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Np3 Recalls 4

Nurse Chaewon is assessing Kazuha who was admitted for an asthma attack. Upon assessment, Nurse Chaewon hears wheezes throughout Kazuha's bronchi that disappear after a minute. Kazuha's bloodwork shows partially compensated respiratory alkalosis. Nurse Chaewon teaches Kazuha how to use an incentive spirometer correctly and that she should monitor her respiratory rate most frequently while on her albuterol prescription. Nurse Will is caring for Stella who has cystic fibrosis. Stella's condition is caused by a failure of chloride pumps which causes thick, sticky mucus. Nurse Will must be aware of Stella's treatment plan and monitor her
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0% found this document useful (0 votes)
3K views9 pages

Np3 Recalls 4

Nurse Chaewon is assessing Kazuha who was admitted for an asthma attack. Upon assessment, Nurse Chaewon hears wheezes throughout Kazuha's bronchi that disappear after a minute. Kazuha's bloodwork shows partially compensated respiratory alkalosis. Nurse Chaewon teaches Kazuha how to use an incentive spirometer correctly and that she should monitor her respiratory rate most frequently while on her albuterol prescription. Nurse Will is caring for Stella who has cystic fibrosis. Stella's condition is caused by a failure of chloride pumps which causes thick, sticky mucus. Nurse Will must be aware of Stella's treatment plan and monitor her
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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SITUATION a.

Clear, viscous mucus


In the emergency ward, Nurse Chaewon is currently b. Thick, sticky mucus
assessing Kazuha who was admitted due to an initial c. Salty, watery mucus
attack of asthma. Nurse Chaewon must be alert to the d. Lumpy, hardened mucus
sudden changes or improvements that Kazuha will
present. 7. Of the following organs, which is not affected by
cystic fibrosis?
1. Nurse Chaewon knows that the mechanism and causes
of asthma involves all but one: (-) a. Brain
b. Lungs
a. Inflammation c. Pancreas
b. Bronchospasm d. Skin
c. Aspirin use(+)
d. Acetaminophen use(-) 8. For lung transplantation, Nurse Will must be aware
that the following are criteria for a possible donor except:
2. Upon assessment, Nurse Chaewon hears wheezes
throughout the bronchi of Kazuha during an asthma a. Donor is younger than 65 years old
attack. She stays by her side and after a minute, assesses b. Donor is psychologically cleared
her lung sounds once more. She noticed that the c. Donor was not coerced into donating
wheezing has disappeared. What is Nurse Chaewon’s d. Donor has close tissue match with the recipient
initial intervention?
9. Stella is conscious yet is having a hypoxemic spell.
She is assessed to have wheezing and an O2 saturation of
a. Document the finding
93%. Which of the following must Nurse Will not do
b. Provide 4L/min oxygen via nasal cannula
independently?
c. Notify the rapid response team
d. Place Kazuha in a left side lying position
a. Chest physiotherapy
3. After the asthma attack, the blood of Kazuha is tested. b. Suctioning
The results show that the blood has a pH of 7.29, pCO2 c. Oxygen therapy
of 56, and HCO3 of 28. Which condition describes d. Head of bed elevation
Kazuha’s laboratory values?
10. Nurse Will knows that which of the following is not
possible sign and symptom of Stella?
a. Partially compensated respiratory alkalosis
b. Uncompensated respiratory acidosis
a. Steatorrhea
c. Partially compensated respiratory acidosis
b. Growth retardation
d. Uncompensated respiratory alkalosis
c. Hemorrhoids
4. When teaching Kazuha how to use the incentive d. Salty urine
spirometer, which of the following is the right statement
SITUATION
made by Nurse Chaewon?
During the dry, cold season in the Philippines, cases of
the common cold and other inflammatory upper
a. “When using the spirometer, you will need to be in
respiratory tract disorders increase.
a semi-fowler’s to fowler’s position.”
b. “You may drink coffee five minutes before using the 11. Jennifer is a four-year-old patient who is living in
spirometer.” Baguio. She is constantly picking her nose which results
c. “The spirometer is used best when you are laying in her having secretions all day long. One day, she was in
down on your left side.” pain and her mother noticed that Jennifer squirms when
d. “Pursed lip breathing must be done when inhaling touched on her forehead. This tenderness between the
through the spirometer.” eyebrows is a possible case of:
5. Kazuha is prescribed with albuterol. Which vital sign
a. Allergic rhinitis
must Nurse Chaewon tell Kazuha to monitor most
b. Sinusitis
frequently?
c. Coryza
d. Rhinitis
a. Blood pressure
b. Temperature 12. To determine if Jennifer has sinusitis, a physical
c. Respiratory rate examination is done wherein light is shone through the
d. Heart rate sinuses in a dim room. This is called ___________.
SITUATION
a. Phototherapy
Stella is admitted in the Richardson General Hospital.
b. Positive electron transmission
She is tended to by Nurse Will. She was diagnosed with
c. Transillumination
cystic fibrosis and is currently undergoing treatments and
d. Laser-assisted in situ keratomileusis
adjustments to promote stability.
13. Kura, the mother of Jennifer, told the nurse that
6. Stella’s condition is caused by the failure of chloride
Jennifer was already given a six-day worth of doses of
pumps to function which causes:
phenylephrine. The nurse’s best response is:
a. “This is good to know as we will need to continue the infusion to prevent further clots. The health team will
decongestants to improve Jennifer’s breathing.” monitor the laboratory parameter __________.
b. “We need to stop the decongestants to prevent
rebound congestion.” a. Partial thromboplastin time
c. “I will need to notify the physician for an increase in b. Prothrombin time
dosage.” c. International Normalized Ratio
d. “Maybe you can try a different drug which contains d. Clotting factor time
ephedrine.”
19. While having an infusion of heparin through the
14. The physician informs Kura the possible surgical intravenous line, the nurse sees air bubbles travel into
treatment if Jennifer does not improve. Which of the Lionel’s arm through the IV line. Which emergency
following is a surgical treatment to relieve sinusitis? intervention must the nurse do?

