COPYRIGHT: JONAS MARVIN ANAQUE, RM, RN

EXLCUSIVE FOR ASTIGNURSE BABIES ONLY!!!

NURSING BOARD CRAMSHEET

(BAWAL ISHARE SA IBA KAHIT PA PAG PUMASA KA NA)

Situation - Roy, 65 years old, came to the outpatient clinic due to dyspnea, fever and on and off
productive cough. He smokes one pack of cigarette per day for the last 30 years. The doctor ordered
sputum examination, chest x-ray and blood culture.

1. In collecting sputum specimen, the nurse should instruct Roy to _____.

A. breathe slowly, cough and expectorate into the specimen container

B. breathe deeply and cough, expectorate into the sputum container,
C. cough and expectorate saliva into the specimen container.
D. cough and expectorate into the specimen container.

2. The patient's diagnostic tests revealed he was positive for bacterial pneumonia. The MOST
likely causative organism of this type of pneumonia is ______.

A. legionella pneumoniae B. mycoplasma pneumoniae

C. streptococcus pneumoniae D. hemophilus pneumoniae

3. The nurse did an admission procedure. The best position to be assumed by Roy is _____.

A. left lateral position with the affected side inferior.

B. semi-fowler position at least 30 degrees.
C. dorsal position with pillows under the chest.
D. lying on his side, the affected side of the lungs should be superior.

4. When a patient is diagnosed to have pneumonia, the breath sounds detected by the nurse
on auscultation of the affected area would be ______.

A. wheezing sounds B. stridor

C. fine crackles D. deep and low-pitched breath sounds

5. When there is respiratory depression resulting from drug overdose, the nurse have to
watch for which of the following?

A. Hyperventilation B. Tachypnea
C. Biot's respiration D. Bradypnea

Situation - Ms. Nilda is a new graduate with a Bachelor of Science degree which she acquired from a
university. She is determined to pass the National Licensure Examination (NLE) to be administered by the
Board of Nursing.

6. The 1icensure examination which is administered by the Professional Regulation

Commission, Board of Nursing is given to ______.

A. apply the theory earned from classroom to practice settings

B. protect the public from incompetent practitioners
C. apply the scope of nursing practice
D. demonstrate expected competency standards

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7. The PRC-Board of Nursing (PR-BON) has the power to regulate Nursing Practice
in the Philippines. The regulatory functions include the following except

A. enforce and monitor quality standards of nursing practice in the county

B. issue, suspend revoke or reissue certification of registered nurses
C. ensure proper conduct. Or nurses 1icensure in the county
D. issue permit for the opening of nursing programs in the country

8. Ms., Sanchez is a new nursing graduate and in dire need for the hospitalization of
her ailing mother She is being offered to endorse a detergent product on TV Commercial
wearing a mini skirt and a plunging neckline shirt. In doing this performance Ms. Sanchez is
violating the ________.

A. oath of professional for new nurses B. nursing practice act 7164

C. code of ethics for nurses D. core competency standards

9. Nurse Rey with the members of the team. from a tertiary hospital is going for their annual
outreach program Operation TULI". There were 3000 patients who came in the morning
with only 4 doctors, 3 nurses and 1 pharmacist. Due to the volume of patients, Nurse
Rey, was asked to participate in per forming circumcision with the rest of the doctors. Nurse
Rey can be 1iable of committing

A. assault B. invasion of privacy

C. tort D. malpractice

10. Which of the following actions is likely to constitute GROSS Negligence?

A. Complied with the request of a bedridden patient not to be turned because of pain.
B. A nasogastric feeding not given on time because patient is feeling nauseated
C. A patient suffering from bleeding due to post-operative wound and the Nurse
failed to report to the attending physician.
D. Urine output that has not been measured because of an emergency admission.

Situation - Nurse Carmi made a study on domestic violence against women in certain province in Luzon

11. Since she wanted to capture the essence and emotion of the victims she chose to use the
qualitative design. Which among the statements below is CORRECT about qualitative
design?

A. It commences study at present but consummates at any future time

B. It allows estimation of relationship between studied variables
C. It provides insights into attitudes, beliefs, motivates and behaviours of target
population
D. It tests results through numerical data and subjects them to statistical analysis

12. Nurse Carmi plans to gather 6 participants who are victims of domestic violence where she
will base her questionnaires. What technique in qualitative research is applicable to this
plan?

A. Data triangulation B. Focus group discussion

C. Interview D. Case study

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13. To have a better analysis and interpretation of the findings, Nurse Carmi reviewed and
compared them with other findings of previous researches on the same topic. This is done
MAINLY by going back to which part of the study? The _____________.

A. Statement of the problem B. Related literature and studies

C. Conceptual framework of the studies D. Theoretical framework of the study

14. Nurse Carmi finally decided to make an indepth study of ONLY ONE SUBJECT of domestic
violence. What design will she use?

A. Causality Design B. Predictive Correlational Design

C. Descriptive Correlational Design D. Descriptive Case Study Design

15. In as much as the research may have some risks on the part of the subject who is 21 years
old, Nurse Carmi must assure the subject of her anonymity, confidentiality and respect for
her human rights. ONE ABSOLUTE WAY is to get an informed and written consent from
whom?

A. Parents B. Guardians
C. Husband D. Subject herself

Situation - Nurse Vergel is newly assigned in the Pediatric Ward in San Isidro Medical Center. Since he
will be taking care of pediatric patients, there is a need for Nurse Vergel to be abreast with the legal
aspects of pediatric nursing care.

16. Which of the following regulates the practice of the nursing profession?

A. Department of Health B. Professional Regulation Commission

C. Civil Service Commision D. Professional Regulatory Board of Nursing

17. One of Nurse Vergel's patients needs to undergo invasive procedure. Based on the
Patient's Bill of Rights, sequence the persons from whom Nurse Vergel could obtain
consent?

1. Parents 2. Legal guardian

3. Next of kin 4. Physician

A. 1, 2, 4 and 3 B. 1, 4, 2 and 3
C. 1, 2, 3 and 4 D. 1, 3, 2 and 4

18. Based on the Right to Privacy and Confidentiality under the Patient's Bill of Rights, the
patient has the right to demand on the following, but NOT _______ pertaining to his care as
confidential.

A. Information B. Communication
C. Records D. Financial status

19. The Right to Information does not include _________.

A. Any change in the plan of care before the change is made

B. Extent to which payment maybe expected from Philhealth
C. Discount for the professional fee of the attending doctor(s)
D. Result of the evaluation of the nature and extent of his/her disease

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20. A patient has the right to leave the hospital regardless if his physical condition provided
s/she is informed of which of the following? Select all that apply.

1. Is informed of the medical consequences of his/her decision

2. Releases those involved in his/her care from any obligation relative to the
consequences of his decision
3. His/her decision will not prejudice public health and safety
4. Appropriate arrangement has been made to settle the unpaid bill

A. 1 and 2 C. 3 and 4
B. 1, 2 and 4 D. 1, 2, 3 and 4

Situation - Patient Ellie, a 28-year-old primigravida, is admitted to a birthing center. She has been in
labor with an interval of 5 minutes apart for 10 hours now. Hypotonic contractions are observed by Nurse
Nora. She feels more pain in her back than in her abdomen, sonogram shows her fetus is "borderline"
large for gestation and in occipito-posterior position.

21. Nurse Nora observes that the Ellie's uterine contractions are irregular in frequency and
short in duration. Ellie screams in pain during contractions. Which of the following actions is
considered BEST for the nurse to perform?

A. Try to divert attention from pain.

B. Administer pain reliever as ordered.
C. Stay with the patient and offer her a back rub
D. Document and report frequency and duration of contractions.

22. The physician is considering augmenting her labor with oxytocin. What would make Nurse
Nora question the use of oxytocin for Patient Ellie?

A. She had an amniocentesis performed during pregnancy

B Her fetus is large for gestational age by a sonogram
C. Her membrane ruptured after only 1 hour of labor
D. Her blood pressure is slightly elevated above normal

23. Nurse Nora notices patient's uterine contractions are 70 seconds long and occur every 90
seconds when assessing the frequency of her contractions after she receives oxytocin.
what would be the nurse's FIRST action?

A. Give an emergency bolus of oxytocin to relaxed the uterus

B. Discontinue the administration of the oxytocin infusion
C. Increase the rate of client's IV infusion
D. Ask client to turn to her left side and breathe deeply

24. Nurse Nora monitors the patient, knowing that which finding indicates an adequate
contraction pattern?

A. Three to 5 contractions in a 10-minute period, with resultant cervical dilatation

B. Four contractions every 5 minutes, without resultant cervical dilatation
C. one contraction every 10 minutes, without resultant cervical
D. One contraction per minute, with resultant cervical dilatation

25. Which of the following nursing measures would the nurse LEAST CONSIDERS to Patient
Ellie with oxytocin drip?

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A. Know, how to recognize potential adverse reactions:

B. Administer oxytocin drug with caution
C. Monitor patient closely when infusing oxytocin
D. Inform patient about potential complications.

Situation- Nurse Rona recognizes the importance of the application of Epidemiology in community health
setting.

26. Her priority in managing community health needs is through knowing in-depth the
PREVALENCE of diseases because it indicates the ______.

A. risks to health problems C. Priority needs of the people.

B. presence of health problems D. magnitude of health problems

27. Nurse Rona and her team has been utilizing the EEPIDEMIOLOGIC TRIAD model -
identifying causative factors of diseases. Which of the following is not relevant this, model?

A. External agent C. Treatment Regimen

B. Susceptible host D. Environment

28. There is an outbreak of measles in some areas of the community where Nurse Rona is
assigned. Which of the following-steps of an outbreak investigation should Nurse Rona and
her team begin?

A. Identify and count cases. C. Define and identify cases.

B. Verify diagnosis D. Prepare for field work.

29. Nurse Rosa is able to know the patterns of occurrence and distribution of diseases in the
community. Per record she found out there had been cases of rabies at irregular intervals
scattered in particular places. This occurrence rates to ______.

A. Endemic C. Pandemic
B. Epidemic D. Sporadic

30. As an epidemiology nurse, Nurse Rona's PRIMARY function and responsibility is to _____.

A. Assist the epidemiologist in making reports

B. Implement public health surveillance
C. Render nursing care to sick residents
D. Follow up cases and contacts

Situation. - Nurse Henie uses the Family coping index in assessing family health needs and problems of
particularly of families who are vulnerable to illness.

31. Which of the following is an evidence of a poor family coping Index related to healthcare
attitudes?

A. A parents who washes the wound of the child with running water
B. The family who observes the habit of cleaning surroundings.
C. A young mother who introduced solid food to her three-month-old baby.
D. A mother who brings her child to be vaccinated for measles,

32. Which of the following is the BEST evidence of a family whose family coping index on
therapeutic competence is rated as coping well?

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A. Shows positive interpersonal relationship

B. Participates in the weekly clean and green program of the community
C. Maintain clean and organized household ambiance
D. Visits the clinic frequently well or sick.

33. Which of the following tools used by nurses in the community setting for assessing health
needs and problems of families that is similar to family coping index

A. Nursing theories
B. Vitals statistics
C. Case study
D. Nursing diagnosis

34. In utilizing family coping index nurses should be knowledgeable that the focus of this tool is
identifying the family's ________.

A. strategies to deal with stressful situations

B. Manner of interaction
C. Ways of managing health needs and challenges
D. Patterns of health habits

35. Nurse Myrna is taking care of a family chose their young children are sick with malnutrition
particularly protein deficiency, which of the following behaviors is indicative of the family's
positive coping index

A. Observing erratic mealtime due to work schedule of parents

B. Bringing children to health enter for consult only when needed.
C. Serving foods that children like but with high in carbohydrates
D. Cooking foods in variety that include meat, dairy products and beans.

SITUATION- Health education is the process whereby knowledge, attitudes, and practices are changed
to improve individual, family and community health.

36. The goals of health education include the following:

1. Client participation on health decision making.

2. Increased potential to comply with health recommendations
3. Reliance on health care system
4. Adoption of healthier lifestyle
5. Provide clients with as many options on health care as possible

A. 1, 2 and 4 C. 2, 3 and 5
B. 2, 4 and 5 D. 1, 3 and 4

37. The nurse is designing a health education program for the community. Show the
CORRECT sequence of the process that the nurse would have to undertake.

1. Write the specific outcomes

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2. Assess the community

3. Prioritize learning needs
4. Select teaching strategies

A. 1, 4, 2, 3 C. 2, 3, 1, 4
B. 3, 1, 4, 2 D. 1, 2, 4, 3

38. The BEST example of how the nurse can create a climate in which clients do not feel
threatened is by teaching on a topic about:

A. Stress, where the nurse plays pop music throughout the first session
B. Good nutrition, while the nurse provides a meal
C. Exercise, where the nurse begins to share her difficulties she sometimes finds in
trying to exercise
D. Diabetes, where the nurse asks diabetics to talk to the class during the first session

39. The nurse is working in a clinic that is designed to provide health education and
immunization. As such, the clinic aims to provide_______________

A. diagnosis and treatment C. Secondary prevention

B. Primary prevention D. Tertiary prevention

40. Clients who are taught a variety of skills such as measuring blood glucose, taking blood
pressure, changing dressings, and bathing infants belong to which domain of learning?

A. Psychomotor domain C. Cognitive domain

B. Social domain D. Affective domain

Situation- As a public health nurse, you may encounter barriers or challenges in communication. Thus, it
is important that you maintain your professional demeanor.

41. During a support group meeting, Nurse Donato, in a teasing manner, has made several
provocative remarks about your appearance and behavior as a group leader. Select your
MOST appropriate response.

A. "Donato, see me after this meeting"

B. "Donato, you are excused from the group"
C. "What do you think Donato is trying to tell us?"
D. "Donato, what are you saying is inappropriate”

42. "The dress code in this facility does not include wearing blue jeans while on duty". This
statement is an example of using which step in giving constructive criticism?

A. Expressing empathy C. Stating expectation

B. Describing the behavior D. Listing consequences

43. Which of the following is an example of a barrier to successful negotiation?

A. Avoiding phrases that are coercive C. Becoming emotional

B. Viewing negotiation as collaborative D. Understanding others' perspectives

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44. In one of your meetings, you reminded the health center staff that there are quite a number
of members in the community who have not reached primary school. Which of the following
is the BEST communication intervention for a client who is illiterate?

A. Use of symbols and images C. Personalize speech by using first name

B. Use touch with speech D. Speak loudly and clearly

45. You also emphasized that, "Communication must be culturally competent to be effective".
Which of the following BEST reflects these statements?

A. Listen actively to what is said

B. Reflect on the meaning of the message
C. Use simple, direct words
D. Provide an appropriate environment

Situation 5 - Nurse Keena is alarmed with the rising number of re-emerging cases of pulmonary
tuberculosis (PTB) in the Philippines.

46. Case finding for PTB n the community requires that the nurse should Identify persons
having sputum characterized as ________.

A. Rusty, frothy C. Blood stained

B. Yellowish D. Greenish

47. In the care of patients with communicable diseases, Nurse Keena should know that feces,
urine, blood and other body fluids are considered as ______.

A. Portal of entry C. Reservoir of agent

B. Vehicles of transmission D. Portal of exit

48. With the onset of the rainy season, the nurses are closely monitoring the increase of
dengue cases. They should focus their health teachings on ways to prevent dengue by
______.

A Destroying breeding places of the vector

B. Using repellent lotion
C. Burning of dried leaves
D. Wearing of protective Clothing

49. Outbreak of cases of typhoid fever occurs in the community. Nurse Keena should inform
the residents that the transmission of the disease is through _______.

A. A vector C. Blood and body fluids

B. Food and water D. Air

50. There are several cases of Rabies in the community. Which of the following preventive
measure should Nurse Keena teach the families?

A. Impound all dogs

B. Impose," No pets allowed"rule
C. Have the dogs vaccinated
D Report to the authorities’ households with dogs

Situation - Nurse Bea engages in both formal and informal learning activities to enhance her knowledge
about Nursing Theories and other concepts in Nursing.

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51. Nurse Bea recall the theory or Nursing as caring by ______.

A. Orem C. Kings
B. Watson D. Benners

52. Which of the following is the central theme of Sr. Calista Roys theory?

A. Self care deficit C. Nursing as caring

B. Adaptation D. Transcultural

53. This theory categorizes professionals as Novice to experts is by ______.

A. Benner C. Pender
B. Abdellah D. Kings

54. Nurse Bea reviewed the elements of nursing as a profession. Which of the following is an
IMPORTANT element that characterizes Nursing as a profession?

A. Has members
B. Possess body of knowledge
C. Service oriented
D. A calling

55. Nurse bea wants to pursue higher education in Nursing for her career advancement. Aside
from enrolling in graduate school, which of the following she could enhance her career?

A. Participates in professional organization

B. Attends seminars.
C. Conduct research
D. Attends symposium

Situation - Nurse Levy reviews all pertinent laws that affect public health nursing

56. RA 9173 is otherwise known as the Philippine Nursing act of 2002. which is the primary aim
of this law?

A. To enhance the competence of professional nurses

B. To regulate practice of professional nursing in the country
C. To facilitate mobility of nurses to other countries
D. To promote well-being of health workers

57. The nurse closely monitors the work she delegated to the barangay health worker. She is
legally guided by this principle

A. Respondent superior
B. The good Samaritan
C. Res ipsa loquitor
D. Jurisprudence

58. This law promotes the well being and living conditions of health workers especially those
from the government managed facilities

A. Continuing professional development

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B. Magna Carta for health workers

C. Philippine qualifications framework
D. Local government code

59. It mandates the compulsory Immunization of children below 8 years

A. PD 996
B. RA 11223
C. RA 9173
D. RA 10912

60. This law allows every Filipino to avail of affordable medicines

A. Local Government Code

B. Primary Health Care
C. Universal Health Care
D. Generic Drug Act

Situation – Nurse Vera made a home visit to a newly married couple whom the wife is a primigravida
and three months pregnant. That would be mother asked questions about pregnancy and prenatal care.

61. In the assessing the health condition of the preganant patient, Nurse Vera should focus on
the _________.

A. last menstrual period

B. number of days of menstruation
C. age of patient during menarche
D. amount of menstrual flow

62. The patient asked Nurse Vera when is the best time to visit the clinic for her 1st prenatal
care. Which should be the APPROPRIATE answer of the nurse?

A. Second trimester C. Third trimester

B. Before delivery D. First trimester

63. The patient seems indecisive whether to breastfeed her baby or not. Which is the desired
nursing action of Nurse Vera to help the pregnant patient make a decision on
breastfeeding?

A. Give pamphlets and books to read.

B. Provide ample time for the patient to decide.
C. Refer the patient to the nutrionist.
D. Assist to identify breastfeeding goal and plan.

64. The patient asks Nurse Vera, when could you hear the fetal heart of my baby? Which of the
following should be the BEST answer of Nurse Vera?

A. Nintth month C. Third month

C. Fifth month D. First month

65. Nurse Vera informs the patient she should be screened for pre-eclmapsia during this term
of pregnancy_______.

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A. first C. Third
B. second D. Before delivery

SITUATION – Nurse Jenny is in-charge of record keeping in the health center.

66. Which of the following is NOT a step of record keeping?

A. Structuring C. Securing
B. Storing D. Easy Disposal

67. In the community setting which is ESSENTIAL record about the patient?

A. Treating record C. Chart

B. Tally sheet D. Kardex

68. WHICH OF THE FOLLOWING IS THE PURPOSE OF RECORD KEEPING?

A. Quantify medication usage

B. Historical background
C. Archive
D. Quality health care

69. Records are IMPORTANT in health care for

A. counting hospital bills

B. evidence of health care
C. Quantifying services provided
D. For the physician to read

70. What is the ultimate purpose of record keeping

A. Safeguard information C. History

B. Archive D. Store information

SITUATION – Nurse Mely considers teamwork and collaboration as important components of community
HEALTH NURSING.

71. Which of the following is the PRIMARY goal of collaboration

A. Less numbebr of people is needed

B. Camaraderie
C. ACOMPLISH GOALS
D. Work is faster

72. Which are KEY ELEMENTS of collaboration

1. Shared vision
2. Partnership
3. Working together
4. Unity

A. 1,2,3 C. 1,2
B. 3,4 D. 1,2,3,4

73. Which of the following is the MOST imporatnat purpose of teamwork?

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1. Work is faster
2. Promotes trust
3. Sense of security
4. Unity

A. 1,2 C. 3,4
B. 1,2,3,4 D. 1,2,3

74. Which of the following BEST describe a strong team?

A. cohesive C. driven
B. shared goal D. Sense of mission

75. Collaboration and teamwork are essential in public health to improve

A. Staff performance C. Equity in services

B. Proper use of resources D. Quality healthcare

SITUATION 9 – When prioritizing problems in the community, the problems are categorized as health
status, health resource or health related.

76. Nurse Maris is correct in identifying whinch of the following is a health resource problem?

A. Increase in number of deaths fromm Pneumonia

B. Feud between Midwife andHead of t he Sanitation Committee
C. Absence of midwife in the communtiy to render health services
D. High Maternal Mortality Rate

77. There are five criteria in prioritizing community health problems. If Nurse Maris is estimating
the proportion of the population affected by the problem, she is using what criterion in
prrioritization?

A. Social concern
B. Nature of the problem
C. Magnitude of the problem
D. Modifiability of the problem

78. Nurse Maris oftentimes encounter barriers. Select a barrier to goal setting between the
nurse and the family.

A. Eeducational attainment
B. Nature of employment
C. Failure of family to perceive existence of problem
D. Socio economic status

79. Which is the MOST appropriate intervention should the nurse do to help family perform the
health tasks?

A. Allow family to decide to use health resources

B. Help the family recognize the problem
C. Leave the family what action take on their problem
D. Refer family to barangay offficials for guidance

80. Choose the step of nursing process that identiffies the famiilyy health seeking behavior.

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A. Assesment C. Planning
B. Implementation D. Evaluation

Situation- Ms. Nena will be involved in an interdisciplinary research to conduct by the City Health Office
to address health problems of the population covered. To prepare for this task, she reviews her
knowledge on the research to process and research designs.

81. Which of the following study designs that uses information on current health status,
personal characteristics, and potential risk factors will be appropriate?

A. Case-control C. Cohort
B. Ecological D. Cross-sectional

82. The type of epidemiologic study that is used to describe a group of persons enrolled in a
study who share some characteristic of interest and who are followed over a period of time
to observe some health outcome is a/an:

A. Cross-sectional study C. Cohort study

B. Experimental study D. Case control study

83. The research team will use summary indicators of health as method to depict health
status. What is this approach called?

A. Analytic C. Descriptive
B. Holistic D. Evaluative

84. Ms. Nena is specifically assigned to talk individually with community leaders like the
primary grade teacher and the barangay official in charge of the health committee. Which
data collection method will the nurse use?
A. Key informant interview C. Participant observer
B. Community mapping D. Social survey

85. Ms. Nena suggested to use an analytic approach in their research. Which of the following
statements BEST describes the analytic approach?

A. Focuses on the community's health problems and issues

B. Utilizes health indicators to define population health
C. Views factors that influence health and by which interventions to improve health
are directed
D. Addresses the social determines of health to solve community's problems.

SITUATION – In the community where Nurse Noli is assigned there are many obese individuals who are
suffering from different heart ailment.

86. Which initiative should Nurse Noli introduce in order to decrease incidence of risk factors
especially Obesity.

A.. Wellness and fitness program

B. Obesity is natural body response
C. Tell them to go to gym
D. They have to undergo strict dietary regimen

87. Which should be emhpasize by the nurse in her health teachings

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A. Jogging a mile a day C. Vigourous exercise

B. No need to diet D. Weight reduction

88. Nurse Noli should advice t he patients the following except:

A. Cut down on salt intake

B. More fruits and vegetables
C. Eat regular meals
D. Eat more saturated fats

89. To prevent complications from their heart disease the nurse recommends to the patient
regular monitoring of their blood

A. Cholesterol C. Type
B. Nitrogen D. Oxygenation

90. Nurse Noli should include in his teachings the following EXCEPT:

A. Less saturated fat

B. Weight within normal limits
C. Exercise regularly
D. More fats in the diet

SITUATION – Nurse Mae is a new supervisor of t he health center. Her prrogram thrusts include excellent
and quality provision of services and performance of the staff.

91. To ensure that the staff adheres to their job responsibilities which should be the
appropriate toool should Nurse Mae utilize in evaluating staff performance?

A. Memorandum C. Incident report

B. Performance evaluation D. Anecdotal report

92. As a nurse manager, which nursing action should do to let the staff imbibe the culture of
quality at the health center?

A. Become a role model

B. Reprimand every now and then
C. Frequent meetings
D. Allow them to read books

93. Which measure will be used in the unit to ensure patient satisfaction of the delivery of
health services?

A. Encourage to use social media

B. Provide means to evaluate services
C. Verbal feedback
D. Ask the local officials

94. Which is the simple meaning of standards of nursing care?

A. What protects the nurse

B. How the nurse will behave
C. How much work is done
D. Ask the local offficials

95. Which is the BEST strategy that Nurse should employ to give feedback on patients

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evaluation of health services?

A. Put the evaluation at supervisors office

B. Send letter to all
C. Conduct staff meeting
D. Through bulletin board

SITUATION – With the onset of rainy seasons, Nurse Nena and her team are on alert for increase in
cases of Dengue Fever.

96. Identify the causative agent of dengue fever.

A. Fomite C. Bacteria
B. Vector D. Virus

97. Which of the following strategies would prove effective in preventing more incidence of
dengue infection?

A. Healthy nutritious food

B. Burning of leaves and garbage
C. Destruction of breeding place of vectors
D. Adequate rest and sleep

98. Bleeding is the most serious complication of Dengue infection. When is the patient be
watched for symptoms of bleeding?

A. 4th to 7 days C. 2nd to 3rd day

B. At the onset of symptoms D. 1St day

99. Which information about the nature of dengue fever the nurse should relay to the
community?

A. It is always life threatening

B. It could be deadly but preventable
C. It could responds well to antibiotics
D. The incubation period is variable

100. Which diagnostic test could be useful in confirming the diagnosis of Dengue Fever?

A. Rumpell – Leede C. Elisa

B. Mantoux D. Widal

SITUATION 15 – Nurse Rica finds effective communication as tthe key to successful community health
nursing.

101. When writting a memorandum, which of the following is the MOST important guideline

A. Purpose is included C. Friendly tone

B. Content clear D. One topic at a time

102. Which of the following is an INDICATOR of effective communication?

A. Receiver C. Sender
B. Feedback D. Non verbal communication

103. Nurse Rica, would like to start a conversation, which comunication technique she should use?

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A. Clarifying C. Challenging
B. Restating D. Broad opening

104. The patient told her something about her treatment to make understood the patient which
communication technique shouuld be used by the nurse?

A. Clarifying C. Validating
B. Focusing D. Restating

105. Non verbal communication is as strong in conveying information because the nurse can
_________.

A. Observe gestures
B. Body language could be observed
C. Sender less effort
D. Action speaks louder than words

SITUATION 16 – Nurse Lyn plans to enhance her personal professional development

106. Choose an indicator that models personal and professional behavior and values.

A. Utilizes communication and social media responsibly

B. Attends conferences
C. Enrolls in school
D. Joins civic organization

107. Nurses should have knowledge about professional organization. Which of t he following is the
accredited professional organization of nurses?

A. Maternal Child Nursing

B. Philippine Nurses Association, Inc.
C. National leaguue of Government Nurses of the Philippines
D. Association Nursing Service Administrators of the Phiilippines

108. A profession is characterized by the following except:

A. Body of knowledge
B. Code of ethics
C. member of professional organization
D. Engages in research

109. Which of the following is an example of self directed learning activity?

A. Research at work
B. Attends webinars
C. Attendance to graduate school
D. Resource person

110. Aside from atttending seminars which of the following informal continuing education programss

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should the nurse engaged herself EXCEPT:

A. Attendding professional conventions

B. Webinars
C. Symposium
D. Doing reseach as academic requirement

SITUATION – Health educataion isi one of the essential services at the community setting. Nurse Nena is
in charge of health education activities of the rural health unit.

