TOPZRANK REIMIEW ACADEMY * NLE * NCLEX * HAD * PROMETRICS* DHA * MIDWIFERY * LET* RAD TECH * CRIMINOLOGY * DENTISTRY * PHARMACY * MED TECH REFRESHER PRE BOARD EXAMINATION Nursing Practice IV: Care of Clients with Physiologic and Psychosocial Alterations (Part B) GENERAL INSTRUCTIONS: 1. This test questionnaire contains 100 test questions 2. Shade only one (1) tox for each question on your answer sheets. Two or more boxes shaded will invalid your answer. 3. AVOID ERASURES. 4. Detach one (1) answer sheet from the bottom of your Examines ID/Answer Sheet Set. 5. Write the subject ttle "NURSING PRACTICE I" on the box provided Situation ‘After experiencing visual disturbances, sudden fatigue and paresthesia in hic arms and leg, Annika, 35 years old teacher, he was rushed to the Emergency Department of Tarlac Doctor's Hospital. He Is diagnosed with Multiple Sclerosis. 1. In planning care and intervention for 2 client Promote the client's regular exercise and inactive lifestyle d. Keep the client active with minimally stressful activities to avoid fatigue ‘Situation: Nurses Alexis is handling patients with immunologic problems. The following questions apply. iagroseé with multiple sclerosis, which of the 6. Nurse Alexis is working with student rurse Alyssa to following aspects should the nurse priontize to re for an HIV postive patient with severe ‘address in reletion to the disease? esophagitis caused by candide albicans. Which action a. Client's coping by the student indicates that you need to intervene b. Glient’s salience and attitude towards his most quickly? treatment ‘putting on mask and gown before entering © Client's actual and potential needs patient's room 4. Client's future plans and direction life b. giving the patient a glass of water after administering the ordered oral nystatin, One of the client's concems is his generalized (Mycostatin) suspension Weakness and fluctuating endurance to activities. suggesting that the patient. should order Which of the. following nursing interventions should chile con came or chicken Soup for next be implemented bythe nurse to address. this meal problem? placing @i"f0 Vistor” sign on patient’ room 2. Conduct an axtivity planning and limit the 7. Nurse Alex is evaluating en HIV patiert who is dlients activities ‘eceiving IV pentamidine (Pertam) as a treatment for b. Restrict activities and maintain clent on bea Pneumocystis roveci (PCP) pneumonia. Which rest informetion is most impottant to communicate to the Ensure that a family. member is always hysician?, present to assist the client ‘20 the patient is reporting pain at the ste'of 4d. Space the client's activities throughout infusion the day . the patient is not taking in an adequate amount of oraliftids The nurse can say that the client experience a bloodpressure is 104/76mmHg after helahtening of the disease & which ofthe following is Dentamidine administration observed during physical assessment? . blood glucose level is 55 mg/dl after ‘2. Dissociation fugue medication administration b. Heightened levels of eneray 8 Afier interviewing en HIV positive patient who is ©. Diplopia and nystagmus Consideringssstarting highly active antiretroviral d._Distended jugular veins therapy/(HAART), which patient information concems Ms. Annika. complains of not being able to 6ohtrol her yu the mos? viding. She said she experiences bed wetting and’ the patient has been HIV postive for 8 years finds it hard to hold her urge to void. What nursing and has never taken any drug therapy for intervention should the nurse implement to address the HIV infection the problem? b. the patient tells you "Ihave never been ’. Initiate bladder training faithtul about taking medications” b. Limit fluid intake from 2000mL/day to the patient is sexualy axtive with multiple 1000mL/cay partners and says “I always use a condom” Insert an indwelling catheter the patient has many question and concerns 4. Regularly check the client's dapers and regarding the effectiveness and safety of the change it frequently medications During discharge planning, the nurse would give an 9. A patient with chronic hepatitis C has been receiving appropriate instruction to Annika if she instructs the dient to: a. Engage dlient to vigorous and strenuous interferon alfa-2a (Roferon-A) injections for the last ‘month. Which information gathered during a home visit is more important to communicate to theb. The patient injects the medication(ift6 the thigh by the intramuscular rite c. The patient's temperature is 37.6 deg Celsius orally 4. The patient reports chronic fatigue, muscle ‘aches, and anorexia 10. An HIV positive patient who hasbeen statted on: HAART is seen in the clinic for follow up. Which test will be most helpful in determining the response to the therapy?’ 2. OD4 kvel b. Complete blood count Total lymphocyte percent 4. Viralload Situation: Nuree Reine is an emergency nurse in Philippine General Hospital. An infant girl was rushed. to the emergency department and Is complaining of multiple burns in different parts of the body. The following questions apply. 11. The patient suffers superficial burns on the chest, posterior left leg, and arterior right thigh; deep partial burns on the whole head, posterior trunk, right, and left forearm; and full thickness burns of the abdomen, and anterior left leg. How much is the TBSA of the patient that would be included in the parkland formula? a. 2.765% b. b. 54% © 895% 4. 4.70% 12. The patient weighs 30Ibs. How much fluid would be given in the first 24 hours? 2. 2.3,819mL. b. b.1,910mL. ee 4izim 4. 4. 2,085mL, 13. What would be the drops/minute in the fist 8 hours given thatthe drop factor is 15 ckops/mi2 a. 2. 119 drops/min bob. 60 drops/min © © 130/dreps/min 4.4. 65 drops/min 14. What would be the priority ofthe patients condition inthe emergent phase? 3.3 flud resuscitation b. by ist forinfection © ¢ patentairway 4.4. optimal functioning 15;)Which of ‘the folowing: conditions| Wold» be_the orionty assessment in tie oven patent, at the acite phase? ‘2. a. compartment syndrome b. by isk forinfection cc shock 4.4: contractures Situation: Basic concepts on neuroanatomy and neurophysiology are important before one iz able to intervene with abnormal occurrences. 16. Which among the following cranial neWeBlarse fom the cerebral hemisphere? 