discharge that can be removed easily from
69. Comprehensive surveys of research reports the outer ear, Nurse Romana positions the child.
and case study literature about intramuscular Which of the following steps follows?
injections revealed that administering medication
intramuscularly can produce a variety of serious A. Gently press the tragus of the ear four times in
adverse effects. When asked by the Headnurse a pumping motion.
what possible complications can arise, Nurse B. Drop the medicine into the ear canal.
Mimi should include which of the following? C. Gently pull the outer ear
D. Keep the up for five minutes
1. Skin and tissue trauma
2. Muscle fibrosis and contracture 74.Based on her knowledge on otitis media,
3. Nerve palsies and paralysis Nurse Romana recalls that children are
4. Infectious processes such as abscesses or predisposed to AOM due to their Eustachian tubes
gangrene being, which of the following? Select all that
apply.
A. 1, 3, and 4
B. 1, 2, 3, 4 1. Shorter
C. 2, 3, 4 2. More horizontal
D. 1, 2, 3 3. More prone to obstruction by enlarge adenoids
4. Longer
70. Prior to administering the drugs ordered by
the Pediatrician, Nurse Mimi needs to know if she A. 1, 2, 4
is giving the ordered medication to the right B. 1 and 3
patient. The FIRST step is __________. C. 3 and 4
D. 1, 2 and 3
A. Check patient’s identification bracelet.
B. Compare medication to order to identification 75. To promote drainage and reduce pressure
bracelet and patient’s stated name and birth from fluid, Nurse Romana’s nursing intervention
date. is to have the child assume any of the following
C. Verify patient’s allergies with chart and with positions, EXCEPT:
patient.
D. Ask patient to state their name and birth date. A. Have the child sit up
B. Put the pillows behind the head
Situation 15 – Karen, 5 years of age, is admitted C. Lie on the non-affected area
to the Pediatric Ward due to severe otalgia, fever D. Lie on the affected ear
and irritability. The mother informed Nurse
Ramona, who is assigned to Karen, that patient Situation 16 – Paraluman, 16 years of age, has
had upper respiratory infection three weeks prior been ordered to be discharged. Nurse Nenet is
to admission. The admission diagnosis is acute faced with a dilemma as Paraluman refuse to be
otitis media (AOM). discharge.

71. Nurse Romana makes her INITIAL assessment 76. Which of the moral problems is nurse Nenet
on Karen. The patient keeps on crying and faced with?
constantly pulls her right ear. What is her MOST
APPROPRIATE action? A. Ethical sensitivity
B. Ethical responsiveness
A. Assess the description and frequency of pain. C. Ethical valuing
B. Take Karen’s vital signs. D. Ethical reasoning
C. Request parent to carry the child.
D. Refer to the attending physician. 77. Which of the following are the rights and
responsibilities of Nurse Nenet’s client while
72. Nurse Romana is preparing to administer confined in the hospital?
ofloxacin eardrop on Karen per Doctor’s order.
She needs to hold the bottle with her hands to A. Code of Ethics
warm up the solution to prevent dizziness for B. Bioethical Ethics
_________. C. Hospital Client Advocacy
D. Patient’s Bill of Rights
A. 10 minutes
B. 5 minutes
78. Which of the following principles of bioethics asked: “Will my baby have HIV too?” What is the
is referred to when Nurse Nenet provides BEST answer that Miss Kat should give the client?
information and supports her client and family in
making a decision? * A. “No, definitely not because your child has not
been exposed to any type of HIV transmission.”
A. Fidelity B. “Yes, because HIV is definitely transmitted to
B. Nonmaleficense the child form the mother through the placenta.
C. Justice C. “One way of transmitting HIV from the mother
D. Autonomy to the baby is through the placenta. However,
your child may or may not have been transmitted
79. When Nurse Nenet values client advocacy, with HIV virus.”
she follows which of the following guidelines? D. “It depends on the viral load of the mother and
many other factors. Let us just see you after you
A. She is more loyal to the hospital than to her give birth.”
client.
B. She chooses the client’s well-being over 84. Miss Kat continued with her health teaching.
client’s autonomy. This time she describes four main routes of HIV
C. She gives priority to the good of the individual transmission. Which one is NOT included?
client rather than to the good of society in
general. A. Childbirth and breastfeeding
D. She makes decisions for her clients who are B. Unprotected vaginal and anal or oral sex
not aware of their rights and privileges. C. Breathing the same air as someone living with
HIV does
80. Which of the following actions best describe D. Sharing unsterilized injecting drug equipment.
the use of the professional value of altruism?
85. Miss Kat gave a few questions to her
A. Protects the privacy of client regarding the audience about HIV transmission to find out if
client’s health condition. they were able to learn about it. “Which of the
B. Demonstrates an understanding of the culture following is the LEAST among HIV transmission
of her client. that can directly enter the body via the blood
C. Lobbies for universal access to healthcare. stream or mucous membranes?” This can be
D. Becomes a mentor to her novice nurses. through the ___________.
Situation 17 – Miss Kat an OB Nurse Specialists,
was invited in a forum. The topic was about HIV- A. Urethra or inside the foreskin of the penis
AIDS and the group was composed of ten B. Lining of the vagina, cervix or womb
pregnant women, and five newly married women C. Dermis of the skin rule
whose husbands are seafarers. D. Lining of the anus

81. Miss Kat’s first topic was on HIV transmission. Situation 18 – Anton, 15 years old, has been
After explaining the different transmission modes, informed that she is due for discharge. He has an
she asked the group: “Which among the following emergency appendectomy. Nurse Mimi give him
is the MAJOR mode of transmission of the some discharge instructions.
disease?”
86. Anton is noted to be very conversant. To
A. Blood Transfusion make her discharge instructions clear, Nurse Mimi
B. Needle pricks should emphasize which of the following?
C. Sexual intercourse
D. Kissing I. Tell Anton that he can clarify or ask questions.
II. Tell him that it is alright to interrupt if he had to
82. One of the pregnant women asked the BEST ask a question to clarify
way to prevent HIV transmission from a pregnant III. Advise him to listen, well
HIV (+) mother to child? IV. Ask for the presence of his mother

A. Deliver the child via normal delivery with A. 4 only

cervical support B. 1 and 2
B. Stop pregnancy by abortion C. 1, 2 and 3
C. Drink antiviral medicines as prescribed by D. 1 only
physician
D. Prenatal check-up more than the standards 87. Nurse Mimi’s discharge instruction should
contain, which of the following?
83. A 20-year-old newly-wed woman, whose
husband has recently been diagnosed with HIV, I. Take home medication, if any.
II. Date to follow up
III. Activity and exercise A. Signs and symptoms of premenstrual period
IV. Diet recur in the luteal phase of the menstrual cycle.
B. Signs and symptoms of premenstrual period
A. 2, 3 and 4 recur in the luteal phase of the menstrual cycle.
B. 1, 2 and 3 C. Symptom-free period occurs in the follicular
C. all the options phase and must include 7 symptom-free days.
D. 3 and 4 D. Symptoms are severe enough to have an
impact on work, lifestyle and relationship.
88. To make Nurse Mimi’s discharge instructions E. None of the Above
to be more effective the following strategies
should be used, EXCEPT _____________. 93. Nurse Catalina read about the nursing
management of primary dysmenorrhea. Which of
A. Treat him as a child. these should Catalina render?
B. Use simple understandable words
C. Eye to eye contact to show interest on what is I. Use of cold compress
being said II. Soft rhythmic rubbing of the abdomen
D. Ask for feedback III. Analgesics as ordered
IV. Antispasmodics as ordered.
89. To get feedback on the discharge instructions,
which questions should Nurse Mimi ask? A. II, III, IV
B. I, II, III
A. Can you repeat to me what my instructions C. I, III, IV
were? D. I, II, IV
B. If you understood my instructions then you
surely be well 94. What is the condition wherein menstrual
C. Did you understand my instructions? interval is 45-50 days?
D. Are my instructions clear?
A. Metrorrhagia
90. The BEST statement of goodbye that Nurse B. Menorrhagia
Mimi is _________. C. Dysmenorrhea
D. Oligomenorrhea
A. “Bye Anton.”
B. “Bye Anton. See you again in the hospital.” 95. What is the condition whereby during
C. “Bye Anton. I don’t want to see you again in menstruation, the patient feels lower abdominal
the hospital.” pain that radiates to her back down to her thighs?
D. “Bye Anton. Remember all my instructions.
Keep well.” A. Hypergonadotrophic amenorrhea
B. Secondary dysmenorrhea
Situation 19 – Catalina is the new nurse assigned C. Hypogonadotrophic amenorrhea
at Fertility Clinic of an OB Specialty Center. She D. Primary dysmenorrhea
had to review about the female reproductive
cycle, menstrual disorders and appropriate Situation 20 – Riza, head nurse at the OB-DR
management. Ward, is planning to have an in-service training
for 25 staff nurses. Based from needs
91. Catalina thought that one of her activities assessment, the training will be on Lactation for 3
would be health teaching and counseling. Which days.
of the following statements by the client
regarding premenstrual syndrome would need a 96. In order to make the activity a success, which
further explanation? of the following resources would be MOST
important?
A. “I will limit my intake of sodas, coffee and tea.”
B. “I will make sure that I will eat small frequent A. Number of speakers
balanced meals.” B. Location of venue
C. “I will stop any physical exercise one week C. Number of Participants
prior to menstruation to conserve my energy.” D. Budget Allocation
D. “I will decrease my intake of high sodium
containing foods such as canned goods.” 97. Which of the following resources should be
MATERIAL/ SUPPLY?
92. The nurse read on how to make a nursing
diagnosis for premenstrual syndrome. Which of A. Bond Paper
the following is NOT TRUE about premenstrual B. Sound system
syndrome? C. food and drinks
D. tables and chairs
 medicines, which of the following nursing action
98. Based from the studies, which among the should be done by nurse Rica?
following is the MOST needed resource of nurses
in order to attend in-service training programs? A. Take the carotid pulse rate for one full minute
B. Take the heart rate for one full minute.
A. Clothes C. Take the respiratory rate.
B. Time D. Take the blood pressure.
C. Drinks
D. Notebooks 4. While nurse Rica was doing her regular rounds,
one of the mother approached her saying that her
99. Evaluation of the training is an important child who a Tetralogy of Fallot. Prepared to squat
form of feedback in order to improve future on bed rather than assuming a supine position.
offerings. Which of the following should be given THE BEST action of the nurse is ______.
MOST emphasis?
A. let the mother continue the position of her
A. Taste and amount of food serve. child is she feels comfortable with it.
B. Discipline of participants B. divert the child’s attention by letting her join
C. Convenience of the venue the nurses’ rounds
D. Knowledge and skills gained C. put her on bed and start to administer oxygeb
inhalation
100. When asking mothers to become real D. discourage the child and let her lie on bed with
models for demonstrating breastfeeding, the 2 pillows instead
nurse’s MOST important responsibility is which of
the following? 5. Another patient in the unit is Letty, 8 years old,
waiting to be scheduled for surgery because of a
A. Word of thanks Coartation of the Aorta. With this disorder, Letty
B. Stipend/honorarium will manifest which one of the following
C. Priority care symptoms?
D. Free hospitalization
A. murmur and bruit of the lungs.
B. Central and peripheral edema.
C. Hypertension and diminished pulses in the
NURSING PRACTICE III – CARE OF CLIENTS (PART extremities.
A) D. hepatomegaly and shortnedd of breathing.
June 2, 2019
Situation 2 – Mr. Joeis 55 year old, ,married , a car
Situation 1- Rica, a Pediatric Cardiovascular Nurse dealer has consulted the ER because of on and
is assigned to take care of 3 children in her unit. fever, indigestion, weight loss, right abdominal
She just admitted a 12-year-old female patient pain, body malaise, and itchiness of the skin.
suffering from Rheumatic Fever (RF) Based on the health history of the patient has
been a chain smoker and drinks alcoholic
1. When doing as assestment, which ONE of the beverages almost every day especially when he
following condition is NOT present based on the has client to entertain. His physical examination
Jones Criteria? showed he has a suspected liver cirrhosis. He was
advised for admission for further work-up and
A. Erythema Marginatum treatment.
B. Subcutaneous nodules
c. Chorea 6. You are the nurse on duty when Mr. Joe was
D. Bronchopneumonia admitted in the pay floor. In your observational
data what additional EARLY SIGN of the liver
2. In Rheumatic Fever, the factor contributory to cirrhosis do you expect patient to manifest?
the development of this disease process is
brought about by _____ A. Gonadal atropy
B. hypotension
A. Auto-immune reaction to streptococcal C. Splenomegaly
infection D. Ankle edema
B. Auto-immune reaction to collagen diseases
C. Parents had rheumatic heart disease 7. Which of the following statements is TRUE of
D. Exposure to colds and droplet infection liver cirrhosis?