111. Which of the ff is TRUE about health education in public health?

A. It only done by professionals like nurses

B. It is every health worker responsibility
C. It remains constant
D. It is seldom use in public health setting

112. The BEST result of health education process is

A. It influences and changes behavior

B. It provides new input
C. Update others
D. Information transfer

113. Which of the following explains health education is creative process?

1. It could emploty a variety of strategies

2. It can be done anywhere
3. It could perform by any member of the healthh team
4. It is a valuable health service

A. 1,2,3 C. 3,4
B. 1,2 D. 1,2,3,4

114. To families and individual in the community, which is the MOST important goal of health
education?

A. To study their life history

B. To identify their weeknesses
C. To totally change their lifestyle
D. To motivate them to develop skills and literacy in healtth

115. As a whole health education in public helath aims the __________.

A. Transfers information
B. Make life changes
C. Better health opportunities
D. Change personality

SITUATION – Nurse Mary is assigned to mange the Non Communicable Disease Prevention and Control.

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She is alar by the increase number of residents who are having Hypertension.

116. Which assessment findings is INDICATIVE of the diagnosis of hypertension?

A. Family members with high blood pressure

B. Elevation of blood cholesterol level
C. Stressful work environment
D. Consistent evaluation of blood pressure

117. Identify the MOST appropriate diagnostic examination that confirms the iincidence of
hypertension amongg residents.

A. Chest xray C. Ultrasound

B. Electrocardiogram D. BP monitoring

118. Which medication will be prescribed to control and maintain the blood pressue of patients at
normal level?

A. Lidocaine C. Amlodipine
B. Epinephrine D. Furosemide

119. Nurse Mary had observedthat most patients with hypertension stop taking their medications
and heard them saying "I feel good already" Which is the APPROPRIATE nursing
diagnosis?

A. Impaired gas exchange C. Knowledge deficit

B. Anxiety D. Ineffective coping

120. During the conduct of his health teachings to the patients, which should the nurse emphasize to
maintain blood pressure at normal level?

1. Smoke in moderation
2. Exercise regularly
3. Consume less salt
4.Maintain normal weight
5.Less stress

A. 2,3,4,5 C. 1.2.4.5
B. 1,2,3,4 D. 1,3,4,

Situation – Risk factors include genetic and physiological factors, age, physical environment and
lifestyle.

121. The presence of any of these risk factors means that ______.

A.Risk modification will have no effect on disease prevention

B.The chances of getting the disease are increased
C.A person with risk factors can get the disease
D.The disease is guaranteed not to get disease

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122. A nurse involves well-being in her definition of health. What will the primary concern or focus of
the nurse when she provides care to a family confronting the imminent death of a family
member?

A.Reinforcing the need for the whole family to adapt to the impending death.
B.Sharing the nurse’s knowledge on the client’s symptoms of grief
C.Discussing the perceived meaning of life with the family
D.Administering pain medication so that the client can be kept comfortable

123. In the care of families, crisis intervention is an important part of _____.

A.Secondary prevention C. Primary prevention

B.Tertiary prevention D. Health promotion

124. The Nurse asks Baste, who is being admitted in a district hospital with uncontrolled diabetes
mellitus, about his employment status. She knows that _____.

A.A person’s compliance is affected by one’s affected economic status

B.Baste's employment will cause complication to his diabetes
C.External variables have little effected on compliance
D.Diabetes mellitus will affect his client’s work condition

125. During a home visit, a member of the family you’re visiting who has been using marijuana for
three years tells theyou that he wants to be “detoxified.” It is important for the nurse to ____.

A.Instruct the patient to change his lifestyle C. Identify the patient’s stage of change
B.Tell the patient that relapses are not tolerated D. Realize that the patient is ready for change

Situation- The public health nurse must have an understanding of demography which should support
health care plan.

126. Demography is concerned with the study of population. Which of the following are included in
demographic profile?

A.Size, composition, health status, and environment.

B.Change in population, distribution, and health status
C.Size, distribution, composition, and change in population.
D.Size, distribution, and composition.

127. Based on the 2017 demography report (July 2016 estimate), the Philippine population has
reached:

A.140 million C. 102 million

B.120 million D. 85 million

128. There are three demographic variables in population growth. Which one is NOT included?

A.Fertility C. Morbidity
B.Migration D. Mortality

129. Population structure is a diagram of population typically presented in a pyramid-like style format
based on ___________.

A.Sex and educational attainment C. Age and civil status

B.Age and fertility D. Age and sex

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130. An aging population refers to a phenomenon in which the median age of the population in a
country rises significantly compared to the total population in a country rises significantly
compared to the total population. This is caused by any or combination of the following:

1.A declining birth rate. 4. Increased child survival.

2.Rising life expectancy. 5. Better health.
3.Decreased fertility.

A.1, 2, 3 and 4. C. 1, 2 and 3.

B.1, 2, 4 and 5. D. 1, 2, 3, 4 and 5.

Situation - Nurse Pedrito makes several home visits to patients who were discharged from a district
hospital.

131. As Nurse Pedrito prepares for the day's visits, which of the following patients should be seen
FIRST? A client with ________.

A.Parkinson's disease with imbalance gait. C. A thoracostomy six months ago.

B.A history of congestive heart failure with dyspnea. D. A stroke with nasogastric tube (NGT).

132. Mang Emilio refuses to take his daily medication for hypertension. Which of the following
actions should Nurse Pedrito take at this time?

A.Tell MangEmilio that he will suffer from stroke.

B.Explore the reason for the client's refusal to take the medication.
C.Administer the medication by injection.
D.Obtain help from relatives in administering the medication.

133. Nurse Pedrito sees a 65 year-old male, who is recovering from stroke. He noticed that Mang Jose
exhibits signs of unilateral neglect. Which behavior is suggestive of this unilateral neglect? Mang
Jose is _________.

A.Unable to carry out cognitive and motor activity at the same time.
B.Observed shaving only one side of his face.
C.Unable to complete a range of vision without turning his head side to side.
D.Unable to distinguish between two tactile stimuli.

134. Nurse Pedrito is teaching a client with Parkinson's disease on ways to prevent curvatures of the
spine associated with the disease. To prevent spinal flexion, the nurse should tell the client to
_________.

A.Rest in supine position with his head elevated.

B.Sleep only in dorsal recumbent position.
C.Periodically lie in prone position without a neck pillow.
D.Sleep on either side, but keep his back straight.

135. A client with congestive heart failure has been receiving digoxin (lanoxin). Which finding indicates
that the medication is having a desired effect?

A.Increased weight C. Increased urinary output

B.Improved appetite D. Increased pedal edema

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Situation - Public Health Nurse Gabriela is tasked for the day to administer vaccination to pediatric
clients in the barangays she covers. She, along with the team of midwives, should be knowledgeable on
how to provide with the most effective, necessary and safest vaccination.

136. The foundation of medication administration is the application for the "Rights of Medication
Administration." which of the following is NOT included in these rights?

A.Right route C. Right dosage

B.Right patient D. Right price.

137. When conducting Parents Education on immunization, which of the following

considerations should Nurse Gabriela include?

1.Welcomes and greets child and family.

2.Explains the vaccines to be administered.
3.Refuse entry to those who came late.
4.Informs attendees about the procedures to be done.
5.Provide parents time to ask questions.
6.Refrain from answering questions from parents.

A.2, 4, 5, 6 C. 1, 2, 4, 5
B.2, 3, 5, 6 D. 1, 3, 4, 6

138. When handling vaccines, the FIRST step Nurse Gabriela should do is to ________.

A.Select the correct needle size. C. Check the content prior to drawing up.
B.Reconstitute using diluent supplied. D. Check the vial for expiration date..

139. If more than one vaccine is given, the following guidelines should be observed, EXCEPT.

A.Do not give more than one dose of the same vaccine in one session.
B.Do not use the same arm or leg for more than one injection.
C.Give doses of the same vaccine at the correct intervals.
D.Use the same syringe and needle in administering two vaccines.

140. When documenting the procedures done, which of the following should NOT be recorded?

A.Date C. Manufacturer
B.Lot number D. Needle gauge

Situation- Public Health nurses participate in health screenings which help in the early detection of a
disease of identify those who are at risk for a particular disease or condition. Early detection, followed by
treatment and management of the condition cam result in better outcomes, and lower the risk of serious
complications.

141. Nurse Filomena organized a health fair in one of the communities she covers, which was well
attended, with several SCREENING TESTS being given simultaneously. What would Nurse
Filomena consider the purpose of the health fair?

A.Community service C. Community bonding

B.Multiphasic screening D. Case finding

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142. What must be stressed to all participants attending a health fair?

A.A screening program is not a substitute for ongoing health supervision from a health
care provider.
B.All test results are only tentative, and so participants who receive negative test results may
nonetheless be suffering from a disease.
C.Results are true today, but disease can develop any time, so participants should attend any
future health fairs as well.
D.There are many other diseases that may be attacking participants that the health fair did not
screen for, and so continued vigilance is necessary.

143. As nursing students were setting up a health screening at a local community center, they
reviewed the need to screen for heart disease and cancer. One student asked, "But colon
cancer is prevalent: why aren't we setting up for sigmoidoscopy?" How would Nurse Filomena
reply?

A."Can find adequate privacy for a sigmoidoscopy?”

B."A sigmoidoscopy is expensive to perform and invasive".
C."Would you like to perform that test for the screening?".
D."What a great idea. Would you like to help arrange it?".

144. Sensitivity is the ability of a screening test to accurately identify what aspect of the screening?

A.Persons with symptoms of the disease. C. Persons who have the disease.
B.Persons who do not have the disease. D. Persons who now have a diagnosis of disease.

145. The ability of a screening test to distinguish correctly between persons with and without a disease
is knows as _________.

A.Reliability C. Validity
B.Sensitivity D. Specificity

146. Some common examples of screening tests are the following, EXCEPT ________.

A.Pap smears for cervical cancer screening in women.

B.Cholesterol levels in heart disease screening.
C.PSA levels for prostate CA in men.
D.Urinalysis for male and female clients.

Situation - Public health nurses use their nursing skills in the application of public health functions and
provisions of social assistance to their clients.

147. Which of the following statements BEST describes Public Health Nursing?

A.Services are best implemented only in far flung and hard-to-reach areas.
B.Services are rendersfree of charge to people in the catchment area.
C.It home care to sick people who cannot be confined in the hospital.
D.It puts emphasis on health promotive and preventive services.

148. The current emphasis for public health practice is ___________.

A.Improving environmental sanitation C. Preventing communicable disease. .

B.Controlling epidemic diseases. D. Advocating for social justice.

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149. The public health nurse must participate in the essential services that are relevant and
accessible to the family and the community. These include:

A.Working in enforcing laws to regulate health and ensure safety.

B.Diagnosing and investigating health problems of the country.
C.Informing, educating, and empowering the people about health.
D.Monitoring health status and completing a community assessment.

150. Collecting data and monitoring the health status of the population defines which of the core
public health functions?

A.Quality assurance C. Policy development

B.Assessment D. Health promotion

151. Public health services are provided by government facilities. What is the most appropriate
response of a public health nurse to the statement: The government should give these
health services free of charge to people?

A."Yes and for that reason, we should choose our government officials wisely during elections".
B."Yes, I agree. But right now, the government does not have enough resources to do that".
C."That is an ideal situation that our government does not have enough resources to do that".
D."Many of the health services are given free, but we people pay for them just the same
through our taxes".

152. The team 1eader, decided to ask Nurse Trining the meaning of informed consent. After
being able to define what the term means further asked the
reasons for its use. Nurse Trining’s answer should be which of the following?

1.To fully understand what the research is all about and what will happen should
the participants to involve themselves in the research study
2. To get assurance that participants have the right to withdraw from participating in the
research at any given time.
3. To get a compete and Full information as to the objective of the study, procedures to
be implemented, data collection, benefit and has and options in the method at treatment.
4. To get assurance how anonymity and confidentiality will be maintained.

A23&3 C. 1,2,3,4
B.2only D. 3 only

153. As to the observance of respecting privacy, nurse Trining explained about___________.

A. breach of contract C. Ethical dilemma

B. anonymity D. Confidentiality

154. In nursing, Nurse Trining explained that the MAIN goal of conducting research is to______.

A. Justify the role of nurses as health care provider

B. establish a credit body of evidence to support and improve the delivery of care.
C. identify research priorities that will justify the Oversupply of nurses
D. develop a body of knowledge to address non-nursing problems

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155. In conducting a study on sleep, Nurse Trining was asked which of the types of research will
be used should it involve collecting numerical data which is most often
under considerable control. Her answer should be _________.

A. Ichnographic C.Qualitative
B. Phenomenological D. Quantitative

156. Should a 24-hour period clinical observations and activities be considered in conducting the
research on sleep, the type of study that study will be conducting is

A.Quantitative C. Phenomenological
B.Descriptive D. Exploratory

Situation – Presley enters the labor and delivery unit in probable preterm labor at 36 weeks ' gestation.
The patient was informed that the fetus is in breech presentation. She has. a Catheterized urine specimen
ordered.

157. Patient Presley asks the nurse why such a diagnostic procedure is required. What is the
MOST APPROPRIATE answer can the nurse give?

A. Urinary tract infections are strongly associated with the occurrence of preterm labor
B. Reduced sensation to urinate usually occur during preterm labor
C. Preterm 1abor treatment usually causes women a bladder infection because of restricted fluid
intake
D. Catheterized urine is usually ordered for any woman admitted to the labor and
delivery unit

158. Betamethasone (Celestone) is prescribed to be administered and the patient asks nurse
Hope about the purpose of this medication?

A. Promote fetal lung maturity.

B. Prevent the premature closure of the ductus arteriosus.
C. Delay delivery for at 1east 48 hours.
D. Stop the premature uterine contractions.

159. Patient Presley who is ordered for diagnostic pelvic ultrasound asks what preparation she'
11 take. Appropriate preparations for this procedure include_________.

A. explanation of the procedure

B. NPO 6 hours before
C. informed consent
D. voiding

160. Pelvic ultrasound can detect, which of the following?

A. Congenital defects in the structure, fetal gender, H-mole

B. Fetal DM, multiple pregnancies, fetal age of gestation
C. Fetal sex, number, and lung maturity
D. Fetal congenital defects, placenta previa, fetal lung maturity

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161. The labor progress and the physician performed amniotomy. Nurse Hope should FIRST
assess tor _______.

A. bladder distention
B. maternal blood pressure
C. cervical dilatation
D. fetal heart rate (FHR) pattern

Situation -Sienna, a patient with severe preeclampsia is admitted to the hospital. She is a
student from one of the local universities and insists on continuing her studies while in the hospital,
despite being instructed to rest. The patient studies approximately 10 hours a day and has numerous
Visits from fellow students, family and friends

162. Which intervention should the nurse use to promote rest?

A. Develop a routine with the patient to balance her studies and her rest needs.
B. Include a significant other in helping the patient understand the need for. rest.
C. Instruct the patient that the: baby 's health is more important than her studies at this time,
D. Ask her why she is not complying with the prescription of bed rest.

163. Patient Sienna who seems to be irritated with the nurse said "I don't want to talk with you
because you're only a nurse. I will wait for my doctor. " Which of the following should the
nurse say I'm response to the patient?

A. Your doctor prescribed this for us to do nursing care.

B. I understand. I should call your doctor.
C. I' m angry with the way you dismiss me.
D. So then you would prefer to speak with your doctor?

164. Nurse Mauve is now on ethical dilemma. This occurs when _______.

A. a decision had to be made quickly under stress full situation

B. choices are unclear
C. there is a conflict between the nurse 's decision and that of his/her superior
D. there is a conflict of two or more ethical principles

165. Despite the reaction of the patient, which of the ethical principle that the nurse is
responsible of providing all patients with caring attention and information?

A. Beneficence C. Veracity
B. Nonmaleficence D. Advocacy

166. Nurse Mauve should plan to initiate which action to provide a safe environment?

A. Take the patient's vital signs every 4 hours.

B. Encourage visits from family and friends for psychosocial support.
C. Maintain fluid and sodium restrictions.
D. Take off the room lights and draw the window shades.

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Situation- Nurse Nanie is admitting five-year-old Krini due to cough, respiratory distress, anxiety and
signs of dehydration. The working diagnosis is pneumonia.

167. Nurse Nanie is aware that history taking and physical exam are critical to the diagnostic
process and often provide more information than can be gained broad testing
strategies. History taking includes the by following, EXCEPT _______.

A. History of present illness

B. Religious Affiliation
C. Social & Family history
D. Past medical history

168. The objective of taking the history of present illness is to illicit the chronologic description
and duration of the chief complaint. Which of the following questions would try to answer
what Nurse Nanie wishes to illicit?

1.History of immunizations
2.Aggravating and alleviating factors
3.Duration of disease onset
4.Any treatment and response to treatment

A. 1,2,3 C.1,2,3 & 4

B. 2,3 &4 D. 1,2 &3

169. Past medical history section of Krini contains. the following, but NOT______

A. Prenatal history C. Current history

B. Child hood illness D. Birth history

170. Which of the following statements is TRUE?

A. History taking must be long regardless if the child appears to be well

B. No proper history can be obtained without observation of the child and the mother.
C. Nurse Nanie should refrain from asking about the illness of other members of the family.
D. An example of what can be elicited from a social history is how the disease started.

171. In order not to frighten small children, it is best to examine things that are uncomfortable or
frightening to them last so as not to lose their cooperation. This means the LAST thing to
do in a child is, which of the following, EXCEPT________.

A. Inspection of the throat with a throat stick.

B. Inspection of the ears with an otoscope
C. Auscultation of the heart
D. Undressing the child

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Situation 5 - Ximena a Chrisan 29-year-oid pregnant woman was admitted to the hospital with a
complaint of moderate hypogastric pain. She intends to visit the clinic for her first prenatal check-up
and informs nurse Parker that she did not realize she's pregnant until a week ago. As a result, she has
been on a diet, weightlifting at the health gym.

172. Patient Ximena was seen by the physician and was ordered for a medication that is larger
than the standard dose. What should the nurse do?

A. Give the drug as prescribed.

B. Inform the supervisor.
C. Give the average dose of the medication
D. Discuss the prescription with the physician.

173. The patient refuses to take the medication because it causes diarrhea. Nurse Parker
explains the action of the drug but the patient vehemently refuses the medication. What
should be the INITIAL action of the nurse?

A. Discuss with a family member the need for the patient to take the medication.
B. Document the patient 's refusal to take the medication.
C. Notify the physician of the patient 's refusal to take the medication.
D. Explain again to the patient the consequences of refusing to take the medication.

174. As a strong believer of her faith and the need for spiritual guidance, patient Ximena
requests that she wants that clergy will visit her. How did nurse Parker function when she
initiated the visit?

A. Dependently C. Interdependently
B. Collegially D. Independently

175. Patient Ximena sought referral to an abort ion clinic from the nurse. She reasons out that
her pregnancy a burden to her work and daily routines. What should be the BEST
RESPONSE of the nurse?

A. It will cause discrimination from friends and relatives.

B. Inform her that abortion is morally and legally wrong by virtue of the law.
C. It will cause infection.
D. It is against any religion.

176. The incoming nurse on duty reported, the nurse is administering a medication, the patient
says, "This pill looks different from the one I had taken before. " What is the
APPROPRIATE action of the nurse?

A. Explain the purpose of the medication.

B. Encourage the patient to take the medication.
C. Check the original medication pre scription.
D. Ask what the other pill looked 1ike.

Situation -A newly hired nurse is assigned in the OB Ward. She was Supervised by a senior nurse.

177. She was asked by the nurse supervisor about her concern and what are the considered
ideal fetal positions for a healthy delivery?

A. Right occipitoposterior with no flexion

B. Right occipitoposterior with full flexion
C. Left transverse anterior in moderate flexion
D. Left Sacroanterior with full flexion

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178. The physician ordered sonography. The nurse informs the ultrasound unit in charge and
prepares the patient for the procedure. The patient asks the importance of the procedure,
the nurse CORRECT response is________.

A. to determine diameters of the fetal skull

B. increase sensitivity for common bile duct of the fetus
C. useful to a visualized cystic duct of the fetus
D. to assess fetus' well-being

179. The newly hired nurse asks for advice from the supervisor. supervisor notices that the
newly hired nurse felt uneasy upon learning that the fetus is on breech presentation. Which
of the following is the BEST RESPONSE by the supervisor?

A. "I understand how you feel. Tell me more."

B. Is this your first time to witness a breech presentation"
C. Are you afraid to assist the case"
D. "Don' t worry. There's always a first time"

180. After the successful vaginal1 delivery, medication was ordered to be given immediately.
The supervisor reassured the newly hired nurse that everything will be fine because the
medication will.

A. promote vasoconstriction of uterine muscles

B. hasten uterine contractility and control bleeding
C. facilitate the return of pre-pregnancy vital signs
D. promote vasodilation of uterine muscles

181. The newly-hired nurse oriented the caregiver hired by the couple. Which of the following
should the nurse encourage the parents to do?

A. Relate to each twin individually to, enhance the attachment process.

B. Avoid assistance from other family members and support groups.
C. Bottle-feed the twins to prevent maternal exhaustion.
D. Plan for each parent to spend equal amounts of time with each twin.

Situation - Lillian, 2-week postpartum mother is seen in the health center. On further assessment, Nurse
Addison noted -a localized area of redness on the left breast, and the mother is diagnosed with mastitis.

182. Which additional finding confirms the diagnosis that the patient has mastitis?

A. Enlarged glands in the axilla

B. Normal temperature
C. Engorged both breasts
D. Hard mass and reddened area

183. Lillian asks the nurse the cause of this ailment. Which of the following would the nurse
explain as predisposing factors of mastitis? (Select all that apply)

I. Milk stasis
II. Nipple trauma
III. Using alcohol in cleaning nipples
IV. Baby 's sitting position

A. II and IV C. I and II
B. I and IV D. II and III

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184. Lillian complains of unbearable pain. Which of the following characteristics axe
EMPHASIZED in a culturally sensitive nursing Care? (Select all that apply)

I.The expression of pain is affected by learned behavior

II.Physiologically, all individuals experience pain in a similar manner,
III.Some Asian people has high response to pain medications
IV.Patients should be assessed for pain regardless of overt symptomatology.

A. III and IV C. I and III

B. I and II D. II and III

185. Nurse Addison provides instructions about measures to prevent postpartum mastitis who is
breast feeding her newborn. Which of the following would indicate that the mother needs
further instruction? "I Should _______.”

A. wash my hands wel1 before breastfeeding

B. breastfeed every 2-3 hours
C. change the breast pads frequently
D. wash my nipples with s0ap and water prior to feeding 3 hours

186. Considering her level of knowledge and the anxiety of her condition, Patient Lillian raised
questions on possible ways of relieving her breast discomfort. Which of the statements
NEEDS further instructions?

A. "I have to stop breastfeeding until this Condition

B."I can take. antibiotics, and should begin to feel better in resolves. 24 to 48 hours,"
C. I can use analgesics to assist in alleviating some of these discomforts, "
D. "I have to wear a supportive bra to relieve the discomfort."

Situation 8 - Nurse Lyca is assigned in the Nursery. She is performing newborn assessment on Baby
Boy Pratts born at 40 Weeks gestation.

187. Using APCAR Score, Nurse Lyca should bear in mind that this method of evaluating a
newborn 's Condition is used at how many minutes after birth?

A. 1 to 10 C. 1 to 7
B. 1 to 3 D. 1 to 5

188. Nurse Lyca is aware that testing of vision in infants and children has been treated
separately from the testing of adult. which of the statement is NOT true?

A. Infants and children often cannot be tested with the same materials and
techniques as adults.
B. Special techniques often must be used, especially to test infants and preschoolers, that
cannot be held to the same standards that apply to tests for adults
C. Some infants who appear visually impaired early in life wil1 not Show normal visual
responses several weeks or months later
D. Course of visual and cognitive development must be taken into account
in evaluating infants and children's visual abilities

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189. The false statement about physiologic jaundice in the statements below is _____

A. Caused by impairment in the removal of bilirubin deficiency in the production

of glucuronide transferase.
B. Begins to decrease by the 6th or 7th day.
C. Is visible in skin and sclera.
D. Begins after 48 hours of 1ife.

190. Neonatal jaundice FIRST becomes visible in which of the following parts? (Select all that
apply.)

1.Face
2.Forehead
3.Trunk
4.Extremities

A.3 & 4 C.1&4

B.1 & 2 D.2 & 3

191. When caring for patients with hyperbilirubinemia, the nursing care plan should focus on the
following, EXCEPT_________.

A. informing appropriately the significant others

B. preventing injury
C. maintaining physiological homeostasis with bilirubin levels increasing
D. preventing complications

Situation- Lily, 23-year-old pregnant woman, 37th week 's gestation, is admitted in the intensive care unit
due to paroxysmal ventricular tachycardia. The patient is conscious; cervix is open so they decided to
induce 1abor.

192. When the patient was informed about induction, she asks Nurse Aurora what it is all about.
which of the following statement by the nurse is correct? Induction is a

A. local anesthesia used for blocking pain during episiotomy

B. deliberate initiation of uterine contractions that stimulates labor
C. medication injected into the subarachnoid space and has a rapid onset of action
D. procedure per formed by artificial rupture of the membranes

193. Which of the following statement is NOT an indication for any uterine stimulants
(Oxytocin)?

A. Pre inducting cervical ripening

B. Controlling postpartum bleeding
C. Inducing or augmenting labor
D. Manages an incomplete abortion

194. Oxytocin drip was started to induce labor. Which assessment findings should cause the
nurse to IMMEDIATELY discontinue the oxytocin infusion? (Select all that apply)

I. Fatigue and drowsiness

II. Early decelerations, of the total heart rate
III. Uterine hyperstimulation
IV. Late decelerations of the fetal heart rate

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A. III and IV C. I and III

B. II and III D. I and II

195. Simultaneous with the oxytocin drip left arm) is the prescribed intravenous (IV) lidocaine
(Xylocaine). Nurse Aurora should dilute the concentrated solution of 1idocaine (right arm)
with which solution?

A.5 percent Dextrose in water

B. Normal saline 0.99 percent
C. Normal saline 0.45 percent
D. Lactated Ringer' s

196. Take home medications given to Patient Lily includes digitalis therapy which was given to
patient since she was pregnant. Which of the following would the nurse anticipate with
patient's drug therapy?

A. Switching to a more potent drug.

B. Continuation of the same dosage.
C. Need for change in medication.
D. Addition of diuretic to the regimen.

Situation -The indication of tracheostomy in children has changed substantially in the last two decades.
Nurse Robert is taking care of admitted to the Pediatric Ward due to pneumonia. The child is hooked to
a tracheostomy tube. Nurse Robert is quite anxious in taking care of Patient Irma, an eight-year-old
female child, who was this patient being her first day o£ duty in the Pediatric Ward.

197. When preparing the patient for suctioning, what is the FIRST step?

A. Perform hand hygiene

B. Gather equipment
C. Assess lung sounds, heart rate and rhythm
D. Check physician's order and patient care plan

198. Patient Irma will be placed in which of the following position? Select all that apply-

1. Fowler
2. Semi-Fowler
3.Supine
4. Sim

A. 1, 2& 3 C.1&2
B. 2 only D.1 only

199. Usually the common indication (s) for the tracheostomy in Patient Irrna' s condition is which
of the following? (Select all that apply.)

1.Prolonged intubation
2. Sepsis
3.Hypoventilation associated with neurologic disorders
4. Severe Sleep Obstructive Apnea Syndrome (SOAS)

A.2 only C. 1, 2, 3 & 4

B.1 & 2 D.1 only

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200. The PRIORITY nursing objective when caring a patient with a tracheostomy is _________.

A. To increase tissue oxygenation

B. To provide patent airway
C. To decrease tissue oxygenation
D. To improve ventilation

201. The TOP nursing expected outcome when performing suctioning is _______.

A. Lessened amount of secretions leading to decreased frequency of suctioning.

B. Secretions removed without complication.
C. Tube-fed patient does not aspirate feeding
D. Prevention of Occurrence of hypoxemia and bradycardia

Situation -Sonny, 11 years old, is admitted due to bronchitis. Upon admission, he manifested the
following signs and symptoms: Cough, production of mucus (Sputum), yellowish in color,
fatigue, shortness of breath, slight fever and chills and chest
discomfort. The physician Orders 4L/min oxygenation

202. The first standard step in oxygen therapy that the nurse should do is________.

A. assess client's condition

B. gather all the equipment and supplies
C. prepare the client for the oxygen treatment
D. check the chart for ordered flow rate and oxygen delivery method

203. In planning for Sonny's oxygen therapy, the nurse should consider which of the following,
EXCEPT

A. need for a humidifier.

B. length of tubing.
C. determine the age of Excel.
D. manner of administering oxygen, continuous or intermittent.

204. Which of the following is the PRIORITY action of the nurse for Sonny who is on Oxygen
therapy?

A. Check the flow.

B. Connect the flow meter to the pipe in oxygen outlet
C. Turn on the oxygen.
D. Attach the humidifier and connecting tubing to the oxygen delivery device.