2. Optic nerve b. Trigeminal nerve Vagus neve 4. Trochlear nerve 17. Which among the following is not an occurrence with agonist simulation of the muscarinic and cholinergic receptors? 2. Bronchoditation b. Increased peristalsis © Bradycarda dé. Miosis 18, Performing Romberg’s test is what part of the neurologic examination? d. Reflexes 19. The Umbiliais corresponds to which of the following dermatomal level? a 74 b. 710 cla a $5 20. The gag refleX|é tested in the assessment of which of ‘the following cranial nerves? a. CNVIL b. CNIXandx c CNV a. CNX 'SITUATION 4: Floro, a practicing registered nurse for 2 years in 2 private hospital hae resigned because she realized that her salary cannot sustain the growing ‘heeds of her family anymore. She has recently been accepted as a staff nurse ina local government hospital. She was assigned to the Emergency Department (ED). 21, Nurse Flore received an unconscious dlient after being involved in a car crash. The cient’ name is unknown and no identification card was found. An emergency exploratory laparotomy is required. Regarding informed consert for surgery, which of the following is his best action? a. Transport the victim to the operating room for surgery b, Request the police to find the dient’ family © Ask the physician to sign the consent d. Obsain a consent order for the surgery 22, A 16-year-dld clent was brought to emergency room for treatment of leg fracture. Assessment revealed that the client is married. Nurse Floro knows that who ‘among the folowing can sign the consent for admission? ‘a. Client's mother b. Client's hustand ¢. Client herself ‘@._ Clients signficant others 23, Suppose the 16-year old client becomes unconscious due to blood Jossjinurse Floro should obtain the consent.forsadmission from? ‘a. Client's mother b. Client's husband Client hersef d._ Clients significant others 724, Nurse floras been granted a 30-minute break after smafiaging is patients well. While on hisway to the ‘canteen, he heard two nursing. aides discussing bis client's condition. Which of the following should primarily be done by him? cApproach them and have a more detailed discussion regarding the patient . Report them to the nursing supervisor Igrore them since’ it would be improper to join in thelr discussion des Approach them and tell them to stop ‘thelr discussion 25, Meanwitile, nurse Floro is about to perform perineal assessment of a former beauty queenadmitted in the ER for possible rape trauma. The client refused but due to his intention to help, he proceaded with the assessment. Unfortunately, if the client wil file for ugation, nurse Floro would be liabe for? ‘a. Assault b. Libel &_Irwasion of privacy d. Battery Situation: Vincentis 56 years old, currently admitted at the Orthopedic Ward of Farview Hospital. His chief ‘complaint was a fracture of his left femur. Workup is26. The pathophysiology behind the condition Is expla by which of the following statements? a. Imasion ofthe bone by bact@Aa, ius, or fungi b. Decreased bone density due to decreased level of testosterone c Osteociastic activity is compensated by osteoblastic activity leading to vascula structurally weak and disorganized bones 4. Thekering of the fibular fascia due to genetic abnormalities 27, Besides the femut, which amorg the folowing/iiSiee @ ‘common area of involvement in the disease? 2. Skull © Ula bi Sternum 4. Ribs 28, Pain in Paget's disease ofthe bone isusually characteriael by all of the following except for one. Chose the esto, Releved by resting or siti down By Acting, shor end eheamserNa EE” rected extremity Worsens with pressure ‘Accompanied with pale and cold skin at the affected site 29, Which among the following laboratory findings s expected in the condition? a. Decreased uric acid b. Increased alkaline phosphatase (ALP) Decreased urinary hydroxyproline 4. Allof the above 30. Bisphosphonate was prescrbed to Vincent. Which among the following bisphosphonates will the nurse administer a parenterally? a. Alendronate Etidronate b. Risedronate d, Pamidronate Situation: Nurse Dindo is assigned with a patient diagnosed with osteosarcoma. The following questions apply. 31. Which among the following is not considered a risk factor for the development of osteosarcoma? 2. Paget’sdicease of thebone =. 3 SO year, old b. Irradiation Nene of the above 32. The most commofi affected bone in osteosarcoma is the: 2. Vertebrae Distal femur b._ Metacarpals d._Scapulze 33, As the condition progresses, ECG findings Show, that the patient has shortened QT interval and ST segment, and bradycarda. Muscular weakness, constipation, and: anorexia were noted. Which among the folowing & likely the compication that has occurred? ‘&. Hyponatremia Hypercalcemia b._Hypomagnesemia Hyperkalemia 34, The patient underwent orthopedic surgery to excise the tumor. Which among the following nursing actions will help prevent constipation postopera ‘The affected extremity is maintaiiédpelevated above the heart. b. Promotion of early ambulation. Prophylactic administration of enoxaparia d. Intermittent catheter is inserted @ prescribed 35. The neurovascular functioning of the extremityis monitored by the nurse 12 hours postoperatively. Which among the folowing findings will alert the nurse to notify the physician? a. Intact cenzation to light teuch and prick b. Cold, clammy skin Capillary refil time 2 seconds d. Mild edema Situation: Totoy was brought to the Emergency Department after he had seizures in his workplace. 36. Which of these observations would likely indicate the location of the seizure origin in the brain? a. Patient shouted immediately prior to the seizure b. Occurrence of an aura in prevous seizure episodes Wffpelectroencephalogram (EEG) was ordered for the " ‘Batient. Which, cf these waves is expected in patients who “are in busy and participating in mental activities? 3 Alpha © Theta ppd. Beta 4. Delta 38) Wien of these would characterize a patient naving an absent seizure? 