3. Leny, 6 years old, is receiving digitalis for 1. Nutritional deficiency with decreased protein
having patent ductus arteriosus with heart intake contributes to liver damage
failure. Prior to the administration of the
2. Cirrhosis can happen to people with alcohol 12. Which of the following nursing goals are
intake achieved when early ambulation is done by post-
3. Women are the greater risk for development of surgery patients?
alcohol-induced liver disease.
4. Most patients affected by liver cirrhosis are 1. improved circulation
between 40 to 60 years of age. 2. improved respiratory functions
3. prevent venous stasis
A. 1, 2, 3 & 4 4. prevent emboli formation
B. 1 & 2
C. 1, 2 & 3 A. 3 & 4
D. 2 & 3 B 1, 2, 3, 4
C. 1, 3, 4
8. During Mr. Joe’s confinement he developed D. 1 and 2
further itchiness of the skin and jaundice. Which
of the following nursing actions is NOT 13. Which of the following patients is MOST at risk
recommended as this will induce skin breakdown? during the induction of anesthesia?

A. Add baking soda when bathing the patient. A. 6-year-old with history of allergy
B. Massage the skin with emollients every 2 B. 65 year old diabetic woman
hours. C. 35 year old TB case
C Use of commercial soaps and alchohol-based D. 25 year old polio case
lotions.
D. Rub the itchy skin with knuckles instead of 14. As a circulation nurse, which of the following
using the nails. is your PRIORITY nursing action to promote safety
of your patient?
9. At early stage of Mr. Joe’s disease process, the
physician ordered this SPECIFIC diet for Mr. Joe. A. Prevent peri-operative position injury
You emphasized to the dietitian that he should be B. Provide adequate lighting during the procedure
served foods that is ______ C. Optimize surgeon’s access to surgical site
D. Maintain surgical aseptic technique during the
A. high carbohydrate and low sodium procedure
B. high calorie and high carbohydrate
C. low protein and high fat 15. Being the nurse in the Post-Anesthesia Care
D. high protein and high fat Unit, which of the following is your PRIORITY
concern after surgery?
10. Mr. Joe started to develop ascites and
complained of heaviness of the lower extremeties A. monitor Vital Signs
to physician. An order of Spironolactone B. observe surgical site for bleeding.
(Aldactone) 25 mg. / day what adverse effect the C. validate doctor’s orders
drug should you monitor? D. check level of consciousness

A. hyperkalemia Situation 4 – the following situations are related

B. palpitation to ethical practices in the workplace.
C. Irregular pulse rate
D. hypokalemia 16. Len a registered nurse, has signed the
contract for two years in medical center. A
Situation 3 - Mr. Perez is surgical nurse in medical recruitment agency has offered her a “fat” salary
center and he had been practicing for almost five for foreign employment. If you are in the position
years in this unit. The staff go on shift rotation. of Len, what should you do?
For that shift, he had two patients for operation.
One is for lobectomy and another is for A. Discuss your plans with your parents.
Nephrectomy. B. accept the recruitment offer and go on
Absence without official leave.
11. When is the BEST time for the operative C. Write a letter of resignation to your employer
consent is be signed by his patients? 30 days before leaving.
D. Accept recruiter’s offer and give an excuse to
A. As soon as the surgical procedure is explained employer on behalf of her “sick” mother.
to the patient.
B. on Admission when the relative are around. 17. Riza is BSN graduate but did not take the
C. A day before the surgery National Liscensure exams. She is in dire need of
D. Before any Pre-op medication are money so she applied and was accepted in a
administered. health facility. As a nurse she submitted a fake
PRC liscense in order to be given the job. Riza is B. crackles on auscultation.
liable to be charged of ______. C. Dry productive cough
D. orthopnea
A. false statement
B. misrepresentation 23. The patient has been receiving Digoxin 0.25
C. fraud and deceit mg. per day to regulate his heart rate. Which of
D. malpractice the following outcomes would indicate that this
medication is achieving its desired effect?
18. Ms. Paras as R.N. was invited as a resource
person in a nursing conference. The curriculum A. improved appetite
vitae she submitted to the PRC Continuing B. increased pedal Edema
Professional Development Council reflects the C. increased urine elimination
word Masters of Arts in Nursing (MAN) after her D. improved bowel elimination
name. She only completed academic
requirements but NOT her thesis writing. Which of 24. The other patient of Ms. Lydia is suffering
the following did Ms. Paras violate? from Buerger’s disease. He has been complaining
of intermittent claudication of the lower
A. R.A 9173 of Nursing Law extremities which has been giving him so much
B. code of Professional Ethics for teachers discomfort. What is the BEST nursing action she
C. Magna Carta for Health Workers should perform to address the patient’s
D. Code of Ethics for Registered Nurse complaint?

19. It is a hospital policy for nurses in a health A. Allow the patient to lie flat on bed
facility that reporting time is 15 minutes before B. Teach him foot care and leg exercises.
the Official designated time. Nurse Claire C. Place affected extremities in a dependent
reported 30 minutes late in requested her co-staff position
to sign in for her. This is an example of _____. D. Apply hot water bag to the affected
extremities
A. Dishonesty
B. falsification of document 25. Which of the following information is NOT True
C. Unprofessional conduct of Buerger’s disease?
D. All of the options
A. Small and medium arteries and veins are
20. What ethical justification is observed when mostly affected.
administering Opiods despite the possibility of B. Smoking is a major cause of Buerger’s disease.
hastening death? C. Incidence of Buerger’s disease is high in men
than women.
A. Rule of Double effect D. A strong relationship exists between diabetes
B. Rule of Single effect and buerger’s disease.
C. maleficence
D. justice Situation 6 - Melanie, 58 year old, beautician has
undergone bowel obstruction surgery. During her
Situation 5 - Lydia is a staff- nurse working in first day post-op, she vomited clear liquids about
medical unit with several patients suffering from three times during your shift. Her vital signs
cardiovascular and peripheral disorders. include: temp- 37.9 degree C. 138/84 PR- 78/min
and RR-26/min. Her surgical incision is intact,
21. There are several factors contributory to the slight bleeding, swelling and tenderness with
development of these conditions. Which of the slightl pain.
following are the PRIORITY causative factors that
should be emphasized by Nurse Lydia I her health 26. Which of the following manifestations would
teaching? indicate the development of wound infection?