a. Functional endoscopic sinus surgery a. Aspirate the IV line


b. Transsphenoidal hypophysectomy b. Place Lionel in a left-lateral Trendelenburg
c. Minimally invasive sinus scoping c. Provide oxygen via a venturi mask delivering 24%
d. Sinus rhinoplasty d. Notify the physician

15. Postoperatively, the nurse should instruct Kura to 20. While in heparin therapy, the nurse must instruct
provide saline nasal sprays to Jennifer every _________. Lionel on proper self-care. Which of the following must
Lionel do?
a. 1-2 hours
b. 2-4 hours a. Dip toothbrush in warm water before using
c. 4-6 hours b. Wear tight-fitting slippers and sandals
d. 6-8 hours c. Eat caramel, cookies, and nuts
d. Trim the nails every two weeks
SITUATION
Various patients are at risk for blood clots which travel SITUATION
through the bloodstream and reach the lungs. These Jay Y. Peace, a celebrity in the Philippines, was stabbed
situations are emergency situations and nurses must be in the chest by a paparazzi who wanted to date him. He
alert to the signs and symptoms caused by the clots. was then admitted to the Kwangya National Hospital for
immediate treatment.
16. Which of the following is the least risk factor for
thromboembolisms? 21. Which finding by the respondents does not solidify
the claim that JYP is suffering from a pneumothorax?
a. Blood hypercoagulability
b. Venous stasis a. Reduced breath sounds on auscultation
c. Tunica damage b. Hyperresonance on percussion
d. Vigorous exercise c. PMI on the left of the left MCL
d. Dull sounds on auscultation
17. Of the following, these are possible emboli which
may lodge into the lung’s vascularity. 22. In a similar case of JYP’s, if there has been another
stabbing incident and the patient is seen in the streets
1. Fat with an open wound, what must be the first action of the
responder?
2. Oil a. Call the emergency services
b. Cover the chest wound
3. Air c. Assess the pulse and responsiveness
d. Determine the type of pneumothorax
4. Tumor cells 23. The most fatal complication of a pneumothorax is
_________________.
5. Amniotic fluid
a. Atelectasis
6. IV catheters b. Mediastinal shift
c. Tracheobronchial necrosis
d. Tension pneumothorax
7. Blood clots
24. For a patient undergoing thoracentesis, which
8. Pus position must the nurse place the patient in?
a. 1,2,3,4,5,7,8
b. 1,2,3,4,5,6,7,8 a. Supine
c. 1,3,4,5,6,7,8 b. Semi-fowler
d. 1,2,3,4,5,6,7 c. Orthopneic
d. Trendelenburg
18. Lionel was diagnosed to have a venous thrombosis
upon ultrasound. The physician has ordered a heparin 25. Mark, a seven-year-old patient is brought to the
emergency department. He is tachypneic and afebrile and
has a respiratory rate of 36 CPM and a non-productive 31. To support Nurse Victor’s hypothesis of an endocrine
cough. From this history; the patient may have which disorder, which of the following statements made by Kai
condition? should be most noted of?