205. What PRIORITY precautionary measure should be done by the nurse during the oxygen
therapy?

A. Humidifier's water should be checked regularly.

B. No Smoking sign.
C. Oxygen tank should have belt.
D. Limit visitors.

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206. One evening, Sonny complained of dyspnea despite continuous oxygen therapy. What
should be the FIRST action of the nurse?

A. Reassess the client.

B. Give PRN medication.
C. Assess the patency of the tubing.
D. Refer client to the physician.

Situation - The senior nurse Reese, 1s planning to revisit and implement a change in the management
system for the 0bstetric unit. This would be a pilot unit as planned by the administration. Many problems
have occurred one of which is the present documentation system, and the charge nurse determines that a
change is required.

207. What should be the INITIAL STEP in the process of change for the senior nurse

A. set goals and priorities regarding the change process.

B. Plan strategies to implement the change.
C. Identify potential solutions and strategies for the change.
D.Identify the inefficiency that needs improvement or correction

208. Nurse Reese is preparing the patient assignment t for the day and needs to assign patients
to a midwife and nursing assistant. Which patient should the nurse assign to the midwife
because of patient needs that cannot be met by the nursing assistant? A
patient requiring________.

A. dressing change of post caesarian Surgery

B. Collecting of urine specimen for urinalysis testing
C. performing range-of-motion exercises twice a day
D. taking of vital signs measurement every hour

209. Because of the scarcity of nurses in the hospital settings, different service delivery models
were proposed. Which Situation represents the primary nursing care delivery model?

A. The nursing aide is assigned to make beds and other errands while the nurse is to give
medications.
B. The nurse develops a plan of care for patients and collaborates with other team members.
C. The nurse performs all tasks needed by the individual patient to optimize health.
D. The nurse provides care to 4 patients while the nursing aide is to care for 2 patients.

210. One of the post-caesarian patients has a private duty nurse and is responsible for providing
holistic care to her patient during the shift. What modality of nursing care is implemented?

A. Primary C. Total care

B. Team D. Functional

211. At which stage of Lewin ' s planned change indicates the nurse identifying, planning, and
implementing appropriate strategies ensuring that driving forces exceed restraining forces?

A. refreezing C. movement
B. unfreezing D. in activism

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Situation - Raman, 6 years old, has been recently diagnosed to have Acute Lymphocytic Leukemia. The
child has undergone chemotherapy. However, the father is witnessing before his very eyes his
first child dying. The father is very much depressed.

212. In what way wil1 the nurse handles the situation?

A. Tell her to trust on God's love and mercy.

B. Te1l her that death is a reality.
C. Encourage her to keep calm because the health care team I doing their best to help Ramon
recover
D. Encourage the mother to express more about her thoughts and feelings

213. The APPROPRIATE nursing diagnosis to protect the patient from further injury is, which of
the following?

A. Altered mucous membrane related to chemotherapy.

B. Interrupted family processes related to life threatening i1lness of a family member.
C. Fatigue related to disease process.
D. Risk for injury related to thrombocytopenia

214. Mouth sores have developed in the child's mouth. The father asked the nurse the reasons
for this. The MOST APPROPRIATE response of the nurse is _________

A. "The child 's oral hygiene needs to be improved. "

B."There s no need to worry as all kids receiving chemotherapy tend to have them. "
C. "He is allergic to the drug so I will report this to the doctor and suggest à change of drug."
D. "Mouth sores result because the cells of the mouth are sensitive to chemotherapy. "

215. Ramon died at 10:00 PM. His father cried much and refused to move Ramon 's body. What
is the APPROPRIATE approach of the nurse?

A. Talk about the reality of death.

B. Leave the mother and the child for the last time.
C. Silence to allow the mother to grieve.
D. Cry with the mother as you remember your own experience of death in family.

216. The nurse's MAIN responsibility in preparing Ramon 's discharge is, which of the
following?

A. Assist the mother to pay the hospital bill

B. Prepare Ramon 's cadaver
C. Prepare the death certificate.
D. Extend condolences to the bereaved family.

Situation - Asst Chief for Education & Training, Nurse Mendoza, is planning to conduct an in-
service training program on intravenous therapy for the staff nurses.

217. To be able to justify the conduct of any in service training program in any hospital, which of
the following should be the bases for the implementation of the program?

1.Needs assessment
2. Needs analysis
3.Per recommendation by the Chief Nurse

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4.Incident Reports

A. 1, 2 &4 C. 1 only
B. 1, 3 &4 D. 1, 2, 3 & 4

218. The BEST rationale for the conduct of the program is which of the following?

A. Ensure safe practice in the hospital

B. Improve nursing practice in general
C. Provide knowledge and skills to all nursing staff in IV Therapy
D. De1iver safe and quality nursing care to patients on intravenous therapy

219. One of the lecturers discussed the complications that patients may have while on IV
therapy. Which of the following is the most common Complication that IV patients may
contract while on IV therapy?

A. Embolism C. Phlebitis
B. Cardiac Overload D. Aneurysm

220. The participants may avail of Continuing Professional Development (CPD) units if Nurse
Mendoza had filed the program to be CPD accredited to which of the following?

A. Professional Regulatory Board of Nursing

B. Professional Regulation Commission
C.Continuing Professional Development
D. Commission on Higher Education

221. The participants should know the way by which they may obtain CPD units
aside from attending in service training programs, which are, EXCEPT _______.

A. Professional seminar and conferences

B. graduate studies
C.Short course training for specialization
D. Joining nursing service committees

Situation -The concept of Reproductive Health is introduced as early as Primary and

secondary levels with different degrees of concentration. Students, interested to continue
health courses were asking questions on human sexuality.

222. Nurse Hailey discusses the 2020 National Health Goals. Which of the following statements
is an EXCEPTION in planning sexual health programs.

A. Make sexual education programs voluntary.

B. increase the proportion of adolescents who have never engaged in sexual intercourse.
C.Reduce deaths from cancer resulting from uterine myomas
D. Reduce deaths from cancer of the uterine cervix.

223. Maternal and child Nursing is a concept under the National Goals. Which objective should
Nurse Pailey emphasize to support the program?

A. Avoid having misdirected children and become street children.

B. Promote the well-being of the mother 's family 1ife and family planning.
C.Consider that every child has love, security, and a better future.
D. Avoid complications of pregnancy and promote vaginal deliveries

224. Which of the following topics should the patient feel MORE comfortable when reproductive

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anatomy and physiology is discussed with the nurse?

A. Sexual health education C.Varied sexual positions

B. Gender reassignment D. Gender identity

225. When can the patient tell all information to the nurse?

A. All diagnostic laboratory tests performed had been completed

B. Once the feeling of security is established in the nurse-patient relationship
C. A change in physical appearance occurs
D. The nurse knows the genogram of the patient

226. Which nursing diagnosis is NOT RELEVANT to sexual health?

A. Anxiety-related inability to conceive after six months.

B. Health-seeking behaviors related to reproductive functioning
C. Sexual dysfunction related to an unknown cause.
D. Risk for infection related to high-risk. sexual behaviors.

Situation - Ruby, a pregnant patient 37 weeks' gestation is admitted due to fever, painful swelling of
hands, feet, joints. and in labor pain who has a diagnosis of sickle cell anemia?

227. Nurse Sophie administers oxygen to patient Ruby and implements additional measures to
prevent a sickling crisis from occurring?

A Maintain strict asepsis.

B. Maintain s adequate hydration.
C. Monitors the temperature.
D. Reassures the patient.

228. Nurse Sophie hooks a 1000 mL intravenous (IV) Solution of D5 Water as Ordered by the
physician at 9 am to infuse 80 ml/hr. Via macro drop nruslon set (20 qtts = 1 ml). On
the assessment of the infusion at what would be the level of the remaining amount in the
TV bag at 2 pm?

A. 500 C. 400
B. 200 D. 300

229. The patient began receiving an intravenous (IV) infusion of packed red blood cells 30
minutes ago. The patient complains of difficulty of breathing, itching and a tight sensation in
the chest. Which is the IMMEDIATE action of the nurse?

A. Recheck the unit of blood for compatibility.

B. Call the physician.
C. Check the patient 's temperature.
D. Stop the infusion.

230. Norse Sophie checks the gauge of the patient ' s intravenous catheter. Which is the
smallest gauge catheter that the nurse can use to administer blood?

A. 22-Gauge C. 20-Gauge
B. 18-Gauge D. 12-Gauge

231. The nurse reviews the patient 's plan of care. Which of the following nursing diagnose will
be the PRIORITY?

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A. Fluid volume, deficit

B. Risk for pain, acute
C. Coping, ineffective
D. Body image, disturbed

Situation - Nurse Nilda is a beginning nurse assigned in the Pediatrics Unit in a government hospital. The
Unit has pediatric patients of different ages. Since she will be dealing with patients of varied ages, she
thought it best to review her notes on human growth and development, specifically Erikson 's
psychosocial theory.

232. The BEST reason why Nurse Nilda opted to review Erikson's psychosocial theory is, which
of the following statements?

A. Completion of task results in a sense of competence and a healthy personality.

B. Failure to master these tasks leads to feelings of inadequacy
C. Helps children grow into successful, contributing members of society.
D. We are motivated by the need to achieve competence in certain areas of our 1ives.

233. Nurse Nilda immediately responds to any cry from her pediatric patients because it is,
which of the following reasons?

A. to attend to her patients who cannot communicate verbally

B. to check if the child is hungry or wet
C. to lessen the noise overload in the Unit
D. a powerful influence over that individual's interactions with others for the remainder of
his/her life

234. Nurse Nilda is attending to a two-year-old Neneng who was admitted

due to chronic bronchitis. Neneng sports a long hair that extends up to her shoulder. As
part of the morning care, Neneng's hair into a pony tail. However, Neneng vehemently
resisted her hair being tied by a rubber band. The BEST thing that Nurse Nilda should do
is, which of the following?

A. Nurse Nilda decided to style

B. Assert her authority.
C.Deny Neneng's preference that a pony tail would make Neneng's more beautiful.
D. Allow Neneng ' preference.

235. Joji, l7 years old, is admitted in a private room due to influenza. In one of Nurse
Nilda's conversations with Joji, the patient expressed is unhappiness with the program he is
taking up in college. This is not his choice but rather the choice of his parents. In which of
Erikson 's stage of development does this case fall?

A. Autonomy versus shame/ doubt

B. Integrity versus despair
C. Identity versus role Confusion
D. Trust versus distrust

236. When a 3-year-old patient of Nurse Nilda asserts to choose the pants and shirt to wear to
include food preference. Based on Erikson 's developmental tasks, the child' s such
behavior is attributed to them which of the following?

1. struggling to acquire a sense of autonomy

2 discovering they have a will of their own
3. awareness that they cannot control others
4. learning which behavior gains approval

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A. 1,2 & 3 C. 1,2, 3& 4.

B. 2, 3 & 4 D. 1,2& 4

Situation - Gwen a unit manager is assigned to evaluate applicants for the position in the OB unit. During
the interview, the applicant was asked 5 questions.

237. When a patient is admitted to the OB ward with complains of dizziness and body
weakness, this is an example of______.

A. secondary source C. objective data

B. primary source D. Subjective data

238. What are the possible cases that need informed consent?

A. Administering skin testing

B. Subjecting the patient to an invasive procedure
C. Hair shampooing of patient
D. Performing a laboratory procedure

239. The applicant was further asked about an incident report. Which of the following is a
PRIORITY Case for an incident report be accomplished?

A. Patient fell from the bed.

B. Refusal to go to the physical therapy session.
C. A visitor encourages a patient on bed rest to ambulate.
D. Nurse left before his duty ends.

240. On which occasion would a nurse can be charged with negligence?

A. Giving the patient the wrong medication.

B. Giving competent care.
C. Following standards of care.
D. Communicating with another health team.

241. What tasks can be delegated to his nursing assistant during his tour of duty.

A. Changing wound dressings.

B. Administering analgesic drug.
C. Performing a physical assessment.
D. Taking vital sign

Situation- A patient with hyperthyroidism is admitted to your unit. She asks the nurse about the endocrine
functions.

242. To begin your discussion, you explain to her that the endocrine glands include, which of the
following?

A. Pituitary, thyroid, parathyroid, adrenals, pancreaticislets, and hypothalamus

B. Pituitary, thyroid, parathyroid, pancreatic islets, ovaries, and testes
C. Pituitary, thyroid, parathyroid, adrenals and pancreatic islets
D. Pituitary, thyroid, parathyroid, adrenals, pancreatic islets, ovaries and testes

243. The __________ is link between the nervous system and the endocrine system

A. Spinal cord C. Pituitary gland

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B. Hypothalamus D. Thyroid gland

244. This endocrine disorder is a severe form of hypothyroidism characterized by an

accumulation of mucopolysaccharide in subcutaneous and other interstitial tissues

A. Myxedema C. Cushing`s syndrome

B. Thyrotoxicosis D. Hashimoto`s disease

245. The patient asks you about goiter. You describe this disorder as ___________-.

A. A condition produced by excessive endogenous or exogenous thyroid hormone

B. The enlargement of the thyroid gland and usually caused by an iodine-deficient
diet
C. None of the choices
D. Inflammation of the thyroid gland that may lead to chronic hypothyroidism

246. The patient asks what is a normal thyroid state? The best response is __________.

A. Euthyroid C. Hyperthyroid
B. Parathyroid D. Panthroid

Situation - Marlene, a kasambahay, is admitted for leukemia in exacerbation. She appears shy and
seldom talks to hospital staff, except with the watcher who is her sister.

247. Nurse Myra wants to draw the patient out of her shell, so she would be better able to elicit
the patient's cooperation. which of the following actions is MOST helpful?

A Just ask Marlene straight the questions that need to be asked.

B. Smile at the patient and allow her to express her concerns.
C. Talk to the sister instead to get more information.
D. Be a professional in every way in dealing with her.

248. Friendly but professional overtures have finally made Marlene open up her circumstances
to the nurse, including their financial difficulty. What has been established at this time?

A. Beginning of a friendship
B. Trusting relationship with the nurse
C. A lifelong commitment
D. A dire need for financial help

249. One morning during rounds, Nurse Myra noticed that Marlene was unduly sad. The nurse 's
BEST way of communicating her concern is _______.

A. whatever it is, you lift it up to God

B. saying you are sad again, that is bad for your health
C. telling Marlene to stop worrying, everything will be okay
D. placing her hand over Marlene 's shoulder and asking why the sad face

250. The day of discharge came and Marlene 's face becomes all the more
sad. When asked why, she answered she has no money to pay the bill. The BEST way of
communicating her piece of advice is stating which of the following?

A. You can go to the cashier for to find out what she can advise you
B. The government has agencies for those who need financial assistance. I will give you the
list.
C. You can always pay in staggered amounts to be given every 15 days

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D. Ask help from generous relatives so you can have additional for down payment.

251. Leukemia is a chronic illness and it is expected that the patient will be in and out of
the hospital. To maintain communication, the nurse will _________.

A. ask the patient to call the hospital number listed in the yellow pages
B. ask for the phone number where the patient can be easily contacted
C. read the information sheet of the patient in the chart
D. tell patient to write the number in a piece of paper and give it to the ward clerk

Situation - You are a staff burse in the Eye Unit of the hospital. In the regular Quality Circle meeting one
of the matters discussed was the increasing complaints of patients who underwent eye surgery in
relation to instillation of eye drops. The case of Claudia who had cataract surgery was presented as
a frame of reference in reviewing the procedure on eye drops instillation.

252. Which of the following is the RATIONALE for instilling eye drops to patients who had eye
surgery?

A. To help control the intra-ocular pressure C. To treat an eye infection

B. To dilate the patient’s pupils D. To constrict the patient’s pupils

253. You have observed presence of drainage in Claudia’s eyes. Which of the following eye
solution would you use in cleaning her eyes?

A. Hydrochloric acid C. Mineral water

B. Normal saline solution D. Soapsuds solution

254. In instilling the eye drops you have to tilt the back slightly Claudia’s head. Which of the
following is the RATIONALE for this nursing action?

A. To prevent any spill from the eye during the procedure

B. To keep any debris away from the lacrimal duct
C. To facilitate the procedure
D. To reach the conjunctival sac easily

255. You accidentally touch Claudia’s eyelid during eye drop instillation causing her to blink.
What should have you done to prevent this from occurring?

A. Touch the inner side of the medicine cap

B. Tilt back Claudia’s head slightly
C. Hold the dropper close to the eye but do not allow the medication to fall into the
cornea
D. Have Claudia look up and focus on something

256. You cannot open Claudia’s eyes due to dried crust. Which of the following actions would
you do?

A. Apply the eye drops the next day

B. Apply eye ointment to soften the crust
C. Instill eye drops
D. Place a warm wet wash cloth over her eyes for at least three minutes

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SITUATION – A manager of an accounting firm is admitted to the hospital due to an acute abdominal
pain and passing out of bloody stools. After several diagnostic and laboratory examinations the physician
ordered him for exploratory laparotomy. You are the nrse duty that day.

257. While performing the assessment your are guided that the organs found in the epigastrium
include which of the following?

A. Protion of duodenum & jejunum, left kidney, appendix & ovary

B. Duodenum, pancreas, portion of the liver and pyloric end of the stomach.
C. Stomach, spleen, tail of pancreas and adrenal gland
D. Gallblader, duodenum, gallbladder and portion of the right kidney.

258. When conducting a nursing history on the Health Perception, Health Management pattern of
functioning what is the APPROPRIATE question to be asked pre-operatively?

A. Do you experience your wound to heal quickly?

B. Do you have shortness of breath when exercising?
C. Are you aware of risk factors for your disease?
D. Have you experience weight changes in the past?

259. Patient was visited by the anesthesiologist and explained the anesthesia for his surgery.
Which of the following type of anesthesia would you expect to be ordered?

A. Spinal C. Local
B. Caudal D. General

260. There are pre operative medications given to the patient. Which of the following druugs
are given in order to decrease intra-operative anesthetic requirements and pain?

A. Celebrex (celecoxib) C. Acetaminaphen (tylenol)

B. Ibuprofen (motrin) D. Demerol (meperidine HCl)

261. The goals for patient's safety in the operating room is imperative for all members of the
surgical team. Which of the following Universal Safety Protocol are adopted and validated
PRIOR to surgery?

I. Patient's Identity
II. Surgical procedure
III. Surgical Site
IV. Surgical equipment

A. II & III C. I, II, & IV

B I & II D. I,II & III

SITUATION 6 - Mely, 68 -year -old, was admitted to the hospital because of decreased appetite, easy
fatigability, dehydration and weight loss of about 15 lbs. for the past weeks. She was examined by
the physician and advised to be admitted. You are the nurse assigned to take care of her.

262. The physician ordered to start Ms. Mely on Total Parenteral Nutrition (TPN). What Is your
INITIAL step to be undertaken PRIOR to this intervention?

A. Determine if the family can afford the whole treatment,

B. Evaluate the tolerance of the patient to glucose.
C. Identify allergies of patient to the supplemental nutrition.

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D. Assess the basic understanding of the patient regarding TPN

263. Choose from the following the primary goals of TPN?

I. promote weight gain

II. improve nutritional status
III. maintain muscle mass
IV. establish nitrogen balance!
V. enhance healing process

A. I, II, & III C. I, & II,

B. I, II, III, & IV D. I, II, III, IV & V

264. When a patient is undergoing TPN, you have to monitor closely for the ___________.

A.serum creatinine level Ç. serum glucose level

B. potassium level D. sodium level

265. While Mrs. Mely is on TPN she suddenly complained of slight chest pain, dyspnea and
appears cyanotic. You suspect that she is experiencing what possible IMMEDIATE
complication?

A. Sepsis due to IV 1ine C. Hyperglycemia.

B. Air embolism D.Allergic reaction to TPN

266. What PRIORITY nursing action should you do with the presenting clinical manifestations of
the patient?

A. Report to the physician status of the patient at once.

B. Take Blood pressure and respiratory rate.
C. Stop temporarily the Total Parenteral Nutrition
D. Administer Oxygen inhalation.

Situation 11 - Nurse Rachel is assigned in the medical unit of a tertiary hospital where most of the
patient's admitted are Suffering from Endocrine disorders. She is currently assigned to
Patients: Claire, 54-year-old, married with hyperthyroidism Aster, 66 yr. old has an impression of
(Cushing Syndrome while Sonia, 48-year-old is suffering from hypothyroidism.

267. While you are doing your physical assessment to patent Aster, she has been exhibiting a
UNIQUE clinical manifestation different from patients Claire and Sonia which is characterized
by________.

A. Cyanosis, increasing growth of hands and feet

B. anemia, weight 1oss and presence of
C. moon facies, purple striae on trunk and buffalo hump
D. moon facies, easy fatigability and peripheral edema

268. Which one of the following diagnostic tests do you expect NOT to be ordered by Dr. Lim to
patient Aster who is suspected to have Cushing Syndrome?

A. 24-hour urine cortisol level

B. D-C reactive Protein level
Ç. ACTH Serum concentration
D. Computerized tomography of the brain, chest and abdomen

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269. Which clinical manifestation should Nurse Rachel watch for patient Claire if she is suffering
from hyperthyroidism?

A. Cold extremities C. Decreased bowel movement

B. Fine motor tremor D. Increased weight

270. Patient Sonia, who bas hypothyroidism is given which ONE of the following drug therapies?

A. Propranolol C. Iron pills

B. Iodine D. Levothyroxine

271. Which of the following should be AVOIDED by patient Sonia while she is being treated for
hypothyroidism?

A. Use of warm blankets C. Taking foods low in fiber

B. Light activities done at home D. Exposure to cold temperature

Situation 13 - Mr. Reynaldo is tasked to conduct a study to determine the level of patient satisfaction on
the care they received from the hospital. In doing so, he plans to include: all adult patients admitted from
May-October, first admission, with an average length of hospital confinement of 4-5 days, and with no
complications.

272. Which of the following is an EXTRANEOUS variable of the study?

A. Age of patients. C. Length of stay 4-5 days.

B. Absence of complications. D. Date of admission January-March.

273. Which of the following variables will he likely EXCLUDE in his study?

A. Salary of nurses C. Responsiveness of staff

B. Caring attitude of nurses D. Competence of nurses

274. He plans to use a Likert Scale to determine:

A. compliance to expected standards C. level of satisfaction

B. degree of agreement and disagreement D. degree of acceptance

275. Which criterion refers-to the ability of the instrument to detect fine differences among
the subjects being studied?

A. Reliability C. objectivity
B. Sensitivity D. Validity

276. This technique refers to the use of multiple referents to draw conclusions about what
constitutes the truth.

A. Delphi technique C. Triangulation

B. Meta-analysis D. Experiment

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Situation 14 - Nurse Tarly, the research coordinator of a Tertiary hospital where there was a growing
concern of patients and family complaints that Nurses are "rude and cranky". In response to this, she
organized a core group to conduct a study on the "Caring behavior of Staff-Nurses and
Satisfaction of Women with Ostomy.

277. Based on the research statement, what is the 'independent variable in the study?

A. Staff-nurses C Women with ostomy

в. Caring behavior D. Satisfaction

278. What is the dependent variable in the study?

A. staff-nurse. C degree of satisfaction

B. ostomy D. caring behavior

279. What are the relevant related literatures that Nurse Tarly and her groupmates can utilize
in this study?

1. Caring behaviour.
2. Ostomy pathogenesis.
3. Contentment and satisfaction.
4. Concept of body image.

A. III and IV C. 1 and II

B. 1, II and III D. 1, II, III and IV

280. If Nurse Tarly and her core group decide to formulate a directional hypothesis it will be
________.

A. There is an increase relationship between the caring staff nurses and degree of
satisfaction of ostomized patients.
B. The caring behaviors of the staff nurses is related to increased satisfaction
of ostomized patients.
C. The staff nurses' behaviors have an effect on the patient's satisfaction
with osomized patients.
D. A significant relationship exists between the caring behaviors of the staff-nurses and degree
of satisfaction of ostomized patients.

281. Based on the research problem, what is the Research design of the study?

A. Quasi-experimental C. Expost-facto
B. Descriptive D. Experimental

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Situation 15 - Nurse Virgo admits Benito,61 yea-old, due to severe abdominal and back pain and
vomiting after attending a party. He had positive alcohol breath and was tentatively diagnosed
with pancreatitis He was scheduled for diagnostic laparotomy to further confirm the diagnosis.

282. Nurse Virgo gathers more appropriate data Erom Patient Benito. Which of the following
APPROPRIATE questions should Nurse Virgo ask?

1. "Can you describe your pain?"

2. "Is your urine yellow?"
3. "IS your stool clay colored?
4. Do you drink alcohol often?"

A. 2 and 4 C. 1, 2 and 4
B. 1 and 3 D. 1, 2. and 3.

283. Patient Benito ask5 Nurse Virgo, "Why can't the surgeon just take out my pancreas?" The
BEST response of Nurse Virgo is

A. "your body needs to function well with your pancreas "

B. "your attack will soon be overcome when you are at rest"
C. "if your pancreas is removed, you can never eat fat and fried foods again"
D. "antibiotic wil1 relieve signs of infection"

284. Before Surgery, Patient Benito is on nothing per orem status (NPO). She tells Nurse Virgo that
he is thirsty and hungry. Which of the following is the BEST response of Nurse Virgo?

A. "You can sip only this amount of water to moisten your mouth"
B."An NGT will be inserted to remove gastric secretions and alleviate your thirst"
C. "I will give you ice chips to relieve your thirst"
D. "Oral and fluid intake stimulates pancreatic enzymes and pain"

285. Nurse Virgo asks Patient Beni to now can he help to reduce pain while waiting for his
operation. Which is the MOST appropriate question of Nurse Virgo?

A."Are you ready for the operation? The pain will soon be over.”
B."After operation, everything will be alright."
C."Is your present position reducing pain?"
D."Does exercise reduce your pain?"

286. Which of the statements of Patient Benito will convince Nurse Virgo that his instructions for the
prevention of pancreatitis were understood by the patient? I wil1 _______.

A. “Increase my intake of high protein products"

B "try to stop drinking alcohol”
C. "follow a high fat diet faithfully"
D. "be careful of exposing myself to infection"

Situation– Ella, a 10-year old grade four pupil in a private school has just lost her best friend, lory, who
died of leukemia. her mother brought her to the emergency room who reported that Ella has been gloomy
and often expresses feeling of joining lory in heaven.

287. Which of the following is precipitating factor for Ella`s feeling of wanting to die?

A. The death of lory C. Her authoritative mother

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B. Her age D. Her fear of death

288. Ella’s feeling of joining lory in heaven is a manifestation of:

A. Suicidal intent C. Paranoia
B. Suicidal threat D. Suicidal ideation

289. Ella states “I will hang my self “this is a manifestation of:

A. Denial C. Suicidal intent

B. Suicidal threat D. Paranoia.

290. Which of the following is the best predictor of adolescents attempting suicide?

A. Depressed mood C. Feeling of euphoria

B. Joyful mood D. Feeling of hopelessness

291. Ella’s states “I wish I were dead. I cannot stand anymore not having lory around.”; your most
appropriate Nursing action would be:

A. Do nothing because Ella will not do it C. Stay with Ella

B. Refer Ella to your supervisor D. Explore Ella’s feelings

Situation - Ms. C, 15 years old, 100 lbs, 5 ft. Tall, admitted to your unit for diagnostic evaluation and
nutritional support. She is moderately dehydrated with potassium level 2.3 mEq/L. She has experienced
weight loss of more than 15 percent within the past 3 months.

292. What is the primary collaborative goal treatment for Ms. C?

A. Resolve possible dysfunctional family roles as an adolescent

B. Increase strong desire to eat
C. Restore normal nutrition and weight
D. Assist her to increase feelings of control over eating

293. For Ms. C, which route for delivery of nutrition and fluid will be health care team try FIRST?

A. Gastrostomy tube C. Nasogastric route

B. Oral route D. Intravenous route

294. In caring for this patient suffering from anorexia nervous, which task can be delegated to the
nursing assistant?

A. Obtaining special food for the patient when she requests it

B. Sitting with the patient during meals and for about an hour after meals
C. Weighing the patient daily and reinforcing that she is underweight
D. Observing for reporting ritualistic behaviors related to food

295. You find Ms. C in her room running and trotting around for about the last 30 minutes. What is
the BEST response to give her at this time?