A. cigarette smoking and hyperlipidemia. A. Presence of elevated red blood cells count.
B. Aging process and alcohol intake B. Profuse and increasing perspiration.
C. Stress and overacidity C. Increased blood pressure, respiratory rate and
D. Sedentary life and obsesity pulse rate
D. Increasing pain on the surgical incision.
22. Mr. Jacob is admitted due to congestive heart
failure. Nurse Lydia would expect that if the 27. If the wound drainage is sero sanguinos, it
failure is on the right side of the heart, the means the secretion is colored______.
patient will manifest which of the following?
A. yellow-tinged
A. Jugular vein distention B. pinkish-red
C. green-tinged supplies and equipment along the corridor as well
D. bright red as O2 tank not properly secured. The Quality
Circle (QC) teams was informed about this
28. Later during the day, Melanie became observation.
confused, started to pull out her IV fluids as well
as her wound dressings. Complained of severe Which of the following is the BEST strategy to be
pain over the wound area. The PRIORITY action of adopted by the team with this concern?
the Nurse is to _____.
A. Adopt the 5 S audit
A. Apply sterile dressings over the surgical wound B. Identify and Prioritize the problem
B. call the surgeon at once for the health status C. Select Alternative Solution
of the patient C. Enhance Continous quality improvement
C. administer the pain medication at once
D. restrain the hands of the patient 34. The approach adopted by quality circle team
was presented to top management. Which of the
29. The drug of choice of pain relief to patient following tools is APPROPRIATE to be utilized as a
Melanie considering the score of 8 which was guide for their time management?
assessed by the nurse based on the rating scale
of 0-10 (0-lowest, 10 is the highest) is _____. A. Pre chart
B. Radar chart
A Morphine SO4 C. Process flow chart
B. ibuprofen D. Gantt Chart
C. Demerol
D. paracetamol 35. In order to determine if the Implementation of
the activity is successful, the First step to be done
30. When a patient is receiving opiod medication, by the team is _____.
the nurse should observe complications from the
side effects by_____. A. Prioritize the problem
B. coordinate with the different units
A. Checking the presence of loose bowel C. Have a random report to the supervisor
movement D. Develop a monitoring plan
B. observing signs and symptoms of addiction
C. assessing changes of circulatory status Situation 8 - Nurse Aida is assigned in the surgical
D. assessing wakefulness of patient at least every ward of the tertiary medical center with several
2 hours. patients who are for diagnostic test and for
surgery
Situation 7 – Mr. Santos, a post-operative patient,
was given Amoxycillin at midnight by the nurse 36. Mr. Rustom, 38 years old, is scheduled for
on duty (NOD). The physician asked the patient Laparoscopic Cholecystectomy in the morning the
during his round if he has receive the drug, the next day. He verbalized to you and say “Dr. Alex
patient answered “NO”. The physician clarified will open me up to remove my gallstone?” which
the claim from the chart and from the NOD. of the following is your BEST response?

31. When the physician clarifies the process of A. “Let us discuss with the surgeon your
drug administration, this Quality Improvement operation before you go to the OR.”
Process is known as. B. “I know the surgeon will remove your stones
with a new technique.”
A. system analysis C. “Let me call the OR supervisor to discuss the
B. Root cause Analysis procedure with you.”
C. problem Identification D. “I will the anesthesiology to explain more the
D. Pareto chart procedure.”

32. Which of the following is the primary reason 37. A critical component before Mr. Rustom, goes
why the physician wanted to clarify the process? for surgery is the nurse preoperative teaching.
Which of the following is NOT advisable prior to
A. Measures the turnaround time of medication surgery?
B. Better communication with patient and results
C. identify gap in the medication administration A. Teach him deep breathing exercises.
D. improve care management in drug B. Fast at midnight, but can drink water if he
administration becomes thirsty.
C. Instruct him to avoid before going to the
33. While the medical director is conducting his operating room.
rounds he observed the presence of scattered D. Teach him leg and coughing exercises.
 2. Ambu Bag
38. While giving health instructions to Rostum. He 3. Suction Apparatus
looks very anxious and said to you, “I might not 4. Endotracheal
be able to wake up from the anesthesia after my
operation.” Your BEST response is _____. A. 1,2,4
B. 1,2,3,4
A. “Do not worry, everything will be alright.” C. 1,2,3
B. “Let me tell to your family your fear.” D. 2,3,4
C. “I will not let you got to OR unit. I have talked
to your surgeon.” 43. Which of the following emergency medicines
D. “Don’t say that, I will discuss your concerns should be available at the emergency cart at the
with your anesthesiologist.” Cardio Ward?

39. Mr. Rostum, returned back to ward, after 1. epinephrine

recovering from anesthesia. He complained of 2. Demerol
pain over the scapular region. Which of the 3. Valium
following nursing actions should you do? 4. Coumadin

A. apply heating pad over the painful area. A. 1,3

B. Turn client from side to side. B. 1,2
C. Give Demerol as ordered C. 2,4
D. Apply cold pack over the affected area. D. 3,4

40. After 5 days, Mr. Rostum is ready to go home, 44. When stocking fluids in the emergency cart,
His discharge instructions include observations of what should nurse Nathalie instruct the nurses?
the following complications, EXCEPT:
1. Put the recently –delivered at the back of the
A. Palpitation old stock
B. Loss of Appetite 2. Put the old stock in front of the newly –
C. Increased body temperature delivered ones
D. Bleeding 3. Check the fluids for sediments and
discoloration
Situation 9 – Nathalie is assigned as charge 4. Keep the fluids inside a cooler
nurse at the cardiovascular ward in a Medical
Center. There are 20 patients, classified as A. 1,2
following: 2 Total Care (TC), Partial Care (PC) and B. 1,4
9 Ambulatory Care (AC). The ward’s morning duty C. 3,4
are 3 staff nurses and 2 nursing attendant (NA). D. 2,3

41. How will you distribute the patients to the 3 45. How will Nurse Nathalie arrange the patients
Registered Nurses and 2 Nursing Attendant? in the ward? Put the ________

A. 2 registered Nurse for Total Care Patients, 1 A. Primary Care in between the Ambulatory Care
Registered Nurse and 1 Nursing Assistant for patients
Primary Care patients, 1 Nursing Assistant for B. Primary Care and Ambulatory Care patients
Ambulatory Care patients . together and Total Care at the corner of the room.
B. 1 Registered Nurse and 1 Nursing Assistant for C. Total Care patients near the Nurses station and
Total Care patients, 1 Registered Nurse and 1 the Ambulatory Care farthest
Nursing assistant for Primary Care patients, 1 D. Ambulatory Care patients near the Total Care
Registered Nurse for Ambulatory Care patients ones.
C. 2 Registered Nurse for Total Care patients, 2
Nursing Assistant for Primary Care patients, 1 Situation 10—Mr. Bang 62 year old, an Executive
Registered Nurse for Ambulatory Care patients. of the shoe company was brought to the hospital
D. 1 Registered Nurse for Total Care patients, 1 after having vomited bright red blood
Registered Nurse and 1 Nursing Assistant for immediately after supper. He claimed he had
Primary Care patients, 1 Registered Nurse and 1 drinking session with his former classmates in
Nursing Assistant for Ambulatory Care patients. college. He was already advised by their family
physician not to drink alcohol due to a suspected
42. In as much as this is a cardio-ward what basic fatty liver. You are the nurse-on-duty when he
equipment/materials should be available at all was admitted.
times?

1. O2
46. Based on your assessment and history taking
for Mr. Bang which PRIORITY findings should you Situation 1 – Nurse Yolan cares for a terminally ill
document and report to the physician? client with cancer.

A. Use of anti-inflammatory drugs. 1. Nurse Yolan assesses the client for depression.
B. Vital signs BP-140/90, PR-88/min. RR-24 /min Which of the following is a key indicator for
C. abdominal pain (3 in a scale of 10) clinical depression?
D. Tense, rigid abdomen
A. Anger due to pain experience
47. You have formulated your Nursing Diagnosis B. Feeling of excessive guilt
for the patient and wrote in the nursing care plan. C. Anorexia and weight loss
Which ONE of the following D. Inability to care for one’s physical self

A. Deficient Fluid Volume R/T vomiting of blood 2. The client has difficulty sleeping. Which of the
and gastric secretion following interventions is LEAST helpful for Nurse
B. Non-compliance R/T alcohol and medication Yolan to incorporate in her care plan?
intake
C. Fear of death R/T unknown cause bleeding A. Instruct the client to drink herbal tea.
D. Risk of Aspiration R/T active bleeding B. Give warm milk at bedtime
C. Perform relaxation routine such as massage,
48. The Physician orders insertion of nasogastric imagery or music
tube with lavage to Mr. Bang. What kind of D. Instruct the client to drink black tea.
solution will you expect to be written in the
doctor’s order when the patient will undergo a 3. The care plan for the client includes family
lavage? support. Which of the following is MOST
appropriate for the family to establish a
A. Normal saline solution relationship with the health care team? Nurse
B. Distilled water Yolan should ___________:
C. tap warm water
D. Dextrose 5 % in water A. Give permission to the family to take time to
maintain friendship with the health care team.
49. When a patient has gastro-intestinal bleeding B. Discuss the roles of the family members to the
and there is the presence of hematemesis, how health care team.
should you describe this in your documentation? C. Explain the roles of all members of the
interdisciplinary team.
A. Bloody vomitus appearing as fresh, bright red D. Provide a brief explanation to the family
blood or “coffee-ground” in appearance. member about the care being delivered to the
B. Brownish vomitus appearing as “chocolate” in client.
appearance from a previous food intake.
C. Black, tarry stools in appearance often foul 4. The client appears to be dehydrated. The
smelling, from a previous food intake. family members are discussing whether their
D. Small amounts of fresh blood observed either loved one should be given intravenous fluid.
through gastric secretions or stools. Which of the following concepts about
dehydration in terminally ill clients should guide
50. The following are the practice guidelines in Nurse Yolan?
documentation. Which ONE of these is NOT
recommended to be written in your charting? A. Peripheral edema occurs because of fluid
overload.
A. Had urine output of 600 cc during the whole B. Thirst is an indication of dehydration.
shift. C. Terminally ill clients are hydrated through oral
B “Appears to be comfortable with good night rest and intravenous routes.
and sleep.” D. All interventions for terminally ill client should
C. Refused to eat her dinner as she feels be directed towards comfort and reduction of
nauseated at meal time. symptoms.
D. slept from 11 PM to 6 AM after Valuim 5 mg.
was given. 5. The client show signs of imminent death. Nurse
Yolan recognizes cardiovascular indicators of
imminent death which are the following EXCEPT
__________:

NURSING PRACTICE IV – CARE OF THE CLIENTS A. bradycardia

(PART B) B. Irregular heart rate
June 3, 2019 C. tachycardia
D. lowered blood pressure D. A score of D is less invasive than a score of B
Situation 2 – A 65 year old male is admitted for in the cancer staging system.
prostate cancer. On assessment, the nurse 11. You are oriented on health care economics.
determines that the patient has experienced The study of economics focuses on how choices
incontinence. The nurse knows that incontinence are made to overcome a scarcity of resources.
is the first most common symptom of prostate Which of the following statements BEST
cancer. illustrates health care economics __________:

6. Based on information gathered, the nurse 1. Providing less health care services that is
writes a nursing diagnosis. Which of the following optimal in order to contain costs.
diagnoses is MOST appropriate? 2. Using individuals with less knowledge and skill
to perform health care services usually performed
A. Deficient knowledge related to self-care and by people with advanced knowledge and training.
risk prevention. 3. Taking economic risks as a health care
B. Fear secondary to the diagnosis of cancer. provider.
C. Risk for urinary infection 4. Providing adequate or appropriate care
D. Risk for impaired urinary elimination minimize risk of expensive utilization.

7. To help manage incontinence, the nurse A. 1 and 2

instructs the patients to do which of the following: B. 3 and 4
C. 1 and 4
A. Eat foods rich in fiber D. 2 and 3
B. Increase fluid intake.
C. Take in medications to manage pain. 12. Which of the following statement is TRUE
D. Perform perineal muscle exercises regarding health care economics?

8. The patient asks for treatment option for his A. Contemporary health care is characterized as a
condition. The Nurse explains that treatment business struggling to balance cost and quality.
options are based on which of the following: B. Profit in health care is synonymous with billing
privileges.
A. gender C. Health care economics is a new concept in
B. ability of the patient to manage physical and nursing.
emotional implications of incontinence D. Health care is becoming affordable and clients
C. Socio-economic status are demanding quality care.
D. grade and stage of the disease
13. You understand that a key factor that
9. The patient asks the nurse what the physician influence client care is the cost involved in the
meant about his prostate cancer as Stage C or delivery of health services. Which of the following
T3. The nurse explains that the tumor is resources is NOT required to support the services
______________: delivered by nurses?

A. palpable and has spread to other organs and A. Time

often to distant sites such as bones and lymph B. Client’s environment
nodes. T4 C. People
B. palpable and has spread beyond the prostate D. Equipment
but not to other organs.
C. confined to the prostate and was not palpable 14. You are aware that there is a need for you to
during digital rectal examination. T1 understand how to manage the cost of client care
D. confined to the prostate and was not palpable as it relates to clinical practice. Which of the
during digital rectal examination. following are nurses accountable for?

10. The nurse recalls the staging and A. Decision regarding cost effective practices.
classification of prostate cancer. Which of the B. The Client’s hospital charges
following statements is TRUE? C. Distribution and consumption of resources
such as time, supplies, drugs, staff and
A. The Gleason grading system is usually used for personnel.
hematological cancers but not prostate cancer. D. Financial viability of nursing department.
B. The normal prostate specific antigen (PSA)
range under 40 years of age is less than 4 to 6 15. While touring the department where you are
ng/mL. assigned, you noticed that the supply room is
C. At least two separate biopsy specimens are stacked with medical supplies and equipment.
graded based on their differentiation from normal Which of the following is the BEST action you will
prostate cells. take?
 C. Enhances venous return and thus reduce ICP
A. Create a task force to assess the situation and D. Reduces cerebral edema thus reducing ICP.
report the findings. Situation 5 – a nurse in the intensive care unit
B. Take an inventory of the supplies and attends to a 20-year old female who was involved
equipment. in a vehicular accident three days prior to
C. Request maintenance to sort out the supplies admission. The prognosis is very poor. No brain
and check the medical equipment to determine if activity was detected after 2 electro
they are still functional. encephalograms (EEGs) were taken.
D. Call for a staff meeting and discuss how best
to utilize the available resources. 21. The family decides to wean the patient from
the ventilator support. The family talks to the
Situation 4 – 34 year old female client complains nurse about their decision to get the nurses’
of experiencing double vision and frequent support. Which of the following actions is NOT
headaches. The client claims to be forgetful and appropriate? The Nurse ___________.
has mood swings. A diagnosis of right frontal lobe
lesion was made and the client was admitted for a. Checks the physician’s orders for sedation and
craniotomy analgesia and make sure that the anticipated
death is comfortable and dignified.
16. The client claims to have a diagnostics work b. Explains to the family what will happen each
up in the outpatient unit before she was phase of the weaning and offer support.
admitted. The admitting nurse prepares the client c. Tells the family that death will occur almost
for which of the procedure that will MOST likely immediately after the patient is removed from
confirm the presence of brain tumor? the ventilator support.
d. Participates in the decision-making process by
A. Myelogram offering the family information
B. CT Scan
C. Lumbar puncture 22. Two hours after the ventilator support was
D. Skull x-ray discontinued, the patient dies. The nurse
discusses with the family the possibility of
17. While the client is being interviewed, she had donating the deceased person’s organs. The
a seizure. The initial intervention of the nurse following are guidelines in organ or tissue
must be directed towards: donation. Which of the guidelines should the
nurse observe?
A. Protecting the client
B. Controlling the Seizure 1. Religious beliefs in organ donation and
C. Reducing circulation to the brain transplantation must be respected.
D. Restraining the client 2. Donors must be free of infectious disease and
cancer
18. After surgery, it is important for the nurse to 3. Consent or written orders by the physician are
position the head of the client properly to: necessary for referral to an organ procurement
organization.
A. Facilitate venous drainage 4. The family of the deceased should be offered
B. Prevent hemorrhage on the suture line. an opportunity to speak with a knowledge organ
C. Provide for client comfort procurement coordinator.
D. Maintain patent airway 5. The person requesting for organ does not have
to believe in the benefits of organ donation but
19. The Nurse is aware that one of the measures should support the process with a positive
listed below is contraindicated in post-operative attitude
pulmonary toilet.
A. 1, 2, 3, 4, 5
A. Suctioning B. 1, 2, 4
B. Deep Breathing C. 2, 3, 4
C. Turning D. 1, 3, 5
D. Coughing
23. The legal definition of death that facilitate
20. The surgeon orders glucocorticoid organ donation is the cessation of:
Dexamethasone (Decadron) to be given following
craniotomy. The nurse recognizes that this drug: A. Function of the entire brain
B. Pulse
A. Creates a feeling of euphoria, which is C. Circulatory and respiratory functions
beneficial in the early post-operative period. D. Respiration
B. Promotes excretion of water which aids in
reducing ICP.
24. The patient is pronounced dead by the 28. The nurse assesses the patient to determine
physician. Which of the following nursing actions the extent of injury. Which of the following signs
VIOLATES the standards of care for a dead is a CARDINAL sign of renal trauma?
person?
A. Shock
A. Removing soiled dressing and tubes. B. Lumbar pain
B. Keeping the dead person in a sitting position C. Abdominal pain
until the family has arrived and said their D. Hematuria
goodbyes.
C. Placing identification tags on both the shroud 29. The nurse writes a nursing diagnosis for the
and ankle. patient with stab wound. The MOST appropriate
D. Preparing to transfer the body to the morgue. nursing diagnosis is ____________.
25. The family goes through the stages of
grieving. What are the stages in the grieving A. Nutrition imbalance, less than body
process? requirements, related to nausea from renal
trauma
1. Acceptance B. Deficient fluid volume related to blood in the
2. Depression urine
3. Denial C. Acute pain in the abdominal area related to
4. Bargaining renal trauma
5. Anger D. Acute pain in the lumbar area related to renal
trauma
A. 3, 5, 1, 4, 2
B. 3, 5, 4, 2, 1 30. The physician prescribes Magnetic Resonance
C. 1, 5, 3, 4, 2 Imaging (MRI) of both kidneys to confirm clinical
D. 1, 2, 5, 4, 3 suspicion and determine the severity of the injury.
Which of the following activities is a PRIMARY
Situation 6- A male teenager was wheeled in the nursing consideration in preparing the patient for
Emergency Department (ED) for injured. MRI?