a. Asthma a. “May nararamdaman po akong pagtusok-tusok sa mga


b. Bronchitis daliri ko sa paa.”
c. Emphysema b. “Kapag ako ay tatakbo, mas madali na ako hingalin at
d. COPD parang sumasakit dibdib ko.”
c. “Nagtatalik kami ng Misis ko ngunit hindi na kasing
SITUATION ‘tikas’ tulad ng dati.”
Nurse Nayeon is a staff nurse in the medical ward. She d. “Itong singsing na ito na pangkasal namin ng Misis
has patients of different conditions. Jihyo, a dancer, is ko, hindi ko na maisuot dahil hindi na kasya.”
admitted in the ward who is constantly urinating.
32. Nurse Victor received an order to prepare Kai for an
26. Nurse Nayeon has followed the physician’s orders MRI scan. Nurse Victor assesses Kai and reports to the
and has deprived Jihyo of fluid intake. However, Jihyo’s physician the following except:
urine output remains at 60mL per hour. Jihyo is
suspected of having ____________. a. Had a hip replacement three years ago
b. Took recreational drugs a year ago
a. Syndrome of inappropriate antidiuretic hormone c. Agitation in small spaces
b. Diabetes mellitus d. Has an implanted pacemaker
c. Polycystic kidney disease
d. Diabetes insipidus 33. While teaching Kai, Nurse Victor determines that the
hormones secreted by the anterior pituitary gland
27. The physician told Nurse Nayeon that Jihyo’s includes:
condition is caused by a defect in the pituitary gland.
Which of the following pertains to this condition? a. Prolactin
b. Oxytocin
a. Nephrogenic c. Antidiuretic hormone
b. Primary d. Glucagon
c. Drug-related
d. Oncologic 34. Kai tells Nurse Victor that he noticed his voice
getting deeper. Which statement made by Nurse Victor is
28. Upon checking Jihyo’s laboratory values, which of most appropriate to tell Kai?
the following is expected?
a. “It is because of the bones in your chest which do not
a. Urine specific gravity less than 1.005 expand easily.”
b. High urine osmolarity b. “You are continuing to grow.”
c. Urine specific gravity more than 1.025 c. “Your vocal cords have grown more than they
d. Amber urine color should.” ACROMEGALY
d. “The muscles in the throat contract lesser than
29. Inhaled Desmopressin was given to Jihyo to aid in
normal.”
her condition. Nurse Nayeon provides health education
to Jihyo regarding the administration of the drug. Which 35. Kai asks Nurse Victor whether or not his bone
of the following indicates that teaching is effective? changes are temporary. Nurse Victor tells Kai that the
condition is:
a. “I will take puffs of the drug while I am laying down.”
b. “I will blow my nose before inhaling the drug.” a. Temporary and reversible
c. “I will weigh myself every other day.” b. Permanent but curable
d. “I will take Acetaminophen for persistent headaches.” c. Temporary with residual effects
d. Permanent and irreversible
30. Which laboratory values of Jihyo indicated to Nurse
Nayeon that another dose of Desmopressin is needed? SITUATION
Kai underwent surgery to address the root cause of his
a. Urine output and specific gravity are increased condition in the previous situation. Nurse Amihan is the
b. Urine output is increased and urine specific gravity postoperative nurse assisting him through his recovery.
is decreased
c. Urine output and specific gravity are decreased 36. Nurse Amihan assesses Kai and sees a clear fluid
d. Urine output is decreased and urine specific gravity is leaking out of his nose. What must Nurse Amihan do
increased first?