1. Excessively ifitated with poor recall of the seizure episode when itis done [Eipjpfonic-clonic contractions of upper extremities d. Suddenloss of consciousness with postictal amnesia ‘Which of these preoperative teachings should not be given r b. Prolonged blank stare with lip smacking J) tothe patient for her EEG? {2:))Stimulants of any kind should not be’ taken before ‘and afterthe EEG is finshed, b. Portions of the head where the electrodes will be placed must be shaved. . Refrain from applying cream the night before the procedure, 4. Analgesics will be given during the procedure as it may cause some pain. 40. Which among the following antiseizure drugs is Indicated only for absence seizures? a. Diazepam BL Phenjtoin . Ethosuximide 4. Valproic acid Situation: A 10-year-old patient is admitted to the ward for possible brain tumor arising from the ventricle. You are the nurse caring for this patient. 41. The doctor said that the patient has ependymoma. Which ‘among the following is true regarding the tumor? ‘a. Ependymomas are considered benign tumors and just need observation. . The most common location of ependymomas in Pediatric patient is the spinal cord. ¢. Ependymoma is a type of glial tumor occurring ‘Supratentorially in pediatric populations. .- Allof the above. 42. Hemiation is a possible complication dues to the space-occupying lesion that is the tumor Which among the folowing findings will alertsyoul that uncal herniation has occurred? a. Pinpoint pupils © Decreased Loc b. Paraplegia <._ Hydrocephalus 43. Which among the following is an early sign of increasing Iniracrenial pressure? 2. Cheynesstokes respirations ¢. Anisocoria b.- Bradycardia ca Decreased 7 sensorium 44, Cushing's triad 's a late manifestation of increased ICP. The folowing are seen inthe tied, except: a. Narrowed pulse pressure —c. Bradycarda D. Bradypnea Systolic rypertension ‘A transsphenoidal craniotomy is indicated. Which amone ‘the following -rursing interventions should not be done post-oreratively? ~~ 3, Maintain and reinforce the nasal packing. bbe Provide frequent oral cae ofc Maintain the head of the bed flat to prevent headache. ‘d.Instrct the patient to avoid blowing ofthe nose. uation: Concepts on cancer chemotherapeutics should be well-studied by nurses to prevent untoward events and to be able to intervene with the unexpected outcomes. 46. Doxorubicin is an anthracycline thet is a major anti-cancer drug used for breast, endometrial, ovarian, liver, and lung cancers. It is commonly used ‘with other anti-cancer agents. Doxorubicin takes effect by all of the following ‘actions except: 3. Blocks synthesis of DNA and RNA b. Generates free radicals447. Which among the following chemotherapeuticsagenits Is cell-cycle speofic for the M phase? a. Topotecan & Cyclophosphamide b. 5-fuorouracl . Paclitaxel 4. Whats the dose-iing toi for Bean? 2. Myelosuppression Dilated cardiomyopathy b. Peripheral neuropathy cd) Pheumonitis 49. Asparaginase is an enzyme occasionally used to treat childhood acute lymphoblastic leukemia (ALL). Which among the following Is not an adverse reaction! to the drug? ‘2. Hypertensive crisis _¢ Bronchospasm b._ Respiratory failure Hypersensitivity 50. Syndrome of inappropriate diuretic hormone (SIADH) iia adverse effect of the following cherrotherapeuti¢ agents, ‘except for one. Choose the exceptions a. Vinblastine © Vincristine b. Topotecan 4. Vinorelbine Situation: A 54-year-old man is brought to the ‘emergency room unconscious. HR 100bpm, BP 100/60, Temp 37.2, RR 22cpm. Hemorrhagic stroke is the primary impression. 51, The most common cause of subarachnoid hemorrhage is a rupture of @ saccular aneurysm located in the ardle of Wills. Which among the following vessels is not a part of the Circle of Wills? 2. Anterior communicating artery b. Basilar artery Posterior communicating artery dd. Posterior cerebral artery 52. What is the mest common symptom that precedes hemorrhagic strokes? a. Projecie vomitng «._—‘Sudden, severe headache b._Nuchal rigidty —d. Ptosis 53. Which among the following drug orders for the patient wi alertthe nurse to ask the physician? a. Niardipine ¢ Labetaol b. Coumadin 4. Nitroprusside 54, Which. acid-base balance is usually seen after subarachnoid hemorrhage? ‘2. Hyponatremia c. Hypocakcema b._Hyperphosphatemiad.. Hypernatremia 55. In the presence of aneurysm, you institute the fallowing interventions except: ‘2. Racing the head of bed to 15 to 30-dégre0 elevation b. Administering enema for constipation c. Providing dim lights in the patients room dd) Instructing the patient to avoid straiingnor doing Valsalva Situation: In the United States, around 40,000 cases of endometrial cancer are documented annually. Gina isa 56-year-old female diagnosed with Stage IT endometrial carcinoma, grade I. 56, Endometrial carcinoma is commonly preceded by which of the flloning condtions? 2. HPV infection c. Endometrial hyperplasia 2. Chfone malnutrition a Ealy menopause 57. What is the most common type of endometrial carcinoma? a, Squamous cell carcinoma ¢. Clear cell carcinema, >. Adenocarcinoma 4 Sercus: papillary carcinoma 58. Which among the following does not contribute to the development of endometrial CA? a. Use of oral combination contraceptives {estrogen + progestin) b. Nulliparity| c. Diabetes melitus 4. Late onset of menopause 59, The patient underwent radical hysterectomy with bilateral lymph node dissection and removal of the upper third of BppBecause of whet was removed from you, Lam afraid 'yoil cAhino longer have intercourse with your spouse b. "You should avoid)Sexual intercourse for at ppp, least 6 weeks.” Elpriaving intercourse as early as one Wee will no longer pose dangers.” d._"You may go ask your gyrecologist about it.” 60. Which among the following signs and symptoms should the patient report after discharge? 2. Occasional vaginal discharges bb. Mild dyspareunie at the first intercourse: Calf pain and tenderness d._ Allof the above tion: Nurse Nina knows that proper knowledge on different causative agents and manifestations of reproductive disorders will help in the proper 3nagement of patients. 