26. The nurse assesses the patient for A. Administer all medications scheduled before
complications. Which are the MOST COMMON the test.
complications? B. Report findings of metal screening; sedate the
patient before sending him for MRI.
1. Urinary leakage C. Coordinate the MRI with other patient care
2. Delayed bleeding from damage activities and inform the patient about the test.
3. Abscess formation D. Ensure the patient is on NPO and hold all
4. Paralytic ileus medications until test is completed.
5. Renal failure
Situation 7 – Nurse Ashley is a staff nurse in the
A. 4 & 5 oncology unit of a tertiary hospital. She reads
B. 3 & 4 literature on antineoplastic medications.
C. 1 & 2
D. 2 & 3 31. Nurse Ashley understands the importance of
continuing professional development. Which of
27. The nurses knows that with renal trauma, the following is the MAIN purpose of continuing
further complications may occur such as: professional development? To ____________.
Which are the POSSIBLE complications?
A. Update one’s professional knowledge and
1. Secondary hemorrhage usually due to competence
infections B. Acquire a certificate of attendance to add to
2. Renal artery stenosis one’s curriculum vitae
3. Renal atrophy C. Establish networking within the nursing
4. Hypotension profession
5. Hydronephrosis D. Fulfill requirements for an advanced degree in
nursing
A. 2, 3, 4, 5
B. 1, 2, 3, 4, 5 32. Nurse Ashley reads that the drug
C. 1, 2, 3, 5 Cyclophosphamide (Cytoxan) is given to patients
D. 1, 3, 4, 5 with breast cancer. Nurse Ashley understand that
this drug is ______:

A. Cell cycle phase-non-specific

B. A hormonal medication
C. An antimetabolite A. Nurse to patient ratio shortens lengths of
D. Cell cycle phase-specific patient stay in the hospital.
B. Nurse to patient ratio results to reduced
33. Nurse Ashley reads in the literature that a patient mortality.
patient with breast cancer taking Cytoxan should C. Number of nurses, infection rates fall.
observe the following. Given a case what should D. Nurse to patient ratio increases costs.
nurse Ashley instruct a patient to do?
38. The head nurse determines to reduce
A. Decrease sodium intake while on medication. medication errors in the trauma unit. She
B. Take the medication with food. recognizes that medication errors often occur in
C. Increase potassium intake while on medication. relation to the following EXCEPT:
D. Increase fluid intake 2000 to 3000 mL daily.
A. Preparing the wrong concentration and
34. Nurse Ashley understands that patients administering the medication via the correct
receiving antineoplastic medications should do route.
which of the following? B. Failure to question unclear medication errors.
C. Lack of knowledge about medication.
1. drinks beverages containing alcohol in D. Failure to identify non-therapeutic client
moderate amounts responses.
2. consult with the physician before receiving
immunizations 39. The head nurse suggests that to reduce
3. be sure to receive flu and pneumonia medication errors, several measures will be
immunizations instituted. Which of the following is MOST
4. take aspirin (Acetylsalicylic Acid, ASA) as for appropriate?
headache
A. Use point-of-care technology to access drug
A. 2 only reference information.
B. 3 & 4 B. Use of drug index
C. All of the options C. Nurses must help educate patients and their
D. 1 & 2 families regarding proper medication
administration.
35. An incident was described in the literature D. Patients must become more involved in
where a patient developed stomatitis after managing their care.
receiving a course of antineoplastic medications.
Which of the following actions would be BEST for 40. The head nurse is aware that managing and
a nurse to do? improving quality care in the trauma unit requires
which of the following?
A. Swab the mouth daily with lemon and
glycerine. A. Personalized attention to patient’s needs and
B. Avoid foods and fluids for the next 24 hours. their families.
C. Brush the teeth and use waxed dental floss 3x B. A blame – free environment.
a day. C. All of the choices.
D. Rinse the mouth with diluted baking soda or D. A clean and orderly trauma unit.
saline.
Situation 9 – Nurse Mirasol is the attending nurse
Situation 8 – the head nurse of a trauma unit of a 40-year old female admitted in the medical
introduce changes to improve the quality of care unit with a probable diagnosis of Scleroderma.
of trauma patients.
41. The patient complains of pain in her fingertips
36. The head nurse presented a set of goals to and pallor followed by blanching of the
the staff nurses. Which of the following goals is extremities and redness. Nurse Mirasol knows
NOT relevant to improving quality of care? that these symptoms are characteristic of which
No_______: of the following disorders?

A. Legal suits. A. Swan-neck deformity

B. Needless deaths. B. Raynaud’s phenomenon
C. Waste of resources. C. Joint swelling and effusion
D. Needless pain or suffering. D. Symmetric Polyarthritis

37. The head nurse reviews reports on nurse 42. Nurse Mirasol assesses the skin of the
staffing. The following findings result to better patient. Which phase of skin changes occur FIRST
patient outcomes EXCEPT: A higher _______: and are usually painless and symmetrical?
A. Indurative A. Independently
B. Primary B. Interdependently
C. Curative C. Dependently
D. Edematous D. Collaboratively

43. Nurse Mirasol writes a nursing diagnosis for 48. A nurse works with a skin care team. The
the patient. Which of the following is a PRIORITY nurse is functioning _________:
nursing diagnosis?
A. Dependently
A. Social isolation B. Interdependently
B. Impaired skin integrity C. Collaboratively
C. Disturbed body image D. Independently
D. Low self-esteem
44. Nurse Mirasol assists the patient in coping 49. A nurse initiates a visit from member of the
with the disorder. During the early stages of a clergy for a terminally ill client. The nurse is
chronic disease, patients tend to focus on which functioning ___________:
of the following behaviors?
A. Interdependently
A. Understanding the disease process B. Collegially
B. Impact on lifestyle changes C. Independently
C. Interpretations of symptoms D. Dependently
D. Schedule of medications
50. When a nurse uses a straight catheter to
45. Nurse Mirasol prepares a discharge plan of obtain a urine specimen for laboratory test, the
care for the patient. Which of the following nurse is functioning ________:
objectives are MOST appropriate? The patient
should _______________. A. Dependently
B. Interdependently
1. Try to prevent breakdown of the skin and C. Independently
ulceration D. Collegially
2. Avoid activities that trigger pain
3. Modify diet to include legumes Situation 11: Marie, an oncology nurse assists in
4. Avoid exposure to extreme cold temperature the care of patients with cancer.

A. 1, 2, 3, 4 51. One of her patients is a 50-year old female

B. 1, 2, 3 named Marcela is in the terminal stage of breast
C. 1, 2, 4 cancer. She tells Nurse Marie. “I have given
D. 2, 3, 4 responses of Nurse Marie is MOST therapeutic?

Situation 10 – Nurse Bessie is a nurse manager of A. “You have given up hope?”

trauma unit. She supervises the staff and B. “You should talk to your physician about your
regularly holds conferences with them and other fears of dying.”
unit personnel. In one meeting she re orients the C. “You should talk about dying with your spiritual
staff nurses on their various functions. She cites adviser.”
clinical situations related to a nurse dependent, D. “You should not give up hope. There are
interdependent, and collaborative functions. research studies being done to cure cancer.”

46. An interdependent function of nurse is when 52. Marcela says to Nurse Marie. “I don’t like to
the nurse _______: spend my final days on earth in a hospital.” The
BEST response of Nurse Marie would be:
A. Irrigates a feeding tube that appears
obstructed. A. “Can you please tell me more how you are
B. Gives ice chips to a client who has an order of feeling right now?”
NPO. B. “I know how you feel. It must be hard to know
C. Applies a dry sterile dressing to an abdominal that you are dying.”
incision. C. “If I were in your place, I should have refused
A. helps the client choose rich foods in protein being admitted to the hospital knowing that I will
from an ordered diet die soon.
D. “What is it that you don’t like being in the
47. A nurse decides to give a partial bath to a hospital?”
client instead of a complete bath. The nurse is
working __________:
53. Marcela tells Nurse Marie that her younger 56. The nurse writes a care plan for the client.
sister was recently diagnosed with cancer. She is The Nurse is aware that this disorder is a/an
concerned because she is aware that breast ________.
cancer “runs in the family” but she could not
recall any family member diagnosed with bone or A. disease caused by over exposure to sunlight
lung cancer. Nurse Marie’s BEST response would B. Local rash that occurs as a result of allergy.
be: C. inflammatory disease of collagen contained in
connective tissues.
A. “I am sorry to hear about your sister. I think D. disease caused by the continuous release of
you should meet with all of your family members histamine in the body.
and share with them their increased risk for
developing lung and bone cancer.” 57. The nurse includes in the care plan dietary
B. “Apparently your sister is so unfortunate. it is instructions. Which of the food items should the
rare to have three such unrelated cancers at one nurse instruct the client to AVOID?
time.”
C. “I think it is important for you to be tested for A. steak
lung cancer as soon as possible, because it has B. broccoli
hereditary link.” C. legumes
D. “I am sorry to hear about your sister’s recant D. fish
diagnosis. Most probably your sister has a breast
cancer that has metastasized or spread to the 58. The nurse is aware that fatigue is experienced
bone and lungs.” by patients with SLE. Which of the following
activities should be a component in the care plan
54. Nurse Marie has another patient, Cena who for the client to manage fatigue? To ________.
was recently diagnosed with ductal cell
carcinoma of the breast. Her oncologist described 1. sit whenever possible
Cena’s cancer as T2, N1, Mx. Cena asked Nurse 2. take a hot shower in the morning
Marie to repeat to her what “all those letters and 3. avoid long periods of rest
numbers mean.” Nurse Marie replies that it 4. engage in moderate low impact exercise when
means the following: not fatigued
5. maintain a balance diet
A. Two tumours present, one lymph node
involved, and many sites of metastasis. A. 2, 3, 5
B. One large tumour present, nodal involvement B. 1, 2, 3
in one region, and metastasis was present. C. 1,2 3, 4, 5
C. Two tumours present, one lymph node involved D. 1, 4, 5
and metastasis was present.
D. One tumor present, which is larger than 2.5 59. The physician schedules the client for
centimeters, nodal involvement in one region, plasmapheresis. The client asks the nurse what is
and metastasis was unable to be determined. plasmapheresis. The nurse explains that it is a
method that will __________.
55. Patient Cena tells Nurse Marie “How did I
acquire breast cancer?” Nurse Marie explains that A. prevent foreign antibodies from damaging
there are risk factors that may have contributed various body tissues
to her condition. Which of the following B. decrease the damage to organs caused by
statements is TRUE concerning the risk factors for attacking T-lymphocytes
breast cancer? C. eliminate eosinophils and basophils from the
A. Hormones are not a risk factor for breast blood
cancer. D. remove antibody-antigen complexes from
B. Other types of cancer history have no circulation
correlation with breast cancer. 60. The nurse monitors the client undergoing
C. Ethnicity is a risk factor. plasmapheresis. Which of the following reactions
D. Environment is not a risk factor for breast should the nurse observe?
cancer.
A. shortness of breath
Situation 12 – A 35-year old female client B. numbness and tingling
presents herself in the outpatient Department C. transfusion reactions
with complaints of rashes particularly on the face, D. high blood pressure
across the bridge of the nose and on the cheeks.
The client is suspected of having systematic Situation 13: The nurse assists in the care of
lupus erythematous (SLE). She is admitted to the clients with chronic obstructive pulmonary
female medical unit. disease (COPD).
61. The nurse is aware that clients with COPD are conduct a study of the incidence of colorectal
at risk for ineffective respirations cancer in the Philippines.
EXCEPT which of the following _________?
66. Nurse Mark formulates a possible title for the
A. Clients undergoing thoracic or abdominal study. Which of the following is the MOST
surgery appropriate title?
B. Clients with rib fractures and kyphosis
C. Clients with neuromuscular disorders such as A. “Incidence of Colorectal Cancer in the
Guillain-Barre’ syndrome Philippines”
D. Clients with fluid volume deficit B. “Perceptions of the Filipinos on Colorectal
Cancer”
62. Nursing interventions for clients with C. “Colorectal Cancer in the Philippines: It’s Risk
respiratory acidosis include the following EXCEPT Factors and Interventions”
to __________. D. “A Comparative Study of Gastrointestinal
Cancer Cases among Filipinos”
A. monitor arterial blood gases (ABGs), pH, PCO2,
and HCO3 67. What research design is the MOST suitable to
B. administer oxygen and medication as ordered gather data for the study?
C. monitor hourly vital signs and respiratory
status A. Quasi Experimental
D. administer sedation as ordered by the B. Correlational Study
physician to relax the client C. Descriptive study
D. Developmental study
63. The nurse understands that excess acid in the
body acts as CNS depressant. Clients with 68. In gathering data for the study, ethical
acidosis may exhibit which of the following guidelines on basic human rights will be
symptoms: observed? Which of the ethical principles is
applicable?
1. reduced level of consciousness
2. confusion 1. Justice
3. lethargy 2. Privacy and dignity
4. coma 3. Respect
4. Confidentiality
A. all of the option
B. 1, 3, & 4 A. 1, 2, 3, 4
C. 1, 2, 3 B. 2, 3, 4
D. 1 & 3 C. 1, 2, 3
D. 2, 3
64. The goal for treatment for respiratory acidosis
is to improve ventilation. Which of the following 69. Nurse Mark formulates an assumption for the
measures is appropriate for clients with COPD study. Which of the following is MOST acceptable?
experiencing respiratory acidosis?
A. Liver cancer cases have decreased in 2017 due
A. Bronchodilators to intensive public awareness
B. Administer medications as ordered B. More Filipinos regardless of gender are
C. Ambulation diagnosed with colorectal cancer.
D. Spirometers C. Male Filipinos are prone to colorectal cancer
than liver cancer.
65. The nurse understands that respiratory D. The leading cause of colorectal cancer among
acidosis occurs when __________: Filipinos is high consumption of alcohol.