SITUATION a. Grab a 4x4 gauze


Kai, a 28-year-old male, comes into the clinic with b. Notify the physician
complaints regarding his body as the years go by. Nurse c. Tell Kai to wipe the fluid
Victor is assessing him and is taking his health history d. Assess Kai’s breathing
and suspects an endocrine disorder.
37. Nurse Amihan reviews Kai’s history and takes note
that Kai underwent a pituitary gland removal. The
endoscope was passed through the nose and nasal
passages. She knows that this surgical procedure is
known as ____________. a. Tachycardia
b. Tachypnea
a. Open lobotomy c. Agitation
b. Transsphenoidal hypophysectomy d. Hypertension
c. Functional endoscopic pituitary surgery
d. Minimally invasive adenoidectomy 45. Which of the following indicates that the patient
needs further teaching regarding his lifestyle?
38. Which of the following must Nurse Amihan tell Kai
not to do to prevent complications? a. Will not drink caffeinated beverages
b. Will change position gradually
a. Straining on bowel movements c. Will attend face-to-face classes diligently
b. Use dental floss d. Will stop smoking
c. Sneeze with the mouth open
d. Rinse the mouth with oral mouthwash SITUATION
Thyroid disorders are common in the Philippines. They
39. Nurse Amihan notes that the mustache dressing of pose multiple risks to the patient and may even be fatal.
Kai who underwent surgery five hours ago is wet. What
is Nurse Amihan’s best action? 46. Nurse Hutao is talking to Shinobu about her health
history. Nurse Hutao notices that Shinobu is sweating
a. Check glucose in the drainage easily while being in an air-conditioned room. Shinobu
b. Notify the physician tells Nurse Hutao that she could not stand the heat. Nurse
c. Reapply a dressing and document the finding Hutao suspects this as a case of ___________.
d. Assess for coryza
a. Hypopituitarism
40. Which statement made by Kai indicates lack of b. Hyperthyroidism
understanding of the health teachings provided by Nurse c. Hypothyroidism
Amihan? d. Hyperpituitarism

a. “I will drink from a straw.” 47. Which of Shinobu’s statements support Nurse
b. “I will not bend at the waist when picking up objects.” Hutao’s hypothesis?
c. “I will not ride roller coasters.”
d. “I will report bleeding around my ears to my a. “I noticed my scalp hair thinning already.”
physician.” b. “My weight began increasing in the past weeks.”
c. “I feel drowsy all of the time.”
SITUATION d. “My heart always feels like it’s about to stop.”
Nurses must be constantly updating their knowledge
regarding endocrine disorders involving the different 48. Knowing Shinobu’s possible condition, which of the
glands of the body such as the adrenal glands. following should Nurse Hutao do best?

41. A patient is suspected of having a a. Place Shinobu in the room near the nurses’ station
pheochromocytoma. To properly diagnose the disease, b. Illuminate the room when assessing Shinobu
the nurse will perform ___________ on the patient. c. Let patients play lato-lato
d. Dim the lights in Shinobu’s room when possible
a. Urine dipstick test
b. Fasting blood glucose test 49. The physician has ordered Shinobu to take
c. Midstream urine collection Propylthiouracil. Which of the following should Shinobu
d. 24-hour urine collection immediately report to the physician?