61. What is the most common caUse/of vaginitis in women? a. Bacterial vaginosis. Trichomoniasis b. Candidiasis d. Lichen planus 62. A 29-year-old patient with history of multiple sexual partners is admitted due to foulsmelling, gray veginal discharge. Upon microscopic examination, clue cells are seen and there are no lactobadili present. What is the ‘causative agent of this condition? a. Treponema pallidum c. Human papilloma virus b. Human simplex virus 4. Gardnerella vaginalis 63. Which among the following strains of human papiloma vis is implicated in the development of, ‘condylomataacuminatum? a. HPV 16 cc HPV3L b. HPV it d. HPV 33, 64. Herpes simplex virus has the propensity to become latent Jn patients. They usually ascend the peripheral sensory hherves and become dormant in which of the following structures? a. Trigeminal nerve . Brachial plexus b. Dorsalroot ganglion —d. Spinal cord 65. A 35-year-old patient complains of thin, frothy discharge ‘accompanied with vulvovaginel pruritus. ‘Upon. colposcopy, the cervix was seen to be erythematous witht multiple strall petechiae appearing likea strawberry. Knowing what usually causes “strawbefty cervix", which among the folowing medications do you expect to be prescribed to A 55-year-old Female patient is admitted due ‘Profuse vaginal bleeding. She underwent ultrasound ‘and laparoscopic examination. She was diagnosed with Which among the following is nat tue regarding Jeiomyoma? 2. Itis a tumor of the uterine endometrium. bi cts a slow-growing tumor ¢_Lemyomas grow with estrogen stimulation. The tumor usually shrinks during the menopausal stage. ‘What i the cel origin ofthe tumor? _ a. Endometrial glands © Smooth muscle cell b, Skeletal muscle cll 4. Neuronal cell Geserein, 2 gonadotropin-releacing hormone agonist, is prescribed to the patient. Which among the following is a commen side effect of the drug during the frst days of ‘administration 2. Flaring c. Hirsutism b. Bone pain 4, Depression 69, After the GnRH agcnst therapy, the patient is about to undergo uterine artery embolization. What is the mechanism of this therapy? 2. A laser is used to conservatively remove the leiomyoma from the uterus. Radioablation is used to destroy the uterine4. Pellets are inserted into the uterine artery to cause blockage 70. To be able to distinguish it from’al{eancerous lesion, what 's the standard diagnostic test that should be performed? a. Intravaginal examination c Papsmear >. Biopsy @. Ultrasound, Situation: Patient Andres, S4years old is recently diagnosed with a testicular tumor after he noticed a painless lump on one of his testes. Workup is done and he was admitted under your care. 7, What type of testicular cancer has the bes prognosis? a. Choriocarcinoma © Yok-sac tumor b. Teratoma d. Seminoma 72. What is the most common cause of secondary testicula a. Squamous cell CA of the skin Renal cell CA >. Lymphoma . Melanoma’ 73, Andres wishes to have his semen colected and stored for future insemination, He asks you when Is the best time for the collection and storage of his sernnal fuid. The correct response is: a. ter one cycle of chemotherapy b. Shortly after the radiation therapy c. Immediately after diagnosis is made 4. Post-radical lymph node dissection 74, You are preparing for the discharge instructions for the patient who underwent orchiectomy with retroperitoneal lymph node dissection, Which among the following will you not include in your instructions? a. Sutures will be removed in the doctor's office 3 days after the surgery. b. Lifting of objects over 15 lbs is not allowed . Avoid stair climbing until advised. 4. Repot if chills, fever, or increasing pain/tenderness ‘around incision site is experienced, 75. Whici among the following markers wil Incréase If the treatment employed was effective? a, Alphe-feto protein © hos b. Lactate dehydrogenase d. None of the above Situation: Louis is a 52-year-old male who went for consult for dribbling of urine. The urologist considers benign prostatic hyperplasia. You are assigned to care for Louis. 76. Digital rectal examination will be done to thlpatient. How ‘would you position Louis for the examination? 2. Side-lying fetal positionc. Lithotomy >. Trendelerburg dims 77. Finasteride is prescribed to the patientsto,be taken for 4 months. Finasteride belongs to which ofthe folowing drug ‘group? 2. Alpha-1 receptot blocker © Thiazide diuretic >. S-alpha reductase inhibitor d. Osmetie diuretic These drugs inhibit 5-alpha reductase and decrease, DHT of the patient 78. Another drug is given to Hé)patient — alfuzosin. Which’ among the folowing drugs should be stopped when taking alfuzosin? a. Sildenafil Paracetamol b. Telmisartan d. Simvastatin 79, Transurethral resection of the prostate is indicated for the patient. You advise the patient that he wil likely to have which among the following post-operatively? a. Incision at the suprapubic area. Holter monitor >. Ebley catheter inseted with tractiond All ofthe above 80. Which among the following is not a complication of BPH? a. Hydronephrosis © Urinary calculi >. Hydroureter . Prostate cancer Situation: Burns are caused by transfer of heat source to the body. It can be thermal, electrical, radiation, or 81, Album characterzed by pale, wiite appearance, charred of ‘with fat exposethyand painless is: ‘A. Superficial partial thickness burn B. Deep partial thickness burn (CeFull thickness burn 1D. Deepitutitnicxness bury ‘82. Which of the following descrives superficial partial thekness or first degree burn? "AeStructures beseath the skin are damaged B. Dermisis partially damaged (C.Epidermis and dermis are both camaged . Epidermis is damaged 1B3yA Lum that 5 sald to be “weeping” is lssified as: ‘A Superficial partial thickness burn B. Deep partial thickness burn Full thickness burn D. Deep fil thickness bum 84. During the acute phase of burn injury, which of the following isa priority? ‘A. Wound healing B. Reconstructive surgery (C. Emetional support D. Fluid resuscitation ‘85, While in the emergent phase, the nurse knows that the priority isto: ‘A. Prevent infection B. Control pain C Prevent deformities and contractures D. Return the hemodynamic stability via fluid resuscitation Situation: Student Nurse Renz is currently rotating at ‘the ophthalmology unit of Jose Rizal Hospital. He Is ‘advised to study well about the anatomy and physiology of the eye. 86. Which among the folowing structures maintain the shape ofthe eye? a. Opticnerve . Vitreous body b. Retina d. Cliary body 87. Which among the follbing ocular muscles is not controled by the'culometor nerve? 