A. the body retains too much carbon dioxide 70. Which of the following is the MOST
B. the client is unable to exhale carbon dioxide appropriate recommendation Nurse Mark should
co2 – is very dependent on your ventilation propose?
C. the client hyperventilates
D. there is loss of acid or retention of base in the A. Warning signs of the effects of alcohol should
body be printed on bottles and cans of alcoholic
beverages.
Situation 14 – Nurse Mark is assigned in the B. Health professionals should educate the public
oncology unit of a tertiary hospital. He is aware of on the risk factors of CRC.
the increase in number of colorectal cancer C. DOH only should intensify its campaign on
patient in his unit. He and a colleague plan to colorectal cancer awareness.
D. Congress should pass a bill banning all cancer- keep a record of all patients admitted in the
producing foods and beverages. hospital.

Situation: The nurses cares for a 30 year old 76. You are aware of the importance of keeping
patient who is admitted for severe vomiting. The hospital records. Which of the following
diagnosis of the patient is hypernatremia. statements is NOT rue about hospital records?
Hospital records _____________.
71. The nurse reads the laboratory results. Which
of the following values indicate that the patient is A. provide data on health information system
experiencing hypernatremia? B. are a key source of data for medical research
on statistical reports.
A. Potassium level of 5.5mEg/L C. provide personal information about the
B. Urine specific gravity below 1.0008 physicians and nurses assigned to care for the
C. Serum osmolality below 280mOsm/kg patients.
D. Serum osmolality above 295mOsm/kg D. provide evidence of a hospital’s accountability

72. The nurse monitors the patient for signs and 77. You are oriented on the hospital policy that
symptoms of complications. The nurse knows when a patient is readmitted, the patient’s file
that one of the PRIMARY risks when treating maybe retrieved from the hospital records
hypernatremia is ___________: department. From which file may be a readmitted
patient’s record be retrieved?
A. renal shutdown
B. cerebral edema A. physician’s ledger
C. cellular dehydration B. master patient index file.
D. RBC destruction C. civil service file
D. hospital library records
73. In planning the care for this patient the nurse
includes the following interventions. Which of the 78. You orient your staff on the common system
following actions should the nurse NOT include in used in recording nursing interventions. The
the plan of care? system used is a nursing index card or Kardex.
What information is NOT included in the Kardex?
A. observe for possible increase in temperature
B. observe and prepare for possible seizure A. Drug regimen of the patient.
attack. B. Allergies if any of the patient.
C. monitor intake and output C. Progress notes of the physician.
D. restrict fluids to 1,200 mL per day. D. Dietary requirements of the patient.

74. The nurse understands that a patient with 79. A patient’s record contains information of the
hyperatremia is at high risk for seizure. Which of medications and treatments administered, and
the following safety measures is MOST observations of the patient’s condition. Which of
appropriate? Use of _________. the following data MUST be filled up in the
patient’s chart when he/she is discharged from
A. pillows placed at the head the hospital?
B. padded tongue blades
C. padded restraints A. Religion
D. padded side rails B. Nursing Diagnosis
C. Final medical diagnosis
75. The nurse formulates a nursing diagnosis for D. Educational attainment
the patient. Which of the following nursing
diagnoses is NOT appropriate for this patient? 80. You are familiar with the ethical aspects of
patients and hospital records. Which of the
A. Impaired Electrolyte, Sodium related vomiting. following statements is NOT true?
B. imbalanced Nutrition, more that body
requirements, related to excess intake of foods A. Health records are the property of the locality
rich in sodium. where the patient is treated.
C. Risk for injury, bleeding, related to the B. Hospital records maybe released without the
interference with blood coagulation secondary to patient’s consent when required in investigation
sodium excess. for serious criminal offense.
D. impaired skin integrity, related to peripheral C. Confidential records must be protected against
edema secondary to sodium and water excess. loss, damage, unauthorized access, modification
and disclosure.
Situation 16 – You are a nurse manager of a
tertiary hospital. One of your responsibilities is to
D. Patients have the right to confidential B. Management
treatment of information they provide to health C. Supervisory skills
professionals. D. Patient advocacy

Situation 17 – Ms. Gina is a staff nurse in a Situation 18 – Nurse Rolly, a triage nurse admits
medical unit of x hospital. She collaborate with clients in the Emergency Department (ED) of X
other members of the health team to provide safe hospital. The following are situations in the ED
and quality patient care. Nurse Rolly encounters.

81. Which of the following statements BEST 86. Four victims are brought to the ED after a
explains the role of the nurse in collaborating motor vehicle crash. Who among the following
with others to plan for the patient’s care? The victims require the HIGHEST priority for the
nurse _____________. treatment?