A. "Tell me why you are running and trotting around the room?"
B. "Stop running right now, otherwise, we will change your exercise program"
C. "We have talked about exercise and agreed to reach your weight goal first"
D. "If you continue to exercise like this, you are going to eat more"

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296. Ms. C is at risk for refeeding syndrome that is caused by rapid feeding. What should be the
priority action of the health care team to prevent complications associated with this syndrome?

A. Assess for signs of pallor of the extremities and sluggish capillary refill
B. Monitor for decreased bowel sounds, nausea, bloating, and abdominal distention
C. Observe for signs of secret purging and ingestion of water to increase weight
D. Monitor for peripheral edema, crackles in the lungs, and jugular vein distention

297. Ms. C (an adolescent admitted for diagnostic evaluation and nutritional support related to
anorexia nervosa)'s self-esteem and weight have gradually improved, but she continues to
refer to herself as "fatty." She is able to appropriately verbalize an appropriate diet and
exercise plan. What is the priority nursing diagnosis?

A. Imbalanced Nutrition: less than body requires C. Risk for situational low self-esteem
B. Disturbed body image D. Ineffective health maintenance

Situation - Nurse Lailanie takes care of her 80-year oldmother and 85 years old father. She noticed her
parents to be forgetting the names of their long-time house help and repeatedly ask the same questions
several times.

298. This condition has difficulty in progressing stimuli and new information. Alzheimer`s is the most
common form of which of these?

A. Fatigue C. Malnutrition
B. Psychosis D. Dementia

299. Physiologically, what happens to the brain as Alzheimer progresses?

A. Brain stem atrophies C. Fluids collect

B. Cells die D. tissues swells

300. No drugs cure this condition. Emphasis is put on delaying the onset of severe symptoms.
Which of the following does NOT help improve Alzheimer's?

A. Smoking C. Social connections and mental activity

B. Eat balanced diet D. Exercise

301. Which of these measures will help stabilize mentally the parents of Nurse Lailanie?

A. Establish a regular routine C. Repaint or buy a new furniture

B. Move to small apartment D. Correct bad behaviors gently

302. Her parents usually become anxious and confused during late in the afternoon and after dark.
What do you call this phenomenon?

A. Agitation C. Sundowning
B. Dark retreat D. Dark reaction

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Situation- Quality documentation is an essential component of the nurse’s role in the Health facilities.
Nurse Gladys is assigned in the Female medical ward where most of her patients have cardiac and
vascular disorders.

303. Nurse Gladys is conducting an assessment of Mrs. Carpio who has edema of the lower
extremities due to congestive heart failure. If edema is graded on a scale of +1 (no visible
edema in the leg) to 4+ (leg very swollen), what will Nurse Gladys document in her chart if her
assessment findings of the edema is SLIGHTLY swollen?

A. +4 C. +2
B. +1 D. +3

304. What specific term should Nurse Gladys write in her charting when a patient is suffering from a
change in the angle between the nail base greater than 180 degrees due to congenital heart
disease?

A. Peripheral neuropathy C. Inflammation of the fingers

B. Peripheral cyanosis D. Clubbing of the fingers

305. Mrs. Carpio has an order of Thiazide diuretics for her edema. The following is the entry that
you expect to be written in her progress report EXCEPT ______.

A. Serum electrolyte monitored everyday C. Intake and output done every shift
B. Weight taken before drug is administered D. Drug is administered at 8o'clock in
the evening

306. Which of the following is NOT APPROPRIATE description and written in the Nurses
notes when a patient has a pitting edema?

A. Degree of edema C. Duration of indentation

B. Degree of temperature D. Depth of edema

307. Ms. Ruby 28-year-old also a patient of Nurse Gladys is suffering from Rheumatic fever due to
a previous streptococcal infection. In monitoring patient's status, the nurse should document
which of the following TYPICAL manifestation EXCEPT ______.

A. Increase body temperature C. Voluntary muscle spasm

B. Non-pruritic rashes D. Migratory joint pains

Situation- Mila, a 35-year old female was brought in the emergency unit complaining of cold, clammy skin,
disorientation, restlessness and confusion. The nurse suspects the patient is developing cardiogenic
shock.

308. Nurse Victor who admitted patient Mila is aware that a decrease in cardiac output results in
cerebral blood flow. Which of the following symptoms is one of the EARLIEST signs of
cardiogenic shock?

A. Tachycardia C. Presence of fourth heart sound (S4)

B. Altered level of consciousness D. Decreased urine output

309. Nurse Victor assesses patient Mil. Decrease of which the following factors would help detect
that the patient is at risk at developing cardiogenic shock?

A. Heart rate C. Cardiac index

B. Cerebral blood flow D. Blood pressure

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310. Nurse Victor reviews the medical history of patient Mila. Which of the following conditions is
the MOST common cause of cardiogenic shock?

A. Decreased hemoglobin level C. Acute myocardial infarction (MI)

B. Hypotension D. Coronary artery disease

311. Which of the following procedures would be MOST helpful to Nurse Victor to confirm the
underlying cause of cardiogenic shock?

A. Monitoring pulmonary artery pressure C. Monitoring mean arterial pressure

B. Monitoring cardiac enzymes D. Measuring central venous pressure

312. The physician prescribes a treatment plan for patient Mila. Nurse Victor understands that the
initial treatment goal is which of the following?

A. Prevent infection C. Correct hypoxia

B. Correct metabolic acidosis D. Increase myocardial oxygen supply

Situation – Nurse Roberto is the Nurse on duty in the medical ward, he cares for several clients with
acid-based imbalances.

313. Nurse Roberto is aware that a client who has experienced cardiac arrest is MOST at risk for
which of the following imbalances?

A. Metabolic alkalosis C. Metabolic acidosis

B. Respiratory alkalosis D. Respiratory acidosis

314. Nurse Roberto assists in the care of a 30-year-old male post surgical client undergoing
nasogastric suctioning. The nurse understands that clients with nasogastric suction is
MOST at risks with what imbalances?

A. Respiratory acidosis C. Metabolic alkalosis

B. Metabolic acidosis D. Respiratory alkalosis

315. Nurse Roberto assesses a 32-year-old female client who appears very anxious, restless and
irritable. The client has marked increase rate and depth of respirations. Based on the
information gathered, the client is experiencing which of the following imbalances?

A. Respiratory alkalosis C. Metabolic alkalosis

B. Metabolic acidosis D. Respiratory acidosis

316. The female client who is very anxious and fidgety is blowing off to much carbon dioxide
develops tingling sensation of the lips and fingers and is not able to control her respirations.
The MOST appropriate nursing intervention for this client is to _____.

A. Instruct the client to blow her nose and take deep breath C. Administer oxygen
B. Have the client breath into a paper bag D. Administer IV fluids as ordered

317. The nurse obtains a sample of a client’s arterial blood gas (ABGs). Which of the following
statements is NOT true about ABGs?

A. Interpretation of the clients ABGs involves evaluation of pH, PCO2 and HCO3; components
of the ABGs.
B. ABGs assess the client oxygenation status and acid base status.
C. ABGs provide information on blood parameters.
D. ABGs asses the client electrolyte and fluid balance.

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Situation- The nurse is assigned to care to teenagers with a diagnosis of allergic rhinitis.

318. Which of the following clinical manifestations would the nurse expect to find in the client with
rhinitis?

A. Nasal congestion, rhinorrhea and sneezing C. Headache, sore throat and sneezing
B. Nasal congestion, pyrexic and rhinorrhea D. Nasal congestion, headache and
sore throat

319. The physician prescribes decongestant intranasal spray. The nurse instructs the client on the
proper use of the spray. Which of the following procedures is the CORRECT method?

A. Finish instillation of spray into one nostril before spraying into the other nostril
B. Inhale quickly to prevent irritation off the mucous membranes
C. Blow the nose after spraying to prevent medications from entering the throat
D. Tilt the head slightly forward and angle the bottle toward the side of the nostril

320. The client asks the nurse about using decongestant nasal sprays. Which of the following
statements by the nurse is CORRECT regarding its use?

A. "Nasal sprays should be use sparingly because they can exacerbate a cough"
B. "It would take several days of using nasal sprays before any effect on congestion is
noted"
C. "Nasal sprays should not be used formore than three days because it can worsen
congestion"
D. "They should be used along with corticosteroid nasal sprays for maximum benefit"

321. The nurse would determine that her teaching goal one the use of a decongestant nasal spray
has been met when the client says ______.

A. "The spray should be used round-the-clock at equally spaced intervals"

B. "Nasal sprays must be combined with an oral antihistamine to achieve relief"
C. “Overuse can result in nosebleeds and mucosal ulceration”
D. “Rebound rhinitis (rhinitis medicamentosa) is common with continued use"

322. The physician orders cromolyn sodium (nasal crom) for the client. The nurse instructs the
client that the most effective administration schedule is ________.

A. When manifestations peak only, with two or three doses per day
B. At the start of the allergy season, with a dose of once-a-day
C. One week before the allergy season begins, with four to six doses per day
D. Just after manifestations begin, with a dose of twice-a-day

Situation - The nurse manager of the Oncology Unit invites an oncology nurse specialist to conduct an
educational session to the nursing staff on the topic Hodgkin`s disease.

323. The nurse specialist explains the characteristics of Hodgkin`s disease. Which of the following
is NOT a characteristic of Hodgkin`s disease?

A. There is presence of Reed-Sternberg cells

B. The disease occurs the most often in the older adult
C. The lymph nodes, spleen, and liver are involved
D. The prognosis depends on the stage of the disease

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324. The nurse is aware that a major difference between Hodgkin's lymphoma and non-Hodgkin's
lymphoma is that: ________________

A. Hodgkin's lymphoma occurs only in young adults

B. Hodgkin's lymphoma is considered potentially curable
C. Non-Hodgkin's lymphoma can manifest in multiple organs
D. Non-Hodgkin's lymphoma is treated only with radiation therapy

325. A client has undergone a lymph node biopsy. The nurse anticipates that the report will reveal
which result if the client has Hodgkin's Lymphoma?

A. Reed-Sternberg cells C. Philadelphia chromosome

B. Epstein-barr virus D. Herpes simplex virus

326. The nurse specialist describes the stages of Hodgkin`s disease. Which of the following
symptoms is MOST commonly an early indicator of Stage I?

A. Chest and Back pains C. Unexplained fever, night sweats

B. Subnormal body temperature D. Swelling of extremities

327. The nurse specialist emphasizes the importance of preventing complications. Which of the
following conditions are complications of Hodgkin`s disease?

1. Nausea 4. Infection
2. Myocardial infarction 5. Hypotension
3. Anemia

A. 1, 2, 3, 5 B. 1, 2, 3, 4, 5 C. 1, 3, 4 D. 2, 3, 4, 5

328. The nurse specialist cites a situation. If a patient experiences episode of severe nausea and
vomiting with more than 1,000 ml. of vomitus with in a period of four hours, which of the
following is the nurses MOST appropriate action?

A. Withhold fluids for four hours C. Observe the patient for another four hours
B. Notify the physician D. Place the patient on a liquid diet

329. The nurse specialist explains that chemotherapyis extremely toxic to the bone marrow and the
patient may develop thrombocytopenia. What is the priority goal of the nurse? To take
precautions to control _______.

A. Bleeding C. Infection
B. Hypotension D. diarrhea

Situation - Diaz, a new Charge Nurse of EENT unit is keen on staff and professional growth of
the nursing team.

330. Ms. Diaz earns that-some leaders are transactional leader the following does
NOT characterize a transactional league

A. Focuses on management tasks

B. Inspires others with vision
C. Is a caretaker
D. Uses bargaining to meet goals

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331. Ms. Diaz finds out that s one managers have benevolent-authoritative style of management.
Which of the following behaviors will be exhibit MOST likely?

A. Have condescending trust and confidence in their subordinates

B. Gives economic or ego awards
C.Communicates downward to the staff.
D. Allows decision making among subordinates

332. Mr. Diaz knows that there are external forces that influence changes in his unit. Which of the
following is NOT an external force?

A. Demands Of the labor sector to 1ncrease wages

B. Exacting regulatory and accreditation standards
C.Low morale of staff in his unit
D. Memo Erom the CEO to cut down on electrical consumption

333. After discussing the possible effects of the low patient satisfaction rate, the staff started to list
down possible strategies to solve the problems head-on. Should they decide to vote on the
best change strategy, which of the following strategies is referred to this?

A. Majority rule C. Collaboration

B. Dominance D. Compromise

334. The nurse asks the aide to weigh a patient. later, the nurse discovered that a patient has been
weighed who is supposed to be on complete bed rest. This situation violates which of the
following rights of delegation?

A. Right person
B. Right direction and communication
C.Right supervision and evaluation.
D.Right task

SITUATION – In the practice of her profession as a public health nurse, Nurse Mary is guided by ethical
and moral principles.

335. The nurse in the practice of her profession is guided by ________.

A. code of ethics C. local government code

B. standards of care D. Nursing processs

336. In the ethical principle of beneficence, which is the BASIS of every nursing action in all work
settings?

A. Treating all patients selectively.

B. Informing patients of hospital bills.
C. Respecting refusal of treatment.
D. Doing good at all times.

337. In handling all information about the famiilies in the community, which of the following
principles should the nurse consider ethical?

A. Confidentialty C. Justice
B. Fair treatment D. Beneficence

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338. Nurse Mary randomly seleted individuals in the community who will be part of a project. Which
of the following ethical principle is observed by the nurse?

A. Autonomy C. Confidentiality
B. Beneficence D. Fair treatment

339. Identify the primary indicator that Nurse Mary observes FIDELITY in the practice of her
profession.

A. Faithfully promotes health and prevents desease.

B. Frequently assists in providing health services.
C. Fairly evaluates health programs and initiatives.
D. Collaborates and works with barangay officials.

SITUATION – Nurse Gina is assigned to supervise the home for the aged in the barangay.

340. In planning the care of the elderly, which should be the important consideration that Nurse
Gina has to consider _____.

A. The educational qualification

B. Family support
C. Activities of daily liiving
D. Residence of the elderly

341. Nurse Gina has also to consider in terms of financial status most of the elderly are

A. Sufficient
B. disoriented
C. Dependent to others financially
D. Have pension

342. In planning their care Nurse Gina should consider _______.

A. Socialization is more important

B. holistic care
C. Physically dependent
D. Spiritually healing

343. In her recommendation, Nurse Gina stated, elderly should be given independence. This
means ________.

A. They must live on their own

B. The environment should be safe for them
C. They are free what to do
D. They have rights

344. The elderly should be affforded health protection by

A. Avoid end hazards

B. Pollution environment
C. Placing them in the home for the aged
D. Regular health check ups

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SITUATION – Nurse Emma was informed that a family who had just moved in has family members who
are infested with Scabies.

345. Which infection control measure should Nurse Emma observe during her visit to the family.

A. Wear mask C. Use face shield

B. Use gloves D. Wear gown

346. During theh history taking, which of the following is the MOST common symptom of Scabies
that the family would report to Nurse Emma?

A. Rashes C. Scaling
B. Swelling D. Itchiness

347. In providing health teaching to the famil, Nurse Emma would include in her teachings the
etioology of Scabies which is __________.

A. virus C. bacteria
B. fungi D. Parasite

348. The mother of the family asked Nurse Emma how to apply the anti – scabies lotion. The nurse
should teach the family to apply anti – scabies lotion to _________.

A. all skin areas C. open lesions

B. affected skin D. Reddened areas

349. In order to PREVENT the spread of Scabies infestation to other residents in the community,
Nurse Emma should teach the family, which of the following?

A. Boil the utensils used by the patients

B. Avoid sharing items used by the infected person.
C. Take a bath three or more times a day.
D. Wear mask and shield at all times even at home.

SITUATION – As nurse supervisor of the health center Nurse Ellen intends to enhhance her
competencies regarding resource management and care of the environment.

350. Which type of plan should the nurse employ to assess the strengths and weaknesses of the
organization?

A. Nursing care C. Strategic

B. Operational D. Program

351. Which BEST describes the planning function of Nurse Ellen in her role as nurse manager?

A. Get and develop people to do work

B. Distributes and arranges work to ensure smooth operation of the unit.
C. Determines the actual performance compared with the desired output.
D. Determine how to achieve the mandate of work.

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352. To assist them enhance their performance at work, the nurse manager should review regularly
pertaining to the staff's

A. Number of submitted incident report

B. Academic performance in college
C. Job description
D. Family dynamics

353. Doing year end performance evaluation of the staff is an example of

A. Planning C. Organizing
B. Controlling D. Staffing

354. Which is the MOST important criterion in budgeting?

A. Flexibility C. Consistency
B. Standardized D. Cost of effectiveness

Situation – An 18 year old, female college student was accompanied by her mother for consultation at
the Municipal Health Center. According to her mother the patient had been having difficulty concentrating
with her lesson, had tendecy to isolate inside her room and frequently in an angry mood. The physician
ordered for psychiatric consult.

355. In order to determine the patient's ability to concentrate and focus, which would be the
PRIORITY nursing action?

A. Asked for the academic performance

B. Conduct paper and pencil test
C. Assess the mental status of the patient
D. Refer the patient to the psychiatrist

356. While the nurse is taking yhe blood pressure, the patient suddenly stated."They are talking
about me!". She was referring to other patients who were waiting for their consultation. Which
of the following should be the APPROPRIATE nursing action?

A. Present the reality situation

B. Distract patient's attention
C. Disagree with the patient
D. Validate the statement

357. In taking the patient's history from the mother, the nurse should ask the mother information
related to the daughters' __________.

A. Schooling C. Pregnancy
B. Menarche D. Immunization

358. Nurse May is alarm by the incidence of number of young adults in the community with mental
problems. Which of the following should be her PRIORITY nursing initiative?

A. Refer all tertiary hospital

B. Request for psychiatrict drugs.
C. Set up debriefing center
D. Set up mental health program

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359. In giving health teaching to the mother how to manage the patient at home, which of the
following she should emphasize?

A. Give the patient more time for self

B. Impose strict discipline
C. Do traditional parenting style
D. Need for emotional support

SITUATION – Nurse Jane is the team leader of group of nurses who plans to utilize Community
Organizing Participatice Acttion Research [CO-PAR]

360. Which of the following BEST describes the PRIMARY goal of CO-PAR?

A. Enhances the skills of the nurse in research

B. Makes the community empowered and self – reliant
C. Increases funding of the community programs
D. Helps clean-up and beautify the community

361. At the pre-Entry phase, which of the following is the FIRST step in the CO-PAR process

A. Survey the community

B. Train technical working group
C. Hold a community assembly
D. Create a core group

362. In Participative Action Research [PAR], which step will empower the community?

A. The nurse performs most of the task

B. Health team directs all the activities of the place
C. Participation and engagement of the community
D. Barangay head appoints people in charge

363. The nurse, as the community organizer, immerses self by joining local folks in their usual
everyday activities in ordwwer to ______.

A. gain trust and rapport of people

B. make self popular among people
C. identify and spot leaders
D. become familiar with the place

364. In CO-PAR, which is the MOST important role of the public health nurse?

A. Caregiver C. Financer
B. Expert D. Adviser

SITUATION – Nuurse Vince is assigned as the team leaderof newly hired community health nurses of
the component ciity in the provvince. He oriented them about primary health care.

365. Which of the following are some elements of primary health care except?

A. Use of appropriate technology

B. Safe water supply
C. Free medicines
D. Maternal child care

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366. Nurse Vince is going to refer patient to secondary health facility. Which of the following is an
example of secondary health facility?

A. District hospital C. Rural health unit

B. Puereculture Center D. Barangay health station

367. Which of the following herbal medicines is recommended by the department for cough?

A. Sambong C. Bawang
B. Guava D. Lagundi

368. Guava leaves are recomended by the department of health to

A. Dissolve kidney stones C. Remedy for cough

B. Lower blood pressure D. Wash wound

369. This global program aims to end poverty and protect the planet?

A. Center for Disease Control

B. Sustainable development goal
C. Millenium development goals
D. World health organization

SITUATION – At present the public knows their right in health care. The community health nurse should
be confident and safe in the practice of her profession.

370. Nurse has a complaint from a parent for administeringgwrong dose of vaccine to the child.
This act is a form of _______.

A. Battery C. Negligence
B. Assault D. Malpractice

371. When Nurse Ace suubitted a report to the physician that she committed an error in medication.
This is an example of

A. Responsibility C. Commitment
B. Accountability D. Delegation

372. Who among the following is the BEST to sign an informed consent during a surgical procedure
of a child at the health center?

A. A 26 year old brother who is a drug addict

B. A father who is 40 years old and illiterate
C. A sister, 21 years old but undergoing dialysis
D. A mother, 35 years old with on and off seizure

illiterate person can sign the surgical consent form with an "X."

373. A nurse administer as extra dose of vaccine to a child and the patient developed adverse
reaction and died. She can be sued for _____.

A. Negligence C. Tort
B. Malpractice D. Battery

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374. A patient was for transfer to a tertiary hospital because of severe asthma, but the nurse do not
prepare the patient right away and the patient dies. Which of the following the nurse is liable?

A. Malpractice C. Murder
B. Assault D. Battery

Situation - Sarah, 38-year-old, a teller from a bank is admitted to a tertiary hospital due to hypertension
and frequent hematoma of the lower extremities every time she bumps herself in the workplace. The
physician who examined her gave an impression of Cushing disease.

375. Which of the following characteristics of Cushing disease is TRUE?

1.The disease occurs in women between 20 to 40 year of age.

II.The use of Corticosteroids for multiple immune conditions is a cause of the disease
process.
III. Condition is aggravated by excessive production of ACTH.
IV.The surgical treatment of choice is Transphenoidal hypophysectomy

A. II & III C. I, II, III, & IV

B. I, II, & III D. I & Il

376. When one has a Cushing disease the focal structure affected is the _______.

A. hypothalamus
B. pituitary gland
C. adrenal gland
D. para thyroid gland

377. Which of the following clinical manifestations will NOT be a complaint from Sarah's condition?

A. Edema of the extremities

B. Poor wound healing
C. Decrease libido
D. Absence of growth in the pubic area

378. The attending physician ordered a Magnetic Resonance Imaging (MRI) to patient Sarah in
order to validate the medical impression. This imaging technique is done to detect
_________.

A. hemorrhagic injury in the brain

B. electrical impulse in the brain
C. level of oxygen in the brain
D. non-hemorrhagic injury in the brain

379. While patient Sarah is confined in the hospital, the safety measure to be observed by the
nurses is prevention from fall. This is brought about by the patient being prone to fracture as a
result of________.

A. aging process C. osteoporosis

B. change in vision D. hematologic condition

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Situation- Romy, 58 years old, has been a cigarette smoker since age 15. He has nagging cough and
hoarseness of voice and dyspnea. Based on the physical and laboratory findings, the physician
suspected him of having lung cancer.

380. Which of the following is NOT a known predisposing factor to lung cancer?

A House is near a banana plantation.

B. Works as a sprayer of vegetables and fruit trees
C. Lives in a suburban area.
D. Living with mother who is a tobacco smoker.

381. Upon history-taking, the nurse notes that the cough of a patient with lung cancer usually
STARTS off to be ___________.

A. blood-tinged C. dark yellow sputum

B. productive D. dry and persistent

382. Which diagnostic procedure is commonly used to establish the diagnosis of lung cancer which
provides a detailed description of the tracheobronchial tree and allows for biopsies of
suspicious areas?

A. Computerized Tomography (CT) scan

B. Bronchoscopy
C. Sputum cytology
D. Positron Emission Tomography (PET)

383. To help the patient with his breathing difficulty, the nurse places him in which position?

A. Prone C. Sim’s lateral

B. Fowler's D. Supine

384. Romy is diagnosed with small cell lung cancer type of cancer. He and his family were shocked
when told by the doctor that the patient will just undergo palliative treatment. Which
nursing (SCLC) a rapidly growing action is MOST APPROPRIATE?

A. Providing relief from symptoms.

B. Reducing fatigue
C. Providing psychological support.
D. Advising treatment options

Situation The 3-year-old child has just finished ingesting the kerosene stored in a Lem-o-1ime bottle.
When the mother saw the child, she immediately brought him to the nearest hospital.

385. The assessment of the patient with ingested poison must include________.

I. determining the poison ingested and the amount

II the time from ingestion and the signs and symptoms
III. weight of the patient
IV. Patient's immunization history

A. I, II, III, and IV C. I, II, and III

B. I, II, and IV D. II, III, and IV

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386. In case of poisoning, the nurse is aware that the main goals in poisoning are to ________.

I. inactivate the poison

II. administer the specific antidote
III. induce the patient to vomit
IV. support vital organ functions

A. I, II, and IV C. I, II, and IV

B. I, II, and III D. II, III, and IV

387. To remove the ingested poisonous substance, the physician ordered a gastric lavage. What is
the role of the nurse immediately prior to the procedure?

A. Get the right size of the nasogastric tube

B. Remind parents to be careful next time
C. Obtain an informed consent immediately
D. Tell the parent that they are negligent

388. The nurse is aware that the proper management of poisoning includes the following EXCEPT
to

A. perform hemoperfusion
B. remove the toxin through dialysis
C. dilute the ingested substance
D. induce vomiting after ingestion of the caustic substance or petroleum distillate

389. Discharge instruction made by the nurse to the parents should include______.

A. close monitoring of the toddler

B. disciplining the child every time
C. Poison-proofing the home
D. lecturing the child on safety

Situation- Mr. Alda, 50-year-old company driver is admitted in the Emergency room (ER) because of pain
of the left chest and difficulty of breathing. History revealed that the patient smokes one half to 1 pack of
cigarette per day especially when he goes on overtime. Vital signs: BP is 150/90, PR-10/min. RR 38/
beats. Has clammy perspiration and quite restless. The physician ordered chest X--ray and revealed
patient has Pneumothorax. You are the nurse to be in-charge of the patent.

390. As a nurse you are guided that pain is usually described BEST as a phenomenon which is a
________.

A) Neurologic activation nociceptors

B) Subjective unpleasant experience
C) Adaptive mechanism to a stimulus
D) Creation of one’s imagination

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391. When a patient has pneumothorax, the nurse’s assessment findings will likely reveal
_______.

I. absent breadth sounds on the affected side

II. Decreased chest expansion unilaterally
III. Sharp chest pain
IV. Burning chest pain

A. I, II, III C. I, II, IV

B. III & IV D. I & II

392. Which of the following statements is NOT true of Pneumothorax?

A. Atmospheric air within the pleural space can result to a rise in intra thoracic pressure and
reduces vital capacity in the lungs
B. The loss of positive intra-pleural pressure can produce pneumothorax
C. The loss of negative intra pleural pressure can result to collapse of the lungs.
D A spontaneous pneumothorax can occur with the rupture of pulmonary bleb.

393. The physician inserted a chest tube drainage to Mr. Alda in order to help re-expand the lungs.
Which of the following should you prepare FIRST as a nurse in case of emergency when the
tube is accidentally disconnected?

A. sterile clamps C. Sterile dressing.

B. Another chest tube D. A bottle of sterile water.

394. In order to relieve Mr. Alda of pain, the physician prescribed morphine So4 2mg/IV PRN
for intolerable pain. The overall goal of the Health Care Professional is to provide adequate
control so the patient can breathe easily. Which of the following would indicate
successful attainment of this goal?

A. Anxiety level of patient will be reduced.

B. Respiratory rate will be decreased to 20 breadths
C.Oxygen saturation is at 76 % level.
D. Pain scale will show 1-to 2, in a rating scale of 10 (highest, 0-Lowest)

Situation - Proper recording is a vital task that the nurse is trained to do properly in nursing school
and expected to practice as a professional

395. Nurses are taught as students that the ideal and PROPER time for recording vital signs and
notes on the patient is __________.

A. to wait for lunch break to do the recording

B. after al11 the tasks are done, in order to conserve time
C. as Soon as they obtain the signs or observations on the patient
D. to wait for lunch break to do the recording

396. Right after endorsement and during the rounds, the incoming nurse observes that the IV fluid
is at 800 cc level and not 400cc, as endorsed. What is the CORRECT information that she
will chart?

A. Anything goes, nobody reads the charting anyway.

B. Record the 400 cc.
C. Chart that she received 800
D. Refer to the Head Nurse on what to do.

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397. Which is the APPROPRIATE way to correct an error in the Nurses Notes?

A. Take the whole page out and replace with a fresh one
B. Draw a single 1ine across the error and initial it
C. Use the sticky side of the plastic tape to erase the error
D. Use a rubber eraser to erase an error.

398. It a medicine is unavailable and therefore not given to the patient, how is it charted?

A. Leave it blank.
B. Sign and make an explanation in the Nurses Notes.
C. With an asterisk or mark, as per hospital protocol.
D. Write the letter.