2. Superior rectus © Medial rectus, Inferior oblique d. Superior oblique CN IIT controts SR, MR, IR, 10. CN IV controls SO. (GN VE controls LR. (1gnat p 1041) 88. The use ofthe Ishihara chart assesses the function of which of the following cranial nerves? a. CNIT NII b. NIV d. CNV Color vision is tested using the Ishihara chart. Vision is a furiction of CN II. (Ignat p1048) '89._Lesion/Gompressing the right optic tract will proauce which (ofthe following visual defects? a. Reye blindness c Bitemporalhemiand pla Lefthomonymoushemianopsiad. © L_ eye blindness ‘90. Lesions affecting the oculomotor nerve will produce the following manifestations, except ‘a. Exophthalmos . Absent pupillary reflex b. Paralysis of the medial rectus d. None is an exception Situation: Angel comes for a consultation with a chief ‘complaint of progressive blurring of vision suggestive of cataract. She is 70 years old. You assess Angel. 91. Which among the folowing is not a predisposing factor to cataract formation? ‘2. Hyperparathyroidism —c. Use of miotic egen's b. Radiation exposure a Down Syndromeb, Decreased color perceptiond. Absent red refle 93, Angel asks you how cataract develops in the older population. Which among the following statements explain: the pathoshysology of cataract? a. Clary bodies continuously produce the aqueous! humo, increasing the intraocular pressures b. There is loss of elasticty of the zonula fibers so the lens is not able to accommodate. ¢. Fibrosis and crystal formation occur in the lens, increasing its density and opacity. Trauma causes hemorthage into the viteouS Cavity ‘eading to spontaneous retinal detacfimient 94. Angel will undergo phacoemulsification to extract her lens. You are explaining to her the postoperative manifestations thet she should report to the physician Which among the following is not a nermal eceurrence immediately post-surgery? a. Mild prurtus surrounding the eye b. Ocular pain accompanied with nausea c. Creamy, wiite, dry, ctusty drainage on the eyelids 4. Bloodshot appearance of the affected eye 95. Two weeks after discharge, the patient tells you that her affected sclera appears red and bloodshot again. This is associated with a decreased vision. She asks you ff this is still a normal occurrence. Which of the following) statements is the correct response? a. “Please see your ophthalmologist as soon as possible.” b. "Recurrence of the Hoodshot appearance of the affected eye is normal. There Is nothing to worry about” c. “That is due to poor complance to your ophthalmic medications. Continue instil the drops and you will be okay in a week.” “Stop scratching your eyes. It is your fault that they look ike that.” Situation: Glaucoma Is a common case in the ward where Nurse Dondi is working. Because of this, his knowledge on the different pharmacologic therapies for glaucoma ie extensive. '96))Which,.among the following drugs for glaucoma is @ prostaglandin analog? a. Timolol &Apracionidine b. Latanoprost — d. Carbachc! Source: Ignat p1066 Timiolol. is a beta-blocker; apracionidine is an adrenergic agonist. Carbachol is a cholinergic agonist. 97, Which among the folowing drugs for glaucoma may cause -bronchoconstrietion and hypoglycemia? @ Brmondine — c. Betaxolol b._ Carbachol d. Pilocarpine Betaxolol is a beta-blocker than can be absorbed systematically and cause. pulmonary airway constriction. Tt can also induce hypoglycemia and ‘mask hypoglycemic symptoms. (Ignat p1066) 198. Brmonidine iS prescribed to Patient Lara. Which among the folowing teachings will Nurse Dondi give to her regarding the use of the drug? a. Immedately after instiling thé!/drops, place the contact lensas to lock in the moisture. b. Avoid oing out in dim-ight areas because the drug can reduce vision. Brimondine decreases the amount of aquecus humor produced by the retina. d. Pheneizine and tranyicypromine can interact with the drug and cause hypertensive crisis. 99. Which among. the following drugs dees not block beta receptors? @ Carbachol —. Carteolol b._ Betaxob! d. Timdol 100.Brinzolamide is a carbonic anhydrase inhibitor used to reduce IOP but not affecting the flow or absorption of the fluid. A contraindication to the use of the drug is hypersensitivity to which of the following drug groups? . Beta-blockersc. Sulfonamides b. Mecrolides —. PenicilinsTOPZRANK REIMIEW ACADEMY * NLE * NCLEX * HAD * PROMETRICS* DHA * MIDWIFERY * LET* RAD TECH * CRIMINOLOGY * DENTISTRY * PHARMACY * MED TECH REFRESHER PRE BOARD EXAMINATION Nursing Practice Il (GENERAL INSTRUCTIONS: 1. This test questionnaire contains 100 test questions |: Care of Healthy and At Risk Mother and Child 2. Shade only one (1) tox for each question on your answer sheets. Two or more bax shaded wil invalid your answer. 3. AVOID ERASURES. 4. Detach one (1) answer steet from the bottom of your Examines ID/Answer Sheet Set. 5. Write the subject ttle "NURSING PRACTICE I" on the box provided. ‘Situation: The birth process affects the holistic aspects of the mother, to include physiologic changes to both the mother and the fetus. Nursing students are now assigned at the OB Admitting Section of the National Hospital 1. Anurse is performing an assessment ofa pregnant woman who is at 28 weeks of gestation: The nurse measures the fundal height in centimeters and expects the finding to be wiich ofthe folowing? The student nurse correctly identfies: a. Dem 36am >. 30m 4.40cm [Xnusing student is preparing a class on the process of fetal circulation. The instructor asks the student specficall to describe the process through the umbilical Cord. Which of the following statements from the studert is correct? a. "The one artery cares freshly oxygenated blood and nutrient-rich blood back from the placenta to the fetus” b. “The two arteries carry freshly oxygenated blood and nutrient-rich blood back from the placental to the fetus.” © “Thetwo arteries in the umbilical cord cary blood that i high in carbon dioxide'and other waste products away from the fetus tothe placenta” 3. Which ofthe following are not presumptive sign/ simptom of pregnancy? a. Amenorthea ¢ Softening ofthe uterus . Urinary changes 4. Nausea) vorniting 4. OF the following probable signs of pregnancy, which describes the bluish discoloration of the vagina? a. Chadwick's sign c Goode’ sign >. Hegar’s sign 4. Balotement 5. A nurse is reviewing the record of a client who has jUSE been told that a pregnancy tes is postive: The physician has documented the presence of Goodels sigm. The staff nurse asks the student nurse and she states that this a. A softening of the cervix >. The presence of fetal movement ¢. The presence of HCG in the urine 4. A sof blowing sound that corresponds to the maternal pulse during auscultation of the uterus. Situation: A G1PO mother went to the health center for a check-up. You are the nurse assigned. 