A. collaborates with colleagues and the patient’s A. 21 year-old male with fracture of the face jaw.
family to provide combined expertise in planning B. 20 year-old female with misaligned right leg.
care. C. 35 year-old male complaining of abdominal
B. works independently to plan and deliver care pain.
and does not depend on other staff for D. 62 year-old female with palpitation and chest
assistance. pain.
C. consults the physician for direction in
establishing goals for clients. 87. Four victims of a car crash are brought to the
D. depends on the latest literature to complete an ED. Nurse Rolly assesses the victims. Select who
excellent plan of care. among the following has the HIGHEST priority for
treatment.
82. Nurse Gina is aware that collaborative
interventions are therapies that require the A. Absence of peripheral pulses
following: Which of the collaborative interventions B. A suckling chest wound
is the MOST therapeutic? C. Severe bleeding of facial and head lacerations
D. An open femur fracture with profuse bleeding
A. Nurse and patient intervention
B. Multiple health care professionals 88. Nurse Rolly performs primary assessment on
C. Physician and nurse intervention one of the trauma victims, and determines that
D. Patient and physician intervention the client has a patent airway. The NEXT
assessment by Nurse Rolly should be to
83. To initiate an intervention in collaboration ___________.
with the health team, Nurse Gina must be
competent in which of the following areas? A. palpate for the presence of peripheral pulses
B. check the level of consciousness
A. Leadership, autonomy, and skills C. examine the client for any external bleeding
B. Experience, advanced education, and skills D. observe/assess client’s breathing or
C. Knowledge, function, and specific skills respiratory effort
D. Leadership, finances, and skills
89. A 45 year-old male client was brought in the
84. Nurse Gina is aware that there are nursing ED with head and neck trauma sustained in a
activities that may be delegated to other health motorcycle accident. The FIRST action of Nurse
care team members. Which principle should Rolly is to ___________.
guide the nurse in delegating tasks?
A. suction of the mouth and oropharynx
A. Delegation occurs only upon a physician’s B. obtain venous access
order. C. immobilize the cervical spine
B. The delegated personnel is accountable for the D. administer supplemental oxygen
care.
C. Delegation may reduce the patient’s cost of 90. Jerome, 65 years old who works as a
care. carpenter fell from a ladder while fixing the roof
D. The nurse has the primary responsibility for of a neighbor. He was brought to the ED by family
the quality of patient care. members. He is unconscious. Nurse Rolly does a
primary assessment on client Jerome which is to:
85. Nurse Gina is a potential team leader of the
health team. Which of the following skills should A. Ask the family about Jerome’s medical
she develop? condition
B. Assess the vital signs
A. Collaborative skills C. Attach a cardiac ECG monitor
D. Obtain a Glasgow Coma Scale Score nausea and vomiting, abdominal pain and lower
back pain. The physician writes a medical
Situation 19 – A 30 year-old female is admitted diagnosis of abdominal aortic aneurysm (AAA)
for fever, fatigue, lymphadenopathy, thrush,
diarrhea and muscle and joint pains. She also has 96. The nurse assesses the patient with AAA.
a rash in her torso and arms. Which of the assessment findings is related to the
aneurysm?
91. The nurse assesses the client. What question
should she ask to determine the client’s possible 1. Pulsatile abdominal mass
exposure to HIV? 2. Hyperactive bowel sounds
3. Systolic bruit over the area of the mass
A. “Do you use public toilet seats?” 4. Subjective sensation of “heart beating” in the
B. Did you shake hands with a person infected abdomen *
with HIV?”
C. “Did you receive blood transfusion recently?” A. 1, 3, 4
D. “Do you practice safe sex?” B. 1, 2, 3, 4
C. 2, 3, 4
92. The nurse writes a care plan for the client. D. 1, 2, 3
Included in the care plan is to provide health
teachings. Before the nurse performs any 97. The nurse auscultates the abdominal area of
teaching, what should the nurse do FIRST? the patient with AAA. Which of the following
sounds can be DISTINCTLY heard over the area?
A. Evaluate the client’s existing level of
knowledge about HIV infection. A. Dullness
B. Assess the client’s immediate clinical status. B. Bruit
C. Assess the emotional status of the client. C. Friction rubs
D. Focus on potential problems the client may D. Crackles
encounter during the illness.
98. The nurse recalls specific anatomic sites for
93. To determine whether the client is infected aneurysm. The most common sites are the aortic
with HIV, the physician writes an order for HIV arch, thoracic aorta and abdominal aorta. Which
antibody testing. What test would confirm a of the following areas is an AAA most commonly
positive ELISA test? located?

A. CD4 cell count A. Proximal to the renal arteries

B. Easter Blot test B. Distal to the iliac arteries
C. HIV antigen test C. Distal to the renal arteries
D. Western Blot test D. Adjacent to the aortic arch

94. The client is being treated for thrush. The 99. The patient complains of severe lower back
patient asks if there are any side effects of the pain. Which of the following is the PRIORITY
medication she is receiving for thrush. Which of action by the nurse?
the following should the nurse include in her
teaching? A. take the vital signs and document results
B. administer pain medication as prescribed
A. “There are few side effects associated with the C. notify the physician
medications to treat thrust.” D. observe for signs of abdominal distention.
B. “Hepatitis can develop as a side effect.”
C. “Nausea, vomiting, and diarrhea are common 100. The nurse is aware that rupture of the
side effects.” aneurysm is a life-threatening emergency. Which
D. “Skin discoloration is a common side effect.” of the following groups of symptoms indicates a
ruptured AAA?
95. The client complains of increasing pain in her
feet and legs. The nurse realizes that the client is A. Intermittent lower back pain, decreased blood
demonstrating a/an _________: pressure, decreased RBC count, increased WBC
count.
A. nervous system manifestation of the disease B. Severe back pain, decreased blood pressure,
B. reaction to a medication decreased RBC count, increased WBC count.
C. opportunistic infection C. Lower back pain, increased blood pressure,
D. secondary cancer decreased RBC count, increased WBC count.
D. Severe lower back pain, decreased blood
Situation 20 – An adult male is wheeled in the pressure, decreased RBC count, increased WBC
Emergency Department with complaints of count.
 C. vomiting
D. sensorineural hearing loss

Situation 2 – You are a staff nurse in the

NURSING PRACTICE V – CARE OF CLIENTS (PART Psychiatric Unit of the hospital taking care of
C) patients with manic disorder. The following
June 3, 2019 questions relate to this statement.

Situation 1 – You are a staff nurse in the Ear Unit 6. What would be your MOST therapeutic
of a government hospital. As such, you are taking response to a manic patient demanding that you
care of patients with different ear conditions. call his attending physician to make an order for
a pass to go out at the middle of the night?
1. Mariel, a 25 year-old radio announcer came in
for consult with the chief complaints of not being A. “You go to the recreation hall now while I call
able to hear well and inability to discriminate your attending physician”
sounds he is hearing. An otoscopic examination B. “You must really be upset to want a pass
was done to her, which revealed that there is immediately. I will give you a medication to make
sensorineural loss. This condition is due to you calm.”
damage to what part of the ear? C. “I can’t call your physician now but you can
talk to me about your request to pass.”
A. Cochlea and auditory nerve D. “Don’t be unreasonable. I can’t call your
B. Vestibular nerve and cochlea attending physician in the middle of the night”
C. Middle ear and auditory nerve
D. Outer ear and cochlea 7. One of your patients lacks food and fluid intake
due to poor appetite. What foods would BEST
2. Which of the following is a predisposing factor meet the patient’s nutritional needs?
for sensory hearing loss?
A. Steak and spaghetti
A. Serous otitis media B. Peanut butter, sandwich and milk
B. Ototoxic agents C. Carrots, celery, raisins, apple
C. Otosclerosis D. Beef and non-diet soda
D. Perforation of the eardrum
8. During lunchtime you have observed that a
3. Which of the following is useful in correcting a patient with mania taking food from other
sensorineural hearing loss? patient. What principle would guide you in
determining the appropriate intervention in this
A. Nothing, the damage is irreversible situation?
B. Myringotomy
C. Stapedectomy A. the patient needs foods and fluids any way
D. Tympanoplasty possible
B. The patient will calm down as soon as
4. One of your patients underwent lunchtime is over.
tympanoplasty. Which of the following C. the intrusive behavior of a manic patient is not
interventions is the MOST APPROPRIATE after a a threat to other patients.
tympanoplasty? D. other patients need to be protected from the
intrusive behavior of other patients.
A. Applying ear drops as ordered by the physician
B. Teaching the patient to avoid heavy physical 9. A patient is manifesting some manic
activity for at least three weeks. depression. Which of the following activities
C. Rinsing ear three times a day using hydrogen would you provide to distract such patient? *
peroxide as ordered
D. Avoiding the use of cotton in cleaning the ears. A. you let the patient go for a walk
B. give him a book to read.
5. A patient came in with the chief complaints of C. let him watch the final game of the UAAP
ringing in the ears and a feeling of whirling D. let him play checkers with another patient.
around. The attending physician suspects
Meneire’s Syndrome. To arrive at a correct 10. What therapeutic activity would you provide a
diagnosis, the patient must be manifesting these patient with mania?
three symptoms: paroxysmal whirling vertigo;
tinnitus; and _____________. A. doing ceramics and whittling
B. playing cards and checkers
A. conductive hearing loss C. playing bingo and knitting
B. bilateral symptoms D. drawing and folding towels
Situation 3 – You are a staff nurse in a A. has stopped taking the Klonopin suddenly
Rehabilitation Center for Substance Abuse. B. has been drinking alcohol with the Klonopin
C. has developed tolerance to the Klonopin and
11. You admitted an intoxicated patient for needs to increase the dose.
alcohol withdrawal. Which of the following D. is having a panic attack and needs to take
interventions should you implement to help the extra Klonopin.
client become sober?
Situation 4 – You are a staff nurse in the Eye Unit
A. have the patient take a cold shower of the hospital. In the regular Quality Circle
B. walk the patient around the unit meeting one of the matters discussed was the
C. Provide the patient a quiet room to sleep in increasing complaints of patients who underwent
D. Give patient a black coffee to drink eye surgery in relation to instillation of eye drops.
The case of Claudia who has cataract surgery was
12. While obtaining the history of a patient with presented as a frame of reference in the
several cases of driving under the influence of reviewing the procedure on eye drops instillation.
alcohol, you asked about the amount of alcohol
the patient consumes daily. He answered “I just 16. Which of the following is the rationale for
have a few drinks with the guys after work”. instilling eye drops to patients who has eye
Which of the following would be your MOST surgery?
therapeutic response?
A. to help control the intra-ocular pressure.
A. “That’s all the patients here say at first”. B. to dilate the patient’s pupils
B. “You say you have a few drinks, but you have a C. to treat an eye infection
multiple arrests”. D. to constrict the patient’s pupil
C. “I think you cannot handle a few drinks”.
D. “Then you should have somebody driving for 17. You have observed presence of drainage in
you”. Claudia’s eyes. Which of the following eye
solutions would you use in cleaning her eyes?
13. Which of the following assessment data
provides the best information on the patient’s A. hydrochloric acid
physiologic response and the effectiveness of the B. Normal saline solution
medication prescribed for alcohol withdrawal? C. Mineral water
D. Soapsuds solutions
a. sleep pattern
b. evidence of tremors 18. In instilling the eye drops you have to tilt the
c. vital signs back slightly Claudia’s head. Which of the
d. nutritional signs following is the rationale for this nursing action?