42. Based on Question 41, which substance is being a. Tachycardia


measured by the procedure? b. Jaundice
c. Cyanosis
a. Adrenocorticotropic hormone d. Weight gain
b. Vanillylmandelic acid
c. Urine hemoglobin 50. After undergoing radioactive iodine therapy, which
d. Bacterial culture of the following should Nurse Hutao teach Shinobu to
do?
43. Which of the following indicates that the caregiver
for a patient with pheochromocytoma is in need of a. Flush the toilet two times after each use
further teaching? b. Spend time and play with her six-month-old son
c. Use cloth handkerchiefs
a. “I grab to the patient’s waist when I help him d. Buy disposable utensils
ambulate.”
b. “I always dim the lights.” Situation
c. “I let him listen to calm white noise.” Martin, a newly registered nurse, is assigned in the
d. “I knock on his door gently before calling him.” coronary care unit of Grey-Sloan Medical Center. During
his first day of work, he was ordered to handle several
44. What is the hallmark sign and most common serious patients with various cardiac problems.
complication post-adrenalectomy of pheochromocytoma?
Situation The following are manifestations of the said disorder
except:
Martin, a newly registered nurse, is assigned in
the coronary care unit of Grey-Sloan Medical a. Leg pain relieved by rest
Center. During his first day of work, he was b. Reddish skin in the leg
ordered to handle several patients with various c. Cold skin in the lower extremities
cardiac problems. d. Diminished pulse in the leg

51. Martin reviews his patient’s electrolyte lab report and 56. Sheena is a hypertensive patient who is currently
notes that the potassium level is 6.5 mEq/L. Which taking an ACE inhibitor (Captopril). As a knowledgeable
patterns should Nurse Martin watch out for on the ECG nurse, which of the following diuretics is contraindicated
report of a patient with this potassium level? Select all to Sheena?
that apply.
1. Flat P wave a. Lasix
2. Prolonged PR interval b. Penicillin
3. Wide QRS complex c. Spironolactone
4. ST depression d. Bumex
5. Prominent U wave
6. Flat T wave 57. Karina was admitted to the ER department due to
suspected abdominal aortic aneurysm. Which among the
a. 1, 2, 3 following should be done during the physical
b. 4, 5, 6 assessment?
c. 4, 5, 3
d. 2, 4, 5 a. Percussing the chest
b. Inspecting the abdomen
c. Palpating the abdomen
52. Martin is now caring for a patient with multiple d. Pressing the abdomen firmly to reduce pain
myeloma who has a calcium level of 12 mg/dL. Which
patterns would Nurse Martin watch out for on the 58. Sean, a 50-year-old male diagnosed with
electrocardiogram? Select all that apply. hypertension was prescribed with Bumex, to be taken
daily. Which among the following assessment should
1. Wide T wave alert the nurse to immediately intervene and notify the
2. Prolonged ST segment HCP?
3. Short ST segment
4. Peak T wave a. BP of 160/90
b. ECG findings reveal NSR
a. 1, 2 c. Serum potassium level of 2.7 mEq/L
b. 2, 3 d. UO of 30 ml/hr.
c. 3, 4
d. 1, 3 59. Mina, a patient diagnosed with chronic heart failure
has been placed on a low sodium diet. Mina
53. A patient with coronary artery disease is prescribed demonstrates adequate knowledge if she avoids which of
with transdermal nitroglycerin, a coronary vasodilator. the following food sets?
Which among the following choices, if stated by the
patient, indicates a need for further teaching? a. Baked potatoes, egg yolks, and nuts
b. Orange, sardines, tofu
a. Patient applies the patch on a non-hairy area. c. Cereal, bacon, and canned tomato soup
b. Patient places the medication over his tongue. d. Dark chocolate, dark green leafy vegetables, tuna
c. Patient removes the old patch before placing a new
one.
60. Mr. Shepherd is admitted to the hospital with a
d. Have a 12 hour “no-nitrate” time to prevent tolerance
diagnosis of right-sided CHF. Upon assessment, the
to nitrates.
nurse should expect to find the following manifestations
except:
54. Nurse Martin is teaching a new patient named Jo
about nitroglycerin and what are the signs to look out for a. Extensive peripheral edema
to assess if the drug is working effectively. Nurse Martin b. Jugular vein distention
is correct is he tells patient Jo the following statements c. Dyspnea on exertion
except?
d. Weight gain
a. Pulse rate increases 61. Aya, a 55-year-old female, has been admitted with a
b. Pain subsides diagnosis of left-sided CHF. Which assessment finding
c. BP lowers would most likely be present?
d. Activity tolerance increases
a. Hepatomegaly
55. Chai, a 2nd year student nurse, asked Nurse Martin b. Weight gain
about the clinical manifestations of arterial insufficiency. c. Peripheral edema
d. Crackles 67. Nurse Hazel, as the nurse manager in her respective
unit, evaluated her staff nurses on how they perform a
62. Luisa has been prescribed with Lanoxin by her step-by-step procedure of NGT insertion and removal.
physician. Right after her consultation, Luisa went to you This evaluation is called:
and ask about the toxic effects that she should be looking
out for while taking this drug. Which among the a. Structure
following manifestations would you tell Luisa? b. Process
c. Input
a. Halos around lights d. Outcome
b. Constipation
c. Increase appetite 68. After evaluating her staff on how they perform NGT
d. Tachycardia insertion and removal, Nurse Hazel went on checking
their satisfaction box to assess the responses they got
63. Shana is on heparin therapy. Which among the from their patients over a specified period with regards to
following statements should not cause for a concern on the quality of care they delivered. This evaluation is
the nurse? called:

a. I use an electric razor when shaving. a. Structure


b. I switched my mouthwash from the commercial one to b. Process
chlorhexidine wash. c. Input
c. I use a soft-bristled toothbrush when I brush my teeth. d. Outcome
d. I love playing basketball every afternoon.
69. Nurse Hazel noticed that the hemodialysis machines
64. Mr. Taylor, a 54-year-old obese, went to the being used in the hemodialysis unit are already due for
emergency room with presenting signs and symptoms of replacement. This evaluation is called:
chest pain. The resident on duty ordered an ECG for
thorough assessment and detected cardiac abnormalities. a. Structure
As an aspiring registered nurse, which among the b. Process
following ECG patterns would tell that the Mr. Taylor c. Input
already had a previous MI? d. Outcome

a. Pathologic Q wave 70. Nurse Hazel noticed that the rooms on their unit are
b. Elevated ST segment no longer well ventilated due to the old air conditioners
c. Inverted T wave installed on each room. This evaluation is called:
d. ST depression
a. Structure
b. Process
65. Cloud is a 54-year-old male patient diagnosed with c. Input
arterial insufficiency. Which of the following set of signs d. Outcome
and symptoms characterize this condition?
Situation
a. swelling of legs, calf pain Yohan is a graduating student nurse who aspires to top
b. dull and crampy pain the boards. As a preparation, she decided to go over her
c. redness along the course of the vein notes on Fundamentals of Nursing and review the most
d. absence of distal pulse, pale skin on legs salient concepts.

66. Laboratory studies are ordered for Karen, a patient 71. What does D stands for in FDAR?
receiving Digoxin and Furosemide. As a competent
registered nurse, you should immediately notify the a. Data
healthcare provider if you see which of the following b. Date
results? c. Delivery
* d. Design
1/1

a. K = 3.9 mEq/L; digoxin level 1.5 ng/mL 72. A patient is receiving 100 ml/hour of continuous IV
b. K = 5.0 mEq/L; digoxin level 1.0 ng/mL fluid therapy. The nurse examined the venipuncture site
c. K = 3.0 mEq/L; digoxin level 2.3 ng/mL and finds it to be red and warm. Which of the following
d. K = 3.8 mEq/L; digoxin level 0.5 ng/mL interventions should the nurse perform?