6. The mother asks the nurse when she will be able to begin feeling the fetal movements. You respond by telling the Sand 10 10nd 12 4. 16 and 20 7. The mother asks about gestational diabetes, as she has familial history and was worried about ber pregnancy. Which statement by the dient indicates a further need for education? “Ineed to be in a diabetic diet” 3. “Twill Perform glucose monitoring at home” ¢. *Ineed to avoid exercise because of the negative effects of insulin production 4, “Ineed to be aware of any infections and report signs of infection immediately” History revealed that there ica history of twins in the family and the client was asking about the possibility of hhaving twins as well. The nurse replies: ‘A. Monozygotic twins result from fertilization of two ova by different sperm, 8. Monozygotic twins occur by chatice regardless of race or heredity. C. Digygoticbwins/are Usually of the same sex. . Digyagie twins occur more often in primigravidthan in multigravid clients. Sheila, the dient’s mother, was Worried that her daughter will ave an enormous amount of blood loss during delivery. Asa nurse, the best response would be: ‘@. The maximum blood loss considered within ‘normal limits is 500 mL." "The minimum blood loss considered within normal limits 54/000 mL.” eg Blood loss during a delivery is rarely estimated unless there is 3 hemorrhage” It WoLld be very, unustil if you lost more than 100 ‘mL of blood during the delivery” Duringthe next visit, the cent attended a childbith Dreparstion class and tels the nurse that her lower beck hhas been aching, Which ofthe following exercises are ‘appropriate for the clent? a. Pelvic rocking ©. Tailor sitting b. Deep breathing d. Squatting 11, Syphilis is a chronic disease cause by Treponema palladium. Which ofthe following isnot true about syphilis? ‘a. Trensmission is by physical contact with syphilitic lesions, which are usually ound on the skin, mucous membranes of the mouth, or genitals b. The infection may not cause abortion or premature labor. a 10.12. 13, 14, 15, 16, 17, 18. 4. Aserum test (Veneral Disease Reseatthl Laboratory or rapid plasmal agi) for syphilis on the first prenatal visit, and repeated on the 36" week of gestation. Gonorrhea is an infection cause by Neisseria gonormhoeae that causes inflammation of mucous membrances of the genital ard urinary tracts. Which of the folowing is true? 32. Transmission of the organism is by airborne. b. Infection is not transmissible to a newbom. c _Itmay cause Opthalmianeonatorum. 4. tis usualy symptomatic, and vaginal discharges common. ’ clinic nurse is performing a psychosocial assessment of ‘lice. Which assessment finding indicates o the nurse that the dient s at high risk for contracting human immunodeficiency virus? ‘a. Aclient who hasa history of intravenous drug use. ‘Acdient who has a significant other who is heterosexual © Adlient who has a history of sexvally transmitted diseases. ‘dient who has had 1 cexual partner for the pasti0 years. When Alice was in her third trimester, she was admitted to the hospital with a diagnosis of saver preeclampsia. A ‘nurse monitors for complications associated with the diagnosis and assesses the client for: 3a. Enlargement of the breasts b. Complaints of feeling hot when the room is cool. Periods of fetal movement fllowed by quiet periods. 4. Evidence of bleeding, such asin the ‘gums, bruises, petechiae, and purpura. ‘Alice gave birth to a stilborn infant. Ater the delivery, the family remained together, holding and touching the infant. Which statement by the nurse would further assist the family in theirassistthe family in thein initial period of orie?? ‘a. “Anong pwede kong gawin para salyo2” ._*Ngayon may anghel ka na sa langit” . "Huwag kang magralala, wala tayong hindi nagawa” *Gagawa tayo ng paraan na mapauwi kaing maaga para dimo na mealala ang mga pinagdaanan mo dito” Which of the following isa proper desétiption for Placenta Accreta? 2. Premature separation of the placenta of the uterine wall after the twentieth week of gestation and before the fetus is delivered b. The placenta penetrates the uterine mustleitsel An abnormally adherent placenta 4. Placenta goes al the way through the uterus. [A nurse in the labor room is preparing to care for a dent with hypertonic uterine contractions. The nurse is told that the dient is experiencing uncoordinated contractions that are erratic in their frequency, duration, and intensity. The priority nursing intervention in caring for the clent is to: a. Provide pain relief measures b. Prepare the client for an amniotomy . Promote ambulation every 30 minutes 4. Monitor the axytocn infusion closely. Jenny, 2 nurse, is performing an initial assessment on 2 ‘cine onlias tenes fnae bees lel Slew ls rani ie BilpiThe client is a 36- year old primigrevida b. The client has a hictory of cardiac disease ©The lient'shaefioglebin level is 13.5 g/dL 4d. The-lient isa 20year old primigravida cf average weight and height. 19. Anurse in/@labor room is monitoring a client with dysfunctional labor for signs of fetal or maternal ‘compremise. Which ef the following assessment findings swould alert the nurse to a compromise? a. Maternal fatigue b. Coordinated uterine contractions ‘C.- Progressive changes inthe cervix d. Persistentnonreassuringfetal heart rate 20. AA Blantin J2bor is transported to the delivery room ard prepared for talcaeserean delivery. After the client is ‘rensferred to the delivery room table, 2 nurse places her ins a. Supine position with a wedge under the right hip ‘Trendelanburg's position with the lege in stirups. Prone position with the legs separated and elevated 4. Semi-Fowlers position with a pillow under the knees. SITUATION: Grounded theory is a general inductive method 'thatis»notyinextricably linked to a particular theoretical perspective or type of data. Grounded theory researchers seek to understand the actions in a substantive area from the perspective: of those involved. Zi. The nurse researcher comprehends that people who pioneered studes in grounded theory includes the following apart from? a. | Glaser & Strauss c — Corbin& Tanner b. Strauss & Corbin d. None of the above 22. Coding in Glaserian grounded theory approach is used to conceptualize data