399. If the patient is referred to another consultant and the latter has made an order already, what
can the nurse CORRECTLY chart?

A. The attending physician has not yet read the order

B. Only one order has been left to be Carried out.
C.She has carried out the orders of the consultant
D. That the consultant has seen the patient with new orders.

Situation - Nurses must continually grow as a person and as a professional.

400. As a newly 1icensed nurse employed in a tertiary hospital, you are required to attend
Continuing Professional Development (CPD) program. When the training program is for the
enrichment of nurses in the hospital, it is called __________.

A. informal training program

B. formal education program
C. self-directed
D. In-service training program

401. The professional development of a nurse can be achieved through various ways, such
as __________.

A. Participating in political rallies

B. Attendance in socio-civic activities
C. Attending demonstration of baking
D. Engaging in CPD Programs

402. When nurses are projected in a television advertisement as sex symbols, what
APPROPRIATE action is expected from a concerned nurse?

A. Keep your silence, it is the television station 's prerogative.

B. Go to the street to manifest displeasure of the nurse's portrayal.
C. Make a position paper to denounce the advertisement
D. Condemn the issue in the radio program.

403. To grow as a person, the student nurse can attend lecture-demonstration on which of
the following procedures?

A. Bathing the newborn C. Doing first aid

B. Proper bandaging D. Doing makeup

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404. Nurse Merry 's application to Canada has finally been approved and she was advised to
depart in three months But, she is also enrolled in the graduate school and ambivalent to go
because of this engagement plus the fact that her mother has just been discharged from the
hospital. Which of the following actions is BEST?

A. Tell family that the. money spent in graduate school can be easily earned in Canada
B. Inform the agency that she could go anytime as they wish.
C. Tell the recruiter to give her more time to settle her personal affairs.
D. Share to friends this is her escape from her sad life with her family.

Situation - 20-Tomny, a 50-year- old chain smoker is suspected to have lung cancer after he was seen
and examined by his physician. He and his wife got very worried about his diaqnosis.

405. Which procedure has to be done to the patient to establish a definitive diagnosis of lung
cancer?

A. Chest x-ray followed by a CT scan

B. Cytological study of the sputum
C. Bronchoscopy
D. Magnetic resonance imaging

406. The MOST significant contributory factor to the development of lung cancer is ________.

A. being a cigarette smoker

B. belonging to the male sex
C. Being extremely obese
D. age over 4 0years

407. The patient while in the hospital 1s complaining of chest pain. When the nurse is assessing
the degree of pain of the patient, the MOST APPROPRIATE basis is

A. watcher 's description of patient's pain

B. patient 's own rating of his pain
C.Non-verbal Cues observed in the patient
D. nurses 's Own rating ot the patient 's pain

408. Health teaching on chemotherapy includes informing Tommy on the adverse effect of bleeding
related to bone marrow depression. Which verbalization of the patient indicates further
teaching?

A. I should watch out for discolorations in my skin

B. I am going to take two tablets of Aspirin for my headache
C.I may need platelet transfusion in the future
D. I should not blow my nose

409. The patient underwent a left pneumonectomy due to Lung cancer. During surgery the phrenic
nerve is accidentally cut. This incident will result to __________.

A. Allow greater expansion of the lungs

B. Make the diaphragm descend with ease
C. produce a partially functioning diaphragm
D. make the diaphragm go up with ease

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Situation - The following scenarios are potential routines that could check work ethics of a professional
nurse.

410. A Patient asks to be discharged from the health care facility against medical advice
(AMA). What should the nurse do?

A Notify the physician.

B. Prevent the patient from leaving.
C. Have the patient sign an AMA form.
D. Call a security guard to help detain the patient.

411. A nursing assistant is assigned to provide morning care to a patient. How should the nurse
document care give by the nursing attendant?

A "Morning care rendered".

B." Morning care rendered by Grace Go, NA" -
C."Morning care provided by G.G., nursing assistant".
D."Morning care refused to be given by nursing assistant

412. A nurse administers the wrong intravenous fluid to a patient. She should accomplish
which of the following documents to be submitted to her immediate supervisor?

A. PatientKardex C. Progress report

B. Incident report D. Endorsement record

413. When developing a care plan for a patient with a do-not-resuscitate order the nurse should
NOT include which intervention on the care plan?

A. Allow access to individuals who can provide spiritual care.

B. Administer pain medications as ordered by physician.
C.Provide usual routine nursing care as ordered by physician.
D.Administer lethal doses of medication as patient request.

414. A patient is to undergo a laminectomy in the morning. The physician

asks the nurse to witness the patient's signing of the consent form. What
is the BEST action the nurse?

A. Provide emotional support for the patient while the patient signs the consent.
B. Make sure the physician explains the risks of undergoing the procedure.
C.Make sure the physician thoroughly describes the procedure.
D.Make sure the patient is competent, awake and alert before he/she signs the consent form.

Situation -Mark, a 25-year-old student suddenly had convulsive movements. After the with loss of
consciousness during their lecture episode he was rushed to the nearest hospital

415. A nurse is conducting physical assessment, which of the following is INAPPROPRIATE action
in this stage?

A. Insert intravenous cannula

B. Assess patient's lifestyle
C.Assess patient source of stress and coping habits
D.Identify the patient's daily activity

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416. Mark is scheduled for an EEG after having a seizure for the first time. What is the BEST
patient preparation instruction before the procedure?

A. Avoid thinking and personal matters for 12 hours before the test.
B. Do not shampoo your hair for 24 hours before the test.
C.Do not eat anything for 12 hours before the test.
D.Avoid stimulants and alcohol f or 24 to 48 hours before the test.

417. Which of the following manifestation should the nurse APPROPRIATELY observe during
generalized seizures?

A. Loss of Consciousness, dilated pupils, and muscular stiffening

B. Jerking movements of al1 extremities.
C. Facial grimace with patting and smacking.
D. Vacant stare with a brief Loss of consciousness

418. What is the FIRST priority which the nurse must observe in caring for patient with seizure?

A. Safety C. Nutrition
B. Airway D. Mobility

419. Phenytoin (Dilantin) has been prescribed for a patient Based on an understanding of the
medicine what 18 the APPROPRIATE nursing instruction of the nurse?

A. Give Dilantin intramuscularly

B. Administer good oral hygiene
C.Dilute IV Dilantin with 5% dextrose
D.Maintain a Dilantin level of 30-50 ug/ml

Situation 8- Charge Nurse Tessie works at the surgical ward. She ensures good record management
is implemented in her unit at a1 times.

420. A patient is having elective surgery under general anesthesia. Who is responsible for obtaining
the informed-consent?

A. Surgeon C. Nurse anesthetist

B. Nurse D. Anesthesiologist

421. Which statement by the patient indicates that the he understands the explanation of
the surgeon?

A “I refuse to sign the consent form; another family member can sign for me-"
B."Now I know what the alternative treatments and procedures are."
C. "If I refuse to sign the consent form, other treatment will be withdrawn. "
D. I can't refuse the procedure after the consent, is signed."

422. The unit secretary who transcribes the physicians' order asks the nurse to interpret an order
because she cannot read the writing. The nurse’s BEST action is to ______.

A. clarify the order with the pharmacies

B. clarify the order by calling the physician
C.interpret the order according to the patient 's previous medication record
D. clarify the order with junior staff

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423. The physician orders to transfuse 500ml packed RBC blood postoperatively. The nurse must
check the name on the label of the blood with the name on the patient 's _______.

A. medication administration record

B. Wristband in the presence of another nurse
C.medical chart
D. wristband

424. The patient 's wife is-so anxious about the condition of her husband. The MOST appropriate
INITIAL intervention for the nurse to make is to ________.

A. describe her husband 's medical treatment since admission

B. reassure her that the important fact is her presence
C. explain the nature of the injury and reassure her that husband's condition is stable
D. allow her to verbalize her feelings and concerns

Situation –Karen is seventeen years old, grade twelve, active in gymnastics. She is five feet and
seven inches tall, weighs 85 lbs. Her family doctor diagnosed her with anorexia nervosa.

425. Which of the following statements should Nurse Cora consider as

TRUE with anorexia nervosa?

A) Thinness is equated with vanity among Peers.

B) Eating disorders are not major health problems -
C) Cultures linking beauty to thinness increase risk of the Illness.
D) Anorexia nervosa is not considered as a mental disorder.

426. Karen is being assessed for eating disorder Which option is suggestive of anorexia nervosa?

A. Lack of knowledge about food and nutrition

B. Guilt and shame about eating patterns
C.Refusal to talk about food-related topics
D.Unrealistic perception of body size even though Karen has been eating

427. Nurse Cora is working with Karen. Even though Karen has been eating all her meals and
snacks, her weight has remained unchanged for a week. Which nursing intervention
APPROPRIATE for Karen?

A Supervise Karcn closely for 2hrs after meals and Snacks.

B. Supervise Karen closely 2 hours before and after meals
C. Increase the daily caloric intake calories from 1500 to 2000
D. Increase the daily caloric intake from 1800 to 3000 calories

428. One morning as Nurse Cora entered Karer's room, she noticed that the patient was engaging
in a rigorous pushup. Which nursing action is MOST APPROPRIATE?

A. Allows her to complete her exercise program.

B. Tell her that she is not allowed to exercise rigorously.
C.Interrupt her and offer to take her for a walk.
D.Interrupt her and explain that exerc1se is not needed.

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429. Which of the following is the INITIAL goal for treating the severely malnourished patient with
anorexia nervosa?

A. Nutritional rehabilitation
B Correction of body image disturbance
C.Weight restoration
D. Correction of electrolyte imbalances

Situation - Annie is a 38-year-old-woman with three children history of otosclerosis. She is admitted for
ear surgery.

430. While taking nursing history on Annie, what will be the response of the patient that indicates
her present condition?

A) She frequently experiences vertigo nausea and nystagmus when sitting.

B) She has ear pain and discharge from the left ear when travelling.
C) She has had impaired hearing since birth.
D) Her hearing loss has become worse with each succeeding pregnancy

431. Annie states, “I 'm afraid to 1et my children out of my sight now that I can't hear them." What is
the nurse's BEST response?

A) Tell me about your fears of losing contact with your children now that you can't hear
them."
B) Children need some freedom, and the mother has to learn trust them. "
C) Do the children usually misbehave when they cannot be seen or heard by you?"
D) "What can the children do to make you feel more comfortable?

432. What should be APPRORIATE the nursing care plan for Annie having otosclerosis?

A Substitute meaningful sensory input by the use of other senses.

B. Orient Annie to the staff, the unit, and all treatments
C. Give nursing care that will meet her psychological needs.
D. Make frequent calls to prevent isolation and loneliness.

433. The day after surgery, Annie expresses concern that hearing is not as good as it was before
admission. What is the BEST nurse action?

A. Encourage Annie to divert her attention by reading.

B. Encourage Annie to blow more her nose to Clear the eustachian tubes.
C. Reassure Annie that it is temporary loss due to post-oedema and ear packing.
D. Check the external ear for blood clots and remove them.

434. What post operative teaching will the patient strictly follow?

A. Reinforce that fact that airplane travel is no longer permitted.

B. Show patient how to gently irrigate the external auditory canal.
C. Inform physician any dizziness that develops after she is discharged.
D.Stress that hair washing should be avoided immediately after surgery

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Situation - Sandy, a 58-year-old teacher had a left total hip replacement due to osteoarthritis.

435. Sandy should be placed in which of these positions for meals?

A. Supine C. Semi-fowlers
B. Trendelenburg's D.Sim's Lateral

436. The nurse did preoperative teaching to Sandy who's admitted for
hip replacement surgery. Which statement of Sandy indicates the
need for further preoperative teaching?

A.” I’ll rest in bed for 2 to 3 hours after surgery."

B.” I’ll begin gait training within 48 hours."
C.” I should do muscle strengthening exercises in both legs”
D.” I need to turn, cough, and breathe deeply every 2 hours.”

437. The physical therapist orders exercise of Sandys left hip, knee nurse
and foot to gradually increase. The nurse can BEST assist Sandy by_______.

A. Observing Sandy's ability to perform the exercises

B. performing the exercises for Sandy
C. administering an analgesic before the exercises
D. stopping the exercises if Sandy experiences pain

438. Sandy should be instructed to avoid _______.

A. assuming prone position

B. abducting her left Leg
C.putting any weight on her left leg
D.adducting her left leg

439. Sandy asks the nurse if her new joint will function normally. The nurse can BEST answer this
by saying that the________.

A) doctor will be able to assess your limitations in 6 weeks and then explain them to you
B) new joint will function almost as well as a normal joint, if you perform your exercises faithfully
C) new joint will be stronger than the old one if you exercise well
D) new joint won't function as well as the new joint, but will be better than the arthritic joint

Situation - When nurses are considering issues on control, shame and stigma, surrounding the subject of
mental illness, one of the primary considerations should be nurse 's own sensitivity in recognizing signs of
mental health problem. Ethics pervades good practice.
The following situations apply.

440. A patient is brought to the hospital by his officemates because he kept on blaming his
immediate superior of getting him fired from his job. Ethical problems may arise
when diagnosing psychiatric patients because of ______.

A. inadequate staffing C. subjectivity

B. lack of Exercise D. inappropriate diagnostic procedures

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441. The nurse is administering psychotropic medication to the patient. The patient refused to take
the medication. Which of the following situations would guide the nurse where a patient
refuse medication?

A. Cannot refuse his medication regardless of his medical diagnosis

B. Need a court order to allow the patient to refuse his medication
C.Can refuse this medication if he has not been deemed incompetent by formal legal
procedures
D. May refuse the medications only if his attending physician agrees

442. Which of the following is a basic safeguard to ethical practice by the nurse in providing care to
patients with borderline personality disorders who are extremely provocative and
manipulative?

A. Observing human to human relationship

B. Seeking clinical expert opinion
C.Practicing self-awareness constantly
D.Applying person centered approach

443. The patient verbalizes to the nurse about thought to kill his wife". The nurse is in dilemma
whether to tell the wife about this Conversation. Given this situation which of the following is
the appropriate action of the nurse?

A) Alert immediately the proper authorities regarding the threat to safeguard the safety of the wife.
B) Tell the wife to be very extra careful as her life is danger.
C) Weigh carefully the situation by viewing it as dilemma between disclosing confidential
information or warning appropriate authorities.
D) Keep the information to herself and be vigilant on action of the patient to protect the wife

444. The psychiatric diagnosing of patients is a morally charged issue and the assigning of
diagnosis may be an ethical issue. The role of the nurse in diagnosing psychiatric patient is
important because nurses are _______.

A) collaborators in the diagnostic process

B) planners of psychiatric nursing care
C) knowledgeable in the field of psychiatry due to extensive clinical experience
D) Competent by virtue of their educational preparation

Situation - Dina, 72 years old, has been diagnosed to have type 2 diabetes mellitus and has been
admitted due to headache and blurring of vision. She had been on insulin therapy for almost 10 years
now.
445. Which of the following is NOT TRUE of type 2 diabetes Mellitus?

A. Increased production of glucose from the liver

B. Insulin resistance in the peripheral tissues
C. Destruction of beta cell from autoimmune mechanism which result in lack of
insulin and hyperglycemia
D. Defective beta cell secretion with loss of insulin

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446. Dina is taking human Insulin injection for diabetes. Which of the following health instructions
should you APPROPRIATELY emphasized in order to avoid hypoglycemia? Inject insulin into
the _______.

a. Anterior part of the leg muscle intramuscularly

b. Gluteal region subcutaneously and rotate
c. Abdominal wall subcutaneously and then rotates
d. Deltoid muscle intramuscularly and rotate

447. The grand daughter of dina ask you. How does regular exercise help my grand mother
overcome her diabetes? Your BEST response is exercise ______.

A. “increases metabolic rate and consumption of glucose by the muscles.”

B. “Lower cholesterol and triglyceride levels”
C. “reduces cardiovascular risks,”
D. “Increase blood sugar level”

448. Which of the following is the cause of Somogyi effect, which occurs during sleep in patients
with diabetes mellitus?

A. too much globulin C. too much albumin

B. increase insulin in the body D. limited insulin in the body

449. A common chronic complication of diabetes due to the thickening of the capillaries and
arterioles of the eye is?

A. Papilledema C. Glaucoma
B. Retinal Detachment D. Diabetic retinopathy

SITUATION 3 – Crisostomo a 40 years old employee has been complaining of difficult painful urination
for almost a week now. He said he saw some fresh blood in his urine but was afraid to see a physician,
instead, he went to his friend who is herbalist. After a week his condition worsen and his wife brought him
into a community clinic.

450. A community clinic does primary care for patients. Most often the one who manages this is
which of the following?

A. Physician C. Nurse
B. Barangay health worker D. Midwife

451. Upon assessment, the patient was referreed immediately to a 25-bed-capacity hospital, which
does not have any capacity to do intensive diagnostic examinations. You are a nurse in this
hospital which you know is a LEVEL _______.

A. 3 C. 4
B. 1 D. 2

452. In the tertiary hospital where the patient is referred , he was considered an emergency case.
The nurse immediately call for a specialist who is ______.

A. Neurologist C. Plebotomist
B. Urologist D. Nephrologist

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453. After a throurough assessment by the physician-specialist, an order for an immediate

sonogram was made specific for the medical condition?

A. Operation Room C. Intervention

B. Laboratory D. CT Scan

454. After the procedure, the patient was ordered for Lithotripsy, under spinal anesthesia. The
nurse has to call the department of ________.

A. Internal medicine C. Surgery

B. Anesthesia D. Imagery

SITUATION 4 – An alert 67 year-old woman with diabetes mellitus is discharged from the hospital. A
referral is made to a community nursing agency. You are asked to reinforce the teaching program started
in the hospital. The patient is using sulfonylurea compound tolbutamide (Orinase)

455. When the patient turned 69 years old, Orinase was discontinued and NPH insulin is prescribed
for her. After several months, she is determined to be suffering from sumogyi effect. Which of
the following conditons will most likely result when the patient is receiving too much insulin?

A. Developing an elevation of the blood glucose level

B. Producing even more insulin
C. Becoming resistant to insulin
D. Conserving excessive amount of fluid

456. A few days later, the patient comes into the emergency department via ambulance stretcher
and reveals a work-up of blood sugar level at 800mg/dl, ketones are absent in the urine, she is
dehydrated, and has an altered mental status. Based on the data, t he patient is most likely
suferring from what specifi medical condition?

A. Hyperosmolar nonketotic coma (HNKC)

B. Diabetic retinopathy
C. Acute renal failure
D. Diabetic ketoacidosis (DKA)

457. Upon interview, the patient reported the she often felt nauseated, restless, perspired a lot, felt
fatigued, and was often hungry when she was younger. What do these signs indicate?

A. Diabetic Nephropathy C. Hypoglycemia

B. Hyperglycemia D. Diabetic retinopathy

458. Upon further assessment, you notices that she had any scratches on her right ankle, a
resulting infection, and cellulitis. When you asked her about the scratches, the patient states,
"Oh, my cat might have been using my leg as a scratiching post again and I did not even feel
it." Which diabetic complicatons suspect the patient to have?

A. Neuropathy C. Retinopathy
B. Macroangiopathy D. Nephropathy

459. You should check the patient for suspect disturbed thought processes related to depressed
metabolism and altered cardiovascular and respiratory status. What is the rationale for
orienting the patient to time, place, date, and events?

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A. Shows improved cognitive functioning

B. Provides reality orientation to patient
C. Permits evaluation of effectiveness of treatment
D. Let the patient identify the time, place, date, and events correctly

Situation 7 - Ms. Monina is a retired Community Health nurse in barangay San Pablo. Due to her
commitment to the nursing profession, she has volunteered in their community to conduct health
education classes. One Saturday morning, several patients who are hypertensive and with
pulmonary health problems attended her session.

460. Mang Luis, is a newly diagnosed patient with Chronic Obstructive Lung Disease (COPD).
Which of the following PRIORTTY teaching instructions should he be given in relation to his
condition?

А. He should assume supine position: when resting.

B. Know early signs of respiratory infection.
C. He has to be taught how to do Bronchial clapping.
D. Family should be advised that patient should sleep in a warm room

461. Which of the following health interventions. should be included in your teaching plan for Mang
Luis?

A. Be on prolonged corticosteroid therapy.

B. Lung exercises must be done with longer. inhalation then exhalation.
C. Reduce risk for infection.
D. Have a high flow of oxygen administration.

462. Pulmonary Rehabilitation for COPD has a duration of at least 4 to 12 weeks. Which of the
following should be avoided while patient is having this program?

A. Pursed lip breathing

B. Smoking cessation
C. Aerobic, upper and lower body conditioning
D. Peripheral muscle wasting

463. Weight loss and Malnutrition are commonly observed among patients with COPD. They should
be taught to avoid ______.

A. have full stomach even when in dyspneic condition

B. keeping body mass between 21-25 kg./m
C. a high caloric and high protein diet
D. exercise one hour before and after eating

464. Which of the following energy conserving strategies should NOT be done by COPD patients?

A. Exhale when pushing or exerting effort when doing daily activities

B. Assume tripod position with elbows supported on the table when shaving or combing
C. Inhale when resting, sitting and lying down.
D. Stand in front of the mirror while shaving or combing hair

Situation 8 - A housewife, appearing jaundice, complaining of abdominal pain, nausea and bloated
sensation were rushed to the hospital. The patient was examined by the physician and ordered for
admission due to a suspected stone in the gall bladder, you are the nurse on duty that day.

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465. When performing an interview, which is the BEST initial question should you ask when a
patient is on pain?

A.How often do you feel the pain?

B. How would you describe your pain?
C. Did you take any drug to relieve the pain?
D. When did you first feel the abdominal pain?

466. Which of the following imaging test that uses transducer will be likely be ordered by the
physician to detect gallstones?

A. Computed Tomography C. Abdominal Ultrasound

B. Abdominal X-ray D. Doppler sonography

467. The test revealed presence of gallstones and inflamed gall bladder. The patient was advised
to undergo open cholecystectomy. This operation compared to laparoscopic cholecystectomy
are _________.

I. invasive
II. less pain
III. longer recovery
IV. shorter hospital stay

A.I, II, & IV C. I, II & III

B. I & II D. I & III

468. After 2 hours post-operatively, the nurse observed reddish drainage from the operative area of
the patient. Which of the following nursing actions should you performed FIRST?

A Check if stitches from the operation have come apart.

B. Check where is the source of possible bleeding.
C. Cover the operative area with sterile gauze bandage.
D. Put hand as a pressure on the operative area.

469. After several days in the hospital, the physician ordered the patient to be discharged. Which
of the following is a PRIORITY restriction that you should emphasize when he goes home?

A. Stool softener to induce bowel elimination.

B. Driving if not using narcotic drug.
C. Take shower even if ´still with surgical drain.
D. Lifting of objects not more than 10 lbs.

Situation-Latest death toll in the Philippines due to Corona virus after Easter 2021 was 13,425. It was so
scary that within a year Covid-19 virus takes its toll. The nurse must understand the importance of self-
awareness and competencies in helping patients and fami1ies during bereavement.

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470. When human needs are taken away or not met for some reason, people experience loss.
Using Maslow s hierarchy of human needs which one of the following will the nurse considers
a loss in case of death?

A. Loss of security and a sense of belonging

B. Loss related to self - actualization
C. Physiologic and safety loss
D. Loss of self esteem

471. Vangie, 73 years old, comorbid with hypertension and asthma died of COVID Ariel grieved and
mourned to the loss of his mother’s untimely death. He is now aware that his mother is one of
those 13, 425 deaths. The nurse will consider stage of grieving process is Ariel at
what experiencing?

A. Depression C. Denial and Anger

B. Bargaining D. Acceptance

472. Which of the following gives cues to the nurse that the patient may be grieving for loss?

A. Thoughts, feelings, behavior, and physiologic complaints

B. Hallucination, panic 1evel of anxiety, sense of impending doom
C. Sad affect, anger anxiety, and sudden change of mood
D. Complaints of abdominal pain, diarrhea, loss of appetite

473. Which of the following situations will the nurse consider as risks factors for complicated grief?

A. Childbirth, marriage and divorce

D. Death of a spouse, child, death by suicide
C. Inadequate perception of the grieving process
D. Inadequate support and old age

474. As a nurse, which of the following are the critical factors for successful integration of loss
during the grieving process?

A. The patient 's predictable and steady movement form one stage of the process to the
next
B. Accurate assessment and intervention by the nurse or helping person
C. The nurse trustworthiness and healthy attitude about grief
D. The patient's adequate perception, adequate support, and adequate coping

Situation - Mrs. Juan, a young female patient, believes that doorknobs are contaminated with Covid
19 and refuses to touch them except with the aid of tissue paper

475. Her diagnosis of obsessive-compulsive disorder constantly does repetitive cleaning. The nurse
knows that this behavior is probably MOST basically, an attempt to _______.

A. Decrease the anxiety to a tolerable level

B. Focus attention on non-threatening tasks
C. Control others
D. Decrease time available for interaction with people

476. What response should the nurse use in dealing with this behavior?

A. Encourage her to scrub the doorknobs with a strong antiseptic so she does not need to

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use tissue papers.

B. Supply her with paper tissue to help her function until her anxiety is reduced.
C. Force her to touch doorknobs by removing all available paper tissue until she learns to
deal with the situation.
D. Explain to her that ideas about doorknobs with covid 19 are part of the i1lness and is not
necessary.

477. Signs such as using tissues to doorknobs develop because the patient is ________.

A. unconsciously controlling unacceptable impulses or feelings

B. Listening to voices that tell her that doorknobs are unclean
C. consciously using this method of punishing herself
D. fulfilling a need to punish others procedure by carrying out annoying

478. Therapeutic treatment for Mrs. Juan should be directed towards helping her to ______.

A. learn that her behavior is not serving a realistic purpose

B. forget her fears by administering antianxiety medications
C. redirect her energy into activities to help others
D. understand her behavior is caused by unconscious impulses that she fears

479. The nurse plans to educate the entire family about obsessive compulsive disorder. Which of
the following plans would be the MOST effective?

a.
The nurse directs resources to help them 1earn about the illness medication to
treat it.
B. The nurse teaches the family about Mrs. Juan’s illness and medication and suggests that
they educate her disease and the medications to treat it.
C. The nurse educates the entire famil1v at the same time about the disease and
medications to treat it.
D. The nurse teaches Mrs. Juan about her illness and
her mediations and suggests that she teaches her family what she has learned.

Situation 3 - Quality and safety are rooted in the daily work of a healthcare professional. Nurses in the
orthopedic Unit attends monthly quality assurance meeting. The following questions were discussed.

480. Who should be involved in quality improvement measures?

A. Everyone C. Professional staff

B. Management staff D. Consumers

481. To start a nursing improvement project, what is the FIRST step that a nurse must keep in
mind?

A. Implement plan to correct the problem

B. Determine the nursing standards
C. Determine findings if warrant correction
D. Collect data determine if standards are met

482. To achieve organized work flow in the unit the staff must be aware of the head nurse's role.

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What is the PRIMARY purpose of supervision and delegation?

A. Enhances the delivery of quality nursing care

B. Influences organization's approach in personnel evaluation
C. Improves staff attendance in seminars
D. Assigns any staff to do the tasks or project.

483. To ensure quality nursing care to a patient in skin traction, what is the PRIORITY intervention
that a nurse has to assess frequently?

A. Signs of infection around the pin site.

B. Signs of skin breakdown
C. Urinary incontinence
D. Presence' of bowel sounds

484. The nursing team plans to do chart audit project on post-op patients who and developed
pressure sores at the Orthopedic unit over the past year to present. What type of audit is?

A. Retrospective C. Concurrent
B. Process D. Outcome

Situation - Effective teamwork and collaboration in nursing is achieved when individuals work together in
harmony, processes and goals are aligned towards achieving safe quality patient care.

485. Which of the following actions is INAPPROPRIATE for a nurse leader to apply in a work
setting?

A. Ask staff members of their opinion on the natter.

B. Modifies his own behavior favoring the needs of individual staff.
C. Gives equal consideration to each staff members
D. Plans and organizes group activities of staff members.

486. In problem solving the head nurse must know what is the MAJOR characteristic of
negotiation?

A. Be positive in your approach since optimism gives further favorable results.

B. Harmony is possible even when strategies are not well planned.
C. It is not important to get anything in writing since the truth will prevail.
D. Resources tend to involve too many individuals in decision-making process.

487. Applying multidisciplinary approach of patient care, which among the members of the
multidisciplinary team that the nurse would MOST likely collaborate with when the
patient is at risk of fall due to an impaired gait?