a. Stop infusion, remove, and restart IV


Situation
b. Place cold towels on the site
Hazel, a nurse manager at Grey-Shepherd Medical
c. Slow the infusion
Center just completed her seminar on standards and
d. Elevate HOB and report to physician
criteria development as part of her management training.
The following questions apply.
73. Solana, a newly registered nurse, is about to do a b. Dry mouth
history taking and an initial assessment on a patient with c. Lacrimation
cervical cancer. Which among the following questions d. Mydriasis
should she ask? Select all that apply.
1. “Do you smoke?” 78. An underweight patient comes to the clinic for a
2. “When was the first time you engaged with a routine physical exam. The nurse chose a standard blood
sexual activity?” pressure cuff to assess the patient’s BP, however, the
3. “Do you eat fruits and vegetables?” cuff turned out to be too big for the patient. Blood
4. “Have you had a history of HPV infection?” pressure readings taken with such cuff would result to
a. 1, 2, 4 which of the following?
b. 2, 3, 4
c. 1, 2 a. Produce a false high measurement
d. 4, 2 b. Cause a brachial artery damage
c. BP apparatus would show no results
74. Nurse Andi is assigned to patient Shai, a 25-year-old d. Produce a false low measurement
female, who has a white blood cell count of 4000 μL.
Which of the following should be included on Nurse 79. Joseph, an aspiring registered nurse, is reviewing the
Andi’s teaching to patient Shai? different kinds of test that could be done on sensory
organs. Which among the following tests measures the
eye’s color vision?
a. Use soft-bristled toothbrush
b. Avoid fresh flowers and fruits a. Rinne’s Test
c. Use an electric razor when shaving b. Ishihara Test
d. Include green leafy vegetables in the diet c. Tonometry
d. Snellen’s Test

75. Nurse Andi is teaching Mona, a 4th year student 80. Ana is currently having a blood transfusion. Which
nurse, regarding herbal medicines. Which of the of the following manifestation is suggestive of an
following is the function and effect of garlic? anaphylactic reaction?

a. Bronchospasm
a. It promotes sleep
b. It lowers blood pressure b. Crackles
c. It acts as an antidepressant c. Distended jugular veins
d. It relieves menstrual cramps d. Flank pain

81. Which statement is false regarding fall among


geriatric patients?
76. Patient Cherry asked Nurse Gabbie on how to
perform a self-breast examination. Which of the
following statements should Nurse Gabbie include in her a. Fall risk increase with addition of medication
teaching? Select all that apply. b. Head fractures from falls are leading cause of
placement in care facilities
c. Sedatives increase risk for fall
1. Use the fingertips when palpating the breasts d. Falls commonly occur in the bathroom
and not the palms of the hands

2. Lying down to assess the symmetry of the 82. What should be included in health teachings for older
breasts clients who are self-medicating?

a. Develop drug reminder and schedule


3. Inspect the breasts in a mirror with arms by
b. Shop for the most expensive medication as they are
sides and then with arms raised
more effective than cheaper ones
c. Eliminate some medication to lessen what needs to be
4. Do the self-breast exam on the 1st day of remembered
menstrual period d. Use herbal medication instead of prescribed
medication
a. 1, 3
b. 2, 4
c. 2, 1 83. An older client complains of difficulty sleeping at
d. 3, 4 night. Which of the following indicates that the client
needs further teaching?