into pattems. The nurse-fesearcher incorrectly identfies conceptualzation of the substance of the topic under study as: a, Substantivecadles| _¢, Selective codes b._Openiodes d. Theoretical codes 23, nevi codes are directly derived from the language of the ‘substantive area, The nurse-researcher correctly identifies these codes as: a. Level c. Level IIL b._Level If d. Level IV 24ceingfBunded theory zpproach, data analysis employ 3. Domain analysis b. Constant comparative analysis ©. Componeatiat analysis Taxonomic analysis 2s.em@llSk (6) CS in families of theoretical codes for grounded theory apelyss developed by Glaser (1978) excludes: Contingencies Continuum ._ Covariances i. Consequences 26cerBlnurse is teaching a postpertum client atout breast feedig. Which ofthe fllowing instructions should the nurse include? '2.. Prenatal vitamins should be discontinued. b. The dict should include additional fruits. Organic, hypoallergenic soap should be used to cleanse the breasts. 4. Gelactagogues should be avoided. 27. A nurseis planning to care fora post-partum client who had a vaginal dlvery 2 hours ago. The client had a 4em midline episiotomy and hes several haemorrhoids. What is the priority nursing diagnosis for this client? a. Acute pain28, A nurse is caring forfour 1-¢ay postpartum clentsWhich dlient has an abnormal finding that would require further intervention? a. The dient with mild afterpains rated 4/10 8. The dient witha pulse rate of 70 beats per minut c. The dient with colostrum discharge from both breasts 4. The client with lochia that is red and has a foul smelling color. 29, Robi, a nurse is providing postpertum instructions toa client who willbe breast-feeding her newkom:Which of the following determines thatthe cent understood the instructions? Select al that @pply 1. “magsusuot ako ng bra na may suporta” 2. *Nakaleasama ang pag-inom ng alak para ea ‘aking gatas-ina” 3. "Ang kape ay maaaring makakapagpababa ng aking gatas-ina” 4, Sisimulan ko ang pag-inom ng estrogen pils pag karating sa amingbahey” 5. "Alam ko na kung ang aking suso ay panandaliang lumaki, hihinto ko ang pagpapasuso” 6. Tinom ako ng maraming tubig upang maparami ang aking gatas-ina” A1,65,3 B.1,2,3,6 2,345 D.3,4,5,6 30. A prolapsed umbilical cord is when the umbilical cord is displaced between the presenting part and the amnion or protruding through the cervix, causing compression of the cord and compromising fetal circulation. Which ofthe following assessment findings are not indicative of @ prolapsed cord? a. The dient has a feeling that something is Coming through the vagina, b. Umbilcal cord is visible or palpable ‘c. Sweating, cool and damp skin d. Fetal heart monitor shows variable G&eBeratiors or bradycardia after rupture of the membranes. Situation: Joshua is a public health nurse assigned in the family planning clinic. Rose, 2.19 year old client roported that she has bean sexually active for one year and is asking about family planning methods. 31. Nurse Joshua talksto the client regarding Natural Family Planning Methods which are based on scientific facts on fetity. Which of the following are notnatural methods oF FP? 2, Sympto-Hormonal Method (SMH) . Sympto-Thermal Method (STM) c. Cervical Mucus Method (CMM) 4. Modified Pomeroy Method (MPM) 32. BT is another natural FP method. Wich of the foloWifg isnot true about this method? ‘8. The basal body temperature of a woman is higher before ovulation, until it decreases to a lower level beginning around thettime of ovulation. . After her ovulation, her BT typically rises slightly and stays in a slightly higher range until her next period begins. This sight increase in BBT from ovulation until menstruation is a sign that she ovulated during this cycle The BBT of 2 woman is lower before her ovulation, a de Wilpwomen who are able to have at least 3 hours of Ebola vrus can stil be transmitted through blood for few years Ebola can stil Be transmitted through sex for onthe except a. . a. Paracetamol is prescribed for muscle pains. Ryan may receive ORESOL cr fluid replacement Via intravenous route, depending on the severity of fluid loss. Aspirin is an alternative if paracetamol ie not available for muscle pains. ‘The treatment for dengue Is symptomatic: Situation: Current epidemiological studies have revealed rent outbreaks of certain dormant diseases. The following questions are relevant: 11. Dengvaxia ™ (CYD-TDV) is the frst dengue vaccineto be licensed in Mexico in 2015 for use in individuals 9-45 years of age living in endemic areas. This was developed by Sanofi Pasteur. What isthe route of administration for this vaccine? b G a Intravenous al Intramuscular ‘Subcutaneous 12,_ Determine the dosage ofthis vaceife ‘2: Ginjections of 0.5m. each at 3-maritilintervals b, injections of 1mL each at 3-month intervals c Ginjections of ImL: each at 6-month intervals d. injections of 0.5mL. each at 6-month intervals. 13, Young wemen in yoUF community are afraid that they could be infected with Zika virlsjand they approached You in request of conducting a small gathering wherein you could share with them information about it. The following are vital points to be discussed about Zika virus) excest a. 14. AS an Developing the infection canijonly, be confirmed by laboratory testing of blood and other bocily fluids. Being affected by Zka virus may cause neurological and autommmune complications tn the newborn. Mothers of children with microcephaly have been exposed to Zika virus. ‘A means to control the spread of Zika virus is by vector side reduction/eradication, ‘occupational nurse, you've been assigned to a response team from your company in controlling the spread (of EBOLA infection in one of the affected areas. One of your tasts Is to conduct health teacting on c. Survivors can safely resume normal sexual practices without fear of Ebola virus transmission after two negative results in laboratory testing. Survivors can safely resume sexual practices provided that condom is used. Situation: Part of Our role as law-abiding and ethical health care professionals come our knowledge of regulatory policies in the Philippines that affect our practice. 