A. Podiatrist C. Speech therapist

B. Physical therapist D. Nutritionist

488. The nurse manager has implemented a change in the method of nursing delivery system from

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functional to team nursing. A nurse is resistant to the change and is not taking an active part
in facilitating the process of change. Which is the BEST approach in dealing with the nurse?

A. Exert coercion on the nurse

B. Provide a positive reward system for the nurse
C. Talk and encourage verbalizing feelings of the change
D. Ignore the resistance of the nurse.

489. Which among the members of the multidisciplinary team that the nurse BEST to collaborate
with when the patient can benefit the use of leg prosthesis?

A. Occupational therapist C. Podiatrist

B. Physical therapist D. Pharmacist

Situation 5 - Patrick, Charge nurse, 1S aware that the uses of resources are essential for patient care.

490. A safe patient environment includes following factors EXCEPT.

A. Socio-economic needs C. sanitation is maintained

B. basic needs are met D. physical hazards are reduced

491. As an individual, which of the following is an INTERNAL variable affecting health status, belief,
or practices

A. Genetics C. Family structure

B. Socioeconomic status D. Living situation

492. Falls are one of the leader environmental hazards reported in health facilities. One of the
MOST common occurrences that precipitate a patient fall is

A. experiencing stress, anxiety, and fatigue

B. leaving the side rails down
C. reaching item at the bedside
D. performing activities of daily living

493. If case a patient falls, the nurse FIRST responsibility is to________.

A. assess the patient's injury C. report the incident to the head nurse
B. write an incident repot D. notify the physician at once

494. In healthcare facility, a planned program of loss prevention and liability control refers to

A. quality assurance C. risk management

B. critical pathways D. peer review

Situation- Peter, a 19-year-oid college student, has been in excellent health until developing a flu-1ike
illness couple of weeks ago. He is admitted with diagnosis of Guillain-Barr syndrome.

495. Which of the following clinical manifestations would the nurse expect to find when performing
admission assessment?

A. Rapid progressive muscular atrophy.

B. Ascending paralysis with ataxia.
C. Hyperactive deep tendon reflexes
D. Paresthesia and muscle weakness of upper body.

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496. What is the MOST APPROPRIATE nursing diagnosis for this patient?

A. Self-care deficit related to neuromuscular impairment.

B. Alteration in nutritional status related to possible choking.
C. Alteration in nutritional status related to anorexia.
D. Alteration in urinary elimination related to sensory motor impairment.

497. What is the PRIORITY of care for patient diagnosed with Guillain-Barre Syndrome?

A. Maintenance of respiratory function C. Prevention of decubitus

B. Control of urinary tract infection D. Replacement of fluid and electrolytes

498. In planning the nursing care for this patient what is the important nursing intervention a nurse
must do?

A. Encourage patient to release anxiety by crying.

B. Reassure family that complete recovery is probable.
C. Assess patient for respiratory distress.
D. Have patient assist with care.

499. What symptom is an INDICATOR of cranial nerve involvement?

A. Difficulty of speaking and chewing. C. Loss of pain sensation

B. Spastic paralysis of the extremities D. Forgetfulness and syncope

Situation - You are the staff nurse in the stroke unit of the medical ward. You have a stroke patient with a
tracheostomy. The following questions relate to this situation.

500. In providing tracheostomy care which of the following is the nurse's PRIORITY nursing action?
The nurse ________.

A. Cuts the dressing using sterile scissors

B. Clean the incisions with iodine-based antiseptic
C. Secures clean ties before removing soiled ones
D. Uses clean technique

501. Which of the following nursing actions should the nurse TEACH the patient's care giver
regarding tracheostomy care?

A. Remove the tracheostomy tube if obstruction occurs

B. Leave the tracheostomy ties in place until the physician change them
C. Remove and clean the inner cannula daily
D. Never put a covering over the tracheostomy stoma

502. After tracheostomy procedure, the nurse documents important observation made during the
procedure such us _________.

A. Response of the patient's after procedure

B. Vital signs of the patient's during the procedure
C. Amount, color and consistency of sputum and appearance of the incision
D. Behavior of the patient during the procedure

503. What is the purpose of a tracheostomy. To _______.

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A. Establish an airway C. Monitor respiratory functions

B. Establish a pathway for nutrition D. Maintain the patency of the airway

504. Which of the following can be a MAJOR PROBLEM for a patient with tracheostomy?

A. Breathing C. Swallowing
B. Ingesting D. Singin

Situation 10 – you are a staff nurse in a psychiatric unit. Use of therapeutic communication is one of your
nursing responsibilities.

505. Verbal communication is the use of words when talking to your patient. The use of literal words
when you speak is the:

A. Understandable phrases C. The circumstances

B. Content D. Understandable sentences

506. Context of a verbal communication is the:

A. Use of understandable C. Use of clear sentences

B. Use of literal words D. Environment where communication occurs

507. Non-verbal communication is the behavior that accompanies verbal communication, which of
the following is NOT an indicator of this.

A. Eye contact C. Grunts and groans

B. Words representing an object D. Bochy language

508. Which of the following give meaning and context to the message?

A. Process C. Context
B. Phrases and sentences D. Thoughts and feelings

509. Which of the following situation is an example of incongruent message?

A. When the nurse means what she says

B. When the words and behavior of the nurse agree
C. When what the nurse says and does do not agree
D. When content and process agre

Situation -Sandro 8 years old,1st grader child has always been the subject of her mother's prompting
and care. He always tests his mom’s rule in preparing for school. Although this has been five months
now, Sandro still has to be reminded in getting dress completely and dilly dally eating his breakfast. He
still plays. With his toys and inter feres with her sister in playing blocks. The mother is so anxious in
reminding Sandro that his school bus will be arriving in 10 minutes every day.

510. Attention deficit, Hyperactivity, disorder (ADHD) is characterized by NOT one of the following?

A. Mental retardation C. Inattentiveness

B. Over activity D. Impulsiveness

511. Which of the following would the nurse expect to see as symptoms in a child with ADHD?

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A. Moody, sullen and pouting behavior

B. Interrupts others and can't take turns
C. Excessive running, climbing and. fidgeting
D. Easily distracted and forgetful

512. Sandro is taking pemoline (Cylert) for ADHD. The nurse must be aware of which of the
following side effects?

A. Decreased red blood cell count C. Elevated white blood cell count
B. Decreased thyroid stimulating hormones D. elevated liver function test results

513. An effective nursing intervention for the impulsive and aggressive behaviors that accompany
conduct disorder is ______.

A. open expression of feelings C. negotiation of rules

B. assertiveness training D. consistent limit setting

514. Nursing diagnosis commonly used when working with Sandro is

A. ineffective role performance C. Compromised family coping

B. impaired social interaction D. risk for injury

Situation 14 -The nurse is teaching a client taking an MAOI about foods with tyramine that he or she
should avoid.

515. Which of the following statements indicates that the client needs further teaching?

A. “I will have to avoid drinking nonalcoholic beer.”

B. “I will be able to eat cottage cheese without worrying."
C. “I can eat green beans on this diet."
D. I'm so glad I can have pizza as long as I don’t order pepperoni."

516. Patient's health teaching for Lamotrigine (Lamictal) should include which of the following?

A. Take each dose with food to avoid nausea.

B. Eat a balanced diet to avoid weight gain.
C. Report any rashes to your doctor immediately.
D. This drug may cause psychological dependence.

517. Which of the following health teaching concern for the nurse as discharged plan for suicidal
patient who had been taking tricyclic antidepressant drugs for 2 weeks and now ready to go
home?

A. The nurse will need to include teaching regarding signs of narcoleptic malignant
syndrome.
B. The patient will need regular laboratory work to monitor therapeutic drug levels.
C. The nurse will evaluate the risk for suicide by overdose of tricyclic antidepressant.
D. The patient may need a prescription for Benadryl to use for side effects.

518. A Patients to take regularly Lithium after discharged. The MOST important information to

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impart to the patient and his family is that the patient should

A. not eat foods which has high tyramine content like cheese, wine, liver
B. limit his fluid intake
C. have a limited intake of sodium
D. have an adequate intake of sodium

519. The patient with diagnosis of schizophrenia who has been taking Clozapine will inform the
patients family that the positive effect of this drug is

A. monthly 1iver function studies change moderately

B. psychotic symptoms, such as hearing loss are reduced
C. patient develops leukopenia
D. patient’s energy level and involvement in activities goes up.

Situation 16- Gloria is a nurse researcher in the Department of Health. She is assigned to conduct
research on patient's safety practices of nurses in the psychiatric unit. She is given 6 months to
conduct the study.

520. After formulating and delimiting the research problem, which following will be
a PRIORITY action of Gloria?

A. Develop the theoretical framework of the study

B. Formulate the hypothesis
C. Plan the research design of the study
D. Conduct a 1iterature search on the topic

521. Gloria decides to include only nurses who have a minimum three years experience as
psychiatric nurses. Which of the following terms refer to this?

A. Concept C. Limitation
B. Variable D. Delimitation

522. The statement “The length of service is not associated with the degree of patient safety
practices of staff nurses is an example of a/an______.

A. Variable C. Hypothesis
B. Assumption D. Theory

523. Which of the following research designs is MOST APPROPRIATE for this study if the aim is to
find a relationship between two variables in the study?

A. Phenomenological study C. Exploratory

B. Experimental D. Correlational

524. She plans to interview the Psyche Nurse Manager about the patient safety practices of
the nurses. What type of sampling includes those who happen to be in the conference room
where the activity is scheduled?

A. Random C. convenience
B. Purposive D. Quota

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Situation 17 -Incidence of drug abuse has greatly increased overtime. Korino has been using drugs for
the past three years.

525. You are a Drug Abuse Treatment and Rehabilitation Center Nurse. During the assessment of
a newly admitted Person Who Uses Drugs (PWUDs) named Korino, which of the following
is the MOST APPROPRIATE question to ask?

A. Ask Korino how long he thought that he could take drugs without someone finding it.
B. Ask Korino why he started taking illegal drugs.
C. Not ask any questions for fear Korino will deny and may become assaultive.
D. Ask Korino about the amount of drug used and its effect and how long he had been
using.

526. Upon data collection he had been failing three times in his math class and Korino was known
for substance dependent for three years. What is the MOST APPROPRIATE nursing
diagnosis for him?

A. Alteration in perception. C. Ineffective individual coping.

B. Alteration in social interaction. D. Impaired judgment.

527. Korino has been using meperidine and codeine for personal consumption. Which of the
following does the nurse understand as the physiologic effect of these drugs?

A. Increases sexual stimulation.

B. Relieves pain by increasing pain threshold.
C. Decrease craving for alcoholic intake.
D. Heightens concentration and alertness

528. Which assessment by the nurse would cause a concern for Meperidine Overdosed?

A. Respiration rate of 12 bpm. C. Dryness of the skin.

B. Hypercapnia D. Pinpoint pupils.

529. What drug should the nurse prepare for administration to reverse all signs of toxicity?

A. Digibind (Digoxin) C. Atropine sulfate

B. Naloxone (Narcan) D. Diazepam (Valium)

Situation 19- Effective communication is a core skill for nurses that a professiona1 nurse must apply in
their daily routine for patient care, colleagues and family.

530. The nurse asks the patient, "What do you fear MOST about your surgery tomorrow?” This
is an example of which communication technique?

A. Providing general leads C. Seeking clarification

B. Summarizing D. Presenting reality

531. The patient made the following statement to the nurse, my doctor just told me that he cannot
save my Leg and that I need to have an above-the-knee-amputation. Which response by the
nurse is MOST APPROPRIATE?

A. “Tell me more”
B. “Dr. Benito is an excellent surgeon.”
C. “If I were you, I will get a second opinion.”
D. “Are you in pain?”

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532. A nurse is communicating with attending physician about the Intervention prescribed for
a patient-post-spine surge statement is INDICATIVE of a collaborative relationship?

A. “Can we talk about Mrs. Santos?”

B. “I am Worried about Mrs. Santos blood pressure. It is not decreasing even with
the new antihypertensive medication”
C. “That new medication you prescribed for Mrs.-Santos ineffective”
D. “We do not need to talk about Mrs. Santos blood pressure.”

533. An 80-years-old male, admitted for emergency suturing of the forehead sustained from
accident fall while gardening under local sedation us received in the ward.
Which nursing intervention is APPROPRIATE to facilitate effective communication with this
patient?

A. Talk to patient when ful1y awake and inform him and family events which may
occur post-surgery.
B. Provide the patient with instruction materials about discharge.
C. Tell the patient, "You are fine nothing to worry."
D. Ask the patient, "Do you know where you are?’’

534. The nurse who uses appropriate therapeutic listening skills will display which BEST behavior?

A. Presume an understanding of the patient needs.

B. Read quickly to the message.
C. Reassure the patient that everything will be fine.
D. Absorb both the content and the feeling which patient is conveying

Situation 20 - Belle is a 30-year-old single mother who is dependent on her family for support. Her
diagnosis is mild mental retardation with post-traumatic disorder with depressive episodes related to her
mother's death. Her current symptoms include depressed mood with irritability, difficulty tolerating
frustration, difficulty falling asleep, increased appetite and weight gain, hyper vigilance, and worry that
something terrible will happen to her child.

535. A cognitive assessment of Belle indicated that according to Piaget's theory she was
functioning at the concrete operational stage. Which of these behaviors would the nurse
observe in Belle?

A. Thinks logically and sees possibilities.

B. Understands only her own viewpoint.
C. Feels her own reasoning should agree with the reasoning of others.
D. Makes and tests hypothesis

536. Belle has a difficulty tolerating frustration The GOAL Of the nurse is to assist Belle
to ________.

A. increase her self-esteem C. recognize her need

B. cope with anxiety D. mobilize her resources

537. Which of the following historical data MOST probably led to a post-traumatic stress disorder?

A. Unstable relationship with ex-fiancé. C. No gang-relationship with peers

B. Suicide of her mother D. Dropping out of school.

538. Given her problems of hyper vigilance and worry that something terrible will happen to her

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child, nursing interventions should be aimed at addressing her needs for _______.

A. Love and belongingness C. psychological security

B. biological integrity D. self-esteem

539. In terms of social support therapy, which of these is the MOST APRROPRIATE
and therapeutic?

A. With appropriate support, lives in the community, either independently or in

supervised setting.
B. Individualized relationship with a caregiver.
C. High structured environment with constant aid and supervision.
D. Vocational training with moderate supervision but not beyond second grade
academic challenges.

Situation –You are the nurse assigned to a patient with Amyotrophic Lateral Sclerosis. ALS is a
debilitating disease.

540. Which of the following is a primary consideration in planning for her care?

A. To prevent problems related to immobility C. To prevent infection

B. Planning for client`s eventual inability communicates D. To prevent complications

541. Which of the following is the INITIAL eaching given to the patient with ALS and her family?

A. Referral to support group

B. Prevention of complications
C. Explaining the disease process, expected course and prognosis
D. Prevention of depression

542. Which of the following is the initial teachinggiven to the patient with ALS having problems in
communication?

A. Referring the client to a speech therapist

B. Documenting any change in the elimination functions
C. Use of pre-signals before the loss of speech
D. Continue to use therapeutic communication technique

543. Rilutekis the only drug approved by the FDA for treatments of ALS. Which of the following
would you observe when administering the medication?

A. Avoid giving the medication when the client is in pain

B. Administer the medication on an empty stomach
C. Administer the medication two hours after meals
D. Administer the medication with food

544. Death in clients with ALS occurs within two to three years and is attributable to ____.

A. Fatigue C. Liver toxicity

B. Respiratory failure D. Malnutrition

Situation- Mr. Steve., 47 years old, was accompanied by his wife and teen-ager daughter to the out-
patient department for complaints of fever, fatigue, malaise and painful swollen joints. The physician

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ordered that the Mr. Steve. be admitted to the hospital for observation and treatment. You are admitting
nurse in the OPD. You found out during the interview that Mr. Steve does not have a regular job. His wife
works as a laundry woman.

545. Before admitting the client, you should FIRST make sure that:

A. The consent for admission is signed by the client

B. The consent for admission is signed by the wife and witnessed by the daughter
C. The client can pay his hospital bills.
D. The consent form is signed by the social worker.

546. Mr. Steve is brought to the medical ward. the next day, he wants to know about his illness. The
nurse on duty replied, “You don’t need to know your diagnosis “. Which of the following rights
of the patient is violated? Right to_____.

A. Obtain from his physician complete current information concerning his

diagnosis, treatment and prognosis
B. Receive from his physician information necessary to give informed consent.
C. Expect reasonable continuity of care.
D. Considerate and respectful care, irrespective of one’s socio-economic status

547. After five days of hospitalization, the physician said Mr. Steeve can be discharged. He ordered
medications to be taken at home. The client is still weak and symptomatic, which of the
following rights could be violated in this case? Right to _______.

A. Know hospital rules C. Refuse treatment

B. Privacy D. Continuity of care

548. Because Mr. Steve cannot pay for his medical bills, he is referred to the social worker. which
of the following rights is applicable in this case the right to_______.

A. Considerate and respectful care and respectful care irrespective of his socio-economics
status.
B. Expect reasonable continuity of care
C. Examine and receive an explanation of his medical bills regardless of the source of
payment
D. Know what hospital rules and regulation apply to his conduct as a client.

549. The nurse discusses and shares the medical records of Mr. Steve to a group of visiting
members of a medical mission team. Which of the following rights could be violated? the right
to

A. Expect that all communications and record pertaining to his care should be
treated as confidential.
B. Obtain information regarding any relationships of the hospital to another health care
and educational
C. Informed consent
D. Privacy

550. Which of the following is NOT covered in Patient's Bill of Rights?

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A. Refusal to treatment
B. Informed consent
C. Right to treatment
D. Civil commitment

Situation 3 - Ethics is a field of moral science which deals with the morality of human acts.
Registered nurses must be aware that their actions have professional and ethical dimensions. They
should strive to perform their work to the best interest of all concerned.

551. Which of the following is NOT aligned to ethics in nursing? A nurse ________.

A. Has the freedom to do what he likes and responsibilities.

B. Is obliged to avoid what is wrong and do what is good.
C. Is a person capable of knowing what is right or wrong
D. Should have a sense of accountability for his actions

552. A professional nurse has a duty to know and respect the Patient's Bill of Rights. Which of the
following is NOT included in the Patient's Bill of Rights? The right to/for ______.

A. A considerate and respectful care

B. Privacy and confidentiality
C. A complete and current information about his illness
D. Expect continuity of care from discharge to full recovery

553. What bio-ethical principle is violated by a nurse if he provides his patient fraudulent information
about his diagnosis and prognosis?

A. Justice C. Beneficence
B. Autonomy D. Veracity

554. Which of the following directly VIOLATES the Patient's Bill of Rights?

A. Informing patients about the billing policies of the hospital.

B. Disclosing the HIV result to members of the patient's family.
C. Honestly telling the patient about his current condition.
D. Immediately referring results of laboratory to the physician.

555. Autonomy is the prerogative of the patient to give consent or refusal of treatment with the
EXCEPTION of which of the following situations?

A. Erroneous belief of a head of a church

B. Negative effect of superstition
C. Near death
D. Peer pressure

Situation - In today's nursing practice, roles have been expanded to include legal responsibilities and
accountability in the work place.

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556. Nurse Lina is on duty at the ER and has been very busy that morning resulting to the
administration of a penicillin injection which is ordered to another patient. With this error, the
nurse can be charged of _______.

A. malpractice
B. negligence
C. assault
D. battery

557. Transcription of doctor's order is a nurse's responsibility to put the order into action.
Which of the following principles of medication safety is NOT considered to belong to
transcription error?

A. Illegible handwriting of the physician.

B. Misinterpretation of the directions ordered.
C. Use of unapproved abbreviation in the chart.
D. Wrong route of medication administration.

558. In order for nurses not to encounter legal problems in drug administration which of the
following 7 Rights of Drug Administration, should be implemented under the category of "Right
Drug"? Read the label of the drug ______.

I. three (3) times.

II. before removing from the shelf.
III. before measuring actual dose.
IV. before opening a unit dose-container.

A. II & III B. I & II

C. I, II & III D. I, II, III, & IV

559. Nurse Edna admits a patient from the ER to the medical unit. The patient is very restless with
IV lines and a urinary catheter. She was put to bed and the nurse applied a body restraint
without the doctor's order. Nurse Edna's action can be liable for _____.

A. invasion of privacy B. assault

C. battery D. neglect

560. Ms. Cruz is the supervisor of a hospital on night shift. Several nurses did not report due to
Jeepney strike. When the supervisor is executing proper allocation of nurses to the
PRIORITY wards to address this concern, she is observing what type of principle?

A. Beneficence B. Non-maleficence
C. Justice D. Fidelity

Situation - Ethical dilemma is becoming a common scenario in the health care delivery system brought
about by the advanced technological changes on health care.

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561. Which of the following is an example of an ethical dilemma?

A. A nurse providing demonstration of the possible risk if a chest tube drainage of a patient is
pulled out.
B. Family member: having ambivalent feelings whether their father will undergo amputation
of a diabetic leg.
C. A nurse is overheard by the daughter that if her mother will not take her insulin
injection she will not serve her food tray.
D. The physician signs the medical directives of a terminally-ill -patient admitted in the
hospital with his spouse.

562. A 70- year-old has been rushed to the hospital due to bradycardia and palpitation. The
physician suggested that a pacemaker be inserted to correct the symptoms. The patient
voluntarily decides not to have the pacemaker Inserted. This is respected by the family. This is
an example of what ethical principles

A. Beneficence B. Autonomy
C. Fidelity D. Justice

563. The ER nurse clarifies the doctor's prescription on the dose of the pain medication based on
the pain scale assessment and patient's age. which ethical principle is applied?

A. Fidelity B. Truthfulness
C. Justice D. Non-maleficence

564. Nurse Pat promised to a post- surgical patient, that she would come back to assist in his
ambulation after carrying out the physician's order. This follows the principle of

A. beneficence B. justice
C. autonomy D. fidelity

565. When a nurse supports the welfare of the patient in relation to health, safety and personal
rights, the ethical principle followed is

A. responsibility B. accountability
C. confidentiality D. advocacy

Situation - Nurse Rina had been working we public health nurse. In working families, she values the
Importance of family care plan and other concepts about community health nursing

566. Nurse Rica is in charge of the animal bite program of the health center, which of the following
is the causative agent of rabies?
A. Parasite C. Bacteria
B. Virus D. Fungi

567. Which is the best strategy to control Incidence of Rabies in the community

A. Impound dogs B. Kill stray dogs

C. Responsible pet owner D. Fine the owner

568. Which BEST advice the nurse should give in case of dog bite

A. Wash wound with garlic B. Do not feed the dog

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C. Bleed the bitten area D. Wash thoroughly with running water

569. What advice should be given to the owner of the dog in case of dog bite

A. Give away the animal B. Impound the dog

C. Kill the dog D. Feed well and observe

570. Which IMPORTANT Information the nurse should inform the public about rabies?

A. It could be prevented B. It is an ordinary disease

C. Rabies is not deadly D. It kills

Situation- Nurse Erica is fully aware that being a public health nurse her work is guided by ethico - moral
principles.

571. Which is the 'MAIN' goal of ethical practice of the nursing profession including the community
setting?

A. To protect the nurse and co workers

B. To prevent reprimand from physician
C. For the patients Family satisfaction
D. Centered on the welfare of clients and protect their rights

572. As public health nurse Nurse erica makes sure all the supplies and medicines needed for the
care of community are available. This is an example of the principle of

A. Justice B. Respect
C. Fair treatment D. Beneficence

573. Select nurses’ action in keeping with principle of confidentiality

A. Hides identity of patient

B. Shares information from patients’ chart in public
C. Keeps all matters about the patient as a secret
D. Discuss the case of the patient with others.

574. Nurse Erika is always guided by the principle of beneficence in all that she does to all her
patients which of the following nursing action is aligned with principle of beneficence.

A. Equal and fair allocation of resources to all

B. Getting informed consent
C. Keep records of patients from public viewing
D. Promoting patient’s safety at all times

A – justice, B-autonomy, C-beneficence secondary to maintaining confidentiality, D-is non-maleficence

575. Nurse Erika tap all the newly hired nurses to be members of her new project. she is observing
the ethical principle of ________.

A. Justice C. Nonmaleficence
C. Autonomy D. Respect

Situation - Nurse Oscar in in charge of the OSTEOPROSIS CONTROL PROGRAM OF THE HEALTH
CENTER

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576. Nurse Oscar Informs the other members of the team about osteoporosis. Which of the
following is TRUE of the disease in the Philippines?

A. There are only few cases in the country

B. The disease is not alarming
C. Filipinos are aware of the incidence of osteoporosis
D. Filipinos have low awareness about the disease.

577. Which is the MOST important risk factor to osteoporosis

A. Menopause C. With history of previous fracture

B. Being male D. Short in height

578. Which of the following is the preventive measure to osteoporosis development?

A. Iron rich food C. Daily jogging

B. Calcium rich food and supplement D. Vigorous exercise

579. Which of the following is TRUE about osteoporosis?

A. it is a silent disease B. It is more common in men

C. it is not that alarming D. It is only discovered after a fracture

580. The diagnostic examination for osteoporosis is geared towards measuring

A. Bone density C. Weight

B. Blood volume D. Height

Situatio - Research is a vital endeavor nurses must engage into in order to contribute to nursing science

581. When the nurse researcher collects data at more than one point over an extended period,
which design is applied?

A. Cross-sectional B. Time-related
C. Time sequenced D. Longitudinal

582. If a research study involves an intervention and "blinding" which research design is being
referred to?

A. Non-descriptive B. Phenomenological
C. Experimental D. Descriptive

583. Which of the following statements is LEAST descriptive of a qualitative research design?

A. Researchers become involved.

B. Gather data from one collection strategy.
C. It is flexible and elastic.
D. Strives for an understanding of the whole strategy

584. Qualitative researchers should choose their participants who can best meet the objectives of
the study, who of the following best qualifies?

A. Cooperative persons in the community

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B. Those readily available thus convenient for the researcher.

C. Able to articulate and reflect on the phenomenon that they experienced.
D. Persons referred by friends.

585. A "full understanding" in research should be understood by the nurse researcher as _____.

A. ensuring that participants are not placed at risk

B. explaining the study including risks and ben
C. the right to decide voluntarily
D. not exploiting information shared by participants

Situation - Nursing student Myra decides to do a qualitative phenomenological study on how the stigma
of AIDS affects the patients. She has previously identified 6 participants: 3 teenage boys and 3 teenage
girls.

586. What is the best way for Myra to collect data from these participants?

A. Focus group discussion B. Survey, questionnaire

C. Individual Interview D. Observation

587. What kind of sampling method should she apply?

A. Network B. Random
C. Stratified D. Purposive

588. The statements of the findings of the study that will be formulated by Myra should be by_

A. summarizing the sharing’s of the participants of both sexes

B. identifying the answers of the males and the females
C. describing answers of the males and females by percentages
D. extracting meanings and themes from significant statements

589. “Informed consent” in this study will be obtained by Myra from the

A. six participants only B. parents only

C. six participants and available relative D. six participants and their parents

590. What is NOT important for Myra to do when listening to tape recordings?

A. Do the listening as soon as possible after the interview.

B. Note for the voice tone and voice inflection.
C. Listen when she feels the motivation for a more productive time.
D. Take notice of the pauses of the participants.

Situation - Emmy, 22 years of age is a midwife in the 03 Ward is now complaining of contact dermatitis
from gloves.

591. Patients like Emmy who have experienced delayed hypersensivity to latex FREQUENTLY
complains of ______.

A. flushing, bronchospasm B. urticaria, laryngeal edema

C. rhinitis, conjunctivitis, blisters D. papules, vesicles, pruritus

592. The nurse knows that the diagnosis of contact latex allergy is based on history and ____.

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A. Latex specific IgE B. finding IgE in serum

C. skin patch test D. ELISA

593. Latex allergy can be a type I IgE-mediated immediate hypersensitivity to plant proteins from
the latex of rubber. It can manifest in its MOST severe form as _____.

A. Pruritus, erythema and swelling B. Asthma

C. Anaphylaxis D. Blisters and other skin lesions

594. Type I IgE-mediated immediate hypersensitivity reaction is promptly managed with ____.

A. theophylline B. epinephrine
C. costicosteroid D. diphenhydramine

595. The best prevention management of contact latex allergy is ______.

A. applying lotion before gloving B. avoidance of latex products

C. avoiding rubberized goods D. resigning from the job

Situation - Susie, 5 years old, is diagnosed with nephrotic syndrome and is manifesting massive
proteinuria resulting to decreased albumin in the blood.