77. Ciara, a patient with sinus bradycardia, was a. “I exercise regularly”


prescribed to take Atropine Sulfate by her physician. The b. “I stopped using my cigarettes”
following are the potential side effects of the drug, c. “I read 30 mins before sleeping”
except: d. “I drink hot chocolate prior sleeping”

a. Tachycardia
84. During physical assessment of an older client, the
nurse noted some changes in the patient’s skin. Which of 90. What should be prioritized by the nurse in the care of
the following would indicate a potential complication? an 82 year old woman with mild forgetfulness?

a. Wrinkling a. Patient tells the nurse that one of her friends died last
b. Thinning week
c. Loss of elasticity b. Patient lost 10 pounds
d. Crusting c. Patient watches TV with her daughter before sleeping
d. Patient forgot to close the refrigerator
85. A nurse in the facility for the elderly is performing
assessment on some of her clients. She is knowledgeable 91. Nurse Robert’s job is to collect secretions from the
that normal age-related physiological changes include? surgical site of one of the patients. If this is done
Select all that applies. unconsented and unwillingly Nurse Robert would be
I. Decrease in heart rate liable for:
II. Decline in visual acuity
III. Increase in respiratory rate a. Assault
IV. Decline in long term memory b. Slander
V. Increased susceptibility to UTI c. Battery
VI. Deeper sleep
d. Breach of Confidentiality
a. All of the above 92. The patient confided with Nurse Blake that her
b. I, II, V companion is not her legal husband. Nurse Blake would
c. I, II, III, IV be liable of what if he exposes this information to his co-
d. II, III, IV, V, VI nurses?
86. A 72-year-old patient with UTI enters the emergency a. Assault
room with his son. Upon assessment, which would b. Slander
necessitate immediate nursing intervention? c. Battery
d. Breach of Confidentiality
a. Temperature of 97.5° F
b. Death of pet dog 3 months ago
c. Presbycusis 93. Erika is not compliant with her treatment and does
d. Confusion not take her medication due to suspicious personality.
Nurse Bando got irritated and threatened Erika. What
87. Mr. O’Neal, a 92-year-old male is dehydrated and is kind of malpractice was present in the situation?
currently having IV fluid replacement. During one of his
nurses’ shifts, he experienced confusion. The nurse's best
action is to assess the patient for which of the following a. Assault
reversible causes? (Select all that apply.) b. Slander
i. Hypoglycemia c. Battery
ii. Cerebral anoxia d. Breach of Confidentiality
iii. Dementia 94. Which of the following acts committed by a nurse is
iv. Electrolyte imbalance an intentional tort?
b. All of the above a. Negligence
c. None of the above b. Abandonment
d. Only I and II c. Battery
d. Breach of Confidentiality
88. Which psychosocial theories of aging manifest
through decrease social interaction? 95. Berto refers to the infection control nurse about the
proper disposal of infectious waste. Which of the
a. Activity theory following laws refer to the Code of Sanitation?
b. Continuity theory
c. Ego Integrity vs Despair a. PD 825
d. Disengagement theory b. PD 856
c. PD 857
89. Nurse Mccoy is performing health teaching on an 84- d. PD 791
year-old patient who will be sent home on anticoagulant
therapy. Which strategy would reflect consideration of
aging changes that may exist with this patient? Situation

a. Develop large print outs that reflect verbal Bioethics


information presented 96. Eliminating racial bias in health care is based on
b. Give the patient colorful pamphlets which of the following ethical principles?
c. Show a black and white video about anticoagulation
therapy a. Justice
d. None of the above b. Fidelity
c. Non-Maleficence
d. Veracity

97. During blood extraction of a 4 year old client, the


nurse stays with him and reads him his favorite book.
This illustrates the ethical principle of?

a. Justice
b. Fidelity
c. Non-Maleficence
d. Veracity

98. A school organization conducts a information drive


on how to prevent COVID-19 during the pandemic. This
is an example of which virtue?

a. Justice
b. Fidelity
c. Beneficence
d. Non-Maleficence

99. Physician informs the patient of all the risk included


in her surgery. All questions asked by the patient was
answered by the physician. This is based on what ethical
principle?

a. Justice
b. Veracity
c. Non-Maleficence
d. Fidelity

100. What principle governs the nurse in making day-to-


day decisions in healthcare making sure proper conduct
and what is right regarding life, biology and health
profession is being followed?

a. Values
b. Bioethics
c. Morality
d. Jurisdiction

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