A. B and C A. to prevent any spill from the eye during the

B. C and D procedure
C. B, C and D B. to keep any debris away from the lacrimal
D. A, B and C duct.
C. to facilitate the procedure.
14. One of your patients is manifesting signs and D. to reach the conjunctival sac easily.
symptoms of alcohol withdrawal such as: tremors,
diaphoresis, and hyperactivity. Blood pressure is 19. You accidentally touch Claudia’s eyelid during
190/92 mm.Hg and pulse rate of 92 beats/min. eye drop instillation causing her to blink. What
which of the following medications should you should have you done to prevent this from
expect to be ordered for this patient? occurring?

A. Lorazepam (Ativan) A. Touch the inner side of the medicine cap

B. Naloxone (Narcan) B. Tilt back Claudia’s head slightly
C. Haloperidol (Haldol) C. Hold the dropper close to the eye but do not
D. Benztropin(Cogentin) allow the medication to fall into the cornea.
D. Have Claudia look up and focus on something
15. A patient discharged from an alcohol
rehabilitation program was on Clonazepam 20. You cannot open Claudia’s eyes due to dried
(Klonopin) 0.5 mg. three times a day. Several crust. Which of the following actions would you
months later he reported having insomnia, do?
shakiness, sweating, and one seizure. Which of
the following questions should you ask FIRST? Ask A. Apply the eye drops the next day
if he _____________. B. Apply eye ointment to soften the crust.
C. Instill eye drops B. make sure the staff has followed the original
D. Place a warm wet wash cloth over her eyes for care plan.
at least three minutes. C. involve the patient in the process of
evaluation.
Situation 5 – Nurse Fatima who is on-duty in a D. identify maladaptive coping behaviors.
psychiatric unit is assigned to care for patients at-
risk for suicide. Situation 6 – The nurse’s work environment plays
a vital role in her ability to provide quality patient
21. Nurse Fatima should pursue assessment of care. Inadequate resources in health care and
suicide risk for individuals who display tendencies unhealthy conditions in the workplace result to
to be _____________. nurse’s work stress.

A. Compulsive, obsessive, or weak 26. Burnout is a phenomenon that is BEST

B. risk-taking, aggressive, or controlling characterized by _____________.
C. hostile, impulsive, or depressed
D. blaming, abusive, or confused A. emotional exhaustion: depersonalization: and
reduced personal accomplishment
22. On admission, the nursing diagnosis for B. growing dissatisfaction among nurses due to
Gringo, who is depressed and suicidal is, “Risk for changing career expectations.
suicide.” An appropriate outcome for this C. increased absenteeism and fast turnover of
diagnosis at discharge from the hospital is, “The nurses due to toxic work environment.
patient will _____________. D. conflict between demands of work and family.

A. not harm self while hospitalized 27. A common response to unhealthy work
B. be able to problem-solve effectively environment is physical tension. This can be
C. increase feelings of self-worth overcome by progressive muscle relaxation which
D. develop a trusting relationship with the nursing basically involves __________.
staff.
A. focusing on an image to relax
23. Which of the following statements would B. active physical exercise like aerobics
BEST represent Nurse Fatima’s attempt to assess C. releasing muscles from tension.
a patient’s current ability to organize and enact a D. listening to a relaxation audio program.
suicide wish?
28. Bio-behavioral interventions are being used
A. “What is your educational background?” increasingly by both nurses and patients in stress
B. “What plan do you have for committing management. The following are examples of such
suicide?” intervention except ___________.
C. “Have you ever thought about hurting
yourself?” A. progressive muscle relaxation
D. “Are your self-destructive thoughts frequent?” B. pharmacotherapy
C. guided imagery
24. A male suicidal patient is found by Nurse D. mindful meditation
Fatima as he tries to hang himself in the
bathroom. What nursing intervention would 29. Ace, a young overweight nurse, is making five
address the patient’s need for safety while to ten sticks of cigarettes a day. He claimed that
maintaining his self-esteem? he learned to smoke to relieve his stress caused
by toxic assignments in the ward. Along with the
A. Advise him to use the bathroom only with staff smoking he became a stress-eater. He decided to
supervision. undergo a lifestyle modification which begins with
B. Tell him that the police is coming to rescue ____________.
him.
C. Place him in the seclusion room with 15-minute A. eating the right kind of foods
checks. B. a recognition of the impact of unhealthy habits
D. Assign a nursing staff to remain with him all C. doing a regular daily exercise.
times. D. a constructive and positive attitude in life.

25. In evaluating the effectiveness of the care 30. Ace is a well-informed nurse on the smoking
provided for a self-destructive patient, the BEST cessation program of the Department of Health.
approach is to __________. As a next step to his decision to stop smoking,
Ace needs ___________.
A. modify the plan as little as possible to avoid
confusing the patient. A. commitment
B. motivation
C. information 36. Marites should know that in narrative
D. skills to implement change charting, documentation of patient care should be
____________.
Situation 7 – Mrs. Andrea Santos, a 43-year old
female came in for consult with the chief A. Extensive
complaint of severe pain of both eyes. She B. Formatted
claimed she sometimes sees rainbow halos C. Chronologic
around light. She also experiences nausea and D. Descriptive
vomiting, the attending physician gave an
impression of Acute Angle-Closure Glaucoma. 37. Which statement is NOT true about medical
record that Marites must understand. Charts
31. In assessing Mrs. Santos, what demographic _____________.
data is/are RELEVANT to ocular movement?
A. Contents must be kept confidential
A. gender B. Can be borrowed by any nursing student
B. age at menarche C. Can be accessed by a researcher.
C. age and gender D. Can be given out only with patient’s consent
D. Race
38. The following are methods of charting,
32. An ophthalmoscopic examination was done to EXCEPT __________.
Mrs. Santos. The following results are expected
EXCEPT ____________. A. Sequential
B. Narrative
A. nonreactive pupil C. POMR
B. corneal cloudiness D. Focus
C. erythematous conjunctiva
D. decreased intraocular pressure 39. In a PIE method of charting, P is for needs,
EXCEPT ___________.
33. Vision loss for Mrs. Santos may progress as
days go by and this is irreparable. An appropriate A. Admission
nursing diagnosis would be ___________. B. Problem
C. Teaching
A. disturbed sensory perception related to severe D. Discharge
pain
B. risk for ineffective therapeutic regimen 40. In charting neurologic assessment, Marites
C. disturbed sensory perception related to recent must understand that the following should be
loss of vision. indicated. SELECT all that apply.
D. grieving related to loss of vision
1. Orientation
34. Select the medication that should be 2. Pupil movement
discussed by the nurse with the attending 3. Sensation
physician before administering it to Mrs. Santos. 4. Quality of speech

A. Isoptocarpine eyedrops A. 3 and 4

B. Corticosporin ophthalmic B. 1 and 2
C. Mannitol C. 1, 2, 3, and 4
D. Atropine D. 1, 3, and 4

35. In a medically-managed patient with Situation 9 – One of your programs as a

glaucoma, independent self-care is the area for community health nurse is related to substance
evaluation. Which of the following is a short-term abuse addiction. You spearheaded an educational
outcome for Mrs. Santos? collaborative activity to address the increasing
drug and alcohol problems in the community. A
A. ability to recognize clinical manifestations of multi-sectoral committee was formed, and an
complications initial organizational committee meeting was
B. Mrs. Santos’ self-care ability held. The following questions apply to this
C. Compliance with the medical management situation.
D. Mrs. Santos ability to instill eye drops
41. To motivate and spark the interest of
Situation 8 – Marites is a beginning nurse in a prospective participants in the proposed program,
government hospital. She still needs which of the following activities will you introduce
enhancement of her competencies in charting. as an initial activity of the group?
A. Lecture-forum on alarming dangers of drug and
alcohol use. 46. What element distinguishes a true
B. A summer sport fest involving all age group. experimental research from a quasi-experimental
C. Values-formation program research?
D. Lecture-forum to increase awareness of
unhealthy lifestyle. A. The use of non-probability sampling
B. Lack of random assignment of subject to group
42. To assess the prevalence and incidence of C. Size of the sample
substance abuse, a community survey was done D. The introduction of experimental treatment.
by the barangay health workers. Using purposive
sampling, what age group is at MOST risk to be 47. You want to determine the effect of a planned
considered as the survey respondents? exercise on low-back pain. Which of the following
research designs would be MOST APPROPRIATE to
A. Pre-schoolers use in this study?
B. Older adults
C. Older Children A. Posttest only control group design
D. Adolescents B. One-shot case study
C. Pretest-posttest control group design
43. A self-help support group for educational and D. One group pretest-posttest design
caring approach for alcoholics is:
48. Which of the following is a type of probability
A. Halfway homes sampling?
B. Psychiatric treatment and rehabilitation
centers A. Cluster
C. Alcoholic Anonymous B. Purposive
D. Detoxification treatment programs C. Quota
D. Convenience
44. The LEAST effective education and preventive
measure for drug abuse is: 49. You want all people who are currently
institutionalized for psychiatric problems to
A. Activity workshops for out of school youths participate in your study. This is an example of
B. Family enrichment programs ____________.
C. Regular advocacy meetings to include families,
store, restaurant, bar owners A. Universal population
D. Leaflets and brochures for mass distribution B. Target population
C. Element
45. The committee organized parent education D. Sample
classes. A representative from the local police
department was invited to discuss: 50. You want to determine the difference of the
anxiety level between male and female patients
A. Stress management scheduled for abdominal surgery. The first 30
B. Parent effectiveness training males and the first 30 females who are admitted
C. The legal implications of illicit drug use to the hospital at the time of the study would be
D. Recognition of deviant child and adolescent asked as study participants. This is an example of
behavior what sampling technique?

Situation 10 – As a beginning professional nurse A. Fish ball technique

one of the competencies expected of you is to B. Simple random
engage in research. Basic knowledge in research, C. Quota sampling
therefore, is very important. The following D. Purposive sampling
questions related to these statements.