596. The nurse understands that the passage of protein in the urine is the result of

A. inherited kidney disorder B. increased glomerular permeability

C. rise in the production of albumin D. intrinsic kidney disease

597. Upon clinical assessment, the nurse observes that the OUTSTANDING manifestation of the
patient is ______.

A. weight gain B. obesity

C. emaciation D. edema

598. The physical appearance of the urine of the patient with nephrotic syndrome is COMMONLY
_______.

À. cloudy B. clear
C. whitish D. frothy

599. The patient with nephrotic syndrome is ordered corticosteroids. Who of the following are NOT
ALLOWED in the patient’s?

A. Parents with diabetes. B. Relatives with upper respiratory tract infection.

C. Visitors with mild asthma. D. Personnel with allergy.

600. Corticosteroids are one of the main therapies for nephrotic syndrome. Which of the following
COMMON side effects should the nurse watch for?

A. Loss of appetite B. Increase in body hair

C. Loss of weight D. Lowering of blood pressure

Situation 18 - The nurse in the exercise of her profession must adhere to the ethico-moral standards set.

601. nurses may be privy to very personal information of patients and should make every effort
to make it confidential, otherwise she can be charged of ______.

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A. negligence B. malpractice
C. invasion of privacy D. defamation

Situation - Rosie, a new staff nurse, was assigned in the Psychiatric Unit. A depressed patient assigned
to her fell from her bed. Her head nurse asked her to submit an Incident Report (IR).

602. The purpose why the head nurse asked Nurse Rosie to submit an IR is to ______.

A. note patterns of incidences in the same unit

B. place it in Nurse Rosie's 201 file
C. document immediately the incident
D. evaluate Nurse Rosie's performance

603. In writing the IR, which of the following is not included?

A. Who was / were involved? B. What daily medications are given to the patient
C. What happened? D. Who witnessed the incident?

604. What guideline s IMPORTANT in relation to incident report (IR)? It is ______.

A. not made part of the patient's chart B. placed in the nurse's 201 file
C. filed in the nurse’s station D. filed in the Records Section of the hospital

605. Which of the following would prove that the nursing action carried out met, the standards of
care on falls?

A. Utilizing the nursing process in providing safe, quality nursing care

B. Documenting the procedures done
C. Carrying out the doctor's order
D. Performing physical assessment

606. Should the investigation of the fall go further, which of the following is the best source of
factual information?

A. incident report. B. nurse's notes in the chart

C. anecdotal record D. process recording

Situation - Nurse Annie is assigned to Sherry, a junior high school student who is treated for her Bulimia.

607. Bulimia is best defined as a /an _____.

A. disorder of the unknown origin associated with starving oneself

B. pathological disorder of binging and vomiting
C. phobic disorder of fear of obesity
D. eating disorder associated with vomiting

608. What condition is NOT likely to developing Sherry?

A. Hyperkalemia B. Tooth decay

C. Gastric ulcer D. Rectal bleeding

609. Which of the following conditions may lead to death in a bulimic patient like sherry?

A. Hypokalemia and cardiac arrhythmias and arrest

B. Metabolic acidosis and renal failure

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C. Hyponatremia and circulatory collapse

D. Hypernatremia and congestive heart failure

610. Endocrine changes often result in a bulimic patient. Which of the following would be an
expected change in Sherry?

A. Delayed Thyroid Stimulating Hormone response to Hormone Replacement Therapy

B. Increased production of Follicle Stimulating Hormone
C. Hypopituitarism
D. Decreased Adrenocorticotropic Hormone in response to cortisone

611. Amitriptyline, an antidepressant is the drug of choice in treating Bulimia. What is a

COMMON side effect of this drug?

A. Anticholinergic effects B. Cholinergic effects

C. Urinary frequency D. Diarrhea

Situation 1 - Nurse G is assigned in the morning shift of the Post-Anesthesia has a patient for admission.

612. The INITIAL priority assessment performed by the nurse, when admitting a patient, the unit
after abdominal surgery is to check for ______.

A. surgical site for drainage and hemorrhage B. skin color and temperature
C. responsiveness to painful stimuli and noise D. respiratory function and airway

613. How should the nurse position the patient who is in a somnolent status and still under the
effect of anesthesia?

A. Supine position with head bed slightly elevate.

B. Prone position with a pillow under the abdomen.
C. Semi-Fowler's position with the head turned to the right.
D. Left lateral position with a pillow supporting the head.

614. What a patient has bleeding after surgery the PACU nurse, expects which color if coming from
the arterial source?

A. Darkly-colored, blood flows fast. B. Bright red and spurts with the heartbeat.
C. slow, dark-colored, generally ooze. D. Pinkish colored- slowly flowing.

615. During the immediate post-operative phase, the PRIMARY goal of the health care team is to
maintain ventilation. Which of the following situations should be observed as a result of
hypoxemia?

A. Excess carbon dioxide in the blood B. Increasing ammonia in the blood

C. Decreased oxygen saturation D. Reduction of blood Ph

616. When a patient develops a temperature of 39.8 degree centigrade after an abdominal surgery
with an ongoing blood transfusion, the PACU nurse should notify the surgeon as this may
indicate ______.

A. abdominal tissue injury B. on going potential infection

C. post-anesthesia drug reaction D. allergic reaction from blood transfusio

Situation 18 - Mo, a 22-yr old nurse graduate, passed the November 2018 Philippine Nurse Licensure
Examination before her birthday which is November 16. The scheduled oath-taking ceremony was set on
January 6, 2019.

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617. Top obtain her license to practice, she must do the following, EXCEPT:

A. Must take the oath to any government official

B. Must register in the registration division of the PRC
C. Must take the oath of professionals before any member of the PRBON
D. Must be issued a certificate of Registration (COR) and profession identification card (PIC)

618. Nurse Merle has to renew her license on or before _____.

A. January 6, 2021 B. November 16, 2022

C. November 16, 2021 D. January 6, 2022

619. For Nurse Merle to continually practice nursing, she must satisfy the requirements set by the
PRC and comply how many units of CPD upon renewal?

A. 45 units B. 10 units
C. 25 units D. 15 units

620. After 3 years being assigned in the Operating Room, Merle in interested to actively join which
appropriate professional organization?

A. ORNAP B. NLGN
C. ADPCN D. APO

621. What would Merle do to keep abreast with the latest trends in peri-operative nursing?

A. Attend training and seminars B. Perform researches

C. All of these D. Pursue graduate studies

Situation 16 - Resources in health care delivery system are one of the challenging concerns of nursing
leadership in the country today. Nurse Gayle is a unit manager in a tertiary hospital and conducts meeting
regularly every two weeks to her staff to address PRIORITY affecting their services.

622. Which of the following statements indicate an effective communication technique used by the
unit manager to her staff?
A. "We need to improve our nursing services otherwise top management will take over,
B. "Lets limit requesting supplies and equipment, our budget for our promotion might be affected."
C. "There are a lot of redundant positions in our unit, there is a need to retrench some staff."
D "We need to discuss strategic approaches to facilitate delivery of nursing services with
less expense on our consumers."

623. For the past 6 months, several nurses are resigning. Some have verbalized in the exit
interview that there are not happy anymore. Which of the following descriptions manifest
BEST, a nurse who has job satisfaction?

A. Competitive, self-centered, euphoric. B. Empowered, enthusiastic, ethical.

C. Loner, egoistic, reactive. D. Outgoing, sensitive, competitive.

624. Delegation is a critical component of leadership and governance. Which of the following
empowering activities should the unit manager applie’s in delegation?

A. In delegation facilitating professional growth and development of a staff is necessary.

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B. When delegating responsibility to a nursing staff, modification of standards of care is

permitted.
C. Delegation of responsibility in patient care has to start from top management to the staff-
nurse level.
D. Delegation requires responsibility with corresponding accountability of a staff-nurse.

625. Nurse Gayle is guided that the initial step of delegation is ______.

A. demonstrate the task and let the staff continue the next activities
B. Assess the capability of the staff, change him if not performing
C. Determine the competency level of staff for the task being given
D. Explain the task to be done with accompanying job description

626. The unit manager the planning to take her regular official business leave for the year. She
has written a letter of recommendation to her Immediate supervisor for her assistant unit
manager to assume her position while she is on leave. This is an example of delegation by
_____.

A. rank B. authority
C. succession D. authority

Situation - Ms Sandra is a newly assigned school nurse in the elementary school of the barangay. She
planned to do physical examination of every school child.

627. In assessing the health condition of school children which of the following would be the
finding common to this age group?

A. Cancer and other malignancies B. Anemia and other blood disorders

C. Lice and parasites D. Fractures and injuries

628. In the performance of her role and functions a school nurse, which guiding principle should be
consider very IMPORTANT?

A. Health is an integral part of the education process.

B. The nurse is in full authority over the children
C. The local health authority supervises the school health
D. School nursing is more focused on socialization

629. Choose how many times at least the nurses conduct physical assessment to school children.

A. Thrice a year B. Every semester

C. Every quarter D. Once a year

630. Who should Nurse Sandra consider as a priority for home visitation?

A. Pedro 9 years old whose parents are both workings

B. Mellisa 10 years old with stunted growth for her age
C. Cindy 7 years old who has been absent due to skin lesions
D. Mike 8 years old who often sleeps during class hour.

631. Which of the indicators BEST describes an effective outcome of school nursing programs and
initiatives?

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A. Zero absenteeism and tardiness of pupils.

B. Teachers are observers of school health program.
C. Limited information in school health initiatives
D. constant visits and phone calls of parents.

Situation - Nurse Cris is about to start her community organizing activities. Together with her core group,
their goal is to be successful in community organization through effective communication.

632. Nurse Cris would like to communicate to the people tha health problems they had identified. In
reaching out every household in the community, which is the BEST strategy the nurse should
employ?

A. Call for general assembly. B. Use social media

C. Send memorandum. D. Write a letter to residents.

633. Which communication technique should Nurse Cris employ in order to successfully capture the
details of the meeting?

A. Summarizing B. Restating
C. Reassuring D. Validating

634. Nurse Cris received information from some community residents who suspect that a
neighbor ls abusing his young child. Which should be the PRIORITY nursing action?

A. Report the police authorities. B. Notify the social worker.

C. Ignore the information D. Validate the information

635. In organizing the community in the midst of a major 'health crisis, which STRATEGY should
the Nurse Cris employ to effectively communicate the importance of health and safety
protocol?

A. Send letter compelling everyone to follow.

B. Use social media to spread the information
C. Request an elder resident to inform everyone.
D. Place posters and flyers in dialect in strategic places.

636. In order for Nurse Cris to facilitate the recognition of the community the existence of their
health problems, which nursing action would yield BETTER results?

A. Asks the barangay head to make the report

B. Set the ground rule that presence of problem is valid
C. Allows people's participation to confirm the health problems.
D. Acts as an expert to communicate to residents.

Situation - Nurse Bea engages in both formal and informal learning activities to enhance her knowledge
about Nursing Theories and other concepts in Nursing.

637. Nurse Bea recall the theory or Nursing as caring by ______.

A. Orem B. Watson
C. Kings D. Benners

638. Which of the following is the central theme of Sr. Calista Roys theory?

A. Self care deficit B. Adaptation

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C. Nursing as caring D. Transcultural

639. This theory categorizes professionals as Novice to experts is by ______.

A. Benner B. Abdellah
C. Pender D. Kings

640. Nurse Bea reviewed the elements of nursing as a profession. Which of the following is an
IMPORTANT element that characterizes Nursing as a profession?

A. Has members B. Possess body of knowledge

C. Service oriented D. A calling

641. Nurse bea wants to pursue higher education in Nursing for her career advancement. Aside
from enrolling in graduate school, which of the following she could enhance her career?

A. Participates in professional organization B. Attends seminars.

C. Conduct research D. Attends symposium

Situation 20 - Nurse Levy reviews all pertinent laws that affect public health nursing

642. RA 9173 is otherwise known as the Philippine Nursing act of 2002. which is the primary
aim of this law?

A. To enhance the competence of professional nurses

B. To regulate practice of professional nursing in the country
C. To facilitate mobility of nurses to other countries
D. To promote well-being of health workers

643. The nurse closely monitors the work she delegated to the barangay health worker. She is
legally guided by this principle

A. Respondent superior B. The good Samaritan

C. Res ipsa loquitor D. Jurisprudence

644. This law promotes the well being and living conditions of health workers especially those from
the government managed facilities

A. Continuing professional development B. Magna Carta for health workers

C. Philippine qualifications framework D. Local government code

645. It mandates the compulsory Immunization of children below 8 years

A. PD 996 B. RA 11223
C. RA 9173 D. RA 10912

646. This law allows every Filipino to avail of affordable medicines

A. Local Government Code B. Primary Health Care

C. Universal Health Care D. Generic Drug Act

Situation 1 - Nurse Kathy is caring for a postpartum patient. Routine postpartum care is rendered to the
patient.

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647. Which assessment finding would lead the nurse to suspect a postpartum hemorrhage? Blood
loss of _____.

A. less than 300 ml/24 hours B. more than 400 ml/24 hours
C. less than 200 ml/2 hours D. more than 500 m2/24 hours

648. Which of the following is caused by the markedly distended uterus and intermittent uterine
contractions within 2 to 3 days after birth?

A. Retained placenta B. Uterine atony

C. Afterpains D. Boggy uterus

649. The nurse prepares a care plan for the patient. Based on Ramona Mercer's becoming a
mother (BAM) theory, which of the following statements fosters the process of becoming a
mother?

A. The woman becomes comfortable with her identity as a married individual.

B. It encompasses the dynamic transformation and evolution of a woman's
persona.
C. A woman learns mothering behavior prior as early as a teenager.
D. It accurately reflects the transitional process from being single to a married
relationship.

650. The mother asks why she has a gush of blood coming out from the vagina that occurs when
she first arises from bed. The nurse's CORRECT response should be

A. "Blood pools at the top of the vagina and forms clots that are passed upon rising or
sitting on the toilet."
B. "Positioning causes blood to flow out when she stands.
C. "Because of the normal pooling of blood in the vagina when the woman lies
down to rest or sleep."
D. "Normal physiologic occurrence that results as the body attempts to eliminate excess
fluids."

651. Some postpartum mothers will experience difficulty voiding because of the edema and trauma
of the perineum. Which PRIORITY nursing measures stimulate the sensation of voiding?

A. Encouraging her to void. B. Running water in the sink or shower.

C. Helping the mother into the shower. D. providing cold tea or fluids of choice.

Situation 2 - A postpartum mother newly delivered her baby per vagina. She keeps on asking the nurse
when the basic physiologic changes occur as her body returns to a pregnant state.

652. The nurse explains to the mother that the uterus will return to its pre-pregnancy state in _____
weeks.

A. Six B. Three
C. Four D. five

653. In her capacity to teach, the nurse describes the changes of the uterus after childbirth to return
to a nonpregnant state as _____

A. catabolism B. subinvolution
C. contraction of muscle fibers D. Involution

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654. Which of the following conditions does the nurse explain to the patient the contributory factor
that slows uterine involution?

A. Full bladder during labor B. Difficult birth

C. Prolonged labor D. Infection during pregnancy

655. The nurse assesses the uterine fundus of the mother. Which part of the abdomen will the
nurse begin?

A. Symphysis pubis B. Midline

C. Umbilicus D. Sides of the abdomen

656. The FIRST PRIORITY nursing intervention during the immediate postpartum period is focused
on

A. Monitoring urinary output B. Taking the vital signs every 4 hours

C. Observing postpartum hemorrhage D. Checking level of responsiveness

Situation 3 - Evelyn a multigravida, in her 20th weeks of gestation visited the community clinic with
complaints of dizziness, vertigo, and heartburns. After the physical assessment, Nurse Harpar finds the
patient as malnourished.

657. Iron supplementation was prescribed because of her low hemoglobin level. which statement, if
made by Evelyn, would indicate an understanding of health instructions?

A. "My body has all the iron it needs and I don't need to take supplements."
B. "Meat does not provide iron and should be avoided."
C."The iron is best absorbed if taken on an empty stomach."
D. "Iron supplements will give green color to my stool."

658. Evelyn was given iron as supplemental vitamin to prevent maternal anemia. She asks if Cat
will not be affected because she is regularly taking vitamin C. Which of the following would
be the best response of the nurse?

A. "Take two other vitamins separately."

B "Take the iron after a full meal."
C. Absorption of iron is enhanced with Vit C.
D."Drink milk when taking the iron supplement."

659. Evelyn was also advised to take calcium supplements on the 2nd and 3rd trimester of
pregnancy. Which of the following would ENHANCE her intestinal absorption of calcium?

A. Fat-soluble vitamins B. Proteins

C. Minerals D. Water soluble vitamins

660. Nurse Harper observes Evelyn has knowledge deficit regarding fetal nutrition. Nurse Harper
has to explain that the MAIN SOURCE of nutrition for the baby is which of the following?

A. Amniotic fluid B. Uterus

C. Placenta D. Chorionic villi

661. Nurse Harper provides health instruction to the patient experiencing heartburn, which
statement by the patient indicates a NEED or further Instructions? I have to drink milk between
meals it

A. Drink milk between meals B. Eat small, frequent meals

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C. avoid fatty or spicy foods D. lie down after eating

Situation 10 - Catherine, 5 years of age, is admitted to the Pediatric Ward due for severe otalgia, fever
and irritability. The mother informed Nurse Selma that patient had upper respiratory infection three weeks
prior to admission. The admission diagnosis is acute otitis media (AOM).

662. Nurse Selma conducts her INITIAL assessment on Catherine. patient keeps on crying and
constantly pulls her right ear. What is her MOST APPROPRIATE action?

A. Request parent to carry the child B. Take Catherine's vital signs.

C. Refer to the attending physician. D. Assess the description and frequency of pain.

663. Nurse Selma is preparing to administer ofloxacin eardrop on Catherine per Doctor's order. She
needs to hold the bottle with her hands to warm up the solution to prevent dizziness for

A. 5-6 minutes B. 1 to 2 minutes

C. 3-4 minutes D. 6-7 minutes

664. After washing her hands and gently cleaning any discharge that can be removed easily from
the outer ear, Nurse Selma positions the child. Which of the following steps follows?

A. Gently press the tragus of the ear four times in a pumping motion.
B. Gently pull the outer ear
C. Drop the medicine into the ear canal.
D. Keep the ear up for five minutes.

665. Based on her knowledge on otitis media, Nurse Selma recalls that children are predisposed to
AOM due to the following rish factors, EXCEPT ______.

A. absence of breastfeeding B. swimming

C. exposure to cigarette smoke D. poor hygiene

666. To promote drainage and reduce pressure from fluid, Nurse Selma nursing intervention is to
have the child assume any of the following positions, EXCEPT _____.

A. tilt head to side if sitting up. B. Lie on the affected area

C. put the pillows behind the head D. lie on the non-affected ear.

Situation 12 - In a birthing station, five postpartum mothers delivered 2 hours, 4 hours, and 6 hours ago,
respectively. All of them are multigravida patients. Adalynn, the nurse educator opted to conduct health
education on a postpartum hemorrhage.

667. Nurse Adalynn explains to the mothers that early indication for hypovolemia caused by
postpartum hemorrhage is _____.

A. increasing pulse and decreasing blood pressure

B. altered mental status and level of consciousness
C. dizziness and increasing respiratory rate
D. Cool, clammy skin, and pale mucous membranes

668. The nurse educator Adalynn reviewed the risk factors for postpartum hemorrhage for the
mothers. Which of the following factors IS NOT included ____?

A. ruptured uterus B. uterine atony

C. overdistended uterus D. retroversion of the uterus

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669. During the normal postpartum course, when would the nurse expect to note the fundal
assessment that will be in line with the umbilicus?

A. Immediately after the delivery B. 4 days after the delivery

C. When the client's bladder is full D. The day after the delivery

670. A postpartum patient asks nurse Adalynn when she may safely resume sexual activity. Which
of the following information should the nurse tell the patient on resumption of sexual activity?

A. In 2 to 4 weeks
B. At any time
C. After the 6-week physician check-up
D. When her normal menstrual period has resume

671. Nurse Adalynn discusses the possibilities of future postpartum hemorrhage with the patients.
Which of the following increases the absorption of vitamin K?

A. Proteins B. Carbohydrates
C. Minerals D. Fats

Situation 18 - Josephine, a multiparous patient is admitted due to labor pains which started an hour ago.
During the vaginal examination, the nurse noted the complete dilatation of the cervix and effacement is
100 percent. The patient is in true labor pains.

672. Which of the following problems with labor and delivery is completed in less than 3 hours?

A. Precipitous B. Preterm
C. Induced D. Prolonged

673. Patient Josephine was referred to the physician, routine blood examinations were taken. After
reviewing the serum electrolyte. levels an order of isotonic intravenous (IV) infusion was
prescribed. Which IV solution should the nurse prepare?

A. 5 percent dextrose in water B. 0.45 percent sodium chloride solution

C. 10 percent dextrose in water D. 3 percent sodium chloride solution

674. The patient during labor would anticipate some emotional support. Which of the following
nursing interventions should Nurse Sarah provide to keep the patient calm?

A. Giving praise for her the sense of satisfaction regarding quick labor.
B. Support in maintaining a sense of control.
C. Explanation of the effect of labor on the newborn.
D. Allowing the patient to express pain and anxiety

675. Patient Josephine asks why her labor is much shorter compared to previous deliveries. Which
of the following is the BEST RESPONSE?

A. Onset of contraction was gradual.

B. Multigravida patient has shorter labor,
C. Cervical lengthening was longer.
D. Induction of labor was done.

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676. Nurse Sarah reads the physician's prescription to administer methylergonovine maleate
(Methergin) intramuscularly after delivery. The rationale for giving this medication is which of
the following?

A. Reduces the amount of lochia drainage. B. Prevents postpartum hemorrhage.

C. Decreases uterine contractions. D. Maintains normal blood pressure.

Situation 19 - Jose, 10 years old, has bronchitis. He needs oxygenation 4L/miin per doctor's order.

677. The first standard-step-in oxygen therapy that the nurse should do is which of the following?

A. Prepare the patient for the oxygen treatment

B. Check the chart for ordered flow rate and oxygen delivery method.
C. Gather all the equipment and supplies.
D. Assess patient's condition.

678. In planning for Jose's oxygen therapy, the nurse shall consider which of the following,
EXCEPT

A. need for a humidifier.

B. length of tubing.
C. determine the age of Jose.
D. manner of administering oxygen, continuous or intermittent.

679. The PRIORITY nursing action of the nurse for Jose due for oxygen therapy is _____.

A. attach the humidifier and connecting tubing to the oxygen de livery device.
B. connect the flow meter to the pipe in oxygen outlet.
C. turn on the oxygen
D. check the flow.

680. What PRIORITY precautionary measure should be done by the nurse during the oxygen
therapy?

A. Limit visitors. B. Attach "No Smoking" signage

C. Check humidifler's water regularly. D. Connect bait to oxygen tank.

681. One evening, Jose complained of dyspnea despite continuous oxygen therapy. What should
be the nurse's INITIAL intervention?

A. Give PRN medication. B. Refer patient to the physician.

C. Assess the patency of the tubing. D. Re-assess the patient.

Situation - Nurse Crisel was talking about HIV-AIDS to a group of teen-agers. Here are some questions
which were asked by them during the open forum.

682. What are some of the general symptoms during the PRIMARY HIV infection? The nurse
enumerated the following. Which among these are CORRECT?

1. Fatigue 3. Fever 2. Headache

4. Sore throat 5. Cough 6. Dyspnea

A. 1, 2, 5, 6 C. 1, 2, 3, 4
B. 1, 2, 4, 5 D. 2, 3, 4, 6

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683. When can AIDS be manifested? The nurse answer was, "It can be as early as _______."

A. 1 year or as late as 2 years B. 2 years or as late as 10 years

C. 1-year D. 6 months

684. Nurse Crissel also asked the participants if they got to know the transmission of HIV based
from her lecture? Which is NOT correct?

A. Accidental blood exposure B. Kissing

C. Unprotected sex D. Mother to child transmission

685. On the question as to which of the following are the effects of AIDS on pregnancy, one
teenager cited a wrong answer which was ________.

A. Mild weight loss C. Repeated abortion

B. Prematurity D. Infertility

686. 1HIV transmission from mother to infant occur at post natal period during ________

A. Bathing C. Bottlefeeding
B. Washing of vagina D. Breastfeeding

Situation 2 - Baby Sharon, a newly delivered baby girl, was delivered normally in maternity clinic. Nurse
Juvy is performing her initial routine assessment.

687. Nurse Juvy's assessment reveals the following: Heart Rate is 110 beats per minute, has a
vigorous cry, moves actively and with good flexion, normal skin color and bluish extremities.
What would be thd APGAR score of Baby Sharon?

A. 7 Points C. 5 Points
B. 10 Points D. 9 Points

688. Baby Sharon was placed on phototherapy. What precaution should Nurses Juvy observe?

A. Put sunglasses on the newborn to protect his/her eyes.

B. Be certain that the newborn's intake is adequate.
C. Assess the newborn for symptoms of headache.
D. Keep the newborn wrapped to prevent sunburn.

689. Physiologic jaundice among newborn babies usually occur on, which of the following? It
occurs ________.

A. Within 24 hours from birth B. 7 days after birth

C. Upon birth D. Between the 2nd and the 3rd day after birth

690. If transient discoloration of Baby Sharon's skin is noted while under phototherapy, what is
this phenomenon called?

A. Cyanosis C. Hyperbilirubinemia
B. Jaundice D. Bronze baby syndrome

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691. If Baby Sharon develops dehydration, what is the FIRST sign to look for by Nurse Juvy?

A. Oliguria
B. Sunken fontanels
C. Soft and depressed eyeballs
D. Non-elastic skin/poor skin turgor on thighs and abdomen

Situation 3 - A nurse assigned in a neonatal intensive care unit receives a telephone call from the
delivery room and is told that a newborn with spina bifida (myelomeningocele type) will be transported to
the unit immediately.

692. Which of the following definition MOST accurately describes meningomyelocele? It

is_______.

A. Spinal cord tumor containing nerve roots.

B. Complete exposure of the spinal cord and meninges.
C. Herniation of spinal cord, cerebro-spinal fluid and meninges into a sac.
D. Sac formation containing meninges and spinal fluid.

693. The NICU nurse prepares for the arrival of the newborn. Which of the following PRIORITY
item should be placed at the newborn's bedside? A _____________.

A. Specific gravity urinometer B. Rectal thermometer

C. Blood pressure cuff D. Bottle of sterile normal saline

694. For this patient who is to undergo surgery (closure of the sac), what would be the PRIORITY
nursing diagnosis? It is risk for __________.

A. Activity intolerance B. Infection

C. Respiration D. Altered growth and development

695. Which of the following is the PRIMARY reason for surgical repair of myelomeningocele? To
____________.

A. Decrease risk of infection B. Correct the neurologic defect

C. Prevent seizure disorders D. Prevent hydrocephalus

696. What would be the BEST response if the nurse when a mother with neural tube defect asks
what she can do to decrease the chances of having another baby with the same defect?

A. "Folic acid should be taken before and after conception".

B. "Multivitamin supplements are recommended during pregnancy".
C." A well balanced diet promotes normal fetal development".
D. "Increased dietary irom improves the health of mother and fetus".

Situation - Patient Edraline, 29 years old, visits the OB clinic accompanied by her husband Victor for a
pregnancy test. The nurse in the clinic took her history which says that Edraline missed her periods for
three (3) week.

697. Which of the following is the PRIMARY purpose of pregnancy test?

A. It allows for counseling on nutrition.

B. It may help in a decision to stop working at home.
C. It enables the husband to follow the desires of the wife.
D. It allows for early initiation of care.

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698. Human chorionic gonadotropin (HCG), the biologic marker on which pregnancy tests are
based, can be detected in the BLOOD as early as which number of DAYS after the last
menstrual period?

A. 15 C. 10
B. 20 D. 5

699. What is the BEST urine sample to be used for an accurate result of pregnancy test done at
home?

A. First-voided evening urine B. First-voided morning urine

C. Mid-afternoon urine sample D. Random urine sample

700. Which of the following is NOT included among the factors that should be considered by the
nurse or the pregnant woman in interpreting results of pregnancy test?