16. MDT — muttiple drug therapy is proven effective in the ‘cure for Leprosy and renders client non-infactious 7 days after the start of treatment. Domicillary advocates; W, A B RA4073 Proclamation #45 Cc. PD996 D. RA7496 ‘What law regulates the use and disposal of toxic waste produe’s in the Philippines? a. RA9003 b. PD856 c. RA9695 d. RA6969) 3. ThissReplible Act legalizes the use of human organs for ‘surgical, medical and sclentific purposes. ey b. a 19, RA 1055 RA 349 Ragattl RA6425, ‘The 16” congress of the Republic of the Philippines reporteaithis senate bill as An Act Instituting Reforms fo Further Protect and Develop the Nursing Profession, Amending forthe Purpose of RA 9173, jotherwise knowneasithe Philippine Nursing Act of 2002" inppla of the six senate bills submitted to the house. ‘a. Senate Bill 1009 b, Senate Bill 2583 ‘Senate Bill 2720 d. Senate Bill 1264 20. The Magna Carta of Pubic Health Workers was instituted in 1992. Which Republic Act legalized this: RA7277 ~ Magna Carta of Disabled Persons RA 7305, RA 7164 — PH Nursing Act RA 7192 -Women in Developmert Nation Building pogoilhess experiences of dinic and street-based homeless"/Bays: ‘aged 15-23 years living in Morayta, 21. Nurse Marian, a community healti/furse wants to conduct her own ethnographic study focusing on the Tull tribe in Ifugao. She wants to seek the broad types of information sought by ethnographers. She nas anseinaccurate understanding of the areas of interest in/an ethnographic study if she has included 2. Cutural behavior b. Cutural artifacts Cultural attitude d. Cutural speech 22, To help her understand and interpret the everts and activites by the Tuall tribe, Nurse Marian sought forthe help of the Tluali tribe cheftan a: her key informant. In-depth interviews were conducted and she realized that the chieftain’s view about their own culture reflects: ‘a. Emic perspective b. _Etic perspective Bt perspective d. Tacit perspective 23, Nurse Marian was not satisfied about what she discovered about the T'ual tribe from the chieftain, She realized that she needs to establish her own view about the tribe practices as means of data triangulation. To suit her curiosity, Nurse Marian is doing well with ethnographic research process if she employs which data collection strategy used by most ethnographers? ‘a Use of cose-ended questions and structured interview with the members of T'uall tbe b. Immersion with the T'uali tribe and participant observation © Groupng the members of the Tali tbe into control and experimental group Fat a comprehensive survey questionnaire to all members of T'uali tree 24, Nurse Marian is now ready to analyze the data she gathered. To aid her in ethnographic deta analysis, she has chosen to utilize Spradleys method. She has an accurate chronological understanding of ts use if she will ber 1. Making domain analysis 2. Asking descriptive questions 3, Locating the informant 4, Interviewing an informant 5, Making an ethnographic record 66. Analyzing ethnographic interviews a. 145632 b. 34,5,2,6,1 © 146532 d. 342,561 25. Ethnographic research iS typically 2 labor-intensive endeavor. Nurse Marian underStands that for ethnographers to fully assimilate the culturelUnder study, their main goal should be directed towards acquistion on revelation of: ‘2. Emic and etic perspective b. Emi and ett perspective c_ Emic perspective and tacit knowledge 4d. Emic perspective and key informant’s knowledge! Situation: Buffers both intracellular and extracellular ‘maintain the fluid and electrolyte homeostasis of our body. Effective circulation ie affected by different physiologic factors such as blood volume, cardiac contractility, and vessel patency. Minute deviations from the normal can already cause drastic effects in cellular metabolism. 26. In which acid-base disturbance is an anion gap present? ‘a. Respiratory acidosis c. Metabolic acidosis, b. Respiratory akalosis d. Metabolic akalosis 27. The maximum infusion time of packed RBCS is: a. 45 mnutes cc 2 hours b. 10to 15 cm above the insertion site {Gil-5 cm distal to the insertion ste d. inches above the insertion site 29, How eften should the nurse check on © patient with ‘continuous Intravenous infusion? a. Every 4 hours ¢. Every 8 hours b. Every 2 hours — d. Every 30 minutes '30._A grade 3 infiltration of an intravenous site is characterized hy the following, except: a. Blanched, translucent skin/G» Numbness and rrild pain . Goobto.touch . Deep pitting edema Situation: Nurses play an active role in the prevention, management and containment of communicable diseases. 31. A client with human immunodeficiency virus positive had 2 mantoux skin test. The nurse notes @)7.mm area of induration et the site of the shin test. The nurse interprets the result as; a. Positive Uncertain b. Negative D. Borderline Leprosy is a chronic mildly communicable disease that mainly affects the:skin, the peripheral nerves and the ‘mucosa of the upper respiratory tract. The Multi-Drug Therapy (MDT) is proven effective cure for leprosy and renders patients non-infectious a week after starting the treatment. 32, In a health education class conducted by the PHN, she informed them about the early signs and symptoms of Leprosy. Which of the following choices is inappropriate description of the disease? a. Lagopthalmus b. Painful nerves C. Muscle weakness D. Nasal bleeding 23, The PHN gave emphasis on sights and symptoms indicating the infection hadvadVanced to a leter stage. Which of the folowing information should be excluded A. Madorosis B, Hend contrectures (C. Loss of sensation on skin lesion D._ChronielUleer ‘German Measles is a viral exanthem infection, caused by 2 Paramyxo virus primarily affecting older childron ‘and young adults ccurring sporadically in the Philippines due to mildness of the infection. The Incubation period ranges from 10-24 days with clinical features simulating Measles, also a viral exanthem infection 34. Procetsllthe exposure of the nursing affliates to the Pediatric-solation unit Mrs. Garcia, their C.I conducted pre-conference. She asks her students to describe the hallmark of Rubella infection which is lymphadenopathy. The CI would not have to corect Elsa, one of the nursing affliates if she states 2. It involves mucocutaneous lymph node syndrome b. The superficial cubital noles are enlarged Ths involves enlargement of axillary node d. The post cervical nodes and post auricular nodes are enlarged 35. Charisse, 2 student rurse is currently performing ‘assessment on Faith, a 9 year old child diaqnosed with