A. Last menstrual period B. Previous pregnancy

C. Type of pregnancy test D. Menstrual cycle length

701. Which of the following medications may produce a false-negative pregnancy test?

A. Anti-hypertensive B. Anticonvulsant
C. Diuretics D. Tranquilizers

Situation 5 - A vehicular accident occurred recently in Barrio Kapitan. About 8 injured. One of them is
Almira, G3P4, 6 months pregnant, her son Jay, 4 years old, the driver, the conductor and the rest were
students. Some had minor injuries, Jay had minor laceration on his arm and right leg, one student had
colle's fracture, the conductor had a broken leg while the driver had lacerations on his head. Almira, on
the other hand, complained of abdominal cramps and vaginal spotting. A rescue team from a nearby
hospital arrived immediately on the scene.

702. Who among the passengers will take PRIORITY for the rescue team to transport to the
hospital?

A. Student with Colle's fracture. B. Jay with lacerations

C. Pregnant women D. Conductor with broken leg

703. In admitting the injured patients, which of the following should be the FIRST that should be
done by the emergency team? They should assess the patients ________.

A. Breathing B. Airway
C. Circulation D. Vital signs

704. In assigning rooms for the injured patients, the nurses should coordinate with the
Administration. Which of the following is the CORRECT room assignment?

A. Insurance company should be followed according to premiums paid by the transport

operator.
B. Mother should be separated from each other for case classification.
C. Mother and child should be together in one room.
D. Transport operator should designate the rooms according to social status of patients.

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705. In as much as Almira complained of vaginal spotting and abdominal cramps, which among
the following will the nurse anticipate as the MOST likely diagnosis of the physician after a
vaginal examination?

A. Eclampsia B. Placenta previa

C. Threatened abortion D. Abruptio placenta

706. One GOOD nursing intervention of the nurse for Almira would be to do which of the
following?

A. Advise her to eat her meals. B. Put her on absolute bed rest.
C. Take the vital signs q 4 hours. D. Advise her to take care of Jay.

Situation - Nursing Service Management should endeavor to update nurses for the improvement of
quality and safe nursing care, especially with the passage of the Universal Health Law.

707. How can nurse contribute to the improvement of Maternal and Child Health (MCH) In the
Philippines? One way is by knowing the 8 Millennium Development Goals. Which of the
TWO of the 8 goals are VERY specific to MCH?

A. Reduce child mortality and improve maternal health

B. Eradicate extreme poverty and hunger and achieve universal primary education
C. Promote gender equality and empower women and global partnership for health
D. Combat HIV/AIDS and ensure environmental sustainability

708. The universal health law focuses on the population. If a pregnant woman has been found
and diagnosed to have preeclampsia, the focus of health care is on the ________.

A. Population group C. Community

B. Individual D. Family

709. Which among the following is TRUE about mother and child health in the Philippines (among
ASEAN) that can be addressed by the Universal Health Law?

I. Fastest decline in maternal mortality rate

II. Number one highest in infant mortality rate
III. Fastest rising HIV/AIDS
IV. Highest TB burden

A. II, III, IV C. I, II
B. I, II, III D. III, IV

710. In the universal health law, which of the following are the government agencies that are
considered as "key players" in its implementation?

A. Family, DOH and Philhealth

B. DOH, LGU and Philippine Health Insurance, Inc. (PhilHealth)
C. Community, DOH, LGU
D. Individual, DOH and LGU

711. What is one of the MAJOR challenges that a beginning nurse may encounter in her service
delivery in the hospital in terms of an individual client or patient?

A. Dysfunctional facilities B. Poor health seeking behaviour.

C. Social determinants of health D. Stock out of essential commodities

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Situation 8 - Nadine, three years old, was admitted to the Pediatric Ward due to frequent coughing,
presence of wheezes when breathing out and chest congestion. Upon physical examination, Nurse Alma
noted some bruises on the back and lower extremities of Nadine. When the mother was asked of the
noted bruises, the mother said it is due to Nadines's being hyperactive and playful. Mother of Nadind said
that the child is bed-wetting. Nurse Alma also observes that Nadine also shows signs of anxiety

712. The toddler’s years are a time of great cognitive, emotional and social development. The
toddlers are a child _______ months old.

A. 6 to 12 C. 36 to 48
B. 9 to 36 D. 12 to 36

713. Upon seeing warning signs of child abuse, the BEST nursing action that Nurse Alma should
make is to report the noted observation to __________.

A. Dept of Social Welfare Development (DSWD) B. Headnurse

C. Philippine National Police (PNP) D. Attending Pediatrician

714. Nurse Alma recalls that there are four kinds of child abuse. Which of the following below are
considered as a child abuse? Select all that apply.

1. Physical 2. Emotional
3. Sexual 4. Neglect

A. 1 and 3 B. 1, 2 and 3
C. 1, 2, 3, 4 D. 1 and 2

715. When there is failure to supervise a child adequately, especially in children younger than 12,
the kind of child abuse is, which of the following?

A. Emotional B. Sexual
C. Neglect D. Physical

716. Since nadine is Four years old, Nurse Alma needs to determine the routines and rituals
concerning, which of the following, EXCEPT ______.

A. Feeding B. Toilet training

C. Sleep pattern D. Favorite toys

Situation 16 - Nurse Kayla is assigned at the postpartum ward. The following questions refer to
postpartum patients.

717. Amy, a multiparous patient, 28 hours after Ceasarian delivery (CS), who is breastfeeding,
complains of severe abdominal cramps. Nurse Kayla explains that these are caused by
which of the following?

A. Flatulence accumulation after CS

B. Release of Oxytocin during the breastfeeding session
C. Healing of the abdominal incision after CS
D. Side effects of the medications administered after delivery

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718. Three hours postpartum, a primiparous patient's fundus is firm and midline. On perineal
inspection by Nurse Kayla, she observes a small constant trickle of blood. What will thee
nurse suspect for the patient to have?

A. Uterine inversion B. Perineal lacerations

C. Retained placenta D. Bladder distention

719. On the first postpartum day, a primiparous patient complains of perineal pain that was
unrelieved by Ibuprofen 400 mg given two hours ago. Nurse Kayla should assess for which
of the following?

A. Vaginal laceration B. Perineal hematoma

C. History of Drug Abuse D. Puerperal infection

720. Twelve hours after vaginal delivery, Nurse Kayla palpates the fundus of a primiparous
patient and finds it to be firm, above the umbilicus and deviated to the right. What is the
BEST thing for Nurse Kayla to do for the patient?

A. Contact the physician for an order of methylergonovine

B. Gently massage the fundus to expel the clots
C. Encourage patient to ambulate and to void
D. Document this is a normal finding in the patient's records

721. After instructing a primiparous patient about episiotomy care, which of the following indicates
successful teaching?

A. "I will wipe the area from front to back using blotting motion"
B. "I will put ice packs on the site 15 minutes once a day for 3 to 4 days"
C. "Before bedtime, I will do a cold water sitz bath"
D. "I'll use sudsy water to clean the episiotomy"

Situation 9 - Nurse Angie is conducting a mother's class at Barangay Riles Rural Health Unit. One of the
participants asked about contraceptive pills.

722. As part of the teaching plan, Nurse Angie teaches that oral contraceptives contain estrogen.
Which of the following is the Action of Estrogen? It inhibits the _______.

A. GnRH thereby inhibiting FSH and LH productions.

B. Luteinising Hormone (LH) thereby inhibiting ovulation.
C. Testosterone production.
D. Follicle Stimulating Hormone (FSH) thereby inhibiting maturation of ovum.

723. Nurse Angie added that oral contraceptives also contain’s progesterone. Which of the
following is the action of progesterone in contraception? It inhibits _______.

A. Testosterone production
B. GnRH thereby inhibiting FSH and LH productions.
C. Luteinising Hormone (LH) thereby inhibiting ovulation.
D. Follicle Stimulating Hormone (FSH) thereby inhibiting maturation of ovum.

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724. Nurse Angie included that contraceptive that have estrogen-like and or progesterone-like
compounds are prepared in a variety of forms. These are the following __________.

1. Oral contraceptive 2. Diaphragms

3. Cervical caps 4. Foam spermicides
5. Norplant 6. Intrauterine devise

A. 2, 3, 5 B. 3, 5, 6
C. 1, 4, 6 D. 1, 5, 6

725. A biphasic anti-ovulatory medication of combined progestin and estrogen is prescribed for a
female patient. What should the nurse include when teaching about this oral contraceptive?

A. Restrict sexual activity temporarily. B. Report any irregular vaginal bleeding.

C. Increase the intake of calcium. D. Have bi-monthly Pap smears.

726. Which danger sign would warrant stoppage of pills?

A. Clear vision B. Decrease blood pressure

C. Simple colds D. Elevation of blood pressure

Situation 10 - a young mother brings her 4 years old Richard to a Pediatric Clinic where you are
assigned.

727. The young mother wanted to know about the motor development APPROPRIATE in a
preschooler. Which of the following statements NOT true?

A. "He can tie shoe lace"

B. "He can alternate feet when climbing"
C. "He has not developed good postures"
D. "He can hop two or more times"

728. Healthy physical development is dependent upon nutrition, brain development, muscle and
bone. Which of the following is NOT APPROPRIATE for physical development of a pre-
schooler?

A. Sleeps 6 to 8 hours of sleep each day

B. Assists in brushing and flossing teeth
C. Gains 5 pounds per year
D. Eruption of the primary teeth

729. Her son’s start’s asking you many questions about the things inside the Pediatric Clinic. You
should inform the mother of which of the following statements?

A. Expected in a pre-schooler as they tend to ask many questions during this age.
B. Expected in toddlers only so he may have a delayed development
C. Not normal in a pre-schooler so the mother may need to consult a child psychiatrist.

730. You informed the mother about the normal psychosocial development of pre-schoolers. She
correctly understands your health teaching if she verbalizes that ________.

A. He may have temper tantrums resulting from his frustration im watching to do

everything for himself.
B. He continues to react to separation from his parents.
C. He son is more active with his parents and tends to be a bit selfish with his toys.
D. He may tend exaggerate, boast, and tattle on others.

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731. Before finishing the check up, which of the following principles is NOT included among the
principles of guidance in handling Richard?

A. Controlling temper tantrums

B. Basing her expectations within the child's limitations.
C. Acceptance of masturbation as a normal phenomenon to be discouraged in
public.
D. Reinforcing the correct use of language.

Situation - Patient Haydee, 23 years old, G2 P1 is in her 9th month of pregnancy. First, she calls the
hospital to receive validation that is alright for her to come for evaluation or admission.

732. During the first contact of the patient with the nurse, the latter should demonstrate the
following behavior, which the EXCEPTION of _______.

A. Caring B. Comforting
C. Encouraging D. Compelling

733. Patient Hydee asks how she could Distinguish between true and false labor? Which is NOT
included among the factors in which the nurse should base her answer from?

A. Contractions B. Cervical by vaginal examination

C. Vital signs D. Engagement of fetus

734. Patient Haydee comes to the perinatal unit of Hospital DEE. Nurse Arcee does through
SCREENING assessment. Which is the Least screening assessment to be used by the
nurse?

A. Physical examination B. Interview

C. Radiologic procedures D. Laboratory review

735. During admission, the nurse needs to take the patient`s obstetric Al data. Which of the
following the MOST important?

A. Laboratory results B. Prenatal check-up records

C. Previous pregnancy experience D. Diagnostic test results

736. Every pregnant woman preparing for labor and delivery have a birth plan. What is the
PRIMARY objective of a birth plan? It describes _________.

A. The repertoire of comfort and relaxation measures

B. Options on her wishes and preferences about her labor, delivery a puerperium
C. The cultural and religious requirement related to care of mother, newborn
D. Her psychosocial data that is necessary in her hospitalization

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Situation - Through health practitioners such as the nurse, provision of quality health care and patient
safety is made possible. Hence, there is a need to properly manage human resources. Nurse Cirila is the
Chief Nurse of a 100 - bed capacity private hospital. Lately, he headnurses have been complaining of
short staffing especially in the Pediatric Ward. The ideal staffing in her ward cannot be attained as nurses
frequently leave for abroad for a greener pasture despite having signed a contract.

737. When the staff nurses in Pediatric Ward work more than they can handle, thus, losing their
enthusiasm in their work, which of the following consequences is referred to?

A. Lower patient care B. Medical errors

C. Low quality patient care D. Burnout

738. Pediatric nurses need to organize their worked to facilitate patient`s safety. Which of the
following indicators would validate that they have organized their workload? Select all that
apply.

1. Determination of resources needed to deliver patient care.

2. Accomplishment of tasks in time.
3. Identification of activities to be done
4. Prioritization of plans in accomplishing activities to be done.

A. 1, 2, 3, 4 B. 1, 2, and 3
C. 2, 3 and 4 D. 1 and 2

739. Despite the short staffing, Nurse Cirila also has the responsibility to maintain safe
environment for her pediatric patients. The following are the indicators that Nurse Cirila has
achieved this goal, EXCEPT __________.

A. Proper disposal of waste according to color coding

B. Adherence to policies, protocols and procedures in the prevention and control of
infection prevention.
C. Assessing the competencies of a staff before delegating a task
D. Observance of protocols in cases of earthquakes, fire and other emergencies.

740. Chief Nurse Cirila has identified common reasons for the fast turn-over of staff nurses not
only in he hospital she works in but in other hospitals all over the country. Which of the
following factors that have contributed to the fast turn-over should be addressed
immediately?

1. Low salary 2. Working condition

3. Work overload 4. Continuing Professional Development

A. 1 and 3 B. 1 and 3
C. 1, 2 and 3 D. 1, 2, 3 and 4

741. Chief Nurse cirila formulates strategies to address the short staffing in her hospital. Which of
the following strategies s the BEST?

A. Continuing Professional Development such as post-graduate study

B. Entry salary of nurses to at par with that of government nurses
C. Research engagement
D. Evaluation and recognition for good performances thru reward system

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Situation-To ensure patient safety at all times, personal and professional growth of nurses is a
necessity than a choice. Nurse Florence is a beginning nurse in one of the hospitals in the suburb. During
the Orientation Program, the need to enhance her skills, knowledge and attitude was emphasized.

742. "Commitment to continual learning and active participation in the development and growth of
the profession are commendable obligations" is contained in which of the following?

A. Code of Ethics B. RA 10912

C. RA 7164 D. RA 9173

743. Which law declares that the policy of the State is to promote and upgrade the practice of
profession in the country?

A. RA 7164 B. RA 9173
C. Code of Ethics D. RA 10912

744. Nursing programs that are based on needs assessment and needs analysis and should ne
offered free is which of the following?

A. Continuing Development Program B. In-service Training Program

C. Nursing Education Program D. Post-graduate program

745. In three year’s, tie, Nurse Florence needs to attain certain number of continuing Professional
Development units to be able to renew her __________.

A. Philippine Nurses Association Membership B. Professional License

C. Professional Identification Card D. Professional Registration

746. Nurse Florence was asked by her Headnurse why she requested permission to enroll in the
Graduate Program for the second semester. Her reply should be, EXCEPT:

A. To have an impressive resume to enable her to be competitive

B. Connect with people professionally
C. Invest for the future
D. Pursue her interest in Pediatric Nursing in more depth

Situation 13 - 0livia, a 15-year-old, high school student visited the health center for her prenatal check-
up. Per nurse 's initial assessment, the patient drinks alcohol and smokes cigarettes about 5 sticks. A day
for 2 years now. Her last menstrual period (LMP) was October 10, 2020.

747. Based on the nurse ' s computation utilizing Nagele's rule, the patients expected date of
birth (EDB) will be on______.

A. September 17, 2021 B. June 17, 2021

C. July 17, 2021 D. August 17, 2021

748. Which of the following is the MOST common emotional response among women during the
First trimester of pregnancy?

A. Ambivalence B. Depression
C. Acceptance D. Jealousy

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749. Olivia mentioned that she can experience uterine squeezing. Which of the following Signs of
normal pregnancy should the nurse consider?

A. Braxton-Hick's contractions B. Hegar 's sign

C. Ballottement D. Goodell 's sign

750. Nurse Emma advised the patient to quit smoking because nicotine wil1 contribute
to _______.

A. low birth weight infant B. ectopic tubal, pregnancy

C. congenital anomalies D. large for gestation age infants

751. Emotional 1ability is common to pregnant women. Identify which of the following reactions is
accepted as part of a normal pregnancy?

A. Feelings are easily hurt by remarks B. Mood swings

C. Amusing or even charming situation D. Narcissism

Situation 1-The Hospital Research Coordinator is discussing the basics of research with the members of
the Research Committee as part of continuing education. Questions and answers were also part of the
program.

752. During the open forum, the Hospital Research Coordinator raised the question as to, who
among the following, provides information in the questionnaires.

A. participants B. key informants

C. respondents D. subjects

753. One of the members of the Research Committee wishes to conduct a study involving an
interdisciplinary team of colleagues. This study is termed as _________.

A. clinical B. exploratory
C. collaborative D. applied

754. In conducting qualitative research, a nurse should follow the logical reasoning process
termed as, which of the following?

A. Deductive B. Intuition
C. Causal D. Inductive.

755. The lecturer reminded the committee members that bias is an influence that distorts study
results. In quantitative research, which will eliminate bias?

A. Trustworthiness B. Credibility
C. Randomness D. Triangulation

756. One of the committee members raised the question on how to make an abstract. The
question was followed by how many words are required in an abstract should (APA) style
be followed.? What is the CORRECT answer?

A. 450-550 B. 250 -350

C. 150-250 D. 350-450

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Situation 2 - The Clinical Instructor (CI) is conducting a ward class on how to perform the breast self-
examination (BSE).

757. The CI is expected to set the atmosphere by welcoming everyone and by _________.

A. showing every one the picture of the breast

B. Discussing the objectives of the ward class
C. giving an anecdote about an old man
D. going ahead with the first part of the lecture

758. For the students better understanding about the anatomy of the breast, the CI
shares ________.

A. various pictures of the breast, external and internal Views

B. pictures of different types of mastectomies
C. the experiences of breastfeeding mothers
D. artistic drawings of the breasts

759. The clinical instructor proceeded with the Lecture to the students using the _________.

A. Question and Answer method B. entertainment style of presentation

C. students as the resource persons D. outline of the lecture she just presented

760. When the lecture presentation was finished, the CI proceeded with the _______.

A. evaluation of the activity

B. Q and A portion on anything the students are interested tackle
C. open forum to solicit questions related to the topic under discussion.
D. cracking of humorous anecdotes to keep the class alive

761. The last and necessary part of the activity is _______.

A. informing the students their next day 's assignment

B. the joke portion for good vibes
C. evaluation so that future. but similar activities can be improved
D. after care of the venue, an earlier reminder by the Head Nurse

Situation 3 -Hypovolemic Shock. The adult patient on his way to the office met a vehicular accident and
was continuously bleeding from the head. He was brought to the nearest hospital by the bystanders.

762. What must the Emergency Room Nurse do FIRST?

A. Start an intravenous line at once. B. Position with head lower than extremities.
C. Request for laboratory examinations. D. Stop the bleeding immediately.

763. Due to continuous bleeding the patient goes into the second stage of shock with BP 80/60.
What are the possible effects on the heart in this stage?

I. Increased heart rate II. Chest pain

III. Increased cardiac troponin IV. Myocardial infarction

A. I, II, III, and IV B.I and II

C. II, and III D. III, and IV

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764. The BEST position for the patient to assume in case of shock is ______.

A. modified Trendelenburg B. high Fowler's

C. recumbent D. low Fowler's

765. What isotonic electrolyte solutions are COMMONLY used as fluid replacement in
hypovolemic shock?

I. Dextrose 5 percent in water II. 0.9 percent sodium chloride

III. Lactated Ringer's solution IV. Dextrose 10 percent in water

A. II, III, and IV B. I, III, and IV

C. II and III D.I and IV

766. In case the patient Would go into cardiovascular overload as a result of the
intravenous fluid therapy the PRIORITY nursing action should focus on _______.

A respiratory distress B. increase in total urine output

C. increase in body temperature D. edema in the lower extremities

Situation 4- Patient Tita, a 53-year-old mother of 6, has been having involuntary urine leaks aggravated
whenever she sneezes or coughs. She is diagnosed with urinary Incontinence. The next 5 questions refer
to this case.

767. The type of incontinence Patient Tita manifests, where there is involuntary loss of urine as
a result of sneezing, coughing or even changing position is called ________.

A. Overflow B. reflex
C. stress D. Functional

768. The nurse is aware that urinary incontinence brings about psychosocial costs including the
following, EXCEPT.

A. increased expenses B. social isolation

C. embarrassment D. loss of self-esteem

769. The nurse instructs the patient that the BEST time for an incontinent patient to take his
diuretics is.

A. Any time of the day B. After 4:00 PM

C. In the morning D. At bedtime

770. When providing health teaching to the patient with urinary incontinence, the nurse
must stress that it is

A. Only surgery can alleviate the condition B. Often reversible and treatable
C. Treatable with drugs all of the time D. Controlled with the aid of alcohol

771. The aim of pelvic muscle exercises for the patient with urinary incontinence is to strengthen
the muscles that control the

A. vagina and rectum B. perineal area

C. bowel and the bladder D. vagina and urethra

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Situation 6 -Ms. Lanni, aged 40, has varying degrees of weakness on the lower extremities, inability to
perform voluntary movements and paresthesia. Her physician gives a tentative diagnosis of Guillain-Barre
Syndrome (GBS)

772. Which is a common verbalization of the patient with GBS regarding the EARLY ONSET
of symptoms?

A. Acute hemiplegia B. Ascending motor weakness

C. Weakness of the four lower extremities D. Acute hemiparesis

773. The nurse is aware that which occurrence in the patient 's health history suggests the
diagnosis of GBS?

A. viral illness few weeks before B. encephalitis

C. severe bacterial infection D. meningitis

774. A PRIORITY nursing diagnosis in Guillain Barre Syndrome is__________.

A. Ineffective breathing pattern B Impaired verbal Communication

C. Imbalanced nutrition D. Impaired physical mobility

775. If the patient is unable to talk, how should the nurse BEST communicate to the patient?

A. Enunciating the words slowly and well.

B. By using picture cards
C. Just stop as he could no longer understand.
D. Talking loudly face-to-face with the patient.

776. The nurse informs the patient and family that rehabilitation prior to discharge is BEST
described as______.

A. a period of ups and downs, physically and emotionally

B. long and one requiring involvement of significant others
C. easy and smooth from discharge onwards
D. a rapid process towards recovery

Situation 7-Elmo, 69 years of age, is diagnosed with Benign Prostatic Hyperplasia (BPH).

777. The nurse anticipates that the signs and symptoms of BPH do NOT include_________.

A. frequency of urination B. pain on urination

C. dribbling of urine D. hesitancy in starting urination

778. Elmo asks the nurse to explain his condition (BPH) Which statements are CORRECT
explanations by the nurse?

I.It blocks the urethra. II.It obstructs the bladder.

III. It spreads to other parts of the body. IV. It leads to urinary retention

A. I and IV B. II, III, and IV

C. I, II and III D. I and III

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779. What IMMEDIATE danger should the nurse anticipate post Transurethral Resection of the
Prostate (TURP)?

A. Infection B. Bleeding
C. Thrombosis D. Shock

780. The nurse knows that the normal color of the bladder irrigation drainage right after TURP
is _________.

A. reddish pink B. bright red

C. Light pink D. yellowish

781. Sexual dysfunctions 1ike impotence, erectile dysfunction, and lack of libido are likely
possibilities in what, prostatic surgery?

A. Suprapubic prostatectomy B. Transurethral resection of the prostate

C. Laparoscopic prostatectomy D. Perineal prostatectomy

Situation 8-General concepts of immunology must be learned by the nurse to appreciate the
management of her patients.

782. Immunity that the baby gets from the immune mother through breastfeeding is:

A. Passive natural B. Active artificial

C. Active natural D. Passive artificial

783. Cell-mediated immunity is NOT usually associated with what condition:

A. Rejection of tissue graft B. Production of antibodies

C. Skin hypersensitivity reaction D. Surveying for malignant cells

784. When a person vaccinated with a Covid-19 vaccine produces antibodies to the disease, the
immunity is termed:

A. Active artificial B. Passive natural

C. Active natural D. Passive artificial

785. The blood protein involved in the immune system is:

A. Thrombin B. Globulin
C. Albumin D. Hemoglobin

786. The immunity conferred by tetanus toxoid is best described as:

A. Lifelong passive B. Long-lasting active

C. Temporary passive D. Lifelong active

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Situation 9-Even if still a staff nurse, Minda, can well contribute to the management of the resources
and environment of her unit.

787. The electric fan in the unit sparks occasionally but continues to function relatively well.
Nurse Minda though knows that she ________.

A. Has to ask one of the staffs to preliminary check it

B. will just wait until the fan stops to function
C. should alert the unit staff to closely observe the fan
D. must have it checked by the Maintenance Department immediately

788. The electric fan now stops every now and then and continues to spark at intervals. The
best thing to DO NEXT is to__________.

A. turn off the fan immediately. B. call the maintenance immediately

C. let it continue to function D. request for another fan as soon as possible (ASAP)

789. The last fire in the hospital was due to a malfunctioning equipment. The Fire extinguisher
was nowhere to be found. What should have been practiced?

A. A dedicated fire extinguisher must be in every strategic Place

B. Place one fire extinguisher between two units.
C. A fire extinguisher can be replaced with fire sensors.
D. Borrowing fire extinguishers may be tolerated if on the same floor

790. The staff assigned to check the fire extinguisher failed to monitor the assigned equipment.
The following statements are "whereabouts" of true, EXCEPT

A. all employees are lazy

B. monitoring staff is important
C. not all staff are diligent in their tasks
D. two errors added together can be potentially devastating

791. Because of the failure to replace the defective electric fan immediately, a fire broke out and
it became big enough to burn a major portion of the unit because the fire extinguisher was
missing. What lesson can be gained from this?

A. Punishment must be imposed on erring employees

B. Reorientation of the new staff.
C. Refer the erring employee to HR.
D. Every protocol must be followed.

Situation 11- Romy, 58 years old, has been a cigarette smoker since age 15. He has nagging cough and
hoarseness of voice and dyspnea. Based on the physical and laboratory findings, the physician
suspected him of having lung cancer.

792. Which of the following is NOT a known predisposing factor to lung cancer?

A. House is near a banana plantation.

B. Works as a sprayer of vegetables and fruit trees
C. Lives in a suburban area.
D. Living with mother who is a tobacco smoker.

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793. Upon history-taking, the nurse notes that the cough of a patient with lung cancer usually
STARTS off to be ___________.

A. blood-tinged B. productive
C. dark yellow sputum D. dry and persistent

794. Which diagnostic procedure is commonly used to establish the diagnosis of lung cancer
which provides a detailed description of the tracheobronchial tree and allows for biopsies of
suspicious areas?

A. Computerized Tomography (CT) scan B. Bronchoscopy

C. Sputum cytology D. Positron Emission Tomography
(PET)

795. To help the patient with his breathing difficulty, the nurse places him in which position?

A. Prone B. Fowler's
C. Sim’s lateral D. Supine

796. Romy is diagnosed with small cell lung cancer (SCLC) a rapidly growing type of cancer. He
and his family were shocked when told by the doctor that the patient will just undergo
palliative treatment. Which nursing action is MOST APPROPRIATE?

A. Providing relief from symptoms. B. Reducing fatigue

C. Providing psychological support. D. Advising treatment options

Situation 13 -Dog Bites are relatively common in the Philippines. The presence of a number of stay dogs
predisposes to the occurrence of rabies.

797. Upon entry of the patient to ER, the nurse must FIRST perform which nursing intervention?

A. Inject with rabies immune globulin.

B. Cleanse the bite with soap and running water.
C. Inject the rabies vaccine immediately.
D. Administer the pain reliever, as ordered.

798. The nurse knows that a dog bite has a shorter incubation for rabies if located in the

A. Leg B. hand
C. abdomen D. face

799. The nurse anticipates that which one is prescribed to prevent a

common bacterial complication from the dog bite?

A. Ibuprofen (Motrin) B. ciprofloxacin (Cipro)

C. tetanus toxoid (Tetavax) D. meperidine (Demerol)

800. In administering the rabies immune globulin (RIG), the nurse infiltrates the calculated dose
around the Wound edges and the rest of the dose injected_________

A. intradermally B. intramuscularly
C. subcutaneously D. intravenously

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801. According to RA 9482 or the anti- Rabies Act of 2007, which of the following statement s
regarding rabies post exposure prophylaxis is APPLICABLE?

A. Have the dogs be regular ly vaccinated against rabies

B. Do not allow the dog to roam the street.
C. Put the dog in a leash when in a public place.
D. The owner will assist the bite victim with the medical expenses.

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